FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Bischoff, DS Makhijani, NS Zhu, JH Yamaguchi, DT AF Bischoff, DS Makhijani, NS Zhu, JH Yamaguchi, DT TI ELR+ CXC chemokine secretion during human mesenchymal stem cell osteogenic differentiation is dependent on dexamethasone. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S236 EP S237 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503803070 ER PT J AU Ghosh-Choudhury, N AF Ghosh-Choudhury, N TI Phosphatidylinositol 3 kinase (PI3K)-dependent Erk1/2 activation represents a novel mechanism of statin-induced BMP-2 expression and osteoblast differentiation. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S79 EP S79 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503801028 ER PT J AU Honjo, T Kurihara, N Windle, JJ Roodman, GD AF Honjo, T Kurihara, N Windle, JJ Roodman, GD TI Measles virus nucleocapsid protein increases TNF-alpha induced osteoclast differentiation. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Pittsburgh, Pittsburgh, PA USA. Virginia Commonwealth Univ, Richmond, VA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S100 EP S100 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503801112 ER PT J AU Iida-Klein, A Bischoff, DS Zhu, J Dempster, DW Hahn, TJ Yamaguchi, DT AF Iida-Klein, A Bischoff, DS Zhu, J Dempster, DW Hahn, TJ Yamaguchi, DT TI RNA interference with Gq and G11 proteins suppresses messenger RNA expression of osteoblast functional genes and induces changes in cellular morphology in mouse osteoblasts. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Helen Hayes Hosp, Reg Bone Ctr, W Haverstraw, NY USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S364 EP S364 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503804281 ER PT J AU Ishizuka, S Kurihara, N Roodman, GD AF Ishizuka, S Kurihara, N Roodman, GD TI The vitamin D receptor antagonist, (23S)-25-dehydro-1 alpha-hydroxyvitamin D-3-26,23-lactone, blocks RANK ligand induced osteoclast formation. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Teijin Inst Biomed Res, Tokyo, Japan. Univ Pittsburgh, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S184 EP S184 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503802152 ER PT J AU Kurihara, N Honjo, T Windle, JJ Roodman, GD AF Kurihara, N Honjo, T Windle, JJ Roodman, GD TI Inhibiting p62(ZIP) expression decreases OCL formation by blocking the effects of RANKL and TNF-alpha. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Pittsburgh, Pittsburgh, PA USA. Virginia Commonwealth Univ, Richmond, VA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S55 EP S55 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503800218 ER PT J AU Kurihara, N Yamana, K Roodman, GD AF Kurihara, N Yamana, K Roodman, GD TI Expression of TAF(II)-17 and IL-6 in osteoclast (OCL) precursors is sufficient for formation of Pagetic-like OCL. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Pittsburgh, Pittsburgh, PA USA. Teijin Inst Biomed Res, Tokyo, Japan. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S52 EP S52 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503800208 ER PT J AU Lu, G Maeda, H Reddy, SV Kurihara, N Roodman, GD AF Lu, G Maeda, H Reddy, SV Kurihara, N Roodman, GD TI Cloning and characterization of the annexin II receptor. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Pittsburgh, Pittsburgh, PA USA. Kyushu Univ Hosp, Kyushu, Japan. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S83 EP S83 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503801045 ER PT J AU Palacjos, VG Subler, MA Chung, HY Choi, SJ Patrene, K Blair, HC Windle, JJ Roodman, GD AF Palacjos, VG Subler, MA Chung, HY Choi, SJ Patrene, K Blair, HC Windle, JJ Roodman, GD TI Overexpression of ADAM8 in osteoclast precursors increases osteoclast formation and decreases trabecular bone volume in vivo. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 Univ Pittsburgh, Pittsburgh, PA USA. Virginia Commonwealth Univ, Richmond, VA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S370 EP S370 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503805006 ER PT J AU Peterson, WJ Yamaguchi, DT AF Peterson, WJ Yamaguchi, DT TI Differential effect of indomethacin on cell number and alkaline phosphatase production during osteogenesis in vitro. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 VA Greater Los Angeles Healthcare Syst, Grecc 691 11g, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Res Serv 691 151, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S350 EP S350 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503804218 ER PT J AU Wiren, KM Toombs, AS Matsumoto, AM Zhang, X AF Wiren, KM Toombs, AS Matsumoto, AM Zhang, X TI Androgen receptor transgenic mice have decreased body fat, reduced adipogensis and an increased osteoblast differentiation program. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 27th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 23-27, 2005 CL Nashville, TN SP Amer Soc Bone & Mineral Res C1 VA Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2005 VL 20 IS 9 SU 1 BP S50 EP S50 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 987FM UT WOS:000233503800199 ER PT J AU Lenzi, R Baile, WF Berek, J Back, A Buckman, R Cohen, L Parker, PA AF Lenzi, R Baile, WF Berek, J Back, A Buckman, R Cohen, L Parker, PA TI Design, conduct and evaluation of a communication course for oncology fellows SO JOURNAL OF CANCER EDUCATION LA English DT Article ID CANCER-PATIENTS; BAD-NEWS; SKILLS; PHYSICIAN; CARE; WORKSHOPS; CLINICIAN; MEDICINE; IMPACT; KEY AB Background. Training in the communication components of cancer care is necessary for the practice of oncology. We conducted a communication course for oncology fellows. Methods. Teaching methods included lectures, role playing and simulated patient interviews. We used self-reports, knowledge questionnaires and course/faculty evaluations. Results. A total of 17 fellows participated. Skills in dealing with bad news, denial and end-of-life issues improved. We obtained information on communication tasks commonly performed during patient interactions, various aspects of the course and faculty performance. Conclusions. Fellows' knowledge and self-efficacy improved postcourse. Information on challenges faced by trainees and their feedback may help focus the design of future courses. C1 Univ Texas, MD Anderson Canc Ctr, Dept GI Med Oncol, Unit 426, Houston, TX 77030 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Washington, Fred Hutchinson Canc Res Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Toronto Sunnybrook Reg Canc Ctr, Toronto, ON, Canada. RP Lenzi, R (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept GI Med Oncol, Unit 426, 1515 Holcombe Blvd, Houston, TX 77030 USA. EM rlenzi@mdanderson.org NR 29 TC 24 Z9 24 U1 3 U2 6 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 0885-8195 J9 J CANCER EDUC JI J. Cancer Educ. PD FAL PY 2005 VL 20 IS 3 BP 143 EP 149 DI 10.1207/s15430154jce2003_7 PG 7 WC Oncology; Education, Scientific Disciplines; Public, Environmental & Occupational Health SC Oncology; Education & Educational Research; Public, Environmental & Occupational Health GA 961TN UT WOS:000231684800004 PM 16122361 ER PT J AU Zhao, WD Wu, Y Zhao, JB Guo, S Bauman, WA Cardozo, CP AF Zhao, WD Wu, Y Zhao, JB Guo, S Bauman, WA Cardozo, CP TI Structure and function of the upstream promotor of the human MAFbx gene: The proximal upstream promotor modulates tissue-specificity SO JOURNAL OF CELLULAR BIOCHEMISTRY LA English DT Article DE muscle atrophy; ubiquitin ligase; promotor structure; developmental regulation ID SKELETAL-MUSCLE ATROPHY; FOXO TRANSCRIPTION FACTORS; UBIQUITIN LIGASES; RECEPTOR GENE; EXPRESSION; DIFFERENTIATION; DEGRADATION; DENERVATION; ATROGIN-1; PROTEINS AB Muscle loss has been linked to increased expression of an ubiquitin ligase termed muscle atrophy F-box (MAFbx), a nuclear protein involved in degradation of MyoD. To gain insights into mechanisms by which the human MAFbx gene is controlled, the structure of its upstream promotor were studied, and its expression in cultured cells was characterized. Expression of MAFbx was found only in cells of muscle lineage. A reporter gene controlled by 948 bases of human MAFbx upstream promotor displayed similar cell-type selectivity. MAFbx levels were greatly enhanced upon myogenic differentiation of C2C12 myoblasts, and differentiation markedly increased activity of a reporter gene constructed with 400 bp of upstream promotor from the MAFbx gene. The core promotor spanned approximately 160 bases beginning at -241 bp upstream of the first codon, included potential binding sites for MyoD and myogenin, and was highly conserved among mouse, rat, and humanMAFbx genes. The major transcription start site for the human MAFbx gene was 340 bases upstream of the ATG and was localized the highly conserved region of 140 bp. The findings indicate an important role for the immediate upstream promotor of the human MAFbxgene in mediating its developmental expression and tissue specificity. C1 Bronx Vet Adm Med Ctr, SCDRC, VA Rehabil Res & Dev Serv, Ctr Excellence, Bronx, NY 10468 USA. Mt Sinai Sch Med, Spinal Cord Damage Res Ctr, Dept Med, New York, NY USA. RP Cardozo, CP (reprint author), Bronx Vet Adm Med Ctr, SCDRC, VA Rehabil Res & Dev Serv, Ctr Excellence, Room 1E-02, Bronx, NY 10468 USA. EM Chris.Cardozo@mssm.edu FU NIDDK NIH HHS [DK 60598] NR 30 TC 13 Z9 14 U1 0 U2 5 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0730-2312 J9 J CELL BIOCHEM JI J. Cell. Biochem. PD SEP 1 PY 2005 VL 96 IS 1 BP 209 EP 219 DI 10.1002/jcb.20468 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 962NM UT WOS:000231739500021 PM 16052482 ER PT J AU Rowan, PJ Al-Jurdi, R Tavakoli-Tabasi, S Kunik, ME Satrom, SL El-Serag, HB AF Rowan, PJ Al-Jurdi, R Tavakoli-Tabasi, S Kunik, ME Satrom, SL El-Serag, HB TI Physical and psychosocial contributors to quality of life in veterans with hepatitis C not on antiviral therapy SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE hepatitis; chronic; quality of life; interview; psychological; depression; behavioral medicine ID CHRONIC LIVER-DISEASE; DEPRESSION; INFECTION; REDUCTION; HOSTILITY; SYMPTOMS; ANXIETY AB Background and Aims: Treatment-naive hepatitis C virus (HCV)infected patients report impaired health-related quality of life (HRQOL), although causes are unclear. Psychosocial factors may be major determinants of HRQOL. Methods: We administered a general (Short Form-36; SF-36) and a liver-specific (Chronic Liver Disease Questionnaire- CLDQ) HRQOL measure to 62 HCV-infected veterans being considered for antiviral therapy. Psychosocial assessment included the Structured Clinical Interview for DSM-IV Axis I Disorders/Non-Patient (SCI D-I/NP), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Abbreviated Cook-Medley (ACM) anger measure, and Medical Outcomes Study Social Support Measure (SSM). We examined the potential determinants of HRQOL, including psychosocial measures, demographic measures (age, sex, race/ethnicity), clinical measures (presence of cirrhosis, comorbid medical conditions), and viral data (quantitative PCR). Results: SF-36 scores were significantly lower in HCV-infected patients than published US. population norms but similar to those reported by previous studies of HCV-infected samples. CLDQ scores were very similar to those reported by previous studies. Demographic, clinical, and viral indicators were not statistically associated with HRQOL, and neither was the presence of a substance abuse or psychotic disorder. Lower BDI-II and BAI scores were associated with better general and disease-specific HRQOL. Lower SSM scores were associated with lower scores on SF-36 but not CLDQ; however, this effect did not persist in multiple linear regression analyses. In these, BDI-II was the strongest independent predictor of both SF-36 and CLDQ. Conclusions: Psychosocial factors, especially depression, are strong indicators of impaired HRQOL for HCV-infected veterans not receiving antiviral therapy. Screening and treatment of psychosocial factors is recommended. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Menminger Dept Psychiat & Behave Sci, Coll Med, Houston, TX 77030 USA. Baylor Coll Med, Gastroenterol Sect, Coll Med, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Coll Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 23 TC 31 Z9 34 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD SEP PY 2005 VL 39 IS 8 BP 731 EP 736 DI 10.1097/01.mcg.0000173860.08478.a6 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 958ZR UT WOS:000231487200016 PM 16082286 ER PT J AU Nahas, Z Marangell, LB Husain, MM Rush, AJ Sackeim, HA Lisanby, SH Martinez, JM George, MS AF Nahas, Z Marangell, LB Husain, MM Rush, AJ Sackeim, HA Lisanby, SH Martinez, JM George, MS TI Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT 41st Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 08-12, 2002 CL SAN JUAN, PR SP Amer Coll Neuropsychopharmacol ID RATING-SCALE; ELECTROCONVULSIVE-THERAPY; EFFICACY AB Background: Vagus nerve stimulation (VNS) had antidepressant effects in an initial open, acute phase pilot study of 59 participants in a treatment-resistant major depressive episode (MDE). We examined the effects of adjunctive VNS over 24 months in this cohort. Method: Adult outpatients (N = 59) with chronic or recurrent major depressive disorder or bipolar (1 or 11) disorder and experiencing a treatment-resistant, nonpsychotic MDE (DSM-IV criteria) received 2 years of VNS. Changes in psychotropic medications and VNS stimulus parameters were allowed only after the first 3 months. Response was defined as >= 50% reduction from the baseline 28-item Hamilton Rating Scale for Depression (HAM-D-28) total score, and remission was defined as a HAM-D-28 score <= 10. Results: Based on last observation carried forward analyses, HAM-D-28 response rates were 31% (18/59) after 3 months, 44% (26/59) after 1 year, and 42% (25/59) after 2 years of adjunctive VNS. Remission rates were 15% (9/59) at 3 months, 27% (16/59) at 1 year, and 22% (13/59) at 2 years. By 2 years, 2 deaths (unrelated to VNS) had occurred, 4 participants had withdrawn from the study, and 81% (48/59) were still receiving VNS. Longer-term VNS was generally well tolerated. Conclusion: These results suggest that patients with chronic or recurrent, treatment-resistant depression may show long-term benefit when treated with VNS. C1 Med Univ S Carolina, Brain Simulat Lab, Dept Psychiat, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Dept Psychiat, Charleston, SC USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. New York State Psychiat Inst & Hosp, Dept Biol Psychiat, New York, NY 10032 USA. Columbia Univ, Coll Phys & Surg, Dept Psychiat, New York, NY USA. Columbia Univ, Coll Phys & Surg, Dept Radiol, New York, NY USA. RP Nahas, Z (reprint author), Inst Psychiat, Brain Stimulat Lab, 67 President St,Room 502 N, Charleston, SC 29403 USA. EM nahasz@musc.edu OI Rush, Augustus/0000-0003-2004-2382 NR 19 TC 162 Z9 165 U1 1 U2 5 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD SEP PY 2005 VL 66 IS 9 BP 1097 EP 1104 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 967TX UT WOS:000232115200002 PM 16187765 ER PT J AU Cook, JM Coyne, JC AF Cook, JM Coyne, JC TI Re-envisioning the training and practice of clinical psychologists: Preserving science and research orientations in the face of change SO JOURNAL OF CLINICAL PSYCHOLOGY LA English DT Article DE boulder model; postdoctoral training ID CONSORT STATEMENT; TRIALS; MODEL; CARE AB We argue for preservation of an expectation of psychologists that approach human problems from an evidence-based perspective. Acquisition of the requisite knowledge, skills, and practical experience require access to resources outside of graduate psychology programs. Whether adhering to a scientist-practitioner or practitioner-scholar model, psychologists must be "scientifically literate." Deficiencies are noted in the training of scientist-practitioner psychologists for the conduct of clinical trials and the dissemination and sustained implementation of evidence-based interventions. (c) 2005 Wiley Periodicals, Inc. C1 Univ Penn, Sch Med, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Cook, JM (reprint author), Columbia Univ, State Psychiat Inst, 1051 Riverside Dr,Box 69, New York, NY 10032 USA. NR 17 TC 3 Z9 3 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9762 J9 J CLIN PSYCHOL JI J. Clin. Psychol. PD SEP PY 2005 VL 61 IS 9 BP 1191 EP 1196 DI 10.1002/jclp.20163 PG 6 WC Psychology, Clinical SC Psychology GA 961EI UT WOS:000231644300029 PM 15965946 ER PT J AU Willett, LL Palonen, K Allison, JJ Heudebert, GR Kiefe, CI Massie, FS Wall, TC Houston, TK AF Willett, LL Palonen, K Allison, JJ Heudebert, GR Kiefe, CI Massie, FS Wall, TC Houston, TK TI Differences in preventive health quality by residency year - Is seniority better? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE internship and residency; quality indicators; health care; preventive health services ID INTERNAL-MEDICINE RESIDENTS; PRIMARY-CARE; GUIDELINES; FEEDBACK; RECORD AB BACKGROUND: It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. OBJECTIVE: To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. DESIGN: Cross-sectional study. PARTICIPANTS: One hundred twenty Internal Medicine residents, postgraduate year (PGY)-1 and PGY-2, attending a University Internal Medicine teaching clinic between June 2000 and May 2003. MEASUREMENTS: We studied 6 preventive health care services offered or received by patients by abstracting data from 1,017 patient records. We examined the differences in performance between PGY-1 and PGY-2 residents. RESULTS: Postgraduaute year-2 residents did not statistically outperform PGY-1 residents on any measure. The overall proportion of patients receiving appropriate preventive health services for pneumococcal vaccination. advising tobacco cessation, breast and colon cancer screening. and lipid screening was similar across levels of training. PGY-1s outperformed PGY-2s for tobacco use screening (58%, 51%, P=.03). These results were consistent after accounting for clustering of patients within provider and adjusting for patient age, gender. race and insurance. resident gender, and number of visits during the measurement year. CONCLUSIONS: Overall. patients cared for by PGY-2 residents did not receive more outpatient preventive health services than those cared for by PGY-1 residents. Efforts should be made to ensure quality patient care in the outpatient setting for all levels of training. C1 Univ Alabama, Dept Med, Div Gen Internal Med, Birmingham, AL 35294 USA. UAB, Dept Med, Div Prevent Med, Birmingham, AL USA. Birmingham VA Med Ctr, Deep S Ctr Effectiveness A HSR&D REAP, Birmingham, AL USA. UAB, Outcome & Effectiveness Res & Educ, Birmingham, AL USA. UAB, Dept Pediat, Div Gen Pediat, Birmingham, AL USA. RP Willett, LL (reprint author), Univ Alabama, Dept Med, Div Gen Internal Med, Boshell Diabet Bldg 339,1530 3rd Ave S, Birmingham, AL 35294 USA. EM lwillett@uabmc.edu RI Houston, Thomas/F-2469-2013 OI Allison, Jeroan/0000-0003-4472-2112 NR 15 TC 5 Z9 5 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2005 VL 20 IS 9 BP 825 EP 829 DI 10.1111/j.1525-1497.2005.0158.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 960MG UT WOS:000231596400006 PM 16117750 ER PT J AU Johnson, KR Johnson, KY Crellin, HG Ogretmen, B Boylan, AM Harley, RA Obeid, LM AF Johnson, KR Johnson, KY Crellin, HG Ogretmen, B Boylan, AM Harley, RA Obeid, LM TI Immunohistochemical distribution of sphingosine kinase 1 in normal and tumor lung tissue SO JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY LA English DT Article DE sphingosine kinase 1; immunolocalization; lung; non-small-cell lung cancer ID FUNCTIONAL-CHARACTERIZATION; MOLECULAR-CLONING; 1-PHOSPHATE; SPHINGOSINE-1-PHOSPHATE; GROWTH; CELLS; DIFFERENTIATION; PROLIFERATION; MODULATION; ACTIVATION AB Sphingosine kinase 1 (SK1) is a key enzyme critical to the sphingolipid metabolic pathway responsible for catalyzing the formation of the bioactive lipid sphingosine-1-phosphate. SK1-mediated production of sphingosine-1-phosphate has been shown to stimulate such biological processes as cell growth, differentiation, migration, angiogenesis, and inhibition of apoptosis. In this study, cell type-specific immunolocalization of SK1 was examined in the bronchus/terminal bronchiole of the lung. Strong immunopositive staining was evident at the apical surface of pseudostratified epithelial cells of the bronchus and underlying smooth muscle cells, submucosal serous glands, immature chondrocytes, type 11 alveolar cells, foamy macrophages, endothelial cells of blood vessels, and neural bundles. Immunohistochemical screening for SK1 expression was performed in 25 samples of normal/tumor patient matched non-small-cell lung cancer tissue and found that 25 of 25 tumor samples (carcinoid [5 samples], squamous [10 samples], and adenocarcinoma tumors [10 samples]), exhibited overwhelmingly positive immunostaining for SK1 as compared with patient-matched normal tissue. In addition, an approximately 2-fold elevation of SK1 mRNA expression was observed in lung cancer tissue versus normal tissue, as well as in several other solid tumors. Taken together, these findings define the localization of SK1 in lung and provide clues as to how SK1 may play a role in normal lung physiology and the pathophysiology of lung cancer. C1 Med Univ S Carolina, Dept Med, Div Pulm & Crit Care Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Hosp, Div Gen Internal Med, Charleston, SC USA. The Citadel, Dept Biol, Charleston, SC USA. RP Obeid, LM (reprint author), Med Univ S Carolina, Dept Med, Div Pulm & Crit Care Med, 114 Doughty St,POB 250779, Charleston, SC 29425 USA. EM obeidl@musc.edu FU NCI NIH HHS [P01 CA-097132]; NIGMS NIH HHS [GM-62887] NR 23 TC 94 Z9 106 U1 1 U2 2 PU HISTOCHEMICAL SOC INC PI SEATTLE PA UNIV WASHINGTON, DEPT BIOSTRUCTURE, BOX 357420, SEATTLE, WA 98195 USA SN 0022-1554 J9 J HISTOCHEM CYTOCHEM JI J. Histochem. Cytochem. PD SEP PY 2005 VL 53 IS 9 BP 1159 EP 1166 DI 10.1369/jhc.4A6606.2005 PG 8 WC Cell Biology SC Cell Biology GA 960HD UT WOS:000231580300011 PM 15923363 ER PT J AU Birdsall, HH Porter, WJ Trial, J Rossen, RD AF Birdsall, HH Porter, WJ Trial, J Rossen, RD TI Monocytes stimulated by 110-kDa fibronectin fragments suppress proliferation of anti-CD3-activated T cells SO JOURNAL OF IMMUNOLOGY LA English DT Article ID ALVEOLAR MACROPHAGES; PERIPHERAL-BLOOD; ADHERENT CELLS; ACTIVATION; RESPONSES; GROWTH; INTERLEUKIN-10; EXPRESSION; PRODUCTS; CONTACT AB One hundred ten to 120-kDa fragments of fibronectin (FNf), generated by proteases released in the course of tissue injury and inflammation, stimulate monocytes to produce proinflammatory cytokines, promote mononuclear leukocytes (MNL) transendothelial migration, up-regulate monocyte CD11b and CD86 expression, and induce monocyte-derived dendritic cell differentiation. To investigate whether the proinflammatory consequences of FNf are offset by responses that can suppress proliferation of activated T lymphocytes, we investigated the effect of FNf-treated MNL on autologous T lymphocytes induced to proliferate by substrate-immobilized anti-CD3. FNf-stimulated MNL suppressed anti-CD3-induced T cell proliferation through both contact-dependent and contact-independent mechanisms. Contact-independent suppression was mediated, at least in part, by IL-10 and TGF-beta released by the FNf-stimulated MNL. After 24-48 h exposure to FNf, activated T cells and monocytes formed clusters displaying CD25, CD14, CD3, and CD4 that were not dissociable by chelation of divalent cations. Killing monocytes with L-leucine methyl ester abolished these T cell-monocyte clusters and the ability of the FNf-stimulated MNL to suppress anti-CD3 induced T cell proliferation. Thus, in addition to activating MNL and causing them to migrate to sites of injury, FNf appears to induce suppressor monocytes. C1 Michael E DeBakey Vet Affairs Med Ctr, Res Ctr AIDS & HIV Infect, Immunol Res Lab, Houston, TX 77030 USA. Baylor Coll Med, Dept Otorhinolaryngol, Houston, TX 77030 USA. Baylor Coll Med, Dept Immunol, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Birdsall, HH (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Res Ctr AIDS & HIV Infect, Immunol Res Lab, Bldg 110,Room 328,2002 Holcombe Blvd, Houston, TX 77030 USA. EM birdsall@bcm.tmc.edu FU NIAID NIH HHS [R0-AI46285]; NIMH NIH HHS [R01-MH63035]; NINDS NIH HHS [R01-NS32583] NR 31 TC 10 Z9 10 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 SEP 1 PY 2005 VL 175 IS 5 BP 3347 EP 3353 PG 7 WC Immunology SC Immunology GA 966HL UT WOS:000232010600069 PM 16116227 ER PT J AU Pekary, AE Faull, KF Paulson, M Lloyd, RL Sattin, A AF Pekary, AE Faull, KF Paulson, M Lloyd, RL Sattin, A TI TRH-like antidepressant peptide, pyroglutamyltyroslyprolineamide, occurs in rat brain SO JOURNAL OF MASS SPECTROMETRY LA English DT Article DE TRH-like peptides; affinity chromatography; HPLC; mass spectrometry ID THYROTROPIN-RELEASING-HORMONE; PGLU-GLU-PRO-NH2 EEP; XENOPUS-LAEVIS; IN-VITRO; CLONING; CDNA; AMIDE; RECEPTORS; ANALOGS; SKIN AB We have previously reported the occurrence of pGlu-Glu-Pro-NH2(Glu-TRH, EEP), Val-TRH, Tyr-TRH, Leu-TRH, Phe-TRH, and Trp-TRH in rat brain using a combination of HPLC and radioimmunoassays with antibodies that cross-react with the general structure pGlu-X-Pro-NH2 where 'X' maybe any amino acid residue (Peptides 2004; 25:647). This new family of TRH-like peptides, along with TRH (pGlu-His-Pro-NH2) has neuroprotective, anticonvulsant, antidepressant, euphoric, anti-amnesic, and analeptic effects. We now report that a combination of affinity chromatography using a rabbit antibody specific for Tyr-TRH and Phe-TRH, along with HPLC and tandem mass spectrometry operating in the multiple reaction monitoring (MRM) mode, provide conclusive evidence for the presence of Tyr-TRH in rat brain. Furthermore, synthetic Tyr-TRH is active in the Porsolt Swim Test suggesting that it is a fourth member of this family of in vivo neuroregulatory agents that have psychopharmacotherapeutic properties. Copyright (c) 2005 John Wiley & Sons, Ltd. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Pasarow Mass Spect Lab, Dept Psychiat & Biobehav Sci, Jane & Terry Semel Inst Neurosci & Human Behav, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Chem & Biochem, Los Angeles, CA 90073 USA. Univ Minnesota, Dept Biol, Duluth, MN 55812 USA. Univ Minnesota, Dept Psychol, Duluth, MN 55812 USA. RP Pekary, AE (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, Bldg 114,Rm 229,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM eugene.pekary@med.va.gov NR 54 TC 17 Z9 17 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1076-5174 J9 J MASS SPECTROM JI J. Mass Spectrom. PD SEP PY 2005 VL 40 IS 9 BP 1232 EP 1236 DI 10.1002/jms.904 PG 5 WC Biophysics; Chemistry, Organic; Spectroscopy SC Biophysics; Chemistry; Spectroscopy GA 967FZ UT WOS:000232078200011 ER PT J AU Quinones, MP Estrada, CA Kalkonde, Y Ahuja, SS Kuziel, WA Mack, M Ahuja, SS AF Quinones, MP Estrada, CA Kalkonde, Y Ahuja, SS Kuziel, WA Mack, M Ahuja, SS TI The complex role of the chemokine receptor CCR2 in collagen-induced arthritis: implications for therapeutic targeting of CCR2 in rheumatoid arthritis SO JOURNAL OF MOLECULAR MEDICINE-JMM LA English DT Review DE arthritis; collagen; antibody; leukocytes; chemokines ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; C57BL/6 H-2(B) MICE; T-CELLS; REGULATORY ACTIVITY; SYNOVIAL-FLUID; INFLAMMATORY ARTHRITIS; HUMAN CHONDROCYTES; DENDRITIC CELLS; CCR2(-/-) MICE; KNOCKOUT MICE AB CCR2 has been widely considered as a potential therapeutic target for autoimmune disease, particularly rheumatoid arthritis, and various CCR2 blocking agents have been developed, some of which have entered clinical trials. In this review, we examine the relevant information regarding the role of CCR2, and to a lesser extent of the closely related chemokine receptor CCR5, in the immunopathogenesis of collagen-induced arthritis, an animal model of rheumatoid arthritis. Experimental evidence showing that CIA is accelerated and exacerbated when CCR2 is genetically inactivated (knockout mice) or blocked with specific antibodies warrant additional investigations before the relevance of the findings in rodent models can be applied to human patients with RA. C1 Univ Munich, Med Policlin, D-80336 Munich, Germany. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med MC 7870, San Antonio, TX 78229 USA. Vet Adm, Ctr Res AIDS & HIV1 Infect, San Antonio, TX USA. Prot Design Lab Inc, Fremont, CA 94555 USA. RP Ahuja, SS (reprint author), Univ Munich, Med Policlin, Pettenkoferstr 8A, D-80336 Munich, Germany. EM ahuja@uthscsa.edu; mack@medpoli.med.uni-muenchen.de FU NIAID NIH HHS [AI48644] NR 67 TC 48 Z9 52 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0946-2716 J9 J MOL MED JI J. Mol. Med. PD SEP PY 2005 VL 83 IS 9 BP 672 EP 681 DI 10.1007/s00109-005-0637-5 PG 10 WC Genetics & Heredity; Medicine, Research & Experimental SC Genetics & Heredity; Research & Experimental Medicine GA 960OE UT WOS:000231602200003 PM 15827759 ER PT J AU Chu, CT Zhu, J Cao, GD Signore, A Wang, SP Chen, J AF Chu, CT Zhu, J Cao, GD Signore, A Wang, SP Chen, J TI Apoptosis inducing factor mediates caspase-independent 1-methyl-4-phenylpyridinium toxicity in dopaminergic cells SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE dopaminergic cells; mitochondria; neuronal cell death; Parkinson's disease; primary midbrain neurons; RNA interference ID ENDOPLASMIC-RETICULUM STRESS; UNFOLDED PROTEIN RESPONSE; PARKINSONS-DISEASE; DISTINCT MECHANISMS; NEURONAL CULTURES; FACTOR AIF; DEATH; ACTIVATION; MICE; 6-HYDROXYDOPAMINE AB Parkinson's disease is a debilitating neurodegenerative disease characterized by loss of midbrain dopaminergic neurons. These neurons are particularly sensitive to the neurotoxin 1-methyl-4-phenylpyridinium (MPP+), the active metabolite of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which causes parkinsonian syndromes in humans, monkeys and rodents. Although apoptotic cell death has been implicated in MPTP/MPP+ toxicity, several recent studies have challenged the role of caspase-dependent apoptosis in dopaminergic neurons. Using the midbrain-derived MN9D dopaminergic cell line, we found that MPP+ treatment resulted in an active form of cell death that could not be prevented by caspase inhibitors or over-expression of a dominant negative inhibitor of apoptotic protease activating factor 1/caspase-9. Apoptosis inducing factor (AIF) is a mitochondrial protein that may mediate caspase-independent forms of regulated cell death following its translocation to the nucleus. We found that MPP+ treatment elicited nuclear translocation of AIF accompanied by large-scale DNA fragmentation. To establish the role of AIF in MPP+ toxicity, we constructed a DNA vector encoding a short hairpin sequence targeted against AIF. Reduction of AIF expression by RNA interference inhibited large-scale DNA fragmentation and conferred significant protection against MPP+ toxicity. Studies of primary mouse midbrain cultures further supported a role for AIF in caspase-independent cell death in MPP+-treated dopaminergic neurons. C1 Univ Pittsburgh, Sch Med, Dept Pathol, Div Neuropathol, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Ctr Neurosci, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Chu, CT (reprint author), UPMC Presbyterian, Room A-516,200 Lothrop St, Pittsburgh, PA 15213 USA. EM ctc4@pitt.edu RI Chu, Charleen/B-1601-2008 OI Chu, Charleen/0000-0002-5052-8271 FU NINDS NIH HHS [NS43802, NS40817, NS44178, R01 NS040817, R01 NS043802, R01 NS044178] NR 46 TC 65 Z9 70 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD SEP PY 2005 VL 94 IS 6 BP 1685 EP 1695 DI 10.1111/j.1471-4159.2005.03329.x PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 959HS UT WOS:000231509400019 PM 16156740 ER PT J AU Anderson, CA Arciniegas, DB Filley, CM AF Anderson, CA Arciniegas, DB Filley, CM TI Treatment of acute ischemic stroke: Does it impact neuropsychiatric outcome? SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article; Proceedings Paper CT 15th Annual Meeting of the American-Neuropsychiatric-Association CY FEB 21-24, 2004 CL Bal Harbour, FL SP Amer Neuropsychiat Assoc ID COMPLICATIONS; DEPRESSION; TRIALS AB Stroke is a leading cause of disability globally. Although neuropsychiatric symptoms are produced by stroke and adversely effect stroke outcome, it is unclear whether neuropsychiatric outcome can be improved by acute stroke treatment. The authors reviewed published acute ischemic stroke treatment trials to determine whether neuropsychiatric outcome measures were employed. Of the 190 trials reviewed, only seven included specific measures of neuropsychiatric outcome, usually a short test of cognition or mood. Further studies are needed to determine the potential benefits of acute stroke treatment on both poststroke neuropsychiatric symptoms and the relationship between such symptoms and stroke outcome. C1 Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Neurol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Sch Med, Dept Psychiat, Denver, CO USA. RP Anderson, CA (reprint author), Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Neurol, 4200 E 9th Ave, Denver, CO 80262 USA. EM al.anderson@UCHSC.edu RI Arciniegas, David/A-3792-2009 NR 17 TC 5 Z9 5 U1 0 U2 1 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD FAL PY 2005 VL 17 IS 4 BP 486 EP 488 DI 10.1176/appi.neuropsych.17.4.486 PG 3 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 993PH UT WOS:000233966900007 PM 16387987 ER PT J AU Bracha, HS Garcia-Rill, E Mrak, RE Skinner, R AF Bracha, HS Garcia-Rill, E Mrak, RE Skinner, R TI Postmortem locus coeruleus neuron count in three American veterans with probable or possible war-related PTSD SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; PARKINSONS-DISEASE; BRAIN COLLECTION; SENILE DEMENTIA; ALZHEIMER TYPE; NOREPINEPHRINE; SCHIZOPHRENIA; PROPRANOLOL; DEPRESSION; VICTIMS AB The authors investigated whether war-related posttraumatic stress disorder (WR-PTSD) is associated with a postmortem change in neuronal counts in the locus coeruleus (LC) since enhanced central nervous system (CNS) noradrenergic postsynaptic responsiveness has been previously shown to contribute to PTSD pathophysiology. Using postmortem neuromorphometry, the number of neurons in the right LC in seven deceased elderly male veterans was counted. Three veterans were classified as cases of probable or possible WR-PTSD. All three veterans with probable or possible WR-PTSD were found to have substantially lower LC neuronal counts compared to four comparison subjects (three nonpsychiatric veterans and one veteran with alcohol dependence and delirium tremens). To the authors' knowledge, this case series is the first report of LC neuronal counts in patients with PTSD or any other DSM-IV-TR anxiety disorder. Previous postmortem brain tissue studies of Alzheimer's Disease (AD) demonstrated an upregulation of NE biosynthetic capacity in surviving LC neurons. The finding reported is consistent with the similar upregulation of NE biosynthetic capacity of surviving LC neurons in veterans who developed WR-PTSD. Especially if replicated, this finding in WR-PTSD may provide further explanation of the dramatic effectiveness of propranolol and prazosin for the secondary prevention and treatment of PTSD, respectively. The LC neurons examined in this study are probably the origin of the first or second "leg" of what might be termed the PTSD candidate circuit. Larger neuromorphometric studies of the LC in veterans with WR-PTSD and in other development-stress-induced and fear-circuitry disorders are warranted, especially using VA registries. C1 US Dept Vet Affairs, VA Natl Ctr Posttraumat Stress Disorder, Pacific Isl Hlth Care Syst, Spark M Matsunaga VA Med Ctr, Honolulu, HI USA. Univ Arkansas Med Sci, Coll Med, Dept Neurobiol & Dev Sci, Ctr Translat Neurosci, Little Rock, AR 72205 USA. Univ Arkansas Med Sci, Dept Pathol, Little Rock, AR 72205 USA. RP Bracha, HS (reprint author), Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, Pacific Isl Hlth Care Syst, Spark M Matsunaga VA Med Ctr, 1132 Bishop St 307, Honolulu, HI 96822 USA. EM H.Bracha@med.va.gov OI Garcia-Rill, Edgar/0000-0003-1367-3071 FU NCRR NIH HHS [P20 RR020146]; NIMH NIH HHS [R01 MH 45729] NR 38 TC 25 Z9 28 U1 0 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD FAL PY 2005 VL 17 IS 4 BP 503 EP 509 DI 10.1176/appi.neuropsych.17.4.503 PG 7 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 993PH UT WOS:000233966900010 PM 16387990 ER PT J AU Davalos, DB Kisley, MA Freedman, R AF Davalos, DB Kisley, MA Freedman, R TI Behavioral and electrophysiological indices of temporal processing dysfunction in schizophrenia SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article; Proceedings Paper CT 11th Annual Meeting of the Cognitive-Neuroscience-Society CY APR, 2004 CL San Francisco, CA SP Cognit Neurosci Soc ID EVENT-RELATED POTENTIALS; MISMATCH NEGATIVITY; TIME-ESTIMATION; AFFECTIVE-DISORDERS; INTERVAL DURATION; INTERNAL CLOCK; MEMORY; DEVIANCE; DEFICIT; BRAIN AB Timing deficits in schizophrenia have been noted in several behavioral studies. However, the involvement of mediating factors, such as inattention, has not been ruled out as contributing to these effects. Mismatch negativity (MMN), an electrophysiological measure, may provide a more direct index of stimulus processing ability in individuals with schizophrenia. The current study explored the relationship between behavioral time judgments and a time-based MMN paradigm. Participants were administered two MMN paradigms consisting of an "easy" or "difficult" deviant and an analogous behavioral measure of time processing. Matched against a healthy comparison group, patients exhibited decreased MMN amplitude on the "difficult" deviant interval only. However, on the behavioral paradigm, the patients made significantly more errors across all conditions. These results suggest that behavioral measures: of time processing may reflect different processes than those captured by preattentive physiological measures in this population. C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Colorado Springs, CO 80907 USA. RP Davalos, DB (reprint author), Colorado State Univ, Dept Psychol, Ft Collins, CO 80523 USA. EM Davalos@ColoState.Edu FU NIMH NIH HHS [MH 152442, MH 56539] NR 37 TC 27 Z9 28 U1 1 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD FAL PY 2005 VL 17 IS 4 BP 517 EP 525 DI 10.1176/appi.neuropsych.17.4.517 PG 9 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 993PH UT WOS:000233966900012 PM 16387992 ER PT J AU Emery, DL Fulp, CT Saatman, KE Schutz, C Neugebauer, E McIntosh, TK AF Emery, DL Fulp, CT Saatman, KE Schutz, C Neugebauer, E McIntosh, TK TI Newly born granule cells in the dentate gyrus rapidly extend axons into the hippocampal CA3 region following experimental brain injury SO JOURNAL OF NEUROTRAUMA LA English DT Article DE BrdU; hippocampus; mossy fiber pathway; neurogenesis; neuronal plasticity; progenitor cells; tract tracing; traumatic brain injury ID CENTRAL-NERVOUS-SYSTEM; TRANSIENT GLOBAL-ISCHEMIA; NMDA RECEPTOR ACTIVATION; ADULT-RAT; STEM-CELLS; ENHANCED NEUROGENESIS; SPINAL-CORD; PSA-NCAM; PROLIFERATION; NEURONS AB We investigated whether new neurons generated in the adult rat brain following lateral fluid percussion traumatic brain injury (TBI) are capable of projecting axons along the mossy fiber pathway to the CA3 region of the hippocampus. Dividing cells were labeled by intraperitoneal injection of bromodeoxyuridine (BrdU) on the day of surgery/injury, and neurons that extended axons to the CA3 region were retrogradely labeled by fluorescent tracers (FluoSpheres(R)), stereotactically injected into the CA3 region of both the ipsi- and contralateral hippocampus at I or 12 days following TBI (n = 12) or sham injury (n = 12) in anaesthetized rats. Animals (11 = 6 injured and n = 6 sham-injured controls per time point) were sacrificed at either 3 or 14 days post-injury. Another group of animals (n = 3) was subjected to experimental TBI and BrdU administration and sacrificed 3 days after TBI to be processed for BrdU and immunohistochemistry for polysialylated neural cell adhesion molecule (PSA-NCAM), a growth-related protein normally observed during CNS development. A fivefold bilateral increase in the number of mitotically active (BrdU+) cells was noted within the dentate gyrus when compared to uninjured controls as early as 3 days following TBI. A subgroup of dividing cells was also immunoreactive for PSA-NCAM at 3 days following TBI. By 2 weeks post-injury the number of BrdU+ cells within the dentate gyrus was increased twofold compared to the uninjured counterparts and a proportion of these newly generated cells showed cytoplasmic staining for the fluorescent tracer. These findings document rapid neurogenesis following TBI and show, for the first time, that newly generated granule neurons are capable of extending projections along the hippocampal mossy fiber pathway in the acute post-traumatic period. C1 Univ Kentucky, Spinal Cord & Brain Injury Ctr, Lexington, KY 40536 USA. Univ Penn, Sch Med, Traumat Brain Injury Lab, Dept Neurosurg, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Cologne, Dept Expt Surg, Cologne, Germany. RP Saatman, KE (reprint author), Univ Kentucky, Spinal Cord & Brain Injury Ctr, B367 BB3RB,741 S Limestone St, Lexington, KY 40536 USA. EM K.Saatman@uky.edu RI Schuetz, Christian/K-5234-2013 OI Schuetz, Christian/0000-0002-6828-4543 FU NINDS NIH HHS [P50-NS08803, R01-NS40978]; PHS HHS [R01-45131] NR 83 TC 45 Z9 47 U1 0 U2 5 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 0897-7151 J9 J NEUROTRAUM JI J. Neurotrauma PD SEP PY 2005 VL 22 IS 9 BP 978 EP 988 DI 10.1089/neu.2005.22.978 PG 11 WC Critical Care Medicine; Clinical Neurology; Neurosciences SC General & Internal Medicine; Neurosciences & Neurology GA 967HP UT WOS:000232082600005 PM 16156713 ER PT J AU Starks, H Pearlman, RA Hsu, C Back, AL Gordon, JR Bharucha, AJ AF Starks, H Pearlman, RA Hsu, C Back, AL Gordon, JR Bharucha, AJ TI Why now? Timing and circumstances of hastened deaths SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE death and dying; physician-assisted suicide; euthanasia; terminal care; qualitative research ID PHYSICIAN-ASSISTED SUICIDE; TERMINALLY-ILL PATIENTS; PATIENT REQUESTS; HOSPICE PATIENTS; EUTHANASIA; ATTITUDES; OREGON; ONCOLOGISTS; EXPERIENCES; CARE AB We interviewed 35 families to understand the liming and circumstances of hastened deaths. We estimated life expectancy for the 26 patients who hastened their deaths and used content analysis to identify patterns in their decisions. On average, patients had lived with their illness for 2.5 years and had actively planned their deaths for 3 months. Those with less than a week to live (n = 10) were 'dying and done, 'having experienced a final functional loss that signaled the end. Those with < 1 month (n = 8) were 'dying, but not fast enough.' Those with 1-6 months (n = 5) saw a 'looming crisis' on their horizon that would prohibit following through with their plans. The 3 patients with > 6 months were 'not recognized by others as dying, but suffering just the same.' Clinicians should regularly assess where patients perceive they are in the dying process and ask about their comfort with the pace of dying to identify for opportunities for intervention. C1 Univ Washington, Dept Med Hist, Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Eth, Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Med, Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychol, Hlth Serv, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Vet Hlth Adm, Natl Ctr Eth Hlth Care, Washington, DC USA. Grp Hlth Community Fdn, Seattle, WA USA. Seattle Canc Care Alliance, Seattle, WA USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Pittsburgh, PA USA. RP Starks, H (reprint author), Univ Washington, Dept Med Hist, Hlth Serv, Seattle, WA 98195 USA. FU AHRQ HHS [T32 HS-013853] NR 37 TC 8 Z9 8 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD SEP PY 2005 VL 30 IS 3 BP 215 EP 226 DI 10.1016/j.jpainsymman.2205.03.012 PG 12 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 974CP UT WOS:000232569200006 PM 16183005 ER PT J AU Rickerson, EM Somers, C Allen, CM Lewis, B Strumpf, N Casarett, D AF Rickerson, EM Somers, C Allen, CM Lewis, B Strumpf, N Casarett, D TI How well are we caring for caregivers? Prevalence of grief-related symptoms and need for bereavement support among long-term care staff SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE bereavement; palliative care; PACE; long-term care; hospice ID COMPLICATED GRIEF; DEPRESSION; RESUSCITATION; FAMILIES; DISTINCT; DEATH AB To define the prevalence and correlates of grief-related symptoms among long term care staff who care for patients near the end of life, a cross-sectional survey was conducted at six Program of All-inclusive Care for the Elderly (PACE) organizations that provide long-term care in the home and in institutions. All clinical and non-clinical program staff were surveyed to examine the prevalence of 20 grief-related symptoms and assess current sources of bereavement support, as well as willingness to use additional sources of support. Suveys were completed by 2031236 staff (86%), who described a wide variety of symptoms they attributed to the death of one of their patients in the past month. Most staff (147/203; 72%) reported at least one symptom. Staff with more symptoms had experienced more patient deaths in the past month (Spearman rho = 0. 20, P = 0.007), had worked for a longer time at a PACE organization (Spearman rho = 0. 16, P = 0. 03 1), and reported a closer and longer relationship with the last patient who died (Spearman rho = 0. 32, P < 0. 001; rho = 0. 24, P = 0.0001). Although staff identified several informal sources of bereavement support (mean 2.3 sources, range 0-6), almost all (n = 194; 96%) said they would use additional support services if they were offered. These community-based long-term care staff experience a variety of symptoms attributable to the deaths of their patients, and would welcome additional sources of bereavement support. C1 Univ Penn, Sch Nursing, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Social Work, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ & Promot, Philadelphia, PA USA. RP Rickerson, EM (reprint author), Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 22 TC 17 Z9 18 U1 3 U2 11 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD SEP PY 2005 VL 30 IS 3 BP 227 EP 233 DI 10.1016/j.jpainsymman.2005.04.005 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 974CP UT WOS:000232569200007 PM 16183006 ER PT J AU Smith, DG Ehde, DM Hanley, MA Campbell, KM Jensen, MP Roffman, AJ Awan, AB Czerniecki, JM Robinson, LR AF Smith, DG Ehde, DM Hanley, MA Campbell, KM Jensen, MP Roffman, AJ Awan, AB Czerniecki, JM Robinson, LR TI Efficacy of gabapentin in treating chronic phantom limb and residual limb pain SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE amputation; chronic pain; gabapentin; limb loss; pain; pain treatment; phantom limb pain; randomized clinical trial; residual limb pain; treatment ID RANDOMIZED CONTROLLED-TRIAL; NEUROPATHIC PAIN; DOUBLE-BLIND; AMPUTATION; AMPUTEES; REHABILITATION; AMITRIPTYLINE; OUTCOMES; SCALE AB Twenty-four adults with phantom limb pain (PLP) and/or residual limb pain (RLP) participated in a double-blind crossover trial. Participants were randomly assigned to receive gabapentin or placebo and later crossed over to the other treatment, with a 5-week washout interval in which they did not receive medication. Gabapentin was titrated from 300 mg to the maximum dose of 3,600 mg. Measures of pain intensity, pain interference, depression, life satisfaction, and functioning were collected throughout the study. Analyses revealed no significant group differences in pre- to posttreatment change scores on any of the outcome measures. More than half of the participants reported a meaningful decrease in pain during the gabapentin phase compared with about one-fifth who reported a meaningful decrease in pain during the placebo phase. In this trial, gabapentin did not substantially affect pain. More research on the efficacy of gabapentin to treat chronic PLP and RLP is needed. C1 Harborview Med Ctr, Dept Rehabil Med, Seattle, WA 98104 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Prosthet Res Study, Seattle, WA USA. Dept Vet Affairs VA, Rehabil Res & Dev Ctr Excellence Limb Loss Preven, VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Ehde, DM (reprint author), Harborview Med Ctr, Dept Rehabil Med, Box 359740,325 9th Ave, Seattle, WA 98104 USA. EM ehde@u.washington.edu RI Robinson , Lawrence/D-8455-2013 FU NICHD NIH HHS [P01 HD/NS33988] NR 28 TC 37 Z9 39 U1 2 U2 3 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD SEP-OCT PY 2005 VL 42 IS 5 BP 645 EP 654 DI 10.1682/JRRD.2005.05.0082 PG 10 WC Rehabilitation SC Rehabilitation GA 036KD UT WOS:000237069100010 PM 16586190 ER PT J AU Ledoux, WR Shofer, JB Smith, DG Sullivan, K Hayes, SC Assal, M Reiber, GE AF Ledoux, WR Shofer, JB Smith, DG Sullivan, K Hayes, SC Assal, M Reiber, GE TI Relationship between foot type, foot deformity, and ulcer occurrence in the high-risk diabetic foot SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE diabetes mellitus; foot; foot deformity; foot type; hallux limitus; hallux valgus; hammer/claw toes; pes cavus; pes planus; ulcer ID PES PLANUS FEET; LIMITED JOINT MOBILITY; HALLUX-VALGUS; PRESSURE; MANAGEMENT; PREDICTORS; NEUROPATHY; MELLITUS; WALKING AB We hypothesized an association between foot type, foot deformity, and foot ulceration and conducted an analysis of a well-characterized, high-risk diabetic population of 398 subjects. The average age was 62 years of age and 74% of the study population were males. Foot-type distributions were 19.5% pes cavus (high arch), 51.5% neutrally aligned (normal arch), and 29.0% pes planus (low arch). We quantified the presence of hallux valgus (23.9%), hammer/claw toes (46.7%), and hallux limitus (24.4%). A significant association was found between foot type and hallux valgus (p = 0.003); pes planus feet had the highest prevalence as compared with neutrally aligned feet (odds ratio [OR] = 2.43, p = 0.0006). Foot type was also significantly associated with fixed hammer/claw toes (p = 0.01); pes cavus feet had the highest prevalence as compared with neutrally aligned feet (OR = 3.89, p = 0.001). Foot type was also significantly associated with hallux limitus (p = 0.006) with pes planus feet having the highest prevalence as compared with neutrally aligned feet (OR = 2.19, p = 0.003). However, foot type was not significantly related to any ulcer outcome (p = 0.7). Fixed hammer/claw toes (OR = 3.91, p = 0.003) and hallux limitus (OR = 3.02, p = 0.006) were associated with increased risk of any ulcer occurrence. This study affirms that foot type and foot deformity are related and that foot deformities are associated with ulcer occurrence. C1 VA Puget Sound Hlth Care Syst, Dept Vet Affairs VA, Rehabil Res & Dev Ctr Excellence Limb Loss Preven, Seattle, WA 98108 USA. Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. Univ Washington, Harborview Med Ctr, Dept Med, Seattle, WA 98104 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA Puget Sound Hlth Care Syst, Dept Vet Affairs VA, Rehabil Res & Dev Ctr Excellence Limb Loss Preven, Ms 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 FU NIDDK NIH HHS [Y-1-DK-0066-01]; PHS HHS [RCD 98-353] NR 29 TC 30 Z9 33 U1 1 U2 6 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD SEP-OCT PY 2005 VL 42 IS 5 BP 665 EP 671 DI 10.1682/JRRD.2004.11.0144 PG 7 WC Rehabilitation SC Rehabilitation GA 036KD UT WOS:000237069100012 PM 16586192 ER PT J AU Eason, SL Petersen, NJ Suarez-Almazor, M Davis, B Collins, TC AF Eason, SL Petersen, NJ Suarez-Almazor, M Davis, B Collins, TC TI Diabetes mellitus, smoking, and the risk for asymptomatic peripheral arterial disease: Whom should we screen? SO JOURNAL OF THE AMERICAN BOARD OF FAMILY PRACTICE LA English DT Article ID ANKLE-ARM INDEX; INTERMITTENT CLAUDICATION; VASCULAR-DISEASE; BLOOD-PRESSURE; OCCLUSIVE DISEASE; EDINBURGH ARTERY; LEG SYMPTOMS; PREVALENCE; POPULATION; WOMEN AB Objective: To describe coexisting medical conditions and lifestyle factors associated with asymptomatic peripheral arterial disease (PAD) in a population of white, African American, and Hispanic patients. Study Design and Setting: White, African American, and Hispanic patients 50 years or older were recruited for this cross-sectional study from 4 primary care clinics in Houston, TX. Patients with an ankle-brachial index (ABI) < 0.9 and without leg symptoms typical of PAD were diagnosed with asymptomatic PAD. Results: 403 patients were screened for PAD. Of these, 25 (6.2%) had asymptomatic PAD. Compared with patients without PAD, diabetes mellitus ([OR] 3.8; 95% CI 1.6, 9.0) and a history of smoking at least 1 pack of cigarettes per day ([OR] 2.5; 95% CI 1.1, 6.0) were significantly associated with asymptomatic PAD. An interaction effect existed between diabetes mellitus and smoking at least 1 pack of cigarettes per day. Diabetes mellitus combined with heavy smoking showed the highest predicted value positive (15%) and the highest specificity (92%). A lack of both demonstrated low rates for predicting asymptomatic PAD (predicted value positive, 1%). Conclusion: The ankle-brachial index could become routine screening among patients with diabetes mellitus and/or who smoke. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Sect Hlth Serv Res, Houston, TX 77021 USA. Univ Texas, Sch Publ Hlth, Houston, TX USA. RP Collins, TC (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Sect Hlth Serv Res, 2450 Holcombe Blvd,Suite 01Y,152, Houston, TX 77021 USA. EM season@bcm.tmc.edu; tcollins@bcm.tmc.edu NR 36 TC 23 Z9 24 U1 0 U2 0 PU AMER BOARD FAMILY PRACTICE PI LEXINGTON PA 2228 YOUNG DR, LEXINGTON, KY 40505 USA SN 0893-8652 J9 J AM BOARD FAM PRACT JI J. Am. Board Fam. Pract. PD SEP-OCT PY 2005 VL 18 IS 5 BP 355 EP 361 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 962GL UT WOS:000231718900003 PM 16148245 ER PT J AU Barshes, NR Gay, AN Williams, B Patel, AJ Awad, SS AF Barshes, NR Gay, AN Williams, B Patel, AJ Awad, SS TI Support for the acutely failing liver: A comprehensive review of historic and contemporary strategies SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Review ID FULMINANT HEPATIC-FAILURE; ADSORBENT RECIRCULATING SYSTEM; HYBRID ARTIFICIAL LIVER; EXTRACORPOREAL ALBUMIN DIALYSIS; PORCINE ENDOGENOUS RETROVIRUS; CROSS-SPECIES TRANSMISSION; EXCHANGE BLOOD-TRANSFUSION; HIGH-VOLUME PLASMAPHERESIS; CONTROLLED CLINICAL-TRIAL; 2-STAGE TOTAL HEPATECTOMY C1 Baylor Coll Med, Michael E De Bakey Dept Surg, Michael E DeBakey Vet Adm Med Ctr, Houston, TX 77030 USA. RP Awad, SS (reprint author), Baylor Coll Med, Michael E De Bakey Dept Surg, Michael E DeBakey Vet Adm Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 206 TC 19 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 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD SEP PY 2005 VL 201 IS 3 BP 458 EP 476 DI 10.1016/j.jamcollsurg.2005.04.007 PG 19 WC Surgery SC Surgery GA 960PY UT WOS:000231606800021 PM 16125082 ER PT J AU Robbins, J Gangnon, RE Theis, SM Kays, SA Hewitt, AL Hind, JA AF Robbins, J Gangnon, RE Theis, SM Kays, SA Hewitt, AL Hind, JA TI The effects of lingual exercise on swallowing in older adults SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE deglutition; tongue; exercise; therapeutics; prevention ID PENETRATION-ASPIRATION SCALE; SKELETAL-MUSCLE; STROKE; PARKINSONISM; DYSPHAGIA; PNEUMONIA; MORTALITY; VALIDATION; PRESSURE; RISK AB OBJECTIVES: To determine the effects of an 8-week progressive lingual resistance exercise program on swallowing in older individuals, the most "at risk'' group for dysphagia. DESIGN: Prospective cohort intervention study. SETTING: Subjects were recruited from the community at large. PARTICIPANTS: Ten healthy men and women aged 70 to 89. INTERVENTION: Each subject performed an 8-week lingual resistance exercise program consisting of compressing an air-filled bulb between the tongue and hard palate. MEASUREMENTS: At baseline and Week 8, each subject completed a videofluoroscopic swallowing evaluation for kinematic and bolus flow assessment of swallowing. Swallowing pressures and isometric pressures were collected at baseline and Weeks 2, 4, and 6. Four of the subjects also underwent oral magnetic resonance imaging (MRI) to measure lingual volume. RESULTS: All subjects significantly increased their isometric and swallowing pressures. All subjects who had the MRI demonstrated increased lingual volume of an average of 5.1%. CONCLUSION: The findings indicate that lingual resistance exercise is promising not only for preventing dysphagia due to sarcopenia, but also as a treatment strategy for patients with lingual weakness and swallowing disability due to frailty or other age-related conditions. The potential effect of lingual exercise on reducing dysphagia-related comorbidities (pneumonia, malnutrition, and dehydration) and healthcare costs while improving quality of life is encouraging. C1 William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI USA. Univ Wisconsin, Dept Biomed Engn, Madison, WI USA. RP Robbins, J (reprint author), William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, 2500 Overlook Terrace GRECC 11G, Madison, WI 53705 USA. EM jrobbin2@wisc.edu NR 39 TC 136 Z9 148 U1 4 U2 14 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2005 VL 53 IS 9 BP 1483 EP 1489 DI 10.1111/j.1532-5415.2005.53467.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 959HO UT WOS:000231509000005 PM 16137276 ER PT J AU Naik, AD Gill, TM AF Naik, AD Gill, TM TI Underutilization of environmental adaptations for bathing in community-living older persons SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE bathing; disability; activities of daily living; geriatric epidemiology; adaptive devices ID ASSISTIVE DEVICES; DISABILITY; HOME; ADULTS; RISK; ASSISTANCE; PEOPLE; CARE; PERFORMANCE; TECHNOLOGY AB OBJECTIVES: To determine the prevalence and utilization of environmental adaptations (home modifications and assistive devices) for bathing in community-living older persons with and without bathing disability. DESIGN: Cross-sectional study. SETTING: General community of greater New Haven, Connecticut. PARTICIPANTS: Five hundred sixty-six community-living persons aged 73 and older. MEASUREMENTS: Trained research nurses performed a comprehensive assessment of bathing function, including an in-home evaluation of the bathing environment and self-reported utilization of environmental adaptations for bathing. RESULTS: The prevalence of most environmental adaptations for bathing was less than 50% and was only modestly greater in participants with bathing disability ( range 6-54%) than in those without bathing disability (2-44%), although important differences in prevalence and utilization were observed according to the type of bathing disability. Participants who had difficulty (without dependence) with bathing were significantly less likely to have most of the environmental adaptations than participants who needed personal assistance (dependence) with bathing. These differences persisted in analyses that specifically evaluated the utilization of environmental adaptations for bathing transfers according to the type of disability with bathing transfers (59% of those with difficulty vs 88% of those with dependence, P <. 001). CONCLUSION: Potentially valuable environmental adaptations are absent from the homes of many older persons with bathing disability and may be particularly underused by older persons reporting difficulty with bathing. To ameliorate or delay the progression of disability in community-living older persons, assessment and remediation strategies should be better targeted to bathing function across the continuum of disability. C1 Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey VA Med Ctr 152, Houston, TX 77030 USA. Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. RP Naik, AD (reprint author), Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM anaik@bcm.tmc.edu FU NIA NIH HHS [R37 AG017560, K24AG021507, R01AG022993, R01AG17560] NR 41 TC 18 Z9 18 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2005 VL 53 IS 9 BP 1497 EP 1503 DI 10.1111/j.1532-5415.2005.53458.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 959HO UT WOS:000231509000007 PM 16137278 ER PT J AU Hajjar, ER Hanlon, JT Sloane, RJ Lindblad, CI Pieper, CF Ruby, CM Branch, LC Schmader, KE AF Hajjar, ER Hanlon, JT Sloane, RJ Lindblad, CI Pieper, CF Ruby, CM Branch, LC Schmader, KE TI Unnecessary drug use in frail older people at hospital discharge SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE unnecessary drug use; drug utilization; elderly ID MEDICATION APPROPRIATENESS INDEX; CONTROLLED TRIAL; PRESCRIPTION DATABASE; PRESCRIBING PATTERNS; GERIATRIC EVALUATION; POLYPHARMACY; MANAGEMENT; REGIMEN; IMPACT; BLACK AB OBJECTIVES: To determine the prevalence and predictors of unnecessary drug use at hospital discharge in frail elderly patients. DESIGN: Cross-sectional. SETTING: Eleven Veterans Affairs Medical Centers. PARTICIPANTS: Three hundred eighty-four frail older patients from the Geriatric Evaluation and Management Drug Study. MEASUREMENTS: Assessment of unnecessary drug use was determined by the consensus of a clinical pharmacist and physician pair applying the Medication Appropriateness Index to each regularly scheduled medication at hospital discharge. Those drugs that received an inappropriate rating for indication, efficacy, or therapeutic duplication were defined as unnecessary. RESULTS: Forty-four percent of patients had at least one unnecessary drug, with the most common reason being lack of indication. The most commonly prescribed unnecessary drug classes were gastrointestinal, central nervous system, and therapeutic nutrients/minerals. Factors associated (P < .05) with unnecessary drug use included hypertension (adjusted odds ratio (AOR) 50.61, 95% confidence interval (CI) = 0.38-0.96), multiple prescribers (AOR = 3.35, 95% CI = 1.16-9.68), and nine or more medications (AOR = 2.24, 95% CI = 1.25-3.99). CONCLUSION: A high prevalence of unnecessary drug use at discharge was found in frail hospitalized elderly patients. Additional studies are needed to identify predictors and prevalence of unnecessary drug use in non-veteran populations so that interventions can be designed to reduce the problem. C1 Univ Sci, Philadelphia Coll Pharm, Philadelphia, PA 19104 USA. Vet Affairs Pittsburgh Hlth Care Syst, Dept Geriatr Med, Sch Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Duke Univ, Med Ctr, Ctr Study Aging & Human Dev, Durham, NC 27710 USA. Duke Univ, Dept Biostat & Bioinformat, Durham, NC USA. Univ Minnesota, Coll Pharm, Inst Study Geriatr Pharmacotherapy, Dept Expt & Clin Pharmacol, Minneapolis, MN 55455 USA. Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Minneapolis, MN USA. Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Durham, NC USA. Univ N Carolina, Sch Pharm, Chapel Hill, NC USA. Univ S Florida, Coll Publ Hlth, Tampa, FL USA. RP Hajjar, ER (reprint author), Univ Sci, Philadelphia Coll Pharm, 600 S 43rd St, Philadelphia, PA 19104 USA. EM e.hajjar@usip.edu FU NIA NIH HHS [R01-AG-14158]; NIAID NIH HHS [K24-AI-51324-01] NR 36 TC 81 Z9 82 U1 2 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2005 VL 53 IS 9 BP 1518 EP 1523 DI 10.1111/j.1532-5415.2005.53523.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 959HO UT WOS:000231509000010 PM 16137281 ER PT J AU Castle, SC Uyemura, K Rafi, A Akande, O Makinodan, T AF Castle, SC Uyemura, K Rafi, A Akande, O Makinodan, T TI Comorbidity is a better predictor of impaired immunity than chronological age in older adults SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE immunosenescence; interleukin-10 and-12; comorbidity; CIRS; immunity; aging ID ILLNESS RATING-SCALE; SENIEUR PROTOCOL; VACCINE AB To determine whether high level of comorbidity, measured using a standardized instrument, can predict impaired immunity in older adults. Geriatric outpatient Clinic and Nursing Home Care Unit of Veterans Affairs Greater Los Angeles Healthcare System. Fifteen men aged 51 to 95 with varying levels of chronic illness. Disease burden was measured using the Cumulative Illness Rating Scale (CIRS) and immunity using proliferation of T cells induced by phytohemagglutinin (PHA) and production of interleukin (IL)-12, a proinflammatory cytokine that promotes T helper cell-dependent immune response, and IL-10, a cytokine that inhibits T helper cell-dependent immune response, in response to mitogenic stimulation of peripheral blood mononuclear cells. With increasing comorbidity (increase in CIRS score) in older adults, there is a proportional decrease in immune response (decrease in T cell proliferation and IL-12 production and increase in IL-10 production in response to PHA stimulation). Neither immune response nor CIRS score was significantly correlated with chronological age in this sample of older adults with varying degrees of chronic illness. This study demonstrates that the level of comorbidity correlates with the magnitude of immune response in older adults and suggests that the CIRS could be used to determine the magnitude of impaired immunity in older adults with different specific illnesses and different levels of severity. C1 VA Greater Los Angeles Healthcare Syst, GREEC 11G, Dept Vet Affairs, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Multicampus Div Geriatr & Gerontol, Los Angeles, CA 90024 USA. RP Castle, SC (reprint author), VA Greater Los Angeles Healthcare Syst, GREEC 11G, Dept Vet Affairs, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM steven.castle@med.va.gov FU NIA NIH HHS [R03AG18497] NR 20 TC 26 Z9 26 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2005 VL 53 IS 9 BP 1565 EP 1569 DI 10.1111/j.1532-5415.2005.53512.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 959HO UT WOS:000231509000017 PM 16137288 ER PT J AU Tiffany, NM Ryan, CW Garzotto, M Wersinger, EM Beer, TM AF Tiffany, NM Ryan, CW Garzotto, M Wersinger, EM Beer, TM TI High dose pulse calcitriol, docetaxel and estramustine for androgen independent prostate cancer: A phase VII study SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; calcitriol; docetaxel; estramustine ID MITOXANTRONE PLUS PREDNISONE; VITAMIN-D; CELL-LINES; INHIBITION; GUIDELINES; ANALOGS; GROWTH AB Purpose: We determined the safety and preliminary efficacy of the combination of high dose pulse calcitriol (1,25-dihydroxycholecalciferol) with a standard regimen of docetaxel plus estramustine in patients with metastatic androgen independent prostate cancer. Materials and Methods: Patients were treated with 60, calcitriol orally on day 1, 280 mg estramustine orally 3 times daily on days 1 to 5 and 60 mg/mg(2) docetaxel on day 2 (70 mg/m(2) after cycle 1) every 21 days for up to 12 cycles. Patients also received 325 mg aspirin and 1 or 2 mg warfarin orally daily. Regimen safety was assessed in the first 6 patients and a dose de-escalation scheme for calcitriol was planned if dose limiting toxicities were noted during treatment cycle 1 in greater than a third of patients. Results: A total of 24 patients, including 11 who were chemotherapy naive and 13 who had previously been treated with docetaxel, were evaluable for toxicity and 22 for prostate specific antigen decrease data. The regimen was generally well tolerated. Treatment related grades 3 or greater toxicity seen in more than 1 patient included hypophosphatemia in 16.7% and neutropenia in 12.5%. Four patients had thromboembolic complications. Asymptomatic hypercalcemia was seen in 4 patients, including grades 2 and 1 in 1 and 3, respectively. Six of 11 evaluable, chemotherapy naive patients (55%) met prostate specific antigen response criteria. One of 11 patients (9%) treated with prior docetaxel met these criteria. Conclusions: High dose calcitriol may be safely added to docetaxel and estramustine administered on a 21-day schedule. C1 Oregon Hlth & Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Div Urol, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Beer, TM (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Hematol & Med Oncol, Mail Code CR145,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM beert@ohsu.edu FU NCRR NIH HHS [3M01RR00334-33S2] NR 18 TC 23 Z9 24 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD SEP PY 2005 VL 174 IS 3 BP 888 EP 892 DI 10.1097/01.ju.0000169261.42298.e6 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 956BU UT WOS:000231274700023 PM 16093981 ER PT J AU Dahi, S Lee, JG Lovett, DH Sarkar, R AF Dahi, S Lee, JG Lovett, DH Sarkar, R TI Differential transcriptional activation of matrix metalloproteinase-2 and membrane type-1 matrix metalloproteinase by experimental deep venous thrombosis and thrombin SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID VEIN ENDOTHELIAL-CELLS; GELATINASE-A; MMP-2; MATRIX-METALLOPROTEINASE-2; ANGIOGENESIS; EXPRESSION; MICE; MIGRATION; PRO-MMP-2; ANEURYSMS AB Objective: Resolution of deep venous thrombosis (DVT) is involved in the pathogenesis of postthrombotic syndrome. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes that are critical in angiogenesis and tissue remodeling. We hypothesized that MMP-2 and its membrane-bound activator membrane type-1 matrix metalloproteinase (MT1-MMP) expression would be expressed and activated during the resolution of DVT Methods:. DVT was generated by caval ligation in wild-type and MMP-2 transgenic reporter mice. Ligated and sham-operated (control) cavae were analyzed for MMP-2 transcription (beta-galactosidase activity in MMP-2 reporter mice) and MT1-MMP mRNA by real-time polymerase chain reaction. MMP-2 activity was determined by zymography, and immunohistochemical staining for beta-galactosidase and MT1-MMP protein was used to localize expression. Human umbilical vascular endothelial cells (HUVEC) were treated with 10 U/mL thrombin and MMP-2 and MTI-MMP mRNA levels and MMP-2 activity was determined. Results. MMP-2 activity increased 71% (n = 5, P <.05) at day 8 in ligated vs control cavae by zymography. P-galactosidase activity showed a 1.2-fold (n = 8, P <.05) and 1.7-fold (n = 8, P <.05) induction in MMP-2 transcription at day 3 and day 8, respectively. No significant MT1-MMP gene induction was seen at day 3 in ligated vs control cavae, but MT1-MMP mRNA was upregulated 2.5-fold (n = 8, P <.05) in ligated cavae at day 8. Immunohistochemical staining localized MMP-2 and MT1-MMP expression to the vein wall and cellular infiltrates of the thrombus. Thrombin-treated HUVEC showed differential responses of MMP-2 and MTI-MMP. Zymography of conditioned media and cell lysates illustrated a 220% (152.6 +/- 8.6 vs 69.445 +/- 5.46 pixels/unit area, n = 5, P <.05) and 150% (74.1 +/- 7.3 vs 49.2 +/- 5.7 pixels/unit area, n = 5, P <.05) increases in MMP-2 activity respectively. MMP-2 mRNA levels were downregulated 30% (0.48 +/- 0.023 vs 0.63 +/- 0.035 copies of NUIP-2 mRNA/copy GA-PDH, n = 5, P <.05), whereas MT1-MMP message was upregulated 250% (0.147 +/- 0.009 vs 0.059 +/- 0.005 copies of MT1-MMP mRNA/copy GAPDH, n = 5, P <.05). Conclusions. Resolution of DVT is associated with increased MMP-2 transcription and activity as well as MT1-MMP expression. Thrombin may mediate the increase in MTI-MMP noted in DVT. This is the first article studying MMP-2 and MT1-MMP transcription in DVT. These findings add DVT resolution to the class of inflammatory and fibrotic disorders in which transcriptional activation of the MT1-MMP/MMP-2 genes occurs and identify a potential therapeutic target to modulate this clinically relevant process. Clinical Relevance: Postthrombotic syndrome remains a significant clinical problem after deep venous thrombosis (DVT), but the cellular and molecular mechanisms involved in thrombus resolution and vein wall fibrosis remain undefined. Matrix metalloproteinase (MMP) enzymes are critical to cell migration and matrix breakdown. We identify gene transcription and activity of two MMP isoforms, MMP-2 and MMP-14 (membrane type MMP 1, MT1-MMP) in the resolution phase of experimental DVT and in thrombin-treated endothelial cells. These studies define new proteases potentially important to resolution of DVT and development of postthrombotic syndrome. C1 Univ Calif San Francisco, Div Vasc Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, Vasc Res Labs, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94143 USA. RP Sarkar, R (reprint author), 4150 Clement St,112G, San Francisco, CA 94121 USA. EM sarkarR@surgery.ucsf.edu FU NHLBI NIH HHS [P01 HL 68738, HL04435] NR 28 TC 15 Z9 15 U1 1 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD SEP PY 2005 VL 42 IS 3 BP 539 EP 545 DI 10.1016/j.jvs.2005.04.051 PG 7 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 966SZ UT WOS:000232043300028 PM 16171603 ER PT J AU Aslam, S Hamill, R Musher, DM AF Aslam, S Hamill, R Musher, DM TI Treatment of Clostridium difficile-associated disease: old therapies and new strategies SO LANCET INFECTIOUS DISEASES LA English DT Review ID ANTIBIOTIC-ASSOCIATED COLITIS; CLINDAMYCIN-ASSOCIATED COLITIS; PLACEBO-CONTROLLED TRIAL; RANDOMIZED CONTROLLED-TRIAL; IN-VITRO ACTIVITY; PSEUDOMEMBRANOUS COLITIS; DOUBLE-BLIND; TOXIN-A; ORAL VANCOMYCIN; ANTIBODY-RESPONSE AB Clostridium difficile-associated disease (CDAD) causes substantial morbidity and mortality. The pathogenesis is multifactorial, involving altered bowel flora, production of toxins, and impaired host immunity, often in a nosocomial setting. Current guidelines recommend treatment with metronidazole; vancomycin is a second-line agent because of its potential effect on the hospital environment. We present the data that led to these recommendations and explore other therapeutic options, including antimicrobials, antibody to toxin A, probiotics, and vaccines. Treatment of CDAD has increasingly been associated with failure and recurrence. Recurrent disease may reflect relapse of infection due to the original infecting organism or infection by a new strain. Poor antibody responses to C difficile toxins have a permissive role in recurrent infection. Hospital infection control and pertinent use of antibiotics can limit the spread of CDAD. A vaccine directed against C difficile toxin may eventually offer a solution to the CDAD problem. C1 Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. RP Aslam, S (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Serv, Room 4B-370,2002 Holocombe Blvd, Houston, TX 77030 USA. EM saslam@bcm.tmc.edu NR 143 TC 194 Z9 210 U1 2 U2 16 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1473-3099 J9 LANCET INFECT DIS JI Lancet Infect. Dis. PD SEP PY 2005 VL 5 IS 9 BP 549 EP 557 DI 10.1016/S1473-3099(05)70215-2 PG 9 WC Infectious Diseases SC Infectious Diseases GA 960AU UT WOS:000231563400017 PM 16122678 ER PT J AU Goemans, BF Zwaan, CM Miller, M Zimmermann, M Harlow, A Meshinchi, S Loonen, AH Hahlen, K Reinhardt, D Creutzig, U Kaspers, GJL Heinrich, MC AF Goemans, BF Zwaan, CM Miller, M Zimmermann, M Harlow, A Meshinchi, S Loonen, AH Hahlen, K Reinhardt, D Creutzig, U Kaspers, GJL Heinrich, MC TI Mutations in KIT and RAS are frequent events in pediatric core-binding factor acute myeloid leukemia SO LEUKEMIA LA English DT Article DE KIT; RAS; CBF; AML; pediatric; exon 8 ID RECEPTOR TYROSINE KINASE; GASTROINTESTINAL STROMAL TUMORS; ACUTE MYELOGENOUS LEUKEMIA; C-KIT; N-RAS; ACTIVATING MUTATIONS; GENE-MUTATIONS; MYELODYSPLASTIC SYNDROME; CLINICAL-SIGNIFICANCE; DRUG-RESISTANCE AB Activating mutations in RAS and receptor tyrosine kinases such as KIT and FLT3 are hypothesized to cooperate with chimeric transcription factors in the pathogenesis of acute myeloid leukemia (AML). To test this hypothesis, we genotyped 150 pediatric AML samples for mutations in KIT (exons 8, 17), NRAS and KRAS ( exons 1, 2) and FLT3/ITD. This is the largest cohort of pediatric AML patients reported thus far screened for all four mutations. Of the children with AML, 40% had a mutation in KIT (11.3%), RAS (18%) or FLT3/ITD (11.1%), and 70% of cases of core-binding factor (CBF) leukemia were associated with a mutation of KIT or RAS. Mutations in RAS or FLT3/ITD were frequently found in association with a normal karyotype. Patients with a FLT3/ITD mutation had a significantly worse clinical outcome. However, the presence of a KIT or RAS mutation did not significantly influence clinical outcome. We demonstrate that KIT exon 8 mutations result in constitutive ligand-independent kinase activation that can be inhibited by clinically relevant concentrations of imatinib. Our results demonstrate that abnormalities of signal transduction pathways are frequent in pediatric AML. Future clinical studies are needed to determine whether selective targeting of these abnormalities will improve treatment results. C1 VU Univ Med Ctr, Dept Pediat Hematol & Oncol, NL-1007 MB Amsterdam, Netherlands. Oregon Hlth Sci Univ, Inst Canc, Div Hematol & Med Oncol, Dept Med, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Hannover Med Sch, Dept Pediat Hematol & Oncol, Hannover, Germany. Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA. Dutch Childhood Oncol Grp, The Hague, Netherlands. AML, BFM Study Grp, Munster, Germany. Sophia Childrens Univ Hosp, Erasmus Med Ctr, Dept Pediat Hematol & Oncol, Rotterdam, Netherlands. RP Goemans, BF (reprint author), VU Univ Med Ctr, Dept Pediat Hematol & Oncol, POB 7057, NL-1007 MB Amsterdam, Netherlands. EM bf.goemans@vumc.nl RI Reinhardt, Dirk/D-3939-2011 OI Reinhardt, Dirk/0000-0003-4313-9056 NR 48 TC 154 Z9 156 U1 0 U2 4 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0887-6924 J9 LEUKEMIA JI Leukemia PD SEP PY 2005 VL 19 IS 9 BP 1536 EP 1542 DI 10.1038/sj.leu.2403870 PG 7 WC Oncology; Hematology SC Oncology; Hematology GA 958IV UT WOS:000231438800005 PM 16015387 ER PT J AU Stineman, MG Kallen, MA Thompson, C Gage, B AF Stineman, MG Kallen, MA Thompson, C Gage, B TI Challenges in paying for effective stays SO MEDICAL CARE LA English DT Editorial Material ID MIX CLASSIFICATION-SYSTEM; MEDICAL REHABILITATION; PAYMENT C1 Univ Penn, Inst Aging, Dept Phys Med & Rehabil, Philadelphia, PA 19104 USA. Univ Penn, Inst Aging, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Inst Aging, Ctr Biostat & Epidemiol, Clin Epidemiol Unit, Philadelphia, PA 19104 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Design & Anal Div, Houston, TX USA. RP Stineman, MG (reprint author), Univ Penn, Inst Aging, Dept Phys Med & Rehabil, Room 101,Ralston Penn Ctr,3615 Chestnut St, Philadelphia, PA 19104 USA. EM mstinema@mail.med.upenn.edu NR 18 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2005 VL 43 IS 9 BP 841 EP 843 DI 10.1097/01.mlr.0000178392.96014.cf PG 3 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 959BU UT WOS:000231492700001 PM 16116348 ER PT J AU Souchek, J Byrne, MM Kelly, PA O'Malley, K Richardson, M Pak, C Nelson, H Suarez-Almazor, ME AF Souchek, J Byrne, MM Kelly, PA O'Malley, K Richardson, M Pak, C Nelson, H Suarez-Almazor, ME TI Valuation of arthritis health states across ethnic groups and between patients and community members SO MEDICAL CARE LA English DT Article DE utilities; quality of life; arthritis; QALYs ID RACIAL DISPARITIES; JOINT REPLACEMENT; KNEE ARTHROPLASTY; DECISION-MAKING; OUTCOMES; CANCER; OSTEOARTHRITIS; METAANALYSIS; PREFERENCES; PERCEPTIONS AB Objective: We sought to examine differences in valuation of health by individuals from different ethnic backgrounds and between patients and community members. Research Design: We surveyed 193 community members identified by random-digit dialing (ie, 64 white, 65 black, and 64 Hispanic) and 198 patients with osteoarthritis (OA), 66 per ethnic group, drawn sequentially from clinic lists of an outpatient institution. Measures: Participants were interviewed and asked to rate 2 scenarios describing arthritis (mild and severe) using visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO). Differences were adjusted for cohort, age, gender, and education. Results: Members of the public had higher preference scores for the 2 health states than patients (SG severe state: 0.77 public, 0.66 patients; SG mild state: 0.90 public, 0.84 patients). The difference score between the mild and severe states was smaller for black than white subjects (P < 0.001) by SG and TTO. Scores for Hispanics and whites did not differ. Preference scores increased with age (SG, TTO). Conclusions: Significant differences were observed in the valuation of health between members of the public and patients, among ethnic groups, and in relation to educational status and age, with the difference between utilities of health states being a more efficient measure of preference than the utility of a single state. Utilities elicited through valuation of hypothetical health scenarios are dependent on sociodemographic traits, experience of disease, and method used. These findings suggest that utilities cannot be used interchangeably across populations, with implications for economic analyses. C1 Michael E DeBakey Vet Affairs Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Pittsburgh, Ctr Bioeth & Hlth Law, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA 15260 USA. Univ Miami, Dept Epidemiol & Publ Hlth, Coral Gables, FL 33124 USA. RP Souchek, J (reprint author), Michael E DeBakey Vet Affairs Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM jsouchek@bcm.tmc.edu FU AHRQ HHS [P01HS10876] NR 38 TC 18 Z9 18 U1 4 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2005 VL 43 IS 9 BP 921 EP 928 DI 10.1097/01.mlr.0000173600.53788.13 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 959BU UT WOS:000231492700010 PM 16116357 ER PT J AU Egede, LE Dagogo-Jack, S AF Egede, LE Dagogo-Jack, S TI Epidemiology of type 2 diabetes: Focus on ethnic minorities SO MEDICAL CLINICS OF NORTH AMERICA LA English DT Review ID URBAN AFRICAN-AMERICANS; RANDOMIZED CONTROLLED-TRIAL; IMPAIRED GLUCOSE-TOLERANCE; NON-HISPANIC WHITES; HEALTH MAINTENANCE ORGANIZATION; INFLUENZA VACCINATION COVERAGE; IMPROVES GLYCEMIC CONTROL; CHRONIC ILLNESS; PRIMARY-CARE; SELF-MANAGEMENT AB African Americans and other ethnic minority groups suffer disproportionately from type 2 diabetes and its complications than do white Americans. Genetic and environmental factors contribute to the ethnic disparities in diabetes and its complications, The key elements of a comprehensive diabetes management strategy include monitoring, education, dietary modification, exercise, and medications. The progressive nature of diabetes requires the use of more than one agent. Drug combinations should be selected for their therapeutic firepower and complementary mechanisms of action, and exogenous insulin need not be delayed unnecessarily if oral agents are ineffective. C1 Med Univ S Carolina, Dept Med, Div Gen Internal Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Dagogo-Jack, S (reprint author), Univ Tennessee, Ctr Hlth Sci, Dept Med, Div Endocrinol Diabet & Metab, 951 Court Ave,Room 335M, Memphis, TN 38163 USA. EM sdj@utmem.edu FU AHRQ HHS [5K08HS11418]; NCRR NIH HHS [M01 RR00211]; NIDDK NIH HHS [U01 DK048400-06, U01 DK048400, U01 DK048489] NR 110 TC 57 Z9 60 U1 1 U2 8 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0025-7125 J9 MED CLIN N AM JI Med. Clin. N. Am. PD SEP PY 2005 VL 89 IS 5 BP 949 EP + DI 10.1016/j.mcna.2005.03.004 PG 28 WC Medicine, General & Internal SC General & Internal Medicine GA 968GL UT WOS:000232149800005 PM 16129107 ER PT J AU Gau, V Ma, SC Wang, H Tsukuda, J Kibler, J Haake, DA AF Gau, V Ma, SC Wang, H Tsukuda, J Kibler, J Haake, DA TI Electrochemical molecular analysis without nucleic acid amplification SO METHODS LA English DT Article DE electrochemical detection; cyclic enzymatic reaction; bionanotechnology; genetic assay; immunoassay; simultaneous multi-channel detection ID RECOGNITION; MONOLAYERS AB Electrochemical biosensors have revolutionized glucose monitoring but have not yet fulfilled their promise of a low cost, direct detection replacement for genetic amplification tests such as PCR [K. Kerman, M. Kobayashi, E. Tamiya, Recent trends in electrochemical DNA biosensor technology, Meas. Sci. Technol. 15 (2004) R1-R11; A. Chaubey, B.D. Malhotra, Mediated biosensors. Biosens. Bioelectron. 17 (6-7) (2002) 441-456]. It has been anticipated that the integration of nanoscale chemical structures such as self-assembled monolayers with electrochemical biosensors would increase sensitivity by decreasing inherent system noise. We have designed a novel biosensing approach incorporating such integration and achieved rapid, ultra-low concentration sensitivities without target amplification. Raw samples are mixed with lysis buffer to allow hybridization of nucleic acid targets with anchor and signal probes before immobilizing a signaling enzyme proximate to the biosensor surface. A bias potential is subsequently applied and the secondary byproduct of a cyclic peroxidase reaction measured. Further studies have demonstrated the application of our approach in protein, clinical chemistry, and ionic assays. (c) 2005 Elsevier Inc. All rights reserved. C1 GeneFluid Inc, Monterrey Pk, CA 91754 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Gau, V (reprint author), GeneFluid Inc, 2540 Corp Pl,B101, Monterrey Pk, CA 91754 USA. EM vgau@genefluidics.com FU NIBIB NIH HHS [R01 EB000127-04, R01 EB000127-01, R01 EB000127-03, R01 EB000127-05, EB00127, R01 EB000127, R01 EB000127-02] NR 11 TC 67 Z9 67 U1 1 U2 11 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1046-2023 J9 METHODS JI Methods PD SEP PY 2005 VL 37 IS 1 BP 73 EP 83 DI 10.1016/j.ymeth.2005.05.008 PG 11 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 979MG UT WOS:000232945500009 PM 16213156 ER PT J AU An, JB Rettig, MB AF An, JB Rettig, MB TI Mechanism of von Hippel-Lindau protein-mediated suppression of nuclear factor kappa B activity SO MOLECULAR AND CELLULAR BIOLOGY LA English DT Article ID RENAL-CELL CARCINOMA; TRANSFORMING-GROWTH-FACTOR; TUMOR-ASSOCIATED MACROPHAGES; HYPOXIA-INDUCIBLE FACTORS; FACTOR RECEPTOR; FACTOR-ALPHA; TRANSCRIPTION FACTOR; INDUCED APOPTOSIS; GENE-EXPRESSION; CANCER-THERAPY AB Biallelic inactivating mutations of the von Hippel-Lindau tumor suppressor gene (VHL) are a hallmark of clear cell renal cell carcinoma (CCRCC), the most common histologic subtype of RCC. Biallelic VHL loss results in accumulation of hypoxia-inducible factor alpha (HIF alpha). Restoring expression of the wild-type protein encoded by VHL (pVHL) in tumors with biallelic VHL inactivation (VHL-/-) suppresses tumorigenesis, and pVHL-mediated degradation of HIF alpha is necessary and sufficient for VHL-mediated tumor suppression. The downstream targets of HIF alpha that promote renal carcinogenesis have not been completely elucidated. Recently, VHL loss was shown to activate nuclear factor kappa B (NF-kappa B), a family of transcription factors that promotes tumor growth. Here we show that VHL loss drives NF-kappa B activation by resulting in HIF alpha accumulation, which induces expression of transforming growth factor alpha, with consequent activation of an epidermal growth factor receptor/phosphatidylinositol-3-OH kinase/protein kinase B (AKT)/I kappa B-kinase alpha/NF-kappa B signaling cascade. We also show that components of this signaling pathway promote the growth of VHL-/- tumor cells. Members of this pathway represent viable drug targets in VHL-/- tumors, such as those associated with CCRCC. C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Div Hematol Oncol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Hematol Oncol, Los Angeles, CA 90095 USA. RP Rettig, MB (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Med, Div Hematol Oncol, 11301 Wilshire Blvd,Bldg 304,Room E1-113, Los Angeles, CA 90073 USA. EM matthew.rettig@med.va.gov NR 63 TC 57 Z9 64 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0270-7306 J9 MOL CELL BIOL JI Mol. Cell. Biol. PD SEP PY 2005 VL 25 IS 17 BP 7546 EP 7556 DI 10.1128/MCB.25.17.7546-7556.2005 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 956VY UT WOS:000231329300014 PM 16107702 ER PT J AU Lyons-Warren, A Chang, JJ Balkissoon, R Kamiya, A Garant, M Nurnberger, J Scheftner, W Reich, T McMahon, F Kelsoe, J Gershon, E Coryell, W Byerley, W Berrettini, W DePaulo, R McInnis, M Sawa, A AF Lyons-Warren, A Chang, JJ Balkissoon, R Kamiya, A Garant, M Nurnberger, J Scheftner, W Reich, T McMahon, F Kelsoe, J Gershon, E Coryell, W Byerley, W Berrettini, W DePaulo, R McInnis, M Sawa, A TI Evidence of association between bipolar disorder and Citron on chromosome 12q24 SO MOLECULAR PSYCHIATRY LA English DT Letter ID SUSCEPTIBILITY; PEDIGREES; LINKAGE; LOCI; SCHIZOPHRENIA; 12Q23-Q24; SCAN C1 Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21287 USA. Univ Maryland, Sch Med, Div Endocrinol Diabet & Nutr, Baltimore, MD 21201 USA. Indiana Univ, Indianapolis, IN 46204 USA. NIMH, Genet Initiat Bipolar Consortium, NIH, US Dept Hlth & Human Serv, Bethesda, MD 20892 USA. Rush Presbyterian Med Ctr, Chicago, IL USA. Washington Univ, St Louis, MO USA. NIMH, Mood & Anxiety Program, NIH, US Dept Hlth & Human Serv, Bethesda, MD 20892 USA. Univ Calif San Diego, San Diego, CA 92103 USA. San Diego Vet Affairs Healthcare Syst, San Diego, CA USA. Univ Chicago, Chicago, IL 60637 USA. Univ Iowa, Iowa City, IA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. Johns Hopkins Univ, Sch Med, Dept Neurosci, Baltimore, MD 21205 USA. RP Sawa, A (reprint author), Johns Hopkins Univ, Sch Med, Dept Psychiat, 600 N Wolfe St,Meyer 2-181, Baltimore, MD 21287 USA. EM asawa1@jhmi.edu RI McMahon, Francis/A-7290-2009; kamiya, atsushi/L-8550-2016 NR 10 TC 27 Z9 29 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1359-4184 J9 MOL PSYCHIATR JI Mol. Psychiatr. PD SEP PY 2005 VL 10 IS 9 BP 807 EP 809 DI 10.1038/sj.mp.4001703 PG 4 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 958YD UT WOS:000231483200002 PM 15983625 ER PT J AU Weintraub, D Morales, KH Moberg, PJ Bilker, WB Balderston, C Duda, JE Katz, IR Stern, MB AF Weintraub, D Morales, KH Moberg, PJ Bilker, WB Balderston, C Duda, JE Katz, IR Stern, MB TI Antidepressant studies in Parkinson's disease: A review and meta-analysis SO MOVEMENT DISORDERS LA English DT Review DE Parkinson's disease; depression; antidepressive agent; treatment; effect size; meta-analysis ID DOUBLE-BLIND PLACEBO; MAJOR DEPRESSION; CONTROLLED TRIAL; OPEN-LABEL; L-DOPA; SELEGILINE; CITALOPRAM; SCALE; MULTICENTER; PREVALENCE AB The objective of this study was to determine effect sizes for both antidepressant treatment and placebo for depression in Parkinson's disease (PD), and to compare the findings with those reported in elderly depressed patients without PD. Recent reviews have concluded that there is little empiric evidence to support the use of antidepressants in PD; however, available data has not been analyzed to determine the effect size for antidepressant treatment in PD depression. A literature review identified antidepressant studies in PD. Suitable studies were analyzed using meta-analytic techniques, and effect sizes were compared with those from antidepressant studies in elderly patients without PD. Large effect sizes were found for both active treatment and placebo in PD, but there was no difference between the two groups. In contrast, active treatment was superior to placebo in depressed elderly patients without PD. In PD, increasing age and a diagnosis of major depression were associated with better treatment response. Results also suggest that newer antidepressants are well tolerated in PD. Despite the high prevalence of depression and anti depressant use in PD, controlled treatment research has been almost nonexistent. Meta-analysis results suggest a large but nonspecific effect for depression treatment in PD. In addition, PD patients may benefit less from antidepressant treatment, particularly selective serotonin reuptake inhibitors, than do elderly patients without PD. (C)005 Movement Disorder Society. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, MIRECC, Philadelphia, PA USA. Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. RP Weintraub, D (reprint author), 3535 Market St,Room 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu OI McGuiness, Catherine/0000-0002-5367-6472 FU NIMH NIH HHS [K23 MH067894, K23 MH067894-04, MH067894] NR 66 TC 96 Z9 99 U1 0 U2 8 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP PY 2005 VL 20 IS 9 BP 1161 EP 1169 DI 10.1002/mds.20555 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 963WW UT WOS:000231838000010 PM 15954137 ER PT J AU Cristian, A Katz, M Cutrone, E Walker, RH AF Cristian, A Katz, M Cutrone, E Walker, RH TI Evaluation of acupuncture in the treatment of Parkinson's disease: A double-blind pilot study SO MOVEMENT DISORDERS LA English DT Article DE acupuncture; Parkinson's disease; double-blind ID VALIDATION; THERAPIES; TRENDS AB As many as 40% of patients with Parkinson's disease (PD) use some form of complementary medicine during the course of their illness, and many try acupuncture. One nonblinded study of the effects of acupuncture in PD suggested that it might be helpful for some aspects of PD. We performed a double-blind, randomized, pilot study comparing acupuncture to a control nonacupuncture procedure to determine the effects of acupuncture upon a variety of PD-associated symptoms. Fourteen patients with Stage II or III PD received acupuncture or a control nonacupuncture protocol. Before and after treatment, patients were evaluated using the Motor subscale of the Unified Parkinson's Disease Rating Scale (UPDRS), the Parkinson's Disease Questionnaire (PDQ-39), and the Geriatric Depression Scale. There were no statistically significant changes for the outcomes measured. In the patients who received acupuncture, nonsignificant trends toward improvement were noted in the Activities of Daily Living score of the PDQ-39, the PDQ-39 Summary Index, and the Motor subscale of the UPDRS. (C) 2005 Movement Disorder Society. C1 Vet Affairs Med Ctr, Dept Rehabil Med, Bronx, NY USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Vet Affairs Med Ctr, Dept Neurol, Bronx, NY USA. RP Walker, RH (reprint author), Bronx Vet Affairs Med Ctr, Dept Neurol 127, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM ruth.walker@mssm.edu NR 11 TC 43 Z9 48 U1 4 U2 12 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP PY 2005 VL 20 IS 9 BP 1185 EP 1188 DI 10.1002/mds.20503 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 963WW UT WOS:000231838000013 PM 15884039 ER PT J AU Zabetian, CP Samii, A Mosley, AD Roberts, JW Leis, BC Yearout, D Raskind, WH Griffith, A AF Zabetian, CP Samii, A Mosley, AD Roberts, JW Leis, BC Yearout, D Raskind, WH Griffith, A TI A clinic-based study of the LRRK2 gene in Parkinson's disease yields new mutations SO MOVEMENT DISORDERS LA English DT Meeting Abstract CT 19th Annual Symposium on Etiology, Pathogenesis and Treatment of Parkinsons Disease and Other Movement Disorders CY SEP 25, 2005 CL San Diego, CA SP Parkinson Study Grp, Huntington Study Grp, Tourettes Syndrome Study Grp, Cooperat Ataxia Grp, Tremor Res Grp, Movement Disorder Soc C1 Univ Washington, Dept Neurol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. VA Puget Sound Hlth Care Syst, NW Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA USA. Virginia Mason Med Ctr, Neurol Sect, Seattle, WA 98101 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP PY 2005 VL 20 IS 9 BP 1235 EP 1235 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 963WW UT WOS:000231838000030 ER PT J AU Kim, HM Samii, A Griffith, A Roberts, JW Mosley, AD Leis, BC Yearout, D Payami, H Zabetian, CP AF Kim, HM Samii, A Griffith, A Roberts, JW Mosley, AD Leis, BC Yearout, D Payami, H Zabetian, CP TI Protective effect of the HFE C282Y mutation in Parkinson's disease SO MOVEMENT DISORDERS LA English DT Meeting Abstract CT 19th Annual Symposium on Etiology, Pathogenesis and Treatment of Parkinsons Disease and Other Movement Disorders CY SEP 25, 2005 CL San Diego, CA SP Parkinson Study Grp, Huntington Study Grp, Tourettes Syndrome Study Grp, Cooperat Ataxia Grp, Tremor Res Grp, Movement Disorder Soc C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, NW Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. New York State Dept Hlth, Wadsworth Ctr Labs & Res, Albany, NY 12201 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP PY 2005 VL 20 IS 9 BP 1245 EP 1245 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 963WW UT WOS:000231838000061 ER PT J AU Polanczyk, M Hopke, C Huan, J Vandenbark, A Offner, H AF Polanczyk, M Hopke, C Huan, J Vandenbark, A Offner, H TI Enhanced FOXP3 expression and Treg cell function in pregnant and oestrogen-treated mice SO MULTIPLE SCLEROSIS LA English DT Meeting Abstract CT 21st Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis/10th Annual Meeting of Rehabilitation in MS CY SEP 28-OCT 01, 2005 CL Thessaloniki, GREECE SP European Comm Treatment & Res Multiple Sclerosis C1 Oregon Hlth & Sci Univ, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU HODDER ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 1352-4585 J9 MULT SCLER JI Mult. Scler. PD SEP PY 2005 VL 11 SU 1 BP S50 EP S50 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 969QO UT WOS:000232249900181 ER PT J AU Vandenbark, A Huan, J Bartholomew, R Offner, H Bourdette, D AF Vandenbark, A Huan, J Bartholomew, R Offner, H Bourdette, D TI TCR peptide vaccination in MS induces high levels of IL-10 and restores decreased FOXP3 levels SO MULTIPLE SCLEROSIS LA English DT Meeting Abstract CT 21st Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis/10th Annual Meeting of Rehabilitation in MS CY SEP 28-OCT 01, 2005 CL Thessaloniki, GREECE SP European Comm Treatment & Res Multiple Sclerosis C1 Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Immune Response Corp, San Diego, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU HODDER ARNOLD, HODDER HEADLINE PLC PI LONDON PA 338 EUSTON ROAD, LONDON NW1 3BH, ENGLAND SN 1352-4585 J9 MULT SCLER JI Mult. Scler. PD SEP PY 2005 VL 11 SU 1 BP S173 EP S173 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 969QO UT WOS:000232249900626 ER PT J AU Zhu, L van de Lavoir, MC Albanese, J Beenhouwer, DO Cardarelli, PM Cuison, S Deng, DF Deshpande, S Diamond, JH Green, L Halk, EL Heyer, BS Kay, RM Kerchner, A Leighton, PA Mather, CM Morrison, SL Nikolov, ZL Passmore, DB Pradas-Monne, A Preston, BT Rangan, VS Shi, MX Srinivasan, M White, SG Winters-Digiacinto, P Wong, S Zhou, W Etches, RJ AF Zhu, L van de Lavoir, MC Albanese, J Beenhouwer, DO Cardarelli, PM Cuison, S Deng, DF Deshpande, S Diamond, JH Green, L Halk, EL Heyer, BS Kay, RM Kerchner, A Leighton, PA Mather, CM Morrison, SL Nikolov, ZL Passmore, DB Pradas-Monne, A Preston, BT Rangan, VS Shi, MX Srinivasan, M White, SG Winters-Digiacinto, P Wong, S Zhou, W Etches, RJ TI Production of human monoclonal antibody in eggs of chimeric chickens SO NATURE BIOTECHNOLOGY LA English DT Article ID DEPENDENT CELLULAR CYTOTOXICITY; EMBRYONIC STEM-CELLS; N-GLYCAN STRUCTURES; TRANSGENIC CHICKENS; OVALBUMIN GENE; MASS-SPECTROMETRY; DOMESTIC-FOWL; OLIGOSACCHARIDES; EXPRESSION; IGG1 AB The tubular gland of the chicken oviduct is an attractive system for protein expression as large quantities of proteins are deposited in the egg, the production of eggs is easily scalable and good manufacturing practices for therapeutics from eggs have been established. Here we examined the ability of upstream and downstream DNA sequences of ovalbumin, a protein produced exclusively in very high quantities in chicken egg white, to drive tissue-specific expression of human mAb in chicken eggs. To accommodate these large regulatory regions, we established and transfected lines of chicken embryonic stem (cES) cells and formed chimeras that express mAb from cES cell-derived tubular gland cells. Eggs from high-grade chimeras contained up to 3 mg of mAb that possesses enhanced antibody-dependent cellular cytotoxicity (ADCC), nonantigenic glycosylation, acceptable half-life, excellent antigen recognition and good rates of internalization. C1 Origen Therapeut, Burlingame, CA 94010 USA. Medarex Inc, Milpitas, CA 95035 USA. Texas A&M Univ, Dept Agr & Biol Engn, College Stn, TX 77843 USA. Univ Calif Los Angeles, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. RP Etches, RJ (reprint author), Origen Therapeut, 1450 Rollins Rd, Burlingame, CA 94010 USA. EM retches@origentherapeutics.com FU NIAID NIH HHS [AI29470, AI51415, AI39187]; NIGMS NIH HHS [GM064261] NR 49 TC 115 Z9 133 U1 1 U2 21 PU NATURE PUBLISHING GROUP PI NEW YORK PA 345 PARK AVENUE SOUTH, NEW YORK, NY 10010-1707 USA SN 1087-0156 J9 NAT BIOTECHNOL JI Nat. Biotechnol. PD SEP PY 2005 VL 23 IS 9 BP 1159 EP 1169 DI 10.1038/nbt1132 PG 11 WC Biotechnology & Applied Microbiology SC Biotechnology & Applied Microbiology GA 963GA UT WOS:000231790600033 PM 16127450 ER PT J AU Zhu, ZT Munhall, A Shen, KZ Johnson, SW AF Zhu, ZT Munhall, A Shen, KZ Johnson, SW TI NMDA enhances a depolarization-activated inward current in subthalamic neurons SO NEUROPHARMACOLOGY LA English DT Article DE NMDA; subthalamic nucleus; whole-cell voltage clamp; depolarization; Ca2+-activated non-selective cation current ID ACTION-POTENTIAL GENERATION; SINGLE-SPIKE ACTIVITY; NUCLEUS NEURONS; IN-VITRO; CATION CHANNEL; BASAL GANGLIA; PARKINSONS-DISEASE; CALCIUM-CHANNELS; GLOBUS-PALLIDUS; NERVOUS-SYSTEM AB Previous studies have shown that N-methyl-D-aspartate (NMDA) receptor stimulation evokes Ca2+- and Na+-dependent burst firing in subthalamic nucleus (STN) neurons. Using whole-cell patch pipettes to record currents under voltage-clamp, we identified a time-dependent depolarization-activated inward current (DIC) that may underlie NMDA-induced burst firing in STN neurons in rat brain slices. Continuous superfusion with NMDA (20 mu M) elicited a marked TTX-insensitive inward current when the membrane was depolarized to the level of -70 or -50 mV, from a holding potential of -100 mV. This current had a long duration, and its peak amplitude occurred at a test potential of -60 mV. DIC could not be evoked using the non-NMDA receptor agonist D,L-alpha-amino-3-hydroxy-5-methylisoxalone-4-propionic acid (AMPA). DIC was blocked by either intracellular BAPTA or by removal of extracellular Ca2+, but selective blockers of T-type (mibefradil), L-type (nifedipine) and N-type (omega-conotoxin GVIA) Ca2+ channels did not. Perfusing slices with a low extracellular concentration of sodium abolished the NMDA-induced DIC, implying that both Ca2+ and Na+ are necessary for the expression of DIC. Transient receptor potential (TRP) channel blockers flufenamic acid and SKF96365 severely reduced DIC amplitude, whereas NMDA-gated currents were either increased or were unchanged. These results suggest that the activation of NMDA receptors enhances a Ca2+-activated non-selective cation current that may be mediated by a member of the TRP channel family in STN neurons. (c) 2005 Elsevier Ltd. All rights reserved. C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97207 USA. RP Johnson, SW (reprint author), SW US Vet Hosp, Portland VA Med Ctr, R&D61, 3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM johnsost@ohsu.edu FU NINDS NIH HHS [NS38715] NR 46 TC 15 Z9 15 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3908 J9 NEUROPHARMACOLOGY JI Neuropharmacology PD SEP PY 2005 VL 49 IS 3 BP 317 EP 327 DI 10.1016/j.neuropharm.2005.03.018 PG 11 WC Neurosciences; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 960DN UT WOS:000231570500005 PM 15993436 ER PT J AU Engel, SM Berkowitz, GS Wolff, MS Yehuda, R AF Engel, SM Berkowitz, GS Wolff, MS Yehuda, R TI Psychological trauma associated with the World Trade Center attacks and its effect on pregnancy outcome SO PAEDIATRIC AND PERINATAL EPIDEMIOLOGY LA English DT Article ID NEW-YORK-CITY; SEPTEMBER-11 TERRORIST ATTACKS; POSTTRAUMATIC-STRESS-DISORDER; BECK DEPRESSION INVENTORY; CENTER DISASTER; PSYCHOMETRIC PROPERTIES; MANHATTAN RESIDENTS; HEAD CIRCUMFERENCE; PRETERM DELIVERY; BIRTH OUTCOMES AB The destruction of the World Trade Center (WTC) on 11 September 2001 was a source of enormous psychological trauma that may have consequences for the health of pregnant women and their fetuses. In this report, we describe the impact of extreme trauma on the birth outcomes of women highly exposed to the WTC. We enrolled 187 women who were pregnant and living or working within close proximity to the WTC on 11 September. Among women with singleton pregnancies, 52 completed at least one psychological assessment prior to delivery. In adjusted multivariable models, both post-traumatic stress symptomatology (PTSS) and moderate depression were associated with longer gestational durations, although only PTSS was associated with decrements in infant head circumference at birth (beta = -0.07, SE = 0.03, P = 0.01). The impact of stress resulting from extreme trauma may be different from that which results from ordinary life experiences, particularly with respect to cortisol production. As prenatal PTSS was associated with decrements in head circumference, this may influence subsequent neurocognitive development. Long-term follow-up of infants exposed to extreme trauma in utero is needed to evaluate the persistence of these effects. C1 Mt Sinai Sch Med, Dept Community & Prevent Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, New York, NY USA. Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, New York, NY 10029 USA. RP Engel, SM (reprint author), Mt Sinai Sch Med, Dept Community & Prevent Med, 1 Gustave L Levy Pl,Box 1043, New York, NY 10029 USA. EM Stephanie.Engel@mssm.edu FU NIEHS NIH HHS [P42 ES07384]; NIMH NIH HHS [5 R01 MH64675-03] NR 52 TC 66 Z9 68 U1 7 U2 18 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-5022 J9 PAEDIATR PERINAT EP JI Paediatr. Perinat. Epidemiol. PD SEP PY 2005 VL 19 IS 5 BP 334 EP 341 DI 10.1111/j.1365-3016.2005.00676.x PG 8 WC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Pediatrics SC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Pediatrics GA 957SJ UT WOS:000231393300001 PM 16115284 ER PT J AU Gallagher, RM AF Gallagher, RM TI Do patient expectations and diagnostic specificity affect outcomes in pharmacological trials in pain medicine SO PAIN MEDICINE LA English DT Editorial Material ID RANDOMIZED CONTROLLED-TRIAL; PERIPHERAL NEUROPATHY; AMITRIPTYLINE; EFFICACY C1 Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Gallagher, RM (reprint author), Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. NR 11 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1526-2375 J9 PAIN MED JI Pain Med. PD SEP-OCT PY 2005 VL 6 IS 5 BP 331 EP 333 DI 10.1111/j.1526-4637.2005.00065.x PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 975LP UT WOS:000232664300001 PM 16266352 ER PT J AU Kawakubo, K Akiba, Y Adelson, D Guth, PH Engel, E Tache, Y Kaunitz, JD AF Kawakubo, K Akiba, Y Adelson, D Guth, PH Engel, E Tache, Y Kaunitz, JD TI Role of gastric mast cells in the regulation of central TRH analog-induced hyperemia in rats SO PEPTIDES LA English DT Article DE mast cell; thyrotropin releasing hormone; mucosal blood flow; histamine ID THYROTROPIN-RELEASING-HORMONE; CONNECTIVE-TISSUE-TYPE; MUCOSAL BLOOD-FLOW; ACID-SECRETION; GASTROINTESTINAL MUCOSA; COMPOUND 48/80; HISTAMINE; STOMACH; STIMULATION; ACTIVATION AB RX 77368 (RX) increases gastric mucosal blood flow by a vagal cholinergic mechanism. The relative roles of mucosal and connective tissue mast cells (MMC and CTMC) were investigated in RX-injected rats. Blood flow and mast cell degranulation were measured after intracisternal RX. RX significantly increased gastric mucosal blood flow, and sequentially degranulated CTMC and MMC. Ketotifen or doxantrazole inhibited the hyperemic response. Ondansetron, RS-039604-90, or famotidine, but not ketanserin or pyrilamine, reduced hyperemia. Mast cells mediate RX-induced gastric hyperemia via 5-HT3, 5-HT4, and H-2 receptors; initial increase depends upon CTMC whereas MMC contributes to the later response. Published by Elsevier Inc. C1 Univ Calif Los Angeles, Vet Adm Med Ctr, Greater Los Angeles Vet Affairs Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE, Div Digest Dis, Digest Dis Res Ctr,Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,Bldg 114,Room 217, Los Angeles, CA 90073 USA. EM jake@ucla.edu OI Adelson, David/0000-0002-4623-6030 FU NIDDK NIH HHS [DK41301, R01 DK 33061, R01 DK 44221] NR 42 TC 5 Z9 6 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD SEP PY 2005 VL 26 IS 9 BP 1580 EP 1589 DI 10.1016/j.peptides.2005.05.023 PG 10 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 966RU UT WOS:000232039600007 PM 16112396 ER PT J AU Mantena, SK Roy, AM Katiyar, SK AF Mantena, SK Roy, AM Katiyar, SK TI Epigallocatechin-3-gallate inhibits photocarcinogenesis through inhibition of anglogenic factors and activation of CD8(+) T cells in tumors SO PHOTOCHEMISTRY AND PHOTOBIOLOGY LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; NONMELANOMA SKIN-CANCER; GREEN TEA POLYPHENOLS; MATRIX METALLOPROTEINASES; INDUCED IMMUNOSUPPRESSION; CONTACT HYPERSENSITIVITY; ULTRAVIOLET-RADIATION; HYDROPHILIC CREAM; MOUSE SKIN; (-)-EPIGALLOCATECHIN-3-GALLATE AB There has been considerable interest in the use of botanical supplements to protect skin from the adverse effects of solar UV radiation, including photocarcinogenesis. We and others have shown that topical application of (-)-epigallocatechin-3-gallate (EGCG) from green tea prevents photocarcinogenesis in mice; however, the chemopreventive mechanism of EGCG in an in vivo tumor model is not clearly understood. In this study, UV-B-induced skin tumors with and without treatment of EGCG (approximate to 1 mg/cm(2)) and age-matched skin biopsies from SKH-1 hairless mice were used to identify potential molecular targets of skin cancer prevention by EGCG. These biopsies were analyzed for various biomarkers of angiogenesis and antitumor immune response using immunostaining, Western blotting and gelatinolytic zymography. We report that compared to non-EGCG-treated tumors, topical application of EGCG in UV-induced tumors resulted in inhibition of protein expression and activity of matrix metalloproteinase (MMP)-2 and MMP-9, which play crucial roles in tumor growth and metastasis. In contrast, tissue inhibitor of MMP-1 (TIMP-1), which inhibits MMP activity, was increased in tumors. With respect to the tumor vasculature, EGCG decreased the expression of CD31, a cell surface marker of vascular endothelial cells, and inhibited the expression of vascular endothelial growth factor in tumors, which are essential for angiogenesis. EGCG inhibited proliferating cell nuclear antigen in UV-B-induced tumors as well. Additionally, higher numbers of cytotoxic T lymphocytes (CD8(+) T cells) were detected in EGCG-treated tumors compared with non-EGCG-treated tumors. Together, these in vivo tumor data suggested that inhibition of photocarcinogenesis in mice by EGCG is associated with inhibition of angiogenic factors and induction of antitumor immune reactivity. C1 Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. Univ Alabama, Skin Dis Res Ctr, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Katiyar, SK (reprint author), Univ Alabama, Dept Dermatol, 1670 Univ Blvd,Volker Hall 557,POB 202, Birmingham, AL 35294 USA. EM skatiyar@uab.edu FU NCI NIH HHS [CA105368]; NIAMS NIH HHS [AR050948-01] NR 27 TC 38 Z9 40 U1 0 U2 6 PU AMER SOC PHOTOBIOLOGY PI AUGUSTA PA BIOTECH PARK, 1021 15TH ST, SUITE 9, AUGUSTA, GA 30901-3158 USA SN 0031-8655 J9 PHOTOCHEM PHOTOBIOL JI Photochem. Photobiol. PD SEP-OCT PY 2005 VL 81 IS 5 BP 1174 EP 1179 DI 10.1562/2005-04-11-RA-487 PG 6 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 975CS UT WOS:000232639200021 PM 15938647 ER PT J AU Filley, CM AF Filley, CM TI Neurobehavioral aspects of cerebral white matter disorders SO PSYCHIATRIC CLINICS OF NORTH AMERICA LA English DT Article ID MILD COGNITIVE IMPAIRMENT; CENTRAL-NERVOUS-SYSTEM; MULTIPLE-SCLEROSIS; DISEASE; DEMENTIA; EVOLUTION; BRAIN; MRI; LEUKOENCEPHALOPATHY; DYSFUNCTION AB White matter comprises nearly half the volume of the brain, increasingly can be well visualized by modern neuroradiologic techniques, and plays a key role in development, aging, and a wide range of neurologic and psychiatric disorders across the lifespan. Understanding the neurobehavioral aspects of cerebral white matter disorders is important for clinical diagnosis, treatment, prognosis, and research on brain-behavior relationships. These considerations justify the notion of a behavioral neurology of white matter based on the concept of distributed neural networks in which white matter connectivity is crucial. C1 Univ Colorado, Hlth Sci Ctr, Behav Neurol Sect, Dept Neurol,Sch Med, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Filley, CM (reprint author), Univ Colorado, Hlth Sci Ctr, Behav Neurol Sect, Dept Neurol,Sch Med, 4200 E 9th Ave,B-183, Denver, CO 80262 USA. EM Christopher.Filley@uchsc.edu NR 64 TC 9 Z9 10 U1 2 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0193-953X J9 PSYCHIAT CLIN N AM JI Psychiatr. Clin. North Amer. PD SEP PY 2005 VL 28 IS 3 BP 685 EP + DI 10.1016/j.psc.2005.05.008 PG 18 WC Psychiatry SC Psychiatry GA 965YZ UT WOS:000231988100011 PM 16122574 ER PT J AU Asch, SM Stoto, M Mendes, M Valdez, RB Gallagher, ME Halverson, P Lurie, N AF Asch, SM Stoto, M Mendes, M Valdez, RB Gallagher, ME Halverson, P Lurie, N TI A review of instruments assessing public health preparedness SO PUBLIC HEALTH REPORTS LA English DT Review ID MEDICAL-CARE; QUALITY; PERFORMANCE AB Objectives. The purpose of this study was to review instruments that assess the level of preparedness of state and local public health departments to respond to health threats such as bioterrorism. Methods. The authors examined 27 published population-based instruments for planning or evaluating preparedness that were mostly unavailable in the peer-reviewed literature. Using the Essential Public Health Services framework, the instruments were evaluated for (1) clarity of measurement parameters, (2) balance between structural and process measures, (3) evidence of effectiveness, and (4) specification of an accountable entity. Results. There was a great deal of overlap but little consistency in what constitutes "preparedness" or how it should be measured. Most instruments relied excessively on subjective or structural measures, lacked scientific evidence for measures assessed, and failed to clearly define what entity was accountable for accomplishing the task or function. Conclusion. Strategies for improvement include measure standardization, better interagency communication, and investment in public health practice research to develop the underlying evidence base required for developing quality measures and assessments. C1 RAND Hlth, Santa Monica, CA USA. RAND Ctr Domest & Int Hlth Secur, Santa Monica, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Arkansas, Fayetteville, AR 72701 USA. RP Asch, SM (reprint author), W Los Angeles VA, 11301 Wilshire Blvd,Mail Code 111G,11301 Wilshire, Los Angeles, CA 90073 USA. EM steven_asch@rand.org NR 60 TC 26 Z9 26 U1 1 U2 2 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1101 15TH ST NW, STE 910, WASHINGTON, DC 20005 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD SEP-OCT PY 2005 VL 120 IS 5 BP 532 EP 542 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 959JI UT WOS:000231513600009 PM 16224986 ER PT J AU Hansen, JE Weisbart, RH Nishimura, RN AF Hansen, James E. Weisbart, Richard H. Nishimura, Robert N. TI Antibody mediated transduction of therapeutic proteins into living cells SO THESCIENTIFICWORLDJOURNAL LA English DT Article DE antibody; antibodies; autoantibody; autoantibodies; single-chain Fv; protein therapy; gene therapy; p53; dystrophin; cancer; muscular dystrophy; protein transduction; ptd; Tat; penetratin; Herpes Simplex VP22 ID DUCHENNE MUSCULAR-DYSTROPHY; CANCER-CELLS; MONOCLONAL-ANTIBODY; MONONUCLEAR-CELLS; GENE-THERAPY; MUTANT P53; DELIVERY; PEPTIDE; EXPRESSION; FUSION AB Protein therapy refers to the direct delivery of therapeutic proteins to cells and tissues with the goal of ameliorating or modifying a disease process. Current techniques for delivering proteins across cell membranes include taking advantage of receptor-mediated endocytosis or using protein transduction domains that penetrate directly into cells. The most commonly used protein transduction domains are small cell-penetrating peptides derived from such proteins as the HIV-1 Tat protein. A novel protein-transduction domain developed as the single-chain fragment (Fv) of a murine anti-DNA autoantibody, mAb 3E10, has recently been developed and used to deliver biologically active proteins to living cells in vitro. This review will provide a brief overview of the development of the Fv fragment and provide a summary of recent studies using Fv to deliver therapeutic peptides and proteins (such as a C-terminal p53 peptide, C-terminal p53 antibody fragment, full-length p53, and microdystrophin) to cells. C1 Univ Calif Los Angeles, San Fernando Valley Program, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Res, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. RP Hansen, JE (reprint author), Univ Calif Los Angeles, San Fernando Valley Program, Dept Med, Los Angeles, CA 90095 USA. EM jameshansen2004@hotmail.com; rweisbar@ucla.edu; rnishimu@ucla.edu NR 36 TC 2 Z9 2 U1 0 U2 2 PU THESCIENTIFICWORLD LTD PI NEWBURY PA 29-34, VENTURE WEST, NEW GREENHAM PARK, NEWBURY, BERKSHIRE RG19 6HX, ENGLAND SN 1537-744X J9 THESCIENTIFICWORLDJO JI TheScientificWorldJOURNAL PD SEP PY 2005 VL 5 BP 782 EP 788 DI 10.1100/tsw.2005.98 PG 7 WC Environmental Sciences; Multidisciplinary Sciences SC Environmental Sciences & Ecology; Science & Technology - Other Topics GA 110NL UT WOS:000242385500010 PM 16170440 ER PT J AU Blom, AS Mukherjee, R Pilla, JJ Lowry, AS Yarbrough, WM Mingoia, JT Hendrick, JW Stroud, RE McLean, JE Affuso, J Gorman, RC Gorman, JH Acker, MA Spinale, FG AF Blom, AS Mukherjee, R Pilla, JJ Lowry, AS Yarbrough, WM Mingoia, JT Hendrick, JW Stroud, RE McLean, JE Affuso, J Gorman, RC Gorman, JH Acker, MA Spinale, FG TI Cardiac support device modifies left ventricular geometry and myocardial structure after myocardial infarction SO CIRCULATION LA English DT Article DE collagen; contractility; myocardial infarction; matrix metalloproteinases; heart-assist device ID MATRIX-METALLOPROTEINASE INHIBITION; HEART-FAILURE; SYSTOLIC DYSFUNCTION; TISSUE INHIBITOR; MATRIX-METALLOPROTEINASE-9; MYOFIBROBLASTS; ENLARGEMENT; PROGRESSION; ENALAPRIL; EXPANSION AB Background - Whether mechanical restraint of the left ventricle ( LV) can influence remodeling after myocardial infarction ( MI) remains poorly understood. This study surgically placed a cardiac support device ( CSD) over the entire LV and examined LV and myocyte geometry and function after MI. Methods and Results - Post- MI sheep ( 35 to 45 kg; MI size, 23 +/- 2%) were randomized to placement of the CorCap CSD ( Acorn Cardiovascular, Inc) ( MI + CSD; n = 6) or remained untreated ( MI only; n = 5). Uninstrumented sheep ( n = 10) served as controls. At 3 months after MI, LV end- diastolic volume ( by MRI) was increased in the MI only group compared with controls ( 98 +/- 8 versus 43 +/- 4 mL; P < 0.05). In the MI + CSD group, LV end- diastolic volume was lower than MI only values ( 56 +/- 7 mL; P < 0.05) but remained higher than controls ( P < 0.05). Isolated LV myocyte shortening velocity was reduced by 35% from control values ( P < 0.05) in both MI groups. LV myocyte beta-adrenergic response was reduced with MI but normalized in the MI + CSD group. LV myocyte length increased in the MI group and was reduced in the MI + CSD group. Relative collagen content was increased and matrix metalloproteinase- 9 was decreased within the MI border region of the CSD group. Conclusions - A CSD beneficially modified LV and myocyte remodeling after MI through both cellular and extracellular mechanisms. These findings provide evidence that nonpharmacological strategies can interrupt adverse LV remodeling after MI. C1 Univ Penn, Med Ctr, Dept Surg, Philadelphia, PA USA. Univ Penn, Med Ctr, Dept Radiol, Philadelphia, PA 19104 USA. Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC USA. Ralph H Johnson Dept Vet Affairs, Charleston, SC USA. RP Acker, MA (reprint author), Hosp Univ Penn, Div Cardiothorac Surg, 6th Floor Silverstein Pavil, Philadelphia, PA 19104 USA. EM macker@mail.med.upenn.edu FU NHLBI NIH HHS [HL-59165, P01-HL-48788-08, R01 HL063954, R01 HL071137] NR 36 TC 62 Z9 63 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD AUG 30 PY 2005 VL 112 IS 9 BP 1274 EP 1283 DI 10.1161/CIRCULATIONAHA.104.499202 PG 10 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 959IJ UT WOS:000231511100007 PM 16129812 ER PT J AU Ikonomidis, JS Barbour, JR Amani, Z Stroud, RE Herron, AR McClister, DM Camens, SE Lindsey, ML Mukherjee, R Spinale, FG AF Ikonomidis, JS Barbour, JR Amani, Z Stroud, RE Herron, AR McClister, DM Camens, SE Lindsey, ML Mukherjee, R Spinale, FG TI Effects of deletion of the matrix metalloproteinase 9 gene on development of murine thoracic aortic aneurysms SO CIRCULATION LA English DT Article DE aneurysm; aorta; thorax; MMP-9; MMP-2 ID MATRIX-METALLOPROTEINASE INHIBITION; PERIARTERIAL APPLICATION; MMP-9 EXPRESSION; CALCIUM-CHLORIDE; ANGIOGENESIS; COLLAGENASE; PROTEOLYSIS; ACTIVATION; GENERATION AB Background-The matrix metalloproteinases (MMPs) contribute to cardiovascular remodeling, and MMPs, such as the gelatinases (MMP-9 and MMP-2), have been identified in thoracic aortic aneurysmal (TAA) tissue, but a cause-effect relationship has not been clearly established. Accordingly, this study examined TAA progression in mice devoid of the MMP-9 gene. Methods and Results-The descending thoracic aortas of wild-type (WT) FVB (n = 17) and MMP-9 gene knockout (KO, n = 11) mice were exposed to 0.5 mol/L of CaCl2 for 15 minutes with terminal studies performed at 4 weeks. Aortic lumen diameter was measured using video micrometry at baseline and at 4 weeks (TAA) followed by aortic tissue analysis. In WT mice, aortic diameter increased by 138 +/- 5% at 4 weeks (P < 0.05), consistent with TAA formation. In the KO mice, aortic diameter increased from baseline by 120 +/- 4% (P < 0.05) but was attenuated from WT TAA values (P < 0.05). Gelatin zymography performed on TAA segments confirmed the absence of MMP-9 in the KO mice but a > 8-fold relative increase in the active form of MMP-2 compared with WT (P < 0.05). Despite this, MMP-2 activity was relatively increased (P < 0.05) and colocalized to smooth muscle cell actin in a differential pattern favoring medial distruction in the WT TAA compared with the KO TAA segments. Conclusions-These results demonstrate that MMP-9 gene deletion attenuated TAA formation despite an increase in the zymographic levels of MMP-2. These unique findings suggest that an interaction between these 2 MMPs is necessary to facilitate TAA progression. C1 Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Ikonomidis, JS (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Suite 409 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM ikonomij@musc.edu RI Lindsey, Merry/B-2650-2012 FU NHLBI NIH HHS [R01 HL075488-01, R01 HL 059165-07, R01 HL 075360, R01 HL 66029, R01 HL075360] NR 28 TC 13 Z9 13 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD AUG 30 PY 2005 VL 112 IS 9 SU S BP I242 EP I248 DI 10.1161/CIRCULATIONAHA.104.526152 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 962OH UT WOS:000231741600038 PM 16159824 ER PT J AU Caetano, SC Fonseca, M Olvera, RL Nicoletti, M Hatch, JP Stanley, JA Hunter, K Lafer, B Pliszka, SR Soares, JC AF Caetano, SC Fonseca, M Olvera, RL Nicoletti, M Hatch, JP Stanley, JA Hunter, K Lafer, B Pliszka, SR Soares, JC TI Proton spectroscopy study of the left dorsolateral prefrontal cortex in pediatric depressed patients SO NEUROSCIENCE LETTERS LA English DT Article DE choline-containing compounds; myo-inositol; major depression; children; dorsolateral prefrontal cortex; proton spectroscopy ID MAGNETIC-RESONANCE-SPECTROSCOPY; ANTERIOR CINGULATE CORTEX; LIFE MAJOR DEPRESSION; ELECTROCONVULSIVE-THERAPY; UNIPOLAR DEPRESSION; BIPOLAR DISORDER; MR SPECTROSCOPY; MOOD DISORDERS; FRONTAL-LOBE; EARLY-ONSET AB The dorsolateral prefrontal cortex (DLPFC) plays an essential role in mood regulation and integration of cognitive functions that are abnormal in major depressive disorder (MDD). Few neuroimaging studies have evaluated the still maturing DLPFC in depressed children and adolescents. We conducted single voxel proton magnetic resonance spectroscopy (H-1 MRS) of the left DLPFC in 14 depressed children and adolescents (13.3 +/- 12.3 years old, 10 males) and 22 matched healthy controls (13.6 +/- 2.8 years old, 13 males). Depressed subjects had significantly lower levels of glycerophosphocholine plus phosphocholine (GPC + PC; or choline-containing compounds) and higher myo-inositol levels in the left DLPFC compared to healthy controls. In the depressed subjects, we found significant inverse correlations between glutamate levels and both duration of illness and number of episodes. In healthy controls there was a significant direct correlation between age and glutamine levels, which was not present in the patient group. Lower GPC + PC levels in pediatric MDD may reflect lower cell membrane content per volume in the DLPFC. Increased myo-inositol levels in MDD may represent a disturbed secondary messenger system. GPC + PC and myo-inositol abnormalities further demonstrate the involvement of DLPFC in pediatric MDD. (c) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Psychiat Serv, San Antonio, TX USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Fed Rio Grande Sul, Sch Med, Psychiat Res Inst, Porto Alegre, RS, Brazil. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Child & Adolescent Psychiat, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78285 USA. Wayne State Univ, Sch Med, Dept Psychiat & Behav Neurosci, Detroit, MI USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78285 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI Lafer, Beny/C-1055-2012; Caetano, Sheila/H-5010-2012; Lafer, Beny/F-9390-2015 OI Lafer, Beny/0000-0002-6132-9999; Caetano, Sheila/0000-0001-8403-7078; Lafer, Beny/0000-0002-6132-9999 FU NCRR NIH HHS [M01-RR-01346]; NIMH NIH HHS [MH01736, MH068662] NR 41 TC 45 Z9 45 U1 3 U2 7 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD AUG 26 PY 2005 VL 384 IS 3 BP 321 EP 326 DI 10.1016/j.neulet.2005.04.099 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 944XF UT WOS:000230463700022 PM 15936878 ER PT J AU Shlipak, MG Sarnak, MJ Fried, LF AF Shlipak, MG Sarnak, MJ Fried, LF TI Cystatin C and the risk of death - The authors reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Tufts New England Med Ctr, Boston, MA 02111 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Shlipak, MG (reprint author), San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu NR 4 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD AUG 25 PY 2005 VL 353 IS 8 BP 843 EP 844 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 957YK UT WOS:000231409300020 ER PT J AU Naylor, DE Liu, HT Wasterlain, CG AF Naylor, DE Liu, HT Wasterlain, CG TI Trafficking of GABA(A) receptors, loss of inhibition, and a mechanism for pharmacoresistance in status epilepticus SO JOURNAL OF NEUROSCIENCE LA English DT Article DE GABA(A) receptor trafficking; status epilepticus; epilepsy; hippocampus; math model; synaptic inhibition ID CEREBELLAR GRANULE CELLS; GAMMA-AMINOBUTYRIC-ACID; SUSTAINING STATUS EPILEPTICUS; KINASE-C ACTIVITY; ELECTRICAL-STIMULATION; HIPPOCAMPAL-NEURONS; SYNAPTIC INHIBITION; A RECEPTORS; GABAERGIC INHIBITION; CALCINEURIN ACTIVITY AB During status epilepticus ( SE), GABAergic mechanisms fail and seizures become self-sustaining and pharmacoresistant. During lithium-pilocarpine-induced SE, our studies of postsynaptic GABA(A) receptors in dentate gyrus granule cells show a reduction in the amplitude of miniature IPSCs (mIPSCs). Anatomical studies show a reduction in the colocalization of the beta 2/beta 3 and gamma 2 subunits of GABA(A) receptors with the presynaptic marker synaptophysin and an increase in the proportion of those subunits in the interior of dentate granule cells and other hippocampal neurons with SE. Unlike synaptic mIPSCs, the amplitude of extrasynaptic GABA(A) tonic currents is augmented during SE. Mathematical modeling suggests that the change of mIPSCs with SE reflects a decrease in the number of functional postsynaptic GABA(A) receptors. It also suggests that increases in extracellular [GABA] during SE can account for the tonic current changes and can affect postsynaptic receptor kinetics with a loss of paired-pulse inhibition. GABA exposure mimics the effects of SE on mIPSC and tonic GABA(A) current amplitudes in granule cells, consistent with the model predictions. These results provide a potential mechanism for the inhibitory loss that characterizes initiation of SE and for the pharmacoresistance to benzodiazepines, as a reduction of available functional GABA(A) postsynaptic receptors. Novel therapies for SE might be directed toward prevention or reversal of these losses. C1 Vet Adm Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA 90073 USA. RP Naylor, DE (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Dept Neurol, Bldg 500 Neurol 127,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dnaylor@ucla.edu FU PHS HHS [N13515] NR 60 TC 201 Z9 206 U1 1 U2 8 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD AUG 24 PY 2005 VL 25 IS 34 BP 7724 EP 7733 DI 10.1523/JNEUROSCI.4944-04.2005 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 958JA UT WOS:000231439300003 PM 16120773 ER PT J AU Kamimura, M Viedt, C Dalpke, A Rosenfeld, ME Mackman, N Cohen, DM Blessing, E Preusch, M Weber, CM Kreuzer, J Bea, F AF Kamimura, M Viedt, C Dalpke, A Rosenfeld, ME Mackman, N Cohen, DM Blessing, E Preusch, M Weber, CM Kreuzer, J Bea, F TI Interleukin-10 suppresses tissue factor expression in lipopolysaccharide-stimulated macrophages via inhibition of Egr-1 and a serum response element/MEK-ERK1/2 pathway SO CIRCULATION RESEARCH LA English DT Article DE atherosclerosis; tissue factor; interleukin; early growth response gene; macrophages ID ANTIINFLAMMATORY CYTOKINE INTERLEUKIN-10; HUMAN ENDOTHELIAL-CELLS; TUMOR-NECROSIS-FACTOR; HUMAN MONOCYTIC CELLS; TNF-ALPHA PRODUCTION; GROWTH-FACTOR-BETA; E-DEFICIENT MICE; FACTOR-KAPPA-B; TRANSCRIPTIONAL REGULATION; MEK-ERK1/2 PATHWAY AB Atherosclerosis is considered to be an inflammatory disease. Tissue factor (TF), a prothrombotic molecule expressed by various cell types within atherosclerotic plaques, is thought to play an essential role in thrombus formation after atherosclerotic plaque rupture. Recent studies suggest that the antiinflammatory cytokine interleukin-10 (IL-10) has many antiatherosclerotic properties. Therefore, the effects of IL-10 on TF expression in response to inflammation were investigated. Mouse macrophages were stimulated with lipopolysaccharide (LPS) in the presence or absence of IL-10. Pretreatment with IL-10 resulted in a 50% decrease in TF mRNA expression and TF promoter activity. Binding of early growth response gene-1 (Egr-1) to the consensus DNA sequence, a key transcriptional activator of TF expression in response to inflammation, and the expression of Egr-1 mRNA were also inhibited by IL-10. This inhibition was independent of the induction of suppressor of cytokine signaling protein-3 by IL-10. Macrophages that had been transfected with luciferase reporter constructs containing the murine Egr-1 5'-flanking sequence exhibited reduced reporter gene activity in response to LPS stimulation with IL-10 pretreatment. Studies with deletion constructs of the Egr-1 promoter identified the proximal serum response element SRE3 as a potential regulatory site for the IL-10 mediated suppression of Egr-1 expression. Furthermore, activation of the upstream signal-transduction elements, such as mitogen-activated protein kinase kinase (MEK) 1/2, extracellular signal-regulated kinase 1/2, and Elk-1 were also inhibited by IL-10 pretreatment. Taken together, these results demonstrate a pathway for the IL-10 mediated inhibition of TF expression during inflammation and may explain the antiatherosclerotic effects of IL-10. C1 Univ Heidelberg, Dept Internal Med 3, D-69120 Heidelberg, Germany. Univ Heidelberg, Dept Hyg & Med Microbiol, D-69120 Heidelberg, Germany. Univ Washington, Dept Pathobiol, Seattle, WA 98195 USA. Univ Washington, Interdisciplinary Grad Program Nutr Sci, Seattle, WA 98195 USA. Scripps Res Inst, La Jolla, CA USA. Oregon Hlth Sci Univ, Dept Hypertens & Nephrol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Bea, F (reprint author), Univ Heidelberg, Dept Internal Med 3, Neuenheimer Feld 410, D-69120 Heidelberg, Germany. EM florian.bea@med.uni-heidelberg.de RI Katus, Hugo/P-1712-2016 NR 44 TC 34 Z9 36 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7330 J9 CIRC RES JI Circ.Res. PD AUG 19 PY 2005 VL 97 IS 4 BP 305 EP 313 DI 10.1161/01.RES.0000177893.24574.13 PG 9 WC Cardiac & Cardiovascular Systems; Hematology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Hematology GA 956JS UT WOS:000231296600003 PM 16037570 ER PT J AU Shlipak, MG Katz, R Fried, LF Newman, AB Siscovick, DS Psaty, B AF Shlipak, MG Katz, R Fried, LF Newman, AB Siscovick, DS Psaty, B TI Chronic kidney disease and cardiovascular risk - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Collaborat Hlth Studies Coordinating Ctr, Seattle, WA USA. VA Pittsburgh Healthcare Syst, Med Serv, Renal Sect, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA. RP Shlipak, MG (reprint author), Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 17 PY 2005 VL 294 IS 7 BP 791 EP 791 DI 10.1001/jama.294.7.791-b PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 955LI UT WOS:000231227000011 ER PT J AU Richardson, SS Yu, W AF Richardson, SS Yu, W TI Controlling for patient case mix at the end of life: Issues in identifying cause of death SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 US Dept Vet Affairs, Hlth Econ Resource Ctr Hlth Serv Res & Dev Serv, Menlo Pk, CA 94025 USA. RP Richardson, SS (reprint author), US Dept Vet Affairs, Hlth Econ Resource Ctr Hlth Serv Res & Dev Serv, Menlo Pk, CA 94025 USA. EM samuel.richardson3@med.va.gov NR 6 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 17 PY 2005 VL 294 IS 7 BP 793 EP 794 DI 10.1001/jama.294.7.793-c PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 955LI UT WOS:000231227000016 PM 16106002 ER PT J AU Baldwin, LM Dobie, SA Billingsley, K Cai, Y Wright, GE Dominitz, JA Barlow, W Warren, JL Taplin, SH AF Baldwin, LM Dobie, SA Billingsley, K Cai, Y Wright, GE Dominitz, JA Barlow, W Warren, JL Taplin, SH TI Explaining black-white differences in receipt of recommended colon cancer treatment SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID AFRICAN-AMERICAN WOMEN; SEER-MEDICARE DATA; QUALITY-OF-CARE; RACIAL-DIFFERENCES; COLORECTAL-CANCER; LUNG-CANCER; ADJUVANT CHEMOTHERAPY; UNITED-STATES; RENAL-TRANSPLANTATION; PROSTATE CARCINOMA AB Background. Black-white disparities exist in receipt of recommended medical care, including colorectal cancer treatment. This retrospective cohort study examines the degree to which health systems (e.g., physician, hospital) factors explain black-white disparities in colon cancer care. Methods: Data from the Surveillance, Epidemiology, and End Results program; Medicare claims; the American Medical Association Masterfile; and hospital surveys were linked to examine chemotherapy receipt after stage III colon cancer resection among 5294 elderly ( >= 66 years of age) black and white Medicare-insured patients. Logistic regression analysis was used to identify factors associated with black-white differences in chemotherapy use. All statistical tests were two-sided. Results: Black and white patients were equally likely to consult with a medical oncologist, but among patients who had such a consultation, black patients were less likely than white patients (59.3% versus 70.4%, difference = 10.9%, 95% confidence interval [CI] = 5.1% to 16.4%, P < .001) to receive chemotherapy. This black-white disparity was highest among patients aged 66-70 years (black patients 65.7%, white patients 86.3%, difference = 20.6%, 95% CI = 10.7% to 30.4%, P < .001) and decreased with age. The disparity among patients aged 66-70 years also remained statistically significant in the regression analysis. Overall, patient, physician, hospital, and environmental factors accounted for approximately 50% of the disparity in chemotherapy receipt among patients aged 66-70 years; surgical length of stay and neighborhood socioeconomic status accounted for approximately 27% of the disparity in this age group, and health systems factors accounted for 12%. Conclusions: Black and white Medicare-insured colon cancer patients have an equal opportunity to learn about adjuvant chemotherapy from a medical oncologist but do not receive chemotherapy equally. Little disparity was explained by health systems; more was explained by illness severity, social support, and environment. Further qualitative research is needed to understand the factors that influence the lower receipt of chemotherapy by black patients. C1 Univ Washington, Dept Family Med, Seattle, WA 98195 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. VA Puget Sound Hlth Care Syst, NW Ctr Outcomes Res Older Adults, Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Med, Div Gastroenterol, Seattle, WA 98195 USA. Canc Res & Biostat, Seattle, WA USA. NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. RP Baldwin, LM (reprint author), Univ Washington, Dept Family Med, Box 354982, Seattle, WA 98195 USA. EM lmb@fammed.washington.edu OI Dominitz, Jason/0000-0002-8070-7086 FU NCI NIH HHS [R01 CA089544, R01 CA089544-01, R01CA089544] NR 71 TC 124 Z9 125 U1 1 U2 4 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0027-8874 J9 J NATL CANCER I JI J. Natl. Cancer Inst. PD AUG 17 PY 2005 VL 97 IS 16 BP 1211 EP 1220 DI 10.1093/jnci/dji241 PG 10 WC Oncology SC Oncology GA 969YT UT WOS:000232272800011 PM 16106026 ER PT J AU Higashi, T Shekelle, PG Adams, JL Kamberg, CJ Roth, CP Solomon, DH Reuben, DB Chiang, L MacLean, CH Chang, JT Young, RT Saliba, DM Wenger, NS AF Higashi, T Shekelle, PG Adams, JL Kamberg, CJ Roth, CP Solomon, DH Reuben, DB Chiang, L MacLean, CH Chang, JT Young, RT Saliba, DM Wenger, NS TI Quality of care is associated with survival in vulnerable older patients SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID MEDICAL-CARE; HEALTH-CARE; COMMUNITY; MORTALITY; ELDERS AB Background: Although assessment of the quality of medical care often relies on measures of process of care, the linkage between performance of these process measures during usual clinical care and subsequent patient outcomes is unclear. Objective: To examine the link between the quality of care that patients received and their survival. Design: Observational cohort study. Setting: Two managed care organizations. Patients: Community-dwelling high-risk patients 65 years of age or older who were continuously enrolled in the managed care organizations from 1 July 1998 to 31 July 1999. Measurements: Quality of care received by patients (as measured by a set of quality indicators covering 22 clinical conditions) and their survival over the following 3 years. Results: The 372 vulnerable older patients were eligible for a mean of 21 quality indicators (range, 8 to 54) and received, on average, 53% of the care processes prescribed in quality indicators (range, 27% to 88%). Eighty-six (23%) persons died during the 3-year follow-up. There was a graded positive relationship between quality score and 3-year survival. After adjustment for sex, health status, and health service use, quality score was not associated with mortality for the first 500 days, but a higher quality score was associated with lower mortality after 500 days (hazard ratio, 0.64 [95% Cl, 0.49 to 0.84] for a 10% higher quality score). Limitations: The observational design limits causal inference regarding the effect of quality of care on survival. Conclusions: Better performance on process quality measures is strongly associated with better survival among community-dwelling vulnerable older adults. C1 RAND Corp, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Wenger, NS (reprint author), RAND Corp, 1700 Main St, Santa Monica, CA 90407 USA. NR 23 TC 131 Z9 133 U1 2 U2 6 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 AUG 16 PY 2005 VL 143 IS 4 BP 274 EP 281 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 955PA UT WOS:000231237100004 PM 16103471 ER PT J AU Good, CB AF Good, CB TI Target blood pressure and kidney disease SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Good, CB (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. NR 1 TC 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 AUG 16 PY 2005 VL 143 IS 4 BP 310 EP 310 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 955PA UT WOS:000231237100012 PM 16103480 ER PT J AU Shannon, J Tewoderos, S Garzotto, M Beer, TM Derenick, R Palma, A Farris, PE AF Shannon, J Tewoderos, S Garzotto, M Beer, TM Derenick, R Palma, A Farris, PE TI Statins and prostate cancer risk: A case-control study SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 40th Annual Meeting of the American-Society-of-Clinical-Oncology CY JUN 05-08, 2004 CL New Orleans, LA SP Amer Soc Clin Oncol DE case-control studies; cholesterol; hydroxymethylglutaryl-CoA reductase inhibitors; mevalonic acid; prostate-specific antigen; prostatic neoplasms; veterans ID A REDUCTASE INHIBITORS; SCANDINAVIAN SIMVASTATIN SURVIVAL; COA REDUCTASE; LIPID RAFTS; FOLLOW-UP; CELLS; LOVASTATIN; APOPTOSIS; 4S AB Observational studies have shown that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) use may be associated with reduced cancer risk. The purpose of this case-control study was to elucidate the association between statin use and prostate cancer risk. Prostate cancer cases (n = 100), recruited upon referral for prostate biopsy, and frequency age-matched, prostate-specific antigen-normal clinic controls (n = 202) were recruited from the Portland,. Oregon, Veterans Affairs Medical Center. Information on any use of statins from May 1997 through August 2004 was obtained from an electronic pharmacy database. Days of use, type of statin, dose, and prescription changes were recorded. Duration and intensity were calculated for each statin type on the basis of days of use and prescribed dose. Thirty-six percent of cases and 49 percent of controls had a record of any statin use. Following adjustment for other potential risk factors, statin use was associated with a significant reduction in prostate cancer risk (odds ratio = 0.38, 95% confidence interval: 0.21, 0.69). Furthermore, in analyses stratified by Gleason score, the inverse association with statin use was maintained only among men with Gleason scores of >= 7 (odds ratio = 0.24, 95% confidence interval: 0.11, 0.53). The results of this case-control study suggest that statins may reduce the risk of total prostate cancer and, specifically, more aggressive prostate cancer. C1 Oregon Hlth Sci Univ, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Shannon, J (reprint author), Oregon Hlth Sci Univ, 3181 SW Sam Jackson Pk Rd CSB669, Portland, OR 97239 USA. EM shannoja@ohsu.edu FU NCRR NIH HHS [M01 RR000334] NR 24 TC 151 Z9 158 U1 0 U2 2 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 15 PY 2005 VL 162 IS 4 BP 318 EP 325 DI 10.1093/aje/kwi203 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 954JE UT WOS:000231150600004 PM 16014776 ER PT J AU Cody, JD Semrud-Clikeman, M Hardies, LJ Lancaster, J Ghidoni, PD Schaub, RL Thompson, NM Wells, L Cornell, JE Love, TM Fox, PT Leach, RJ Kaye, CI Hale, DE AF Cody, JD Semrud-Clikeman, M Hardies, LJ Lancaster, J Ghidoni, PD Schaub, RL Thompson, NM Wells, L Cornell, JE Love, TM Fox, PT Leach, RJ Kaye, CI Hale, DE TI Growth hormone benefits children with 18q deletions SO AMERICAN JOURNAL OF MEDICAL GENETICS PART A LA English DT Article DE 18q-; growth hormone treatment; cognitive development; myelination; chromosome abnormalities ID MYELIN BASIC-PROTEIN; DEFICIENT; HAPLOINSUFFICIENCY AB Most individuals with constitutional deletions of chromosome 18q have developmental delays, dysmyelination of the brain, and growth failure due to growth hormone deficiency. We monitored the effects of growth hormone treatment by evaluating 23 individuals for changes in growth, nonverbal intelligence quotient (nIQ), and quantitative brain MRI changes. Over an average of 37 months, the treated group of 13 children had an average nIQ increase of 17 points, an increase in height standard deviation score of 1.7, and significant change in T1 relaxation times in the caudate and frontal white matter. Cognitive changes of this magnitude are clinically significant and are anticipated to have an effect on the long-term outcomes for the treated individuals. (c) 2005 Wiley-Liss, Inc. C1 Univ Texas, Hlth Sci Ctr, Dept Pediat, San Antonio, TX 78229 USA. Univ Texas, Dept Educ Psychol, Austin, TX 78712 USA. Univ Texas, Hlth Sci Ctr, Res Imaging Ctr, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Anesthesiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Washington, Dept Psychiat & Behav Hlth Sci, Seattle, WA 98195 USA. Iowa State Univ, Dept Stat, Ames, IA USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX USA. RP Cody, JD (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pediat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM cody@uthscsa.edu RI Love, Tanzy/F-3954-2010; Fox, Peter/B-4725-2010 OI Love, Tanzy/0000-0002-7154-0229; Fox, Peter/0000-0002-0465-2028 FU NCRR NIH HHS [M01-RR-01346] NR 26 TC 11 Z9 12 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1552-4825 J9 AM J MED GENET A JI Am. J. Med. Genet. A PD AUG 15 PY 2005 VL 137A IS 1 BP 9 EP 15 DI 10.1002/ajmg.a.30848 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 952ND UT WOS:000231009900002 PM 16007630 ER PT J AU Flagg, SD Meador, R Hsia, E Kitumnuaypong, T Schumacher, HR AF Flagg, SD Meador, R Hsia, E Kitumnuaypong, T Schumacher, HR TI Decreased pain and synovial inflammation after etanercept therapy in patients with reactive and undifferentiated arthritis: An open-label trial SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE synovium; chlamydia; etanercept; polymerase chain reaction ID TUMOR-NECROSIS-FACTOR; ALPHA MONOCLONAL-ANTIBODY; POLYMERASE-CHAIN-REACTION; CHLAMYDIA-TRACHOMATIS; RHEUMATOID-ARTHRITIS; ANKYLOSING-SPONDYLITIS; TNF-ALPHA; CYTOKINES; TISSUE; INHIBITION AB Objective. Elevated levels of tumor necrosis factor alpha (TNF alpha) have been identified in the synovium of patients with reactive and undifferentiated arthritis, implicating TNF alpha in the pathogenesis of these disorders. This finding has provided a rationale for the use of TNF alpha antagonists in the treatment of reactive arthritis; however, the possibility that the triggering microorganism might persist in affected joints and become activated with use of these agents has been of concern. Methods. The efficacy and safety of etanercept (25 mg subcutaneous twice weekly) in 16 patients with undifferentiated or reactive arthritis was assessed in a 6-month open-label trial. Synovial biopsies were performed before and after treatment with etanercept. Polymerase chain reaction (PCR) analysis was performed on the synovial biopsy samples to evaluate for the presence of nucleic acid material of bacterial organisms. Outcome measures including tender and swollen joint counts, pain assessment on a 10-point visual analog scale, and functional ability as measured by the Health Assessment Questionnaire were determined before and after etanercept therapy. Results. Ten of 16 patients completed the trial. Six patients withdrew, but none had a worsening of arthritis or infection. Of the 10 completers, 9 could be classified as treatment responders, despite the evidence of bacterial organisms on PCR analysis prior to initiating etanercept in 3 patients; 2 patients became PCR negative on etanercept. Five of 6 patients with adequate synovial biopsy specimens showed improvement, but not normalization of histology. Conclusion. Etanercept was well-tolerated without clinical exacerbation of any suspected underlying infections and appeared to provide therapeutic benefit in our cohort of patients with reactive and undifferentiated arthritis. C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Vet Affairs Med Ctr, 38th St & Woodland Ave, Philadelphia, PA 19104 USA. EM schumacr@mail.med.upenn.edu NR 20 TC 32 Z9 34 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0004-3591 J9 ARTHRIT RHEUM-ARTHR JI Arthritis Rheum-Arthritis Care Res. PD AUG 15 PY 2005 VL 53 IS 4 BP 613 EP 617 DI 10.1002/art.21323 PG 5 WC Rheumatology SC Rheumatology GA 952YI UT WOS:000231041900021 PM 16082643 ER PT J AU Shin, JM Sachs, G AF Shin, JM Sachs, G TI Differences in binding properties of two proton pump inhibitors on the gastric H+, K+-ATPase in vivo (vol 68, pg 2117, 2004) SO BIOCHEMICAL PHARMACOLOGY LA English DT Correction C1 Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Sachs, G (reprint author), Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. EM gsachs@ucla.edu NR 1 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0006-2952 J9 BIOCHEM PHARMACOL JI Biochem. Pharmacol. PD AUG 15 PY 2005 VL 70 IS 4 BP 648 EP 648 DI 10.1016/j.bcp.2004.07.035 PG 1 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 951RY UT WOS:000230949700018 ER PT J AU Singh, BN Singh, SN Reda, D AF Singh, BN Singh, SN Reda, D TI Amiodarone versus sotalol for atrial fibrillation - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter ID CONGESTIVE-HEART-FAILURE; METAANALYSIS C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Vet Affairs Med Ctr, Washington, DC 20422 USA. Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Singh, BN (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu NR 5 TC 0 Z9 0 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 AUG 11 PY 2005 VL 353 IS 6 BP 629 EP 630 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 953ST UT WOS:000231101500021 ER PT J AU Corless, CL Schroeder, A Griffith, D Town, A McGreevey, L Harrell, P Shiraga, S Bainbridge, T Morich, J Heinrich, MC AF Corless, CL Schroeder, A Griffith, D Town, A McGreevey, L Harrell, P Shiraga, S Bainbridge, T Morich, J Heinrich, MC TI PDGFRA mutations in gastrointestinal stromal tumors: Frequency, spectrum and in vitro sensitivity to imatinib SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID FACTOR-RECEPTOR-ALPHA; KINASE INHIBITORS; C-KIT; WILD-TYPE; SYSTEMIC MASTOCYTOSIS; EXPRESSION PROFILES; D816V MUTATION; PROTEIN-KINASE; PRIMARY SITE; SOFT-TISSUE AB Purpose Gastrointestinal stromal tumors (GISTs) commonly harbor oncogenic mutations of the KIT tyrosine kinase, which is a target for the kinase inhibitor imatinib. A subset of GISTs, however, contains mutations in the homologous kinase platelet derived growth factor receptor alpha (PDGFRA), and the most common of these mutations is resistant to imatinib in vitro. Little is known of the other types of PDGFRA mutations that occur in GISTs. Materials and Methods We determined the KIT and PDGFRA mutation status of 1,105 unique GISTS using a combination of denaturing high-performance liquid chromatography and direct sequencing. Results There were 80 tumors (7.2%) with a PDGFRA mutation: 66 in exon 18, 11 in exon 12, and three in exon 14. Transient expression of representative PDGFRA isoforms in CHO cells revealed imatinib sensitivity of exon 12 mutations (SPDHE566-571R and insertion ER561-562) and an exon 14 substitution (N659K). However, most isoforms with a substitution involving codon D842 in exon 18 (D842V, RD841-842KI, D1842-8431M) were resistant to the drug, with the exception of D842Y. Interestingly, other mutations in exon 18 (D846Y, N848K, Y849K and HDSN845-848P) were all imatinib sensitive. Proliferation studies with BA/F3 cell lines stably expressing selected PDGFRA mutant isoforms supported these findings. Conclusion Including our cases, there are 289 reported PDGFRA-mutant GISTS, of which 181 (62.6%) had the imatinib-resistant substitution D842V. However, our findings suggest that more than one third of GISTS with PDGFRA mutations may respond to imatinib and that mutation screening may be helpful in the management of these tumors. C1 Oregon Hlth & Sci Univ, Inst Canc, Dept Pathol, Portland, OR USA. Oregon Hlth & Sci Univ, Inst Canc, Div Hematol & Oncol, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. RP Heinrich, MC (reprint author), R&D-19 3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM heinrich@ohsu.edu NR 42 TC 384 Z9 411 U1 0 U2 7 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD AUG 10 PY 2005 VL 23 IS 23 BP 5357 EP 5364 DI 10.1200/JCO.2005.14.068 PG 8 WC Oncology SC Oncology GA 955NG UT WOS:000231232100009 PM 15928335 ER PT J AU Bailey, FA Burgio, KL Woodby, LL Williams, BR Redden, DT Kovac, SH Durham, RM Goode, PS AF Bailey, FA Burgio, KL Woodby, LL Williams, BR Redden, DT Kovac, SH Durham, RM Goode, PS TI Improving processes of hospital care during the last hours of life SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT Meeting of the VA-Health-Services-Research-and-Development-Program CY FEB 16-18, 2005 CL Baltimore, DC SP VA Hlth Serv Res Dev Program ID OF-LIFE; PHYSICIAN PERFORMANCE; ILL PATIENTS; CANCER; PERSPECTIVES; PROGNOSES; SURVIVAL; OUTCOMES; SUPPORT; DEATH AB Background: Known for excellence in care in the last days and hours of life, hospice programs can help individuals have a "good death" and lead to higher family satisfaction with quality of care. Our objective was to evaluate the effectiveness of a multicomponent palliative care intervention based on the best practices of home hospice and designed to improve the quality of care provided for patients dying in an acute care inpatient setting. Methods: This study was a before-after intervention trial conducted between 2001 and 2003. Participants included physician, nursing, and ancillary staff on inpatient services of an urban, tertiary care Veterans Affairs medical center. The palliative care intervention included staff education and support to identify patients who were actively dying and implement care plans guided by a comfort care order set template for the last days or hours of life. Data abstracted from computerized medical records of 203 veterans who died during a 6-month period before (n = 108) and after (n = 95) intervention were used to determine the impact of intervention on symptom documentation and 5 process of care indicators. Results: There was a significant increase in the mean (SD) number of symptoms documented from 1. 7 (2.1) to 4.4 (2.7) (P < .001), and the number of care plans increased from 0.4 (0.9) to 2.7 (2.3) (P < .001). Opioid medication availability increased from 57.1% to 83.2% (P < .001), and do-not-resuscitate orders increased from 61.9% to 85.1% (P < .001). There were nonsignificant changes in the proportion of deaths that occurred in intensive care units (P =. 17) and in the use of nasogastric tubes (P =. 40), and there was a significant increase in the use of restraints (P < .001). Conclusion: Our results indicate that end-of-life care improved after the introduction of the palliative care program. C1 Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Birmingham, AL USA. Dept Vet Affairs Med Ctr, Res Enhancement Award Program, Birmingham, AL USA. Univ Alabama, Sch Med, Birmingham, AL USA. Univ Alabama, Sch Publ Hlth, Birmingham, AL 35294 USA. Dept Vet Affairs Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Dept Med, Durham, NC USA. RP Burgio, KL (reprint author), Birmingham VA Med Ctr, Geriatr Res Educ & Clin Ctr, GRECC-11G,700 19th St S, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu NR 40 TC 68 Z9 68 U1 1 U2 10 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD AUG 8 PY 2005 VL 165 IS 15 BP 1722 EP 1727 DI 10.1001/archinte.165.15.1722 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 952VW UT WOS:000231034800008 PM 16087819 ER PT J AU Mariappan, MM Senthil, D Natarajan, KS Choudhury, GG Kasinath, BS AF Mariappan, MM Senthil, D Natarajan, KS Choudhury, GG Kasinath, BS TI Phospholipase C gamma-Erk axis in vascular endothelial growth factor-induced eukaryotic initiation factor 4E phosphorylation and protein synthesis in renal epithelial cells SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID MAP KINASE PATHWAYS; TRANSLATION INITIATION; ANGIOTENSIN-II; MESSENGER-RNA; SMOOTH-MUSCLE; TYROSINE PHOSPHORYLATION; DIABETIC-NEPHROPATHY; DEPENDENT ACTIVATION; FACTOR EIF-4E; PLC-GAMMA AB Vascular endothelial growth factor ( VEGF) increases protein synthesis and induces hypertrophy in renal tubular epithelial cells ( Senthil, D., Choudhury, G. G., McLaurin, C., and Kasinath, B. S. ( 2003) Kidney Int. 64, 468 - 479). We examined the role of Erk1/2 MAP kinase in protein synthesis induced by VEGF. VEGF stimulated Erk phosphorylation that was required for induction of protein synthesis. VEGF-induced Erk activation was not dependent on phosphoinositide ( PI) 3-kinase activation but required sequential phosphorylation of type 2 VEGF receptor, PLC gamma and c-Src, as demonstrated by inhibitors SU1498, U73122, and PP1, respectively. c-Src phosphorylation was inhibited by U73122, indicating it was downstream of phospholipase ( PL)C gamma. Studies with PP1/2 showed that phosphorylation of c-Src was required for tyrosine phosphorylation of Raf-1, an upstream regulator of Erk. VEGF also stimulated phosphorylation of Pyk-2; VEGF-induced phosphorylation of Pyk2, c-Src and Raf-1 could be abolished by BAPTA/AM, demonstrating requirement for induction of intracellular calcium currents. We examined the downstream events following the phosphorylation of Erk. VEGF stimulated phosphorylation of Mnk1 and eIF4E and induced Mnk1 to shift from the cytoplasm to the nucleus upon phosphorylation. VEGF-induced phosphorylation of Mnk1 and eIF4E required phosphorylation of PLC gamma, c-Src, and Erk. Expression of dominant negative Mnk1 abrogated eIF4E phosphorylation and protein synthesis induced by VEGF. VEGF-stimulated protein synthesis could be blocked by inhibition of PLC gamma by a chemical inhibitor or expression of a dominant negative construct. Our data demonstrate that VEGF-stimulated protein synthesis is Erk-dependent and requires the activation of VEGF receptor 2, PLC gamma, c-Src, Raf, and Erk pathway. VEGF also stimulates Erk-dependent phosphorylation of Mnk1 and eIF4E, crucial events in the initiation phase of protein translation. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. O Brien Kidney Res Ctr, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Kasinath, BS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr,Mail Code 7882, San Antonio, TX 78229 USA. EM Kasinath@uthscsa.edu FU NIDDK NIH HHS [DK 55815, P50-DK 061597, DK 50190] NR 50 TC 21 Z9 21 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD AUG 5 PY 2005 VL 280 IS 31 BP 28402 EP 28411 DI 10.1074/jbc.M504861200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 950KZ UT WOS:000230857300029 PM 15919658 ER PT J AU Peng, ZC Houser, CR AF Peng, ZC Houser, CR TI Temporal patterns of fos expression in the dentate gyrus after spontaneous seizures in a mouse model of temporal lobe epilepsy SO JOURNAL OF NEUROSCIENCE LA English DT Article DE pilocarpine; hippocampus; granule cells; interneurons; immunohistochemistry; GABA neurons ID C-FOS; GRANULE CELLS; KAINIC ACID; STATUS EPILEPTICUS; RAT HIPPOCAMPUS; NERVOUS-SYSTEM; MESSENGER-RNA; SYNAPTIC REORGANIZATION; GENE-EXPRESSION; MOSSY FIBERS AB Identifying the brain regions and neuronal cell types that become active at the time of spontaneous seizures remains an important challenge for epilepsy research, and the involvement of dentate granule cells in early seizure events continues to be debated. Although Fos expression is commonly used to evaluate patterns of neuronal activation, there have been few studies of Fos localization after spontaneous seizures. Thus, in a pilocarpine model of recurrent seizures in C57BL/6 mice, Fos expression was examined at multiple time points after spontaneous seizures to follow the temporal and spatial patterns of Fos activation. By 15 min after the beginning of a spontaneous behavioral seizure, Fos labeling was evident in dentate granule cells. This labeling was particularly striking because of its wide extent and relatively uniform appearance in the granule cell layer. At later time points, from 30 min to 4 h after a spontaneous seizure, Fos labeling was also detected in interneurons within the dentate gyrus and in widespread regions of the temporal lobe. Interestingly, the timing of Fos activation appeared to differ among different types of GABAergic interneurons in the dentate gyrus, with labeling of parvalbumin neurons along the base of the granule cell layer preceding that of GABA neurons in the molecular layer. The findings in this mouse model are consistent with previous suggestions that spontaneous seizures in temporal lobe epilepsy may result from a periodic breakdown of the normal filter functions of the dentate gyrus and a resulting increase in hypersynchronous activity of dentate granule cells. C1 Univ Calif Los Angeles, Dept Neurobiol, Ctr Hlth Sci 73235, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Brain Res Inst, David Geffen Sch Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. RP Houser, CR (reprint author), Univ Calif Los Angeles, Dept Neurobiol, Ctr Hlth Sci 73235, David Geffen Sch Med, 10833 LeConte Ave, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU BLRD VA [I01 BX000404]; NINDS NIH HHS [NS046524] NR 56 TC 51 Z9 54 U1 0 U2 0 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD AUG 3 PY 2005 VL 25 IS 31 BP 7210 EP 7220 DI 10.1523/JNEUROSCI.0838-05.2005 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 952FB UT WOS:000230987300014 PM 16079403 ER PT J AU O'Brien, CP AF O'Brien, CP TI Opiate detoxification: what are the goals? SO ADDICTION LA English DT Editorial Material C1 Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP O'Brien, CP (reprint author), Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. EM obrien@mail.trc.upenn.edu NR 1 TC 5 Z9 5 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0965-2140 J9 ADDICTION JI Addiction PD AUG PY 2005 VL 100 IS 8 BP 1035 EP 1035 DI 10.1111/j.1360-0443.2005.01213.x PG 1 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 949FC UT WOS:000230769400001 PM 16042623 ER PT J AU Oslin, DW Slaymaker, VJ Blow, FC Owen, PL Colleran, C AF Oslin, DW Slaymaker, VJ Blow, FC Owen, PL Colleran, C TI Treatment outcomes for alcohol dependence among middle-aged and older adults SO ADDICTIVE BEHAVIORS LA English DT Article DE treatment; alcohol dependence; aged ID USE DISORDERS; RELIABILITY; CARE AB Aims: The purpose of this study was to examine differences in the clinical presentation and treatment outcomes of older adults with a diagnosis of alcohol dependence compared to middle-aged adults. Design: The study is a prospective naturalistic study. Participants included 1358 patients admitted to a residential rehabilitation program for alcohol dependence. Results: Older adults entering an alcohol rehabilitation program are less impaired on a number measures of psychiatric distress and addiction severity but more impaired in somatic health. While there were no significantly different outcomes in abstinence rates at I month, older adults engaged in formal post-discharge aftercare less than middle-aged adults. Conclusions: These results confirm impressions that older adults seeking alcohol treatment may have a lower severity of alcohol dependence compared to those at younger ages. However, results suggest that traditional outpatient substance abuse care is not accepted at the same rates as middle-aged adults. The low rates of engagement suggest the need for age appropriate treatment options and are potentially of concern if treatment is necessary to maintain short-term success. (c) 2005 Elsevier Ltd. All rights reserved. C1 Univ Penn, Sect Geriatr Psychiat, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Study Addict, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Mental Illness Res Educ, Philadelphia, PA USA. Philadelphia VA Med Ctr, Ctr Clin, Philadelphia, PA USA. Hazelden Fdn, Butler Ctr Res, Ctr City, MN USA. Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. Ann Arbor VA Healthcare Syst, SMITREC, Hlth Serv Res & Dev, Ann Arbor, MI USA. Hanley Ctr, W Palm Beach, FL USA. RP Oslin, DW (reprint author), Univ Penn, Sect Geriatr Psychiat, Dept Psychiat, 3535 Market St,Room 3002, Philadelphia, PA 19104 USA. EM oslin@mail.med.upenn.edu FU NIMH NIH HHS [1K08 MH01599-01] NR 8 TC 17 Z9 17 U1 2 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4603 J9 ADDICT BEHAV JI Addict. Behav. PD AUG PY 2005 VL 30 IS 7 BP 1431 EP 1436 DI 10.1016/j.addbeh.2005.01.007 PG 6 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 952CR UT WOS:000230980000014 PM 16022937 ER PT J AU Giordano, TP Visnegarwala, F White, AC Troisi, CL Frankowski, RF Hartman, CM Grimes, RM AF Giordano, TP Visnegarwala, F White, AC Troisi, CL Frankowski, RF Hartman, CM Grimes, RM TI Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure SO AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV LA English DT Article; Proceedings Paper CT 2nd International-AIDS-Society Conference on HIV Pathogenesis and Treatment CY JUL 13-16, 2003 CL Paris, FRANCE SP Int AIDS Soc ID HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIRETROVIRAL THERAPY; INFECTED WOMEN; MEDICAL-CARE; ADHERENCE; SERVICES; SEX AB To measure the success with which patients newly entering outpatient care establish regular care, and assess whether race/ethnicity was a predictive factor, we conducted a medical record review of new patients seen 20 April 1998 to 31 December 1998 at The Thomas Street Clinic, a county clinic for uninsured persons. Patients were considered 'not established' if they never saw a physician in the 6 months after intake ( the 'initial period'), 'poorly established' if seen but a > 6-month gap in care began in the initial period, and 'established' if there were no such gaps. Of 404 patients, 11% were 'not established', 37% 'poorly established', and 53% 'established'. Injection drug use as HIV risk factor (IDU), admitted current alcohol and drug use, age <35 years, and CD4 count / = 200 cells/mm(3) were most common in the 'not established' group and least common in the 'established' group. In multivariate ordinal logistic regression, difficulty establishing care was associated with IDU, admitted current alcohol use, and admitted former drug use. Age > 35 years was protective. Half the indigent patients entering care in this single-site study fail to establish regular care. Substance use and younger age are predictors of failure to establish care. C1 Vet Affairs Med Ctr, Houston, TX 77030 USA. Harris Cty Hosp Dist, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Houston Sch Publ Hlth, Houston, TX USA. RP Giordano, TP (reprint author), Vet Affairs Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM tpg@bcm.tmc.edu OI White, A Clinton/0000-0002-9668-4632 FU NIAID NIH HHS [T32AI07456]; NIMH NIH HHS [K23MH67505] NR 23 TC 89 Z9 89 U1 0 U2 2 PU ROUTLEDGE TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0954-0121 J9 AIDS CARE JI Aids Care-Psychol. Socio-Med. Asp. Aids-Hiv PD AUG PY 2005 VL 17 IS 6 BP 773 EP 783 DI 10.1080/09540120412331336652 PG 11 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychology, Multidisciplinary; Respiratory System; Social Sciences, Biomedical SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychology; Respiratory System; Biomedical Social Sciences GA 945CI UT WOS:000230478600012 PM 16036264 ER PT J AU Gazdzinski, S Durazzo, TC Studholme, C Song, E Banys, P Meyerhoff, DJ AF Gazdzinski, S Durazzo, TC Studholme, C Song, E Banys, P Meyerhoff, DJ TI Quantitative brain MRI in alcohol dependence: Preliminary evidence for effects of concurrent chronic cigarette smoking on regional brain volumes SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol dependence; cigarette smoking; regional brain volumes; magnetic resonance; brain structure-function relationship ID WHITE-MATTER CHANGES; COGNITIVE PERFORMANCE; NICOTINE DEPENDENCE; SUBSTANCE USE; DRINKING HISTORY; ADOLESCENT BRAIN; GRAY-MATTER; AGE; ATROPHY; ADULTS AB Background: Recent in vivo research using magnetic resonance spectroscopy demonstrated that chronic cigarette smoking exacerbates regional chronic alcohol-induced brain injury. Other studies associated cigarette smoking with gray matter volume reductions in healthy adults, with greater brain atrophy in aging, and with poorer neurocognition. Although cigarette smoking is common among alcohol-dependent individuals, previous research did not account for the potential effects of chronic smoking on regional brain volumes in alcoholism. Methods: High-resolution T-1-weighted magnetic resonance images from one-week-abstinent, alcohol-dependent individuals and light drinkers were automatically segmented into gray matter, white matter, and cerebral spinal fluid of lobes and subcortical structures. A brief neuropsychological test battery was used to assess cognition in alcohol-dependent individuals. The alcoholic and nondrinking groups were retrospectively divided into chronic smokers and nonsmokers, and the volumetric data were analyzed as a function of alcohol and smoking status. Results: Chronic alcohol dependence was associated with smaller volumes of frontal and parietal white matter, parietal and temporal gray matter, and thalami, accompanied by widespread sulcal but not ventricular enlargements. Chronic cigarette smoking was associated with less parietal and temporal gray matter and with more temporal white matter. Among alcoholics, better visuospatial learning and memory and greater visuomotor scanning speed were correlated with larger lobar white matter volumes in the nonsmoking alcohol-dependent group only. Conclusions: These data provide preliminary evidence that comorbid chronic cigarette smoking accounts for some of the variance associated with cortical gray matter loss and appears to alter relationships between brain structure and cognitive functions in alcohol-dependent individuals. C1 Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. No Calif Inst Res & Educ, San Francisco, CA USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. RP Gazdzinski, S (reprint author), Univ Calif San Francisco, Dept Vet Affairs Med Ctr, 4150 Clement St 114M, San Francisco, CA 94121 USA. EM spg@itsa.ucsf.edu FU NIAAA NIH HHS [AA10788] NR 78 TC 104 Z9 105 U1 3 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD AUG PY 2005 VL 29 IS 8 BP 1484 EP 1495 DI 10.1097/01.alc.0000175018.72488.61 PG 12 WC Substance Abuse SC Substance Abuse GA 962XY UT WOS:000231767900016 PM 16131857 ER PT J AU Edwards, MS Wilson, DB Craven, TE Stafford, J Fried, LF Wong, TY Klein, R Burke, GL Hansen, KJ AF Edwards, MS Wilson, DB Craven, TE Stafford, J Fried, LF Wong, TY Klein, R Burke, GL Hansen, KJ TI Associations between retinal microvascular abnormalities and declining renal function in the elderly population: The Cardiovascular Health Study SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE retina; chronic kidney disease (CKD); microvascular; epidemiology; elderly ID DIALYSIS-FREE SURVIVAL; DIABETIC-RETINOPATHY; OLDER POPULATION; BLOOD-PRESSURE; RISK-FACTORS; ATHEROSCLEROSIS RISK; ISCHEMIC NEPHROPATHY; VESSEL DIAMETERS; SURGICAL REPAIR; HYPERTENSION AB Background: Microvascular abnormalities in the kidney are common histopathologic findings in individuals with chronic kidney disease or renal failure. These abnormalities may represent one manifestation of ongoing systemic microvascular damage. We hypothesized that retinal microvascular abnormalities, when present, would be associated with progressive renal dysfunction in elderly individuals. Methods: The Cardiovascular Health Study (CHS) is a prospective, multicenter, cohort study initiated in 1989 designed to examine cardiovascular risk factors, morbidity, and mortality in elderly Americans. As part of an ancillary study, CHS participants underwent retinal photography in 1997 and 1998. Retinal microvascular abnormalities were assessed and graded by using standardized measures. Retinal microvascular abnormalities were defined as retinopathy (hard and soft exudates, hemorrhages, or microaneurysms) and/or retinal arteriolar abnormalities (arteriovenous nicking, focal arteriolar narrowing, or lowest quartile arteriole-venule ratio). Associations between these abnormalities and observed 4-year changes in serum creatinine levels and estimated glomerular filtration rates (eGFRs) from study years 5 to 9 (encompassing years 1994 to 2001) were examined by using regression modeling. Results: A total of 1,394 CHS participants had retinal and serum creatinine data. After adjustments for age, race, sex, weight, diabetes, hypertension, angiotensin-converting enzyme inhibitor use, and proteinuria, participants with retinopathy showed a significant increase in serum creatinine level and decline in eGFR compared with those without retinopathy during the 4-year study period (+0.24 mg/dL [+21 mu mol/L] versus -0.21 mg/dL [-19 mu mol/L] and -0.48 mL/min/1.73 m(2) [-0.01 mL/s/1.73 m(2)] versus +1.74 mL/min/1.73 m(2) [+0.03 mL/s/1.73 m(2)], respectively). Participants with retinopathy also were significantly more likely to have an observed significant deterioration in renal function, defined as a 0.3-mg/dL (27-mu mol/L) increase in serum creatinine level or 20% or greater decline in eGFR (odds ratio, 3.20; 95% confidence interval, 1.58 to 6.50; and odds ratio, 2.84; 95% confidence interval, 1.56 to 5.16, respectively). These associations remained in separate stratified analyses of patients with and without diabetes. The presence of retinal arteriolar abnormalities was not associated with deteriorating renal function. Conclusion: Retinal microvascular abnormalities defined as retinopathy were significantly associated with renal function deterioration. The observed findings were independent of effects of any associated diabetes or hypertension. These findings suggest that systemic microvascular disease may be associated with progressive renal dysfunction in the elderly population. C1 Wake Forest Univ, Bowman Gray Sch Med, Dept Surg, Winston Salem, NC 27157 USA. Natl Univ Singapore, Singapore Eye Res Inst, Singapore 117548, Singapore. Univ Wisconsin, Dept Optometry & Visual Sci, Madison, WI 53706 USA. VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. RP Edwards, MS (reprint author), Wake Forest Univ, Bowman Gray Sch Med, Dept Surg, Med Ctr Blvd, Winston Salem, NC 27157 USA. EM medwards@wfubmc.edu FU NHLBI NIH HHS [N-01-HL-85079]; NIDDK NIH HHS [1-R01-DK-47414] NR 32 TC 81 Z9 83 U1 1 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD AUG PY 2005 VL 46 IS 2 BP 214 EP 224 DI 10.1053/j.ajkd.2005.05.005 PG 11 WC Urology & Nephrology SC Urology & Nephrology GA 951JM UT WOS:000230926100004 PM 16112039 ER PT J AU Stone, RA Mor, MK Lave, JR Hough, LJ Fine, MJ AF Stone, RA Mor, MK Lave, JR Hough, LJ Fine, MJ TI Implementation of an inpatient management and discharge strategy for patients with community-acquired pneumonia SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID INITIAL ANTIMICROBIAL THERAPY; ANTIBIOTIC-THERAPY; HOSPITAL STAY; EARLY SWITCH; PRACTICE GUIDELINES; MEDICAL OUTCOMES; CONTROLLED-TRIAL; LENGTH; ADULTS; DURATION AB Objective: To assess the effectiveness and safety of implementing an inpatient management and discharge strategy based on empiric antibiotic therapy with ceftriaxone sodium and a guideline to promote timely discharge for clinically stable patients hospitalized with community-acquired pneumonia. Study Design: A cluster randomized controlled clinical trial with 30 days of patient follow-up at 8 teaching hospitals and 17 nonteaching hospitals nationwide. Methods: Participants included 240 intervention patients and 209 control patients admitted by 85 physician groups between December 1998 and December 1999. Within each hospital, defined physician practice groups were randomized to the intervention arm (physician notification coupled with ceftriaxone sodium as empiric therapy) or control arm (neither component). Physicians in the intervention arm were notified when their patients met guideline criteria for clinical stability; physicians in the control arm were not contacted. Results: The median length of stay was 4 days in both study arms. The observed reduction in costs associated with the intervention was riot statistically significant when cost outliers were excluded. Mortality, serious adverse event, and rehospitalization rates did not differ significantly across study arms. Conclusions: Implementation of an inpatient management strategy based on physician reminders coupled with empiric use of ceftriaxone sodium did not reduce length of stay or associated medical care costs for patients hospitalized with community-acquired pneumonia. These negative findings are most likely due to insufficient potency of the intervention, inadequate guideline implementation, or imbalances in baseline Patient characteristics. C1 Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Hlth Policy & Management, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Div Gen Med, Dept Med, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15261 USA. VA Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Stone, RA (reprint author), Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, 304 Parran Hall, Pittsburgh, PA 15261 USA. EM roslyn@pitt.edu NR 41 TC 8 Z9 8 U1 0 U2 0 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD AUG PY 2005 VL 11 IS 8 BP 491 EP 499 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 955QX UT WOS:000231243000004 PM 16095435 ER PT J AU Kim, AI Saab, S AF Kim, AI Saab, S TI Treatment of hepatitis C SO AMERICAN JOURNAL OF MEDICINE LA English DT Review DE hepatitis C ID INTERFERON-ALPHA-2B PLUS RIBAVIRIN; HUMAN-IMMUNODEFICIENCY-VIRUS; LIVER-TRANSPLANT RECIPIENTS; PEGINTERFERON ALPHA-2A; UNITED-STATES; LONG-TERM; PEGYLATED INTERFERON-ALPHA-2B; INITIAL TREATMENT; INFECTED PATIENTS; CONTROLLED-TRIAL AB Hepatitis C virus is a leading cause of chronic liver disease, with over 170 million people infected worldwide. It is also the leading indication for liver transplantation. Complications from chronic hepatitis C infection include cirrhosis, hepatic decompensation, and hepatocellular carcinoma. As a result, treatment strategies to prevent such complications have been widely researched, although many questions remain unanswered. To date, the standard therapy for chronic hepatitis C infection is the combination of peginterferon and ribavirin. Treatment strategies differ based on factors such as genotype and liver biopsy results. Other strategies must be considered for special groups, such as patients with acute hepatitis C infection, hepatitis C/human immunodeficiency virus (HIV) coinfection, and prior nonresponse to interferon or relapse after its use. The goal of therapy is to achieve a sustained virologic response (ie, no detectable hepatitis C ribonucleic acid 6 months after completion of therapy). The substantial adverse effects associated with both interferon alfa and ribavirin often make it difficult for patients to continue with their therapies. (C) 2005 Elsevier Inc. All rights reserved. C1 W Los Angeles VA Med Ctr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90024 USA. RP Saab, S (reprint author), Pfleger Liver Inst, 200 Med Plaza,Suite 214,Box 957302, Los Angeles, CA 90095 USA. EM SSaab@mednet.ucla.edu NR 85 TC 53 Z9 60 U1 5 U2 8 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD AUG PY 2005 VL 118 IS 8 BP 808 EP 815 DI 10.1016/j.amjmed.2005.01.073 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 952WR UT WOS:000231037100002 PM 16084169 ER PT J AU McLean, DC Spruill, I Argyropoulos, G Page, GP Shriver, MD Garvey, WT AF McLean, DC Spruill, I Argyropoulos, G Page, GP Shriver, MD Garvey, WT TI Mitochondrial DNA (mtDNA) haplotypes reveal maternal population genetic affinities of sea island Gullah-speaking African Americans SO AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY LA English DT Article DE admixture; population genetic substructure; phi-statistics ID ADMIXTURE; INHERITANCE; HAPLOGROUPS; PROPORTIONS; MECHANISMS; DISTANCES; EVOLUTION; ANCIENT; NEGROES; MODELS AB To better understand the population substructure of African Americans living in coastal South Carolina, we used restriction site polymorphisms and an insertion/deletion in mitochondrial DNA (mtDNA) to construct seven-position haplotypes across 1,395 individuals from Sierra Leone, Africa, from U.S. European Americans, and from the New World African-derived populations of Jamaica, Gullah-speaking African Americans of the South Carolina Sea Islands (Gullahs), African Americans living in Charleston, South Carolina, and West Coast African Americans. Analyses showed a high degree of similarity within the New World African-derived populations, where haplotype frequencies and diversities were similar. Phi-statistics indicated that very little genetic differentiation has occurred within New World African-derived populations, but that there has been significant differentiation of these populations from Sierra Leoneans. Genetic distance estimates indicated a close relationship of Gullahs and Jamaicans with Sierra Leoneans, while African Americans living in Charleston and the West Coast were progressively more distantly related to the Sierra Leoneans. We observed low maternal European American admixture in the Jamaican and Gullah samples (m = 0.020 and 0.064, respectively) that increased sharply in a clinal pattern from Charleston African Americans to West Coast African Americans (m = 0.099 and 0.205, respectively). The appreciably reduced maternal European American admixture noted in the Gullah indicates that the Gullah may be uniquely situated to allow genetic epidemiology studies of complex diseases in African Americans with low European American admixture. (c) 2004 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Sea Isl Families Project, Charleston, SC USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Project Sugar, Charleston, SC USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Penn State Univ, Dept Anthropol, University Pk, PA 16802 USA. RP McLean, DC (reprint author), Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, 135 Cannon St,Suite 305R,POB 250835, Charleston, SC 29425 USA. EM mcleandc@musc.edu FU NIDDK NIH HHS [DK-47461] NR 35 TC 28 Z9 28 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0002-9483 J9 AM J PHYS ANTHROPOL JI Am. J. Phys. Anthropol. PD AUG PY 2005 VL 127 IS 4 BP 427 EP 438 DI 10.1002/ajpa.20047 PG 12 WC Anthropology; Evolutionary Biology SC Anthropology; Evolutionary Biology GA 947RO UT WOS:000230664100006 PM 15624208 ER PT J AU Burns, SP Rad, MY Bryant, S Kapur, V AF Burns, SP Rad, MY Bryant, S Kapur, V TI Long-term treatment of sleep apnea in persons with spinal cord injury SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article; Proceedings Paper CT 47th Annual Conference of the American-Paraplegia-Society CY SEP 05, 2001 CL Las Vegas, NV SP Amer Paraplegia Soc DE spinal cord injuries; sleep apnea syndromes; continuous positive airway pressure; patient compliance ID POSITIVE AIRWAY PRESSURE; CPAP THERAPY; APNEA/HYPOPNEA SYNDROME; NASAL CPAP; DAYTIME SLEEPINESS; HEART HEALTH; DISEASE; MEN AB Objective: Although numerous studies have documented a high prevalence of sleep apnea in persons with spinal cord injury, relatively little has been published regarding treatment of sleep apnea in this population. The purpose of this study was to describe long-term treatment outcomes and side effects of sleep apnea treatment in persons with spinal cord injury. Design: Descriptive, postal mail survey to spinal cord injury individuals with sleep apnea followed by a Veterans Affairs Spinal Cord Injury Service. Results: The response rate to the mailed survey was 54%, with complete surveys obtained from 40 individuals with spinal cord injury and sleep apnea. The majority of participants (93%) had been diagnosed with sleep apnea through routine clinical care, and patients had been diagnosed a mean of 4 yrs earlier. Continuous positive airway pressure was the most commonly used treatment. Continuous positive airway pressure was tried by 80% of patients, and of these, 63% continued to use continuous positive airway pressure, with mean usage 6.5 nights per week and 6.9 hrs per night. Continuous positive airway pressure was rated as beneficial in comparison with its side effects. The most common side effects were nasal congestion and mask discomfort. Conclusion: Many spinal cord injury individuals with sleep apnea become long-term users of continuous positive airway pressure and perceive a subjective benefit from the treatment. C1 VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv 128, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. Univ Washington, Harborview Med Ctr, Harborview Injury Prevent & Res Ctr, Seattle, WA 98104 USA. RP Burns, SP (reprint author), VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv 128, 1660 S Columbian Way, Seattle, WA 98108 USA. RI Kapur, Vishesh/K-1054-2014 OI Kapur, Vishesh/0000-0002-5417-1097 NR 30 TC 12 Z9 13 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD AUG PY 2005 VL 84 IS 8 BP 620 EP 626 DI 10.1097/01.phm.0000171008.69453.b9 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 950LO UT WOS:000230858900008 PM 16034232 ER PT J AU Jarrahy, R Huang, WB Rudkin, GH Lee, JM Ishida, K Berry, MD Sukkarieh, M Wu, BM Yamaguchi, DT Miller, TA AF Jarrahy, R Huang, WB Rudkin, GH Lee, JM Ishida, K Berry, MD Sukkarieh, M Wu, BM Yamaguchi, DT Miller, TA TI Osteogenic differentiation is inhibited and angiogenic expression is enhanced in MC3T3-E1 cells cultured on three-dimensional scaffolds SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE gene expression; osteogenesis; angiogenesis ID ENDOTHELIAL GROWTH-FACTOR; VIVO GENE-THERAPY; MARROW STROMAL CELLS; MESENCHYMAL STEM-CELLS; BONE REGENERATION; IN-VITRO; POLY(LACTIDE-CO-GLYCOLIDE) SCAFFOLDS; BIODEGRADABLE POLYMERS; MECHANICAL-PROPERTIES; OSTEOBLAST FUNCTION AB Osteogenic differentiation of osteoprogenitor cells in three-dimensional (3D) in vitro culture remains poorly understood. Using quantitative real-time RT-PCR techniques, we examined mRNA expression of alkaline phosphatase, osteocalcin, and vascular endothelial growth factor (VEGF) in murine preosteoblastic MC3T3-E1 cells cultured for 48 h and 14 days on conventional two-dimensional (2D) poly(L-lactide-coglycolide) (PLGA) films and 3D PLGA scaffolds. Differences in VEGF secretion and function between 2D and 3D culture systems were examined using Western blots and an in vitro Matrigel-based angiogenesis assay. Expression of both alkaline phosphatase and osteocalcin in cells cultured on 3D scaffolds was significantly down-regulated relative to 2D controls in 48 h and 14 day cultures. In contrast, elevated levels of VEGF expression in 3D culture were noted at every time point in short- and long-term culture. VEGF protein secretion in 3D cultures was triple the amount of secretion observed in 2D controls. Conditioned medium from 3D cultures induced an enhanced level of angiogenic activity, as evidenced by increases in branch points observed in in vitro angiogenesis assays. These results collectively indicate that MC3T3-E1 cells commit to osteogenic differentiation at a slower rate when cultured on 3D PLGA scaffolds and that VEGF is preferentially expressed by these cells when they are cultured in three dimensions. C1 Vet Adm Greater Los Angeles Healthcare Syst, Plast Surg Sect, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Surg, Div Plast Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Bioengn, Los Angeles, CA USA. RP Miller, TA (reprint author), GLAHS, Plast Surg Lab, 11301 Wilshire Blvd,Rm 221,Bldg 114, Los Angeles, CA 90073 USA. EM millerlab@hotmail.com NR 59 TC 26 Z9 27 U1 1 U2 5 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6143 J9 AM J PHYSIOL-CELL PH JI Am. J. Physiol.-Cell Physiol. PD AUG PY 2005 VL 289 IS 2 BP C408 EP C414 DI 10.1152/ajpcell.00196.2004 PG 7 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 943CB UT WOS:000230328300020 PM 16002625 ER PT J AU Chacko, BK Chandler, RT Mundhekar, A Khoo, N Pruitt, HM Kucik, DF Parks, DA Kevil, CG Barnes, S Patel, RP AF Chacko, BK Chandler, RT Mundhekar, A Khoo, N Pruitt, HM Kucik, DF Parks, DA Kevil, CG Barnes, S Patel, RP TI Revealing anti-inflammatory mechanisms of soy isoflavones by flow: modulation of leukocyte-endothelial cell interactions SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE inflammation; genistein; peroxisomal proliferator-activated receptor-gamma; atherosclerosis; monocytes ID ACTIVATED-RECEPTOR-GAMMA; AKT-DEPENDENT ACTIVATION; LOW-DENSITY-LIPOPROTEIN; CORONARY-HEART-DISEASE; NITRIC-OXIDE SYNTHASE; PHYTOESTROGEN GENISTEIN; ANTIOXIDANT PROPERTIES; PLATELET-AGGREGATION; POSTMENOPAUSAL WOMEN; ATHEROSCLEROSIS AB The antiatherogenic effects of soy isoflavone consumption have been demonstrated in a variety of studies. However, the mechanisms involved remain poorly defined. Adhesion of monocytes to vascular endothelial cells is a key step within the inflammatory cascade that leads to atherogenesis. Many factors, including the physical forces associated with blood flow, regulate this process. Using an in vitro flow assay, we report that genistein, a principal component of most isoflavone preparations, inhibits monocyte adhesion to cytokine (TNF-alpha)-stimulated human vascular endothelial cells at physiologically relevant concentrations (0-1 mu M). This effect is absolutely dependent on flow and is not observed under static conditions. Furthermore, this inhibition was dependent on activation of endothelial peroxisomal proliferator-activated receptor-gamma. No significant role for other reported properties of genistein, including antioxidant effects, inhibition of tyrosine kinases, or activation of estrogen receptors, was observed. Furthermore, the antiadhesive effects of genistein did not occur via modulation of the adhesion molecules E-selectin, ICAM-1, VCAM-1, or platelet-endothelial cell adhesion molecule-1. These data reveal a novel anti-inflammatory mechanism for isoflavones and identify the physical forces associated with blood flow and a critical mediator of this function. C1 Purdue Univ, Birmingham Bot Ctr Age Related Dis, Dept Pathol, Birmingham, AL USA. Purdue Univ, Birmingham Bot Ctr Age Related Dis, Dept Pharmacol, Birmingham, AL USA. Purdue Univ, Birmingham Bot Ctr Age Related Dis, Dept Anesthesiol, Birmingham, AL USA. Univ Alabama, Ctr Free Radical Biol, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Res Serv, Birmingham, AL USA. Louisiana State Univ, Dept Pathol, Shreveport, LA 71105 USA. RP Patel, RP (reprint author), Univ Alabama, Dept Pathol, 901 19th St S,BMR-2,Rm 307, Birmingham, AL 35294 USA. EM patel@path.uab.edu RI Kevil, Christopher/G-9318-2011 OI Patel, Rakesh/0000-0002-1526-4303 FU NCCIH NIH HHS [P50 AT-00477]; NIAID NIH HHS [R21 AI-054552]; NIEHS NIH HHS [R03 ES/DK-11504] NR 50 TC 53 Z9 56 U1 0 U2 3 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD AUG PY 2005 VL 289 IS 2 BP H908 EP H915 DI 10.1152/ajpheart.00781.2004 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 944VO UT WOS:000230458800052 PM 15805228 ER PT J AU O'Brien, CP AF O'Brien, CP TI Anticraving medications for relapse prevention: A possible new class of psychoactive medications SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 157th Annual Meeting of the American-Psychiatric-Association CY MAY 01-06, 2004 CL New York, NY SP Amer Psychiat Assoc ID PLACEBO-CONTROLLED TRIAL; OPIOID RECEPTOR GENE; RANDOMIZED CONTROLLED-TRIAL; GAMMA-VINYL-GABA; ALCOHOL DEPENDENCE; COCAINE DEPENDENCE; DOUBLE-BLIND; BETA-ENDORPHIN; CLINICAL-TRIAL; DRUG-ABUSE AB Psychiatrists have gradually developed a list of medications that are effective in the treatment of addictive disorders. Although alcoholism has received the most attention, nicotine, heroin, and cocaine have all been shown to be influenced by heredity. Of course, the immediate goal is the reduction of drug craving and the prevention of relapse to compulsive drug taking. A medication that can aid in the maintenance of the opiate-free state is naltrexone, a specific opiate antagonist. Naltrexone is also a good example of an anticraving medication used in the treatment of alcoholism. Clinicians currently have two types of medication to aid in the treatment of tobacco use disorder, arguably the most important addiction. Bupropion propion and nicotine replacement can be given in a coordinated fashion to provide the best available results. At present, no medication is approved by the Food and Drug Administration for the indication of cocaine addiction. Recently, however, five different medications, already approved for other purposes, have been found to be effective among cocaine addicts. Despite clinical trials that show benefit, anti-craving medications are not well known and are underused by clinicians. Addiction is a heterogeneous condition, with variability in reactivity to the drug of abuse and to the medications available to treat it. Recent developments in pharmacogenetics may result in improved selection of medications based on genotype. C1 Univ Penn, Treatment Res Ctr, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP O'Brien, CP (reprint author), Univ Penn, Treatment Res Ctr, Philadelphia VA Med Ctr, 3900 Chestnut St,Rm 6178, Philadelphia, PA 19104 USA. EM obrien@mail.trc.upenn.edu FU NIDA NIH HHS [DA-P50-12756, DA-P60-05186] NR 71 TC 221 Z9 226 U1 5 U2 20 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD AUG PY 2005 VL 162 IS 8 BP 1423 EP 1431 DI 10.1176/appi.ajp.162.8.1423 PG 9 WC Psychiatry SC Psychiatry GA 950LA UT WOS:000230857400004 PM 16055763 ER PT J AU Rassovsky, Y Green, MF Nuechterlein, KH Breitmeyer, B Mintz, J AF Rassovsky, Y Green, MF Nuechterlein, KH Breitmeyer, B Mintz, J TI Modulation of attention during visual masking in schizophrenia SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID CONSCIOUSNESS; MECHANISM AB Objective: Schizophrenia patients consistently demonstrate performance deficits on visual masking procedures. The present study examined whether attentional manipulation would improve subjects' performance on visual masking. Method: A metacontrast task was administered to 105 schizophrenia patients and 52 healthy comparison subjects. Attention was manipulated by associating selected trials of the task with monetary reward. Results: Schizophrenia patients exhibited poorer performance than the comparison subjects across conditions. Patients demonstrated modest, but statistically significant, improvement in performance with the attentional manipulation. This improvement was not significant for the comparison subjects. Conclusions: These findings suggest that early visual processes in schizophrenia are responsive to attentional manipulation but that the degree of improvement is relatively small, suggesting that these processes are not easily altered. C1 Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Houston, Dept Psychol, Houston, TX 77004 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Rassovsky, Y (reprint author), Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Geffen Sch Med, 760 Westwood Plaza C8-747-NPI, Los Angeles, CA 90024 USA. EM yurir@ucla.edu FU NIMH NIH HHS [MH-43292, MH-37705] NR 12 TC 27 Z9 28 U1 0 U2 1 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD AUG PY 2005 VL 162 IS 8 BP 1533 EP U8 DI 10.1176/appi.ajp.162.8.1533 PG 3 WC Psychiatry SC Psychiatry GA 950LA UT WOS:000230857400020 PM 16055778 ER PT J AU Xie, AL Skatrud, JB Khayat, R Dempsey, JA Morgan, B Russell, D AF Xie, AL Skatrud, JB Khayat, R Dempsey, JA Morgan, B Russell, D TI Cerebrovascular response to carbon dioxide in patients with congestive heart failure SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE central sleep apnea; cerebral blood flow; hypercapnia; hypocapnia ID CEREBRAL-BLOOD-FLOW; CHEYNE-STOKES RESPIRATION; CENTRAL SLEEP-APNEA; OXYGEN-SENSING NEURONS; END-TIDAL PCO2; DILATED CARDIOMYOPATHY; GRADED REDUCTION; CARDIAC-FAILURE; NERVOUS-SYSTEM; HUMANS AB Rationale: Cerebrovascular reactivity to CO2 provides an important counterregulatory mechanism that serves to minimize the change in H+ at the central chemoreceptor, thereby stabilizing the breathing pattern in the face of perturbations in Pa-CO2. However, there are no studies relating cerebral circulation abnormality to the presence or absence of central sleep apnea in patients with heart failure. Objectives: To determine whether patients with congestive heart failure and central sleep apnea have an attenuated cerebrovascular responsibility to CO2. Methods: Cerebral blood flow velocity in the middle cerebral artery was measured in patients with stable congestive heart failure with (n = 9) and without (n = 8) central sleep apnea using transcranial ultrasound during eucapnia (room air), hypercapnia (inspired CO2, 3 and 5%), and hypocapnia (voluntary hyperventilation). In addition, eight subjects with apnea and nine without apnea performed a 20-second breath-hold to investigate the dynamic cerebrovascular response to apnea. Measurements and Main Results: The overall cerebrovascular reactivity to CO2 (hyper- and hypocapnia) was lower in patients with apnea than in the control group (1.8 +/- 0.2 vs. 2.5 +/- 0.2%/mm Hg, p < 0.05), mainly due to the prominent reduction of cerebrovascular reactivity to hypocapnia (1.2 +/- 0.3 vs. 2.2 +/- 0.1%/mm Hg, p < 0.05). Similarly, brain blood flow demonstrated a smaller surge after a 20-second breath-hold (peak velocity, 119 +/- 4 vs. 141 +/- 8% of baseline, p < 0.05). Conclusion: Patients with central sleep apnea have a diminished cerebrovascular response to PETCO2, especially to hypocapnia. The compromised cerebrovascular reacticity to CO2 might affect stability of the breathing pattern by causing ventilatory overshooting during hypercapnia and undershooting during hypocapnia. C1 William S Middleton Mem Vet Adm Med Ctr, Pulm Physiol Lab, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. Univ Wisconsin, Dept Orthopaed & Rehabil, Madison, WI 53706 USA. Univ Wisconsin, Dept Populat Hlth Sci, Madison, WI 53706 USA. RP Xie, AL (reprint author), William S Middleton Mem Vet Adm Med Ctr, Pulm Physiol Lab, 2500 Overlook Terrace, Madison, WI 53705 USA. EM axie@facstaff.wisc.edu RI Khayat, Rami/E-3380-2011 NR 58 TC 81 Z9 83 U1 0 U2 3 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD AUG 1 PY 2005 VL 172 IS 3 BP 371 EP 378 DI 10.1164/rccm.200406-807OC PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 949IM UT WOS:000230778600016 PM 15901613 ER PT J AU Parimon, T Madtes, DK Au, DH Clark, JG Chien, JW AF Parimon, T Madtes, DK Au, DH Clark, JG Chien, JW TI Pretransplant lung function, respiratory failure, and mortality after stem cell transplantation SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE bone marrow transplantation; mortality; pretransplant pulmonary function tests; respiratory failure ID BONE-MARROW TRANSPLANTATION; PULMONARY-FUNCTION TESTS; VERSUS-HOST-DISEASE; CHRONIC GRAFT; VENTILATION; CAPACITY AB Rationale: The role of pulmonary function before stem cell transplant as a potential risk factor for the development of early post-transplant respiratory failure and mortality is controversial. Methods: We conducted a retrospective analysis of the pretransplant pulmonary function of 2,852 patients who received their transplant between 1990 and 2001. Measurements: Pretransplant FEV1, FVC, total lung capacity (TLC), diffusing capacity of carbon monoxide (DLCO), and the alveolar-arterial oxygen tension difference P(A-a)O-2 were measured and assessed for association with development of early respiratory failure and mortality in Cox proportional hazard logistic models. Main Results: In multivariate analyses, progressive decrease of all lung function parameters was associated with a stepwise increase in risk of developing early respiratory failure and mortality when assessed in independent models. On the basis of a significant correlation between FEV1 and FVC (r = 0.81), FEV, and TLC (r = 0.61), and FVC and TLC (r = 0.80), and a lack of correlation between FEV, and DLCO, we developed a pretransplant lung function score based on pretransplant FEV, and DLCO to determine the extent of pulmonary compromise before transplant. Multivariate analysis indicated that higher pretransplant lung function scores are associated with a significant increased risk for developing early respiratory failure (category II hazard ratio [HR], 1.4; category III HR, 2.2; category IV HR, 3.1; p < 0.001) and death (category II HR, 1.2; category III HR, 2.2; category IV HR, 2.7; p < 0.005). Conclusions: These results suggest that not only does compromised pretransplant lung function contribute to the risk for development of early respiratory failure and mortality but this risk may be estimated before transplant by grading the extent of FEV, and DLCO compromise. C1 Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA. US Dept Vet Affairs, VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. RP Chien, JW (reprint author), Fred Hutchinson Canc Res Ctr, Div Clin Res, 1100 Fairview Ave N,Suite D5-280, Seattle, WA 98109 USA. EM jchien@fhcrc.org FU NCI NIH HHS [CA15704, CA18029, CA78902, P01 CA078902]; NHLBI NIH HHS [1K23HL69860-01, 1R01 HL71914-01, HL36444] NR 22 TC 51 Z9 52 U1 0 U2 2 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD AUG 1 PY 2005 VL 172 IS 3 BP 384 EP 390 DI 10.1164/rccm.200502-212OC PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 949IM UT WOS:000230778600018 PM 15894602 ER PT J AU Darouiche, RO Berger, DH Khardori, N Robertson, CS Wall, MJ Metzler, MH Shah, S Mansouri, MD Cerra-Stewart, C Versalovic, J Reardon, MJ Raad, II AF Darouiche, RO Berger, DH Khardori, N Robertson, CS Wall, MJ Metzler, MH Shah, S Mansouri, MD Cerra-Stewart, C Versalovic, J Reardon, MJ Raad, II TI Comparison of antimicrobial impregnation with tunneling of long-term central venous catheters - A randomized controlled trial SO ANNALS OF SURGERY LA English DT Article ID BLOOD-STREAM INFECTION; BACTERIAL-RESISTANCE; IN-VITRO; PREVENTION; MINOCYCLINE; EFFICACY; RIFAMPIN; COLONIZATION; TECHNOLOGY; DEVICES AB Objective: We sought to compare the impact of antimicrobial impregnation to that of tunneling of long-term central venous catheters on the rates of catheter colonization and catheter-related bloodstream infection. Summary Background Data: Tunneling of catheters constitutes a standard of care for preventing infections associated with long-term vascular access. Although antimicrobial coating of short-term central venous catheters has been demonstrated to protect against catheter-related bloodstream infection, the applicability of this preventive approach to long-term vascular access has not been established. Methods: A prospective, randomized clinical trial in 7 university-affiliated hospitals of adult patients who required a vascular access for >= 2 weeks. Patients were randomized to receive a silicone central venous catheter that was either impregnated with minocycline and rifampin or tunneled. The occurrence of catheter colonization and catheter-related bloodstream infection was determined. Results: Of a total of 351 inserted catheters, 346 (186 antimicrobial-impregnated and 160 tunneled) were analyzed for catheter-related bloodstream infection. Clinical characteristics were comparable in the 2 study groups, but the antimicrobial-impregnated catheters remained in place for a shorter period of time (mean, 30.2 versus 43.8 days). Antimicrobial-impregnated catheters were as likely to be colonized as tunneled catheters (7.9 versus 6.3 per 1000 catheter-days). Bloodstream infection was 4 times less likely to originate from anti microbial-impregnated than from tunneled catheters (0.36 versus 1.43 per 1000 catheter-days). Conclusions: Antimicrobial impregnation of long-term central venous catheters may help obviate the need for tunneling of catheters. C1 Baylor Coll Med, Ctr Prostheses Infect, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. So Illinois Univ, Sch Med, Dept Med, Springfield, IL 62708 USA. Univ Missouri, Dept Surg, Columbia, MO USA. Univ Texas, MD Anderson Canc Ctr, Dept Infect Dis, Houston, TX 77030 USA. RP Darouiche, RO (reprint author), Baylor Coll Med, Ctr Prostheses Infect, 1333 Moursund Ave,Suite A221, Houston, TX 77030 USA. EM rdarouiche@aol.com NR 32 TC 63 Z9 65 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD AUG PY 2005 VL 242 IS 2 BP 193 EP 200 DI 10.1097/01.sla.0000171874.29934.61 PG 8 WC Surgery SC Surgery GA 950LG UT WOS:000230858000007 PM 16041209 ER PT J AU Chamlin, SL Mattson, CL Frieden, IJ Williams, ML Mancini, AJ Cella, D Chren, MM AF Chamlin, SL Mattson, CL Frieden, IJ Williams, ML Mancini, AJ Cella, D Chren, MM TI The price of pruritus - Sleep disturbance and cosleeping in atopic dermatitis SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID EUROPEAN TASK-FORCE; CONSENSUS REPORT; SCORAD INDEX; CHILDREN; ECZEMA; INFANT AB Background: Atopic dermatitis is a common skin disorder that most often begins in infancy. Sleep disturbances in children with atopic dermatitis are likely due to itching and scratching and not only impact the afflicted child but may also affect the entire family. Sleep characteristics in young children with atopic dermatitis and their families have not been thoroughly investigated. Objective: To evaluate sleep disturbance and cosleeping in young children with atopic dermatitis and evaluate the association between sleep characteristics and features of the disease. Design and Methods: Parents of 300 children ranging in age from birth to 6 years with atopic dermatitis responded to 4 questions about sleep characteristics of their child and family. Analyses determined the prevalence of reported sleep disturbance and cosleeping, and their association with features of the patients and disease severity. Results: Sleep disturbance attributed to atopic dermatitis was common; most parents (> 60%) reported that the dermatitis affected how well they or their child slept. Cosleeping because of the skin condition was reported by 30% of families, and most of these parents (66%) were bothered by the cosleeping. Sleep disturbance and cosleeping were directly associated with severity of atopic dermatitis and with the degree to which parents reported that the atopic dermatitis affected the child and family's happiness. Conclusions: Sleep disturbances were more common in children with atopic dermatitis than have been reported in children overall. These results demonstrate important sequelae of a very common childhood condition that warrant further investigation and the development of intervention strategies. C1 Childrens Mem Hosp, Div Pediat Dermatol, Chicago, IL 60614 USA. Univ Calif San Francisco, Dept Dermatol & Pediat, San Francisco, CA USA. San Francisco Vet Affairs Med Ctr, Serv Dermatol, San Francisco, CA USA. Northwestern Univ, Feinberg Sch Med, Evanston Northwestern Healthcare, Ctr Outcomes Res & Educ, Evanston, IL USA. RP Chamlin, SL (reprint author), Childrens Mem Hosp, Div Pediat Dermatol, Chicago, IL 60614 USA. EM schamlin@childrensmemorial.org OI Frieden, Ilona/0000-0001-7305-5940 NR 15 TC 62 Z9 63 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD AUG PY 2005 VL 159 IS 8 BP 745 EP 750 DI 10.1001/archpedi.159.8.745 PG 6 WC Pediatrics SC Pediatrics GA 951RR UT WOS:000230948900008 PM 16061782 ER PT J AU Khanna, D Ranganath, VK FitzGerald, J Park, GS Altman, RD Elashoff, D Gold, RH Sharp, JT Furst, DE Paulus, HE AF Khanna, D Ranganath, VK FitzGerald, J Park, GS Altman, RD Elashoff, D Gold, RH Sharp, JT Furst, DE Paulus, HE CA Western Consortium Practicing Rheu TI Increased radiographic damage scores at the onset of seropositive rheumatoid arthritis in older patients are associated with osteoarthritis of the hands, but not with more rapid progression of damage SO ARTHRITIS AND RHEUMATISM LA English DT Article ID COLLEGE-OF-RHEUMATOLOGY; DISEASE-ACTIVITY; UNITED-STATES; AGE; PREVALENCE; YOUNGER; ABNORMALITIES; DEFINITION; VALIDITY; SEX AB Objective. To investigate the impact of patient age at symptom onset on radiographic joint damage at study entry, and on subsequent progression of damage in a cohort of patients with early seropositive rheumatoid arthritis (RA). Methods. We studied 186 patients with RA of < 15 months' duration. All patients had active disease and had not received disease-modifying antirheumatic drugs. At study entry and during followup, total Sharp scores (TSS), RA-associated joint space narrowing (RA-JSN), and erosions were determined on hand and foot radiographs. Baseline radiographs were also scored for osteoarthritis (OA)-related JSN (OA-JSN) and osteophytes. Older patients (> 55 years) and younger patients (<= 55 years) were compared by t-test, Mann-Whitney U test, chi-square, or Fisher's exact test. Multiple linear regression models were also constructed. Results. The older group (n = 74) had a higher baseline total Sharp score (median 6.21) compared with the younger group (n = 112) (median 2.33) (P = 0.0002). This was mainly due to a higher baseline JSN score in the older group (median 3.96 versus 1.08) and not to differences in erosion score (median 0.91 versus 0.70). Disease activity and duration of RA symptoms were similar in the 2 groups, as were progression rates of the TSS, JSN score, and erosion score. At baseline, 26% of patients had osteophytes, with a prevalence of 13% in the younger age group and 50% in the older group. The presence of OA-JSN was highly correlated with the presence of osteophytes (r = 0.72). Also, increased age and RA-JSN were associated with increased severity of osteophytes and OA-JSN at baseline. Multiple linear regression analysis showed that both age and hand osteophytes contributed to the increase in baseline RA-JSN score and TSS, but not to erosion score. Conclusion. In a cohort of patients with early RA, an increase in the baseline RA-JSN score and TSS can be accounted for in part by the presence of hand OA. C1 Univ Cincinnati, Dept Med, Div Immunol, Cincinnati, OH 45267 USA. VAMC, Cincinnati, OH 45267 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Washington, Seattle, WA 98195 USA. RP Khanna, D (reprint author), Univ Cincinnati, Dept Med, Div Immunol, 231 Albert Sabin Way,ML0563,POB 670563, Cincinnati, OH 45267 USA. EM dinesh.khanna@uc.edu NR 34 TC 18 Z9 18 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD AUG PY 2005 VL 52 IS 8 BP 2284 EP 2292 DI 10.1002/art.21221 PG 9 WC Rheumatology SC Rheumatology GA 953LW UT WOS:000231078800010 PM 16052588 ER PT J AU Castellon, SA Silverman, DHS Ganz, PA AF Castellon, SA Silverman, DHS Ganz, PA TI Breast cancer treatment and cognitive functioning: current status and future challenges in assessment SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Editorial Material DE adjuvant therapy; breast cancer; chemotherapy; cognitive functioning; late effects; neuroimaging; neuropsychological ID QUALITY-OF-LIFE; RECEIVING ADJUVANT CHEMOTHERAPY; POSTTRAUMATIC-STRESS-DISORDER; HIPPOCAMPAL VOLUME; ALZHEIMERS-DISEASE; ENTORHINAL CORTEX; HORMONE-THERAPY; LONG-TERM; WOMEN; TAMOXIFEN C1 Univ Calif Los Angeles, David Geffen Sch Med, Neuropsychiat Inst & Hosp, Los Angeles, CA 90024 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Div Canc Prevent & Control Res, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Castellon, SA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Neuropsychiat Inst & Hosp, 760 Westwood Plaza,Room C8-747, Los Angeles, CA 90024 USA. EM scastell@ucla.edu NR 47 TC 24 Z9 24 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD AUG PY 2005 VL 92 IS 3 BP 199 EP 206 DI 10.1007/s10549-005-5342-0 PG 8 WC Oncology SC Oncology GA 963LQ UT WOS:000231806200001 PM 16155790 ER PT J AU Hussein, MR Ahmed, RA AF Hussein, MR Ahmed, RA TI Analysis of the mononuclear inflammatory cell infiltrate in the non-tumorigenic, pre-tumorigenic and tumorigenic keratinocytic hyperproliferative lesions of the skin SO CANCER BIOLOGY & THERAPY LA English DT Article DE inflammatory cells; actinic keratosis; squamous cell carcinoma ID PSORIASIS; EXPRESSION; ANTIGENS AB Background: The keratinocytic hyperproliferative lesions include non-tumorigenic, pre-tumorigenic (actinic keratoses, AK), and tumorigenic (squamous cell carcinomas, SCC) conditions. Although mononuclear inflammatory cell infiltrate (MICs) is a constant feature in these lesions, their immunophenotypic characterization is still incomplete. We hypothesized that the development of non-tumorigenic, pre-tumorigenic, and tumorigenic keratinocytic hyperproliferative lesions is associated with alterations in the mononuclear inflammatory cell infiltrate in response to altered antigenicity of the lesional cells. This study tries to test this hypothesis and to characterize MICs in these lesions. Methods: Fifty lesions (non-tumorigenic lesions, 29; AK, 9 and SCC, 12) were examined using immunoperoxidase staining methods and antibodies targeting histiocytes (CD68), T cells (CD3), B cells (CD20), and T cells with cytotoxic potential (TIA-1). Results: As compared to the normal skin, the development of the keratinocytic hyperproliferative lesions (normal skin; non-tumorigenic; AK and SCC) was associated with a statistically significant increase(p = < 0.05) in: (1) CD20(+) B lymphocytes (0.0 +/- 0.0 vs. 3.1 +/- 0.5 vs. 7.5 +/- 0.3 vs. 14.5 +/- 5.5); (2) CD68 histiocytes (4.0 +/- 1.0 vs. 26.5 +/- 3.9 vs. 23 +/- 1.9 vs. 41.3 +/- 6.8); (3) CD3(+) T lymphocytes (3.0 +/- 1.1 vs. 58.3 +/- 10.3 vs. 54.5 +/- 0.2 vs. 41.0 +/- 16.0); and (4) TIA-1(+) cytotoxic T cells (1.8 +/- 0.4 vs. 2.9 +/- 0.7 vs. 9.6 +/- 1.1 vs. 13.7 +/- 5.2). Conclusions: The increase in the number of infiltrating mononuclear cells in all pathologic lesions compared to normal skin may reflect increased antigenicity of the lesional cells. Both humoral and cell mediated immunity are involved in these lesions. C1 Assiut Univ, Assiut Univ Hosp, Fac Med, Dept Pathol, Assiut, Egypt. Univ Wisconsin, Sch Med, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Assiut Univ Hosp, Fac Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 15 TC 26 Z9 26 U1 0 U2 1 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD AUG PY 2005 VL 4 IS 8 BP 819 EP 821 PG 3 WC Oncology SC Oncology GA 022GK UT WOS:000236043200012 PM 16210913 ER PT J AU Lieberman, DA Holub, J Eisen, G Kraemer, D Morris, CD AF Lieberman, DA Holub, J Eisen, G Kraemer, D Morris, CD TI Prevalence of polyps greater than 9 mm in a consortium of diverse clinical practice settings in the United States SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID FECAL OCCULT-BLOOD; COLORECTAL-CANCER; ASYMPTOMATIC ADULTS; TASK-FORCE; COLONOSCOPY; RISK; AGE; GUIDELINES; CARCINOMA; ADENOMAS AB Background & Aims: Colonoscopy is often performed with the goal of identification of patients with serious colon neoplasia. We determined the prevalence of colon masses or polyps greater than 9 mm on the basis of age, gender, race, and procedure indication in diverse clinical practice settings and compared occurrence in patients receiving colonoscopy for screening, surveillance, or evaluation of symptoms. Methods: We obtained patient demographics, procedure indication, and endoscopic findings from colonoscopy reports in the Clinical Outcomes Research Initiative data repository, which receives endoscopy reports from 73 diverse practice sites in the United States. A multivariate model was developed to measure risk variables for a mass or polyps >9 mm. Absolute risk was calculated in the model on the basis of the number needed to endoscope (NNE) to identify 1 patient with a mass or polyp >9 mm. Results: From 2000-2002, colonoscopies in 141,413 unique patients were analyzed. Sixty-nine percent of the reports came from private practice (nonacademic) settings. Increasing age, male gender, and black race were associated with increased risk of mass or polyps >9 mm. In the 50- to 59-year-old average-risk group, 28 women and 18 men would need to have screening colonoscopy to identify 1 patient with a mass/polyp >9 mm. Patients with positive fecal occult blood test results, hematochezia, and anemia had lower NNE, whereas men older than 60 years receiving adenoma surveillance and patients with irritable bowel symptoms had similar NNE compared with average-risk subjects. Conclusions: The prevalence of a colon lesion >9 mm varies on the basis of age, gender, race, and procedure indication. Understanding utilization and outcomes can lead to more optimal use of colonoscopy. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA. RP Lieberman, DA (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol, P3-GI,1037 SW Vet Hosp Rd, Portland, OR 97239 USA. EM lieberma@ohsu.edu FU NCI NIH HHS [U01 CA 89389-01]; NIDDK NIH HHS [R33-DK61778-01] NR 30 TC 56 Z9 56 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 AUG PY 2005 VL 3 IS 8 BP 798 EP 805 DI 10.1053/S1542-3565(05)00405-2 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 995MZ UT WOS:000234105700014 PM 16234009 ER PT J AU Sigg, D Rich, R Ashby, S Jabour, B Glass, E AF Sigg, D Rich, R Ashby, S Jabour, B Glass, E TI Radionuclide shuntogram demonstrating migration of distal ventriculoperitoneal shunt tubing out of the peritoneal cavity SO CLINICAL NUCLEAR MEDICINE LA English DT Editorial Material DE hydrocephalus; cisternogram; ventriculoperitoneal shunt; In-111 DTPA; scintigraphy ID COILING AB An 81-year-old man with a history of ventriculoperitoneal (V-P) shunt placement for symptomatic normal pressure hydrocephalus presented with recurrence of confusion and gait disturbance. Radionuclide cisternography demonstrated loculation of In-111 DTPA in the abdominal wall. A soft tissue mass palpated at the location of tracer accumulation was confirmed to be extraperitoneal pooling of fluid at the site of coiling of the distal shunt tip. After surgical revision, with repositioning of the distal tube in the peritoneal cavity, the patient's symptoms promptly improved. When symptoms of hydrocephalus recur after successful V-P shunt placement, shunt malfunction should be suspected and evaluation for mechanical failure pursued. Catheter migration should be recognized as a correctable cause of shunt malfunction. C1 Med Imaging Ctr So Calif, Santa Monica, CA USA. RP Glass, E (reprint author), W Los Angeles VAMC, Nucl Med Serv 115, 11301 Wilshire Blvd, Los Angeles, CA USA. EM edwin.glass@med.va.gov NR 9 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD AUG PY 2005 VL 30 IS 8 BP 552 EP 554 DI 10.1097/01.rlu.0000170041.00657.fe PG 3 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 947GL UT WOS:000230631300007 PM 16024953 ER PT J AU Ranganath, VK Furst, DE AF Ranganath, VK Furst, DE TI Disease-modifying antirheumatic drug use in the elderly rheumatoid arthritis patient SO CLINICS IN GERIATRIC MEDICINE LA English DT Article ID LOW-DOSE METHOTREXATE; DOUBLE-BLIND; CONTROLLED TRIAL; CLINICAL-TRIAL; ETANERCEPT ENBREL(R); PULSE METHOTREXATE; 2ND-LINE DRUGS; OLDER PATIENTS; EFFICACY; THERAPY AB During the 10-year period since the last review was done by Gardner and Furst, studies have furthered our knowledge of use of disease-modifying antirheumatic drugs (DMARDs) in the elderly rheumatoid arthritis (RA) patient. This article will briefly review the clinical pharmacology of human as they age, and detail the effects of aging on the specific pharmacokinetics and responses to commonly used DMARDs. There has been some progress in understanding the elderly RA patient, however, there is insufficient data for much confidence in DMARDs effects in the elderly. C1 Univ Calif Los Angeles, Dept Med, Div Rheumatol, David Geffen Sch Med, Los Angeles, CA 90025 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Furst, DE (reprint author), Univ Calif Los Angeles, Dept Med, Div Rheumatol, David Geffen Sch Med, 1000 Vet Ave,Room 32-59, Los Angeles, CA 90025 USA. EM defurst@mednet.ucla.edu NR 89 TC 3 Z9 3 U1 1 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0749-0690 EI 1879-8853 J9 CLIN GERIATR MED JI Clin. Geriatr. Med. PD AUG PY 2005 VL 21 IS 3 BP 649 EP + DI 10.1016/j.cger.2005.02.010 PG 22 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 940FE UT WOS:000230128300012 PM 15911212 ER PT J AU Whitsel, EA Boyko, EJ Rautaharju, PM Raghunathan, TE Lin, DY Pearce, RM Weinmann, SA Siscovick, DS AF Whitsel, EA Boyko, EJ Rautaharju, PM Raghunathan, TE Lin, DY Pearce, RM Weinmann, SA Siscovick, DS TI Electrocardiographic QT interval prolongation and risk of primary cardiac arrest in diabetic patients SO DIABETES CARE LA English DT Article ID RECOGNIZED HEART-DISEASE; SUDDEN CORONARY DEATH; AUTONOMIC NEUROPATHY; MYOCARDIAL-INFARCTION; UNITED-STATES; CRITERIA; WOMEN; TIME C1 Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA. Univ N Carolina, Dept Med, Chapel Hill, NC USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Wake Forest Univ, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. Univ N Carolina, Dept Biostat, Chapel Hill, NC USA. Kaiser Permanente, Portland, OR USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Whitsel, EA (reprint author), Bank Amer Ctr, Dept Epidemiol, Cardiovasc Dis Program, Suite 306,137 E Franklin St, Chapel Hill, NC 27514 USA. EM ewhitsel@email.unc.edu OI Boyko, Edward/0000-0002-3695-192X FU NHLBI NIH HHS [5-T32-HL07055, HL-42456-03] NR 29 TC 27 Z9 30 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD AUG PY 2005 VL 28 IS 8 BP 2045 EP 2047 DI 10.2337/diacare.28.8.2045 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 950PP UT WOS:000230869700036 PM 16043757 ER PT J AU Simpson, TL Kivlahan, DR Bush, KR McFall, ME AF Simpson, TL Kivlahan, DR Bush, KR McFall, ME TI Telephone self-monitoring among alcohol use disorder patients in early recovery: a randomized study of feasibility and measurement reactivity SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE daily monitoring; feasibility; alcohol use disorders; PTSD ID POSTTRAUMATIC-STRESS-DISORDER; ECOLOGICAL MOMENTARY ASSESSMENT; SUBSTANCE USE DISORDERS; TIMELINE FOLLOW-BACK; MAJOR MENTAL-ILLNESS; TREATED ALCOHOLICS; DRINKING PATTERNS; CONSUMPTION; ABUSE; PTSD AB Frequent symptom self-monitoring protocols have become popular tools in the addiction field. Interactive Voice Response (IVR) is a telephone monitoring system that has been shown to be feasible for collecting frequent self-reports from a variety of research populations. Little is known, however, about the feasibility of using IVR monitoring in clinical samples, and few controlled trials exist assessing the impact of any type of frequent self-report monitoring on the behaviors monitored. This pilot study with patients in early recovery from an alcohol use disorder (n =98) evaluated compliance with two IVR monitoring protocols, subjective experiences with monitoring, and change in symptoms associated with monitoring (i.e., measurement reactivity). Participants were randomly assigned to call an IVR system daily for 28 days, once per week for 4 weeks, or only to complete 28-day follow-up assessment including retrospective drinking reports. Monitoring calls assessed alcohol craving, substance use, emotional well-being, and PTSD symptoms. Most monitoring participants completed calls on at least 75% of scheduled days (72.2% and 59.2% for daily and weekly, respectively). Including reconstructed data from follow-up of missed calls yielded 77.8% and 74.1% of maximum data points, respectively. Most monitoring participants indicated the protocol was manageable and reported positive or no effects of monitoring on urges to use alcohol, actual drinking, and PTSD symptoms. Analyses of measurement reactivity based on assessment one month after randomization found no significant group differences on drinking, craving for alcohol, or PTSD-related symptoms. Results suggest that IVR technology is feasible and appropriate for telephone symptom monitoring in similar clinical samples. Published by Elsevier Ireland Ltd. C1 Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Simpson, TL (reprint author), Mental Illness Res Educ & Clin Ctr, VISN 20, Seattle, WA 98108 USA. EM tracy.simpson@med.va.gov NR 50 TC 51 Z9 51 U1 1 U2 9 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD AUG 1 PY 2005 VL 79 IS 2 BP 241 EP 250 DI 10.1016/j.drugalcdep.2005.02.001 PG 10 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 949OB UT WOS:000230796900013 PM 16002033 ER PT J AU Krupitsky, EM Horton, NJ Williams, EC Lioznov, D Kuznetsova, M Zvartau, E Samet, JH AF Krupitsky, EM Horton, NJ Williams, EC Lioznov, D Kuznetsova, M Zvartau, E Samet, JH TI Alcohol use and HIV risk behaviors among HIV infected hospitalized patients in St. Petersburg, Russia SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE HIV risk; alcohol abuse; Russia ID INCONSISTENT CONDOM USE; INJECTION-DRUG USERS; SEXUAL-BEHAVIOR; CONSUMPTION; PREVALENCE; DEPENDENCE; EXPECTANCIES; TRANSMISSION; STUDENTS; MEN AB Purpose: Russia has high per capita alcohol consumption and an injection-drug-use-driven HIV epidemic. However, the role of alcohol in the spread of HIV infection in Russia is largely unexplored. Thus, we assessed recent alcohol use and associated HIV risk behaviors among HIV-infected persons in St. Petersburg, Russia. Methods: we recruited HIV-infected hospitalized patients from the Botkin Irfectious Disease Hospital between June 2001 and March 2002. Interviewers assessed alcohol and drug use with the addiction severity index (ASI) and sex- and drug-risk behaviors with the risk assessment battery (RAB). Lifetime abuse or dependence diagnoses for alcohol and drugs were established by a physician with addiction medicine training. Results: Among 201 subjects, diagnoses of abuse or dependence (AB/DEP) were common: 9% (19/201) had only alcohol AB/DEP; 39% (78/201) had alcohol and drug AB/DEP; 47% (95/201) had only drug AWDEP; and 4% (9/201) had no diagnosis of alcohol or drug AB/DEP. Sex- and drug-risk behaviors varied significantly by substance use diagnosis. Subjects with any alcohol AB/DEP had higher sex-risk RAB scores than those with drug only AB/DEP (6.1 versus 3.9, p <.0001). Among subjects with any diagnosis of drug AB/DEP, having in addition an alcohol diagnosis was associated with unclean needle use in the last six months (33% (26/78) versus 21% (20/95), p=0.08). Conclusions: Lifetime alcohol diagnoses of abuse or dependence were present in nearly one-half of hospitalized HIV-infected patients in St. Petersburg. Russia and were associated with significantly higher sex-risk behaviors and borderline significantly higher drug-risk behaviors. As HIV infection spreads rapidly in Russia and Eastern Europe, these data support the need for HIV risk-reduction interventions in alcohol abusing populations and raise the potential of benefit by addressing alcohol use in HIV-infected populations. (c) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Boston Univ, Med Ctr, Dept Med, Sect Gen Internal Med,CARE, Boston, MA 02118 USA. St Petersburg State Pavlov Med Univ, St Petersburg Sci Res Ctr Addict & Psychopharmaco, St Petersburg 197089, Russia. Boston Univ, Sch Med, Boston, MA 02118 USA. Smith Coll, Dept Math, Northampton, MA 01063 USA. Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA 02118 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Treatment & Educ, Seattle, WA 98108 USA. RP Samet, JH (reprint author), Boston Univ, Med Ctr, Dept Med, Sect Gen Internal Med,CARE, Boston, MA 02118 USA. EM jsamet@bu.edu RI Horton, Nicholas/A-2493-2008; Lioznov, Dmitry/J-2539-2013 OI Lioznov, Dmitry/0000-0003-3643-7354; Samet, Jeffrey/0000-0002-0897-3400; Horton, Nicholas/0000-0003-3332-4311 FU NIAAA NIH HHS [R01 AA011785, R01-AA11785] NR 41 TC 27 Z9 27 U1 3 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD AUG 1 PY 2005 VL 79 IS 2 BP 251 EP 256 DI 10.1016/j.drugalcdep.2005.01.015 PG 6 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 949OB UT WOS:000230796900014 PM 16002034 ER PT J AU Calon, F Lim, GP Morihara, T Yang, FS Ubeda, O Salem, N Frautschy, SA Cole, GM AF Calon, F Lim, GP Morihara, T Yang, FS Ubeda, O Salem, N Frautschy, SA Cole, GM TI Dietary n-3 polyunsaturated fatty acid depletion activates caspases and decreases NMDA receptors in the brain of a transgenic mouse model of Alzheimer's disease SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article ID LONG-TERM POTENTIATION; DOCOSAHEXAENOIC ACID; LIPID-PEROXIDATION; NEURODEGENERATIVE DISORDERS; NEUROFIBRILLARY TANGLES; PRECURSOR PROTEIN; OXIDATIVE STRESS; BETA-PEPTIDE; APOPTOSIS; DEMENTIA AB Epidemiological data indicate that low n-3 polyunsaturated fatty acids (PFA) intake is a readily manipulated dietary risk factor for Alzheimer's disease (AD). Studies in animals confirm the deleterious effect of n-3 PFA depletion on cognition and on dendritic scaffold proteins. Here, we show that in transgenic mice overexpressing the human AD gene APPswe (Tg2576), safflower oil-induced n-3 PFA deficiency caused a decrease in N-methyl-D-aspartate (NMDA) receptor subunits, NR2A and NR2B, in the cortex and hippocampus with no loss of the presynaptic markers, synaptophysin and synaptosomal-associated protein 25 (SNAP-25). n-3 PFA depletion also decreased the NR1 subunit in the hippocampus and Ca(2+)/calmodulin-dependent protein kinase (CaMKII) in the cortex of Tg2576 mice. These effects of dietary n-3 PFA deficiency were greatly amplified in Tg2576 mice compared to nontransgenic mice. Loss of the NR2B receptor subunit was not explained by changes in mRNA expression, but correlated with p85 alpha phosphatidylinositol 3-kinase levels. Most interestingly, n-3 PFA deficiency dramatically increased levels of protein fragments, corresponding to caspase/calpain-cleaved fodrin and gelsolin in Tg2576 mice. This effect was minimal in nontransgenic mice suggesting that n-3 PFA depletion potentiated caspase activation in the Tg2576 mouse model of AD. Dietary supplementation with docosahexaenoic acid (DHA; 22 : 6n-3) partly protected from NMDA receptor subunit loss and accumulation of fodrin and gelsolin fragments but fully prevented CaMKII decrease. The marked effect of dietary n-3 PFA on NMDA receptors and caspase/calpain activation in the cortex of an animal model of AD provide new insights into how dietary essential fatty acids may influence cognition and AD risk. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. NIAAA, Sect Nutr Neurosci, Lab Membrane Biochem & Biophys, Div Intramural Clin & Biol Res,NIH, Rockville, MD 20852 USA. RP Cole, GM (reprint author), Vet Adm Med Ctr, Greater Los Angeles Healthcare Syst, 16111 Plummer St,Bldg 7,Room A102, North Hills, CA 91343 USA. EM gmcole@ucla.edu FU NCCIH NIH HHS [R01 AT003008]; NIA NIH HHS [AG13471, AG10685, AG16793, P50 AG016570, R01 AG010685, R01 AG013741]; NINDS NIH HHS [NS43946] NR 84 TC 144 Z9 155 U1 1 U2 17 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD AUG PY 2005 VL 22 IS 3 BP 617 EP 626 DI 10.1111/j.1460-9568.2005.04253.x PG 10 WC Neurosciences SC Neurosciences & Neurology GA 954IE UT WOS:000231147700008 PM 16101743 ER PT J AU Sangeorzan, BJ Beskin, JL Britt, SM Brage, M Holt, S Kadel, NJ Legro, MW Sands, AK SooHoo, NF Stroud, CC AF Sangeorzan, BJ Beskin, JL Britt, SM Brage, M Holt, S Kadel, NJ Legro, MW Sands, AK SooHoo, NF Stroud, CC TI Issues of importance to patients seeking care from members of the AOFAS: A preliminary report of the outcomes committee of the AOFAS SO FOOT & ANKLE INTERNATIONAL LA English DT Article DE AOFAS members; outcomes ID OSTEOARTHRITIS; QUALITY; TRIALS; ANKLE; WANT AB Background. The purpose of this multi-center study was to examine the outcomes of importance for patients seeking treatment for foot and ankle disorders. An improved understanding of patient outcome preferences will assist surgeons in improving patient satisfaction. Methods: An open-ended priority function questionnaire was administered to 235 patients presenting as new patients to five different outpatient locations. The questionnaire was designed to identify activities of importance to patients and was based on the McMaster Toronto Arthritis (MACTAR) patient preference disability questionnaire. Subjects were asked to list the specific activities that were limited by their condition. Open-ended answers were written on five blank spaces and then ranked as to their importance. The visual analog pain scale was recorded as a measure of the severity of the patient's symptoms at the time the response was made. The outpatient settings were two university hospitals, two private offices with academic affiliation, and one private office. Two hundred thirty-five surveys were collected between September and November of 2000; 227 surveys were acceptable for analysis. The respondents included 132 females (58.1%), 94 males (41.4%) and one patient who did not specify his gender (0.4%). The mean age was 45.8 (range 18 to 83) years. Results: Average pain at the time of assessment was 2.7 on a scale of 0 to 9 and was reported to increase to 4.8 in a typical day. The most frequently ranked limitations were difficulty with walking (1159), running (73), standing (55), and exercise (54). Walking also was the issue ranked as the highest priority (77 of 159), while running (111 of 73), standing (110 of 55) and exercise (3 of 54) were assigned lesser priority values. Only 68 of 227 respondents failed to list walking as an issue. Work, sleep, and social activities were not commonly cited as issues of importance. Conclusion: Patients presenting to off ice practices identified as specializing in foot and ankle disorders are predominantly middle-aged women in mild to moderate pain. Walking is the function most frequently identified as a problem and ranked as the highest priority for improvement. Social limitations were unlikely to be named as a limitation in this population. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98109 USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98195 USA. Peachtree Orthopaed Clin, Atlanta, GA USA. Univ Calif San Diego, San Diego, CA 92103 USA. St Vincents Med Ctr, New York, NY USA. Univ Calif Los Angeles, Los Angeles, CA USA. Orthopaed & Spine Surg Troy, Troy, MI USA. RP Britt, SM (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,MS 151, Seattle, WA 98109 USA. EM sarah.britt@med.va.gov NR 15 TC 5 Z9 5 U1 0 U2 0 PU AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC PI SEATTLE PA 2517 EASTLAKE AVE EAST, STE 200, SEATTLE, WA 98102 USA SN 1071-1007 J9 FOOT ANKLE INT JI Foot Ankle Int. PD AUG PY 2005 VL 26 IS 8 BP 638 EP 644 PG 7 WC Orthopedics SC Orthopedics GA 949SI UT WOS:000230808000012 PM 16115422 ER PT J AU Satoh, A Gukovskaya, AS Edderkaoui, M Daghighian, MS Reeve, JR Shimosegawa, T Pandol, SJ AF Satoh, A Gukovskaya, AS Edderkaoui, M Daghighian, MS Reeve, JR Shimosegawa, T Pandol, SJ TI Tumor necrosis factor-alpha mediates pancreatitis responses in acinar cells via protein kinase C and proline-rich tyrosine kinase 2 SO GASTROENTEROLOGY LA English DT Article ID KAPPA-B ACTIVATION; INDUCED APOPTOSIS; HUMAN NEUTROPHILS; PKC-DELTA; IN-VIVO; CHOLECYSTOKININ; PYK2; CYTOSKELETON; RAT; SRC AB Background & Aims: Although tumor necrosis factor alpha is implicated as an important mediator of the inflammatory response in acute pancreatitis, its role in other pathologic features of the disease remains unknown. We investigated the role for tumor necrosis factor alpha in cytoskeletal responses and the underlying signaling mechanisms in pancreatic acinar cells. Methods: In isolated rat pancreatic acini and AR42J cells, we determined the effect of tumor necrosis factor (x on the actin cytoskeleton by rhodamine-phalloidin. Using pharmacological and molecular approaches, we assessed the involvement of protein kinase C, Src kinases, and proline-rich tyrosine kinase 2 in the process. We also studied the involvement of these signaling pathways in tumor necrosis factor-alpha-induced nuclear factor-kappa B activation and apoptosis. Results: Tumor necrosis factor-alpha increased the tyrosine phosphorylation of proline-rich tyrosine kinase 2 in acinar cells. The broad-spectrum protein kinase C inhibitor and the Src kinase inhibitor both inhibited tumor necrosis factor-alpha-induced proline-rich tyrosine kinase 2 phosphorylation, but at different tyrosine residues. Using protein kinase C isoform-specific inhibitors and the antisense approach, we showed that protein kinase C delta and epsilon mediate proline-rich tyrosine kinase 2 tyrosine phosphorylation. Tumor necrosis factor-alpha caused disorganization of the actin cytoskeleton by a mechanism dependent on protein kinase C, Src kinases, and proline-rich tyrosine kinase 2. Inhibition of protein kinase C, but not Src kinases, decreased tumor necrosis factor-alpha-induced apoptosis. Furthermore, with antisense transfections, we showed that protein kinase C delta and epsilon, but not proline-rich tyrosine kinase 2, mediate tumor necrosis factor alpha-induced nuclear factor-kappa B activation. Conclusions: Tumor necrosis factor-alpha activates proline-rich tyrosine kinase 2 to cause cytoskeletal disorganization and nuclear factor-kappa B to cause inflammatory response, and it triggers cell death signaling through divergent mechanisms mediated by protein kinase C. The results provide insights into the mechanisms in pancreatic acinar cells that link tumor necrosis factor alpha to critical processes in acute pancreatitis. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, W Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Tohoku Univ, Grad Sch Med, Div Gastroenterol, Sendai, Miyagi 980, Japan. RP Gukovskaya, AS (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, W Los Angeles Healthcare Ctr, Bldg 258,Room 340,11301 Willshire Blvd, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NIAAA NIH HHS [1 U56 AA 0114643]; NIDDK NIH HHS [DK-59508]; PHS HHS [P50-A11999] NR 51 TC 34 Z9 37 U1 0 U2 2 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD AUG PY 2005 VL 129 IS 2 BP 639 EP 651 DI 10.1053/j.gastro.2005.05.005 PG 13 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 953IU UT WOS:000231070600025 PM 16083718 ER PT J AU Jensen, DM Gornbein, J AF Jensen, DM Gornbein, J TI Liver transplantation is a time dependent prognostic predictor in cirrhotic patients with esophageal varices - Reply SO GASTROENTEROLOGY LA English DT Letter C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Dept Med,VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Biomath, Los Angeles, CA 90024 USA. RP Jensen, DM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Dept Med,VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD AUG PY 2005 VL 129 IS 2 BP 770 EP 770 DI 10.1053/j.gastro.2005.06.041 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 953IU UT WOS:000231070600043 ER PT J AU Fung, CH Elliott, MN Hays, RD Kahn, KL Kanouse, DE McGlynn, EA Spranca, MD Shekelle, PG AF Fung, CH Elliott, MN Hays, RD Kahn, KL Kanouse, DE McGlynn, EA Spranca, MD Shekelle, PG TI Patients' preferences for technical versus interpersonal quality when selecting a primary care physician SO HEALTH SERVICES RESEARCH LA English DT Article DE quality; health care; primary care; physician profiling ID PLAN PERFORMANCE INFORMATION; HEALTH-CARE; CONSUMER ASSESSMENT; PSYCHOMETRIC PROPERTIES; DIFFERENCE; PRIORITIES; RATINGS; IMPACT AB Objective. To assess patients' use of and preferences for information about technical and interpersonal quality when using simulated, computerized health care report cards to select a primary care provider (PCP). Data Sources/Study Setting. Primary data collected from 304 adult consumers living in Los Angeles County in January and February 2003. Study Design/Data Collection.We constructed computerized report cards for seven pairs of hypothetical individual PCPs (two internal validity check pairs included). Participants selected the physician that they preferred. A questionnaire collected demographic information and assessed participant attitudes towards different sources of report card information. The relationship between patient characteristics and number of times the participant selected the physician who excelled in technical quality are estimated using an ordered logit model. Principal Findings. Ninety percent of the sample selected the dominant physician for both validity checks, indicating a level of attention to task comparable with prior studies. When presented with pairs of physicians who varied in technical and interpersonal quality, two-thirds of the sample (95 percent CI: 62, 72 percent) chose the physician who was higher in technical quality at least three out of five times (one-sample binomial test of proportion). Age, gender, and ethnicity were not significant predictors of choosing the physician who was higher in technical quality. Conclusions. These participants showed a strong preference for physicians of high technical quality when forced to make tradeoffs, but a substantial proportion of the sample preferred physicians of high interpersonal quality. Individual physician report cards should contain ample information in both domains to be most useful to patients. C1 RAND Corp, Santa Monica, CA 90407 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Fung, CH (reprint author), RAND Corp, 1776 Main St,M5N, Santa Monica, CA 90407 USA. RI Hays, Ronald/D-5629-2013 NR 43 TC 51 Z9 51 U1 1 U2 6 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 2005 VL 40 IS 4 BP 957 EP 977 DI 10.1111/j.1475-6773.2005.00395.x PG 21 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 942OT UT WOS:000230292400002 PM 16033487 ER PT J AU Volpp, KGM Ketcham, JD Epstein, AJ Williams, SV AF Volpp, KGM Ketcham, JD Epstein, AJ Williams, SV TI The effects of price competition and reduced subsidies for uncompensated care on hospital mortality SO HEALTH SERVICES RESEARCH LA English DT Article DE quality of health care; health care markets; hospital competition; mortality ID MARKET-STRUCTURE; MANAGED CARE; NEW-JERSEY; COST; QUALITY; PROGRAM AB Objective. To determine whether hospital mortality rates changed in New Jersey after implementation of a law that changed hospital payment from a regulated system based on hospital cost to price competition with reduced subsidies for uncompensated care and whether changes in mortality rates were affected by hospital market conditions. Data Source/Study Setting. State discharge data for New Jersey and New York from 1990 to 1996. Study Design. We used an interrupted time series design to compare risk-adjusted in-hospital mortality rates between states over time. We compared the effect sizes in markets with different levels of health maintenance organization penetration and hospital market concentration and tested the sensitivity of our results to different approaches to defining hospital markets. Data Collection/Extraction Methods. The study sample included all patients under age 65 admitted to New Jersey or New York hospitals with stroke, hip fracture, pneumonia, pulmonary embolism, congestive heart failure, hip fracture, or acute myocardial infarction (AMI). Principal Findings. Mortality among patients in New Jersey improved less than in New York by 0.4 percentage points among the insured (p=.07) and 0.5 percentage points among the uninsured (p=.37). There was a relative increase in mortality for patients with AMI, congestive heart failure, and stroke, especially for uninsured patients with these conditions, but not for patients with the other four conditions we studied. Less competitive hospital markets were significantly associated with a relative decrease in mortality among insured patients. Conclusions. Market-based reforms may adversely affect mortality for some conditions but it appears the effects are not universal. Insured patients in less competitive markets fared better in the transition to price competition. C1 Philadelphia Vet Affairs Med Ctr Univ & Woodlands, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Arizona State Univ, Casey Sch Business, Tempe, AZ 85287 USA. Yale Univ, Sch Med, New Haven, CT 06520 USA. RP Volpp, KGM (reprint author), Philadelphia Vet Affairs Med Ctr Univ & Woodlands, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. NR 38 TC 16 Z9 16 U1 1 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 2005 VL 40 IS 4 BP 1056 EP 1077 DI 10.1111/j.1475-6773.2005.00396.x PG 22 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 942OT UT WOS:000230292400007 PM 16033492 ER PT J AU Mims, MP Prchal, JT AF Mims, MP Prchal, JT TI Divalent metal transporter 1 SO HEMATOLOGY LA English DT Article DE iron metabolism; microcytic anemia; alternative splicing; tissue specific mRNA processing; Nramp2 ID DUODENAL IRON TRANSPORTERS; BELGRADE B RAT; MICROCYTIC ANEMIA; HEREDITARY HEMOCHROMATOSIS; SUBCELLULAR-LOCALIZATION; DEPENDENT REGULATION; MEDIATED REGULATION; DMT1 NRAMP2/DCT1; ERYTHROID-CELLS; ION TRANSPORTER AB In the last few years, the field of iron metabolism has exploded with the discovery of many new proteins including ferroportin, hephaestin, hepcidin, duodenal cytochrome b and the topic of this review, divalent metal ion transporter 1 (DMT1). DMT1 fimctions in transport of ferrous iron, and some, but not all divalent metal ions across the plasma membrane and/or out of the endosomal compartment. DMT1 mRNA has been found in every cell type in which it has been sought and its structure is highly conserved in evolution with similar proteins expressed in plants, insects, microorganisms and vertebrate animals. Rodents with defects in iron absorption and utilization were identified long before it was determined that the defect was due to a single nucleotide mutation in DMT1. Study of these animals reveals that transport of iron and other divalent metal ions by DMT1 is pH dependent, but the exact manner in which pH exerts its effect is unknown. The structure of the DMT1 gene is complex. Alternative usage of 3' exons, results in forms with and without iron responsive elements (IREs), while alternative usage of 5' exons and less well defined products of alternative splicing results in an array of isoforms with incompletely defined function. Expression of some isoforms is tissue specific and appears to affect subcellular targeting of the protein. At least one signal for DMT1 expression appears to be intracellular iron status,, however, other, as yet undefined signals may also contribute to DMT1 expression. Interestingly, DMT1 function may differ subtly between humans and other animals; the spontaneous DMT1 mutation found in mice and rats appears to limit iron uptake in the intestine and iron utilization in red cell precursors, whereas the only known human mutation has its primary effect on iron utilization by erythroid cells. The importance of DMT1 function at the level of the whole organism and the individual cell and mechanisms of its regulation on a molecular scale are only beginning to be understood; an appreciation of these process will lead to an understanding of the role of iron in various cellular processes and improved treatments for both anemia and iron-overload. C1 Baylor Coll Med, Dept Med, Div Hematol Oncol, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. RP Mims, MP (reprint author), Baylor Coll Med, Dept Med, Div Hematol Oncol, 1 Baylor Plaza Room 802E, Houston, TX 77030 USA. EM mmims@bcm.tmc.edu FU NHLBI NIH HHS [R01 HL 50077-11] NR 61 TC 61 Z9 63 U1 3 U2 16 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1024-5332 J9 HEMATOLOGY JI Hematology PD AUG PY 2005 VL 10 IS 4 BP 339 EP 345 DI 10.1080/10245330500093419 PG 7 WC Hematology SC Hematology GA 956KO UT WOS:000231298800012 PM 16085548 ER PT J AU Smith, PD Ochsenbauer-Jambor, C Smythies, LE AF Smith, PD Ochsenbauer-Jambor, C Smythies, LE TI Intestinal macrophages: unique effector cells of the innate immune system SO IMMUNOLOGICAL REVIEWS LA English DT Review ID INFLAMMATORY-BOWEL-DISEASE; HUMAN-IMMUNODEFICIENCY-VIRUS; GROWTH-FACTOR-BETA; LAMINA PROPRIA LYMPHOCYTES; REGULATORY T-CELLS; CROHNS-DISEASE; QUANTITATIVE-ANALYSIS; TARGETED DISRUPTION; MUCOSAL MACROPHAGES; NEGATIVE REGULATION AB The gastrointestinal mucosa is the largest reservoir of macrophages in the body. These important effector cells are derived from blood monocytes that are recruited to the lamina propria by endogenous chemoattractants in the non-inflamed mucosa and by inflammatory chemokines and bacterial products during inflammation. In the non-inflamed mucosa, newly recruited pro-inflammatory monocytes are exposed to lamina propria stromal (extracellular matrix) factors that induce phenotypic and functional differentiation into non-inflammatory macrophages. As a consequence of this differentiation, resident lamina propria macrophages are strikingly downregulated for the expression of innate response receptors, such as the receptors for lipopolysaccharide, immunoglobulin G (IgG), and IgA, and the production of pro-inflammatory cytokines, including interleukin-1 (IL-1), IL-6, IL-8, and tumor necrosis factor-alpha. Despite downregulated pro-inflammatory function, strong phagocytic and bactericidal activities remain intact. Thus, in the non-inflamed intestinal mucosa, lamina propria macrophages are non-inflammatory but retain avid scavenger and host defense functions, a unique but ideal phenotype and functional profile for effector cells in close proximity to immunostimulatory microorganisms and products. C1 Univ Alabama, Dept Med Gastroenterol & Hepatol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Smith, PD (reprint author), Univ Alabama, Dept Med Gastroenterol & Hepatol, 703,19th St S, Birmingham, AL 35294 USA. EM pdsmith@uab.edu FU NICHD NIH HHS [HD-41361]; NIDCR NIH HHS [DE-16005]; NIDDK NIH HHS [DK-47322, DK-54495, DK-64400] NR 66 TC 129 Z9 138 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0105-2896 J9 IMMUNOL REV JI Immunol. Rev. PD AUG PY 2005 VL 206 BP 149 EP 159 DI 10.1111/j.0105-2896.2005.00288.x PG 11 WC Immunology SC Immunology GA 949VW UT WOS:000230817200010 PM 16048547 ER PT J AU Cullen, PA Xu, XY Matsunaga, J Sanchez, Y Ko, AI Haake, DA Adler, B AF Cullen, PA Xu, XY Matsunaga, J Sanchez, Y Ko, AI Haake, DA Adler, B TI Surfaceome of Leptospira spp. SO INFECTION AND IMMUNITY LA English DT Article ID OUTER-MEMBRANE PROTEINS; PATHOGENIC LEPTOSPIRA; LIPOPOLYSACCHARIDE ANTIGENS; MONOCLONAL-ANTIBODIES; MAMMALIAN INFECTION; EXPOSED LIPOPROTEIN; MASS-SPECTROMETRY; MOLECULAR-CLONING; SEQUENCE-ANALYSIS; INTERROGANS AB The identification of the subset of outer membrane proteins exposed on the surface of a bacterial cell (the surfaceome) is critical to understanding the interactions of bacteria with their environments and greatly narrows the search for protective antigens of extracellular pathogens. The surfaceome of Leptospira was investigated by biotin labeling of viable leptospires, affinity capture of the biotinylated proteins, two-dimensional gel electrophoresis, and mass spectrometry (MS). The leptospiral surfaceome was found to be predominantly made up of a small number of already characterized proteins, being in order of relative abundance on the cell surface: LipL32 > LipL21 > LipL41. Of these proteins, only LipL32 had not been previously identified as surface exposed. LipL32 surface exposure was subsequently verified by three independent approaches: surface immunofluorescence, whole-cell enzyme-linked immunosorbent assay (ELISA), and immunoelectron microscopy. Three other proteins, Q8F8Q0 (a putative transmembrane outer membrane protein) and two proteins of 20 kDa and 55 kDa that could not be identified by MS, one of which demonstrated a high degree of labeling potentially representing an additional, as-yet-uncharacterized, surface-exposed protein. Minor labeling of p31(LipL45), GroEL, and FlaB1 was also observed. Expression of the surfaceome constituents remained unchanged under a range of conditions investigated, including temperature and the presence of serum or urine. Immunization of mice with affinity-captured surface components stimulated the production of antibodies that bound surface proteins from heterologous leptospiral strains. The surfaceomics approach is particularly amenable to protein expression profiling using small amounts of sample (< 10(7) cells) offering the potential to analyze bacterial surface expression during infection. C1 Monash Univ, Dept Microbiol, Victorian Bioinformat Consortium, Australian Bacterial Pathogenesis Program, Clayton, Vic 3800, Australia. Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Brazilian Minist Hlth, Oswaldo Cruz Fdn, Goncalo Moniz Res Ctr, Salvador, BA, Brazil. Cornell Univ, Weil Med Coll, Div Int Med & Infect Dis, New York, NY 10021 USA. RP Adler, B (reprint author), Monash Univ, Dept Microbiol, Victorian Bioinformat Consortium, Australian Bacterial Pathogenesis Program, Clayton, Vic 3800, Australia. EM Ben.Adler@med.monash.edu.au RI Ko, Albert/P-2343-2015 OI Ko, Albert/0000-0001-9023-2339 FU NIAID NIH HHS [R01 AI034431-08, AI-01605, AI-34431, R01 AI034431, R21 AI034431, R29 AI034431] NR 42 TC 115 Z9 124 U1 0 U2 8 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD AUG PY 2005 VL 73 IS 8 BP 4853 EP 4863 DI 10.1128/IAI.73.8.4853-4863.2005 PG 11 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 949BT UT WOS:000230760600044 PM 16040999 ER PT J AU Menzies, BE Kenoyer, A AF Menzies, BE Kenoyer, A TI Staphylococcus aureus infection of epidermal keratinocytes promotes expression of innate antimicrobial peptides SO INFECTION AND IMMUNITY LA English DT Article ID EPITHELIAL-CELLS; BETA-DEFENSINS; GENE; DIFFERENTIATION; CALCIUM; HBD-2; ACID AB Keratinocytes upregulate expression of endogenous antimicrobial peptides in response to inflammatory stimuli. We show that both viable and heat-inactivated Staphylococcus aureus and lipoteichoic acid differentially alter expression of these peptides upon contact with human keratinocytes. The findings indicate a diversity of staphylococcal factors involved in upregulation of antimicrobial peptide expression in cutaneous epithelia. C1 Vet Affairs Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Univ Washington, Div Allergy & Infect Dis, Seattle, WA 98195 USA. RP Menzies, BE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Med Res Serv, S-111-ID,1660 S Columbian Way, Seattle, WA 98108 USA. EM bmenzies@u.washington.edu NR 15 TC 36 Z9 36 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD AUG PY 2005 VL 73 IS 8 BP 5241 EP 5244 DI 10.1128/IAI.73.8.5241-5244.2005 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 949BT UT WOS:000230760600093 PM 16041048 ER PT J AU Schumacher, HR AF Schumacher, HR TI Why I do research SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Article ID REITERS-SYNDROME; EARLY ARTHRITIS; CHLAMYDIA-TRACHOMATIS; IDENTIFICATION; SYNOVITIS; CRYSTALS; ANTIGEN; DISEASE; JOINTS C1 Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), VA Med Ctr, 151-K Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM schumacher@mail.med.upenn.edu NR 17 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD AUG PY 2005 VL 11 IS 4 BP 228 EP 232 DI 10.1097/01.rhu.0000173617.98775.8d PG 5 WC Rheumatology SC Rheumatology GA 956CM UT WOS:000231276500011 PM 16357764 ER PT J AU Kolasinski, SL Garfinkel, M Tsai, AG Matz, W Van Dyke, A Schumacher, HR AF Kolasinski, SL Garfinkel, M Tsai, AG Matz, W Van Dyke, A Schumacher, HR TI Iyengar yoga for treating symptoms of osteoarthritis of the knees: A pilot study SO JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE LA English DT Article ID IMPACT MEASUREMENT SCALES; HEALTH-STATUS; CLINICAL-TRIALS; EXERCISE; ARTHRITIS; HIP; THERAPY; RECOMMENDATIONS; INTERVENTION; DISABILITY AB Objectives: The American College of Rheumatology (ACR) Guidelines for the medical management of osteoarthritis (OA) emphasize the use of nonpharmacologic interventions including exercise. Implementation of an exercise program can be difficult for patients, and little is known about the benefits of alternative therapies such as yoga. The aim of this pilot study was to assess the feasibility of using yoga in the tradition of B.K.S. Iyengar to treat the symptoms of osteoarthritis of the knee. Design: Participants were instructed in modified Iyengar yoga postures during 90-minute classes once weekly for 8 weeks. Subjects: Participants met ACR criteria for osteoarthritis of the knee and completed a medical history and physical examination, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Arthritis Impact Measurement Scale 2 (AIMS2), Patient Global Assessment (GA) by Visual Analog Scale (VAS), Physician GA by VAS, and 50-foot Walk Time before and following an 8-week course of yoga instruction. Eleven (11) subjects enrolled, nine completed at least one session and seven (six of whom were obese) had data from pre- and post-course time points available for analysis. Results: Statistically significant reductions in WOMAC Pain, WOMAC Physical Function, and AIMS2 Affect were observed when participants' status were compared to their pre-course status. WOMAC Stiffness, AIMS2 Symptoms, Social and Role, Physician GA, and Patient GA measured trends in improvement of symptoms. No adverse events from treatment were reported. Conclusions: This pilot study suggests that yoga may provide a feasible treatment option for previously yoga-naive, obese patients > 50 years of age and offers potential reductions in pain and disability caused by knee OA. Future studies should compare yoga to other nonpharmacologic interventions for knee OA, such as patient education or quadriceps-strengthening exercises. C1 Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. BKS Iyengar Yoga Studio Philadelphia, Philadelphia, PA USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Kolasinski, SL (reprint author), Univ Penn, Sch Med, Div Rheumatol, 504 Maloney Bldg,36th & Spruce Bldg, Philadelphia, PA 19104 USA. EM sharonk@mail.med.upenn.edu NR 23 TC 69 Z9 72 U1 0 U2 11 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 AUG PY 2005 VL 11 IS 4 BP 689 EP 693 DI 10.1089/acm.2005.11.689 PG 5 WC Integrative & Complementary Medicine SC Integrative & Complementary Medicine GA 961SE UT WOS:000231681300017 PM 16131293 ER PT J AU Trautner, BW Hull, RA Darouiche, RO AF Trautner, BW Hull, RA Darouiche, RO TI Colicins prevent colonization of urinary catheters SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE bacteriocins; UTIs; uropathogens ID INFECTION; BACTERIOCINS AB Objectives: Natural microbial defence systems, such as bacteriocins, may be a novel means to prevent catheter-associated urinary tract infection. We investigated in vitro whether a colicin-expressing strain of Escherichia, coli could prevent urinary catheter colonization by a colicin-susceptible, uropathgenic strain of E. coli. Methods: Segments of urinary catheter were inoculated with colicin-producing E. coli K-12 and then exposed to either colicin-susceptible E. coli (a uropathogenic clinical isolate) or colicin-resistant E. coli (derived from the susceptible clinical isolate). Catheters were then incubated overnight, rinsed and sonicated. Results: The presence of colicin-producing E. coli K-12 on the catheter surface completely prevented catheter colonization by colicin-susceptible E. coli but not by resistant E. coli. The colicin-susceptible strain but not the colicin-resistant strain also disappeared from broth cultures in the presence of colicin-producing E. coli K-12. Conclusions: The observed inhibition of catheter colonization by the uropathogenic clinical isolate of E. coli can be attributed to the presence of a colicin-producing strain of E. coli on the catheter surface. Bacteriocin production by a non-pathogenic organism may have clinical applicability as a means to prevent catheter-associated urinary tract infection. C1 Baylor Coll Med, Infect Dis Sect, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Baylor Coll Med, Ctr Prostheses Infect, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Trautner, BW (reprint author), MEDVAMC, Spinal Cord Injury 128, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM trautner@bcm.tmc.edu FU NICHD NIH HHS [K23 HD042014, K23 HD042014-02, K23 HD042014-01, K23 HD042014-03, HD42014] NR 10 TC 20 Z9 24 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD AUG PY 2005 VL 56 IS 2 BP 413 EP 415 DI 10.1093/jac/dki228 PG 3 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 953QK UT WOS:000231094000030 PM 15980093 ER PT J AU Baker, DW Asch, SM Keesey, JW Brown, JA Chan, KS Joyce, G Keeler, EB AF Baker, DW Asch, SM Keesey, JW Brown, JA Chan, KS Joyce, G Keeler, EB TI Differences in education, knowledge, self-management activities, and health outcomes for patients with heart failure cared for under the chronic disease model: The improving chronic illness care evaluation SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE chronic care; quality improvement; self-management ID HOSPITAL READMISSION; CONTROLLED-TRIAL; COMMUNICATION; QUESTIONNAIRE; FRAMEWORK AB Background: The objective of this study was to determine whether participation in a quality improvement (QI) collaborative for heart failure (HF) was associated with better interpersonal aspects of care and health outcomes. Methods and Results: We conducted a cross-sectional telephone survey of patients in 6 organizations who participated in a QI collaborative for HF (participants, n = 387) and 6 comparable control organizations (controls, n = 414) and measured provider-patient communication, education received, knowledge of HE, self-management behaviors, satisfaction, and quality of life. The participant group patients were more likely to report their doctor and nurse discussed treatment options and reviewed self-management (P <.01 for both). A total of 88% of participants were told to weigh themselves daily and record their weight compared with 34% of controls (P <.01). Participants were more likely to know how often to check their weight (P <.01), recognize symptoms of worsening HF (P <=.01 for all), have a scale (P =.002), and monitor their weight daily (P <.001). Participants had similar quality of life but fewer emergency department visits and hospitalizations. Conclusion: Participation in a QI collaborative for HF was associated with better communication, education, and knowledge, and lower health care use. Collaboratives may be a useful method for disseminating quality improvement strategies. C1 Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med, Dept Med, Chicago, IL 60611 USA. RAND Corp, Hlth Program, Santa Monica, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. RP Baker, DW (reprint author), Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med, Dept Med, 676 N St Clair,Suite 200, Chicago, IL 60611 USA. NR 23 TC 36 Z9 40 U1 2 U2 10 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2005 VL 11 IS 6 BP 405 EP 413 DI 10.1016/j.cardfail.2005.03.010 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 961DZ UT WOS:000231643400001 PM 16105630 ER PT J AU Luther, SA McCullough, PA Havranek, EP Rumsfeld, JS Jones, PG Heidenreich, PA Peterson, ED Rathore, SS Krumholz, HM Weintraub, WS Spertus, JA Masoudi, FA AF Luther, SA McCullough, PA Havranek, EP Rumsfeld, JS Jones, PG Heidenreich, PA Peterson, ED Rathore, SS Krumholz, HM Weintraub, WS Spertus, JA Masoudi, FA CA Cardiovascular Outcomes Res Consor TI The relationship between B-type natriuretic peptide and health status in patients with heart failure SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE heart failure; natriuretic peptides; health status ID QUALITY-OF-LIFE; 6-MINUTE WALK TEST; FUNCTIONAL-CAPACITY; MORTALITY; IMPACT; QUESTIONNAIRE; RELIABILITY; PREDICTOR; MORBIDITY; PRESSURE AB Background: Although B-type natriurefic peptide (BNP) levels have been proposed as a means of assessing disease severity in patients with heart failure. it is not known if BNP levels are correlated with health status (symptom burden, functional limitation, and quality of life), Methods and Results: We studied 342 outpatients with systolic heart failure from 14 centers at baseline and 6 +/- 2 weeks with BNP levels and the Kansas City Cardioniyopathy Questionaire (KCCQ). a heart-failure-specific health status instrument. We assessed the correlation between KCCQ scores and BNP at baseline and changes in KCCQ according to changes in BNP levels between baseline and follow-up, Mean baseline BNP levels were 379 +/- 387 pg/mL and mean KCCQ summary,cores were 62 2 23 points. Although baseline BNP and KCCQ were both associated with New York Heart Association classification (P <.001 for both), BNP and KCCQ were not correlated (r(2) - 0,008, P = .15). There was no significant relationship between changes in BNP and KCCQ regardless of the threshold used to define a clinically meaningful BNP change. For example, using > 50% BNP change threshold, KCCQ improved by 3.7 +/- 14.2 in patients with decreasing BNR improved by 1.7 +/- 13.6 in patients with no BNP change. and improved by 1.0 +/- 13.4 in patients with increasing BNP (P =.6). Conclusion: BNP and health status are not correlated in outpatients with heart failure in the short term, This suggests that these measures may assess different aspects of heart failure severity, and that physiologic measures do not reflect patients ' perceptions of the impact of heart failure on their health status. C1 Denver Hlth Med Ctr, Div Cardiol MC 0960, Dept Med, Denver, CO 80204 USA. Denver VA Med Ctr, Dept Med, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. William Beaumont Hosp, Dept Med, Royal Oak, MI 48072 USA. Univ Missouri, Mid Amer Heart Inst, Kansas City, MO 64110 USA. VA Palo Alto Hlth Care Syst, Dept Med, Palo Alto, CA USA. Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. Yale Univ, Sch Med, Dept Med, New Haven, CT 06510 USA. Yale Univ, Sch Med, MD PhD Training Program, New Haven, CT 06510 USA. Yale Univ, Sch Med, Sect Hlth Policy & Adm, Dept Epidemiol & Publ Hlth, New Haven, CT 06510 USA. Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. Emory Univ, Dept Med, Atlanta, GA 30322 USA. RP Masoudi, FA (reprint author), Denver Hlth Med Ctr, Div Cardiol MC 0960, Dept Med, 777 Bannock St, Denver, CO 80204 USA. OI Heidenreich, Paul/0000-0001-7730-8490 FU NIA NIH HHS [AG01011, K08-AG01011]; NIGMS NIH HHS [GM07205] NR 35 TC 27 Z9 30 U1 0 U2 1 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2005 VL 11 IS 6 BP 414 EP 421 DI 10.1016/j.cardfail.2005.02.004 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 961DZ UT WOS:000231643400002 PM 16105631 ER PT J AU Corvera-Tindel, TE Doering, LV Dracup, K AF Corvera-Tindel, TE Doering, LV Dracup, K TI Impact of age on functional status, moods and quality of life in patients with heart failure SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 9th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 18-21, 2005 CL Boca Raton, FL SP Heart Failure Soc Amer C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. Univ Calif San Francisco, Sch Nursing, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2005 VL 11 IS 6 SU S MA 318 BP S174 EP S175 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 962PV UT WOS:000231745600319 ER PT J AU Sayers, SL Hanrahan, N Kutney, AM Clark, S Reis, B Riegel, B AF Sayers, SL Hanrahan, N Kutney, AM Clark, S Reis, B Riegel, B TI Comorbid mental disorder among patients hospitalized with heart failure SO JOURNAL OF CARDIAC FAILURE LA English DT Meeting Abstract CT 9th Annual Scientific Meeting of the Heart-Failure-Society-of-America CY SEP 18-21, 2005 CL Boca Raton, FL SP Heart Failure Soc Amer C1 Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. Widener Univ, Inst Grad Clin Psychol, Chester, PA 19013 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD AUG PY 2005 VL 11 IS 6 SU S MA 283 BP S165 EP S165 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 962PV UT WOS:000231745600284 ER PT J AU Goodarzi, MO Wong, H Quinones, MJ Taylor, KD Guo, XQ Castellani, LW Antoine, HJ Yang, HY Hsueh, WA Rotter, JI AF Goodarzi, MO Wong, H Quinones, MJ Taylor, KD Guo, XQ Castellani, LW Antoine, HJ Yang, HY Hsueh, WA Rotter, JI TI The 3 ' untranslated region of the lipoprotein lipase gene: Haplotype structure and association with post-heparin plasma lipase activity SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CORONARY-ARTERY-DISEASE; 3'-UNTRANSLATED REGION; INSULIN-RESISTANCE; TRANSLATIONAL REGULATION; MYOCARDIAL-INFARCTION; MEXICAN-AMERICANS; BLOOD-PRESSURE; MESSENGER-RNA; LPL GENE; POPULATION AB Context: Haplotypes comprising six single nucleotide polymorphisms (SNPs) (intron 7 to intron 9) of the lipoprotein lipase (LPL) gene appear to influence risk for atherosclerosis and insulin resistance in Mexican-Americans. Objective: Based on rodent studies, we hypothesized that these haplotypes are in linkage disequilibrium with functional variants in the 3' untranslated region of LPL, which is encoded by exon 10, and that these variants influence phenotype by altering LPL expression. Design: We sequenced exon 10 in subjects with divergent insulin sensitivity and divergent haplotypes. We also sequenced the other common LPL haplotypes. Variants identified by sequencing were genotyped in a large, family-based population along with the six SNPs spanning intron 7 to intron 9. We tested the potential functional significance of variation in exon 10 by evaluating association of haplotypes with post-heparin plasma LPL activity. Setting: The study took place within the general community, with the Mexican-American Coronary Artery Disease Project cohort. Participants: Participants included 847 subjects from 163 families. Main Outcome Measures: We determined LPL haplogenotype and post-heparin plasma LPL activity. Results: Exon 10 sequencing identified 15 variants. Thirteen of these variants were genotyped in large-scale along with the six SNPs spanning intron 7 to intron 9. LPL haplotypes and their relative frequencies in Mexican-Americans were determined. The fourth most common haplotype based on 19 SNPs (haplotype 19-4) was associated with increased LPL activity as well as multiple phenotypes related to the metabolic syndrome. Conclusions: These results support the possibility that variation in the 3' untranslated region of LPL affects LPL expression and activity, consequently influencing risk of atherosclerosis and insulin resistance, and provides important tools for further dissection of LPL regulation. C1 Cedars Sinai Med Ctr, Div Endocrinol Diabet & Metab, Dept Med, Los Angeles, CA 90048 USA. Cedars Sinai Med Ctr, Inst Med Genet, Los Angeles, CA 90048 USA. Univ Calif Los Angeles, Lipid Res Lab, Vet Affairs Greater Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Div Endocrinol, Los Angeles, CA 90025 USA. Univ Calif Los Angeles, Div Diabet & Hypertens, Los Angeles, CA 90025 USA. Univ Calif Los Angeles, Div Cardiol, Dept Med, David Geffen Sch Med, Los Angeles, CA 90025 USA. RP Goodarzi, MO (reprint author), Cedars Sinai Med Ctr, Div Endocrinol Diabet & Metab, Dept Med, 8700 Beverly Blvd,Becker B-128, Los Angeles, CA 90048 USA. EM mark.goodarzi@cshs.org OI Antoine, Heath/0000-0002-1914-3576 FU NHLBI NIH HHS [HL-28481, HL-60030] NR 40 TC 22 Z9 24 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 AUG PY 2005 VL 90 IS 8 BP 4816 EP 4823 DI 10.1210/jc.2005-0389 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 953HZ UT WOS:000231068500058 PM 15928243 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI How to predict the future - (Outcome of gastrointestinal disease) SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Review DE confidence interval; epidemiology; prognosis; risk factors; statistics AB This short review is aimed to illustrate three simple rules to predict the outcome of a gastrointestinal disease. The first rule relates to the principle of WYSIWYG, that is, "what you see is what you get." To predict the future of a given digestive disease, the gastroenterologist needs to pay close attention to its present appearance and develop clear understanding of its pathophysiology. To delineate future trends, as a second rule, the gastroenterologist needs to delineate past trends and try to extrapolate them into the near future. Third, the length of the past medical history also provides a reliable estimate for the expected future lifetime of a gastrointestinal disease. These rules enable gastroenterologists to enlighten themselves, as well as their patients, about the future outcome of a given gastrointestinal disease. C1 Portland VA Med Ctr, Gastroenterol Sect, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, Gastroenterol Sect, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 7 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD AUG PY 2005 VL 39 IS 7 BP 570 EP 571 DI 10.1097/01.mcg.0000170738.36263.7b PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 950NK UT WOS:000230863900003 PM 16000922 ER PT J AU Dombrovski, AY Mulsant, BH Haskett, RF Prudic, J Begley, AE Sackeim, HA AF Dombrovski, AY Mulsant, BH Haskett, RF Prudic, J Begley, AE Sackeim, HA TI Predictors of remission after electroconvulsive therapy in unipolar major depression SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID TREATMENT-RESISTANT DEPRESSION; RANDOMIZED CONTROLLED-TRIAL; SHORT-TERM RESPONSE; MEDICATION RESISTANCE; CONTINUATION PHARMACOTHERAPY; CLINICAL-RESPONSE; MENTAL-HEALTH; RATING-SCALE; ECT RESPONSE; FOLLOW-UP AB Context: Electroconvulsive therapy (ECT) is the most effective biological treatment for major depression. However, there is little agreement about clinically useful predictors of acute ECT outcomes. Objective: To assess whether age, sex, burden of comorbid physical illness, age at onset, history of recurrence, episode duration, chronic depression or comorbid dysthymia, melancholic features, episode severity, and medication resistance are predictors of remission after an acute course of ECT. Design: We performed an analysis using data gathered prospectively in 328 patients with unipolar major depression (according to Research Diagnostic Criteria) treated with ECT. The study was conducted from 1993 through 1999. Patients had a pretreatment score of 21 or higher on the 24-item Hamilton Rating Scale for Depression (HAM-D). Treatment history was assessed using the Antidepressant Treatment History Form. Remission was defined as a 24-item HAM-D score of 10 or less and a 60% or more relative reduction of the HAM-D score. Results: On univariate logistic regression, statistically significant predictors of nonremission were chronic depression/dysthymia, medication resistance, longer episode duration, and younger age. On backward elimination logistic regression, only medication resistance (OR = 1.67, 95% CI = 1.05 to 2.67) and chronic depression/dysthymia (OR = 1.84, 95% CI = 1.06 to 3.21) were statistically significant predictors of nonremission. Conclusions: In patients with major depression, lower rates of remission after acute ECT are associated with medication resistance and chronicity, but not with age or burden of physical illness. C1 Univ Pittsburgh, Sch Med, WPIC, Dept Psychiat, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Syst, GRECC, Pittsburgh, PA USA. Columbia Univ, Coll Phys & Surg, New York, NY USA. New York State Psychiat Inst & Hosp, New York, NY 10032 USA. RP Mulsant, BH (reprint author), Univ Pittsburgh, Sch Med, WPIC, Dept Psychiat, 3811 OHara St,E837, Pittsburgh, PA 15213 USA. EM mulsantbh@upmc.edu OI Dombrovski, Alexandre/0000-0002-2054-4772 FU NIMH NIH HHS [MH48512, MH01613, MH30915, MH52247] NR 62 TC 65 Z9 67 U1 0 U2 2 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD AUG PY 2005 VL 66 IS 8 BP 1043 EP 1049 PG 7 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 957AK UT WOS:000231341400013 PM 16086621 ER PT J AU Beresford, TP Clapp, L Martin, B Wiberg, JL Alfers, J Beresford, HF AF Beresford, TP Clapp, L Martin, B Wiberg, JL Alfers, J Beresford, HF TI Aripiprazole in schizophrenia with cocaine dependence - A pilot study SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Article ID SUBSTANCE-ABUSE; RELIABILITY; HALOPERIDOL; OLANZAPINE; PSYCHOSIS; ALCOHOL; SYSTEM AB The debilitation of schizophrenia (SCHZ) worsens markedly with comorbid cocaine dependence (CD) and alcohol abuse. To date, no medications have conclusively demonstrated effects against both SCHZ and CD (SCHZ + CD) simultaneously. Because of its dopamine-modulating properties, we hypothesized that aripiprazole would alleviate cocaine craving in patients with SCHZ + CD. We conducted a prospective, 8-week, open-label trial in poorly compliant SCHZ + CD subjects. Each received aripiprazole as their sole neuroleptic agent at a maximum dose of 15 mg/d. The Brief Psychiatric Rating Scale (BPRS) and the Brief Substance Craving Scale (BSCS) measured psychosis and subjective cocaine and alcohol cravings. Urine tests for cocaine provided data on actual use. Of 10 male subjects entered, 6 (60%) completed the 8-week trial. In those cases, positive urine tests dropped significantly (P < 0.001) after 2 weeks, when aripiprazole had reached steady state. Mean cocaine craving scores declined significantly (P = 0.026) as did mean alcohol craving scores (P = 0.006). Declining psychosis scores were associated with declining cocaine craving (r = 0.87, P < 0.01) and alcohol craving (r = 0.88, P < 0.01), respectively. This experience suggests possible aripiprazole effects in lowering both desire for and the use of cocaine in comorbid SCHZ subjects. These data suggest double-blind, randomized, comparison study in this severely ill, comorbid patient group. C1 Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver Med Ctr, Dept Vet Affairs, Denver Res Inst, Denver, CO USA. RP Beresford, TP (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. EM thomas.beresford@uchsc.edu FU NIAAA NIH HHS [AA 014010] NR 32 TC 68 Z9 69 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD AUG PY 2005 VL 25 IS 4 BP 363 EP 366 DI 10.1097/01.jcp.0000169419.38899.5b PG 4 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 950SD UT WOS:000230876800012 PM 16012280 ER PT J AU Robert, S Hamner, MB Kose, S Ulmer, HG Deitsch, SE Lorberbaum, JP AF Robert, S Hamner, MB Kose, S Ulmer, HG Deitsch, SE Lorberbaum, JP TI Quetiapine improves sleep disturbances in combat veterans with PTSD - Sleep data from a prospective, open-label study SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Letter C1 Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Robert, S (reprint author), Ralph H Johnson VA Med Ctr, Charleston, SC USA. EM robertso@musc.edu NR 13 TC 36 Z9 39 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD AUG PY 2005 VL 25 IS 4 BP 387 EP 388 DI 10.1097/01.jcp.0000169624.37819.60 PG 2 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 950SD UT WOS:000230876800017 PM 16012285 ER PT J AU Hayward, RA Asch, SM Hogan, MM Hofer, TP Kerr, EA AF Hayward, RA Asch, SM Hogan, MM Hofer, TP Kerr, EA TI Sins of omission - Getting too little medical care may be the greatest threat to patient safety SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE quality of care; adverse events; patient safety; medical errors ID ADVERSE DRUG EVENTS; QUALITY-OF-CARE; DIABETES CARE; HOSPITALIZED-PATIENTS; HEALTH; ERRORS; CHOICE; MODEL; APPROPRIATENESS; PREVENTABILITY AB BACKGROUND: Little is known about the relative incidence of serious errors of omission versus errors of commission. OBJECTIVE: To identify the most common substantive medical errors identified by medical record review. DESIGN: Retrospective cohort study. SETTING: Twelve Veterans Affairs health care systems in 2 regions. PARTICIPANTS: Stratified random sample of 621 patients receiving care over a 2-year period. MAIN OUTCOME MEASURE: Classification of reported quality problems. METHODS: Trained physicians reviewed the full inpatient and outpatient record and described quality problems, which were then classified as errors of omission versus commission. RESULTS: Eighty-two percent of patients had at least 1 error reported over a 13-month period. The average number of errors reported per case was 4.7 (95% confidence intervals [CI]: 4.4, 5.0). Overall, 95.7% ( 95% CI: 94.9%, 96.4%) of errors were identified as being problems with under-use. Inadequate care for people with chronic illnesses was particularly common. Among errors of omission, obtaining insufficient information from histories and physicals (25.3%), inadequacies in diagnostic testing (33.9%), and patients not receiving needed medications (20.7%) were all common. Out of the 2,917 errors identified, only 27 were rated as being highly serious, and 26 (96%) of these were errors of omission. CONCLUSIONS: While preventing iatrogenic injury resulting from medical errors is a critically important part of quality improvement, we found that the overwhelming majority of substantive medical errors identifiable from the medical record were related to people getting too little medical care, especially for those with chronic medical conditions. C1 Vet Affairs Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA. Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA. Univ Calif Los Angeles, David Geffen Sch Med, Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Gen Internal Med, Los Angeles, CA USA. Rand Hlth Program, Santa Monica, CA USA. RP Hayward, RA (reprint author), POB 130170, Ann Arbor, MI 48113 USA. EM rhayward@umich.edu FU PHS HHS [P60-972573] NR 55 TC 44 Z9 44 U1 1 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2005 VL 20 IS 8 BP 686 EP 691 DI 10.1111/j.1525-1497.2005.0152.