FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Zhou, XH Liang, H AF Zhou, XH Liang, H TI Semi-parametric single-index two-part regression models SO COMPUTATIONAL STATISTICS & DATA ANALYSIS LA English DT Article DE logistic regression; kernel regression; skewed data; single-index model ID LIMITED DEPENDENT-VARIABLES; ESTIMATOR AB In this paper, we proposed a semi-parametric single-index two-part regression model to weaken assumptions in parametric regression methods that were frequently used in the analysis of skewed data with additional zero values. The estimation procedure for the parameters of interest in the model was easily implemented. The proposed estimators were shown to be consistent and asymptotically normal. Through a simulation study, we showed that the proposed estimators have reasonable finite-sample performance. We illustrated the application of the proposed method in one real study on the analysis of health care costs. (C) 2004 Elsevier B.V. All rights reserved. C1 Univ Washington, Biostat Unit, NW HSR Ctr Excellence, Vet Affairs Puget Sound Hlth Care Syst,Dept Biost, Seattle, WA 98108 USA. St Jude Childrens Res Hosp, Dept Biostat, Memphis, TN 38105 USA. RP Zhou, XH (reprint author), Univ Washington, Biostat Unit, NW HSR Ctr Excellence, Vet Affairs Puget Sound Hlth Care Syst,Dept Biost, 1660 S Columbian Way, Seattle, WA 98108 USA. EM azhou@u.washington.edu FU AHRQ HHS [R01 HS013105]; NIAID NIH HHS [R01 AI062247, R01 AI059773-01A2] NR 18 TC 3 Z9 3 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-9473 EI 1872-7352 J9 COMPUT STAT DATA AN JI Comput. Stat. Data Anal. PD MAR 1 PY 2006 VL 50 IS 5 BP 1378 EP 1390 DI 10.1016/j.csda.2004.12.001 PG 13 WC Computer Science, Interdisciplinary Applications; Statistics & Probability SC Computer Science; Mathematics GA 007AS UT WOS:000234940200012 PM 20191094 ER PT J AU Harris, LA Chang, L AF Harris, LA Chang, L TI Irritable bowel syndrome: new and emerging therapies SO CURRENT OPINION IN GASTROENTEROLOGY LA English DT Article DE irritable bowel syndrome; pathophysiology; therapy ID FUNCTIONAL GASTROINTESTINAL DISORDERS; INTESTINAL BACTERIAL OVERGROWTH; CORTICOTROPIN-RELEASING HORMONE; RANDOMIZED CONTROLLED-TRIAL; OPIOID RECEPTOR AGONISTS; PREDOMINANCE IBS-D; DOUBLE-BLIND; DIARRHEA-PREDOMINANT; RECTAL DISTENSION; ANTAGONIST ALOSETRON AB Purpose of review Irritable bowel syndrome refers to abdominal discomfort associated with altered bowel habits. Recent evidence suggests that the primary pathophysiologic mechanism is brain-gut dysregulation. Many central and peripheral factors are involved. This article will review important pathophysiologic mechanisms with a focus on new and emerging therapies. Recent findings Prior gastroenteritis and small intestinal bacterial overgrowth may be important for treatment of irritable bowel syndrome. Understanding of serotonergic receptors in gastrointestinal function has led to the development of serotonergic agents such as alosetron and tegaserod. Novel agents targeting other receptor sites include neurokinin and neurohormonal modulators, chloride channels and opioid receptors. Other therapeutic approaches - behavioral treatments, probiotics, antibiotics and alternative therapies - have developing roles in the treatment of irritable bowel syndrome. Summary A better understanding of pathophysiologic mechanisms has resulted in therapeutic advances. Prokinetic therapies may have a role in nondiarrhea predominant irritable bowel syndrome. Antidepressants are used to modulate pain and treat comorbid psychological distress. Newer agents target various receptor sites. Advances in psychological/behavioral treatments and alternative modalities hold promise for the future. C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis, Los Angeles, CA 90073 USA. Mayo Clin, Coll Med, Scottsdale, AZ USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Chang, L (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis, CURE Bldg 115,Room 223,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM linchang@mednet.ucla.edu NR 88 TC 4 Z9 4 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0267-1379 J9 CURR OPIN GASTROEN JI Curr. Opin. Gastroenterol. PD MAR PY 2006 VL 22 IS 2 BP 128 EP 135 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 026DP UT WOS:000236317300008 PM 16462168 ER PT J AU Izumi, Y Satterfield, K Lee, S Harkless, LB AF Izumi, Y Satterfield, K Lee, S Harkless, LB TI Risk of reamputation in diabetic patients stratified by limb and level of amputation - A 10-year observation SO DIABETES CARE LA English DT Article ID LOWER-EXTREMITY AMPUTATION; TRANSMETATARSAL AMPUTATION; MEXICAN-AMERICANS; ETHNICITY; MELLITUS; DISEASE; COHORT AB OBJECTIVE - This study examined the risk of reamputation, stratified by original level of amputation, in a population of diabetic patients. We also illustrated reamputation rates by ipsilateral and contralateral limbs. RESEARCH DESIGN AND METHODS - The study population included 277 diabetic patients with a first lower-extremity amputation performed between 1993 and 1997 at University Hospital in San Antonio, Texas. Reamputation episodes for the ipsilateral and contralateral limbs were recorded through 2003. Using a cumulative incidence curve analysis, we compare the reamputation rate by limb. Cumulative rates of reamputation were calculated for each limb at each amputation level at 1, 3, and 5 years. RESULTS - Cumulative rates of reamputation per person were 26.7% at 1 year, 48.3% at 3 years, and 60.7% at 5 years. lpsilateral reamputation per amputation level at the 1-, 3-, and 5-year points were toe: 22.8, 39.6, and 52.3%; ray: 28.7, 41.2, and 50%; midfoot: 18.8, 33.3, and 42.9%, and major: 4.7, 11.8, and 13.3%. For contralateral reamputation, the rates at 1, 3, and 5 years were toe: 3.5, 18.8, and 29.5%; ray: 9.3, 21.6, and 29.2%; midfoot: 9.4, 18.5, and 33.3%; and major: 11.6, 44.1, and 53.3%. CONCLUSIONS - This study showed that a patient is at greatest risk for further same-limb amputation in the 6 months after the initial amputation. Although risk to the contralateral limb rises steadily, it never meets the level of that of the ipsilateral limb. This finding will help clinicians focus preventive efforts and medical resources during individualized at-risk periods for diabetic patients undergoing first-time amputations. C1 Univ Texas, Hlth Sci Ctr, Dept Orthoped, San Antonio, TX 78229 USA. Natl Hosp Org, WHO Collaborating Ctr Diabet Treatment & Educ, Kyoto Med Ctr, Kyoto, Japan. S Texas Vet Hlth Care Syst, Res & Dev Serv, Audie L Murphy Div, San Antonio, TX USA. RP Izumi, Y (reprint author), Univ Texas, Hlth Sci Ctr, Dept Orthoped, Mail Code 776,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM dfootjapan@hotmail.co.jp NR 29 TC 53 Z9 58 U1 0 U2 4 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 MAR PY 2006 VL 29 IS 3 BP 566 EP 570 DI 10.2337/diacare.29.03.06.dc05-1992 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 018KW UT WOS:000235764100014 PM 16505507 ER PT J AU Bhavnani, SM Ambrose, PG Craig, WA Dudley, MN Jones, RN AF Bhavnani, SM Ambrose, PG Craig, WA Dudley, MN Jones, RN TI Outcomes evaluation of patients with ESBL- and non-ESBL-producing Escherichia coli and Klebsiella species as defined by CLSI reference methods: report from the SENTRY Antimicrobial Surveillance Program SO DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE LA English DT Article; Proceedings Paper CT 44th Interscience Conference on Antimicrobial Agents and Chemotherapy CY OCT 30-NOV 02, 2004 CL Washington, DC DE extended-spectrum beta-lactamase; Klebsiella species; Enterobacteriaceae; Escherichia coli ID SPECTRUM-BETA-LACTAMASE; BLOOD-STREAM INFECTIONS; RISK-FACTORS; PNEUMONIAE BACTEREMIA; ORGANISMS; CEFEPIME; CHILDREN; STRAINS AB As extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae continue to emerge worldwide, selection of empiric treatment modalities is an increasing challenge. Data describing the clinical outcomes associated with different treatment regimens have been limited. Using data froth centers with continued ESBL- and non-ESBL-producing Escherichia coli and Klebsiella species isolates in North America, Latin America, and Europe, potential risk factors for the occurrence of invasive ESBL- and non-ESBL-producing Enterobacteriaceae infections and factors associated with clinical outcome were evaluated. Of the 175 cases considered evaluable, 77% were ESBL-producing organisms. Underlying comorbidities and potential risk factors were generally similar between ESBL and non-ESBL cases with a statistically greater proportion of ESBL cases requiring gastrostomy or jejunostomy tubes, ventilatory assistance, or care in the intensive care unit before culture (P <= 0.008). Among ESBL cases, carbapenem monotherapy and combination therapy were often selected for treatment (32.6% and 13.3%, respectively). Among non-ESBL cases, fluoroquinolones and beta-lactam/beta-lactamase inhibitor combination agents accounted for the highest proportion of treatment regimens (25.0% and 22.5%, respectively), whereas cephalosporin monotherapy and combination therapy were each used as treatment for 10% of cases. Clinical success was similar between patients with ESBL and non-ESBL-producing isolates (83% and 80%, respectively). Although infections arising from E. coli and Klebsiella species are associated with significant mortality, ESBL production alone did not appear to be an independent risk factor for treatment failure. (C) 2006 Elsevier Inc. All rights reserved. C1 Ordway Res Inst, Inst Clin Pharmacodynam, Albany, NY 12208 USA. SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Dept Pharm Practice, Buffalo, NY 14260 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Med, Clin Pharmacol Sect, Madison, WI 53705 USA. Mpex Pharmaceut, San Diego, CA 92109 USA. JMI Labs, N Liberty, IA 52317 USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. RP Bhavnani, SM (reprint author), Ordway Res Inst, Inst Clin Pharmacodynam, Albany, NY 12208 USA. EM sbhavnani-icpd@ordwayresearch.org NR 28 TC 45 Z9 48 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0732-8893 J9 DIAGN MICR INFEC DIS JI Diagn. Microbiol. Infect. Dis. PD MAR PY 2006 VL 54 IS 3 BP 231 EP 236 DI 10.1016/j.diagmicrobio.2005.09.011 PG 6 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 024VK UT WOS:000236224200013 PM 16423491 ER PT J AU McGory, ML Zingmond, DS Sekeris, E Bastani, R Ko, CY AF McGory, ML Zingmond, DS Sekeris, E Bastani, R Ko, CY TI A patient's race/ethnicity does not explain the underuse of appropriate adjuvant therapy in colorectal cancer 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 APR 30-MAY 05, 2005 CL Philadelphia, PA SP Amer Soc Colon & Rectal Surg DE colorectal cancer; race/ethnicity; disparities; adjuvant therapy; chemotherapy; radiation therapy ID RECTAL-CANCER; COMORBIDITY INDEX; COLON-CANCER; SURVIVAL; RACE; CHEMOTHERAPY; SURVEILLANCE; DISPARITIES; OUTCOMES; QUALITY AB Introduction: To improve colorectal cancer outcomes, appropriate adjuvant therapy (chemotherapy, radiation therapy) should be given. Numerous studies have demonstrated underuse of adjuvant therapy in colorectal cancer. The current study examines variables associated with underuse of adjuvant therapy. methods: Three population-based databases were linked: California Cancer Registry, California Patient Discharge Database, 2000 Census. All colorectal cancer patients diagnosed from 1994 to 2001 were studied. Patient characteristics (age, gender, race/ethnicity, comorbidities, payer, diagnosis year, socioeconomic status) were used in five multivariate regression analyses to predict receipt of chemotherapy for Stage III colon cancer, and receipt of chemotherapy and radiation therapy for Stages II, III rectal cancer. Results: The overall cohort was 18,649 Stage III colon cancer and Stages II, III rectal cancer patients. Mean age was 68.9 years, 50 percent male, 74 percent non-Hispanic white, 6 percent black, 11 percent Hispanic, 9 percent Asian, and 65 percent had no significant comorbid disease. Receipt of chemotherapy was 48 percent for Stage III colon cancer, 48 percent for Stage II rectal cancer, and 66 percent for Stage III rectal cancer. Receipt of radiation therapy was 52 percent for Stage II rectal cancer and 66 percent for Stage III rectal cancer. In all five models, low socioeconomic status predicted underuse of chemotherapy or radiation therapy (P < 0.016). Race/ethnicity was not statistically associated with underuse in any of the models. Conclusions: Most literature identifies race/ethnicity as the reason for disparate receipt of adjuvant therapy in colorectal cancer. Using a more robust database of three population-based sources, our analysis demonstrates that socioeconomic status is a more important predictor of (in)appropriate care than race/ethnicity. Explicit measures to improve care to the poor with colorectal cancer are needed. C1 Univ Calif Los Angeles, Dept Surg, David Geffen Sch Med, Ctr Hlth Sci 72 215, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Gen Internal Med, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Hlth Serv Res, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Hlth Serv, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP McGory, ML (reprint author), Univ Calif Los Angeles, Dept Surg, David Geffen Sch Med, Ctr Hlth Sci 72 215, 10833 Le Conte Ave,Box 956904, Los Angeles, CA 90095 USA. EM mmcgory@mednet.ucla.edu FU NCI NIH HHS [5U01CA086322-06] NR 26 TC 36 Z9 37 U1 0 U2 1 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 MAR PY 2006 VL 49 IS 3 BP 319 EP 329 DI 10.1007/s10350-005-0283-6 PG 11 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 020YJ UT WOS:000235949000004 PM 16475031 ER PT J AU Mitchell, GF Arnold, JMO Dunlap, ME O'Brien, TX Marchiori, G Warner, E Granger, CB Desai, SS Pfeffer, MA AF Mitchell, GF Arnold, JMO Dunlap, ME O'Brien, TX Marchiori, G Warner, E Granger, CB Desai, SS Pfeffer, MA TI Pulsatile hemodynamic effects of candesartan in patients with chronic heart failure: The CHARM Program SO EUROPEAN JOURNAL OF HEART FAILURE LA English DT Article DE hemodynamics; pulse pressure; aorta; vascular stiffness; angiotensin receptor blocker; candesartan ID AORTIC INPUT IMPEDANCE; ANGIOTENSIN-CONVERTING ENZYME; LEFT-VENTRICULAR DYSFUNCTION; PULSE PRESSURE; SYSTOLIC HYPERTENSION; ARTERIAL COMPLIANCE; THERAPY; DISTENSIBILITY; DETERMINANTS; HYPERTROPHY AB Background: Abnormal large artery function and increased pulsatile load are exacerbated by excess angiotensin-II acting through the AT(1) receptor and contribute to the pathogenesis and progression of chronic heart failure (CHF). Aims: To evaluate effects of the AT(1) receptor blocker candesartan (N=30) or placebo (N=34) on pulsatile hemodynamics in participants with CHF in the CHAR-M program. Methods and results: Noninvasive hemodynamics were assessed following 6 and 14 months of treatment and averaged. Using calibrated tonometry and aortic outflow Doppler, characteristic impedance was calculated as the ratio of the change in carotid pressure and aortic flow in early systole. Total arterial compliance was calculated by the diastolic area method. Brachial blood pressure, cardiac output and peripheral resistance did not differ between groups. Lower central pulse pressure in the candesartan group (57 +/- 20 vs. 67 +/- 17 mmHg, P=0.043) was accompanied by lower characteristic impedance (200 +/- 78 vs. 240 +/- 74 dyne s/cm(5), P=0.039) and higher total arterial compliance (1.87 +/- 0.70 vs. 1.47 +/- 0,48 ml/mmHg, P=0.008). Similar favorable differences were seen when analyses were stratified for ejection firaction (<= 0.40 vs. > 0.40) and baseline angiotensin converting enzyme inhibitor use. Conclusions: Candesartan has a favorable effect on large artery function in patients with chronic heart failure. (c) 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved. C1 Cardiovasc Engn Inc, Holliston, MA 01746 USA. London Hlth Sci Ctr, London, ON, Canada. Louis Stokes VA Med Ctr, Cleveland, OH USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Duke Univ, Med Ctr, Durham, NC USA. Univ Penn, Med Ctr, Philadelphia, PA 19104 USA. Brigham & Womens Hosp, Boston, MA 02115 USA. RP Mitchell, GF (reprint author), Cardiovasc Engn Inc, Univ Off Pk,Bldg 2,51 Sawyer Rd,Suite 100, Waltham, MA 02453 USA. EM GaryFMitchell@mindspring.com RI Granger, Christopher/D-3458-2014 OI Granger, Christopher/0000-0002-0045-3291 NR 32 TC 18 Z9 19 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1388-9842 J9 EUR J HEART FAIL JI Eur. J. Heart Fail. PD MAR PY 2006 VL 8 IS 2 BP 191 EP 197 DI 10.1016/j.ejheart.2005.07.006 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 029ZJ UT WOS:000236602600013 PM 16188495 ER PT J AU Lee, YH Harley, JB Nath, SK AF Lee, YH Harley, JB Nath, SK TI Meta-analysis of TNF-alpha promoter-308 A/G polymorphism and SLE susceptibility SO EUROPEAN JOURNAL OF HUMAN GENETICS LA English DT Article DE meta-analysis; TNF-alpha; SLE ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; NECROSIS-FACTOR-ALPHA; MAJOR HISTOCOMPATIBILITY COMPLEX; GENE POLYMORPHISM; ASSOCIATION; NEPHRITIS; DISEASE; ALLELE; POPULATION; CONTRIBUTE AB Alleles of tumor necrosis factor-alpha (TNF-alpha) gene have been inconsistently associated with systemic lupus erythematosus (SLE), particularly the 308-A/G functional promoter polymorphism. To generate large-scale evidence on whether 308-A/G promoter polymorphism is associated with SLE susceptibility we have conducted a meta-analysis. We have identified 21 studies of this polymorphism and SLE using MEDLINE search. Meta-analysis was performed for genotypes A/A (recessive effect), A/A+A/G (dominant effect), and A allele in fixed or random effects models. All control samples were in Hardy-Weinberg proportion. The overall odds ratio ( OR) of the A/A genotype was 3.2 (95% CI = 2.0-5.3, P < 0.001). Stratification by ethnicity indicated that the A/A genotype was associated with SLE in European-derived population (OR 4.0, CI = 2.5-6.4, P < 0.001). No association was detected in Asian-derived population (OR, 1.3, CI = 0.3-6.3, P = 0.76). The overall OR for the risk genotypes (A/A and A/G) was 2.0 (CI = 1.3-3.1, P < 0.001). Similar results were found between the risk allele A and SLE where a significant association was found in European population (OR = 2.1, CI = 1.6-2.7, P < 0.001), but not in Asian (OR = 1.4, CI = 0.8-2.3, P = 0.2) or African (OR = 1.2, CI = 0.6-2.5, P = 0.59) populations. In summary, this meta-analysis demonstrates that the TNF-alpha promoter -308 A/G polymorphism may confer susceptibility to SLE, especially in European-derived population. C1 Oklahoma Med Res Fdn, Arthrit & Immunol Res Program, Oklahoma City, OK 73104 USA. Korea Univ, Div Rheumatol, Seoul 136701, South Korea. Oklahoma Med Res Fdn, Genet Epidemiol Unit, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Nath, SK (reprint author), Oklahoma Med Res Fdn, Arthrit & Immunol Res Program, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM swapan-nath@omrf.ouhsc.edu FU NCRR NIH HHS [RR01577, RR020143, RR14467]; NIAID NIH HHS [AI24717, AI053747, AI063622]; NIAMS NIH HHS [AR048928, AR048940, AR049084, AR12253, AR42460]; NIDCR NIH HHS [DE15223] NR 45 TC 132 Z9 139 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1018-4813 J9 EUR J HUM GENET JI Eur. J. Hum. Genet. PD MAR PY 2006 VL 14 IS 3 BP 364 EP 371 DI 10.1038/sj.ejhg.5201556 PG 8 WC Biochemistry & Molecular Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Genetics & Heredity GA 014SD UT WOS:000235499300018 PM 16418737 ER PT J AU Chiappelli, F Prolo, P Rosenblum, M Edgerton, M Cajulis, OS AF Chiappelli, F Prolo, P Rosenblum, M Edgerton, M Cajulis, OS TI Evidence-based research in complementary and alternative medicine II: The process of evidence-based research SO EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE LA English DT Article DE evidence-based research; systematic review; consolidated standards of randomized trials; Markov model; complementary and alternative medicine ID EVALUATING COMPLEMENTARY; CLINICAL-TRIALS; METAANALYSIS; CAM; EPIDEMIOLOGY AB It is a common practice in contemporary medicine to follow stringently the scientific method in the process of validating efficacy and effectiveness of new or improved modes of treatment intervention. It follows that these complementary or alternative interventions must be validated by stringent research before they can be reliably integrated into Western medicine. The next decades will witness an increasing number of evidence-based research directed at establishing the best available evidence in complementary and alternative medicine (CAM). This second paper in this lecture series examines the process of evidence-based research (EBR) in the context of CAM. We outline the fundamental principles, process and relevance of EBR, and its implication to CAM. We underscore areas of future development in EBR. We note that the main problem of applying EBR to CAM at present has to do with the fact that the contribution of EBR can be significant only to the extent to which studies used in the process of EBR are of good quality. All too often CAM research is not of sufficient quality to warrant the generation of a consensus statement. EBR, nevertheless, can contribute to CAM by identifying current weaknesses of CAM research. We present a revised instrument to assess quality of the literature. C1 Univ Calif Los Angeles, Sch Dent, Div Oral Biol & Med, Los Angeles, CA 90095 USA. W Los Angeles Vet Adm Med Ctr, Northridge, CA USA. Psychoneuroimmunol Grp Inc, Northridge, CA USA. Calif State Univ Northridge, Northridge, CA 91330 USA. RP Chiappelli, F (reprint author), Univ Calif Los Angeles, Sch Dent, Div Oral Biol & Med, CHS 63-090, Los Angeles, CA 90095 USA. EM chiappelli@dent.uclia.edu NR 29 TC 35 Z9 37 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1741-427X J9 EVID-BASED COMPL ALT JI Evid.-based Complement Altern. Med. PD MAR PY 2006 VL 3 IS 1 BP 3 EP 12 DI 10.1093/ecam/nek017 PG 10 WC Integrative & Complementary Medicine SC Integrative & Complementary Medicine GA 020VF UT WOS:000235940300002 PM 16550218 ER PT J AU Pandolfino, JE El-Serag, HB Zhang, Q Shah, N Ghosh, SK Kahrilas, PJ AF Pandolfino, JE El-Serag, HB Zhang, Q Shah, N Ghosh, SK Kahrilas, PJ TI Obesity: A challenge to esophagogastric junction integrity SO GASTROENTEROLOGY LA English DT Article ID LOWER ESOPHAGEAL SPHINCTER; GASTROESOPHAGEAL-REFLUX; HIATAL-HERNIA; INTRAABDOMINAL PRESSURE; BODY-MASS; SYMPTOMS; ASSOCIATION; PREVALENCE; GERD AB Background & Aims: The aim of the current study was to analyze the relationship between obesity and the morphology of the esophagogastric junction (EGJ) pressure segment using high-resolution manometry. Methods: Two hundred eighty-five patients (108 men, aged 18-87) were studied. A solid-state manometric assembly with 36 circumferential sensors spaced 1 cm apart was placed transnasally, and simultaneous intra-esophageal and intragastric pressures were measured over 6-8 respiratory cycles. Separation of the lower esophageal sphincter (LES) and crural diaphragm was quantified by measuring the distance between the two EGJ elements during inspiration. The association between anthropometric variables and pressure values were examined using univariate and multivariate analysis. Results: There was a significant correlation of body mass index (BMI) and waist circumference (WC) with intragastric pressure (inspiration, BMI [r = 0.57], WC [r = 0.62] P <.0001; expiration, BMI [r = 0,581, WC [r = 0.64], P <.0001) and gastroesophageal pressure gradient (GEPG) (inspiration, BMI [r 0.37], WC [r = 0,43], P <.0001; expiration, BMI [r = 0.24], WC [r = 0.26], P <.0001). Multivariate analysis adjusting for age, gender, and patient type did not alter the direction or magnitude of this relationship. In addition, obesity was associated with separation of the EGJ pressure components (BMI, r = 0.17, P <.005; WC, r = 0.21, P <.001). Conclusions: Obese subjects are more likely to have EGJ disruption (leading to hiatal hernia) and an augmented GEPG providing a perfect scenario for reflux to occur. Whether or not weight loss can reverse these abnormalities is unknown. C1 Northwestern Univ, Feinberg Sch Med, Dept Med, Div Gastroenterol, Chicago, IL 60611 USA. Baylor Coll Med, Houston VA Med Ctr, Dept Med, Houston, TX 77030 USA. RP Northwestern Univ, Feinberg Sch Med, Dept Med, Div Gastroenterol, 676 N St Clair St,Suite 1400, Chicago, IL 60611 USA. EM j-pandolfino@northwestern.edu FU NIDCD NIH HHS [R01 DC00646]; NIDDK NIH HHS [K23 DK062170-01] NR 23 TC 236 Z9 248 U1 2 U2 8 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 EI 1528-0012 J9 GASTROENTEROLOGY JI Gastroenterology PD MAR PY 2006 VL 130 IS 3 BP 639 EP 649 DI 10.1053/j.gastro.2005.12.016 PG 11 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 024QC UT WOS:000236210100006 PM 16530504 ER PT J AU Rosenfeld, K AF Rosenfeld, K TI Palliative care assessment: What are we looking for? SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Article ID OF-LIFE CARE; KARNOFSKY PERFORMANCE STATUS; CANCER-PATIENTS; END; SCALE; PERSPECTIVES; MULTICENTER; PHYSICIANS; CISPLATIN; DISTRESS AB This article provides an overview of palliative care assessment for the gastroenterologic specialist. An evidence-based conceptual model of high-quality end-of-life care is proposed, and an approach to assessment is offered, recognizing that comprehensive palliative assessment generally requires participation of an interdisciplinary team with expertise in each of the important palliative domains. The gastroenterologist has the opportunity and responsibility to screen for problems in each domain, refer the patient to appropriate team members for a more detailed assessment, and integrate data to collaboratively develop a management plan. Because the relief of suffering and the cure of disease are dual obligations, in situations in which cure is no longer possible, alleviating suffering in patients and their caregivers must be emphasized. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Vet Integrated Palliat Program, Los Angeles, CA 90037 USA. RP Rosenfeld, K (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, Vet Integrated Palliat Program, 11301 Wilshire Blvd, Los Angeles, CA 90037 USA. EM Kenneth.rosenfeld@med.va.gov NR 43 TC 7 Z9 7 U1 6 U2 7 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0889-8553 J9 GASTROENTEROL CLIN N JI Gastroenterol. Clin. North Am. PD MAR PY 2006 VL 35 IS 1 BP 23 EP + DI 10.1016/j.gtc.2005.12.002 PG 18 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 027ME UT WOS:000236418900003 PM 16530108 ER PT J AU Patterson, JE AF Patterson, JE TI Clinic shift SO HEALTH AFFAIRS LA English DT Editorial Material C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Patterson, JE (reprint author), Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. EM pattersonj@uthscsa.