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 946VR UT WOS:000230601900003 PM 16050875 ER PT J AU Shrank, WH Kutner, JS Richardson, T Mularski, RA Fischer, S Kagawa-Singer, M AF Shrank, WH Kutner, JS Richardson, T Mularski, RA Fischer, S Kagawa-Singer, M TI Focus group findings about the influence of culture on communication preferences in end-of-life care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE end-of-life; communication; cultural sensitivity; focus groups; ethnicity ID NOT-RESUSCITATE ORDERS; ILL HOSPITALIZED ADULTS; NURSING-HOME RESIDENTS; ADVANCE DIRECTIVES; AFRICAN-AMERICANS; SUSTAINING TREATMENTS; DECISION-MAKING; ETHNICITY; RACE; PERSPECTIVES AB BACKGROUND: Little guidance is available for health care providers who try to communicate with patients and their families in a culturally sensitive way about end-of-life care. OBJECTIVE: To explore the content and structure of end-of-life discussions that would optimize decision making by conducting focus groups with two diverse groups of patients that vary in ethnicity and socioeconomic status. DESIGN: Six focus groups were conducted; 3 included non-Hispanic white patients recruited from a University hospital (non- Hispanic white groups) and 3 included African-American patients recruited from a municipal hospital (African-American groups). A hypothetical scenario of a dying relative was used to explore preferences for the content and structure of communication. PARTICIPANTS: Thirty-six non-Hispanic white participants and 34 African-American participants. APPROACH: Content analysis of focus group transcripts. RESULTS: Non-Hispanic white participants were more exclusive when recommending family participants in end-of-life discussions while African-American participants preferred to include more family, friends and spiritual leaders. Requested content varied as non-Hispanic white participants desired more information about medical options and cost implications while African-American participants requested spiritually focused information. Underlying values also differed as non-Hispanic white participants expressed more concern with quality of life while African-American participants tended to value the protection of life at all costs. CONCLUSIONS: The groups differed broadly in their preferences for both the content and structure of end-of-life discussions and on the values that influence those preferences. Further research is necessary to help practitioners engage in culturally sensitive end-of-life discussions with patients and their families by considering varying preferences for the goals of end-of-life care communication. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, Los Angeles, CA 90073 USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Boulder, CO 80309 USA. Kaiser Permanente, Denver, CO USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Colorado, Hlth Sci Ctr, Div Hlth Care Policy & Res, Denver, CO USA. Asian Amer Studies, Los Angeles, CA USA. RP Shrank, WH (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM William.Shrank@med.va.gov NR 34 TC 47 Z9 48 U1 0 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2005 VL 20 IS 8 BP 703 EP 709 DI 10.1111/j.1525-1497.2005.0151.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 946VR UT WOS:000230601900006 PM 16050878 ER PT J AU Nicolaidis, C Curry, M Gerrity, M AF Nicolaidis, C Curry, M Gerrity, M TI Measuring the impact of the Voices of survivors program on health care workers' attitudes toward survivors of intimate partner violence SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE intimate partner violence; continuing medical education; survey instrument; provider attitudes; measurement ID DOMESTIC VIOLENCE; FAMILY-VIOLENCE; CLINICAL CHARACTERISTICS; MEDICAL-EDUCATION; PUBLIC-HEALTH; WOMEN; ABUSE; KNOWLEDGE; PRACTITIONERS; CONSEQUENCES AB BACKGROUND: Most continuing medical education programs on intimate partner violence (IPV) use an expert-driven approach and focus on changing knowledge and screening behaviors. The Voices of Survivors program aims to also improve attitudes and empathy. OBJECTIVES: To test the Attitudes Toward Survivors of IPV (ATSI) survey psychometrically. To assess the effectiveness of the Voices of Survivors program in changing health care workers' responsibility to assess for and counsel about IPV, respect for patient autonomy, empathy toward patients in abusive relationships, barriers, confidence, knowledge, and self-reported assessment behaviors. SETTING: Thirty-one unaffiliated primary care practices in Washington County, Ore. DESIGN: Comparison of ATSI survey results before and after a two-hour workshop including a 30-minute video and an advocate-led discussion. PARTICIPANTS: Convenience sample of primary care providers, medical support staff, and other clinic employees. RESULTS: Two hundred and eighty-four health care workers participated in the training. Two hundred and sixty-seven (94%) completed workshop evaluations and 187 (66%) completed both pre- and postintervention surveys. Cronbach's alpha for all scales ranged from 0.68 to 0.92. Postintervention, participants' summary scores improved for responsibility to assess for IPV (3.96 vs 3.64; P < .0001), respect for patient autonomy (2.78 vs 2.41; P < . 0001), empathy (3.24 vs. 2.99; P = .002), confidence (2.33 vs 2.07; P < .0001), knowledge (2.08 vs 1.64; P < .0001), and self-reported behaviors (3.08 vs 2.53; P = .0001). Barriers related to availability of resources and referrals also improved. CONCLUSIONS: The ATSI scales demonstrated good internal reliability and responsiveness to change in all domains except responsibility to counsel. The Voices of Survivors documentary, along with a workshop based on its companion guide, improved clinic employees' knowledge, attitudes, empathy, and self-reported assessment behaviors about IPV. C1 Oregon Hlth Sci Univ, Dept Med, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Sch Nursing, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. RP Nicolaidis, C (reprint author), Oregon Hlth Sci Univ, Dept Med, L475,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM nicolaid@ohsu.edu NR 38 TC 6 Z9 6 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2005 VL 20 IS 8 BP 731 EP 737 DI 10.1111/j.1525-1497.2005.0141.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 946VR UT WOS:000230601900011 PM 16050883 ER PT J AU Jha, AK Perlin, JB Steinman, MA Peabody, JW Ayanian, JZ AF Jha, AK Perlin, JB Steinman, MA Peabody, JW Ayanian, JZ TI Quality of ambulatory care for women and men in the veterans affairs health care system SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE gender; quality; veterans; prevention; diabetes mellitus ID ACUTE MYOCARDIAL-INFARCTION; SERVICES-TASK-FORCE; OF-CARE; FEMALE VETERANS; MEDICAL-CENTER; HEART-DISEASE; MANAGED CARE; RISK; RACE; OUTCOMES AB BACKGROUND: Gender differences in inpatient quality of care are well known. However, whether men and women receive equivalent ambulatory care is less well understood. OBJECTIVE: To study gender differences in quality of care for patients receiving primary care in the Veterans Affairs (VA) Health Care System. DESIGN: Cross-sectional samples of VA enrollees during fiscal years 1999 to 2000. PARTICIPANTS: Samples of 6,442 to 86,405 men and women treated at VA facilities for whom at least 1 of 9 quality measures was available. MEASUREMENTS: Appropriate general preventive services (pneumococcal vaccination, influenza vaccination, colorectal cancer screening), and specific services for diabetes (annual hemoglobin A1c [HbA1c] testing, good glycemic control, annual diabetic eye exam), hypertension (good blood pressure control), or prior myocardial infarction (use of beta-blockers or aspirin). RESULTS: In adjusted analyses, there were no substantial gender differences in rates of appropriate care. For women compared with men, the adjusted relative risk for appropriate care ranged from 0.96 for blood pressure control (95% confidence interval: 0.93 to 0.99; P=.02) to 1.05 for HbA1c <= 8.0% (95% confidence interval: 1.03 to 1.07; P <.01). Analyses stratified by age demonstrated equivalent care between men and women in 9 of the 14 subgroups evaluated. CONCLUSION: In this large national health care system that predominantly serves men, the quality of ambulatory care is equivalent for women and men on numerous measures. C1 Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. Boston VA Hlth Care Syst, Boston, MA USA. Vet Hlth Adm, Off Undersecretary, Washington, DC USA. San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA USA. Inst Global Hlth, San Francisco, CA USA. RP Jha, AK (reprint author), Harvard Univ, Sch Publ Hlth, Dept Hlth Policy & Management, 677 Huntington Ave, Boston, MA 02115 USA. EM ajha@hsph.harvard.edu FU AHRQ HHS [T32 HS000020, 5T32HS00020-16] NR 27 TC 32 Z9 32 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2005 VL 20 IS 8 BP 762 EP 765 DI 10.1111/j.1525-1497.2005.0160.x PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 946VR UT WOS:000230601900017 PM 16050889 ER PT J AU Zipkin, DA Steinman, MA AF Zipkin, DA Steinman, MA TI Interactions between pharmaceutical representatives and doctors in training SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE medical students; interns and residents; medical education; drug industry ID PHYSICIAN PRESCRIBING PATTERNS; SALES REPRESENTATIVES; MEDICINE RESIDENTS; COMPANY REPRESENTATIVES; DRUG COMPANIES; INDUSTRY; ATTITUDES; PROGRAMS; FACULTY; GIFTS AB OBJECTIVE: Medical school and residency are formative years in establishing patterns of prescribing. We aimed to review the literature regarding the extent of pharmaceutical industry contact with trainees, attitudes about these interactions, and effects on trainee prescribing behavior, with an emphasis on points of potential intervention and policy formation. DESIGN: We searched MEDLINE from 1966 until May 2004 for English language articles. All original articles were included if the abstract reported content relevant to medical training and the pharmaceutical industry. Editorials, guidelines, and policy recommendations were excluded. MEASUREMENTS AND RESULTS: Contact with pharmaceutical representatives was common among residents. The majority of trainees felt that the interactions were appropriate. A minority felt that their own prescribing could be influenced by contact or gifts, but were more likely to believe that others' prescribing could be influenced. Resident prescribing was associated with pharmaceutical representative visits and the availability of samples. A variety of policy and educational interventions appear to influence resident attitudes toward interactions with industry, although data on the long-term effects of these interventions are limited. Overall, residents reported insufficient training in this area. CONCLUSION: The pharmaceutical industry has a significant presence during residency training, has gained the overall acceptance of trainees, and appears to influence prescribing behavior. Training programs can benefit from policies and curricula that teach residents about industry influence and ways in which to critically evaluate information that they are given. Recommendations for local and national approaches are discussed. C1 Calif Pacific Med Ctr, Dept Internal Med, San Francisco, CA USA. San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Zipkin, DA (reprint author), 3801 Sacramento St,306, San Francisco, CA 94118 USA. EM zipkind@sutterhealth.org NR 58 TC 77 Z9 79 U1 0 U2 7 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2005 VL 20 IS 8 BP 777 EP 786 DI 10.1111/j.1525-1497.2005.0134.x PG 10 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 946VR UT WOS:000230601900021 PM 16050893 ER PT J AU Baratelli, F Lin, Y Zhu, L Yang, SC Heuze-Vourc'h, N Zeng, G Reckamp, K Dohadwala, M Sharma, S Dubinett, SM AF Baratelli, F Lin, Y Zhu, L Yang, SC Heuze-Vourc'h, N Zeng, G Reckamp, K Dohadwala, M Sharma, S Dubinett, SM TI Prostaglandin E-2 induces FOXP3 gene expression and T regulatory cell function in human CD4(+) T cells SO JOURNAL OF IMMUNOLOGY LA English DT Article ID HUMAN DENDRITIC CELLS; PERIPHERAL-BLOOD; LUNG-CANCER; DOWN-REGULATION; CUTTING EDGE; TGF-BETA; IN-VITRO; PROLIFERATION; IL-2; INDUCTION AB Naturally occurring CD4(+)CD25(+) regulatory T cells (T reg) are pivotal in suppressing immune responses and maintaining tolerance. The identification of molecules controlling T reg differentiation and function is important in understanding host immune responses in malignancy and autoimmunity. In this study we show that PGE(2) enhances the in vitro inhibitory function of human purified CD4(+)CD25(+) T reg cells. Moreover, PGE(2) induces a regulatory phenotype in CD4(+)CD25(-) T cells. PGE(2)-treated T cell-mediated inhibition of anti-CD3-stimulated lymphocyte proliferation did not require cell contact. Phenotypic analysis revealed that PGE(2) diminished CD25 expression in both CD4(+)CD2(dim) T cells and CD4(+)CD25(bright) T reg cells. PGE(2) exposure induced the T reg cell-specific transcription factor forkhead/winged helix transcription factor gene (FOXP3) in CD4(+)CD25(-) T cells and significantly up-regulated its expression in CD4(+)CD25(+) T reg cells. Similarly, 24-h incubation with supernatants from cyclooxygenase-2-overexpressing lung cancer cells that secrete high levels of PGE(2) significantly induced FOXP3 in CD4(+)CD25(-) T cells. Finally, PGE(2) up-regulated FOXP3 at both mRNA and protein levels and enhanced FOXP3 promoter activity. This is the first report indicating that PGE(2) can modulate FOXP3 expression and T reg function in human lymphocytes. C1 Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Jonsson Comprehens Canc Ctr, Room 37-131 Ctr Hlth Sci,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu RI HEUZE-VOURC'H, Nathalie/P-8081-2016 OI Reckamp, Karen/0000-0002-9213-0325 FU NCI NIH HHS [R01CA85686, P50CA90388] NR 50 TC 305 Z9 324 U1 0 U2 9 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD AUG 1 PY 2005 VL 175 IS 3 BP 1483 EP 1490 PG 8 WC Immunology SC Immunology GA 989BN UT WOS:000233648000016 PM 16034085 ER PT J AU McInturff, JE Wang, SJ Machleidt, T Lin, TR Oren, A Hertz, CJ Krutzik, SR Hart, S Zeh, K Anderson, DH Gallo, RL Modlin, RL Kim, J AF McInturff, JE Wang, SJ Machleidt, T Lin, TR Oren, A Hertz, CJ Krutzik, SR Hart, S Zeh, K Anderson, DH Gallo, RL Modlin, RL Kim, J TI Granulysin-derived peptides demonstrate antimicrobial and anti-inflammatory effects against Propionibacterium acnes SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Article DE acne; antimicrobial peptide; inflammation; innate immunity; skin ID INFLAMMATORY ACNE; DEFENSINS; ACTIVATION; INDUCTION; RESPONSES; IMMUNITY; INNATE; CELLS; BETA AB Propionibacterium acnes is a key therapeutic target in acne, yet this bacterium has become resistant to standard antibiotic agents. We investigated whether the human antimicrobial protein granulysin is a potential candidate for the treatment of acne. Granulysin and synthetic granulysin-derived peptides possessing a helix-loop-helix motif killed P. acnes in vitro. Modi. cation of a helix-loop-helix peptide, 31-50, by substitution of a tryptophan for the valine at amino acid 44 (peptide 31-50v44w) to increase its interaction with bacterial surfaces also increased its antimicrobial activity. Moreover, when synthesized with D- rather than L-type amino acids, this peptide (D-31-50v44w) became less susceptible to degradation by proteases and more effective in killing P. acnes. Granulysin peptides were bactericidal, demonstrating an advantage over standard bacteriostatic antibiotics in their control of P. acnes. Moreover, peptide D-31-50v44w killed P. acnes in isolated human microcomedone preparations. Importantly, peptides 31-50, 31-50v44w, and D-31-50v44w also have potential anti-inflammatory effects, as demonstrated by suppression of P. acnes-stimulated cytokine release. Taken together, these data suggest that granulysin peptides may be useful as topical therapeutic agents, providing alternatives to current acne therapies. C1 Univ Calif Los Angeles, Inst Mol Biol, Inst Genom & Prote, Dept Dermatol,DOE, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Dermatol, Los Angeles, CA USA. Ansata Therapeut Inc, La Jolla, CA USA. W Los Angeles Vet Adm Med Ctr, Dept Med, Div Pulm & Crit Care Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Microbiol, Los Angeles, CA USA. Howard Hughes Med Inst, Los Angeles, CA USA. Univ Calif San Diego, Div Dermatol, San Diego, CA 92103 USA. Vet Adm San Diego Healthcare Syst, San Diego, CA USA. RP Kim, J (reprint author), Univ Calif Los Angeles, Inst Mol Biol, Inst Genom & Prote, Dept Dermatol,DOE, 52-121 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM JeKim@mednet.ucla.edu RI Gallo, Richard/A-8931-2009 OI Modlin, Robert/0000-0003-4720-031X FU NIAMS NIH HHS [K08 AR048551, K08 AR48551-01] NR 26 TC 40 Z9 44 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD AUG PY 2005 VL 125 IS 2 BP 256 EP 263 DI 10.1111/j.0022-202X.2005.23805.x PG 8 WC Dermatology SC Dermatology GA 945HI UT WOS:000230493200012 PM 16098035 ER PT J AU Baratelli, F Krysan, K Heuze-Vourc'h, N Zhu, L Escuadro, B Sharma, S Reckamp, K Dohadwala, M Dubinett, SM AF Baratelli, F Krysan, K Heuze-Vourc'h, N Zhu, L Escuadro, B Sharma, S Reckamp, K Dohadwala, M Dubinett, SM TI PGE(2) confers survivin-dependent apoptosis resistance in human monocyte-derived dendritic cells SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Article DE lipid mediators; immune cells; antiapoptotic proteins ID ACTIVATION-INDUCED APOPTOSIS; NORMAL CORD BLOOD; LUNG-CANCER; PROSTAGLANDIN E-2; PROTEIN SURVIVIN; UP-REGULATION; DOWN-REGULATION; CD34(+) CELLS; T-CELLS; EXPRESSION AB Control of apoptosis is fundamental for dendritic cell (DC) homeostasis. Numerous factors maintain DC viability throughout their lifespan, including inhibitor of apoptosis proteins. Among them, survivin is overexpressed in many human malignancies, but its physiological function in normal cells has not been fully delineated. Prostaglandin E-2 (PGE(2)), also overproduced in several malignancies, has shown to induce proapoptotic and antiapoptotic effects in different cell types, including immune cells. In DC, PGE(2) predominantly affects maturation and modulates immune functions. Here, we show that exposure of monocyte-derived DC to PGE(2) (10(-5) M) for 72 h significantly increased DC survivin mRNA and protein expression. In contrast, DC, matured with lipopolysaccharide or tumor necrosis factor alpha, did not reveal survivin induction in response to PGE(2). Following exposure to apoptotic stimuli, DC treated with PGE(2) exhibited an overall increased viability compared with control DC, and this effect was correlated inversely with caspase-3 activation. Moreover, PGE(2)-treated, survivin-deficient DC demonstrated reduced viability in response to apoptotic stimuli. Further analysis indicated that PGE(2) induced DC survivin expression in an E prostanoid (EP)(2)/EP4 receptor and phosphatidylinositol-3 kinase-dependent manner. These findings suggest that PGE(2)-dependent regulation of survivin is important in modulating apoptosis resistance in human DC. C1 Univ Calif Los Angeles, Lung Canc Res Program, Div Pulm & Crit Care Med,Dept Med, Geffen Sch Med,Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Mol Gene Med Lab, Los Angeles, CA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Lung Canc Res Program, Div Pulm & Crit Care Med,Dept Med, Geffen Sch Med,Jonsson Comprehens Canc Ctr, 37-131 CHS,10833 Le Conte Ave,Room 37-131 CHS, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu RI HEUZE-VOURC'H, Nathalie/P-8081-2016 OI Reckamp, Karen/0000-0002-9213-0325 FU NCI NIH HHS [CA-16042, P50 CA 90388, R01 CA85686]; NIAID NIH HHS [AI-28697] NR 55 TC 34 Z9 34 U1 0 U2 2 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PD AUG PY 2005 VL 78 IS 2 BP 555 EP 564 DI 10.1189/jlb.1004569 PG 10 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 950MG UT WOS:000230860700026 PM 15908458 ER PT J AU Nath, N Giri, S Prasad, R Salem, ML Singh, AK Singh I AF Nath, N Giri, S Prasad, R Salem, ML Singh, AK Singh, I TI 5-aminoimidazole-4-carboxamide ribonucleoside: A novel immunomodulator in experimental autoimmune encephalomyelitis SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 20th Biennial Meeting of the International-Society-for-Neurochemistry/European-Society-for-Neurochemi stry CY AUG 21-26, 2005 CL Innsbruck, AUSTRIA SP Int Soc Neurochem, European Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2005 VL 94 SU 2 BP 182 EP 182 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 961PD UT WOS:000231673401103 ER PT J AU Le, SS Loucks, FA Udo, H Richardson-Burns, S Phelps, RA Bouchard, RJ Barth, H Aktories, K Tyler, KL Kandel, ER Heidenreich, KA Linseman, DA AF Le, SS Loucks, FA Udo, H Richardson-Burns, S Phelps, RA Bouchard, RJ Barth, H Aktories, K Tyler, KL Kandel, ER Heidenreich, KA Linseman, DA TI Inhibition of Rac GTPase triggers a c-Jun- and Bim-dependent mitochondrial apoptotic cascade in cerebellar granule neurons SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE Bax; BH3-only; c-jun N-terminal protein kinase; neuronal survival; Rho GTPase ID RHO FAMILY GTPASES; N-TERMINAL KINASE; GROWTH-FACTOR-I; CELL-DEATH; SIGNALING PATHWAY; CLOSTRIDIAL CYTOTOXINS; BH3-ONLY PROTEIN; LETHAL TOXIN; ACTIVATION; SURVIVAL AB Rho GTPases are key transducers of integrin/extracellular matrix and growth factor signaling. Although integrin-mediated adhesion and trophic support suppress neuronal apoptosis, the role of Rho GTPases in neuronal survival is unclear. Here, we have identified Rac as a critical pro-survival GTPase in cerebellar granule neurons (CGNs) and elucidated a death pathway triggered by its inactivation. GTP-loading of Rac1 was maintained in CGNs by integrin-mediated ( RGDdependent) cell attachment and trophic support. Clostridium difficile toxin B ( ToxB), a specific Rho family inhibitor, induced a selective caspase-mediated degradation of Rac1 without affecting RhoA or Cdc42 protein levels. Both ToxB and dominant-negative N17Rac1 elicited CGN apoptosis, characterized by cytochrome c release and activation of caspase-9 and -3, whereas dominant - negative N19RhoA or N17Cdc42 did not cause significant cell death. ToxB stimulated mitochondrial translocation and conformational activation of Bax, c-Jun activation, and induction of the BH3-only protein Bim. Similarly, c-Jun activation and Bim induction were observed with N17Rac1. A c-jun N-terminal protein kinase (JNK)/p38 inhibitor, SB203580, and a JNK-specific inhibitor, SP600125, significantly decreased ToxB-induced Bim expression and blunted each subsequent step of the apoptotic cascade. These results indicate that Rac acts downstream of integrins and growth factors to promote neuronal survival by repressing c-Jun/Bim-mediated mitochondrial apoptosis. C1 Denver Vet Affairs Med Ctr, Res Serv, Denver, CO 80220 USA. Columbia Univ, Howard Hughes Med Inst, New York, NY 10032 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Ulm, Dept Pharmacol & Toxicol, Ulm, Germany. Univ Freiburg, Inst Expt & Klin Pharmakol & Toxikol, Freiburg, Germany. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Neurosci Program, Denver, CO USA. RP Linseman, DA (reprint author), Denver Vet Affairs Med Ctr, Res Serv, 111H,1055 Clermont St, Denver, CO 80220 USA. EM Dan.Linseman@UCHSC.edu RI Barth, Holger/E-7920-2013 OI Tyler, Kenneth/0000-0003-3294-5888 FU NINDS NIH HHS [R01 NS050138-04, R01 NS051403-03, R01 NS051403, R01 NS050138] NR 65 TC 36 Z9 36 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2005 VL 94 IS 4 BP 1025 EP 1039 DI 10.1111/j.1471-4159.2005.03252.x PG 15 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 950WA UT WOS:000230888200016 PM 16092944 ER PT J AU Subramanian, S West, RB Marinelli, RJ Nielsen, TO Rubin, BP Goldblum, JR Patel, RM Zhu, S Montgomery, K Ng, TL Corless, CL Heinrich, MC van de Rijn, M AF Subramanian, S West, RB Marinelli, RJ Nielsen, TO Rubin, BP Goldblum, JR Patel, RM Zhu, S Montgomery, K Ng, TL Corless, CL Heinrich, MC van de Rijn, M TI The gene expression profile of extraskeletal myxoid chondrosarcoma SO JOURNAL OF PATHOLOGY LA English DT Article DE extraskeletal myxoid chondrosarcoma; expressing profile; lipid metabolism; Neuromedin B gene; tissue microarray ID ACTIVATED-RECEPTOR-GAMMA; GASTROINTESTINAL STROMAL TUMORS; FINE-NEEDLE-ASPIRATION; SOFT-TISSUE TUMORS; NEUROENDOCRINE DIFFERENTIATION; FUSION PROTEIN; FATTY-ACIDS; PPAR-GAMMA; DERMATOFIBROSARCOMA PROTUBERANS; MOLECULAR CHARACTERIZATION AB Extraskeletal myxoid chondrosarcoma (EMC) is a soft tissue tumour that occurs primarily in the extremities and is characterized by a balanced translocation most commonly involving t(9;22) (q22;q12). The morphological spectrum of EMC is broad and thus a diagnosis based on histology alone can be difficult. Currently, no systemic therapy exists that improves survival in patients with EMC. In the present study, gene expression profiling has been performed to discover new diagnostic markers and potential therapeutic targets for this tumour type. Global gene expression profiling of ten EMCs and 26 other sarcomas using 42 000 spot cDNA microarrays revealed that the cases of EMC were closely related to each other and distinct from the other tumours profiled. Significance analysis of microarrays (SAM) identified 86 genes that distinguished EMC from the other sarcomas with 0.25% likelihood of false significance. NMB, DKK1, DNER, CLCN3, and DEF6 were the top five genes in this analysis. In situ hybridization for NMB gene expression on tissue microarrays (TMAs) containing a total of 1164 specimens representing 62 different sarcoma types and 15 different carcinoma types showed that NMB was highly expressed in 17 of 22 EMC cases and very rarely expressed in other tumours and thus could function as a novel diagnostic marker. High levels of expression of PPARG and the gene encoding its interacting protein, PPARGC1A, in most EMCs suggest activation of lipid metabolism pathways in this tumour. Small molecule inhibitors for PPARG exist and PPARG could be a potential therapeutic target for EMC. Copyright (c) 2005 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. C1 Stanford Univ, Ctr Med, Dept Pathol, Stanford, CA 94035 USA. Stanford Univ, Ctr Med, Dept Biochem, Stanford, CA USA. Vancouver Gen Hosp, Dept Pathol & Genet Pathol, Evaluat Ctr, Vancouver, BC, Canada. Univ Washington, Ctr Med, Dept Anat Pathol, Seattle, WA USA. Cleveland Clin Fdn, Dept Pathol Anat, Cleveland, OH USA. Oregon Hlth Sci Univ, OHSU Canc Inst, Dept Pathol, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med, Portland, OR USA. RP van de Rijn, M (reprint author), Stanford Univ, Ctr Med, Dept Pathol, 300 Pasteur Dr,L-235, Stanford, CA 94035 USA. EM mrijn@stanford.edu FU NCI NIH HHS [CA85129] NR 97 TC 36 Z9 37 U1 0 U2 2 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0022-3417 J9 J PATHOL JI J. Pathol. PD AUG PY 2005 VL 206 IS 4 BP 433 EP 444 DI 10.1002/path.1792 PG 12 WC Oncology; Pathology SC Oncology; Pathology GA 947QV UT WOS:000230662100009 PM 15920699 ER PT J AU Chan, PLS Nutt, JG Holford, NHG AF Chan, PLS Nutt, JG Holford, NHG TI Importance of within subject variation in levodopa pharmacokinetics: A 4 year cohort study in Parkinson's disease SO JOURNAL OF PHARMACOKINETICS AND PHARMACODYNAMICS LA English DT Article DE levodopa; within subject variability; pharmacokinetics; Parkinson's disease; population approach ID ON-OFF FLUCTUATIONS; L-DOPA THERAPY; POPULATION PHARMACOKINETICS; ORAL LEVODOPA; MOTOR FLUCTUATIONS; PHARMACODYNAMICS; 1ST; BIOAVAILABILITY; 3-O-METHYLDOPA; EVOLUTION AB The purpose of the study was to describe the population pharmacokinetics of levodopa in patients with Parkinson's disease studied in 5 trials (10 occasions) over 4 years. Twenty previously untreated Parkinsonian patients were investigated. Each trial consisted of a 2-hr IV infusion of levodopa (1 mg/kg/h) with concomitant oral carbidopa given on two occasions separated by 72hr with no levodopa in between. This trial design was repeated at 6, 12, 24 and 48 months. A two-compartment pharmacokinetic model with central volume (V-1), peripheral volume (V-2), clearance (CL) and inter-compartmental clearance (CLic) was used to fit plasma levodopa concentrations. The model accounted for levodopa dosing prior to each trial and endogenous levodopa synthesis. Population parameter estimates (geometric mean) and population parameter variability (PPV; SD of normal distribution) were V-1 11.4 l/70 kg (0.44), CL 30.9 l/h/70 kg (0.25), V-2 27.3 l/70 kg (0.27), and CLic 34.6 l/h/70 kg (0.48). PPV was partitioned into between subject variability (BSV) which was 0.12 V-1, 0.13 CL, 0.15 V-2, 0.28 CLic, within trial variability (WTV) which was 0.16 V-1, 0.13 CL, 0.08 V-2, 0.18 CLic and between trial variability (BTV) which was 0.40 V-1, 0.17 CL, 0.21 V-2, 0.34 CLic. Neither structural nor random levodopa pharmacokinetic parameters were associated with the time course of development of fluctuation in motor response. Variability in levodopa pharmacokinetic parameters (particularly V-1) may result in variability in plasma levodopa concentrations that could contribute to fluctuations in motor response. C1 Univ Auckland, Dept Pharmacol & Clin Pharmacol, Auckland 1, New Zealand. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Portland VA Med Ctr, Dept Neurobiol Physiol & Pharmacol, Portland, OR USA. Pfizer Inc, Ann Arbor, MI 48105 USA. RP Chan, PLS (reprint author), Univ Auckland, Dept Pharmacol & Clin Pharmacol, Auckland 1, New Zealand. EM Phylinda.Chan@pfizer.com OI Holford, Nick/0000-0002-4031-2514 NR 40 TC 11 Z9 12 U1 1 U2 1 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1567-567X J9 J PHARMACOKINET PHAR JI J. Pharmacokinet. Pharmacodyn. PD AUG PY 2005 VL 32 IS 3-4 BP 307 EP 331 DI 10.1007/s10928-005-0039-x PG 25 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 990DT UT WOS:000233724100001 PM 16320098 ER PT J AU Chan, PLS Nutt, JG Holford, NHG AF Chan, PLS Nutt, JG Holford, NHG TI Pharmacokinetic and pharmacodynamic changes during the first four years of levodopa treatment in Parkinson's disease SO JOURNAL OF PHARMACOKINETICS AND PHARMACODYNAMICS LA English DT Article DE levodopa; pharmacokinetics; pharmacodynamics; disease progression; Parkinson's disease; fluctuations ID LONG-DURATION RESPONSES; MOTOR FLUCTUATIONS; SLEEP BENEFIT; ORAL LEVODOPA; L-DOPA; THERAPY; MECHANISMS; DYSKINESIAS; EVOLUTION; TIME AB The purpose of this analysis is to describe how levodopa pharmacokinetic and pharmacodynamic parameters change over the first 4 years of long-term levodopa treatment in patients with Parkinson's disease. Twenty previously untreated Parkinsonian patients were admitted to the general clinical research center (GCRC) for 4 days at the beginning of long-term levodopa therapy and 6, 12, 24 and 48 months later. On each GCRC admission, patients received a 2 hr IV infusion of levodopa on day 1 and day 4 with no oral levodopa between the infusions. After the first GCRC admission patients were treated with oral levodopa dosed for optimal control of Parkinsonism. Motor function was measured by finger tapping rate. A pharmacokinetic-pharmacodynamic model incorporating 3 effect compartments was used to fit the individual plasma levodopa concentrations and tapping rates. Motor function before the first levodopa infusion (E0(1)) improved over the first 20 months and subsequently returned to the initial baseline at the start of the study. A similar pattern was seen in motor function before the second infusion (E0(2)) after the 3 days levodopa withdrawal, with a decline predicted to fall below the initial baseline at the start of the study by 6 years. Eight patients showed an increase in maximum tapping rate with levodopa (E-max) approaching a steady state after 16 months. Ten patients showed an increase in E-max with a peak at 31 months. One patient showed a linear decrease and another patient did not change over the 48 months. Longitudinal progress models were used to describe the time course of pharmacokinetic and pharmacodynamic parameters over 4 years. Peak treatment benefit, defined as the difference between E-max and E0(1) or E0(2) (D-max1 or D-max2), increased with time particularly after the 3-day levodopa withdrawal. Deterioration of pre-dose motor function (E0) as disease progresses coupled with a greater amplitude of response due to levodopa (D-max) could be a key factor contributing to motor fluctuations associated with long-term levodopa treatment. C1 Univ Auckland, Dept Pharmacol & Clin Pharmacol, Auckland 1, New Zealand. Portland VA Med Ctr, Dept Neurol & Physiol & Pharmacol, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Pfizer Inc, Ann Arbor, MI 48105 USA. RP Chan, PLS (reprint author), Univ Auckland, Dept Pharmacol & Clin Pharmacol, Auckland 1, New Zealand. EM Phylinda.Chan@pfizer.com OI Holford, Nick/0000-0002-4031-2514 NR 39 TC 15 Z9 15 U1 1 U2 3 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1567-567X J9 J PHARMACOKINET PHAR JI J. Pharmacokinet. Pharmacodyn. PD AUG PY 2005 VL 32 IS 3-4 BP 459 EP 484 DI 10.1007/s10928-005-0055-x PG 26 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 990DT UT WOS:000233724100008 PM 16320101 ER PT J AU Maudsley, S Martin, B Luttrell, LM AF Maudsley, S Martin, B Luttrell, LM TI The origins of diversity and specificity in G protein-coupled receptor signaling SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID BETA(2) ADRENERGIC-RECEPTOR; A-MEDIATED PHOSPHORYLATION; TERNARY COMPLEX MODEL; MU-OPIOID RECEPTOR; BETA(2)-ADRENERGIC RECEPTOR; EFFECTOR PATHWAY; KINASE-A; CONSTITUTIVE ACTIVATION; ANTAGONISTS PROMOTE; PERTUSSIS-TOXIN AB The modulation of transmembrane signaling by G protein-coupled receptors ( GPCRs) constitutes the single most important therapeutic target in medicine. Drugs acting on GPCRs have traditionally been classified as agonists, partial agonists, or antagonists based on a two- state model of receptor function embodied in the ternary complex model. Over the past decade, however, many lines of investigation have shown that GPCR signaling exhibits greater diversity and "texture" than previously appreciated. Signal diversity arises from numerous factors, among which are the ability of receptors to adopt multiple "active" states with different effector-coupling profiles; the formation of receptor dimers that exhibit unique pharmacology, signaling, and trafficking; the dissociation of receptor "activation" from desensitization and internalization; and the discovery that non-G protein effectors mediate some aspects of GPCR signaling. At the same time, clustering of GPCRs with their downstream effectors in membrane microdomains and interactions between receptors and a plethora of multidomain scaffolding proteins and accessory/ chaperone molecules confer signal preorganization, efficiency, and specificity. In this context, the concept of agonist-selective trafficking of receptor signaling, which recognizes that a bound ligand may select between a menu of active receptor conformations and induce only a subset of the possible response profile, presents the opportunity to develop drugs that change the quality as well as the quantity of efficacy. As a more comprehensive understanding of the complexity of GPCR signaling is developed, the rational design of ligands possessing increased specific efficacy and attenuated side effects may become the standard mode of drug development. C1 NIA, Neurosci Lab, Intramural Res Program, Gerontol Res Ctr,Johns Hopkins Med Ctr, Baltimore, MD USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Maudsley, S (reprint author), NIA, Neurosci Lab, Intramural Res Program, Gerontol Res Ctr,Johns Hopkins Med Ctr, 5600 Nathan Shock Dr, Baltimore, MD USA. EM maudsleyst@grc.nia.nih.gov FU Intramural NIH HHS [Z01 AG000318-01]; NIDDK NIH HHS [DK 55524, DK 58283, DK 64353, R01 DK055524, R01 DK058283, R01 DK064353, R56 DK055524] NR 95 TC 128 Z9 130 U1 1 U2 16 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 AUG PY 2005 VL 314 IS 2 BP 485 EP 494 DI 10.1124/jpet.105.083121 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 946CS UT WOS:000230550300001 PM 15805429 ER PT J AU Pugh, MJV Fincke, BG Bierman, AS Chang, BH Rosen, AK Cunningham, FE Amuan, ME Burk, ML Berlowitz, DR AF Pugh, MJV Fincke, BG Bierman, AS Chang, BH Rosen, AK Cunningham, FE Amuan, ME Burk, ML Berlowitz, DR TI Potentially inappropriate prescribing in elderly veterans: Are we using the wrong drug, wrong dose, or wrong duration? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE pharmacoepidemiology; patient safety; prescribing; appropriateness; geriatrics ID NURSING-HOME RESIDENTS; MEDICATION USE; BENZODIAZEPINE USE; EXPLICIT CRITERIA; BEERS CRITERIA; UNITED-STATES; OLDER-ADULTS; POPULATION; RISK; PRESCRIPTIONS AB OBJECTIVES: To identify the extent of inappropriate prescribing using criteria for proper use developed by the Agency for Healthcare Research and Quality (AHRQ) and dose-limitation criteria defined by Beers, as well as to describe duration of use and patient characteristics associated with inappropriate prescribing for older people. DESIGN: Retrospective national Veterans Health Administration (VA) administrative database analysis. SETTING: VA outpatient facilities during fiscal year 2000 (FY00). PARTICIPANTS: Veterans aged 65 and older having at least one VA outpatient visit in FY00 (N=1,265,434). MEASUREMENTS: Operational definitions of appropriate use were developed based on recommendations of an expert panel convened by the AHRQ (Zhan criteria). Inappropriate use was identified based on these criteria and inappropriate use of drugs per Beers criteria for dose-limitations in older people. Furthermore, duration of use and patient characteristics associated with inappropriate use were described. RESULTS: After adjusting for diagnoses, dose, and duration, inappropriate prescribing decreased from 33% to 23%. Exposure to inappropriate drugs was prolonged. Pain relievers, benzodiazepines, antidepressants, and musculoskeletal agents constituted 61% of inappropriate prescribing. Whites, patients with psychiatric comorbidities, and patients receiving more medications were most likely to receive inappropriate drugs. Women were more likely to receive Zhan criteria drugs; men were more likely to receive dose-limited drugs CONCLUSION: For the most part, the Zhan criteria did not explain inappropriate prescribing, which includes problems related to dose and duration of prescriptions. Interventions targeted at prescriptions for pain relievers, benzodiazepines, antidepressants, and musculoskeletal agents may dramatically decrease inappropriate prescribing and improve patient outcomes. C1 S Texas Vet Hlth Care Syst, Vet Evidence Based Res Disseminat & Implementat C, Audie L Murphy Div, San Antonio, TX USA. Dept Vet Affairs Hosp, Bedford, MA USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. Univ Toronto, St Michaels Hosp, Toronto, ON M5B 1W8, Canada. Inner City Hlth Res Unit, Toronto, ON M5B 1W8, Canada. US Dept Vet Affairs, Pharm Benefits Management Strateg Hlth Grp, Hines, IL 60141 USA. Univ Illinois, Coll Pharm, Chicago, IL 60680 USA. RP Pugh, MJV (reprint author), STVHCS, VERDICT, ALMD, 7400 Merton Minter Blvd 11C6, San Antonio, TX 78229 USA. EM pughm@uthscsa.edu OI Pugh, Mary Jo/0000-0003-4196-7763 NR 39 TC 48 Z9 50 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2005 VL 53 IS 8 BP 1282 EP 1289 DI 10.1111/j.1532-5415.2005.53402.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 948OY UT WOS:000230726800002 PM 16078952 ER PT J AU Ullian, ME Gelasco, AK Fitzgibbon, WR Beck, CN Morinelli, TA AF Ullian, ME Gelasco, AK Fitzgibbon, WR Beck, CN Morinelli, TA TI N-acetylcysteine decreases angiotensin II receptor binding in vascular smooth muscle cells SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article; Proceedings Paper CT 35th Annual Meeting of the American-Society-of-Nephrology CY OCT 30-NOV 06, 2002 CL PHILADELPHIA, PA SP Amer Soc Nephrol ID ALPHA-LIPOIC ACID; OXIDATIVE STRESS; EXTRACELLULAR DOMAINS; SUPEROXIDE-PRODUCTION; DISULFIDE BRIDGES; TYPE-1 RECEPTOR; GENE-EXPRESSION; LIGAND-BINDING; PROTEIN-KINASE; MESSENGER-RNA AB Antioxidants seem to inhibit angiotensin II (Ang II) actions by consuming stimulated reactive oxygen species. An alternative hypothesis was investigated: Antioxidants that are also strong reducers of disulfide bonds inhibit the binding of Ang II to its surface receptors with consequent attenuation of signal transduction and cell action. Incubation of cultured vascular smooth muscle cells, which possess Ang II type 1 alpha receptors, with the reducing agent n-acetylcysteine (NAC) for 1 h at 37 degrees C resulted in decreased Ang II radioligand binding in a concentration-dependent pattern. NAC removal restored Ang II binding within 30 min. Incubation with n-acetylserine, a nonreducing analogue of NAC, did not lower Ang II binding, and oxidized NAC was less effective than reduced NAC in lowering Ang II binding. NAC did not decrease Ang II type 1 alpha receptor protein content. Other antioxidants regulated Ang II receptors differently: alpha-Lipoic acid lowered Ang II binding after 24 h, and vitamin E did not lower Ang II binding at all. NAC inhibited Ang II binding in cell membranes at 21 or 37 but not VC. Dihydrolipoic acid (the reduced form of alpha-lipoic acid), which contains free sulfhydryl groups as NAC does, decreased Ang II receptor binding in cell membranes, whereas alpha-lipoic acid, which does not contain free sulfhydryl groups, did not. Ang II-stimulated inositol phosphate formation was decreased by preincubation with NAC (1 h) or alpha-lipoic acid (24 h) but not vitamin E. In conclusion, certain antioxidants that are reducing agents lower Ang II receptor binding, and Ang II-stimulated signal transduction is decreased in proportion to decreased receptor binding. C1 Med Univ S Carolina, Div Nephrol, Ralph H Johnson Vet Adm Hosp, Charleston, SC 29425 USA. RP Ullian, ME (reprint author), Med Univ S Carolina, Div Nephrol, Ralph H Johnson Vet Adm Hosp, CSB 829,96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. EM ullianme@musc.edu NR 48 TC 22 Z9 22 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD AUG PY 2005 VL 16 IS 8 BP 2346 EP 2353 DI 10.1681/ASN.2004060458 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 949HC UT WOS:000230774700013 PM 15944340 ER PT J AU Weisbord, SD Fried, LF Arnold, RM Fine, MJ Levenson, DJ Peterson, RA Switzer, GE AF Weisbord, SD Fried, LF Arnold, RM Fine, MJ Levenson, DJ Peterson, RA Switzer, GE TI Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID QUALITY-OF-LIFE; STAGE RENAL-DISEASE; AMBULATORY AIDS PATIENTS; ERECTILE DYSFUNCTION; DIALYSIS PATIENTS; BEHAVIORAL COMPLIANCE; PSYCHOSOCIAL FACTORS; MEDICAL-CENTER; DEPRESSION; PAIN AB The prevalence, severity, and clinical significance of physical and emotional symptoms in patients who are on maintenance hemodialysis remain incompletely characterized. This study sought to assess symptoms and their relationship to quality of life and depression. The recently developed Dialysis Symptom Index was used to assess the presence and the severity of 30 symptoms. The Illness Effects Questionnaire and Beck Depression Inventory were used to evaluate quality of life and depression, respectively. Correlations among symptom burden, symptom severity, quality of life, and depression were assessed using Spearman correlation coefficient. A total of 162 patients from three dialysis units were enrolled. Mean age was 62 y, 48% were black, 62% were men, and 48% had diabetes. The median number of symptoms was 9.0 (interquartile range 6 to 13). Dry skin, fatigue, itching, and bone/joint pain each were reported by >= 50% of patients. Seven additional symptoms were reported by > 33% of patients. Sixteen individual symptoms were described as being more than "somewhat bothersome." Overall symptom burden and severity each were correlated directly with impaired quality of life and depression. In multivariable analyses adjusting for demographic and clinical variables including depression, associations between symptoms and quality of life remained robust. Physical and emotional symptoms are prevalent, can be severe, and are correlated directly with impaired quality of life and depression in maintenance hemodialysis patients. Incorporating a standard assessment of symptoms into the care provided to maintenance hemodialysis patients may provide a means to improve quality of life in this patient population. C1 VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Inst Canc,Inst Performance Improvement, Div Gen Internal Med,Ctr Bioeth & Hlth Law, Dept Med,Sect Palliat Care & Med Eth, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Dept Med, Ctr Hlth Equ Res & Promot,VA Pittsburgh Healthcar, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. George Washington Univ, Dept Psychol, Washington, DC 20052 USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, 7E,Room 120,Mailstop 111F-U, Pittsburgh, PA 15240 USA. EM steven.weisbord@med.va.gov FU NHLBI NIH HHS [T32HL07820-05] NR 48 TC 174 Z9 188 U1 0 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD AUG PY 2005 VL 16 IS 8 BP 2487 EP 2494 DI 10.1681/ASN.2005020157 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 949HC UT WOS:000230774700029 PM 15975996 ER PT J AU Patten, LC Awad, SS Berger, DH Fagan, SP AF Patten, LC Awad, SS Berger, DH Fagan, SP TI Rectus abdominus myonecrosis: An unrecognized complication of rectus sheath hematoma SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article; Proceedings Paper CT 54th Annual Meeting of the Southwestern-Surgical-Congress CY APR 07-10, 2002 CL CORONADO, CA SP Southwestern Surg Congress C1 Houston Vet Affairs Med Ctr, Surg Serv VA 112, Houston, TX 77030 USA. Baylor Coll Med, Michael E Debakey Dept Surg, Houston, TX 77030 USA. RP Fagan, SP (reprint author), Houston Vet Affairs Med Ctr, Surg Serv VA 112, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM shawnp.fagan@med.va.gov NR 5 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-6061 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD AUG PY 2005 VL 59 IS 2 BP 473 EP 475 DI 10.1097/01.TA.0000068991.11522.2E PG 3 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 014BX UT WOS:000235454800045 ER PT J AU Cook, JM Elhai, JD Arean, PA AF Cook, JM Elhai, JD Arean, PA TI Psychometric properties of the PTSD checklist with older primary care patients SO JOURNAL OF TRAUMATIC STRESS LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; NEUROPSYCHIATRIC INTERVIEW MINI; WAR-II VETERANS; VALIDATION; VALIDITY; SAMPLE; ADULTS AB In this article the authors evaluated the posttraumatic stress disorder (PTSD) Checklist's (PCL) psychometric properties in 142 older adult primary care patients screened for several psychiatric disorders. Several established PCL scoring rules were assessed. Receiver operating characteristic analyses revealed a PCL score of 37 achieving optimal sensitivity and specificity, when compared to the PCL's algorithm-derived PTSD diagnosis (based on whether at least one reexperiencing, three avoidance/numbing, and two hyperarousal symptoms were endorsed with a rating of 3 or higher, indicating at least moderate severity). Among depressed, anxious, and substance abusing older adults, the PCL demonstrated adequate internal consistency. It also revealed similar convergence with the Center for Epidemiological Studies-Depression scale, found in previous research. Implications for using the PTSD Checklist with community-dwelling older adults in primary care are discussed. C1 Columbia Univ, New York State Psychiat Inst, New York, NY 10032 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ S Dakota, Philadelphia Vet Affairs Med Ctr, Vermillion, SD USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Langley Porter Psychiat Inst, San Francisco, CA 94143 USA. RP Cook, JM (reprint author), Columbia Univ, New York State Psychiat Inst, 1051 Riverside Dr,Box 69, New York, NY 10032 USA. EM cook_j@mail.trc.upenn.edu NR 39 TC 44 Z9 45 U1 5 U2 10 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD AUG PY 2005 VL 18 IS 4 BP 371 EP 376 DI 10.1002/jts.20038 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 986JS UT WOS:000233446500010 PM 16281234 ER PT J AU Hernandez, J Syed, S Weiss, G Fernandes, G von Merveldt, D Troyer, DA Basler, JW Thompson, IM AF Hernandez, J Syed, S Weiss, G Fernandes, G von Merveldt, D Troyer, DA Basler, JW Thompson, IM TI The modulation of prostate cancer risk with alpha-tocopherol: A pilot randomized, controlled clinical trial SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; alpha-tocopherol; prostate-specific antigen; tumor markers; biological ID GROWTH-FACTOR-I; VITAMIN-E; BETA-CAROTENE; SELECT; CELLS; MEN AB Purpose: Studies suggest that vitamin E may decrease the risk of prostate cancer. The Prevention Research Veteran Affairs E-vitamin Nutrition Trial is a randomized, double-blind, placebo controlled study designed to assess the effects of vitamin E supplementation on biomarkers associated with prostate cancer risk in peripheral blood and prostate tissue. Materials and Methods: A total of 44 patients with increased prostate specific antigen (PSA) and/or abnormal digital rectal examination on initial evaluation were randomized to receive 400 IU vitamin E (22) vs placebo (22). Serum vitamin E, PSA, dehydroepiandrosterone, testosterone and insulin-like growth factor-1 (IGF-1) were measured in the 2 groups at baseline and then at 3-month intervals. Results are reported in 28 patients (placebo in 14 and vitamin E in 14) who completed the treatment as specified by the protocol. Results: Serum Vitamin E was significantly higher in patients on vitamin E supplementation. a-Tocopherol supplementation did not affect the levels of PSA, serum androgens (testosterone and dehydroepiandrosterone) or (IGF-1). Conclusions: Serum a-tocopherol is increased by oral supplementation of vitamin E. We found that a-tocopherol supplementation has no effect on serum androgens, IGF-1 or PSA. The lack of an effect of vitamin supplementation on PSA avoids any bias in the diagnosis of prostate cancer in vitamin E treated patients. Our results suggest that a decrease in prostate cancer risk with alpha-tocopherol is likely to occur through a mechanism that is nonhormonal and independent of IGF-1. C1 Univ Texas, Hlth Sci Ctr, Dept Surg, Div Urol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med Clin Immunol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med Med Oncol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Canc Therapy Res Ctr, Inst Drug Dev, San Antonio, TX USA. S Texas Vet Healthcare Syst, Audie L Murphy Div, San Antonio, TX USA. RP Thompson, IM (reprint author), Univ Texas, Hlth Sci Ctr, Dept Surg, Div Urol, 7703 Floyd Curl Dr,MC7845, San Antonio, TX 78229 USA. EM thompsoni@uthscsa.edu NR 19 TC 9 Z9 10 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD AUG PY 2005 VL 174 IS 2 BP 519 EP 522 DI 10.1097/01.ju.0000165151.08560.6a PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 946WP UT WOS:000230604300031 PM 16006884 ER PT J AU Poon, B Hsu, JF Gudeman, V Chen, ISY Grovit-Ferbas, K AF Poon, B Hsu, JF Gudeman, V Chen, ISY Grovit-Ferbas, K TI Formaldehyde-treated, heat-inactivated virions with increased human immunodeficiency virus type 1 Env can be used to induce high-titer neutralizing antibody responses SO JOURNAL OF VIROLOGY LA English DT Article ID T-LYMPHOCYTE RESPONSES; EXPERIMENTAL VACCINE PROTECTION; ENVELOPE GLYCOPROTEIN; CYTOPLASMIC DOMAIN; HIV TYPE-1; INTERNALIZATION SIGNAL; MONOCLONAL-ANTIBODIES; IMMUNE-RESPONSES; SUBUNIT VACCINES; RHESUS-MONKEYS AB The lack of success of subunit human immunodeficiency virus (HIV) type I vaccines to date suggests that multiple components or a complex virion structure may be required. We hypothesized that the failure of current vaccine strategies to induce protective antibodies is linked to the inability of native envelope structures to readily elicit these types of antibodies. We have previously reported on the ability of a formaldehyde-treated, heat-inactivated vaccine to induce modest antibody responses in animal vaccine models. We investigated here whether immunization for HIV with an envelope-modified, formaldehyde-stabilized, heat-inactivated virion vaccine could produce higher-titer and/or broader neutralizing antibody responses. Thus, a clade B vaccine which contains a single point mutation in gp41 (Y706C) that results in increased incorporation of oligomeric Env into virions was constructed. This vaccine was capable of inducing high-titer antibodies that could neutralize heterologous viruses, including those of clades A and C. These results further support the development of HIV vaccines with modifications in native Env structures for the induction of neutralizing antibody responses. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Microbiol Mol Genet & Immunol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, AIDS Inst, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Grovit-Ferbas, K (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, 11-934 Factor Bldg, Los Angeles, CA 90095 USA. EM kferbas@ucla.edu FU NCI NIH HHS [CA016042, P30 CA016042]; NIAID NIH HHS [R01 AI052012, P30 AI028697, 1R01AI052012, AI028697, R21AI42687] NR 55 TC 22 Z9 25 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD AUG PY 2005 VL 79 IS 16 BP 10210 EP 10217 DI 10.1128/JVI.79.16.10210-10217.2005 PG 8 WC Virology SC Virology GA 950UX UT WOS:000230884700012 PM 16051814 ER PT J AU Melnychuk, RA Smith, P Kreklywich, CN Ruchti, F Vomaske, J Hall, L Loh, L Nelson, JA Orloff, SL Streblow, DN AF Melnychuk, RA Smith, P Kreklywich, CN Ruchti, F Vomaske, J Hall, L Loh, L Nelson, JA Orloff, SL Streblow, DN TI Mouse cytomegalovirus M33 is necessary and sufficient in virus-induced vascular smooth muscle cell migration SO JOURNAL OF VIROLOGY LA English DT Article ID COUPLED RECEPTOR HOMOLOG; BETA-CHEMOKINE RECEPTOR; APOE KNOCKOUT MICE; FRAME U12 ENCODES; MURINE CYTOMEGALOVIRUS; INDUCED ATHEROSCLEROSIS; DEFICIENT MICE; PROTEIN; INFECTION; CMV AB Mouse cytomegalovirus (MCMV) encodes two potential seven-transmembrane-spanning proteins with homologies to cellular chemokine receptors, M33 and M78. While these virus-encoded chemokine receptors are necessary for the in vivo pathogenesis of MCMV, the function of these proteins is unknown. Since vascular smooth muscle cell (SMC) migration is of critical importance for the development of atherosclerosis and other vascular diseases, the ability of M33 to promote SMC motility was assessed. Similar to human CMV, MCMV induced the migration of mouse aortic SMCs but not mouse fibroblasts. To demonstrate whether M33 was required for MCMV-induced SMC migration, we employed interfering-RNA technology to specifically knock down M33 expression in the context of viral infection. The knockdown of M33 resulted in the specific reduction of M33 protein expression and ablation of MCMV-mediated SMC migration but failed to reduce viral growth in cultured cells. Adenovirus vector expression of M33 was sufficient to promote SMC migration, which was enhanced in the presence of recombinant mouse RANTES (mRANTES). In addition, M33 promoted the activation of Rac1 and extracellular signal-related kinase 1/2 upon stimulation with mRANTES. These findings demonstrate that mRANTES is a ligand for this chemokine receptor and that the activation of M33 occurs in a ligand-dependent manner. Thus, M33 is a functional homologue of US28 that is required for MCMV-induced vascular SMC migration. C1 Oregon Hlth Sci Univ, Vaccine & Gene Therapy Inst, Beaverton, OR 97006 USA. Oregon Hlth Sci Univ, Dept Mol Microbiol & Immunol, Beaverton, OR 97006 USA. Oregon Hlth Sci Univ, Dept Surg, Beaverton, OR 97006 USA. Portland VA Med Ctr, Portland, OR 97239 USA. Univ Saskatchewan, Dept Microbiol, Saskatoon, SK 57N 5E5, Canada. RP Streblow, DN (reprint author), Oregon Hlth Sci Univ, Vaccine & Gene Therapy Inst, Beaverton, OR 97006 USA. EM streblow@ohsu.edu FU NHLBI NIH HHS [R01 HL066238, HL 66238-01, HL71695, HL65754, R01 HL071695, R01 HL065754] NR 37 TC 31 Z9 34 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD AUG PY 2005 VL 79 IS 16 BP 10788 EP 10795 DI 10.1128/JVI.79.16.10788-10795.2005 PG 8 WC Virology SC Virology GA 950UX UT WOS:000230884700068 PM 16051870 ER PT J AU Gibney, EM Casebeer, AW Schooley, LM Cunningham, F Grover, FL Bell, MR McDonald, GO Shroyer, AL Parikh, CR AF Gibney, EM Casebeer, AW Schooley, LM Cunningham, F Grover, FL Bell, MR McDonald, GO Shroyer, AL Parikh, CR TI Cardiovascular medication use after coronary bypass surgery in patients with renal dysfunction: A National Veterans Administration study SO KIDNEY INTERNATIONAL LA English DT Article DE cardiovascular disease; cardiac surgery; mortality ID CONVERTING-ENZYME-INHIBITOR; ACUTE MYOCARDIAL-INFARCTION; PLACEBO-CONTROLLED TRIAL; DIALYSIS PATIENTS; HEART-FAILURE; SERUM CREATININE; KIDNEY-DISEASE; BETA-BLOCKER; OUTCOMES; RISK AB Cardiovascular medication use after coronary bypass surgery in patients with renal dysfunction: A national Veterans Administration study. Background. Chronic kidney disease is now recognized as an independent risk factor for cardiovascular events. We sought to determine if cardiovascular medications were utilized less in patients with renal dysfunction following coronary artery bypass grafting (CABG) and if the association of decreased medication use was independent of comorbid conditions. We also examined associations between cardiovascular medication use and mortality at 6 months. Methods. Data from the National Veterans Adminstration (VA) Continuous Improvement in Cardiac Surgery Program were merged with the national VA pharmacy database. Prescription rates within 6 months of discharge for CABG were obtained for four classes of medicines: beta blockers, lipid-lowering agents, antiplatelet agents, and angiotensin antagonists. Utilization of medications in patients with estimated glomerular filtration rate (GFR) 60 to 90, 30 to 60, and < 30 were compared with the reference group of GFR > 90. Results. In a retrospective analysis of 19,411 patients, the frequency of nonprescription increased with declining GFR. Decreased utilization for patients with GFR 30 to 60 and < 30 remained highly significant after adjustment for age, race, hypertension, diabetes, and prior myocardial infarction. In patients with more advanced renal dysfunction (GFR < 60), cardiovascular medication use for all medication classes was associated with survival at 6 months after adjusting for demographic and clinical variables. Cumulative protection was seen with use of medication from each additional class. Conclusion. In a large VA population undergoing CABG, renal disease is associated with highly significant decreases in utilization of cardiovascular medications. Nonprescription of medications was associated with adverse outcomes in those with renal dysfunction. C1 Univ Colorado, Hlth Sci Ctr, Div Renal Dis & Hypertens, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO USA. Dept Vet Affairs, Chicago, IL USA. Univ Colorado, Hlth Sci Ctr, Dept Surg, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Continuous Improvement Cardiac Surg Program, Dept Vet Affairs, Eastern Colorado Hlth Care Syst, Denver, CO USA. Dept Vet Affairs, Off Patient Care Serv, Cent Off, Washington, DC USA. RP Gibney, EM (reprint author), 1101 E Marshall St,POB 980160, Richmond, VA 23298 USA. EM chirag.parikh@yale.edu FU NIDDK NIH HHS [T32-DK007135-30, K23-DK064689-01] NR 31 TC 18 Z9 18 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD AUG PY 2005 VL 68 IS 2 BP 826 EP 832 DI 10.1111/j.1523-1755.2005.00463.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 943GW UT WOS:000230342500043 PM 16014062 ER PT J AU Kennedy, TC Franklin, WA Prindiville, SA Cooka, R Dempsey, EC Keith, RL Hirsch, FR Merrick, TA Shroyer, KR Petty, TL Byers, T Bunn, PA Miller, YE AF Kennedy, TC Franklin, WA Prindiville, SA Cooka, R Dempsey, EC Keith, RL Hirsch, FR Merrick, TA Shroyer, KR Petty, TL Byers, T Bunn, PA Miller, YE TI High prevalence of occult endobronchial malignancy in high risk patients with moderate sputum atypia SO LUNG CANCER LA English DT Article DE sputum cytology; bronchoscopy; autofluorescence bronchoscopy; lung cancer; early detection; risk assessment; biomarkers ID LUNG-CANCER DETECTION; SQUAMOUS-CELL CARCINOMA; AIR-FLOW OBSTRUCTION; CYTOLOGY; FLUORESCENCE; BRONCHOSCOPY; LESIONS AB Early stage radiographically occult lung cancer has a high cure rate, but comprises a small fraction of all lung cancer. Abnormal sputum cytology is one indication for bronchoscopy in patients with chest imaging that is not suspicious for lung cancer. While there is good evidence that sputum cytologic findings of carcinoma, carcinoma in situ or severe atypia predict high rates of diagnosis of lung cancer, less is known of the frequency in which lung cancer is diagnosed in bronchoscopies carried out for the indication of moderate sputum atypia. One small series, published in abstract form only, reported an 8% rate of diagnosis of Lung cancer in subjects bronchoscoped for moderate atypia. We tested the hypothesis that moderate sputum atypia is an indicator of occult central airway cancer in a retrospective analysis of a group of high risk subjects, defined as current or former smokers with >30 pack-years tobacco smoking and airflow obstruction with moderate atypia sputum cytology. Seventy-nine such subjects with no evidence of malignancy on chest radiograph at the time bronchoscopy was scheduled underwent white light and autofluorescence bronchoscopy. Lung cancer was found in five subjects; three had invasive squamous cell carcinomas and two had carcinoma in situ. Seven additional subjects had severe dysplasia found on endobronchial biopsy. Moderate sputum atypia may be an important marker of risk for occult endobronchial malignancy in high risk subjects. C1 Denver Vet Affairs Med Ctr, Pulm Sect 111A, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Ctr Comprehens Canc, Denver, CO USA. Lung Canc Inst Colorado HealthOne, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Med Oncol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biostat, Denver, CO USA. RP Miller, YE (reprint author), Denver Vet Affairs Med Ctr, Pulm Sect 111A, 1055 Clermont St, Denver, CO 80220 USA. EM york.miller@uchsc.edu FU NCI NIH HHS [P50 CA58187]; PHS HHS [P30 46934] NR 22 TC 16 Z9 16 U1 1 U2 1 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD AUG PY 2005 VL 49 IS 2 BP 187 EP 191 DI 10.1016/j.lungcan.2005.02.009 PG 5 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 955UO UT WOS:000231253300006 PM 16022912 ER PT J AU Duncan, GE Li, SM Zhou, XH AF Duncan, GE Li, SM Zhou, XH TI Cardiovascular fitness among US adults: NHANES 1999-2000 and 2001-2002 SO MEDICINE AND SCIENCE IN SPORTS AND EXERCISE LA English DT Article DE maximal oxygen consumption; race; epidemiology; body mass index ID CARDIORESPIRATORY FITNESS; MEN; MORTALITY; HEALTH; WOMEN; AMERICAN; CAPACITY AB Purpose: To present information on cardiovascular fitness (estimated maximal oxygen uptake [VO(2)max] and cardiovascular fitness levels based on sex- and age-specific cut-points of estimated VO2max among U.S. adults. Methods: Analysis of data on 1978 adults (20-49 yr) who had completed a submaximal exercise test, from the National Health and Nutrition Examination Survey (1999-2000 and 2001-2002), a cross-sectional health survey of a nationally representative sample of the noninstitutionalized U.S. population Results: Estimated VO2max was significantly lower (P < 0.01) in non-Hispanic black ([mean +/- standard error] 38.2 +/- 0.7 mL(.)min(-1)center dot-kg(-1)) than Mexican-American and non-Hispanic white adults (41.5 +/- 0.6 and 40.6 +/- 0.4 mL(.)min(-1.)kg(-1), respectively). Estimated VO2max was also significantly lower (P < 0.001) in non-Hispanic black females (33.1 +/- 0.6 mL(.)min(-1.)kg(-1)) than in Mexican-American and non-Hispanic white females (37.0 +/- 0.7 and 36.4 +/- 0.4 mL(.)min(-1.)kg(-1), respectively). The proportion of low, moderate, and high cardiovascular fitness differed (P < 0.001) among race and race-sex groups. This difference was most striking among females, where 30.9% [95% confidence interval = 23.6-38.2%] of non-Hispanic black women had a low cardiovascular fitness level, compared with only 13.5% [10.0-17.0%] of non-Hispanic white and 18.9% [14.0-23.8%] of Mexican-American women. Conclusions: Adults of non-Hispanic black race have lower cardiovascular fitness than other major race groups in the United States. Nearly one third of non-Hispanic black women had a low cardiovascular fitness level, suggesting that this group in particular may be at increased health risk due to low cardiovascular fitness. C1 Univ Washington, Dept Epidemiol, Interdisciplinary Grad Program Nutrit Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Seattle, WA USA. RP Duncan, GE (reprint author), Univ Washington, Dept Epidemiol, Interdisciplinary Grad Program Nutrit Sci, 305 Raitt Hall,Box 353410, Seattle, WA 98195 USA. EM duncag@u.washington.edu RI Duncan, Glen/A-3771-2008 OI Duncan, Glen/0000-0001-6909-1869 FU NIDDK NIH HHS [K01 DK061999-03, K01 DK061999, K01 DK61999] NR 17 TC 21 Z9 23 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0195-9131 J9 MED SCI SPORT EXER JI Med. Sci. Sports Exerc. PD AUG PY 2005 VL 37 IS 8 BP 1324 EP 1328 DI 10.1249/01.mss.0000174893.74326.11 PG 5 WC Sport Sciences SC Sport Sciences GA 958VJ UT WOS:000231476000011 PM 16118579 ER PT J AU Klaustermeyer, WB Gowda, VC AF Klaustermeyer, WB Gowda, VC TI Penicillin skin testing: A 20-year study at the west Los Angeles Veterans Affairs Medical Center SO MILITARY MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the American-College-of-Allergy-Asthma-and-Immunology CY NOV 07-12, 2003 CL New Orleans, LA SP Amer Coll Allergy, Asthma & Immunol ID BETA-LACTAM ANTIBIOTICS; IMMEDIATE HYPERSENSITIVITY REACTIONS; CLINICAL-EXPERIENCE; CROSS-REACTIVITY; ORAL CHALLENGE; ALLERGY; AZTREONAM; DESENSITIZATION; ANAPHYLAXIS; AMOXICILLIN AB Penicillin (PCN) may cause a reaction in up to 10% of the population. No study has examined PCN skin testing longitudinally over a 20-year period. A total of 122 patients underwent PCN skin testing between September 1978 and May 1998. Patients were skin tested with the major determinant, penicilloyl polylysine, and three minor determinants, PCN, benzylpenilloate, and benzylpenicilloate. Ten of a total of 122 patients had positive skin test reactions. Nine reactions were to penicilloyl polylysine and one reaction was to the minor determinant benzylpenilloate. There was a total of four patients (3.6%) with false-negative results on skin testing. PCN skin testing with both the major and minor determinants should be performed when there is a history of PCN allergy, a serious illness, and no suitable alternatives. If either the major or minor determinants are positive without suitable alternative antibiotics, then the patient should undergo desensitization. C1 Univ Calif Los Angeles, David Geffen Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Div Allergy & Immunol,Dept Med, Los Angeles, CA 90073 USA. RP Klaustermeyer, WB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Div Allergy & Immunol,Dept Med, 111R,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 39 TC 6 Z9 6 U1 0 U2 1 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD AUG PY 2005 VL 170 IS 8 BP 701 EP 704 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 019JP UT WOS:000235831700014 PM 16173213 ER PT J AU Pettus, BJ Kitatani, K Chalfant, CE Taha, TA Kawamori, T Bielawski, J Obeid, LM Hannun, YA AF Pettus, BJ Kitatani, K Chalfant, CE Taha, TA Kawamori, T Bielawski, J Obeid, LM Hannun, YA TI The coordination of prostaglandin E-2 production by sphingosine-1-phosphate and ceramide-1-phosphate SO MOLECULAR PHARMACOLOGY LA English DT Article ID CYTOSOLIC PHOSPHOLIPASE A(2); SPHINGOSINE; KINASE AB The ability of pro-inflammatory cytokines such as interleukin-1 beta (IL-1 beta) to induce the major inflammatory mediator prostaglandin (PG) E-2 depends on the activation of two rate-limiting enzymes, phospholipase A(2) (PLA(2)) and cyclooxygenase 2 (COX-2). PLA(2) acts to generate arachidonic acid, which serves as the precursor substrate for COX-2 in the metabolic pathway leading to PGE(2) production. However, less is known about the mechanisms that coordinate the regulation of these two enzymes. We have provided prior evidence that sphingosine kinase 1 and its bioactive lipid product sphingosine-1-phosphate (S1P) mediate the effects of cytokines on COX-2 induction, whereas ceramide kinase and its distinct product, ceramide-1-phosphate (C1P), are required for the activation and translocation of cPLA(2) (FASEB J 17: 1411 - 1421. 2003; J Biol Chem 278: 38206 - 38213, 2003; J Biol Chem 279: 11320 - 11326, 2004). Herein, we show that these two pathways are independent but coordinated, resulting in synergistic induction of PGE(2). Moreover, the combination of both S1P and C1P recapitulates the temporal and spatial activation of cPLA(2) and COX-2 seen with IL-1 beta. Taken together, the results provide, for the first time, a mechanism that assures the coordinate expression and activation in time and space of COX-2 and cPLA(2), assuring maximal production of PGE(2). C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Virginia Commonwealth Univ, Dept Biochem, Richmond, VA USA. Ralph Johnson H Vet Affairs Med Ctr, Charleston, SC USA. RP Hannun, YA (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, Room 501,BAsic Sci Bldg,173 Ashley Ave,POB 250509, Charleston, SC 29425 USA. EM hannun@musc.edu RI Kawamori, Toshihiko/G-7636-2012 OI Kitatani, Kazuyuki/0000-0002-8516-6135; obeid, lina/0000-0002-0734-0847 FU NCI NIH HHS [CA87584]; NHLBI NIH HHS [HL072925]; NIGMS NIH HHS [GM08716, GM62887] NR 12 TC 87 Z9 88 U1 0 U2 1 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0026-895X J9 MOL PHARMACOL JI Mol. Pharmacol. PD AUG PY 2005 VL 68 IS 2 BP 330 EP 335 DI 10.1124/mol.104.008722 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 946CO UT WOS:000230549900009 PM 15900018 ER PT J AU Swarztrauber, K Anau, J Peters, D AF Swarztrauber, K Anau, J Peters, D TI Identifying and distinguishing cases of parkinsonism and Parkinson's disease using ICD-9 CM codes and pharmacy data SO MOVEMENT DISORDERS LA English DT Article DE sensitivity and specificity; prevalence; Parkinson's disease; ICD-9 CM codes; administrative data ID INTERNATIONAL CLASSIFICATION; CLINICAL-DIAGNOSIS; ACCURACY; NEUROLOGISTS; VETERANS; FEATURES; RECORDS; RATES C1 Portland VA Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Gen Clin Res Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. RP Swarztrauber, K (reprint author), P-3 PADRECC,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM swarztra@ohsu.edu NR 25 TC 36 Z9 36 U1 2 U2 4 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD AUG PY 2005 VL 20 IS 8 BP 964 EP 970 DI 10.1002/mds.20479 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 958JM UT WOS:000231440600008 PM 15834854 ER PT J AU Kay, DM Kramer, P Higgins, D Zabetian, CP Payami, H AF Kay, DM Kramer, P Higgins, D Zabetian, CP Payami, H TI Escaping Parkinson's disease: A neurologically healthy octogenarian with the LRRK2 G2019S mutation SO MOVEMENT DISORDERS LA English DT Letter C1 New York State Dept Hlth, Genom Inst, Wadsworth Ctr, Albany, NY 12237 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Albany Med Ctr, Parkinsons Dis & Movement Disorder Clin, Albany, NY USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. Dept Neurol, Seattle, WA USA. RP Kay, DM (reprint author), New York State Dept Hlth, Genom Inst, Wadsworth Ctr, Albany, NY 12237 USA. EM hpayami@wadsworth.org OI Zabetian, Cyrus/0000-0002-7739-4306; Kay, Denise/0000-0002-9928-2698 FU NINDS NIH HHS [K08 NS044138] NR 6 TC 58 Z9 61 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD AUG PY 2005 VL 20 IS 8 BP 1077 EP 1078 DI 10.1002/mds.20618 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 958JM UT WOS:000231440600032 PM 16001413 ER PT J AU Gupta, R Jovin, TG Yonas, H AF Gupta, R Jovin, TG Yonas, H TI Xenon CT cerebral blood flow in acute stroke SO NEUROIMAGING CLINICS OF NORTH AMERICA LA English DT Article ID ACUTE ISCHEMIC-STROKE; POSITRON-EMISSION-TOMOGRAPHY; TISSUE-PLASMINOGEN ACTIVATOR; COMPUTED-TOMOGRAPHY; INTRAARTERIAL THROMBOLYSIS; BRAIN ISCHEMIA; ENHANCED CT; CEREBROVASCULAR-DISEASE; VESSEL RECANALIZATION; ARTERY INFARCTION AB Acute stroke therapy is evolving rapidly as research moves toward extending the time window for treatment so that more patients can benefit. As physiology-based imaging increasingly is used in patient selection, it is becoming evident that rigid time windows are not applicable to individual patients. Xenon CT has an important role in acute stroke therapeutic intervention as a quantitative, reproducible, rapid, and safe modality, which can provide valuable physiologic data that can optimize patient triage and aid in management. C1 Univ Pittsburgh, Med Ctr, Stroke Inst, Dept Neurol, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ New Mexico, Hlth Sci Ctr, Dept Neurosurg, Albuquerque, NM 87131 USA. RP Jovin, TG (reprint author), Univ Pittsburgh, Med Ctr, Stroke Inst, Dept Neurol, 200 Lothrop St,Suite C-400, Pittsburgh, PA 15213 USA. EM colejl2@upmc.edu NR 62 TC 6 Z9 7 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1052-5149 J9 NEUROIMAG CLIN N AM JI Neuroimaging Clin. N. Am. PD AUG PY 2005 VL 15 IS 3 BP 531 EP + DI 10.1016/j.nic.2005.08.007 PG 13 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 998FK UT WOS:000234303800005 PM 16360587 ER PT J AU Katz, IR Morales, K Datto, C Streim, J Oslin, D DiFilippo, S Ten Have, T AF Katz, IR Morales, K Datto, C Streim, J Oslin, D DiFilippo, S Ten Have, T TI Probing for affective side effects of drugs used in geriatric practice: Use of daily diaries to test for effects of metoclopramide and naproxen SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE mood disorders; daily diaries; metoclopramide; naproxen; randomized clinical trial; affect ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RELIABILITY; VALIDITY; EVENTS; LIFE; AGE AB The aim of this study was to develop the use of daily diaries of affects and events as measures of pharmacological effects on affective processes and to apply them to evaluate the possible affective toxicity of metoclopramide and naproxen, two medications commonly used in geriatric practice. In all, 105 adults aged 65 years or older were randomized to receive metoclopramide (up to 40 mg/day), naproxen (up to 1000 mg/day), or placebo under double-blind conditions for a period of 5 weeks. Patients were seen weekly for evaluations of affective and cognitive outcomes as well as safety. In addition, patients kept diaries with daily records of positive and negative affect and reports of significant daily events. Findings included mixed model analyses of drug assignment, time, events, and interactions for both positive affect and days with significant negative affect. Subjects exhibited high levels of adherence in completing daily diaries. Neither the pattern of dropouts nor the weekly assessments demonstrated significant drug effects on mood or affect. However, diary data demonstrated that metoclopramide increased the apparent impact of negative events on both positive and negative affect relative to placebo, and that naproxen increased the apparent impact of positive events on positive affect and, possibly, of negative events on negative affect relative to placebo. The findings confirm the utility of diary methods for studying drug effects on affective processes in normal elderly subjects. They suggest that both metoclopramide and naproxen can affect the associations between daily events and affects. If replicated, they would demonstrate that drug effects can extend beyond the intensity of affect and/or the emergence of full-fledged psychiatric disorders to include moderation of the interactions between daily events and affect. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, MIRECC, Philadelphia, PA USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Katz, IR (reprint author), Univ Penn, Dept Psychiat, 3535 Market St,Room 3001, Philadelphia, PA 19104 USA. EM katzi@mail.med.upenn.edu NR 30 TC 5 Z9 5 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD AUG PY 2005 VL 30 IS 8 BP 1568 EP 1575 DI 10.1038/sj.npp.1300751 PG 8 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 946QJ UT WOS:000230586900017 PM 15856076 ER PT J AU Ao, Y Wu, SY Go, VLW Toy, N Yang, H AF Ao, Y Wu, SY Go, VLW Toy, N Yang, H TI Maintaining euglycemia prevents insulin-induced Fos expression in brain autonomic regulatory circuits SO PANCREAS LA English DT Article DE dorsal motor nucleus of the vagus; nucleus tractus solitarii; paraventricular nucleus of the hypothalamus; hypoglycemia; vagus ID EXTRACELLULAR GLUCOSE-CONCENTRATIONS; SOLITARY TRACT NUCLEUS; CENTRAL-NERVOUS-SYSTEM; SENSITIVE K+ CHANNELS; PORTAL-VEIN AREA; GASTRIC-MOTILITY; ACID-SECRETION; VAGAL COMPLEX; VAGUS NERVE; RAT-BRAIN AB Objective: Insulin-induced hypoglycemia activates neurons in hypothalamic and brain medullary nuclei involved in central autonomic regulation. We investigated whether these central neuronal activations relates to a deficiency of glucose supply. Methods: Three groups of non-fasted, conscious rats received intravenous (iv) saline infusion ( control), a hyperinsulinemic/hypoglycemic clamp, or a hyperinsulinemic/euglycemic clamp for 120 minutes and then the brains were collected for Fos immunohistochemistry. Results: The number of Fos positive cells significantly increased in the paraventricular nucleus of the hypothalamus (PVN, 191 +/- 63 versus 66 +/- 18), pontine locus coeruleus (LC, 53 +/- 19 versus 5 +/- 2), brain medullary dorsal motor nucleus of the vagus ( DMV, 26 6 4 versus 1 +/- 0), and nucleus tractus solitarii (NTS, 38 +/- 3 versus 10 +/- 35) in rats with hyperinsulinemic/hypoglycemic clamp compared with the controls. Maintaining blood glucose levels within physiological range by hyperinsulinemic/euglycemic clamp prevented insulin infusion-induced Fos expression in the PVN, DMV, and NTS. The numbers of Fos positive cells in these nuclei were significantly lower (-87%, -75%, and -51%, respectively) than that in the hypoglycemic rats. Conclusion: These results indicate that neuronal activation in hypothalamic and medullary autonomic regulatory nuclei induced by insulin administration is caused by hypoglycemia rather than a direct action of insulin. In addition, certain neurons in the medullary DMV and NTS respond to declines in glucose levels within physiological range. C1 Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), VA Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, 11301 Wilshire Blvd,Bldg 115,Room 203, Los Angeles, CA 90073 USA. EM hoyang@ucla.edu FU NIDDK NIH HHS [DK-41301] NR 43 TC 10 Z9 10 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD AUG PY 2005 VL 31 IS 2 BP 142 EP 147 DI 10.1097/01.mpa.0000172562.96168.59 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 950YN UT WOS:000230895300007 PM 16025001 ER PT J AU Cronise, K Finn, DA Metten, P Crabbe, JC AF Cronise, K Finn, DA Metten, P Crabbe, JC TI Scheduled access to ethanol results in motor impairment and tolerance in female C57BL/6J mice SO PHARMACOLOGY BIOCHEMISTRY AND BEHAVIOR LA English DT Article DE intoxication; alcohol; consumption; tolerance; motor incoordination; self-administration; mouse; rotarod ID ALCOHOL-PREFERRING RATS; FREE-CHOICE DRINKING; WATER RESTRICTION; LOW-LEVEL; CONSUMPTION; INTOXICATION; SENSITIVITY; DEPENDENCE; EXPOSURE; MODEL AB We recently reported a method where water-restricted mice were given scheduled access to ethanol followed by access to water. C57BL/ 6J mice would repeatedly self-administer ethanol in amounts that produced high and stable blood ethanol concentrations (BEC) [Finn DA, Belknap JK, Cronise K, Yoneyama N, Murillo A, Crabbe X. A procedure to produce high alcohol intake in mice. Psychopharmacol 2005;178:471-480]. The studies reported here demonstrate that behavioral signs of motor impairment result from these high alcohol intakes, and that there was some evidence of tolerance development across repeated sessions. Female C57BL/6J mice were allowed 30 min access to ethanol (5% v/v) followed by 2.5 h access to water either: every 3rd day for 12 days-, every 2nd day for 28 days; or every 2nd day for 9 days. On intervening days, mice had 3 h access to water. A control group had daily access to water only. Mice consumed 2-2.5 g/kg ethanol in 30 min, resulting in BECs of 1.4-1.5 mg/ml. Motor impairment was assessed using the accelerating or fixed speed rotarod, balance beam or screen test. In all studies, mice were tested for motor impairment immediately after 30 min access to ethanol or water. In Experiment 1, ethanol-exposed mice had shorter latencies to fall from the fixed speed rotarod and more foot slips on the balance beam than the control group, indicating motor impairment. After drinking ethanol, mice also fell from a screen more quickly than during sober pretraining. In Experiment 2, mice tested (without prior training) for motor impairment and tolerance on the fixed speed rotarod at 6.5 and 10 RPM showed repeated motor impairment in the ethanol group, but did not develop tolerance. In Experiment 3, mice were first given rotarod training at 10 RPM. Following each fluid access period, performance was impaired in mice self-administering ethanol at 10, but not 15 RPM, when compared to control mice. There was no evidence of tolerance across days. However, on the last day, all mice were tested at both RPM following an i.p. injection of 2 g/kg ethanol. Ethanol-experienced mice were less impaired at both RPM than the ethanol-naive mice, indicating tolerance development according to this between-groups index. These results suggest that C57BL/6J mice will repeatedly consume alcohol in amounts that produce motor impairment under these scheduled fluid access conditions, and that a modest degree of tolerance can be detected using appropriate tests. Published by Elsevier Inc. C1 Portland VA Med Ctr, R&D 12, Portland Alcohol Res Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. RP Crabbe, JC (reprint author), Portland VA Med Ctr, R&D 12, Portland Alcohol Res Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM kcronise@middlebury.edu; crabbe@ohsu.edu FU NIAAA NIH HHS [P60 AA010760, AA07468, AA10760, AA13478, AA13519] NR 44 TC 17 Z9 17 U1 3 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0091-3057 J9 PHARMACOL BIOCHEM BE JI Pharmacol. Biochem. Behav. PD AUG PY 2005 VL 81 IS 4 BP 943 EP 953 DI 10.1016/j.pbb.2005.07.005 PG 11 WC Behavioral Sciences; Neurosciences; Pharmacology & Pharmacy SC Behavioral Sciences; Neurosciences & Neurology; Pharmacology & Pharmacy GA 965AQ UT WOS:000231922500032 PM 16099022 ER PT J AU Sharf, BF Stelljes, LA Gordon, HS AF Sharf, BF Stelljes, LA Gordon, HS TI 'A little bitty spot and I'm a big man': Patients' perspectives on refusing diagnosis or treatment for lung cancer SO PSYCHO-ONCOLOGY LA English DT Article DE treatment refusal; lung neoplasms; patient acceptance of health care; decision-making rationale; physician-patient relationship; coping; uncertainty; problematic integration ID INDIVIDUAL PATIENTS; DECISION-MAKING; BREAST-CANCER; CHEMOTHERAPY; SURVIVAL; THERAPY AB Patient refusal of physicians' recommendations may partially account for variations in lung cancer treatment affecting survival. Reasons for refusal have not been well researched, and patients who refuse are often labeled derogatorily as irrational or enigmatically non-compliant. This study explored why patients refused recommendations for further diagnosis or treatment of lung cancer. We conducted in-depth interviews with nine patients, identified and recruited over a 2-year period, with documented refusal of doctors' recommendations. Recruiting was hampered by deaths, logistics, and refusal to participate. Questions focused on participants' understanding of disease, medical recommendations, and perceptions of decision-making. Transcripts were analyzed using a grounded theory approach. Participants emphasized selfefficacy, minimizing threat, fatalism or faith, and distrust of medical authority; explanations were often multidimensional. Comments included complaints about communication with physicians, health system discontinuities, and impact of social support. Explanations of participants' decisions reflected several ways of coping with an undesirable situation, including strategies for reducing, sustaining, and increasing uncertainty. Problematic Integration Theory helps to explain patients' difficulties in managing uncertainty when assessments of disease outcomes and treatment recommendations diverge. Implications for clinical communication include increasing trust while delivering bad news, understanding the source of resistance to recommendations, and discussing palliative care. Copyright (c) 2005 John Wiley & Sons, Ltd. C1 Texas A&M Univ, Dept Commun, College Stn, TX 77843 USA. Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. RP Sharf, BF (reprint author), Texas A&M Univ, Dept Commun, MS 4234, College Stn, TX 77843 USA. EM bsharf@tamu.edu RI Gordon, Howard/E-4420-2010 OI Gordon, Howard/0000-0002-6712-5954 FU AHRQ HHS [5PO1 HS10876] NR 30 TC 37 Z9 37 U1 2 U2 7 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1057-9249 J9 PSYCHO-ONCOL JI Psycho-Oncol. PD AUG PY 2005 VL 14 IS 8 BP 636 EP 646 DI 10.1002/pons.885 PG 11 WC Oncology; Psychology; Psychology, Multidisciplinary; Social Sciences, Biomedical SC Oncology; Psychology; Biomedical Social Sciences GA 954QF UT WOS:000231168900003 PM 15744761 ER PT J AU Yehuda, R Golier, JA Harvey, PD Stavitsky, K Kaufman, S Grossman, RA Tischler, L AF Yehuda, R Golier, JA Harvey, PD Stavitsky, K Kaufman, S Grossman, RA Tischler, L TI Relationship between cortisol and age-retated memory impairments in Holocaust survivors with PTSD SO PSYCHONEUROENDOCRINOLOGY LA English DT Article DE posttraumatic stress disorder (PTSD); Holocaust survivors; memory performance; cortisol; circadian rhythm; aging ID POSTTRAUMATIC-STRESS-DISORDER; PITUITARY-ADRENAL AXIS; DEHYDROEPIANDROSTERONE-SULFATE DHEAS; HEALTHY ELDERLY-MEN; ALZHEIMERS-DISEASE; HIPPOCAMPAL ATROPHY; DECLARATIVE MEMORY; BASAL CORTISOL; DEXAMETHASONE SUPPRESSION; FEEDBACK INHIBITION AB Rationale: Holocaust survivors with PTSD appear to show an accelerated aging effect as evidenced by their performance on tests of explicit memory, and also show more exaggerated patterns on age-related alterations in cortisol release over the diurnal cycle than Holocaust survivors without PTSD and nonexposed subjects. To investigate the implications of age-related HPA axis alterations on cognition, we examined correlations between parameters reflecting circadian cortisol release and implicit and explicit memory performance. Methods: Nineteen Holocaust survivors with PTSD (7 men, 12 women), 16 Holocaust survivors without PTSD (7 men, 9 women), and 28 non-exposed healthy comparison subjects (13 men, 15 women) collected salivary samples at six times over the diurnal cycle, and were tested with Paired Associates and Word Stem Completion Tests. Results: Negative correlations were observed between several measures of salivary cortisol concentrations and explicit memory in Holocaust survivors with PTSD after adjusting for IQ, years of education and current age reflecting poorer performance in association with higher cortisol levels. This relationship was absent in Holocaust survivors without PTSD and in demographically-comparable subjects who were not exposed to the Holocaust or other extremely traumatic events. Conclusion: The significantly different relationship between cortisol and memory performance in these groups suggests that the neuropsychological impairments observed in Holocaust survivors with PTSD may reflect an interaction of PTSD and aging effects. (c) 2005 Elsevier Ltd. All rights reserved. C1 Mt Sinai Sch Med, Dept Psychiat OOMH, Div Traumat Stress Studies, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Yehuda, R (reprint author), Mt Sinai Sch Med, Dept Psychiat OOMH, Div Traumat Stress Studies, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@med.va.gov FU NIMH NIH HHS [R01 MH64675-01] NR 59 TC 31 Z9 31 U1 1 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4530 J9 PSYCHONEUROENDOCRINO JI Psychoneuroendocrinology PD AUG PY 2005 VL 30 IS 7 BP 678 EP 687 DI 10.1016/j.psyneuen.2005.02.007 PG 10 WC Endocrinology & Metabolism; Neurosciences; Psychiatry SC Endocrinology & Metabolism; Neurosciences & Neurology; Psychiatry GA 928BO UT WOS:000229246300007 PM 15854784 ER PT J AU Bloomfield, HE Nelson, DB van Ryn, M Neil, BJ Koets, NJ Basile, JN Samaha, FF Kaul, R Mehta, JL Bouland, D AF Bloomfield, HE Nelson, DB van Ryn, M Neil, BJ Koets, NJ Basile, JN Samaha, FF Kaul, R Mehta, JL Bouland, D TI A trial of education, prompts, and opinion leaders to improve prescription of lipid modifying therapy by primary care physicians for patients with ischemic heart disease SO QUALITY & SAFETY IN HEALTH CARE LA English DT Article ID DENSITY-LIPOPROTEIN CHOLESTEROL; PREVENTIVE CARE; INTERVENTIONS; REMINDERS; BEHAVIOR AB Background: Recent clinical trials indicate that treatment with lipid modifying therapy improves outcomes in patients with ischemic heart disease (IHD) and low levels of high density lipoprotein (HDL) cholesterol. The results of these trials, however, have not been widely implemented in clinical practice. Objectives: To develop and test an intervention designed to increase the rate of prescription of lipid modifying therapy and to determine the relative effectiveness of three different prompts ( progress notes, patient letters, or computer chart reminders). Methods: The study was conducted in 11 US Department of Veterans Affairs Medical Centers. The effect of the intervention on the proportion of eligible patients receiving lipid modifying therapy was compared between five intervention sites and six matched control sites using a controlled before and after study design. Additionally, 92 providers within the intervention clinics were randomized to receive one of the three prompts. Data were analyzed using logistic regression modeling which incorporated terms to account for the clustered nature of the data. Results: At the intervention sites the prescription rate increased from 8.3% during the pre-intervention period to 39.1% during the intervention ( OR = 6.5, 95% CI 5.2 to 8.2, p < 0.0001) but remained unchanged at the control sites. The interaction between group ( control v intervention) and time period was highly significant (p < 0.0001). The adjusted odds of receiving a prescription during the intervention period was 3.1 times higher at the intervention sites than at the control sites ( 95% CI 2.1 to 4.7). Overall, there was no significant difference in prescription rates among the three prompt groups. However, there was a significant interaction between prompt group and site, indicating that the efficacy of the prompts differed by site. Conclusion: An intervention for primary care providers consisting of an educational workshop, opinion leader influence, and prompts substantially increased the prescription rate of lipid modifying therapy. C1 VA Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. Ralph H Johnson VA Med Ctr, Div Gen Internal Med Geriatr, Charleston, SC USA. Philadelphia VA Med Ctr, Cardiovasc Sect, Philadelphia, PA USA. VA Med Ctr, Fargo, ND USA. Univ Arkansas, Div Cardiovasc, Little Rock, AR 72204 USA. VA Pacific Isl Hlth Care Syst, Honolulu, HI USA. RP Bloomfield, HE (reprint author), VA Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. EM hanna.bloomfield@med.va.gov RI VAN RYN, MICHELLE/B-1664-2010 OI bloomfield, hanna/0000-0002-0756-7064 NR 20 TC 13 Z9 13 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1475-3898 J9 QUAL SAF HEALTH CARE JI Qual. Saf. Health Care PD AUG PY 2005 VL 14 IS 4 BP 258 EP 263 DI 10.1136/qshc.2004.012617 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 950YT UT WOS:000230896000007 PM 16076789 ER PT J AU Hirschkowitz, M Schmidt, MH AF Hirschkowitz, M Schmidt, MH TI Sleep-related erections: Clinical perspectives and neural mechanisms SO SLEEP MEDICINE REVIEWS LA English DT Review DE sleep-related erections; nocturnal penile tumescence; erectile dysfunction; mechanisms of erection ID NOCTURNAL PENILE TUMESCENCE; FOREBRAIN INHIBITORY MECHANISMS; MEDIAL PREOPTIC AREA; MALE-RATS; COPULATORY-BEHAVIOR; PARADOXICAL SLEEP; HYPOGONADAL MEN; BASAL FOREBRAIN; SEXUAL-BEHAVIOR; NUCLEUS PARAGIGANTOCELLULARIS AB Involuntary sleep-related erections (SREs) occur naturally during REM sleep in sexually potent men and other mammals. The regularity of their pattern and non-volitional nature made SREs useful clinically for differentiating psychogenic and organic erectile dysfunction (ED) in candidates for surgical intervention. Normative data available for different age groups added to the attractiveness of SRE measurement for clinical decision-making. Clinical SIRE testing is less commonly applied today with the advent of minimally invasive medical therapies for ED. Nonetheless, as an objective measure of erectile function, SRE recording for research provides a precise technique for examining the mechanisms of erection and is still conducted to resolve legal disputes. SIRE alterations provoked hormonally and pharmacologically are discussed. Different SIRE patterns are associated with comorbid factors and some of these are illustrated, described, or both. Recording techniques developed for rats have proved extremely valuable for furthering our understanding of brain centers mediating erectile response. Data from lesion and stimulation studies are examined in the present review, moving us a step closer to understanding the underpinnings of erectile function. Published by Elsevier Ltd. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Sleep Ctr, Dept Psychiat, Houston, TX 77030 USA. Baylor Coll Med, Houston Vet Affairs Med Ctr, Sleep Ctr, Dept Med, Houston, TX 77030 USA. Ohio Sleep Med & Neurosci Inst, Dublin, OH 43017 USA. RP Hirschkowitz, M (reprint author), VAMC, Sleep Ctr 1111, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM maxh@bcm.tmc.edu NR 121 TC 33 Z9 37 U1 1 U2 12 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 1087-0792 J9 SLEEP MED REV JI Sleep Med. Rev. PD AUG PY 2005 VL 9 IS 4 BP 311 EP 329 DI 10.1016/j.smrv.2005.03.001 PG 19 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 954QQ UT WOS:000231170000006 PM 15994100 ER PT J AU Studenski, S Duncan, PW Perera, S Reker, D Lai, SM Richards, L AF Studenski, S Duncan, PW Perera, S Reker, D Lai, SM Richards, L TI Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors SO STROKE LA English DT Article DE disability; exercise; quality of life; rehabilitation; stroke ID POST-STROKE; REHABILITATION; PERFORMANCE; COMMUNITY AB Background and Purpose - The ability of therapeutic exercise after stroke to improve daily functioning and quality of life (QOL) remains controversial. We examined treatment effects on these outcomes in a randomized controlled trial (RCT) of exercise in subacute stroke survivors. Methods - This is a secondary analysis of a single-blind RCT of a 12-week program versus usual care. Baseline, post-treatment and 6-month post-treatment daily functioning and QOL were assessed by Barthel index, Functional Independence Measure, instrumental activities of daily living, Medical Outcomes Study short-form 36-item questionnaire (SF-36), and Stroke Impact Scale (SIS). Results - Of 100 randomized subjects, 93 completed the postintervention assessment, ( mean age 70; 54% male; 81% white; mean Orpington Prognostic Score 3.4), and 80 had 6-month post-treatment assessment. Immediately after intervention, the intervention group improved more than usual care in SF-36 social function ( 14.0 points; P = 0.0051) and in SIS ( strength [9.2 points; P = 0.0003], emotion [5.6 points; P = 0.0240], social participation [6.6 points; P = 0.0488], and physical function [5.0 points; P = 0.0145]). Treatment was marginally more effective on Barthel score (3.3 points; P = 0.0510), SF-36 ( physical function [6.8 points; P = 0.0586], physical role function [14.4 points; P = 0.0708]), and SIS upper extremity function (7.2 points; P = 0.0790). Effects were diluted 6 months after treatment ended. Conclusion - This rehabilitation exercise program led to more rapid improvement in aspects of physical, social, and role function than usual care in persons with subacute stroke. Adherence interventions to promote continued exercise after treatment might be needed to continue benefit. C1 Univ Pittsburgh, Div Geriatr Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Florida, Dept Hlth Serv Res, Gainesville, FL USA. Univ Florida, Brooks Ctr Rehabil Studies, Gainesville, FL USA. Univ Kansas, N Florida S Georgia Vet Hlth Syst, Gainesville Dept Hlth Policy & Adm, Lawrence, KS 66045 USA. Kansas City VA Med Ctr, Kansas City, KS USA. Univ Kansas, Dept Prevent Med & Publ Hlth, Lawrence, KS 66045 USA. Univ Florida, Dept Occupat Therapy, Gainesville, FL USA. RP Studenski, S (reprint author), 3471 5th Ave,Suite 500, Pittsburgh, PA 15213 USA. EM sas33@pitt.edu RI Perera, Subashan/D-7603-2014 FU NIA NIH HHS [P60AG14635] NR 25 TC 72 Z9 82 U1 3 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD AUG PY 2005 VL 36 IS 8 BP 1764 EP 1770 DI 10.1161/01.STR.0000174192.87887.70 PG 7 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 949WA UT WOS:000230817600026 PM 16040590 ER PT J AU Heuze-Vourc'h, N Liu, M Dalwadi, H Baratelli, FE Zhu, L Goodglick, L Pold, M Sharma, S Ramirez, RD Shay, JW Minna, JD Strieter, RM Dubinett, SM AF Heuze-Vourc'h, N Liu, M Dalwadi, H Baratelli, FE Zhu, L Goodglick, L Pold, M Sharma, S Ramirez, RD Shay, JW Minna, JD Strieter, RM Dubinett, SM TI IL-20, an anti-angiogenic cytokine that inhibits COX-2 expression SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE interleukin-20; cyclooxygenase-2; prostaglandin-E-2; lung cancer; angiogenesis; NSCLC; human bronchial epithelial cells ID CELL LUNG-CANCER; CYCLOOXYGENASE-2; INTERLEUKIN-10; PREVENTION; RECEPTOR; TARGET AB COX-2 overexpression and subsequent PGE(2) production are frequently associated with non-small cell lung cancer and are implicated in tumor-mediated angiogenesis. Here, we report for the first time that IL-20 downregulates COX-2 and PGE(2) in human bronchial epithelial and endothelial cells. Flow cytometry analysis suggests that IL-20-dependent inhibition of COX-2/PGE(2) occurs through the IL-22R1/IL-2OR2 dimers. In addition, we report that IL-20 exerts anti-angiogenic effects, inhibiting experimental angiogenesis. IL-20-mediated inhibition of PMA-induced angiogenesis occurs through the COX-2 regulatory pathway. Altogether our findings revealed that IL-20 is a negative modulator of COX-2/PGE(2) and inhibits angiogenesis. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Dept Med, Div Pulm & Crit Care Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Hamon Ctr Therapuet Oncol Res, Dallas, TX USA. Dallas Vet Affairs Med Ctr, Dallas, TX USA. Univ Texas, SW Med Ctr, Dept Cell Biol, Dallas, TX USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Dept Med, Div Pulm & Crit Care Med, Los Angeles, CA 90024 USA. EM sdubinett@mednet.ucla.edu RI Shay, Jerry/F-7878-2011; HEUZE-VOURC'H, Nathalie/P-8081-2016 FU NCI NIH HHS [CA-16042, P50 CA90388, R01 CA85686]; NIAID NIH HHS [AI-28697] NR 21 TC 30 Z9 32 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD JUL 29 PY 2005 VL 333 IS 2 BP 470 EP 475 DI 10.1016/j.bbrc.2005.05.122 PG 6 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 944HU UT WOS:000230418700026 PM 15950941 ER PT J AU Kleinschmidt-DeMasters, BK Tyler, KL AF Kleinschmidt-DeMasters, BK Tyler, KL TI Brief report - Progressive multifocal leukoencephalopathy complicating treatment with natalizumab and interferon beta-1a for multiple sclerosis SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID HUMAN POLYOMAVIRUSES; DISEASE; ENCEPHALOMYELITIS; INTEGRIN; ANTIBODY AB A 46-year-old woman with relapsing-remitting multiple sclerosis died from progressive multifocal leukoencephalopathy (PM) after having received 37 doses of natalizumab (300 mg every four weeks) as part of a clinical trial of natalizumab and interferon beta-1a. PML was diagnosed on the basis of the finding of JC viral DNA in cerebrospinal fluid on polymerase-chain-reaction assay and was confirmed at autopsy. Nearly every tissue section from bilateral cerebral hemispheres contained either macroscopic or microscopic PML lesions. There was extensive tissue destruction and cavitation in the left frontoparietal area, large numbers of bizarre astrocytes, and inclusion-bearing oligodendrocytes, which were positive for JC virus DNA on in situ hybridization. C1 Univ Colorado, Hlth Sci Ctr, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurosurg, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Kleinschmidt-DeMasters, BK (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Pathol, B-216,4200 E 9th Ave, Denver, CO 80262 USA. OI Tyler, Kenneth/0000-0003-3294-5888 NR 13 TC 632 Z9 655 U1 2 U2 16 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 28 PY 2005 VL 353 IS 4 BP 369 EP 374 DI 10.1056/NEJMoa051782 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 949JW UT WOS:000230782800009 PM 15947079 ER PT J AU Hayes, JM Walczak, H Prochazka, A AF Hayes, JM Walczak, H Prochazka, A TI Comparison of drug regimen costs between the medicare prescription discount program and other purchasing systems SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Hayes, JM (reprint author), Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. EM john.hayes@med.va.gov NR 4 TC 4 Z9 4 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 27 PY 2005 VL 294 IS 4 BP 427 EP 428 DI 10.1001/jama.294.4.427-b PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 948RM UT WOS:000230733400016 PM 16046648 ER PT J AU Cummings, DE AF Cummings, DE TI Gastric bypass and nesidioblastosis - Too much of a good thing for islets? SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID TYPE-2 DIABETES-MELLITUS; GLUCAGON-LIKE PEPTIDE-1; BARIATRIC SURGERY; WEIGHT-LOSS; GHRELIN; OBESITY C1 Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Cummings, DE (reprint author), Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. NR 16 TC 54 Z9 58 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 JUL 21 PY 2005 VL 353 IS 3 BP 300 EP 302 DI 10.1056/NEJMe058170 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 946YH UT WOS:000230608700013 PM 16034017 ER PT J AU Kliethermes, CL Cronise, K Crabbe, JC AF Kliethermes, CL Cronise, K Crabbe, JC TI Home cage activity and ingestive behaviors in mice following chronic ethanol vapor inhalation SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE alcohol withdrawal; mice; anxiety-like behaviors; home cage ID ELEVATED PLUS-MAZE; WITHDRAWAL-INDUCED ANXIETY; ALCOHOL-WITHDRAWAL; RATS; DEPENDENCE; EXPOSURE; NITRENDIPINE; ANTAGONISTS; MANAGEMENT; RESPONSES AB Although drug withdrawal may induce an anxiety-like state, decreased locomotion in tests of anxiety-like behavior is an almost universal finding in rodent studies of ethanol withdrawal. Decreased locomotion in many behavioral apparatus, either as a result of a withdrawal-induced lethargy, malaise, or reduced motivation to explore confounds interpreting the effects of withdrawal as specifically increasing an anxiety-like state. To address this issue, we measured home cage activity levels as well as food and water intake for 3 days prior to and up to 5 days after chronic ethanol vapor exposure in genetically heterogeneous mice. In the first experiment, ethanol-withdrawing WSC-2 mice drank less water than controls, but did not differ from controls on any other behavioral measure during the withdrawal assessments. When the dose of ethanol was elevated in a subsequent experiment in WSC-2 mice, a similar temporary decrease in food and water intake, but not in locomotion, was observed during withdrawal. These results differed from those of mice placed into activity monitors during peak withdrawal, which exhibited profoundly reduced activity levels compared to controls. Finally, home cage activity levels during withdrawal were only transiently decreased in a mouse line that has been selectively bred to display high ethanol withdrawal handling-induced convulsion severity (WSP mice). The reduction in food and water consumption seen in most experiments suggests that withdrawal may induce a temporary malaise-like state, but this state is not reflected in altered home cage activity levels. Further, even in a relatively severe mouse model of alcohol withdrawal, any decreases in general home cage activity are short-lived. Published by Elsevier Inc. C1 Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. Portland VA Med Ctr, Portland Alcohol Res Ctr, Portland, OR 97239 USA. RP Kliethermes, CL (reprint author), Oregon Hlth Sci Univ, Dept Behav Neurosci, R&D 12,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM kliether@ohsu.edu FU NIAAA NIH HHS [P60 AA010760, AA10760, AA015015] NR 39 TC 9 Z9 9 U1 1 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD JUL 21 PY 2005 VL 85 IS 4 BP 479 EP 488 DI 10.1016/j.physbeh.2005.05.009 PG 10 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 953UJ UT WOS:000231105800013 PM 16005034 ER PT J AU Kawaguchi, K Hickey, RW Rose, ME Zhu, L Chen, J Graham, SH AF Kawaguchi, K Hickey, RW Rose, ME Zhu, L Chen, J Graham, SH TI Cyclooxygenase-2 expression is induced in rat brain after kainate-induced seizures and promotes neuronal death in CA3 hippocampus SO BRAIN RESEARCH LA English DT Article DE cyclooxygenase; kainate; cell death; seizure ID PENTYLENETETRAZOL-INDUCED SEIZURES; SUSTAINED ELECTRICAL-STIMULATION; KAINIC ACID; CELL-DEATH; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); ANTIINFLAMMATORY AGENTS; SELECTIVE-INHIBITION; INDUCED CONVULSIONS; ALZHEIMERS-DISEASE; PILOCARPINE MODEL AB Cyclooxygenase-2 (COX-2) is the predominant isoform of cyclooxygenase in brain. COX-2 activity produces oxidative stress and results in the production of prostaglandins that have many injurious effects. COX-2 transcription is induced by synaptic activity; therefore, COX-2 activity could contribute to epileptic neuronal injury. To address this hypothesis, COX-2 protein expression and PGE(2) production were determined after kainate-induced limbic seizures in rats. The effects of a specific COX-2 inhibitor, SC58125, on neuronal survival and PGE2 concentration in the hippocampus were also determined. COX-2 protein expression was increased in CA3, dentate gyrus, and cortex at 18-24 h after seizures. Hippocampal PGE(2) levels were increased at 24 h following seizures, and treatment with the selective COX-2 inhibitor SC58125, 3 mg/kg p.o., attenuated the increase in PGE(2) concentration. The survival of CA3 neurons at 7 days after seizures was increased in rats treated with SC58125 compared to vehicle controls. There was no effect of drug treatment on body or brain temperature, nor on the duration or rate of Type IV EEG activity. These results suggest that COX-2 activity can contribute to epileptic neuronal injury and that selective COX-2 inhibitors are neuroprotective. C1 Vet Affairs Pittsburgh Healthcare Syst, Geriatr Res & Educ Ctr 151, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Pediat, Pittsburgh, PA 15260 USA. RP Graham, SH (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Geriatr Res & Educ Ctr 151, Univ Dr C, Pittsburgh, PA 15240 USA. EM sgra@pitt.edu FU NICHD NIH HHS [K08 HD040848, K08 HD40848]; NINDS NIH HHS [R01 NS037459, R01 NS037459-05, R01 NS37459] NR 59 TC 64 Z9 67 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JUL 19 PY 2005 VL 1050 IS 1-2 BP 130 EP 137 DI 10.1016/j.brainres.2005.05.038 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 954AT UT WOS:000231127200017 PM 15979590 ER PT J AU Hirano, AA Brandstatter, JH Brecha, NC AF Hirano, AA Brandstatter, JH Brecha, NC TI Cellular distribution and subcellular localization of molecular components of vesicular transmitter release in horizontal cells of rabbit retina SO JOURNAL OF COMPARATIVE NEUROLOGY LA English DT Review DE SNARE complex; exocytosis; GABA; amacrine cells; immunocytochemistry ID GAMMA-AMINOBUTYRIC-ACID; GABA-LIKE IMMUNOREACTIVITY; SYNAPTIC VESICLE PROTEINS; OUTER PLEXIFORM LAYER; CONE BIPOLAR CELLS; MOUSE RETINA; MAMMALIAN RETINA; RIBBON SYNAPSES; GLUTAMIC-ACID; CAT RETINA AB The mechanism underlying transmitter release from retinal horizontal cells is poorly understood. We investigated the possibility of vesicular transmitter release from mammalian horizontal cells by examining the expression of synaptic proteins that participate in vesicular transmitter release at chemical synapses. Using immunocytochemistry, we evaluated the cellular and subcellular distribution of complexin I/II, syntaxin-1, and synapsin I in rabbit retina. Strong labeling for complexin I/II, proteins that regulate a late step in vesicular transmitter release, was found in both synaptic layers of the retina, and in somata of A- and B-type horizontal cells, of gamma-aminobutyric acid (GABA)- and glycinergic amacrine cells, and of ganglion cells. Immunoelectron microscopy demonstrated the presence of complexin I/II in horizontal cell processes postsynaptic to rod and cone ribbon synapses. Syntaxin-1, a core protein of the soluble N-ethylmaleimide-sensitive-factor attachment protein receptor (SNARE) complex known to bind to complexin, and synapsin 1, a synaptic vesicle-associated protein involved in the Ca(2+)-dependent recruitment of synaptic vesicles for transmitter release, were also present in the horizontal cells and their processes at photoreceptor synapses. Photoreceptors and bipolar cells did not express any of these proteins at their axon terminals. The presence of complexin I/II, syntaxin-1, and synapsin I in rabbit horizontal cell processes and tips suggests that a vesicular mechanism may underlie transmitter release from mammalian horizontal cells. Published 2005 Wiley-Liss, Inc. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Geffen Sch Med, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Geffen Sch Med, Ctr Ulcer Res, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Geffen Sch Med, Educ Digest Dis Res Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Max Planck Inst Brain Res, Dept Neuroanat, D-60528 Frankfurt, Germany. Univ Erlangen Nuernberg, Inst Zool, D-91058 Erlangen, Germany. RP Hirano, AA (reprint author), Univ Calif Los Angeles, Geffen Sch Med, Dept Neurobiol, 10833 Le Conte Ave,Box 951763, Los Angeles, CA 90095 USA. EM ahirano@mednet.ucla.edu FU NEI NIH HHS [R56 EY004067, EY 04067, R01 EY015573-01A1, R01 EY015573, R01 EY004067] NR 105 TC 33 Z9 33 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0021-9967 J9 J COMP NEUROL JI J. Comp. Neurol. PD JUL 18 PY 2005 VL 488 IS 1 BP 70 EP 81 DI 10.1002/cne.20577 PG 12 WC Neurosciences; Zoology SC Neurosciences & Neurology; Zoology GA 932MH UT WOS:000229557300006 PM 15912504 ER PT J AU Krysan, K Reckamp, KL Dalwadi, H Sharma, S Rozengurt, E Dohadwala, M Dubinett, SM AF Krysan, K Reckamp, KL Dalwadi, H Sharma, S Rozengurt, E Dohadwala, M Dubinett, SM TI Prostaglandin E-2 activates mitogen-activated protein kinase/Erk pathway signaling and cell proliferation in non-small cell lung cancer cells in an epidermal growth factor receptor-independent manner SO CANCER RESEARCH LA English DT Article ID EGF RECEPTOR; COUPLED RECEPTORS; EPITHELIAL-CELLS; CARCINOMA-CELLS; CYCLOOXYGENASE-2; PHOSPHORYLATION; MUTATIONS; GEFITINIB; THERAPY; GENE AB Cyclooxygenase 2 (COX-2) overexpression is found in a wide variety of human cancers and is linked to all stages of tumorigenesis. Elevated tumor COX-2 expression is associated with increased angiogenesis, tumor invasion, suppression of host immunity and promotes tumor cell resistance to apoptosis. Previous reports have linked the COX-2 product prostaglandin E-2 (PGE(2)) to the abnormal activation of the mitogen-activated protein kinase/Erk kinase pathway. Here we show that PGE(2) is able to rapidly stimulate Erk phosphorylation in a subset of non-small cell lung cancer (NSCLC) cell lines. This effect is not evident in bronchial epithelial cells. In contrast to previous reports in colon cancer, we found that Erk activation as well as cellular proliferation induced by PGE2 was not inhibited by pretreatment of the cells with epidermal growth factor receptor (EGFR) inhibitors. Activation of the Erk pathway by PGE2 was also resistant to src kinase inhibitors but sensitive to the protein kinase C inhibition. PGE2 effects are mediated through four G protein-coupled receptors. Selective inhibition of EP receptors revealed the possible involvement of Ca2+-dependent signaling in PGE(2)-mediated activation of Erk. Our data indicate the presence of an EGFR-independent activation of the mitogen-activated protein kinase/Erk pathway by PGE2 in NSCLC cells. These findings provide evidence for the possible link between tumor COX-2 overexpression and elevated Erk-mediated cancer cell proliferation and migration. Importantly, these findings suggest that COX-2 overexpression may contribute to EGFR inhibitor resistance in NSCLC. C1 Univ Calif Los Angeles, David Geffen Sch Med, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, CURE Digest Dis Res Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Inst Mol Biol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Jonsson Comprehens Canc Ctr, Lung Canc Res Program, 37-131 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu OI Reckamp, Karen/0000-0002-9213-0325 FU NCI NIH HHS [P50 CA90388] NR 49 TC 149 Z9 157 U1 1 U2 5 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JUL 15 PY 2005 VL 65 IS 14 BP 6275 EP 6281 DI 10.1158/0008-5472.CAN-05-0216 PG 7 WC Oncology SC Oncology GA 947HG UT WOS:000230633400037 PM 16024629 ER PT J AU Fox, RK Currie, SL Evans, J Wright, TL Tobler, L Phelps, B Busch, MP Page-Shafer, K AF Fox, RK Currie, SL Evans, J Wright, TL Tobler, L Phelps, B Busch, MP Page-Shafer, K TI Hepatitis C virus infection among prisoners in the California State correctional system SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID INJECTION-DRUG USERS; HUMAN-IMMUNODEFICIENCY-VIRUS; ANTI-D IMMUNOGLOBULIN; GENDER-DIFFERENCES; RISK-FACTORS; HETEROSEXUAL TRANSMISSION; PLUS RIBAVIRIN; HIV; PREVALENCE; WOMEN AB Background. Incarcerated populations are at high risk for hepatitis C virus (HCV) infection, yet prisoners are not routinely screened or treated for HCV infection. Understanding the risk factors of HCV infection among prisoners could help improve HCV interventions. Methods. Prevalence and risk of HCV infection among 469 prisoners entering California State correctional facilities were assessed using HCV antibody screening, HCV RNA measurement, and structured interviews. Multivariate logistic regression analysis was used to identify independent correlates of HCV infection. Results. The prevalence of HCV infection was 34.3% overall (95% confidence interval [CI], 30% - 38%) and was 65.7% among those with a history of injection drug use (IDU), compared with 10.2% among those with no history of IDU (odds ratio [OR], 17.24; 95% CI, 10.52 - 28.25). Significant differences in HCV antibody positivity were found in association with age at first detention but not with the nature of the crime. Independent correlates of HCV infection included age, history of IDU, cumulative time of incarceration, biological sex ( OR for females subjects compared with males subjects, 0.35; 95% CI, 0.13 - 0.96), and a history of having sex with a male IDU (OR, 4.42; 95% CI, 1.46 - 13.37). We identified significant differences in risk factors between male and female subjects - notably, that the risk of HCV infection was significantly elevated among female non-IDUs who reported having sexual partners with a history of IDU. Among non-IDUs, correlates of HCV infection included history of receipt of blood products and cumulative years of incarceration. Conclusions. HCV infection is pervasive among the California prison population, including prisoners who are non-IDUs and women with high-risk sexual behavior. These results should promote consideration of routine HCV antibody screening and behavioral interventions among incarcerated men and women. C1 Univ Calif San Francisco, Ctr AIDS Prevent Studies, Dept Med, San Francisco, CA 94105 USA. Univ Calif San Francisco, Div Gen Internal Med, San Francisco, CA 94105 USA. Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94105 USA. San Francisco Vet Adm Med Ctr, Div Gastroenterol, San Francisco, CA USA. Blood Syst Res Inst, San Francisco, CA USA. Chiron Corp, Emeryville, CA 94608 USA. RP Page-Shafer, K (reprint author), Univ Calif San Francisco, Ctr AIDS Prevent Studies, Dept Med, 74 New Montgomery,Ste 600, San Francisco, CA 94105 USA. EM kshafer@psg.ucsf.edu OI Page, Kimberly/0000-0002-7120-1673 FU NIDDK NIH HHS [R03 DK065113] NR 38 TC 62 Z9 65 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 15 PY 2005 VL 41 IS 2 BP 177 EP 186 DI 10.1086/430913 PG 10 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 936YF UT WOS:000229890800006 PM 15983913 ER PT J AU Sethi, S AF Sethi, S TI Moxifloxacin for the treatment of acute exacerbations of chronic obstructive pulmonary disease SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; REQUIRING MECHANICAL VENTILATION; CHRONIC-BRONCHITIS; ANTIBIOTIC-TREATMENT; COPD; FLUOROQUINOLONES; LEVOFLOXACIN; MANAGEMENT; INFECTION; HEALTH AB Background/purpose. The significant impact of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is now recognized. This recognition has led to increased efforts to provide evidence-based, appropriate treatment of AECOPD, to minimize its negative impact. This article reviews the bacterial etiology of AECOPD and clinical trials (both placebo-controlled and antibiotic comparison trials) that support the use of antibiotics for AECOPD, with an emphasis on the role of newer fluoroquinolones for the treatment of patients with this condition. A discussion of patient stratification that permits identification of those who require initial aggressive antibiotic therapy is presented. Main findings. Among the treatment modalities for exacerbations, the role and choice of antibiotics is hotly debated. Current evidence supports the use of antibiotics in the treatment of AECOPD, because bacterial pathogens cause approximately half the exacerbations, and because empirical antibiotics have a significant benefit in most exacerbations. Several recent investigations have aided in the development of a rational antibiotic strategy for AECOPD. These include outcome studies that have identified patients who are likely to have a poor outcome of their exacerbation and, therefore, are candidates for aggressive initial antibiotic therapy. Studies of the new fluoroquinolone agents have shown superior short- and long-term clinical results among patients with AECOPD who are at risk of a poor outcome. Conclusions. Theoretical concerns about the emergence of resistance to the fluoroquinolones dictate not only the appropriate use of these drugs but, also, the use of the most-potent agents available in this class, to sustain their usefulness over time. Such selected use of the new fluoroquinolones balances individual benefit with societal concerns regarding the use of these agents for the treatment of AECOPD. C1 SUNY Buffalo, Div Pulm Crit Care & Sleep Med, Buffalo, NY USA. US Dept Vet Affairs, Western New York Healthcare Syst, Buffalo, NY USA. RP Sethi, S (reprint author), VA Med Res, 151,3495 Bailey Ave, Buffalo, NY 14215 USA. EM ssethi@buffalo.edu NR 42 TC 8 Z9 8 U1 1 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 15 PY 2005 VL 41 SU 2 BP S177 EP S185 DI 10.1086/428058 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 936YI UT WOS:000229891100009 PM 15942884 ER PT J AU Sharma, S Zhu, L Yang, SC Zhang, L Lin, J Hillinger, S Gardner, B Reckamp, K Strieter, RM Huang, M Batra, RK Dubinett, SM AF Sharma, S Zhu, L Yang, SC Zhang, L Lin, J Hillinger, S Gardner, B Reckamp, K Strieter, RM Huang, M Batra, RK Dubinett, SM TI Cyclooxygenase 2 inhibition promotes IFN-gamma-dependent enhancement of antitumor responses SO JOURNAL OF IMMUNOLOGY LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; COLON-CANCER CELLS; LUNG-CANCER; DENDRITIC CELLS; PROSTAGLANDIN E(2); SOLUBLE MEDIATORS; ANTICANCER AGENTS; TUMOR-DEVELOPMENT; T-LYMPHOCYTES; UP-REGULATION AB In previous studies, we demonstrated an immune suppressive network in non-small cell lung cancer that is due to overexpression of tumor cyclooxygenase 2 (COX-2). In this study, we assessed the vaccination response to tumor challenge following either pharmacological or genetic inhibition of COX-2 in a murine lung cancer model. Treatment of naive mice with the COX-2 inhibitor, SC-58236, skewed splenocytes toward a type I cytokine response, inducing IFN-gamma, IL-12, and IFN-gamma-inducible protein 10, whereas the type 2 cytokines IL-4, IL-5, and IL-10 remained unaltered. Fifty percent of mice receiving SC-58236 and an irradiated tumor cell vaccine completely rejected tumors upon challenge. Those mice that did form tumors following challenge demonstrated a reduced tumor growth. In contrast, all mice either vaccinated with irradiated tumor cells alone or receiving SC-58236 alone showed progressive tumor growth. Studies performed in CD4 and CD8 knockout mice revealed a requirement for the CD4 T lymphocyte subset for the complete rejection of tumors. To determine the role of host COX-2 expression on the vaccination responses, studies were performed in COX-2 gene knockout mice. Compared with control littermates, COX-2(-/-) mice showed a significant tumor growth reduction, whereas heterozygous COX-2(-/+) mice had an intermediate tumor growth reduction following vaccination. In vivo depletion of IFN-gamma abrogated the COX-2 inhibitor-mediated enhancement of the vaccination effect. These findings provide a strong rationale for additional evaluation of the capacity of COX-2 inhibitors to enhance vaccination responses against cancer. C1 Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare, Mol Gene Med Lab, Los Angeles, CA 90073 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Dept Med, 37-131 Ctr Hlth Sci,10833 LeConte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu FU NCI NIH HHS [CA 85686, P50 CA 90388, R01 CA 78654] NR 57 TC 57 Z9 65 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 JUL 15 PY 2005 VL 175 IS 2 BP 813 EP 819 PG 7 WC Immunology SC Immunology GA 989BJ UT WOS:000233647600022 PM 16002678 ER PT J AU Burns, JC Shimizu, C Gonzalez, E Kulkarni, H Patel, S Shike, H Sundel, RS Newburger, JW Ahuja, SK AF Burns, JC Shimizu, C Gonzalez, E Kulkarni, H Patel, S Shike, H Sundel, RS Newburger, JW Ahuja, SK TI Genetic variations in the receptor-ligand pair CCR5 and CCL3L1 are important determinants of susceptibility to Kawasaki disease SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Annual Meeting of the Pediatric-Academic-Societies CY MAY 01-04, 2004 CL San Francisco, CA SP Pediat Acad Soc ID HIV-1 DISEASE; IMMUNODEFICIENCY-VIRUS; LINKAGE ANALYSIS; TRANSMISSION; PROGRESSION; ALLELE; FREQUENCY; CHILDREN; DELETION; DISEQUILIBRIUM AB Kawasaki disease (KD) is an enigmatic, self-limited vasculitis of childhood that is complicated by development of coronary-artery aneurysms. The high incidence of KD in Asian versus European populations prompted a search for genetic polymorphisms that are differentially distributed among these populations and that influence KD susceptibility. Here, we demonstrate a striking, inverse relationship between the worldwide distribution of CCR5-Delta 32 allele and the incidence of KD. In 164 KD patient-parent trios, 4 CCR5 haplotypes including the CCR5-Delta 32 allele were differentially transmitted from heterozygous parents to affected children. However, the magnitude of the reduced risk of KD associated with the CCR5-Delta 32 allele and certain CCR5 haplotypes was significantly greater in individuals who also possessed a high copy number of the gene encoding CCL3L1, the most potent CCR5 ligand. These findings, derived from the largest genetic study of any systemic vasculitis, suggest a central role of CCR5-CCL3L1 gene-gene interactions in KD susceptibility and the importance of gene modifiers in infectious diseases. C1 Univ Calif San Diego, Sch Med, Dept Pediat, La Jolla, CA 92093 USA. S Texas Vet Hlth Care Syst, Vet Adm Res Ctr AIDS & HIV1 Infect, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78285 USA. Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Pediat Cardiol, Boston, MA 02115 USA. RP Ahuja, SK (reprint author), Univ Calif San Diego, Sch Med, Dept Pediat, 9500 Gilman Dr, La Jolla, CA 92093 USA. EM ahujas@uthscsa.edu RI Burns, Jane/J-6167-2015; Shimizu, Chisato/J-6516-2015 OI Sundel, Robert/0000-0002-0083-5695 FU NHLBI NIH HHS [R01 HL069413-08, HL69413, R01 HL069413]; NIAID NIH HHS [AI043279, AI046326, R01 AI043279, R01 AI046326, R21 AI046326, R37 AI046326] NR 42 TC 67 Z9 71 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL 15 PY 2005 VL 192 IS 2 BP 344 EP 349 DI 10.1086/430953 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 943WX UT WOS:000230387300020 PM 15962231 ER PT J AU Wu, SV Chen, MC Rozengurt, E AF Wu, SV Chen, MC Rozengurt, E TI Genomic organization, expression, and function of bitter taste receptors (T2R) in mouse and rat SO PHYSIOLOGICAL GENOMICS LA English DT Article DE calcium flux; neuroendocrine cells; gustducin; transducin ID CELL-LINE AR42J; ALPHA-GUSTDUCIN; IDENTIFICATION; FAMILY; GENES; PHENYLTHIOCARBAMIDE; SENSITIVITY; PERCEPTION; SECRETION; EVOLUTION AB Mammalian type 2 taste receptors (T2R) are a family of G protein-coupled receptors that mediate bitter signals in taste cells. In the present study, we compared the genomic organization of rodent T2R genes based on the recently completed mouse and rat genomes and examined tissue-and cell-specific expression of T2Rs. Both mouse and rat T2R families consist of 36 intact genes and at least 7 pseudogenes that are mapped to mouse chromosomes 15, 2, and 6 and to rat chromosomes 2, 3, and 4, respectively. All but two T2R genes are clustered on mouse chromosome 6 and rat chromosome 4 with virtually identical genomic organization. The orthologs of the first human T2R gene identified, mT2R119 and rT2R1, are located on mouse chromosome 15 and rat chromosome 2, whereas the novel rodent-specific T2R genes, mT2R134 and rT2R34, are located on mouse chromosome 2 and rat chromosome 3, respectively. Our results, using RT-PCR, demonstrate the presence of transcripts corresponding to the putative denatonium benzoate (DB) and phenylthiocarbamide (PTC) receptors in the antrum, fundus, and duodenum as well as in STC-1 and AR42J cells. The novel rodent-specific T2R gene (mT2R134 and rT2R34) was also expressed in these tissues and cell lines. The addition of DB, PTC, or cycloheximide to AR42J cells induced a rapid increase in the intracellular Ca2+ concentration. The specificity of these effects is shown by the fact that these bitter stimuli did not induce any detectable Ca2+ signaling in many other rodent or human cells that do not express receptors or G proteins implicated in bitter taste signaling. These results demonstrate that mouse and rat T2R genes are highly conserved in terms of genomic organization and tissue expression, suggesting that rodent T2Rs are evolved under similar dietary pressure and share bitter sensing functions in the lingual and gastrointestinal systems. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Div Digest Dis, Dept Med,David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Rozengurt, E (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Div Digest Dis, Dept Med,David Geffen Sch Med, 900 Vet Ave,Rm 11-115, Los Angeles, CA 90095 USA. EM erozengurt@mednet.ucla.edu FU NIDDK NIH HHS [R01 DK-41301, R01 DK-17294, R01 DK-55003, R01 DK-56930] NR 29 TC 74 Z9 82 U1 1 U2 9 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD JUL 14 PY 2005 VL 22 IS 2 BP 139 EP 149 DI 10.1152/physiolgenomics.00030.2005 PG 11 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 952FD UT WOS:000230987900003 PM 15886333 ER PT J AU Casarett, D Karlawish, J Morales, K Crowley, R Mirsch, T Asch, DA AF Casarett, D Karlawish, J Morales, K Crowley, R Mirsch, T Asch, DA TI Improving the use of hospice services in nursing homes - A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID OF-LIFE CARE; ADVANCE DIRECTIVES; HEALTH-CARE; PALLIATIVE CARE; END; PREFERENCES; COMPLETION; PATIENT; PAIN; ILL AB Context Hospice care may improve the quality of end-of-life care for nursing home residents, but hospice is underutilized by this population, at least in part because physicians are not aware of their patients' preferences. Objective To determine whether it is possible to increase hospice utilization and improve the quality of end-of-life care by identifying residents whose goals and preferences are consistent with hospice care. Design, Setting, and Participants Randomized controlled trial (December 2003-December 2004) of nursing home residents and their surrogate decision makers (N=205) in 3 US nursing homes. Intervention A structured interview identified residents whose goals for care, treatment preferences, and palliative care needs made them appropriate for hospice care. These residents' physicians were notified and asked to authorize a hospice informational visit. Main Outcome Measures The primary outcome measures were (1) hospice enrollment within 30 days of the intervention and (2) families' ratings of the quality of care for residents who died during the 6-month follow-up period. Results Of the 205 residents in the study sample, 107 were randomly assigned to receive the intervention, and 98 received usual care. Intervention residents were more likely than usual care residents to enroll in hospice within 30 days (21/107 [20%] vs 1/98 [1%]; P<.001 [Fisher exact test]) and to enroll in hospice during the follow-up period (27/207 [25%] vs 6/98 [6%]; P<.001). Intervention residents had fewer acute care admissions (mean: 0.28 vs 0.49; P=.04 [Wilcoxon rank sum test]) and spent fewer days in an acute care setting (mean: 1.2 vs 3.0; P=.03 [Wilcoxon rank sum test]). Families of intervention residents rated the resident's care more highly than did families of usual care residents (mean on a scale of 1-5: 4.1 vs 2.5; P=.04 [Wilcoxon rank sum test]). Conclusion A simple communication intervention can increase rates of hospice referrals and families' ratings of end-of-life care and may also decrease utilization of acute care resources. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Div Geriatr Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Temple Univ, Sch Law, Philadelphia, PA 19122 USA. Holy Redeemer Home Hlth & Hospice Care, Philadelphia, PA USA. RP Casarett, D (reprint author), 3615 Chestnut St, Philadelphia, PA 19104 USA. EM casarett@mail.med.upenn.edu NR 51 TC 108 Z9 109 U1 2 U2 8 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 13 PY 2005 VL 294 IS 2 BP 211 EP 217 DI 10.1001/jama.294.2.211 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 944DO UT WOS:000230406100025 PM 16014595 ER PT J AU Mehta, KM Yin, M Resendez, C Yaffe, K AF Mehta, KM Yin, M Resendez, C Yaffe, K TI Ethnic differences in acetylcholinesterase inhibitor use for Alzheimer disease SO NEUROLOGY LA English DT Article ID DEMENTIA; PREVALENCE; HEALTH AB Acetylcholinesterase inhibitors (AChIs) have been demonstrated to improve Alzheimer disease symptoms. Whether the use of AChIs varies by ethnicity is unknown. More than 2500 ethnically diverse patients (6% African American, 14% Latino, and 7% Asian patients) from the Alzheimer's Disease Research Centers in California were studied. Compared with white patients with AD, minority patients had 40% lower odds of AChI use (odds ratio 0.6, 95% confidence interval: 0.5 to 0.7). C1 Univ Calif San Francisco, Div Geriatr, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol & Epidemiol, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Mehta, KM (reprint author), 4150 Clement St,Box 181G, San Francisco, CA 94121 USA. EM kala@itsa.ucsf.edu FU NIA NIH HHS [K01 AG025444-01A1, P30 AG 15272, P30 AG015272, R-01 AG021918-02, R01 AG021918]; NIMH NIH HHS [R25 MH 60482, R25 MH060482] NR 10 TC 24 Z9 24 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JUL 12 PY 2005 VL 65 IS 1 BP 159 EP 162 DI 10.1212/01.wnl.0000167545.38161.48 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 944KP UT WOS:000230427200036 PM 16009909 ER PT J AU Gupta, S Volpp, H Klaustermeyer, WB AF Gupta, S Volpp, H Klaustermeyer, WB TI Demographics and long-term follow-up in a Veterans Affairs Allergy/Immunology Center: A 10-year analysis SO ALLERGY AND ASTHMA PROCEEDINGS LA English DT Article; Proceedings Paper CT 60th Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 18-23, 2004 CL San Francisco, CA SP Amer Acad Allergy Asthma & Immunol ID PREVALENCE; SYMPTOMS; ASTHMA AB Between 1985 and 1992, patients were evaluated as new outpatient consultations in the Allergy/Immunology Center at the Veterans Affairs Greater Los Angeles Health Care System (VAGLAHS). Data collected included age, gender, ethnicity, and diagnosis. After 10 years, patient follow-up status was determined and classified into five categories: gender, ethnic distribution, age distribution, disorders seen, and follow-up pattern. A total of 1116 patients were evaluated. The gender of our population was 7.8% women and 92.2% men. The ethnic distribution was 59.5% white, 32.2% black, 6.5% Hispanic, and 1.9% other. Neither age nor ethnic distribution was significantly different from the general veterans affairs population. Age of patients ranged from 20 to 90 years old. The largest peak for age at initial presentation was 60 years. The three most common disorders seen in the clinic were rhinitis (36.6%), asthma (24.5%), and sinusitis (12.3%). The 10-year follow-up pattern of patients revealed that 6% were seen in the past year, 6.2% of patients were seen longer than I year ago but within the 5 past years, 29% of patients who were still seen at VAGLAHS but were no longer patients of the allergy clinic, 32.7% of patients who were no longer seen at VAGLAHS, and 26.2% died. Women and patients who were 50-60 years old were more likely to follow-up. There was no difference in follow-up visits among ethnic groups. C1 Univ Calif Los Angeles, David Geffen Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,Div Allergy & Immunol, Los Angeles, CA 90073 USA. RP Klaustermeyer, WB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,Div Allergy & Immunol, 11301 Wilshire Blvd,111R, Los Angeles, CA 90073 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1088-5412 J9 ALLERGY ASTHMA PROC JI Allergy Asthma Proc. PD JUL-AUG PY 2005 VL 26 IS 4 BP 310 EP 315 PG 6 WC Allergy SC Allergy GA 960UL UT WOS:000231618600010 PM 16270725 ER PT J AU Ho, PM Masoudi, FA Peterson, PN Shroyer, AL McCarthy, M Grover, FL Hammermeister, KE Rumsfeld, JS AF Ho, PM Masoudi, FA Peterson, PN Shroyer, AL McCarthy, M Grover, FL Hammermeister, KE Rumsfeld, JS TI Health-related quality of life predicts mortality in older but not younger patients following cardiac surgery SO AMERICAN JOURNAL OF GERIATRIC CARDIOLOGY LA English DT Article ID BYPASS GRAFT-SURGERY; SELF-RATED HEALTH; VALVE-REPLACEMENT; OPERATIVE MORTALITY; VETERAN POPULATION; MEDICAL OUTCOMES; RISK; DISEASE; CARE AB The investigators assessed preoperative health-related quality of life as a predictor of 6-month mortality after cardiac surgery in older. (65 years of age and older) vs. younger patients. Multivariable regression, stratified by age groups, was used to compare the association between preoperative Physical Component Summary and Mental Component Summary scores from the Short Form-36 health status survey and mortality. In multivariable analyses of older patients, lower preoperative Physical Component Summary (odds ratio, 1.54; 95% confidence interval, 1.19-2.00; p=0.01) and Mental Component Summary (odds ratio, 1.26; 95% confidence interval, 1.06-1.49; p=0.03) scores were independently associated with mortality. In contrast, neither Physical Component Summary (p=0.82) nor Mental Component Summary (p=0.79) scores were associated with mortality in the younger subgroup. This study demonstrated that preoperative health status is an independent predictor of mortality following cardiac surgery in older but not younger patients. Preoperative patient self-report of health status may be particularly useful in refining risk stratification and informing decision-making before and following cardiac surgery in older patients. C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL USA. Colorado Hlth Outcomes Program, Denver, CO USA. RP Ho, PM (reprint author), 111B,1055 Clermont St, Denver, CO 80220 USA. EM michael.ho@uchsc.edu RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 FU NIA NIH HHS [K08-AG01011] NR 26 TC 15 Z9 15 U1 0 U2 0 PU LE JACQ LTD PI DARIEN PA 3 PARKLANDS DRIVE, DARIEN, CT 06820 USA SN 1076-7460 J9 AM J GERIATR CARDIOL JI Am. J. Geriatr. Cardiol. PD JUL-AUG PY 2005 VL 14 IS 4 BP 176 EP 182 DI 10.1111/j.1076-7460.2005.04312.x PG 7 WC Cardiac & Cardiovascular Systems; Geriatrics & Gerontology SC Cardiovascular System & Cardiology; Geriatrics & Gerontology GA 009AM UT WOS:000235083500003 PM 16015058 ER PT J AU Chopra, MP Zubritsky, C Knott, K Ten Have, T Hadley, T Coyne, JC Oslin, DW AF Chopra, MP Zubritsky, C Knott, K Ten Have, T Hadley, T Coyne, JC Oslin, DW TI Importance of subsyndromal symptoms of depression in elderly patients SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article ID PRIMARY-CARE PATIENTS; MINOR DEPRESSION; LATE-LIFE; FUNCTIONAL DISABILITY; SERVICE UTILIZATION; OLDER-ADULTS; FOLLOW-UP; PREVALENCE; DISORDERS; COMMUNITY AB Objective: There is a debate about the importance of subsyndromal symptoms of depression (SSD). The current study examined the cross-sectional and longitudinal significance of SSD in geriatric subjects both with and without a past history of major depression. Methods: Elderly primary-care subjects with SSD, both with ( SSD +; N = 54) and without ( SSD -; N = 204) a history of major depression, were compared with subjects with major depression (MDD; N = 111), minor depression ( MinD; N = 74), and symptom-free comparison subjects ( N = 59). Assessment domains included physical and psychological disability, health-care utilization, hopelessness, death and suicidal ideation, and a diagnostic evaluation at a 3-month follow-up. Results: Both subjects with SSD + and SSD - differed from the symptom-free comparison subjects on measures of psychological disability, hopelessness, and death ideation, with SSD + subjects being more severely psychologically disabled than SSD - subjects. There were few differences between SSD + and MinD subjects or those with MDD, except on measures of psychological disability. Finally, more than 24% of SSD + subjects progressed to meet criteria of MDD, MinD, or dysthymia over a 3-month period. Utilization of outpatient services did not differ among any of the depression groups or comparison subjects. Conclusions: SSD (with or without a past history of MDD) is associated with significant disability. Moreover, the risk of developing a diagnosis of MDD, MinD, or dysthymia is substantially elevated in subjects with a past history of MDD. C1 Univ Penn, Hlth Syst, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Ctr Mental Hlth Care Policy & Serv Res, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Ctr Study Addict, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, VISN Mental Illness Res Educ & Clin Ctr 4, Philadelphia, PA 19104 USA. RP Oslin, DW (reprint author), Univ Penn, Hlth Syst, Dept Psychiat, Sect Geriatr Psychiat, 3535 Market St,Room 3002, Philadelphia, PA 19104 USA. EM oslin@mail.med.upenn.edu RI Chopra, Mohit P/F-7250-2013 OI Chopra, Mohit P/0000-0002-9208-7224 FU CMHS SAMHSA HHS [1UD1SM53033]; NIMH NIH HHS [1K08MH01599, 5P30MH52129] NR 43 TC 52 Z9 52 U1 3 U2 8 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD JUL PY 2005 VL 13 IS 7 BP 597 EP 606 DI 10.1176/appi.ajgp.13.7.597 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 944KO UT WOS:000230427100008 PM 16009736 ER PT J AU Charytan, C Coburn, JW Chonchol, M Herman, J Lien, YH Liu, W Klassen, PS McCary, LC Pichette, V AF Charytan, C Coburn, JW Chonchol, M Herman, J Lien, YH Liu, W Klassen, PS McCary, LC Pichette, V TI Cinacalcet hydrochloride is an effective treatment for secondary hyperparathyroidism in patients with CKD not receiving dialysis SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE calcimimetic; chronic kidney disease (CKD); hyperparathyroidism; predialysis ID CHRONIC-RENAL-FAILURE; REDUCES PARATHYROID-HORMONE; CHRONIC KIDNEY-DISEASE; BONE-DISEASE; CALCIMIMETIC COMPOUND; HEMODIALYSIS-PATIENTS; CALCIUM RECEPTOR; MORTALITY RISK; INSUFFICIENCY; PHOSPHORUS AB Background. Secondary hyperparathyroidism develops early in patients with chronic kidney disease (CKD). Clinical guidelines from the National Kidney Foundation-Kidney/Disease Outcomes Quality Initiative emphasize the need to control parathyroid hormone (PTH), calcium, and phosphorus levels in patients with CKD not receiving dialysis to reduce poor outcomes. This phase 2 study evaluated the effects of the oral calcimimetic cinacalcet hydrochloride in patients with CKD not on dialysis therapy. Methods: A randomized, double-blind, placebo-controlled, 18-week study enrolled adults with an estimated glomerular filtration rate of 15 to 50 mL/min/1.73 m(2) (0.25 to 0.83 mL/s/1.73 m(2)) and an intact PTH (iPTH) level greater than 130 pg/mL (ng/L). Cinacalcet (or placebo) was titrated from 30 to 180 mg once daily to obtain a 30% or greater reduction in iPTH levels from baseline. Results: Baseline mean iPTH levels were 243 pg/mL (ng/L) in the cinacalcet group (n = 27) and 236 pg/mL (ng/L) in the control group (n = 27). At baseline, 28% of subjects were being administered vitamin D sterols and 43% were being administered phosphate binders or calcium supplements. The addition of cinacalcet significantly decreased iPTH concentrations compared with controls during the efficacy-assessment phase: 56% versus 19% of subjects achieved a 30% or greater reduction in iPTH levels (P = 0.006), and mean iPTH levels decreased by 32% in the cinacalcet group, but increased by 6% in the control group (P < 0.001). Mean serum calcium and phosphorus levels remained within normal range throughout the study. Cinacalcet generally was well tolerated; the most frequent adverse events were gastrointestinal. Conclusion: This preliminary study provides evidence that cinacalcet is efficacious for the treatment of secondary hyperparathyroidism in subjects with CKD not receiving dialysis. (c) 2005 by the National Kidney Foundation, Inc. C1 New York Hosp, Queens Med Ctr, Flushing, NY 11355 USA. Vet Affairs Greater Los Angeles Hlth Care Serv, Los Angeles, CA USA. Univ Colorado, Denver, CO 80202 USA. Palmetto Internal Med, Columbia, SC USA. Univ Arizona, Tucson, AZ USA. Amgen Inc, Thousand Oaks, CA 91320 USA. Hop Maison Neuve Rosemont, Montreal, PQ H1T 2M4, Canada. RP Charytan, C (reprint author), New York Hosp, Queens Med Ctr, 56-45 Main St, Flushing, NY 11355 USA. EM charytan@pol.net NR 38 TC 74 Z9 77 U1 0 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUL PY 2005 VL 46 IS 1 BP 58 EP 67 DI 10.1053/j.ajkd.2005.04.013 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 947CY UT WOS:000230622000008 PM 15983958 ER PT J AU McFarland, LV Reiber, GE Norman, JE AF McFarland, LV Reiber, GE Norman, JE TI Recruitment of medicaid and dual-enrolled medicare beneficiaries with diabetes mellitus into a randomized controlled trial SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID SELF-MANAGEMENT; PRIMARY-CARE; CLINICAL-TRIALS; INTERVENTIONS; EXPERIENCE; PROGRAM; DISPARITIES; ETHNICITY AB Objective: To document the recruitment of Medicaid and dual-enrolled Medicare beneficiaries with diabetes mellitus into a randomized clinical trial. Study Design: Randomized controlled trial with 1-year follow-up. Methods: A total of 2242 Medicaid or dual-enrolled Medicare beneficiaries with diabetes residing in King County, Washington, were recruited by direct mail for a clinical trial of diabetes self-care management. Washington State Medicaid program databases were used to identify the target population who received recruitment packets from the program director. Individuals who did not return a participation refusal letter were telephoned to determine study eligibility. Subjects were screened during a study visit, and written informed consent was obtained. Enrolled subjects were randomized to a self-care intervention group or a usual care group. Results: Of 2242 recruitment packets sent, we were unable to contact 40% of the target population, despite the fact that packets were sent to the same mailing addresses used for monthly Medicaid check distributions. The primary recruitment challenges were missing telephone contact information and a lack of interpreters speaking needed dialects. Of the 146 subjects enrolled, 71% were nonwhite, 28% were non-English speaking, 69% were women, and the mean age was 59.8 years. Conclusions: Research in Medicaid and Medicare populations is possible but requires additional time, energy, and resources. The finding that 40% of the Medicaid population could not be contacted suggests that Medicaid may want to revisit their contact information procedures to facilitate case management and other programs. C1 VA Puget Sound Hlth Care Syst, Dept Hlth Serv Res & Dev, Seattle, WA 98101 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Washington State Dept Hlth, Diabet Prevent & Control Program, Olympia, WA USA. RP McFarland, LV (reprint author), VA Puget Sound Hlth Care Syst, Dept Hlth Serv Res & Dev, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM lynne.mcfarland@med.va.gov NR 24 TC 0 Z9 0 U1 1 U2 2 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD JUL PY 2005 VL 11 IS 7 BP 445 EP 450 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 945AO UT WOS:000230472900004 ER PT J AU Segreti, J House, HR Siegel, RE AF Segreti, J House, HR Siegel, RE TI Principles of antibiotic treatment of community-acquired pneumonia in the outpatient setting SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE antibiotics; community-acquired pneumonia; fluoroquinolones; short-course therapy ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; OPEN-LABEL; ANTIMICROBIAL RESISTANCE; RANDOMIZED-TRIAL; THERAPY; LEVOFLOXACIN; ADULTS; MULTICENTER; EFFICACY; GATIFLOXACIN AB Community-acquired pneumonia (CAP) is a common illness with high rates of morbidity and mortality. Nearly 80% of the treatment for this condition is provided in the outpatient setting. Among the etiologic agents associated with bacterial CAP, the predominant pathogen is Streptococcus pneumoniae. Treatment of CAP for the most part is empirical; therefore, any antibiotic treatment should cover both typical and atypical pathogens. The beta-lactams have historically been considered standard therapy for the treatment of CAP. However, the impact of rising resistance rates is now a primary concern facing physicians. For patients with comorbidifies or recent antibiotic therapy, current guidelines recommend either combination therapy with a beta-lactam and a macrolide or an antipneumococcal fluoroquinolone alone. Fluoroquinolones are broad-spectrum antibiotics that exhibit high levels of penetration into the lungs and low levels of resistance. Evidence from clinical trials indicates clinical success rates of >90% for moxifloxacin, gatifloxacin, and levofloxacin in the treatment of CAP due to S pneumoniae. Data from comparative clinical trials suggest fluoroquinolone monotherapy is as efficacious as beta-lactam-macrolide combination therapy in the treatment of CAP patients. The respiratory fluoroquinolone levofloxacin has also been shown to be effective in CAP patients for the treatment of macrolide-resistant S pneumoniae. The use of azithromycin, telithromycin, and fluoroquinolones in short-course regimens has been shown to be efficacious, safe, and tolerable in patients with CAP. Based on clinical evidence, high-dose, short-course therapies may represent a significant advance in the management of CAP. (C) 2005 Elsevier Inc. All rights reserved. C1 Rush Univ, Rush Med Coll, Med Ctr, Dept Internal Med,Sect Infect Dis, Chicago, IL 60612 USA. Univ Iowa, Dept Emergency Med, Iowa City, IA USA. Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Crit Care Ctr, New York, NY USA. RP Segreti, J (reprint author), Rush Univ, Rush Med Coll, Med Ctr, Dept Internal Med,Sect Infect Dis, 600 S Paulina,Suite 143, Chicago, IL 60612 USA. EM john_segreti@rush.edu NR 51 TC 19 Z9 19 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUL PY 2005 VL 118 SU 7A BP 21 EP 28 DI 10.1016/j.amjmed.2005.05.010 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 946JF UT WOS:000230567600004 ER PT J AU Matsumoto, N Jo, OD Shih, RNJ Brochmann, EJ Murray, SS Hong, V Yanagawa, J Yanagawa, N AF Matsumoto, N Jo, OD Shih, RNJ Brochmann, EJ Murray, SS Hong, V Yanagawa, J Yanagawa, N TI Increased cathepsin D release by Hyp mouse osteoblast cells SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE hypophosphatemia; rickets; bone; pepstatin ID MATRIX EXTRACELLULAR PHOSPHOGLYCOPROTEIN; ABNORMAL PHEX EXPRESSION; DEFECTIVE BONE-FORMATION; X-LINKED RICKETS; PROCATHEPSIN-D; PARATHYROID-HORMONE; CANCER CELLS; NORMAL MICE; MEPE; MINERALIZATION AB The X-linked hypophosphatemia (XLH), the most common form of hereditary rickets, is caused by loss-of-function mutations of PHEX (phosphate-regulating gene with homology to endopeptidases on the X chromosome) leading to rachitic bone disease and hypophosphatemia. Available evidence today indicates that the bone defect in XLH is caused not only by hypophosphatemia and altered vitamin D metabolism but also by factor(s) locally released by osteoblast cells (ObCs). The identity of these ObC-derived pathogenic factors remains unclear. In our present study, we report our finding of a prominent protein in the culture media derived from ObC of the hypophosphatemic (Hyp) mice, a murine homolog of human XLH, which was identified as the murine procathepsin D ( Cat D). By metabolic labeling studies, we further confirmed that Hyp mouse ObCs released greater amount of Cat D into culture media. This increased Cat D release by Hyp mouse ObCs was unlikely to be due to nonspecific cell damage or heterogeneous cell population and was found to be associated with an increased Cat D expression at the protein level, possibly due to a reduced Cat D degradation. However, we were not able to detect a direct effect of PHEX protein on Cat D cleavage. In support of the involvement of Cat D in mediating the inhibitory effect of Hyp mouse ObC-conditioned media on ObC calcification, we found that exposure to Cat D inhibited ObC Ca-45 incorporation and that inhibition of Cat D abolished the inhibitory effect of Hyp mouse-conditioned media on ObC calcification. In conclusion, results from our present study showed that Hyp mouse ObCs release a greater amount of Cat D, which may contribute to the inhibitory effect of Hyp mouse ObC-conditioned media on ObC mineralization. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Med Serv, Sepulveda, CA USA. Greater Los Angeles Vet Affairs Healthcare Syst, Res Serv, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Yanagawa, N (reprint author), Vet Adm Med Ctr, 111R,16111 Plummer St, Sepulveda, CA 91343 USA. EM nori@ucla.edu FU NIDDK NIH HHS [DK-AR58886] NR 42 TC 9 Z9 9 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD JUL PY 2005 VL 289 IS 1 BP E123 EP E132 DI 10.1152/ajpendo.00562.2004 PG 10 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 939ZR UT WOS:000230113600018 PM 15958652 ER PT J AU Bradesi, S Schwetz, I Ennes, HS Lamy, CMR Ohning, G Fanselow, M Pothoulakis, C McRoberts, JA Mayer, EA AF Bradesi, S Schwetz, I Ennes, HS Lamy, CMR Ohning, G Fanselow, M Pothoulakis, C McRoberts, JA Mayer, EA TI Repeated exposure to water avoidance stress in rats: a new model for sustained visceral hyperalgesia SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE chronic psychological stress; visceral nociception ID IRRITABLE-BOWEL-SYNDROME; CORTICOTROPIN-RELEASING-FACTOR; MAST-CELLS; GASTROINTESTINAL-TRACT; EXPERIMENTAL COLITIS; COLON IRRITATION; FOS EXPRESSION; LEWIS RATS; ADULT RATS; HYPERSENSITIVITY AB Chronic stress plays an important role in the development and exacerbation of symptoms in functional gastrointestinal disorders. To better understand the mechanisms underlying this relationship, we aimed to characterize changes in visceral and somatic nociception, colonic motility, anxiety-related behavior, and mucosal immune activation in rats exposed to 10 days of chronic psychological stress. Male Wistar rats were submitted daily to either 1-h water avoidance (WA) stress or sham WA for 10 consecutive days. The visceromotor response to colorectal distension, thermal somatic nociception, and behavioral responses to an open field test were measured at baseline and after chronic WA. Fecal pellets were counted after each WA stress or sham WA session as a measure of stress-induced colonic motility. Colonic samples were collected from both groups and evaluated for structural changes and neutrophil infiltration, mast cell number by immunohistochemistry, and cytokine expression by quantitative RT-PCR. Rats exposed to chronic WA ( but not sham stress) developed persistent visceral hyperalgesia, whereas only transient changes in somatic nociception were observed. Chronically stressed rats also exhibited anxiety-like behaviors, enhanced fecal pellet excretion, and small but significant increases in the mast cell numbers and the expression of IL-1 beta and IFN-gamma. Visceral hyperalgesia following chronic stress persisted for at least a month. Chronic psychological stress in rats results in a robust and long-lasting alteration of visceral, but not somatic nociception. Visceral hyperalgesia is associated with other behavioral manifestations of stress sensitization but was only associated with minor colonic immune activation arguing against a primary role of mucosal immune activation in the maintenance of this phenomenon. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Ulcer Res & Educ, Ctr Neurovisceral Sci & Womens Hlth,Brain Res Ins, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Physiol, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Ulcer Res & Educ, Digest Dis Res Ctr,David Geffen Sch Med, Los Angeles, CA 90073 USA. Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gastroenterol,Gastroenterol Neuropeptide Ctr, Boston, MA 02115 USA. RP Mayer, EA (reprint author), Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Ulcer Res & Educ, Ctr Neurovisceral Sci & Womens Hlth,Brain Res Ins, Bldg 115 Rm 223,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM emayer@ucla.edu RI Lamy, Christophe/B-6432-2016 OI Lamy, Christophe/0000-0001-6944-9787 FU NIDDK NIH HHS [P50-DK-64539, R21-DK-066065] NR 52 TC 124 Z9 135 U1 1 U2 10 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 JUL PY 2005 VL 289 IS 1 BP G42 EP G53 DI 10.1152/ajpgi.00500.2004 PG 12 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 936GJ UT WOS:000229843200007 PM 15746211 ER PT J AU Breusegem, SY Halaihel, N Inoue, M Zajicek, H Lederer, E Barry, NP Sorribas, V Levi, M AF Breusegem, SY Halaihel, N Inoue, M Zajicek, H Lederer, E Barry, NP Sorribas, V Levi, M TI Acute and chronic changes in cholesterol modulate Na-P-i cotransport activity in OK cells SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE two-photon fluorescence microscopy; filipin; lipid microdomains; laurdan; opossum kidney cells ID RENAL PHOSPHATE-TRANSPORT; LIPID RAFTS; BRUSH-BORDER; GENERALIZED POLARIZATION; PLASMA-MEMBRANE; MODEL MEMBRANES; RAT; PROTEINS; RECEPTOR; EXPRESSION AB Acute and chronic changes in cholesterol modulate Na-P-i cotransport activity in OK cells. Am J Physiol Renal Physiol 289: F154 - F165, 2005. First published March 15, 2005; doi: 10.1152/ ajprenal. 00331.2004. - We previously showed an inverse correlation between membrane cholesterol content and Na-P-i cotransport activity during the aging process and adaptation to alterations in dietary P-i in the rat (Levi M, Jameson DM, and van der Meer BW. Am J Physiol Renal Fluid Electrolyte Physiol 256: F85 - F94, 1989). The purpose of the present study was to determine whether alterations in cholesterol content per se modulate Na-P-i cotransport activity and apical membrane Na-P-i protein expression in opossum kidney (OK) cells. Acute cholesterol depletion achieved with beta-methyl cyclodextrin (beta-MCD) resulted in a significant increase in Na-P-i cotransport activity accompanied by a moderate increase in apical membrane Na-P-i protein abundance and no alteration of total cellular Na-P-i protein abundance. Conversely, acute cholesterol enrichment achieved with beta-MCD/cholesterol resulted in a significant decrease in Na-P-i cotransport activity with a moderate decrease in apical membrane Na-P-i protein abundance and no change of the total cellular Na-P-i protein abundance. In contrast, chronic cholesterol depletion, achieved by growing cells in lipoprotein-deficient serum (LPDS), resulted in parallel and significant increases in Na-P-i cotransport activity and apical membrane and total cellular Na-P-i protein abundance. Cholesterol depletion also resulted in a significant increase in membrane lipid fluidity and alterations in lipid microdomains as determined by laurdan fluorescence spectroscopy and imaging. Chronic cholesterol enrichment, achieved by growing cells in LPDS followed by loading with low-density lipoprotein, resulted in parallel and significant decreases in Na-P-i cotransport activity and apical membrane and total cellular Na-P-i protein abundance. Our results indicate that in OK cells acute and chronic alterations in cholesterol content per se modulate Na-P-i cotransport activity by diverse mechanisms that also include significant interactions of Na-P-i protein with lipid microdomains. C1 Univ Colorado, Ctr Hlth Sci, Dept Physiol & Biophys, Denver, CO 80262 USA. Univ Colorado, Ctr Hlth Sci, Dept Med, Div Renal Dis & Hypertens, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Texas, SW Med Ctr, Dept Cell Biol, Dallas, TX USA. Univ Louisville, Dept Internal Med, Louisville, KY USA. Univ Zaragoza, Dept Toxicol, Zaragoza, Spain. RP Levi, M (reprint author), Univ Colorado, Ctr Hlth Sci, Dept Physiol & Biophys, 4200 E 9th Ave, Denver, CO 80262 USA. EM Moshe.Levi@UCHSC.edu RI Halaihel , Nabil/J-2973-2016 OI Levi, Moshe/0000-0002-6225-946X; Sorribas, Victor/0000-0003-3457-323X FU NCRR NIH HHS [RR-03155]; NIA NIH HHS [7R03-AG-20361-2]; NIDDK NIH HHS [5R01-DK-062209-02, K08 DK-62220-01, 1 F32 DK-09689-01, R01-DK-066029] NR 61 TC 15 Z9 15 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD JUL PY 2005 VL 289 IS 1 BP F154 EP F165 DI 10.1152/ajprenal.00331.2004 PG 12 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 934XC UT WOS:000229741900017 PM 15769937 ER PT J AU Mahimainathan, L Ghosh-Choudhury, N Venkatesan, BA Danda, RS Choudhury, GG AF Mahimainathan, L Ghosh-Choudhury, N Venkatesan, BA Danda, RS Choudhury, GG TI EGF stimulates mesangial cell mitogenesis via PI3-kinase-mediated MAPK-dependent and AKT kinase-independent manner: involvement of c-fos and p27(Kip1) SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE epidermal growth factor; signal transduction; DNA synthesis ID ACTIVATED PROTEIN-KINASE; GROWTH-FACTOR RECEPTOR; PHOSPHATIDYLINOSITOL 3-KINASE; DNA-SYNTHESIS; PHOSPHOINOSITIDE 3-KINASE; GENE-TRANSCRIPTION; INHIBITOR P27(KIP1); SIGNALING PATHWAY; INTERFERON-GAMMA; PDGF AB Mahimainathan, Lenin, Nandini Ghosh-Choudhury, Balachandar A. Venkatesan, Ratna S. Danda, and Goutam Ghosh Choudhury. EGF stimulates mesangial cell mitogenesis via PI 3 kinase-mediated MAPK-dependent and AKT kinase-independent manner: involvement of c-fos and p27(Kip1). Am J Physiol Renal Physiol 289: F72-F82, 2005. First published February 8, 2005; doi: 10.1152/ ajprenal.00277.2004. - Epidermal growth factor ( EGF) is a potent mitogen for mesangial cells. The mechanism by which EGF induces DNA synthesis is not precisely understood. We investigated the role of phosphatidylinositol (PI)3-kinase in regulating mitogenesis. EGF increased PI3-kinase activity resulting in stimulation of PDK-1 and Akt kinase activities. Blocking of PI3-kinase activity using LY-294002 or adenoviral expression of PTEN, which dephosphorylates PI3,4,5-tris-phosphate and thus inactivates PI3-kinase signaling, significantly inhibits EGF-induced DNA synthesis. Expression of dominant-negative Akt kinase, however, had no effect on DNA synthesis. But it inhibited EGF-induced phosphorylation of FoxO3a transcription factor, thus demonstrating its functional consequences. These data indicate that EGF increases the DNA synthesis in a PI3-kinase-dependent but Akt-independent manner. In addition to activating PI3-kinase signaling, EGF increased Erk1/2 MAPK activity, leading to transcriptional activation of its nuclear target Elk-1 and resulting in c-fos expression. Inhibition of MAPK activity by MEK inhibitor U-0126 abolished EGF-induced DNA synthesis. Because EGF activates PI3-kinase, which also regulates DNA synthesis, the effect of PI3-kinase on MAPK activity was also examined. Inhibition of PI3- kinase signaling blocked EGF- induced MAPK activity as well as Elk-1-dependent reporter transcription and c-fos gene transcription. To further determine the mechanism of EGF- induced DNA synthesis, we investigated the effect of EGF on the cyclin-dependent kinase inhibitor p27(Kip1). EFG reduced the expression of p27(Kip1). Inhibition of PI3- kinase action or MAPK activity abolished the reduction in p27(Kip1) expression induced by EGF. These data provide the evidence that a linear signal transduction pathway involving PI3-kinase-dependent MAPK regulates EGF-induced DNA synthesis in mesangial cells by regulating c-fos and p27(Kip1) expression. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Educ & Clin Ctr, San Antonio, TX USA. RP Choudhury, GG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr,Mail Code 7882, San Antonio, TX 78229 USA. EM choudhuryg@uthscsa.edu OI /0000-0001-5077-3552 FU NIDDK NIH HHS [P50-DK-061597, R01-DK-55815] NR 54 TC 30 Z9 30 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD JUL PY 2005 VL 289 IS 1 BP F72 EP F82 DI 10.1152/ajprenal.00277.2004 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 934XC UT WOS:000229741900008 PM 15701816 ER PT J AU Gorton, GE AF Gorton, GE TI Milton Hyland Erickson, 1901-1980 SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Biographical-Item C1 Philadelphia VA Med Ctr, Dept Psychiat, Philadelphia, PA 19140 USA. RP Gorton, GE (reprint author), Philadelphia VA Med Ctr, Dept Psychiat, Mailstop 116,Univ & Woodland Ave, Philadelphia, PA 19140 USA. EM gregg.gorton@med.va.gov NR 0 TC 1 Z9 1 U1 1 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUL PY 2005 VL 162 IS 7 BP 1255 EP 1255 DI 10.1176/appi.ajp.162.7.1255 PG 1 WC Psychiatry SC Psychiatry GA 941EB UT WOS:000230196500005 ER PT J AU Saxe, GN Stoddard, F Hall, E Chawla, N Lopez, C Sheridan, R King, D King, L Yehuda, R AF Saxe, GN Stoddard, F Hall, E Chawla, N Lopez, C Sheridan, R King, D King, L Yehuda, R TI Pathways to PTSD, part I: Children with burns SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 18th Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY NOV 07-10, 2002 CL Baltimore, MD SP Int Soc Traumat Stress Studies ID ACUTE STRESS DISORDER; HEART-RATE-VARIABILITY; POSTTRAUMATIC-STRESS; PREDICTORS; TRAUMA; INJURY; HOSPITALIZATION; DISSOCIATION; SURVIVORS; SYMPTOMS AB Objective: The goal of this study was to develop a model of risk factors for post-traumatic stress disorder (PTSD) in a group of acutely burned children. Method: Seventy-two children between the ages of 7 and 17 who were admitted to the hospital for an acute burn were eligible for study. Members of families who consented completed the Child PTSD Reaction Index, the Multidimensional Anxiety Scale for Children, and other self-report measures of psychopathology and environmental stress both during the hospitalization and 3 months following the burn. A path analytic strategy was used to build a model of risk factors for PTSD. Results: Two pathways to PTSD were discerned: 1) from the size of the burn and level of pain following the burn to the child's level of acute separation anxiety, and then to PTSD, and 2) from the size of the burn to the child's level of acute dissociation following the burn, and then to PTSD. Together these pathways accounted for almost 60% of the variance in PTSD symptoms and constituted a model with excellent fit indices. Conclusions: These findings support a model of complex etiology for childhood PTSD in which two independent pathways may be mediated by different biobehavioral systems. C1 Boston Univ, Sch Med, Dept Child & Adolescent Psychiat, Boston, MA 02118 USA. Shriners Burns Hosp, Dept Psychiat, Boston, MA USA. Bronx Vet Adm Med Ctr, Dept Psychiat, Bronx, NY USA. RP Saxe, GN (reprint author), Boston Univ, Sch Med, Dept Child & Adolescent Psychiat, Dowling 1 N,1 Boston Med Ctr Pl, Boston, MA 02118 USA. EM glenn.saxe@bmc.org OI Saxe, Glenn/0000-0002-4756-1169 FU CMHS SAMHSA HHS [U79 SM 54305]; NIMH NIH HHS [R01 MH 57370] NR 45 TC 71 Z9 72 U1 0 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUL PY 2005 VL 162 IS 7 BP 1299 EP 1304 PG 6 WC Psychiatry SC Psychiatry GA 941EB UT WOS:000230196500011 PM 15994712 ER PT J AU McFall, M Saxon, AJ Thompson, CE Yoshimoto, D Malte, C Straits-Troster, K Kanter, E Zhou, XHA Dougherty, CM Steele, B AF McFall, M Saxon, AJ Thompson, CE Yoshimoto, D Malte, C Straits-Troster, K Kanter, E Zhou, XHA Dougherty, CM Steele, B TI Improving the rates of quitting smoking for veterans with posttraumatic stress disorder SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 17th Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY DEC 04-09, 2001 CL NEW ORLEANS, LA SP Int Soc Traumat Stress Studies ID VIETNAM COMBAT VETERANS; MAJOR DEPRESSION; CESSATION INTERVENTIONS; DEPENDENCE TREATMENT; NICOTINE DEPENDENCE; CIGARETTE-SMOKING; MENTAL-DISORDERS; RANDOMIZED TRIAL; UNITED-STATES; SMOKERS AB Objective: Smoking is highly prevalent and refractory among people with post-traumatic stress disorder ( PTSD). This study aimed to improve the rate of quitting smoking for veterans with PTSD by integrating treatment for nicotine dependence into mental health care. Method: Smokers undergoing treatment for PTSD (N = 66) were randomly assigned to 1) tobacco use treatment delivered by mental health providers and integrated with psychiatric care ( integrated care) versus 2) cessation treatment delivered separately from PTSD care by smoking-cessation specialists ( usual standard of care). Seven-day point prevalence abstinence was the primary outcome, measured at 2, 4, 6, and 9 months after random assignment. Data were analyzed by using a generalized estimating equations approach following the intent-to-treat principle. Results: Subjects assigned to integrated care were five times more likely than subjects undergoing the usual standard of care to abstain from smoking across follow-up assessment intervals (odds ratio = 5.23). Subjects in the integrated care condition were significantly more likely than subjects in usual standard of care to receive transdermal nicotine and nicotine gum. They also received a greater number of smoking-cessation counseling sessions. Stopping smoking was not associated with worsening symptoms of PTSD or depression. Conclusions: Smoking-cessation interventions can be safely incorporated into routine mental health care for PTSD and are more effective than treatment delivered separately by a specialized smoking-cessation clinic. Integrating cessation treatment into psychiatric care may have the potential for improving smoking quit rates in other populations of chronically mentally ill smokers. C1 Dept Vet Affairs, NW Network Mental Illness Res Educ & Clin Ctr, Ctr Excellence Substance Abuse Treatment & Educ, Seattle, WA USA. Dept Vet Affairs, Biostat Unit, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. RP McFall, M (reprint author), VA Puget Sound Hlth Care Syst, PTSD Programs, S-116 MHC,1660 S Columbian Way, Seattle, WA 98108 USA. EM miles.mcfall@med.va.gov NR 72 TC 77 Z9 78 U1 1 U2 3 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUL PY 2005 VL 162 IS 7 BP 1311 EP 1319 DI 10.1176/appi.ajp.162.7.1311 PG 9 WC Psychiatry SC Psychiatry GA 941EB UT WOS:000230196500013 PM 15994714 ER PT J AU Magid, DJ Masoudi, FA Vinson, DR van der Vlugt, TM Padgett, TG Tricomi, AJ Lyons, EE Crounse, L Brand, DW Go, AS Ho, PM Rumsfeld, JS AF Magid, DJ Masoudi, FA Vinson, DR van der Vlugt, TM Padgett, TG Tricomi, AJ Lyons, EE Crounse, L Brand, DW Go, AS Ho, PM Rumsfeld, JS TI Older emergency department patients with acute myocardial infarction receive lower quality of care than younger patients SO ANNALS OF EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT Research Forum of the American-College-of-Emergency-Physicians CY OCT 17-18, 2004 CL San Francisco, CA SP Amer Coll Emergency Physicians ID COOPERATIVE CARDIOVASCULAR PROJECT; WORCESTER HEART-ATTACK; BETA-BLOCKER THERAPY; AGE-RELATED TRENDS; THROMBOLYTIC THERAPY; NATIONAL REGISTRY; ELDERLY-PATIENTS; PRIMARY ANGIOPLASTY; MORTALITY; PATTERNS AB Study objective: We assessed the independent relationship between age and the quality of medical care provided to patients presenting to the emergency department (ED) with acute myocardial infarction. Methods: We conducted a 2-year retrospective cohort study of 2,216 acute myocardial infarction patients presenting urgently to 5 EDs in Colorado and California from July 1, 2000, through June 30, 2002. Data on patient characteristics, clinical presentation, and ED processes of care were obtained from the ED record and ECG review. Patients were divided into 6 groups based on their age at the time of their ED visit: younger than 50 years, 50 to 59 years, 60 to 69 years, 70 to 79 years, 80 to 89 years, and 90 years or older. Hierarchic multivariable regression was used to assess the independent association between age and the provision of aspirin, beta-blockers, and reperfusion therapy (fibrinolytic agent or percutaneous coronary intervention) in the ED to eligible acute myocardial infarction patients. Results: Of ideal candidates for treatment in the ED, 1,639 (80.5%) of 2,036 received aspirin, 552 (60.3%) of 916 received beta-blockers, and 358 (77.8%) of 460 received acute reperfusion therapy. After adjustment for demographic, medical history, and clinical factors, older patients were less likely to receive aspirin (odds ratio [OR] 0.85, 95% confidence interval [Cl] 0.77 to 0.93), beta-blockers (OR 0.79, 95% CI 0.71 to 0.88), and reperfusion therapy (OR 0.30, 95% CI 0.18 to 0.52). Conclusion: Older patients presenting to the ED with acute myocardial infarction receive lower-quality medical care than younger patients. Further investigation to identify the reasons for this disparity and to intervene to reduce gaps in care quality will likely lead to improved outcomes for older acute myocardial infarction patients. C1 Kiaser Permanente Colorado, Clin Res Unit, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Div Emergency Med, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80202 USA. Denver Hlth Med Ctr, Div Cardiol, Denver, CO USA. Permanente Med Grp Inc, Oakland, CA USA. Kaiser Permanente No Calif, Div Res, Oakland, CA USA. Denver VA Med Ctr, Denver, CO USA. Denver Hlth Med Ctr, Dept Med, Denver, CO USA. RP Magid, DJ (reprint author), Kiaser Permanente Colorado, Clin Res Unit, POB 378066, Denver, CO USA. EM David.J.Magid@kp.org OI Vinson, David/0000-0001-6559-1858 FU NIA NIH HHS [K08-AG01011] NR 48 TC 30 Z9 30 U1 1 U2 3 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD JUL PY 2005 VL 46 IS 1 BP 14 EP 21 DI 10.1016/j.annemergmed.2004.12.012 PG 8 WC Emergency Medicine SC Emergency Medicine GA 941PP UT WOS:000230227000004 PM 15988420 ER PT J AU Silber, JH Rosenbaum, PR Trudeau, ME Chen, W Zhang, XM Lorch, SA Kelz, RR Mosher, RE Even-Shoshan, O AF Silber, JH Rosenbaum, PR Trudeau, ME Chen, W Zhang, XM Lorch, SA Kelz, RR Mosher, RE Even-Shoshan, O TI Preoperative antibiotics and mortality in the elderly SO ANNALS OF SURGERY LA English DT Article ID TOTAL HIP-REPLACEMENT; PROPHYLACTIC ANTIBIOTICS; ANTIMICROBIAL PROPHYLAXIS; PROPENSITY SCORE; BIAS REDUCTION; SURGERY; RISK; GUIDELINES; SEVERITY; OUTCOMES AB Objective and Background: It is generally thought that the use of preoperative antibiotics reduces the risk of postoperative infection, yet few studies have described the association between preoperative antibiotics and the risk of dying. The objective of this study was to determine whether preoperative antibiotics are associated with a reduced risk of death. Methods: We performed a multivariate matched, population-based, case-control study of death following surgery on 1362 Pennsylvania Medicare patients between 65 and 85 years of age undergoing general and orthopedic surgery. Cases (681 deaths within 60 days from hospital admission) were randomly selected throughout Pennsylvania using claims from 1995 and 1996. Models were developed to scan Medicare claims, looking for controls who did not die and who were the closest matches to the previously selected cases based on preoperative characteristics. Cases and their controls were identified, and charts were abstracted to define antibiotic use and obtain baseline severity adjustment data. Results: For general surgery, the odds of dying within 60 days were less than half in those treated with preoperative antibiotics within 2 hours of incision as compared with those without such treatment: (odds ratio = 0.44; 95% confidence interval, 0.32-0.60), P < 0.0001). For orthopedic surgery, no significant mortality reduction was observed (OR = 0.85; 95% confidence interval, 0.54-1.32; P < 0.464). Interpretation: Preoperative antibiotics are associated with a substantially lower 60-day mortality rate in elderly patients undergoing general surgery. In patients who appear to be comparable, the risk of death was half as large among those who received preoperative antibiotics. C1 Childrens Hosp Philadelphia, Ctr Outcomes Res, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Anesthesia, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Stat, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Hosp Univ Penn, Dept Surg, Philadelphia, PA 19104 USA. Hosp Univ Penn, VA Ctr Hlth Equi Res & Promot, Philadelphia, PA 19104 USA. RP Silber, JH (reprint author), Childrens Hosp Philadelphia, Ctr Outcomes Res, 3535 Market St,Suite 1029, Philadelphia, PA 19104 USA. EM silberj@wharton.upenn.edu RI Rosenbaum, Paul/H-8687-2012 FU AHRQ HHS [HS-R01-9460] NR 35 TC 19 Z9 19 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD JUL PY 2005 VL 242 IS 1 BP 107 EP 114 DI 10.1097/01.sla.0000167850.49819.ea PG 8 WC Surgery SC Surgery GA 940OB UT WOS:000230152700015 PM 15973108 ER PT J AU Ang, GC Werth, VP AF Ang, GC Werth, VP TI Combination antimalarials in the treatment of cutaneous dermatomyositis - A retrospective study SO ARCHIVES OF DERMATOLOGY LA English DT Article ID NECROSIS-FACTOR-ALPHA; LUPUS-ERYTHEMATOSUS; JUVENILE DERMATOMYOSITIS; TNF-ALPHA-308A ALLELE; QUINACRINE ATABRINE; OCULAR SAFETY; HYDROXYCHLOROQUINE; ASSOCIATION; CHLOROQUINE; RETINOPATHY AB Objective: To observe whether the use of antimalarials in combination resulted in significant improvement in the cutaneous signs and symptoms of patients with dermatomyositis who did not other-wise respond to the use of single-agent antimalarial therapy. Design: Retrospective case series of 17 patients treated between January 1, 199 1, and December 31, 2002. Setting: An ambulatory medical dermatology clinic in an academic center. Patients: Patients had adult-onset dermatomyositis with predominantly cutaneous symptoms and a follow-up period at our clinic of at least 6 months. Cases in which it was not possible to assess the effect of treatment on cutaneous symptoms were not included. Intervention: Treatment regimens varied and included the use of antimalarials, prednisone, methotrexate, and other medications. Main Outcome Measures: Physician-observed and patient-reported improvement based on erythema, pruritus, and extent of affected skin. Results: Seven of 17-patients experienced at least near clearance in cutaneous symptoms with the use of antimalarial therapy alone: 4 of these patients required combination therapy (hydroxychloroquine sulfate-quinacrine hydrochloride or chloroquine phosphatequinacrine), while 3 of them responded well to antimalarial monotherapy. The median time required to reach the response milestones on the final working therapeutic regimen was 3 months (mean, 4.8 months; range, 2-14 months). Six patients did not respond significantly to any type of therapy, including nonantimalarials. Conclusion: Our experience suggests that a significant subgroup of patients whose skin lesions have been unresponsive to a single antimalarial benefit from combination therapy with hydroxychloroquine and quinacrine or chloroquine and quinacrine, but controlled clinical trials are warranted to assess the extent of benefit. C1 Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. Univ Penn, Jefferson Med Coll, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia Vet Affairs Med Ctr, Dept Dermatol, Philadelphia, PA 19104 USA. RP Werth, VP (reprint author), Univ Penn, Dept Dermatol, 2 Rhoads Pavil,36th & Spruce, Philadelphia, PA 19104 USA. FU NIAMS NIH HHS [1K24 AR02207] NR 21 TC 24 Z9 25 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-987X J9 ARCH DERMATOL JI Arch. Dermatol. PD JUL PY 2005 VL 141 IS 7 BP 855 EP 859 DI 10.1001/archderm.141.7.855 PG 5 WC Dermatology SC Dermatology GA 944PV UT WOS:000230442100006 PM 16027300 ER PT J AU Suhler, EB Smith, JR Wertheim, MS Lauer, AK Kurz, DE Pickard, TD Rosenbaum, JT AF Suhler, EB Smith, JR Wertheim, MS Lauer, AK Kurz, DE Pickard, TD Rosenbaum, JT TI A prospective trial of infliximab therapy for refractory uveitis - Preliminary safety and efficacy outcomes SO ARCHIVES OF OPHTHALMOLOGY LA English DT Article ID TUMOR-NECROSIS-FACTOR; JUVENILE IDIOPATHIC ARTHRITIS; RHEUMATOID-ARTHRITIS; FACTOR-ALPHA; POSTERIOR UVEITIS; MONOCLONAL-ANTIBODY; BEHCETS-SYNDROME; CROHNS-DISEASE; CLINICAL-TRIAL; TNF-ALPHA AB Objective: Infliximab, a monoclonal antibody against tumor necrosis factor a, is approved by the US Food and Drug Administration for treatment of numerous autoimmune disorders. We conducted a prospective, open-label phase 2 clinical trial to assess the effectiveness of infliximab in treating refractory autoimmune uveitis. Methods: We prospectively enrolled 23 patients from the uveitis clinic of the Casey Eye Institute, Portland, Ore, into this trial. All patients meeting eligibility criteria received 3 infliximab infusions at weeks 0, 2, and 6. Clinical success was ascertained at week 10. Patients meeting initial criteria for success received an infusion at week 14 and every 8 weeks thereafter, with dose escalation permitted for breakthrough inflammation, and underwent outcome measurements at week 50. Results: All patients underwent outcome assessment at week 10. Eighteen (78%) of these subjects met criteria for clinical success at this time. Success was judged by the composite clinical end point of visual acuity, control of intraocular inflammation, ability to taper concomitant medication therapy, and improvement in inflammatory signs on fluorescein angiography and/or ocular coherence tomography. Successful grading required improvement in at least 1 of 4 subcomponents and worsening in none. Seven of 14 patients enrolled for I year continued infliximab therapy and maintained their successful grading. Five did not complete I year of treatment because of significant adverse events, and 2 terminated treatment early for reasons unrelated to the study. Serious adverse events that were potentially related to infliximab included pulmonary embolus, congestive heart failure, lupus-like reaction in 2, and vitreous hemorrhage in 2 patients. Antinuclear antibodies developed in 15 of 20 enrolled patients receiving 3 or more infusions. Conclusions: Infliximab was an effective short-term immunosuppressive agent in most of the patients, with 18 of 23 meeting criteria for clinical success at week 10. Infliximab was effective in the long term in all patients able to complete 50 weeks of therapy. Although some patients achieved clear benefit, the rate of serious toxic effects was unexpectedly high. Further long-term studies are warranted to determine the safety and efficacy of infliximab in treating intraocular inflammation. C1 Case Eye Inst, Uveitis Div, Portland, OR 97239 USA. Case Eye Inst, Retina Div, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Cell Biol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Dept Ophthalmol, Portland, OR USA. RP Suhler, EB (reprint author), Case Eye Inst, Uveitis Div, 3375 SW Terwilliger Blvd, Portland, OR 97239 USA. EM suhlere@ohsu.edu FU NCRR NIH HHS [5M01 RR 000334] NR 39 TC 169 Z9 176 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9950 J9 ARCH OPHTHALMOL-CHIC JI Arch. Ophthalmol. PD JUL PY 2005 VL 123 IS 7 BP 903 EP 912 DI 10.1001/archopht.123.7.903 PG 10 WC Ophthalmology SC Ophthalmology GA 943KR UT WOS:000230352900002 PM 16009830 ER PT J AU Burns, SP Spanier, DE AF Burns, SP Spanier, DE TI Break-technique handheld dynamometry: Relation between angular velocity and strength measurements SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE muscle spasticity; rehabilitation; reproducibility of results; spinal cord injuries ID MUSCLE STRENGTH; AGED 20; RELIABILITY; TORQUE; ACTIVATION; EXTREMITY; ADULTS; TESTS; EMG AB Objectives: To determine whether the muscle strength, as measured with break-technique handheld dynamomety (HHD), is dependent on the angular velocity achieved during testing and to compare reliability at different angular velocities. Design: Repeated-measures study. Participants underwent HHD by using make-technique (isometric) and break-technique (eccentric) dynamometry at 3 prespecified angular velocities. Elbow movement was recorded with an electrogoniometer. Setting: Inpatient spinal cord injury unit. Participants: Convenience sample of 20 persons with tetraplegia with weakness of elbow flexors or extensors. Interventions: Not applicable. Main Outcome Measures: Elbow angular velocity and muscle strength recorded during HHD. Results: With the break technique, angular velocities averaging 15 degrees, 33 degrees, and 55 degrees/s produced 16%, 30%, and 51% greater strength measurements, respectively, than velocities recorded by using the make technique (all P <.006 for comparisons between successive techniques). The intraclass correlation coefficient for intrarater reliability was.89 or greater for all testing techniques. Conclusions: Greater strength is recorded with faster angular velocities during HHD. Differences in angular velocity may explain the wide range previously reported for break- versus make-technique strength measurements. Variation in angular velocity is a potential source of variability in serial HHD strength measurements, and for this reason the make technique may be preferable. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. C1 VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA 98109 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Harborview Injury Prevent & Res Ctr, Seattle, WA 98104 USA. RP Burns, SP (reprint author), VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, SCI 128,1660 S Columbian Way, Seattle, WA 98109 USA. EM spburns@u.washington.edu NR 26 TC 15 Z9 15 U1 0 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JUL PY 2005 VL 86 IS 7 BP 1420 EP 1426 DI 10.1016/j.apmr.2004.12.041 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 944FR UT WOS:000230412500025 PM 16003675 ER PT J AU Xu, GG Spivak, G Mitchell, DL Mori, T McCarrey, JR McMahan, CA Walter, RB Hanawalt, PC Walter, CA AF Xu, GG Spivak, G Mitchell, DL Mori, T McCarrey, JR McMahan, CA Walter, RB Hanawalt, PC Walter, CA TI Nucleotide excision repair activity varies among murine spermatogenic cell types SO BIOLOGY OF REPRODUCTION LA English DT Article DE aging; gamete biology; gametogenesis; spermatogenesis ID CYCLOBUTANE PYRIMIDINE DIMERS; UNSCHEDULED DNA-SYNTHESIS; GENE-EXPRESSION; ESCHERICHIA-COLI; CHILDHOOD-CANCER; GERM-CELLS; DHFR GENE; OLD MICE; DAMAGE; TRANSCRIPTION AB Germ cells perform a unique and critical biological function: they propagate the DNA that will be used to direct development of the next generation. Genetic integrity of germ cell DNA is essential for producing healthy and reproductively fit offspring, and yet germ cell DNA is damaged by endogenous and exogenous agents. Nucleotide excision repair (NER) is an important mechanism for coping with a variety of DNA lesions. Little is known about NER activity in spermatogenic cells. We expected that germ cells would be more efficient at DNA repair than somatic cells, and that this efficiency may be reduced with age when the prevalence of spontaneous mutations increases. In the present study, NER was measured in defined spermatogenic cell types, including premeiotic cells (A and B type spermatogonia), meiotic cells (pachytene spermatocytes), and postmeiotic haploid cells (round spermatids) and compared with NER in keratinocytes. Global genome repair and transcription-coupled repair subpathways of NER were examined. All spermatogenic cell types from young mice displayed good repair of (6-4) pyrimidone photoproducts, although the repair rate was slower than in primary keratinocytes. In aged mice, repair of 6-4 pyrimidone photoproducts was depressed in postmeiotic cells. While repair of cyclobutane pyrimidine dimers was not detected in spermatogenic cells or in keratinocytes, the transcribed strands of active genes were repaired with greater efficiency than nontranscribed strands or inactive genes in keratinocytes and in meiotic and postmeiotic cells; spermatogonia displayed low to moderate ability to repair cyclobutane pyrimidine dimers on both DNA strands regardless of transcriptional status. Overall, the data suggest cell type-specific NER activity during murine spermatogenesis, and our results have possible implications for germ cell aging. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, San Antonio Canc Inst, San Antonio, TX 78229 USA. Stanford Univ, Dept Biol Sci, Stanford, CA 94305 USA. Univ Texas, MD Anderson Canc Ctr, Dept Carcinogenesis, Div Res, Smithville, TX 78957 USA. Nara Med Univ, Radioisotope Ctr, Kashihara, Nara 6340821, Japan. Univ Texas, Dept Biol, San Antonio, TX 78249 USA. SW Texas State Univ, Dept Chem & Biochem, San Marcos, TX 78666 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78201 USA. RP Walter, CA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM walter@uthscsa.edu OI Spivak, Graciela/0000-0001-6093-5965 FU NIA NIH HHS [AG19316, AG21163, AG24364] NR 49 TC 38 Z9 40 U1 0 U2 3 PU SOC STUDY REPRODUCTION PI MADISON PA 1603 MONROE ST, MADISON, WI 53711-2021 USA SN 0006-3363 J9 BIOL REPROD JI Biol. Reprod. PD JUL PY 2005 VL 73 IS 1 BP 123 EP 130 DI 10.1095/biolreprod.104.039123 PG 8 WC Reproductive Biology SC Reproductive Biology GA 938CY UT WOS:000229978700015 PM 15758148 ER PT J AU Corbin, AS Demehri, S Griswold, IJ Wang, YH Metcalf, CA Sundaramoorthi, R Shakespeare, WC Snodgrass, J Wardwell, S Dalgarno, D Iuliucci, J Sawyer, TK Heinrich, MC Druker, BJ Deininger, MWN AF Corbin, AS Demehri, S Griswold, IJ Wang, YH Metcalf, CA Sundaramoorthi, R Shakespeare, WC Snodgrass, J Wardwell, S Dalgarno, D Iuliucci, J Sawyer, TK Heinrich, MC Druker, BJ Deininger, MWN TI In vitro and in vivo activity of ATP-based kinase inhibitors AP23464 and AP23848 against activation-loop mutants of Kit SO BLOOD LA English DT Article ID RECEPTOR TYROSINE KINASE; ACUTE MYELOID-LEUKEMIA; GASTROINTESTINAL STROMAL TUMORS; MAST-CELL DISEASE; C-KIT; WILD-TYPE; SIGNAL-TRANSDUCTION; SYSTEMIC MASTOCYTOSIS; HEMATOPOIETIC-CELLS; IMATINIB MESYLATE AB Oncogenic mutations of the Kit receptor tyrosine kinase occur in several types of malignancy. Juxtamembrane domain mutations are common in gastrointestinal stromal tumors, whereas mutations in the kinase activation loop, most commonly D816V, are seen in systemic mastocytosis and acute myelogenous leukemia. Kit activation-loop mutants are insensitive to imatinib mesylate and have been largely resistant to targeted inhibition. We determined the sensitivities of both Kit mutant classes to the adenosine triphosphate (ATP)-based inhibitors AP23464 and AP23848. In cell lines expressing activation-loop mutants, low-nM concentrations of AP23464 inhibited phosphorylation of Kit and its downstream targets Akt and signal transducer and activator of transcription 3 (STAT3). This was associated with cell-cycle arrest and apoptosis. Wild-type Kit- and juxtamembrane-mutant-expressing cell lines required considerably higher concentrations for equivalent inhibition, suggesting a therapeutic window in which cells harboring D816V Kit could be eliminated without interfering with normal cellular function. Additionally, AP23464 did not disrupt normal hematopoietic progenitor-cell growth at concentrations that inhibited activationloop mutants of Kit. in a murine model, AP23848 inhibited activation-loop mutant Kit phosphorylation and tumor growth. Thus, AP23464 and AP23848 potently and selectively target activation-loop mutants of Kit in vitro and in vivo and could have therapeutic potential against D816V-expressing malignancies. C1 Oregon Hlth & Sci Univ, Inst Canc, BMT Leukemia Ctr, Portland, OR 97239 USA. Howard Hughes Med Inst, Chevy Chase, MD USA. ARIAD Pharmaceut Inc, Cambridge, MA 02139 USA. Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. RP Deininger, MWN (reprint author), Oregon Hlth & Sci Univ, Inst Canc, BMT Leukemia Ctr, L592,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM deininge@ohsu.edu NR 42 TC 43 Z9 46 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 JUL 1 PY 2005 VL 106 IS 1 BP 227 EP 234 DI 10.1182/blood-2004-12-4771 PG 8 WC Hematology SC Hematology GA 940PN UT WOS:000230156500039 PM 15746079 ER PT J AU Liu, XB Yang, FM Haile, DJ AF Liu, XB Yang, FM Haile, DJ TI Functional consequences of ferroportin 1 mutations SO BLOOD CELLS MOLECULES AND DISEASES LA English DT Article DE ferroportin 1; hemochromatosis; mutations ID AUTOSOMAL-DOMINANT HEMOCHROMATOSIS; MEMBRANE-PROTEIN STRUCTURE; CELLULAR IRON EFFLUX; GENE SLC11A3; HEREDITARY HEMOCHROMATOSIS; JUVENILE HEMOCHROMATOSIS; STRUCTURE PREDICTION; AFRICAN-AMERICANS; COMMON MUTATION; OVERLOAD AB The cellular iron exporter ferroportin I is expressed in both the duodenum and in cells of the mononuclear phagocyte system. Expression of ferroportin I protein on the cell surface is regulated by the interaction of ferroportin I with hepcidin. Hepcidin treatment of cells results in internalization and lysosomal degradation of cell surface ferroportin 1. Recently, ferroportin I mutations leading to hemochromatosis (HFE4) have been identified. HFE4 differs from classical hemochromatosis in that there is a greater amount of macrophage iron sequestration. The data presented here demonstrate that HFE4 mutations are heterogeneous in their effects on protein function. Some mutations result in loss of function with partial protein sequestration in the ER. Others are indistinguishable from native ferroportin I and have a similar ability to deplete transfected cells of iron as evidenced by activation of the iron-response proteins and cellular ferritin depletion. Significantly, all mutants appear to be unresponsive to hepcidin and do not demonstrate the expected internalization on exposure to hepcidin. The clinical phenotypes observed in patients may be secondary to cell-type-specific defects in hepcidin-mediated inhibition of ferroportin I expression. Published by Elsevier Inc. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Vet Adm Hosp, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. RP Haile, DJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM Haile@uthscsa.edu FU NHLBI NIH HHS [R01HL68842]; NIDDK NIH HHS [R01DK53079] NR 34 TC 82 Z9 84 U1 0 U2 3 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1079-9796 J9 BLOOD CELL MOL DIS JI Blood Cells Mol. Dis. PD JUL-AUG PY 2005 VL 35 IS 1 BP 33 EP 46 DI 10.1016/j.bcmd.2005.04.005 PG 14 WC Hematology SC Hematology GA 946PP UT WOS:000230584800006 PM 15935710 ER PT J AU Liu, XB Nguyen, NBH Marquess, KD Yang, FM Haile, DJ AF Liu, XB Nguyen, NBH Marquess, KD Yang, FM Haile, DJ TI Regulation of hepcidin and ferroportin expression by lipopolysaccharide in splenic macrophages SO BLOOD CELLS MOLECULES AND DISEASES LA English DT Article DE hepcidin; ferroportin; splenic macrophage; lipopolysaccharide ID ANTIMICROBIAL PEPTIDE HEPCIDIN; IRON OVERLOAD; INFLAMMATION; ANEMIA; MICE; PROTEIN; GENE; ERYTHROPHAGOCYTOSIS; TRANSCRIPTION; IL-6 AB Acute and chronic inflammatory states are associated with many changes in intracellular iron metabolism including sequestration of iron in the mononuclear-phagocyte system (NIPS) and a decline in serum iron. Previous work in rodent models of acute inflammation has demonstrated inflammation-induced downregulation of intestinal and MPS iron exporter, ferroportin 1, mRNA and protein. In addition, these models have also demonstrated hepatic induction of mRNA of the small 25 amino acid peptide hepcidin. Hepcidin has been hypothesized to be the mediator of iron- and inflammation-induced changes in iron metabolism. The molecular details of the connection between iron metabolism, hepcidin and inflammation have become clearer with the recent finding of hepcidin-induced internalization and degradation of FPN1. The work presented here demonstrates that the lipopolysaccharide-induced splenic macrophage FPN1 mRNA downregulation is not dependent upon the action of a single cytokine such as IL-6, IL-1 or TNF-alpha because mice deficient in these pathways downregulate FPN1 normally. Furthermore, hepcidin is also synthesized in the spleen of normal mice and induced by lipopolysaccharide. Additionally, in vitro, splenic adherent cells produce hepcidin in response to lipopolysaccharide in an IL-6-dependent manner. There appear to be both probable transcriptional and post-transcriptional control of FPN1 expression by lipopolysaccharide-induced inflammation. The former effect is on mRNA expression and is independent of hepcidin, whereas the latter is IL-6- and hepcidin-dependent. Published by Elsevier Inc. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Vet Adm Hosp, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. RP Haile, DJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM Haile@uthscsa.edu FU NHLBI NIH HHS [R01HL68842]; NIDDK NIH HHS [R01DK53079] NR 19 TC 77 Z9 83 U1 0 U2 3 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1079-9796 J9 BLOOD CELL MOL DIS JI Blood Cells Mol. Dis. PD JUL-AUG PY 2005 VL 35 IS 1 BP 47 EP 56 DI 10.1016/j.bcmd.2005.04.006 PG 10 WC Hematology SC Hematology GA 946PP UT WOS:000230584800007 PM 15932798 ER PT J AU Clark, DG Charuvastra, A Miller, BL Shapira, JS Mendez, MF AF Clark, DG Charuvastra, A Miller, BL Shapira, JS Mendez, MF TI Fluent versus nonfluent primary progressive aphasia: A comparison of clinical and functional neuroimaging features SO BRAIN AND LANGUAGE LA English DT Article DE aphasia; primary progressive aphasia; PET; SPECT; functional imaging; dementia; frontotemporal dementia; semantic dementia; fluency ID TEMPORAL-LOBE ATROPHY; SEMANTIC DEMENTIA; ALZHEIMERS-DISEASE; FRONTOTEMPORAL DEMENTIA; NEURAL BASIS; ANATOMY; SPEECH; LANGUAGE; DEGENERATION; RETRIEVAL AB To better characterize fluent and nonfluent variants of primary progressive aphasia (PPA). Although investigators have recognized both fluent and nonfluent patients with PPA (Mesulam, 2001), the clinical and neuroimaging features of these variants have not been fully defined. We present clinical and neuropsychological data on 47 PPA patients comparing the fluent (n = 21) and nonfluent (n = 26) subjects. We further compared language features with PET/SPECT data available on 39 of these patients. Compared to the nonfluent PPA patients, those with fluent PPA had greater impairment of confrontational naming and loss of single word comprehension. They also exhibited semantic paraphasic errors and loss of single word comprehension. Patients with nonfluent PPA were more likely to be female, were more often dysarthric, and exhibited phonological speech errors in the absence of semantic errors. No significant differences were seen with regard to left hemisphere abnormalities, suggesting that both variants result from mechanisms that overlap frontal, temporal, and parietal regions. Of the language measures, only semantic paraphasias were strongly localized, in this case to the left temporal lobe. Fluent and nonfluent forms of PPA are clinically distinguishable by letter fluency, single word comprehension, object naming, and types of paraphasic errors. Nevertheless, there is a large amount of overlap between dysfunctional anatomic regions associated with these syndromes. (c) 2004 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobhev Sci, Los Angeles, CA USA. Univ Calif San Francisco, Memory & Aging Ctr, San Francisco, CA 94143 USA. RP Clark, DG (reprint author), Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,3 S Neurobehv Unit,116AF, Los Angeles, CA 90073 USA. EM dgclark@mednet.ucla.edu FU NIA NIH HHS [AG19724-01A1, P01 AG019724] NR 42 TC 34 Z9 40 U1 0 U2 5 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0093-934X J9 BRAIN LANG JI Brain Lang. PD JUL PY 2005 VL 94 IS 1 BP 54 EP 60 DI 10.1016/j.bandl.2004.11.007 PG 7 WC Audiology & Speech-Language Pathology; Linguistics; Neurosciences; Psychology, Experimental SC Audiology & Speech-Language Pathology; Linguistics; Neurosciences & Neurology; Psychology GA 933XV UT WOS:000229667100005 PM 15896383 ER PT J AU Loftis, JM Hauser, P Rifai, MA AF Loftis, JM Hauser, P Rifai, MA TI The association between viral clearance and depression in patients with hepatitis C receiving interferon-alpha and ribavirin SO BRAIN BEHAVIOR AND IMMUNITY LA English DT Letter ID VIRUS-INFECTION C1 Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. Portland VA Med Ctr, JENS Lab, Portland, OR USA. NIMH, Off Clin Director, Bethesda, MD 20892 USA. RP Loftis, JM (reprint author), Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR USA. EM peter.hauser2@med.va.gov NR 9 TC 4 Z9 4 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0889-1591 J9 BRAIN BEHAV IMMUN JI Brain Behav. Immun. PD JUL PY 2005 VL 19 IS 4 BP 271 EP 272 DI 10.1016/j.bbi.2005.03.007 PG 2 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 938JH UT WOS:000229995300001 PM 15944066 ER PT J AU Mularski, RA Heine, CE Osborne, ML Ganzini, L Curtis, JR AF Mularski, RA Heine, CE Osborne, ML Ganzini, L Curtis, JR TI Quality of dying in the ICU - Ratings by family members SO CHEST LA English DT Article DE critical care; death; end-of-life care; ethics; intensive care; outcome and process assessment (health care); quality of health care; rating; research, clinical; terminal care ID END-OF-LIFE; ILL HOSPITALIZED-PATIENTS; INTENSIVE-CARE-UNIT; OUTCOMES; DEATH; PREFERENCES; EXPERIENCE; SUPPORT; SYSTEM; OLDER AB Study objectives: To explore the quality of the dying experience and associations to higher quality ratings for people who died in an ICU. Design: Retrospective study using medical record review and surveys of family members with the Quality of Dying and Death (QODD) instrument. Setting: Four ICUs affiliated with a university and a Veterans Affairs Medical Center. Participants: Ninety-four family members of 38 ICU decedents. Measurements and results: We explored associations between components of the ICU experience and the overall rating of the quality of the dying experience. Overall, family members reported that symptoms were poorly controlled: pain under control most or all of the time in 47%, and breathing comfortably most or all of the time in 3% of patients. Families expressed a moderate and variable view of the quality of dying resulting in an overall ICU QODD score of 60 +/- 14 (on a scale of 0 to 100) [mean +/- SD]. Higher ICU QODD scores were associated with control of pain (r = 0.42, p = 0.009), control of events (r = 0.62, p < 0.001), a "preparation for death" aspect of the dying experience-feeling at peace with dying (r = 0.69, p < 0.001), and a "whole-person concern- keeping one's dignity and self-respect (r = 0.50, p < 0.001). Conclusions: After adjusting for symptom and personal care scores, certain whole-person and preparation-for-death aspects of the dying process, and not aggressiveness of end-of-life care, remained the most associated to quality ratings. While future research should explore the important predictors of quality of dying in the ICU, this study suggests that care at the end of life in the ICU include not only managing pain, but also supporting dignity, respect, and peace, and maximizing patient control. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Virginia Hlth SYst, Dept Emergency Med, Charlottesville, VA USA. Oregon Hlth & Sci Univ, Dept Med, Div Pulm & Crit Care Med, Portland, OR USA. Portland Vet Affairs Med Ctr, Dept Psychiat, Portland, OR USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Harborview Med Ctr, Seattle, WA USA. RP Mularski, RA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, 11301 Wilshire Blvd,Mailcode 111G, Los Angeles, CA 90073 USA. EM Richard.Mularski@med.va.gov FU NCRR NIH HHS [5M01 RR 00334] NR 29 TC 77 Z9 84 U1 4 U2 9 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD JUL PY 2005 VL 128 IS 1 BP 280 EP 287 DI 10.1378/chest.128.1.280 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 945VN UT WOS:000230530500045 PM 16002947 ER PT J AU Ozen, M Ittmann, M AF Ozen, M Ittmann, M TI Increased expression and activity of CDC25C phosphatase and an alternatively spliced variant in prostate cancer SO CLINICAL CANCER RESEARCH LA English DT Article ID 14-3-3 PROTEIN-BINDING; DIFFERENTIAL EXPRESSION; OVEREXPRESSION; KINASE; PHOSPHORYLATION; CELLS; CHK1; PROGRESSION; ACTIVATION AB Alterations in the control of cell cycle progression have been implicated in a wide variety of malignant neoplasms, including prostate cancer. CDC25 phosphatases belong to the tyrosine phosphatase family and play a critical role in regulating cell cycle progression by dephosphorylating cyclin-dependent kinases at inhibitory residues. CDC25C plays an important role in the G(2)-M transition by activating Cdc2/Cyclin B1 complexes. To determine whether CDC25C activity is altered in prostate cancer, we have examined the expression of CDC25C and an alternatively spliced variant in human prostate cancer samples and cell lines. CDC25C protein is up-regulated in prostate cancer in comparison with normal prostate tissue and is present almost exclusively in its active dephosphorylated form. Expression of a biologically active alternatively spliced CDC25C isoform is also increased in prostate cancer and expression of alternatively spliced CDC25 C is correlated to occurrence of biochemical (prostate-specific antigen) recurrence. We have also developed a quantitative reverse transcriptase-PCR analysis of Ki-67 expression as a method of measuring proliferative activity in prostate cancer from RNA samples. Based on this analysis of Ki67 expression, some but not all of this increase in CDC25C and its alternatively spliced variants is correlated with increased proliferation in prostate cancer. This data suggests that CDC25C might play an important role in prostate cancer progression and could be used to monitor and predict the aggressiveness of this disease. C1 Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. RP Ittmann, M (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Res Serv, 2002 Holocombe Blve, Houston, TX 77030 USA. EM mittmann@bcm.tmc.edu FU NCI NIH HHS [P50CA058204] NR 32 TC 37 Z9 41 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD JUL 1 PY 2005 VL 11 IS 13 BP 4701 EP 4706 DI 10.1158/1078-0432.CCR-04-2551 PG 6 WC Oncology SC Oncology GA 944BQ UT WOS:000230400300012 PM 16000564 ER PT J AU Hilsabeck, RC Castellon, SA Hinkin, CH AF Hilsabeck, RC Castellon, SA Hinkin, CH TI Neuropsychological aspects of coinfection with HIV and hepatitis C virus SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; INTERFERON-ALPHA; NEUROPSYCHIATRIC SYMPTOMS; TEST-PERFORMANCE; DRUG-USERS; INFECTION; IMPAIRMENT; DISORDERS; BRAIN; AIDS AB Infection with hepatitis C virus (HCV) is commonly seen in persons with human immunodeficiency virus (HIV) infection, because the viruses share risk factors for transmission; coinfection is a leading cause of morbidity and mortality among HIV-infected persons. Neuropsychological consequences of HIV infection are well established, and studies of HCV-infected persons have revealed neuropsychiatric dysfunction in this population as well. Investigators now are focusing on neuropsychological sequelae of coinfection with HIV and HCV, and preliminary results suggest that coinfection has a possible deleterious effect on global cognitive functioning consistent with frontal-subcortical dysfunction. Data on neuropsychiatric symptoms in coinfected persons are inconclusive at this time and are complicated by important differences in study populations (e. g., injection drug use and disease severity). This review summarizes what is known about neuropsychological aspects of monoinfection with HIV and HCV, as well as coinfection, discusses implications of these findings, and suggests future directions for this research area. C1 S Texas Vet Hlth Care Syst, Psychol Serv, San Antonio, TX 78229 USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Hilsabeck, RC (reprint author), S Texas Vet Hlth Care Syst, Psychol Serv, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM Robin.Hilsabeck@med.va.gov FU NIDA NIH HHS [R01 DA013799, R01 DA013799-01A1, DA-13799]; NIMH NIH HHS [MH-58552, R01 MH058552, R01 MH058552-02, T32 MH019535] NR 48 TC 34 Z9 35 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 1 PY 2005 VL 41 SU 1 BP S38 EP S44 DI 10.1086/429494 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 932CB UT WOS:000229530700007 PM 16265612 ER PT J AU Mao, JT Cui, XY Reckamp, K Liu, M Krysan, K Dalwadi, H Sharma, S Hazra, S Strieter, R Gardner, B Dubinett, SM AF Mao, Jenny T. Cui, Xiaoyan Reckamp, Karen Liu, Ming Krysan, Kostyantyn Dalwadi, Harnisha Sharma, Sherven Hazra, Saswati Strieter, Robert Gardner, Brian Dubinett, Steven M. TI Chemoprevention strategies with cyclooxygenase-2 inhibitors for lung cancer SO CLINICAL LUNG CANCER LA English DT Review DE angiogenesis; arachidonic acid cascade; celecoxib; fluorescence bronchoscopy; invasion; prostaglandin E-2 ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; ENDOTHELIAL GROWTH-FACTOR; DENDRITIC CELL-DIFFERENTIATION; LAMININ-5 GAMMA-2 CHAIN; NITRIC-OXIDE SYNTHASE; NF-KAPPA-B; PROSTAGLANDIN E-2; COLORECTAL-CANCER; PROSTATE-CANCER; FACTOR RECEPTOR AB Clinical lung cancer is the ultimate event resulting from a series of genetic and epigenetic alterations in the respiratory epithelium at risk. According to the "field carcinogenesis" theory, these alterations can occur throughout the entire lung. In individuals with a genetic predisposition combined with a sufficient amount of procarcinogenic environmental influences, a few of these sites may eventually progress to malignancies. Recent advances in the understanding of tumor biology have identified new therapeutic targets for lung cancer chemoprevention, among which is cyclooxgygenase (COX)-2. Ample preclinical data suggest that the COX-2/prostaglandin E-2 (PGE(2)) Signaling pathway plays a pivotal role in conferring the malignant phenotype. Produced primarily by the action of COX on the free arachidonic acid liberated from membrane phospholipids, overproduction of PGE(2), which is predominantly generated by upregulation of COX-2, is associated with a variety of mechanisms known to facilitate tumorigenesis. These mechanisms include abnormal expression of epithelial growth factors, epithelial and microvascular proliferation, resistance to apoptosis, and suppression of antitumor immunity. The lung is one of the major sites of PGE(2) production, and previous studies have shown elevated PGE(2) levels in bronchoalveolar lavage fluid of patients with bronchogenic carcinoma. In animal models, inhibition of COX-2 and PGE(2) synthesis suppresses lung tumorigenesis. These preclinical data suggesting the antineoplastic effect of COX-2 inhibitors provide the basis for several ongoing pilot clinical trials to determine the feasibility of COX-2 inhibition in chemoprevention of bronchogenic carcinoma. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Pulm & Crit Care Med,Lung Canc Chemoprevent P, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Lung Canc Res Program, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Mao, JT (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Pulm & Crit Care Med,Lung Canc Chemoprevent P, 37-131 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM jmao@mednet.ucla.edu OI Reckamp, Karen/0000-0002-9213-0325 FU NCI NIH HHS [K23 CA 88068, U01 CA 96134-01, P50 CA 90388] NR 141 TC 34 Z9 35 U1 0 U2 2 PU CIG MEDIA GROUP, LP PI DALLAS PA 3500 MAPLE AVENUE, STE 750, DALLAS, TX 75219-3931 USA SN 1525-7304 J9 CLIN LUNG CANCER JI Clin. Lung Cancer PD JUL PY 2005 VL 7 IS 1 BP 30 EP 39 DI 10.3816/CLC.2005.n.019 PG 10 WC Oncology SC Oncology GA 113LZ UT WOS:000242600700005 PM 16098242 ER PT J AU Topeli, A Laghi, F Cakir, B Tobin, MJ AF Topeli, A Laghi, F Cakir, B Tobin, MJ TI Simpson's paradox - Reply SO CRITICAL CARE MEDICINE LA English DT Letter C1 Univ Hacettepe, Fac Med, Med Intens Care Unit, TR-06100 Ankara, Turkey. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Hines, IL USA. Univ Hacettepe, Fac Med, Dept Publ Hlth, TR-06100 Ankara, Turkey. RP Topeli, A (reprint author), Univ Hacettepe, Fac Med, Med Intens Care Unit, TR-06100 Ankara, Turkey. NR 5 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD JUL PY 2005 VL 33 IS 7 BP 1674 EP 1674 DI 10.1097/01.CCM.0000170185.05101.BE PG 1 WC Critical Care Medicine SC General & Internal Medicine GA 947GB UT WOS:000230630300050 ER PT J AU Dean, BB Dylan, M Gano, A Knight, K Ofman, JJ Levine, BS AF Dean, BB Dylan, M Gano, A Knight, K Ofman, JJ Levine, BS TI Erythropoiesis-stimulating protein therapy and the decline of renal function: a retrospective analysis of patients with chronic kidney disease SO CURRENT MEDICAL RESEARCH AND OPINION LA English DT Article DE chronic kidney disease; disease progression; erythropoiesis-stimulating protein; renal function ID INTRAVENOUS IRON; SERUM CREATININE; HEART-FAILURE; UNITED-STATES; PROGRESSION; ANEMIA; CARE; INSUFFICIENCY; NEPHROPATHY; PREVALENCE AB Background/Aims: Previous studies have hinted at possible associations between anemia and progression of renal disease. The study objective was to determine whether treatment with erythropoiesis-stimulating proteins (ESPs) can curb the rate of decline in renal function in pre-dialysis patients with chronic kidney disease (CKD). Methods: Observational, before/after analysis using electronic medical records from the Veterans Administration (VA). Included patients had at least two measurements of serum creatinine levels before and after ESP treatment initiation. The Cockcroft-Gault formula was used to derive estimates of glomerular filtration rate (GFR). Rate of renal function decline prior to and following initiation of therapy were compared. Results: One hundred and twenty two patients with renal impairment levels of Stage 3 (moderate) or Stage 4 (severe) at ESP treatment initiation were identified. Over 80% of patients initiated therapy with either Grade 1 or Grade 2 anemia. The rate of renal function decline was calculated as the slope of the least-squares linear regression line of the inverse serum creatinine over time during the pre-treatment initiation and post-treatment initiation time periods. Overall, patients experienced a slowing in the rate of renal function decline after treatment was initiated (mean pretreatment initiation rate of -0.094 dL/mg/yr versus mean post-treatment initiation rate of -0.057 dL/mg/yr). Conclusion: Renal function declined at a slower rate following ESP initiation. Results are consistent with prior studies indicating delayed dialysis initiation in patients treated with ESPs. Analyses were limited by the observational study design and lack of information regarding some potential confounders. Longer-term, prospective trials are needed to determine whether ESPs slow progression of renal disease and the potential magnitude of such an effect. C1 Cerner Hlth Insights, Beverly Hills, CA 90212 USA. Cedars Sinai Dept Med, Los Angeles, CA USA. Cedars Sinai Dept Hlth Serv Res, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Gano, A (reprint author), Cerner Hlth Insights, 9100 wilshire Blvd,Suite 655,E Tower, Beverly Hills, CA 90212 USA. EM agano@cerner.com NR 23 TC 30 Z9 33 U1 0 U2 0 PU LIBRAPHARM PI NEWBURY PA C/O DR. PETER L CLARKE, 26-32 VENTURE WEST, NEW GREENHAM PARK, NEWBURY RG19 6HX, BERKSHIRE, ENGLAND SN 0300-7995 J9 CURR MED RES OPIN JI Curr. Med. Res. Opin. PD JUL PY 2005 VL 21 IS 7 BP 981 EP 987 DI 10.1185/030079905X49644 PG 7 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 946HF UT WOS:000230562300001 PM 16004664 ER PT J AU Keith, RL Miller, YE AF Keith, RL Miller, YE TI Lung cancer: genetics of risk and advances in chemoprevention SO CURRENT OPINION IN PULMONARY MEDICINE LA English DT Article DE chemoprevention; genetic susceptibility; lung cancer; prostacyclin; retinoids ID SQUAMOUS-CELL CARCINOMA; AIR-FLOW OBSTRUCTION; 2ND PRIMARY TUMORS; PHASE IIB TRIAL; BETA-CAROTENE; VITAMIN-A; BRONCHIAL EPITHELIUM; RANDOMIZED-TRIAL; DIETARY MYOINOSITOL; NECK-CANCER AB Purpose of review The current article reviews recent advances in genetic susceptibility and chemoprevention of lung cancer. Recent findings Linkage analysis has identified a locus on chromosome 6q23-25 that determines susceptibility to lung cancer in families with multiple members with cancer of the lung, throat, and larynx. Obligate gene carriers are sensitive to even small tobacco smoke exposure in terms of increased lung cancer risk. Variation in other genes, particularly those regulating the activation or inactivation of carcinogens, has been implicated in determining lung cancer risk. Epidemiologic and preclinical studies suggest that chemoprevention of lung cancer is an achievable goal. Early trials with beta-carotene supplementation, however, have revealed a harmful effect. Promising new agents must be evaluated in both preclinical models and in intermediate end point biomarker trials before being taken to large primary prevention trials, and lung cancer chemoprevention should only be attempted within controlled clinical trials. Summary We are poised to learn a great deal about the genetic susceptibility to lung cancer, which will not only allow definition of groups with extremely high risk, but may also yield new insights into processes that determine innate susceptibility or resistance to lung carcinogenesis, Chemoprevention of lung cancer is not yet ready for clinical application. As a result of the large number of lung cancer deaths and the large number of at-risk individuals, even modestly effective chemoprevention could save many lives. C1 Univ Colorado, Denver Vet Affairs Med Ctr, Ctr Canc,Pulm Sect, Pulm Sci & Crit Care Med Div,Tobacco Related Mali, Denver, CO 80220 USA. RP Miller, YE (reprint author), Univ Colorado, Denver Vet Affairs Med Ctr, Ctr Canc,Pulm Sect, Pulm Sci & Crit Care Med Div,Tobacco Related Mali, 1055 Clermont St, Denver, CO 80220 USA. EM york.miller@uchsc.edu FU NCI NIH HHS [P30 CA46934, P50 CA58187] NR 70 TC 20 Z9 20 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1070-5287 J9 CURR OPIN PULM MED JI Curr. Opin. Pulm. Med. PD JUL PY 2005 VL 11 IS 4 BP 265 EP 271 DI 10.1097/01.mcp.0000166493.77412.2d PG 7 WC Respiratory System SC Respiratory System GA 938QC UT WOS:000230016900001 PM 15928489 ER PT J AU Hull, RL Shen, ZP Watts, MR Kodama, K Carr, DB Utzschneider, KM Zraika, S Wang, F Kahn, SE AF Hull, RL Shen, ZP Watts, MR Kodama, K Carr, DB Utzschneider, KM Zraika, S Wang, F Kahn, SE TI Long-term treatment with rosiglitazone and metformin reduces the extent of, but does not prevent, islet antyloid deposition in mice expressing the gene for human islet antyloid polypeptide SO DIABETES LA English DT Article ID BETA-CELL APOPTOSIS; TYPE-2 DIABETES-MELLITUS; AMYLOID FIBRIL FORMATION; FREE FATTY-ACID; IMPAIRED GLUCOSE-TOLERANCE; HUMAN PANCREATIC-ISLETS; INSULIN SENSITIVITY; TRANSGENIC MICE; MOUSE MODEL; PHARMACOLOGICAL-TREATMENT AB Islet amyloid deposition in type 2 diabetes is associated with reduced beta-cell mass. Therefore, interventions aimed at reducing islet amyloid formation may help preserve P-cell mass in type 2 diabetes. Rosiglitazone and metformin act by different mechanisms to improve insulin sensitivity and thereby reduce P-cell secretory demand, resulting in decreased release of insulin and islet amyloid polypeptide (IAPP), the unique constituent of islet amyloid deposits. We hypothesized that this reduced P-cell secretory demand would lead to reduced islet amyloid formation. Human IAPP (MAPP) transgenic mice, a model of islet amyloid, were treated for 12 months with rosiglitazone (1.5 mg (.) kg(-1) (.) day(-1), n = 19), metformin (1 g (.) kg(-1) (.) day(-1), n = 18), or control (n = 17). At the end of the study, islet amyloid prevalence (percent islets containing amyloid) and severity (percent islet area occupied by amyloid), islet mass, P-cell mass, and insulin release were determined. Islet amyloid prevalence (44 8, 13 4, and 11 3% for control, metformin-, and rosiglitazone-treated mice, respectively) and severity (9.2 +/- 3.0, 0.22 +/- 0.11, and 0.10 +/- 0.05% for control, metformin-, and rosiglitazone-treated mice, respectively) were markedly reduced with both rosiglitazone (P < 0.001 for both measures) and metformin treatment (P < 0.001 for both measures). Both treatments were associated with reduced insulin release assessed as the acute insulin response to intravenous glucose (2,189 857, 621 256, and 14 158 pmol/l for control, metformin-, and rosiglitazone-treated mice, respectively; P < 0.05 for metformin vs. control and P < 0.005 for rosiglitazone vs. control), consistent with reduced secretory demand. Similarly, islet mass (33.4 +/- 7.0, 16.6 +/- 3.6, and 12.2 +/- 2.1 mg for control, metformin-, and rosiglitazone-treated mice, respectively) was not different with metformin treatment (P = 0.06 vs. control) but was significantly lower with rosiglitazone treatment (P < 0.05 vs. control). When the decreased islet mass was accounted for, the islet amyloid-related decrease in beta-cell mass (percent P-cell mass/islet mass) was ameliorated in both rosiglitazone and metformin-treated animals (57.9 +/- 3.1, 64.7 +/- 1.4, and 66.1 +/- 1.6% for control, metformin-, and rosiglitazone-treated mice, respectively; P < 0.05 for metformin or rosiglitazone vs. control). In summary, rosiglitazone and metformin protect beta-cells from the deleterious effects of islet amyloid, and this effect may contribute to the ability of these treatments to alleviate the progressive loss of beta-cell mass and function in type 2 diabetes. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Dept Obstet & Gynecol, Div Maternal Fetal Med, Seattle, WA 98108 USA. RP Hull, RL (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM rhull@u.washington.edu OI Hull, Rebecca/0000-0001-9690-4087 FU NCRR NIH HHS [RR16066] NR 50 TC 50 Z9 55 U1 1 U2 4 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JUL PY 2005 VL 54 IS 7 BP 2235 EP 2244 DI 10.2337/diabetes.54.7.2235 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 940SI UT WOS:000230164000040 PM 15983227 ER PT J AU Russell, LB Valiyeva, E Roman, SH Pogach, LM Suh, DC Safford, MM AF Russell, LB Valiyeva, E Roman, SH Pogach, LM Suh, DC Safford, MM TI Hospitalizations, nursing home admissions, and deaths attributable to diabetes SO DIABETES CARE LA English DT Article ID MANAGED-CARE POPULATION; LIFE-STYLE; MEDICAL-CARE; COMPLICATIONS; MELLITUS; COSTS; INTERVENTION; MORTALITY; RISK; REDUCTION AB OBJECTIVE - To estimate all-cause hospitalizations, nursing home admissions, and deaths attributable to diabetes using a new methodology based on longitudinal data for a representative sample of older U.S. adults. RESEARCH DESIGN AND METHODS - A simulation model, based on data from the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Followup Study was used to represent the natural history of diabetes and control for a variety of baseline rise factors. The model was applied to 6,265 NHANES III adults aged 45-74 years. The prevalence of risk factors in NHANES III, fielded in 1988-1994, better represents today's adults. RESULTS - For all NHANES III adults aged 45-74 years, a diagnosis of diabetes accounted for 8.6% of hospitalizations, 12.3% of nursing home admissions, and 10.3% of deaths in 1988-1994. For people with diabetes, diabetes alone was responsible for 43.4% of hospitalizations, 52.1% of nursing home admissions, and 47% of deaths. Adjusting for related cardiovascular conditions, which may provide more accurate estimates of attributable risks for people with diabetes, increased these estimates to 51.4, 57.1, and 56.8%, respectively. CONCLUSIONS - Risks of institutionalization and death attributable to diabetes are large. Efforts to translate recent trials of primary prevention into practice and continued efforts to prevent complications of diabetes could have a substantial impact on hospitalizations, nursing home admissions, and deaths and their societal costs. C1 Rutgers State Univ, Inst Hlth, New Brunswick, NJ 08901 USA. Rutgers State Univ, Dept Econ, New Brunswick, NJ 08901 USA. Rutgers State Univ, Ernest Mario Sch Pharm, New Brunswick, NJ 08901 USA. Univ Med & Dent New Jersey, Sch Publ Hlth, Piscataway, NJ 08854 USA. New Jersey Vet Adm Hlth Care Syst, E Orange, NJ USA. Univ Alabama, Deep S Ctr Effectivesness, Birmingham VA Med Ctr, Birmingham, AL USA. RP Russell, LB (reprint author), Rutgers State Univ, Inst Hlth, 30 Coll Ave, New Brunswick, NJ 08901 USA. EM lrussell@rci.rutgers.edu NR 26 TC 25 Z9 26 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUL PY 2005 VL 28 IS 7 BP 1611 EP 1617 DI 10.2337/diacare.28.7.1611 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 940SG UT WOS:000230163800011 PM 15983309 ER PT J AU Jackson, SL Scholes, D Boyko, EJ Abraham, L Fihn, SD AF Jackson, SL Scholes, D Boyko, EJ Abraham, L Fihn, SD TI Urinary incontinence and diabetes in postmenopausal women SO DIABETES CARE LA English DT Article ID NORWEGIAN EPINCONT; TRACT-INFECTION; BLADDER DYSFUNCTION; RESIDUAL URINE; RISK-FACTORS; HEALTH; IMPACT; AGE; EPIDEMIOLOGY; ASSOCIATION AB OBJECTIVE- This study evaluates diabetes characteristics and other risk factors for urinary incontinence among community-dwelling post menopausal women. RESEARCH DESIGN AND METHODS - We performed a cross-sectional analyst of a population-based study of 1,017 postmenopausal women (218 with diabetes), aged 55-75 years, enrolled from a health maintenance organization, Outcomes included any incontinence and severe incontinence in the prior month, RESULTS - Overall, 60% of women had any incontinence in the prior month and 8% had severe incontinence. parity and postvoid residual bladder volume were not associated with Incontinence, Oral estrogen and vaginal estrogen use were positively associated with a report of any incontinence but not severe incontinence, A history of urinary tract infection (UTI) and measures of general health were associated with both outcomes. Women with diabetes reported disproportionately more severe incontinence, difficulty controlling urination, mixed (stress and urge) incontinence, use of pads, inability to Completely empty the bladder, being unaware of leakage, and discomfort with urination (P <= 0.06). Diabetes duration, treatment type peripheral neuropathy, and retinopathy were significantly associated with severe incontinence in multiple regression models adjusted for age, education, and history of UTI (P = 0.01-0.06) ; however additional adjustment for BMI diminished the strength of association (P = 0.17-0.52). CONCLUSIONS- Urinary incontinence is highly prevalent among postmenopausal women. Women with diabetes are more likely to experience severe and symptomatic urinary incontinence. UTI history is a major risk factor, postvoid residual bladder volume plaids no demonstrable role, and BMI confounds the relationship between diabetes and incontinence among healthy postmenopausal women. C1 Univ Washington, Dept Med, VA Puget Sound, NW Hlth Serv Res Dev Program, Seattle, WA 98103 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. VA Puget Sound, Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Jackson, SL (reprint author), Univ Washington, Dept Med, VA Puget Sound, NW Hlth Serv Res Dev Program, 1825 N 52nd St, Seattle, WA 98103 USA. EM sljack@u.washington.edu OI Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [R01 DK43134] NR 35 TC 57 Z9 60 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUL PY 2005 VL 28 IS 7 BP 1730 EP 1738 DI 10.2337/diacare.28.7.1730 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 940SG UT WOS:000230163800029 PM 15983327 ER PT J AU Jones, RN Craig, WA Ambrose, PG Dudley, MN Pottumarthy, S AF Jones, RN Craig, WA Ambrose, PG Dudley, MN Pottumarthy, S TI Reevaluation of Enterobacteriaceae MIC/disk diffusion zone diameter regression scattergrams for 9 beta-lactams: adjustments of breakpoints for strains producing extended spectrum beta-lactamases SO DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE LA English DT Article DE Enterobacteriaceae; beta-lactams; extended spectrum beta-lactamases ID BLOOD-STREAM INFECTIONS; ESCHERICHIA-COLI; KLEBSIELLA-PNEUMONIAE; SUSCEPTIBILITY; CEPHALOSPORIN; EPIDEMIOLOGY; BACTERIA AB Validity of the Current susceptibility breakpoint criteria for 9 beta-lactam antimicrobials and performance of proposed alternative breakpoints to improve prediction of clinical outcomes were analyzed by testing a contemporary collection of 350 Enterobacteriaceae, enriched for an overrepresentative collection of 70 (20.0%) strains producing extended-spectrum beta-lactamases (ESBLs). The majority of the strains were isolated from bloodstream infections (83.7% of the entire collection and 85.7% of the ESBL subset). The 9 beta-lactam antimicrobials analyzed were aztreonam, cefepime, cefotaxime, cefotetan, cefoxitin, ceftazidime, ceftriaxone, ceftizoxime, and cefuroxime. Reference broth microdilution MIC results were compared with those zone diameters obtained by the standardized disk diffusion test. The correlation coefficient (r) was acceptable for all antimicrobials, ranging from 0.87 (cefotetan) to 0.97 (aztreonam, cefotaxime, and ceflazidime). Using the current susceptible breakpoint criteria for Enterobacteriaceae, the intermethod categorical agreement ranged from 90.6% (cefotaxime) to 98.0% (ceftazidime). Very major (false-susceptible by disk test) and major errors (false-resistant) were nil (0.0%) for 6 of the 9 beta-lactams. Minor error rates ranged from only 0.9% (cefotetan) to 9.4% (cefotaxime). The proposed MIC breakpoint criteria (generally lower) adjusted to levels to accurately detect ESBL-producing strains and better predict clinical outcomes, also had acceptable intermethod concordance ranging from 90.6% (cefotetan) to 100.0% (ceftazidime). Remarkably, an improvement in the intermethod categorical agreement ranging from + 1.7% to + 8.3% was observed for 7 of the 9 antimicrobials, including the ESBL index or screening compounds (aztreonam, ceftazidime, cefotaxime, and ceftriaxone). No change in the breakpoint criteria, with removal of the intermediate category was tentatively proposed for cefoxitin and cefuroxime, resulting in an increase of the serious intermethod errors (very major and major), but the absolute intermethod agreement remained highly acceptable at 90.6% to 93.4%. Although the current breakpoint criteria remain acceptable in minimizing intermethod discords, the alternative susceptible breakpoint criteria proposed by combining pharmacokinetic/pharmacodynamic (PK/PD), microbiology MIC population analyses, and clinical success parameters possess improved intermethod agreement for the ESBL screening drugs and 5 other broad-spectrum beta-lactani compounds. The Clinical Laboratory Standards Institute (formerly, the National Committee for Clinical Laboratory Standards) should consider these changes to facilitate the detection of all Enterobacteriaceae with low PK/PD target attainment rates, therefore having the potential for suboptimal responses with usual therapeutic dosing. (c) 2005 Elsevier Inc. All rights reserved. C1 JMI Labs, Beaver Kreek Ctr 345, N Liberty, IA 52317 USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Inst Clin Pharmacodynam Ordway, Albany, NY USA. Diversa Pharmaceut, San Diego, CA USA. RP Jones, RN (reprint author), JMI Labs, Beaver Kreek Ctr 345, Suite A, N Liberty, IA 52317 USA. EM ronald-jones@jmilabs.com NR 23 TC 17 Z9 19 U1 1 U2 8 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0732-8893 J9 DIAGN MICR INFEC DIS JI Diagn. Microbiol. Infect. Dis. PD JUL PY 2005 VL 52 IS 3 BP 235 EP 246 DI 10.1016/j.diagmicrobio.2005.02.006 PG 12 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 969LW UT WOS:000232236700011 PM 16105568 ER PT J AU Sonntag, WE Carter, CS Ikeno, Y Ekenstedt, K Carlson, CS Loeser, RF Chakrabarty, S Lee, S Bennett, C Ingram, R Moore, T Ramsey, M AF Sonntag, WE Carter, CS Ikeno, Y Ekenstedt, K Carlson, CS Loeser, RF Chakrabarty, S Lee, S Bennett, C Ingram, R Moore, T Ramsey, M TI Adult-onset growth hormone and insulin-like growth factor I deficiency reduces neoplastic disease, modifies age-related pathology, and increases life span SO ENDOCRINOLOGY LA English DT Article ID MALE FISCHER-344 RATS; DIETARY RESTRICTION; DWARF MICE; LONG-TERM; SPATIAL MEMORY; IGF-1; LONGEVITY; MOUSE; EXPRESSION; IMMUNE AB Disruption of the insulin/IGF-I pathway increases life span in invertebrates. However, effects of decreased IGF-I signaling in mammalian models remain controversial. Using a rodent model with a specific and limited deficiency of GH and IGF-I, we report that GH and IGF-I deficiency throughout life [ GH deficiency (GHD)] has no effect on life span compared with normal, heterozygous animals. However, treatment of GHD animals with GH from 4 - 14 wk of age [adult-onset (AO) GHD] increased median and maximal life span by 14% and 12%, respectively. Analysis of end-of-life pathology indicated that deficiency of these hormones decreased tumor incidence in GHD and AO-GHD animals ( 18 and 30%, respectively) compared with heterozygous animals and decreased the severity of, and eliminated deaths from, chronic nephropathy. Total disease burden was reduced by 24% in GHD and 16% in AO-GHD animals. Interestingly, the incidence of intracranial hemorrhage increased by 154 and 198% in GHD and AO-GHD animals, respectively, compared with heterozygous animals. Deaths from intracranial hemorrhage in AO-GHD animals were delayed by 14 wk accounting for the increased life span compared with GHD animals. The presence of GH and IGF-I was necessary to maximize reproductive fitness and growth of offspring early in life and to maintain cognitive function and prevent cartilage degeneration later in life. The diverse effects of GH and IGF-I are consistent with a model of antagonistic pleiotropy and suggest that, in response to a deficiency of these hormones, increased life span is derived at the risk of functional impairments and tissue degeneration. C1 Wake Forest Univ Hlth Sci, Dept Physiol, Winston Salem, NC 27012 USA. Wake Forest Univ Hlth Sci, Dept Pharmacol, Winston Salem, NC 27012 USA. Wake Forest Univ Hlth Sci, Sticht Ctr Aging, Winston Salem, NC 27012 USA. Wake Forest Univ Hlth Sci, Roena Kulynych Ctr Memory & Cognit Res, Winston Salem, NC 27012 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Res Serv, San Antonio, TX 78229 USA. Univ Minnesota, Coll Vet Med, Dept Vet Populat Med, St Paul, MN 55108 USA. Rush Med Coll, Dept Med, Chicago, IL 60612 USA. Rush Med Coll, Dept Biochem, Chicago, IL 60612 USA. Univ Texas, Med Branch, Dept Obstet & Gynecol, Galveston, TX 77555 USA. RP Sonntag, WE (reprint author), Wake Forest Univ Hlth Sci, Dept Physiol & Pharmacol, 1 Med Ctr Blvd, Winston Salem, NC 27157 USA. EM wsonntag@wfubmc.edu RI Carter, Christy/A-6828-2011; Carter, Christy/E-6630-2011 FU NIA NIH HHS [P01 AG011370, P01AG11370, 5P60AG10484, R01 AG019392, R01AG19392] NR 67 TC 78 Z9 78 U1 1 U2 4 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD JUL PY 2005 VL 146 IS 7 BP 2920 EP 2932 DI 10.1210/en.2005-0058 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 935HZ UT WOS:000229772700008 PM 15790724 ER PT J AU Kogai, T Kanamoto, Y Li, AI Che, LH Ohashi, E Taki, K Chandraratna, RA Saito, T Brent, GA AF Kogai, T Kanamoto, Y Li, AI Che, LH Ohashi, E Taki, K Chandraratna, RA Saito, T Brent, GA TI Differential regulation of sodium/iodide symporter gene expression by nuclear receptor ligands in MCF-7 breast cancer cells SO ENDOCRINOLOGY LA English DT Article ID TRANS-RETINOIC ACID; SODIUM-IODIDE SYMPORTER; RAT-THYROID CELLS; MESSENGER-RNA; RADIOIODIDE UPTAKE; FRTL-5 CELLS; 13-CIS-RETINOIC ACID; INDUCE APOPTOSIS; CARCINOMA-CELLS; MAMMARY-GLAND AB The sodium/iodide symporter (NIS) mediates iodide uptake in lactating breast tissue and is expressed in some breast cancers. We have previously demonstrated that all-trans retinoic acid (tRA) stimulates NIS gene expression and the selective cytotoxic effect of beta-emitting radioiodide-131 (I-131) in both in vitro and in vivo MCF-7 breast cancer cell systems. We studied the ability of natural and synthetic retinoids, in combination with other nuclear receptor ligands, to achieve greater and more sustained induction of NIS in MCF-7 cells and enhance I-131-mediated cytotoxicity. Selective stimulation of retinoic acid receptor (RAR) beta/gamma produced marked NIS induction; and selective stimulation of RAR alpha, RAR gamma, or retinoid X receptor produced more modest induction. Maximal NIS induction was seen with 9-cis retinoic acid and AGN190168, a RAR beta/gamma-agonist. Dexamethasone (Dex), but not the other nuclear receptor ligands, in combination with tRA synergistically induced iodide uptake and NIS mRNA expression, predominantly by prolonging NIS mRNA half-life. The addition of Dex reduced the EC50 of tRA for NIS stimulation to approximately 7%, such that 10(-7) M tRA with addition of Dex enhanced iodide uptake and selective cytotoxicity of I-131 greater than 10(-6) M tRA alone. AGN190168 combined with Dex synergistically increased iodide uptake and significantly prolonged induction (5 d) of iodide uptake compared with that induced by the combination of tRA/Dex or 9-cis retinoic acid/Dex. The addition of Dex reduced the effective dose of retinoid and prolonged the induction of NIS, especially with AGN190168, suggesting higher efficacy of I-131 after combination treatment. C1 Univ Calif Los Angeles, David Geffen Sch med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,Mol Endocrinol Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Physiol,Mol Endocrinol Lab, Los Angeles, CA 90073 USA. Vitae Pharmaceut, Irvine, CA 92618 USA. Univ Yamanashi, Dept Med 3, Yamanashi 4093898, Japan. RP Brent, GA (reprint author), Univ Calif Los Angeles, David Geffen Sch med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med,Mol Endocrinol Lab, Bldg 114,Room 230,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gbrent@ucla.edu FU NCI NIH HHS [CA89364] NR 62 TC 37 Z9 37 U1 1 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 JUL PY 2005 VL 146 IS 7 BP 3059 EP 3069 DI 10.1210/en.2004-1334 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 935HZ UT WOS:000229772700024 PM 15817668 ER PT J AU Gooz, M Gooz, P Raymond, JR AF Gooz, M Gooz, P Raymond, JR TI Serotonin-induced ERK phosphorylation involves ADAM-17/TACE activation in mesangial cells SO FEBS JOURNAL LA English DT Meeting Abstract CT IUBMB 50th Anniversary Symposium CY JUL 02-07, 2005 CL Budapest, HUNGARY SP Int Union Biochem Molecular Biol C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Charleston, SC USA. EM beckm@musc.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1742-464X J9 FEBS J JI FEBS J. PD JUL PY 2005 VL 272 SU 1 BP 180 EP 180 PG 1 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 005MG UT WOS:000234826101142 ER PT J AU Leung, FW Lieberman, J Fagen, N Kasimian, D Wick, R AF Leung, FW Lieberman, J Fagen, N Kasimian, D Wick, R TI Colonoscopic features of simvastatin-induced colitis suggest ischemia as an etiologic mechanism SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID DENSITY-LIPOPROTEIN CHOLESTEROL; INFLAMMATORY-BOWEL-DISEASE; ULCERATIVE-COLITIS; BLOOD-FLOW; COLON; ATORVASTATIN; THERAPY C1 VA Greater Los Angeles Healthcare Syst, Div Gastroenterol, Sepulveda Ambulatory Care Ctr, Res & Med Serv, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Leung, FW (reprint author), VA Greater Los Angeles Healthcare Syst, Div Gastroenterol, Sepulveda Ambulatory Care Ctr, Res & Med Serv, 111G,16111 Plummer St, Sepulveda, CA 91343 USA. NR 25 TC 6 Z9 6 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD JUL PY 2005 VL 62 IS 1 BP 175 EP 178 AR PII S0016-5107(05)00503-1 DI 10.1016/S0016-5107(05)00503-1 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 944ZQ UT WOS:000230470300036 PM 15990847 ER PT J AU Won, JS Im, YB Khan, M Singh, AK Singh, I AF Won, JS Im, YB Khan, M Singh, AK Singh, I TI Involvement of phospholipase A(2) and lipoxygenase in lipopolysaccharide-induced inducible nitric oxide synthase expression in glial cells SO GLIA LA English DT Article DE PLA(2); COX; 5-LO; 12-LO; iNOS; NF kappa B; nitric oxide; glial cells ID ACTIVATED PROTEIN-KINASE; SMOOTH-MUSCLE-CELLS; FACTOR-KAPPA-B; HUMAN-NEUTROPHILS; ARACHIDONIC-ACID; PHOSPHATIDATE PHOSPHOHYDROLASE; NORDIHYDROGUAIARETIC ACID; P388D(1) MACROPHAGES; MULTIPLE-SCLEROSIS; BROMOENOL LACTONE AB The present study underlines the importance of phospholipase A(2) (PLA(2))- and lipoxygenase (LO)-mediated signaling processes in the regulation of inducible nitric oxide synthase (iNOS) gene expression. In glial cells, lipopolysaccharide (LPS) induced the activities of PLA(2) (calcium-independent PLA(2); iPLA(2) and cytosolic PLA(2); cPLA(2)) as well as gene expression of iNOS. The inhibition of cPLA(2) by methyl arachidonyl fluorophosphates (MAFP) or antisense oligomer against cPLA(2) and inhibition of iPLA2 by bromoenol lactone reduced the LPS-induced iNOS gene expression and NF kappa B activation. In addition, the inhibition of LO by nordihydroguaiaretic acid (NDGA; general LO inhibitor) or MK886 (5-LO inhibitor), but not baicalein (12-LO inhibitor), completely abrogated the LPS-induced iNOS expression. Because NDGA could abrogate the LPS-induced activation of NF kappa B, while MK886 had no effect on it, LO-mediated inhibition of iNOS gene induction by LPS may involve an NF kappa B-dependent or -independent (by 5-LO) pathway. In contrast to LO, however, the cyclooxygenase (COX) may not be involved in the regulation of LPS-mediated induction of iNOS gene because COX inhibition by indomethacin (general COX nhibitor), SC560 (COX-1 inhibitor), and NS398 (COX-2 inhibitor) affected neither the LPS-induced iNOS expression nor activation of NF kappa B. These results indicate a role for cPLA(2) and iPLA(2) in LPS-mediated iNOS gene induction glial cells and the involvement of LO in these reactions. (C) 2005 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Lab Med Serv, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Dept Pediat, 96 Jonathan Lucas St,Clin Sci Bldg,Room 316, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-34741, NS-22576, NS-37766] NR 58 TC 16 Z9 18 U1 0 U2 3 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-1491 J9 GLIA JI Glia PD JUL PY 2005 VL 51 IS 1 BP 13 EP 21 DI 10.1002/glia.20178 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 934IZ UT WOS:000229703800002 PM 15779087 ER PT J AU Saxon, AJ Oreskovich, MR Brkanac, Z AF Saxon, AJ Oreskovich, MR Brkanac, Z TI Genetic determinants of addiction to opioids and cocaine SO HARVARD REVIEW OF PSYCHIATRY LA English DT Review DE genomics; polymorphism; substance-related disorders ID SEROTONIN TRANSPORTER GENE; SUBSTANCE USE DISORDERS; DOPAMINE-RECEPTOR GENE; CENTRAL-NERVOUS-SYSTEM; NO ASSOCIATION; UDP-GLUCURONOSYLTRANSFERASES; MOLECULAR-BIOLOGY; DRUG-ADDICTION; FUNCTIONAL POLYMORPHISM; FAMILIAL TRANSMISSION AB Objective: The completion of the human genome sequence has spurred investigation of the genetic contribution to substance dependence. In this article some of the recent scientific evidence for genetic determinants of opioid and cocaine dependence is reviewed. Method: An electronic search of the medical literature was conducted to locate published studies relevant to the genetics of opioid and cocaine dependence. The collected information judged to be most pertinent is described and discussed. Results: Genetic epidemiologic studies support a high degree of heritable vulnerability for both opioid and cocaine dependence. Polymorphisms in the genes coding for dopamine receptors and transporter, opioid receptors, endogenous opioid peptides, cannabinoid receptors, and serotonin receptors and transporter all appear to be associated with the phenotypic expression of this vulnerability once opioids or cocaine are consumed. Conclusions: Despite this initial progress, identification of specific genes and quantification of associated risk for the expression of each gene remain to be elucidated. While alteration of an individual's genome to change the phenotype seems remote, future interventions for treatment of opioid and cocaine dependence may include precise medications targeted to block the effects of proteins that have been identified through genetic research. C1 Univ Washington, Sch Med, Dept Psychiat, Seattle, WA 98108 USA. Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Washington Phys Hlth Plan, Seattle, WA USA. RP Saxon, AJ (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, S-116 ATC,1660 S Columbian Way, Seattle, WA 98108 USA. EM Andrew.Saxon@med.va.gov NR 114 TC 31 Z9 32 U1 5 U2 17 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1067-3229 J9 HARVARD REV PSYCHIAT JI Harv. Rev. Psychiatr. PD JUL-AUG PY 2005 VL 13 IS 4 BP 218 EP 232 DI 10.1080/10673220500243364 PG 15 WC Psychiatry SC Psychiatry GA 965RS UT WOS:000231968600003 PM 16126608 ER PT J AU Aberra, FN Lichtenstein, GR AF Aberra, FN Lichtenstein, GR TI Methods to avoid infections in patients with inflammatory bowel disease SO INFLAMMATORY BOWEL DISEASES LA English DT Review DE inflammatory bowel disease; ulcerative colitis; Crohn's disease; anti-inflammatory medications; immunomodulators; infections; prevention ID SEVERE ULCERATIVE-COLITIS; ACTIVE CROHNS-DISEASE; LOW-DOSE METHOTREXATE; EARLY POSTOPERATIVE COMPLICATIONS; ISRAELI MULTICENTER TRIAL; POPULATION-BASED COHORT; OF-THE-LITERATURE; DOUBLE-BLIND; CYTOMEGALOVIRUS-INFECTION; RHEUMATOID-ARTHRITIS AB Infections have been reported in patients with inflammatory bowel disease (IBD), especially in association with anti-inflammatory and immunomodulatory medications used to treat IBD. Unfortunately, there is a dearth of information on infectious complication risk in patients with IBD. This review describes infectious complications reported in patients with IBD and provides a framework for future studies to assess potential risk factors and incidence for infection. Recommendations are also provided for prevention of infection. C1 Univ Penn, Sch Med, Dept Med, Div Gastroenterol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Med, Div Gastroenterol, Philadelphia, PA USA. RP Aberra, FN (reprint author), Hosp Univ Penn, Div Gastroenterol, 3rd Floor Ravdin Bldg, Philadelphia, PA 19104 USA. EM Faten.aberra@uphs.upenn.edu NR 112 TC 34 Z9 35 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1078-0998 J9 INFLAMM BOWEL DIS JI Inflamm. Bowel Dis. PD JUL PY 2005 VL 11 IS 7 BP 685 EP 695 DI 10.1097/01.MIB.0000160742.91602.b7 PG 11 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 944NL UT WOS:000230435600010 PM 15973124 ER PT J AU Bedwell, JS Horner, MD Yamanaka, K Li, XB Myrick, H Nahas, Z George, MS AF Bedwell, JS Horner, MD Yamanaka, K Li, XB Myrick, H Nahas, Z George, MS TI Functional neuroanatomy of subcomponent cognitive processes involved in verbal working memory SO INTERNATIONAL JOURNAL OF NEUROSCIENCE LA English DT Article DE functional magnetic resonance imaging; healthy adults; neuroimaging; Sternberg working memory task; subcomponent cognitive processes; verbal working memory ID AGE-RELATED-CHANGES; PREFRONTAL CORTEX; NEURAL MECHANISMS; BRAIN-REGIONS; REACTION-TIME; FMRI; MAINTENANCE; ROLES; MANIPULATION; PERFORMANCE AB bRecent research has used functional magnetic resonance imaging (fMRI) to examine brain regions related to specific subcomponent cognitive processes of verbal working memory. which include initial encoding of material, maintenance of the information over a brief delay interval, and later retrieval of the information. The present study examined each of these subcomponents in 14 healthy adults using a Sternberg verbal working memory task and fMRI. Group proanalysis revealed several brain regions active during all subcomponent processes, which included dorsolateral and ventrolateral prefrontal, parietal, hippocampal, and premotor cortex. Several other brain regions showed activation limited to specific subcomponent processes. C1 Univ Cent Florida, Dept Psychol, Orlando, FL 32816 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Mental Hlth Serv, Charleston, SC USA. Med Univ S Carolina, CAIR, Dept Psychiat, Charleston, SC 29425 USA. RP Bedwell, JS (reprint author), Univ Cent Florida, Dept Psychol, Orlando, FL 32816 USA. EM jbedwell@mail.ucf.edu FU NIA NIH HHS [R01-AG40956] NR 36 TC 18 Z9 19 U1 1 U2 3 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0020-7454 J9 INT J NEUROSCI JI Int. J. Neurosci. PD JUL PY 2005 VL 115 IS 7 BP 1017 EP 1032 DI 10.1080/00207450590901530 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 941EJ UT WOS:000230197800008 PM 16051547 ER PT J AU Li, FH Chung, H Reddy, SV Lu, GW Kurihara, N Zhao, AZ Roodman, GD AF Li, FH Chung, H Reddy, SV Lu, GW Kurihara, N Zhao, AZ Roodman, GD TI Annexin II stimulates RANKL expression through MAPK SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE annexin II; RANKL; MAPK pathway; osteoclast formation; primary human bone marrow cells ID INCREASES OSTEOCLAST FORMATION; HUMAN MARROW CULTURES; KAPPA-B LIGAND; RECEPTOR ACTIVATOR; CELLS; DIFFERENTIATION; PROTEIN; OSTEOPROTEGERIN; IDENTIFICATION; INTERLEUKIN-1 AB We report that AX-II, in addition to inducing GM-CSF expression, also increases membrane-bound RANKL synthesis by marrow stromal cells and does so through a previously unreported MAPK-dependent pathway. Thus, both GM-CSF and RANKL are required for AX-II stimulation of OCL formation. Introduction: Annexin II (AX-II) is an autocrine/paracrine factor secreted by osteoclasts (OCLs) that stimulates human OCL formation and bone resorption in vitro by inducing bone marrow stromal cells and activated CD4+ T cells to produce granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF in turn increases OCL precursor proliferation and further enhances OCL formation. However, the induction of GM-CSF by AX-II cannot fully explain its effects on OCL formation. In this study, we tested the capacity of AX-II to induce the expression of RANKL and the corresponding signaling pathways AX-II employs in human marrow stromal cells to induce RANKL. We also showed that both GM-CSF and RANKL are required for OCL formation induced by AX-II. Materials and Methods: Real-time RT-PCR and Western blot analysis were used to detect RANKL and osteoprotegerin (OPG) mRNA and protein expression in unfractionated human bone marrow mononuclear cells stimulated with AX-II. Soluble RANKL in the conditioned medium was analyzed by ELISA. Activation of the MAPK pathway by AX-II was tested by Western blot. The effects of OPG and anti-GM-CSF on AX-II-induced OCL formation were also examined. Results and Conclusion: In addition to upregulating GM-CSF mRNA, AX-II increased RANKL mRNA expression dose-dependently in unfractionated human bone marrow mononuclear cells and modestly increased soluble RANKL in unfractionated human bone marrow mononuclear cell conditioned medium. However, AX-II markedly increased membrane-bound RANKL on human bone marrow stromal cells. Treatment of marrow stromal cells with AX-II activated MAP-kinase (ERKs) and PD 98059 abolished the effect but did not block the increase in GM-CSF. Interestingly, OPG, a natural decoy receptor for RANKL, or anti-GM-CSF partially inhibited OCL formation by AX-II in human bone marrow cells, and the combination of OPG and anti-GM-CSF completely blocked AX-II-induced OCL formation. These data show that AX-II stimulates both the proliferation and differentiation of OCL precursors through production of GM-CSF and RANKL respectively. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Med Hematol Oncol, Pittsburgh, PA USA. Sungkyunkwan Univ, Samsung Cheil Hosp, Dept Med, Seoul, South Korea. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA USA. RP Roodman, GD (reprint author), VA Pittsburgh Healthcare Syst, Med Hematol Oncol 111-H,Univ Dr, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu FU NIA NIH HHS [R01 AG13625] NR 23 TC 30 Z9 37 U1 0 U2 4 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD JUL PY 2005 VL 20 IS 7 BP 1161 EP 1167 DI 10.1359/JBMR.050207 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 940HK UT WOS:000230134100009 PM 15940368 ER PT J AU Tofovic, SP Salah, EM Dubey, RK Melhem, MF Jackson, EK AF Tofovic, SP Salah, EM Dubey, RK Melhem, MF Jackson, EK TI Estradiol metabolites attenuate renal and cardiovascular injury induced by chronic nitric oxide synthase inhibition SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY LA English DT Article DE estradiol; metabolites; cardiovascular disease; chronic renal failure ID ESTROGEN PLUS PROGESTIN; ANGIOTENSIN-II; POSTMENOPAUSAL WOMEN; DISEASE; HYPERTENSION; 2-HYDROXYESTRADIOL; GENDER; PROGRESSION; RAT; 2-METHOXYESTRADIOL AB Our previous studies in rodent models of nephropathy demonstrate that 2-hydroxyestradiol (2HE), an estradiol metabolite with little estrogenic activity, exerts renoprotective effects. In vivo, 2HE is readily converted to 2-methoxyestradiol (2ME), a major estradiol metabolite with no estrogenic activity. The goal of this study was to determine whether 2ME has renal and cardiovascular protective effects in vivo. First, the acute (90 minutes) and chronic (14 days) effects of 2ME (10 mu g/kg/h) on blood pressure and renal function were examined in normotensive and spontaneously hypertensive rats (SHR). Second, a rat model of cardiovascular and renal injury induced by chronic nitric oxide synthase inhibition (N-omega-nitro-L-arginine; 40 mg/kg/d; LNNA group) was used to examine the protective effects of estradiol metabolites. Subsets of LNNA-treated rats were administered either 2HE or 2ME (10 mu g/kg/h via osmotic minipump; LNNA+2ME and LNNA+2HE groups, respectively. 2-Methoxyestradiol had no acute or chronic effects on blood pressure or renal function in normotensive animals or on hypertension in SHR. Prolonged, 5-week NOS inhibition induced severe cardiovascular and renal disease and high mortality (75%, LNNA group). 2ME, but not 2HE, significantly decreased elevated blood pressure and attenuated the reduction in GFR. 2HE delayed the onset of proteinuria, whereas no proteinuria was detected in the 2-ME group. 2HE and 2ME reduced mortality rate by 66% and 83%, respectively (P < 0.001). In the kidney 2HE and 2ME abolished LNNA-induced interstitial and glomerular inflammation, attenuated glomerular collagen IV synthesis, and inhibited glomerular and tubular cell proliferation. In the heart, 2HE and 2ME markedly reduced vascular and interstitial inflammation and reduced collagen synthesis and vascular/interstitial cell proliferation. This study provides the first evidence that, in a model of severe cardiovascular and renal injury, 2-methoxyestradiol (a major nonestrogenic estradiol metabolite) exerts renal and cardiovascular protective effects and reduces mortality. C1 Univ Pittsburgh, Sch Med, Ctr Clin Pharmacol, Dept Med, Pittsburgh, PA 15219 USA. VA Pittsburgh Hlth Syst, Dept Pathol, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. RP Tofovic, SP (reprint author), Univ Pittsburgh, Sch Med, Ctr Clin Pharmacol, Dept Med, 100 Technol Dr,Suite 450, Pittsburgh, PA 15219 USA. EM tofovic@msx.dom.pitt.edu NR 49 TC 28 Z9 28 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0160-2446 J9 J CARDIOVASC PHARM JI J. Cardiovasc. Pharmacol. PD JUL PY 2005 VL 46 IS 1 BP 25 EP 35 DI 10.1097/01.fjc.0000162765.89437.ae PG 11 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 940PH UT WOS:000230155900004 PM 15965351 ER PT J AU Yehuda, R Engel, SM Brand, SR Seckl, J Marcus, SM Berkowitz, GS AF Yehuda, R Engel, SM Brand, SR Seckl, J Marcus, SM Berkowitz, GS TI Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the world trade center attacks during pregnancy SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CORTISOL-LEVELS; HOLOCAUST SURVIVORS; PTSD; TRAUMA; RISK AB Context: Reduced cortisol levels have been linked with vulnerability to posttraumatic stress disorder ( PTSD) and the risk factor of parental PTSD in adult offspring of Holocaust survivors. 3 Objective: The purpose of this study was to report on the relationship between maternal PTSD symptoms and salivary cortisol levels in infants of mothers directly exposed to the World Trade Center collapse on September 11, 2001 during pregnancy. Design: Mothers (n = 38) collected salivary cortisol samples from themselves and their 1-yr-old babies at awakening and at bedtime. Results: Lower cortisol levels were observed in both mothers (F = 5.15, df = 1, 34; P = 0.030) and babies of mothers (F = 8.0, df = 1, 29; P = 0.008) who developed PTSD in response to September 11 compared with mothers who did not develop PTSD and their babies. Lower cortisol levels were most apparent in babies born to mothers with PTSD exposed in their third trimesters. Conclusions: The data suggest that effects of maternal PTSD related to cortisol can be observed very early in the life of the offspring and underscore the relevance of in utero contributors to putative biological risk for PTSD. C1 Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, Bronx, NY 10471 USA. Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Dept Community & Prevent Med, Bronx, NY 10471 USA. Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Dept Psychiat, Div Biostat, Bronx, NY 10471 USA. Univ Edinburgh, Western Gen Hosp, Mol Med Ctr, Edinburgh EH4 2XU, Midlothian, Scotland. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, Bronx, NY 10471 USA. RI Seckl, Jonathan/C-3555-2013 FU NIEHS NIH HHS [P42 ES07384]; NIMH NIH HHS [5 R01 MH64675-03] NR 20 TC 244 Z9 262 U1 4 U2 36 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD JUL PY 2005 VL 90 IS 7 BP 4115 EP 4118 DI 10.1210/jc.2005-0550 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 943FT UT WOS:000230339100047 PM 15870120 ER PT J AU Traina, SB MacLean, CH Park, GS Kahn, KL AF Traina, SB MacLean, CH Park, GS Kahn, KL TI Telephone reminder calls increased response rates to mailed study consent forms SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE increasing; mail; response rates; rheumatoid arthritis; telephone calls ID QUESTIONNAIRE; PHYSICIANS; ARTHRITIS AB Background: This study assessed the impact of follow-up reminder phone calls on response rates to a mailed consent form packet. Methods: Patients with rheumatoid arthritis were invited to enroll in a study by signing and returning consent forms by mail. Patients not returning completed study consent forms were called and reminded to return the signed consent forms. Results: Among 724 mailed consent form packets, 376 (52%) were returned without further follow-up. Follow-up reminder calls were made to 220 of the 348 patients who did not return signed consent forms. Among subjects contacted by phone, 67 (31% of those called) returned signed consent forms. Conclusion: Follow-up reminder phone calls raised the overall consent rate of 52 to 61%, suggesting that they can be an effective technique in increasing response rates. (c) 2005 Elsevier Inc. All rights reserved. C1 VA Greater LA Healthcare Syst, Div Rheumatol W 111J, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Rheumatol W 111J, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med, Los Angeles, CA 90095 USA. RP Traina, SB (reprint author), VA Greater LA Healthcare Syst, Div Rheumatol W 111J, Los Angeles, CA 90073 USA. EM straina@mednet.ucla.edu NR 15 TC 4 Z9 4 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD JUL PY 2005 VL 58 IS 7 BP 743 EP 746 DI 10.1016/j.jclinepi.2005.02.001 PG 4 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 938YB UT WOS:000230038200016 PM 15939228 ER PT J AU Takahashi, TA Johnson, KM Bradley, KA AF Takahashi, TA Johnson, KM Bradley, KA TI A population-based study of HIV testing practices and perceptions in 4 US states SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med DE HIV; HIV risk perception; HIV risk behaviors; sexual behavior; testing practices ID UNITED-STATES; RISK; BEHAVIOR; ADULTS; CARE AB OBJECTIVE: To evaluate testing practices and perceptions of HIV risk among a geographically diverse, population-based sample of sexually active adults who reported behaviors that could transmit HIV. DESIGN: Secondary analysis of the Centers for Disease Control and Preventions Behavioral Risk Factor Surveillance System (BRFSS) 2000 survey. PATIENTS/PARTICIPANTS: Sexually active adults less than 50 years old, who completed the Sexual Behavior Module of the BRFSS 2000 survey administered in 4 U. S. states. MEASUREMENTS AND MAIN RESULTS: Nineteen percent of the study population reported one or more behaviors in the past year that increased their risk of HIV infection (men 23%; women 15%). In this subgroup at any increased risk of HIV infection, 49% reported having had an HIV test in the past year. For 71% of those tested, the HIV test was self-initiated. Younger age was the only factor independently associated with whether or not individuals with behaviors that increased their risk of HIV infection had had a recent HIV test. Among the 51% of individuals at risk who reported no recent HIV test, 84% perceived their risk as low or none. CONCLUSIONS: In this study, about half of the individuals who reported behaviors that could transmit HIV had not been recently tested for HIV. Of those not tested, most considered their risk of HIV to be low or none. Interventions to expand HIV testing and increase awareness of HIV risk appear to be needed to increase early detection of HIV infection and to reduce its spread. C1 VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Takahashi, TA (reprint author), VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, 1660 S Columbian Way, Seattle, WA 98108 USA. EM traci@u.washington.edu FU NIAAA NIH HHS [K23 AA000313, K23AA00313]; NIDA NIH HHS [R03DA14518] NR 20 TC 14 Z9 14 U1 2 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2005 VL 20 IS 7 BP 618 EP 622 DI 10.1111/j.1525-1497.2005.0112.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 942OD UT WOS:000230290800010 PM 16050856 ER PT J AU Zipser, RD Farid, M Baisch, D Patel, B Patel, D AF Zipser, RD Farid, M Baisch, D Patel, B Patel, D TI Physician awareness of Celiac disease - A need for further education SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 68th Annual Meeting of the American-College-of-Gastroenterology CY OCT 10-15, 2003 CL Baltimore, MD SP Amer Coll Gastroenterol DE celiac disease; primary care physicians; endomysial antibodies; education ID PREVALENCE; MULTICENTER; SPRUE AB BACKGROUND: Celiac disease is a common disorder (up to 0.7%); however, it is uncommonly diagnosed in the United States. OBJECTIVE: We sought to determine physician awareness of celiac disease. DESIGN: Surveys completed by 2,440 (47%) of 5,191 patients in a support group were analyzed for frequency of diagnosis by physician specialties. Questionnaires were then sent to primary care physicians (PCPs) ( n= 132) in a southern California county to assess knowledge of celiac disease. RESULTS: In patient surveys, only 11% were diagnosed by PCPs (internists and family physicians) versus 65% by gastroenterologists. Physician surveys (70% response) showed that only 35% of PCPs had ever diagnosed celiac disease. Almost all physicians (95%) knew of wheat intolerance, but few (32%) knew that onset of symptoms in adulthood is common. Physicians were well aware (90%) of diarrhea as a symptom, but fewer knew of common symptoms of irritable bowel syndrome (71%), chronic abdominal pain (67%), fatigue (54%), depression and irritability (24%) or of associations with diabetes (13%), anemia (45%) or osteoporosis (45%), or of diagnosis by endomysial antibody tests (44%). CONCLUSIONS: Lack of physician awareness of adult onset of symptoms, associated disorders, and use of serology testing may contribute to the underdiagnosis of celiac disease. C1 Univ Calif Los Angeles, Med Ctr, Torrance, CA 90509 USA. W Los Angeles Vet Adm Hosp, Los Angeles, CA USA. Celiac Dis Fdn, Studio City, CA USA. RP Zipser, RD (reprint author), 1330 W Covina Blvd,Suite 205, San Dimas, CA 91773 USA. EM rzipser@msn.com NR 18 TC 18 Z9 21 U1 2 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2005 VL 20 IS 7 BP 644 EP 646 DI 10.1111/j.1525-1497.2005.0107.x PG 3 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 942OD UT WOS:000230290800015 PM 16050861 ER PT J AU Bent, S Goldberg, H Padula, A Avins, AL AF Bent, S Goldberg, H Padula, A Avins, AL TI Spontaneous bleeding associated with Ginkgo biloba - A case report and systematic review of the literature SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE herbal medicine; alternative medicine; bleeding ID GINGKO-BILOBA; DOUBLE-BLIND; HEMORRHAGE; INGESTION; EXTRACT; HEALTHY AB BACKGROUND: Ginkgo biloba (ginkgo) is a herbal remedy used by over 2% of the adult population in the United States. Several review articles have suggested that ginkgo may increase the risk of bleeding. OBJECTIVE: To report a case of bleeding associated with using ginkgo, to systematically review the literature for similar case reports, and to evaluate whether using ginkgo is causally related to bleeding. DATA SOURCES: We searched MEDLINE, EMBASE, IBIDS, and the Cochrane Collaboration Database from 1966 to October 2004 with no language restrictions. REVIEW METHODS: Published case reports of bleeding events in persons using ginkgo were selected. Two reviewers independently abstracted a standard set of information to assess whether ginkgo caused the bleeding event. RESULTS: Fifteen published case reports described a temporal association between using ginkgo and a bleeding event. Most cases involved serious medical conditions, including 8 episodes of intracranial bleeding. However, 13 of the case reports identified other risk factors for bleeding. Only 6 reports clearly described that ginkgo was stopped and that bleeding did not recur. Bleeding times, measured in 3 reports, were elevated when patients were taking ginkgo. CONCLUSION: A structured assessment of published case reports suggests a possible causal association between using ginkgo and bleeding events. Given the widespread use of this herb and the serious nature of the reported events, further studies are needed. Patients using ginkgo, particularly those with known bleeding risks, should be counseled about a possible increase in bleeding risk. C1 San Francisco VA Med Ctr, Dept Med, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Osher Ctr Integrat Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Family Practice, San Francisco, CA 94143 USA. Kaiser Permanente No Calif, Div Res, Oakland, CA USA. RP Bent, S (reprint author), San Francisco VA Med Ctr, Dept Med, Gen Internal Med Sect, 111-A1,4150 Clement St, San Francisco, CA 94121 USA. EM bent@itsa.ucsf.edu FU NCCIH NIH HHS [1 K08 ATO1338-01, K08 AT001338] NR 29 TC 77 Z9 83 U1 1 U2 14 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2005 VL 20 IS 7 BP 657 EP 661 DI 10.1111/j.1525-1497.2005.0121.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 942OD UT WOS:000230290800019 PM 16050865 ER PT J AU Faller, LD Lin, SH AF Faller, LD Lin, SH TI Implications of dependence on ionic strength for the mechanism of the conformational change in unphosphorylated sodium pump. SO JOURNAL OF GENERAL PHYSIOLOGY LA English DT Meeting Abstract CT 59th annual Meeting of the Society-of-General-Physiologists CY SEP 06-11, 2005 CL Marine Biol Lab, Woods Hole, MA SP Soc Gen Physiologists HO Marine Biol Lab C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Physiol Sci, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0022-1295 J9 J GEN PHYSIOL JI J. Gen. Physiol. PD JUL PY 2005 VL 126 IS 1 MA 58 BP 26A EP 26A PG 1 WC Physiology SC Physiology GA 943XI UT WOS:000230388500066 ER PT J AU Faller, LD Nagy, AK Diaz, UA Farley, RA AF Faller, LD Nagy, AK Diaz, UA Farley, RA TI Oxygen exchange studies of the phosphoryl group transfer mechanism. SO JOURNAL OF GENERAL PHYSIOLOGY LA English DT Meeting Abstract CT 59th annual Meeting of the Society-of-General-Physiologists CY SEP 06-11, 2005 CL Marine Biol Lab, Woods Hole, MA SP Soc Gen Physiologists HO Marine Biol Lab C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ So Calif, Sch Med, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0022-1295 J9 J GEN PHYSIOL JI J. Gen. Physiol. PD JUL PY 2005 VL 126 IS 1 MA 59 BP 26A EP 27A PG 2 WC Physiology SC Physiology GA 943XI UT WOS:000230388500067 ER PT J AU Shin, JM Sachs, G AF Shin, JM Sachs, G TI Oligomeric functional form of the gastric H,K-ATPase. SO JOURNAL OF GENERAL PHYSIOLOGY LA English DT Meeting Abstract CT 59th annual Meeting of the Society-of-General-Physiologists CY SEP 06-11, 2005 CL Marine Biol Lab, Woods Hole, MA SP Soc Gen Physiologists HO Marine Biol Lab C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0022-1295 J9 J GEN PHYSIOL JI J. Gen. Physiol. PD JUL PY 2005 VL 126 IS 1 MA 90 BP 40A EP 40A PG 1 WC Physiology SC Physiology GA 943XI UT WOS:000230388500098 ER PT J AU Vagin, O Turdikulova, S Sachs, G AF Vagin, O Turdikulova, S Sachs, G TI N-linked glycosylation provides apical sorting information to the gastric H,K-ATPase beta and to the Na,KATPase beta(2) subunit. SO JOURNAL OF GENERAL PHYSIOLOGY LA English DT Meeting Abstract CT 59th annual Meeting of the Society-of-General-Physiologists CY SEP 06-11, 2005 CL Marine Biol Lab, Woods Hole, MA SP Soc Gen Physiologists HO Marine Biol Lab C1 Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0022-1295 J9 J GEN PHYSIOL JI J. Gen. Physiol. PD JUL PY 2005 VL 126 IS 1 MA 94 BP 42A EP 42A PG 1 WC Physiology SC Physiology GA 943XI UT WOS:000230388500102 ER PT J AU Nath, N Giri, S Prasad, R Salem, ML Singh, AK Singh, I AF Nath, N Giri, S Prasad, R Salem, ML Singh, AK Singh, I TI 5-Aminoimidazole-4-carboxamide ribonucleoside: A novel immunomodulator with therapeutic efficacy in experimental autoimmune encephalomyelitis SO JOURNAL OF IMMUNOLOGY LA English DT Article ID ACTIVATED PROTEIN-KINASE; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; CELL-PERMEABLE ACTIVATOR; MULTIPLE-SCLEROSIS; T-CELLS; TRANSCRIPTION FACTOR; NERVOUS-SYSTEM; AICA-RIBOSIDE; ACADESINE; TOLERANCE AB Experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, is a Th1-mediated inflammatory demyelinating disease of the CNS. AMP-activated protein kinase was reported recently to have anti-inflammatory activities by negatively regulating NF-kappa B signaling. In this study, we investigated the prophylactic and therapeutic efficacy of an AMP-activated protein kinase activator, 5-aminoimidazole-4-carboxamide ribonucleoside (AICAR), in active and passive EAE induced by active immunization with PLP139-151 or MOG(35-55) and in adoptive transfer of PLP139-151-sensitized T cells, respectively. In vivo treatment with AICAR exerted both prophylactic and therapeutic effects on EAE, attenuating the severity of clinical disease. The anti-inflammatory effects of AICAR were associated with the inhibition of the Ag-specific recall responses and inhibition of the Th1-type cytokines IFN-gamma and TNF-alpha, whereas it induced the production of Th2 cytokines IL-4 and IL-10. Treatment of PLP139-151-specific T cells in vitro with AICAR decreased their expression of T-bet in response to IL-12, a Th1 transcription factor, whereas in response to IL-4, it induced the expression and phosphorylation of Th2 transcription factors GATA3 and STAT6, respectively. Moreover, treatment of APCs in vitro with AICAR inhibited their capability to present the proteolipid protein peptide to PLP139-151-specific T cells. In an irrelevant Th1-mediated, OT-2 TCR transgenic mouse model, AICAR impaired in vivo Ag-specific expansion of CD4(+) T cells. Together, these findings show for the first time that AICAR is a novel immunomodulator with promising beneficial effects for the treatment of multiple sclerosis and other Th1-mediated inflammatory diseases. C1 Med Univ S Carolina, Childrens Res Inst, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Surg, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Dept Pathol, Charleston, SC 29425 USA. RP Singh, I (reprint author), Med Univ S Carolina, Childrens Res Inst, Dept Pediat, 173 Ashley Ave,Suite 505, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-22576, NS-34741, NS-37766, NS-40144, NS-40810] NR 49 TC 90 Z9 93 U1 1 U2 4 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JUL 1 PY 2005 VL 175 IS 1 BP 566 EP 574 PG 9 WC Immunology SC Immunology GA 939CW UT WOS:000230050900071 PM 15972693 ER PT J AU Werth, VP Strober, BE Connolly, M Korman, N Greenstein, D Fantasia, J Kalish, R Anhalt, G AF Werth, VP Strober, BE Connolly, M Korman, N Greenstein, D Fantasia, J Kalish, R Anhalt, G TI An open-label phase I clinical study to assess the safety of PI-0824 in patients with pemphigus vulgaris SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 66th Annual Meeting of the Society-for-Investigative-Dermatology CY MAY 04-07, 2005 CL St Louis, MO SP Soc Investigat Dermatol C1 Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. CUNY, New York, NY 10021 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. E Coast Clin Res, Salisbury, MA USA. Long Isl Jewish Med Ctr, New Hyde Pk, NY USA. SUNY Stony Brook, Stony Brook, NY 11794 USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD JUL PY 2005 VL 125 IS 1 MA 930 BP A5 EP A5 PG 1 WC Dermatology SC Dermatology GA 943GR UT WOS:000230342000048 ER PT J AU Fu, YC Luo, NL Klein, RL Garvey, WT AF Fu, YC Luo, NL Klein, RL Garvey, WT TI Adiponectin promotes adipocyte differentiation, insulin sensitivity, and lipid accumulation SO JOURNAL OF LIPID RESEARCH LA English DT Article DE obesity/diabetes; gene expression; adipocytokine; glucose; lipid metabolism ID BINDING-PROTEIN-ALPHA; PIMA INDIAN POPULATION; FATTY-ACID OXIDATION; 3T3-L1 ADIPOCYTES; ADIPOSE CONVERSION; GENE-EXPRESSION; PPAR-GAMMA; DIFFERENT MECHANISMS; HORMONE ADIPONECTIN; ENERGY HOMEOSTASIS AB Adiponectin is secreted from adipocytes, and low circulating levels have been epidemiologically associated with obesity, insulin resistance, type 2 diabetes, and cardiovascular disease. To investigate whether adiponectin could exert autocrine effects in adipocytes, we expressed the adiponectin gene in 3T3-L1 fibroblasts. We observed that 3T3-L1 fibroblasts expressing adiponectin have a fast growth phase and reach confluence more rapidly compared with control cells or LacZ-transduced cells. Furthermore, cells with overexpressed adiponectin were observed to differentiate into adipocytes more rapidly, and during adipogenesis, they exhibited more prolonged and robust gene expression for related transcriptional factors, CCAAT/enhancer binding protein alpha (C/EBP2), peroxisome proliferator-activated receptor gamma ( PPAR gamma), and adipocyte determination and differentiation factor 1/stero/regulatory element binding protein 1c ( ADD1/SREBP1c) and earlier suppression of PPAR gamma coactivator-1 alpha (PGC-1 alpha). In fully differentiated adipocytes, adiponectin-overexpressing cells accumulated more and larger lipid droplets compared with control cells. Also, adiponectin increased insulin's ability to maximally stimulate glucose uptake by 78% through increased glucose transporter 4 ( GLUT4) gene expression and increased GLUT4 recruitment to the plasma membrane. These data suggest a new role for adiponectin as an autocrine factor in adipose tissues: promoting cell proliferation and differentiation from preadipocytes into adipocytes, augmenting programmed gene expression responsible for adipogenesis, and increasing lipid content and insulin responsiveness of the glucose transport system in adipocytes. - Fu, Y., N. Luo, R. L. Klein, and W. T. Garvey. Adiponectin promotes adipocyte differentiation, insulin sensitivity, and lipid accumulation. C1 Univ Alabama, Dept Nutr Sci, Birmingham, AL 35294 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Charleston VA Med Ctr, Charleston, SC 29425 USA. Birmingham VA Med Ctr, Birmingham, AL 35233 USA. RP Fu, YC (reprint author), Univ Alabama, Dept Nutr Sci, Birmingham, AL 35294 USA. EM yfu@uab.edu FU NHLBI NIH HHS [P01-HL-55782]; NIDDK NIH HHS [DK-38764] NR 53 TC 260 Z9 277 U1 1 U2 17 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 JUL PY 2005 VL 46 IS 7 BP 1369 EP 1379 DI 10.1194/jlr.M400373-JLR200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 934XA UT WOS:000229741700003 PM 15834118 ER PT J AU Prasad, R Giri, S Nath, N Singh, I Singh, AK AF Prasad, R Giri, S Nath, N Singh, I Singh, AK TI Inhibition of phosphoinositide 3 kinase-Akt (protein kinase B)-nuclear factor-kappa B pathway by lovastatin limits endothelial-monocyte cell interaction SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE endothelial; experimental autoimmune encephalomyelitis; lovastatin; monocytes; nuclear factor-kappa B; PI3-kinase ID NITRIC-OXIDE SYNTHASE; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; RHO-FAMILY GTPASES; PHOSPHATIDYLINOSITOL 3-KINASE; ADHESION MOLECULE-1; E-SELECTIN; 15-DEOXY-DELTA(12,14)-PROSTAGLANDIN J(2); REDUCTASE INHIBITOR; MULTIPLE-SCLEROSIS; LEWIS RATS AB Integrity of the blood-brain barrier is essential for the normal functioning of CNS. Its disruption contributes to the pathobiology of various inflammatory neurodegenerative disorders. We have shown that the HMG-CoA reductase inhibitor (lovastatin) attenuated experimental autoimmune encephalomyelitis (EAE, an inflammatory disease of CNS) in rodents by inhibiting the infiltration of mononuclear cells into the CNS. Here, using an in vitro system, we report that lovastatin inhibits endothelial-monocyte cell interaction by down-regulating the expression of vascular cell adhesion molecule-1 and E-selectin by inhibiting the phosphoinositide 3 kinase (PI3-kinase)/protein kinase B (Akt)/nuclear factor-kappa B (NF-kappa B) pathway in endothelial cells. It inhibits tumor necrosis factor alpha (TNF alpha)-induced PI3-kinase, Akt and NF-kappa B activation in these cells. Co-transfection of constitutively active forms of PI3-kinase and Akt reversed the lovastatin-mediated inhibition of TNF alpha-induced adhesion, as well as activation of NF-kappa B, indicating the involvement of the PI3-kinase/Akt pathway in the interaction of adhesion molecules and the process of adhesion. This study reports that lovastatin down-regulates the pathway affecting the expression and interaction of adhesion molecules on endothelial cells, which in turn restricts the migration and infiltration of mononuclear cells thereby attenuating the pathogenesis of inflammatory diseases. C1 Ralph Johnson Vet Affairs Med Ctr, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. RP Singh, I (reprint author), Ralph Johnson Vet Affairs Med Ctr, Dept Pathol & Lab Med, Charleston, SC 29425 USA. EM singhi@musc.edu FU NINDS NIH HHS [NS-22576, NS-40144, NS-34741, NS 37766, NS-40810] NR 60 TC 41 Z9 45 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-3042 EI 1471-4159 J9 J NEUROCHEM JI J. Neurochem. PD JUL PY 2005 VL 94 IS 1 BP 204 EP 214 DI 10.1111/j.1471-4159.2005.03182.x PG 11 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 934JO UT WOS:000229705300020 PM 15953363 ER PT J AU Lacerda, ALT Brambilla, P Sassi, RB Nicoletti, MA Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC AF Lacerda, ALT Brambilla, P Sassi, RB Nicoletti, MA Mallinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC TI Anatomical MRI study of corpus callosum in unipolar depression SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article DE neuroimaging; Corpus callosuni; mood disorders; major depressive disorder; magnetic resonance imaging ID SUBGENUAL PREFRONTAL CORTEX; MAJOR DEPRESSION; MOOD DISORDERS; MAGNETIC-RESONANCE; BIPOLAR DISORDER; FIBER COMPOSITION; LOBE DYSFUNCTION; ABNORMALITIES; BRAIN; SCHIZOPHRENIA AB Previous studies have suggested abnormal cerebral lateralization in major depressive disorder (MDD). Few controlled MRI studies have investigated the corpus callosum (CC), the largest commissura connecting the two cerebral hemispheres, in MDD. This study investigated anatomical abnormalities in the CC and its subdivisions in MDD patients. Twenty-two unmedicated MDD patients and 39 healthy subjects underwent brain magnetic resonance imaging (MRI). Measurements of the CC and its sub-regions were performed with a semi-automated software (NIH Image, version 1.62). ANCOVA with age, gender, and intra-cranial volume (ICV) as covariates showed no significant differences in CC measurements between patients and controls (df = 1,56; p > 0.05). However, patients with familial MDD had a significantly larger middle germ area (F-1.45 = 4.252; p = 0.045) compared to healthy controls, and significantly larger middle genu (F-1.13 = 5.366; p = 0.037), anterior splenium (F-1.13 = 6.27; p = 0.026), and middle splenium areas (F-1.13 = 4.706; p = 0.049) compared to patients with non-familial MDD. Although preliminary, our findings suggest that anatomical abnormalities in CC may be restricted to patients with familial MDD, with possible enlargement of CC in this particular sub-group. The possible role of callosal abnormalities in the pathogenesis of mood disorders should be further examined. (c) 2004 Elsevier Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. Univ Greater ABC UniABC, Dept Psychol, Santo Andre, Brazil. Univ Pittsburgh, Sch Med, Dept Psychiat, Western Psychiat Inst & Clin, Pittsburgh, PA USA. Univ Udine, Sect Psychiat, Dept Pathol & Expt & Clin Med, I-33100 Udine, Italy. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Neurosci, Pittsburgh, PA 15261 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, 7703 Floyd Curl Dr,MC 7792, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI Lacerda, Acioly/A-7052-2010; brambilla, paolo/B-4184-2010 OI Lacerda, Acioly/0000-0002-9370-0449; brambilla, paolo/0000-0002-4021-8456 FU NIMH NIH HHS [MH01736, MH30915] NR 53 TC 53 Z9 53 U1 2 U2 7 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3956 J9 J PSYCHIAT RES JI J. Psychiatr. Res. PD JUL PY 2005 VL 39 IS 4 BP 347 EP 354 DI 10.1016/j.jpsychires.2004.10.001 PG 8 WC Psychiatry SC Psychiatry GA 942QC UT WOS:000230295900002 PM 15804385 ER PT J AU Fausti, SA Wilmington, DJ Helt, PV Helt, WJ Konrad-Martin, D AF Fausti, SA Wilmington, DJ Helt, PV Helt, WJ Konrad-Martin, D TI Hearing health and care: The need for improved hearing loss prevention and hearing conservation practices SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Review DE antioxidant; auditory brainstem response; early detection; hearing conservation; hearing protection; noise-induced hearing loss; otoacoustic emission; ototoxic-induced hearing loss; prevention; tinnitus ID PRODUCT OTOACOUSTIC EMISSIONS; CISPLATIN-INDUCED OTOTOXICITY; NUTRITION EXAMINATION SURVEY; DRUG-INDUCED OTOTOXICITY; 3RD NATIONAL-HEALTH; HIGH-FREQUENCY; DISTORTION-PRODUCT; ANTIOXIDANT SYSTEM; SODIUM THIOSULFATE; AUDITORY FUNCTION AB Hearing loss affects 31 million Americans, particularly veterans who were exposed to harmful levels of noise during military Functions. Many veterans also receive treatment with ototoxic medications, which may exacerbate preexisting hearing loss. Thus, hearing loss is the most common and tinnitus the third most common service-connected disability among veterans. Poor implementation of hearing protection programs and a lack of audiometric testing during medical treatment leave veterans vulnerable to unrecognized and untreated hearing loss until speech communication is impaired. Individualized audiometric testing techniques, including assessment of high frequencies, can be used in clinical and occupational settings to detect early hearing loss. Antioxidants also may alleviate cochlear damage Caused by noise and ototoxicity. Ultimately, hearing loss prevention requires education on reducing Occupational and recreational noise exposure and Counseling on the risks and options available to patients. Technological advances will improve monitoring, allow better noise engineering controls, and lead to more effective hearing protection. C1 Natl Ctr Rehabil Auditory Res, Dept Vet Affairs, Rehabil Res & Dev Serv, Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Otolaryngol, Portland, OR 97201 USA. RP Fausti, SA (reprint author), Natl Ctr Rehabil Auditory Res, Dept Vet Affairs, Rehabil Res & Dev Serv, Portland VA Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM stephen.fausti@med.va.gov RI Legarth, Jonas/A-9156-2012 NR 108 TC 40 Z9 47 U1 4 U2 18 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JUL-AUG PY 2005 VL 42 IS 4 SU 2 BP 45 EP 61 DI 10.1682/JRRD.2005.02.0039 PG 17 WC Rehabilitation SC Rehabilitation GA 019OE UT WOS:000235845800005 PM 16470464 ER PT J AU Lim, HK Sherwood, AM AF Lim, HK Sherwood, AM TI Reliability of surface electromyographic measurements from subjects with spinal cord injury during voluntary motor tasks SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE central nervous system; electromyography; lower limb; muscle (voluntary); quantitative evaluation; rehabilitation; reliability; similarity index; spinal cord injury; surface electromyography ID EMG VARIABLES; ISOMETRIC CONTRACTIONS; MUSCLE; GAIT; REPEATABILITY; STIMULATION; ACTIVATION; LOCOMOTION; PATTERNS; FATIGUE AB In this study, the reliability of surface electromyographic data (root-mean-square) for volitional motor tasks drawn from a standardized protocol was assessed. For each motor task, 5 s epochs of data were analyzed with a new method to generate a measure called the voluntary response index (VPI). The VRI consists of two components, magnitude and similarity index (SI), that were separately analyzed for repeatability. We examined three repetitions of each of 10 volitional motor tasks in 69 subjects with spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS], classifications C and D: 34 AIS-C and 35 AIS-D) for short-term (within-day) reliability. In 6 of the 69 subjects (3 each, AIS-C and AIS-D), the entire Study was repeated after I week and results were assessed for intermediateterm (I week apart) reliability. The reliability of the method for voluntary motor tasks was assessed by intraclass correlation coefficient (ICC), analysis of variance, coefficient of variance, and Pearson's correlation. Good reliability was found for magnitude (ICC = 0.71-0.99, Pearson's r = 0.77-0.99) and for SI (ICC = 0.65-0.96, Pearson's r = 0.72-0.93) for three repeated tests (within-day). Significant difference was found for studies completed I week apart for magnitude (p = 0.02) but not for SI (p = 0.57). In addition, SI showed less variation than magnitude (p < 0.001). No significant difference of magnitude and SI between tasks was observed. C1 Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX USA. RP Lim, HK (reprint author), Korea Res Inst Stand & Sci, Biomagnetism Res Ctr, Div Electromagnet Metrol, 1 Doryong Dong, Taejon 305340, South Korea. EM hlim@kriss.re.kr OI Sherwood, Arthur/0000-0002-0110-4317 NR 38 TC 14 Z9 14 U1 1 U2 1 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JUL-AUG PY 2005 VL 42 IS 4 BP 413 EP 421 DI 10.1682/JRRD.2004.07.0079 PG 9 WC Rehabilitation SC Rehabilitation GA 995NB UT WOS:000234105900006 PM 16320138 ER PT J AU Koontz, AM Cooper, RA Boninger, ML Yang, YS Impink, BG van der Woude, LHV AF Koontz, AM Cooper, RA Boninger, ML Yang, YS Impink, BG van der Woude, LHV TI A kinetic analysis of manual wheelchair propulsion during start-up on select indoor and outdoor surfaces SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-of-Biomechanics CY SEP 25-27, 2003 CL Toledo, OH SP Amer Soc Biomech DE access; biomechanics; community access; driving surfaces; manual wheelchair; propulsion forces; ramps; rolling resistance; sidewalks; standards; surface resistances; wheelchair propulsion ID SPINAL-CORD INJURIES; MECHANICAL EFFICIENCY; UPPER EXTREMITY; NERVE FUNCTION; ENERGY-COST; USERS; BIOMECHANICS; WEIGHT; PEOPLE AB The objective of this study was to conduct a kinetic analysis of manual wheelchair propulsion during start-LIP on select indoor and Outdoor surfaces. Eleven manual wheelchairs were fitted with a SMART(Wheel) and their users were asked to Push on a Course consisting of high- and low-pile carpet, indoor tile, interlocking concrete pavers, smooth level concrete, grass, hardwood flooring, and a sidewalk with a 5-degree grade. Peak resultant force, wheel torque, mechanical effective force, and maximum resultant force rate of rise were analyzed during start-up for each Surface and normalized relative to their steady-state values on the smooth level concrete. Additional variables included peak velocity, distance traveled, and number of strokes in the first 5 s of the trial. We compared biomechanical data between surfaces using repeated-measures mixed models and paired comparisons with a Bonferroni adjustment. Applied resultant force (p = 0.0154), wheel torque (p < 0.0001), and mechanical effective force (p = 0.0047) were significantly different between surfaces. The kinetic values for grass, interlocking pavers, and ramp ascent were typically higher compared with tile, wood, smooth level concrete, and high- and low-pile carpet. Users were found to travel shorter distances up the ramp and across grass (p < 0.0025) and had a higher stroke Count on the ramp (p = 0.0124). While peak velocity was not statistically different, average velocity was slower for the ramp and grass, which indicates greater wheelchair/user deceleration between strokes. The differences noted between surfaces highlight the importance of evaluating wheelchair propulsion ability over a range of surfaces. C1 Dept Vet Affairs Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Hlth Syst, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Vrije Univ, Fac Human Movement Sci, Inst Fundamental & Clin Human Movement Sci, Amsterdam, Netherlands. RP Koontz, AM (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R 1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM akoontz@pitt.edu OI Yang, Yu-Sheng/0000-0002-2767-9354; Boninger, Michael/0000-0001-6966-919X NR 32 TC 47 Z9 47 U1 2 U2 13 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PD JUL-AUG PY 2005 VL 42 IS 4 BP 447 EP 458 DI 10.1682/JRRD.2004.08.0106 PG 12 WC Rehabilitation SC Rehabilitation GA 995NB UT WOS:000234105900009 PM 16320141 ER PT J AU Sevick, MA Piraino, B Sereika, S Starrett, T Bender, C Bernardini, J Stark, S Burke, LE AF Sevick, MA Piraino, B Sereika, S Starrett, T Bender, C Bernardini, J Stark, S Burke, LE TI A preliminary study of PDA-based dietary self-monitoring in hemodialysis patients SO JOURNAL OF RENAL NUTRITION LA English DT Article ID C-REACTIVE PROTEIN AB Objective: The purpose of this study was to pilot test an intervention to enhance the adherence of study participants to the hemodialysis dietary regimen. Design: A single case study design was used to examine the potential effectiveness of the intervention over a 4-month period of time. Setting: A dialysis center in southwestern Pennsylvania. Patients: Of the five individuals entered into the study, one was male and four were female, four were black, and one was white. Participants were 63 to 70 years of age, and had been receiving dialysis for a median of 36 months (range, 18 to 84 months). Intervention: The intervention included counseling to enhance self-efficacy, by a renal dietitian, paired with personal digital assistant-based dietary self-monitoring. Participants met twice per week with interventionists during the first 6 weeks, weekly during the second 6-week period, and biweekly in the final 4-week period. Main outcome measures: Monthly laboratory data regarding serum albumin, potassium, and phosphorus levels; Kt/V; and data on average monthly interdialytic weight gain were abstracted from the participants' medical records. C-reactive protein level was determined at baseline and at 4 months. Results: Four of five study participants had an increase in serum albumin level from baseline to their final measurement, and one participant maintained a stable albumin level. Four of five participants also experienced a small increase in serum phosphorus level. Mixed results were obtained with regard to serum potassium and average monthly interdialytic weight gain. Conclusions: Because of the small sample and single case study design, caution must be used in drawing firm conclusions from this study. Data suggest that the intervention may result in improved dietary intake and improved serum albumin levels. With increased dietary intake, serum phosphorus levels may increase. Additional research is needed to determine the potential efficacy and cost-effectiveness of this intervention for improving dietary adherence. (c) 2005 by the National Kidney Foundation, Inc. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Nursing, Dept Hlth & Community Syst, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. RP Sevick, MA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C, Pittsburgh, PA 15240 USA. EM mary.sevick@med.pd.gov OI Piraino, Beth/0000-0001-5061-0841 FU NCRR NIH HHS [5M01-RR00056]; NIDDK NIH HHS [DK-046204]; NINR NIH HHS [P30-NR03924] NR 19 TC 20 Z9 20 U1 0 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1051-2276 J9 J RENAL NUTR JI J. Renal Nutr. PD JUL PY 2005 VL 15 IS 3 BP 304 EP 311 DI 10.1016/j.jrn.2005.04.003 PG 8 WC Nutrition & Dietetics; Urology & Nephrology SC Nutrition & Dietetics; Urology & Nephrology GA 949GN UT WOS:000230773200004 PM 16007560 ER PT J AU Weisbart, RH Min, Y Wong, AL Kang, J Kwunyeun, S Lin, A Kim, J Chan, G Wakelin, R Sohn, W Chang, SS Nishimura, RN AF Weisbart, RH Min, Y Wong, AL Kang, J Kwunyeun, S Lin, A Kim, J Chan, G Wakelin, R Sohn, W Chang, SS Nishimura, RN TI Selective IgA immune unresponsiveness to Proteus mirabilis fumarate reductase A-chain in rheumatoid arthritis SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE Proteus mirabilis; rheumatoid arthritis; antibodies; immune tolerance; antibody response ID ANTIPROTEUS ANTIBODIES; RADIOLOGICAL PROGRESSION; HELICOBACTER-PYLORI; FECAL FLORA; DISEASE; ANTIGEN AB Objective. To determine if selective immune unresponsiveness to microbial antigens is associated with predisposition to rheumatoid arthritis (RA). Methods. Proteins from Proteus mirabilis lysate were isolated by SDS-PAGE and examined by Western blotting for antibody responses in sera from patients with RA compared to healthy subjects and patients with psoriatic arthritis (PsA). Results. Although RA patients had marked IgA immune responses to many P. mirabilis proteins compared to healthy subjects, selective unresponsiveness was found in RA to a 66 kDa protein identified as fumarate reductase A-chain (FRD-A) by mass spectroscopy. This was confirmed in Western blots with recombinant FRD-A from P. mirabilis. IgA unresponsiveness to FRD-A was found in 21/59 (35.6%) RA patients compared to 7/63 (11.1%) healthy individuals (p < 0.01) and 6/52 (11.5%) patients with PsA (p < 0.01). IgA unresponsiveness to FRD-A was present in 20/46 (43.5%) RA patients with IgA rheumatoid factors (RF) compared to 1/13 (7.7%) without RF (p < 0.025). Conclusion. Our results identify a selective bole in the IgA immune repertoire for P. mirabilis FRDA in a subset of IgA RF-positive patients with RA. C1 VAGLAHS 11S, Dept Med, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Med Ctr, Dept Med, Sylmar, CA USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Weisbart, RH (reprint author), VAGLAHS 11S, Dept Med, 16111 Plummer St, Sepulveda, CA 91343 USA. EM tweisbar@ucla.edu NR 34 TC 5 Z9 5 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 JUL PY 2005 VL 32 IS 7 BP 1208 EP 1212 PG 5 WC Rheumatology SC Rheumatology GA 945WA UT WOS:000230532000008 PM 15996053 ER PT J AU Ali, AAA Espinoza, R Kavirajan, H Read, S AF Ali, AAA Espinoza, R Kavirajan, H Read, S TI The effect of risperidone on nursing burden associated with caring for patients with dementia SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter ID PLACEBO; TRIAL; PSYCHOSIS C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Ali, AAA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. OI Espinoza, MD, MPH, Randall/0000-0003-2895-4212 NR 5 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2005 VL 53 IS 7 BP 1261 EP 1262 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 944WB UT WOS:000230460500030 ER PT J AU Saleem, JJ Patterson, ES Militello, L Render, ML Orshansky, G Asch, SM AF Saleem, JJ Patterson, ES Militello, L Render, ML Orshansky, G Asch, SM TI Exploring barriers and facilitators to the use of computerized clinical reminders SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article ID DECISION-SUPPORT-SYSTEMS; CARE; QUALITY AB Objective: Evidence-based practices in preventive care and chronic disease management are inconsistently implemented. Computerized clinical reminders (CRs) can improve compliance with these practices in outpatient settings. However, since clinician adherence to CR recommendations is quite variable and declines over time, we conducted observations to determine barriers and facilitators to the effective use of CRs. Design: We conducted an observational study of nurses and providers interacting with CRs in outpatient primary care clinics for two days in each of four geographically distributed Veterans Administration (VA) medical centers. Measurements: Three observers recorded interactions of 35 nurses and 55 physicians and mid-level practitioners with the CRs, which function as part of an electronic medical record. Field notes were typed, coded in a spreadsheet, and then sorted into logical categories. We then integrated findings across observations into meaningful patterns and abstracted the data into themes, such as recurrent strategies. Several of these themes translated directly to barriers and facilitators to effective CR use. Results: Optimally using the CR system for its intended purpose was impeded by (1) lack of coordination between nurses and providers; (2) using the reminders while not with the patient, impairing data acquisition and/or implementation of recommended actions; (3) workload; (4) lack of CR flexibility; and (5) poor interface usability. Facilitators included (1) limiting the number of reminders at a site; (2) strategic location of the computer workstations; (3) integration of reminders into workflow; and (4) the ability to document system problems and receive prompt administrator feedback. Conclusion: We identified barriers that might explain some of the variability in the use of CRs. Although these barriers may be difficult to overcome, some strategies may increase user acceptance and therefore the effectiveness of the CRs. These include explicitly assigning responsibility for each CR to nurses or providers, improving visibility of positive results from CRs in the electronic medical record, creating a feedback mechanism about CR use, and limiting the overall number of CRs. C1 VAMC, VA GAPS Ctr, Cincinnati, OH 45220 USA. Ohio State Univ, Inst Ergon, Columbus, OH 43210 USA. Univ Dayton, Res Inst, Dayton, OH 45469 USA. Univ Cincinnati, Coll Med, Dept Internal Med, Div Pulm Crit Care, Cincinnati, OH USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Saleem, JJ (reprint author), VAMC, VA GAPS Ctr, 3200 Vine St,MDP 111, Cincinnati, OH 45220 USA. EM Jason.Saleem@med.va.gov RI Patterson, Emily/B-4398-2011 OI Patterson, Emily/0000-0002-4514-2075; Militello, Laura G/0000-0001-8445-5640 NR 21 TC 106 Z9 107 U1 2 U2 20 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD JUL-AUG PY 2005 VL 12 IS 4 BP 438 EP 447 DI 10.1197/jamia.M1777 PG 10 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Information Science & Library Science; Medical Informatics SC Computer Science; Information Science & Library Science; Medical Informatics GA 950LR UT WOS:000230859200010 PM 15802482 ER PT J AU Haas, CE Lin, L Cloen, D Kufel, T Moon, R Frerichs, V AF Haas, Curtis E. Lin, Lydia Cloen, Denise Kufel, Thomas Moon, Richard Frerichs, Valerie TI Omeprazole absorption from a compounded Transdermal formulation in healthy volunteers SO JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION LA English DT Article DE transdermal drug administration; omeprazole; pharmacokinetics; compounding ID STRUCTURE-PERMEABILITY RELATIONSHIPS; SKIN PERMEABILITY; DELIVERY; DRUGS AB Objective: To evaluate the plasma concentration versus time profile of omeprazole following the administration of a compounded transdermal gel formulation in healthy volunteers. Design: Single-dose transdermal pharmacokinetic (PK) study including a comparison with historical data from an oral PK study. Setting: Academic clinical research center. Participants: Eight healthy volunteers between 18 and 50 years of age. Interventions: Omeprazole gel 40 mg (0.8 mL) was applied to the ventral surface of the forearm covering an area of 7 x 15 cm without an occlusive dressing. Blood samples were collected just before application and then at 1, 2, 3, 4, 6, and 8 hours. Plasma concentrations of omeprazole were determined using a validated liquid chromatography tandem mass spectrometry method. Main Outcome Measures: PK parameters ( maximal plasma concentration [C(max)], the time of C(max) [T(max)], the area under the omeprazole concentration versus time curve from 0 to 8 hours, the elimination rate constant, and the half-life of the elimination phase) following transdermal administration, compared with historical controls who had received an oral omeprazole 40 mg dose during a previous study. Results: Of the eight volunteers, five had undetectable plasma omeprazole concentrations throughout the 8-hour study, precluding a complete PK analysis. For the three volunteers with detectable plasma omeprazole concentrations, the values ranged from 0.204 to 0.552 ng/mL. Including values of 0 for the patients with undetectable levels, the mean (+/- SD) C(max) was 0.153 +/- 0.241 ng/mL, and the T(max) in patients with detectable levels occurred at approximately 6 hours. The plasma concentrations following transdermal administration were approximately 1,000- fold lower than those observed with oral dosing. Conclusion: Transdermal absorption from a single dose of the omeprazole gel formulation used in this study was poor. This transdermal gel formulation is clearly not bioequivalent to the oral capsule. C1 [Haas, Curtis E.] SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Dept Pharm Practice, Buffalo, NY 14260 USA. [Haas, Curtis E.; Cloen, Denise] Clin Res Ctr, US Dept Vet Affairs, Buffalo, NY USA. [Kufel, Thomas] Dept Med, Buffalo, NY USA. [Moon, Richard] Pharm Innovat, Jamestown, NY USA. RP Haas, CE (reprint author), SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Dept Pharm Practice, 311 Hochstetter Hall, Buffalo, NY 14260 USA. EM haas@buffalo.edu FU NCRR NIH HHS [S10RR14572] NR 19 TC 3 Z9 3 U1 0 U2 1 PU AMER PHARMACEUTICAL ASSOC PI WASHINGTON PA 2215 CONSTITUTION AVE NW, WASHINGTON, DC 20037 USA SN 1544-3191 J9 J AM PHARM ASSOC JI J. Am. Pharm. Assoc. PD JUL-AUG PY 2005 VL 45 IS 4 BP 473 EP 478 DI 10.1331/1544345054475603 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA V47JM UT WOS:000203201800012 PM 16128503 ER PT J AU Wang, JC Riley, BM AF Wang, JC Riley, BM TI A new fixation technique for the lapidus bunionectomy SO JOURNAL OF THE AMERICAN PODIATRIC MEDICAL ASSOCIATION LA English DT Article ID HALLUX-VALGUS AB Presented here is a preliminary report of 102 patients who underwent first metatarsocuneiform joint arthrodeses performed with external fixation for the correction of hallux valgus. The advantages of using external fixation are the ability to initiate early weightbearing, predictable fusion, and removal of all of the hardware postoperatively. In the 102 patients reported here, the average time to initiation of unassisted full weightbearing was 13.1 days. The average time to fusion was 5.3 weeks, with removal of the external fixator at an average of 5.5 weeks postoperatively. There was no incidence of delayed union or nonunion. There was one case of pin-tract irritation, which resolved with appropriate pin care and a short course of oral antibiotics. External fixation is an effective alternative to traditional internal fixation techniques in metatarsocuneiform joint arthrodesis. C1 Century City Hosp, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. RP Wang, JC (reprint author), 2428 Santa Monica Blvd,Ste 100, Santa Monica, CA 90404 USA. NR 16 TC 14 Z9 15 U1 0 U2 2 PU AMER PODIATRIC MED ASSN PI BETHESDA PA 9312 OLD GEORGETOWN ROAD, BETHESDA, MD 20814-1621 USA SN 8750-7315 J9 J AM PODIAT MED ASSN JI J. Am. Podiatr. Med. Assoc. PD JUL-AUG PY 2005 VL 95 IS 4 BP 405 EP 409 PG 5 WC Orthopedics SC Orthopedics GA 947RI UT WOS:000230663500014 PM 16037560 ER PT J AU Kurella, M Chertow, GM Fried, LF Cummings, SR Harris, T Simonsick, E Satterfield, S Ayonayon, H Yaffe, K AF Kurella, M Chertow, GM Fried, LF Cummings, SR Harris, T Simonsick, E Satterfield, S Ayonayon, H Yaffe, K TI Chronic kidney disease and cognitive impairment in the elderly: The health, aging, and body composition study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID CARDIOVASCULAR HEALTH; RISK-FACTORS; HEMODIALYSIS-PATIENTS; RENAL-INSUFFICIENCY; PLASMA HOMOCYSTEINE; ALZHEIMERS-DISEASE; SERUM CREATININE; OLDER-ADULTS; DEMENTIA; STROKE AB Previous studies suggest a link between chronic kidney disease (CKD) and cognitive impairment, Whether he longitudinal course of cognitive impairment differs among people with or without CKD is unknown. Data collected in 3034 elderly individuals who participated in the Health, Aging, and Body Composition study were analyzed. Cognitive function was assessed with the Modified Mini-Mental State Exam (3MS) at baseline and then 2 and 4 yr after baseline. Cognitive impairment was defined as a 3MS score < 80 or a decline in 3MS > 5 points after 2 or 4 yr of follow-up among participants with baseline 3MS scores >= 80. Participants with CKD, defined as an estimated GFR (eGFR) < 60 ml/min per 1.73 m(2), were further divided into two eGFR strata. Unadjusted mean baseline 3MS scores and mean declines in 3MS scores over 4 yr were significantly more pronounced for participants with lower baseline eGFR. More advanced stages of CKD were associated with an increased risk for cognitive impairment: Odds ratio (OR) 1.32 (95% confidence interval [Cl] 1.03 to 1.69) and OR 2.43 (95% Cl, 1.38 to 4.29) for eGFR 45 to 59 ml/min per 1.73 m(2) and < 45 ml/min per 1.73 m(2), respectively, adjusted for case mix, baseline 3MS scores, and other potential confounders. CKD is associated with an increased risk for cognitive impairment in the elderly that cannot be fully explained by other well-established risk factors. Studies aimed at understanding the mechanism(s) responsible for cognitive impairment in CKD and efforts to interrupt this decline are warranted. C1 Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA 94118 USA. Univ Calif San Francisco, Dept Med, Div Neurol, San Francisco, CA 94118 USA. Univ Calif San Francisco, Dept Med, Div Psychiat, San Francisco, CA 94118 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Nephrol, San Francisco, CA 94118 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Neurol, San Francisco, CA 94118 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Psychiat, San Francisco, CA 94118 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. San Francisco Coordinating Ctr, San Francisco, CA USA. NIA, Intramural Res Program, Bethesda, MD 20892 USA. NIA, Lab Epidemiol Demog & Biometry, Bethesda, MD 20892 USA. Univ Tennessee, Coll Med, Dept Prevent Med, Memphis, TN USA. RP Kurella, M (reprint author), Univ Calif San Francisco, Dept Med, Div Nephrol, Laurel Hts,3333 Calif St,Suite 430, San Francisco, CA 94118 USA. EM kurella@itsa.ucsf.eclu RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU NIA NIH HHS [N01-AG-6-2103, N01-AG-6-2101, AG00888, N01-AG-6-2106]; NIDDK NIH HHS [R01 DK01005, R01 DK58411] NR 31 TC 191 Z9 198 U1 1 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD JUL PY 2005 VL 16 IS 7 BP 2127 EP 2133 DI 10.1681/ASN.2005010005 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 939BK UT WOS:000230046900032 PM 15888561 ER PT J AU Carnes, M Handelsman, J Sheridan, J AF Carnes, M Handelsman, J Sheridan, J TI Diversity in academic medicine: The stages of change model SO JOURNAL OF WOMENS HEALTH LA English DT Editorial Material ID SMOKING C1 Univ Wisconsin, Ctr Womens Hlth Res, Madison, WI 53715 USA. Univ Wisconsin, Dept Med, Madison, WI 53715 USA. Univ Wisconsin, WISELI, Madison, WI 53715 USA. Univ Wisconsin, Dept Plant Pathol, Madison, WI 53715 USA. William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53705 USA. RP Carnes, M (reprint author), Univ Wisconsin, Ctr Womens Hlth Res, Meriter Hosp 6 W,202 S Pk St, Madison, WI 53715 USA. EM mlcarnes@wisc.edu NR 18 TC 10 Z9 10 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1540-9996 J9 J WOMENS HEALTH JI J. Womens Health PD JUL PY 2005 VL 14 IS 6 BP 471 EP 475 DI 10.1089/jwh.2005.14.471 PG 5 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 971SE UT WOS:000232404000005 PM 16115000 ER PT J AU Ward, WF Qi, WB Van Remmen, H Zackert, WE Roberts, LJ Richardson, A AF Ward, WF Qi, WB Van Remmen, H Zackert, WE Roberts, LJ Richardson, A TI Effects of age and caloric restriction on lipid peroxidation: Measurement of oxidative stress by F-2-isoprostane levels SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID ADULT DROSOPHILA-MELANOGASTER; LIFE-SPAN; SUPEROXIDE-DISMUTASE; OVEREXPRESSION; ISOPROSTANES; EXPRESSION; INDUCTION; DISEASE; DAMAGE AB The free radical theory of aging proposes that the accumulation of oxidative damage is a key component of the aging process. The discovery of F-2-isoprostanes (F-2-isoPs) and their establishment as a sensitive and accurate biomarker of lipid peroxidation represents a major advance for measuring the oxidative stress status of an organism. We have shown that plasma free and total (free plus esterified) F-2-isoPs increase with age (185% and 66%, respectively), and that these increases are reduced by life-extending caloric restriction (50% and 23%, respectively). In addition, we found that levels of esterified F-2-isoPs increase 68% with age in liver, and 76% with age in kidney. Caloric restriction modulated the age-related increase, reducing the esterified F-2-isoPs levels 27% in liver and 35% in kidney. These age-related increases in esterified F-2-isoPs levels correlate well with DNA oxidation, as measured by 8-oxodeoxyguanosine production demonstrating that F-2-isoPs are an excellent biomarker for age-related changes in oxidative damage to membranes. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr & Res Serv, San Antonio, TX USA. Vanderbilt Univ, Dept Pharmacol, Nashville, TN USA. Vanderbilt Univ, Dept Med, Nashville, TN USA. RP Ward, WF (reprint author), Univ Texas, Hlth Sci Ctr, Dept Physiol, MSC-7756,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM wardw@uthscsa.edu FU NIA NIH HHS [R01 AG23843, R01 AG025362-01]; NIGMS NIH HHS [R37 GM42053] NR 23 TC 72 Z9 73 U1 1 U2 4 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2005 VL 60 IS 7 BP 847 EP 851 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 951TC UT WOS:000230952900005 PM 16079206 ER PT J AU Moody-Ayers, SY Mehta, KM Lindquist, K Sands, L Covinsky, KE AF Moody-Ayers, SY Mehta, KM Lindquist, K Sands, L Covinsky, KE TI Black-white disparities in functional decline in older persons: The role of cognitive function SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article; Proceedings Paper CT 26th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 30-MAY 03, 2003 CL VANCOUVER, CANADA SP Soc Gen Internal Med ID NORTH-CAROLINA EPESE; MINI-MENTAL-STATE; AFRICAN-AMERICAN; ALZHEIMER-DISEASE; UNITED-STATES; APOLIPOPROTEIN-E; TEST-PERFORMANCE; ELDERLY PERSONS; RISK; DISABILITY AB Background. Black elders have a greater frequency of functional decline than do white elders. The impact of cognitive function on explaining black-white disparities in functional decline has not been extensively explored. Methods. To compare the extent to which different risk domains (comorbidity, smoking, socioeconomic status (SES), self-rated health, and cognitive function) explain more frequent functional decline in black elders, we studied 779 black and 4892 white community-dwelling adults aged 70 and older from the Assets and Health Dynamics Among the Oldest Old (AHEAD), a population-based cohort study begun in 1993. Our primary outcome was worse functional status at 2 years than at baseline. We used logistic regression to compare the unadjusted with the adjusted black-white odds ratios (ORs) after adjusting for each risk domain. Results. At baseline black participants aged 70-79 had higher rates of smoking, diabetes, and hypertension; lower SES; and worse cognitive function than did white participants (p <.05 for all). The mean cognitive score was 15.7 in black and 21.8 in white participants (p <.01). Black participants had a higher frequency of 2-year functional decline than did white participants (10.9% vs 4.7%; OR = 2.61, 95% confidence interval [CI], 1.69-4.03 adjusted for age and sex). Adjustment for comorbidity and smoking did not significantly change the black-white OR, whereas self-rated health and SES accounted for about half the risk. Adjustment for cognitive function accounted for nearly all the associated decline (OR 1.10, 95% CI, 0.67-1.79). Among participants aged 80 and over, those who were black had significantly lower risk for functional decline after adjustment for cognitive function (OR = 0.61, 95% CI, 0.38-0.96 vs OR = 1.08, 95% CI, 0.70-1.66 adjusted for age and sex only). Conclusions. Cognitive function mediated the higher frequency of functional decline among black elders. Efforts to understand cognitive function may enhance our understanding of black-white disparities in health outcomes. C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Geriatr, Dept Med, San Francisco, CA 94143 USA. Purdue Univ, Sch Nursing, W Lafayette, IN 47907 USA. Purdue Univ, Ctr Aging & Life Course, W Lafayette, IN 47907 USA. RP Moody-Ayers, SY (reprint author), San Francisco VA Med Ctr, 181G,4150 Clement St, San Francisco, CA 94121 USA. EM sandra.moody@med.va.gov; covinsky@medicine.ucsf.edu RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU AHRQ HHS [K02HS000006-01]; NIA NIH HHS [1R01AG019827-01] NR 48 TC 33 Z9 33 U1 1 U2 4 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2005 VL 60 IS 7 BP 933 EP 939 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 951TC UT WOS:000230952900020 PM 16079221 ER PT J AU Yang, J Maarek, JMI Holschneider, DP AF Yang, J Maarek, JMI Holschneider, DP TI In vivo quantitative assessment of catheter patency in rats SO LABORATORY ANIMALS LA English DT Article DE indwelling catheters; catheter patency; fibrosis; steroids ID MUSCLE CELL-PROLIFERATION; CENTRAL VENOUS CATHETER; INTIMAL HYPERPLASIA; MYOINTIMAL HYPERPLASIA; JUGULAR-VEIN; VENA-CAVA; HEPARIN; BLOOD; DEXAMETHASONE; INHIBITION AB Formation of fibrin sleeves around catheter tips is a central factor in catheter failure during chronic implantation, and such tissue growth can occur despite administration of anticoagulants. We developed a novel method for monitoring catheter patency. This method recognizes the progressive nature of catheter occlusion, and tracks this process over time through measurement of changes in catheter resistance to a standardized 1 mL bolus infusion from a pressurized reservoir. Two indirect measures of catheter patency were used: (a) reservoir residual pressure and (b) reservoir discharge time. This method was applied to the study of catheter patency in rats comparing the effect of catheter material (silastic, polyurethane, Microrenathane(TM)), lock solution (heparin, heparin/dexamethasone) and two different cannulation sites (superior vena cava via the external jugular vein, inferior vena cava via the femoral vein). Our findings reveal that application of flexible smaller-size silastic catheters and a dexamethasone lock solution resulted in prolonged catheter patency. Patency could be maintained over nine weeks with the femoral vein catheters, compared with five weeks with the external jugular vein catheters. The current method for measuring catheter patency provides a useful index for the assessment of tissue growth around the catheter tip. The method also provides an objective and quantitative way of comparing changes in catheter patency for different surgical methods and catheter types. Our method improves on the conventional method of assessing catheter occlusion by judging the ability to aspirate from the catheter. C1 Univ So Calif, Dept Cell & Neurobiol, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA USA. Univ So Calif, Sch Engn, Dept Biomed Engn, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Holschneider, DP (reprint author), Univ So Calif, Dept Cell & Neurobiol, Keck Sch Med, 1333 San Pablo St,BMT 401,MC 9112, Los Angeles, CA 90089 USA. EM holshne@usc.edu FU NIBIB NIH HHS [R01 EB-00300-03, R01 EB000300] NR 37 TC 15 Z9 16 U1 1 U2 2 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 0023-6772 J9 LAB ANIM-UK JI Lab. Anim. PD JUL PY 2005 VL 39 IS 3 BP 259 EP 268 DI 10.1258/0023677054307033 PG 10 WC Veterinary Sciences; Zoology SC Veterinary Sciences; Zoology GA 946FR UT WOS:000230558300001 PM 16004684 ER PT J AU Merrick, D Winterhalder, R Kittelson, J Franklin, W Kotantoulas, G Ingeberg, S Miller, Y Hirsch, F AF Merrick, D Winterhalder, R Kittelson, J Franklin, W Kotantoulas, G Ingeberg, S Miller, Y Hirsch, F TI Increased expression of C-erb-B1 (EGF-R) but not C-erb-B2 (HER2) is associated with dysplastic change in bronchial airways: Correlation with increased Ki67, MCM2 and P53 expression SO LUNG CANCER LA English DT Meeting Abstract CT 11th World Conference on Lung Cancer CY JUL 03-06, 2005 CL Barcelona, SPAIN C1 Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD JUL PY 2005 VL 49 SU 2 BP S83 EP S83 DI 10.1016/S0169-5002(05)80390-3 PG 1 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 956NV UT WOS:000231307800265 ER PT J AU Merrick, D Sugita, M Hirsch, F Keith, R Miller, Y Coldren, C Lapadat, R Witta, S Geraci, M Franklin, W AF Merrick, D Sugita, M Hirsch, F Keith, R Miller, Y Coldren, C Lapadat, R Witta, S Geraci, M Franklin, W TI Affymetrix gene expression profiles in premalignant bronchial mucosa SO LUNG CANCER LA English DT Meeting Abstract CT 11th World Conference on Lung Cancer CY JUL 03-06, 2005 CL Barcelona, SPAIN C1 Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD JUL PY 2005 VL 49 SU 2 BP S19 EP S20 DI 10.1016/S0169-5002(05)80181-3 PG 2 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 956NV UT WOS:000231307800056 ER PT J AU Miller, Y Keith, R Hirsch, F Dempsey, E Franklin, W Kennedy, T AF Miller, Y Keith, R Hirsch, F Dempsey, E Franklin, W Kennedy, T TI Natural history of untreated endobronchial carcinoma in situ SO LUNG CANCER LA English DT Meeting Abstract CT 11th World Conference on Lung Cancer CY JUL 03-06, 2005 CL Barcelona, SPAIN C1 Univ Colorado, Ctr Canc, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD JUL PY 2005 VL 49 SU 2 BP S184 EP S184 PG 1 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 956NV UT WOS:000231307801187 ER PT J AU Miller, Y Hyun, D Blatchford, P Lewis, M Keith, R Kennedy, T Franklin, W Kittelson, J Hirsch, F AF Miller, Y Hyun, D Blatchford, P Lewis, M Keith, R Kennedy, T Franklin, W Kittelson, J Hirsch, F TI Ki67 proliferation index in endbronchial biopsies: Association with lung cancer, airflow obstruction and smoking history SO LUNG CANCER LA English DT Meeting Abstract CT 11th World Conference on Lung Cancer CY JUL 03-06, 2005 CL Barcelona, SPAIN C1 Univ Colorado, Ctr Canc, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0169-5002 J9 LUNG CANCER-J IASLC JI Lung Cancer PD JUL PY 2005 VL 49 SU 2 BP S183 EP S184 PG 2 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 956NV UT WOS:000231307801186 ER PT J AU Aspinall, SL Good, CB Glassman, PA Valentino, MA AF Aspinall, SL Good, CB Glassman, PA Valentino, MA TI The evolving use of cost-effectiveness analysis in formulary management within the Department of Veterans Affairs SO MEDICAL CARE LA English DT Article DE cost-effectiveness analysis; formulary management; pharmacy benefits management; drug use evaluation ID CORONARY-HEART-DISEASE; PULMONARY-ARTERIAL-HYPERTENSION; AVERAGE CHOLESTEROL LEVELS; PLACEBO-CONTROLLED TRIAL; RHEUMATOID-ARTHRITIS; SUBCUTANEOUS INFUSION; MULTIPLE-SCLEROSIS; EVENTS; PREVENTION; PRAVASTATIN AB The Veterans Health Administration (VHA) runs the largest integrated healthcare system in the nation. Formulary management within VHA primarily involves 3 national groups: the Medical Advisory Panel, the Veterans Integrated Service Network Formulary Leaders, and the Pharmacy Benefits Management Strategic Healthcare Group. Together, these groups manage the VHA national drug formulary with a goal of providing a comprehensive, safe, and cost-effective pharmacy benefit for veterans. Traditionally, VHA has relied on cost-minimization analyses in formulary decisions. More recently, VHA has emphasized the use of cost-effectiveness data, especially for newer, costly drugs. In addition to including this data in drug monographs, the VHA has begun requiring formal cost-effectiveness analysis from manufacturers of selected pharmaceuticals. VHA has also requested that clinically relevant information such as quality of life plus mortality benefit be made available from industry so that internal cost analyses can be performed. It is hoped that by setting the expectation that cost-effectiveness will be formally considered in all VHA formulary decisions, the pharmaceutical industry and others will be stimulated to collect and report data that enables these analyses. We believe that if other organizations also place an emphasis on economic evaluations, industry and the public will be more accepting of decisions that incorporate cost considerations. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. VA Greater Los Angeles Healthcare Syst W LA, Div Gen Internal Med 111G, Los Angeles, CA USA. Dept Vet Affairs, Pharm Benefits Management Strateg Healthcare Grp, Hines, IL USA. RP Aspinall, SL (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 151-C, Pittsburgh, PA 15240 USA. EM Sherrie.Aspinall@med.va.gov NR 36 TC 18 Z9 18 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 2005 VL 43 IS 7 SU S BP 20 EP 26 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 942ZX UT WOS:000230322500004 PM 16056005 ER PT J AU Helfand, M AF Helfand, M TI Incorporating information about cost-effectiveness into evidence-based decision-making - The Evidence-Based Practice Center (EPC) model SO MEDICAL CARE LA English DT Article DE cost effectiveness; evidence-based medicine; decision making ID SERVICES-TASK-FORCE; PREVENTIVE-SERVICES; ECONOMIC EVALUATIONS; THYROID-DISEASE; TRIALS; RECOMMENDATIONS; GUIDELINES; MANAGEMENT; DYSPEPSIA; REVIEWS AB Rationale: There is a pressing need for guidance on how to incorporate economic information into evidence-based decision-making. Such guidance should take account of the quality and relevance of economic evaluations. Objective: To summarize lessons learned in integrating information from decision analyses and cost-effectiveness analyses. Key Issues: Several methods used by the Evidence-Based Practice Centers (EPCs) to conduct systematic reviews are applicable to assessing economic studies. We discuss methods to identify key questions for the review of economic studies. Reviews should assess how an economic model incorporates clinical logic and handles uncertainty about effectiveness. As is the case for metaanalysis of interventions, qualitative or quantitative synthesis of economic studies should explore heterogeneity to identify key uncertainties underlying divergent results as well as unsuspected sources of bias. Conclusions: Applying EPC methods to synthesis of economic information can increase their relevance to clinicians and policy-makers and inform decisions that require tradeoffs between effectiveness and harms of interventions. C1 Portland VA Med Ctr, Dept Hosp & Specialty Med, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Oregon Evidence Based Practice Ctr, Portland, OR 97201 USA. RP Helfand, M (reprint author), Portland VA Med Ctr, Dept Hosp & Specialty Med, P3-MED,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM helfand@ohsu.edu NR 38 TC 8 Z9 8 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 2005 VL 43 IS 7 SU S BP 33 EP 43 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 942ZX UT WOS:000230322500006 PM 16056007 ER PT J AU Asch, SM Baker, DW Keesey, JW Broder, M Schonlau, M Rosen, M Wallace, PL Keeler, EB AF Asch, SM Baker, DW Keesey, JW Broder, M Schonlau, M Rosen, M Wallace, PL Keeler, EB TI Does the collaborative model improve care for chronic heart failure? SO MEDICAL CARE LA English DT Article DE quality improvement; collaboratives; congestive heart failure ID CONTINUOUS QUALITY IMPROVEMENT; CHRONIC ILLNESS; DISEASE MANAGEMENT; PERFORMANCE; ENALAPRIL; INTERVENTIONS; IMPACT; LIFE AB Background: Organizationally based, disease-targeted collaborative quality improvement efforts are widely applied but have not been subject to rigorous evaluation. We evaluated the effects of the Institute of Healthcare Improvement's Breakthrough Series (IHI BTS) on quality of care for chronic heart failure (CHF). Research Design: We conducted a quasi-experiment in 4 organizations participating in the IHI BTS for CHF in 1999-2000 and 4 comparable control organizations. We reviewed a total of 489 medical records obtained from the sites and used a computerized data collection tool to measure performance on 23 predefined quality indicators. We then compared differences in indicator performance between the baseline and postintervention periods for participating and nonparticipating organizations. Results: Participating and control patients did not differ significantly with regard to measured clinical factors at baseline. After adjusting for age, gender, number of chronic conditions, and clustering by site, participating sites showed greater improvement than control sites for I I of the 21 indicators, including use of lipid-lowering and angiotensin converting enzyme inhibition therapy. When all indicators were combined into a single overall process score, participating sites improved more than controls (17% versus 1%, P < 0.0001). The improvement was greatest for measures of education and counseling (24% versus -1%, P < 0.0001). Conclusions: Organizational participation in a common disease-targeted collaborative provider interaction improved a wide range of processes of care for CHF, including both medical therapeutics and education and counseling. Our data support the use of programs like the IHI BTS in improving the processes of care for patients with chronic diseases. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Corp, Hlth Program, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA 90024 USA. Northwestern Univ, Feinberg Sch Med, Inst Hlth Serv & Policy Res, Div Gen Internal Med, Chicago, IL 60611 USA. Zynx, Los Angeles, CA USA. RP Asch, SM (reprint author), 11301 Wilshire Blvd,Mailstop 111G, Los Angeles, CA 90073 USA. EM sasch@rand.org NR 36 TC 42 Z9 42 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUL PY 2005 VL 43 IS 7 BP 667 EP 675 DI 10.1097/01.mlr.0000167182.72251.a1 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 940QJ UT WOS:000230158700005 PM 15970781 ER PT J AU Copeland, LA Fletcher, CE Patterson, JE AF Copeland, LA Fletcher, CE Patterson, JE TI Veterans' health and access to care in the year after September 11, 2001 SO MILITARY MEDICINE LA English DT Article; Proceedings Paper CT AcademyHealth Annual Meeting CY JUN, 2004 CL San Diego, CA ID TERRORIST ATTACKS; SURVEY SF-36; SELECTION; SERVICES; STRESS; CITY AB Objective: The goal was to explore veterans' perceptions of their health care in the year after September 11, 2001. Methods: A random sample of outpatients seen at a Manhattan (New York City) or Midwestern Veterans Affairs facility between September 12, 2001, and September 30, 2002, received a mailed questionnaire. Regression assessed the effects of site, demographic features, military service, and symptoms of post-traumatic stress disorder (PTSD) on health status, care-seeking, and satisfaction with health care among 490 patients. Results: Veterans from New York City reported better health and more satisfaction that their providers listened to them. Patients with more PTSD symptoms reported poorer health, more September 11-related symptoms, and less satisfaction with care and were more likely to seek care outside the Veterans Affairs system. Conclusions: Proximity to the September 11 terrorist attacks had little relationship to patients' perceptions of their health and health care, whereas PTSD symptoms had a pervasive effect. Patients with PTSD symptoms may require out-reach programs to assist them in dealing with catastrophic events, regardless of their proximity to the events. C1 VA Ann Arbor Healthcare Syst, Dev Ctr Excellence, Ann Arbor, MI 48105 USA. VA Ann Arbor Healthcare Syst, VA Hlth Serv Res, Ann Arbor, MI 48105 USA. VA New York Harbor Healthcare Syst Ctr, Dept Psychol, Brooklyn, NY 11209 USA. RP Copeland, LA (reprint author), S Texas Vet Hlth Care Syst, VERDICT, San Antonio, TX 78229 USA. OI Copeland, Laurel/0000-0002-9478-0209 NR 20 TC 3 Z9 3 U1 1 U2 1 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD JUL PY 2005 VL 170 IS 7 BP 602 EP 606 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 019JN UT WOS:000235831500011 PM 16130642 ER PT J AU Zou, JH Ichikawa, H Blackburn, ML Hu, HM Zielinska-Kwiatkowska, A Mei, Q Roth, GJ Chansky, HA Yang, L AF Zou, JH Ichikawa, H Blackburn, ML Hu, HM Zielinska-Kwiatkowska, A Mei, Q Roth, GJ Chansky, HA Yang, L TI The oncogenic TLS-ERG fusion protein exerts different effects in hernatopoietic cells and fibroblasts SO MOLECULAR AND CELLULAR BIOLOGY LA English DT Article ID ETV6-NTRK3 GENE FUSION; HUMAN MYELOID-LEUKEMIA; RNA-BINDING PROTEIN; EWINGS-SARCOMA; CHROMOSOMAL TRANSLOCATION; DNA; EXPRESSION; EWS/FLI; DOMAIN; TRANSCRIPTION AB The oncogenic TLS-ERG fusion protein is found in human myeloid leukemia and Ewing's sarcoma as a result of specific chromosomal translocation. To unveil the potential mechanism(s) underlying cellular transformation, we have investigated the effects of TLS-ERG on both gene transcription and RNA splicing. Here we show that the TLS protein forms complexes with RNA polymerase II (Pol II) and the serine-arginine family of splicing factors in vivo. Deletion analysis of TLS-ERG in both mouse L-G myeloid progenitor cells and NIH 3T3 fibroblasts revealed that the RNA Pol II-interacting domain of TLS-ERG resides within the first 173 amino acids. While TLS-ERG repressed expression of the luciferase reporter gene driven by glycoprotein IX promoter in L-G cells but not in NIH 3T3 cells, the fusion protein was able to affect splicing of the E1A reporter in NIH 3T3 cells but not in L-G cells. To identify potential target genes of TLS-ERG, the fusion protein and its mutants were stably expressed in both L-G and NIH 3T3 cells through retroviral transduction. Microarray analysis of RNA samples from these cells showed that TLS-ERG activates two different sets of genes sharing little similarity in the two cell lines. Taken together, these results suggest that the oncogenic TLS-ERG fusion protein transforms hematopoietic cells and fibroblasts via different pathways. C1 Univ Washington, Dept Orthoped, Seattle, WA 98195 USA. Univ Washington, Dept Med Hematol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Natl Canc Ctr, Res Inst, Canc Transcriptome Project, Chuo Ku, Tokyo 104, Japan. RP Yang, L (reprint author), Univ Arkansas Med Sci, Dept Pathol, BRCII, Room 641-B2,4301 W Markham St, Little Rock, AR 72205 USA. EM lyang@uams.edu FU NCI NIH HHS [R01 CA090941, 1R01CA090941]; NIAMS NIH HHS [1R01AR051455, R01 AR051455] NR 44 TC 15 Z9 15 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0270-7306 J9 MOL CELL BIOL JI Mol. Cell. Biol. PD JUL PY 2005 VL 25 IS 14 BP 6235 EP 6246 DI 10.1128/MCB.25.14.6235-6246.2005 PG 12 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 942EZ UT WOS:000230267000036 PM 15988032 ER PT J AU Chaiswing, L Cole, MP Ittarat, W Szweda, LI St Clair, DK Oberley, TD AF Chaiswing, L Cole, MP Ittarat, W Szweda, LI St Clair, DK Oberley, TD TI Manganese superoxide dismutase and inducible nitric oxide synthase modify early oxidative events in acute Adriamycin-induced mitochondrial toxicity SO MOLECULAR CANCER THERAPEUTICS LA English DT Article ID TRANSGENIC MICE; IN-VIVO; EPITHELIAL-CELLS; PEROXYNITRITE; INJURY; OXYGEN; DAMAGE; CARDIOMYOPATHY; LOCALIZATION; GENERATION AB In the present study, we used genetically engineered B6C3 mice [mice overexpressing manganese superoxide dismutase (TgM(+/+)), mice in which inducible nitric oxide synthase had been inactivated (iNOSKO(-/-)), and crosses of these two genotypes] to study the role of manganese superoxide dismutase (MnSOD) and inducible nitric oxide synthase (iNOS) in the development of acute Adriamycin-induced cardiotoxicity. Both nontransgenic and genetically engineered mice were treated with 20 mg/kg Adriamycin and cardiac left ventricular tissues studied at 0, 3, 6, and 24 hours. Ultrastructural damage and levels of 4-hydroxy-2-nonenal (4HNE) protein adducts and 3-nitrotyrosine (3NT) were determined in cardiomyocytes using immunogold ultrastructural techniques. Our previous results showed that Adriamycin caused mitochondrial injury without significant nuclear or cytoplasmic damage at early time points. Interestingly, overexpression of MnSOD protected against acute mitochondrial injury, whereas deficiency in NOS potentiated mitochondrial injury in comparison with levels of injury present in cardiomyocyte mitochondria of nontransgenic mice. In TgM(+/+) mice, there was a significant inverse correlation between mitochondrial injury and 4HNE/3NT levels at all time points analyzed, suggesting that reactive oxygen species/reactive nitrogen species damage products directly regulated acute Adriamycin-induced mitochondrial injury in these mice. The present studies are the first to directly quantify the effects of MnSOD and NOS on mitochondrial injury during acute Adriamycin-induced cardiotoxicity and show extensive and specific patterns of posttranslational modifications of mitochondrial proteins following Adriamycin treatment. C1 William S Middleton Mem Vet Adm Med Ctr, Dept Pathol & Lab Med, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Madison, WI USA. Mahidol Univ, Fac Med Technol, Bangkok 10700, Thailand. Univ Kentucky, Dept Toxicol, Lexington, KY USA. Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Adm Med Ctr, Dept Pathol & Lab Med, Room A-35,2500 Overlook Terrace, Madison, WI 53705 USA. EM toberley@wisc.edu FU NCI NIH HHS [CA 80152, CA 49797, CA 94853]; NIDDK NIH HHS [T32DK07778] NR 28 TC 38 Z9 39 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1535-7163 J9 MOL CANCER THER JI Mol. Cancer Ther. PD JUL PY 2005 VL 4 IS 7 BP 1056 EP 1064 DI 10.1158/1535-7163.MCT-04-0322 PG 9 WC Oncology SC Oncology GA 945XY UT WOS:000230537500004 PM 16020663 ER PT J AU Crosby, MB Svenson, J Gilkeson, GS Nowling, TK AF Crosby, MB Svenson, J Gilkeson, GS Nowling, TK TI A novel PPAR response element in the murine iNOS promoter SO MOLECULAR IMMUNOLOGY LA English DT Article DE PPAR gamma; iNOS; TZD; gene regulation ID ACTIVATED RECEPTOR-GAMMA; NITRIC-OXIDE SYNTHASE; MRL-LPR/LPR MICE; SYSTEMIC-LUPUS-ERYTHEMATOSUS; INFLAMMATORY CYTOKINES; AUTOIMMUNE-DISEASE; BINDING PROTEIN; IFN-GAMMA; AGONISTS; GENE AB The nuclear hormone receptor peroxisome proliferation activated receptor gamma (PPAR gamma) is a modulator of inflammation including down-regulation of inducible nitric oxide synthase (iNOS) and nitric oxide (NO) production. PPAR gamma agonists reduce iNOS expression and NO production in a dose-dependent manner in macrophages, mesangial cells and other inflammatory cells. However, the mechanisms involved in the inhibition of iNOS expression by PPAR gamma and its agonists are not fully understood. Here we show that the PPAR gamma agonist ciglitazone dose-dependently inhibited a murine iNOS-luciferase reporter construct by up to 50% in transfected mesangial cells. Blocking de novo protein synthesis in mesangial cells had no effect on PPAR gamma agonist activity, indicating that ciglitazone acts directly to inhibit iNOS transcription. We identified a novel PPAR response element (PPRE) in the murine iNOS promoter that is homologous to the PPRE consensus sequence. In binding assays PPAR gamma directly binds to this response element in vitro and can function as a positive element in response to PPAR gamma agonists when placed in front of a reporter gene. Site-directed mutagenesis of this PPRE in a murine iNOS promoter/reporter construct did not block the inhibitory activity of a synthetic PPAR gamma agonist on the iNOS promoter/reporter construct in transfected mesangial cells. However, the mutated construct exhibited lower basal expression, and higher expression in response to inflammatory stimuli compared to the intact construct. These data suggest that the iNOS PPRE contributes to positive basal expression and negative expression of iNOS in response to inflammatory stimuli. The PPRE is not necessary, however, for synthetic PPAR gamma agonists to inhibit iNOS expression. (c) 2005 Elsevier Ltd. All rights reserved. C1 Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Med Res Serv, Charleston, SC 29425 USA. RP Nowling, TK (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol, 96 Jonathon Lucas St,Ste 912 CSB, Charleston, SC 29425 USA. EM nowling@musc.edu FU NIAMS NIH HHS [AR47451]; NIGMS NIH HHS [GM08716] NR 29 TC 31 Z9 34 U1 0 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0161-5890 J9 MOL IMMUNOL JI Mol. Immunol. PD JUL PY 2005 VL 42 IS 11 BP 1303 EP 1310 DI 10.1016/j.molimm.2004.12.009 PG 8 WC Biochemistry & Molecular Biology; Immunology SC Biochemistry & Molecular Biology; Immunology GA 943EX UT WOS:000230336400005 PM 15950726 ER PT J AU Million, M Maillot, C Adelson, DA Nozu, T Gauthier, A Rivier, J Chrousos, GP Bayati, A Mattsson, H Tache, Y AF Million, M Maillot, C Adelson, DA Nozu, T Gauthier, A Rivier, J Chrousos, GP Bayati, A Mattsson, H Tache, Y TI Peripheral injection of sauvagine prevents repeated colorectal distension-induced visceral pain in female rats SO PEPTIDES LA English DT Article DE antalarmin; sauvagine; CRF; visceral pain; colorectal distension; female Fisher rats ID CORTICOTROPIN-RELEASING-FACTOR; IRRITABLE-BOWEL-SYNDROME; RECEPTOR ANTAGONIST; UROTENSIN-I; RECTAL DISTENSION; CRF1 RECEPTOR; PARAVENTRICULAR NUCLEUS; TYPE-1 RECEPTOR; NMDA RECEPTORS; FOS EXPRESSION AB We investigated the effects of peripheral injection of sauvagine, a CRF(2) > CRF(1) receptor (corticotropin-releasing factor) agonist compared with CRF, on two sets of tonic colorectal distension (CRDs 30, 40, 50 mmHg, 3-min on/off)-induced visceromotor response (VMR) measured as area under the curve (AUC) of abdominal muscle contraction in conscious female rats. Sauvagine (10 or 20 mu g/kg, s.c.) abolished the 226.7 +/- 64.3 % and 90.4 +/- 38.1 % increase in AUC to the 2nd CRD compared with the 1st CRD (performed 30 min before) in female Fisher and Sprague-Dawley (SD) rats, respectively. CRF had no effect while the CRF1 antagonist, antalarmin (20 mg/kg, s.c.), alone or with sauvagine, blocked the enhanced response to the 2nd CRD, performed 60 min after the 1st CRD, and reduced further the AUC by 33.5 +/- 23.3 % and 63.5 +/- 7.2 %, respectively in Fisher rats. These data suggest that peripheral CRF receptor activation exerts antinociceptive effects on CRD-induced visceral pain, whereas CRF(1) contributes to visceral sensitization. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, CURE, VA Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, VA Greater Los Angeles Healthcare Syst, Div Digest Dis,Ctr Neurovisceral Sci & Womens Hlt, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, San Diego, CA 92186 USA. NICHHD, Pediat & Reprod Endocrinol Branch, NIH, Bethesda, MD 20892 USA. AstraZeneca R&D, S-43183 Molndal, Sweden. RP Million, M (reprint author), Univ Calif Los Angeles, CURE, VA Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, CURE Bldg 115,Rm 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmuluget@ucla.edu OI Adelson, David/0000-0002-4623-6030 FU NIDDK NIH HHS [P50 DK 64539, DK-57238-01A1S1, DK26741, R01 DK-33061, R01 DK-57238] NR 70 TC 30 Z9 30 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD JUL PY 2005 VL 26 IS 7 BP 1188 EP 1195 DI 10.1016/j.peptides.2005.02.004 PG 8 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 940PE UT WOS:000230155600012 PM 15949637 ER PT J AU Li, X Li, WH Wang, H Cao, J Maehashi, K Huang, LQ Bachmanov, AA Reed, DR Legrand-Defretin, V Beauchamp, GK Brand, JG AF Li, X Li, WH Wang, H Cao, J Maehashi, K Huang, LQ Bachmanov, AA Reed, DR Legrand-Defretin, V Beauchamp, GK Brand, JG TI Pseudogenization of a sweet-receptor gene accounts for cats' indifference toward sugar SO PLOS GENETICS LA English DT Article ID CANDIDATE TASTE RECEPTOR; SACCHARIN PREFERENCE; SPECIES DIFFERENCES; POSITIONAL CLONING; LOCUS SAC; TAS1R3; IDENTIFICATION; PHYLOGENY; RESPONSES; NEURONS AB Although domestic cats (Felis silvestris catus) possess an otherwise functional sense of taste, they, unlike most mammals, do not prefer and may be unable to detect the sweetness of sugars. One possible explanation for this behavior is that cats lack the sensory system to taste sugars and therefore are indifferent to them. Drawing on work in mice, demonstrating that alleles of sweet-receptor genes predict low sugar intake, we examined the possibility that genes involved in the initial transduction of sweet perception might account for the indifference to sweet-tasting foods by cats. We characterized the sweet-receptor genes of domestic cats as well as those of other members of the Felidae family of obligate carnivores, tiger and cheetah. Because the mammalian sweet-taste receptor is formed by the dimerization of two proteins (T1R2 and T1R3; gene symbols Tas1r2 and Tas1r3), we identified and sequenced both genes in the cat by screening a feline genomic BAC library and by performing PCR with degenerate primers on cat genomic DNA. Gene expression was assessed by RT-PCR of taste tissue, in situ hybridization, and immunohistochemistry. The cat Tas1r3 gene shows high sequence similarity with functional Tas7r3 genes of other species. Message from Tas1r3 was detected by RT-PCR of taste tissue. In situ hybridization and immunohistochemical studies demonstrate that Tas1r3 is expressed, as expected, in taste buds. However, the cat Tas1r2 gene shows a 247-base pair microdeletion in exon 3 and stop codons in exons 4 and 6. There was no evidence of detectable mRNA from cat Tas1r2 by RT-PCR or in situ hybridization, and no evidence of protein expression by immunohistochemistry. Tas1r2 in tiger and cheetah and in six healthy adult domestic cats all show the similar deletion and stop codons. We conclude that cat Tas7r3 is an apparently functional and expressed receptor but that cat Tas1r2 is an unexpressed pseudogene. A functional sweet-taste receptor heteromer cannot form, and thus the cat lacks the receptor likely necessary for detection of sweet stimuli. This molecular change was very likely an important event in the evolution of the cat's carnivorous behavior. C1 Monell Chem Senses Ctr, Philadelphia, PA 19104 USA. Waltham Ctr Pet Nutr, Melton Mowbray, Leics, England. Univ Penn, Sch Arts & Sci, Dept Psychol, Philadelphia, PA 19104 USA. Univ Penn, Sch Vet Med, Dept Anat, Philadelphia, PA 19104 USA. Univ Penn, Sch Dent Med, Dept Biochem, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Brand, JG (reprint author), Monell Chem Senses Ctr, Philadelphia, PA 19104 USA. EM brand@monell.org OI Bachmanov, Alexander/0000-0002-2861-3322; Reed, Danielle/0000-0002-4374-6107 FU NIDCD NIH HHS [T32 DC000014, R01 DC000882, R01 DC004698, R03 DC005154]; NIDDK NIH HHS [R01 DK025759] NR 40 TC 139 Z9 150 U1 3 U2 30 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1553-7390 J9 PLOS GENET JI PLoS Genet. PD JUL PY 2005 VL 1 IS 1 BP 27 EP 35 AR e3 DI 10.1371/journal.pgen.0010003 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 998CP UT WOS:000234295900005 PM 16103917 ER PT J AU Sohn, L Harada, ND AF Sohn, L Harada, ND TI Knowledge and use of preventive health practices among Korean women in Los Angeles county SO PREVENTIVE MEDICINE LA English DT Article DE health services; preventive health practices; acculturation; Asian American Pacific Islander; Korean American ID AMERICAN WOMEN; ASIAN-AMERICANS; PAP-SMEAR; MAMMOGRAPHY; PREDICTORS; BEHAVIORS; INSURANCE; ATTITUDES; SERVICES; CARE AB Background. The aims of this study are to determine (1) knowledge and use of preventive health practices, and (2) the relationship between acculturation and preventive health practices, in Korean women. Methods. The data came from the 2000 Korean American Health Survey (KAHS), which includes 656 women. The dependent variables included use of pap smears, physical examinations and mammograms, and use and knowledge of self-breast examinations. Independent variables included demographic and acculturation variables. Logistic regression modeling was used to assess the role of acculturation on dependent variables. Results. Some of the acculturation variables significantly predicted preventive practices. Being married (P < 0.0001) and insured (P < 0.05) were significantly associated with receipt of preventive services. A married Korean woman was more likely than an unmarried Korean woman to have a pap smear within 2 years (P < 0.0001), physical exam within 1 year (P < 0.0001), and perform self-breast examinations (P < 0.05). Conclusions. Factors related to acculturation influence use of preventive health practices by Korean American women, highlighting the need to consider cultural background in developing systems of care. Published by Elsevier Inc. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, Los Angeles, CA 90024 USA. RP Sohn, L (reprint author), VA Greater Los Angeles Healthcare Syst, 11G 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Linda.sohn@med.va.gov NR 29 TC 23 Z9 23 U1 1 U2 3 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0091-7435 J9 PREV MED JI Prev. Med. PD JUL PY 2005 VL 41 IS 1 BP 167 EP 178 DI 10.1016/j.ypmed.2004.09.039 PG 12 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 933RY UT WOS:000229651800023 PM 15917008 ER PT J AU Koenigsberg, HW Buchsbaum, MS Buchsbaum, BR Schneiderman, JS Tang, CY New, A Goodman, M Siever, LJ AF Koenigsberg, HW Buchsbaum, MS Buchsbaum, BR Schneiderman, JS Tang, CY New, A Goodman, M Siever, LJ TI Functional MRI of visuospatial working memory in schizotypal personality disorder: a region-of-interest analysis SO PSYCHOLOGICAL MEDICINE LA English DT Article ID DORSOLATERAL PREFRONTAL CORTEX; SCHIZOPHRENIC SUBJECTS; PERFORMANCE; TASK; FMRI; DYSFUNCTION; RECOGNITION; ACTIVATION; WORDS AB Background. Functional MRI studies have begun to identify neural networks implicated in visuo-spatial working memory in healthy volunteers and patients with schizophrenia. The study of schizotypal personality disorder (SPD) provides regional analysis in unmedicated patients in the schizophrenia spectrum. Method. Unmedicated patients with SPD by DSM-IV criteria and normal controls were assessed with fMRI while performing a visuospatial working-memory task. It required the subjects to retain the location of three dots located on the circumference of an imaginary circle and then respond to a query display in which one dot was presented and the subject required to press a button to indicate whether the probe dot location was previously displayed. Subject groups did not differ significantly in spatial memory scores. The exact Talairach and Tournoux coordinates of brain areas previously reported to show activation with spatial memory tasks were assessed. Results. The majority of these locations showed BOLD response activation significantly less in patients during the memory retention period, including the left ventral prefrontal cortex, superior frontal gyrus, intraparietal cortex and posterior inferior gyrus. Regions in the right middle prefrontal and prestriate cortex showed greater activation at a trend level for patients with SPD than for normal controls. In addition, we replicated the findings of increased activation with the task in healthy volunteers in the premotor areas, ventral prefrontal cortex and parietal cortex. Conclusions. SPD patients show decreased activation compared to healthy volunteers in key frontal regions and we also provided a partial replication of findings reported in healthy subjects. C1 Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. NIH, Bethesda, MD 20892 USA. Mt Sinai Sch Med, Dept Radiol, New York, NY USA. RP Koenigsberg, HW (reprint author), Bronx Vet Affairs Med Ctr, 130 W Kingsbridge, Bronx, NY 10468 USA. EM harold.koenigsberg@med.va.gov RI Schneiderman, Jason/E-1528-2013 OI Schneiderman, Jason/0000-0002-9313-0415 FU NCRR NIH HHS [5M01 RR00071] NR 31 TC 21 Z9 21 U1 1 U2 4 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 0033-2917 J9 PSYCHOL MED JI Psychol. Med. PD JUL PY 2005 VL 35 IS 7 BP 1019 EP 1030 DI 10.1017/S0033291705004393 PG 12 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 959EN UT WOS:000231500000010 PM 16045068 ER PT J AU Hanlon, FM Miller, GA Thoma, RJ Irwin, J Jones, A Moses, SN Huang, MX Weisend, MP Paulson, KM Edgar, JC Adler, LE Canive, JM AF Hanlon, FM Miller, GA Thoma, RJ Irwin, J Jones, A Moses, SN Huang, MX Weisend, MP Paulson, KM Edgar, JC Adler, LE Canive, JM TI Distinct M50 and M100 auditory gating deficits in schizophrenia SO PSYCHOPHYSIOLOGY LA English DT Article DE auditory sensory gating; schizophrenia; M50; M100; magnetoencephalography ID EVOKED MAGNETIC-FIELDS; TEMPORAL GYRUS VOLUME; P50 SUPPRESSION; NEUROPHYSIOLOGICAL EVIDENCE; 1ST-EPISODE SCHIZOPHRENIA; RESPONSE SUPPRESSION; PREFRONTAL CORTEX; LEFT-HEMISPHERE; MEG; RELIABILITY AB The time course of the schizophrenia auditory gating deficit may provide clues to mechanisms of impaired cognition. Magnetoencephalography was recorded during a standard paired-click paradigm. Using source strength of the M50 and M100 components for each click, calculated from dipole locations identified as underlying each component for the first click, a ratio of the second divided by the first was used to measure gating. Patients showed a left-hemisphere gating deficit in M50 and a bilateral gating deficit in M100. Hypothesizing that an early deficit may affect later processing, hierarchical regression was used to examine variance shared between the components. A left-hemisphere M100 gating deficit was coupled with the left M50 gating deficit. In contrast, a right-hemisphere M 100 gating deficit was unrelated to M50 gating in either hemisphere. Investigations of interhemisphere gating relations may clarify group differences in regional connectivity and their role in gating. C1 New Mexico VA Hlth Care Syst, Ctr Funct Brain Imaging, Albuquerque, NM USA. Univ New Mexico, Dept Psychol, Albuquerque, NM 87131 USA. Mental Illness & Neurosci Discovery Inst Imaging, Albuquerque, NM USA. Univ New Mexico, Hlth Sci Ctr, Dept Psychiat, Albuquerque, NM 87131 USA. Univ Illinois, Dept Psychol, Urbana, IL 61801 USA. Univ Illinois, Dept Psychiat, Urbana, IL 61801 USA. Univ Illinois, Beckman Inst, Biomed Imaging Ctr, Urbana, IL 61801 USA. New Mexico VA Hlth Care Syst, Dept Psychiat, Albuquerque, NM 87108 USA. Baycrest Ctr Geriatr Care, Rotman Res Inst, Toronto, ON, Canada. Univ Calif San Diego, Dept Radiol, San Diego, CA 92103 USA. VA Hlth Care Syst, San Diego, CA USA. New Mexico VA Hlth Care Syst, Dept Radiol, Albuquerque, NM USA. Denver VA Med Ctr, Dept Psychiat, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. RP Canive, JM (reprint author), VAMC, New Mexico VA Hlth Care Syst, 116A,1501 San Pedro SE, Albuquerque, NM 87108 USA. EM Jose.Canive@med.va.gov FU NIMH NIH HHS [R01 MH65304] NR 66 TC 50 Z9 54 U1 1 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD JUL PY 2005 VL 42 IS 4 BP 417 EP 427 DI 10.1111/j.1469-8986.2005.00299.x PG 11 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 950QY UT WOS:000230873500006 PM 16008770 ER PT J AU Hardin, JM Woodby, LL Crawford, MA Windsor, RA Miller, TM AF Hardin, JM Woodby, LL Crawford, MA Windsor, RA Miller, TM TI Data collection in a multisite project: Teleform (TM) SO PUBLIC HEALTH NURSING LA English DT Article DE AHRQ guideline; automated forms processing; data validation; Medicaid maternity care; Teleform (TM) ID DATA-ENTRY; FORMS AB Data collection, entry, validation, and management are salient time- and resource-consuming dimensions of all research projects. This is especially true for multisite studies, which pose unique, additional challenges because of their research design requirements. To save time and reduce the number of manual data entry errors, automated processing systems are becoming more widely used. Our research team chose Teleform(TM) for data entry and collection for the Smoking Cessation or Reduction in Pregnancy Trial study. This article presents our experience with this new technology. C1 Univ Alabama, Dept Informat Syst Stat & Management, Culverhouse Coll Commerce, Tuscaloosa, AL 35487 USA. Univ Alabama, Dept Family & Community Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL USA. George Washington Univ, Sch Publ Hlth & Hlth Serv, Dept Prevent & Community Hlth, Washington, DC USA. Alabama Dept Publ Hlth, Bur Family Hlth Sci, Montgomery, AL 36102 USA. RP Hardin, JM (reprint author), Univ Alabama, Dept Informat Syst Stat & Management, Culverhouse Coll Commerce, 300 Alston Hall,Box 870226, Tuscaloosa, AL 35487 USA. EM mhardin@cba.ua.edu NR 12 TC 8 Z9 8 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0737-1209 J9 PUBLIC HEALTH NURS JI Public Health Nurs. PD JUL-AUG PY 2005 VL 22 IS 4 BP 366 EP 370 DI 10.1111/j.0737-1209.2005.220410.x PG 5 WC Public, Environmental & Occupational Health; Nursing SC Public, Environmental & Occupational Health; Nursing GA 959IA UT WOS:000231510200013 PM 16150019 ER PT J AU Koike, K Hashimoto, K Takai, N Shimizu, E Komatsu, N Watanabe, H Nakazato, M Okamura, N Stevens, KE Freedman, R Iyo, M AF Koike, K Hashimoto, K Takai, N Shimizu, E Komatsu, N Watanabe, H Nakazato, M Okamura, N Stevens, KE Freedman, R Iyo, M TI Tropisetron improves deficits in auditory P50 suppression in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE nicotinic receptors; serotonin receptors; evoked potentials auditory; schizophrenia; tropisetron; drug therapy ID ACETYLCHOLINE-RELEASE; NICOTINIC RECEPTORS; CIGARETTE-SMOKING; CORTEX; BRAIN; NORMALIZATION; RELATIVES AB Physiological deficits in inhibition of the P50 auditory evoked potential in schizophrenia have been related to diminished expression of alpha 7 nicotinic acetylcholine receptors. Diminished P50 inhibition is correlated with neuropsychological deficits in attention, one of the principal neurocognitive disturbances in schizophrenia. Nicotine administration improves P50 inhibition, presumably by achieving additional activation of these diminished receptors, but its toxicity and marked tachyphytaxis make it an ineffective therapeutic. Nicotine also has weak positive effects on several neurocognitive deficits in schizophrenia, which raises the possibility that the alpha 7 nicotinic receptor is a clinically relevant therapeutic target that should be addressed by less toxic agents. Tropisetron, a drug already approved for clinical use outside the United States as an anti-emetic, is a partial agonist at a7 nicotinic receptors and an antagonist at 5-HT3 receptors. As an initial proof-of-principle study, we determined that a single administration of tropisetron significantly improves P50 inhibition in schizophrenia. These data are consistent with biological activity at a pathophysiological mechanism in schizophrenia and support further trials of this drug as a possible therapeutic for neurocognitive deficits in schizophrenia. (c) 2005 Elsevier B.V. All rights reserved. C1 Chiba Univ, Grad Sch Med, Dept Psychiat, Chiba 2608670, Japan. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80262 USA. RP Hashimoto, K (reprint author), Chiba Univ, Grad Sch Med, Dept Psychiat, 1-8-1 Inohana, Chiba 2608670, Japan. EM hashimoto@faculty.chiba-u.jp FU NIMH NIH HHS [MH-68582, MH-59565] NR 34 TC 96 Z9 100 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JUL 1 PY 2005 VL 76 IS 1 BP 67 EP 72 DI 10.1016/j.schres.2004.12.016 PG 6 WC Psychiatry SC Psychiatry GA 937AR UT WOS:000229897400005 PM 15927799 ER PT J AU Andress, DL AF Andress, DL TI Vitamin D in health and disease - Introduction SO SEMINARS IN DIALYSIS LA English DT Editorial Material C1 Univ Washington, Sch Med, Nephrol Sect, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Andress, DL (reprint author), Univ Washington, Sch Med, Nephrol Sect, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD JUL-AUG PY 2005 VL 18 IS 4 BP 265 EP 265 DI 10.1111/j.1525-139X.2005.18401.x PG 1 WC Urology & Nephrology SC Urology & Nephrology GA 945HG UT WOS:000230493000001 ER PT J AU Andress, DL AF Andress, DL TI Vitamin D treatment in chronic kidney disease SO SEMINARS IN DIALYSIS LA English DT Article ID CHRONIC-RENAL-FAILURE; SERUM PARATHYROID-HORMONE; SECONDARY HYPERPARATHYROIDISM; 1,25-DIHYDROXYVITAMIN D-3; HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; 1-ALPHA-HYDROXYVITAMIN D-2; CARDIOVASCULAR-DISEASE; INTRAVENOUS CALCITRIOL; NEPHRECTOMIZED RATS AB Activated vitamin D continues to be the major treatment for suppressing parathyroid hormone (PTH) levels in dialysis patients who have secondary hyperparathyroidism. Active vitamin D compounds are distinguished by their ability to bind with high affinity to vitamin D receptors (VDRs) not only in the parathyroid glands, but in cells throughout the body. Because of recent data showing that pulsatile, intravenous vitamin D treatment (calcitriol or paricalcitol) confers a survival advantage in the dialysis population, there is new interest in understanding the systemic effects of VDR activation, particularly in the predialysis stages of chronic kidney disease (CKD), where high mortality rates from cardiovascular disease have recently been documented. Previous underutilization of calcitriol treatment to control PTH levels in stages 3 and 4 CKD was often due to concerns about its potential for accelerating the progression of CKD as a consequence of hypercalcemia, hypercalciuria, or hyperphosphatemia. Vitamin D analogs with selective VDR activity (such as paricalcitol) have great potential for preventing parathyroid hyperplasia and bone loss in early CKD without adversely affecting kidney function. Whether they also reduce cardiovascular morbidity and mortality in early CKD, as they appear to do in dialysis patients, remains to be determined. C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. RP Andress, DL (reprint author), Vet Affairs Med Ctr, Mailstop 111A,1660 S Columbian Way, Seattle, WA 98108 USA. EM Dennis.Andress@med.va.gov NR 83 TC 39 Z9 43 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD JUL-AUG PY 2005 VL 18 IS 4 BP 315 EP 321 DI 10.1111/j.1525-139X.2005.18408.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 945HG UT WOS:000230493000009 PM 16076355 ER PT J AU Chang, VW Christakis, NA AF Chang, VW Christakis, NA TI Income inequality and weight status in US metropolitan areas SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE income inequality; obesity; body mass index; contextual analysis; socioeconomic factors; USA ID SELF-RATED HEALTH; BODY-MASS INDEX; UNITED-STATES; POPULATION HEALTH; MULTILEVEL ANALYSIS; INDIVIDUAL INCOME; YOUNG ADULTHOOD; LIFE EXPECTANCY; NATIONAL SURVEY; MORTALITY AB Prior empirical studies have demonstrated an association between income inequality and general health endpoints such as mortality and self-rated health, and findings have been taken as support for the hypothesis that inequality is detrimental to individual health. Unhealthy weight statuses may function as an intermediary link between inequality and more general heath endpoints. Using individual-level data from the 1996-98 Behavioral Risk Factor Surveillance System, we examine the relationship between individual weight status and income inequality in US metropolitan areas. Income inequality is calculated with data from the 1990 US Census 5% Public Use Microsample. In analyses stratified by race-sex groups, we do not find a positive association between income inequality and weight outcomes such as body mass index, the odds of being overweight, and the odds of being obese. Among white women, however, we do find a statistically significant inverse association between inequality and each of these weight outcomes, despite adjustments for individual-level covariates, metropolitan-level covariates, and census region. We also find that greater inequality is associated with higher odds for trying to lose weight among white women, even adjusting for current weight status. Although our findings are suggestive of a contextual effect of metropolitan area income inequality, we do not find an increased risk for unhealthy weight outcomes, adding to recent debates surrounding this topic. © 2004 Elsevier Ltd. All rights reserved. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Philadelphia VAMC, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. Univ Penn, Populat Studies Ctr, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Harvard Univ, Sch Med, Dept Hlth Care Policy, Cambridge, MA 02138 USA. Harvard Univ, Dept Sociol, Cambridge, MA 02138 USA. RP Chang, VW (reprint author), Univ Penn, Sch Med, Dept Med, 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM vwchang@mail.med.upenn.edu RI Christakis, Nicholas/B-6690-2008; Christakis, Nicholas/C-3205-2009 FU NICHD NIH HHS [5-K12-HD043459] NR 68 TC 31 Z9 31 U1 3 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD JUL PY 2005 VL 61 IS 1 BP 83 EP 96 DI 10.1016/j.socscimed.2004.11.036 PG 14 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 923CY UT WOS:000228887800008 PM 15847964 ER PT J AU King, D Chase, J Havey, RM Voronov, L Sartori, M McEwen, HA Beamer, WG Patwardhan, AG AF King, D Chase, J Havey, RM Voronov, L Sartori, M McEwen, HA Beamer, WG Patwardhan, AG TI Effects of growth hormone transgene expression on vertebrae in a mouse model of osteogenesis imperfecta SO SPINE LA English DT Article DE osteogenesis imperfecta; oim; transgenic; growth hormone; biomechanics ID COLLAGEN-SYNTHESIS; MICE; OIM; MORPHOLOGY AB Study Design. A human growth hormone transgene was bred into mice of the Cola2(oim) (oim) lineage. Caudal ( tail) vertebrae from male and female mice at early skeletal maturity and at midlife were evaluated for physical and biomechanical properties. Objective. To test whether constant low-level growth hormone expression within the marrow could improve structural or material properties of caudal vertebrae in oim mice. Summary of Background Data. A spontaneous genetic defect in a type I procollagen gene created the oim mouse model for osteogenesis imperfecta. Bones of heterozygous oim mice are biomechanically inferior to wild-type controls. Bone marrow expression of human growth hormone was demonstrated previously to enhance bone deposition and structural biomechanical properties in caudal vertebrae of transgenic mice. Methods. Compression tests were performed individually on three caudal vertebrae (Ca4, 5, and 6) from each mouse to determine their structural biomechanical properties. Volumetric and mineral content measurements were also made. In a subset of vertebrae, the ashing measurements were confirmed and extended by peripheral quantitative tomographic scanning, which also allowed calculation of the failure stress. Results. Heterozygous oim mouse vertebrae had structural and material properties inferior to the wild-type controls. Growth hormone transgene expression increased the size and mineral content of the vertebrae from mutant mice, and increased biomechanical structural values for maximum load and energy to failure. Failure stress was not improved. Conclusions. Growth hormone stimulation of size and bone mineral content of osteogenesis imperfecta mutant mouse caudal vertebrae contributed to their improved performance in axial compression. There was no evidence for improved material properties, however. C1 Northeastern Ohio Univ Coll Med & Pharm, Dept Biochem & Mol Pathol, Coll Med, Rootstown, OH 44272 USA. Loyola Univ, Med Ctr, Dept Orthopaed Surg & Rehabil, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Musculoskeletal Biomech Lab, Hines, IL 60141 USA. Jackson Lab, Bar Harbor, ME 04609 USA. RP King, D (reprint author), Northeastern Ohio Univ Coll Med & Pharm, Dept Biochem & Mol Pathol, Coll Med, 4209 State Route 44, Rootstown, OH 44272 USA. EM dk@neoucom.edu RI McEwen, Heather/B-2314-2008 OI McEwen, Heather/0000-0001-7922-192X FU NIAMS NIH HHS [AR43618] NR 17 TC 7 Z9 8 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-2436 J9 SPINE JI SPINE PD JUL 1 PY 2005 VL 30 IS 13 BP 1491 EP 1495 DI 10.1097/01.brs.0000168550.65726.cb PG 5 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 943EN UT WOS:000230335300004 PM 15990661 ER PT J AU Jarvik, JG Hollingworth, W Heagerty, PJ Haynor, DR Boyko, EJ Deyo, RA AF Jarvik, JG Hollingworth, W Heagerty, PJ Haynor, DR Boyko, EJ Deyo, RA TI Three-year incidence of low back pain in an initially asymptomatic cohort - Clinical and imaging risk factors SO SPINE LA English DT Article DE cohort study; epidemiology; low back pain; prognosis; risk factors; magnetic resonance imaging ID DEGENERATIVE DISK DISEASE; MAGNETIC-RESONANCE; LUMBAR SPINE; PSYCHOSOCIAL FACTORS; PREVALENCE; PROTRUSIONS; DISABILITY; INTENSITY; SCIATICA; TEARS AB Study Design. Prospective cohort study of randomly selected Veterans Affairs out-patients without baseline low back pain (LBP). Objective. To determine predictors of new LBP as well as the 3-year incidence of magnetic resonance imaging (MRI) findings. Summary of Background Data. Few prospective studies have examined clinical and anatomic risk factors for the development of LBP, or the incidence of new imaging findings and their relationship to back pain onset. Methods. We randomly selected 148 Veterans Affairs out-patients (aged 35 to 70) without LBP in the past 4 months. We compared baseline and 3-year lumbar spine MRI. Using data collected every 4 months, we developed a prediction model of back pain-free survival. Results. After 3 years, 131 subjects were contacted, and 123 had repeat MRI. The 3-year incidence of pain was 67% ( 88 of 131). Depression had the largest hazard ratio (2.3, 95% CI = 1.2-4.4) of any baseline predictor of incident back pain. Among baseline imaging findings, central spinal stenosis and nerve root contact had the highest, though nonsignificant, hazard ratios. We did not find an association between new LBP and type 1 end-plate changes, disc degeneration, annular tears, or facet degeneration. The incidence of new MRI findings was low, with the most common new finding being disc signal loss in 11 (9%) subjects. All five subjects with new disc extrusions and all four subjects with new nerve root impingement had new pain. Conclusion. Depression is an important predictor of new LBP, with MRI findings likely less important. New imaging findings have a low incidence; disc extrusions and nerve root contact may be the most important of these findings. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. Univ Washington, Ctr Cost & Outcomes Res, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Seattle Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Jarvik, JG (reprint author), Univ Washington, Dept Radiol, Box 357115,1959 NE Pacific St, Seattle, WA 98195 USA. EM jarvikj@u.washington.edu FU AHRQ HHS [HS-08194, HS-094990]; NIAMS NIH HHS [P60-AR48093-01] NR 30 TC 116 Z9 124 U1 2 U2 15 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-2436 J9 SPINE JI SPINE PD JUL 1 PY 2005 VL 30 IS 13 BP 1541 EP 1548 DI 10.1097/01.brs.0000167536.60002.87 PG 8 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 943EN UT WOS:000230335300013 PM 15990670 ER PT J AU Bravata, DM Wells, CK Gulanski, B Kernan, WN Brass, LM Long, J Concato, J AF Bravata, DM Wells, CK Gulanski, B Kernan, WN Brass, LM Long, J Concato, J TI Racial disparities in stroke risk factors - The impact of socioeconomic status SO STROKE LA English DT Article DE ischemia; risk factors; social class ID ETHNIC-DIFFERENCES; AFRICAN-AMERICANS; ISCHEMIC-STROKE; SOCIAL-CLASS; MORTALITY; REGISTER; BLACKS; RACE; ATHEROSCLEROSIS; ENDARTERECTOMY AB Background and Purpose - In the US, blacks have a higher incidence of stroke and more severe strokes than whites. Our objective was to determine if differences in income, education, and insurance, as well as differences in the prevalence of stroke risk factors, accounted for the association between ethnicity and stroke. Methods - We used data from the Third National Health and Nutrition Survey (NHANES III), a cross-sectional sample of the noninstitutionalized US population (1988 - 1994), and included blacks and whites aged 40 years or older with a self-reported stroke history. Income was assessed using a ratio of income to US Census Bureau annual poverty threshold. Results - Among 11 163 participants, 2752 (25 %) were black and 619 (6 %) had a stroke history (blacks: 160/ 2752 [6 %]; whites: 459/8411 [6 %]; P = 0.48). Blacks had a higher prevalence of 5 risk factors independently associated with stroke: hypertension, treated diabetes, claudication, higher C-reactive protein, and inactivity; whites had a higher prevalence of 3 risk factors: older age, myocardial infarction, and lower high-density lipoprotein cholesterol. Ethnicity was independently associated with stroke after adjusting for the 8 risk factors ( adjusted odds ratio, 1.32; 95 % CI, 1.04 to 1.67). Ethnicity was not independently associated with stroke after adjustment for income and income was independently associated with stroke (adjusted odds ratios for: ethnicity, 1.15; 95 % CI, 0.88 to 1.49; income, 0.89; 95 % CI, 0.82 to 0.95). Adjustment for neither education nor insurance altered the ethnicity - stroke association. Conclusions - In this study of community-dwelling stroke survivors, ethnic differences exist in the prevalence of stroke risk factors and income may explain the association between ethnicity and stroke. C1 W Haven VA Med Ctr, VA Connecticut Healthcare Syst, CERC, West Haven, CT 06516 USA. VA Connecticut Healthcare Syst, Internal Med Serv, West Haven, CT 06516 USA. VA Connecticut Healthcare Syst, Neurol Serv, West Haven, CT 06516 USA. Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06510 USA. Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Dept Internal Med, Philadelphia, PA USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Bravata, DM (reprint author), W Haven VA Med Ctr, VA Connecticut Healthcare Syst, CERC, Bldg 35A,Mailcode 151B,950 Campbell Ave, West Haven, CT 06516 USA. EM Dawn.Bravata@yale.edu NR 30 TC 56 Z9 58 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JUL PY 2005 VL 36 IS 7 BP 1507 EP 1511 DI 10.1161/01.STR.0000170991.63594.b6 PG 5 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 941BW UT WOS:000230190600035 PM 15961710 ER PT J AU Rigato, L Ostrow, JD Tiribelli, C AF Rigato, L Ostrow, JD Tiribelli, C TI bilirubin and non-hepatic disease: a less jaundiced view - Response SO TRENDS IN MOLECULAR MEDICINE LA English DT Editorial Material ID DIPHOSPHO-GLUCURONOSYLTRANSFERASE 1A1; GENETIC POLYMORPHISMS; BREAST-CANCER; UGT1A1; ASSOCIATION; INDUCTION; RISK C1 Ctr Studi Fegato, Basovizza, Italy. Univ Trieste, Dept BBCM, I-34012 Trieste, Italy. Univ Washington, Sch Med, Div Gastroenterol Hepatol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98195 USA. RP Tiribelli, C (reprint author), Ctr Studi Fegato, Bldg Q,Area Sci Pk, Basovizza, Italy. EM ctliver@csf.units.it NR 13 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1471-4914 J9 TRENDS MOL MED JI Trends Mol. Med PD JUL PY 2005 VL 11 IS 7 BP 314 EP 315 PG 2 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 953OA UT WOS:000231084900004 ER PT J AU Liljelund, P Handforth, A Homanicsc, GE Olsen, RW AF Liljelund, P Handforth, A Homanicsc, GE Olsen, RW TI GABA(A) receptor beta 3 subunit gene-deficient heterozygous mice show parent-of-origin and gender-related differences in beta 3 subunit levels, EEG, and behavior SO DEVELOPMENTAL BRAIN RESEARCH LA English DT Article DE genomic imprinting; Angelman syndrome; epilepsy; GABA(A) receptor; knockout ID ANGELMAN-SYNDROME; A RECEPTOR; PRADER-WILLI; BETA(3) SUBUNIT; EPILEPSY; BRAIN; DELETION; MOUSE; IDENTIFICATION; CHROMOSOME-15 AB The homozygous knockout mouse for the beta 3 subunit of the GABA(A) receptor has been proposed as a model for the neurodevelopmental disorder, Angelman syndrome, based on phenotypic similarities of craniofacial abnormalities, cognitive defects, hyperactivity, motor incoordination, disturbed rest-activity cycles, and epilepsy. Since most children with Angelman syndrome are autosomal heterozygotes of maternal origin, apparently through genomic imprinting, we used gabrb3-deficient heterozygote mice of defined parental origin to investigate whether this phenotype is also maternally imprinted in mouse. Whole brain extracts showed greatly reduced beta 3 subunit levels in male mice of maternal origin but not in male mice of paternal origin. Females of both parental origin showed greatly reduced beta 3 subunit levels. Heterozygotes did not exhibit hyperactive circling behavior, convulsions, or electrographically recorded seizures. EEGs showed qualitative differences among heterozygotes, with male mice of maternal origin demonstrating more abnormalities including increased theta activity. Ethosuximide inhibited theta bursts, suggesting an alteration in the thalamocortical relay. Carbamazepine induced EEG slowing in males and EEG acceleration in females, with a larger effect in paternal-origin heterozygotes. Evidence thus suggests both parent-of-origin and gender-related components in developmental regulation of beta 3 expression, in particular, that the maternally-derived male heterozygote may carry a developmental modification resulting in less beta 3 protein, which may reflect partial genomic imprinting of the gabrb3 gene in mice. (C) 2005 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles, Los Angeles, CA 90073 USA. Univ Pittsburgh, Dept Anesthesiol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Pharmacol, Pittsburgh, PA 15261 USA. RP Olsen, RW (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. EM ROlsen@mednet.ucla.edu NR 63 TC 29 Z9 32 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-3806 J9 DEV BRAIN RES JI Dev. Brain Res. PD JUN 30 PY 2005 VL 157 IS 2 BP 150 EP 161 DI 10.1016/j.devbrainres.2005.03.014 PG 12 WC Developmental Biology; Neurosciences SC Developmental Biology; Neurosciences & Neurology GA 941ZW UT WOS:000230253700005 ER PT J AU Prochazka, AV Lundahl, K Pearson, W Oboler, SK Anderson, RJ AF Prochazka, AV Lundahl, K Pearson, W Oboler, SK Anderson, RJ TI Support of evidence-based guidelines for the annual physical examination - A survey of primary care providers SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID PERIODIC HEALTH EXAMINATION AB Background: Current evidence does not support an annual screening physical examination for asymptomatic adults, but little is known about primary care provider (PCP) attitudes and practices regarding an annual physical examination. Methods: We conducted a postal survey (32 items) of attitudes and practices regarding the annual physical examination (in asymptomatic patients 18 years or older) of a random sample of PCPs (specializing in internal medicine, family practice, and obstetrics/gynecology) from 3 geographic areas (Boston, Mass; Denver, Colo; and San Diego, Calif). Results: Respondents included 783 (47%) of 1679 PCPs. Overall, 430 (65%) of 664 agreed that an annual physical examination is necessary. Three hundred ninety-three (55%) of 712 disagreed with the statement that national organizations do not recommend an annual physical examination, and 641 (88%) of 726 perform such examinations. Most PCPs agreed that an annual physical examination provides time to counsel patients about preventive health services (696/739 [94%]), improves patient-physician relationships (693/737 [94%]), and is desired by most patients (572/737 [78%]). Most also believe that an annual physical examination improves detection of subclinical illness (545/738 [74%]) and is of proven value (461/736 [63%]). Many believed that tests should be part of an annual physical examination, including mammography (44%), a lipid panel (48%), urinalysis (44%), testing of blood glucose level (46%), and complete blood cell count (39%). Conclusions: Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests. Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems. C1 Denver Vet Affairs Med Ctr, Ambulatory Care Sect 11B, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Boulder, CO 80309 USA. RP Prochazka, AV (reprint author), Denver Vet Affairs Med Ctr, Ambulatory Care Sect 11B, 1055 Clermont, Denver, CO 80220 USA. EM Allan.Prochazka@med.va.gov NR 20 TC 50 Z9 52 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUN 27 PY 2005 VL 165 IS 12 BP 1347 EP 1352 DI 10.1001/archinte.165.12.1347 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 940BR UT WOS:000230119200003 PM 15983282 ER PT J AU Yellaturu, CR Deng, X Cagen, LM Wilcox, HG Park, EA Raghow, R Elam, MB AF Yellaturu, CR Deng, X Cagen, LM Wilcox, HG Park, EA Raghow, R Elam, MB TI Posttranslational processing of SREBP-1 in rat hepatocytes is regulated by insulin and cAMP SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE SREBP-1; insulin; cAMP; hepatocyte; insig; ubiquitin ID ELEMENT-BINDING PROTEIN-1C; CHOLESTEROL HOMEOSTASIS; MESSENGER-RNA; SCAP; INSIG-1; LIPOGENESIS; EXPRESSION; GENE; OVEREXPRESSION; PATHWAY AB Insulin and cAMP have opposing effects on de novo fatty acid synthesis in liver and in cultured hepatocytes mediated by sterol-regulatory element binding protein (SREBP). To determine whether these agents regulate the cleavage of full-length SREBP to generate the transcriptionally active N-terminal fragment (nSREBP) in primary rat hepatocytes, an adenoviral vector (Ad-SREBP-1a) was constructed to constitutively express full-length SREBP-la. Insulin increased, and dibutyryl (db)-cAMP inhibited, generation of nSREBP-1a from its full-length precursor. Insulin stimulated processing of SREBP-1a within 1 h, and the effect was sustained for at least 24 h. The initial stimulation of SREBP processing by insulin preceded measurable reduction in Insig-2 mRNA levels. Rat hepatocytes were also infected with an adenovirus expressing the nuclear form of SREBP-1c (Ad-nSREBP-1c). Insulin increased the half-life of constitutively expressed nSREBP-1c, and this effect of insulin was also inhibited by db-cAMP. Published by Elsevier Inc. C1 US Dept Vet Affairs, Med Ctr, Memphis, TN USA. Univ Tennessee, Hlth Sci Ctr, Div Clin Pharmacol, Dept Pharm, Knoxville, TN 37996 USA. Univ Tennessee, Hlth Sci Ctr, Div Clin Pharmacol, Dept Med, Knoxville, TN 37996 USA. RP Cagen, LM (reprint author), US Dept Vet Affairs, Med Ctr, Memphis, TN USA. EM lcagen@utmem.edu FU NIDDK NIH HHS [DK-059368] NR 24 TC 37 Z9 39 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD JUN 24 PY 2005 VL 332 IS 1 BP 174 EP 180 DI 10.1016/j.bbrc.2005.04.112 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 929OK UT WOS:000229355200025 PM 15896314 ER PT J AU Werner, RM Asch, DA AF Werner, RM Asch, DA TI Publicly reporting quality information - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID SURGERY C1 Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Werner, RM (reprint author), Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. EM rwerner@wharton.upenn.edu NR 3 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 22 PY 2005 VL 293 IS 24 BP 3000 EP 3001 DI 10.1001/jama.293.24.3000 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 937SG UT WOS:000229945200013 ER PT J AU Shekelle, PG Morton, SC Suftorp, MJ Buscemi, N Friesen, C AF Shekelle, PG Morton, SC Suftorp, MJ Buscemi, N Friesen, C TI Challenges in systematic reviews of complementary and alternative medicine topics SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID LOW-BACK-PAIN; CLINICAL-TRIALS; MANIPULATIVE THERAPY; PUBLICATION BIAS; PLACEBO; METAANALYSIS; ACUPUNCTURE; DEPRESSION; STROKE AB The use of complementary and alternative medicine (CAM) continues to grow in the United States. The Agency for Healthcare Research and Quality has devoted a substantial proportion of the Evidence-based Practice Center (EPC) program to systematic reviews of CAM. Such syntheses present different challenges from those conducted on western medicine topics, and in many ways are more difficult. We discuss 3 challenges: identifying evidence about CAM, assessing the quality of individual studies, and addressing rare serious adverse events. We use illustrations from EPC evidence reports to show readers approaches to the 3 areas and then present specific recommendations for each issue. C1 RAND Corp, So Calif Evidence Based Pract Ctr, Santa Monica, CA 90401 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Shekelle, PG (reprint author), RAND Corp, So Calif Evidence Based Pract Ctr, 1776 Main St, Santa Monica, CA 90401 USA. EM Paul_Shekelle@rand.org OI Friesen, Carol/0000-0001-6437-9126 NR 33 TC 41 Z9 42 U1 1 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 21 PY 2005 VL 142 IS 12 SU S BP 1042 EP 1047 PN 2 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 938CN UT WOS:000229977600003 PM 15968028 ER PT J AU Santaguida, PL Helfand, M Raina, P AF Santaguida, PL Helfand, M Raina, P TI Challenges in systematic reviews that evaluate drug efficacy or effectiveness SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIALS; ALZHEIMER-DISEASE; NETWORK METAANALYSIS; HEALTH-POLICY; HEPATITIS-C; COMBINATION; PROGRESSION; DEMENTIA; VALIDITY; THERAPY AB Increasingly, consumers, clinicians, regulatory bodies, and insurers are using systematic reviews of drug interventions to select treatments and set policies. Although a systematic review cannot provide all the information a clinician needs to make an informed choice for therapy, it can help decision makers distinguish what claims about effectiveness are based on evidence, identify critical information gaps, describe features of the evidence that limit applicability in practice, and address whether drug effectiveness differs for particular subgroups of patients. To improve the relevance and validity of reviews of drug therapies, reviewers need to delineate clinically important subgroups, specific aims of therapy, and most important outcomes. They may need to find unpublished trials, studies other than direct comparator (head-to-head) trials, and additional details of published trials from pharmaceutical manufacturers and regulatory agencies. In this paper, we address ways to formulate questions relevant to specific clinical therapeutic aims; discuss types of studies to include in drug efficacy and effectiveness reviews and how to find them; and describe ways to assess applicability of studies to actual practice. C1 McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8S 4L8, Canada. Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Evidence Based Pract Ctr, Portland, OR USA. RP Raina, P (reprint author), McMaster Univ, Dept Clin Epidemiol & Biostat, DTC Room 306,1280 Main St W, Hamilton, ON L8S 4L8, Canada. NR 38 TC 18 Z9 18 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 21 PY 2005 VL 142 IS 12 SU S BP 1066 EP 1072 PN 2 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 938CN UT WOS:000229977600006 PM 15968031 ER PT J AU Pignone, M Saha, S Hoerger, T Lohr, KN Teutsch, S Mandelblatt, J AF Pignone, M Saha, S Hoerger, T Lohr, KN Teutsch, S Mandelblatt, J TI Challenges in systematic reviews of economic analyses SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID SERVICES-TASK-FORCE; COST-EFFECTIVENESS ANALYSES; COLORECTAL-CANCER; PREVENTIVE-SERVICES; AVERAGE-RISK; GUIDELINES; QUALITY; HEALTH; RECOMMENDATIONS; UTILITY AB Economic analyses can provide valuable information for health care decision makers. Systematic reviews of economic analyses can integrate information from multiple studies and provide important insights by systematically examining how differences between models lead to different results. We use our experience in developing and implementing systematic reviews of economic analyses for the U.S. Preventive Services Task Force, particularly our systematic review of the cost-effectiveness of colorectal cancer screening, to illustrate key methodologic challenges and suggest a framework for other researchers in this area. C1 Univ N Carolina, Chapel Hill, NC 27515 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR USA. RTI Univ N Carolina, Evidence Based Practice Ctr, Res Triangle Pk, NC USA. Merck & Co Inc, W Point, PA USA. Georgetown Univ, Ctr Med, Washington, DC 20057 USA. Lombardi Comprehens Canc Ctr, Washington, DC USA. RP Pignone, M (reprint author), Univ N Carolina Hosp, Dept Med, Div Gen Internal Med, 5039 Old Clin Bldg, Chapel Hill, NC 27599 USA. EM Pignone@med.unc.edu FU NCI NIH HHS [K05CA96940, U01CA88283A] NR 26 TC 50 Z9 51 U1 0 U2 7 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 21 PY 2005 VL 142 IS 12 SU S BP 1073 EP 1079 PN 2 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 938CN UT WOS:000229977600007 PM 15968032 ER PT J AU Chou, R Helfand, M AF Chou, R Helfand, M TI Challenges in systematic reviews that assess treatment harms SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID ADVERSE DRUG-REACTIONS; SEROTONIN REUPTAKE INHIBITORS; RANDOMIZED CONTROLLED-TRIALS; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; CONFLICT-OF-INTEREST; HEALTH-CARE; CAUSALITY ASSESSMENT; BALANCING BENEFITS; GASTROINTESTINAL TOXICITY; METHODOLOGICAL QUALITY AB An evidence synthesis of a medical intervention should assess the balance of benefits and harms. Investigators performing systematic reviews of harms face challenges in finding data, rating the quality of harms reporting, and synthesizing and displaying data from different sources. Systematic reviews of harms often rely primarily on published clinical trials. Identifying important harms of treatment and quantifying the risk associated with them, however, often require a broader range of data sources, including unpublished trials, observational studies, and unpublished information on published trials submitted to the U.S. Food and Drug Administration. Each source of data has some potential for yielding important information. Criteria for judging the quality of harms assessment and reporting are still in their early stages of development. Investigators conducting systematic reviews of harms should consider empirically validating the criteria they use to judge the validity of studies reporting harms. Synthesizing harms data from different sources requires careful consideration of internal validity, applicability, and sources of heterogeneity. This article highlights examples of approaches to methodologic issues associated with performing systematic reviews of harms from 96 Evidence-based Practice Center evidence reports. C1 Oregon Hlth Sci Univ, Oregon Evidence Based Pract Ctr, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Chou, R (reprint author), Oregon Hlth Sci Univ, Oregon Evidence Based Pract Ctr, 3181 SW Sam Jackson Pk Rd,Mail Code BICC, Portland, OR 97201 USA. EM chour@ohsu.edu NR 109 TC 83 Z9 84 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 21 PY 2005 VL 142 IS 12 SU S BP 1090 EP 1099 PN 2 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 938CN UT WOS:000229977600009 PM 15968034 ER PT J AU Mozaffarian, D Bryson, CL Lemaitre, RN Burke, GL Siscovick, DS AF Mozaffarian, D Bryson, CL Lemaitre, RN Burke, GL Siscovick, DS TI Fish intake and risk of incident heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article; Proceedings Paper CT 44th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 03-06, 2004 CL San Francisco, CA SP Amer Heart Assoc ID POLYUNSATURATED FATTY-ACIDS; CARDIOVASCULAR HEALTH; CONTRACTILE FUNCTION; SYSTOLIC FUNCTION; BLOOD-PRESSURE; TRAINED RATS; OIL; CONSUMPTION; OMEGA-3-FATTY-ACIDS; MODULATION AB OBJECTIVES Our aim was to investigate the relation between fish consumption and incidence of congestive heart failure (CHF). BACKGROUND The incidence and health burden of CHF are rising, particularly in older persons. Although n-3 fatty acids have effects that could favorably influence risk of CHF, the relation between fish intake and CHF incidence is unknown. METHODS Among 4,738 adults age >= 65 years and free of CHF at baseline in 1989-90, usual dietary intake was assessed using a food frequency questionnaire. In a participant subsample, consumption of tuna or other broiled or baked fish, but not fried fish, correlated with plasma phospholipid n-3 fatty acids. Incidence of CHF was prospectively adjudicated. RESULTS During 12 years' follow-up, 955 participants developed CHF. In multivariate-adjusted analyses, tuna/other fish consumption was inversely associated with incident CHF, with 20% lower risk with intake 1 to 2 times/week (hazard ratio [HR] = 0.80, 95% confidence interval [CI] = 0.64 to 0.99), 31% lower risk with intake 3 to 4 times/week (HR = 0.69, 95% Cl = 0.52 to 0.91), and 32% lower risk with intake >= 5 times/week (HR = 0.68, 95% CI = 0.45 to 1.03), compared with intake < 1 time/month (p trend = 0.009). In similar analyses, fried fish consumption was positively associated with incident CHF (p trend = 0.01). Dietary long-chain n-3 fatty acid intake was also inversely associated with CHF (p trend = 0.009), with 37% lower risk in the highest quintile of intake (HR = 0.73, 95% CI = 0.57 to 0.94) compared with the lowest. CONCLUSIONS Among older adults, consumption of tuna or other broiled or baked fish, but not fried fish, is associated with lower incidence of CHF. Confirmation in additional studies and evaluation of potential mechanisms is warranted. (c) 2005 by the American College of Cardiology Foundation. C1 Brigham & Womens Hosp, Channing Lab, Dept Med, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA USA. Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA. RP Mozaffarian, D (reprint author), 665 Huntington Ave,Bldg 2,Room 315, Boston, MA 02115 USA. EM dmozaffa@hsph.harvard.edu RI Mozaffarian, Dariush/B-2276-2008 FU NHLBI NIH HHS [K08 HL 075628, N01 HC 35129, N01 HC 85079, N01 HC 15103, N01 HC 85086] NR 34 TC 149 Z9 152 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JUN 21 PY 2005 VL 45 IS 12 BP 2015 EP 2021 DI 10.1016/j.jacc.2005.03.038 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 936IK UT WOS:000229848500018 PM 15963403 ER PT J AU Shiotani, A Ishi, H Uedo, N Kumamoto, M Nakae, Y Ishiguro, S Tatsuta, M Graham, DY AF Shiotani, A Ishi, H Uedo, N Kumamoto, M Nakae, Y Ishiguro, S Tatsuta, M Graham, DY TI Histologic and serum risk markers for noncardia early gastric cancer SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article DE corpus dominant gastritis; early gastric cancer; gastrin 17; intestinal metaplasia; pepsinogen I ID HELICOBACTER-PYLORI INFECTION; INTESTINAL METAPLASIA; ATROPHIC GASTRITIS; PEPSINOGEN-I; ENDOSCOPIC DIAGNOSIS; STOMACH; CARCINOGENESIS; CARCINOMA; DYSPLASIA; SEQUENCE AB Corpus dominant gastritis and intestinal metaplasia (IM) are considered markers of increased risk of gastric carcinoma. The aim of our study was to determine serum and histologic risk markers of gastric cancer. Antral and corpus histology, pepsinogen and gastrin 17 levels were compared among patients with history of endoscopic mucosal resection (EMR) for early gastric cancer and controls. Serum pepsinogen (PG) and gastrin 17 levels were measured by RIA. There were 53 gastric cancer patients and 75 controls. The scores for IM in each region and atrophy at the lesser curvature of the corpus were significantly higher in the cancer group than in the H. pylori-positive control group. IM at the greater curvature of the corpus and atrophy at the lesser curvature of the corpus were associated with multiple malignant lesions. Although corpus gastritis was associated with an increased risk of gastric cancer (odds ratio [OR] = 3.4; 95% confidence interval [CI) 1.6-7.0) (p = 0.001), the most important marker was the presence of IM at the lesser curvature of the corpus (OR = 15.1; 95% CI 4.3-52.6) (p < 0.001)). The best cut-off points of serum markers for gastric cancer were a PG I concentration of 45 ng/mL or less and a gastrin 17 > 60 pg/mL (sensitivity = 83%; specificity = 68%). IM at the lesser curvature of the corpus and the combination of serum gastrin 17 and PG I identified a group at high risk for development of gastric cancer. Annual endoscopic follow-up is warranted for patients with IM found at the greater curvature of the corpus. © 2005 Wiley-Liss, Inc. C1 Wakayama Univ, Hlth Adm Ctr, Wakayama 6408510, Japan. Osaka Med Ctr Canc & Cardiovasc Dis, Dept Gastrointestinal Oncol, Osaka, Japan. VA Med Ctr, Dept Med, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Shiotani, A (reprint author), Wakayama Univ, Hlth Adm Ctr, 930 Sakaedani, Wakayama 6408510, Japan. EM shiotani@center.wakayama-u.ac.jp NR 32 TC 49 Z9 52 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD JUN 20 PY 2005 VL 115 IS 3 BP 463 EP 469 DI 10.1002/ijc.20852 PG 7 WC Oncology SC Oncology GA 925BD UT WOS:000229025600018 PM 15688378 ER PT J AU Pennathur, S Ido, Y Heller, JI Byun, J Danda, R Pergola, P Willliamson, JR Heinecke, JW AF Pennathur, S Ido, Y Heller, JI Byun, J Danda, R Pergola, P Willliamson, JR Heinecke, JW TI Reactive carbonyls and polyunsaturated fatty acids produce a hydroxyl radical-like species - A potential pathway for oxidative damage of retinal proteins in diabetes SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; MASS-SPECTROMETRIC QUANTIFICATION; AUTOXIDATIVE GLYCOSYLATION; LIPID-PEROXIDATION; VASCULAR-DISEASE; MICROVASCULAR COMPLICATIONS; GLUCOSE AUTOXIDATION; NITRATIVE STRESS; ORTHO-TYROSINE; SKIN COLLAGEN AB The pattern of oxidized amino acids in aortic proteins of nonhuman primates suggests that a species resembling hydroxyl radical damages proteins when blood glucose levels are high. However, recent studies argue strongly against a generalized increase in diabetic oxidative stress, which might instead be confined to the vascular wall. Here, we describe a pathway for glucose-stimulated protein oxidation and provide evidence of its complicity in diabetic microvascular disease. Low density lipoprotein incubated with pathophysiological concentrations of glucose became selectively enriched in ortho-tyrosine and meta-tyrosine, implicating a hydroxyl radical-like species in protein damage. Model system studies demonstrated that the reaction pathway requires both a reactive carbonyl group and a polyunsaturated fatty acid, involves lipid peroxidation, and is blocked by the carbonyl scavenger aminoguanidine. To explore the physiological relevance of the pathway, we used mass spectrometry and high pressure liquid chromatography to quantify oxidation products in control and hyperglycemic rats. Hyperglycemia raised levels of ortho-tyrosine, meta-tyrosine, and oxygenated lipids in the retina, a tissue rich in polyunsaturated fatty acids. Rats that received aminoguanidine did not show this increase in protein and lipid oxidation. In contrast, rats with diet-induced hyperlipidemia in the absence of hyperglycemia failed to exhibit increased protein and lipid oxidation products in the retina. Our observations suggest that generation of a hydroxyl radical-like species by a carbonyl/polyunsaturated fatty acid pathway might promote localized oxidative stress in tissues vulnerable to diabetic damage. This raises the possibility that antioxidant therapies that specifically inhibit the pathway might delay the vascular complications of diabetes. C1 Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Washington Univ, Sch Med, Dept Pathol, St Louis, MO 63110 USA. Rush Univ, Dept Pathol, Chicago, IL 60612 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Heinecke, JW (reprint author), Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. EM heinecke@u.washington.edu FU NEI NIH HHS [EY06600]; NHLBI NIH HHS [HL39934]; NIA NIH HHS [AG021191]; NIDDK NIH HHS [DK02456, DK20579]; NIEHS NIH HHS [P30ES07033] NR 61 TC 43 Z9 43 U1 2 U2 6 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 17 PY 2005 VL 280 IS 24 BP 22706 EP 22714 DI 10.1074/jbc.M500839200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 934XB UT WOS:000229741800020 PM 15855169 ER PT J AU Mulky, A Sarafianos, SG Jia, YJ Arnold, E Kappes, JC AF Mulky, A Sarafianos, SG Jia, YJ Arnold, E Kappes, JC TI Identification of amino acid residues in the human immunodeficiency virus type-1 reverse transcriptase tryptophan-repeat motif that are required for subunit interaction using infectious virions SO JOURNAL OF MOLECULAR BIOLOGY LA English DT Article DE reverse transcriptase; subunit-specific; Trp-motif; dimerization; NNRTI ID POLYMERASE DOMAIN; PRIMER GRIP; H ACTIVITY; HIV-1; DIMERIZATION; INHIBITOR; MUTAGENESIS; INTERFACE; PROTEIN; DESTABILIZATION AB The human immunodeficiency virus type-1 (HIV-1) reverse transcriptase (RT) functions as a heterodimer (p51/p66), which makes disruption of subunit interactions a possible target for antiviral drug design. Our understanding of subunit interface interactions has been limited by the lack of virus-based approaches for studying the heterodimer. Therefore, we developed a novel subunit-specific mutagenesis approach that enables precise molecular analysis of the heterodimer in the context of infectious HIV-1 particles. Here, we analyzed the contributions of amino acid residues comprising the Trp-motif to RT subunit interaction and function. Our results reveal important inter- and intra-subunit interactions of residues in the Trp-motif. A tryptophan cluster in p51. (W398, W402, W406, W414), proximal to the interface, was found to be important for p51/p66 interaction and stability. At the dimer interface, residues W401, Y405 and N363 in p51 and W410 in p66 mediate inter-subunit interactions. The W401 residue is critical for RT dimerization, exerting distinct effects in p51 and p66. Our analysis of the RT heterodimerization enhancing nonnucleoside RT inhibitor (NNRTI), efavirenz, indicates that the effects of drugs on RT dimer stability can be examined in human cells. Thus, we provide the first description of subunit-specific molecular interactions that affect RT heterodimer function and virus infection in vivo. Moreover, with heightened interest in novel RT inhibitors that affect dimerization, we demonstrate the ability to assess the effects of RT inhibitors on subunit interactions in a physiologically relevant context. (c) 2005 Elsevier Ltd. All rights reserved. C1 Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. Rutgers State Univ, Dept Chem, Piscataway, NJ 08854 USA. Rutgers State Univ, Ctr Adv Biotechnol & Med, Piscataway, NJ 08854 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35233 USA. RP Kappes, JC (reprint author), Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. EM kappesjc@uab.edu OI Sarafianos, Stefan G/0000-0002-5840-154X FU NIAID NIH HHS [AI47714, P10-AI-27767]; NIDDK NIH HHS [R24 DK-64400] NR 46 TC 26 Z9 26 U1 0 U2 1 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2836 J9 J MOL BIOL JI J. Mol. Biol. PD JUN 17 PY 2005 VL 349 IS 4 BP 673 EP 684 DI 10.1016/j.jmb.2005.03.057 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 933PQ UT WOS:000229645800001 PM 15893326 ER PT J AU Huehnergarth, KV Mozaffarian, D Sullivan, MD Crane, BA Wilkinson, CW Lawler, RL McDonald, GB Fishbein, DP Levy, WC AF Huehnergarth, KV Mozaffarian, D Sullivan, MD Crane, BA Wilkinson, CW Lawler, RL McDonald, GB Fishbein, DP Levy, WC TI Usefulness of relative lymphocyte count as an independent predictor of death/urgent transplant in heart failure SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID T-LYMPHOCYTES; ENDOTOXIN; APOPTOSIS; ACTIVATION AB The usefulness of low relative lymphocyte count as an independent predictor of death/urgent transplant in patients with heart failure (HF) and the association between low relative lymphocyte count and neurohormone and cytokine activation were investigated. Relative lymphocyte count, clinical variables, neurohormones, and cytokines were measured in 129 outpatients with HF. Follow-up extended to a mean of 3.0 +/- 1.2 years for death/urgent transplant. Low relative lymphocyte count was independently associated with a 3.4-fold increased risk of death/urgent transplant. Relative lymphocyte count was positively associated with hemoglobin and inversely associated with age, jugular venous pressure, creatinine, leukocyte count, and soluble tumor necrosis factor receptor-1. There was only a borderline inverse association with cortisol levels during evening hours. (c) 2005 by Excerpta Medica Inc. C1 Univ Washington, Dept Internal Med, Div Cardiol, Seattle, WA 98195 USA. Univ Washington, Div Psychiat, Seattle, WA USA. Channing Labs, Boston, MA USA. Brigham & Womens Hosp, Harvard Sch Publ Hlth, Dept Nutr & Epidemiol, Boston, MA USA. Harvard Univ, Sch Med, Dept Med, Boston, MA USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci & Clin Res, Seattle, WA USA. RP Huehnergarth, KV (reprint author), Univ Washington, Dept Internal Med, Div Cardiol, Box 356422,1959 NE Pacific St, Seattle, WA 98195 USA. EM levywc@u.washington.edu RI Mozaffarian, Dariush/B-2276-2008 FU NCI NIH HHS [CA18029]; NCRR NIH HHS [M01-RR-0037] NR 16 TC 33 Z9 34 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUN 15 PY 2005 VL 95 IS 12 BP 1492 EP 1495 DI 10.1016/j.amjcard.2005.02.022 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 937VB UT WOS:000229952900023 PM 15950581 ER PT J AU Sharma, S Yang, SC Zhu, L Reckamp, K Gardner, B Baratelli, F Huang, M Batra, RK Dubinett, SM AF Sharma, S Yang, SC Zhu, L Reckamp, K Gardner, B Baratelli, F Huang, M Batra, RK Dubinett, SM TI Tumor cyclooxygenase-2/prostaglandin E-2-dependent promotion of FOXP3 expression and CD4(+)CD25(+) T regulatory cell activities in lung cancer SO CANCER RESEARCH LA English DT Article ID IMMUNOLOGICAL SELF-TOLERANCE; PERIPHERAL-BLOOD; CYCLOOXYGENASE-2-DEPENDENT INVASION; PROSTAGLANDIN E(2); SOLUBLE MEDIATORS; DOWN-REGULATION; CUTTING EDGE; TGF-BETA; LYMPHOCYTES; APOPTOSIS AB Cyclooxygenase (COX)-2 and its product prostaglandin (PG) E-2 underlie an immunosuppressive network that is important in the pathogenesis of non-small cell lung cancer. CD4(+)CD25(+) T regulatory (Treg) cells play an important role in maintenance of immunologic self-tolerance. CD4(+)CD25(+) Treg cell activities increase in lung cancer and appear to play a role in suppressing antitumor immune responses. Definition of the pathways controlling Treg cell activities will enhance our understanding of limitation of the host antitumor immune responses. Tumor-derived COX-2/PGE(2) induced expression of the Treg cell-specific transcription factor, Foxp3, and increased Treg cell activity. Assessment of E-prostanoid (EP) receptor requirements revealed that PGE(2)-mediated induction of Treg cell Foxp3 gene expression was significantly reduced in the absence of the EP4 receptor and ablated in the absence of the EP2 receptor expression. In vivo, COX-2 inhibition reduced Treg cell frequency and activity, attenuated Foxp3 expression in tumor-infiltrating lymphocytes, and decreased tumor burden. Transfer of Treg cells or administration of PGE(2) to mice receiving COX-2 inhibitors reversed these effects. We conclude that inhibition of COX-2/PGE(2) suppresses Treg cell activity and enhances antitumor responses. C1 Univ Calif Los Angeles, David Geffen Sch Med, Hlth Sci Ctr, Dept Med,Lung Canc Res Program, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Mol Gene Med Lab, Los Angeles, CA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Hlth Sci Ctr, Dept Med,Lung Canc Res Program, 37-131,10833 LeConte Ave, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu OI Reckamp, Karen/0000-0002-9213-0325 FU NCI NIH HHS [1P50 CA90388, R01 CA85686] NR 52 TC 258 Z9 296 U1 3 U2 8 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JUN 15 PY 2005 VL 65 IS 12 BP 5211 EP 5220 DI 10.1158/0008-5472.CAN-05-0141 PG 10 WC Oncology SC Oncology GA 934UN UT WOS:000229734300033 PM 15958566 ER PT J AU Anstead, GM Corcoran, G Lewis, J Berg, D Graybill, JR AF Anstead, GM Corcoran, G Lewis, J Berg, D Graybill, JR TI Refractory coccidioidomycosis treated with posaconazole SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID FLUCONAZOLE; IMMITIS AB Background. Disseminated coccidioidomycosis ( which is caused by the endemic fungi of the genus Coccidioides) can be a life-threatening systemic fungal infection. Although conventional antifungal therapies have activity against Coccidioides, the disease can be refractory to standard therapies. Drug-associated toxicities also may limit the clinical utility of the standard antifungal drugs. In addition, relapses in patients with disseminated coccidioidomycosis are common, making long-term management of this disease challenging. Methods. We report the outcomes of 6 patients with coccidioidomycosis who were treated with posaconazole salvage therapy after treatment with conventional antifungal therapies failed to produce sustained clinical improvement. Patients were administered posaconazole oral suspension 800 mg/ day in divided doses as part of an open-label clinical trial. A modified version of the Mycoses Study Group Coccidioides scoring system was used to evaluate the burden of disease. Posaconazole therapy resulted in rapid clinical improvements in the signs and symptoms of coccidioidomycosis. Results. At the end of therapy, 5 of 6 patients had successful outcomes. Posaconazole was well tolerated despite long-termadministration (1 - 2 years), and 2 patients continued to receive posaconazole maintenance therapy at the time of writing Conclusions. The successful outcomes observed in this case series suggest that posaconazole is an effective therapy for coccidioidomycosis. C1 Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, San Antonio, TX USA. Schering Plough Res Inst, Kenilworth, NJ USA. RP Graybill, JR (reprint author), Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM graybill@uthscsa.edu NR 16 TC 68 Z9 72 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 JUN 15 PY 2005 VL 40 IS 12 BP 1770 EP 1776 DI 10.1086/430303 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 927OW UT WOS:000229204300010 PM 15909265 ER PT J AU Raitt, MH Connor, WE Morris, C Kron, J Halperin, B Chugh, SS McClelland, J Cook, J MacMurdy, K Swenson, R Connor, SL Gerhard, G Kraemer, DF Oscran, D Marchant, C Calhoun, D Shnider, R McAnulty, J AF Raitt, MH Connor, WE Morris, C Kron, J Halperin, B Chugh, SS McClelland, J Cook, J MacMurdy, K Swenson, R Connor, SL Gerhard, G Kraemer, DF Oscran, D Marchant, C Calhoun, D Shnider, R McAnulty, J TI Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators - A randomized controlled trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID POLYUNSATURATED FATTY-ACIDS; SUDDEN CARDIAC DEATH; MYOCARDIAL-INFARCTION; N-3; PREVENTION; ARRHYTHMIAS; OMEGA-3-FATTY-ACIDS; ERYTHROCYTES; CONSUMPTION; MYOCYTES AB Context Clinical studies of omega-3 polyunsaturated fatty acids (PUFAs) have shown a reduction in sudden cardiac death, suggesting that omega-3 PUFAs may have antiarrhythmic effects. Objective To determine whether omega-3 PUFAs have beneficial antiarrhythmic effects in patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). Design and Setting Randomized, double-blind, placebo-controlled trial performed at 6 US medical centers with enrollment from February 1999 until January 2003. Patients Two hundred patients with an implantable cardioverter defibrillator (ICD) and a recent episode of sustained VT or VF Intervention Patients were randomly assigned to receive fish oil, 1.8 g/d, 72% omega-3 PUFAs, or placebo and were followed up for a median of 718 days (range, 20-828 days). Main Outcome Measures Time to first episode of ICD treatment for VT/VF, changes in red blood cell concentrations of omega-3 PUFAs, frequency of recurrent VT/VF events, and predetermined subgroup analyses. Results Patients randomized to receive fish oil had an increase in the mean percentage of omega-3 PUFAs in red blood cell membranes from 4.7% to 8.3% (P<.001), with no change observed in patients receiving placebo. At 6, 12, and 24 months, 46% (SE, 5%), 51% (5%), and 65% (5%) of patients randomized to receive fish oil had ICD therapy for VT/VF compared with 36% (5%), 41% (5%), and 59% (5%) for patients randomized to receive placebo (P=.19). In the subset of 133 patients whose qualifying arrhythmia was VT, 61% (SE, 6%), 66% (6%), and 79% (6%) of patients in the fish oil group had VT/VF at 6, 12, and 24 months compared with 37% (6%), 43% (6%), and 65% (6%) of patients in the control group (P=.007). Recurrent VT/VF events were more common in patients randomized to receive fish oil (P<.001). Conclusion Among patients with a recent episode of sustained ventricular arrhythmia and an ICD, fish oil supplementation does not reduce the risk of VT/VF and may be proarrhythmic in some patients. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Baystate Med Ctr, Springfield, MA USA. SW Med Ctr, Vancouver, WA USA. Sacred Heart Med Ctr, Eugene, OR USA. Oregon State Univ, Portland, OR USA. St Vincents Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Raitt, MH (reprint author), Portland VA Med Ctr, 3710 SW US Vet Rd,P-3-CARD, Portland, OR 97239 USA. EM merritt.raitt@med.va.gov FU NCRR NIH HHS [5 M01 RR00334]; NHLBI NIH HHS [R01HL61682] NR 27 TC 222 Z9 234 U1 0 U2 8 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 15 PY 2005 VL 293 IS 23 BP 2884 EP 2891 DI 10.1001/jama.293.23.2884 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 935MD UT WOS:000229785500023 PM 15956633 ER PT J AU Choudhury, A Maldonado, MA Cohen, PL Eisenberg, RA AF Choudhury, A Maldonado, MA Cohen, PL Eisenberg, RA TI The role,of host CD4 T cells in the pathogenesis of the chronic graft-versus-host model of systemic lupus erythematosus SO JOURNAL OF IMMUNOLOGY LA English DT Article ID MAJOR HISTOCOMPATIBILITY COMPLEX; HEAT-STABLE ANTIGEN(HI); ZONE B-CELLS; COSTIMULATORY MOLECULES; CD4-DEFICIENT MICE; UP-REGULATION; AUTOANTIBODY PRODUCTION; INFECTED INDIVIDUALS; AUTOIMMUNE-DISEASE; IL-4 PROMOTES AB Systemic lupus erythematosus is characterized by production of autoantibodies and glomerulonephritis. The murine chronic graft-vs-host (cGVH) model of systemic lupus erythematosus is induced by allorecognition of foreign MHC class II determinants. Previous studies have shown that cGVH could not be induced in CD4 knockout (CD4KO) mice. We have further explored the role of host CD4 T cells in this model. Our studies now show that B cells in CD4KO mice have intrinsic defects that prevent them from responding to allohelp. In addition, B cells in CD4KO mice showed phenotypic differences compared with congeneic C57BL/6 B cells, indicating some degree of in vivo activation and increased numbers of cells bearing a marginal zone B cell phenotype. The transfer of syngeneic CD4 T cells at the time of initiation of cGVH did not correct these B cell abnormalities; however, if CD4 T cells were transferred during the development and maturation of B cells, then the B cells from CD4KO mice acquire the ability to respond in cGVH. These studies clearly indicate that B cells need to coexist with CD4 T cells early in their development to develop full susceptibility to alloactivation signals. C1 Univ Penn, Div Rheumatol, Dept Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Eisenberg, RA (reprint author), Univ Penn, Div Rheumatol, Dept Med, 756 BRB 2-3,421 Curie Blvd, Philadelphia, PA 19104 USA. EM raemd@mail.med.upenn.edu FU NIAID NIH HHS [U19-AI-46358]; NIAMS NIH HHS [R01-AR26574, R01-AR34156] NR 50 TC 20 Z9 20 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JUN 15 PY 2005 VL 174 IS 12 BP 7600 EP 7609 PG 10 WC Immunology SC Immunology GA 935OK UT WOS:000229791400018 PM 15944260 ER PT J AU Tsokas, P Grace, EA Chan, P Ma, T Sealfon, SC Iyengar, R Landau, EM Blitzer, RD AF Tsokas, P Grace, EA Chan, P Ma, T Sealfon, SC Iyengar, R Landau, EM Blitzer, RD TI Local protein synthesis mediates a rapid increase in dendritic elongation factor 1A after induction of late long-term potentiation SO JOURNAL OF NEUROSCIENCE LA English DT Article DE hippocampus; LTP; local protein synthesis; mTOR; eEF1A; TOP mRNA ID MESSENGER-RNA TRANSLATION; FREELY MOVING RATS; SYNAPTIC PLASTICITY; HIPPOCAMPAL-NEURONS; LATE-PHASE; SIGNALING PATHWAY; FACTOR 1-ALPHA; DENTATE GYRUS; F-ACTIN; ACTIVATION AB The maintenance of long-term potentiation (LTP) requires a brief period of accelerated protein synthesis soon after synaptic stimulation, suggesting that an early phase of enhanced translation contributes to stable LTP. The mechanism regulating protein synthesis and the location and identities of mRNAs translated are not well understood. Here, we show in acute brain slices that the induction of protein synthesis-dependent hippocampal LTP increases the expression of elongation factor 1A (eEF1A), the mRNA of which contains a 5' terminal oligopyrimidine tract. This effect is blocked by rapamycin, indicating that the increase in EF1A expression is mediated by the mammalian target of rapamycin ( mTOR) pathway. We find that mRNA for eEF1A is present in pyramidal cell dendrites and that the LTP-associated increase in eEF1A expression was intact in dendrites that had been severed from their cell bodies before stimulation. eEF1A levels increased within 5 min after stimulation in a translation-dependent manner, and this effect remained stable for 3 h. These results suggest a mechanism whereby synaptic stimulation, by signaling through the mTOR pathway, produces an increase in dendritic translational capacity that contributes to LTP maintenance. C1 Mt Sinai Sch Med, Dept Pharmacol & Biol Chem, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Neurosci, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY 10468 USA. RP Blitzer, RD (reprint author), Mt Sinai Sch Med, Dept Pharmacol & Biol Chem, Box 1215,1 Gustave L Levy Pl, New York, NY 10029 USA. EM robert.blitzer@mssm.edu FU NIDA NIH HHS [DA017135, DA15863]; NIDDK NIH HHS [DK46943]; NIGMS NIH HHS [GM54508] NR 50 TC 149 Z9 153 U1 0 U2 4 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD JUN 15 PY 2005 VL 25 IS 24 BP 5833 EP 5843 DI 10.1523/JNEUROSCI.0599-05.2005 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 935XC UT WOS:000229815700018 PM 15958750 ER PT J AU Khan, M Haq, E Giri, S Singh, I Singh, AK AF Khan, M Haq, E Giri, S Singh, I Singh, AK TI Peroxisomal participation in psychosine-mediated toxicity: Implications for Krabbe's disease SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE peroxisomes; Krabbe's disease; plasmalogen; redox; oligodendrocytes; psychosine ID GLOBOID-CELL LEUKODYSTROPHY; CHAIN FATTY-ACIDS; RAT-LIVER PEROXISOMES; CYTOCHROME-C-OXIDASE; GLIAL-CELLS; TWITCHER MOUSE; MITOCHONDRIAL-FUNCTION; SIGNAL-TRANSDUCTION; OXIDATIVE STRESS; MURINE MODEL AB Psychosine (galactosylsphingosine) accumulation in globoid cell leukodystrophy (Krabbe's disease) results in the loss of myelin and oligodendrocytes. To understand the role of psychosine toxicity in Krabbe's disease, we examined the effects of psychosine on peroxisomal functions and their relationship with reactive oxygen species. Rat C-6 glial cells were treated with psychosine with and without cytokines. Peroxisomal beta-oxidation was significantly inhibited and very long chain fatty acid levels and free radicals were increased in treated cells. Furthermore, psychosine treatment decreased glutathione and ATP levels, plasmalogen content, and expression of alkyl-DHAP synthase. Brain tissue of twitcher mice (animal model of Krabbe's) had decreased beta-oxidation activity, low glutathione, and reduced plasmalogens. Psychosine treatment of rat primary oligodendrocytes inhibited peroxisomal activities. Psychosine-mediated loss of peroxisomal function and free radical production was inhibited with the antioxidant N-acetylcysteine in glial cells. Our results suggest that inhibition of peroxisomal functions and increased free radical production by psychosine may be partly responsible for oligodendrocyte and myelin loss observed in the Krabbe's brain, and that antioxidant therapy may be useful in the treatment of Krabbe's disease. (c) 2005 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Dept Pediat, Charleston, SC 29425 USA. Ralph H Johnson Vet Aff Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. RP Singh, AK (reprint author), Med Univ S Carolina, Dept Pathol & Lab Med, 316 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM singha@musc.edu OI Haq, Ehtishamul/0000-0002-4195-0606 FU NINDS NIH HHS [NS-22576, NS-34741, NS-37766, NS-40144, NS-40810] NR 58 TC 47 Z9 49 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD JUN 15 PY 2005 VL 80 IS 6 BP 845 EP 854 DI 10.1002/jnr.20529 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 931KT UT WOS:000229484900012 PM 15898099 ER PT J AU Kaafarani, HMA Itani, KMF Petersen, LA Thornby, J Berger, DH AF Kaafarani, HMA Itani, KMF Petersen, LA Thornby, J Berger, DH TI Does resident hours reduction have an impact on surgical outcomes? SO JOURNAL OF SURGICAL RESEARCH LA English DT Article DE resident; work hours; quality of care; NSQIP; surgical outcomes; ACGME ID OF-VETERANS-AFFAIRS; SLEEP-DEPRIVATION; QUALITY; CARE; PERFORMANCE; RISK; IMPROVEMENT; FATIGUE; PROGRAM; WORK AB Background. We assessed the impact of restricting surgical resident work hours as required by the Accreditation Council for Graduate Medical Education (ACGME), on postoperative outcomes. Materials and methods. The divisions of General and Vascular Surgery at the Michael E. DeBakey Houston Veteran Affairs Medical Center implemented a limited work hours schedule effective October 1, 2002. We compared the rate of postoperative morbidity and mortality before and after the new schedule. Clinical data were collected by the VA National Surgical Quality Improvement Program (NSQIP) for the periods of October 1, 2001 to September 30, 2002 (preintervention), and October 1, 2002 to September 30, 2003 (postintervention). We assessed risk-adjusted observed to expected (O/E) ratios of mortality and pre-specified postoperative morbidity for each study period. Results. In the preintervention period, there were 405 general surgery and 202 vascular surgery cases as compared to 382 and 208 cases, respectively in the postintervention period. There were no significant differences in mortality O/E ratios between the pre- and postintervention periods (0.63 versus 0.60 in general surgery; 0.78 versus 0.81 in vascular surgery; P = 0.90 and 0.94, respectively) or in morbidity O/E ratios (1.06versus 1.27 in general surgery; 1.47 versus 1.50 in vascular surgery; P = 0.20 and 0.90, respectively). Conclusion. The restricted resident work hour schedule in general and vascular surgery in our facility did not significantly affect postoperative outcomes. © 2005 Elsevier Inc. All rights reserved. C1 Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Ctr Excellence, Houston, TX USA. RP Itani, KMF (reprint author), VABHCS 112, Dept Surg, 1400 VFW Pkwy, W Roxbury, MA 02132 USA. EM kitani@med.va.gov NR 20 TC 49 Z9 49 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD JUN 15 PY 2005 VL 126 IS 2 BP 167 EP 171 DI 10.1016/j.jss.2004.12.024 PG 5 WC Surgery SC Surgery GA 933BF UT WOS:000229598200006 PM 15919415 ER PT J AU Rowan, AJ Ramsay, RE Collins, JF Pryor, F Boardman, KD Uthman, BM Spitz, M Frederick, T Towne, A Carter, GS Marks, W Felicetta, J Tomyanovich, ML AF Rowan, AJ Ramsay, RE Collins, JF Pryor, F Boardman, KD Uthman, BM Spitz, M Frederick, T Towne, A Carter, GS Marks, W Felicetta, J Tomyanovich, ML CA VA Cooperat Study 428 Grp TI New onset geriatric epilepsy - A randomized study of gabapentin, lamotrigine, and carbamazepine SO NEUROLOGY LA English DT Article ID TONIC CLONIC SEIZURES; EFFICACY; AGE AB Objective: To determine the relative tolerability and efficacy of two newer antiepileptic drugs, lamotrigine (LTG) and gabapentin (GBP), as compared to carbamazepine (CBZ) in older patients with epilepsy. Methods: This was an 18-center, randomized, double-blind, double dummy, parallel study of 593 elderly subjects with newly diagnosed seizures. Patients were randomly assigned to one of three treatment groups: GBP 1,500 mg/day, LTG 150 mg/day, CBZ 600 mg/ day. The primary outcome measure was retention in trial for 12 months. Results: Mean age was 72 years. The most common etiology was cerebral infarction. Patients had multiple medical conditions and took an average of seven comedications. Mean plasma levels at 6 weeks were as follows: GBP 8.67 +/- 4.83 mu g/mL, LTG 2.87 +/- 1.60 mu g/mL, CBZ 6.79 +/- 2.92 mu g/mL. They remained stable throughout the trial. Early terminations: LTG 44.2 %, GBP 51 %, CBZ 64.5 % (p = 0.0002). Significant paired comparisons: LTG vs CBZ: p < 0.0001; GBP vs CBZ: p = 0.008. Terminations for adverse events: LTG 12.1 %, GBP 21.6 %, CBZ 31 % (p = 0.001). Significant paired comparisons: LTG vs CBZ: p < 0.0001; LTG vs GBP: p < 0.015. There were no significant differences in seizure free rate at 12 months. Conclusions: The main limiting factor in patient retention was adverse drug reactions. Patients taking lamotrigine ( LTG) or gabapentin ( GBP) did better than those taking carbamazepine. Seizure control was similar among groups. LTG and GBP should be considered as initial therapy for older patients with newly diagnosed seizures. C1 Bronx Vet Adm Med Ctr, Neurol Serv 127, Bronx, NY 10468 USA. VA Med Ctr, Miami, FL USA. VA Med Ctr, Perry Point, MD USA. VA Cooperat Studies Program, Albuquerque, NM USA. VA Med Ctr, Gainesville, FL USA. VA Med Ctr, Denver, CO USA. VA Med Ctr, New Orleans, LA USA. VA Med Ctr, Richmond, VA USA. VA Med Ctr, Dallas, TX USA. VA Med Ctr, San Francisco, CA USA. VA Med Ctr, Phoenix, AZ USA. VA Med Ctr, Chicago, IL USA. RP Rowan, AJ (reprint author), Bronx Vet Adm Med Ctr, Neurol Serv 127, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM james.rowan@mssm.edu RI Ramsay, R. Eugene/D-4491-2011 NR 20 TC 240 Z9 247 U1 5 U2 19 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JUN 14 PY 2005 VL 64 IS 11 BP 1868 EP 1873 DI 10.1212/01.WNL.0000167384.68207.3E PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 935IJ UT WOS:000229774000010 PM 15955935 ER PT J AU Jovin, TG Boosupalli, V Zivkovic, SA Wechsler, LR Gebel, JM AF Jovin, TG Boosupalli, V Zivkovic, SA Wechsler, LR Gebel, JM TI High titers of CA-125 may be associated with recurrent ischemic strokes in patients with cancer SO NEUROLOGY LA English DT Article ID CEREBROVASCULAR COMPLICATIONS; MUCIN; MALIGNANCY; INFARCTS; EMBOLI AB In addition to etiologies common in the general population, strokes in cancer patients may be caused by hypercoagulable states, hyperviscosity, cardiogenic embolism, and neoplastic vessel infiltration. Intravascular mucins were reported in patients with recurrent thromboembolism. The authors report four patients with metastatic cancer, brain infarcts, and other thromboembolic disease with markedly elevated levels of the tumor marker CA-125 and explore possible associations between this mucinous protein and strokes. C1 Univ Pittsburgh, Med Ctr, Stroke Inst, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Med Ctr, Dept Neurol, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. Childrens Hosp Pittsburgh, Dept Neurol, Pittsburgh, PA USA. RP Jovin, TG (reprint author), Univ Pittsburgh, Med Ctr, Stroke Inst, VA Pittsburgh Healthcare Syst, 200 Lothrop St,Suite C400, Pittsburgh, PA 15213 USA. EM jovintg@upmc.edu NR 10 TC 14 Z9 16 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JUN 14 PY 2005 VL 64 IS 11 BP 1944 EP 1945 DI 10.1212/01.WNL.0000163850.07976.63 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 935IJ UT WOS:000229774000024 PM 15955949 ER PT J AU Shekelle, PG Delitto, AM AF Shekelle, PG Delitto, AM TI Treating low back pain SO LANCET LA English DT Editorial Material ID THERAPY C1 Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Shekelle, PG (reprint author), Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. EM shekelle@rand.org NR 7 TC 5 Z9 5 U1 0 U2 0 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUN 11 PY 2005 VL 365 IS 9476 BP 1987 EP 1989 DI 10.1016/S0140-6736(05)66676-7 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 934IB UT WOS:000229701400006 PM 15950702 ER PT J AU Eisen, SA Kang, HK Murphy, FM Blanchard, MS Reda, DJ Henderson, WG Toomey, R Jackson, LW Alpem, R Parks, BJ Klimas, N Hall, C Pak, HS Hunter, J Karlinsky, J Battistone, MJ Lyons, MJ AF Eisen, SA Kang, HK Murphy, FM Blanchard, MS Reda, DJ Henderson, WG Toomey, R Jackson, LW Alpem, R Parks, BJ Klimas, N Hall, C Pak, HS Hunter, J Karlinsky, J Battistone, MJ Lyons, MJ CA Gulf War Study Participating Inves TI Gulf war veterans' health: Medical evaluation of a US cohort SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID CHRONIC-FATIGUE-SYNDROME; POPULATION-BASED SURVEY; OPERATION-DESERT-STORM; AL ESKAN DISEASE; VISCERAL INFECTION; LEISHMANIA-TROPICA; ILLNESS; FIBROMYALGIA; PREVALENCE; ACTIVATION AB Background: United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial. Objective: To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations. Design: A cross-sectional prevalence study performed 10 years after the 1991 Gulf War. Setting: Veterans were examined at 1 of 16 Veterans Affairs medical centers. Participants: Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War. Measurements: Primary outcome measures included fibromyalgia, the chronic fatigue syndrome, dermatologic conditions, dyspepsia, physical health-related quality of life (Short Form-36 [SF36]), hypertension, obstructive lung disease, arthralgias, and peripheral neuropathy. Results: Of 12 conditions, only 4 conditions were more prevalent among deployed than nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% Cl, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [Cl, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [Cl, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 6.0%; odds ratio, 1.87 [Cl, 1.16 to 2.99]). The mean physical component summary score of the SF-36 for deployed and nondeployed veterans was 49.3 and 50.8, respectively. Limitations: Relatively low participation rates introduce potential participation bias, and deployment-related illnesses that resolved before the research examination could not, by design, be detected. Conclusions: Ten years after the Gulf War, the physical health of deployed and nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36 physical component score. C1 Washington Univ, Sch Med, Med Affairs Med Ctr 151 JC, St Louis, MO 63103 USA. St Louis Univ, St Louis, MO 63103 USA. US Dept Vet Affairs, Vet Hlth Adm, Environm Epidemiol Serv, Washington, DC USA. Uniformed Serv Univ Hlth Sci, Washington, DC USA. Hines Vet Affairs Hosp, Cooperat Studies Program, Coodinating Ctr, Hines, IL USA. Harvard Univ, Vet Affairs Med Ctr, Brockton, MA 02401 USA. Harvard Univ, Sch Med, Massachusetts Mental Hlth Ctr,Vet Affairs Med Ctr, Harvard Inst Psychiat Epidemiol & Genet, Boston, MA 02115 USA. Boston Univ, Sch Med, Boston, MA 02215 USA. Vet Affairs Med Ctr, Miami, FL 33125 USA. Brooke Army Med Ctr, Ft Sam Houston, TX 78234 USA. Vet Affairs Salt Lake City Hlth Care Syst, Salt Lake City, UT USA. Univ Utah, Hlth Sci Ctr, Salt Lake City, UT USA. RP Eisen, SA (reprint author), Washington Univ, Sch Med, Med Affairs Med Ctr 151 JC, 915 N Grand Ave, St Louis, MO 63103 USA. EM seth.eisen@med.va.gov RI Lyons, Michael/B-6119-2011 NR 50 TC 61 Z9 63 U1 1 U2 4 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUN 7 PY 2005 VL 142 IS 11 BP 881 EP 890 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 932LX UT WOS:000229556300001 PM 15941694 ER PT J AU Mann, DL AF Mann, DL TI Targeted anticytokine therapy and the failing heart SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article; Proceedings Paper CT Symposium on Immue Activation and Inflammation in Chronic Heart Failure CY NOV 17, 2002 CL Chicago, IL ID TUMOR-NECROSIS-FACTOR; LEFT-VENTRICULAR DYSFUNCTION; FC FUSION PROTEIN; FACTOR-ALPHA; DILATED CARDIOMYOPATHY; TNF-ALPHA; MONOCLONAL-ANTIBODY; EJECTION FRACTION; SOLUBLE RECEPTORS; CYTOKINE LEVELS AB Recent studies have identified the importance of proinflammatory mediators in the development and progression of chronic heart failure (CHF). The growing appreciation of the pathophysiologic consequences of sustained expression of proinflammatory mediators in preclinical and clinical CHF models culminated in a series of multicenter clinical trials that used targeted approaches to neutralize tumor necrosis factor in patients with moderate-to-advanced CHF. However, these targeted approaches have resulted in worsening CHF, thereby raising a number of important questions about what role, if any, proinflammatory cytokines play in the pathogenesis of CHF. This review summarizes what has been learned from the negative clinical trials, as well as the potential direction of future research in this area. (c) 2005 by Excerpta Medica Inc. C1 Winters Ctr Heart Failure Res, Cardiol Sect, Dept Med, Michael E DeBakey Vet Adm Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Methodist DeBakey Heart Ctr, Houston, TX USA. RP Mann, DL (reprint author), Winters Ctr Heart Failure Res, Cardiol Sect, Dept Med, Michael E DeBakey Vet Adm Med Ctr, MS 524,6565 Fannin St, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL61543-01, R01 HL58081-01, HL-42250-10/10] NR 47 TC 54 Z9 57 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUN 6 PY 2005 VL 95 IS 11A SU S BP 9C EP 16C DI 10.1016/j.amjcard.2005.03.007 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 932ZQ UT WOS:000229593800003 PM 15925559 ER PT J AU Epstein, AJ Rathore, SS Krumholz, HM Volpp, KGM AF Epstein, AJ Rathore, SS Krumholz, HM Volpp, KGM TI Volume-based referral for cardiovascular procedures in the United States: a cross-sectional regression analysis SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID BYPASS GRAFT-SURGERY; CORONARY ANGIOPLASTY VOLUME; SHORT-TERM MORTALITY; POTENTIAL BENEFITS; PATIENT MORTALITY; HOSPITALS; LEAPFROG; REGIONALIZATION; STANDARDS; CARE AB Background: We sought to estimate the numbers of patients affected and deaths avoided by adopting the Leapfrog Group's recommended hospital procedure volume minimums for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). In addition to hospital risk-adjusted mortality standards, the Leapfrog Group recommends annual hospital procedure minimums of 450 for CABG and 400 for PCI to reduce procedure-associated mortality. Methods: We conducted a retrospective analysis of a national hospital discharge database to evaluate in-hospital mortality among patients who underwent PCI (n = 2,500,796) or CABG ( n = 1,496,937) between 1998 and 2001. We calculated the number of patients treated at low volume hospitals and simulated the number of deaths potentially averted by moving all patients to high volume hospitals under best-case conditions (i.e., assuming the full volume-associated reduction in mortality and the capacity to move all patients to high volume hospitals with no related harms). Results: Multivariate adjusted odds of in-hospital mortality were higher for patients treated in low volume hospitals compared with high volume hospitals for CABG ( OR 1.16, 95% CI 1.10 - 1.24) and PCI ( OR 1.12, 95% CI 1.05 - 1.20). A policy of hospital volume minimums would have required moving 143,687 patients for CABG and 87,661 patients for PCI from low volume to high volume hospitals annually and prevented an estimated 619 CABG deaths and 109 PCI deaths. Thus, preventing a single death would have required moving 232 CABG patients or 805 PCI patients from low volume to high volume hospitals. Conclusion: Recommended hospital CABG and PCI volume minimums would prevent 728 deaths annually in the United States, fewer than previously estimated. It is unclear whether a policy requiring the movement of large numbers of patients to avoid relatively few deaths is feasible or effective. C1 Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Div Hlth Policy & Adm, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. Philadelphia Vet Affairs Hosp, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Med, Gen Internal Med Sect, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch Business, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. RP Epstein, AJ (reprint author), Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Div Hlth Policy & Adm, New Haven, CT 06510 USA. EM andrew.epstein@yale.edu; saif.rathore@yale.edu; harlan.krumholz@yale.edu; volpp70@mail.med.upenn.edu FU AHRQ HHS [T32 HS000009, T32-HS00009]; NIGMS NIH HHS [T32 GM007205, GM07205] NR 25 TC 21 Z9 21 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD JUN 3 PY 2005 VL 5 AR 42 DI 10.1186/1472-6963-5-42 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 945BS UT WOS:000230476700001 PM 15935099 ER PT J AU Suh, Y Vijg, J AF Suh, Y Vijg, J TI SNP discovery in associating genetic variation with human disease phenotypes SO MUTATION RESEARCH-FUNDAMENTAL AND MOLECULAR MECHANISMS OF MUTAGENESIS LA English DT Review DE single nucleotide polymorphism (SNP); association analysis; candidate pathway approach; functional variants; pre-screening methods for SNP discovery ID GRADIENT GEL-ELECTROPHORESIS; CYSTIC-FIBROSIS GENE; LINKAGE DISEQUILIBRIUM; POLYMORPHISM ANALYSIS; COMPLEX DISEASE; COMMON DISEASE; HUMAN GENOME; HAPLOTYPE VARIATION; SEQUENCE VARIATION; MUTATION DATABASE AB With the completion of the human genome project, attention is now rapidly shifting towards the study of individual Genetic variation. The most abundant source of genetic variation in the human genome is represented by single nucleotide polymorphisms (SNPs), which can account for heritable inter-individual differences in complex phenotypes. Identification of SNPs that contribute to susceptibility to common diseases will provide highly accurate diagnostic information that will facilitate early diagnosis, prevention, and treatment of human diseases. Over the past several years, the advancement of increasingly high-throughput and cost-effective methods to discover and measure SNPs has begun to open the door towards this endeavor. Genetic association studies are considered to be an effective approach towards the detection of SNPs with moderate effects, as in most common diseases with complex phenotypes. This requires careful study design, analysis and interpretation. In this review, we discuss genetic association studies and address the prospect for candidate gene association Studies, comparing the strengths and weaknesses of indirect and direct study designs. Our focus is on the continuous need for SNP discovery methods and the use of currently available prescreening methods for large-scale Genetic epidemiological research until more advanced sequencing methods currently under development will become available. © 2005 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, Dept Physiol, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr, San Antonio, TX 78229 USA. RP Suh, Y (reprint author), Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, Dept Physiol, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM suny@uthscsa.edu; vijg@uthscsa.edu FU NIA NIH HHS [R01 AG024391-04, AG023292, AG024391, AG17242, AG20438, R01 AG024391, R01 AG024391-01, R01 AG024391-02, R01 AG024391-03, R01 AG024391-05, R03 AG023292, R03 AG023292-01, R03 AG023292-02]; NIEHS NIH HHS [ES11044] NR 81 TC 110 Z9 117 U1 1 U2 14 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0027-5107 J9 MUTAT RES-FUND MOL M JI Mutat. Res.