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 MAR-APR PY 2006 VL 25 IS 2 BP 484 EP 486 DI 10.1377/hlthaff.25.2.484 PG 3 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 022ZK UT WOS:000236094500028 PM 16522596 ER PT J AU Okonofua, EC Simpson, KN Jesri, A Rehman, SU Durkalski, VL Egan, BM AF Okonofua, EC Simpson, KN Jesri, A Rehman, SU Durkalski, VL Egan, BM TI Therapeutic inertia is an impediment to achieving the healthy people 2010 blood pressure control goals SO HYPERTENSION LA English DT Article DE population; antihypertensive agents; blood pressure monitoring; compliance; blood pressure; hypertension, arterial ID PRIMARY-CARE PHYSICIANS; HYPERTENSION MANAGEMENT; UNITED-STATES; UNCONTROLLED HYPERTENSION; ETHNIC-DIFFERENCES; AFRICAN-AMERICANS; CLINICAL-PRACTICE; GUIDELINES; TRENDS; POPULATION AB Therapeutic inertia (TI), defined as the providers' failure to increase therapy when treatment goals are unmet, contributes to the high prevalence of uncontrolled hypertension ( >= 140/90 mm Hg), but the quantitative impact is unknown. To address this gap, a retrospective cohort study was conducted on 7253 hypertensives that had >= 4 visits and >= 1 elevated blood pressure ( BP) in 2003. A 1-year TI score was calculated for each patient as the difference between expected and observed medication change rates with higher scores reflecting greater TI. Antihypertensive therapy was increased on 13.1% of visits with uncontrolled BP. Systolic BP decreased in patients in the lowest quintile of the TI score but increased in those in the highest quintile ( - 6.8 +/- 0.5 versus + 1.8 +/- 0.6 mm Hg; P < 0.001). Individuals in the lowest TI quintile were approximate to 33 times more likely to have their BP controlled at the last visit than those in highest quintile ( odds ratio, 32.7; 95% CI, 25.1 to 42.6; P < 0.0001). By multivariable analysis, TI accounted for approximate to 19% of the variance in BP control. If TI scores were decreased approximate to 50%, that is, increasing medication dosages on approximate to 30% of visits, BP control would increase from the observed 45.1% to a projected 65.9% in 1 year. This study confirms the high rate of TI in uncontrolled hypertensive subjects. TI has a major impact on BP control in hypertensive subjects receiving regular care. Reducing TI is critical in attaining the Healthy People 2010 goal of controlling hypertension in 50% of all patients. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Okonofua, EC (reprint author), Med Univ S Carolina, 135 Rutledge Ave,Rm 1111, Charleston, SC 29425 USA. EM okonofua@musc.edu FU AHRQ HHS [P01HS1087]; NHLBI NIH HHS [HL04290, HL58794]; NIMHD NIH HHS [P60-MD00267] NR 36 TC 244 Z9 250 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD MAR PY 2006 VL 47 IS 3 BP 345 EP 351 DI 10.1161/01.HYP.0000200702.76436.4b PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 012WT UT WOS:000235372300014 PM 16432045 ER PT J AU Guo, SF Grindle, GG Authier, EL Cooper, RA Fitzgerald, SG Kelleher, A Cooper, R AF Guo, SF Grindle, GG Authier, EL Cooper, RA Fitzgerald, SG Kelleher, A Cooper, R TI Development and qualitative assessment of the GAME(Cycle) exercise systern SO IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING LA English DT Article DE cardiovascular system; exercise; games; wheelchairs ID MAXIMAL OXYGEN-CONSUMPTION; PHYSICAL-ACTIVITY; WHEELCHAIR USERS; COMPUTER GAMES; VIDEO-GAME; ERGOMETRY; PARAPLEGIA; INTERFACE AB Increased physical activity is important for reducing the risk of cardiovascular disease. However, among people with disabilities, inactivity is prevalent. In order to encourage exercise among members of this group, an exercise system combining arm ergometry with video gaming, called the GAME Cycle was previously developed. User input was received through an arm crank ergometer on a swivel, with the angular velocity of the ergometer resistance wheel controlling one axis and rotation of ergometer about the swivel controlling the other. The purpose of this study was to detail the algorithms used in this device and present novel features included in a second generation of the GAME(Cycle). The features include a wheel on base, a steering return mechanism, and wireless fire buttons. A focus group of clinicians (n = 8), wheelchair users (n = 8), and clinician wheelchair users (n = 2) was conducted to evaluate the features of the GAME(Cycle). The focus group suggested improvements to the steering mechanism and to reduce vibration in the system. However, the focus group enjoyed the GAME(Cycle) and felt that it would encourage exercise among persons with disabilities. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Med Ctr, Dept Phys Med & Rehabil, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Med Ctr, Dept Orthopaed Surg, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Med Ctr, Ctr Assist Technol, Pittsburgh, PA 15213 USA. RP Guo, SF (reprint author), Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. EM sguo@pitt.edu; grindleg@herlpitt.org; authiera@herlpitt.org; rcooper@pitt.edu FU NICHD NIH HHS [1R41HD39535-01] NR 21 TC 4 Z9 4 U1 1 U2 3 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI PISCATAWAY PA 445 HOES LANE, PISCATAWAY, NJ 08855 USA SN 1534-4320 J9 IEEE T NEUR SYS REH JI IEEE Trans. Neural Syst. Rehabil. Eng. PD MAR PY 2006 VL 14 IS 1 BP 83 EP 90 DI 10.1109/TNSRE.2006.870493 PG 8 WC Engineering, Biomedical; Rehabilitation SC Engineering; Rehabilitation GA 028WH UT WOS:000236519000011 PM 16562635 ER PT J AU Caetano, SC Olvera, RL Hunter, K Hatch, JP Najt, P Bowden, C Pliszka, S Soares, JC AF Caetano, SC Olvera, RL Hunter, K Hatch, JP Najt, P Bowden, C Pliszka, S Soares, JC TI Association of psychosis with suicidality in pediatric bipolar I, II and bipolar NOS patients SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article; Proceedings Paper CT 59th Annual Meeting of the Society-of-Biological-Psychiatry CY APR 29-MAY 01, 2004 CL NEW YORK, NY SP Soc Biol Psychiat DE bipolar disorder; psychosis; suicide; children; adolescents; hospitalization ID DISORDER; CHILDREN; ADOLESCENTS; MANIA; RISK; ONSET; MOOD; PHENOMENOLOGY; RECOVERY; BEHAVIOR AB Background: Psychosis in pediatric mood disorder patients may be related to suicidal ideation. Bipolar (BP) adolescents are at high risk of completed suicide. We examined whether pediatric BP patients with psychosis have a higher prevalence of suicidality than non-psychotic BP patients. Based on previous findings in adult BP patients, we predicted that pediatric BP patients with psychotic symptoms would have higher prevalence of suicidality, higher occurrence of lifetime psychiatric hospitalizations and worse current Global Assessment of Functioning Scale (GAF) scores compared to non-psychotic BP patients. Methods: We studied 43 BP children and adolescents (mean age +/- S.D=11.2 +/- 2.8 y, range=8-17) who did (n=17) or did not have (n=26) a lifetime history of psychotic symptoms. Indicators of suicidality (thoughts of death and Suicidal ideation, plans, and attempts), psychiatric diagnoses, psychotic symptoms, psychiatric hospitalizations and GAF scores were assessed with the KSADS-PL interview. Limitations: Small sample size, cross-sectional study and exclusion of substance abuse comorbidity. Results: Pediatric BP patients with a lifetime history of psychotic symptoms compared to BP patients without psychosis were more likely to have thoughts of death (100% versus 69.2%, p=0.01), suicidal ideation (94.1% versus 42.3%, p=0.001) and suicidal plans (64.7% versus 15.4%, p=0.002). Occurrence of psychiatric hospitalization was higher in psychotic BP patients compared to non-psychotic BP patients (82.4%, versus 46.2%, p=0.018). Conclusions: Psychotic symptoms in pediatric BP patients are associated with suicidal ideation and plans, and psychiatric hospitalizations. Psychotic symptoms are a risk factor for suicidality amongst pediatric BP patients. (c) 2005 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr San Antonio, Div Mood & Anxiety Disorders, Dept Psychiat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Dept Psychiat, Audie L Murphy Div, San Antonio, TX USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Texas, Hlth Sci Ctr San Antonio, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr San Antonio, Dept Radiol, San Antonio, TX 78229 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr San Antonio, Div Mood & Anxiety Disorders, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI Caetano, Sheila/H-5010-2012 OI Caetano, Sheila/0000-0001-8403-7078 FU NCRR NIH HHS [RR020571, M01-RR-01346]; NIMH NIH HHS [MH69774, MH01736] NR 24 TC 24 Z9 27 U1 0 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 MAR PY 2006 VL 91 IS 1 BP 33 EP 37 DI 10.1016/j.jad.2005.12.008 PG 5 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 023VN UT WOS:000236154400005 PM 16445989 ER PT J AU Wen, Y Feng, J Scott, DR Marcus, EA Sachs, G AF Wen, Y Feng, J Scott, DR Marcus, EA Sachs, G TI Involvement of the HP0165-HP0166 two-component system in expression of some acidic-pH-upregulated genes of Helicobacter pylori SO JOURNAL OF BACTERIOLOGY LA English DT Article ID UREASE-NEGATIVE MUTANT; GASTRIC SURFACE PH; ESCHERICHIA-COLI; ALLELIC EXCHANGE; PEPTIC-ULCER; COLONIZATION; RESISTANCE; UREI; DISEASE; HYDROGENASE AB About 200 genes of the gastric pathogen Helicobacter pylori increase expression at medium pHs of 6.2, 5.5, and 4.5, an increase that is abolished or much reduced by the buffering action of urease. Genes up-regulated by a low pH include the two-component system HP0165-HP0166, suggesting a role in the regulation of some of the pH-sensitive genes. To identify targets of HP0165-HP0166, the promoter regions of genes up-regulated by a low pH were grouped based on sequence similarity. Probes for promoter sequences representing each group were subjected to electrophoretic mobility shift assays (EMSA) with recombinant HP0166-His(6) or a mutated response regulator, HP0166-D52N-HiS(6), that can specifically determine the role of phosphorylation of HP0166 in binding (including a control EMSA with in-vitro-phosphorylated HP0166-His(6)). Nineteen of 45 promoter-regulatory regions were found to interact with HP0166-His(6). Seven promoters for genes encoding alpha-carbonic anhydrase, omp11,fecD, lpp20, hypA, and two with unknown function (pHP1397-1396 and pHP0654-0675) were clustered in gene group A, which may respond to changes in the periplasmic pH at a constant cytoplasmic pH and showed phosphorylation-dependent binding in EMSA with HP0166-D52N-HiS6. Twelve promoters were clustered in groups B and C whose up-regulation likely also depends on a reduction of the cytoplasmic pH at a medium pH of 5.5 or 4.5. Most of the target promoters in groups B and C showed phosphorylation-dependent binding with HP0166-D52N-HiS6, but promoters for ompR (pHP0166-0162), pHP0682-0681, and pHP1288-1289 showed phosphorylation-independent binding. These findings, combined with DNase I footprinting, suggest that HP0165-0166 is an acid-responsive signaling system affecting the expression of pH-sensitive genes. Regulation of these genes responds either to a decrease in the periplasmic pH alone (HP0165 dependent) or also to a decrease in the cytoplasmic pH (HP0165 independent). C1 Univ Calif Los Angeles, Membrane Biol Lab, Dept Physiol, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Wen, Y (reprint author), 11301 Wilshire Blvd,Bldg 113,Rm 324, Los Angeles, CA 90073 USA. EM ywen@ucla.edu FU NIDDK NIH HHS [DK46917, DK58333, DK53462, R01 DK046917] NR 45 TC 29 Z9 33 U1 0 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0021-9193 J9 J BACTERIOL JI J. Bacteriol. PD MAR PY 2006 VL 188 IS 5 BP 1750 EP 1761 DI 10.1128/JB.188.5.1750-1761.2006 PG 12 WC Microbiology SC Microbiology GA 019EU UT WOS:000235819200009 PM 16484186 ER PT J AU Kurihara, N Zhou, H Reddy, SV Palacios, VG Subler, MA Dempster, DW Windle, JJ Roodman, GD AF Kurihara, N Zhou, H Reddy, SV Palacios, VG Subler, MA Dempster, DW Windle, JJ Roodman, GD TI Expression of measles virus nucleocapsid protein in osteoclasts induces Paget's disease-like bone lesions in mice SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE Paget's disease; osteoclast; TAF(II)-17; IL-6; measles virus nucleocapsid ID LARGE T-ANTIGEN; BCL-X-L; TRANSGENIC MICE; 1,25-DIHYDROXYVITAMIN D-3; GENETIC-HETEROGENEITY; CHROMOSOME 18Q; CELLS; PRECURSORS; ACID; HYPERPARATHYROIDISM AB We targeted the MVNP gene to the OCL lineage in transgenic mice. These mice developed abnormal OCLs and bone lesions similar to those found in Paget's patients. These results show that persistent expression of MVNP in OCLs can induce pagetic-like bone lesions in vivo. Introduction: Paget's disease (PD) of bone is the second most common bone disease. Both genetic and viral factors have been implicated in its pathogenesis, but their exact roles in vivo are unclear. We previously reported that transfection of normal human osteoclast (OCL) precursors with the measles virus nucleocapsid (MVNP) or measles virus (MV) infection of bone marrow cells from transgenic mice expressing a MV receptor results in formation of pagetic-like OCLs. Materials and Methods: Based on these in vitro studies, we determined if the MVNP gene from either an Edmonston-related strain of MV or a MVNP gene sequence derived from a patient with PD (P-MVNP), when targeted to cells in the OCL lineage of transgenic mice with the TRACP promoter (TRACP/MVNP mice), induced changes in bone similar to those found in PD. Results: Bone marrow culture studies and histomorphometric analysis of bones from these mice showed that their OCLs displayed many of the features of pagetic OCLs and that they developed bone lesions that were similar to those in patients with PD. Furthermore, IL-6 seemed to be required for the development of the pagetic phenotype in OCLs from TRACP/MVNP mice. Conclusions: These results show that persistent expression of the MVNP gene in cells of the OCL lineage can induce pagetic-like bone lesions in vivo. C1 VA Pittsburgh Healthcare Syst, R&D U 151, Pittsburgh, PA 15240 USA. Columbia Univ, Coll Phys & Surg, Dept Pathol, New York, NY USA. Virginia Commonwealth Univ, Richmond, VA USA. Childrens Res Inst, Dept Pediat, Charleston, SC USA. Helen Hayes Hosp, Reg Bone Ctr, W Haverstraw, NY USA. Univ Pittsburgh, Pittsburgh, PA USA. RP Roodman, GD (reprint author), VA Pittsburgh Healthcare Syst, R&D U 151, Univ Dr, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu OI Windle, Jolene/0000-0001-6690-385X FU NCI NIH HHS [P30-CA16059]; NIAMS NIH HHS [P01-AR049363] NR 41 TC 53 Z9 54 U1 0 U2 1 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 MAR PY 2006 VL 21 IS 3 BP 446 EP 455 DI 10.1359/JBMR.051108 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 016UE UT WOS:000235645100013 PM 16491293 ER PT J AU Hart, DL Cook, KF Mioduski, JE Teal, CR Crane, PK AF Hart, DL Cook, KF Mioduski, JE Teal, CR Crane, PK TI Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE computerized adaptive testing; item response theory; rehabilitation; Flexilevel Scale of Shoulder Function ID ITEM RESPONSE THEORY; DISCRIMINANT VALIDITY; RELATIVE PRECISION; HEADACHE IMPACT; RASCH ANALYSIS; HEALTH-STATUS; SCALE PF-10; UNIDIMENSIONALITY; MODELS; OUTCOMES AB Background and Objective: To test unidimensionality and local independence of a set of shoulder functional status (SFS) items, develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (theta(IRT)) and measures generated using the simulated CAT (theta(CAT)). Study Design and Setting: We performed a secondary analysis of data collected prospectively during rehabilitation of 400 patients with shoulder impairments who completed 60 SFS items. Results: Factor analytic techniques supported that the 42 SFS items formed a unidimensional scale and were locally independent. Except for five items, which were deleted, the RSM fit the data well. The remaining 37 SFS items were used to generate the CAT. On average, 6 items were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The theta(IRT) and theta(CAT) measures were highly correlated (r = .96) and resulted in similar classifications of patients. Conclusion: The simulated SFS CAT was efficient and produced precise, clinically relevant measures of functional status with good discriminating ability. (C) 2006 Elsevier Inc. All rights reserved. C1 Focus Therapeut Outcomes Inc, White Stone, VA 22578 USA. US Dept Vet Affairs, Vet Affairs Measurement Excellence Training Res &, Houston, TX USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Focus Therapeut Outcomes Inc, Knoxville, TN USA. Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Washington, Sch Med, Div Gen Internal Med, Seattle, WA USA. RP Hart, DL (reprint author), Focus Therapeut Outcomes Inc, 551 Yopps Cove Rd, White Stone, VA 22578 USA. EM dsailhart@verizon.net RI Crane, Paul/C-8623-2014 OI Crane, Paul/0000-0003-4278-7465 FU NIA NIH HHS [K08 AG 022232] NR 57 TC 56 Z9 57 U1 2 U2 4 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 MAR PY 2006 VL 59 IS 3 BP 290 EP 298 DI 10.1016/j.jclinepi.2005.08.006 PG 9 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 019GR UT WOS:000235824100010 PM 16488360 ER PT J AU Gunn, SR Reveles, XT Hamlington, JD Sadkowski, LC Johnson-Pais, TL Jorgensen, JH AF Gunn, SR Reveles, XT Hamlington, JD Sadkowski, LC Johnson-Pais, TL Jorgensen, JH TI Use of DNA sequencing analysis to confirm fungemia due to Trichosporon dermatis in a pediatric patient SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID IDENTIFICATION; LOUBIERI; REGIONS AB This is the first reported case of human disease caused by Tricosporon dermatis, an organism recently transferred to the genus Trichosporon from Cryptococcus and now confirmed to be a human pathogen. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, VA Mycol Reference Lab, San Antonio, TX 78284 USA. RP Gunn, SR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM gunn@uthsesa.edu FU NCI NIH HHS [P30 CA054174, P30 CA54174] NR 11 TC 13 Z9 16 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 2006 VL 44 IS 3 BP 1175 EP 1177 DI 10.1128/JCM.44.3.1175-1177.2006 PG 3 WC Microbiology SC Microbiology GA 022ZP UT WOS:000236095000086 PM 16517924 ER PT J AU Blank, S Lenze, EJ Mulsant, BH Dew, MA Karp, JF Shear, MK Houck, PR Miller, MD Pollock, BG Tracey, B Reynolds, CF AF Blank, S Lenze, EJ Mulsant, BH Dew, MA Karp, JF Shear, MK Houck, PR Miller, MD Pollock, BG Tracey, B Reynolds, CF TI Outcomes of late-life anxiety disorders during 32 weeks of citalopram treatment SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID MAJOR DEPRESSIVE DISORDER; CONTROLLED-TRIAL; OLDER-ADULTS; EFFICACY; PHARMACOTHERAPY; COMORBIDITY; RECOVERY; AGE AB Background: Anxiety disorders are common in later life, but little is known about the longterm benefits and risks of pharmacotherapy. Method: 30 patients aged 60 years and older, with a DSM-IV anxiety disorder, entered a 32-week trial of citalopram. Data gathered at baseline and follow-up included anxiety symptoms using Hamilton Rating Scale for Anxiety (HAM-A) scores, quality of life using the Medical Outcomes Study 36-item Short Form (SF-36), and sleep using the Pittsburgh Sleep Quality Index (PSQI). Data analysis consisted of mixed effect repeated measures models of HAM-A scores and pre-post comparison of SF-36 and PSQI scores. Results: 30 persons entered treatment: most (27/30) had a primary DSM-IV diagnosis of generalized anxiety disorder (2 had panic disorder; I had posttraurnatic stress disorder). Three subjects discontinued study medication clue to side effects. 5 were terminated because of nonresponse, and 5 dropped out of the study for other reasons; thus, 17 subjects (57%) completed 32 weeks of treatment. Subjects' HAM-A scores improved significantly, with continuing improvements up until about 20 weeks of treatment. On the basis of a criterion of reduction in HAM-A to < 10 during the trial, 60% (18/30) of subjects were responders. Those who completed the 32-week trial had significant improvements in sleep and quality of life-including social functioning, vitality, mental health, and role difficulties due to emotional problems. Conclusions: In this 32-week study of citalopram for elderly persons with anxiety disorders, 60% responded. Those who received a full course of treatment experience significant improvements in quality of life and sleep quality. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Intervent Res Ctr Late Life Mood Disorders, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. RP Lenze, EJ (reprint author), Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. EM lenzeej@msx.upmc.edu FU NIMH NIH HHS [K23 MH 64196, P30 MH 52247, T32 MH8619986] NR 27 TC 14 Z9 15 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 MAR PY 2006 VL 67 IS 3 BP 468 EP 472 PG 5 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 031RL UT WOS:000236721600018 PM 16649835 ER PT J AU Deneys, ML Ahearn, EP AF Deneys, ML Ahearn, EP TI Exacerbation of PTSD symptoms with use of duloxetine SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Letter ID POSTTRAUMATIC-STRESS-DISORDER; COMBAT VETERANS; NOREPINEPHRINE; PHARMACOTHERAPY; VENLAFAXINE; SEVERITY C1 Univ Wisconsin, Dept Psychiat, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Deneys, ML (reprint author), Univ Wisconsin, Dept Psychiat, Madison, WI 53706 USA. NR 10 TC 4 Z9 5 U1 0 U2 0 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 MAR PY 2006 VL 67 IS 3 BP 496 EP 497 PG 2 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 031RL UT WOS:000236721600024 PM 16649841 ER PT J AU Tejerina, E Frutos-Vivar, F Restrepo, MI Anzueto, A Abroug, F Palizas, F Gonzalez, M D'Empaire, G Apezteguia, C Esteban, A AF Tejerina, E Frutos-Vivar, F Restrepo, MI Anzueto, A Abroug, F Palizas, F Gonzalez, M D'Empaire, G Apezteguia, C Esteban, A CA Int Mech Ventilation Stdy Grp TI Incidence, risk factors, and outcome of ventilator-associated pneumonia SO JOURNAL OF CRITICAL CARE LA English DT Article DE critical care; epidemiology; mechanical ventilation; ventilator-associated pneumonia; mortality; outcome ID INTENSIVE-CARE UNITS; NOSOCOMIAL PNEUMONIA; HOSPITAL STAY; MORTALITY; INFECTION; MORBIDITY; DIAGNOSIS; PROGNOSIS; COHORT; ONSET AB Objective: The purpose of this study is to determine the incidence, risk factors, and outcome of ventilator-associated pneumonia (VAP). Design: Prospective cohort. Setting: Three hundred sixty-one intensive care units (ICUs) from 20 countries. Patients and Participants: Two thousand eight hundred ninety-seven patients mechanically ventilated for more than 12 hours. Measurements and Results: Baseline demographic data, primary indication for mechanical ventilation, daily ventilator settings, multiple organ failure over the course of mechanical ventilation, and outcome were collected. Ventilator-associated pneumonia was present in 439 patients (15%). Patients with VAP were more likely to have chronic pulmonary obstructive disease, aspiration, sepsis, and acute respiratory distress syndrome. Mortality in patients with VAP was 38%. Factors associated with mortality were severity of illness, limited activity before the onset of mechanical ventilation and development of shock, acute renal failure, and worsening of hypoxemia during the period of mechanical ventilation. Casecontrol analysis showed no increased mortality in patients with VAP (38.1% vs 37.9%, P =.95) but prolonged duration of mechanical ventilation and ICU stay. Conclusion: In a large cohort of mechanically ventilated patients, VAP is more likely in patients with underlying lung disease (acute or chronic). Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay but no increase in mortality. (c) 2006 Elsevier Inc. All rights reserved. C1 Hosp Univ Getafe, Intens Care Unit, Madrid 28905, Spain. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, Intens Care Unit, San Antonio, TX USA. Ctr Hosp Univ Fattouma Burghuiba, Intens Care Unit, Monastir 5000, Tunisia. Clin Bazterr, Intens Care Unit, RA-1425 Buenos Aires, DF, Argentina. Hosp Gen Medellin, Intens Care Unit, Medellin, Colombia. Hosp Clin Caracas, Intens Care Unit, Caracas, Venezuela. Hosp Nacl Prof Alejandro Posadas, Intens Care Unit, RA-1706 Haedo, Argentina. RP Esteban, A (reprint author), Hosp Univ Getafe, Intens Care Unit, Madrid 28905, Spain. EM aesteban@ucigetafe.com OI Frutos-Vivar, Fernando/0000-0002-4648-9636 NR 24 TC 60 Z9 78 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0883-9441 J9 J CRIT CARE JI J. Crit. Care PD MAR PY 2006 VL 21 IS 1 BP 56 EP 65 DI 10.1016/j.jcrc.2005.08.005 PG 10 WC Critical Care Medicine SC General & Internal Medicine GA 036JE UT WOS:000237066600010 PM 16616625 ER PT J AU Anderson, B Mishory, A Nahas, Z Borckardt, JJ Yamanaka, K Rastogi, K George, MS AF Anderson, B Mishory, A Nahas, Z Borckardt, JJ Yamanaka, K Rastogi, K George, MS TI Tolerability and safety of high daily doses of repetitive transcranial magnetic stimulation in healthy young men SO JOURNAL OF ECT LA English DT Article DE rTMS; transcranial magnetic stimulation; safety; seizure ID HUMAN MOTOR CORTEX; RESISTANT DEPRESSION; DOUBLE-BLIND; RTMS; EFFICACY; SEIZURE; MEMORY AB Repetitive transcranial magnetic stimulation (rTMS) is an experimental technology that involves a powerful magnetic pulse applied to the scalp, which is sufficient to cause neuronal depolarization. Transcranial magnetic stimulation has been used in treatment studies for psychiatric disorders, primarily unipolar depression, and as a tool to map brain function. Although thousands of rTMS sessions have been given with few side effects, rTMS can produce serious adverse effects such as an unintended seizure. Safety guidelines for frequency, duration, and intensity of rTMS have aided in the prevention of such adverse side effects. However, the total dose (number of stimuli) able to be delivered safely to human subjects within a day or within a week has not been established. For example, previous rTMS Studies as a treatment for depression consisted of delivering 800 to 3000 magnetic pulses per day, with 8000 to 30,000 magnetic pulses over 2 to 3 weeks. This study examined whether high doses of rTMS within a day or over a week would produce significant side effects. As part of a study to examine rTMS effects in sleep deprivation, we exposed healthy men to 12,960 magnetic pulses a day for up to 3 days in I week. This equals 38,880 magnetic pulses over I week, which is likely one of the largest exposures of TMS to date. Despite this intense treatment regimen, we failed to produce significant side effects. Doses of up to 12,960 pulses per day appear safe and tolerable in healthy Young men. C1 Med Univ S Carolina, Dept Psychiat, Brain Stimulat