-Fundam. Mol. Mech. Mutagen. PD JUN 3 PY 2005 VL 573 IS 1-2 BP 41 EP 53 DI 10.1016/j.mrfmmm.2005.01.005 PG 13 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology SC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology GA 923CX UT WOS:000228887700004 PM 15829236 ER PT J AU Mileykovskiy, BY Kiyashchenko, LI Siegel, JM AF Mileykovskiy, BY Kiyashchenko, LI Siegel, JM TI Behavioral correlates of activity in identified hypocretin/orexin neurons SO NEURON LA English DT Article ID DORSAL RAPHE NUCLEUS; FREELY MOVING CATS; HYPOTHALAMIC AROUSAL SYSTEM; MEDIAL PREFRONTAL CORTEX; POWER SPECTRAL-ANALYSIS; SLEEP-WAKING DISCHARGE; VENTRAL TEGMENTAL AREA; OREXIN NEURONS; LOCUS-COERULEUS; RETICULAR-FORMATION AB Micropipette recording with juxtacellular Neurobiotin ejection, linked micropipette-microwire recording, and antidromic and orthodromic activation from the ventral tegmental area and locus coeruleus were used to identify hypocretin (Hcrt) cells in anesthetized rats and develop criteria for identification of these cells in unanesthetized, unrestrained animals. We found that Hcrt cells have broad action potentials with elongated later positive deflections that distinguish them from adjacent antidromically identified cells. They are relatively inactive in quiet waking but are transiently activated during sensory stimulation. Hcrt cells are silent in slow wave sleep and tonic periods of REM sleep, with occasional burst discharge in phasic REM. Hcrt cells discharge in active waking and have moderate and approximately equal levels of activity during grooming and eating and maximal activity during exploratory behavior. Our findings suggest that these cells are activated during emotional and sensorimotor conditions similar to those that trigger cataplexy in narcoleptic animals. C1 Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90095 USA. Vet Adm Greater Los Angeles Healthcare Syst Sepul, North Hills, CA 91343 USA. RP Mileykovskiy, BY (reprint author), Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. EM bmileyko@ucla.edu; jsiegel@ucla.edu FU NIMH NIH HHS [MH064109, MH071350]; NINDS NIH HHS [NS14610] NR 83 TC 437 Z9 449 U1 3 U2 18 PU CELL PRESS PI CAMBRIDGE PA 1100 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138 USA SN 0896-6273 J9 NEURON JI Neuron PD JUN 2 PY 2005 VL 46 IS 5 BP 787 EP 798 DI 10.1016/j.neuron.2005.04.035 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 934EN UT WOS:000229689800012 PM 15924864 ER PT J AU Chinman, M Hannah, G Wandersman, A Ebener, P Hunter, SB Imm, P Sheldon, J AF Chinman, M Hannah, G Wandersman, A Ebener, P Hunter, SB Imm, P Sheldon, J TI Developing a community science research agenda for building community capacity for effective preventive interventions SO AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY LA English DT Article DE capacity; technical assistance; prevention ID SUBSTANCE-ABUSE PREVENTION; TECHNICAL ASSISTANCE; ORGANIZATIONAL CAPACITY; HEALTH; EMPOWERMENT; PROGRAMS; DIFFUSION; ACCOUNTABILITY; IMPLEMENTATION; ENVIRONMENTS AB Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available ( e. g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research - one based in Community Science - is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level. C1 RAND Corp, Santa Monica, CA 90407 USA. W Los Angeles VA Healthcare Ctr, Mental Illness Res Educ & Clin Ctr VISN22, Los Angeles, CA USA. Univ S Carolina, Dept Psychol, Columbia, SC 29208 USA. RP Chinman, M (reprint author), RAND Corp, 1776 Main St, Santa Monica, CA 90407 USA. EM chinman@rand.org FU ODCDC CDC HHS [CCR921459] NR 78 TC 84 Z9 85 U1 3 U2 12 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0091-0562 J9 AM J COMMUN PSYCHOL JI Am. J. Community Psychol. PD JUN PY 2005 VL 35 IS 3-4 BP 143 EP 157 DI 10.1007/s10464-005-3390-6 PG 15 WC Public, Environmental & Occupational Health; Psychology, Multidisciplinary; Social Work SC Public, Environmental & Occupational Health; Psychology; Social Work GA 922UC UT WOS:000228863200004 PM 15909791 ER PT J AU El-Serag, HB Graham, DY Satia, JA Rabeneck, L AF El-Serag, HB Graham, DY Satia, JA Rabeneck, L TI Obesity is an independent risk factor for GERD symptoms and erosive esophagitis SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID GASTROESOPHAGEAL-REFLUX DISEASE; GASTRIC-ACID SECRETION; BODY-MASS; HELICOBACTER-PYLORI; MORBIDLY OBESE; MOTILITY DISORDERS; BARIATRIC SURGERY; POPULATION; ADENOCARCINOMA; ASSOCIATION AB INTRODUCTION: An association between obesity and GERD symptoms has been reported; however, study results have been inconsistent and it is not known whether an association persists after adjusting for other known GERD risk factors. METHODS: We carried out a cross-sectional study to determine the prevalence and risk factors of GERD in volunteers (VA employees). Participants completed a Gastroesophageal Reflux Questionnaire, the Block 98 Food Frequency Questionnaire, provided height and weight information, and were invited for upper endoscopy with biopsies. Associations of body mass index (BMI) with GERD symptoms and erosive esophagitis were examined separately in multiple logistic regression analyses adjusting for age, sex, race, GERD symptoms, dietary intake, education level, family history of GERD, H. pylori infection, and the presence and distribution of gastritis. RESULTS: Four hundred and fifty-three persons (mean age 44 yr, 70% women and 43% black) provided complete information on heartburn, regurgitation, and BMI (50% of 915 who received questionnaires). Of the 196 who underwent endoscopy, 44 (22%) had esophageal erosions and 118 (26%) reported at least weekly heartburn or regurgitation. A dose-response relationship between frequency of heartburn or regurgitation and higher BMI was observed. Compared to participants without weekly symptoms, a significantly larger proportion of the 118 with these symptoms were either overweight (BMI 25-30) (35%vs 32%) or obese (BMI > 30) (39%vs 26%), p for linear trend 0.004. Relative to those with no esophageal erosions, those with erosions were more likely to be overweight (39%vs 26%) or obese (41%vs 32%), p= 0.04. Obese participants were 2.5 times as likely as those with normal BMI (< 25) to have reflux symptoms or esophageal erosions. The association between BMI and GERD symptoms persisted in direction and magnitude after adjustment for potential confounders. CONCLUSIONS: Overweight and obesity are strong independent risk factor of GERD symptoms and esophageal erosions. The amount or composition of dietary intake does not appear to be a likely explanation for these findings. C1 Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. Houston Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ N Carolina, Dept Nutr, Chapel Hill, NC USA. Univ Toronto, Dept Med, Toronto, ON, Canada. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 43 TC 239 Z9 252 U1 1 U2 6 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JUN PY 2005 VL 100 IS 6 BP 1243 EP 1250 DI 10.1111/j.1572-0241.2005.41703.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 930QU UT WOS:000229432000007 PM 15929752 ER PT J AU Streim, JE AF Streim, JE TI Nursing homes and research in geriatric psychiatry SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Editorial Material ID DEPRESSION; PREVALENCE; RESIDENTS; PERSPECTIVE; DISORDERS C1 Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, VISN Mental Illness Res Educ & Clin Ctr 4, Philadelphia, PA USA. RP Streim, JE (reprint author), Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, 3535 Market St,Room 3055, Philadelphia, PA 19104 USA. EM jstreim@mail.med.upenn.edu NR 18 TC 2 Z9 2 U1 1 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD JUN PY 2005 VL 13 IS 6 BP 437 EP 440 DI 10.1176/appi.ajgp.13.6.437 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 933AZ UT WOS:000229597600001 ER PT J AU Oslin, DW AF Oslin, DW TI Treatment of late-life depression complicated by alcohol dependence SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT 16th Annual Meeting of the American-Association-for-Geriatric-Psychiatry CY MAR 01-04, 2003 CL HONOLULU, HI SP Amer Assoc Geriatr Psychiat ID PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; MAJOR DEPRESSION; GENERAL-POPULATION; CLINICAL-TRIAL; GENDER DIFFERENCES; FOLLOW-UP; NALTREXONE; DRINKING; DISORDERS AB Objectives: Among elderly patients, mental and physical illness are often present along with alcohol dependence. The interaction between alcohol use and concurrent physical or mental disabilities is complex and complicates treatment planning. The aim of this study was to test the efficacy of naltrexone combined with sertraline for the treatment of older adults with major depression and alcohol dependence. Methods: The sample was 74 subjects, age 55 and older, who met criteria for a depressive disorder along with alcohol dependence. All subjects were randomly assigned to 12 weeks of naltrexone 50 mg/day or placebo. Also, all subjects received sertraline 100 mg/day and individual weekly psychosocial support. Treatment response for alcohol consumption and depression was measured during the 12 weeks of treatment. Results: At baseline, the average age of subjects was 63.4, and subjects were drinking an average of 10.7 drinks per drinking day. The overall results are encouraging; 42% of the subjects had a remission of their depression and had no drinking relapses during the trial. There was no evidence for an added benefit of naltrexone in combination with sertraline, but there was significant correlation between any alcohol relapse during the trial and poor response to depression treatment. Conclusion: Patients with concurrent mental disorders, such as major depression and alcohol dependence, are increasingly prevalent in clinical practice and have been demonstrated to show poorer treatment response and higher treatment costs. The results of this trial underscore the importance of addressing alcohol use in the context of treating late-life depression. C1 Univ Penn, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Study Addict, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, VISN Mental Illness Res Educ & Clin Ctr 4, Philadelphia, PA USA. RP Oslin, DW (reprint author), Univ Penn, Sect Geriatr Psychiat, 3535 Market St,Room 3002, Philadelphia, PA 19104 USA. EM oslin@mail.med.upenn.edu FU NIMH NIH HHS [K08 MH001599-05, 1K08 MH 01599-01, 5P30 MH 52129, K08 MH001599] NR 55 TC 29 Z9 30 U1 2 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD JUN PY 2005 VL 13 IS 6 BP 491 EP 500 DI 10.1176/appi.ajgp.13.6.491 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 933AZ UT WOS:000229597600008 PM 15956269 ER PT J AU Chew, ML Mulsant, BH Pollock, BG AF Chew, ML Mulsant, BH Pollock, BG CA CPAD Study Grp TI Serum anticholinergic activity and cognition in patients with moderate-to-severe dementia SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article ID ALZHEIMERS-DISEASE; SENILE DEMENTIA; OLDER-ADULTS; PERFORMANCE AB Objective: The authors investigated the association between serum anticholinergic activity (SAA) and cognitive performance in a group of patients with moderate-to-severe dementia. Methods: SAA and cognitive performance were assessed in 26 patients admitted to a geropsychiatric unit for the treatment of behavioral disturbances associated with dementia. SAA was measured by radioreceptor competitive binding assay. Cognition was tested with the Mini-Mental State Exam and the Severe Impairment Battery. Results: Higher SAA was associated with lower cognitive performance. Conclusion: This study extends to patients with moderate-to-severe dementia the finding that higher SAA is associated with lower cognitive performance. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Div Geriatr & Neuropsychiat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Mulsant, BH (reprint author), Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. EM mulsantbh@upmc.edu FU NCRR NIH HHS [RR 00056]; NIA NIH HHS [AG 05133]; NIMH NIH HHS [MH 01509, MH 01613, MH 30915, MH 52247, MH 59666, MH 65416] NR 10 TC 37 Z9 38 U1 1 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD JUN PY 2005 VL 13 IS 6 BP 535 EP 538 DI 10.1176/appi.ajgp.13.6.535 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 933AZ UT WOS:000229597600013 PM 15956274 ER PT J AU Ansani, NT Vogt, M Henderson, BAF McKaveney, TP Weber, RJ Smith, RB Burda, M Kwoh, CK Osial, TA Starz, T AF Ansani, NT Vogt, M Henderson, BAF McKaveney, TP Weber, RJ Smith, RB Burda, M Kwoh, CK Osial, TA Starz, T TI Quality of arthritis information on the Internet SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article DE arthritis; comprehension; computers; Internet; quality assurance; World Wide Web ID WORLD-WIDE-WEB; HEALTH INFORMATION; PATIENT EDUCATION; MEDICAL INFORMATION; MANAGEMENT; ONLINE; SEARCH; UPDATE; BEWARE; GUIDE AB Purpose. The quality and reliability of Internet-based arthritis information were studied. Methods. The search terms "arthritis," "osteoarthritis," and "rheumatoid arthritis" were entered into the AOL, MSN, Yahoo, Google, and Lycos search engines. The Web sites for the first 40 matches generated by each search engine were grouped by URL suffix and evaluated on the basis of four categories of criteria: disease and medication information content, Web-site navigability, required literacy level, and currentness of information. Ratings were assigned by using an assessment tool derived from published literature (maximum score of 15 points). Results. Of the 600 arthritis Web sites identified, only 69 were unique and included in the analysis. Fifty-seven percent were .com sites, 20% .org sites, 7% .gov sites, 6% .edu sites, and 10% other sites. Total scores for individual sites reviewed ranged from 3 to 14. Eighty percent of .gov sites, 75% of .edu sites, 29% of other sites, 36% of .com sites, and 21% of .org sites were within the top tertile of scores. No Web site met the criterion for being understandable to people with no more than a sixth-grade reading ability. .Gov sites scored significantly higher overall than .com sites, .org sites, and other sites. .Edu sites also scored relatively well. Conclusion. The quality of arthritis information on the Internet varied widely. Sites with URLs having suffixes of .gov and .edu were ranked higher than other types of sites. C1 Pfizer Inc, Pittsburgh, PA 15212 USA. Univ Pittsburgh, Sch Pharm, Drug Informat Ctr, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Ctr Hlth Equity Res & Promot, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Hlth Sci Lib Syst, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Rheumatol & Clin Immunol, Pittsburgh, PA 15260 USA. RP Ansani, NT (reprint author), Pfizer Inc, 114 Alpine Circle, Pittsburgh, PA 15212 USA. EM nicole.ansani@pfizer.com NR 36 TC 38 Z9 41 U1 2 U2 4 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD JUN 1 PY 2005 VL 62 IS 11 BP 1184 EP 1189 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 931WV UT WOS:000229517100014 PM 15984050 ER PT J AU Sheffer, PJ Stout, JE Wagener, MM Muder, RR AF Sheffer, PJ Stout, JE Wagener, MM Muder, RR TI Efficacy of new point-of-use water filter for preventing exposure to Legionella and waterborne bacteria SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article ID RESISTANT PSEUDOMONAS-AERUGINOSA; COPPER-SILVER IONIZATION; LEGIONNAIRES-DISEASE; NOSOCOMIAL INFECTIONS; TAP WATER; SYSTEMS; TRANSMISSION; CULTURE; UNIT AB Background: Legionella species cause health care-acquired infections in which immunocompromised patients are disproportionately affected. Epidemiologic studies have demonstrated that point-of-use water fixtures are the reservoirs for these infections. The current approach to prevention is system-wide chemical disinfection of the hospital water system. These methods affect both low-risk and high-risk areas. A more effective approach to prevention may be a targeted approach aimed at protecting high-risk patients. One option is the application of a physical barrier (filter) at the point-of-use water fixture. Objectives: To evaluate the ability of point-of-use filters to eliminate Legionella and other pathogens from water. Methods: One hundred twenty-milliliter hot water samples were collected from 7 faucets (4 with filters and 3 without) immediately and after a 1-minute flush. Samples were collected every 2 or 3 days for 1 week. This cycle was repeated for 12 weeks. Samples were cultured for Legionella total heterotrophic plate count (HPC) bacteria, and Mycobacterium species. Results: Five hundred ninety-four samples were collected over 12 cycles. No Legionella or Mycobacterium were isolated from the faucets with filters between T = 0 and T = 8 days. The mean concentration of L pneumophila and Mycobacterium from the control faucets was 104.5 CFU/mL and 0.44 CFU/mL, respectively. The filters achieved a greater than 99% reduction in HPC bacteria in the immediate and postflush samples. Conclusions: Point-of-use filters completely eliminated L pneumophila and Mycobacterium from hot water samples. These Filter units could prevent exposure of high-risk patients to waterborne pathogens. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Stout, JE (reprint author), Vet Adm Med Ctr, Special Pathogens Lab, Univ Dr C, Pittsburgh, PA 15240 USA. EM Janet.Stout2@med.va.gov NR 23 TC 34 Z9 37 U1 3 U2 13 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD JUN PY 2005 VL 33 IS 5 SU 1 BP S20 EP S25 DI 10.1016/j.ajic.2005.03.012 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 937QJ UT WOS:000229940300002 PM 15940113 ER PT J AU Kraut, JA Kurtz, I AF Kraut, JA Kurtz, I TI Metabolic acidosis of CKD: Diagnosis, clinical characteristics, and treatment SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Review DE metabolic acidosis; chronic kidney disease (CKD); renal failure; glomerular filtration rate (GFR) ID CHRONIC-RENAL-FAILURE; CHRONIC KIDNEY-DISEASE; SODIUM-BICARBONATE TREATMENT; NUTRITION EXAMINATION SURVEY; SERUM ELECTROLYTE PATTERNS; 3RD NATIONAL-HEALTH; HEMODIALYSIS-PATIENTS; AMMONIUM-CHLORIDE; TUBULAR-ACIDOSIS; BONE-DISEASE AB Metabolic acidosis is noted in the majority of patients with chronic kidney disease (CKD) when glomerular filtration rate (GFR) decreases to less than 20% to 25% of normal, although as many as 20% of individuals can have acid-base parameters close to or within the normal range. Acidosis generally is mild to moderate in degree, with plasma bicarbonate concentrations ranging from 12 to 22 mEq/L (mmol/L), and it is rare to see values less than 12 mEq/L (mmol/L) in the absence of an increased acid load. Degree of acidosis approximately correlates with severity of renal failure and usually is more severe at a lower GFR. The metabolic acidosis can be of the high-anion-gap variety, although anion gap can be normal or only moderately increased even with stage 4 to 5 CKD. Several adverse consequences have been associated with metabolic acidosis, including muscle wasting, bone disease, impaired growth, abnormalities in growth hormone and thyroid hormone secretion, impaired insulin sensitivity, progression of renal failure, and exacerbation of O-2-microglobulin accumulation. Administration of base aimed at normalization of plasma bicarbonate concentration might be associated with certain complications, such as volume overload, exacerbation of hypertension, and facilitation of vascular calcifications. Whether normalization of plasma bicarbonate concentrations in all patients is desirable therefore requires additional study. In the present review, we describe clinical and laboratory characteristics of metabolic acidosis, discuss potential adverse effects, and address benefits and complications of therapy. (c) 2005 by the National Kidney Foundation, Inc. C1 VA Greater Los Angeles Hlth Care Syst, Nephrol Sect, Med & Res Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Hlth Care Syst, Div Nephrol, Los Angeles, CA 90073 USA. David Geffen Sch Med, Div Nephrol, Los Angeles, CA USA. RP Kraut, JA (reprint author), VA Greater Los Angeles Hlth Care Syst, Nephrol Sect, Med & Res Serv, 691-111L,11301 Wiltshire Blvd, Los Angeles, CA 90073 USA. EM jkraut@ucla.edu NR 132 TC 112 Z9 115 U1 0 U2 8 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUN PY 2005 VL 45 IS 6 BP 978 EP 993 DI 10.1053/j.ajkd.2005.03.003 PG 16 WC Urology & Nephrology SC Urology & Nephrology GA 936LH UT WOS:000229857000003 PM 15957126 ER PT J AU Subramanya, A Houghton, D Watnick, S AF Subramanya, A Houghton, D Watnick, S TI Steroid-responsive idiopathic glomerular capillary endotheliosis: Case report and literature review SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Review DE glomerular capillary endotheliosis; glomerulonephritis; proteinuria; kidney diseases ID GROWTH-FACTOR RECEPTOR; RENAL INVOLVEMENT; THROMBOTIC MICROANGIOPATHIES; ANTIPHOSPHOLIPID ANTIBODIES; FACTOR-H; PREECLAMPSIA; PREGNANCY; LESION; NEPHROPATHY; DISEASE AB Glomerular capillary endotheliosis is a lesion of endothelial cell injury. Morphological characteristics are endothelial swelling with glomerular hypertrophy and a reduction in capillary lumen size. This lesion commonly is found in patients with thrombotic microangiopathy, but similar histopathologic characteristics have been reported in patients with other diseases. A previously healthy 39-year-old woman presented with progressive lower-extremity swelling and arthralgias for 1 week. She had no other symptoms and denied prior illness. Her examination was remarkable for hypertension and pitting edema. Urine showed dysmorphic red blood cells and proteinurla. Serum creatinine level increased from 1.1 to 2.0 mg/dL (97 to 177 mu mol/L) during several weeks. She did not meet criteria for systemic lupus erythematosus. Other test results included a negative pregnancy test and normal complement levels. Additional workup was negative for other causes of glomerular capillary endothellosis. She underwent 2 renal biopsies. The first showed marked endothelial cell swelling, and the second biopsy 2 months later showed disease progression. Both were consistent with glomerular capillary endotheliosis. Proteinuria and serum creatinine level elevation responded to methylprednisolone therapy within 1 week, recurred after steroid doses were tapered, and responded again after restarting steroid therapy with monthly cyclophosphamide infusions. The differential diagnosis for glomerular capillary endotheliosis is limited. Various causes have been implicated, such as dysregulation of vascular endothelial growth factor, abnormal collagen production, and endothelial abnormalities. We did not identify prior cases of idiopathic glomerular capillary endotheliosis in the literature. Idiopathic glomerular capillary endotheliosis may be a newly recognized entity potentially responsive to steroid and cytotoxic regimens. (c) 2005 by the National Kidney Foundation, Inc. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, VA Dialysis Unit, Dept Med, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Portland VA Med Ctr, VA Dialysis Unit, Dept Pathol, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. RP Watnick, S (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, VA Dialysis Unit, Dept Med, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM watnicks@ohsu.edu NR 26 TC 8 Z9 11 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUN PY 2005 VL 45 IS 6 BP 1090 EP 1095 DI 10.1053/j.ajkd.2005.03.010 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 936LH UT WOS:000229857000016 PM 15957139 ER PT J AU Aujesky, D Smith, KJ Roberts, MS AF Aujesky, D Smith, KJ Roberts, MS TI Oral anticoagulation strategies after a first idiopathic venous thromboembolic event SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE warfarin; idiopathic venous thromboembolism; effectiveness; cost effectiveness ID DEEP-VEIN THROMBOSIS; COST-EFFECTIVENESS ANALYSIS; FACTOR-V-LEIDEN; INTENSITY WARFARIN THERAPY; MOLECULAR-WEIGHT HEPARIN; MEDICAL DECISION-MAKING; BLEEDING RISK INDEX; PULMONARY-EMBOLISM; LONG-TERM; EXTENDED ANTICOAGULATION AB PURPOSE: The optimal duration and intensity of warfarin therapy after a first idiopathic venous thromboembolic event are uncertain. We used decision analysis to evaluate clinical and economic outcomes of different anticoagulation strategies with warfarin. METHODS: We built a Markov model to assess 6 strategies to treat 40- to 80-year-old men and women after their first idiopathic venous thromboembolic event: 3-month, 6-month, 12-month, 24month, and unlimited-duration conventional-intensity anticoagulation (International Normalized Ratio, 2-3) and unlimited-duration low-intensity anticoagulation (international Normalized Ratio, 1.5-2). The model incorporated age- and sex-specific clinical parameters, utilities, and costs. Using a societal perspective, we compared strategies based on quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness ratios. RESULTS: In our baseline analysis, incremental cost-effectiveness ratios were lower in younger patients and in men, reflecting the higher bleeding risk at older ages, and the lower risk of recurrence among women. Based on a willingness-to-pay of <$50 000/QALY, the 24-month strategy was most cost-effective in 40-year-old men ($48 805/QALY), while the 6-month strategy was preferred in 40-year-old women ($35 977/QALY) and 60-year-old men ($29 878/QALY). In patients aged >= 80 years, 3-month anticoagulation was less costly and more effective than other strategies. Cost-effectiveness results were influenced by the risks associated with recurrent venous thromboembolism, the major bleeding risk of conventional-intensity anticoagulation and the disutility of taking warfarin. CONCLUSION: Longer initial conventional-intensity anticoagulation is cost-effective in younger patients while 3 months of anticoagulation is preferred in elderly patients. Patient age, sex, clinical factors, and patient preferences should be incorporated into medical decision making when selecting an appropriate anticoagulation strategy. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Med, Sect Decis Sci & Clin Syst Modeling, Pittsburgh, PA 15260 USA. RP Aujesky, D (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Drive C, Pittsburgh, PA 15240 USA. EM aujesky@swissonline.ch OI Smith, Kenneth J/0000-0001-8088-566X NR 52 TC 16 Z9 17 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 JUN PY 2005 VL 118 IS 6 BP 625 EP 635 DI 10.1016/j.amjmed.2005.02.018 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 932MD UT WOS:000229556900011 PM 15922694 ER PT J AU Wang, X Rintala, DH Garber, SL Henson, H AF Wang, X Rintala, DH Garber, SL Henson, H TI Association of hemoglobin levels, acute hemoglobin decrease, age, and co-morbidities with rehabilitation outcomes after total knee replacement SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article; Proceedings Paper CT Meeting of the Association-of-Academic-Physiatrists CY MAR 26-30, 2003 CL Ft Lauderdale, FL SP Assoc Acad Phys DE total knee replacement; hemoglobin; functional outcomes; age; co-morbidities ID LENGTH-OF-STAY; ARTHROPLASTY; TRANSFUSION; HIP AB Objective: A study was undertaken to assess the association of preoperative and postoperative hemoglobin levels with rehabilitation outcomes, age, and selected co-morbidities Design: Charts of 49 patients admitted to rehabilitation after total knee arthroplasty due to degenerative joint disease were reviewed. Outcome measures included rehabilitation admission and discharge motor FIM (TM) scores, motor FIM gain, and rehabilitation length of stay. Results: Patients with higher preoperative hemoglobin levels had higher rehabilitation admission motor FIM scores (r = 0.38, P < 0.01) and lower motor FIM gains (r = -0.45, P < 0.001). Patients who had higher hemoglobin levels at rehabilitation admission had higher admission motor FIM scores and shorter length of stay. Patients with diabetes had lower preoperative hemoglobin levels. Patients with hypertension had longer length of stay. Older patients had lower admission and discharge motor FIM scores and longer length of stay. Conclusions: Patients admitted to rehabilitation after total knee replacement have the potential to improve motor function, regardless of their preoperative and rehabilitation admission hemoglobin levels and the decrease in hemoglobin levels. However, those admitted to rehabilitation with lower hemoglobin levels, those with lower admission motor FIM scores, those who are older, and those who have hypertension may expect longer hospital stays to reach their functional goals. C1 Univ Texas, Baylor Coll Med, Houston Phys Med & Rehabill Alliance, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Rintala, DH (reprint author), Vet Affairs Med Ctr, 153,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 14 TC 11 Z9 12 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD JUN PY 2005 VL 84 IS 6 BP 451 EP 456 DI 10.1097/01.phm.0000163719.93855.b7 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 934DG UT WOS:000229686500008 PM 15905659 ER PT J AU Yeh, CK Ghosh, PM Dang, H Liu, Q Lin, AL Zhang, BX Katz, MS AF Yeh, CK Ghosh, PM Dang, H Liu, Q Lin, AL Zhang, BX Katz, MS TI beta-Adrenergic-responsive activation of extracellular signal-regulated protein kinases in salivary cells: role of epidermal growth factor receptor and cAMP SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE mitogen-activated protein kinase; CD44 ID BETA(2)-ADRENERGIC RECEPTOR; COUPLED RECEPTORS; DNA-SYNTHESIS; GLAND; ISOPROTERENOL; STIMULATION; PROLIFERATION; TRANSACTIVATION; CASCADES; PATHWAY AB The beta-adrenergic receptor agonist isoproterenol exerts growth-promoting effects on salivary glands. In this study, activation of ERKs, members of the mitogen-activated protein kinase family, by isoproterenol was examined in a human salivary gland cell line (HSY). Immunoblot analysis indicated that isoproterenol (10(-5) M) induced transient activation of ERK1/2 (4.4-fold relative to basal at 10 min) similar to that caused by EGF (6.7 fold). Isoproterenol, like EGF, also induced phosphorylation of the EGF receptor. However, inhibition of EGF receptor phosphorylation by the tyrphostin AG-1478 only partially attenuated isoproterenol-induced ERK phosphorylation, whereas EGF-responsive ERK activation was completely blocked. The G(i) inhibitor pertussis toxin also caused partial inhibition of isoproterenol-stimulated ERK activation. The cAMP analog 8-(4-chlorophenylthio) adenosine 3', 5'-cyclic monophosphate (CPT-cAMP) and the cAMP-elevating agents IBMX and cholera toxin produced transient ERK1/2 activation, similar to the effect of isoproterenol, in HSY cells. The stimulatory effects of isoproterenol and cAMP on ERK phosphorylation were not reduced by the PKA inhibitor H-89, whereas the Src family inhibitor 4-amino-5-( 4-chlorophenyl)-7-(t-butyl) pyrazolo[3,4-d] pyrimidase (PP2) and transfection of a dominant-negative Src construct diminished isoproterenol-induced ERK activation. Isoproterenol induced marked overexpression of the cell growth-related adhesion molecule CD44, and this effect of isoproterenol was abolished by the ERK pathway inhibitor PD-98059. In summary, we show a dual mechanism of isoproterenol-induced ERK phosphorylation in HSY cells - one pathway mediated by EGF receptor transactivation and the other by an EGF receptor-independent pathway possibly mediated by cAMP. Our results also suggest that isoproterenol-induced growth of salivary tissue may involve ERK-mediated CD44 expression. C1 S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182, Audie L Murphy Div, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Res Serv, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Community Dent, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX USA. RP Katz, MS (reprint author), S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182, Audie L Murphy Div, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM katz@uthscsa.edu FU NIDCR NIH HHS [R21-DE-15381] NR 35 TC 18 Z9 18 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6143 J9 AM J PHYSIOL-CELL PH JI Am. J. Physiol.-Cell Physiol. PD JUN PY 2005 VL 288 IS 6 BP C1357 EP C1366 DI 10.1152/ajpcell.00370.2004 PG 10 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 926MQ UT WOS:000229127700018 PM 15689414 ER PT J AU Coppola, JD Horwitz, BA Hamilton, J Blevins, JE McDonald, RB AF Coppola, JD Horwitz, BA Hamilton, J Blevins, JE McDonald, RB TI Reduced feeding response to muscimol and neuropeptide Y in senescent F344 rats SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE anorexia of aging; brain; food intake control; hypothalamus ID HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; FISCHER-344 RATS; ENERGY-METABOLISM; BODY-WEIGHT; FOOD-INTAKE; EXPRESSION; RECEPTORS; NEURONS AB Many mammals experience spontaneous declines in their food intake and body weight near the end of life, a stage we refer to as senescence. We have previously demonstrated that senescent rats have blunted food intake responses to intracerebroventricular injections of neuropeptide Y (NPY). In the present study, we tested the hypothesis that responsiveness to GABA, a putative potentiator of NPY's effect, is also diminished. Young and old male F344 rats received injections of NPY, muscimol, (MUS, a GABA-A receptor agonist), combinations of these two agents, and vehicle [artificial cerebrospinal fluid (aCSF)] into the hypothalamic paraventricular nucleus (PVN). Both young and old presenescent rats increased their food intake in response to NPY, MUS, and the combination of the two (in comparison to injections of aCSF). The combination treatment was generally more effective than either NPY or MUS alone. These data are consistent with suggestions that both NPY and GABA play a role in the regulation of feeding behavior. Senescent rats exhibited an attenuated NPY-induced food intake, no increase in response to MUS, and a response to NPY + MUS that was no larger than that of NPY alone. We conclude that PVN injections of GABA, as well as NPY, are less effective in stimulating feeding in senescent rats and suggest that alterations in their signaling pathways play a role in the involuntary feeding decrease seen near the end of life. C1 Univ Calif Davis, Dept Nutr, Davis, CA 95616 USA. Univ Calif Davis, Div Biol Sci, Sect Neurobiol Physiol & Behav, Davis, CA 95616 USA. Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol Metab, Seattle, WA USA. RP McDonald, RB (reprint author), Univ Calif Davis, Dept Nutr, 1 Shields Ave, Davis, CA 95616 USA. EM rbmcdonald@ucdavis.edu FU NIA NIH HHS [AG-06665] NR 25 TC 7 Z9 8 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD JUN PY 2005 VL 288 IS 6 BP R1492 EP R1498 DI 10.1152/ajpregu.00554.2004 PG 7 WC Physiology SC Physiology GA 924XD UT WOS:000229013400010 PM 15731400 ER PT J AU Altshuler, L Bookheimer, S Proenza, MA Townsend, J Sabb, F Firestine, A Bartzokis, G Mintz, J Mazziotta, J Cohen, MS AF Altshuler, L Bookheimer, S Proenza, MA Townsend, J Sabb, F Firestine, A Bartzokis, G Mintz, J Mazziotta, J Cohen, MS TI Increased amygdala activation during mania: A functional magnetic resonance imaging study SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 41st Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 08-12, 2002 CL SAN JUAN, PR SP Amer Coll Neuropsychopharmacol ID BIPOLAR DISORDER; DYSFUNCTION; BRAIN; STATE; MRI AB Objective: This study sought to investigate neural activity in the amygdala during episodes of mania. Method: Nine manic subjects and nine healthy comparison subjects underwent functional magnetic resonance imaging ( fMRI) while performing a neuropsychological paradigm known to activate the amygdala. Subjects viewed faces displaying affect ( experimental task) and geometric forms (control task) and matched them to one of two simultaneously presented similar images. Results: Manic subjects had significantly increased activation in the left amygdala and reduced bilateral activation in the lateral orbitofrontal cortex relative to the comparison subjects. Conclusions: Increased activation in the amygdala and decreased activation in the orbitofrontal cortex may represent disruption of a specific neuroanatomic circuit involved in mania. These brain regions may be implicated in disorders involving regulation of affect. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Dept Psychiat, W Los Angeles Healthcare Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Ahmanson Lovelace Brain Mapping Ctr, Los Angeles, CA USA. RP Altshuler, L (reprint author), 300 UCLA Med Plaza,Suite 1544,Box 957057, Los Angeles, CA 90095 USA. EM laltshuler@mednet.ucla.edu RI Bartzokis, George/K-2409-2013; Cohen, Mark/C-6610-2011 OI Cohen, Mark/0000-0001-6731-4053 FU NCRR NIH HHS [RR-12619, RR-13642]; NIDA NIH HHS [DA-13054]; NIMH NIH HHS [K24 MH-01848] NR 13 TC 137 Z9 141 U1 0 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUN PY 2005 VL 162 IS 6 BP 1211 EP 1213 DI 10.1176/appi.ajp.162.6.1211 PG 3 WC Psychiatry SC Psychiatry GA 931SA UT WOS:000229504300028 PM 15930074 ER PT J AU Houston, TK Scarinci, IC Person, SD Greene, PG AF Houston, TK Scarinci, IC Person, SD Greene, PG TI Patient smoking cessation advice by health care providers: The role of ethnicity, socioeconomic status, and health SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID MEDICAL-CARE; UNITED-STATES; MYOCARDIAL-INFARCTION; PHYSICIAN ADVICE; BEHAVIORAL-MODEL; AFRICAN-AMERICAN; QUIT SMOKING; US ADULTS; SMOKERS; INTERNISTS AB Objectives. We assessed differences by ethnicity in ever receiving advice from providers to quit smoking. We evaluated whether socioeconomic status and health status were moderators of the association. Methods. We used 2000 Behavioral Risk Factor Surveillance Survey data, a population-based cross-sectional survey. Results. After adjusting for complex survey design, 69% of the 14089 current smokers reported ever being advised to quit by a provider. Hispanics (50%) and African Americans (61%) reported receiving smoking counseling less frequently compared with Whites (72%, P<.01 for each). Ethnic minority status, lower education, and poorer health status remained significantly associated with lower rates of advice to quit after adjustment for number of cigarettes, time from last provider visit, income, comorbidities, health insurance, gender, and age. Smoking counseling differences between African Americans and Whites were greater among those with lower income and those without health insurance. Compared with Whites, differences for both Hispanics and African Americans were also greater among those with lower education. Conclusion. We found lower rates of smoking cessation advice among ethnic minorities. However, we also found complex interactions of ethnicity with socioeconomic factors. C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL 35294 USA. Univ Arkansas Med Sci, Little Rock, AR 72205 USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness Res, Birmingham, AL USA. RP Houston, TK (reprint author), Univ Alabama, Dept Med, 1530 3rd Ave S,FOT 720B, Birmingham, AL 35294 USA. EM tkhouston@uabmc.edu RI Houston, Thomas/F-2469-2013 NR 39 TC 77 Z9 77 U1 0 U2 4 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUN PY 2005 VL 95 IS 6 BP 1056 EP 1061 DI 10.2105/AJPH.2004.039909 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 929YF UT WOS:000229381800033 PM 15914833 ER PT J AU Bestermann, W Houston, MC Basile, J Egan, B Ferrario, CM Lackland, D Hawkins, RG Reed, J Rogers, P Wise, D Moore, MA AF Bestermann, W Houston, MC Basile, J Egan, B Ferrario, CM Lackland, D Hawkins, RG Reed, J Rogers, P Wise, D Moore, MA TI Addressing the global cardiovascular risk of hypertension, dyslipidemia, diabetes mellitus, and the metabolic syndrome in the Southeastern United States, Part II: Treatment recommendations for management of the global cardiovascular risk of hypertension, dyslipidemia, diabetes mellitus, and the metabolic syndrome SO AMERICAN JOURNAL OF THE MEDICAL SCIENCES LA English DT Article; Proceedings Paper CT 11th Annual Meeting of the Consortium-for-Southeastern-Hypertension-Control (COSEHC) CY AUG 26-28, 2004 CL New Orleans, LA SP Consortium SE Hypertens Control ID CORONARY-HEART-DISEASE; RANDOMIZED CONTROLLED-TRIAL; POLYCYSTIC-OVARY-SYNDROME; SCANDINAVIAN SIMVASTATIN SURVIVAL; TERM PROPRANOLOL TREATMENT; AVERAGE CHOLESTEROL LEVELS; LIPID-LOWERING THERAPY; BLOOD-PRESSURE; INSULIN-RESISTANCE; MYOCARDIAL-INFARCTION AB An aggressive global approach to screening and to the management of the metabolic syndrome is recommended to slow the growth of the syndrome throughout the United States. Prevention should begin in childhood with healthy nutrition, daily physical activity, and annual measurement of weight, height, and blood pressure beginning at 3 years of age. Such screenings will identify cardiovascular risk factors early, allow the health care provider to define global cardiovascular risk with the COSEHC Cardiovascular Risk Assessment Tool, and allow treatment of each risk factor. Lifelong lifestyle modifications and pharmacologic therapy will be required in most patients. Anti hypertensive therapy for these patients should begin with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker unless a compelling indication for another drug is present. Metformin should be considered the first drug for glucose control in the patient with type 2 diabetes. A statin should be used initially for hyperlipidemia unless contraindicated. Combinations of anti hypertensive, antiglycemic, and lipid-lowering agents will often be required. C1 COSEHC, Low Country Med Grp, Danville, VA 24541 USA. Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA. St Thomas Hosp, Nashville, TN USA. Ralph H Johnson VA Med, Charleston, SC USA. Univ S Carolina, Ctr Med, Charleston, SC USA. Wake Forest Univ, Baptist Med Ctr, Winston Salem, NC USA. Morehouse Sch Med, Atlanta, GA 30310 USA. Hattiesburg Clin, Hattiesburg, MS USA. Presbyterian Ctr Preventat Cardiol, Charlotte, NC USA. RP Moore, MA (reprint author), COSEHC, Low Country Med Grp, 144 Winston Court, Danville, VA 24541 USA. EM mamls@earthlink.net NR 108 TC 39 Z9 41 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0002-9629 J9 AM J MED SCI JI Am. J. Med. Sci. PD JUN PY 2005 VL 329 IS 6 BP 292 EP 305 DI 10.1097/00000441-200506000-00009 PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 936WM UT WOS:000229886100004 PM 15958871 ER PT J AU Barchiesi, F Spreghini, E Fothergill, AW Arzeni, D Greganti, G Giannini, D Rinaldi, MG Scalise, G AF Barchiesi, F Spreghini, E Fothergill, AW Arzeni, D Greganti, G Giannini, D Rinaldi, MG Scalise, G TI Caspofungin in combination with amphotericin B against Candida glabrata SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID SURVEILLANCE; ALBICANS AB The effects of caspofungin combined with amphotericin B were investigated with Candida glabrata. Although in vitro experiments showed an indifferent interaction, the combination regimen was the only therapeutic approach yielding organ sterilization in a murine candidemia model. C1 Univ Politecn Marche, Ist Malattie Infett & Med Pubbl, Ancona, Italy. Univ Politecn Marche, Ctr Gestione Presidenza Med & Chirurg, Ancona, Italy. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. RP Barchiesi, F (reprint author), Univ Politecn Marche, Azienda Osped Univ, Ist Malattie Infett & Med Pubbl, Osped Riuniti Umberto I GM Lancisi G Salesi, Via Conca, I-60020 Ancona, Italy. EM l.infettive@ao-umbertoprimo.marche.it RI Spreghini, Elisabetta/G-9378-2012 NR 9 TC 18 Z9 18 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JUN PY 2005 VL 49 IS 6 BP 2546 EP 2549 DI 10.1128/AAC.49.6.2546-2549.2005 PG 4 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 931YO UT WOS:000229521600063 PM 15917570 ER PT J AU Heaphy, MR Albrecht, J Werth, VP AF Heaphy, MR Albrecht, J Werth, VP TI Dapsone as a glucocorticoid-sparing agent in maintenance-phase pemphigus vulgaris SO ARCHIVES OF DERMATOLOGY LA English DT Article ID EOSINOPHILIC SPONGIOSIS; LYSOSOMAL ENZYMES; INHIBITION; SULFONES AB Objective: To determine the effect of dapsone on glucocorticoid-dependent patients with active or maintenance-phase pemphigus vulgaris. Design: Retrospective study of consecutive patients treated with dapsone. Setting: University of Pennsylvania, Philadelphia (a tertiary referral hospital). Patients: We observed 9 consecutive adult patients with pemphigus vulgaris being treated with immunosuppressants who were unable to taper prednisone use without abrupt worsening of their disease. Interventions: Dapsone treatment added to prednisone and other inummosuppressive therapy. Main Outcome Measure: Steroid dosage. Results: All patients were unable to taper their steroid dose during the 3 months prior to the initiation of dapsone therapy or had active disease that was not well controlled by prednisone prior to dapsone treatment. With the exception of 1 patient with uncontrolled disease, all 9 patients were able to taper their steroid dose below the adrenal replacement level during dapsone treatment. Maintenance-phase patients taking 15 mg/d or more of prednisone (n=5) experienced a mean +/- SEM drop of 67%+/- 7.1% inprednisone dose by 4 months of maximal dapsone treatment and an 84%+/- 3.5% drop in prednisone dose after 8 months of dapsone treatment. Conclusions: These retrospective study findings suggest that dapsone reduces steroid dependence in patients with pemphigus vulgaris, provided they are in the maintenance phase of their disease. These data support the need for a prospective, randomized trial to confirm these findings. C1 Univ Penn, Dept Dermatol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Pathol, San Francisco, CA 94143 USA. RP Werth, VP (reprint author), Univ Penn, Dept Dermatol, 2 Rhodes Pavil,3600 Spruce St, Philadelphia, PA 19104 USA. EM werth@mail.med.upenn.edu FU NIAMS NIH HHS [K24-AR02207] NR 26 TC 22 Z9 23 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-987X J9 ARCH DERMATOL JI Arch. Dermatol. PD JUN PY 2005 VL 141 IS 6 BP 699 EP 702 DI 10.1001/archderm.141.6.699 PG 4 WC Dermatology SC Dermatology GA 933LB UT WOS:000229628800005 PM 15967915 ER PT J AU Frey, LC Ringel, SP Filley, CM AF Frey, LC Ringel, SP Filley, CM TI The natural history of cognitive dysfunction in late-onset GM(2) gangliosidosis SO ARCHIVES OF NEUROLOGY LA English DT Article ID HEXOSAMINIDASE-A DEFICIENCY; CHRONIC GM2 GANGLIOSIDOSIS; SPINAL MUSCULAR-ATROPHY; TAY-SACHS-DISEASE; NEUROPSYCHIATRIC ASPECTS; PROGRESSIVE DYSTONIA; ADULT HEXOSAMINIDASE; G(M2) GANGLIOSIDOSIS; CEREBELLAR-ATAXIA; ASHKENAZI-JEWISH AB Background: Late-onset GM(2) gangliosidosis (LGG) is a rare disease that is often considered in the differential diagnosis of adolescents and young adults who present with multiple realms of neurologic dysfunction. Cognitive disturbances are common but have not been systematically studied. Objective: To determine the natural history of cognitive dysfunction in patients with LGG. Design: Case series and literature review. Setting: Urban tertiary referral clinic. Patients: Individuals with hexosaminidase A deficiency as the origin of LGG. Main Outcome Measures: Cognitive dysfunction, psychiatric symptoms, and cerebellar, upper motor neuron, lower motor neuron, or extrapyramidal symptoms and signs. Results: Historical and examination data from 62 patients were found. Forty-four percent of LGG patients had some degree of cognitive dysfunction. Cognitive dysfunction was associated with a greater number of other elemental neurologic deficits. In 21 patients with acceptable longitudinal information, 8 (38%) had a static cognitive disorder, whereas progressive dementia was evident in 13 patients (62%), including 2 of our cases with serial neuropsychological testing. Neuroimaging often showed nonspecific cerebellar and/or cerebral atrophy. Conclusions: Cognitive dysfunction is a frequent manifestation of LGG. Patients who experience cognitive dysfunction are more likely to have a greater number of other neurologic manifestations of the disease. Cognitive dysfunction may take the form of static encephalopathy, but progressive dementia is more often encountered. The pathogenesis of cognitive dysfunction in this disease is unknown, highlighting the need for further study. C1 Univ Colorado, Sch Med, Dept Neurol, Boulder, CO 80309 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Frey, LC (reprint author), 1635 N Ursula St,POB 6510,Mailstop F727, Aurora, CO 80045 USA. EM Lauren.Frey@uchsc.edu NR 40 TC 21 Z9 23 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD JUN PY 2005 VL 62 IS 6 BP 989 EP 994 DI 10.1001/archneur.62.6.989 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 933AK UT WOS:000229596000018 PM 15956171 ER PT J AU Altshuler, LL Post, R Black, DO Denicoff, KD Frye, MA Grunze, H Keck, PE Kupka, R Leverich, G McElroy, SL Nolen, WA Suppes, T Walden, J AF Altshuler, LL Post, R Black, DO Denicoff, KD Frye, MA Grunze, H Keck, PE Kupka, R Leverich, G McElroy, SL Nolen, WA Suppes, T Walden, J TI Subsyndromal depression and impaired life functioning in bipolar disorder SO BIPOLAR DISORDERS LA English DT Meeting Abstract CT 6th International Conference on Bipolar Disorder CY JUN 16-18, 2005 CL Pittsburgh, PA DE bipolar disorder; subsyndromal depression; subthreshold depression C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX USA. Cincinnati Vet Affairs Med Ctr, Mental Hlth Care Line & Gen Clin Res Ctr, Cincinnati, OH USA. Altrech Inst Mental Hlth Care, Utrecht, Netherlands. Univ Groningen Hosp, Dept Psychiat, Groningen, Netherlands. Ludwig Maximilians Univ Munchen, Dept Psychiat, Munich, Germany. Univ Freiburg, Dept Psychiat, D-7800 Freiburg, Germany. Univ Munster, Dept Psychiat, Munster, Germany. RI Nolen, Willem/E-9006-2014 NR 0 TC 0 Z9 0 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1398-5647 EI 1399-5618 J9 BIPOLAR DISORD JI Bipolar Disord. PD JUN PY 2005 VL 7 SU 2 BP 28 EP 28 PG 1 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 929TO UT WOS:000229369500038 ER PT J AU Rasgon, NL Altshuler, LL Fairbanks, L Elman, S Bitran, J Labarca, R Saad, M Kupka, R Nolen, WA Frye, MA Suppes, T McElroy, SL Keck, PE Leverich, G Grunze, H Walden, J Post, R Mintz, J AF Rasgon, NL Altshuler, LL Fairbanks, L Elman, S Bitran, J Labarca, R Saad, M Kupka, R Nolen, WA Frye, MA Suppes, T McElroy, SL Keck, PE Leverich, G Grunze, H Walden, J Post, R Mintz, J TI Reproductive function and risk for PCOS in women treated for bipolar disorder SO BIPOLAR DISORDERS LA English DT Article DE bipolar disorder; hirsutism; menstrual abnormalities; polycystic ovary syndrome; weight gain; women ID POLYCYSTIC-OVARY-SYNDROME; ENDOCRINE DISORDERS; EPILEPSY; VALPROATE; LAMOTRIGINE; OBESITY; ABNORMALITIES; PREVALENCE; OVERWEIGHT; THERAPY AB Introduction: This study examined the reproductive function and prevalence of polycystic ovary syndrome (PCOS) in women with bipolar disorder taking antimanic medications. Method: Women aged 18-45 treated for bipolar disorder and not taking steroid contraceptives were recruited to complete questionnaires about their menstrual cycle and to provide blood samples for measurement of a range of reproductive endocrine and metabolic hormone levels. Eighty women participated in completing the questionnaires and 72 of them provided blood samples. Results: Fifty-two of the 80 women (65%) reported current menstrual abnormalities, 40 of which (50%) reported one or more menstrual abnormalities that preceded the diagnosis of bipolar disorder. Fifteen women (38%) reported developing menstrual abnormalities since treatment for bipolar disorder, 14 of which developed abnormalities since treatment with valproate (p = 0.04). Of the 15 patients reporting menstrual abnormalities since starting medication, 12 (80%) reported changes in menstrual flow (heavy or prolonged bleeding) and five (33%) reported changes in cycle frequency. No significant differences were observed between women receiving or not receiving valproate in mean levels of free or total serum testosterone levels. This was true for the total sample and for the sub-group without preexisting menstrual problems. However, within the valproate group, duration of use was significantly correlated with free testosterone levels (r = 0.33, p = 0.02). Three of the 50 women (6%) taking VPA, and 0% of the 22 taking other antimanic medications, met criteria for PCOS (p = 0.20). Other reproductive and metabolic values outside the normal range across treatment groups included elevated 17 alpha-OH progesterone levels, luteinizing hormone: follicle-stimulating hormone ratios, homeostatic model assessment (HOMA) values, and low estrogen and dehydroepiandrosterone sulfate (DHEAS) levels. Preexisting menstrual abnormalities predicted higher levels of 17 alpha-OH progesterone, free testosterone, and estrone as well as development of new menstrual abnormalities. Body mass index (BMI) was significantly positively correlated with free testosterone levels and insulin resistance (HOMA) across all subjects, regardless of medication used. Conclusions: Rates of menstrual disturbances are high in women with bipolar disorder and, in many cases, precede the diagnosis and treatment for the disorder. Treatment with valproate additionally contributes significantly to the development of menstrual abnormalities and an increase in testosterone levels over time. A number of bipolar women, regardless of type of medication treatment received, have reproductive and metabolic hormonal abnormalities, yet the etiology of such abnormalities requires further study. Women with preexisting menstrual abnormalities may represent a group at risk for development of reproductive dysfunction while being treated for bipolar disorder. C1 Stanford Sch Med, Dept Psychiat, Palo Alto, CA 94305 USA. VA Greater Los Angeles Healthcare Syst, Dept Psychiat, W Los Angeles Healthcare Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Inst Neuropsiquiat Chile, Santiago, Chile. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Altrech Inst Mental Hlth Care, Utrecht, Netherlands. Univ Groningen, Med Ctr, Dept Psychiat, Groningen, Netherlands. Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX USA. Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, Cincinnati, OH USA. Cincinnati Vet Affairs Med Ctr, Mental Hlth Care Line & Gen Clin Res Ctr, Cincinnati, OH USA. NIMH, Biol Psychiat Branch, NIH, Bethesda, MD 20892 USA. LMU Munich, Dept Psychiat, Munich, Germany. Univ Freiburg, Dept Psychiat, Freiburg, Germany. Univ Munster, Dept Psychiat, D-4400 Munster, Germany. RP Rasgon, NL (reprint author), Stanford Sch Med, Dept Psychiat & Behav Sci, 401 Quarry Rd,Room 2360, Palo Alto, CA 94305 USA. EM nrasgon@stanford.edu RI Nolen, Willem/E-9006-2014 FU NIMH NIH HHS [R01 MH079261] NR 36 TC 79 Z9 81 U1 0 U2 5 PU BLACKWELL MUNKSGAARD PI FREDERIKSBERG C PA 1 ROSENORNS ALLE, DK-1970 FREDERIKSBERG C, DENMARK SN 1398-5647 J9 BIPOLAR DISORD JI Bipolar Disord. PD JUN PY 2005 VL 7 IS 3 BP 246 EP 259 DI 10.1111/j.1399-5618.2005.00201.x PG 14 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 925VJ UT WOS:000229081100004 PM 15898962 ER PT J AU Eriksson, A Mellstrom, D Orwoll, ES Ljunggren, O Johnell, O Ohlsson, C AF Eriksson, A Mellstrom, D Orwoll, ES Ljunggren, O Johnell, O Ohlsson, C TI A polymorphism in the gene coding for estrogen receptor beta is associated with bone mineral density in elderly Swedish men - Mr Os Sweden SO BONE LA English DT Meeting Abstract CT 2nd Joint Meeting of the European-Calcified-Tissue-Society/International-Bone-and-Mineral-Society CY JUN 25-29, 2005 CL Geneva, SWITZERLAND SP European Calcified Tissue Soc, Int Bone & Mineral Soc, Eli Lilly, Elsevier, Merck, Novartis, Nycomed, Roche & GlaxoSmithKline, Servier, Alliance Better Bone Hlth C1 Sahlgrenska Acad, Ctr Bone Res, Dept Internal Med, Gothenburg, Sweden. Gothenburg Univ, Dept Geriatr, S-41124 Gothenburg, Sweden. Oregon Hlth Sci Univ, Dept Med, Bone Mineral Res Unit, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Univ Uppsala, Dept Med Sci, S-75105 Uppsala, Sweden. Malmo Univ Hosp, Dept Orthopaed, Malmo, Sweden. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 8756-3282 J9 BONE JI Bone PD JUN PY 2005 VL 36 SU 2 BP S396 EP S396 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 938DK UT WOS:000229979900643 ER PT J AU Mellstrom, D Eriksson, A Lorentzon, M Orwoll, ES Ljunggren, O Johnell, O Ohlsson, C AF Mellstrom, D Eriksson, A Lorentzon, M Orwoll, ES Ljunggren, O Johnell, O Ohlsson, C TI Free testosterone is a positive while free estradiol is a negative predictor of bone area in elderly Swedish men - Mr Os Sweden SO BONE LA English DT Meeting Abstract CT 2nd Joint Meeting of the European-Calcified-Tissue-Society/International-Bone-and-Mineral-Society CY JUN 25-29, 2005 CL Geneva, SWITZERLAND SP European Calcified Tissue Soc, Int Bone & Mineral Soc, Eli Lilly, Elsevier, Merck, Novartis, Nycomed, Roche & GlaxoSmithKline, Servier, Alliance Better Bone Hlth C1 Malmo Univ Hosp, Dept Orthopaed, Malmo, Sweden. Univ Uppsala, Dept Med Sci, S-75105 Uppsala, Sweden. Oregon Hlth Sci Univ, Dept Med, Bone & Mineral Res Unit, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Sahlgrenska Acad, Ctr Bone Res, Dept Internal Med, Gothenburg, Sweden. Sahlgrenska Acad, Ctr Bone Res, Dept Geriatr, Gothenburg, Sweden. Gothenburg Univ, Div Clin Pharmacol, S-41124 Gothenburg, Sweden. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 8756-3282 J9 BONE JI Bone PD JUN PY 2005 VL 36 SU 2 BP S386 EP S386 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 938DK UT WOS:000229979900621 ER PT J AU Shoback, DM AF Shoback, DM TI Calcimimetics in the treatment of hyperparathyroidism SO BONE LA English DT Meeting Abstract CT 2nd Joint Meeting of the European-Calcified-Tissue-Society/International-Bone-and-Mineral-Society CY JUN 25-29, 2005 CL Geneva, SWITZERLAND SP European Calcified Tissue Soc, Int Bone & Mineral Soc, Eli Lilly, Elsevier, Merck, Novartis, Nycomed, Roche & GlaxoSmithKline, Servier, Alliance Better Bone Hlth C1 San Francisco VA Med Ctr, Endocrine Res Unit 111N, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 8756-3282 J9 BONE JI Bone PD JUN PY 2005 VL 36 SU 2 BP S113 EP S113 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 938DK UT WOS:000229979900027 ER PT J AU Frueh, BC Elhai, JD Grubaugh, AL Monnier, J Kashdan, TB Sauvageot, JA Hamner, MB Burkett, BG Arana, GW AF Frueh, BC Elhai, JD Grubaugh, AL Monnier, J Kashdan, TB Sauvageot, JA Hamner, MB Burkett, BG Arana, GW TI Documented combat exposure of US veterans seeking treatment for combat-related post-traumatic stress disorders SO BRITISH JOURNAL OF PSYCHIATRY LA English DT Article ID ADMINISTERED PTSD SCALE; TIME; WAR AB Background There are concerns regarding the validity of combat exposure reports of veterans seeking treatment for combat-related post-traumatic stress disorder (PTSD) within US Veterans Affairs Medical Centers. Aims To verify combat exposure history for a relevant sample through objective historical data. Method Archival records were reviewed from the US National Military Personnel Records Center for 100 consecutive veterans reporting Vietnam combat in a Veterans Affairs PTSD clinic. Cross-sectional clinical assessment and 12-month service use data were also examined. Results Although 93% had documentation of Vietnam war-zone service, only 41% of the total sample had objective evidence of combat exposure documented in their military record. There was virtually no difference between the Vietnam 'combat' and 'no combat' groups on relevant clinical variables. Conclusions A significant number of treatment-seeking Veterans Affairs patients may misrepresent their combat involvement in Vietnam. There are implications for the integrity of the PTSD database and the Veterans Affairs healthcare system. Declaration of interest None. Funding detailed in Acknowledgements. C1 VA Med Ctr 116, Charleston, SC 29401 USA. Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD 57069 USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Frueh, BC (reprint author), VA Med Ctr 116, 109 Bee St, Charleston, SC 29401 USA. EM fruehbc@musc.edu FU NIMH NIH HHS [MH61983, MH01660] NR 21 TC 81 Z9 81 U1 0 U2 4 PU ROYAL COLLEGE OF PSYCHIATRISTS PI LONDON PA BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND SN 0007-1250 J9 BRIT J PSYCHIAT JI Br. J. Psychiatry PD JUN PY 2005 VL 186 BP 467 EP 472 DI 10.1192/bjp.186.6.467 PG 6 WC Psychiatry SC Psychiatry GA 934FN UT WOS:000229692400005 PM 15928355 ER PT J AU Waldman, KL AF Waldman, KL TI The STRESS owner's manual: Meaning, balance & health in your life-2nd edition SO BULLETIN OF THE MENNINGER CLINIC LA English DT Book Review C1 Michael E Debakey Vet Affairs Med Ctr, Houston, TX USA. RP Waldman, KL (reprint author), Michael E Debakey Vet Affairs Med Ctr, Houston, TX USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0025-9284 J9 B MENNINGER CLIN JI Bull. Menninger Clin. PD SUM PY 2005 VL 69 IS 3 BP 258 EP 258 PG 1 WC Psychiatry; Psychology, Psychoanalysis SC Psychiatry; Psychology GA 965EV UT WOS:000231934000014 ER PT J AU Hussein, MR Nassar, MI Kamel, NA Osman, ME Georguis, MN AF Hussein, MR Nassar, MI Kamel, NA Osman, ME Georguis, MN TI Analysis of fibronectin expression in the Bilharzial granulomas and of laminin in the transformed urothelium in Schistosoma haematobium infested patients SO CANCER BIOLOGY & THERAPY LA English DT Article DE fibronectin; laminin; bilharziasis ID EXTRACELLULAR-MATRIX PROTEINS; MANSONI INFECTION; FIBROSIS AB The bilharzial granulomas and urothelial transformation are common findings in Schistosoma haematobium infested patients. We hypothesize that the distribution of extrinsic (fibronectin, FN) and intrinsic basement membrane (BM) proteins (laminin, LN) is altered during the evolution of these lesions. Methods: To test this hypothesis, 70 cystectomy specimens, entailing variable associations of normal and dysplastic urothelium (all cases), and bilharzial granulomas were examined for FN and LN protein expression. Results: The biharzial granulomas were formed of admixture of CD3(+) T cells, CD68(+) histiocytes and CD220B cells. The CD3(+) T cells and and CD68(+) histiocytes were the predominant cell populations. Increased deposition of FN occurred with the evolution from cellular (loose fibrillary network, 20 cases) to fibrocellualr (dense fibrillary network, 30 cases) to fibrotic (tight conglomerates, 20 cases) granulomas. Alternatively, BM staining for LN was linear and continuous underlying normal and metaplastic urothelium. In dysplastic urothelium (20 cases), it showed breaks in continuity. Conclusions: Alterations of FN and LN occur during the development of the bilharzial granuloma and urothelial transformation. C1 Assiut Univ Hosp, Dept Pathol, Fac Med, Assiut, Egypt. Assiut Univ Hosp, Dept Urol, Fac Med, Assiut, Egypt. Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Fac Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 14 TC 7 Z9 7 U1 0 U2 0 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD JUN PY 2005 VL 4 IS 6 BP 676 EP 678 PG 3 WC Oncology SC Oncology GA 022GE UT WOS:000236042600026 PM 15970682 ER PT J AU O'Hare, T Walters, DK Stoffregen, EP Jia, TP Manley, PW Mestan, J Cowan-Jacob, SW Lee, FY Heinrich, MC Deininger, MWN Druker, BJ AF O'Hare, T Walters, DK Stoffregen, EP Jia, TP Manley, PW Mestan, J Cowan-Jacob, SW Lee, FY Heinrich, MC Deininger, MWN Druker, BJ TI In vitro activity of Bcr-Abl inhibitors AMN107 and BMS-354825 against clinically relevant imatinib-resistant Abl kinase domain mutants SO CANCER RESEARCH LA English DT Article ID CHRONIC MYELOID-LEUKEMIA; CHRONIC MYELOGENOUS LEUKEMIA; TYROSINE KINASE; PHILADELPHIA-CHROMOSOME; MESYLATE; STI571; MUTATION; STI-571; CELLS; CML AB Imatinib, a Bcr-Ab1 tyrosine kinase inhibitor, is a highly effective therapy for patients with chronic myelogenous leukemia (CML). Despite durable responses in most chronic phase patients, relapses have been observed and are much more prevalent in patients with advanced disease. The most common mechanism of acquired imatinib resistance has been traced to Bcr-Ab1 kinase domain mutations with decreased imatinib sensitivity. Thus, alternate Bcr-Ab1 kinase inhibitors that have activity against imatinib-resistant mutants would be useful for patients who relapse on imatinib therapy. Two such Bcr-Ab1 inhibitors are currently being evaluated in clinical trials: the improved potency, selective Ab1 inhibitor AMN107 and the highly potent dual Src/Ab1 inhibitor BMS-354825. In the current article, we compared imatinib, AMN107, and BMS354825 in cellular and biochemical assays against a panel of 16 kinase domain mutants representing > 90% of clinical isolates. We report that AMN107 and BMS-354825 are 20-fold and 325-fold more potent than imatinib against cells expressing wildtype Bcr-Ab1 and that similar improvements are maintained for all imatinib-resistant mutants tested, with the exception of T315I. Thus, both inhibitors hold promise for treating imatinib-refractory CML. C1 Oregon Hlth Sci Univ, Howard Hughes Med Inst, Inst Canc, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Inst Canc, Div Hematol & Med Oncol, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Novartis Inst Biomed Res, Basel, Switzerland. Bristol Myers Squibb Co, Oncol, Princeton, NJ 08543 USA. RP O'Hare, T (reprint author), Oregon Hlth Sci Univ, Howard Hughes Med Inst, Inst Canc, L592,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM oharet@ohsu.edu NR 23 TC 646 Z9 666 U1 4 U2 29 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JUN 1 PY 2005 VL 65 IS 11 BP 4500 EP 4505 DI 10.1158/0008-5472.CAN-05-0259 PG 6 WC Oncology SC Oncology GA 930HZ UT WOS:000229407800006 PM 15930265 ER PT J AU Quinn, LBS Strait-Bodey, L Anderson, BG Argiles, JM Havel, PJ AF Quinn, LBS Strait-Bodey, L Anderson, BG Argiles, JM Havel, PJ TI Interleukin-15 stimulates adiponectin secretion by 3T3-L1 adipocytes: Evidence for a skeletal muscle-to-fat signaling pathway SO CELL BIOLOGY INTERNATIONAL LA English DT Article DE interleukin-15; adipocyles; skeletal muscle; adiponectin; cytokines ID NECROSIS-FACTOR-ALPHA; ACTIVATED PROTEIN-KINASE; INSULIN-RESISTANCE; GENE-EXPRESSION; GROWTH-FACTOR; BODY-WEIGHT; IN-VITRO; OBESITY; OVEREXPRESSION; INFLAMMATION AB Interleukin-15 (IL-15) is a cytokine which is highly expressed in skeletal muscle tissue, and which has anabolic effects on skeletal muscle protein dynamics both in vivo and in vitro. Additionally, administration of IL-15 to rats and mice inhibits white adipose tissue deposition. To determine if the action of IL-15 on adipose tissue is direct, the capacity of cultured murine 3T3-L1 preadipocytes and adipocytes to respond to IL-15 was examined. IL-15 administration inhibited lipid accumulation in differentiating 3T3-L1 preadipocytes, and stimulated secretion of the adipocyte-specific hormone adiponectin by differentiated 3T3-L1 adipocytes. The latter observation constitutes the first report of a cytokine or growth factor which stimulates adiponectin production. IL-15 mRNA expression by Cultured 3T3-L1 adipogenic cells and C2C12 murine skeletal myogenic cells was also examined. Quantitative real-time PCR indicated IL-15 mRNA was expressed by C2C12 skeletal myogenic cells, and was upregulated more than 10-fold in differentiated skeletal myotubes compared to undifferentiated myolblasts. In contrast, 3T3-L1 cells expressed little or no IL-15 mRNA at either the undifferentiated preadipocyte or differentiated adipocyte stages. These findings provide support for the hypothesis that IL-15 functions in a muscle-to-fat endocrine axis which modulates fat:lean body composition and insulin sensitivity. (c) 2005 International Federation for Cell Biology. Published by Elsevier Ltd. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Tacoma, WA 98493 USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Res Serv, Tacoma, WA USA. Univ Barcelona, Fac Biol, Dept Biochem & Mol Biol, Barcelona, Spain. Univ Calif Davis, Dept Nutr, Davis, CA USA. RP Quinn, LBS (reprint author), VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, 151 Amer Lake Div, Tacoma, WA 98493 USA. EM quinnl@u.washington.edu FU NIDDK NIH HHS [DK-50129, DK-58108, DK17047] NR 39 TC 71 Z9 77 U1 0 U2 7 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1065-6995 J9 CELL BIOL INT JI Cell Biol. Int. PD JUN PY 2005 VL 29 IS 6 BP 449 EP 457 DI 10.1016/j.cellbi.2005.02.005 PG 9 WC Cell Biology SC Cell Biology GA 954XQ UT WOS:000231189200007 PM 15951205 ER PT J AU Denslow, S Bohning, DE Bohning, PA Lomarev, MP George, MS AF Denslow, S Bohning, DE Bohning, PA Lomarev, MP George, MS TI An increased precision comparison of TMS-induced motor cortex BOLD fMRI response for image-guided versus function-guided coil placement SO COGNITIVE AND BEHAVIORAL NEUROLOGY LA English DT Review DE neuronavigation; functional magnetic resonance imaging; transcranial magnetic stimulation; motor cortex ID TRANSCRANIAL MAGNETIC STIMULATION; CEREBRAL-CORTEX; PREFRONTAL CORTEX; BRAIN-STIMULATION; HAND AREA; LOCALIZATION; MRI; REPRESENTATION; VARIABILITY; PERCEPTION AB Objective: To examine with high precision the differences between function-guided and image-guided transcranial magnetic stimulation (T M S). Method: Using a calibrated TMS coil holder/positioner, interleaved TMS/functional magnetic resonance imaging (fMRI), and individualized anatomy-based regional normalization, we conducted a two-phase study of TMS coil positioning guided by either function (elicited thumb motion) or image-based targeting of the "hand knob," the anatomy associated with fMRI activation during thumb motion. Results: in every case, image-guided TMS coil placement produced a thumb movement response at thresholds similar to those found under function guidance. Unexpectedly, function-guided coil locations clustered bimodally over central and precentral sulci. Image-guided locations clustered as anticipated toward the targeted gyral crown. Despite these differences, blood oxygenation level-dependent (BOLD) activation locations and magnitude for the two methods displayed no consistent differences in mean or variance between or within subjects. Image guidance produced more consistent coil placement from subject to subject relative to targeted anatomy. Surprisingly, BOLD time courses from image-guided experiments showed significantly slower return to baseline after TMS than was observed under function guidance. Conclusions: The results demonstrate the effectiveness and precision of image-guided positioning of TMS coils combined with a precisely adjustable holder/positioner and regional normalization. Image guidance provides an accurate TMS placement relative to individual anatomy when no external sign is available. C1 Med Univ S Carolina, Dept Radiol, Ctr Adv Imaging Res & Brain Stimulat Labs, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. NINDS, Bethesda, MD 20892 USA. Inst Human Brain, St Petersburg, Russia. Med Univ S Carolina, Dept Neurol, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. RP Denslow, S (reprint author), Med Univ S Carolina, Dept Radiol, Ctr Adv Imaging Res & Brain Stimulat Labs, 169 Ashley Ave, Charleston, SC 29425 USA. EM denslows@musc.edu FU NCRR NIH HHS [R01 RR14080-02] NR 50 TC 21 Z9 21 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1543-3633 J9 COGN BEHAV NEUROL JI Cogn. Behav. Neurol. PD JUN PY 2005 VL 18 IS 2 BP 119 EP 126 DI 10.1097/01.wnn.0000160821.15459.68 PG 8 WC Behavioral Sciences; Clinical Neurology SC Behavioral Sciences; Neurosciences & Neurology GA 941OK UT WOS:000230223900007 PM 15970732 ER PT J AU Kohn, CS Sayers, SL AF Kohn, CS Sayers, SL TI Extreme relationship standards in the context of discordant and nondiscordant couples SO COGNITIVE AND BEHAVIORAL PRACTICE LA English DT Article ID MARITAL RELATIONSHIPS; LONGITUDINAL ANALYSIS; CLOSE RELATIONSHIPS; ATTRIBUTIONS; BELIEFS; SATISFACTION; DEPRESSION; COGNITIONS; MARRIAGE; AGREEMENT AB Research suggests that extreme, relationship standards are both positively and negatively associated with relationship satisfaction. This study tested the hypothesis that the association between relationship satisfaction and extreme standards is moderated by the status of the couple (i.e., discordant versus nondiscordant). Sixty-two couples completed a thought-listing task designed to assess relationship standards. Regression analyses supported the study hypothesis. Extreme standards were associated with higher levels of relationship satisfaction among nondiscordant wives but with lower levels of relationship satisfaction among discordant husbands and discordant wives. This study helps clarify the role of extreme standards in relationship functioning, and their potential contributions to both theoretical constructs of relationships as well as the increased efficacy of couples therapy. C1 Univ Pacific, Dept Psychol, Stockton, CA 95211 USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Kohn, CS (reprint author), Univ Pacific, Dept Psychol, 3601 Pacific Ave, Stockton, CA 95211 USA. EM ckohn@pacific.edu NR 34 TC 4 Z9 4 U1 1 U2 2 PU ASSOC ADV BEHAVIOR THERAPY PI NEW YORK PA 305 7TH AVE #16A, NEW YORK, NY 10001-6008 USA SN 1077-7229 J9 COGN BEHAV PRACT JI Cogn. Behav. Pract. PD SUM PY 2005 VL 12 IS 3 BP 319 EP 323 DI 10.1016/S1077-7229(05)80054-9 PG 5 WC Psychology, Clinical SC Psychology GA 989OH UT WOS:000233682900006 ER PT J AU Weissman, EM Covell, NH Kushner, M Irwin, J Essock, SM AF Weissman, EM Covell, NH Kushner, M Irwin, J Essock, SM TI Implementing peer-assisted case management to help homeless veterans with mental illness transition to independent housing SO COMMUNITY MENTAL HEALTH JOURNAL LA English DT Article ID CONSUMERS; ILL; PROVIDERS; BENEFITS AB Formerly homeless mentally ill veterans are at an important crossroads when they move from living in an institutional setting such as a shelter or supportive residential facility to independent living. We hypothesized that peer advisors, veterans with severe mental illness who had been homeless previously, graduated from a Healthcare for Homeless Veterans program, and subsequently maintained independent, stable housing could assist other veterans make a successful transition to independent living. Pilot data suggests that participants who received peer advisors were more likely to follow up with assessments than were controls. In this report, we describe a pilot peer advisor program, its implementation, and pilot data on program administration. C1 Bronx Vet Adm Med Ctr, Vet Integrated Serv Network 3, Mental Illness Res Educ & Clin Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Connecticut Dept Mental Hlth & Addict Serv, Hartford, CT USA. Univ Connecticut, Dept Psychol, Storrs, CT USA. Vet Affairs New York Harbor Healthcare Syst, Brooklyn, NY USA. RP Weissman, EM (reprint author), Bronx Vet Adm Med Ctr, Vet Integrated Serv Network 3, Mental Illness Res Educ & Clin Ctr, 130 W Kingsbridge RdOOMH, Bronx, NY 10468 USA. EM ellen.weissman@med.va.gov NR 13 TC 7 Z9 7 U1 0 U2 3 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0010-3853 J9 COMMUNITY MENT HLT J JI Community Ment. Health J. PD JUN PY 2005 VL 41 IS 3 BP 267 EP 276 DI 10.1007/s10597-005-5001-2 PG 10 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 948AL UT WOS:000230688300003 PM 16131006 ER PT J AU Koek, RJ Hejran, RN Mintz, J AF Koek, RJ Hejran, RN Mintz, J TI Psychotherapy in controlled psychopharmacology trials. Does it matter if we ignore it? SO CONTEMPORARY CLINICAL TRIALS LA English DT Article DE controlled clinical trials; confounding variables; psychopharmacology; psychotherapy; methodology; psychiatry research ID CONSORT STATEMENT; CLINICAL-TRIALS; INTELLECTUAL FRAMEWORK; BEHAVIORAL-THERAPY; RANDOMIZED TRIALS; DEPRESSION; MEDICINE; QUALITY; RECOMMENDATIONS; COMBINATION AB The controlled trial is now the standard for assessing efficacy of new treatments in Psychiatry, as it is in the rest of medicine. Psychiatric outcomes with treatment are influenced by concurrent psychosocial factors. Psychotherapy, alone or in combination with pharmacotherapy is an effective treatment. Thus, if concomitant receipt of psychotherapy is not controlled for in a psychopharmacology trial, outcome may be biased. In this study, all peer reviewed journal articles describing the results of randomized, controlled psychopharmacology trials in two separate years were carefully reviewed to assess the possible influence of control versus lack of explicit control for effect of concomitant psychotherapy on clinical outcome. One hundred sixteen articles, published in the years 1996 and 2000, were reviewed. Those with categorically positive or non-positive global outcome were assessed for description of concomitant receipt of psychotherapy by subjects randomized to different pharmacotherapy treatments. Description of comparability in potentially confounding demographic and clinical variables was present in all studies. Only 22% of 89 studies meeting inclusion criteria explicitly controlled for concomitant psychotherapy. Seventy five percent of 20 studies that did, and only 46% of 69 studies that did not, found different outcomes in groups randomized to different pharmacotherapy interventions (p = .024). This result was not accounted for by other aspects of study design such as placebo-vs.-active control comparison, trial size, length, geographic location, number of sites or authors, source of funding, or diagnostic composition)-suggesting that uncontrolled receipt of psychotherapy may reduce likelihood of finding a difference between a new treatment and a control pharmacotherapy intervention. If confirmed by further investigation, the results may warrant adoption of relevant recommendations for controlled trial design in psychopharmacology research. The method used in this report may be useful in other areas of controlled trial research to assess influence of confounding variables. Published by Elsevier Inc. C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Clin, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Med Ctr, Los Angeles, CA USA. RP Koek, RJ (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, 16111 Plummer St 116A-11,North Hills, Los Angeles, CA 90024 USA. EM rkoek@ucla.edu NR 29 TC 3 Z9 3 U1 0 U2 1 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 JUN PY 2005 VL 26 IS 3 BP 338 EP 348 DI 10.1016/j.cct.2005.02.002 PG 11 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 937VU UT WOS:000229954900009 PM 15911468 ER PT J AU Michael, ST Snyder, CR AF Michael, ST Snyder, CR TI Getting unstuck: The roles of hope, finding meaning, and rumination in the adjustment to bereavement among college students SO DEATH STUDIES LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Association-for-the-Advancement-of-Behavior-Therapy CY NOV, 2002 CL Reno, NV SP Assoc Advancement Behav Therapy ID TRAUMA; DEPRESSION; VALIDATION; SENSE; MODEL AB The relationships between hope, bereavement-related rumination, and finding meaning (making sense and benefit finding) were examined in 158 college students who experienced the death of a loved one within the latter half of their lives. Greater rumination was related significantly to lessened psychological well-being, and it mediated the relationship between being able to make sense of the death and superior well-being. Finding benefits in bereavement was associated with positive adjustment for those who recently experienced the death of a loved one, whereas it was related to negative adjustment for those who experienced the death longer ago. Higher hope predicted greater well-being, but it was not related to rumination or finding meaning. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Kansas, Lawrence, KS 66045 USA. RP Michael, ST (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way 116-MHC, Seattle, WA 98108 USA. EM Scott.Michael@med.va.gov NR 34 TC 56 Z9 57 U1 2 U2 18 PU BRUNNER/MAZEL INC PI BRISTOL PA 1900 FROST RD, STE 101, BRISTOL, PA 19007-1598 USA SN 0748-1187 J9 DEATH STUD JI Death Stud. PD JUN PY 2005 VL 29 IS 5 BP 435 EP 458 DI 10.1080/07481180590932544 PG 24 WC Psychology, Multidisciplinary; Social Issues; Social Sciences, Biomedical SC Psychology; Social Issues; Biomedical Social Sciences GA 932ID UT WOS:000229546500004 PM 15971360 ER PT J AU Belfort, R Mandarino, L Kashyap, S Wirfel, K Pratipanawatr, T Berria, R DeFronzo, RA Cusi, K AF Belfort, R Mandarino, L Kashyap, S Wirfel, K Pratipanawatr, T Berria, R DeFronzo, RA Cusi, K TI Dose-response effect of elevated plasma free fatty acid on insulin signaling SO DIABETES LA English DT Article ID PROTEIN-KINASE-C; DEPENDENT DIABETES-MELLITUS; SKELETAL-MUSCLE CELLS; PHOSPHATIDYLINOSITOL 3-KINASE ACTIVITY; GLUCOSE-UPTAKE; RECEPTOR SUBSTRATE-1; FASTING HYPERGLYCEMIA; GLYCOGEN-SYNTHESIS; HEALTHY-SUBJECTS; KAPPA-B AB The dose-response relationship between elevated plasma free fatty acid (FFA) levels and impaired insulin-mediated glucose disposal and insulin signaling was examined in 21 lean, healthy, normal glucose-tolerant subjects. Following a 4-h saline or Liposyn infusion at 30 (n = 9), 60 (n = 6), and 90 (n = 6) ml/h, subjects received a 2-h euglycemic insulin (40 mU. m(-2) - min(-1)) clamp. Basal plasma FFA concentration (&SIM; 440 μ mol/l) was increased to 695, 1,251, and 1,688 μ mol/l after 4 h of Liposyn infusion and resulted in a dose-dependent reduction in insulin-stimulated glucose disposal (R-d) by 22, 30, and 34%, respectively (all P < 0.05 vs. saline control). At the lowest lipid infusion rate (30 ml/h), insulin receptor and insulin receptor substrate (IRS)-1 tyrosine phosphorylation, phosphatidylinositol (PI) 3-kinase activity associated with IRS-1, and Akt serine phosphorylation were all significantly impaired (P < 0.05-0.01). The highest lipid infusion rate (90 ml/h) caused a further significant reduction in all insulin signaling events compared with the low-dose lipid infusion (P < 0.05-0.01) whereas the 60-ml/h lipid infusion caused an intermediate reduction in insulin signaling. However, about two-thirds of the maximal inhibition of insulin-stimulated glucose disposal already occurred at the rather modest increase in plasma FFA induced by the low-dose (30-ml/h) lipid infusion. Insulin-stimulated glucose disposal was inversely correlated with both the plasma FFA concentration after 4 h of lipid infusion (r = -0.50, P = 0.001) and the plasma FFA level during the last 30 min of the insulin clamp (r = -0.54, P < 0.001). PI 3-kinase activity associated with IRS-1 correlated with insulin-stimulated glucose disposal (r = 0.45, P < 0.01) and inversely with both the plasma FFA concentration after 4 h of lipid infusion (r = -0.39, P = 0.01) and during the last 30 min of the insulin clamp (r = -0.43, P < 0.01). In summary, in skeletal muscle of lean, healthy subjects, a progressive increase in plasma FFA causes a dose-dependent inhibition of insulin-stimulated glucose disposal and insulin signaling. The inhibitory effect of plasma FFA was already significant following a rather modest increase in plasma FFA and develops at concentrations that are well within the physiological range (i.e., at plasma FFA levels observed in obesity and type 2 diabetes). C1 Univ Texas, Hlth Sci Ctr, Dept Med, Diabet Div, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, Diabet Div, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, Diabet Div, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Cusi, K (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Diabet Div, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM cusi@uthscsa.edu FU NCRR NIH HHS [M01-RR-01346]; NIDDK NIH HHS [R01 DK-24092] NR 75 TC 170 Z9 172 U1 0 U2 8 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JUN PY 2005 VL 54 IS 6 BP 1640 EP 1648 DI 10.2337/diabetes.54.6.1640 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 931QI UT WOS:000229499600004 PM 15919784 ER PT J AU Egede, LE Nietert, PJ Zheng, D AF Egede, LE Nietert, PJ Zheng, D TI Depression and all-cause and coronary heart disease mortality among adults with and without diabetes SO DIABETES CARE LA English DT Article; Proceedings Paper CT 64th Annual Meeting of the American-Diabetes-Association CY JUN 04-08, 2004 CL Orlando, FL SP Amer Diabet Assoc ID NATIONAL DEATH INDEX; MAJOR DEPRESSION; RISK-FACTOR; COMORBID DEPRESSION; CARDIAC MORTALITY; EXCESS MORTALITY; OLDER PERSONS; UNITED-STATES; US ADULTS; COMMUNITY AB OBJECTIVE - The aim of this study was to evaluate the effect of depression on all-cause and coronary heart disease (CHD) mortality among adults with and without diabetes. RESEARCH DESIGN AND METHODS - We studied 10,025 participants in the population-based National Health and Nutrition Examination Survey I Epidentiologic Follow-up Study who were alive and interviewed in 1982 and had complete data for the Center for Epidemiologic Studies Depression Scale. Four groups were created based on diabetes and depression status in 1982: 1) no diabetes, no depression (reference group); 2) no diabetes, depression present; 3) diabetes present, no depression; and i4) diabetes present, depression present. Cox proportional hazards regression models were used to calculate multivariate-adjusted hazard ratios (HRs) of death for each group compared with the reference group. RESULTS - Over 8 years (83,624 person-years of follow-up), 1,925 deaths were documented, including 522 deaths from CHD. Mortality rate per 1,000 person-years of follow-up was highest in the group with both diabetes and depression. Compared with the reference group, HRs for all-cause mortality were no diabetes, depression present, 1.20 (95% CI 1.03-1.40); diabetes present, no depression 1.88 (1.55-2.27); and diabetes present, depression present, 2 50 (2.04-3.08). HRs for CHD mortality were no diabetes, depression present, 1.29 (0.96-1.74); diabetes present, no depression 2.26 (1.60-3.21); and diabetes present, depression present, 2.43 (1.66-3.56). CONCLUSIONS - The coexistence of diabetes and depression is associated with a significantly increased risk of death from all causes, beyond that due to having either diabetes or depression alone. C1 Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. Univ S Carolina, Sch Med, Dept Family & Prevent Med, Palmetto Hlth Richland, Columbia, SC USA. RP Egede, LE (reprint author), Med Univ S Carolina, Ctr Hlth Care Res, 135 Cannon St,Sutie 403,POB 250837, Charleston, SC 29425 USA. EM egedel@musc.edu OI Nietert, Paul/0000-0002-3933-4986 FU AHRQ HHS [5K08 HS 11418] NR 48 TC 221 Z9 225 U1 4 U2 20 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUN PY 2005 VL 28 IS 6 BP 1339 EP 1345 DI 10.2337/diacare.28.6.1339 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 931QM UT WOS:000229500000011 PM 15920049 ER PT J AU Schneider, A Lawrence, EC Barmada, MM Norris, JM Hamman, RF Marshall, JA Ferrell, RE Whitcomb, DC AF Schneider, A Lawrence, EC Barmada, MM Norris, JM Hamman, RF Marshall, JA Ferrell, RE Whitcomb, DC TI The SPINK1N34S mutation is not associated with Type 2 diabetes mellitus in a population of the USA SO DIABETIC MEDICINE LA English DT Article DE chronic pancreatitis; pancreatic secretory trypsin inhibitor; serine protease inhibitor Kazal type 1; Type 2 diabetes mellitus ID IDIOPATHIC CHRONIC-PANCREATITIS; TROPICAL CALCIFIC PANCREATITIS; TRYPSIN-INHIBITOR MUTATIONS; SERINE-PROTEASE INHIBITOR; SPINK1/PSTI MUTATIONS; KAZAL TYPE-1; GENOME SCAN; GENE; LINKAGE; PREVALENCE AB Aims Mutations in the serine protease inhibitor (SPINK1) gene have been associated with all forms of chronic pancreatitis. Recently, an association of SPINK1 mutations with early-onset Type 2 diabetes mellitus has been reported in patients from Bangladesh. Therefore, we determined the frequency of SPINK1 N34S mutations in patients with Type 2 diabetes mellitus from the USA. Methods The study population of Hispanic and non-Hispanic white people consisted of 387 patients with Type 2 diabetes and familial clustering of the ease, 232 family members without diabetes, 259 patients with Type 2 diabetes without a family history, and 302 ethnically matched healthy controls as part of the San Luis Valley Diabetes Study. We performed linkage- and association-analysis in 82 multiplex families with Type 2 diabetes mellitus. Results No significant linkage or allele sharing was detected between Type 2 diabetes mellitus and the SPINK1 locus. The frequency of the N34S mutation was determined by fluorescence polarization and was similar between patients (n = 14/387 patients with familial clustering; n = 2/259 patients without family history) and controls (n = 5/232 family members without diabetes; n = 10/302 individuals). Variables such as ethnicity, age of diabetes onset and percentage of individuals with impaired glucose tolerance did not differ significantly between carriers and homozygous normal individuals. Conclusion The SPINK1 N34S mutation appears not to predispose Hispanic or non-Hispanic white people from the USA to the development of Type 2 diabetes mellitus. C1 Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Cell Biol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Physiol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Human Genet, Pittsburgh, PA 15261 USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. RP Whitcomb, DC (reprint author), UPMC Presbyterian, Mezzanine Level,C Wing,200 Lothrop St, Pittsburgh, PA 15213 USA. EM whitcomb@pitt.edu OI Barmada, M Michael/0000-0002-3604-6460 FU NIDDK NIH HHS [DK54709, DK54981] NR 33 TC 2 Z9 2 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0742-3071 J9 DIABETIC MED JI Diabetic Med. PD JUN PY 2005 VL 22 IS 6 BP 744 EP 748 DI 10.1111/j.1464-5491.2005.01513.x PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 935KP UT WOS:000229781500013 PM 15910626 ER PT J AU Kang, HJ O'Connell, JB Maggard, MA Sack, J Ko, CY AF Kang, HJ O'Connell, JB Maggard, MA Sack, J Ko, CY TI A 10-year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum SO DISEASES OF THE COLON & RECTUM LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-of-Colon-and-Rectal-Surgeons CY MAY 08-13, 2004 CL Dallas, TX SP Amer Soc Colon & Rectal Surg ID MULTIVARIATE-ANALYSIS; COLORECTAL-CARCINOMA; CANCER; ADENOCARCINOMA; SURVIVAL; DISEASE AB PURPOSE: Most studies examining mucinous or signet-ring cell colorectal cancers are single institution reports. This study used a national cancer registry to analyze the epidemiology and survival outcomes of these two subtypes of colorectal cancer compared with adenocarcinoma tumors. METHODS: All patients diagnosed with mucinous (n = 16,991), signet-ring cell (n = 1,522), or adenocarcinoma (n = 146,115) colorectal cancer in the Surveillance, Epidemiology, and End Results database (1991-2000) were evaluated. Analyses were performed to obtain age-adjusted incidence rates, stage at presentation, tumor grade, and five-year relative survival for each subtype. RESULTS: Mucinous were slightly more common in females (53.4 percent). Incidence rates per 100,000 persons were: mucinous, 5.5; signet-ring cell, 0.6; and adenocarcinoma 46.6. The annual percent change during ten years was stable for mucinous, increased for signet-ring cell (4.8 percent; P < 0.05), and decreased for adenocarcinoma (-1.1 percent; P < 0.05). Fewer mucinous (18 percent) and signet-ring cell (21 percent) tumors were located in the rectum compared with adenocarcinoma (29 percent). Signet-ring cell presented at later stage (III/IV, 80.9 percent) more often than mucinous (52.8 percent) and adenocarcinoma (49.5 percent), and also had worse tumor grade (high grade: signet-ring cell, 73.5 percent; mucinous, 20.9 percent; adenocarcinoma, 17.5 percent). Relative five-year survival was worse for signetring cell than mucinous or adenocarcinoma. CONCLUSIONS: We present a large population-based review of colorectal cancer subtypes by analyzing national data from the past decade. Although the incidence of colorectal adenocarcinoma is decreasing in the United States, mucinous and signet-ring cell subtypes are stable and increasing, respectively. Importantly, it seems that the signet-ring cell subtype has worse outcomes, whereas survival rates for mucinous tumors are similar to adenocarcinomas. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. Daehang Hosp, Dept Surg, Seoul, South Korea. Vet Adm Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Ko, CY (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 Le Conte Ave,72-215 CHS, Los Angeles, CA 90095 USA. EM cko@mednet.ucla.edu NR 24 TC 128 Z9 135 U1 1 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-3706 J9 DIS COLON RECTUM JI Dis. Colon Rectum PD JUN PY 2005 VL 48 IS 6 BP 1161 EP 1168 DI 10.1007/s10350-004-0932-1 PG 8 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 930KY UT WOS:000229415900009 PM 15868237 ER PT J AU Maslow, JN Lee, B Lautenbach, E AF Maslow, JN Lee, B Lautenbach, E TI Fluoroquinolone-resistant Escherichia coli carriage in long-term care facility SO EMERGING INFECTIOUS DISEASES LA English DT Article ID NURSING-HOME RESIDENTS; GRAM-NEGATIVE BACILLI; RISK-FACTORS; ANTIMICROBIAL RESISTANCE; ENTEROCOCCUS-FAECIUM; ANTIBIOTIC USE; CIPROFLOXACIN RESISTANCE; MOLECULAR EPIDEMIOLOGY; KLEBSIELLA-PNEUMONIAE; CANCER AB We conducted a cross-sectional study to determine the prevalence of, and risk factors for, colonization with fluoroquinolone (FQ)-resistant Escherichia coli in residents in a long-term care facility. FQ-resistant E. coli were identified from rectal swabs for 25 (51%) of 49 participants at study entry. On multivariable analyses, prior FQ use was the only independent risk factor for FQ-resistant E. coli carriage and was consistent for FQ exposures in the previous 3, 6, 9, or 12 months. Pulsed-field gel electrophoresis of FQ-resistant E. coli identified clonal spread of 1 strain among 16 residents. Loss (6 residents) or acquisition (7 residents) of FQ-resistant E. coli was documented and was associated with de novo colonization with genetically distinct strains. Unlike the case in the hospital setting, FQ-resistant E. coli carriage in long-term care facilities is associated with clonal spread. C1 Dept Vet Affairs Med Ctr, ACOS Res, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia, PA 19104 USA. RP Maslow, JN (reprint author), Dept Vet Affairs Med Ctr, ACOS Res, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM joel.maslow@med.va.gov FU NIAID NIH HHS [AI 450008, AI32783, U01 AI032783]; NIDDK NIH HHS [DK-02987-01] NR 39 TC 37 Z9 37 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUN PY 2005 VL 11 IS 6 BP 889 EP 894 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 928YG UT WOS:000229307400015 PM 15963284 ER PT J AU Liou, AKF Zhou, ZG Pei, W Lim, TM Yin, XM Chen, J AF Liou, AKF Zhou, ZG Pei, W Lim, TM Yin, XM Chen, J TI BimEL up-regulation potentiates AIF translocation and cell death in response to MPTP SO FASEB JOURNAL LA English DT Article DE mitochondria; calpain I; MPP plus treatment ID APOPTOSIS-INDUCING FACTOR; SPINAL-CORD-INJURY; DOPAMINERGIC NEURONAL CELLS; CEREBELLAR GRANULE NEURONS; CYTOCHROME-C RELEASE; BH3-ONLY PROTEIN BIM; BCL-2 FAMILY MEMBER; PARKINSONS-DISEASE; OXIDATIVE STRESS; PC12 CELLS AB This study attempted to elucidate the signaling mechanism underlying dopaminergic cell death in the MPP+ model for Parkinson's disease. In neuronal-differentiated PC12 cells, through the regulation by activated JNK and c-jun, BimEL expression was markedly increased in response to MPP+ treatment, which led to the cell degeneration. In lieu of Smac translocation as seen in other paradigms, up-regulation of BimEL effected an increase in calpain I activity that, in turn, mediated AIF release from the mitochondria. In support, we found that knocking down BimEL expression resulted in a decrease in calpain I activity, as well as AIF release from the mitochondria and cell death. Finally, inhibition of calpain activity mitigated AIF release from the mitochondria and cell death. Under cell-free conditions, activated purified calpain I could induce the release of AIF from isolated mitochondria without the participation of BimEL or activated JNK, suggesting that AIF release is a direct consequence of calpain I activity. In concert, the results suggest a novel signaling pathway for dopaminergic cell degeneration, in which MPP+ induces the up-regulation of BimEL, which in turn potentiates an elevation in calpain I activity that mediates AIF release and cell death in a caspase-independent manner. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15261 USA. Pittsburgh Inst Neurodegenerat Disorders, Pittsburgh, PA USA. Natl Univ Singapore, Dept Sci Biol, Singapore 117548, Singapore. Vet Affairs Pittsburgh Hlth Care Syst, Educ & Clin Ctr, Pittsburgh, PA USA. RP Liou, AKF (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S507 Biomed Sci Tower,3500 Terrace St, Pittsburgh, PA 15261 USA. EM lioukf@upmc.edu FU NINDS NIH HHS [NS45048, NS43802, NS44178] NR 63 TC 55 Z9 57 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 JUN PY 2005 VL 19 IS 8 BP 1350 EP + DI 10.1096/fj.04-3258fje PG 30 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 941IF UT WOS:000230207800029 PM 15941767 ER PT J AU Chang, L AF Chang, L TI Brain responses to visceral and somatic stimuli in irritable bowel syndrome: a central nervous system disorder? SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Article ID 5-HT3 RECEPTOR ANTAGONIST; CEREBRAL ACTIVATION; RECTAL DISTENSION; GENDER-DIFFERENCES; CUTANEOUS PAIN; PERCEPTION; ALOSETRON; HYPERSENSITIVITY; REPRESENTATION; FIBROMYALGIA AB This article reviews the findings from functional neuroimaging studies that have evaluated central processing of visceral and somatic stimuli in healthy individuals and also provides evidence for alterations of these central networks to visceral and somatic stimuli in irritable bowel syndrome. C1 Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Chang, L (reprint author), Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, David Geffen Sch Med, CURE Bldg 115,Room 223,11301 Wilshire Blvd, Los Angeles, CA 90024 USA. EM linchang@ucla.edu NR 42 TC 37 Z9 39 U1 1 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8553 J9 GASTROENTEROL CLIN N JI Gastroenterol. Clin. North Am. PD JUN PY 2005 VL 34 IS 2 BP 271 EP + DI 10.1016/j.gtc.2005.02.003 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 930HO UT WOS:000229406700009 PM 15862935 ER PT J AU Graham, DY Shiotani, A AF Graham, DY Shiotani, A TI The time to eradicate gastric cancer is now SO GUT LA English DT Article ID HELICOBACTER-PYLORI INFECTION; CHRONIC ATROPHIC GASTRITIS; INTESTINAL METAPLASIA; SUBSEQUENT DEVELOPMENT; ENDOSCOPIC RESECTION; MUCOSAL ATROPHY; DUODENAL-ULCER; ACID-SECRETION; JAPAN; CARCINOMA AB Worldwide gastric cancer remains one of the most common cancers, killing upwards of one million people each year. While the molecular pathogenesis remains unclear, infection with the bacterium Helicobacter pylori is considered a `` necessary but not sufficient'' cause, not surprisingly as gastric cancer has long been known to be associated with atrophic gastritis. Eradication of H pylori is expected to virtually eliminate gastric cancer and H pylori associated peptic ulcer within approximately 40 years and thus reduce overall mortality. In the USA, the incidence of gastric cancer in the general population is low, reflecting the change in the pattern of gastritis from atrophic to nonatrophic and in the low and decreasing prevalence of H pylori infection in the middle and upper classes. However, the plan for eradication of this important pathogen must be considered within the context of the prevalence and outcome within specific populations. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Med & Mol Virol, Houston, TX 77030 USA. Baylor Coll Med, Dept Microbiol, Houston, TX 77030 USA. Wakayama Univ, Hlth Adm Ctr, Wakayama, Japan. RP Graham, DY (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, RM 3A-320 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu FU NIDDK NIH HHS [DK56338, P30 DK056338] NR 44 TC 80 Z9 81 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD JUN PY 2005 VL 54 IS 6 BP 735 EP 738 DI 10.1136/gut.2004.056549 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 925FP UT WOS:000229037700001 PM 15888771 ER PT J AU Schwartz, DL Ford, EC Rajendran, J Yueh, B Coltrera, MD Virgin, J Anzai, Y Haynor, D Lewellen, B Mattes, D Kinahan, P Meyer, J Phillips, M LeBlanc, M Krohn, K Eary, J Laramore, GE AF Schwartz, DL Ford, EC Rajendran, J Yueh, B Coltrera, MD Virgin, J Anzai, Y Haynor, D Lewellen, B Mattes, D Kinahan, P Meyer, J Phillips, M LeBlanc, M Krohn, K Eary, J Laramore, GE TI FDG-PET/CT-guided intensity modulated head and neck radiotherapy: A pilot investigation SO HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK LA English DT Article; Proceedings Paper CT 6th International Conference on Head and Neck Cancer CY AUG 09, 2004 CL Washington, DC SP Amer Head & Neck Soc DE head and neck cancer; positron emission tomography; intensity modulated radiotherapy; multimodality imaging; dose escalation ID POSITRON-EMISSION-TOMOGRAPHY; SQUAMOUS-CELL CARCINOMA; CLINICALLY NEGATIVE NECK; QUALITY-OF-LIFE; RADIATION-THERAPY; COMPUTED-TOMOGRAPHY; DOSE-ESCALATION; CONFORMAL RADIATION; POSTOPERATIVE IMRT; EXTRACRANIAL HEAD AB Background. 2-deoxy-2[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) imaging can be registered with CT images and can potentially improve neck staging sensitivity and specificity in patients with head and neck squamous cell cancer. The intent of this study was to examine the use of registered FDG-PET/CT imaging to guide head and neck intensity modulated radiotherapy (IMRT) planning. Methods. Twenty patients with squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx underwent FDG-PET and contrast-enhanced CT imaging of the head and neck before neck dissection surgery, Combined FDG-PET/CT images were created by use of a nonrigid image registration algorithm. All IMRT plans were theoretical and were not used for treatment. We prescribed 66 Gy in 30 fractions to FDG-avid CT abnormalities and nodal zones directly involved with disease, without prophylactic coverage of uninvolved neck levels. Matched CT-guided IMRT plans designed according to the specifications of Radiation Therapy Oncology Group (RTOG) H-0022 were available for comparison. We investigated the feasibility of FDG-PET/CT-directed IMRT dose escalation in five patients with FDG-avid disease located away from critical normal structures. After 66 Gy, FDG-avid disease with 0.5-cm margins was boosted in 220 cGy increments until dose-limiting criteria were reached. Results. Elimination of prophylactic coverage to FDG-PET/CT-negative neck levels markedly reduced mean dose (Dmean) to the contralateral parotid gland (p < .001) and Dmean to the laryngeal cartilage (p = .001). No FDG-PET/CT-directed plan missed pathologically verified nodal disease. During the dose escalation exercise, we successfully increased the dose to 95% of the planning target volume (PTV95%) to a mean of 7490 cGy (range, 7153-8098 cGy). Conclusions. We demonstrate early proof of the principle that FDG-PET/CT-guided IMRT planning can selectively target and intensify treatment of head and neck disease while reducing critical normal tissue doses. Routine clinical use of such planning should not be engaged until the accuracy of FDG-PET/CT is fully validated. Future directions, including refinement of treatment to gross disease and radiologically uninvolved neck nodal levels, are discussed. (c) 2005 Wiley Periodicals, Inc. C1 Univ Washington, Dept Radiat Oncol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Radiat Oncol, Seattle, WA USA. Univ Washington, Div Nucl Med, Seattle, WA 98195 USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Otolaryngol Head & Neck Surg, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Dept Pathol, Seattle, WA USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Schwartz, DL (reprint author), Univ Texas, MD Anderson Canc Ctr, Dept Radiat Oncol, Unit 97, 1515 Holcombe Blvd, Houston, TX 77030 USA. EM docdls@mdanderson.org OI Yueh, Bevan/0000-0003-1380-1053; Meyer, Juergen/0000-0003-4350-2222; Kinahan, Paul/0000-0001-6461-3306 FU NCI NIH HHS [CA42045] NR 45 TC 87 Z9 91 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1043-3074 J9 HEAD NECK-J SCI SPEC JI Head Neck-J. Sci. Spec. Head Neck PD JUN PY 2005 VL 27 IS 6 BP 478 EP 487 DI 10.1002/hed.20177 PG 10 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 931BU UT WOS:000229461600005 PM 15772953 ER PT J AU Maciejewski, ML Liu, CF Derleth, A McDonell, M Anderson, S Fihn, SD AF Maciejewski, ML Liu, CF Derleth, A McDonell, M Anderson, S Fihn, SD TI The performance of administrative and self-reported measures for risk adjustment of veterans affairs expenditures SO HEALTH SERVICES RESEARCH LA English DT Article DE risk adjustment; health status; expenditures; VA; risk segmentation ID CASE-MIX MEASURES; HEALTH-STATUS; CAPITATION RATES; POPULATION; MEDICARE; VALIDATION; DIAGNOSES; SELECTION; QUALITY; PAYMENT AB Objective. To evaluate the performance of different prospective risk adjustment models of outpatient, inpatient, and total expenditures of veterans who regularly use Veterans Affairs (VA) primary care. Data Sources. We utilized administrative, survey and expenditure data on 14,449 VA patients enrolled in a randomized trial that gave providers regular patient health assessments. Study Design. This cohort study compared five administrative data-based, two self-report risk adjusters, and base year expenditures in prospective models. Data Extraction Methods. VA outpatient care and nonacute inpatient care expenditures were based on unit expenditures and utilization, while VA expenditures for acute inpatient care were calculated from a Medicare-based inpatient cost function. Risk adjusters for this sample were constructed from diagnosis, medication and self-report data collected during a clinical trial. Model performance was compared using adjusted R 2 and predictive ratios. Principal Findings. In all expenditure models, administrative-based measures performed better than self-reported measures, which performed better than age and gender. The Diagnosis Cost Groups (DCG) model explained total expenditure variation (R-2 = 7.2 percent) better than other models. Prior outpatient expenditures predicted outpatient expenditures best by far (R-2 =42 percent). Models with multiple measures improved overall prediction, reduced over-prediction of low expenditure quintiles, and reduced under-prediction in the highest quintile of expenditures. Conclusions. Prediction of VA total expenditures was poor because expenditure variation reflected utilization variation, but not patient severity. Base year expenditures were the best predictor of outpatient expenditures and nearly the best for total expenditures. Models that combined two or more risk adjusters predicted expenditures better than single-measure models, but are more difficult and expensive to apply. C1 Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev NW Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Maciejewski, ML (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev NW Ctr Excellence, Seattle, WA USA. NR 26 TC 47 Z9 47 U1 4 U2 9 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD JUN PY 2005 VL 40 IS 3 BP 887 EP 904 DI 10.1111/j.1475-6773.2005.00390.x PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 928NX UT WOS:000229279700015 PM 15960696 ER PT J AU Blom, AS Pilla, JJ Gorman, RC Gorman, JH Mukherjee, R Spinale, FG Acker, MA AF Blom, AS Pilla, JJ Gorman, RC Gorman, JH Mukherjee, R Spinale, FG Acker, MA TI Infarct size reduction and attenuation of global left ventricular remodeling with the CorCap (TM) stop cardiac support device following acute myocardial infarction in sheep SO HEART FAILURE REVIEWS LA English DT Article DE remodeling; myocardial infarction; MRI; pressure-volume analysis; matrix metalloproteinase ID MATRIX-METALLOPROTEINASE INHIBITION; TACHYCARDIA-INDUCED CARDIOMYOPATHY; HEART-FAILURE; DILATED CARDIOMYOPATHY; CLINICAL-IMPLICATIONS; TISSUE INHIBITOR; NATURAL-HISTORY; REPERFUSION; MATRIX-METALLOPROTEINASE-9; DYSFUNCTION AB Background:Whether mechanical restraint of the left ventricle (LV) can influence remodeling following myocardial infarction (MI) remains poorly understood. The following discussion details three studies examining the effects of surgically placing a cardiac support device (CSD) over the entire epicardial surface, on infarct expansion, global cardiac function and myocyte geometry and function post-MI. Methods: The effects of passive constraint on infarct expansion and global cardiac function/myocardial energetics were investigated in 10 sheep (5 MI only; 5 MI + CSD) using pressure-volume analysis and magnetic resonance imaging (MRI). Additionally, 11 sheep (5 MI only; 6 MI + CSD) were used to study the effects of passive restraint on myocyte geometry and function post-MI, with 10 additional uninstrumented sheep serving as controls. Baseline data was collected followed by the creation of an anterior infarct. 1 week post-infarct the animals underwent a second set of data collection studies followed by placement of the CSD in the experimental groups. Additional data was collected at 2 and 3 months post-MI. The animals in the myocyte function group underwent additional studies immediately following the 3 month time point. Results: Infarct expansion was diminished as a result of the CSD. At 1 week post-MI the akinetic area was similar in both groups. At the terminal time-point, the akinetic area in the control group was similar to the 1-week time-point whereas, in the CSD group, the area of akinesis decreased (P = 0.001). A comparison of the two groups at the terminal time-point demonstrates a significantly diminished area of akinesis in the CSD group (P = 0.004). The relative area of akinesis followed a similar pattern. The CSD group also exhibited a decrease in end-diastolic volume (control 110.3 +/- 19.8 mL vs. CSD 67.6 +/- 4.7 mL, P = .006) and an improved ejection fraction (control 15.5% +/- 5.7% vs. CSD 29.46% +/- 4.42%, P = .008) relative to the control group. Myocardial energetics were also enhanced in the CSD group as evidenced by significant improvements in potential energy (control 2015 +/- 503 mL (.) mm Hg/beat vs. CSD 885 +/- 220 mL (.) Hg/beat, P = .006), efficiency (control 39.4% +/- 13.6% vs. CSD 59.8% +/- 8.5%, P = .044), and oxygen consumption (control 0.072 +/- 0.013 mL O-2/beat vs. CSD 0.052 +/- 0.007 mL O-2/beat, P = .034). Isolated LV myocyte shortening velocity was reduced by 35% from control values (P < 0.05) in both MI groups. LV myocyte beta-adrenergic response was reduced with MI, but normalized in the MI + CSD group. Relative collagen content was increased and matrix metalloproteinase-9 was decreased within the MI border region of the CSD group. Conclusions:The CorCap cardiac support device retarded infarct expansion, improved global and regional cardiac function and beneficially modified LV and myocyte remodeling post-MI. These findings provide evidence that non-pharmacological strategies can interrupt adverse LV remodeling post-MI. C1 Univ Penn, Med Ctr, Dept Surg, Philadelphia, PA 19104 USA. Univ Penn, Med Ctr, Dept Radiol, Philadelphia, PA 19104 USA. Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs, Charleston, SC USA. RP Acker, MA (reprint author), Hosp Univ Penn, Div Cardiovasc Surg, 6th Floor Silverstein Pavil, Philadelphia, PA 19104 USA. FU NHLBI NIH HHS [R01 HL071137, R01 HL063954] NR 44 TC 22 Z9 22 U1 0 U2 3 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 1382-4147 J9 HEART FAIL REV JI Heart Fail. Rev. PD JUN PY 2005 VL 10 IS 2 BP 125 EP 139 DI 10.1007/s10741-005-4640-2 PG 15 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 979CJ UT WOS:000232919500006 PM 16258720 ER PT J AU Kaplan, DE Sugimoto, K Ikeda, F Stadanlick, J Valiga, M Shetty, K Reddy, KR Chang, KM AF Kaplan, DE Sugimoto, K Ikeda, F Stadanlick, J Valiga, M Shetty, K Reddy, KR Chang, KM TI T-cell response relative to genotype and ethnicity during antiviral therapy for chronic hepatitis C SO HEPATOLOGY LA English DT Article ID ALPHA-2B PLUS RIBAVIRIN; VIRUS-INFECTION; IMMUNE-RESPONSE; B-VIRUS; NONSTRUCTURAL PROTEIN-3; AFRICAN-AMERICANS; DENDRITIC CELLS; HCV INFECTION; INTERFERON; PEGINTERFERON AB Viral genotype and host ethnicity are important predictors of viral clearance during antiviral therapy for chronic hepatitis C virus (HCV) infection. Based on the role of T cells in natural HCV clearance, we hypothesized that T cells may contribute to the genotypic and ethnic difference in treatment outcome. To test this hypothesis, T-cell response to HCV antigens (core, nonstructural NS3/4 and NS5) and control phytohemagglutinin (PRA) was monitored prospectively and was correlated with virological outcome in 41 patients chronically infected with HCV (27 genotype 1, 14 genotype 2 or 3; 19 black persons, 22 white persons) undergoing combined interferon alfa and ribavirin therapy. Interestingly, in patients with genotype 2 or 3 infection, enhanced virological response coincided with a greater T-cell response to HCV NS3/4 antigen at baseline (50% vs. 15%; P =.026) that augmented further during therapy (29% vs. 4%; P =.035) compared with genotype 1-infected patients. However, HCV-specific T-cell response remained weak in genotype 1-infected patients regardless of virological outcome or ethnicity. Furthermore, virological outcome was associated with a suppressed baseline proliferative response to phytohemagglutinin (P <.03) that increased during therapy (P <.003) independent of ethnicity or genotype. In conclusion, HCV-specific T-cell response was associated with HCV genotype but not with therapeutic clearance of HCV infection. The association between treatment outcome and phytohemagglutinin response suggests more global and antigen-nonspecific mechanisms for therapeutic HCV clearance. C1 Univ Penn, Dept Med, Div Gastroenterol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Dept Med, Div Gastroenterol, Philadelphia, PA 19104 USA. Georgetown Univ, Dept Med, Div Gastroenterol, Washington, DC USA. RP Chang, KM (reprint author), Univ Penn, Dept Med, Div Gastroenterol, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM kmchang@mail.med.upenn.edu OI Kaplan, David E./0000-0002-3839-336X FU NCRR NIH HHS [M01-RR00040]; NIAAA NIH HHS [AA12849]; NIAID NIH HHS [AI47519]; NIDDK NIH HHS [P30DK50306, T32 DK 07066] NR 48 TC 41 Z9 41 U1 1 U2 5 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JUN PY 2005 VL 41 IS 6 BP 1365 EP 1375 DI 10.1002/hep.20706 PG 11 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 931WX UT WOS:000229517300020 PM 15915458 ER PT J AU Lattemann, DF AF Lattemann, DF TI Brain food reward circuitry is a target for adiposity signals. SO HORMONES AND BEHAVIOR LA English DT Meeting Abstract CT 9th Annual Meeting of the Society-for-Behavioral-Neuroendocrinology CY JUN 22-25, 2005 CL Univ Texas Austin, Austin, TX SP Soc Behav Neuroendocrinol HO Univ Texas Austin C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0018-506X J9 HORM BEHAV JI Horm. Behav. PD JUN PY 2005 VL 48 IS 1 MA 8 BP 81 EP 81 PG 1 WC Behavioral Sciences; Endocrinology & Metabolism SC Behavioral Sciences; Endocrinology & Metabolism GA 934KR UT WOS:000229708200016 ER PT J AU Peralta, CA Hicks, LS Chertow, GM Ayanian, JZ Vittinghoff, E Lin, F Shlipak, MG AF Peralta, CA Hicks, LS Chertow, GM Ayanian, JZ Vittinghoff, E Lin, F Shlipak, MG TI Control of hypertension in adults with chronic kidney disease in the United States SO HYPERTENSION LA English DT Article DE kidney; race ID ISOLATED SYSTOLIC HYPERTENSION; BLOOD-PRESSURE CONTROL; STAGE RENAL-DISEASE; PULSE PRESSURE; ANTIHYPERTENSIVE THERAPY; CARDIOVASCULAR EVENTS; ARTERIAL STIFFNESS; STROKE PREVENTION; ELDERLY-PATIENTS; HEART-FAILURE AB Although improved control of hypertension is known to attenuate progression of chronic kidney disease (CKD), little is known about the adequacy of hypertension treatment in adults with CKD in the United States. Using data from the Fourth National Health and Nutrition Survey, we assessed adherence to national hypertension guideline targets for patients with CKD ( blood pressure < 130/80 mm Hg), we assessed control of systolic ( < 130 mm Hg) and diastolic ( < 80 mm Hg) blood pressure, and we evaluated determinants of adequate blood pressure control. Presence of CKD was defined as glomerular filtration rate < 60 mL/min per 1.73 m(2) or presence of albuminuria ( albumin: creatinine ratio > 30 mu g/mg). Multivariable logistic regression with appropriate weights was used to determine predictors of inadequate hypertension control and related outcomes. Among 3213 participants with CKD, 37% had blood pressure < 130/ 80 mm Hg (95% confidence interval [CI], 34.5% to 41.8%). Of those with inadequate blood pressure control, 59% ( 95% CI, 54% to 64%) had systolic > 130 mm Hg, with diastolic <= 80 mm Hg, whereas only 7% ( 95% CI, 3.9 to 9.8%) had a diastolic pressure > 80 mm Hg, with systolic blood pressure <= 130 mm Hg. Non-Hispanic black race ( odds ratio [ OR], 2.4; 95% CI, 1.5 to 3.9), age > 75 years ( OR, 4.7; 95% CI, 2.7 to 8.2), and albuminuria ( OR, 2.4; 95% CI, 1.4 to 4.1) were independently associated with inadequate blood pressure control. We conclude that control of hypertension is poor in participants with CKD and that lack of control is primarily attributable to systolic hypertension. Future guidelines and antihypertensive therapies for patients with CKD should target isolated systolic hypertension. C1 San Francisco Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Brigham & Womens Hosp, Div Gen Internal Med, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. RP Peralta, CA (reprint author), Dept Vet Affairs, Box 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM Carmen.Peralta@med.va.gov FU NIDDK NIH HHS [R01 DK01005, R01 DK58411] NR 46 TC 99 Z9 103 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD JUN PY 2005 VL 45 IS 6 BP 1119 EP 1124 DI 10.1161/01.HYP.0000164577.81087.70 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 930DS UT WOS:000229396600017 PM 15851626 ER PT J AU Wang, Y Carter, RH AF Wang, Y Carter, RH TI CD19 regulates B cell maturation, proliferation, and positive selection in the FDC zone of murine splenic germinal centers SO IMMUNITY LA English DT Article ID FOLLICULAR DENDRITIC CELLS; IMMUNE-RESPONSES; MARGINAL-ZONE; T-CELLS; IMMUNOGLOBULIN GENES; AFFINITY MATURATION; SOMATIC MUTATION; CR2(-/-) MICE; ANTIBODY; HYPERMUTATION AB Mice with mutations in CD19 Y482/Y513 form germinal centers (GC) but fail to produce high-affinity antibodies. In these mice, GC B cell differentiation, proliferation, and class switching occur but are defective. Altered CD19 signaling results in retention of early GC B cells and reduced proliferation in the follicular dendritic cell (FDC) zone of GC, and causes failure to select for high-affinity mutations. In normal mice, the earliest detectable aggregates of GC B cells are in contact with FDC and IgM(+) cells are only found in the FDC zone, further evidence that the FDC zone is the site of initial GC B cell proliferation, differentiation, and class switching. Proliferation in the non-FDC zone and somatic mutation are not dependent on CD19, indicating separate signaling requirements for the two GC compartments, but these CD19-independent GC functions are not sufficient to generate high-affinity antibodies and B cell memory. C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL 35294 USA. RP Carter, RH (reprint author), Univ Alabama, Dept Med, Birmingham, AL 35294 USA. EM rcarter@uab.edu FU NIAID NIH HHS [AI42265, T32 AI007051]; NIAMS NIH HHS [AR74315] NR 50 TC 61 Z9 63 U1 0 U2 5 PU CELL PRESS PI CAMBRIDGE PA 1100 MASSACHUSETTS AVE, CAMBRIDGE, MA 02138 USA SN 1074-7613 J9 IMMUNITY JI Immunity PD JUN PY 2005 VL 22 IS 6 BP 749 EP 761 DI 10.1016/j.immuni.2005.04.012 PG 13 WC Immunology SC Immunology GA 940XX UT WOS:000230180300012 PM 15963789 ER PT J AU Bluthenthal, RN Heinzerling, K Martinez, A Kral, AH AF Bluthenthal, RN Heinzerling, K Martinez, A Kral, AH TI Police crackdowns, societal cost, and the need for alternative approaches SO INTERNATIONAL JOURNAL OF DRUG POLICY LA English DT Editorial Material ID DRUG-USERS; INCARCERATION; SERVICES C1 RAND Corp, Hlth Program, Santa Monica, CA 90407 USA. RAND Corp, Drug Policy Res Ctr, Drew Ctr AIDS Res Educ & Serv, Dept Psychiat,Charles R Drew Univ Med & Sci,CARES, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, VA Robert Wood Johnson Clin Scholars Program, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Bluthenthal, RN (reprint author), RAND Corp, Hlth Program, 1776 Main St,POB 2138, Santa Monica, CA 90407 USA. EM rickyb@rand.org OI Bluthenthal, Ricky/0000-0003-3491-1702 NR 13 TC 4 Z9 4 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0955-3959 J9 INT J DRUG POLICY JI Int. J. Drug Policy PD JUN PY 2005 VL 16 IS 3 BP 137 EP 138 DI 10.1016/j.drugpo.2005.05.003 PG 2 WC Substance Abuse SC Substance Abuse GA 962DZ UT WOS:000231712500001 ER PT J AU Rosin, RA Raskind, MA AF Rosin, RA Raskind, MA TI Gonadotrophin-releasing hormone agonist treatment of aggression in Alzheimer's disease: a case report SO INTERNATIONAL PSYCHOGERIATRICS LA English DT Article DE agitation; aggressive behavior; hormonal therapy; LHRH analogue; psychotropic ID PLASMA TESTOSTERONE; ESTROGEN THERAPY; ELDERLY-PATIENTS; BEHAVIOR; DEMENTIA; SYMPTOMS; MOOD; MEN AB No medication has received regulatory approval in the U.S.A. for the distressing agitation and aggressive behaviors that often complicate dementia. Although studies suggest that several psychotropic medications are sometimes useful for these behavioral problems, response is variable and adverse effects often limit treatment. Theoretical considerations suggest that increasing estrogenic activity or reducing androgenic activity could reduce agitation and aggression in dementia. Estrogen has been reported helpful for these symptoms, but adverse effects are problematic. Chronic administration of the synthetic gonadotropin (luteinising hormone) releasing hormone analogue, goserelin, reduces testosterone activity. Here we describe the apparently sustained elimination of previously treatment-resistant agitation and aggression with goserelin treatment in a 78-year-old male nursing-home resident with Alzheimer's disease. C1 VA Puget Sound Hlth Care Syst, Dept Vet Affairs, MIRECC, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Rosin, RA (reprint author), VA Puget Sound Hlth Care Syst, Dept Vet Affairs, MIRECC, 1660 S Columbian Way, Seattle, WA 98108 USA. EM richard.rosin@med.va.gov NR 20 TC 4 Z9 4 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1041-6102 J9 INT PSYCHOGERIATR JI Int. Psychogeriatr. PD JUN PY 2005 VL 17 IS 2 BP 313 EP 318 DI 10.1017/S1041610205001614 PG 6 WC Psychology, Clinical; Geriatrics & Gerontology; Gerontology; Psychiatry; Psychology SC Psychology; Geriatrics & Gerontology; Psychiatry GA 950LC UT WOS:000230857600015 PM 16050439 ER PT J AU Revicki, DA Hirschfeld, RMA Ahearn, EP Weisler, RH Palmer, C Keck, PE AF Revicki, DA Hirschfeld, RMA Ahearn, EP Weisler, RH Palmer, C Keck, PE TI Effectiveness and medical costs of divalproex versus lithium in the treatment of bipolar disorder: Results of a naturalistic clinical trial SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE divalproex; lithium; cost-effectiveness analysis; bipolar disorder; clinical trials ID MANIC-DEPRESSIVE ILLNESS; I DISORDER; PHARMACOECONOMIC EVALUATION; UNITED-STATES; FOLLOW-UP; EFFICACY; PLACEBO; HOSPITALIZATION; OUTPATIENTS; PREVALENCE AB Objective: The clinical, quality of life (QOL), and medical cost outcomes of treatment with divalproex were compared with lithium in patients with bipolar I disorder over 1 year. Methods: In a pragmatic, randomized clinical trial, 201 adults hospitalized with bipolar I manic or mixed episodes were randomized to divalproex or lithium, in addition to usual psychiatric care, and followed for I year. All subsequent treatment of bipolar disorder was managed by the patient's psychiatrist. Symptoms of mania and depression were evaluated at baseline and at hospital discharge. Assessments at the start of maintenance therapy and after 1, 3, 6, 9 and 12 months included manic and depressive symptoms, disability days and QOL. Medical resource use data were also collected monthly and costs were estimated using national sources. Results: Divalproex-treated patients (12%) were less likely to discontinue study medications for lack of efficacy or adverse effects than lithium-treated patients (23%). No statistically significant differences between the treatment groups were observed over the 1-year maintenance phase for clinical symptoms, QOL outcomes, or disability days. Mean estimated total medical costs were $28,911 for the divalproex group compared with $30,666 for the lithium treatment group. Patients continuing mood stabilizer therapy at 3 months had slightly better health outcomes and substantially lower total medical costs than those who discontinued therapy ($10,091 versus $34,432, respectively). Conclusions: Divalproex maintenance treatment for bipolar disorder resulted in comparable medical costs, clinical and QOL outcomes compared with lithium. Patients remaining on mood stabilizer therapy had substantially lower total medical costs and better health outcomes compared with those who discontinued therapy. (c) 2005 Elsevier B.V. All rights reserved. C1 MEDTAP Int, Ctr Hlth Outcomes Res, Bethesda, MD 20814 USA. Univ Texas, Med Branch, Dept Psychiat, Galveston, TX 77550 USA. William S Middleton Mem Vet Adm Med Ctr, Mental Hlth Serv, Madison, WI USA. Duke Univ, Med Ctr, Durham, NC USA. Agcy Hlth Res & Qual, Ctr Org & Delivery Studies, Rockville, MD USA. Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, Cincinnati, OH USA. RP Revicki, DA (reprint author), MEDTAP Int, Ctr Hlth Outcomes Res, 7101 Wisconsin Ave,Suite 600, Bethesda, MD 20814 USA. EM Revicki@Medtap.com NR 41 TC 24 Z9 26 U1 2 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD JUN PY 2005 VL 86 IS 2-3 BP 183 EP 193 DI 10.1016/j.jad.2005.01.002 PG 11 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 936TX UT WOS:000229879400009 PM 15935238 ER PT J AU Yan, LJ Hammen, C Cohen, AN Daley, SE Henry, RM AF Yan, LJ Hammen, C Cohen, AN Daley, SE Henry, RM TI Corrigendum to "Expressed emotion versus relationship quality prediction of recurrence in bipolar patients" (vol 83, pg 199, 2005) SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Correction C1 Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. W Los Angeles VA Healthcare Ctr, Los Angeles, CA USA. MIRECC, Los Angeles, CA USA. Univ So Calif, Dept Psychol, Los Angeles, CA 90089 USA. Univ So Calif, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. RP Yan, LJ (reprint author), Univ Calif Los Angeles, Dept Psychol, 1285 Franz Hall,POB 951563,405 Hilgard Ave, Los Angeles, CA 90095 USA. EM ljyan@ucla.edu NR 1 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD JUN PY 2005 VL 86 IS 2-3 BP 337 EP 337 DI 10.1016/j.jad.2005.02.011 PG 1 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 936TX UT WOS:000229879400029 ER PT J AU Evans, CT Smith, B Parada, JP Kurichi, JE Weaver, FM AF Evans, CT Smith, B Parada, JP Kurichi, JE Weaver, FM TI Trends in antibiotic prescribing for acute respiratory infection in veterans with spinal cord injury and disorder SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE upper respiratory infections; prescription rates; bronchitis; pneumonia; disabilities ID COMMUNITY-ACQUIRED PNEUMONIA; UNITED-STATES; ADULTS; GUIDELINES; MANAGEMENT; BRONCHITIS AB Objectives: Most acute respiratory infections (ARIs) are viral and do not warrant antibiotic therapy. Studies to date have not examined trends in antibiotic use in ARIs in populations with disabilities, thus we assessed antibiotic prescribing for veterans with spinal cord injury and disorder (SCI&D) with outpatient ARI visits. Patients and methods: Retrospective study using Department of Veterans Affairs (VA) administrative and pharmacy datasets (1 October 1998-30 September 2001; fiscal years 1999-2001) to assess antibiotic prescribing for upper respiratory infection (URI), lower respiratory infection (LRI), and pneumonia in veterans with SCI&D. Results: There were 5713 ARI visits; 50% received new antibiotic prescriptions. URI and LRI visits were 2.3 times and almost 4 times (P < 0.0001), respectively, more likely to have antibiotics prescribed than pneumonia visits. The majority of URI visits with antibiotic prescriptions had a diagnosis of the common cold or URI not otherwise specified (78%). Acute bronchitis without exacerbation was associated with 95% of LRI visits that received antibiotics. Broad-spectrum antibiotic use increased over time (1999,46%; 2001, 62%; P < 0.0001). Conclusions: Although rates of antibiotic prescribing remained stable, prescriptions for broad-spectrum antibiotics increased. Most prescriptions were for indications for which antibiotic use is generally not recommended. Since patients with SCI&D are susceptible to multiple complications, providers may be more concerned with ensuring that any infection is treated, rather than the potential for overuse and resistance. Future efforts should focus on defining benefits of antibiotic use for ARIs in those with disabilities, predictors of prescribing, and interventions to prevent injudicious use of antibiotics. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Qual Enhancement Res Initiat, Midw Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Loyola Univ, Dept Med, Stritch Sch Med, Div Infect Dis, Maywood, IL 60153 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Hlth Serv & Policy Res, Chicago, IL 60611 USA. RP Evans, CT (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Qual Enhancement Res Initiat, Midw Ctr Hlth Serv & Policy Res, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. EM Charlesnika.Evans@med.va.gov NR 10 TC 9 Z9 9 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD JUN PY 2005 VL 55 IS 6 BP 1045 EP 1049 DI 10.1093/jac/dki137 PG 5 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 938UE UT WOS:000230028100041 PM 15879492 ER PT J AU Nguyen, T Rubinstein, NA Vijayasarathy, C Rome, LC Kaiser, LR Shrager, JB Levine, S AF Nguyen, T Rubinstein, NA Vijayasarathy, C Rome, LC Kaiser, LR Shrager, JB Levine, S TI Effect of chronic obstructive pulmonary disease on calcium pump ATPase expression in human diaphragm SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE SERCA1; SERCA2; myosin heavy chain ID SKELETAL-MUSCLE FIBERS; TERM ELECTRICAL-STIMULATION; SARCOPLASMIC-RETICULUM; FAST-TWITCH; RELAXATION RATE; SLOW SKELETAL; SINGLE FIBERS; MYOSIN; FREQUENCY; ISOFORMS AB We have previously demonstrated that human diaphragm remodeling elicited by severe chronic obstructive pulmonary disease ( COPD) is characterized by a fast-to-slow myosin heavy chain isoform transformation. To test the hypothesis that COPD-induced diaphragm remodeling also elicits a fast-to-slow isoform shift in the sarcoendoplasmic reticulum Ca2+ ATPase (SERCA), the other major ATPase in skeletal muscle, we obtained intraoperative biopsies of the costal diaphragm from 10 severe COPD patients and 10 control subjects. We then used isoform-specific monoclonal antibodies to characterize diaphragm fibers with respect to the expression of SERCA isoforms. Compared with control diaphragms, COPD diaphragms exhibited a 63% decrease in fibers expressing only fast SERCA (i.e., SERCA1; P < 0.001), a 190% increase in fibers containing both fast and slow SERCA isoforms ( P < 0.01), and a 19% increase ( P < 0.05) in fibers expressing only the slow SERCA isoform (i.e., SERCA2). Additionally, immunoblot experiments carried out on diaphragm homogenates indicated that COPD diaphragms expressed only one-third the SERCA1 content noted in control diaphragms; in contrast, COPD and control diaphragms did not differ with respect to SERCA2 content. The combination of these histological and immunoblot results is consistent with the hypothesis that diaphragm remodeling elicited by severe COPD is characterized by a fast-to-slow SERCA isoform transformation. Moreover, the combination of these SERCA data and our previously reported myosin heavy chain isoform data ( Levine S, Nguyen T, Kaiser LR, Rubinstein NA, Maislin G, Gregory C, Rome LC, Dudley GA, Sieck GC, and Shrager JB. Am J Respir Crit Care Med 168: 706 - 713, 2003) suggests that diaphragm remodeling elicited by severe COPD should decrease ATP utilization by the diaphragm. C1 Univ Penn, Sch Arts & Sci, Dept Biol, Philadelphia, PA 19104 USA. NEI, NIH, Bethesda, MD 20892 USA. Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Cell & Dev Biol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Surg Serv, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Res Serv, Philadelphia, PA USA. RP Levine, S (reprint author), Hosp Univ Penn, Resp Muscle Res Lab, Sect Gen Thorac Surg, 3400 Spruce St,7 Silverstein Pavil, Philadelphia, PA 19104 USA. EM sdlevine@mail.med.upenn.edu FU NIAMS NIH HHS [AR 38404, AR 46125] NR 44 TC 18 Z9 20 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD JUN PY 2005 VL 98 IS 6 BP 2004 EP 2010 DI 10.1152/japplphysiol.00767.2004 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 929SF UT WOS:000229365500006 PM 15718407 ER PT J AU Patterson, ES Doebbeling, BN Fung, CH Militello, L Anders, S Asch, SM AF Patterson, ES Doebbeling, BN Fung, CH Militello, L Anders, S Asch, SM TI Identifying barriers to the effective use of clinical reminders: Bootstrapping multiple methods SO JOURNAL OF BIOMEDICAL INFORMATICS LA English DT Article DE clinical reminder; electronic medical record; computerized provider order entry; human factors; patient safety; evidence based medicine ID SYSTEMS; HEALTH; IMPLEMENTATION; CARE AB Advances in electronic medical record capabilities enable clinical reminders to inform providers when recommended actions are "due" for a patient. Despite evidence that they improve adherence to guidelines, the Veteran's Health Administration (VHA) has experienced challenges in having providers consistently use clinical reminders as intended. In this paper, we describe how multiple methods were used to opportunistically triangulate, or "bootstrap," an understanding of barriers to the effective use of clinical reminders in the VHA. In an initial study using ethnographic observations and semi-structured interviews of HIV clinical reminders, we identified six barriers to effective use: workload, time to remove inapplicable reminders, false alarms, training, reduced eye contact, and the use of paper forms rather than software. In a second study, we collected open-ended and closed-ended data regarding barriers and facilitators to the use of clinical reminders in general in the VHA through a survey of 261 participants at a national informatics meeting, where 104 of 142 VHA health care facilities were represented. The findings from the second study extended our understanding of the previously identified barriers. In addition, four new barriers were identified: case of use issues, accessibility of workstations, resident physicians and trainees, and administration benefiting more than providers from clinical reminder use. We discuss potential implications regarding the similarities and differences in study findings for factors to consider in planning interventions to improve clinical reminder use. Published by Elsevier Inc. C1 Univ Cincinnati, Sch Med, VA Getting Patient Safety GAPS Ctr, VAMC, Cincinnati, OH USA. Roudebush VA Med Ctr, Ctr Excellence Implementing Evidence Based Practi, Indianapolis, IN USA. Indiana Univ, Dept Internal Med, Regenstrief Inst Inc, Bloomington, IN 47405 USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, RAND Hlth, Los Angeles, CA USA. Univ Dayton, Res Inst, Dayton, OH 45469 USA. RP Patterson, ES (reprint author), 210 Baker Syst,1971 Neil Ave, Columbus, OH 43210 USA. EM patterson.150@osu.edu RI Doebbeling, Bradley/C-6620-2009; Patterson, Emily/B-4398-2011 OI Patterson, Emily/0000-0002-4514-2075; Militello, Laura G/0000-0001-8445-5640 NR 20 TC 60 Z9 63 U1 1 U2 7 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1532-0464 J9 J BIOMED INFORM JI J. Biomed. Inform. PD JUN PY 2005 VL 38 IS 3 BP 189 EP 199 DI 10.1016/j.jbi.2004.11.015 PG 11 WC Computer Science, Interdisciplinary Applications; Medical Informatics SC Computer Science; Medical Informatics GA 931OJ UT WOS:000229494300003 PM 15896692 ER PT J AU Gao, YQ Signore, AP Yin, W Cao, GD Yin, XM Sun, FY Luo, YM Graham, SH Chen, J AF Gao, YQ Signore, AP Yin, W Cao, GD Yin, XM Sun, FY Luo, YM Graham, SH Chen, J TI Neuroprotection against focal ischemic brain injury by inhibition of c-Jun N-terminal kinase and attenuation of the mitochondrial apoptosis-signaling pathway SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE Bax; Bim; caspase-3; caspase-9; cytochrome c ID CEREBRAL-ARTERY OCCLUSION; ACTIVATED PROTEIN-KINASE; NEURONAL CELL-DEATH; TRANSIENT FOREBRAIN ISCHEMIA; TRANSGENIC MICE PROTECTS; BAX-DEPENDENT APOPTOSIS; SUPEROXIDE-DISMUTASE; CYTOCHROME-C; TRANSDUCTION PATHWAY; GERBIL HIPPOCAMPUS AB c-Jun N-terminal kinase (JNK) is an important stress-responsive kinase that is activated by various forms of brain insults. In this study, we have examined the role of JNK activation in neuronal cell death in a murine model of focal ischemia and reperfusion; furthermore, we investigated the mechanism of JNK in apoptosis signaling, focusing on the mitochondrial-signaling pathway. We show here that JNK activity was induced in the brain 0.5 to 24h after ischemia. Systemic administration of SP600125, a small molecule JNK-specific inhibitor, diminished JNK activity after ischemia and dose-dependently reduced infarct volume. c-Jun N-terminal kinase inhibition also attenuated ischemia-induced expression of Bim, Hrk/DP5, and Fas, but not the expression of Bcl-2 or FasL. In strong support of a role for JNK in promoting the mitochondrial apoptosis-signaling pathway, JNK inhibition prevented ischemia-induced mitochondrial translocation of Bax and Bim, release of cytochrome c and Smac, and activation of caspase-9 and caspase-3. The potential mechanism by which JNK promoted Bax translocation after ischemia was further studied using coimmunoprecipitation, and the results revealed that JNK activation caused serine phosphorylation of 14-3-3, a cytoplasmic sequestration protein of Bax, leading to Bax disassociation from 14-3-3 and subsequent translocation to mitochondria. These results confirm the role of JNK as a critical cell death mediator in ischemic brain injury, and suggest that one of the mechanisms by which JNK triggers the mitochondrial apoptosis-signaling pathway is via promoting Bax and Bim translocation. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Fudan Univ, Sch Med, Natl Key Lab Med Neurobiol, Shanghai, Peoples R China. Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA USA. Vet Affairs Pittsburgh Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S-507 Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu RI Gao, Yanqin/I-6790-2016 OI Gao, Yanqin/0000-0002-4915-9819 FU NINDS NIH HHS [NS36736, NS38560, NS43802, NS45048] NR 76 TC 150 Z9 161 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD JUN PY 2005 VL 25 IS 6 BP 694 EP 712 DI 10.1038/sj.jcbfm.9600062 PG 19 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 928BK UT WOS:000229245900004 PM 15716857 ER PT J AU Bramstedt, KA Schneider, PL AF Bramstedt, KA Schneider, PL TI Saying "good-bye": Ethical issues in the stewardship of bed spaces SO JOURNAL OF CLINICAL ETHICS LA English DT Article C1 Cleveland Clin Fdn, Dept Bioeth, Cleveland, OH 44195 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Bramstedt, KA (reprint author), Cleveland Clin Fdn, Dept Bioeth, 9500 Euclid Ave, Cleveland, OH 44195 USA. EM bioethics@go.com NR 10 TC 1 Z9 1 U1 0 U2 1 PU UNIV PUBLISHING GROUP PI HAGERSTOWN PA 138 W WASHINGTON ST, STE 403-405, HAGERSTOWN, MD 21740 USA SN 1046-7890 J9 J CLIN ETHIC JI J. Clin. Ethics PD SUM PY 2005 VL 16 IS 2 BP 170 EP 175 PG 6 WC Ethics; Social Sciences, Biomedical SC Social Sciences - Other Topics; Biomedical Social Sciences GA 006OQ UT WOS:000234907200009 PM 16106768 ER PT J AU Garzotto, M Collins, L Priest, R Spurgeon, S Hsieh, YC Beer, TM Mori, M AF Garzotto, M Collins, L Priest, R Spurgeon, S Hsieh, YC Beer, TM Mori, M TI Nomogram for the prediction of high-grade prostate cancer on ultrasoundguided needle biopsy SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Meeting Abstract CT 41st Annual Meeting of the American-Society-of-Clinical-Oncology CY MAY 13-17, 2005 CL Orlando, FL SP Amer Soc Clin Oncol C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. NR 0 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 EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUN 1 PY 2005 VL 23 IS 16 SU S BP 408S EP 408S PN 1 PG 1 WC Oncology SC Oncology GA 943BK UT WOS:000230326602450 ER PT J AU Schittenhelm, MM Shiraga, SH Griffith, DJ Schroeder, AJ Lee, FY Bokemeyer, C Heinrich, MC AF Schittenhelm, MM Shiraga, SH Griffith, DJ Schroeder, AJ Lee, FY Bokemeyer, C Heinrich, MC TI BMS-354825 (BMS) inhibits the kinase activity of mutant KIT proteins associated with seminomas (S) and has synergistic effects with cisplatin (CDDP). SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Meeting Abstract CT 41st Annual Meeting of the American-Society-of-Clinical-Oncology CY MAY 13-17, 2005 CL Orlando, FL SP Amer Soc Clin Oncol C1 Oregon Hlth Sci Univ, Portland, OR 97201 USA. Bristol Myers Squibb Co, Princeton, NJ USA. Univ Hosp Hamburg Eppendorf, Hamburg, Germany. OHSU Canc Inst, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. NR 0 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 EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUN 1 PY 2005 VL 23 IS 16 SU S BP 424S EP 424S PN 1 PG 1 WC Oncology SC Oncology GA 943BK UT WOS:000230326602514 ER PT J AU Wei, SJ Hampshire, MK Devine, PA Metz, JM AF Wei, SJ Hampshire, MK Devine, PA Metz, JM TI Differences in expectations of clinical trials between patients who participate in clinical cancer trials and those who do not. SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Meeting Abstract CT 41st Annual Meeting of the American-Society-of-Clinical-Oncology CY MAY 13-17, 2005 CL Orlando, FL SP Amer Soc Clin Oncol C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affiars Med Ctr, Philadelphia, PA USA. NR 0 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 EI 1527-7755 J9 J CLIN ONCOL JI J. Clin. Oncol. PD JUN 1 PY 2005 VL 23 IS 16 SU S BP 544S EP 544S PN 1 PG 1 WC Oncology SC Oncology GA 943BK UT WOS:000230326603398 ER PT J AU Sorror, ML Maris, MB Sandmaier, BM Storer, BE Stuart, MJ Hegenbart, U Agura, E Chauncey, TR Leis, J Pulsipher, M McSweeney, P Radich, JP Bredeson, C Bruno, B Langston, A Laken, MR Al-Ali, H Blume, KG Storb, R Maloney, DG AF Sorror, ML Maris, MB Sandmaier, BM Storer, BE Stuart, MJ Hegenbart, U Agura, E Chauncey, TR Leis, J Pulsipher, M McSweeney, P Radich, JP Bredeson, C Bruno, B Langston, A Laken, MR Al-Ali, H Blume, KG Storb, R Maloney, DG TI Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article; Proceedings Paper CT Meeting for Tandem Bone Marrow Transplantation CY FEB 13-17, 2004 CL Orlando, FL ID BONE-MARROW-TRANSPLANTATION; PREVIOUSLY TREATED PATIENTS; TOTAL-BODY IRRADIATION; PROGNOSTIC FACTORS; HEMATOLOGIC MALIGNANCIES; FUNGAL-INFECTIONS; YOUNGER PATIENTS; CD38 EXPRESSION; PHASE-II; P53 GENE AB Purpose Patients with chemotherapy-refractory chronic lymphocytic leukemia (CLL) have a short life expectancy. The aim of this study was to analyze the outcome of patients with advanced CLL when treated with nonmyeloablative conditioning and hematopoietic cell transplantation (HCT). Patients and Methods Sixty-four patients diagnosed with advanced CLL were treated with nonmyeloabiative conditioning (2 Gy total-body irradiation with [n = 53] or without [n = 11] fludarabine) and HCT from related (n = 44) or unrelated (n = 20) donors. An adapted form of the Charlson comorbidity index was used to assess pretransplantation comorbidities. Results Sixty-one of 64 patients had sustained engraftment, whereas three patients rejected their grafts. The incidences of grades 2, 3, and 4 acute and chronic graft-versus-host disease were 39%, 14%, 2%, and 50%, respectively. Three patients who underwent transplantation in complete remission (CR) remained in CR. The overall response rate among 61 patients with measurable disease was 67% (50% CR), whereas 5% had stable disease. All patients with morphologic CR who were tested by polymerase chain reaction (n = 11) achieved negative molecular results, and one of these patients subsequently experienced disease relapse. The 2-year incidence of relapse/progression was 26%, whereas the 2-year relapse and nonrelapse mortalities were 18% and 22%, respectively. Two-year rates of overall and disease-free survivals were 60% and 52%, respectively. Unrelated HCT resulted in higher CR and lower relapse rates than related HCT, suggesting more effective graft-versus-leukemia activity. Conclusion CLL is susceptible to graft-versus-leukemia effects, and allogeneic HCT after nonmyeloablative conditioning might prolong median survival for patients with advanced CLL. C1 Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Hematolog Inc, Seattle, WA USA. Stanford Univ, Stanford, CA 94305 USA. Univ Leipzig, D-7010 Leipzig, Germany. Baylor Univ, Dallas, TX USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Univ Utah, Salt Lake City, UT USA. Univ Colorado, Denver, CO 80202 USA. Med Coll Wisconsin, Milwaukee, WI 53226 USA. Univ Turin, Turin, Italy. Emory Univ, Atlanta, GA 30322 USA. RP Maloney, DG (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,D1-100,POB 19024, Seattle, WA 98109 USA. EM drnaloney@ihcrc.org RI al-ali, haifa kathrin/B-3390-2014 FU NCI NIH HHS [CA15704, CA78902, P01 CA078902, CA92058, CA18029, CA49605] NR 67 TC 142 Z9 148 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 JUN 1 PY 2005 VL 23 IS 16 BP 3819 EP 3829 DI 10.1200/JCO.2005.04.569 PG 11 WC Oncology SC Oncology GA 931CA UT WOS:000229462200024 PM 15809448 ER PT J AU Cook, JM O'Donnell, C AF Cook, JM O'Donnell, C TI Assessment and psychological treatment of posttraumatic stress disorder in older adults SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article DE posttraumatic stress disorder; aging; assessment; measurement; psychotherapy ID WORLD-WAR-II; EYE-MOVEMENT DESENSITIZATION; ADMINISTERED PTSD SCALE; CHILDHOOD SEXUAL ABUSE; GROUP-THERAPY; HOLOCAUST SURVIVORS; COMBAT VETERANS; MMPI SUBSCALE; INTEGRATION; POPULATION AB Knowledge regarding the assessment and treatment of posttraumatic stress disorder in older adults continues to be limited in both psychological research and practice. This article provides a summary of this literature. In particular, the psychometric properties of several posttraumatic stress disorder assessment measures in their use with older individuals are reviewed. Although the evidence base on effective treatments for posttraumatic stress disorder in older adults is virtually nonexistent, this article highlights the innovative clinical endeavors that have been conducted in this regard. Explicit suggestions for best practices are made. C1 Univ Penn, Sch Med, Treatment Res Ctr, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. LaSalle Univ, Philadelphia, PA USA. RP Cook, JM (reprint author), Univ Penn, Sch Med, Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM cook_j@mail.trc.upenn.edu NR 96 TC 28 Z9 28 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD JUN PY 2005 VL 18 IS 2 BP 61 EP 71 DI 10.1177/0891988705276052 PG 11 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 932FT UT WOS:000229540300002 PM 15911934 ER PT J AU Lenze, EJ Karp, JF Mulsant, BH Blank, S Shear, MK Houck, PR Reynolds, CH AF Lenze, EJ Karp, JF Mulsant, BH Blank, S Shear, MK Houck, PR Reynolds, CH TI Somatic symptoms in late-life anxiety: Treatment issues SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article DE anxiety; pain; somatic symptoms; treatment ID COGNITIVE-BEHAVIORAL TREATMENT; NORD-TRONDELAG HEALTH; COMORBID ANXIETY; OLDER-ADULTS; DEPRESSED-PATIENTS; CLINICAL PREDICTORS; GENERAL-POPULATION; PHYSICAL SYMPTOMS; DOUBLE-BLIND; CHRONIC PAIN AB Understanding and addressing somatic symptoms are complex in older adults, who have more comorbid medical illnesses. This article describes a systematic review of the literature on somatic symptoms in older patients with anxiety disorders. Additionally, the hypothesis was tested that somatic symptoms would respond to selective serotonin reuptake inhibitor treatment in 30 anxious patients aged 60 years and older who participated in a 32-week trial of citalopram. The literature review showed few original data articles about somatic symptoms in older patients with anxiety disorders. These articles suggest that such a relationship is common and that treatment of anxiety, or anxious depression, is associated with a reduction in somatic symptoms. In the analysis, citalopram treatment was associated with a significant decrease in several somatic symptoms from pretreatment baseline. It is concluded that somatic symptoms in older adults with anxiety disorders or anxious depression often improve with successful antidepressant treatment. However, additional treatment and integrated approaches are likely to be necessary for many such individuals. C1 Univ Pittsburgh, Sch Med, Intervent Res Ctr Late Life Mood Disorders, Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. RP Lenze, EJ (reprint author), Western Psychiat Inst & Clin, Room E835,3811 OHara St, Pittsburgh, PA 15213 USA. EM lenzeej@upmc.edu FU NIMH NIH HHS [K23 MH 64196, P30 MH 52247] NR 59 TC 24 Z9 24 U1 3 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD JUN PY 2005 VL 18 IS 2 BP 89 EP 96 DI 10.1177/0891988705276251 PG 8 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 932FT UT WOS:000229540300005 PM 15911937 ER PT J AU Rose, A Peters, N Shea, JA Armstrong, K AF Rose, A Peters, N Shea, JA Armstrong, K TI The association between knowledge and attitudes about genetic testing for cancer risk in the United States SO JOURNAL OF HEALTH COMMUNICATION LA English DT Article ID BREAST-OVARIAN CANCER; GENERAL-POPULATION; HUMAN GENOME; BRCA1; WOMEN; SUSCEPTIBILITY; DISCRIMINATION; AWARENESS AB Attitudes about genetic testing are likely to be an important determinant of uptake of predictive genetic tests among the general public. Several prior studies have suggested that positive attitudes about genetic testing may be inversely related to knowledge about genetic testing. We conducted a random-digit-dialing (RDD) telephone survey of 961 adults in the continental United States to determine the associations among knowledge of, attitudes about, and perceptions of eligibility for genetic testing for cancer risk. Knowledge about genetic testing for cancer risk was generally high, with a mean accuracy score of 72%. Attitudes about genetic testing for cancer risk were also generally positive, with 87% of respondents reporting genetic testing for cancer risk would be used to help doctors manage their health care and 85% to help scientists find cures for diseases. In contrast, 58% of respondents thought genetic testing for cancer risk would be used to prevent them from getting health insurance and 31% to allow the government to label groups as inferior. Twenty-nine percent of respondents thought they were currently eligible for testing. After adjustment for sociodemographic characteristics and family cancer history, higher knowledge was correlated with more positive attitudes about testing, but not with negative attitudes or perceptions of testing eligibility. Family history was positively associated with perceptions of eligibility (OR 3.49, 95% CI 2.36-5.18), and higher levels of education were inversely associated with perceptions of eligibility (OR 0.55, 95% CI 0.32-0.94 for comparison of college or higher vs. less than high school). These results suggest that most members of the general public are knowledgeable and have positive attitudes about genetic testing for cancer risk and that greater knowledge is correlated with more positive attitudes about the benefits of testing. C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM karmstro@mail.med.upenn.edu NR 27 TC 38 Z9 38 U1 4 U2 12 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1081-0730 J9 J HEALTH COMMUN JI J. Health Commun. PD JUN PY 2005 VL 10 IS 4 BP 309 EP 321 DI 10.1080/10810730590950039 PG 13 WC Communication; Information Science & Library Science SC Communication; Information Science & Library Science GA 940EX UT WOS:000230127600006 PM 16036738 ER PT J AU Chu, BC Zhao, XQ Saam, T Yarnykh, VL Kerwin, WS Flemming, KD Huston, J Insull, W Morrisett, JD Rand, SD DeMarco, KJ Polissar, NL Balu, N Cai, JM Kampschulte, A Hatsukami, TS Yuan, C AF Chu, BC Zhao, XQ Saam, T Yarnykh, VL Kerwin, WS Flemming, KD Huston, J Insull, W Morrisett, JD Rand, SD DeMarco, KJ Polissar, NL Balu, N Cai, JM Kampschulte, A Hatsukami, TS Yuan, C TI Feasibility of in vivo, multicontrast-weighted MR imaging of carotid atherosclerosis for multicenter studies SO JOURNAL OF MAGNETIC RESONANCE IMAGING LA English DT Article DE magnetic resonance imaging; carotid arteries; image quality; atherosclerosis; slice coverage ID HIGH-RESOLUTION MRI; INVERSION-RECOVERY; CEREBRAL-ISCHEMIA; ARTERY STENOSIS; PLAQUE; HEMORRHAGE; ACCURACY; RUPTURE; CLASSIFICATION; THROMBUS AB Purpose: To test the image quality (ImQ) and interscan coverage of MRI for measuring carotid atherosclerosis across multiple centers. Materials and Methods: Thirty-nine subjects from five 1 clinical sites (site 1: n = 11; site 2: n = 16; site 3: n = 2; site 4: n = 3; site 5: n = 7) were imaged on GE 1.5T scanners U sing a standardized carotid imaging protocol with five weightings (T1, proton density (PD), T2, time-of-flight (TOF), contrast-enhanced (CE) T1). MR technologists from the five sites received comprehensive protocol training. A maximum coverage of 24 mm (12 slices) was designed for, each of four scans (baseline and at four, eight, and 13 weeks). The adequacy of coverage was calculated as the percentage of arteries with at least six slices matched across all four scans. ImQ was evaluated using an established five-point scale for each image. ImQ >= 3 was considered acceptable for image analysis. Results: Across five sites, the mean ImQ was 3.4-4.2 for T1W, 3.6-4.4 for CE-T1W, 3.4-4.2 for PDW, 3.3-4.2 for T2W, and 3.4-4.0 for TOF. The mean ImQ per site was 3.5-4.2. All sites generated at least six-slice coverage (mean = 8.0-9.1) for all index carotid arteries. Conclusion: The ImQ and coverage values were comparable among clinical sites using a standardized carotid imaging protocol. With comprehensive protocol training, carotid MRI is technically feasible for use in multicenter studies. (c) 2005 Wiley-Liss, Inc. C1 Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Surg, Seattle, WA 98195 USA. Mayo Clin & Mayo Fdn, Dept Neurol, Rochester, MN 55905 USA. Mayo Clin & Mayo Fdn, Dept Radiol, Rochester, MN 55905 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Med Coll Wisconsin, Dept Radiol, Milwaukee, WI 53226 USA. Laurie Imaging Ctr, Dept Radiol, New Brunswick, NJ USA. Mt Whisper Light Imaging Ctr, Seattle, WA USA. VA Puget Sound, Hlth Care Syst, Dept Surg, Seattle, WA USA. RP Chu, BC (reprint author), Univ Washington, Dept Radiol, Box 357115,1959 NE Pacific St, Seattle, WA 98195 USA. EM chubc@u.washington.edu RI Yarnykh, Vasily/G-8757-2016; Yarnykh, Vasiliy/N-7635-2014 OI Yarnykh, Vasily/0000-0002-1583-8979; NR 31 TC 19 Z9 21 U1 0 U2 2 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1053-1807 J9 J MAGN RESON IMAGING JI J. Magn. Reson. Imaging PD JUN PY 2005 VL 21 IS 6 BP 809 EP 817 DI 10.1002/jmri.20308 PG 9 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 930YV UT WOS:000229453900019 PM 15906345 ER PT J AU Yao, JK Reddy, RD Keshavan, MS AF Yao, JK Reddy, RD Keshavan, MS TI Reduced RBC membrane lipids in first-episode neuroleptic-naive patients with schizophrenia and other psychoses SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 36th Annual Meeting of the American-Society-for-Neurochemistry CY JUN 25-29, 2005 CL Madison, WI SP Amer Soc Neurochem C1 Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Dept Pharmaceut Sci, Pittsburgh, PA USA. Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JUN PY 2005 VL 94 SU 1 BP 84 EP 84 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 942XW UT WOS:000230317200231 ER PT J AU Pannu, R Singh, AK Singh, I AF Pannu, R Singh, AK Singh, I TI A novel role of lactosylceramide in the regulation of TNF alpha-mediated proliferation of rat primary astrocytes SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 36th Annual Meeting of the American-Society-for-Neurochemistry CY JUN 25-29, 2005 CL Madison, WI SP Amer Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JUN PY 2005 VL 94 SU 1 BP 86 EP 86 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 942XW UT WOS:000230317200237 ER PT J AU Yenari, MA Lee, JE Han, HS AF Yenari, MA Lee, JE Han, HS TI Influence of hypothermia on post ischemic inflammation: role of nuclear factor kappa B SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 36th Annual Meeting of the American-Society-for-Neurochemistry CY JUN 25-29, 2005 CL Madison, WI SP Amer Soc Neurochem C1 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. San Francisco VAMC, Neurol Serv, San Francisco, CA USA. Kyungpook Natl Univ, Dept Physiol, Taegu, South Korea. Yonsei Univ, Dept Anat, Seoul 120749, South Korea. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JUN PY 2005 VL 94 SU 1 BP 116 EP 116 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 942XW UT WOS:000230317200330 ER PT J AU Offner, H Huan, J Bartholomew, R Bourdette, D Vandenbark, A AF Offner, H Huan, J Bartholomew, R Bourdette, D Vandenbark, A TI Expression of the Treg cell associated FOXP3 gene is decreased in MS patients and increases following immunisation with a T cell receptor peptide vaccine SO JOURNAL OF NEUROLOGY LA English DT Meeting Abstract CT 15th Meeting of the European-Neurological-Society CY JUN 18-22, 2005 CL Vienna, AUSTRIA SP European Neurol Soc C1 Oregon Hlth & Sci Univ, Portland, OR USA. Immune Response Corp, Carlsbad, CA USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU DR DIETRICH STEINKOPFF VERLAG PI DARMSTADT PA PO BOX 10 04 62, D-64204 DARMSTADT, GERMANY SN 0340-5354 J9 J NEUROL JI J. Neurol. PD JUN PY 2005 VL 252 SU 2 BP 20 EP 20 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 937QV UT WOS:000229941500060 ER PT J AU Starr, PA Rau, GM Davis, V Marks, WJ Ostrem, JL Simmons, D Lindsey, N Turner, RS AF Starr, PA Rau, GM Davis, V Marks, WJ Ostrem, JL Simmons, D Lindsey, N Turner, RS TI Spontaneous pallidal neuronal activity in human dystonia: Comparison with Parkinson's disease and normal macaque SO JOURNAL OF NEUROPHYSIOLOGY LA English DT Article ID HUMAN GLOBUS-PALLIDUS; BASAL GANGLIA; SUBTHALAMIC NUCLEUS; GENERALIZED DYSTONIA; SUBSTANTIA-NIGRA; DENSITY-FUNCTION; FIRING PATTERNS; CORTEX NEURONS; SPIKE TRAINS; DISCHARGE AB Dystonia is a movement disorder defined by sustained muscle contractions, causing twisting and repetitive movements and abnormal postures. To understand the abnormalities in pallidal discharge in dystonia, we have analyzed the spontaneous activity of 453 neurons sampled from the internal or external pallidum (GPi or GPe) of 22 patients with dystonia, 140 neurons from 11 patients with Parkinson's disease (PD), and 157 neurons from two normal non-human primates (NHPs; Macacca mulatta). All recordings were performed without systemic sedation. Mean GPi discharge rate in dystonia was 55.3 +/- 1.3 (SE) Hz. This was significantly lower than in the normal NHPs (82.5 +/- 2.5 Hz) and lower than in PD patients (95.2 +/- 2.3 Hz). Mean GPe discharge rate in dystonia (54.0 +/- 1.9 Hz) was lower than in the normal NHPs (69.7 +/- 3.3 Hz) and was indistinguishable from that in PD patients (56.6 +/- 3.5 Hz). Mean GPi discharge rate was inversely correlated with dystonia severity. GPi showed increased oscillatory activity in the 2- to 10-Hz range and increased bursting activity in both dystonia and PD as compared with the normal NHPs. Because the abnormalities in discharge patterns were similar in dystonia compared with PD, we suggest that bursting and oscillatory activity superimposed on a high background discharge rate are associated with parkinsonism, whereas similar bursting and oscillations superimposed on a lower discharge rate are associated with dystonia. Our findings are most consistent with a model of dystonia pathophysiology in which the two striatal cell populations contributing to the direct and indirect intrinsic pathways of the basal ganglia both have increased spontaneous activity. C1 Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Nursing, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, San Francisco, CA USA. RP Starr, PA (reprint author), Univ Calif San Francisco, Dept Neurosurg, 505 Parnassus Ave,779 Moffitt, San Francisco, CA 94143 USA. EM starrp@itsa.ucsf.edu FU NINDS NIH HHS [K08 NS-002201, NS-39146, R01 NS044551, R01 NS044551-01] NR 57 TC 122 Z9 126 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-3077 J9 J NEUROPHYSIOL JI J. Neurophysiol. PD JUN PY 2005 VL 93 IS 6 BP 3165 EP 3176 DI 10.1152/jn.00971.2004 PG 12 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 929AE UT WOS:000229313100022 PM 15703229 ER PT J AU Mendez, ME Shapira, JS AF Mendez, ME Shapira, JS TI Loss of insight and functional neuroimaging in frontotemporal dementia SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID ALZHEIMERS-DISEASE; ANOSOGNOSIA; AWARENESS; DEFICITS; DEGENERATION; SYMPTOMS AB Loss of insight is a diagnostic criterion for frontotemporal dementia. It is associated with hypoperfusion/hypometabolism in the right hemisphere, particularly the frontal lobe. Loss of insight is often an anosodiaphoria (i.e., lack of concern) rather than an anosognosia (i.e., decreased awareness). C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. RP Mendez, ME (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU NIA NIH HHS [P01 AG19724-01A1] NR 15 TC 46 Z9 46 U1 0 U2 3 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2005 VL 17 IS 3 BP 413 EP 416 DI 10.1176/appi.neuropsych.17.3.413 PG 4 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 962BB UT WOS:000231704900017 PM 16179666 ER PT J AU Mendez, MF AF Mendez, MF TI Moria and Witzelsucht from frontotemporal dementia SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Letter ID CONSENSUS; CRITERIA C1 Univ Calif Los Angeles, Dept Neurol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Mendez, MF (reprint author), Univ Calif Los Angeles, Dept Neurol, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. NR 5 TC 6 Z9 6 U1 1 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2005 VL 17 IS 3 BP 429 EP 430 DI 10.1176/appi.neuropsych.17.3.429 PG 2 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 962BB UT WOS:000231704900024 PM 16179673 ER PT J AU Chen, Q Long, Y Yuan, XQ Zou, LL Sun, J Chen, SD Perez-Polo, JR Yang, KY AF Chen, Q Long, Y Yuan, XQ Zou, LL Sun, J Chen, SD Perez-Polo, JR Yang, KY TI Protective effects of bone marrow stromal cell transplantation in injured rodent brain: Synthesis of neurotrophic factors SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE marrow stromal cells; traumatic brain injury; nerve growth factor; transplantation; neurotrophic factor ID NERVE GROWTH-FACTOR; ADULT RATS; INTRACEREBRAL TRANSPLANTATION; FUNCTIONAL RECOVERY; PURKINJE NEURONS; UP-REGULATION; STEM-CELLS; IN-VIVO; EXPRESSION; MICE AB Several groups have suggested that transplantation of marrow stromal cells (MSCs) promotes functional recovery in animal models of brain trauma. Recent studies indicate that tissue replacement by this method may not be the main source of therapeutic benefit, as transplanted MSCs have only limited ability to replace injured central nervous system (CNS) tissue. To gain insight into the mechanisms responsible for such effects, we systematically investigated the therapeutic potential of MSCs for treatment of brain injury. Using in vitro studies, we detected the synthesis of various growth factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and neurotrophin-3 (NT-3). Enzyme-linked immunosorbent assay (ELISA) demonstrated that MSCs cultured in Dulbecco's modified Eagle medium (DMEM) produced substantial amounts of NGF for at least 7 weeks, whereas the levels of BDNF, GDNF and NT-3 remained unchanged. In studies in mice, after intraventricular injection of MSCs, NGF levels were increased significantly in cerebrospinal fluid by ELISA, confirming our cell culture results. Further studies showed that treatment of traumatic brain injury with MSCs could attenuate the loss of cholinergic neuronal immunostaining in the medial septum of mice. These studies demonstrate for the first time that by increasing the brain concentration of NGF, intraventricularly transplanted MSCs might play an important role in the treatment of traumatic brain injury. (c) 2005 Wiley-Liss, Inc. C1 Baylor Coll Med, Ctr Cell & Gene Therapy, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. VA Med Ctr, PADRECC, Houston, TX USA. Univ Texas, Med Branch, Dept Human Biol Chem & Genet, Galveston, TX 77555 USA. Shanghai Med Univ 2, Ruijin Hosp, Dept Neurol, Shanghai, Peoples R China. RP Chen, Q (reprint author), Baylor Coll Med, Ctr Cell & Gene Therapy, 1 Baylor Plaza, Houston, TX 77030 USA. EM qchen1@bcm.tmc.edu RI Perez-Polo, Jose/B-6250-2009 FU NINDS NIH HHS [R01-NS35502-05] NR 45 TC 106 Z9 128 U1 0 U2 4 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD JUN 1 PY 2005 VL 80 IS 5 BP 611 EP 619 DI 10.1002/jnr.20494 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 931KS UT WOS:000229484800003 PM 15880454 ER PT J AU Fiala, M Eshleman, AJ Cashman, J Lin, J Lossinsky, AS Suarez, V Yang, W Zhang, J Popik, W Singer, E Chiappelli, F Carro, E Weinand, M Witte, M Arthos, J AF Fiala, M Eshleman, AJ Cashman, J Lin, J Lossinsky, AS Suarez, V Yang, W Zhang, J Popik, W Singer, E Chiappelli, F Carro, E Weinand, M Witte, M Arthos, J TI Cocaine increases human immunodeficiency virus type 1 neuroinvasion through remodeling brain microvascular endothelial cells SO JOURNAL OF NEUROVIROLOGY LA English DT Article DE cocaine; brain microvascular endothelial cells; HIV-1; HIV-1 macropinocytosis ID AIDS DEMENTIA COMPLEX; SEROTONIN TRANSPORTER; HIV; INFECTION; INVASION; BARRIER; ABUSE; PHOSPHORYLATION; LOCALIZATION; PERMEABILITY AB Cocaine is a suspected cofactor in human immunodeficiency virus (HIV)-associated dementia but cocaine's effects are not clear. Herein the authors describe investigations of the mechanisms by which cocaine increases HIV-1 invasion through brain microvascular endothelial cells (BMVECs). Cocaine binds to a site on BMVECs, which is not a biogenic amine transporter, a binding site for estrogen, or a muscarinic receptor and for which benztropine and tamoxifen have the highest affinity. Cocaine treatment of BMVECs disrupts intercellular junctions and induces cell ruffling, which could account for their increased permeability and decreased electrical resistance. HIV-1 enters BMVECs by macropinocytosis and is transported to lysosomes and inactivated. In cocaine-treated BMVECs, the virus enters and persists in large cytoplasmic "lakes." Cocaine exposure of BMVECs up-regulates transcription of genes important in cytoskeleton organization, signal transduction, cell swelling, vesicular trafficking, and cell adhesion. The toxicity of cocaine for the blood-brain barrier may lead to increased virus neuroinvasion and neurovascular complications of cocaine abuse. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. VA Med Ctr, Dept Pharmacol, Portland, OR USA. Human Biomol Res Inst, San Diego, CA USA. Huntington Med Res Inst, Pasadena, CA USA. Johns Hopkins Univ, Sch Med, Ctr Oncol, Baltimore, MD 21205 USA. CSIC, Inst Cajal, Neuroendocrinol Lab, E-28002 Madrid, Spain. Univ Arizona, Dept Surg, Tucson, AZ USA. NIAID, Immunoregulat Lab, NIH, Bethesda, MD 20892 USA. RP Fiala, M (reprint author), Univ Calif Los Angeles, Sch Med, Dept Neurol, CHS 63-090,10833 Le Conte, Los Angeles, CA 90095 USA. EM Fiala@ucla.edu FU NHLBI NIH HHS [HL48493, HL63639]; NIAID NIH HHS [AI42557, AI50461]; NIDA NIH HHS [DA10442]; PHITPO CDC HHS [HK63065] NR 34 TC 43 Z9 47 U1 2 U2 3 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1355-0284 J9 J NEUROVIROL JI J. Neurovirol. PD JUN PY 2005 VL 11 IS 3 BP 281 EP 291 DI 10.1080/13550280590952835 PG 11 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 945LS UT WOS:000230504600006 PM 16036808 ER PT J AU Feuerstein, M Nicholas, RA Huang, GD Haufler, AJ Pransky, G Robertson, M AF Feuerstein, M Nicholas, RA Huang, GD Haufler, AJ Pransky, G Robertson, M TI Workstyle: Development of a measure of response to work in those with upper extremity pain SO JOURNAL OF OCCUPATIONAL REHABILITATION LA English DT Article DE workstyle; upper extremity symptoms; risk factors; job stress; pain; functional limitations; office workers; ergonomic risk ID SIGN-LANGUAGE INTERPRETERS; MUSCULOSKELETAL DISORDERS; NERVE COMPRESSION; COMPUTER USERS; RISK-FACTORS; JOB STRESS; SYMPTOMS; PREVALENCE; DISABILITY; PATTERNS AB Workstyle or the behavioral, cognitive, and physiological response that can occur in some individuals to increases in work demands has been proposed to help explain the link between ergonomic and psychosocial factors in the exacerbation of work-related upper extremity symptoms. Currently, there is no measure of this construct, hindering research on its potential link to work related upper extremity problems in the workplace. The present study describes the development and psychometric properties of a measure of workstyle. Questionnaire items reflecting dimensions of workstyle as per the original conceptualization were generated primarily through focus groups with office workers and separate groups held with occupational physicians, physical therapists, occupational health psychologists, and experts in ergonomics, behavioral science, and human factors. Items created through this process were then administered to 282 symptomatic and asymptomatic office workers. Measures of job stress, ergonomic risk, upper extremity symptoms, and functional limitations were also obtained. The workstyle questionnaire was divided into two broad dimensions: Characteristic responses to work and Response to increased work demands. The scale development process as indicated by factor analysis yielded subscales that are theoretically consistent with the workstyle construct. These subscales include: working through pain, social reactivity at work, limited workplace support, deadlines/ pressure, self imposed work pace/workload, breaks, mood, pain/tension, autonomic response, and numbness tingling. The internal consistency of these subscales varied from 0.61 to 0.91, n = 282 while the test - retest ( 3 weeks) reliability for the various subscales ranged from r = 0.68 to 0.89, n = 143. A total workstyle score was computed that excluded the pain/tension and numbness/ tingling subscales to avoid circular reasoning in terms of the measure's relationship to outcomes of pain and functional limitations. The total score was stable over time and provided unique variance in relation to traditional measures of job stress. Total workstyle score was significantly associated with higher levels of pain, and greater functional limitations. Dimensions of the workstyle construct were identified. The workstyle measure possesses acceptable psychometric properties in office workers who work with computers. This measure can be used in future studies on the interaction of psychosocial and ergonomic factors in the exacerbation of upper extremity pain and functional limitation. C1 Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, Bethesda, MD 20814 USA. Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biometr, Bethesda, MD 20814 USA. Georgetown Univ, Sch Med, Dept Psychiat, Div Behav Med, Washington, DC USA. US Dept Vet Affairs, Off Res & Dev, Hopkinton, MA USA. Liberty Mutual Res Ctr Safety & Hlth, Hopkinton, MA USA. Univ Massachusetts, Sch Med, Worcester, MA USA. RP Feuerstein, M (reprint author), Uniformed Serv Univ Hlth Sci, Dept Med & Clin Psychol, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA. EM mfeuerstein@usuhs.mil NR 39 TC 38 Z9 38 U1 2 U2 7 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1053-0487 J9 J OCCUP REHABIL JI J. Occup. Rehabil. PD JUN PY 2005 VL 15 IS 2 BP 87 EP 104 DI 10.1007/s10926-005-3420-0 PG 18 WC Rehabilitation; Social Issues SC Rehabilitation; Social Issues GA 913ZF UT WOS:000228193500001 PM 15844670 ER PT J AU Daniels, C Huang, GD Feuerstein, M Lopez, M AF Daniels, C Huang, GD Feuerstein, M Lopez, M TI Self-report measure of low back-related biomechanical exposures: Clinical validation SO JOURNAL OF OCCUPATIONAL REHABILITATION LA English DT Article DE biomechanical exposure; ergonomics; assessment; self-report; low back pain ID UPPER EXTREMITY DISORDERS; PSYCHOSOCIAL RISK-FACTORS; FORM HEALTH SURVEY; US ARMY PERSONNEL; MUSCULOSKELETAL DISORDERS; PHYSICAL WORK; ERGONOMIC EPIDEMIOLOGY; POSTURAL LOAD; PAIN; PREVALENCE AB Low back pain and symptoms are major contributors to ambulatory visits, economic burden, and reduced readiness among military personnel and employers in the civilian workplace as well. While a link between low back pain and biomechanical exposures has been established, efficient surveillance methods of such exposures are still needed. Furthermore, the utility of self-report measures for biomechanical exposures has not been examined extensively. The present cross-sectional study analyzed questionnaire data from US Army soldiers ( n = 279) working in previously identified occupational specialties that were associated with high risk for low back pain and/or low back pain disability. Demographic characteristics, physical workload, health behaviors, and psychosocial factors were assessed in addition to self-reported workplace biomechanical exposures using the Job Related Physical Demands (JRPDs). Outcomes included self-reported low back pain severity, low back symptoms, functional limitations, and general physical health. The results indicated that the self-report measure of biomechanical exposure had a high degree of internal consistency (Cronbach alpha, 0.95). The JRPD index correlated with low back symptoms, pain intensity, function, and perceived work load using the Borg scale. Regression analyses indicated statistically significant associations between the JRPD and back pain specific pain severity and physical function, but not for general physical health (SF-12) after controlling for age, gender, educational level, job type, and reported exercise and work stress. Specifically, higher JRPD scores ( representing greater biomechanical exposure) were associated with higher levels of pain intensity and functional limitations. Higher JRPD scores were found to place an individual at a greater likelihood for being a case with low back pain within the past 12 months ( OR = 1.01 per point increase in scale-95%; range 38 - 152; CI = 1.00 - 1.02, p = 0.05). While future longitudinal studies of the JRPD determining the predictive validity of the measure are needed, the present study provides evidence of the utility of the JRPD for assessing biomechanical exposures associated with low back pain within high-risk jobs. The findings suggest that the JRPD may assist with surveillance efforts and be useful as a process and/or outcome measure in research related to occupational rehabilitation. C1 Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA. USA, Ctr Hlth Promot & Prevent Med, Aberdeen, MD USA. US Dept Vet Affairs, Cooperat Studies Program, Washington, DC USA. Georgetown Univ, Med Ctr, Washington, DC 20007 USA. RP Feuerstein, M (reprint author), Uniformed Serv Univ Hlth Sci, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA. EM mfeuerstein@usuhs.mil NR 49 TC 15 Z9 15 U1 1 U2 4 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1053-0487 J9 J OCCUP REHABIL JI J. Occup. Rehabil. PD JUN PY 2005 VL 15 IS 2 BP 113 EP 128 DI 10.1007/s10926-005-1214-z PG 16 WC Rehabilitation; Social Issues SC Rehabilitation; Social Issues GA 913ZF UT WOS:000228193500003 PM 15844672 ER PT J AU Guthrie, CR Murray, AT Franklin, AA Hamblin, MW AF Guthrie, CR Murray, AT Franklin, AA Hamblin, MW TI Differential agonist-mediated internalization of the human 5-hydroxytryptamine 7 receptor isoforms SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID 5-HT7 RECEPTOR; PHARMACOLOGICAL CHARACTERIZATION; SPLICE VARIANTS; SMOOTH-MUSCLE; EXPRESSION; SUBTYPES; CLONING; LOCALIZATION; TRAFFICKING; RELAXATION AB The human 5-hydroxytryptamine 7 (5-HT7) serotonin receptor is a class A G-protein coupled receptor that has three isoforms, 5-HT7(a), 5-HT7(b), and 5-HT7(d), which are produced by alternative splicing. The 5-HT7 receptors are expressed in discrete areas of the brain and in both vascular and gastrointestinal smooth muscle. Central nervous system 5-HT7 receptors may play a role in mood and sleep disorders. 5-HT7 receptors show high affinity for a number of antidepressants and typical and atypical antipsychotics. We report here that the human 5-HT7(d) isoform expressed in human embryonic kidney (HEK) 293 cells exhibits a pattern of receptor trafficking in response to agonist that differ from 5-HT7(a) or 5-HT7(b) isoforms. We employed a modification of a live cell-labeling technique to demonstrate that surface 5-HT7(d) receptors are constitutively internalized in the absence of agonist. This is in contrast to 5-HT7(a) and 5-HT7(b) isoforms, which do not show this profound agonist-independent internalization. Indeed, the 5-HT7(d) isoform displays this internalization in the presence of a 5-HT7-specific antagonist. In addition, the human 5-HT7(d) isoform shows a diminished efficacy in stimulation of cAMP-responsive reporter gene activity in transfected cells compared with 5-HT7(a) or 5-HT7(b) receptors expressed at comparable levels. Thus, the carboxy-terminal tail of 5-HT7(d), which is the longest among known human 5-HT7 isoforms, may contain a motif that interacts with cellular transport mechanisms that is distinct from 5-HT7(a) and 5-HT7(b). C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Guthrie, CR (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM cguthrie@u.washington.edu NR 28 TC 28 Z9 28 U1 0 U2 0 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 JUN PY 2005 VL 313 IS 3 BP 1003 EP 1010 DI 10.1124/jpet.104.081919 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 927OM UT WOS:000229203200007 PM 15716386 ER PT J AU Konrad-Martin, D Keefe, DH AF Konrad-Martin, D Keefe, DH TI Transient-evoked stimulus-frequency and distortion-product otoacoustic emissions in normal and impaired earsa SO JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA LA English DT Article; Proceedings Paper CT 27th Midwinter Research Meeting of the Association-for-Research-in-Otolaryngology CY FEB, 2004 CL Daytona Beach, FL SP Assoc Res Otolaryngol ID AUDITORY FILTER NONLINEARITY; PHASE DELAY MEASUREMENTS; TRAVELING-WAVE DELAY; NORMAL-HEARING; FINE-STRUCTURE; SIMULTANEOUS MASKING; HUMAN ADULTS; SUPPRESSION; LATENCY; MODEL AB Transient-evoked stimulus-frequency otoacoustic emissions (SFOAEs), recorded using a nonlinear differential technique, and distortion-product otoacoustic emissions (DPOAEs) were measured in 17 normal-hearing and 10 hearing-impaired subjects using pairs of tone pips (pp), gated tones (gg), and for DPOAEs, continuous and gated tones (cg). Temporal envelopes of stimulus and OAE waveforms were obtained by narrow-band filtering at the stimulus or DP frequency. Mean SFOAE latencies in normal ears at 2.7 and 4.0 kHz decreased with increasing stimulus level and were larger at 4.0 kHz than latencies in impaired ears. Equivalent auditory filter bandwidths were calculated as a function of stimulus level from SFOAE latencies by assuming that cochlear transmission is minimum phase. DPOAE latencies varied less with level than SFOAE latencies. The ppDPOAEs often had two (or more) peaks separated in time with latencies consistent with model predictions for distortion and reflection components. Changes in ppDPOAE latency with level were sometimes explained by a shift in relative amplitudes of distortion and reflection components. The ppSFOAE SPL within the main spectral lobe of the pip stimulus was higher for normal ears in the higher-frequency half of the pip than the lower-frequency half, which is likely an effect of basilar membrane two-tone suppression. C1 Oregon Hlth Sci Univ, Dept Otolaryngol Head & Neck Surg, Portland, OR 97239 USA. Boys Town Natl Res Hosp, Omaha, NE 68131 USA. RP Konrad-Martin, D (reprint author), Portland VA Med Ctr, VA RR&D Natl Ctr Rehabil Auditory Res, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM dawn.martin@med.va.gov FU NIDCD NIH HHS [R01 DC003784, T32 DC000013] NR 86 TC 19 Z9 19 U1 1 U2 4 PU ACOUSTICAL SOC AMER AMER INST PHYSICS PI MELVILLE PA STE 1 NO 1, 2 HUNTINGTON QUADRANGLE, MELVILLE, NY 11747-4502 USA SN 0001-4966 J9 J ACOUST SOC AM JI J. Acoust. Soc. Am. PD JUN PY 2005 VL 117 IS 6 BP 3799 EP 3815 DI 10.1121/1.1904403 PG 17 WC Acoustics; Audiology & Speech-Language Pathology SC Acoustics; Audiology & Speech-Language Pathology GA 934OQ UT WOS:000229718500050 PM 16018483 ER PT J AU Hayden, KM Zandi, PP Lyketsos, CG Tschanz, JT Norton, MC Khachaturian, AS Pieper, CF Welsh-Bohmer, KA Breitner, JCS AF Hayden, KM Zandi, PP Lyketsos, CG Tschanz, JT Norton, MC Khachaturian, AS Pieper, CF Welsh-Bohmer, KA Breitner, JCS CA Cache County Investigators TI Apolipoprotein E genotype and mortality: Findings from the Cache County study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE apolipoprotein E; mortality; Alzheimer's disease; cardiovascular disease ID ALZHEIMERS-DISEASE; E POLYMORPHISM; APOE GENOTYPE; COGNITIVE DECLINE; AFRICAN-AMERICAN; OLDEST-OLD; DEMENTIA; ALLELE; GENE; AGE AB OBJECTIVES: To evaluate the association between apolipoprotein E (apo E) epsilon 4 and mortality, the population attributable risk for mortality with epsilon 4, and relative contributions of cardiovascular disease (CVD) and Alzheimer's disease (AD). DESIGN: Population-based cohort study. SETTING: Community-based. PARTICIPANTS: Permanent residents of Cache County, Utah, aged 65 and older as of January 1, 1995. MEASUREMENTS: Participants were genotyped at the apo E locus using buccal-swab deoxyribonucleic acid. Cardiovascular health was ascertained using self- or proxy-report interviews at participants' residences. AD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders criteria. Utah Department of Vital Statistics quarterly reports were reviewed to identify participants who died. RESULTS: Crude evaluations showed nonsignificantly greater risk of death for epsilon 2/2 (hazard ratio (HR)=1.66, 95% confidence interval (CI)=0.92-2.76) and epsilon 3/4 (HR=1.11, 95% CI=0.97-1.26) genotypes and significantly greater risk for epsilon 4/4 (HR=1.48, 95% CI=1.09-1.96). After adjustment for age, age(2), sex, and education, risks increased to 1.98 (95% CI=1.08-3.35), 1.28 (95% CI=1.12-1.46), and 2.02 (95% CI=1.47-2.71), respectively, compared with epsilon 3/3 genotypes. Adjustment for presence of any CVD did not change the risk of death for epsilon 3/4 and epsilon 4/4. Adjustment for AD reduced the risk of death for epsilon 3/4 (HR=1.13, 95% CI=0.99-1.30) and epsilon 4/4 (HR=1.59, 95% CI=1.15-2.14). The population attributable risk of death for epsilon 3/4 and epsilon 4/4 genotypes combined is estimated at 9.6%. CONCLUSION: These findings suggested that the epsilon 2/2, epsilon 3/4, and epsilon 4/4 genotypes have greater early mortality risks. Further analyses showed that AD partially mediates the association between epsilon 3/4, epsilon 4/4, and death. C1 Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Ctr Study Aging & Human Dev, Durham, NC 27705 USA. Duke Univ, Med Ctr, Dept Biometry & Bioinformat, Ctr Study Aging & Human Dev, Durham, NC 27705 USA. Johns Hopkins Univ, Sch Med, Dept Psychiat, Div Ggeriatr Psychiat & Neuropsychiat, Baltimore, MD 21205 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD 21205 USA. Utah State Univ, Dept Psychol, Ctr Epidemiol Studies, Logan, UT 84322 USA. Utah State Univ, Dept Family Consumer & Human Dev, Logan, UT 84322 USA. Khachaturian & Associates Inc, Potomac, MD USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Welsh-Bohmer, KA (reprint author), Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Ctr Study Aging & Human Dev, 2200 W Main St,Suite A230, Durham, NC 27705 USA. EM kwe@duke.edu RI Tschanz, JoAnn/E-5986-2010; Norton, Maria/E-6994-2013; Hayden, Kathleen/B-6442-2012 OI Hayden, Kathleen/0000-0002-7745-3513 FU NIA NIH HHS [AG-11380, T32-AG-00029]; NIMH NIH HHS [T32-MH-14592] NR 50 TC 36 Z9 36 U1 2 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2005 VL 53 IS 6 BP 935 EP 942 DI 10.1111/j.1532-5415.2005.53301.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 928NV UT WOS:000229279500002 PM 15935014 ER PT J AU Metlay, JP Cohen, A Polsky, D Kimmel, SE Koppel, R Hennessy, S AF Metlay, JP Cohen, A Polsky, D Kimmel, SE Koppel, R Hennessy, S TI Medication safety in older adults: Home-based practice patterns SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE aged; ambulatory care; medication errors; drug assessment ID ADVERSE DRUG EVENTS; ELDERLY-PATIENTS; DEPRESSION; QUALITY; PROGRAM AB OBJECTIVES: To identify the current state of medication-taking practices of community-dwelling older adults on high-risk medications. DESIGN: Telephone survey of older adults filling prescriptions for warfarin, digoxin, or phenytoin from May 2, 2002, through June 30, 2003. SETTING: The Pennsylvania Pharmacy Assistance Contract for the Elderly (PACE) Program, a state-run program providing prescription drug coverage for poor older adults. PARTICIPANTS: PACE members. MEASUREMENTS: Patients self-reported sources of information on current medications as well as home-based practices for organizing medication regimens. RESULTS: Four thousand nine hundred fifty-five PACE members were interviewed. Thirty-two percent of the sample reported that they had not received any specific instructions about their medications, 35% reported that they received instructions from their primary care provider, and 46% indicated they received them from a pharmacist. Fifty-four percent of participants indicated that they used a pillbox for organizing their medications. Older adults prescribed warfarin were more likely to report receiving instructions than those prescribed digoxin or phenytoin. CONCLUSION: A substantial proportion of older adults on high-risk medications do not recall receiving instructions for the use of their medications and do not take advantage of existing systems for organizing medication regimens. Improved patient education and delivery of medication organization systems are immediate opportunities to potentially reduce the risk of medication errors in older people. C1 Univ Penn, Ctr Clin Epidemiol & Biostat, Penn Program Reduct Medicat Errors, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Sociol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Ctr Hlth Equit Res & Promot, Philadelphia, PA USA. RP Metlay, JP (reprint author), Univ Penn, Ctr Clin Epidemiol & Biostat, Penn Program Reduct Medicat Errors, 712 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM jmetlay@cceb.med.upenn.edu RI Cohen, Abigail/K-9180-2013 OI Cohen, Abigail/0000-0002-7425-7218 FU AHRQ HHS [P01-HS11530] NR 20 TC 45 Z9 48 U1 0 U2 8 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2005 VL 53 IS 6 BP 976 EP 982 DI 10.1111/j.1532-5415.2005.53308.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 928NV UT WOS:000229279500008 PM 15935020 ER PT J AU Webber, AP Martin, JL Harker, JO Josephson, KR Rubenstein, LZ Alessi, CA AF Webber, AP Martin, JL Harker, JO Josephson, KR Rubenstein, LZ Alessi, CA TI Depression in older patients admitted for postacute nursing home rehabilitation SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE depression; nursing home; postacute rehabilitation; functional status ID ELDERLY MEDICAL INPATIENTS; MENTAL-DISORDERS; CORNELL SCALE; PRIMARY-CARE; FOLLOW-UP; RECOGNITION; HEALTH; COMORBIDITY; PHYSICIANS; DEMENTIA AB OBJECTIVES: To describe the prevalence, recognition, and persistence of depression in older adults undergoing postacute rehabilitation in a nursing home (NH) setting and to explore the effect of depression on rehabilitation outcomes. DESIGN: Prospective cohort study. SETTING: One rehabilitative NH in the Los Angeles area. PARTICIPANTS: One hundred fifty-eight patients (aged >= 65) admitted for postacute rehabilitation over a 9-month recruitment period. MEASUREMENTS: Depression was assessed using the 15-item Geriatric Depression Scale (GDS-15) or the Cornell Scale for Depression (in participants with dementia). Medical records were reviewed for documentation of depression and antidepressant use before and during the rehabilitative NH stay. Rehabilitation process was assessed using total amount of successfully completed therapy (minutes). Rehabilitation outcome was assessed using the motor component of the Functional Independence Measure (mFIM). Measures were performed at admission and 2 months later. RESULTS: Of the 646 potentially eligible patients admitted during the study, 158 consented, and 151 were screened for depression. Forty-two (27.8%) had depressive symptoms (GDS=6 or Cornell=5). Of these, only 15 had a documented diagnosis of depression, and 12 were receiving antidepressants. Depression was associated with longer NH stay but not with discharge mFIM score. Two months later, depression persisted in 24 participants and was associated with worse mFIM (55.5 +/- 22.7 vs 67.0 +/- 23.7, depressed vs nondepressed; P=.03). CONCLUSION: Depression was common, underrecognized, and undertreated in these postacute rehabilitation patients. Depression generally persisted and was associated with worse functional status at 2-month follow-up. C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA USA. RP Webber, AP (reprint author), Flat 3,31 Sunningfields Rd, London NW4 4QS, England. EM awebber@ucla.edu NR 24 TC 21 Z9 22 U1 1 U2 3 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2005 VL 53 IS 6 BP 1017 EP 1022 DI 10.1111/j.1532-5415.2005.53322.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 928NV UT WOS:000229279500015 PM 15935027 ER PT J AU Chin, EE Zimmerman, PT Grant, EG AF Chin, EE Zimmerman, PT Grant, EG TI Sonographic evaluation of upper extremity deep venous thrombosis SO JOURNAL OF ULTRASOUND IN MEDICINE LA English DT Article DE Doppler sonography; upper extremity; venous thrombosis ID CATHETER-RELATED THROMBOSIS; COLOR DOPPLER ULTRASOUND; VEIN-THROMBOSIS; JUGULAR VEINS; DIAGNOSIS; VENOGRAPHY; US AB Objective. The purpose of this presentation is to review the techniques of performing an upper extremity Doppler examination, in addition to illustrating the sonographic appearances of acute and chronic upper extremity deep venous thrombosis (UEDVT). Methods. The risk factors and complications of UEDVT are discussed, and the anatomy of the upper extremity deep venous system as well as examination techniques are described. Cases of acute and chronic deep venous thrombosis were also chosen to illustrate the spectrum of sonographic appearances. Results. Color Doppler sonography is accurate in the diagnosis of UEDVT. However, in cases of equivocal Doppler findings, or when the sonographic findings are normal but clinical suspicion for central venous thrombosis is high, magnetic resonance or contrast venography is necessary for further evaluation. Conclusions. Color Doppler sonography is a rapid and noninvasive technique in the evaluation of venous disease in the upper extremity and is the modality of choice in screening for UEDVF. C1 W Los Angeles Vet Adm Med Ctr, Dept Radiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Radiol, Sch Med, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Radiol, Los Angeles, CA USA. RP Chin, EE (reprint author), W Los Angeles Vet Adm Med Ctr, Dept Radiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM evachin@aol.com NR 18 TC 35 Z9 36 U1 0 U2 1 PU AMER INST ULTRASOUND MEDICINE PI LAUREL PA SUBSCRIPTION DEPT, 14750 SWEITZER LANE, STE 100, LAUREL, MD 20707-5906 USA SN 0278-4297 J9 J ULTRAS MED JI J. Ultrasound Med. PD JUN PY 2005 VL 24 IS 6 BP 829 EP 838 PG 10 WC Acoustics; Radiology, Nuclear Medicine & Medical Imaging SC Acoustics; Radiology, Nuclear Medicine & Medical Imaging GA 931BX UT WOS:000229461900011 PM 15914687 ER PT J AU Seal, KH Thawley, R Gee, L Bamberger, J Kral, AH Ciccarone, D Downing, M Edlin, BR AF Seal, KH Thawley, R Gee, L Bamberger, J Kral, AH Ciccarone, D Downing, M Edlin, BR TI Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: A pilot intervention study SO JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE LA English DT Article DE heroin; heroin-related deaths; injection drug use; overdose; prevention ID TAKE-HOME NALOXONE; OPIATE OVERDOSE; SAN-FRANCISCO; CPR; AREA AB Fatal heroin overdose has become a leading cause of death among injection drug users (ID Us). Several recent feasibility studies have concluded that naloxone distribution programs for heroin injectors should be implemented to decrease heroin overdose deaths, but there have been no prospective trials of such programs in North America. This pilot study was undertaken to investigate the safety and feasibility of training injection drug using partners to perform cardiopulmonary resuscitation (CPR) and administer naloxone in the event of heroin overdose. During May and June 2 001, 24 IDUs (12 pairs of injection partners) were recruited from street settings in San Francisco. Participants took part in 8-hour training in heroin overdose prevention, CPR, and the use of naloxone. Following the intervention, participants were prospectively followed for 6 months to determine the number and outcomes of witnessed heroin overdoses, outcomes of participant interventions, and changes in participants' knowledge of overdose and drug use behavior. Study participants witnessed 20 heroin overdose events during 6 months follow-up. They performed CPR in 16 (80%) events,, administered naloxone in 15 (75%) and did one or the other in 19 (95%). All overdose victims survived. Knowledge about heroin overdose management increased, whereas heroin use decreased. IDUs can be trained to respond to heroin overdose emergencies by performing CPR and administering naloxone. Future research is needed to evaluate the effectiveness of this peer intervention to prevent fatal heroin overdose. C1 Univ Calif San Francisco, Dept Med, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Urban Hlth Study, San Francisco, CA 94143 USA. San Francisco Dept Publ Hlth, San Francisco, CA USA. Cornell Univ, Ctr Hepatitis C, Weill Med Coll, New York, NY 10021 USA. RP Seal, KH (reprint author), Univ Calif San Francisco, Dept Med, San Francisco VA Med Ctr, 4150 Clement St,Box 111-A1, San Francisco, CA 94121 USA. EM karens@itsa.ucsf.edu RI Ciccarone, Dan/I-5404-2013 OI Ciccarone, Dan/0000-0002-2355-5477; Edlin, Brian/0000-0001-8172-8797 FU NIDA NIH HHS [K23 DA016165, K23 DA016165-02] NR 30 TC 99 Z9 101 U1 0 U2 17 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1099-3460 J9 J URBAN HEALTH JI J. Urban Health PD JUN PY 2005 VL 82 IS 2 BP 303 EP 311 DI 10.1093/jurban/jti053 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 936HX UT WOS:000229847200014 PM 15872192 ER PT J AU Hiramoto, J Hansen, KJ Pan, XM Edwards, MS Sawhney, R Rapp, JH AF Hiramoto, J Hansen, KJ Pan, XM Edwards, MS Sawhney, R Rapp, JH TI Atheroemboli during renal artery angioplasty: An ex vivo study SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID ATHEROSCLEROTIC RENOVASCULAR DISEASE; ISCHEMIC NEPHROPATHY; STENT PLACEMENT; HYPERTENSIVE PATIENTS; SURGICAL-MANAGEMENT; BALLOON ANGIOPLASTY; FOLLOW-UP; STENOSIS; REVASCULARIZATION; EXPERIENCE AB Objective: We hypothesized that atheroemboli released during renal angioplasty could be responsible for the modest functional result of renal angioplasty even after anatomic reduction of renal artery stenosis. To test this hypothesis, we enumerated and sized fragments released during ex vivo angioplasty and stenting of human renal artery atherosclerotic specimens removed during aortorenal endarterectomy. Methods. Thirty-three intact aortorenal atheroma specimens (16 pairs with adjacent aortic atheroma and one specimen with a single renal artery orifice) were removed from 17 patients with renal artery occlusive disease who underwent renal artery endarterectomy. specimens. Endarterectomy specimens were removed with a ring of aortic plaque and "fitted" with a polytetrafluoroethylene "adventitia". Ex vivo angioplasty was technically successful in 31 of the 33 specimens and was performed by using a 0.018-inch guidewire and 3.0-mm and 5.0-mm angioplasty balloons inflated for 30 seconds at 15 atmospheres pressure. Stenting was performed with either a 5-mm or 6-mm self-expanding Wallstent. Each artery was flushed with 20 mL of saline after guidewire placement, each angioplasty, and stent placement. The effluent was collected for analysis for counting with either a microscope (size > 100 mu m) or a Coulter counter (size < 100 tun). The number and size of embolic fragments in the effluent collected after each manipulation was recorded. Results: Each manipulation of the specimens, including simply advancing the guidewire through the atherosclerotic lesion, released thousands of fragments. The numbers of fragments in each size category increased with decreasing particle size. Positioning and deploying the Wallstent released an additional bolus of fragments similar to that released after balloon angioplasty. Conclusions: Ex vivo renal angioplasty releases thousands of atherosclerotic fragments of sufficient size to create vascular occlusions and initiate significant renal parenchymal damage. The results of renal angioplasty procedures could be improved by placing distal protection devices to prevent atheroembolization. Clinical Relevance: Athero-emboli produce a local arteritis in the kidney and could cause substantial damage to the renal parenchyma. This report explores the quantity of athero-emboli released during ex vivo angioplasty and stenting of renal V atheroma specimens. The number of emboli found in this ex vivo study suggest that the use of protection devices may be advisable to protect the end organ, as done with angioplasty of the carotid artery. Of necessity, this was an ex vivo study and direct application to the clinical setting will need further study. Fortunately, multi-center trials examining the value of protection devices are currently in progress. C1 San Francisco VA Med Ctr, Surg Serv, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Wake Forest Univ, Sch Med, San Francisco, CA USA. RP Rapp, JH (reprint author), San Francisco VA Med Ctr, Surg Serv, 4150 Clement St, San Francisco, CA 94121 USA. EM rappj@surgery.ucsf.edu NR 42 TC 59 Z9 63 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD JUN PY 2005 VL 41 IS 6 BP 1026 EP 1030 DI 10.1016/j.jvs.2005.02.042 PG 5 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 933IL UT WOS:000229622000021 PM 15944605 ER PT J AU Komers, R Zdychova, J Cahova, M Kazdova, L Lindsley, JN Anderson, S AF Komers, R Zdychova, J Cahova, M Kazdova, L Lindsley, JN Anderson, S TI Renal cyclooxygenase-2 in obese Zucker (fatty) rats SO KIDNEY INTERNATIONAL LA English DT Article DE Zucker rat; diabetic nephropathy; cyclooxygenase-2; hyperinsulinemia; thromboxane A2 ID DIABETIC RATS; THROMBOXANE SYNTHESIS; INSULIN; EXPRESSION; GLUCOSE; KIDNEY; HYPERFILTRATION; PROSTAGLANDIN; NEPHROPATHY; INHIBITION AB Background. Cyclooxygenase (COX) isoforms, COX-1 and COX-2, are involved in production of prostanoids in the kidney. Increases in renal COX-2 expression have been implicated in the pathophysiology of progressive renal injury, including type 1 diabetes. Thromboxane A(2) (TxA(2)) has been suggested as the key mediator of these effects resulting in up-regulation of prosclerotic cytokines and extracellular matrix proteins. Unlike type 1 diabetes, renal COX has not been studied in models of type 2 diabetes. Methods. Renal cortical COX protein expression, and urinary excretion of stable metabolites of prostaglandin E-2 (PGE(2)) and TxA(2), in association with metabolic parameters, were determined in 4-and 12-week-old Zucker fatty rats (fa/fa rat) (ZDF4 and ZDF12), a model of type 2 diabetes, and in age-matched littermates with no metabolic defect (Zucker lean) (ZL4 and ZL12). Results. Western blotting revealed increased COX-2 expression in ZDF4 as compared to ZL4 (245 +/- 130%) (P < 0.05). This increase in COX-2 was even more apparent in 12-week-old ZDF rats (650 +/- 120%) (P < 0.01). All groups of rats demonstrated COX-2-positive cells in typical cortical localizations [macula densa, thick ascending loop of Henle (TALH)]. In contrast to COX-2, COX-1 expression was 30% lower in ZDF12. These changes in COX expression were associated with enhanced urinary excretion of prostanoids, in parallel with the development of metabolic abnormalities. Moreover, increases in prostanoid excretion in ZDF12 were in part reduced by wortmannin (100 mu g/kg), used as inhibitor of insulin signaling. Conclusion. Renal cortical COX-2 protein expression and function were increased in ZDF rats, as compared to controls, whereas COX-1 exhibited opposite regulation. The changes in COX-2 paralleled metabolic abnormalities, and were at least in part a four consequence of hyperinsulinemia. These abnormalities may play a role in renal pathophysiology in this model of type 2 diabetes. C1 Inst Clin & Expt Med, Ctr Diabet, Prague 14021, Czech Republic. Inst Clin & Expt Med, Ctr Med Expt, Prague, Czech Republic. Oregon Hlth Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Komers, R (reprint author), Inst Clin & Expt Med, Ctr Diabet, Videnska 1958, Prague 14021, Czech Republic. EM radko.komers@medicon.cz FU NIDDK NIH HHS [DK 63231] NR 36 TC 34 Z9 34 U1 0 U2 1 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JUN PY 2005 VL 67 IS 6 BP 2151 EP 2158 DI 10.1111/j.1523-1755.2005.00320.x PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 929ZC UT WOS:000229384300007 PM 15882258 ER PT J AU Kertesz, SG Larson, MJ Horton, NJ Winter, M Saitz, R Samet, JH AF Kertesz, SG Larson, MJ Horton, NJ Winter, M Saitz, R Samet, JH TI Homeless chronicity and health-related quality of life trajectories among adults with addictions SO MEDICAL CARE LA English DT Article; Proceedings Paper CT Annual Meeting of the Association-for-Medical-Education-and-Research-on-Substance-Abuse CY NOV 08, 2003 CL Baltimore, MD SP Assoc Med Educ & Res Substance Abuse DE homelessness; quality of life; substance abuse; longitudinal models ID PRIMARY-CARE PATIENTS; PSYCHIATRIC COMORBIDITY; LONGITUDINAL DATA; MENTAL-DISORDERS; URBAN HOMELESS; MEDICAL-CARE; SURVEY SF-36; ALCOHOL; DRUG; POPULATION AB Background: New federal initiatives target funds toward chronically homeless as distinct from other homeless persons. Few data exist, however, to substantiate the implications of chronic homelessness for major health outcomes. Objectives: Using data from a 2-year cohort of addicted persons, we tested whether changes in mental and physical health-related quality of life (HRQOL) differed according to homeless chronicity. Methods: Using self-reported homelessness, we classified subjects as chronically homeless (CH; n = 60), transitionally homeless (TRANS; n = 108), or as housed comparison subjects (HSD; n = 106). The Short Form-36 Health Survey, administered at baseline and 2 follow-ups over a period of 2 years, provided a Mental Component Summary (MCS) and a Physical Component Summary (PCS) for HRQOL. Mixed model linear regression was used to test the association between housing status, MCS, and PCS. Additional models assessed whether medical, psychiatric, addiction. and social support measures could account fir HRQOL differences. Results: All subjects had low MCS scores at study entry (mean, 31.2; SD, 12.6). However, there was a significant housing status-by-time interaction (P = 0.01). At final follow-up, CII and TRANS subjects had lower adjusted MCS scores than HSD subjects (33.4, 38.8, and 43.7 for the 3 groups, rcspectivcly; all P <= 0.01). By contrast, housing status and PCS were not significantly associated (P = 0.19). Medical. psychiatric, addiction, and social support variables had significant associations with MCS, and their inclusion in the regression reduced the apparent effect of housing status on MCS. Conclusions: Chronic homelessness was associated with especially poor mental but not physical HRQOL over time. These findings reinforce a new typology of homelessness. C1 Univ Alabama, Sch Med, Div Prevent Med, Dept Med, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. New England Res Inst, Inst Hlth Serv Res & Policy, Watertown, MA 02172 USA. Smith Coll, Dept Math, Northampton, MA 01063 USA. Boston Univ, Sch Publ Hlth, Data Coordinating Ctr, Boston, MA USA. Boston Univ, Sch Med, Boston Med Ctr, Sect Gen Internal Med, Boston, MA 02118 USA. Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA. Boston Univ, Sch Publ Hlth, Youth Alcohol Prevent Ctr, Boston, MA USA. Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA USA. RP Kertesz, SG (reprint author), Univ Alabama, Sch Med, Div Prevent Med, Dept Med, 1530 3rd Ave S MT608, Birmingham, AL 35294 USA. EM skertesz@uab.edu RI Horton, Nicholas/A-2493-2008; Reis, Aline/G-9573-2012 OI Horton, Nicholas/0000-0003-3332-4311; Kertesz, Stefan/0000-0001-6101-8421 FU NIDA NIH HHS [K23-DA15847]; PHS HHS [R01-10870, R0108701-10019] NR 50 TC 50 Z9 50 U1 3 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 2005 VL 43 IS 6 BP 574 EP 585 DI 10.1097/01.mlr.0000163652.91463.b4 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 929XF UT WOS:000229379200008 PM 15908852 ER PT J AU Vlachaki, MT Teslow, TN Amosson, C Uy, NW Ahmad, S AF Vlachaki, MT Teslow, TN Amosson, C Uy, NW Ahmad, S TI IMRT versus conventional 3DCRT on prostate and normal tissue dosimetry using an endorectal balloon for prostate immobilization SO MEDICAL DOSIMETRY LA English DT Article DE prostate cancer; IMRT; 3DCRT; prostate immobilization ID DOSE-VOLUME HISTOGRAMS; RADIATION-THERAPY; CONFORMAL RADIOTHERAPY; CANCER; PROBABILITY; IRRADIATION; TOLERANCE; TOXICITY; BLADDER; RECTUM AB This study was undertaken to compare prostate and normal tissue dosimetry in prostate cancer patients treated with intensity-modulated radiation therapy (IMRT) and conventional 3-dimensional conformal radiotherapy (3DCRT) using an endorectal balloon for prostate immobilization. Ten prostate cancer patients were studied using both IMRT and conventional 3DCRT at Houston Veterans Affairs Medical Center. For IMRT, the prescription was 70 Gy at 2 Gy/fraction at the 83.4% isodose line, allowing no more than 15% of the rectum and 33% of the bladder to receive above 68 and 65 Gy, respectively. For conventional 3DCRT, a 6-field arrangement with lateral and oblique fields was used to deliver 76 Gy at 2Gy/fraction, ensuring complete tumor coverage by the 72-Gy isodose line. Mean doses for prostate and seminal vesicles were 75.10 and 75.11 Gy, respectively, for IMRT and 75.40 and 75.02 Gy, respectively, for 3DCRT (p>0.218). 3DCRT delivered significantly higher doses to 33%,50%, and 66% volumes of rectum by 3.55, 6.64, and 10.18 Gy, respectively (p<0.002), and upper rectum by 7.26, 9.86, and 9.16 Gy, respectively (p<0.007). 3DCRT also delivered higher doses to femur volumes of 33% and 50% by 9.38 and 10.19 Gy, respectively, (p<0.001). Insignificant differences in tumor control probability (TCP) values between IMRT and 3DCRT were calculated for prostate (p=0.320) and seminal vesicles (p=0.289). Compared to 3DCRT, IMRT resulted in significantly reduced normal tissue complication probability (NTCP) only for upper rectum (p=0.025) and femurs (p=0.021). This study demonstrates that IMRT achieves superior normal tissue avoidance, especially for rectum and femurs compared to 3DCRT, with comparable target dose escalation. (C) 2005 American Association of Medical Dosimetrists. C1 NYU, Med Ctr, Dept Radiat Oncol, Sch Med, New York, NY 10016 USA. Dept Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD USA. Arlington Canc Ctr, Arlington, TX USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. RP Vlachaki, MT (reprint author), NYU, Med Ctr, Dept Radiat Oncol, Sch Med, 566 1st Ave, New York, NY 10016 USA. EM vlachaki@med.nyu.edu NR 28 TC 15 Z9 15 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0958-3947 J9 MED DOSIM JI Med. Dosim. PD SUM PY 2005 VL 30 IS 2 BP 69 EP 75 DI 10.1016/j.meddos.2005.01.002 PG 7 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 018XO UT WOS:000235798300003 PM 15922172 ER PT J AU Opekun, AR Yeh, CW Opekun, JL Graham, DY AF Opekun, AR Yeh, CW Opekun, JL Graham, DY TI In vivo tests of natural therapy, Tibetan yogurt or fresh broccoli, for Helicobacter pylori infection SO METHODS AND FINDINGS IN EXPERIMENTAL AND CLINICAL PHARMACOLOGY LA English DT Article DE broccoli; clinical trial; Helicobacter pylori; humans; sulforaphane; urea breath test; yogurt ID SPROUTS; SULFORAPHANE; DIAGNOSIS; PREVENTS; EFFICACY; MICE AB Plants and Probiotics have a long history in the treatment of gastrointestinal ailments. Our aim was to evaluate the effectiveness of Tibetan yogurt and fresh broccoli tips in Helicobacter pylori- (H. pylori) infected volunteers, using the urea breath test (UBT) to assess the effect on H. pylori. Clinical trials consisted of ingestion of similar to 135 g of fresh, finely minced juvenile broccoli tips (var. Emperor) in commercial plain yogurt t.i.d, for ten servings (33 days) or ingestion of freshly made Tibetan yogurt whey (120 ml) given twice a day for 3.5 days. Urea breath testing vas done before and after the natural therapies. Five volunteers received broccoli tips and seven received Tibetan yogurt. No trend for a beneficial effect was seen: the UBT results (delta over baseline) before and after yogurt (35.5 +/- 12.8 vs. 40.7 +/- 12.2) (p = 0.76) or broccoli (15.8 vs. 19.4) (p = 1.0) were unchanged. Antimicrobial end products derived from Tibetan yogurt or broccoli tips have little or no anti-H. pylori effect in vivo. It appears that the gastric mucosal microenvironment apparently shielded H. pylori. In vitro studies suggesting anti-H. pylori activity of compounds should be considered as hypotheses to be tested. (C) 2005 Science All rights reserved. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, RM 3A-320 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu NR 20 TC 7 Z9 7 U1 0 U2 4 PU PROUS SCIENCE, SA PI BARCELONA PA PO BOX 540, PROVENZA 388, 08025 BARCELONA, SPAIN SN 0379-0355 J9 METHOD FIND EXP CLIN JI Methods Find. Exp. Clin. Pharmacol. PD JUN PY 2005 VL 27 IS 5 BP 327 EP 329 DI 10.1358/mf.2005.27.5.896760 PG 3 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 950GU UT WOS:000230846400006 PM 16082421 ER PT J AU Mendez, MF Shapira, JS Miller, BL AF Mendez, MF Shapira, JS Miller, BL TI Stereotypical movements and frontotemporal dementia SO MOVEMENT DISORDERS LA English DT Article DE stereotypical movements; stereotypies; frontotemporal dementia; compulsions ID OBSESSIVE-COMPULSIVE DISORDER; LOBAR DEGENERATION; BEHAVIOR; CONSENSUS; CIRCUITS; CRITERIA; DISEASE; SCALE; SPECT AB Stereotypical movements are characteristic of autism or mental retardation but can also occur in patients with dementia, particularly frontotemporal dementia (FTD). In this study, we administered the Abnormal Involuntary Movement Scale (AIMS) to 18 patients with FTD and to 18 patients with the most common form of dementia, Alzheimer's disease (AD). The AIMS scores were gathered at the initial presentation of patients who had not received antipsychotic medications. Compared to the AD patients, the FTD patients had significantly more stereotypical movements, including frequent rubbing behaviors and some selfinjurious acts. All the FTD patients with stereotypical movements had compulsive-like behaviors, suggesting a similar pathophysiologic cause, and most had a decrease in their stereotypical movements with the administration of sertraline, a serotonin selective reuptake inhibitor. (c) 2005 Movement Disorder Society. C1 VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691 116AF, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit 691 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU NIA NIH HHS [P01 AG019724, AG 19724-01] NR 26 TC 47 Z9 49 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JUN PY 2005 VL 20 IS 6 BP 742 EP 745 DI 10.1002/mds.20465 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 934UJ UT WOS:000229733800013 PM 15786492 ER PT J AU Weisbord, SD Ramkumar, M LaPidus, SA McBride, DJ Palevsky, PM AF Weisbord, SD Ramkumar, M LaPidus, SA McBride, DJ Palevsky, PM TI Functional renal artery obstruction following percutaneous kidney biopsy SO NEPHROLOGY DIALYSIS TRANSPLANTATION LA English DT Letter ID COMPLICATIONS C1 VA Pittsburgh Healthcare Syst, Med Serv, Renal Sect, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Serv Radiol, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Radiol, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Med Serv, Renal Sect, Pittsburgh, PA 15240 USA. EM steven.weisbord@med.va.gov OI Palevsky, Paul/0000-0002-7334-5400 NR 4 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0931-0509 J9 NEPHROL DIAL TRANSPL JI Nephrol. Dial. Transplant. PD JUN PY 2005 VL 20 IS 6 BP 1274 EP 1275 DI 10.1093/ndt/gfh828 PG 2 WC Transplantation; Urology & Nephrology SC Transplantation; Urology & Nephrology GA 934JH UT WOS:000229704600049 PM 15840676 ER PT J AU Lu, XY Mazarati, A Sanna, P Shinmei, S Bartfai, T AF Lu, XY Mazarati, A Sanna, P Shinmei, S Bartfai, T TI Distribution and differential regulation of galanin receptor subtypes in rat brain: effects of seizure activity SO NEUROPEPTIDES LA English DT Article; Proceedings Paper CT 3rd International Symposium on Galanin and its Receptors CY OCT 21-22, 2004 CL San Diego, CA DE galanin; galanin receptor subtypes; down-regulation; distribution; GalR2; GalR3 ID CENTRAL-NERVOUS-SYSTEM; SPINAL-CORD; STATUS EPILEPTICUS; MESSENGER-RNAS; BINDING-SITES; GALR1; EXPRESSION; NEUROGENESIS; PHARMACOLOGY; AGONIST AB Galanin, acting at the GalR1-3 subtypes of galanin receptors, is involved in the regulation of cognition, mood, feeding, seizure activity and pain. The understanding of galanin's effects in molecular and cellular terms has been hampered by the lack of receptor subtype selective ligands and antibodies. Previous in situ hybridization data showed that GalR1 and GalR2 receptors are abundant in the rat brain, while the distribution of GalR3 is contradictory and most studies demonstrated a low expression levels in the rat brain. The distribution of galanin receptor subtypes at protein level is unknown. In the present study, we report the regional distribution of the galanin receptors: GalR1 and non-GalR1 receptors, using a recently synthesized high affinity GalR2/3 selective ligand, galanin (2-11), and galanin (1-29), as competitors, in saturating I-125-galanin membrane binding assay. We show that paraventricular nucleus (PVN) express predominantly GalR1, whereas areas like the dorsal raphe nucleus (DRN), hippocampus and amygdala express both the GalR1 and non-GalR1 receptors. We speculate that the GalR2/3 binding sites detected by galanin (2-11) binding in our study probably represent mostly GalR2 receptors. In addition, we show regionally specific and subtype specific regulation of galanin receptors. Status epilepticus (SE), known to deplete galanin from axonal projections of locus coeruleus and septum/diagonal band neurons in the hippocampus and to induce galanin expression in a subset of hippocampal cells, down regulates GalR2 receptor mRNA and proteins by 30% without altering the GalR1 receptors. (c) 2004 Elsevier Ltd. All rights reserved. C1 Scripps Res Inst, Harold L Dorris Neurol Res Ctr, Dept Neuropharmacol, La Jolla, CA 92037 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, D Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. RP Lu, XY (reprint author), Scripps Res Inst, Harold L Dorris Neurol Res Ctr, Dept Neuropharmacol, 10550 N Torrey Pines Rd, La Jolla, CA 92037 USA. EM tbartfai@scripps.edu FU NIMH NIH HHS [R01MH63080-02]; NINDS NIH HHS [NS 43409] NR 28 TC 35 Z9 37 U1 0 U2 2 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0143-4179 J9 NEUROPEPTIDES JI Neuropeptides PD JUN PY 2005 VL 39 IS 3 BP 147 EP 152 DI 10.1016/j.mpep.2004.12.011 PG 6 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 939MD UT WOS:000230076000003 PM 15944003 ER PT J AU Mazarati, A Lu, XY AF Mazarati, A Lu, XY TI Regulation of limbic status epilepticus by hippocampal galanin type 1 and type 2 receptors SO NEUROPEPTIDES LA English DT Article; Proceedings Paper CT 3rd International Symposium on Galanin and its Receptors CY OCT 21-22, 2004 CL San Diego, CA DE neuropeptide; galanin; seizures; G protein-coupled receptor; knockout mouse; peptide nucleic acid antisense ID SEIZURES; NEUROGENESIS; MODULATION; MODELS; RAT AB It has been well established that galanin is a potent endogenous anticonvulsant peptide. However, the role of galanin receptor subtypes in mediating anticonvulsant effects of the peptide is poorly understood. Using pharmacological, transgenic and antisense approaches, we examined the involvement of galanin receptors GalR1 and GalR2 in regulating seizures and associated neuronal degenerative changes. In the rat model of status epilepticus (SE) induced by electrical stimulation of perforant path, in vivo uncoupling of G protein coupled receptors (GPCR) through intrahippocampal administration of pertussis toxin (PTX) facilitated the initiation of SE, and increased the severity of the established SE. Injection of a non-selective GalR1/GalR2 agonist galanin (1-29) and a preferential GalR2 agonist galanin (2-11) into the hippocampus of PTX-pretreated rats revealed that while during early phase of SE galanin inhibited seizures predominantly through GalR1, GalR2 mediated anticonvulsant effects of the peptide during advanced stage of SE. GalR1 knockout mice showed increased severity of both pilocarpine- and perforant path stimulation-induced SE, compared to wild type (WT) littermates. In GalR1 knockout animals SE led to more severe and wider-spread hippocampal injury, than in WT. Focal downregulation of GalR2, which had been achieved in rats by intrahippocampal infusion of anti-GalR2 peptide nucleic acid (PNA) antisense, significantly increased the severity of perforant path stimulation- induced SE. Downregulation of GalR2 led to mild injury to hilar interneurons and potentiated seizure-induced hippocampal damage. In conclusion, both GalR1 and GalR2 mediate anticonvulsant effects of galanin. GalR1 and GalR2 exhibit differential effects on the initiation and the maintenance phases of SE. Activation of both galanin receptor subtypes exerts neuro protective effects under conditions of excitotoxic injury. (c) 2004 Elsevier Ltd. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, D Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Scripps Res Inst, Harold L Dorris Neurol Res Ctr, Dept Neuropharmacol, La Jolla, CA 92037 USA. RP Mazarati, A (reprint author), W Los Angeles Vet Affairs Med Ctr, Res 151, Los Angeles, CA 90073 USA. EM mazarati@ucla.edu FU NINDS NIH HHS [NS 43409] NR 9 TC 39 Z9 40 U1 0 U2 0 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0143-4179 J9 NEUROPEPTIDES JI Neuropeptides PD JUN PY 2005 VL 39 IS 3 BP 277 EP 280 DI 10.1016/j.npep.2004.12.003 PG 4 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 939MD UT WOS:000230076000025 PM 15944022 ER PT J AU Anselmi, L Stella, SL Lakhter, A Hirano, A Tonini, M Sternini, C AF Anselmi, L Stella, SL Lakhter, A Hirano, A Tonini, M Sternini, C TI Galanin receptors in the rat gastrointestinal tract SO NEUROPEPTIDES LA English DT Article; Proceedings Paper CT 3rd International Symposium on Galanin and its Receptors CY OCT 21-22, 2004 CL San Diego, CA DE real time RT-PCR; voltage-dependent calcium channel; enteric nervous system ID SMALL-INTESTINE; SUBTYPES; TRANSMISSION; CLONING; ILEUM AB Galanin functions are mediated by three distinct G-protein-coupled receptors, galanin receptor 1 (GaIR1), GaIR2 and GaIR3, which activate different intracellular signaling pathways. Here, we quantified mRNA levels of GaIR 1, GaIR2 and GaIR3 in the gastrointestinal tract using real time RT-PCR. GaIR1 and GaIR2 mRNAs were detected in all segments with the highest levels in the large intestine and stomach, respectively. GaIR3 mRNA levels were quite low and mostly confined to the colon. We also investigated the effect of galanin 1-16, which has high affinity for GaIR1 and GaIR2 and low affinity for GaIR3 on depolarization-evoked Ca2+ increases in rat cultured myenteric neurons using Ca2+-imaging. Intracellular Ca2+ changes in myenteric neurons were monitored using the Ca2+ sensitive dye, fluo-4, and confocal microscopy. Galanin 1-16 (1 mu M) markedly inhibited the K+-evoked Ca2+ increases in myenteric neurons. In summary, the differential distribution of GalRs supports the hypothesis that the complex effects of galanin in the gastrointestinal tract result from the activation of multiple receptor subtypes. Furthermore, this study confirms the presence of functional GalRs and suggests that galanin modulates transmitter release from myenteric neurons through inhibition of voltage-dependent calcium channels involving a G(i/o)-coupled GaIR. (c) 2005 Elsevier Ltd. All rights reserved. C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. CURE, Digest Dis Res Ctr, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Pavia, Dept Physiol & Pharmacol Sci, I-27100 Pavia, Italy. RP Anselmi, L (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM lanselmi@mednet.ucla.edu OI Stella Jr., Salvatore/0000-0003-1971-2537 FU NIDDK NIH HHS [R01 DK057037] NR 12 TC 20 Z9 20 U1 0 U2 0 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0143-4179 J9 NEUROPEPTIDES JI Neuropeptides PD JUN PY 2005 VL 39 IS 3 BP 349 EP 352 DI 10.1016/j.npep.2004.12.023 PG 4 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 939MD UT WOS:000230076000039 PM 16044511 ER PT J AU Morihara, T Teter, B Yang, FS Lim, GP Boudinot, S Boudinot, FD Frautschy, SA Cole, GM AF Morihara, T Teter, B Yang, FS Lim, GP Boudinot, S Boudinot, FD Frautschy, SA Cole, GM TI Ibuprofen suppresses interleukin-1 beta induction of pro-amyloidogenic alpha(1)-antichymotrypsin to ameliorate beta-amyloid (A beta) pathology in Alzheimer's models SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE APP transgenic mice (Tg2576); nonsteroidal anti-inflammatory drugs (NSAIDs); inflammation ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; E MESSENGER-RNA; TRANSGENIC MOUSE MODEL; FACTOR-KAPPA-B; PROLIFERATOR-ACTIVATED RECEPTOR; FIBRILLARY ACIDIC PROTEIN; GAMMA-SECRETASE ACTIVITY; APOLIPOPROTEIN-E; PRECURSOR PROTEIN; REGULATORY REGION AB Epidemiological and basic research suggests that nonsteroidal anti-inflammatory drugs ( NSAIDs) should protect against the most common forms of Alzheimer's disease (AD). Ibuprofen reduces amyloid (A beta) pathology in some transgenic models, but the precise mechanisms remain unclear. Although some reports show select NSAIDs inhibit amyloid production in vitro, the possibility that in vivo suppression of amyloid pathology occurs independent of A beta production has not been ruled out. We show that ibuprofen reduced A beta brain levels in rats from exogenously infused A beta in the absence of altered A beta production. To determine whether ibuprofen inhibits pro-amyloidogenic factors, APPsw (Tg2576) mice were treated with ibuprofen for 6 months, and expression levels of the A beta and inflammation-related molecules alpha(1) antichymotrypsin (ACT), apoE, BACE1, and peroxisome proliferator-activated receptor gamma) (PPAR gamma) were measured. Among these, ACT, a factor whose overexpression accelerates amyloid pathology, was reduced by ibuprofen both in vivo and in vitro. IL-1 beta, which was reduced in our animals by ibuprofen, induced mouse ACT in vitro. While some NSAIDs may inhibit A beta 42 production, these observations suggest that ibuprofen reduction of A beta pathology may not be mediated by altered A beta 42 production. We present evidence supporting the hypothesis that ibuprofen-dependent amyloid reduction is mediated by inhibition of an alternate pathway (IL-1 beta and its downstream target ACT). C1 Greater Los Angeles VA Healthcare Syst, GRECC, Sepulveda, CA USA. Virginia Commonwealth Univ, Dept Pharmaceut, Richmond, VA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. RP Cole, GM (reprint author), Univ Calif Los Angeles, Dept Med, Greater Los Angeles VA Healthcare Syst GRECC 11E, Res 151,16111 Plummer St, North Hills, CA 91343 USA. EM gmcole@ucla.edu FU NCCIH NIH HHS [R01 AT003008]; NIA NIH HHS [AG10685, AG00962, AG13471, AG16793, P50 AG016570, R01 AG010685, R01 AG013741]; NINDS NIH HHS [NS43946] NR 80 TC 70 Z9 76 U1 0 U2 5 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JUN PY 2005 VL 30 IS 6 BP 1111 EP 1120 DI 10.1038/sj.npp.1300668 PG 10 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 928UQ UT WOS:000229297600009 PM 15688088 ER PT J AU Lotempio, MM Wang, KH Sadeghi, A Delacure, MD Juillard, GF Wang, MB AF Lotempio, MM Wang, KH Sadeghi, A Delacure, MD Juillard, GF Wang, MB TI Comparison of quality of life outcomes in laryngeal cancer patients following chemoradiation vs. total laryngectomy SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article; Proceedings Paper CT 108th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 19-22, 2004 CL New York, NY SP Amer Acad Otolaryngol Head & Neck Surg ID NECK-CANCER; OROPHARYNGEAL CANCER; HEAD; PRESERVATION; TONGUE; COMMUNICATION; PERFORMANCE; RADIATION; THERAPY; BASE AB OBJECTIVE. To evaluate quality of life issues in patients with laryngeal cancer after treatment with either chemoradiation or total laryngectomy and radiation therapy. METHODS: Forty-nine patients with a history of stage II-IV laryngeal squamous cell carcinoma treated primarily with either chemoradiation or by total laryngectomy with postoperative radiation completed the University of Washington Quality of Life instrument, version 4. Patients were identified on a volunteer basis in an academic university head and neck clinic setting. Each patient completed the above instrument, and statistical analysis was performed by Wilcoxon and x(2) tests. RESULTS: Instruments were completed by all 49 patients: 15 patients who underwent primary chemoradiation and 34 patients who underwent a total laryngectomy followed by radiation. Domains reported in both treatment groups without significant differences were appearance, activity, recreation, moods, taste, saliva, anxiety, and general questions. However, there were significant differences between the 2 groups in the domains of pain, swallowing, chewing, speech, and shoulder function. The laryngectomy patients reported greater impairment of speech (P = 0.001), and shoulder function (P = 0.018), whereas the chemoradiation patients suffered from greater pain, difficulty swallowing (P = 0.061), and problems chewing (P = 0.027). CONCLUSIONS: Most patients with laryngeal cancer, whether treated primarily with chemoradiation or total laryngectomy, reported excellent functional outcomes and health-related quality of life. Pain, swallowing, chewing, saliva, and shoulder function were recorded as significant factors affecting their daily quality of life. C1 Univ Calif Los Angeles, Div Head & Neck Surg, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Radiat Oncol, David Geffen Sch Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Radiat Oncol, Los Angeles, CA USA. NYU, Sch Med, Dept Otolaryngol, New York, NY USA. RP Wang, MB (reprint author), Univ Calif Los Angeles, Div Head & Neck Surg, David Geffen Sch Med, 10833 Conte Ave, Los Angeles, CA 90095 USA. EM mbwang@ucla.edu NR 24 TC 29 Z9 32 U1 1 U2 7 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD JUN PY 2005 VL 132 IS 6 BP 948 EP 953 DI 10.1016/j.tohns.2004.12.014 PG 6 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 935OD UT WOS:000229790700024 PM 15944570 ER PT J AU Grande, LA Spain, WJ AF Grande, LA Spain, WJ TI Synaptic depression as a timing device SO PHYSIOLOGY LA English DT Review ID NEOCORTICAL PYRAMIDAL NEURONS; ACTIVITY-DEPENDENT DEPRESSION; THALAMOCORTICAL SYNAPSES; SENSORY SUPPRESSION; NUCLEUS LAMINARIS; DYNAMIC SYNAPSES; NEURAL-NETWORKS; IN-VIVO; PLASTICITY; INFORMATION AB A depressing synapse transforms a time interval into a voltage amplitude. The effect of that transformation on the output of the neuron and network depends on the kinetics of synaptic depression and properties of the postsynaptic neuron and network. Using as examples neural circuits that incorporate depressing synapses, we show how short-term depression can contribute to a surprising variety of time-dependent computational and behavioral tasks. C1 Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Spain, WJ (reprint author), Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. EM spain@u.washington.edu FU BLRD VA [I01 BX000386] NR 36 TC 22 Z9 22 U1 0 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1548-9213 J9 PHYSIOLOGY JI Physiology PD JUN PY 2005 VL 20 BP 201 EP 210 DI 10.1152/physiol.00006.2005 PG 10 WC Physiology SC Physiology GA 929MT UT WOS:000229350900007 PM 15888577 ER PT J AU Turner, E Tramer, M AF Turner, E Tramer, M TI The debate over placebo-controlled trials - Reply SO PLOS MEDICINE LA English DT Letter ID ASPIRIN USE; CARDIOVASCULAR EVENTS; ADENOMATOUS POLYPS; COLORECTAL-CANCER; RISK; ROFECOXIB; INDIVIDUALS; COLON C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Univ Hosp Geneva, Geneva, Switzerland. RP Turner, E (reprint author), Portland VA Med Ctr, Portland, OR 97207 USA. EM turnere@ohsu.edu NR 15 TC 0 Z9 0 U1 0 U2 0 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1549-1277 J9 PLOS MED JI PLos Med. PD JUN PY 2005 VL 2 IS 6 BP 566 EP 567 AR e187 DI 10.1371/journal.pmed.0020187 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 946BI UT WOS:000230546500027 ER PT J AU Brambilla, P Glahn, DC Balestrieri, M Soares, JC AF Brambilla, P Glahn, DC Balestrieri, M Soares, JC TI Magnetic resonance findings in bipolar disorder SO PSYCHIATRIC CLINICS OF NORTH AMERICA LA English DT Review ID ANTERIOR CINGULATE CORTEX; WHITE-MATTER HYPERINTENSITIES; SUBGENUAL PREFRONTAL CORTEX; N-ACETYL-ASPARTATE; SUBCORTICAL SIGNAL HYPERINTENSITIES; STRUCTURAL BRAIN ABNORMALITIES; CHOLINE-CONTAINING COMPOUNDS; COGNITIVE-AFFECTIVE SYNDROME; MANIC-DEPRESSIVE ILLNESS; TEMPORAL-LOBE STRUCTURES AB This article reviews structural, physiologic, and functional MRI findings. in bipolar disorder and suggests future strategies for investigations in this field. C1 Univ Udine, Dept Pathol & Expt & Clin Med, Sect Psychiat, I-33100 Udine, Italy. Univ Udine, InterUniv Ctr Behav Neurosci, Verona Udine Brain Imaging Program, I-33100 Udine, Italy. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Schizophrenia & Related Disorders, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, San Antonio, TX 78284 USA. Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NCRR NIH HHS [M01-RR-01346]; NIMH NIH HHS [MH 01736, MH068662, MH068766] NR 213 TC 56 Z9 57 U1 4 U2 9 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0193-953X J9 PSYCHIAT CLIN N AM JI Psychiatr. Clin. North Amer. PD JUN PY 2005 VL 28 IS 2 BP 443 EP + DI 10.1016/j.psc.2005.01.006 PG 26 WC Psychiatry SC Psychiatry GA 925JG UT WOS:000229048800010 PM 15826742 ER PT J AU Ray, MN Wall, T Casebeer, L Weissman, N Spettell, C Abdolrasulnia, M Mian, MAH Collins, B Kiefe, CI Allison, JJ AF Ray, MN Wall, T Casebeer, L Weissman, N Spettell, C Abdolrasulnia, M Mian, MAH Collins, B Kiefe, CI Allison, JJ TI Chlamydia screening of at-risk young women in managed health care: Characteristics of top-performing primary care offices SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID DISPARITIES GEOCODING PROJECT; SOCIOECONOMIC MEASURES; UNITED-STATES; PHYSICIANS; INFECTIONS; TRACHOMATIS; GENDER; RATES; ADOLESCENTS; DISEASE AB Objectives: Despite effective approaches for managing chlamydial infection, asymptomatic disease remains highly prevalent. We linked administrative data with physician data from the American Medical Association physician survey to identify characteristics of primary care offices associated with best chlamydia screening practices. Study: Criteria from the National Committee for Quality Assurance provided chlamydia screening rates. We defined top-performing offices as those with rates in the top decile among 978 primary care offices from 26 states. Results: Offices screened an average of 16.2% of at-risk, young women, but top-performing offices screened 42.2%. Top-performing offices on average had more black physicians (12.5%, 5.1%, P = 0.001) and were more often located in zip code areas with median income less than $30,000 (22.6%, 5.5%, P = 0.001) Conclusions: Although chlamydia screening rates are alarmingly low overall, there is substantial variation across offices. Understanding predictors of better office performance may lead to effective interventions to promote screening. C1 Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL 35294 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL 35294 USA. Univ Alabama, Div Continuing Med Educ, Birmingham, AL 35294 USA. Univ Alabama, Dept Pediat, Birmingham, AL 35294 USA. Univ Alabama, Div Gen Internal Med, Birmingham, AL 35294 USA. Univ Alabama, Div Prevent Med, Birmingham, AL 35294 USA. Aetna Integrated Informat Inc, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Ray, MN (reprint author), Univ Alabama, Dept Hlth Serv Adm, 1675 Univ Blvd, Birmingham, AL 35294 USA. EM midgeray@uab.edu OI Allison, Jeroan/0000-0003-4472-2112 FU AHRQ HHS [HS11124] NR 30 TC 8 Z9 9 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD JUN PY 2005 VL 32 IS 6 BP 382 EP 386 DI 10.1097/01.olq.0000162367.39209.01 PG 5 WC Infectious Diseases SC Infectious Diseases GA 929JY UT WOS:000229343600010 PM 15912086 ER PT J AU Xu, W Ericson, MN Cote, GL Baba, J Britton, CL Wilson, MA AF Xu, W Ericson, MN Cote, GL Baba, J Britton, CL Wilson, MA TI An implantable micro-sensor for real-time tissue perfusion monitoring. SO SHOCK LA English DT Meeting Abstract CT 28th Annual Conference on Shock CY JUN 04-07, 2005 CL Marco Isl, FL C1 Oak Ridge Natl Lab, Oak Ridge, TN 37831 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Pittsburgh, PA 15240 USA. Texas A&M Univ, College Stn, TX 77843 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 1073-2322 J9 SHOCK JI Shock PD JUN PY 2005 VL 23 SU 3 BP 89 EP 89 PG 1 WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System & Cardiology GA 928DU UT WOS:000229252100254 ER PT J AU Taub, E Lum, PS Hardin, P Mark, VW Uswatte, G AF Taub, E Lum, PS Hardin, P Mark, VW Uswatte, G TI AutoCITE - Automated delivery of CI therapy with reduced effort by therapists SO STROKE LA English DT Article DE stroke; rehabilitation; treatment outcome ID INDUCED MOVEMENT THERAPY; CHRONIC STROKE PATIENTS; UPPER EXTREMITY; LEARNED NONUSE; REHABILITATION; DEFICITS AB Background and Purpose - To evaluate the effectiveness of a device that automates Constraint-Induced Movement therapy (CI therapy), termed AutoCITE, when only partially supervised by therapists. Methods - Twenty-seven participants with chronic stroke trained with AutoCITE for 3 hours per day for 10 consecutive weekdays. Participants were assigned to 1 of 3 groups in a fixed irregular order (ie, in alternating blocks): supervision from a therapist for 100%, 50%, or 25% of training time. Results - The effect sizes of the treatment gains for the 3 groups on the Motor Activity Log ( MAL) were very large and for the Wolf Motor Function Test they were large ( all P < 0.001) but were not significantly different from one another. Gains were comparable to those previously reported for participants who received an equal amount of standard one-on-one CI therapy without the device. At 1-month and long-term follow-up, gains from pretreatment on the MAL were also significant ( P < 0.001). Conclusion - These results demonstrate that AutoCITE training with greatly reduced supervision from a therapist is as effective as standard one-on-one CI therapy. C1 Univ Alabama Birmingham, Dept Psychol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. Hunter Holmes McGuire VA Med Ctr, Richmond, VA USA. Virginia Commonwealth Univ, Richmond, VA USA. Univ Alabama Birmingham, Dept Phys Med & Rehabil, Birmingham, AL USA. RP Taub, E (reprint author), Univ Alabama Birmingham, Dept Psychol, CPM 712,1530 3rd Ave S, Birmingham, AL 35294 USA. EM etaub@uab.edu RI Uswatte, Gitendra/C-4913-2009 NR 15 TC 57 Z9 62 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD JUN PY 2005 VL 36 IS 6 BP 1301 EP 1304 DI 10.1161/01.STR.0000166043.27545.e8 PG 4 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 929EL UT WOS:000229324800047 PM 15879335 ER PT J AU Rigato, L Ostrow, JD Tiribelli, C AF Rigato, L Ostrow, JD Tiribelli, C TI Bilirubin and the risk of common non-hepatic diseases SO TRENDS IN MOLECULAR MEDICINE LA English DT Article ID CORONARY-ARTERY DISEASE; ALBUMIN-BOUND BILIRUBIN; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; AMYOTROPHIC-LATERAL-SCLEROSIS; LOW-DENSITY-LIPOPROTEIN; ISCHEMIC-HEART-DISEASE; SERUM BILIRUBIN; UNCONJUGATED BILIRUBIN; OXIDATIVE STRESS; HEME OXYGENASE-1 AB Bilirubin is a potent antioxidant but can be toxic at high concentrations. This article critically reviews the reported relationships of plasma bilirubin levels to the severity and/or incidence of various common nonhepatic diseases. Plasma bilirubin levels are reportedly negatively related to the risk of atherosclerotic diseases, cancers, demyelinating neuropathies and seasonal affective disorder. By contrast, the incidence and severity of schizophrenia are increased by elevated bilirubin levels. The data strongly suggest that the level of plasma bilirubin should be considered as a risk factor for several common non-hepatic diseases. Additional studies are needed to clarify the mechanisms of this influence, which are thought to be related to unconjugated bilirubin counteracting the oxidative stress underlying these disorders. C1 Univ Trieste, Ctr Studi Fegato, Basovizza, I-34012 Trieste, Italy. Univ Trieste, Dept BBCM, I-34012 Trieste, Italy. Univ Washington, Sch Med, Gastroenterol & Hepatol Div, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA 98195 USA. RP Tiribelli, C (reprint author), Univ Trieste, Ctr Studi Fegato, Basovizza, Bldg Q,Area Sci Pk, I-34012 Trieste, Italy. EM ctliver@csf.units.it NR 78 TC 7 Z9 8 U1 0 U2 2 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1471-4914 J9 TRENDS MOL MED JI Trends Mol. Med PD JUN PY 2005 VL 11 IS 6 BP 277 EP 283 DI 10.1016/j.molmed.2005.04.008 PG 7 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 941UC UT WOS:000230238700005 ER PT J AU Mann, DL Bristow, MR AF Mann, DL Bristow, MR TI Mechanisms and models in heart failure the biomechanical model and beyond SO CIRCULATION LA English DT Review ID CARDIAC-RESYNCHRONIZATION THERAPY; LEFT-VENTRICULAR DYSFUNCTION; BETA-ADRENERGIC-BLOCKADE; RENIN-ANGIOTENSIN SYSTEM; FAILING HUMAN HEART; IDIOPATHIC DILATED CARDIOMYOPATHY; MATRIX-METALLOPROTEINASE ACTIVITY; MARROW-CELL TRANSPLANTATION; ACUTE MYOCARDIAL-INFARCTION; RANDOMIZED CLINICAL-TRIAL C1 Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Cardiovasc Inst, Denver, CO 80262 USA. RP Mann, DL (reprint author), Baylor Coll Med, Winters Ctr Heart Failure Res, Dept Med, Michael E DeBakey Vet Affairs Med Ctr, MS F524,6565 Fannin, Houston, TX 77030 USA. EM dmann@bcm.tmc.edu RI bristow, michael/G-7850-2011 OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL58081-01, HL-42250-10/10, R01 HL61543-01] NR 136 TC 374 Z9 389 U1 6 U2 29 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 31 PY 2005 VL 111 IS 21 BP 2837 EP 2849 DI 10.1161/CIRCULATIONAHA.104.500546 PG 13 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 931DE UT WOS:000229465200020 PM 15927992 ER PT J AU Golier, JA Yehuda, R De Santi, S Segal, S Dolan, S de Leon, MJ AF Golier, JA Yehuda, R De Santi, S Segal, S Dolan, S de Leon, MJ TI Absence of hippocampal volume differences in survivors of the Nazi Holocaust with and without posttraumatic stress disorder SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE memory; cognition; trauma; neuroimaging; depression; temporal lobe ID INTIMATE PARTNER VIOLENCE; ALZHEIMERS-DISEASE; MEMORY PERFORMANCE; PYRAMIDAL NEURONS; MAJOR DEPRESSION; TRAUMA SURVIVORS; FEMALE VICTIMS; SEXUAL ABUSE; RISK-FACTORS; ATROPHY AB It remains unclear whether smaller hippocampal volume is a consistent feature of chronic posttraumatic stress disorder (PTSD) and whether it accounts for the associated memory deficits observed in this illness. Hippocampal volume, comparison regions and memory performance were examined in Holocaust survivors with PTSD (PTSD+: n=14; 5 men, 9 women) and without PTSD (PTSD-: it = 13; 6 men, 7 women) and a non-exposed control group of healthy Jewish adults (n = 20; 13 men, 7 women). The subjects had medical examinations, high-resolution magnetic resonance imaging, and memory testing. PTSD+ subjects had poorer memory performance than non-exposed subjects and PTSD- subjects, but they did not differ from either group in right or left hippocampal volume when gender and head size were taken into account. Older age and smaller left hippocampal volume were more strongly associated in the PTSD+ group than in the PTSD- groups. Holocaust survivors had larger superior temporal gyral and lateral temporal lobe volumes bilaterally than non-exposed subjects. Smaller hippocatnpal volume is not invariably associated with chronic PTSD and does not explain the substantial explicit memory impairment observed in Holocaust survivors with this disorder. Larger temporal lobe volumes may be associated with early traumatization and survival or may reflect some other characteristic of Holocaust survivors. (c) \Published by Elsevier Ireland Ltd. C1 Mt Sinai Sch Med, Dept Psychiat, Bronx, NY 10468 USA. Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. NYU, Sch Med, Ctr Brain Hlth, New York, NY USA. Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA. RP Golier, JA (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustave L Levy Pl, Bronx, NY 10468 USA. EM Julia.golier@med.va.gov OI de Leon, Mony/0000-0003-2245-4380 FU NIMH NIH HHS [MH49555] NR 50 TC 48 Z9 50 U1 5 U2 9 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD MAY 30 PY 2005 VL 139 IS 1 BP 53 EP 64 DI 10.1016/j.pscychresns.2005.02.007 PG 12 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 946WI UT WOS:000230603600006 PM 15939577 ER PT J AU Barry, LC Lichtman, JH Spertus, J Rumsfeld, J Vaccarino, V Jones, P Krumholz, HM AF Barry, LC Lichtman, JH Spertus, J Rumsfeld, J Vaccarino, V Jones, P Krumholz, HM TI Patient satisfaction with treatment after AMI: The role of psychosocial factors SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Yale Univ, Sch Med, New Haven, CT USA. Mid Amer Heart Inst, Kansas City, MO USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Emory Univ, Sch Med, Atlanta, GA 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 MAY 24 PY 2005 VL 111 IS 20 BP E326 EP E326 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000105 ER PT J AU Curtis, JP Rathore, SS Jones, P Kernis, S Rumsfeld, J Bach, R Cohen, D Brush, JE Messenger, J Spertus, J Krumholz, HM AF Curtis, JP Rathore, SS Jones, P Kernis, S Rumsfeld, J Bach, R Cohen, D Brush, JE Messenger, J Spertus, J Krumholz, HM TI Predictors of use of drug-eluting stents in patients with acute coronary syndromes SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Yale Univ, Sch Med, New Haven, CT USA. Mid Amer Heart Inst, Kansas City, MO USA. Denver VA Med Ctr, Denver, CO USA. Univ Washington, Sch Med, St Louis, MO USA. Harvard Univ, Sch Med, Boston, MA USA. Cardiol Consultants Ltd, Norfolk, VA USA. Colorado Hlth Sci 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 MAY 24 PY 2005 VL 111 IS 20 BP E319 EP E319 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000070 ER PT J AU Groeneveld, PW Kruse, G Chen, Z Asch, DA AF Groeneveld, PW Kruse, G Chen, Z Asch, DA TI Racial disparity in cardiovascular procedures within the veterans health administration: The role of hospitals SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 24 PY 2005 VL 111 IS 20 BP E323 EP E323 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000088 ER PT J AU Groeneveld, PW Kruse, G Brookstein, EK Zhu, JS Chen, Z Volpp, KG AF Groeneveld, PW Kruse, G Brookstein, EK Zhu, JS Chen, Z Volpp, KG TI Hospital market effects on uptake and utilization of innovative cardiovascular technologies SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 24 PY 2005 VL 111 IS 20 BP E312 EP E312 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000037 ER PT J AU Kopjar, B Sun, HL Greiner, G Sales, AE AF Kopjar, B Sun, HL Greiner, G Sales, AE TI Choice of dose titration and persistence in use of statins SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. RI Sales, Anne/D-9678-2012 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 MAY 24 PY 2005 VL 111 IS 20 MA P232 BP E355 EP E355 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000249 ER PT J AU Kopjar, B Sales, AE Au, DH Young, B Sun, HL Wagner, T Rusch, R Rumsfeld, J AF Kopjar, B Sales, AE Au, DH Young, B Sun, HL Wagner, T Rusch, R Rumsfeld, J TI Acute myocardial infarction among the inpatients in VA hospitals SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. Vet Affairs, Washington, DC USA. RI Sales, Anne/D-9678-2012 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 MAY 24 PY 2005 VL 111 IS 20 BP E322 EP E322 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000081 ER PT J AU Levine, DA Kiefe, CI Houston, TK Allison, JJ McCarthy, EP Ayanian, JZ AF Levine, DA Kiefe, CI Houston, TK Allison, JJ McCarthy, EP Ayanian, JZ TI Do US stroke survivors have reduced access to care and medications? SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL USA. Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA. Harvard Univ, Sch Med, Brigham & Womens Hosp, Boston, MA 02115 USA. RI Houston, Thomas/F-2469-2013 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 MAY 24 PY 2005 VL 111 IS 20 BP E311 EP E312 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000036 ER PT J AU Peterson, PN Ho, PM Reid, KJ Spertus, JA Rumsfeld, JS AF Peterson, PN Ho, PM Reid, KJ Spertus, JA Rumsfeld, JS TI Quality of life at the time of acute coronary syndrome predicts cardiac rehospitalization in women but not men SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Univ Colorado, Denver VAMC, Denver, CO 80202 USA. UMKC, Amer Heart Inst, Kansas City, MO 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 MAY 24 PY 2005 VL 111 IS 20 BP E326 EP E326 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000102 ER PT J AU Safford, MM Kirk, KA Kiefe, CI AF Safford, MM Kirk, KA Kiefe, CI TI Progress in reducing cardiovascular risk in diabetes: Is it enough? SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Birmingham VA Med Ctr, Birmingham, AL USA. Univ Alabama, Birmingham, AL 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 MAY 24 PY 2005 VL 111 IS 20 MA P234 BP E356 EP E356 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000251 ER PT J AU Schelbert, E Rumsfeld, J Krumholz, H Canto, J Reid, K Magid, D Spertus, J AF Schelbert, E Rumsfeld, J Krumholz, H Canto, J Reid, K Magid, D Spertus, J TI Acute myocardial infarction, ischemic symptoms, and in-hospital mortality SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 Univ Iowa, Iowa City, IA USA. Denver VA Med Ctr, Denver, CO USA. Yale Univ, Sch Med, New Haven, CT USA. Univ Alabama, Birmingham, AL USA. Mid Amer Heart Inst, Kansas City, MO 64111 USA. Colorado Permanente Med Grp, 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 MAY 24 PY 2005 VL 111 IS 20 BP E314 EP E314 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000046 ER PT J AU Sun, HL Kopjar, B Greiner, G Sales, AE AF Sun, HL Kopjar, B Greiner, G Sales, AE TI Patient characteristics associated with discontinuation of statin therapy SO CIRCULATION LA English DT Meeting Abstract CT 6th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke CY MAY 14-16, 2005 CL Washington, DC SP Amer Heart Assoc, Qual Care & Outcomes Res Interdiciplinary Working Grp, Councils Cardiovasc Nursing, Councils Cardiovasc Surg & Anesthesia, Councils Clin Cardiol, Councils Epidemiol & Prevent & Stroke, Amer Coll Cardiol Fdn, Ctr Dis Control & Prevent, Dept Vet Affairs C1 VA Puget Sound Healthcare Syst, Seattle, WA USA. RI Sales, Anne/D-9678-2012 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 MAY 24 PY 2005 VL 111 IS 20 MA P233 BP E355 EP E356 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 929AD UT WOS:000229313000250 ER PT J AU Siderowf, A Newberg, A Chou, KL Lloyd, M Colcher, A Hurtig, HI Stern, MB Doty, RL Mozley, PD Wintering, N Duda, JE Weintraub, D Moberg, PJ AF Siderowf, A Newberg, A Chou, KL Lloyd, M Colcher, A Hurtig, HI Stern, MB Doty, RL Mozley, PD Wintering, N Duda, JE Weintraub, D Moberg, PJ TI [Tc-99m] TRODAT-1 SPECT imaging correlates with odor identification in early Parkinson disease SO NEUROLOGY LA English DT Article ID OLFACTORY FUNCTION; DOPAMINE TRANSPORTERS; DE-NOVO; DYSFUNCTION; STAGE; SMELL; PROGRESSION; DIAGNOSIS; RELATIVES; HYPOSMIA AB Background: In vivo imaging of the dopamine transporter with [Tc-99m] TRODAT-1 (TRODAT) and olfactory testing have both been proposed as potential biomarkers in Parkinson disease (PD). Objective: To evaluate the relationship between TRODAT SPECT imaging, odor identification skills, and motor function in patients with early PD. Methods: Twenty-four patients with a clinical diagnosis of early-stage PD (mean Hoehn & Yahr stage = 1.4) underwent TRODAT imaging, Unified PD Rating Scale (UPDRS) ratings of motor function, and administration of the University of Pennsylvania Smell Identification Test (UPSIT). Brain images were obtained using a standardized processing protocol and specific uptake ratios for striatal regions of interest were calculated. Partial correlations between the imaging indices, disease duration, UPSIT scores, and UPDRS motor scores were then calculated. Results: UPSIT scores were correlated with TRODAT uptake in the striatum as a whole (r = 0.66, p = 0.001). The putamen showed the strongest correlation with the UPSIT (r = 0.74; p = 0.001). The correlation between dopamine transporter density in the caudate and UPSIT was moderate (r = 0.36, p = 0.11), but was not significant. Conclusions: Olfactory function is highly correlated with dopamine transporter imaging abnormalities in early Parkinson disease (PD). Further studies are warranted to determine whether changes over time in these two measures are also correlated in early PD. C1 Univ Penn, Parkinsons Dis & Movement Disorders Ctr, Dept Neurol, Philadelphia, PA 19104 USA. Univ Penn, Med Ctr, Ctr Smell & Taste, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Mem Hosp Rhode Isl, Div Neurol, Pawtucket, RI USA. Philadelphia Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. Eli Lilly & Co, Lilly Corp Ctr, Indianapolis, IN 46285 USA. Hosp Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Hosp Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. RP Siderowf, A (reprint author), Penn Hosp, Parkinsons Dis & Movement Disorders Ctr, 330 S 9th St, Philadelphia, PA 19107 USA. EM siderowa@pahosp.com RI Doty, Richard/B-7623-2012; Doty, Richard/G-1602-2013 OI Chou, Kelvin/0000-0002-2597-7315 FU AHRQ HHS [K-08 HS00004]; NCRR NIH HHS [M01-RR00040]; NIA NIH HHS [R01 AG-17524, R01-AG 17496]; NIMH NIH HHS [MH63381] NR 33 TC 87 Z9 90 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD MAY 24 PY 2005 VL 64 IS 10 BP 1716 EP 1720 DI 10.1212/01.WNL.0000161874.52302.5D PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 929AC UT WOS:000229312900012 PM 15911797 ER PT J AU Suarez-Almazor, ME Souchek, J Kelly, PA O'Malley, K Byrne, M Richardson, M Pak, C AF Suarez-Almazor, ME Souchek, J Kelly, PA O'Malley, K Byrne, M Richardson, M Pak, C TI Ethnic variation in knee replacement - Patient preferences or uninformed disparity? SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT Annual Convention of the Association-for-the-Advancement-of-Behavior-Therapy CY 2002 CL Reno, NV SP Assoc Advancement Behav Therapy ID QUALITY-OF-LIFE; TOTAL HIP; MEDICARE BENEFICIARIES; JOINT ARTHROPLASTY; RACIAL-DIFFERENCES; AFRICAN-AMERICAN; UNITED-STATES; HEALTH-CARE; OUTCOMES; ARTHRITIS AB Background: Despite the efficacy and cost-effectiveness of total knee replacement (TKR), minority patients with knee osteoarthritis (OA) are half as likely as their white counterparts to undergo this procedure. Patient preferences may play a large role in the variations in utilization of TKR. We evaluated the preferences and beliefs of patients with knee OA from diverse ethnic backgrounds in relation to TKR. Methods: The 198 patients with knee OA surveyed were of different ethnicities. Patients were asked about physician recommendations of TKR and whether they had considered having the procedure, their perceptions about the benefits and risks of TKR, their expectations if they were to undergo the procedure, and their trust in physicians and the health system. Bivariate and multivariate analyses were performed. Results: A physician had discussed TKR with 27% of African Americans, 15% of whites, and 11% of Hispanics (P=.04). White patients were more likely than minority patients to have considered undergoing TKR (P=.04), more likely to consider TKR if their OA worsened and the procedure were recommended by their physician (P=.002), and more likely to consider TKR as a beneficial procedure (P=.02). Ethnic differences in preferences remained after controlling for severity of OA. Conclusions: Ethnic minority patients with knee OA are less likely to consider TKR. In our study, these differences were not related to physician recommendation biases. The ethnic variation in preferences was associated with differences in perception of benefit, lack of personal experiences with TKR, and trust. C1 Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA 15260 USA. RP Suarez-Almazor, ME (reprint author), Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey Vet Affairs Med Ctr, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM mes@bcm.tmc.edu FU AHRQ HHS [P01HS10876] NR 39 TC 78 Z9 78 U1 2 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 23 PY 2005 VL 165 IS 10 BP 1117 EP 1124 DI 10.1001/archinte.165.10.1117 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 929FE UT WOS:000229326700004 PM 15911724 ER PT J AU Bohnen, NI Kaufer, DI Hendrickson, R Ivanco, LS Lopresti, B Davis, JG Constantine, G Mathis, CA Moore, RY DeKosky, ST AF Bohnen, NI Kaufer, DI Hendrickson, R Ivanco, LS Lopresti, B Davis, JG Constantine, G Mathis, CA Moore, RY DeKosky, ST TI Cognitive correlates of alterations in acetylcholinesterase in Alzheimer's disease SO NEUROSCIENCE LETTERS LA English DT Article DE acetylcholinesterase; Alzheimer's disease; cognitive functions; PET ID POSITRON-EMISSION-TOMOGRAPHY; IN-VIVO; HIPPOCAMPAL-FORMATION; CHOLINERGIC SYSTEM; BASAL FOREBRAIN; NUCLEUS BASALIS; HUMAN BRAIN; MEMORY; IMPAIRMENT; DEMENTIA AB We recently reported findings of modest loss of cortical acetylcholinesterase (AChE) activity in patients with overall mild Alzheimer's disease (AD) using IV-[C-11]methyl-pi-peridin-4-yl propionate ([C-11]PMP) AChEpositron emission tomography (PET). To determine cognitive correlates of in vivo cortical AChE activity in patients with mild to moderate AD (n = 15), and in normal controls (NC, n = 12) using [C-11]PMP AChE PET imaging. Mean cortical AChE activity in the AD subjects was mildly reduced (-11.1%) compared to the control subjects (P < 0.05). Analysis of the cognitive data showed that mean cortical AChE activity was significantly associated with performance on a test of attention and working memory (WAIS-III Digit Span, R = 0.46, P = 0.01) but not with tests of delayed short or long-term memory functions. Similar findings were present when the analysis was limited to the temporal cortex. Cortical AChE activity is more robustly associated with functions of attention and working memory compared to performance on primary memory tests in AD. © 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Radiol, PET Facil, Pittsburgh, PA USA. Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Math & Stat, Pittsburgh, PA USA. RP Bohnen, NI (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, Lilane S Kaufmann Bldg,Suite 811,3471 5th Ave, Pittsburgh, PA 15213 USA. EM nbohnen@pitt.edu RI Mathis, Chester/A-8607-2009 FU NIA NIH HHS [AG05133] NR 53 TC 56 Z9 57 U1 1 U2 3 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD MAY 20 PY 2005 VL 380 IS 1-2 BP 127 EP 132 DI 10.1016/j.neulet.2005.01.031 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 924DI UT WOS:000228958600025 PM 15854764 ER PT J AU Shlipak, MG Sarnak, MJ Katz, R Fried, LF Seliger, SL Newman, AB Siscovick, DS Stehman-Breen, C AF Shlipak, MG Sarnak, MJ Katz, R Fried, LF Seliger, SL Newman, AB Siscovick, DS Stehman-Breen, C TI Cystatin C and the risk of death and cardiovascular events among elderly persons SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID GLOMERULAR-FILTRATION-RATE; SERUM CREATININE; RENAL-INSUFFICIENCY; MYOCARDIAL-INFARCTION; OLDER-ADULTS; MORTALITY; OUTCOMES; DYSFUNCTION; HOSPITALIZATION; PREDICTION AB BACKGROUND: Cystatin C is a serum measure of renal function that appears to be independent of age, sex, and lean muscle mass. We compared creatinine and cystatin C levels as predictors of mortality from cardiovascular causes and from all causes in the Cardiovascular Health Study, a cohort study of elderly persons living in the community. METHODS: Creatinine and cystatin C were measured in serum samples collected from 4637 participants at the study visit in 1992 or 1993; follow-up continued until June 30, 2001. For each measure, the study population was divided into quintiles, with the fifth quintile subdivided into thirds (designated 5a, 5b, and 5c). RESULTS: Higher cystatin C levels were directly associated, in a dose-response manner, with a higher risk of death from all causes. As compared with the first quintile, the hazard ratios (and 95 percent confidence intervals) for death were as follows: second quintile, 1.08 (0.86 to 1.35); third quintile, 1.23 (1.00 to 1.53); fourth quintile, 1.34 (1.09 to 1.66); quintile 5a, 1.77 (1.34 to 2.26); 5b, 2.18 (1.72 to 2.78); and 5c, 2.58 (2.03 to 3.27). In contrast, the association of creatinine categories with mortality from all causes appeared to be J-shaped. As compared with the two lowest quintiles combined (cystatin C level, lessthan/equal 0.99 mg per liter), the highest quintile of cystatin C (greater/equal 1.29 mg per liter) was associated with a significantly elevated risk of death from cardiovascular causes (hazard ratio, 2.27 [1.73 to 2.97]), myocardial infarction (hazard ratio, 1.48 [1.08 to 2.02]), and stroke (hazard ratio, 1.47 [ 1.09 to 1.96]) after multivariate adjustment. The fifth quintile of creatinine, as compared with the first quintile, was not independently associated with any of these three outcomes. CONCLUSIONS: Cystatin C, a serum measure of renal function, is a stronger predictor of the risk of death and cardiovascular events in elderly persons than is creatinine. C1 Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Tufts New England Med Ctr, Dept Med, Div Nephrol, Boston, MA USA. Collaborat Hlth Studies Coordinating Ctr, Seattle, WA USA. Vet Affairs Pittsburgh Healthcare Syst, Med Serv, Renal Sect, Pittsburgh, PA USA. Univ Maryland, Sch Med, Div Nephrol, Baltimore, MD 21201 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Amgen Inc, Thousand Oaks, CA USA. RP Shlipak, MG (reprint author), Vet Affairs Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150 FU NHLBI NIH HHS [N01-HC-35129, N01 HC-15103, N01-HC-85079, N01-HC-85080, N01-HC-85081, N01-HC-85082, N01-HC-85083, N01-HC-85084, N01-HC-85085, N01-HC-85086, R01 HL073208-01] NR 28 TC 714 Z9 760 U1 3 U2 24 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 MAY 19 PY 2005 VL 352 IS 20 BP 2049 EP 2060 DI 10.1056/NEJMoa043161 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 927GJ UT WOS:000229180100003 PM 15901858 ER PT J AU Kanwal, F Gralnek, AM Martin, P Dulai, GS Farid, M Spiegel, BMR AF Kanwal, F Gralnek, AM Martin, P Dulai, GS Farid, M Spiegel, BMR TI Treatment alternatives for chronic hepatitis B virus infection: A cost-effectiveness analysis SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID TERM-FOLLOW-UP; E-ANTIGEN SEROCONVERSION; CHRONIC ACTIVE HEPATITIS; PRIMARY HEPATOCELLULAR-CARCINOMA; LAMIVUDINE/INTERFERON COMBINATION THERAPY; LYMPHOBLASTOID INTERFERON-ALPHA; CHRONIC PERSISTENT HEPATITIS; LONG-TERM; SURFACE-ANTIGEN; NATURAL-HISTORY AB Background: Treatment options for chronic hepatitis B virus (HBV) infection have disparate risks and benefits. interferon has clinically significant side effects, and lamivudine is associated with viral resistance. In contrast, adefovir is safe and has lower viral resistance but is more expensive. The most cost-effective approach is uncertain. Objective: To determine whether and under what circumstances the improved efficacy of adefovir offsets its increased cost compared with lamivudine or interferon. Design: Cost-utility analysis stratified by hepatitis B e antigen (HBeAg) status. Data Sources: Systematic review of MEDLINE from 1970 to 2005. Target Population: Patients with chronic HBV infection, elevated aminotransferase levels, and no cirrhosis. Time Horizon: Lifetime. Perspective: Third-party payer. Interventions: 1) No HBV treatment ("do nothing" strategy), 2) interferon monotherapy, 3) lamivudine monotherapy, 4) adefovir monotherapy, or 5) lamivudine with crossover to adefovir upon resistance ("adefovir salvage" strategy). Outcome Measure: Incremental cost per quality-adjusted life-year (QALY) gained. Results of Base-Case Analysis: The "do nothing" strategy was least effective yet least expensive. Compared with the "do nothing" strategy, using interferon cost an incremental $6337 to gain 1 additional CIALY. Compared with interferon, the adefovir salvage strategy cost an incremental $8446 per QALY gained. Both the lamivudine and adefovir monotherapy strategies were more expensive yet less effective than the alternative strategies and were therefore dominated. Results of Sensitivity Analysis: In sensitivity analysis, interferon was most cost-effective in health care systems with tight budgetary constraints and a high prevalence of HBeAg-negative patients. Limitations: These results apply only to patients with chronic HBV infection, elevated aminotransferase levels, and no clinical or histologic evidence of cirrhosis. They do not apply to alternative populations. Conclusions: Neither lamivudine nor adefovir monotherapy is cost-effective in chronic HBV infection. However, a hybrid salvage strategy reserving adefovir only for lamivudine-associated viral resistance may be highly cost-effective across most health care settings. Interferon therapy may still be preferred in health care systems with limited resources, especially in those serving populations with a high prevalence of HBeAg-negative HBV. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Ctr Study Digest Healthcare Qual & Outcomes, Los Angeles, CA USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM BSpiegel@mednet.ucla.edu FU NCRR NIH HHS [RR-16188] NR 132 TC 91 Z9 95 U1 0 U2 8 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAY 17 PY 2005 VL 142 IS 10 BP 821 EP 831 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 926CE UT WOS:000229099600003 PM 15897532 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Personal view: victim blaming as management strategy for the gastroenterologist - a game theoretical approach SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article AB Background: A multitude of digestive diseases elude simple management strategies. Rather than admit failure of disease management, a gastroenterologist could resort to blaming patients for their own medical conditions. Blaming the patient constitutes an easy exit strategy for otherwise unsolvable disease conditions. Aim: To shed light on the problem of patient blaming in gastroenterology and provide means for its resolution. Methods: The interaction between physician and patient can be formulated in terms of a non-zero-sum game between two adversaries. The outcomes associated with two behavioural strategies available to both adversaries are arranged in a two-by-two game matrix. Results: Blaming the patient is characterized by the general game pattern of the 'prisoner's dilemma'. If the physician-patient interaction is restricted to one single event, patient blaming represents the management strategy of choice with the highest expected payoff under all foreseeable circumstances. If there is a high probability for repeated physician-patient interactions, however, a physician admitting and a patient accepting the limits of medical performance yield a dominant strategy. Conclusion: Only for single physician-patient encounters does a non-cooperative strategy of blaming one's adversary for a poor medical outcome yield the highest expected outcome. In the long run, the strategy of shifting blame becomes unproductive for both sides alike. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Portland, OR USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 27 TC 4 Z9 4 U1 0 U2 3 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD MAY 15 PY 2005 VL 21 IS 10 BP 1179 EP 1184 DI 10.1111/j.1365-2036.2005.02491.x PG 6 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 924KJ UT WOS:000228977400001 PM 15882237 ER PT J AU Bonham, M Posakony, J Coleman, I Montgomery, B Simon, J Nelson, PS AF Bonham, M Posakony, J Coleman, I Montgomery, B Simon, J Nelson, PS TI Characterization of chemical constituents in Scutellaria baicalensis with antiandrogenic and growth-inhibitory activities toward prostate carcinoma SO CLINICAL CANCER RESEARCH LA English DT Article ID CELL-CYCLE ARREST; CANCER CELLS; ANDROGEN RECEPTOR; INDUCED APOPTOSIS; PC-SPES; 12-LIPOXYGENASE INHIBITION; LINE LNCAP; EXPRESSION; WOGONIN; LIPOXYGENASE AB Purpose: Botanical preparations are widely used by patients with prostate cancer. Scutellaria baicalensis, a botanical with a long history of medicinal use in China, was a constituent of the herbal mixture PC-SPES, a product that inhibited prostate cancer growth in both laboratory and clinical studies. Due to the difficulties encountered when evaluating the efficacy of complex natural products, we sought to identify active chemical constituents within Scutellaria and determine their mechanisms of action. Experimental Design and Results: We used high-performance liquid chromatography to fractionate S. baicalensis and identified four compounds capable of inhibiting prostate cancer cell proliferation; baicalein, wogonin, neobaicalein, and skullcapflavone. Comparisons of the cellular effects induced by the entire extract versus the four-compound combination produced comparable cell cycle changes, levels of growth inhibition, and global gene expression profiles (r(2) = 0.79). Individual compounds exhibited antiandrogenic activities with reduced expression of the androgen receptor and androgen-regulated genes. In vivo, baicalein (20 mg/kg/d p.o.) reduced the growth of prostate cancer xenografts in nude mice by 55% at 2 weeks compared with placebo and delayed the average time for tumors to achieve a volume of &SIM; 1,000 mm(3) from 16 to 47 days (P < 0.001). Conclusions: Most of the anticancer activities of S. baicalensis can be recapitulated with four purified constituents that function in part through inhibition of the androgen receptor signaling pathway. We conclude that clinical studies evaluating the efficacy of these agents in the context of chemoprevention or the treatment of prostate cancer are warranted. C1 Univ Washington, Fred Hutchinson Canc Res Ctr, Div Human Biol, Seattle, WA 98109 USA. Univ Washington, Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98109 USA. RP Nelson, PS (reprint author), Univ Washington, Fred Hutchinson Canc Res Ctr, Div Human Biol, Mailstop D4-100,1100 Fairview Ave N, Seattle, WA 98109 USA. EM pnelson@fhcrc.org FU NCI NIH HHS [T32 CA09657, T32 CA09437]; NIDDK NIH HHS [R01DK65204] NR 50 TC 69 Z9 73 U1 1 U2 12 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 MAY 15 PY 2005 VL 11 IS 10 BP 3905 EP 3914 DI 10.1158/1078-0432.CCR-04-1974 PG 10 WC Oncology SC Oncology GA 925XJ UT WOS:000229086600040 PM 15897592 ER PT J AU Weiner, M Benator, D Burman, W Peloquin, CA Khan, A Vernon, A Jones, B Silva-Trigo, C Zhao, Z Hodge, T AF Weiner, M Benator, D Burman, W Peloquin, CA Khan, A Vernon, A Jones, B Silva-Trigo, C Zhao, Z Hodge, T CA Tuberculosis Trials Consortium TI Association between acquired rifamycin resistance and the pharmacokinetics of rifabutin and isoniazid among patients with HIV and tuberculosis SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID RIFAMPIN-MONORESISTANT TUBERCULOSIS; ONCE-WEEKLY RIFAPENTINE; RISK-FACTORS; PULMONARY TUBERCULOSIS; RELAPSE; MODEL AB Background. The occurrence of acquired rifamycin resistance despite use of directly observed therapy for tuberculosis is associated with advanced human immunodeficiency virus (HIV) disease and highly intermittent administration of antituberculosis drugs. Beyond these associations, the pathogenesis of acquired rifamycin resistance is unknown. Methods. We performed a pharmacokinetic substudy of patients in a trial of treatment with twice-weekly rifabutin and isoniazid. Results. A total of 102 (60%) of 169 patients in the treatment trial participated in the pharmacokinetic substudy, including 7 of 8 patients in whom tuberculosis treatment failure or relapse occurred in association with acquired rifamycin-resistant mycobacteria (hereafter, "ARR failure or relapse"). The median rifabutin area under the concentration-time curve (AUC(0-24)) was lower for patients with than for patients without ARR failure or relapse (3.3 vs. 5.2 mu g*h/mL; P = .06, by the Mann-Whitney exact test). In a multivariate analysis adjusted for CD4(+) T cell count, the mean rifabutin AUC(0-24) was significantly lower for patients with ARR failure or relapse than for other patients (3.0 mu g*h/mL [95% confidence interval {CI}, 1.9-4.5] vs. 5.2 mu g*h/mL [95% CI, 4.6-5.8]; P = .02, by analysis of covariance). The median isoniazid AUC(0-12) was not significantly associated with ARR failure or relapse (20.6 vs. 28.0 mu g*h/mL; P = .24, by the Mann-Whitney exact test). However, in a multivariate logistic regression model that adjusted for the rifabutin AUC(0-24), a lower isoniazid AUC(0-12) was associated with ARR failure or relapse (OR, 10.5; 95% CI, 1.1-100; P = .04). Conclusions. Lower plasma concentrations of rifabutin and, perhaps, isoniazid were associated with ARR failure or relapse in patients with tuberculosis and HIV infection treated with twice-weekly therapy. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Vet Affairs Med Ctr, Washington, DC 20422 USA. George Washington Univ, Med Ctr, Washington, DC 20037 USA. Denver Publ Hlth, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Natl Jewish Med & Res Ctr, Denver, CO USA. Univ Colorado, Sch Pharm, Denver, CO 80202 USA. Univ Colorado, Sch Med, Denver, CO USA. Ctr Dis Control & Prevent, Div TB Eliminat, Atlanta, GA USA. Los Angeles Cty Univ So Calif Med Ctr, Los Angeles, CA USA. RP Weiner, M (reprint author), VAMC, Div Infect Dis 111F, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM weiner@uthscsa.edu FU NCRR NIH HHS [M01-RR-01346] NR 23 TC 135 Z9 138 U1 0 U2 4 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY 15 PY 2005 VL 40 IS 10 BP 1481 EP 1491 DI 10.1086/429321 PG 11 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 917MG UT WOS:000228465500015 PM 15844071 ER PT J AU Davis, L Thornburg, KL Giraud, GD AF Davis, L Thornburg, KL Giraud, GD TI The effects of anaemia as a programming agent in the fetal heart SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Review ID PRESSURE-OVERLOAD HYPERTROPHY; CORONARY BLOOD-FLOW; GUINEA-PIG HEART; VENTRICULAR HYPERTROPHY; CARDIAC-HYPERTROPHY; ADULT SHEEP; RAT-HEART; GROWTH; RESERVE; HYPOXIA AB The intrauterine environment plays a powerful role in determining the life-long risk of cardiovascular disease. A number of stressors are well known to affect the development of the cardiovascular system in utero including over/under maternal nutrition, excess glucocorticoid and chronic hypoxia. Chronic fetal anaemia in sheep is a complex stressor that alters cardiac loading conditions, causes hypoxic stress and stimulates large changes in flow to specific tissues, including large increases in resting coronary blood flow and conductance. Decreased viscosity can account for approximately half of the increased flow. It appears that immature hearts are 'plastic' in that increases in coronary conductance with fetal anaemia persist into adulthood even if the anaemia is corrected before birth. These large changes in conductance are possible only through extensive remodelling of the coronary tree. Adult hearts that were once anaemic in utero are more resistant to hypoxic stress as adults but it is not known whether such an adaptation would be deleterious in later life. These studies indicate the need for investigation into the basic mechanisms of coronary tree remodelling in the immature myocardium. New information on these mechanisms is likely to lead to better prevention of and therapies for adult-onset coronary disease. C1 Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97034 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97034 USA. Oregon Hlth Sci Univ, Heart Res Ctr, Portland, OR 97034 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97034 USA. Oregon Hlth Sci Univ, Dept Obstet & Gynecol, Portland, OR 97034 USA. RP Davis, L (reprint author), Oregon Hlth Sci Univ, Dept Obstet & Gynecol, 3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM davislo@ohsu.edu FU NHLBI NIH HHS [R01 HL045043, HL45043]; NICHD NIH HHS [P01HD34430, P01 HD034430] NR 42 TC 24 Z9 24 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD MAY 15 PY 2005 VL 565 IS 1 BP 35 EP 41 DI 10.1113/jphysiol.2004.082388 PG 7 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 929KI UT WOS:000229344600006 PM 15760943 ER PT J AU Ludwig, MA Burns, SP AF Ludwig, MA Burns, SP TI Spinal cord infarction following cervical transforaminal epidural injection - A case report SO SPINE LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Academy-of-Physical-Medicine-and-Rehabilitation CY OCT 10, 2003 CL Chicago, IL SP Amer Acad Phys Med & Rehabilitat DE spinal cord; injection; epidural; spinal cord injuries; complications ID INTRAVASCULAR PENETRATION; STEROID INJECTIONS; ARTERY; ROOT; MRI AB Study Design. Case Report. Objective. A review of the literature about spinal cord infarction with epidural steroid injections and report of one case. Summary of Background Data. A 53-year-old man with a history of chronic cervical pain and multilevel degenerative disc disease with multiple posterior disc protrusions on cervical imaging. The patient received a left C6 tranforaminal injection for therapeutic pain relief, with fluoroscopic confirmation of left C6 nerve root sheath spread of injectable contrast. Approximately 10 to 15 minutes post-procedure, he noted weakness in his left arm and bilateral lower limbs. Initial cervical magnetic resonance imaging revealed no cord signal change, but a follow-up study 24 hours later demonstrated patchy increased T2 and short tau inversion recovery signal in the cervical cord from the odontoid to C4-C5 vertebral levels. This was consistent with a diffuse vascular infarct to the cervical cord, resulting in motor-incomplete tetraplegia. Results. This is one of a few reported cases of spinal cord infarction after cervical epidural injections. No direct cord trauma occurred. Previously reported risk factors of spinal infarction, such as hypotension and large injectate volumes, were noncontributory in this case. Conclusions. Cervical epidural injections, despite careful localization, carry a risk of vascular infarction to the spinal cord, even in the absence of direct cord trauma. The etiology of these infarctions and identifying those patients at risk remain uncertain. C1 Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA USA. RP Ludwig, MA (reprint author), 188 J St, Salt Lake City, UT 84103 USA. EM drlugnut@hotmail.com NR 16 TC 77 Z9 80 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0362-2436 J9 SPINE JI SPINE PD MAY 15 PY 2005 VL 30 IS 10 BP E266 EP E268 DI 10.1097/01.brs.0000162401.47054.00 PG 3 WC Clinical Neurology; Orthopedics SC Neurosciences & Neurology; Orthopedics GA 927QB UT WOS:000229209100023 PM 15897816 ER PT J AU Ganz, DA Simmons, SF Schnelle, JF AF Ganz, DA Simmons, SF Schnelle, JF TI Cost-effectiveness of recommended nurse staffing levels for short-stay skilled nursing facility patients SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID HOME RESIDENTS; HOSPITALIZATION; CARE AB Background: Among patients in skilled nursing facilities for post-acute care, increased registered nurse, total licensed staff, and nurse assistant staffing is associated with a decreased rate of hospital transfer for selected diagnoses. However, the cost-effectiveness of increasing staffing to recommended levels is unknown. Methods: Using a Markov cohort simulation, we estimated the incremental cost-effectiveness of recommended staffing versus median staffing in patients admitted to skilled nursing facilities for post-acute care. The outcomes of interest were life expectancy, quality-adjusted life expectancy, and incremental cost-effectiveness. Results: The incremental cost-effectiveness of recommended staffing versus median staffing was $321,000 per discounted quality-adjusted life year gained. One-way sensitivity analyses demonstrated that the cost-effectiveness ratio was most sensitive to the likelihood of acute hospitalization from the nursing home. The cost-effectiveness ratio was also sensitive to the rapidity with which patients in the recommended staffing scenario recovered health-related quality of life as compared to the median staffing scenario. The cost-effectiveness ratio was not sensitive to other parameters. Conclusion: Adopting recommended nurse staffing for short-stay nursing home patients cannot be justified on the basis of decreased hospital transfer rates alone, except in facilities with high baseline hospital transfer rates. Increasing nurse staffing would be justified if health-related quality of life of nursing home patients improved substantially from greater nurse and nurse assistant presence. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Jewish Home Aging, Reseda, CA 91335 USA. RP Ganz, DA (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, Robert Wood Johnson Clin Scholars Program, 911 Broxton Plaza, Los Angeles, CA 90024 USA. EM dganz@mednet.ucla.edu; ssimmons@ucla.edu; jschnell@ucla.edu NR 21 TC 6 Z9 6 U1 4 U2 8 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD MAY 10 PY 2005 VL 5 AR 35 DI 10.1186/1472-6963-5-35 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 933OK UT WOS:000229642600001 PM 15885148 ER PT J AU Karlawish, JHT Casarett, DJ Bioethics, J Kim, SYH AF Karlawish, JHT Casarett, DJ Bioethics, J Kim, SYH TI The ability of persons with Alzheimer disease (AD) to make a decision about taking an AD treatment SO NEUROLOGY LA English DT Article ID MILD COGNITIVE IMPAIRMENT; DIFFERENT LEGAL STANDARDS; MINI-MENTAL-STATE; COMPETENCE; CAPACITY; CONSENT; TRIAL AB Objective: To examine the severity of impairments in the decision-making abilities (understanding, appreciation, reasoning, and choice) and competency to make a decision to use an Alzheimer disease (AD)-slowing medication in patients with AD and the relationships between these impairments, insight, and overall cognition. Methods: Semistructured in-home interviews were conducted with 48 patients with very mild to moderate AD and 102 family caregivers of patients with mild to severe AD recruited from the Memory Disorders Clinic of an AD center. The interview measured performance on the decision-making abilities and three expert psychiatrists' judgment of competency based on their independent review of the patient interviews. Results: There was considerable variation in patients' performance on the measures of decision-making abilities. Three expert raters found 19 of 48 (40%) of the subjects competent. Competent patients were more likely to show awareness of their symptoms, prognosis, and diagnosis. A sensitivity analysis suggests that a MMSE score is helpful in discriminating capacity from incapacity only when below 19 or above 23. Conclusions: Persons with mild to moderate Alzheimer disease (AD) have notable impairments in their ability to make an AD treatment decision, especially persons with moderate AD and persons who lack awareness of symptoms, prognosis, or diagnosis. C1 Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Alzheimers Dis Ctr, Ctr Bioeth, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Ctr Clin Epidemiol & Biostat, Philadelphia, PA USA. Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. Bioeth Program, Ann Arbor, MI USA. Program Improving Healthcare Decis, Ann Arbor, MI USA. RP Karlawish, JHT (reprint author), Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM jasonkar@mail.med.upenn.edu FU NIA NIH HHS [K01-AG00931, P30-AG01024, P30-AG10124, U19 AG010483]; NIMH NIH HHS [K23-MH64172] NR 27 TC 79 Z9 86 U1 3 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD MAY 10 PY 2005 VL 64 IS 9 BP 1514 EP 1519 DI 10.1212/01.WNL.0000160000.01742.9D PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 924QS UT WOS:000228995600007 PM 15883310 ER PT J AU Kuller, LH Lopez, OL Jagust, WJ Becker, JT DeKosky, ST Lyketsos, C Kawas, C Breitner, JCS Fitzpatrick, A Dulberg, C AF Kuller, LH Lopez, OL Jagust, WJ Becker, JT DeKosky, ST Lyketsos, C Kawas, C Breitner, JCS Fitzpatrick, A Dulberg, C TI Determinants of vascular dementia in the Cardiovascular Health Cognition Study SO NEUROLOGY LA English DT Article ID ALZHEIMERS-DISEASE; RISK-FACTORS; CEREBROVASCULAR PATHOLOGY; NINDS-AIREN; BRAIN; DIAGNOSIS; CRITERIA; INFARCTS; STROKE; ATHEROSCLEROSIS AB Objective: The authors evaluated 3,375 participants without dementia at the time of MRI in 1991 to 1994 over 5.7 years for incident dementia and type of dementia. Methods: Incidence of and risk factors for vascular dementia (VaD) were measured using both pre-MRI and modified State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) post-MRI review and further classified Alzheimer disease (AD) by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Results: Approximately 44% (213) of 480 incident dementia cases were classified as possible or probable VaD by ADDTC. The incidence of VaD increased with age and was greater in blacks than whites. Risk factors for VaD included age, Modified Mini-Mental State Examination, high white matter grade, number of MRI infarcts, ventricular size, and history of stroke. Conclusions: Vascular disease in the brain is prevalent among incident dementia cases. There is a substantial overlap between cases classified as Alzheimer disease by Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association and vascular dementia (VaD) by modified State of California Alzheimer's Disease Diagnostic and Treatment Centers criteria. The substantial contribution of vascular disease would be missed without inclusion of MRI. Treatment of risk factors for VaD could have an important impact on incidence of dementia. C1 Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Calif Davis, Dept Neurol, Sacramento, CA 95817 USA. Johns Hopkins Univ, Dept Psychiat, Div Geriatr Psychiat & Neuropsychiat, Baltimore, MD USA. Univ Calif Irvine, Dept Neurol, Irvine, CA 92717 USA. Univ Washington, Dept Epidemiol, VA Puget Sound Hlth Care Syst, Div Geriatr Psychiat Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. RP Kuller, LH (reprint author), Univ Pittsburgh, Dept Epidemiol, 130 N Bellefield Ave,Room 550, Pittsburgh, PA 15213 USA. EM KullerL@edc.pitt.edu FU NHLBI NIH HHS [N01-HC-85084, N01HC85079, N01HC85086, N01-HC-85083, N01-HC-85079, N01-HC-85086, N01 HC015103, N01-HC-85081, N01-HC-85085, N01 HC035129, N01-HC-85082]; NIA NIH HHS [AG15928, R01 AG015928, R01 AG021055] NR 26 TC 87 Z9 88 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD MAY 10 PY 2005 VL 64 IS 9 BP 1548 EP 1552 DI 10.1212/01.WNL.0000160115.55756.DE PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 924QS UT WOS:000228995600012 PM 15883315 ER PT J AU Rehman, SU Hutchison, FN Hendrix, K Okonofua, EC AF Rehman, SU Hutchison, FN Hendrix, K Okonofua, EC TI Ethnic differences in blood pressure control among men at veterans affairs clinics and other health care sites SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID UNITED-STATES; RACIAL-DIFFERENCES; AFRICAN-AMERICANS; MEDICAL-CARE; INNER-CITY; HYPERTENSION; ACCESS; BLACK; SERVICES; RACE AB Background: Differential access to health care may contribute to lower blood pressure (BP) control rates to under 140/90 mm Hg in African American compared with white hypertensive patients, especially men (26.5% vs 36.5% of all hypertensive patients in the National Health and Nutrition Examination Survey 1999-2000). The Department of Veterans Affairs (VA) system, which provides access to health care and medications across ethnic and economic boundaries, may reduce disparities in BP control. Methods: To test this hypothesis, BP treatment and control groups were compared between African American (VA, n = 4379;non-VA, n = 2754) and white (VA, n = 7987; non-VA, n:=4980) hypertensive men. Results: In both groups, whites were older than African-Americans (P<.05), had lower BP (P<.001),and had BP controlled to below 140/90 mm Hg more often on their last visit (P<.01). Blood pressure control to below 140/90 mm Hg was comparable among white hypertensive men at VA (55.6%) and non-VA (54.2%) settings (P = .12). In contrast, BP control was higher among African American hypertensive men at VA (49.4%) compared with non-VA (44.0%) settings (P<.01), even after controlling for age, numerous comorbid conditions, and rural-urban classification. African American hypertensive men received a comparable number of prescriptions for BP medications at VA sites (P = .18) and more prescriptions at non-VA sites than did whites (P<.001). African Americans had more visits in the previous year at VA sites (P<.001) and fewer visits at non-VA sites (P<.001) compared with whites. Conclusions: The ethnic disparity in BP control between African Americans and whites was approximately 40% less at VA than at non-VA health care sites (6.2% vs 10.2%; P<.01). Ensuring access to health care could constitute one constructive component of a national initiative to reduce ethnic disparities in BP control and cardiovascular risk. C1 Ralph H Johnson VA Med Ctr, Dept Med, Charleston, SC USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Rehman, SU (reprint author), Johnson Vet Affairs Hosp, 109 Bee St 11C, Charleston, SC 29401 USA. EM shakaib.rehman@med.va.gov FU AHRQ HHS [P01HS1087]; NHLBI NIH HHS [HL58794, HL04290]; NIMHD NIH HHS [P60-MD00267] NR 35 TC 59 Z9 59 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 9 PY 2005 VL 165 IS 9 BP 1041 EP 1047 DI 10.1001/archinte.165.9.1041 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 924ST UT WOS:000229001400011 PM 15883244 ER PT J AU Najt, P Glahn, D Bearden, CE Hatch, JP Monkul, ES Kaur, S Villarreal, V Bowden, C Soares, JC AF Najt, P Glahn, D Bearden, CE Hatch, JP Monkul, ES Kaur, S Villarreal, V Bowden, C Soares, JC TI Attention deficits in bipolar disorder: a comparison based on the Continuous Performance Test SO NEUROSCIENCE LETTERS LA English DT Article DE Continuous Performance Test; attention; bipolar disorder; mood disorders; trait marker; neurocognitive impairment ID SUSTAINED ATTENTION; RATING-SCALE; SCHIZOPHRENIA; NEUROANATOMY; MANIA AB Although attentional deficits measured by Continuous Performance Tests (CPTs) have been observed in patients with bipolar disorder, their relationship with clinical state is not well understood. The identical pairs Continuous Performance Test (CPT-IP) shows particular promise as a measure sensitive to trait abnormalities in attentional function. In this study, the CPT-lP was administered to 27 patients with bipolar disorder (22 type 1, 5 type 11) and 25 demographically matched healthy comparison subjects, in order to assess the presence and nature of attentional deficits as a function of mood symptoms. Results showed significantly impaired CPT performance in bipolar patients compared with healthy subjects. Patients made fewer hits (p < 0.0 1), were slower to respond (p < 0.007), and had poorer discrimination (p < 0.05) and bias (p < 0.006) than comparison subjects. Severity of mania and depression was not correlated with any of the CPT measures. Our findings suggest that attentional dysfunction may be a trait deficit associated with bipolar illness. However, within-subjects longitudinal studies examining fluctuations in performance over time are needed. (c) 2004 Elsevier Ireland Ltd. All rights reserved. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78285 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78285 USA. Dokuz Eylul Univ, Sch Med, Dept Psychiat, Izmir, Turkey. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78285 USA. RP Soares, JC (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. EM soares@uthscsa.edu FU NCRR NIH HHS [M01-RR-01346]; NIMH NIH HHS [MH 01736] NR 22 TC 27 Z9 28 U1 2 U2 5 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD MAY 6 PY 2005 VL 379 IS 2 BP 122 EP 126 DI 10.1016/j.neulet.2004.12.051 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 919PG UT WOS:000228629400009 PM 15823428 ER PT J AU Singh, BN Singh, SN Reda, DJ Tang, XC Lopez, B Harris, CL Fletcher, RD Sharma, SC Atwood, JE Jacobson, AK Lewis, HDJ Raisch, DW Ezekowitz, MD Singh, BN Lopez, B Singh, SN Fletcher, R Platt, M Paul, P Crawford, K Meza, D Harrington, R Reda, D Henderson, WG Tang, XC Abdellatif, M Motyka, D Mackay, B Reinhard, M Anfinsen, L Alvardado-Garcia, N Jimenez, J Semlow, DJ Sather, MR Buchanan, SL Harris, C Fye, C Gagne, W Gifford, L Guidarelli, L Lewis, HD Ezekowitz, M Falk, R Antman, E Lewis, HD Atwood, JE Jacobson, A Singh, BN Singh, SN Fletcher, R Atwood, JE Jacobson, AK Sharma, S Ezekowitz, M Lewis, HD Fye, C Reda, D Henderson, WG Podrid, PJ Torner, JC Brodsky, MA Kowey, PR Feussner, J Berkowitz, S Gough, J Cadman, C Cataldo, R Beeman, L Ahmed, R Verma, S Jordan, J Shettigar, UR Appunn, G Norvalis, R Dove, D El-Sherif, N Graham, S Mohamed, A Caref, E Hamdan, M Willis, C Mull, S Nichols, J Roesle, M Deedwania, P Barker, J Frigon, C Kanefield, R Hariman, R O'Sullivan, M Martins, JB Lee, HC Morse, J Wolfe, L Liston, M Lewis, D Martin, B Payne, W Voshall, B Keeton, S Bisett, J Cotter, B Jacobson, AK Simpson, V Russell, DC Luick, E Williams, LE Ramanathan, KB Johnson, L Qualls, Z Anand, I Berg, S Atwood, JE Danabar, B Myers, J Zipp, C Ferguson, C Shalaby, A Thompson, E Weiss, R Hickey, K Zana, K Jones, K DiTommaso, M Raitt, MH Martin, K Sharma, S Marquis, L Beliard, M Jesse, R Gilligan, D Dan, D Mohanty, P Spencer, T Mark, A Stratmann, HG Manns, H Isenberg, C Heng, MK Birner-Burley, G Rhee, J Reynolds, S Church, D Lyu, C Zoble, RG Dejesus, I Garrett, D Dellaportas, A Goldman, S Pennock, G Gregorio, B Ohm, J Bernheim, C Quattlander, C Karasik, P Vogel, KD Abbott, B Cohen, IS Ezekowitz, M Sheehan, L Pace, K Mody, FV Ziff, EL Davidson, T Orlov, M Katcher, M Stambler, BS Faber, JA Bogosh, C AF Singh, BN Singh, SN Reda, DJ Tang, XC Lopez, B Harris, CL Fletcher, RD Sharma, SC Atwood, JE Jacobson, AK Lewis, HDJ Raisch, DW Ezekowitz, MD Singh, BN Lopez, B Singh, SN Fletcher, R Platt, M Paul, P Crawford, K Meza, D Harrington, R Reda, D Henderson, WG Tang, XC Abdellatif, M Motyka, D Mackay, B Reinhard, M Anfinsen, L Alvardado-Garcia, N Jimenez, J Semlow, DJ Sather, MR Buchanan, SL Harris, C Fye, C Gagne, W Gifford, L Guidarelli, L Lewis, HD Ezekowitz, M Falk, R Antman, E Lewis, HD Atwood, JE Jacobson, A Singh, BN Singh, SN Fletcher, R Atwood, JE Jacobson, AK Sharma, S Ezekowitz, M Lewis, HD Fye, C Reda, D Henderson, WG Podrid, PJ Torner, JC Brodsky, MA Kowey, PR Feussner, J Berkowitz, S Gough, J Cadman, C Cataldo, R Beeman, L Ahmed, R Verma, S Jordan, J Shettigar, UR Appunn, G Norvalis, R Dove, D El-Sherif, N Graham, S Mohamed, A Caref, E Hamdan, M Willis, C Mull, S Nichols, J Roesle, M Deedwania, P Barker, J Frigon, C Kanefield, R Hariman, R O'Sullivan, M Martins, JB Lee, HC Morse, J Wolfe, L Liston, M Lewis, D Martin, B Payne, W Voshall, B Keeton, S Bisett, J Cotter, B Jacobson, AK Simpson, V Russell, DC Luick, E Williams, LE Ramanathan, KB Johnson, L Qualls, Z Anand, I Berg, S Atwood, JE Danabar, B Myers, J Zipp, C Ferguson, C Shalaby, A Thompson, E Weiss, R Hickey, K Zana, K Jones, K DiTommaso, M Raitt, MH Martin, K Sharma, S Marquis, L Beliard, M Jesse, R Gilligan, D Dan, D Mohanty, P Spencer, T Mark, A Stratmann, HG Manns, H Isenberg, C Heng, MK Birner-Burley, G Rhee, J Reynolds, S Church, D Lyu, C Zoble, RG Dejesus, I Garrett, D Dellaportas, A Goldman, S Pennock, G Gregorio, B Ohm, J Bernheim, C Quattlander, C Karasik, P Vogel, KD Abbott, B Cohen, IS Ezekowitz, M Sheehan, L Pace, K Mody, FV Ziff, EL Davidson, T Orlov, M Katcher, M Stambler, BS Faber, JA Bogosh, C CA SAFE-T Investigators TI Amiodarone versus sotalol for atrial fibrillation SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CONGESTIVE-HEART-FAILURE; QUALITY-OF-LIFE; LOW-DOSE AMIODARONE; SINUS RHYTHM; ELECTRICAL CARDIOVERSION; ANTIARRHYTHMIC-DRUGS; MYOCARDIAL-INFARCTION; RANDOMIZED-TRIAL; CARDIAC MUSCLE; THERAPY AB BACKGROUND: The optimal pharmacologic means to restore and maintain sinus rhythm in patients with atrial fibrillation remains controversial. METHODs: In this double-blind, placebo-controlled trial, we randomly assigned 665 patients who were receiving anticoagulants and had persistent atrial fibrillation to receive amiodarone (267 patients), sotalol (261 patients), or placebo (137 patients) and monitored them for 1 to 4.5 years. The primary end point was the time to recurrence of atrial fibrillation beginning on day 28, determined by means of weekly transtelephonic monitoring. RESULTS: Spontaneous conversion occurred in 27.1 percent of the amiodarone group, 24.2 percent of the sotalol group, and 0.8 percent of the placebo group, and direct-current cardioversion failed in 27.7 percent, 26.5 percent, and 32.1 percent, respectively. The median times to a recurrence of atrial f ibrillation were 487 days in the amiodarone group, 74 days in the sotalol group, and 6 days in the placebo group according to intention to treat and 809, 209, and 13 days, respectively, according to treatment received. Amiodarone was superior to sotalol (P<0.001) and to placebo (P<0.001), and sotalol was superior to placebo (P<0.001). In patients with ischemic heart disease, the median time to a recurrence of atrial fibrillation was 569 days with amiodarone therapy and 428 days with sotalol therapy (P=0.53). Restoration and maintenance of sinus rhythm significantly improved the quality of life and exercise capacity. There were no significant differences in major adverse events among the three groups. CONCLUSIONS: Amiodarone and sotalol are equally efficacious in converting atrial fibrillation to sinus rhythm. Amiodarone is superior for maintaining sinus rhythm, but both drugs have similar efficacy in patients with ischemic heart disease. Sustained sinus rhythm is associated with an improved quality of life and improved exercise performance. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Dept Vet Affairs Med Ctr, Washington, DC USA. Dept Vet Affairs Hosp, Hines, IL USA. Dept Vet Affairs Med Ctr, Albuquerque, NM USA. Dept Vet Affairs Med Ctr, Providence, RI USA. Walter Reed Army Med Ctr, Washington, DC 20307 USA. Dept Vet Affairs Med Ctr, Loma Linda, CA USA. Dept Vet Affairs Med Ctr, Kansas City, MO USA. Med Coll Penn & Hahnemann Univ, Philadelphia, PA USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Singh, BN (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu NR 40 TC 365 Z9 392 U1 1 U2 12 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 MAY 5 PY 2005 VL 352 IS 18 BP 1861 EP 1872 DI 10.1056/NEJMoa041705 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 922SM UT WOS:000228858600006 PM 15872201 ER PT J AU Shirley, RL Buck, KJ AF Shirley, RL Buck, KJ TI Using bacterial artificial chromosome (BAC) transgenic models to test the involvement of Mpdz in ethanol withdrawal SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland Alcohol Res Ctr, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 7A EP 7A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900007 ER PT J AU Rasmussen, DD Burke, B Crites, NJ AF Rasmussen, DD Burke, B Crites, NJ TI Chronic daily ethanol and withdrawal: Melatonin treatment reverses persistently increased acoustic startle response during abstinence SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, MIRECC, Seattle, WA 98195 USA. NR 0 TC 4 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 16A EP 16A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900057 ER PT J AU Au, D Bryson, CL Kivlahan, DR Bradley, KA AF Au, D Bryson, CL Kivlahan, DR Bradley, KA TI Alcohol screening results predict GI admissions. SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 VA Puget Sound, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98101 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 37A EP 37A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900183 ER PT J AU Tolliver, BK Myrick, H AF Tolliver, BK Myrick, H TI Increased five-year mortality in alcohol-dependent males with withdrawal seizures observed by medical personnel SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Med Univ S Carolina, Charleston Alcohol Res Ctr, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 37A EP 37A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900184 ER PT J AU Veatch, LM Cummings, SC Becker, HC AF Veatch, LM Cummings, SC Becker, HC TI Alterations in sleep architecture differ by age in a mouse model of repeated alcohol withdrawal SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Charleston Alcohol Res Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 57A EP 57A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900303 ER PT J AU Durazzo, TC Gazdinski, S Ezekiel, F Jahng, GH Meyeroff, DJ AF Durazzo, TC Gazdinski, S Ezekiel, F Jahng, GH Meyeroff, DJ TI Effects of chronic alcohol dependence and chronic cigarette smoking on cerebral perfusion SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 101A EP 101A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375900569 ER PT J AU Conigliaro, J McGinnis, K AF Conigliaro, J McGinnis, K TI Alcohol & HIV progression SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 164A EP 164A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375901355 ER PT J AU Bradley, KA Achtmeyer, CE Williams, EC Merrill, JO Kivlahan, DR AF Bradley, KA Achtmeyer, CE Williams, EC Merrill, JO Kivlahan, DR TI Use of a clinical reminder for follow-up of alcohol misuse screening in primary care. SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 VA Puget Sound, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98101 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 169A EP 169A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375901388 ER PT J AU Saxon, AJ AF Saxon, AJ TI Planning subject flow: Workload and consistency during long-term studies SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 180A EP 180A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375901449 ER PT J AU Durazzo, TC AF Durazzo, TC TI Cigarette smoking and alcohol dependence MR studies of their independent and combined effects on the human brain. SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Meeting Abstract CT 28th Annual Meeting of the Research-Society-on-Alcoholism CY JUN 25-30, 2005 CL Santa Barbara, CA SP Res Soc Alcoholism C1 San Francisco VA Med Ctr, NCIRE, San Francisco, CA 94121 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 SU S BP 200A EP 200A PG 1 WC Substance Abuse SC Substance Abuse GA 929VY UT WOS:000229375901570 ER PT J AU Fehr, C Shirley, RL Crabbe, JC Belknap, JK Buck, KJ Phillips, TJ AF Fehr, C Shirley, RL Crabbe, JC Belknap, JK Buck, KJ Phillips, TJ TI The syntaxin binding protein 1 gene (Stxbp1) is a candidate for an ethanol preference drinking locus on mouse chromosome 2 SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE dependence and withdrawal; soluble N-ethylmaleimide-sensitive factor attachment; protein receptor; vesicle release; Sec-1/Munc-18 ID QUANTITATIVE TRAIT LOCI; RECOMBINANT INBRED MICE; CROSS-FOSTERING ANALYSIS; ALCOHOL PREFERENCE; WITHDRAWAL SEVERITY; MEMBRANE-FUSION; ENVIRONMENTAL CONTRIBUTIONS; CONGENIC STRAINS; BXD; CONSUMPTION AB Background: We previously mapped a quantitative trait locus (QTL) for ethanol preference drinking to mouse chromosome 2 (mapped with high confidence, LOD = 15.5,p 3 X 10(16)). The specific gene(s) in the QTL interval responsible for phenotypic variation in ethanol preference drinking has not been identified. Methods: In the current study, we investigated the association of the syntaxin binding protein 1 gene (Stxbp1) with ethanol preference drinking and other ethanol traits using a panel of B6 X D2 (BXD) recombinant inbred (RI) strains derived from the C57BL/6J (B6) and DBA/2J (B2) inbred mouse strains. Confirmation analyses for ethanol consumption and withdrawal were performed using a large B6D2 F-2 cross, short-term selected lines derived from the B6 and D2 progenitor strains, and standard inbred strains. Results: BXD RI strain analysis detected provisional associations between Stxbp1 molecular variants and ethanol consumption, as well as severity of acute ethanol withdrawal, ethanol-conditioned taste aversion, and ethanol-induced hypothermia. Confirmation analyses using three independent genetic models supported the involvement of Stxbp1 in ethanol preference drinking but not in ethanol withdrawal. Conclusions: Stxbp1 encodes a Sec1/Munc18-type protein essential for vesicular neurotransmitter release. The present study provides supporting evidence for the involvement of Stxbp1 in ethanol preference drinking. C1 US Dept Vet Affairs, Med Ctr, R&D 32, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland Alcohol Res Ctr, Portland, OR 97201 USA. RP Phillips, TJ (reprint author), US Dept Vet Affairs, Med Ctr, R&D 32, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM phillipt@ohsu.edu FU NIAAA NIH HHS [AA06243, AA10760, AA11114, P60 AA010760] NR 67 TC 37 Z9 38 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAY PY 2005 VL 29 IS 5 BP 708 EP 720 DI 10.1097/01.ALC.0000164366.18376.EF PG 13 WC Substance Abuse SC Substance Abuse GA 927TU UT WOS:000229224200003 PM 15897714 ER PT J AU Sonnenberg, A AF Sonnenberg, A TI Why do complications of gastrointestinal disease and procedures come as serial rather than singular events? SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID ENDOSCOPY; GUIDELINES AB Background: It often appears as if complications arising from gastrointestinal disease and interventional procedures come in 'series' and 'cluster' in individual patients. Aim: The aim of this study was to analyse the clustering of complications in terms of stochastic modelling and Markov chains. Methods: A patient with gastrointestinal disease is simulated to move along either a 'bad track' associated with multiple consecutive complications or a 'good track' free of complications, the transitions within each track and between the two tracks being governed by probability values. Results: Because the occurrence of a single complication increases the risk of further complications, subjects who encounter their first complication are more likely to experience a second, third or even more complications, before they leave the 'bad track' and their personal chain of cascading complications becomes discontinued. The model of a Markov chain explains why the overall number of complications in the total population of patients with digestive disease remains low even if individual patients are expected to encounter more than a single complication. Conclusions: Published complication rates for gastrointestinal procedures underestimate the true risk to the patient, because they do not consider the added vulnerability to cascading complications after the first event. C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Gastroenterol Sect, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, Gastroenterol Sect, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 17 TC 0 Z9 0 U1 1 U2 1 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD MAY 1 PY 2005 VL 21 IS 9 BP 1149 EP 1153 DI 10.1111/j.1365-2036.2005.02439.x PG 5 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 919TT UT WOS:000228641200013 PM 15854178 ER PT J AU Christofferson, RD Lehmann, KG Martin, GV Every, N Caldwell, JH Kapadia, SR AF Christofferson, RD Lehmann, KG Martin, GV Every, N Caldwell, JH Kapadia, SR TI Effect of chronic total coronary occlusion on treatment strategy SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID BALLOON ANGIOPLASTY; REVASCULARIZATION; INTERVENTION; EXPERIENCE; ARTERIES; DISEASE AB In a registry analysis of 8,004 consecutive patients presenting for diagnostic catheterization at a single institution from 1990 to 2000, chronic total occlusion (CTO) was found in 52% of patients with significant (>= 70% diameter stenosis) coronary artery disease. Peripheral vascular disease was the strongest clinical predictor of the presence of a CTO. In a multivariate analysis, CTO was the strongest predictor against the selection of percutaneous coronary intervention (PCI) as a treatment strategy, indicating that efforts to improve the success rate of PCI in CTO may have a significant impact on management of coronary disease. (c) 2005 by Excerpta Medica Inc. C1 Cleveland Clin Fdn, Div Cardiovasc Dis, Cleveland, OH 44195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Div Cardiol, Seattle, WA 98195 USA. RP Kapadia, SR (reprint author), Cleveland Clin Fdn, Div Cardiovasc Dis, 9500 Euclid Ave,F25, Cleveland, OH 44195 USA. EM kapadis@ccf.org NR 14 TC 147 Z9 157 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 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD MAY 1 PY 2005 VL 95 IS 9 BP 1088 EP 1091 DI 10.1016/j.amjcard.2004.12.065 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 921BF UT WOS:000228738500014 PM 15842978 ER PT J AU Tran, T Spechler, SJ Richardson, P El-Serag, HB AF Tran, T Spechler, SJ Richardson, P El-Serag, HB TI Fundoplication and the risk of esophageal cancer in gastroesophageal reflux disease: A Veterans Affairs cohort study SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID BARRETTS-ESOPHAGUS; ANTIREFLUX SURGERY; PROPENSITY SCORE; SURGICAL THERAPY; ADENOCARCINOMA AB BACKGROUND AND AIMS: It has been proposed that fundoplication can reduce the risk of esophageal cancer in patients with gastroesophageal reflux disease (GERD). In this cohort study, we assessed the effect of fundoplication on the incidence of esophageal cancer. METHODS: We identified all Veterans Affairs (VA) patients with GERD who had fundoplication between 1986 and 1990 and matched (1-2) to controls with GERD and no fundoplication and to controls with no GERD. We calculated incidence rates for esophageal cancer through October 2002 and examined the effect of fundoplication on the risk of esophageal cancer using Kaplan-Meier survival analysis and Cox proportional hazard analysis. We calculated and adjusted for the propensity score for receiving fundoplication. RESULTS: We identified 946 patients who had fundoplication, 1,892 patients who had GERD without fundoplication, and 5,676 patients with no GERD. The mean age was 55 yr and 97.5% were men in all three groups. During a follow-up of 11,156 patient-years (PY), there were eight cases of esophageal cancer (72/100,000) in the fundoplication group. During a follow-up of 20,115 PY, there were eight cases of esophageal cancer (40/100,000) in the GERD without fundoplication group. During a follow-up of 59,439 PY, no patients in the group with no GERD developed esophageal cancer. The Kaplan-Meier analysis showed no significant difference in cumulative esophageal cancer rates between the fundoplication group and the GERD no-fundoplication group. The adjusted hazard ratio of esophageal cancer with fundoplication was 1.88 (95% CI: 0.70-5.03). CONCLUSIONS: GERD is a risk factor for esophageal cancer, but there is insufficient evidence that fundoplication reduces that risk. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Dallas Vet Affairs Med Ctr, Dallas, TX USA. Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Sect Gastroenterol, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 30 TC 45 Z9 45 U1 0 U2 2 PU BLACKWELL PUBLISHING INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD MAY PY 2005 VL 100 IS 5 BP 1002 EP 1008 DI 10.1111/j.1572-0241.2005.41007.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 917SQ UT WOS:000228489900003 PM 15842570 ER PT J AU Snow, AL Dani, R Souchek, J Sullivan, G Ashton, CM Kunik, ME AF Snow, AL Dani, R Souchek, J Sullivan, G Ashton, CM Kunik, ME TI Comorbid psychosocial symptoms and quality of life in patients with dementia SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY 15-18, 2003 CL BALTIMORE, MD SP Amer Geriatr Soc ID ALZHEIMERS-DISEASE; NURSING-HOME; ELDERLY-PATIENTS; RATING-SCALE; PAIN; DEPRESSION; RESIDENTS; AGITATION; VALIDITY; BEHAVIOR AB Objective: The authors examined the association between treatable comorbid psychosocial symptoms and quality of life (QOL) in patients with dementia. In an effort to develop a more comprehensive understanding of this relationship, this study included both patient reports of their QOL and caregiver reports of patient QOL. Methods: Eighty-nine dyads, consisting of a community-residing veteran with dementia and his family caregiver, were interviewed once to determine the correlation between patient QOL and depression, functional disability, pain, and agitation. Results: Higher patient-rated QOL was significantly associated with lower patient depression. Higher caregiver-rated patient QOL was associated with lower caregiver depression and higher patient functional status. Agitation was not related to patient-rated or caregiver-rated patient QOL. Conclusions: Authors discuss the psychometric and conceptual implications of possible differences between self-and other-ratings of QOL, and treatment implications for caregiver-education interventions. C1 Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Little Rock Vet Affairs Med Ctr, Little Rock, AR USA. Univ Arkansas, Sch Med Sci, Dept Psychiat & Behav Sci, Fayetteville, AR 72701 USA. RP Snow, AL (reprint author), 2002 Holcombe 152, Houston, TX 77030 USA. EM asnow@bcm.tmc.edu NR 37 TC 26 Z9 26 U1 0 U2 3 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD MAY PY 2005 VL 13 IS 5 BP 393 EP 401 DI 10.1176/appi.ajgp.13.5.393 PG 9 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 923TR UT WOS:000228932700008 PM 15879588 ER PT J AU Almendral, JL Shick, VI Atlas, SA Rosendorff, C AF Almendral, JL Shick, VI Atlas, SA Rosendorff, C TI Transforming growth factor-beta 1: A marker of left ventricular hypertrophy in hypertension SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 20th Annual Meeting of the American-Society-of-Hypertension CY MAY 14-18, 2005 CL San Francisco, CA SP Amer Soc Hypertension DE hypertension; left ventricular hypertrophy; transforming growth factor beta-1 C1 Bronx Vet Adm Med Ctr, Dept Med, Bronx, NY USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2005 VL 18 IS 5 SU S BP 118A EP 118A DI 10.1016/j.amjhyper.2005.03.327 PN 2 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 927VW UT WOS:000229229600327 ER PT J AU Jesri, A Okonofua, E Martin, K Romanowska, K Egan, BM AF Jesri, A Okonofua, E Martin, K Romanowska, K Egan, BM TI Dash is more effective in lowering blood pressure in metabolic syndrome patients than potassium, magnesium and fiber supplements SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 20th Annual Meeting of the American-Society-of-Hypertension CY MAY 14-18, 2005 CL San Francisco, CA SP Amer Soc Hypertension DE DASH eating plan; lowering blood pressure; metabolic syndrome C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2005 VL 18 IS 5 SU S BP 197A EP 198A DI 10.1016/j.amjhyper.2005.03.541 PN 2 PG 2 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 927VW UT WOS:000229229600541 ER PT J AU Nyby, MD Abedi, K Smutko, V Eslami, P Berger, M Tuck, ML AF Nyby, MD Abedi, K Smutko, V Eslami, P Berger, M Tuck, ML TI Inhibition of the renin-angiotensin system reduces vascular oxidative stress and vascular dysfunction in insulin-resistant rats SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Meeting Abstract CT 20th Annual Meeting of the American-Society-of-Hypertension CY MAY 14-18, 2005 CL San Francisco, CA SP Amer Soc Hypertension DE insulin resistance; oxidative stress; renin-angiotensin system C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Sepulveda, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD MAY PY 2005 VL 18 IS 5 SU S BP 202A EP 202A DI 10.1016/j.amjhyper.2005.03.553 PN 2 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 927VW UT WOS:000229229600553 ER PT J AU Schutzer, WE Reed, JF Mader, SL AF Schutzer, WE Reed, JF Mader, SL TI Decline in caveolin-1 expression and scaffolding of G protein receptor kinase-2 with age in Fischer 344 aortic vascular smooth muscle SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE aging; aorta; beta-adrenergic; blood vessel; caveolae; hypertension ID ADENYLYL-CYCLASE; RAT AORTA; SIGNALING COMPLEXES; PLASMA-MEMBRANE; LIPID RAFTS; SYSTEM; COLOCALIZATION; PURIFICATION; PHARMACOLOGY; STIMULATION AB beta- Adrenergic receptor ( beta- AR)- mediated vasorelaxation declines with age in humans and animal models. This is not caused by changes in expression of beta- AR, G alpha s, adenylyl cyclase, or protein kinase A but is associated with decreased cAMP production. Expression and activity of G protein receptor kinase- 2 ( GRK- 2), which phosphorylates and desensitizes the beta- AR, increases with age in rat aortic tissue. Caveolin scaffolds the beta- AR, GRK, and other proteins within " signaling pockets" and inhibits GRK activity when bound. We questioned the effect of age on caveolin- 1 expression and interaction between caveolin- 1 and GRK- 2 in vascular smooth muscle ( VSM) isolated from 2-, 6-, 12-, and 24- mo- old male Fischer 344 rat aorta. Western blot analysis found expression of caveolin- 1 declined with age ( 6-, 12- and 24- mo-old rat aortas express 92, 50, and 42% of 2- mo- old rat aortas, respectively). Results from density- buoyancy analysis showed a lower percentage of GRK in caveolin- 1- specific fractions with age ( 6-, 12- and 24- mo- old rat aortas express 95, 56, and 12% of 2- mo- old rat aortas, respectively). Coimmunoprecipitation confirmed this finding; density of GRK in caveolin- 1 immunoprecipitates was 97, 30, and 21% of 2- mo- old aortas compared with 6-, 12- and 24- mo- old animals, respectively. Immunohistocytochemistry and confocal microscopy confirmed that GRK- 2 and caveolin- 1 colocalize in VSM. These results suggest that in nonoverexpressed, intact tissue, the decline in beta- AR- mediated vasorelaxation may be caused by both a reduction in caveolin- 1 expression and a reduction in binding of GRK- 2 by caveolin- 1. This could lead to an increase in the fraction of free GRK- 2, which could phosphorylate and desensitize the beta- AR. C1 Portland Vet Affairs Med Ctr, Res Serv, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Sch Med, Portland, OR USA. RP Mader, SL (reprint author), Portland Vet Affairs Med Ctr, Res Serv, R&D 26,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. EM scott.mader@med.va.gov NR 39 TC 12 Z9 14 U1 1 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD MAY PY 2005 VL 288 IS 5 BP H2457 EP H2464 DI 10.1152/ajpheart.01090.2004 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 918DU UT WOS:000228520400053 PM 15626685 ER PT J AU Frankle, WG Lombardo, I New, AS Goodman, M Talbot, PS Huang, YY Hwang, DR Slifstein, M Curry, S Abi-Dargham, A Laruelle, M Siever, LJ AF Frankle, WG Lombardo, I New, AS Goodman, M Talbot, PS Huang, YY Hwang, DR Slifstein, M Curry, S Abi-Dargham, A Laruelle, M Siever, LJ TI Brain serotonin transporter distribution in subjects with impulsive aggressivity: A positron emission study with [C-11]McN 5652 SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID OBSESSIVE-COMPULSIVE DISORDER; H-3 PAROXETINE BINDING; SCRIPT-DRIVEN IMAGERY; SYMPTOM PROVOCATION; CEREBROSPINAL-FLUID; UPTAKE SITES; BENZODIAZEPINE-RECEPTORS; PERSONALITY-DISORDER; NONHUMAN-PRIMATES; PREFRONTAL CORTEX AB Objective: The serotonin system is believed to play a role in modulating impulsivity and violence. Previous imaging studies have implicated the anterior cingulate and orbitofrontal cortex in impulsive aggression. This study evaluated regional serotonin transporter distribution in the brain of individuals with impulsive aggression by using positron emission tomography (PET) with the serotonin transporter PET radiotracer [C-11] McN 5652. Method: Ten individuals with impulsive aggression and 10 age- and sex-matched healthy comparison subjects underwent [C-11] McN 5652 PET. All individuals were medication free at the time of scanning. Regional total distribution volumes were derived by using a one-tissue compartment kinetic model with arterial input function. Outcome measures of serotonin transporter availability included the binding potential and the specific-to-nonspecific partition coefficient (V-3''). Results: Serotonin transporter availability was significantly reduced in the anterior cingulate cortex of individuals with impulsive aggression compared with healthy subjects, as noted by differences in both binding potential ( mean = 3.1 ml/g [SD = 1.9] versus 5.0 ml/g [SD = 2.0], respectively) and V-3'' (mean = 0.15 [SD = 0.09] versus 0.26 [SD = 0.09]). In other regions examined, serotonin transporter density was nonsignificantly lower in individuals with impulsive aggression compared with healthy subjects. Conclusions: Pathological impulsive aggressivity might be associated with lower serotonergic innervation in the anterior cingulate cortex, a region that plays an important role in affective regulation. C1 New York State Psychiat Inst & Hosp, New York, NY 10032 USA. Columbia Univ, Coll Phys & Surg, Dept Psychiat, New York, NY 10027 USA. Columbia Univ, Coll Phys & Surg, Dept Radiol, New York, NY 10027 USA. Bronx Vet Affairs Med Ctr, Psychiat Serv, Bronx, NY USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. RP Frankle, WG (reprint author), New York State Psychiat Inst & Hosp, 1051 Riverside Dr,Box 31, New York, NY 10032 USA. EM wf2004@columbia.edu OI Frankle, William/0000-0003-0356-4197; Talbot, Peter/0000-0003-3492-0801 FU NIMH NIH HHS [5R01 MH-56606, 1-K02 MH-01603-01, 1R01 MH-63875] NR 62 TC 157 Z9 160 U1 6 U2 22 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD MAY PY 2005 VL 162 IS 5 BP 915 EP 923 DI 10.1176/appi.ajp.162.5.915 PG 9 WC Psychiatry SC Psychiatry GA 922JJ UT WOS:000228833100014 PM 15863793 ER PT J AU McConnell, DB O'Rourke, RW Deveney, CW AF McConnell, DB O'Rourke, RW Deveney, CW TI Common channel length predicts outcomes of biliopancreatic diversion alone and with the duodenal switch surgery SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 91st Annual Meeting of the North-Pacific-Surgical-Association CY NOV 12-13, 2004 CL Tacoma, WA SP N Pacific Surg Assoc DE biliopancreatic diversion; biliopancreatic diversion with duodenal switch; common channel ID BILIO-PANCREATIC BYPASS; GASTRIC BYPASS; BARIATRIC SURGERY; MORBID-OBESITY AB Background: The optimal common channel (CC) length for malabsorptive weight loss surgeries is unknown even though these surgeries were developed in the 1970s (biliopancreatic diversion [BPD]) and the 1990s (biliopancreatic diversion with a duodenal switch [BPD DS]). We hypothesized that the length of the CC correlates with a successful weight loss result. Methods: We evaluated 3 groups of patients based on the length of the CC whose duration of follow-up evaluation was at least I year. We reviewed all patients who had either an open BPD (5 patients) or a BPD DS (119 patients) from August 1998 to October 2003, for which D.B.M. was the participating surgeon. Results: Group I comprised 15 patients: their preoperative body mass index (BMI) was 53.9 kg/m(2); 73.3% of patients had a BMI more than 50, and the CC length was 150 cm. Group II comprised 76 patients: their preoperative BMI was 54.25 kg/m(2); 73.3% of patients had a BMI more than 50, and the CC length was 100 cm. Group III comprised 33 patients: their preoperative BMI was 60.1 kg/m(2); 84% of patients had a BMI more than 50, and the CC length was 80 to 90 cm. The mean weight loss in group I was 45 kg (44% mean excess weight loss). The mean weight loss in groups II and III was 55.8 and 61.5 kg, respectively (a 57% and 54.8% mean excess weight loss, respectively) (all P < .05 by analysis of variance). A weight loss of greater than 50% of excess body weight occurred in 40% of patients in group I versus 63% of patients in groups II and III combined (P < .01 by chi(2)). Conclusions: The length of the CC contributes significantly to successful excess weight loss in BPD and BPD DS patients. In general, the length of the CC should not exceed 100 cm. (c) 2005 Excerpta Medica Inc. All rights reserved. C1 Oregon Hlth Sci Univ, Div Gen Surg, Portland VA Med Ctr, Portland, OR 97239 USA. RP McConnell, DB (reprint author), Oregon Hlth Sci Univ, Div Gen Surg, Portland VA Med Ctr, 3710 SW US Vet Hosp Rd,P3GS, Portland, OR 97239 USA. EM mcconnel@ohsu.edu NR 16 TC 15 Z9 15 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD MAY PY 2005 VL 189 IS 5 BP 536 EP 540 DI 10.1016/j.amjsurg.2005.01.023 PG 5 WC Surgery SC Surgery GA 922MV UT WOS:000228842900013 PM 15862492 ER PT J AU Saab, S Ibrahim, AB Shpaner, A Brito, I Fraser, K Marehbian, J Durazo, F Han, S Farmer, DG Ghobrial, RM Holt, C Yersiz, H Goldstein, LI Tong, MJ Busutil, RW AF Saab, S Ibrahim, AB Shpaner, A Brito, I Fraser, K Marehbian, J Durazo, F Han, S Farmer, DG Ghobrial, RM Holt, C Yersiz, H Goldstein, LI Tong, MJ Busutil, RW TI Prevalence and risk factors for diabetes mellitus in liver transplant recipients SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT 6th American Transplant Congress CY MAY 21-25, 2005 CL Seattle, WA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Univ Calif Los Angeles, Dept Med & Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA. W Los Angeles Vet Adm Med Ctr, Dept Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PD MAY PY 2005 VL 5 SU 11 MA 192 BP 205 EP 205 PG 1 WC Surgery; Transplantation SC Surgery; Transplantation GA 927WQ UT WOS:000229231600193 ER PT J AU Ahmad, J Akoad, M Daly, IM Cacciarelli, TV AF Ahmad, J Akoad, M Daly, IM Cacciarelli, TV TI Impact of the model for end-stage liver disease (MELD) score on waiting time and disease severity in US veterans undergoing liver transplantation SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT 6th American Transplant Congress CY MAY 21-25, 2005 CL Seattle, WA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PD MAY PY 2005 VL 5 SU 11 MA 233 BP 215 EP 215 PG 1 WC Surgery; Transplantation SC Surgery; Transplantation GA 927WQ UT WOS:000229231600234 ER PT J AU Ahmad, J Bryce, C Roberts, M Cacciarelli, TV AF Ahmad, J Bryce, C Roberts, M Cacciarelli, TV TI Racial differences in waiting time and model for end-stage liver disease (MELD) scores of liver transplant recipients in the united states. SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT 6th American Transplant Congress CY MAY 21-25, 2005 CL Seattle, WA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Univ Pittsburgh, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA USA. Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PD MAY PY 2005 VL 5 SU 11 MA 430 BP 265 EP 265 PG 1 WC Surgery; Transplantation SC Surgery; Transplantation GA 927WQ UT WOS:000229231600431 ER PT J AU Treff, NR Jacobson, LM Roenneburg, DA Knechtle, SJ Odorico, JS AF Treff, NR Jacobson, LM Roenneburg, DA Knechtle, SJ Odorico, JS TI Molecular markers and signaling pathways of acute pancreatic allograft rejection identified by microarray analysis. SO AMERICAN JOURNAL OF TRANSPLANTATION LA English DT Meeting Abstract CT 6th American Transplant Congress CY MAY 21-25, 2005 CL Seattle, WA SP Amer Soc Transplant Surg, Amer Soc Transplantat C1 Univ Wisconsin, Dept Surg, 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 BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1600-6135 J9 AM J TRANSPLANT JI Am. J. Transplant. PD MAY PY 2005 VL 5 SU 11 MA 924 BP 391 EP 391 PG 1 WC Surgery; Transplantation SC Surgery; Transplantation GA 927WQ UT WOS:000229231601342 ER PT J AU Martin, B Mangum, L Beresford, TP AF Martin, B Mangum, L Beresford, TP TI Use of court-ordered supervised disulfiram therapy at DVA medical centers in the United States SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID ALCOHOL-CONSUMPTION; PROBLEM DRINKING; ABUSE; NONVETERANS; VETERANS AB Having reported high adherence to court-mandated disulfiram treatment, we hypothesized that other Department of Veterans Affairs (DVA) medical centers would report frequent use of this modality. Telephone interviews with DVA substance abuse clinics in 48 of the 50 states matched the national DVA frequencies. Phone survey responders reported disulfiram prescription as never/rarely 63%, sometimes 32%, and often 5%, while court-ordered disulfiram was used never/rarely 95%, sometimes 3%, and often 2%. Nationally, disulfiram prescriptions covered only 0.07% of all veterans seen. These data suggest a need for a re-evaluation of disulfiram as an underused treatment for alcohol dependence. C1 Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver VA Med Ctr, Denver, CO 80220 USA. RP Beresford, TP (reprint author), Denver VA Med Ctr, 1055 Clermont St,116, Denver, CO 80220 USA. EM thomas.beresford@uchsc.edu FU NIAAA NIH HHS [AA12095, AA140010] NR 23 TC 2 Z9 2 U1 2 U2 2 PU ROUTLEDGE TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD MAY-JUN PY 2005 VL 14 IS 3 BP 208 EP 212 DI 10.1080/10550490590949541 PG 5 WC Substance Abuse SC Substance Abuse GA 940EP UT WOS:000230126800002 PM 16019971 ER PT J AU Krahn, DD Bohn, MJ Henk, HJ Grossman, JL Gosnell, B AF Krahn, DD Bohn, MJ Henk, HJ Grossman, JL Gosnell, B TI Patterns of urges during early abstinence in alcohol-dependent subjects SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID TREATED ALCOHOLICS; NALTREXONE; VALIDATION; REACTIVITY; DRINKING AB Urges for alcohol can lead to relapse, but some alcoholics report few urges. We hypothesized that ecological momentary assessment techniques would reveal multiple urge patterns in newly-abstinent alcoholics. Forty-eight alcohol-dependent subjects used PDAs to assess urges to drink in abstinence. Mean and standard deviation of urges were used in cluster analysis, and cluster characteristics were compared. Four clusters were defined, the largest cluster including 29 subjects with low mean urge and low variability. Clusters differed in negative affect and anger but not in abstinence rates. Four distinct urge patterns during abstinence were identified, and 60% of abstinent, alcohol-dependent subjects reported low, stable urge levels. C1 William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. Univ Wisconsin, Dept Psychiat, Madison, WI 53706 USA. Aurora Behav Hlth Ctr, Wauwatosa, WI USA. Neuropsychiat Res Inst, Fargo, ND USA. Univ N Dakota, Sch Med, Dept Neurosci, Fargo, ND USA. RP Krahn, DD (reprint author), William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM dean.krahn@med.va.gov NR 20 TC 12 Z9 12 U1 0 U2 1 PU ROUTLEDGE TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD MAY-JUN PY 2005 VL 14 IS 3 BP 248 EP 255 DI 10.1080/10550490590949424 PG 8 WC Substance Abuse SC Substance Abuse GA 940EP UT WOS:000230126800006 PM 16019975 ER PT J AU Comtois, KA Tisdall, WA Holdcraft, LC Simpson, T AF Comtois, KA Tisdall, WA Holdcraft, LC Simpson, T TI Dual diagnosis: Impact of family history SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID SEVERELY MENTALLY-ILL; SUBSTANCE-ABUSE; ALCOHOLISM; SCHIZOPHRENIA; TRANSMISSION; ILLNESS; COMORBIDITY; OUTPATIENTS; DISORDERS; MORBIDITY AB Psychiatric outpatients with severe and persistent mental illness and a current or past substance use disorder (N = 89) were interviewed. Information from the Family Informant Schedule and Criteria was configured in three ways to capture the degree of familial substance abuse: biological parents only, all first-degree biological relatives, and all caregivers. All three configurations predicted the severity of lifetime drug abuse on the Inventory of Drug Use Consequences, controlling for any gender and non-substance-related Axis I diagnosis. Differences in means represent low to very low substance abuse severity for those without family history and low to medium severity for those with family history. The clinical implications are discussed. C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Comtois, KA (reprint author), Univ Washington, Dept Psychiat & Behav Sci, Box 359911, Seattle, WA 98104 USA. EM comtois@u.washington.edu NR 33 TC 5 Z9 5 U1 1 U2 3 PU ROUTLEDGE TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD MAY-JUN PY 2005 VL 14 IS 3 BP 291 EP 299 DI 10.1080/10550490590949479 PG 9 WC Substance Abuse SC Substance Abuse GA 940EP UT WOS:000230126800010 PM 16019979 ER PT J AU Reavis, KM Chang, EY Hunter, JG Jobe, BA AF Reavis, KM Chang, EY Hunter, JG Jobe, BA TI Utilization of the delay phenomenon improves blood flow and reduces collagen deposition in esophagogastric anastomoses SO ANNALS OF SURGERY LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; INTRATHORACIC ESOPHAGEAL-CARCINOMA; GASTRIC TUBE; COLON INTERPOSITION; CERVICAL ESOPHAGOGASTROSTOMY; VASCULAR ENDOTHELIUM; RISK-FACTORS; RECONSTRUCTION; RAT; ANGIOGENESIS AB Objective: Complications of anastomotic healing are a common source of morbidity and mortality after esophagogastrostomy. The delay phenomenon is seen when a skin flap is partially devascularized in a staged procedure prior to its definitive placement, resulting in increased blood flow at the time of grafting. This effect may be applied to esophagogastrectomy, potentially reducing anastomotic complications. Summary Background Data: The purpose of this investigation was to apply the delay principle to the gastrointestinal tract, investigate mechanisms by which it occurs and examine the effects of delay on anastomotic healing. Methods: Thirty-seven opossums were assigned to Sham (n = 5), Immediate (n 14), and Delay (n = 18) groups. Each underwent laparotomy and measurement of baseline gastric fundus blood flow. The Delay and Immediate animals underwent ligation of the left, right, and short gastric vessels and subsequent measurement of gastric fundus blood flow. The Delay group underwent repeat measurement of blood flow, esophagogastrectomy, gastric tubularization, and esophagogastrostomy 28 days after vessel ligation. The Immediate group completed the procedure immediately after vessel ligation. The anastomoses in both groups were harvested 32 days after esophagogastrostomy. The Sham group underwent blood flow measurement on initial laparotomy, followed by harvesting of esophagogastric junction 60 days later. Sections taken through the anastomoses were examined with trichrome-staining and immunohistochemistry (IHC) for actin. Collagen content of the gastric submucosa 5 mm below the anastomosis was quantified, and preservation of the muscularis propria and muscularis mucosa was determined histologically. Capillary content of the esophagogastric junction was quantified using IHC for vascular endothelium in the Delay and Sham groups. Results: Blood flow decreased by 73% following vessel ligation in Delay and Immediate groups. The Delay group had over 3 times the gastric blood flow of the Immediate group at the time of anastomosis at 16 (interquartile range [IQR] 11-17) versus 5, (IQR 5-6) mL/min/100 g (P = 0.000003). Two Immediate animals developed anastomotic leak and died; the Delay group had no complications. Submucosal collagen content in Sham, Delay, and Immediate groups were 57% (IQR 52-62), 65% (IQR 57-72), and 71% (IQR 60-82), respectively (P = 0.0004). The median distance of full-thickness atrophy of the muscularis propria was 0.10 mm (IQR 0-0.60 mm) in the Delay group and 0.53 mm (IQR 0.03-0.80 mm) in the Immediate group (P = 0.346). Five percent of the Delay group had atrophy of the muscularis mucosa, whereas 19% of Immediate animals had atrophy of this layer (P = 0.023). Compared with the Sham group, all Delay animals developed dilation of the right gastroepiploic artery and vein. A median of 27 (IQR 23-33) capillaries per 20X field was observed in the Sham fundus and 38 (IQR 31-46) in the Delay fandus (P = 0.037). Conclusions: The delay effect is associated with both vasodilation and angiogenesis and results in increased blood flow to the gastric fundus prior to esophagogastric anastomosis. Animals undergoing delayed operations have less anastomotic collagen deposition and ischemic injury than those undergoing immediate resection. Clinical application of the delay effect in patients undergoing esophagogastrectomy may lead to a decreased incidence of leak and stricture formation. C1 Oregon Hlth Sci Univ, Dept Surg, Portland VA Med Ctr, Portland, OR USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, Surg Serv P3GS, POB 1034, Portland, OR 97207 USA. EM jobeb@ohsu.edu FU NCI NIH HHS [R03 CA105959, R03 CA105959-01]; NIDDK NIH HHS [DK066165-01, K23 DK066165] NR 46 TC 36 Z9 37 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD MAY PY 2005 VL 241 IS 5 BP 736 EP 747 DI 10.1097/01.sla.0000160704.50657.32 PG 12 WC Surgery SC Surgery GA 920ID UT WOS:000228681700007 PM 15849509 ER PT J AU Hawn, MT Bian, J Leeth, RR Ritchie, G Allen, N Bland, KI Vickers, SM AF Hawn, MT Bian, J Leeth, RR Ritchie, G Allen, N Bland, KI Vickers, SM TI Impact of obesity on resource utilization for general surgical procedures SO ANNALS OF SURGERY LA English DT Article ID BODY-MASS INDEX; UNITED-STATES; SURGERY; CARE; SHORTAGE; WEIGHT; CANCER AB Objective: To deter-mine the impact of the obesity epidemic on workload for general surgeons. Summary Back-ground Data: In 2001, the prevalence of obesity in the United States reached 26%, more than double the rate in 1990. This study focuses on the impact of obesity on surgical practice and resource utilization. Methods: A retrospective analysis was done on patients undergoing cholecystectomy. unilateral mastectomy, and colectomy from January 2000 to December 2003 at a tertiary care center. The main outcome variables were operative time (OT), length of stay (LOS), and complications. The key independent variable was body mass index. We analyzed the association of obesity status with OT, LOS, and complications for each surgery, using multivariate regression models controlling for surgeon time-invariant characteristics. Results: There were 623 cholecystectomies, 322 unilateral mastectomies, and 430 colectomies suitable for analysis from 2000 to 2003. Multivariable regression analyses indicated that obese patients had statistically significantly longer OT (P < 0.01) but not longer LOS (P > 0.05) or more complications (P > 0.05). Compared with a normal-weight patient.. an obese patient had an additional 5.19 (95% confidence interval [CI], 0.15-10.24), 23.67 (95% Cl, 14.38-32.96), and 21.42 (95% CI, 9.54-33.30) minutes of OT with respect to cholecystectomy.. unilateral mastectomy, and colectomy. These estimates were robust in sensitivity analyses. Conclusions: Obesity significantly increased OT for each procedure studied. These data have implications for health policy and surgical resource utilization. We suggest that a CPT modifier to appropriately reimburse surgeons caring for obese patients be considered. C1 Univ Alabama, Dept Surg, Birmingham, AL USA. Univ Alabama, Dept Med, Birmingham, AL USA. Univ Alabama, Dept Anesthesia, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Hawn, MT (reprint author), 3rd Ave S, Birmingham, AL 35294 USA. EM mhawn@uab.edu NR 31 TC 81 Z9 83 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD MAY PY 2005 VL 241 IS 5 BP 821 EP 828 DI 10.1097/01.sla.0000161044.20857.24 PG 8 WC Surgery SC Surgery GA 920ID UT WOS:000228681700016 PM 15849518 ER PT J AU Ghobrial, IM McCormick, DJ Kaufmann, SH Leontovich, AA Loegering, DA Dai, NT Krajnik, KL Stenson, MJ Melhem, MF Novak, AJ Ansell, SM Witzig, TE AF Ghobrial, IM McCormick, DJ Kaufmann, SH Leontovich, AA Loegering, DA Dai, NT Krajnik, KL Stenson, MJ Melhem, MF Novak, AJ Ansell, SM Witzig, TE TI Proteomic analysis of mantle-cell lyrnphoma by protein microarray SO BLOOD LA English DT Article ID ACTIVATING POLYPEPTIDE-II; MYC-INDUCED LYMPHOMAGENESIS; NON-HODGKINS-LYMPHOMA; BINDING PROTEIN; CANCER CELLS; MDM2; P53; OVEREXPRESSION; REGULATOR; APOPTOSIS AB Mantle-cell lymphoma (MCL) is a unique subtype of B-cell non-Hodgkin lymphoma (NHL) that behaves aggressively and remains incurable. In order to understand the pathogenesis of MCL and design new therapies, it is important to accurately analyze molecular changes in pathways dysregulated in MCL. We used antibody microarrays to compare patterns of protein expression between CD19(+) purified B lymphocytes from normal tonsil and 7 cases of histologically confirmed MCL. Protein overexpression was defined as a higher than 1.3-fold or 2-fold increase in at least 67% of tumor samples compared wit. h normal B-cell control. Of the polypeptides, 77 were overexpressed using the higher than 1.3-fold cutoff, and 13 were overexpressed using the 2-fold cutoff. These included cell cycle regulators (regulator of chromosome condensation 1 [RCC1], murine double minute 2 [MDM2]), a kinase (citron Rho-interacting kinase [CRIK]), chaperone proteins (heat shock 90-kDa protein [Hsp90], Hsp10), and phosphatase regulators (A-kinase anchor protein 1 [AKAP149], protein phosphatase 5 [PP5], and inhibitor 2). The elevated expression of some of these polypeptides was confirmed by immunoblotting and immunohistochemistry, whereas elevated expression of others could not be confirmed, illustrating the importance of confirmatory studies. This study describes a novel technique that identifies proteins dysregulated in MCL. C1 Mayo Clin, Div Hematol, Dept Internal Med, Rochester, MN USA. Mayo Clin, Prote Core Biochem & Mol Biol, Rochester, MN USA. Mayo Clin, Dept Oncol, Rochester, MN USA. Mayo Clin, Dept Pathol, Rochester, MN USA. Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Dept Pathol, Pittsburgh, PA USA. RP Witzig, TE (reprint author), 200 1st St,Stabile 6 Res Bldg, Rochester, MN 55905 USA. EM witzig.thomas@mayo.edu FU NCI NIH HHS [CA15083-29C1, CA97274] NR 37 TC 97 Z9 103 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 MAY 1 PY 2005 VL 105 IS 9 BP 3722 EP 3730 DI 10.1182/blood-2004-10-3999 PG 9 WC Hematology SC Hematology GA 921WX UT WOS:000228797400055 PM 15650054 ER PT J AU Mielcarek, M Burroughs, L Leisenring, W Diaconescu, R Martin, PJ Sandmaier, BM Maloney, DG Maris, MB Chauncey, TR Shizuru, JA Blume, KG Hegenbart, U Niederwieser, D Forman, S Bruno, B Woolfrey, A Storb, R AF Mielcarek, M Burroughs, L Leisenring, W Diaconescu, R Martin, PJ Sandmaier, BM Maloney, DG Maris, MB Chauncey, TR Shizuru, JA Blume, KG Hegenbart, U Niederwieser, D Forman, S Bruno, B Woolfrey, A Storb, R TI Prognostic relevance of 'early-onset' graft-versus-host disease following non-myeloablative haematopoietic cell transplantation SO BRITISH JOURNAL OF HAEMATOLOGY LA English DT Article DE non-myeloablative; transplantation; graft-versus-host disease; prednisone; human leucocyte antigen-matched ID BONE-MARROW-TRANSPLANTATION; NECROSIS-FACTOR-ALPHA; HEMATOLOGIC MALIGNANCIES; HUMAN RECIPIENTS; DONOR; MORTALITY; THERAPY; MORBIDITY; GVHD; CYCLOSPORINE AB We retrospectively analysed outcomes among 395 patients with haematologic malignancies who underwent non-myeloablative haematopoietic cell transplantation ( HCT) from human leucocyte antigen ( HLA)-matched related ( n = 297) or unrelated donors ( n = 98) in order to identify a possible correlation between the time of onset of graft-versus-host disease (GVHD) and survival. The non-myeloablative regimen consisted of 2 Gy total body irradiation with or without fludarabine, followed by postgrafting immunosuppression with mycophenolate mofetil and cyclosporine. The cumulative incidences of grades II-IV acute GVHD and extensive chronic GVHD were 45% and 47%, respectively, with related donors, and 68% and 68%, respectively, with unrelated donors. High-dose corticosteroid treatment for acute or chronic GVHD was started at a median of 79 ( range, 8 - 799) days and 30 ( range, 5 - 333) days after transplantation from related and unrelated donors respectively. With related donors, the cumulative incidence of non-relapse mortality among patients with GVHD was 55% at 4 years when prednisone was started before day 50 ( n = 72), compared with 29% when treatment was started after day 50 ( n = 115) ( P < 0.001). With unrelated donors, time to onset of treatment for GVHD was not associated with survival. Patients with early-onset GVHD after non-myeloablative HCT from HLA-identical related donors might benefit from intensified primary immunosuppressive treatment. C1 Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98109 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA. Univ Washington, Sch Med, Dept Biostat, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Dept Med Oncol, Seattle, WA USA. Stanford Univ, Blood & Marrow Transplant Program, Stanford, CA 94305 USA. Univ Leipzig, Dept Haematol & Oncol, D-7010 Leipzig, Germany. City Hope Natl Med Ctr, Dept Haematol & Haematopoiet Cell Transplanstat, Duarte, CA 91010 USA. Univ Turin, Div Haematol, Turin, Italy. RP Mielcarek, M (reprint author), Fred Hutchinson Canc Res Ctr, Div Clin Res, 1100 Fairview AveN,D1-100, Seattle, WA 98109 USA. EM mmielcar@fhcrc.org FU NCI NIH HHS [CA09515, CA18029, CA92058, CA78902, CA15074, P01 CA078902]; NHLBI NIH HHS [HL36444]; NIDDK NIH HHS [DK064715] NR 37 TC 29 Z9 29 U1 0 U2 0 PU BLACKWELL PUBLISHING LTD PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DG, OXON, ENGLAND SN 0007-1048 J9 BRIT J HAEMATOL JI Br. J. Haematol. PD MAY PY 2005 VL 129 IS 3 BP 381 EP 391 DI 10.1111/j.1365-2141.2005.05458.x PG 11 WC Hematology SC Hematology GA 917SO UT WOS:000228489700011 PM 15842663 ER PT J AU Hussein, MR AF Hussein, MR TI Dendritic cells and melanoma tumorigenesis - An insight SO CANCER BIOLOGY & THERAPY LA English DT Review DE melanoma; lymphocytes; immune system ID COLONY-STIMULATING FACTOR; CYTOTOXIC T-LYMPHOCYTES; HUMAN BLOOD; LANGERHANS CELLS; METASTATIC MELANOMA; IMMUNE-RESPONSES; PERIPHERAL LYMPH; CD1 MOLECULES; B16 MELANOMA; IN-VITRO AB Dendritic cells, a distinct class of leukocytes, are professional antigen-presenting cells. They are characterized by their ability to migrate through tissues where they can take up, process, and present antigens. They can interact with, stimulate, and direct T-lymphocyte responses. As such, they are capable of triggering a primary T cell response. Evidence suggest that DCs can elicit strong antitumor immunity. Melanoma is an aggressive malignancy with a poor prognosis. In these tumors, there is a reduced density of DCs in the epidermal, intratumoral and peritumoral sites. This seems to lead to a defective T-Cell response and ultimately to a poor prognosis in these tumors. Since 1975, more than 806 papers appeared in the literature with melanomas and DCs as keywords. However, in spite of these extensive investigations, a lack of side-by-side analysis of these studies has resulted in tentative conclusions that merely offer a first glimpse at the role of DCs in melanoma. To remedy this issue, this review seeks to examine the background information about DCs including their derivation, morphologic features, functional properties, growth characteristics, and differentiation pathways. This review provides insights into DCs' status in the skin and their roles in melanoma. It also sheds light on the possible use of DCs in melanoma therapy. C1 Assiut Univ, Assiut Univ Hosp, Fac Med, Dept Pathol, Assiut, Egypt. Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Assiut Univ Hosp, Fac Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 51 TC 14 Z9 14 U1 0 U2 1 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD MAY PY 2005 VL 4 IS 5 BP 501 EP 505 PG 5 WC Oncology SC Oncology GA 015IB UT WOS:000235544000013 PM 15917653 ER PT J AU Hussein, MR AF Hussein, MR TI Skin cancer in Egypt - A word in your ear SO CANCER BIOLOGY & THERAPY LA English DT Article DE melanoma; squamous cell carcinoma; basal cell carcinoma ID SQUAMOUS-CELL CARCINOMA; MALIGNANT-MELANOMA; TUMORIGENESIS; AFRICANS AB Background and Objectives: In Egypt, the clinicopathologic features of skin cancer are still unknown. registries of the Pathology Departments, Materials and Methods: To define these features, Assiut and South Valley University Hospitals were reviewed. The lesions included 21 melanomas, 39 squamous cell carcinomas (SCCs), and 202 basal cell carcinomas (BCCs). Results: Skin cancer represented 5% of the malignant tumors of the entire body. BCC (77%) was the most common skin cancer followed by SCC (15%) and melanomas (8%). The mean age was 54 +/- 3 (melanomas), 66 +/- 10 (BCC), and 60 +/- 5.18 (SCC). The most common sites were the face (BCCs), face and extremities (SCCs), and face and lower limbs (melanomas). The average size (mm) was 21 +/- 0.3 (melanomas), 28 +/- 0.3 (BCC) and 30 +/- 1.1 (SCC). Melanomas, BCCs and SCCs were of nodular, keratotic invasive and nodular infiltrative types, respectively. Conclusions: In Egypt, skin cancer is uncommon malignancy. As compared to Western societies, the incidence rate of melanoma is very low and its topographic distribution is different. Alternatively, the rates for SCCs/BCCs are comparably high and their topographic distribution is similar. This is the first investigation that reports the clinicopathologic features of skin cancer in Egypt and compares it to other parts of Africa and Western societies. C1 Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Fac Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 17 TC 6 Z9 6 U1 0 U2 0 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD MAY PY 2005 VL 4 IS 5 BP 593 EP 595 PG 3 WC Oncology SC Oncology GA 015IB UT WOS:000235544000029 PM 15908785 ER PT J AU Huang, R Sacks, J Thai, H Goldman, S Morrison, DA Barbiere, C Ohm, J AF Huang, R Sacks, J Thai, H Goldman, S Morrison, DA Barbiere, C Ohm, J TI Impact of stents and abciximab on survival from cardiogenic shock treated with percutaneous coronary intervention SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE cardiogenic shock; coronary artery disease; myocardial infarction; percutaneous coronary intervention; reperfusion; stents ID ACUTE MYOCARDIAL-INFARCTION; GLYCOPROTEIN-IIB/IIIA BLOCKADE; PLACEBO-CONTROLLED TRIAL; LONG-TERM SURVIVAL; EARLY REVASCULARIZATION; CARDIOPULMONARY BYPASS; ANGIOPLASTY THERAPY; IMPROVES SURVIVAL; MULTICENTER REGISTRY; THROMBOLYTIC THERAPY AB This retrospective observational review compares patient characteristics and in-hospital and long-term outcomes of cohorts of patients undergoing percutaneous coronary intervention (PCI) for cardiogenic shock complicating acute myocardial infarction (MI) prior to the use of stents (as well as glycoprotein IIb/IIIa inhibitor and dual-antiplatelet therapy) with PCI in the stent era. Cardiogenic shock remains the leading cause of hospital mortality from acute MI. This is a report of consecutive patients with cardiogenic shock complicating acute MI, without mechanical complication, referred for emergency catheterization to a single operator at two consecutive Veterans Affairs medical centers over a 15-year period (1988 to August 2003). PCI was attempted in all 93 cases: 44 consecutive patients in the prestent era and 49 consecutive patients in the stent era. Patients with comparable extent of coronary disease, more ST elevation myocardial infarction, multiple areas of infarction, and greater comorbidity underwent PCI in the stent era. Nevertheless, PCI in the stent era was associated with higher rates of acute success and improved in-hospital survival. Kaplan-Meier curves and log-rank testing showed highly significant improvement in overall survival (P < 0.0001). Logistic regression of in-hospital survival demonstrated that stent use (collinear with glycoprotein IIb/IIIa use and dual-antiplatelet therapy) was significantly associated with survival in a model adjusting for extent of coronary disease and comorbidities (P = 0.007). Stents and abciximab have been associated with improved acute angiographic and procedural success of PCI for cardiogenic shock, leading to improved survival. Published 2005 Wiley-Liss, Inc. C1 So Arizona Vet Affairs Healthcare Syst, Cardiac Catheterizat Lab, Cardiovasc Dis Sect, Tucson, AZ 85723 USA. Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA. Hines Vet Affairs Cooperat Studies Program, Coordinating Ctr, Hines, IL USA. Denver Vet Affairs Healthcare Syst, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. RP Morrison, DA (reprint author), So Arizona Vet Affairs Healthcare Syst, Cardiac Catheterizat Lab, Cardiovasc Dis Sect, 3601 S 6th Ave, Tucson, AZ 85723 USA. EM douglass.morrison@med.va.gov NR 59 TC 12 Z9 12 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1522-1946 J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD MAY PY 2005 VL 65 IS 1 BP 25 EP 33 DI 10.1002/ccd.20334 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 921OI UT WOS:000228773700006 PM 15800889 ER PT J AU Aberra, FN Brensinger, CM Bilker, WB Lichtenstein, GR Lewis, JD AF Aberra, FN Brensinger, CM Bilker, WB Lichtenstein, GR Lewis, JD TI Antibiotic use and the risk of flare of inflammatory bowel disease SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID ACTIVE CROHNS-DISEASE; PRACTICE RESEARCH DATABASE; ULCERATIVE-COLITIS; CONTROLLED-TRIAL; DOUBLE-BLIND; METRONIDAZOLE; CIPROFLOXACIN; THERAPY; ACTIVATION; BACTERIA AB Background & Aims: Intestinal microbial flora participate in the pathogenesis of inflammatory bowel disease. Because antibiotic therapy alters intestinal microbial flora, we hypothesized that use of antibiotics might decrease the risk of flare. Methods: We conducted a case-crossover study by using the General Practice Research Database from 1989-1997. Flares of disease were identified by receipt of a new prescription for either corticosteroids or mesalamine medications after an interval of at least 4 months without prescriptions for either class of medication. The primary exposure was receipt of any antibiotics in the 60 days preceding the index date. Results: Among 1205 patients with Crohn's disease, exposure to antibiotics was associated with a reduced risk of flare (adjusted odds ratio [OR], 0.78; 95% confidence interval [CI], 0.64-0.96; P =.019). The effect was strongest with more recent exposure (test for trend, P <.05). Among 2230 patients with ulcerative colitis, use of any antibiotics within 60 days was not associated with flare of disease (adjusted OR, 0.96; 95% Cl, 0.82-1.12; P =.581), although a potentially protective effect was observed in those patients with very recent exposure (exposure within 15 days: OR, 0.66; 95% Cl, 0.51-0.85). Conclusions: Antibiotic use within 60 days was associated with a lower risk of flare of Crohn's disease, but not ulcerative colitis. The strength of the protective effect of antibiotics in Crohn's disease wanes over time. C1 Univ Penn, Sch Med, Div Gastroenterol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Aberra, FN (reprint author), Univ Penn Hlth Syst, Div Gastroenterol, 3rd Floor Ravdin Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. EM Faten.aberra@uphs.upenn.edu RI Research Datalink, Clinical Practice/H-2477-2013 FU AHRQ HHS [U18-HS10399]; NIDDK NIH HHS [K08-DK02589] NR 36 TC 22 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 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD MAY PY 2005 VL 3 IS 5 BP 459 EP 465 DI 10.1053/S1542-3565(05)00020-0 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 995MV UT WOS:000234105300009 PM 15880315 ER PT J AU Subramanian, S Tovey, M Afentoulis, M Krogstad, A Vandenbark, AA Offner, H AF Subramanian, S Tovey, M Afentoulis, M Krogstad, A Vandenbark, AA Offner, H TI Ethinyl estradiol treats collagen-induced arthritis in DBA/1LacJ mice by inhibiting the production of TNF-alpha and IL-1 beta SO CLINICAL IMMUNOLOGY LA English DT Article DE collagen-induced arthritis; ethinyl estradiol; oral therapy; cytokines; regulation of T cells and antibodies ID TUMOR-NECROSIS-FACTOR; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; BONE-RESORPTION; RHEUMATOID-ARTHRITIS; INDUCED SUPPRESSION; ESTROGEN-RECEPTORS; TRANSGENIC MICE; IN-VIVO; PREGNANCY; 17-BETA-ESTRADIOL AB We previously demonstrated the therapeutic effects of ethinyl estradiol (EE), an orally active estrogen and a component of birth control pills, in encephalitogenic autoimmune encephalomyelitis (EAE). In this study, we report the effectiveness of EE in treating collagen-induced arthritis (CIA) induced with bovine type II collagen (bCII) in DBA/1 LacJ mice, a CIA susceptible strain. Both low and high doses of EE notably suppressed clinical and histological signs of CIA in a dose-dependent manner compared to vehicle-treated controls. Oral treatment with EE decreased proliferation and secretion of pro-inflammatory factors, TNF-α IFN-γ, MCP-1 and IL-6 by bCII peptide-specific T cells, production of bCII-specific IgG2a antibodies, and mRNA for cytokines, chemokines and chemokine receptors in joint tissue. This is the first report demonstrating effective treatment of joint inflammation and clinical signs of CIA with orally administered ethinyl estradiol, thus supporting its possible clinical use for treating rheumatoid arthritis in humans. © 2005 Elsevier Inc. All rights reserved. C1 Vet Affairs Med Ctr, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. Univ Missouri, Dept Vet Pathobiol, Columbia, MO 65211 USA. RP Offner, H (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU NIAID NIH HHS [AI 42376]; NINDS NIH HHS [NS 23444, NS 23221] NR 41 TC 20 Z9 22 U1 0 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD MAY PY 2005 VL 115 IS 2 BP 162 EP 172 DI 10.1016/j.clim.2005.01.006 PG 11 WC Immunology SC Immunology GA 927DR UT WOS:000229173100009 PM 15885639 ER PT J AU Klein, HA DiSibio, KJ Sims, D Singleton, HC Worthy, LJ AF Klein, HA DiSibio, KJ Sims, D Singleton, HC Worthy, LJ TI I-123 whole body scanning: case report and discussion SO CLINICAL NUCLEAR MEDICINE LA English DT Article DE thyroid carcinoma; thyroid stunning; I-131; I-123; scintigraphy ID DIFFERENTIATED THYROID-CANCER; RADIOIODINE SCANS; DIAGNOSTIC I-131; DOSE I-131; FOLLOW-UP; CARCINOMA; THERAPY; SCINTIGRAPHY; ABLATION; REMNANTS AB Purpose: In managing differentiated thyroid carcinoma, concern over the stunning that may occur with traditional whole body imaging using I-131 has fostered an interest in using I-123 for this purpose. A case is presented as a focus for discussion of the issues, with special reference to accuracy and the effect thereon of technical factors. Case Report: A 43-year-old man with papillary carcinoma of the thyroid was scanned after thyroidectomy using 10 mCi I-123. Images at 24 and 48 hours demonstrated foci including multiple regional metastases. They were less well demonstrated in images 7 days after therapeutic I-131, and negative imaging I year later implied therapeutic success. Discussion: I-131 has the advantages of a longer half-life, facilitating delayed imaging and lower price. I-123 has the advantages of favorable gamma-ray energy and less useless radiation to thyroid tissue and the whole body. Despite its short half-life, with a sufficient amount, images at 48 hours are practical. In the case presented, there are several possible reasons why superior lesion detection occurred in diagnostic I-123 images. In any case, the outcome demonstrates that I-131 posttherapy images are not an absolute "gold standard" for accuracy. Investigations comparing I-123 with I-131 imaging have been subject to biases, including insufficient dose of I-123, lack of delayed I-123 imaging, suboptimal collimation for I-131, and the relatively high dose of I-131 in posttherapy scanning. Conclusions: The evidence, although not definitive, strongly suggests that I-123 is at least as accurate for diagnostic whole body imaging as I-131. C1 Vet Affairs Pittsburgh Healthcare Syst, Nucl Med Program, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Radiol, Pittsburgh, PA USA. RP Klein, HA (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Nucl Med Program, Univ Dr, Pittsburgh, PA 15240 USA. EM herbert.klein@med.va.gov NR 30 TC 8 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD MAY PY 2005 VL 30 IS 5 BP 312 EP 316 DI 10.1097/01.rlu.0000159526.99677.ed PG 5 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 918UT UT WOS:000228573800004 PM 15827398 ER PT J AU Deschamps, AM Spinale, FG AF Deschamps, AM Spinale, FG TI Matrix modulation and heart failure: new concepts question old beliefs SO CURRENT OPINION IN CARDIOLOGY LA English DT Review DE extracellular matrix; matrix metalloproteinase; myocardial remodeling ID ACUTE MYOCARDIAL-INFARCTION; IDIOPATHIC DILATED CARDIOMYOPATHY; METALLOPROTEINASE INHIBITION; MATRICELLULAR PROTEINS; CARDIAC-HYPERTROPHY; TISSUE INHIBITOR; ANGIOTENSIN-II; COLLAGEN; MATRIX-METALLOPROTEINASE-9; OSTEOPONTIN AB Purpose of review Myocardial remodeling is a complex process involving several molecular and cellular factors. Extracellular matrix has been implicated in the remodeling process. Historically, the myocardial extracellular matrix was thought to serve solely as a means to align cells and provide structure to the tissue. Although this is one of its important functions, evidence suggests that the extracellular matrix plays a complex and divergent role in influencing cell behavior. This paper characterizes some of the notable studies on this dynamic entity and on adverse myocardial remodeling that have been published over the past year, which further question the belief that the extracellular matrix is a static structure. Recent findings Progress has been made in understanding how the extracellular matrix is operative in the three major conditions (myocardial infarction, left ventricular hypertrophy due to overload, and dilated cardiomyopathy) that involve myocardial remodeling. Several studies have examined plasma profiles of matrix metalloproteinases and tissue inhibitors of matrix metalloproteinases following myocardial infarction and during left ventricular hypertrophy as surrogate markers of remodeling/remodeled myocardium. It has been demonstrated that bioactive signaling molecules and growth factors, proteases, and structural proteins influence cell-matrix interactions in the context of left ventricular hypertrophy. Finally, studies that either removed or added tissue inhibitor of metalloproteinases species in the myocardium demonstrated the importance of this regulatory protein in the remodeling process. Summary Understanding the cellular and molecular triggers that in turn give rise to changes in the extracellular matrix could provide opportunities to modify the remodeling process. C1 Med Univ S Carolina, Div Cardiothorac Surg, Charleston, SC 29403 USA. Ralph H Johnson Vet Assoc Med Ctr, Charleston, SC USA. RP Deschamps, AM (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, 114 Doughty St,Room 625,Strom Thurmond Res Bldg, Charleston, SC 29403 USA. EM wilburnm@musc.edu OI Deschamps, Anne/0000-0001-7415-1408 NR 35 TC 20 Z9 25 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0268-4705 J9 CURR OPIN CARDIOL JI Curr. Opin. Cardiol. PD MAY PY 2005 VL 20 IS 3 BP 211 EP 216 DI 10.1097/01.hco.0000162397.44843.83 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 927XJ UT WOS:000229233500006 PM 15861009 ER PT J AU Porte, D Baskin, DG Schwartz, MW AF Porte, D Baskin, DG Schwartz, MW TI Perspectives in diabetes - Insulin signaling in the central nervous system - A critical role in metabolic homeostasis and disease from C-elegans to humans SO DIABETES LA English DT Review ID BETA-CELL FUNCTION; HYPOTHALAMIC ARCUATE NUCLEUS; TRANSCRIPTION FACTOR FOXO1; MESSENGER-RNA EXPRESSION; RAT HIPPOCAMPAL-NEURONS; JAPANESE-AMERICAN MEN; SNELL DWARF MOUSE; ATP-SENSITIVE K+; FOOD-INTAKE; BODY-WEIGHT AB Insulin and its signaling systems are implicated in both central and peripheral mechanisms governing the ingestion, distribution, metabolism, and storage of nutrients in organisms ranging from worms to humans. Input from the environment regarding the availability and type of nutrients is sensed and integrated with humoral information (provided in part by insulin) regarding the sufficiency of body fat stores. In response to these afferent inputs, neuronal pathways are activated that influence energy flux and nutrient metabolism in the body and ensure reproductive competency. Growing evidence supports the hypothesis that reduced central nervous system insulin signaling from either defective secretion or action contributes to the pathogenesis of common metabolic disorders, including diabetes and obesity, and may therefore help to explain the close association between these two disorders. These considerations implicate insulin action in the brain, an organ previously considered to be insulin independent, as a key determinant of both glucose and energy homeostasis. C1 VA San Diego Hlth Care Syst, La Jolla, CA 92161 USA. Univ Calif San Diego, Div Metab Diabet & Endocrinol, San Diego, CA 92103 USA. Univ Washington, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Harborview Med Ctr, Seattle, WA USA. RP Porte, D (reprint author), VA San Diego Hlth Care Syst, 3350 La Jolla Village Dr, La Jolla, CA 92161 USA. EM dporte@ucsd.edu RI Schwartz, Michael/H-9950-2012 FU NIDDK NIH HHS [DK12829, DK035816, DK17046, DK52989]; NINDS NIH HHS [NS32273] NR 111 TC 168 Z9 173 U1 5 U2 20 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD MAY PY 2005 VL 54 IS 5 BP 1264 EP 1276 DI 10.2337/diabetes.54.5.1264 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 920OW UT WOS:000228701000002 PM 15855309 ER PT J AU Retnakaran, R Hanley, A Raif, N Hirning, C Connelly, P Sermer, M Kahn, S Zinman, B AF Retnakaran, R Hanley, A Raif, N Hirning, C Connelly, P Sermer, M Kahn, S Zinman, B TI Adiponectin and beta cell dysfunction in gestational diabetes: pathophysiological implications SO DIABETOLOGIA LA English DT Article DE Adiponectin; Beta cell dysfunction; Gestational diabetes; Insulin secretion-sensitivity index ID ORAL GLUCOSE-TOLERANCE; ADIPOSE-SPECIFIC PROTEIN; INSULIN SENSITIVITY; PLASMA ADIPONECTIN; RESISTANCE; SECRETION; MELLITUS; OBESITY; PATHOGENESIS; INDEXES AB Aims/hypothesis: Gestational diabetes mellitus (GDM) identifies a population of young women at high risk of developing type 2 diabetes and thus provides an excellent model for studying early events in the natural history of this disease. Adiponectin, a novel adipocyte-derived protein with insulin-sensitising properties, has been proposed as a factor linking insulin resistance and beta cell dysfunction in the pathogenesis of type 2 diabetes. We conducted the current investigation to determine whether adiponectin is associated with beta cell dysfunction in GDM. Methods: We studied 180 women undergoing OGTT in late pregnancy. Based on the OGTT results, participants were stratified into three groups: (1) NGT (n = 93); (2) IGT (n = 39); and (3) GDM (n = 48). First-phase insulin secretion was determined using a validated index previously proposed by Stumvoll. Insulin sensitivity was assessed using the validated OGTT insulin sensitivity index of Matsuda and DeFronzo (ISOGTT). Results: To evaluate beta cell function in relation to ambient insulin sensitivity, an insulin secretion-sensitivity index (ISSI) was derived from the product of the Stumvoll index and the ISOGTT, based on the existence of the predicted hyperbolic relationship between these two measures. Mean ISSI was highest in the NGT group (6,731), followed by that in the IGT group (4,976) and then that in the GDM group (3,300) (overall p < 0.0001), compatible with the notion of declining beta cell function across these glucose tolerance groups. Importantly, adiponectin was significantly correlated with ISSI (r = 0.34, p < 0.0001), with a stepwise increase in mean ISSI observed per tertile of adiponectin concentration (trend p < 0.0001). In multivariate linear regression analysis, ISSI was positively correlated with adiponectin and negatively correlated with GDM, IGT and C-reactive protein (r(2) = 0.54). Conclusions/interpretation: Adiponectin concentration is an independent correlate of beta cell function in late pregnancy. As such, adiponectin may play a key role in mediating insulin resistance and beta cell dysfunction in the pathogenesis of diabetes. C1 Mt Sinai Hosp, Leadership Sinai Ctr Diabet, Toronto, ON M5G 1X5, Canada. Univ Toronto, Div Endocrinol, Toronto, ON, Canada. Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada. St Michaels Hosp, J Alick Little Lipid Res Lab, Toronto, ON M5B 1W8, Canada. Mt Sinai Hosp, Div Obstet & Gynecol, Toronto, ON, Canada. Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98195 USA. Univ Washington, Seattle, WA 98195 USA. RP Zinman, B (reprint author), Mt Sinai Hosp, Leadership Sinai Ctr Diabet, Lebov Bldg,Room L5-024,600 Univ Ave, Toronto, ON M5G 1X5, Canada. EM zinman@mshri.on.ca RI Connelly, Philip/B-7583-2012; Zinman, Bernard/E-7266-2013; Retnakaran, Ravi/P-2002-2015 OI Connelly, Philip/0000-0001-7244-6843; Retnakaran, Ravi/0000-0003-1989-027X; Kahn, Steven/0000-0001-7307-9002 FU NIDDK NIH HHS [DK 02654] NR 45 TC 88 Z9 102 U1 1 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD MAY PY 2005 VL 48 IS 5 BP 993 EP 1001 DI 10.1007/s00125-005-1710-x PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 926AN UT WOS:000229095200026 PM 15778860 ER PT J AU Oh, DS Ohning, GV Pisegna, JR AF Oh, DS Ohning, GV Pisegna, JR TI Rabeprazole controls GERD symptoms in a patient for whom treatment with lansoprazole failed: First report of "cluster GERD" SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE gastroesophageal reflux disease; proton pump inhibitor; gastric acid secretion ID GASTROESOPHAGEAL-REFLUX DISEASE; PROTON PUMP INHIBITOR; GASTRIC-ACID-SECRETION C1 Vet Adm Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, CURE VA UCLA Digest Dis Res Ctr, Div Digest Dis, Los Angeles, CA 90073 USA. RP Pisegna, JR (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, 111C,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 14 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 MAY PY 2005 VL 50 IS 5 BP 853 EP 857 DI 10.1007/s10620-005-2652-3 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 923AB UT WOS:000228879900010 PM 15912621 ER PT J AU Finegold, SM Song, Y Liu, C Hecht, DW Summanen, P Kononen, E Allen, SD AF Finegold, SM Song, Y Liu, C Hecht, DW Summanen, P Kononen, E Allen, SD TI Clostridium clostridioforme: a mixture of three clinically important species SO EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES LA English DT Article ID IN-VITRO ACTIVITIES; GEMIFLOXACIN SB 265805; ANAEROBIC-BACTERIA; SP NOV.; HATHEWAYI; MICROFLORA; INFECTION; PATIENT; OSTEOMYELITIS; QUANTITATION AB Clostridium clostridioforme shows much variability in phenotypic and antimicrobial susceptibility tests, suggesting it may be more than a single species even though all strains share unique morphology. This study was designed to determine if there are multiple species and, if so, to demonstrate the differences that exist between them. A total of 107 strains of C. clostridioforme were investigated by sequencing of the 16S rRNA gene, phenotypic studies, and antimicrobial susceptibility testing. In addition, clinical data from patients whose infections yielded an organism identified as C. clostridioforme was reviewed. Data from the above studies revealed three principal species in what has been called C. clostridioforme: Clostridium bolteae, C. clostridioforme, and Clostridium hathewayi. Each species may be distinguished by certain phenotypic tests. All three species were involved in infections, including bacteremia. C. clostridioforme appears to be associated with more serious or invasive human infections than the other two species in the group. Resistance to penicillin G is common and is due to β-lactamase production. Resistance to clindamycin and moxifloxacin is also seen. The three species differ in terms of virulence and antimicrobial resistance. "C. clostridioforme" actually represents three distinct species that are different in terms of 16S rRNA sequences, phenotypic characteristics, and antimicrobial susceptibility. It is important for microbiology laboratories to distinguish between these species and for clinicians to be aware of the differences between them. C1 W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111 F, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111 F, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Res Serv, Los Angeles, CA 90073 USA. Loyola Univ, Med Ctr, Dept Med, Div Infect Dis, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Microbiol & Immunol, Chicago, IL 60611 USA. Hines VA Hosp, Infect Dis Sect, Chicago, IL USA. Natl Publ Hlth Inst KTL, Dept Microbiol, Anaerobe Reference Lab, Helsinki 00300, Finland. Indiana Univ, Med Ctr, Indiana Univ Hosp, Dept Pathol & Lab Med,Div Clin Microbiol, Indianapolis, IN 46202 USA. Roudebush VA Hosp, Clin Microbiol Lab, Indianapolis, IN USA. Methodist IU Riley Hosp, Clarian Hlth Partners, Indianapolis, IN USA. RP Finegold, SM (reprint author), W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111 F, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sidfinegol@aol.com NR 41 TC 27 Z9 28 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0934-9723 J9 EUR J CLIN MICROBIOL JI Eur. J. Clin. Microbiol. Infect. Dis. PD MAY PY 2005 VL 24 IS 5 BP 319 EP 324 DI 10.1007/s10096-005-1334-6 PG 6 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 932TX UT WOS:000229577500003 PM 15891914 ER PT J AU Gralnek, IM AF Gralnek, IM TI Obscure-overt gastrointestinal bleeding SO GASTROENTEROLOGY LA English DT Article ID WIRELESS CAPSULE ENDOSCOPY; PUSH ENTEROSCOPY; THERAPEUTIC IMPACT; DIAGNOSTIC YIELD; ORIGIN; OCCULT C1 Univ Calif Los Angeles, Daivd Geffen Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Study Digest Healthcare Qual & Outcomes, Los Angeles, CA USA. RP Gralnek, IM (reprint author), 11301 Wilshire Blvd,CURE Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM igralnek@mednet.ucla.edu NR 21 TC 23 Z9 28 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD MAY PY 2005 VL 128 IS 5 BP 1424 EP 1430 DI 10.1053/j.gastro.2005.03.067 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 926NP UT WOS:000229130200028 PM 15887123 ER PT J AU Magruder, KM Frueh, BC Knapp, RG Davis, L Hamner, MB Martin, RH Gold, PB Arana, GW AF Magruder, KM Frueh, BC Knapp, RG Davis, L Hamner, MB Martin, RH Gold, PB Arana, GW TI Prevalence of posttraumatic stress disorder in veterans affairs primary care clinics SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE posttraumatic stress disorder; prevalence; VA primary care clinics; DSM-IV; CAPS ID NEUROPSYCHIATRIC INTERVIEW MINI; GULF-WAR VETERANS; MENTAL-HEALTH TREATMENT; SUBSTANCE USE DISORDERS; VIETNAM VETERANS; PSYCHOMETRIC PROPERTIES; NATIONAL SAMPLE; PTSD CHECKLIST; COMBAT; RELIABILITY AB Although posttraumatic stress disorder (PTSD) is relatively common in community epidemiologic surveys (5-6% for men, 10-12% for women), and psychiatric patients with PTSD are known to have poor functioning and high levels of psychiatric comorbidity, there are no studies that address PTSD prevalence, functioning, and burden in primary care settings. This article reports on (1) the prevalence of PTSD using Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnostic criteria in Veterans Affairs (VA) primary care settings, (2) associated sociodemographic characteristics and comorbidities, (3) functional status related to PTSD, (4) the extent to which PTSD was recognized by providers and (5) health services use patterns (including specialty mental health) of PTSD patients. Patients were randomly selected from those who had an outpatient visit in FY 1999 at one of four VA hospitals; 888 patients consented (74.1% of 1198 contacted); 746 patients (84.0% of consenting patients; 62.3% of contacted patients) were reached for telephone diagnostic interviews. Diagnostic interviews with the Clinician Administered PTSD Scale yielded estimates of current PTSD prevalence of 11.5%. At statistically significant levels, PTSD was positively associated with a variety of comorbid psychiatric disorders, war zone service, age < 65 years, not working, less formal education and decreased functioning. Of patients diagnosed with PTSD by study procedures, 12-month medical record review indicated that providers identified only 46.5% and only 47.7% had used mental health specialty services. PTSD-positive [PTSD(+)] patients who used mental health care in the past 12 months were more apt to be identified as having PTSD than nonmental health service users (78.0% vs. 17.8%). Although PTSD(+) patients had more medical record diagnoses than PTSD-negative [PTSD(-)] patients (6.28 vs. 4.95), their use of primary care, urgent care and inpatient care was not different from PTSD(-) patients. (c) 2005 Elsevier Inc. All rights reserved. C1 Ralph H Johnson Vet Affairs Med Ctr, Mental Hlth Serv 116, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. Vet Affairs Med Ctr, Tuscaloosa, AL 35404 USA. Vet Adm Med Ctr, Birmingham, AL 35233 USA. RP Magruder, KM (reprint author), Ralph H Johnson Vet Affairs Med Ctr, Mental Hlth Serv 116, 109 Bee St, Charleston, SC 29401 USA. EM magrudkm@musc.edu NR 57 TC 134 Z9 135 U1 3 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD MAY-JUN PY 2005 VL 27 IS 3 BP 169 EP 179 DI 10.1016/j.genhosppsych.2004.11.001 PG 11 WC Psychiatry SC Psychiatry GA 930HW UT WOS:000229407500004 PM 15882763 ER PT J AU Saito, H Yamaoka, Y Ishizone, S Maruta, F Sugiyama, A Graham, DY Yamauchi, K Ota, H Miyagawa, S AF Saito, H Yamaoka, Y Ishizone, S Maruta, F Sugiyama, A Graham, DY Yamauchi, K Ota, H Miyagawa, S TI Roles of virD4 and cagG genes in the cag pathogenicity island of Helicobacter pylori using a Mongolian gerbil model SO GUT LA English DT Article ID GASTRIC EPITHELIAL-CELLS; CLINICAL PRESENTATION; IV SECRETION; VIRULENCE FACTORS; DUODENAL-ULCER; ACID SECRETION; HOST-CELLS; INFECTION; TRANSLOCATION; INTERLEUKIN-8 AB Background and Aims: The roles of the virD4 and the cagG genes in the cag pathogenicity island of Helicobacter pylori for gastroduodenal pathogenesis are unclear and their roles in vivo have not been examined. \ Methods: Seven week old male Mongolian gerbils were inoculated with the wild type H pylori TN2GF4, its isogenic virD4, or cagG mutants. Animals were sacrificed at 4, 12, and 24 weeks after inoculation. Gastric inflammation and H pylori density were evaluated by histology, inflammatory response (as measured by interleukin (IL)-1 beta mRNA levels), proliferative activity (as assessed by 5'-bromo-2'-deoxyuridine labelling indices), and host systemic reaction (as measured by anti-H pylori IgG antibody). Results: Degree of gastric inflammation, proliferative activity, and mucosal IL-1 beta mRNA levels remained low throughout the first 12 weeks in gerbils infected with the virD4 mutants. Degree of gastric inflammation and proliferative activity increased at 24 weeks with the virD4 mutants reaching levels comparative with those seen at four weeks with the wild-type strains. Mucosal IL-1 beta mRNA levels were also increased at 24 weeks with the virD4 mutants and levels at 24 weeks were similar between the wild-type and virD4 mutants. In contrast, gerbils infected with the cagG mutants had reduced ability to colonise gerbils, and no or little gastric inflammation or proliferative activity was observed. Conclusions: Loss of the virD4 gene temporally retarded but did not abrogate gastric inflammation. Loss of the cagG gene abolished gastric inflammation partially via reduced ability to colonise gerbils. Unknown factors related to the type IV secretion system other than CagA may influence gastric inflammation. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Shinshu Univ, Sch Med, Dept Surg, Nagano, Japan. Baylor Coll Med, Houston, TX 77030 USA. Shinshu Univ Hosp, Dept Lab Med, Sch Hlth Sci, Nagano, Japan. Shinshu Univ Hosp, Dept Biomed Lab Sci, Sch Hlth Sci, Nagano, Japan. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, 111D,Rm 3A-320,200 Holcombe Blvd, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu FU NIDDK NIH HHS [R01 DK062813, R01 DK62813, R01 DK062813-03] NR 37 TC 11 Z9 12 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD MAY PY 2005 VL 54 IS 5 BP 584 EP 590 DI 10.1136/gut.2004.058982 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 916MB UT WOS:000228388100006 PM 15831899 ER PT J AU Dent, J El-Serag, HB Wallander, MA Johansson, S AF Dent, J El-Serag, HB Wallander, MA Johansson, S TI Epidemiology of gastrooesophageal reflux disease: A systematic review SO GUT LA English DT Review ID IRRITABLE-BOWEL-SYNDROME; RISK-FACTORS; BARRETTS-ESOPHAGUS; NATURAL-HISTORY; GASTROINTESTINAL SYMPTOMS; EROSIVE ESOPHAGITIS; CHINESE POPULATION; CLINICAL SPECTRUM; ELDERLY-PATIENTS; GENERAL-PRACTICE AB A systematic review of the epidemiology of gastro-oesophageal reflux disease (GORD) has been performed, applying strict criteria for quality of studies and the disease definition used. The prevalence and incidence of GORD was estimated from 15 studies which defined GORD as at least weekly heartburn and/or acid regurgitation and met criteria concerning sample size, response rate, and recall period. Data on factors associated with GORD were also evaluated. An approximate prevalence of 10-20% was identified for GORD, defined by at least weekly heartburn and/or acid regurgitation in the Western world while in Asia this was lower, at less than 5%. The incidence in the Western world was approximately 5 per 1000 person years. A number of potential risk factors (for example, an immediate family history and obesity) and comorbidities (for example, respiratory diseases and chest pain) associated with GORD were identified. Data reported in this systematic review can be interpreted with confidence as reflecting the epidemiology of "true'' GORD. The disease is more common in the Western world than in Asia, and the low rate of incidence relative to prevalence reflects its chronicity. The small number of studies eligible for inclusion in this review highlights the need for global consensus on a symptom based definition of GORD. C1 Royal Adelaide Hosp, Dept Gastroenterol Hepatol & Gen Med, Adelaide, SA 5000, Australia. Houston Vet Affairs Med Ctr 152, Gastroenterol Sect, Houston, TX USA. AstraZeneca R&D Molndal, SE-43183 Molndal, Sweden. RP Dent, J (reprint author), Royal Adelaide Hosp, Dept Gastroenterol Hepatol & Gen Med, Level 7,N Wing,N Terrace, Adelaide, SA 5000, Australia. EM jdent@mail.rah.sa.gov.au NR 55 TC 875 Z9 927 U1 2 U2 40 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD MAY PY 2005 VL 54 IS 5 BP 710 EP 717 DI 10.1136/gut.2004.051821 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 916MB UT WOS:000228388100028 PM 15831922 ER PT J AU Meredith, CW Jaffe, C Ang-Lee, K Saxon, AJ AF Meredith, CW Jaffe, C Ang-Lee, K Saxon, AJ TI Implications of chronic methamphetamine use: A literature review SO HARVARD REVIEW OF PSYCHIATRY LA English DT Review DE amphetamine; catecholamine; cognition; dopamine; methamphetamine; neurobiology; neuropsychology; neurotoxicity syndromes ID DEFICIT HYPERACTIVITY DISORDER; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; TYROSINE-HYDROXYLASE ACTIVITY; IDIOPATHIC PARKINSONS-DISEASE; POSITRON-EMISSION-TOMOGRAPHY; DISMUTASE TRANSGENIC MICE; ILLICIT AMPHETAMINE USERS; AGE-DEPENDENT DECLINE; DOPAMINE UPTAKE SITES; GAMMA-VINYL GABA AB Methamphetamine (MA) abuse is increasing to epidemic proportions, both nationally and globally. Chronic MA use has been linked to significant impairments in different arenas of neuropsychological function. To better understand this issue, a computerized literature search (PubMed, 1964-2004) was used to collect research studies examining the neurobiological and neuropsychiatric consequences of chronic MA use. Availability of MA has markedly increased in the United States due to recent technological improvements in both mass production and clandestine synthesis, leading to significant public health, legal, and environmental problems. MA intoxication has been associated with significant psychiatric and medical comorbidity. Research in animal models and human subjects reveals complicated mechanisms of neurotoxicity by which chronic MA use affects catecholamine neuro-transmission. This pathology may underlie the characteristic cognitive deficits that plague chronic MA users, who experience impairments in memory and learning, psychomotor speed, and information processing. These impairments have the potential to compromise, in turn, the ability of MA abusers to engage in, and benefit from, psychosocially based chemical-dependency treatment. Development of pharmacological interventions to improve these cognitive impairments in this population may significantly improve the degree to which they may be able to participate in treatment. Atypical antipsychotics may have some promise in this regard. C1 Univ Washington, Dept Psychiat & Behav Sci, VA Puget Sound Hlth Care Syst S116 ATC, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA USA. RP Meredith, CW (reprint author), Univ Washington, Dept Psychiat & Behav Sci, VA Puget Sound Hlth Care Syst S116 ATC, 1160 S Columbian Way, Seattle, WA 98195 USA. EM cwmeredi@u.washington.edu NR 198 TC 161 Z9 165 U1 10 U2 34 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1067-3229 J9 HARVARD REV PSYCHIAT JI Harv. Rev. Psychiatr. PD MAY-JUN PY 2005 VL 13 IS 3 BP 141 EP 154 DI 10.1080/10673220591003605 PG 14 WC Psychiatry SC Psychiatry GA 944IP UT WOS:000230421000002 PM 16020027 ER PT J AU Haidet, P Osorio, G AF Haidet, P Osorio, G TI You gotta draw the line somewhere SO HEALTH AFFAIRS LA English DT Editorial Material C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Haidet, P (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. EM phaidet@bcm.tmc.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD MAY-JUN PY 2005 VL 24 IS 3 BP 811 EP 816 DI 10.1377/hlthaff.24.3.811 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 924YK UT WOS:000229017000030 PM 15886176 ER PT J AU Lazzarini, L Lipsky, BA Mader, JT AF Lazzarini, L Lipsky, BA Mader, JT TI Antibiotic treatment of osteomyelitis: what have we learned from 30 years of clinical trials? SO INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES LA English DT Review DE osteomyelitis; infection; bone; antibiotic; therapy; treatment ID GRAM-NEGATIVE BACILLI; ORAL CIPROFLOXACIN THERAPY; PLUS CLAVULANIC ACID; SOFT-TISSUE INFECTIONS; JOINT INFECTIONS; PSEUDOMONAS-AERUGINOSA; SEPTIC ARTHRITIS; STAPHYLOCOCCUS-AUREUS; BACTERIAL-INFECTIONS; SKELETAL INFECTIONS AB Objectives and design: To determine the most appropriate approach to antibiotic therapy for osteomyelitis, the medical literature for articles published from 1968 to 2000 was reviewed. Results: Ninety-three clinical trials in children and adults were identified using almost every antibiotic class. Most studies were non-comparative and the comparative trials involved relatively few patients. Publications generally did not provide clinically important information regarding infection staging or classification, surgical treatment provided, or the presence of orthopedic hardware. The median duration of follow-up after treatment was only 12 months. The clinical outcome was better for acute than chronic osteomyelitis in eight of the 12 studies allowing comparison. In the comparative trials, few statistically significant differences were observed between the tested treatments. In one small trial, the combination of nafcillin plus rifampin was more effective than nafcillin alone. In pediatric osteomyelitis, oral therapy with cloxacillin was more effective than tetracycline in one study, and oral clindamycin was as effective as parenteral. antistaphylococcal penicillins in another. In several investigations oral. fluoroquinolones were as effective as standard parenteral treatments. Conclusions: Although the optimal duration of antibiotic therapy remains undefined, most investigators treated patients for about six weeks. Despite three decades of research, the available Literature on the treatment of osteomyelitis is inadequate to determine the best agent(s), route, or duration of antibiotic therapy. © 2005 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved. C1 S Bortolo Hosp, Dept Infect Dis & Trop Med, I-36100 Vicenza, Italy. VA Puget Sound Hlth Care Syst, Med Serv, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Antibiot Res Clin, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Texas, Med Branch, Galveston, TX USA. RP Lazzarini, L (reprint author), S Bortolo Hosp, Dept Infect Dis & Trop Med, I-36100 Vicenza, Italy. EM luca.lazzarini@ulssvicenza.it OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 107 TC 134 Z9 140 U1 4 U2 16 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1201-9712 J9 INT J INFECT DIS JI Int. J. Infect. Dis. PD MAY PY 2005 VL 9 IS 3 BP 127 EP 138 DI 10.1016/j.ijid.2004.09.009 PG 12 WC Infectious Diseases SC Infectious Diseases GA 925SQ UT WOS:000229074000005 PM 15840453 ER PT J AU Fung, MT Raine, A Loeber, R Lynam, DR Steinhauer, SR Venables, PH Stouthamer-Loeber, M AF Fung, MT Raine, A Loeber, R Lynam, DR Steinhauer, SR Venables, PH Stouthamer-Loeber, M TI Reduced electrodermal activity in psychopathy-prone adolescents SO JOURNAL OF ABNORMAL PSYCHOLOGY LA English DT Article ID FLEDGLING PSYCHOPATH; ANTISOCIAL-BEHAVIOR; CONDUCT PROBLEMS; AUTONOMIC RESPONSIVITY; PERSONALITY-DISORDER; EARLY IDENTIFICATION; PASSIVE-AVOIDANCE; CHILDREN; TENDENCIES; AROUSAL AB This study tests the hypothesis that psychopathy-prone adolescents show reduced anticipatory skin conductance responding. Electrodermal activity was recorded while participants anticipated and responded to a 105dB signaled or unsignaled white-noise burst. Using an extreme groups design, the authors used Child Psychopathy Scale (D. R. Lynam, 1997) scores from a community sample of 335 male adolescents (age 16) to form control (n = 65) and psychopathy-prone (n = 65) groups. Significantly more psychopathy-prone participants were nonresponders in the signaled anticipatory (p =.014), signaled responsivity (p =.037), and unsignaled responsivity (p =.003) conditions compared with controls. Anticipatory hyporesponsivity of psychopathy-prone adolescents similar to the electrodermal hyporesponsivity found in psychopathic adults suggests that this autonomic impairment is present by adolescence and may predispose individuals to adult psychopathy. C1 Univ So Calif, Dept Psychol, Los Angeles, CA 90089 USA. Univ Pittsburgh, Med Ctr, Life Hist Studies Program, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Pittsburgh, PA 15260 USA. Univ Kentucky, Dept Psychol, Lexington, KY 40506 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ York, Dept Psychol, York YO10 5DD, N Yorkshire, England. RP Fung, MT (reprint author), Univ So Calif, Dept Psychol, SGM 501, Los Angeles, CA 90089 USA. EM mfung@usc.edu RI Lynam, Donald/J-5755-2014 OI Lynam, Donald/0000-0001-8306-498X FU NIMH NIH HHS [R01 MH51091-01A1, K02 MH01114-01, MH50778]; PHS HHS [411018] NR 81 TC 67 Z9 67 U1 14 U2 27 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0021-843X J9 J ABNORM PSYCHOL JI J. Abnorm. Psychol. PD MAY PY 2005 VL 114 IS 2 BP 187 EP 196 DI 10.1037/0021-843X.114.2.187 PG 10 WC Psychology, Clinical; Psychology, Multidisciplinary SC Psychology GA 925CE UT WOS:000229028300001 PM 15869350 ER PT J AU Fenn, HH Bauer, MS Alshuler, L Evans, DR Williford, WO Kilbourne, AM Beresford, TP Kirk, G Stedman, M Fiore, L AF Fenn, HH Bauer, MS Alshuler, L Evans, DR Williford, WO Kilbourne, AM Beresford, TP Kirk, G Stedman, M Fiore, L CA VA Cooperatove Study 430 Team TI Medical comorbidity and health-related quality of life in bipolar disorder across the adult age span SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE bipolar disorder; medical comorbidity; health-related quality of life; anxiety disorders; substance disorders ID ILLNESS RATING-SCALE; I DISORDER; PSYCHIATRIC-PATIENTS; DEPRESSIVE SYMPTOMS; PHYSICAL ILLNESS; OLD-AGE; SCHIZOPHRENIC-PATIENTS; UNIPOLAR DEPRESSION; DIABETES-MELLITUS; MENTAL-DISORDERS AB Background: Little is known about medical comorbidity or health-related quality of life (HRQOL) in bipolar disorder across the adult age span, especially in public sector patients. Methods: We obtained cross-sectional demographic, clinical, and functional ratings for 330 veterans hospitalized for bipolar disorder with Mini-Mental State score >= 27 and without active alcohol/substance intoxication or withdrawal, who had had at least 2 prior psychiatric admissions in the last 5 years. Structured medical record review identified current/lifetime comorbid medical conditions. SF-36 Physical (PCS) and Mental (MCS) Component Scores, measured physical and mental HRQOL. Univariate and multivariate analyses addressed main hypotheses that physical and mental function decrease with age with decrements due to increasing medical comorbidity. Results: PCs decreased (worsened) with age; number of current comorbid medical diagnoses, but not age, explained the decline. Older individuals had higher (better) MCS, even without controlling for medical comorbidity. Multivariate analysis indicated association of MCS with age, current depressed/mixed episode, number of past-year depressive episodes, and current anxiety disorder, but not with medical comorbidity, number of past-year manic episodes, current substance disorder or lifetime comorbidities. Limitations: This cross-sectional design studied a predominantly male hospitalized sample who qualified for and consented to subsequent randomized treatment. Conclusions: Medical comorbidity is associated with lower (worse) physical HRQOL, independent of age. Surprisingly, younger rather than older subjects reported lower mental HRQOL. This appears due in part to more complex psychiatric presentations, and several mechanisms are discussed. Both results suggest that age-specific assessment and treatment may enhance HRQOL outcome. Published by Elsevier B.V. C1 Stanford Univ, Vet Affairs Palo Alto Hlth Care Syst, Menlo Pk Div, Menlo Pk, CA 94025 USA. Providence VAMC, Providence, RI USA. Brown Univ, Providence, RI 02912 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Augusta VAMC, Augusta, GA USA. Med Coll Georgia, Augusta, GA 30912 USA. Perry Point Cooperat Studies Coordinating Ctr, Perry Point, MD USA. Univ Maryland, College Pk, MD 20742 USA. Pittsburgh VAMC, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. Denver VAMC, Denver, CO USA. Univ Colorado, Boulder, CO 80309 USA. MAVERIC, Boston, MA USA. RP Fenn, HH (reprint author), Stanford Univ, Vet Affairs Palo Alto Hlth Care Syst, Menlo Pk Div, Bldg 348,795 Willow Rd, Menlo Pk, CA 94025 USA. EM howard.fenn@med.va.gov OI Stedman, Margaret/0000-0001-9271-8332 NR 86 TC 69 Z9 70 U1 1 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD MAY PY 2005 VL 86 IS 1 BP 47 EP 60 DI 10.1016/j.jad.2004.12.006 PG 14 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 919QN UT WOS:000228632700006 PM 15820270 ER PT J AU Brambilla, P Stanley, JA Nicoletti, MA Sassi, RB Mallinger, AG Frank, E Kupfer, D Keshavan, MS Soares, JC AF Brambilla, P Stanley, JA Nicoletti, MA Sassi, RB Mallinger, AG Frank, E Kupfer, D Keshavan, MS Soares, JC TI H-1 magnetic resonance spectroscopy investigation of the dorsolateral prefrontal cortex in bipolar disorder patients SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE neuroimaging; affective disorder; mood disorder; NAA; lithium ID N-ACETYL-ASPARTATE; CHOLINE-CONTAINING COMPOUNDS; HUMAN BRAIN; BASAL GANGLIA; LITHIUM; ACETYLASPARTATE; PATHOLOGY; MATTER AB Background: Magnetic resonance spectroscopy studies (MRS) reported abnormally low levels of N-acetylaspartate (NAA, a marker of neuronal integrity) in dorsolateral prefrontal cortex (DLPFC) of adult bipolar patients, suggesting possible neuronal dysfunction. Furthermore, recent MRS reports suggested possible lithium-induced increase in NAA levels in bipolar patients. We examined with in vivo H-1 MRS NAA levels in the DLPFC of adult bipolar patients. Methods: Ten DSM-IV bipolar disorder patients (6 lithium-treated, 4 drug-free) and 32 healthy controls underwent a short echo-time H-1 MRS session, which localized an 8 cm(3) single-voxel in the left DLPFC using a STEAM sequence. Results: No significant differences between the two groups were found for NAA, choline-containing molecules (GPC+PC), or phosphocreatine plus creatine (PCr+Cr) (Student t-test, p > 0.05). Nonetheless, NAA/PCr+Cr ratios were significantly increased in lithium-treated bipolar subjects compared to unmedicated patients and healthy controls (Mann-Whitney U-test, p < 0.05). Limitations: Relatively small sample size may have reduced the statistical power of our analyses and the utilization of a single-voxel approach did not allow for the examination of other cortical brain areas. Conclusions: This study did not find abnormally reduced levels of NAA in left DLPFC of adult bipolar patients, in a sample of patients who were mostly on medications. However, elevated NAA/PCr+Cr ratios were shown in lithium-treated bipolar patients. Longitudinal H-1 MRS studies should further examine NAA levels in prefrontal cortex regions in untreated bipolar patients before and after mood stabilizing treatment. (c) 2005 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. Univ Udine, Sch Med, Sect Psychiat, Dept Pathol & Expt & Clin Med, I-33100 Udine, Italy. Univ Genoa, Adv Biotechnol Ctr, Genoa, Italy. Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, BR-05508 Sao Paulo, Brazil. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NIMH NIH HHS [MH 01736, MH 29618, MH 30915] NR 28 TC 55 Z9 59 U1 2 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD MAY PY 2005 VL 86 IS 1 BP 61 EP 67 DI 10.1016/j.jad.2004.12.008 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 919QN UT WOS:000228632700007 PM 15820271 ER PT J AU Ferris, DP Czerniecki, JM Hannaford, B AF Ferris, DP Czerniecki, JM Hannaford, B TI An ankle-foot orthosis powered by artificial pneumatic muscles SO JOURNAL OF APPLIED BIOMECHANICS LA English DT Article DE locomotion; exoskeleton; gait; rehabilitation; proportional myoelectric control ID ACTUATORS; WALKING; GAIT AB We developed a pneumatically powered orthosis for the human ankle joint. The orthosis consisted of a carbon fiber shell, hinge joint, and two artificial pneumatic muscles. One artificial pneumatic muscle provided plantar flexion torque and the second one provided dorsiflexion torque. Computer software adjusted air pressure in each artificial muscle independently so that artificial muscle force was proportional to rectified low-pass-filtered electromyography (EMG) amplitude (i.e., proportional myoelectric control). Tibialis anterior EMG activated the artificial dorsiflexor and soleus EMG activated the artificial plantar flexor. We collected joint kinematic and artificial muscle force data as one healthy participant walked on a treadmill with the orthosis. Peak plantar flexor torque provided by the orthosis was 70 Nm, and peak dorsiflexor torque provided by the orthosis was 38 Nm. The orthosis could be useful for basic science studies on human locomotion or possibly for gait rehabihtation after neurological injury. C1 Univ Michigan, Dept Movement Sci, Ann Arbor, MI 48109 USA. Univ Michigan, Dept Biomed Engn, Ann Arbor, MI 48109 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98105 USA. Univ Washington, Dept Elect Engn, Seattle, WA 98105 USA. VA Puget Sound Healthcare Syst, Seattle, WA 98108 USA. RP Ferris, DP (reprint author), Univ Michigan, Dept Movement Sci, Ann Arbor, MI 48109 USA. RI Ferris, Daniel/A-9624-2008 OI Ferris, Daniel/0000-0001-6373-6021 FU NIAMS NIH HHS [AR08602, F32 AR008602]; NINDS NIH HHS [R01 NS045486, NS045486] NR 18 TC 173 Z9 178 U1 6 U2 33 PU HUMAN KINETICS PUBL INC PI CHAMPAIGN PA 1607 N MARKET ST, CHAMPAIGN, IL 61820-2200 USA SN 1065-8483 J9 J APPL BIOMECH JI J. Appl. Biomech. PD MAY PY 2005 VL 21 IS 2 BP 189 EP 197 PG 9 WC Engineering, Biomedical; Sport Sciences SC Engineering; Sport Sciences GA 926DT UT WOS:000229103800007 PM 16082019 ER PT J AU Coviello, AD Matsumoto, AM Bremner, WJ Herbst, KL Amory, JK Anawalt, BD Sutton, PR Wright, WW Brown, TR Yan, XH Zirkin, BR Jarow, JP AF Coviello, AD Matsumoto, AM Bremner, WJ Herbst, KL Amory, JK Anawalt, BD Sutton, PR Wright, WW Brown, TR Yan, XH Zirkin, BR Jarow, JP TI Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID FOLLICLE-STIMULATING-HORMONE; ADVANCED SPERMATOGENIC CELLS; ISOLATED HYPOGONADOTROPIC HYPOGONADISM; ENANTHATE-INDUCED AZOOSPERMIA; LUTEINIZING-HORMONE; SPERM PRODUCTION; QUANTITATIVE RELATIONSHIP; CONTRACEPTIVE EFFICACY; RAT TESTIS; MAINTENANCE AB In previous studies of testicular biopsy tissue from healthy men, intratesticular testosterone (ITT) has been shown to be much higher than serum testosterone ( T), suggesting that high ITT is needed relative to serum T for normal spermatogenesis in men. However, the quantitative relationship between ITT and spermatogenesis is not known. To begin to address this issue experimentally, we determined the dose-response relationship between human chorionic gonadotropin (hCG) and ITT to ascertain the minimum dose needed to maintain ITT in the normal range. Twenty-nine men with normal reproductive physiology were randomized to receive 200 mg T enanthate weekly in combination with either saline placebo or 125, 250, or 500 IU hCG every other day for 3 wk. ITT was assessed in testicular fluid obtained by percutaneous fine needle aspiration at baseline and at the end of treatment. Baseline serum T ( 14.1 nmol/liter) was 1.2% of ITT ( 1174 nmol/ liter). LH and FSH were profoundly suppressed to 5% and 3% of baseline, respectively, and ITT was suppressed by 94% ( 1234 to 72 nmol/ liter) in the T enanthate/placebo group. ITT increased linearly with increasing hCG dose ( P < 0.001). Posttreatment ITT was 25% less than baseline in the 125 IU hCG group, 7% less than baseline in the 250 IU hCG group, and 26% greater than baseline in the 500 IU hCG group. These results demonstrate that relatively low dose hCG maintains ITT within the normal range in healthy men with gonadotropin suppression. Extensions of this study will allow determination of the ITT concentration threshold required to maintain spermatogenesis in man. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Ctr Res Reprod & Contracept, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Charles R Drew Univ Med & Sci, Dept Med, Los Angeles, CA 90059 USA. Johns Hopkins Univ, Sch Med, Dept Urol, Baltimore, MD 21287 USA. Johns Hopkins Univ, Sch Publ Hlth, Dept Biochem & Mol Biol, Div Reprod Biol, Baltimore, MD 21205 USA. RP Coviello, AD (reprint author), Northwestern Univ, Feinberg Sch Med, Tarry 15-751,303 E Chicago Ave, Chicago, IL 60611 USA. EM a-coviello@northwestern.edu FU NCRR NIH HHS [M01RR00037]; NICHD NIH HHS [U54HD42454, HD44258, T32HD07453, U54HD12629, U54HD36209] NR 41 TC 52 Z9 52 U1 1 U2 2 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 MAY PY 2005 VL 90 IS 5 BP 2595 EP 2602 DI 10.1210/jc.2004-0802 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 923MO UT WOS:000228914200017 PM 15713727 ER PT J AU Garcia, JM Garcia-Touza, M Hijazi, RA Taffet, G Epner, D Mann, D Smith, RG Cunningham, GR Marcelli, M AF Garcia, JM Garcia-Touza, M Hijazi, RA Taffet, G Epner, D Mann, D Smith, RG Cunningham, GR Marcelli, M TI Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID NECROSIS-FACTOR-ALPHA; TUMOR-BEARING RATS; FOOD-INTAKE; PLASMA GHRELIN; INSULIN RESISTANCE; SYMPTOM ASSESSMENT; TNF-ALPHA; APPETITE; HUMANS; ACTIVATION AB Anorexia and weight loss are negative prognostic factors in patients with cancer. Although total ghrelin levels are increased in energy-negative states, levels of the biologically active octanoylated ghrelin and the anorexigenic peptide YY (PYY) have not been reported in patients with cancer-induced cachexia. We hypothesized that abnormal ghrelin and/or PYY levels contribute to cancer-induced cachexia. We evaluated 21 patients with cancer-induced cachexia; 24 cancer patients without cachexia; and 23 age-, sex-, race-, and BMI-matched subjects without cancer. Active ghrelin levels and the active to total ghrelin ratio were significantly increased in subjects with cancer-induced cachexia, compared with cancer and noncancer controls. PYY levels were similar among groups. Appetite measured by a visual analog scale was not increased in subjects with cachexia. The increase in active ghrelin levels is likely to be a compensatory response to weight loss. Cachexia may be a state of ghrelin resistance because appetite does not correlate with ghrelin levels. Changes in the active to total ghrelin ratio suggest that a mechanism other than increased secretion must be responsible for the increase in active ghrelin levels. PYY is unlikely to play an important role in cancer-induced cachexia. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Div Endocrinol Diabet & Metab, Houston, TX 77030 USA. Baylor Coll Med, Huffington Ctr Aging, Houston, TX 77030 USA. RP Garcia, JM (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM jgarcia1@bcm.tmc.edu OI Mann, Douglas /0000-0002-2516-0145 NR 51 TC 147 Z9 152 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 MAY PY 2005 VL 90 IS 5 BP 2920 EP 2926 DI 10.1210/jc.2004-1788 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 923MO UT WOS:000228914200065 PM 15713718 ER PT J AU Zhang, YP Da, RR Guo, WZ Ren, HM Hilgenberg, LG Sobel, RA Tourtellotte, WW Smith, MA Olek, M Gupta, S Robertson, RT Nagra, R van den Noort, S Qin, YF AF Zhang, YP Da, RR Guo, WZ Ren, HM Hilgenberg, LG Sobel, RA Tourtellotte, WW Smith, MA Olek, M Gupta, S Robertson, RT Nagra, R van den Noort, S Qin, YF TI Axon reactive B cells clonally expanded in the cerebrospinal fluid of patients with multiple sclerosis SO JOURNAL OF CLINICAL IMMUNOLOGY LA English DT Article DE CSFB cell clonal expansion; CSFC-scFv antibody; axonal immunity; multiple sclerosis ID CLINICAL DISABILITY; GERMINAL-CENTERS; BASIC-PROTEIN; BRAIN ATROPHY; ANTIBODY; EXPANSION; MEMORY; RESPONSES; ANTIGEN; HEAVY AB Demyelination and axonal loss have been described as the histological hallmarks of inflammatory lesions of multiple sclerosis (MS) and are the pathological correlates of persistent disability. However, the immune mechanisms underlying axonal damage in MS remain unknown. Here, we report the use of single chain-variable domain fragments (scFv) from clonally expanded cerebrospinal fluid (CSF) B cells to show the role of an anti-axon immune response in the central nervous system (CNS) in MS. The cellular and subcellular distribution of the antigen(s) recognized by these CSF-derived clonal scFv antibodies (CSFC-scFv Abs) was studied by immunochemical staining of brain tissues obtained at autopsy from patients with MS. Immunochemistry showed specific binding of CSFC-scFv Abs to axons in acute MS lesions. The stained axons showed three major types of axonal pathological changes: 1) linear axons, axonal ovoid formation, and axonal transection were seen in the myelinated white matter adjacent to the lesion; 2) accumulation of axonal ovoid formations and Wallerian degeneration were seen at the border between demyelinated lesions and the adjacent white matter; and 3) Wallerian degeneration occurred at the center and edge of acute demyelinated lesions. These findings suggest a B cell axonal specific immune response in the CNS in MS. C1 Univ Calif Irvine, Dept Neurol, Irvine, CA 92697 USA. Univ Calif Irvine, Dept Anat & Neurobiol, Irvine, CA 92697 USA. Stanford Univ, Sch Med, Dept Pathol, Stanford, CA 94305 USA. VA Greater Los Angeles Healthcare Syst, Neurol Serv, Los Angeles, CA USA. Univ Calif Irvine, Dept Med, Irvine, CA 92697 USA. RP Qin, YF (reprint author), Univ Calif Irvine, Dept Neurol, 100 Irvine Hall, Irvine, CA 92697 USA. EM qiny@uci.edu FU NINDS NIH HHS [R01 NS40534-01A1, NS 046414] NR 41 TC 34 Z9 35 U1 0 U2 0 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0271-9142 J9 J CLIN IMMUNOL JI J. Clin. Immunol. PD MAY PY 2005 VL 25 IS 3 BP 254 EP 264 DI 10.1007/s10875-005-4083-5 PG 11 WC Immunology SC Immunology GA 942VI UT WOS:000230310600010 PM 15981091 ER PT J AU Yang, CL Zhu, XM Wang, ZH Subramanya, AR Ellison, DH AF Yang, CL Zhu, XM Wang, ZH Subramanya, AR Ellison, DH TI Mechanisms of WNK1 and WNK4 interaction in the regulation of thiazide-sensitive NaCl cotransport SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID FAMILIAL HYPERKALEMIC HYPERTENSION; INHERITED HYPERTENSION; CL COTRANSPORTER; BLOOD-PRESSURE; MUTANT WNK4; KINASE; GENE; PERMEABILITY; EXPRESSION; EPITHELIA AB With-no-lysine (WNK) kinases are highly expressed along the mammalian distal nephron. Mutations in either WNK1 or WNK4 cause familial hyperkalemic hypertension (FHHt), suggesting that the protein products converge on a final common pathway. We showed previously that WNK4 downregulates thiazide-sensitive NaCl cotransporter (NCC) activity, an effect suppressed by WNK1. Here we investigated the mechanisms by which WNK1 and WNK4 interact to regulate ion transport. We report that WNK1 suppresses the WNK4 effect on NCC activity and associates with WNK4 in a protein complex involving the kinase domains. Although a kinase-dead WNK1 also associates with WNK4, it fails to suppress WNK4-mediated NCC inhibition; the WNK1 kinase domain alone, however, is not sufficient to block the WNK4 effect. The carboxyterminal 222 amino acids of WNK4 are sufficient to inhibit NCC, but this fragment is not blocked by WNK1. Instead, WNK1 inhibition requires an intact WNK4 kinase domain, the region that binds to WNK1. In summary, these data show that: (a) the WNK4 carboxyl terminus mediates NCC suppression, (b) the WNK1 kinase domain interacts with the WNK4 kinase domain, and (c) WNK1 inhibition of WNK4 is dependent on WNK1 catalytic activity and an intact WNK1 protein. These findings provide insight into the complex interrelationships between WNK1 and WNK4 and provide a molecular basis for FHHt. C1 Oregon Hlth Sci Univ, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. RP Ellison, DH (reprint author), Oregon Hlth Sci Univ, Div Nephrol & Hypertens, Portland, OR 97239 USA. EM ellisond@ohsu.edu OI Ellison, David/0000-0003-2915-265X FU NIDDK NIH HHS [R01 DK51496, F32 DK072865, R01 DK051496] NR 24 TC 123 Z9 128 U1 1 U2 3 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD MAY PY 2005 VL 115 IS 5 BP 1379 EP 1387 DI 10.1172/JCI200522452 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 923KH UT WOS:000228908300040 PM 15841204 ER PT J AU Hussein, MR AF Hussein, MR TI Analysis of Bcl-2 protein expression in choroidal melanomas SO JOURNAL OF CLINICAL PATHOLOGY LA English DT Article ID CUTANEOUS MALIGNANT MELANOMAS; MISMATCH REPAIR; MICROSATELLITE INSTABILITY; UVEAL MELANOMA; APOPTOSIS; P53; PATHWAYS; CELLS; BAX AB Background: Bcl-2 protooncogene alterations are involved in tumorigenesis and may have prognostic ramifications. Aims: To investigate normal ocular structures and choroidal melanoma for: ( 1) Bcl-2 protein expression ( semiquantitative staining values: SI, staining intensity; PP, percentage of positive cells; and IRS, immunoreactivity score) and ( 2) any associations between the staining values and clinicopathological features in these lesions. Materials/Methods: Bcl-2 protein expression was analysed in 24 choroidal melanomas using immunoperoxidase staining methods. Results: Bcl-2 protein expression was seen in corneal epithelium, lens epithelium, the ciliary body, and retinal cells. In these structures, the mean (SEM) values were: 1.1 (0.1), 1.6 (0.3), 1.1 ( 0.1), and 2.3 ( 0.3), respectively, for SI; 1.6 ( 0.2), 1.7 ( 0.1), 1.7 ( 0.2), and 1.7 ( 0.2) for PP, respectively; and 1.9 (0.4), 2.7 (0.5), 1.9 ( 0.1), and 4.0 (0.8), respectively, for IRS. Based on Bcl-2 immunoreactivity, the lesions were divided into two groups. The first group comprised 12 tumours with Bcl-2 expression. Bcl-2 expression was significantly higher in this group compared with normal ocular structures (1.5 ( 0.1) v 2.8 ( 0.2), 1.7 ( 0.1) v 3.5 ( 0.1), and 2.6 ( 0.3) v 9.3 (0.9) for mean ( SEM) SI, PP, and IRS scores, respectively; p = 0.00). The second group comprised 12 tumours lacking Bcl-2 protein expression. There was no significant correlation between Bcl-2 protein expression and most of the clinicopathological features of these lesions. Conclusions: Bcl-2 protein expression is altered in choroidal melanomas. C1 Univ Wisconsin, Sch Med, Madison, WI 53705 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Sch Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 23 TC 10 Z9 11 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0021-9746 J9 J CLIN PATHOL JI J. Clin. Pathol. PD MAY PY 2005 VL 58 IS 5 BP 486 EP 489 DI 10.1136/jcp.2004.023291 PG 4 WC Pathology SC Pathology GA 920TD UT WOS:000228712100006 PM 15858118 ER PT J AU McElroy, SL Suppes, T Keck, PE Black, D Frye, MA Altshuler, LL Nolen, WA Kupka, RW Leverich, GS Walden, J Grunze, H Post, RM AF McElroy, SL Suppes, T Keck, PE Black, D Frye, MA Altshuler, LL Nolen, WA Kupka, RW Leverich, GS Walden, J Grunze, H Post, RM TI Open-label adjunctive zonisamide in the treatment of bipolar disorders: A prospective trial SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID LITHIUM MAINTENANCE TREATMENT; RANDOMIZED CONTROLLED-TRIAL; CONTROLLED 18-MONTH TRIAL; I DISORDER; ANTIEPILEPTIC DRUG; DOUBLE-BLIND; OBESITY; ANTICONVULSANT; LAMOTRIGINE; MANIA AB Background: The response of 62 outpatients with DSM-IV bipolar disorders to open-label adjunctive zonisamide was evaluated in a prospective 8-week acute trial, followed by a 48-week continuation trial, conducted from June 2001 through May 2002. Method: During the acute trial, response to zonisamide was assessed weekly for the first 4 weeks and every 2 weeks for the second 4 weeks with the Clinical Global Impressions scale modified for bipolar illness (CGI-BP), the Young Mania Rating Scale (YMRS), and the Inventory for Depressive Symptomatology (IDS). During the continuation trial, patients were assessed with these scales every 4 weeks. Patients' weights and side effects were also evaluated. Outcome measures were analyzed with repeated-measures analyses of variance. Results: Patients with manic symptoms at study entry (N = 34) displayed significant reductions in CGI-BP-Mania Severity and YMRS scores in the acute and continuation (N = 19) trials (p values < .0001 and < .001, respectively). Patients with depressive symptoms at study entry (N = 22) showed significant decreases in CGI-BP-Depression Severity and IDS scores in the acute trial (p values < .001 and < .05, respectively), but only 9 patients entered the continuation trial. Among these 9 patients, maintenance of antidepressant response was mostly maintained. Initially euthymic patients (N = 6) showed no change in any rating scale scores acutely, but 2 of 4 patients who entered the continuation trial developed depressive symptoms. The 62 patients as a group showed significant weight loss in both trials (p values < .001). However, 20 patients (32%) discontinued zonisamide for worsening mood symptoms. Conclusion: Adjunctive zonisamide was associated with beneficial effects on mood and body weight in some patients with bipolar disorders, but was also associated with a high discontinuation rate due to worsening mood symptoms. Double-blind, placebo-controlled studies are necessary to determine zonisamide's thymoleptic properties, if any, in bipolar disorders. C1 Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, Cincinnati, OH 45267 USA. Univ Texas, SW Med Ctr, Dallas, TX USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Groningen Hosp, Groningen, Netherlands. Altrecht Inst Mental Hlth Care, Utrecht, Netherlands. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Freiburg Klinikum, Zent Innovat Therapie Bipolarer Storurgen, Freiburg, Germany. Univ Munich, Psychiat Klin, Munich, Germany. RP McElroy, SL (reprint author), Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, POB 670559,231 Albert Sabin Way, Cincinnati, OH 45267 USA. EM susan.mcelroy@uc.edu RI Nolen, Willem/E-9006-2014 FU NIMH NIH HHS [R01 MH079261] NR 39 TC 51 Z9 51 U1 0 U2 1 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD MAY PY 2005 VL 66 IS 5 BP 617 EP 624 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 928WR UT WOS:000229302900012 PM 15889949 ER EF