Lab, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Mental Hlth Serv, Charleston, SC USA. Med Univ S Carolina, Brain Stimulat Lab, Charleston, SC 29425 USA. RP Anderson, B (reprint author), Med Univ S Carolina, Dept Psychiat, Brain Stimulat Lab, 67 President St,502 N, Charleston, SC 29425 USA. EM andersob@musc.edu FU NCRR NIH HHS [M01 RR01070]; NIA NIH HHS [AG40956]; NIMH NIH HHS [R01-MH069896, R01-MH069887] NR 33 TC 41 Z9 44 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1095-0680 J9 J ECT JI J. ECT PD MAR PY 2006 VL 22 IS 1 BP 49 EP 53 DI 10.1097/00124509-200603000-00011 PG 5 WC Behavioral Sciences; Psychiatry SC Behavioral Sciences; Psychiatry GA 033BU UT WOS:000236822100011 PM 16633208 ER PT J AU Peden-Adams, MM EuDaly, JG Heesemann, LM Smythe, J Miller, J Gilkeson, GS Keil, DE AF Peden-Adams, MM EuDaly, JG Heesemann, LM Smythe, J Miller, J Gilkeson, GS Keil, DE TI Developmental immunotoxicity of trichloroethylene (TCE): Studies in B6C3F1 mice SO JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH PART A-TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING LA English DT Article DE TCE; immune; PFC; developmental immunotoxicology; DTH ID LUPUS-ERYTHEMATOSUS SLE; RISK-ASSESSMENT; AUTOIMMUNE-RESPONSE; HOST-RESISTANCE; EXPOSURE; SINGLE; IMMUNE; CELLS; WATER; HYPERSENSITIVITY AB This study assessed the developmental immunotoxicity of trichloroethylene (TCE) in B6C3F1 mice exposed via drinking water (0, 1,400, 14,000 ppb) from gestation day 0 (GD0) to either 3 or 8 weeks of age. Lymphocyte proliferation, NK cell activity, SRBC-specific IgM production (PFC response), splenic B220+ cells, and thymic and splenic T-cell immunophenotypes were assessed at 3 and 8 weeks of age. Delayed type hypersensitivity (DTH) and autoantibodies to ds-DNA were assessed in 8-week old animals only. Proliferation and NK cell activity were not affected at either age. Decreased PFC responses were noted in male offspring at both ages and both TCE treatment levels. PFC responses in female offspring were suppressed by treatment with 14,000 ppb TCE at both ages assessed and at 1,400 ppb TCE at 8 weeks of age. Splenic numbers of B220 cells were only decreased in 3-week old pups exposed to 14,000 ppb TCE. The most pronounced alteration in T-cell subpopulations were increases in all thymic (CD4+, CD8+, CD4+/CD8+, and CD4-/CD8-) T-cell types in 8-week old animals. DTH was increased in females at both TCE levels and in males at the high dose only. These results indicate that TCE may be an effective developmental immunotoxicant and suggests that additional studies are required to determine the health risks associated with developmental exposure to TCE. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29412 USA. Med Univ S Carolina, Div Rheumatol & Immunol, Charleston, SC 29412 USA. Med Univ S Carolina, Dept Hlth Profess, Charleston, SC 29412 USA. Med Univ S Carolina, Marine Biomed & Environm Sci Ctr, Charleston, SC 29412 USA. Ralph Johnson VAMC, Med Res Serv, Charleston, SC USA. RP Peden-Adams, MM (reprint author), Med Univ S Carolina, Dept Pediat, 221 Ft Johnson Rd, Charleston, SC 29412 USA. EM pedenada@musc.edu NR 29 TC 24 Z9 25 U1 0 U2 3 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1093-4529 J9 J ENVIRON SCI HEAL A JI J. Environ. Sci. Health Part A-Toxic/Hazard. Subst. Environ. Eng. PD MAR PY 2006 VL 41 IS 3 BP 249 EP 271 DI 10.1080/10934520500455289 PG 23 WC Engineering, Environmental; Environmental Sciences SC Engineering; Environmental Sciences & Ecology GA 012NN UT WOS:000235346000001 PM 16484062 ER PT J AU McLaughlin, MA Orosz, GM Magaziner, J Hannan, EL McGinn, T Morrison, RS Hochman, T Koval, K Gilbert, M Siu, AL AF McLaughlin, MA Orosz, GM Magaziner, J Hannan, EL McGinn, T Morrison, RS Hochman, T Koval, K Gilbert, M Siu, AL TI Preoperative status and risk of complications in patients with hip fracture SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE preoperative assessment; complications; elderly; noncardiac surgery; hip fracture ID NONCARDIAC SURGERY; ELDERLY PATIENTS; CARDIAC RISK; MORTALITY; OUTCOMES; VALIDATION; INDEX; ASSOCIATION; PREDICTION; GUIDELINE AB Background: Limited information is available on preoperative status and risks for complications for older patients having surgery for hip fracture. Our objective was to identify potentially modifiable clinical findings that should be considered in decisions about the timing of surgery. Methods: We conducted a prospective cohort study with data obtained from medical records and through structured interviews with patients. A total of 571 adults with hip fracture who were admitted to 4 metropolitan hospitals were included. Results: Multiple logistic regression was used to identify risk factors (including 11 categories of physical and laboratory findings, classified as mild and severe abnormalities) for in-hospital complications. The presence of more than 1 (odds ratiol [OR] 9.7, 95% confidence interval [CI] 2.8 to 33.0) major abnormality before surgery or the presence of major abnormalities on admission that were not corrected prior to surgery (OR 2.8, 95% CI 1.2 to 6.4) was independently associated with the development of postoperative complications. We also found that minor abnormalities, while warranting correction, did not increase risk (OR 0.70, 95% CI 0.28 to 1.73). Conclusions: In this study of older adults undergoing urgent surgery, potentially reversible abnormalities in laboratory and physical examination occurred frequently and significantly increased the risk of postoperative complications. Major clinical abnormalities should be corrected prior to surgery, but patients with minor abnormalities may proceed to surgery with attention to these medical problems perioperatively. C1 CUNY, Mt Sinai Med Ctr, Mt Sinai Sch Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. Univ Arkansas Med Sci, Ft Smith, AR USA. Univ Maryland, Sch Med, Baltimore, MD 21201 USA. SUNY Albany, Sch Publ Hlth, Albany, NY 12222 USA. Hosp Joint Dis & Med Ctr, New York, NY USA. RP McLaughlin, MA (reprint author), CUNY, Mt Sinai Med Ctr, Mt Sinai Sch Med, Box 1030,1 Gustave L Levy Pl, New York, NY 10029 USA. EM maryann.mclaughlin@mssm.edu FU AHRQ HHS [U18 HS009459, U18HS09459-0]; NIA NIH HHS [K24 AG000918, R01 AG021992] NR 33 TC 34 Z9 44 U1 1 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 MAR PY 2006 VL 21 IS 3 BP 219 EP 225 DI 10.1111/j.1525-1497.2006.00318.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024UY UT WOS:000236223000003 PM 16390507 ER PT J AU Palonen, KP Allison, JJ Heudebert, GR Willett, LL Kiefe, CI Wall, TC Houston, TK AF Palonen, KP Allison, JJ Heudebert, GR Willett, LL Kiefe, CI Wall, TC Houston, TK TI Measuring resident physicians' performance of preventive care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE education; medical; preventive health services; patient survey; medical record review; cost evaluation ID MEDICAL-RECORD AUDIT; QUALITY-OF-CARE; STANDARDIZED PATIENTS; PATIENT QUESTIONNAIRES; CLINICAL VIGNETTES; CHART ABSTRACTION; HEALTH-CARE; SELF-REPORT; GUIDELINES; SMOKING AB Background: The Accreditation Council for Graduate Medical Education has suggested various methods for evaluation of practice-based learning and improvement competency, but data on implementation of these methods are limited. Objective: To compare medical record review and patient surveys on evaluating physician performance in preventive services in an outpatient resident clinic. Design: Within an ongoing quality improvement project, we collected baseline performance data on preventive services provided for patients at the University of Alabama at Birmingham (UAB) Internal Medicine Residents' ambulatory clinic. Participants:eventy internal medicine and medicine-pediatrics residents from the UAB Internal Medicine Residency program. Measurements: Resident- and clinic-level comparisons of aggregated patient survey and chart documentation rates of (1) screening for smoking status, (2) advising smokers to quit, (3) cholesterol screening, (4) mammography screening, and (5) pneumonia vaccination. Results: Six hundred and fifty-nine patient surveys and 761 charts were abstracted. At the clinic level, rates for screening of smoking status, recommending mammogram, and for cholesterol screening were similar (difference < 5%) between the 2 methods. Higher rates for pneumonia vaccination (76% vs 67%) and advice to quit smoking (66% vs 52%) were seen on medical record review versus patient surveys. However, within-resident (N=70) comparison of 2 methods of estimating screening rates contained significant variability. The cost of medical record review was substantially higher ($107 vs $17/physician). Conclusions: Medical record review and patient surveys provided similar rates for selected preventive health measures at the clinic level, with the exception of pneumonia vaccination and advising to quit smoking. A large variation among individual resident providers was noted. C1 Birmingham VA Med Ctr, HSR&D Res Enhancement Award Program, Birmingham, AL USA. Univ Alabama, Dept Med, Div Gen Internal Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA. Vet Hlth Adm, Off Acad Affiliat, VA Natl Qual Scholars, Birmingham, AL USA. Univ Alabama, Dept Pediat, Div Gen Pediat, Birmingham, AL USA. RP Palonen, KP (reprint author), 1530 3rd Ave S,FOT 720, Birmingham, AL 35294 USA. EM palonen@uab.edu RI Houston, Thomas/F-2469-2013 NR 29 TC 12 Z9 12 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 MAR PY 2006 VL 21 IS 3 BP 226 EP 230 DI 10.1111/j.1525-1497.2006.00338.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024UY UT WOS:000236223000004 PM 16499544 ER PT J AU Borrero, S Kwoh, CK Sartorius, J Ibrahim, SA AF Borrero, S Kwoh, CK Sartorius, J Ibrahim, SA TI Brief Report: Gender and total knee/hip arthroplasty utilization rate in the VA system SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE osteoarthritis; gender; arthroplasty; Veterans Administration ID TOTAL HIP-ARTHROPLASTY; MEDICARE POPULATION; UNITED-STATES; REPLACEMENT; OUTCOMES; SURGERY; WOMEN; MEN AB Objective: Osteoarthritis (OA) is a leading cause of disability and is more prevalent in women than men. Total joint arthroplasty is an effective treatment option for end-stage OA. We examined gender differences in utilization rates of total knee/hip arthroplasty in the Veterans Administration (VA) system. Methods: The sample consisted of all VA patients for fiscal year (FY) 1999, 50 years of age or older, with or without the diagnosis of OA in any joint. We calculated the odds of patients undergoing total knee/hip arthroplasty adjusting for age, comorbidities, and presence of OA. We included the hospital site as a random effects variable to adjust for clustering. Results: Of the 1,968,093 (2.3% women) VA patients in FY 1999 who were 50 years of age or older, 329,461 (2.9% women) patients carried a diagnosis of OA. For women, 2-year adjusted odds of undergoing total knee or hip arthroplasty were 0.97 (0.83 to 1.14) and 1.00 (0.79 to 1.27), respectively. Conclusion: Among patients potentially at risk for the procedure, men and women in the VA system were equally likely to undergo knee/hip arthroplasty. C1 VA Pittsburgh Hlth Care Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Hlth Care Syst, Ctr Hlth Equity Res & Promot, 151-C, Pittsburgh, PA 15240 USA. EM said.ibrahim2@med.va.gov NR 20 TC 11 Z9 11 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 MAR PY 2006 VL 21 SU 3 BP S54 EP S57 DI 10.1111/j.1525-1497.2006.00375.x PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500011 PM 16637947 ER PT J AU Cope, JR Yano, EM Lee, ML Washington, DL AF Cope, JR Yano, EM Lee, ML Washington, DL TI Determinants of contraceptive availability at medical facilities in the department of veterans affairs SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT Meeting of the Academy-of-Health-Services-Research CY JUN 06-08, 2004 CL San Diego, CA SP Acad Hlth Serv Res DE women's health; veterans; contraception; birth control; family planning; US Department of Veterans Affairs ID WOMENS HEALTH-CARE; FAMILY-PLANNING AGENCIES; UNITED-STATES; OUTPATIENT CLINICS; PERFORMANCE-MEASURES; INTRAUTERINE-DEVICE; SERVICES; PHYSICIANS; PROVISION; PREGNANCY AB Objective: To describe the variation in provision of hormonal and intrauterine contraception among Veterans Affairs (VA) facilities. Design: Key informant, cross-sectional survey of 166 VA medical facilities. Data from public use data sets and VA administrative databases were linked to facility data to further characterize their contextual environments. Participants: All VA hospital-based and affiliated community-based outpatient clinics delivering services to at least 400 unique women during fiscal year 2000. Measurements: Onsite availability of hormonal contraceptive prescription and intrauterine device (IUD) placement. Results: Ninety-seven percent of facilities offered onsite prescription and management of hormonal contraception whereas 63% offered placement of IUDs. After adjusting for facility caseload of reproductive-aged women, 3 organizational factors were independently associated with onsite IUD placement: (1) onsite gynecologist (adjusted odds ratio [OR], 20.35; 95% confidence interval [CI], 7.02 to 58.74; P <.001); (2) hospital-based in contrast to community-based practice (adjusted OR, 5.49; 95% CI, 1.16 to 26.10; P=.03); and (3) availability of a clinician providing women's health training to other clinicians (adjusted OR, 3.40; 95% CI 1.19 to 9.76; P=.02). Conclusions: VA's provision of hormonal and intrauterine contraception is in accordance with community standards, although onsite availability is not universal. Although contraception is a crucial component of a woman's health maintenance, her ability to obtain certain contraceptives from the facility where she obtains her primary care is largely influenced by the availability of a gynecologist. Further research is needed to determine how fragmentation of women's care into reproductive and nonreproductive services impacts access to contraception and the incidence of unintended pregnancy. C1 VA Greater Los Angeles HSR&D Ctr Excellenc, VA Sepulveda Ambulatory Care Ctr, Sepulveda, CA 91343 USA. Dept Hlth Serv, ValleyCare, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Family Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Yano, EM (reprint author), VA Greater Los Angeles HSR&D Ctr Excellenc, VA Sepulveda Ambulatory Care Ctr, 16111 Plummer St 152, Sepulveda, CA 91343 USA. EM Elizabeth.Yano@va.gov NR 40 TC 13 Z9 15 U1 1 U2 5 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 MAR PY 2006 VL 21 SU 3 BP S33 EP S39 DI 10.1111/j.1525-1497.2006.00372.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500008 PM 16637943 ER PT J AU Goldzweig, CL Balekian, TM Rolon, C Yano, EM Shekelle, PG AF Goldzweig, CL Balekian, TM Rolon, C Yano, EM Shekelle, PG TI The state of women veterans' health research SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE women; veterans; systematic review ID POSTTRAUMATIC-STRESS-DISORDER; PERSIAN-GULF-WAR; FEMALE VIETNAM VETERANS; AFFAIRS MEDICAL-CENTER; US MILITARY PERSONNEL; HORMONE REPLACEMENT THERAPY; SELF-REPORTED HEALTH; MENTAL-HEALTH; SEXUAL ASSAULT; NATIONAL SAMPLE AB Objective: Assess the state of women veterans' health research. Design: Systematic review of studies that pertained specifically to or included explicit information about women veterans. A narrative synthesis of studies in 4 domains/topics was conducted: Stress of military life; Health and performance of military/VA women; Health services research/quality of care; and Psychiatric conditions. Measurements and Main Results: We identified 182 studies. Of these, 2 were randomized-controlled trials (RCTs) and the remainder used observational designs. Forty-five percent of studies were VA funded. We identified 77 studies pertaining to the stress of military life, of which 21 reported on sexual harassment or assault. Rates of harassment ranged from 55% to 79% and rates of sexual assault from 4.2% to 7.3% in active duty military women and 11% to 48% among women veterans. Forty-two studies concerned the health and performance of military/VA women, with 21 studies evaluating sexual assault and posttraumatic stress disorder (PTSD) and their effect on health. Fifty-nine studies assessed various aspects of health services research. Eight studies assessed quality of care and 5, patient satisfaction. Twenty-five studies assessed utilization and health care organization, and findings include that women veterans use the VA less than men, that gender-specific reasons for seeking care were common among female military and veteran personnel, that provision of gender-specific care increased women veterans' use of VA, and that virtually all VAs have available on-site basic women's health services. Fifty studies were classified as psychiatric; 31 of these were about the risk, prevalence, and treatment of PTSD. Conclusions: Most research on VA women's health is descriptive in nature and has concerned PTSD, sexual harassment and assault, the utilization and organization of care, and various psychiatric conditions. Experimental studies and studies of the quality of care are rare. C1 Greater Los Angeles VA Healthcare Syst, So Calif Evidence Based Practice Ctr, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. RP Goldzweig, CL (reprint author), VA W Los Angeles Healthcare Ctr, 111G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM caroline.goldzweig@va.gov NR 141 TC 88 Z9 89 U1 2 U2 8 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 MAR PY 2006 VL 21 SU 3 BP S82 EP S92 DI 10.1111/j.1225-1497.2006.00380.x PG 11 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500016 PM 16637952 ER PT J AU Johnson, KM Nelson, KM Bradley, KA AF Johnson, KM Nelson, KM Bradley, KA TI Television viewing practices and obesity among women veterans 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 obesity; television; women veterans ID POSTTRAUMATIC-STRESS-DISORDER; FEMALE VETERANS; HEALTH-PROFESSIONALS; SOCIOECONOMIC-STATUS; PHYSICAL-ACTIVITY; ACTIVITY PROGRAMS; AFFAIRS PATIENTS; OVERWEIGHT; ASSOCIATION; DEPRESSION AB Background: Obesity is epidemic in the U.S. and has been associated with television viewing. Objective: To describe the association between obesity and television viewing practices among women veterans. Design, Setting and Participants: Cross-sectional, mailed survey completed by 1,555 female veterans enrolled at the VA Puget Sound Health Care System in 2000. Measurements and Methods: We used bivariate and multivariate analyses to assess the association of obesity (body mass index > 30 kg/m(2) based on self-reported height and weight) with self-reported number of hours of television or videos viewed per day, and frequency of eating meals or snacking while watching television, controlling for other covariates. Results: Watching television > 2 hours per typical day on week days and/or weekends was associated with obesity (P <.001), as was eating or snacking while watching television (P=.003). In multivariate logistic regression analyses, watching television > 2 hours per day and eating or snacking while watching television were each associated with obesity (odds ratio [OR] 1.4, 95% confidence interval [CI] 1.1 to 1.8; and OR 1.3, 95% CI 1.0 to 1.7, respectively), after adjusting for demographic variables, smoking, physical activity, and depression. Results were similar when posttraumatic stress disorder was included in the model instead of depression. Women who both watched > 2 hours of television per day and ate or snacked while viewing were almost twice as likely to be obese (OR 1.9, 95% CI 1.4 to 2.6). Conclusions: Watching television over 2 hours per day and eating while watching television were each associated with obesity among female VA patients and may be modifiable risk factors for obesity. C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Div Gen Internal Med, Seattle, WA 98195 USA. RP Johnson, KM (reprint author), VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Mailstop S-111-GIMC,1660 S Columbian Way, Seattle, WA 98108 USA. EM Kay.Johnson2@med.va.gov FU NIAAA NIH HHS [K23 AA000313, K23AA00313] NR 37 TC 14 Z9 15 U1 2 U2 4 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 MAR PY 2006 VL 21 SU 3 BP S76 EP S81 DI 10.1111/j.1525-1497.2006.00379.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500015 PM 16637951 ER PT J AU Johnson, KM Bradley, KA Bush, K Gardella, C Dobie, DJ Laya, MB AF Johnson, KM Bradley, KA Bush, K Gardella, C Dobie, DJ Laya, MB TI Frequency of mastalgia among women veterans - Association with psychiatric conditions and unexplained pain syndromes SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE mastalgia; breast pain; mastodynia; women veterans; unexplained pain syndromes ID POSTTRAUMATIC-STRESS-DISORDER; CYCLICAL MASTALGIA; FEMALE VETERANS; PRIMARY-CARE; BREAST PAIN; AFFAIRS PATIENTS; PREVALENCE; MANAGEMENT; VALIDATION; HEALTH AB Objective: To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes. Design, Setting and Participants: Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998. Measurements: Breast pain in the past year, unrelated to pregnancy, was categorized as infrequent (<= monthly) or frequent (>= weekly) mastalgia. Surveys assessed posttraumatic stress disorder (PTSD), depression, panic disorder, and alcohol misuse with validated screening tests, as well as self-reported past-year chronic pelvic pain, fibromyalgia, and irritable bowel syndrome. Results: The response rate was 63%. Fifty-five percent of the respondents reported past-year mastalgia. Of these, 15% reported frequent mastalgia. Compared to women without mastalgia, women reporting frequent mastalgia were more likely to screen positive for PTSD (odds ratio [OR] 5.2, 95% confidence interval [CI] 3.2 to 8.4), major depression (OR 4.2, 2.6 to 6.9), panic disorder (OR 7.1, 3.9 to 12.8), eating disorder (OR 2.6, 1.5 to 4.7), alcohol misuse (OR 1.8, 1.1 to 2.8), or domestic violence (OR 3.1, 1.9 to 5.0), and to report fibromyalgia (OR 3.9, 2.1 to 7.4), chronic pelvic pain (OR 5.4, 2.7 to 10.5), or irritable bowel syndrome (OR 2.8, 1.6 to 4.8). Women with infrequent mastalgia were also more likely than women without mastalgia to screen positive for PTSD, depression, or panic disorder, or report pelvic pain or irritable bowel syndrome, although associations were weaker than with frequent mastalgia. Conclusions: Like other unexplained pain syndromes, frequent mastalgia is strongly associated with PTSD and other psychiatric conditions. Clinicians seeing patients with frequent mastalgia should inquire about anxiety, depression, alcohol misuse, and trauma history. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Gen Internal Med, Seattle, WA USA. Univ Washington, Sch Med, Dept Obstet & Gynecol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat, Seattle, WA USA. RP Johnson, KM (reprint author), VA Puget Sound Hlth Care Syst, Mailstop S-111-GIMC,1660 S Columbian Way, Seattle, WA 98108 USA. EM Kay.Johnson2@med.va.gov FU NIAAA NIH HHS [K23 AA000313, K23AA00313] NR 30 TC 18 Z9 19 U1 0 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 MAR PY 2006 VL 21 SU 3 BP S70 EP S75 DI 10.1111/j.1525-1497.2006.00378.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500014 PM 16637950 ER PT J AU Murdoch, M Bradley, A Mather, SH Klein, RE Turner, CL Yano, EM AF Murdoch, M Bradley, A Mather, SH Klein, RE Turner, CL Yano, EM TI Women and war - What physicians should know SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE veterans; female; combat disorders; sexual trauma; review ID POSTTRAUMATIC-STRESS-DISORDER; PERSIAN-GULF-WAR; SEXUAL ASSAULT; VIETNAM VETERANS; MILITARY ENVIRONMENT; COMBAT VETERANS; ARMED-FORCES; RISK-FACTORS; HEALTH; FEMALE AB Most of today's 1.7 million women veterans obtain all or most of their medical care outside the VA health care system, where their veteran status is rarely recognized or acknowledged. Several aspects of women's military service have been associated with adverse psychologic and physical outcomes, and failure to assess women's veteran status, their deployment status, and military trauma history could delay identifying or treating such conditions. Yet few clinicians know of women's military history-or of military service's impact on women's subsequent health and well being. Because an individual's military service may be best understood within the historical context in which it occurred, we provide a focused historical overview of women's military contributions and their steady integration into the Armed Forces since the War for Independence. We then describe some of the medical and psychiatric conditions associated with military service. C1 Vet Adm Med Ctr, Gen Internal Med Sect, CCDOR 111 0, Minneapolis, MN 55417 USA. Univ Minnesota, Sch Med, Dept Internal Med, Minneapolis, MN 55455 USA. VA Roseburg Healthcare Syst, Roseburg, OR USA. Vet Hlth Adv, Off Publ Hlth & Environm Hazard, Washington, DC USA. Dept Vet Affairs, Off Actuary, Washington, DC USA. Vet Hlth Adm, Women Vet Hlth Program, Washington, DC USA. VA Greater Los Angeles Ctr Study Healthcare Provi, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Murdoch, M (reprint author), Vet Adm Med Ctr, Gen Internal Med Sect, CCDOR 111 0, 1 Vet Dr, Minneapolis, MN 55417 USA. EM Maureen.Murdoch@med.va.gov NR 80 TC 48 Z9 49 U1 3 U2 6 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 MAR PY 2006 VL 21 SU 3 BP S5 EP S10 DI 10.1111/j.1525-1497.2006.00368.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500004 PM 16637946 ER PT J AU Washington, DL Yano, EM Simon, B Sun, S AF Washington, DL Yano, EM Simon, B Sun, S TI To use or not to use - What influences why women veterans choose VA health care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE women's health services; ambulatory care/utilization; hospitals; veterans/utilization; health services accessibility; decision making; choice behavior ID AFFAIRS MEDICAL-CENTER; QUALITY-OF-CARE; NATIONAL SAMPLE; FEMALE VETERANS; SERVICES; RELIABILITY; VALIDITY; PROJECT AB Background and Objective: Effects of advances in Department of Veterans Affairs (VA) women's health care on women veterans' health care decision making are unknown. Our objective was to determine why women veterans use or do not use VA health care. Desing and Participants: Cross-sectional survey of 2,174 women veteran VA users and VA-eligible nonusers throughout southern California and southern Nevada. Measurements: VA utilization, attitudes toward care, and socio-demographics. Results: Reasons cited for VA use included affordability (67.9%); women's health clinic (WHC) availability (58.8%); quality of care (54.8%); and convenience (47.9%). Reasons for choosing health care in non-VA settings included having insurance (71.0%); greater convenience of non-VA care (66.9%); lack of knowledge of VA eligibility and services (48.5%); and perceived better non-VA quality (34.5%). After adjustment for socio-demographics, health characteristics, and VA priority group, knowledge deficits about VA eligibility and services and perceived worse VA care quality predicted outside health care use. VA users were less likely than non-VA users to have after-hours access to nonemergency care, but more likely to receive both general and gender-related care from the same clinic or provider, to use a WHC for gender-related care, and to consider WHC availability very important. Conclusions: Lack of information about VA, perceptions of VA quality, and inconvenience of VA care, are deterrents to VA use for many women veterans. VA WHCs may foster VA use. Educational campaigns are needed to fill the knowledge gap regarding women veterans' VA eligibility and advances in VA quality of care, while VA managers consider solutions to after-hours access barriers. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. VA Sepulveda Ambulatory Care Ctr & Nursing Home, VA Greater Los Angeles Hlth Serv Res & Dev Ctr Ex, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. EM donna.washington@va.gov NR 35 TC 73 Z9 73 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 MAR PY 2006 VL 21 SU 3 BP S11 EP S18 DI 10.1111/j.1525-1497.2006.00369.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500005 PM 16637939 ER PT J AU Washington, DL Yano, EM Horner, RD AF Washington, DL Yano, EM Horner, RD TI The health and health care of women veterans - Perspectives, new insights, and future research directions SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID AFFAIRS MEDICAL-CENTER; QUALITY C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Cincinnati, Med Ctr, Inst Study Hlth, Cincinnati, OH 45267 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,111G, Los Angeles, CA USA. EM donna.washington@va.gov NR 7 TC 6 Z9 6 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 MAR PY 2006 VL 21 SU 3 BP S3 EP S4 DI 10.1111/j.1525-1497.2006.00367.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500002 ER PT J AU Yaeger, D Himmelfarb, N Cammack, A Mintz, J AF Yaeger, D Himmelfarb, N Cammack, A Mintz, J TI DSM-IV diagnosed posttraumatic stress disorder in women veterans with and without military sexual trauma SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE military sexual trauma; PTSD; women's health ID FEMALE VIETNAM VETERANS; HEALTH-CARE UTILIZATION; PREVALENCE; ASSAULT; PTSD; RISK; ASSOCIATION; OUTPATIENTS; ENVIRONMENT; PERSONNEL AB Background: This study compares rates of posttraumatic stress disorder (PTSD) in female veterans who had military sexual trauma (MST) with rates of PTSD in women veterans with all other types of trauma. Methods: Subjects were recruited at the Women's Comprehensive Healthcare Center when attending medical or psychiatric appointments or through a mailing; 230 women agreed and 196 completed the study. They completed questionnaires on health and military history, along with the Stressful Life Events Questionnaire (SLEQ). Those who met DSM-IV PTSD Criterion A completed the PTSD Symptom Scale-Interview (PSS-I) on which PTSD diagnoses were based. Results: Ninety-two percent reported at least 1 trauma. Forty-one percent had MST, alone or with other trauma, and 90% had other trauma, with or without MST. Overall, 43% of subjects with trauma had PTSD. Those with MST had higher rates of PTSD than those with other trauma. Sixty percent of those with MST had PTSD; 43% of subjects with other traumas (with or without MST) had PTSD. Military sexual trauma and other trauma both significantly predicted PTSD in regression analyses (P=.0001 and .02, respectively) but MST predicted it more strongly. Prior trauma did not contribute to the relationship between MST and PTSD. Discussion: Findings suggest that MST is common and that it is a trauma especially associated with PTSD. C1 VA Greater Los Angeles Healthcare Syst, Womens Comprehens Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Irvine, Dept Psychiat & Human Behav, Irvine, CA 92717 USA. RP Yaeger, D (reprint author), VA Greater Los Angeles Healthcare Syst, Womens Comprehens Healthcare Ctr, Mailcode OQAC WC,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Deborah.Yaeger@va.gov NR 29 TC 53 Z9 53 U1 4 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 MAR PY 2006 VL 21 SU 3 BP S65 EP S69 DI 10.1111/j.1525-1497.2006.00377.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 021AK UT WOS:000235954500013 PM 16637949 ER PT J AU Chen, AJW Abrams, GM D'Esposito, M AF Chen, AJW Abrams, GM D'Esposito, M TI Functional reintegration of prefrontal neural networks for enhancing recovery after brain injury SO JOURNAL OF HEAD TRAUMA REHABILITATION LA English DT Article; Proceedings Paper CT Galveston Brain Injury Conference (GBIC) CY APR, 2005 CL Galveston, TX SP Moody Fdn DE brain injuries; craniocerebral trauma; frontal lobe; learning; magnetic resonance imaging; neuronal plasticity; prefrontal cortex; recovery of function; rehabilitation ID POSITRON-EMISSION-TOMOGRAPHY; WORKING-MEMORY IMPAIRMENT; COGNITIVE REHABILITATION; UTILIZATION BEHAVIOR; FRONTAL LOBES; FMRI DATA; CORTEX; CONNECTIVITY; REORGANIZATION; REPRESENTATION AB Functions of the prefrontal cortex (PFC) are fundamental to learning and rehabilitation after brain injuries, but the PFC is particularly vulnerable to trauma. We propose approaches to cognitive training that are hypothesized to specifically enhance PFC function. We present a theoretical framework that generates hypotheses regarding the effects of training on the functional integration of processes across distributed networks of brain regions. Specific outcome measurements that may be used to test these hypotheses in clinical trials are proposed. This neural network-level approach may guide cognitive rehabilitation and facilitate development of adjunctive biologic treatments to enhance the effects of training. C1 Univ Calif Berkeley, Brain Imaging Ctr, Helen Wills Neurosci Inst, Berkeley, CA 94720 USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Chen, AJW (reprint author), Univ Calif Berkeley, Brain Imaging Ctr, Helen Wills Neurosci Inst, 132 Barker Hall,Mailing Ctr 3190, Berkeley, CA 94720 USA. EM anthony.chen@ucsf.edu NR 56 TC 23 Z9 23 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-9701 J9 J HEAD TRAUMA REHAB JI J. Head Trauma Rehabil. PD MAR-APR PY 2006 VL 21 IS 2 BP 107 EP 118 PG 12 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 031PK UT WOS:000236716300003 PM 16569985 ER PT J AU Basile, JN Chrysant, S AF Basile, JN Chrysant, S TI The importance of early antihypertensive efficacy: the role of angiotensin II receptor blocker therapy SO JOURNAL OF HUMAN HYPERTENSION LA English DT Review DE angiotensin II type 1 receptor blockers; calcium channel blockers; blood pressure goal rates; early antihypertensive efficacy ID RANDOMIZED CLINICAL-TRIALS; TO-MODERATE HYPERTENSION; HIGH CARDIOVASCULAR RISK; BLOOD-PRESSURE; ELDERLY SCOPE; DOUBLE-BLIND; SYSTOLIC HYPERTENSION; COMBINATION THERAPY; STROKE PREVENTION; VALSARTAN AB Desirable features of antihypertensive agents include efficacy, tolerability, prolonged duration of action and rapid achievement of target blood pressure (BP). Recent studies have examined the relationship between the onset of antihypertensive effect and cardiovascular events. Data from the Valsartan Antihypertensive Longterm Use Evaluation (VALUE), the Study on Cognition and Prognosis in the Elderly (SCOPE), and the Systolic Hypertension in Europe (Syst-Eur) trials support the hypothesis that the time it takes to reach target BP influences cardiovascular outcomes. VALUE, which compared BP-lowering and clinical event rates between patients treated with the angiotensin II receptor blocker (ARB) valsartan or the calcium channel blocker (CCB) amlodipine as well as between those who achieved immediate or delayed BP control, provides the strongest evidence of this to date. Additional data from SCOPE and Syst-Eur suggest that delays of 3 months to 2 years in starting antihypertensive therapy can increase the risk of certain cardiovascular end points, especially stroke. These data suggest that it may be beneficial to examine the efficacy of antihypertensive agents, not only long term, but also at earlier times to assess the onset and impact of early antihypertensive effect. The ARB olmesartan medoxomil (olmesartan) and the CCB amlodipine were compared in a randomized, double-blind, placebo-controlled clinical trial, which demonstrated that the onset of antihypertensive effect of olmesartan is comparable with that of amlodipine. Another study demonstrated that more patients treated with olmesartan achieved target BPs within 2 weeks of treatment compared with the ARBs losartan, valsartan and irbesartan. C1 Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. Univ Oklahoma, Sch Med, Oklahoma City, OK 73190 USA. Oklahoma Cardiovasc & Hypertens Ctr, Oklahoma City, OK 73190 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM jan.basile@med.va.gov NR 40 TC 23 Z9 24 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9240 J9 J HUM HYPERTENS JI J. Hum. Hypertens. PD MAR PY 2006 VL 20 IS 3 BP 169 EP 175 DI 10.1038/sj.jhh.1001972 PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 013JA UT WOS:000235404400001 PM 16397516 ER PT J AU Das, S Suarez, G Beswick, EJ Sierra, JC Graham, DY Reyes, VE AF Das, S Suarez, G Beswick, EJ Sierra, JC Graham, DY Reyes, VE TI Expression of B7-H1 on gastric epithelial cells: Its potential role in regulating T cells during Helicobacter pylori infection SO JOURNAL OF IMMUNOLOGY LA English DT Article ID NITRIC-OXIDE SYNTHASE; B7 FAMILY; LYMPHOCYTE-ACTIVATION; VACUOLATING CYTOTOXIN; IMMUNE-RESPONSES; APOPTOSIS; ANTIGEN; LIGAND; PD-1; CD4(+) AB Helicobacter pylori infection is associated with gastritis, ulcers, and gastric cancer. The infection becomes chronic as the host response is unable to clear it. Gastric epithelial cells (GEC) play an important role during the host response, and their expression of class II MHC and costimulatory molecules such as CD80 and CD86 suggests their role in local Ag presentation. Although T cells are recruited to the infected gastric mucosa, they have been reported to be hyporesponsive. In this study, we detected the expression of B7-H1 (programmed death-1 ligand 1), a member of B7 family of proteins associated with T cell inhibition on GEC. Quantitative real-time RT-PCR revealed that B7-H1 expression increased significantly on GEC after H. pylori infection. Western blot analysis showed that B7-H1 expression was induced by various H. pylori strains and was independent of H. pylori virulence factors such as Cag, VacA, and Urease. The functional role of B7-H1 in the cross talk between GEC and T cells was assessed by coculturing GEC or H. pylori-infected GEC with CD4(+) T cells isolated from peripheral blood. Using blocking Abs to B7-H1 revealed that B7-H1 was involved in the suppression of T cell proliferation and IL-2 synthesis, and thus suggested a role for B7-H1 on the epithelium as a contributor in the chronicity of H. pylori infection. C1 Univ Texas, Med Branch, Dept Pediat, Galveston, TX 77555 USA. Univ Texas, Med Branch, Dept Microbiol & Immunol, Galveston, TX 77555 USA. Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Reyes, VE (reprint author), Univ Texas, Med Branch, Childrens Hosp, Room 2-300,301 Univ Blvd, Galveston, TX 77555 USA. EM vreyes@utmb.edu FU NIDDK NIH HHS [DK50669, DK56338] NR 55 TC 68 Z9 75 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 MAR 1 PY 2006 VL 176 IS 5 BP 3000 EP 3009 PG 10 WC Immunology SC Immunology GA 059YL UT WOS:000238768000038 PM 16493058 ER PT J AU Kulig, CC Beresford, TP Everson, GT AF Kulig, CC Beresford, TP Everson, GT TI Rapid, accurate, and sensitive fatty acid ethyl ester determination by gas chromatography-mass spectrometry SO JOURNAL OF LABORATORY AND CLINICAL MEDICINE LA English DT Article ID ETHANOL-CONSUMPTION; ALCOHOL-CONSUMPTION; MARKERS; SERUM; METABOLITES; BLOOD; QUANTIFICATION; INGESTION; BIOMARKER; MECONIUM AB Background: Fatty acid ethyl esters (FAEEs) are useful markers of ongoing alcohol use and may be associated with alcohol-induced damage to the liver and pancreas. In this article, we describe a novel method for rapid determination of the three major FAEEs found in human plasma. Methods: Internal standard, ethyl heptadecanoate, was added to plasma samples, and FAEEs were isolated by acetone precipitation, hexane lipid extraction, and amino-propyl silica solid phase extraction. FAEEs were quantitated by gas chromatography-mass spectrometry (GC-MS) using a nonpolar dimethylpolysiloxane column. The accuracy, precision, specificity, and sensitivity of the assay were defined from plasma samples from recently drinking and abstinent persons, with and without the addition of FAEEs. Results: Individual FAEE peaks demonstrated excellent resolution. Instrument time was reduced by more than 60%. The lower limit of detection was 5 to 10 nM, and the lower limit of quantitation for each FAEE was 60 nM (for 22 samples with known concentration 60 nM, x +/- SD: 61 +/- 5.7, 57 +/- 5.7, and 57 +/- 5.9 nM, for ethyl palmitate, ethyl oleate, and ethyl stearate, respectively). Instrument precision (coefficient of variance, CV) for these three FAEEs was 0.3%, 0.4%, and 0.7%, respectively. Intra-assay precision (CV) for total FAEEs was less than 7%. FAEEs were absent in 49 samples from abstinent persons. FAEEs were detected in all 76 samples with associated positive blood alcohol levels. Conclusions: Our method of FAEE analysis is rapid and potentially useful in research and clinical studies. FAEE determination using this method is precise, accurate, sensitive, and specific and deserves broader application. C1 Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Mental Hlth Serv, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. RP Kulig, CC (reprint author), Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, B-158,4200 E 9th Ave, Denver, CO 80262 USA. EM clark.kulig@uchsc.edu NR 27 TC 17 Z9 17 U1 2 U2 7 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-2143 J9 J LAB CLIN MED JI J. Lab. Clin. Med. PD MAR PY 2006 VL 147 IS 3 BP 133 EP 138 DI 10.1016/j.lab.2005.11.006 PG 6 WC Medical Laboratory Technology; Medicine, General & Internal; Medicine, Research & Experimental SC Medical Laboratory Technology; General & Internal Medicine; Research & Experimental Medicine GA 022ZG UT WOS:000236094100005 PM 16503243 ER PT J AU Neuwelt, EA Wu, J Varallyay, C Muldoon, L Jones, R AF Neuwelt, EA Wu, J Varallyay, C Muldoon, L Jones, R TI In vivo leukocyte iron labeling with intravenous ferumoxides and protamine sulfate for cellular magnetic resonance imaging SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem 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 BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD MAR PY 2006 VL 96 SU 1 BP 43 EP 43 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900112 ER PT J AU Ying, W Lu, H Zhu, K Swanson, RA AF Ying, W Lu, H Zhu, K Swanson, RA TI NADH transport in murine astrocytes is mediated by P2X7 receptors SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem C1 UCSF, Dept Neurol, San Francisco, CA USA. San Francisco VA Med Ctr, San Francisco, 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 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD MAR PY 2006 VL 96 SU 1 BP 103 EP 103 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900258 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 5-Aminoimidazole-4-carboxamide ribonucleoside attenuates EAE via modulation of endothelial-monocyte interaction SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph Johnson Vet Affairs Med Ctr, Charleston, SC USA. NR 1 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 MAR PY 2006 VL 96 SU 1 BP 107 EP 107 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900269 ER PT J AU Prasad, R Giri, S Singh, I Singh, AK AF Prasad, R Giri, S Singh, I Singh, AK TI GSNO attenuates EAE disease by S-nitrosylation mediated modulation of endothelial-monocyte interactions SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph Johnson Vet Affairs Med Ctr, Charleston, SC USA. NR 1 TC 0 Z9 0 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 MAR PY 2006 VL 96 SU 1 BP 108 EP 108 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900272 ER PT J AU Yao, JK Thomas, EA AF Yao, JK Thomas, EA TI Antipsychotic drug-induced changes in membrane lipids of mouse brain lacking apolipoprotein d SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA. Scripps Res Inst, La Jolla, CA 92037 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 MAR PY 2006 VL 96 SU 1 BP 115 EP 115 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900293 ER PT J AU Sarkey, JP Richards, MP Stubbs, EB AF Sarkey, JP Richards, MP Stubbs, EB TI Therapeutic potential of lovastatin for the treatment of experimental autoimmune neuritis SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT Annual Meeting of the American-Society-for-Neurochemistry CY MAR 11-15, 2006 CL Portland, OR SP Amer Soc Neurochem C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Res & Neurol Serv, Hines, IL 60141 USA. Loyola Univ, Program Neurosci, Maywood, IL 60153 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 MAR PY 2006 VL 96 SU 1 BP 131 EP 131 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 021KU UT WOS:000235982900338 ER PT J AU Venneman, S Leuchter, A Bartzokis, G Beckson, M Simon, SL Schaefer, M Rawson, R Newton, T Cook, IA Uijtdehaage, S Ling, W AF Venneman, S Leuchter, A Bartzokis, G Beckson, M Simon, SL Schaefer, M Rawson, R Newton, T Cook, IA Uijtdehaage, S Ling, W TI Variation in neurophysiological function and evidence of quantitative electroencephalogram discordance: Predicting cocaine-dependent treatment attrition SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID DOUBLE-BLIND; CEREBRAL PERFUSION; CONTROLLED TRIAL; BRAIN-FUNCTION; PLACEBO; ABNORMALITIES; DESIPRAMINE; EFFICACY; ABUSE; INDIVIDUALS AB Cocaine treatment trials suffer from a high rate of attrition. We examined pretreatment neurophysiological factors to identify participants at greatest risk. Twenty-five participants were divided into concordant and discordant groups following electroencephalogram ( EEG) measures recorded prior to a double-blind, placebo-controlled treatment trial. Three possible outcomes were examined: successful completion, dropout, and removal. Concordant ( high perfusion correlate) participants had an 85% rate of successful completion, while discordant participants had a 15% rate of successful completion. Twenty-five percent of dropouts and 50% of participants removed were discordant ( low perfusion correlate), while only 25% of those who completed were discordant. Failure to complete the trial was not explained by depression, craving, benzoylecgonine levels or quantitative electroencephalogram ( QEEG) power; thus cordance may help identify attrition risk. C1 Univ Houston Victoria, Dept Psychol, Victoria, TX 77901 USA. W Los Angeles VA Med Ctr, Medicat Dev Unit, Res Serv, Los Angeles, CA USA. W Los Angeles VA Med Ctr, Psychiat Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Quantitat EEG Lab, Los Angeles Neuropsychiat Inst & Hosp, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Venneman, S (reprint author), Univ Houston Victoria, Dept Biol, 3007 Ben Wilson, Victoria, TX 77901 USA. EM VennemanS@uhv.edu RI Bartzokis, George/K-2409-2013 OI newton, thomas/0000-0002-3198-5901; Uijtdehaage, Sebastian/0000-0001-8598-4683 FU NIDA NIH HHS [1 Y01 DA 50038]; NIMH NIH HHS [1 K02 MH 01165]; PHS HHS [1R01 40705-09] NR 39 TC 6 Z9 6 U1 2 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 SPR PY 2006 VL 18 IS 2 BP 208 EP 216 DI 10.1176/appi.neuropsych.18.2.208 PG 9 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 044KU UT WOS:000237672000010 PM 16720798 ER PT J AU Cook, JM Walser, RD Kane, V Ruzek, JI Woody, G AF Cook, JM Walser, RD Kane, V Ruzek, JI Woody, G TI Dissemination and feasibility of a cognitive-behavioral treatment for substance use disorders and posttraumatic stress disorder in the veterans administration SO JOURNAL OF PSYCHOACTIVE DRUGS LA English DT Article DE posttraumatic stress disorder; PTSD; substance-related disorders; therapy; trauma ID DUAL DIAGNOSIS; WOMEN; INTERVENTIONS; PSYCHOTHERAPY; OUTCOMES AB This article describes a small dissemination effort and provides initial efficacy data for use of Seeking Safety, a cognitive-behavioral treatment for comorbid substance use disorders (SUD) and posttraumatic stress disorder (PTSD), in a VA setting. After providing a daylong interactive training in Seeking Safety to front-line clinicians, a cotherapist group practice model was implemented. Following 14 months of clinician training and an uncontrolled pilot study of four groups with 18 veterans, initial efficacy data indicate significant symptom reduction for patients and acceptability to clinicians. Findings are encouraging in that Seeking Safety treatment appears to have the potential to be beneficial for veterans with SUD-PTSD and also appeal to clinicians. Dissemination of Seeking Safety is feasible in the VA, yet there are likely barriers to sustaining it as a routine treatment. Recommendations for future dissemination are proposed, including ways VA administration can facilitate this process. C1 Columbia Univ, New York State Psychiat Inst, Med Ctr, New York, NY 10032 USA. Natl Ctr PTSD & VISN 21 MIRECC, VA Palo Alto Hlth Care Syst, Palo Alto, CA USA. Univ Penn, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, VISN MIRECC 4, Behav Hlth Serv, Philadelphia, PA USA. RP Cook, JM (reprint author), Columbia Univ, New York State Psychiat Inst, Med Ctr, 1051 Riverside Drve,Box 69, New York, NY 10032 USA. EM jc2676@columbia.edu NR 20 TC 29 Z9 29 U1 1 U2 4 PU HAIGHT-ASHBURY PUBL PI SAN FRANCISCO PA 409 CLAYTON ST, SAN FRANCISCO, CA 94117 USA SN 0279-1072 J9 J PSYCHOACTIVE DRUGS JI J. Psychoact. Drugs PD MAR PY 2006 VL 38 IS 1 BP 89 EP 92 PG 4 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 032NE UT WOS:000236780500010 PM 16681179 ER PT J AU Hirai, M Stanley, MA Novy, DM AF Hirai, M Stanley, MA Novy, DM TI Generalized anxiety disorder in hispanics: Symptom characteristics and prediction of severity SO JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT LA English DT Article DE generalized anxiety disorder; hispanic; adult ID DSM-III-R; STATE WORRY QUESTIONNAIRE; PSYCHOMETRIC PROPERTIES; PRIMARY-CARE; PSYCHIATRIC-DISORDERS; MEXICAN-AMERICANS; OLDER ADULTS; LANGUAGE; PREVALENCE; LIFETIME AB Literature suggests that an increasing number of Hispanic people suffer with GAD, and possible associated problems include high costs for treatment and elevated risk of severe impairment. The current study examined components of anxiety, as measured by currently available assessment instruments in both English and Spanish languages, among bilingual Hispanic individuals with GAD. Participants completed all instruments in both languages. Relations between these self-report measures and clinician-rated GAD severity were also studied. In factor analyses, the Spanish measures yielded two factors, the first of which included all instruments assessing physiological components of anxiety and one content specific measure of worry. The second factor included one worry scale and one trait anxiety scale. The English measures yielded a single factor solution. Regression analyses revealed that for the English measures, the BAI and PSWQ were statistically significant predictors of GAD severity. For the Spanish measures, the BAI was the only statistically significant predictor. C1 Washington State Univ, Dept Psychol, Pullman, WA 99164 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Univ Texas, Sch Med, Dept Anesthesiol, Houston, TX 77030 USA. Univ Texas, Sch Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP Hirai, M (reprint author), Washington State Univ, Dept Psychol, POB 644820, Pullman, WA 99164 USA. EM hiraim@wsu.edu NR 46 TC 17 Z9 17 U1 5 U2 6 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0882-2689 J9 J PSYCHOPATHOL BEHAV JI J. Psychopathol. Behav. Assess. PD MAR PY 2006 VL 28 IS 1 BP 49 EP 56 DI 10.1007/s10862-006-4541-2 PG 8 WC Psychology, Clinical SC Psychology GA 966JY UT WOS:000232017200007 ER PT J AU Johnston, MV Pogach, L Rajan, M Mitchinson, A Krein, SL Bonacker, K Reiber, G AF Johnston, Mark V. Pogach, Leonard Rajan, Mangala Mitchinson, Allison Krein, Sarah L. Bonacker, Kristin Reiber, Gayle TI Personal and treatment factors associated with foot self-care among veterans with diabetes SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE diabetes; diabetic foot; healthcare quality; health education; minority; outcome assessment; podiatry; primary healthcare; self-care; veterans ID COST-EFFECTIVENESS; CONTROLLED-TRIAL; ULCER; PREVENTION; AMPUTATION; OUTCOMES; RISK; BENEFICIARIES; MORTALITY; SERVICES AB We developed and validated a survey of foot selfcare education and behaviors in 772 diabetic patients with high-risk feet at eight Department of Veterans Affairs medical centers. Principal components analysis identified six subscales with satisfactory internal consistency: basic foot-care education, extended foot-care education, basic professional foot care, extended professional foot care, basic foot self-care, and extended foot self-care (alpha = 0.77-0.91). Despite high illness burden, adherence to foot self-care recommendations was less than optimal; only 32.2% of participants reported looking at the bottom of their feet daily. Independent predictors of greater adherence to basic foot self-care practices included African-American or Hispanic background, perceived neuropathy, foot ulcers in the last year, prior amputation (beta = 0.080.12, p < 0.04-0.001), and provision of greater basic and extended education (beta = 0. 16, p < 0.004, and beta = 0. 15, p < 0.007). The survey subscales can now be used for evaluating foot care and education needs for persons with high-risk feet. C1 Univ Wisconsin, Sch Med, Dept Internal Med, Milwaukee, WI 53201 USA. VA New Jersey Hlth Care Syst, Dept Vet Affairs, Ctr Healthcare Knowledge Management, E Orange, NJ USA. Kessler Med Rehabil Res & Educ Corp, W Orange, NJ USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. HSR&D, Ctr Practice Management & Outcomes Res, VA Ann Arbor Healthcare Syst, Ann Arbor, MI USA. HSR&D, VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Hlth Serv & Epidemiol, Seattle, WA USA. RP Johnston, MV (reprint author), Univ Wisconsin, Sch Med, Dept Internal Med, POB 413, Milwaukee, WI 53201 USA. EM johnsto@uwm.edu RI Krein, Sarah/E-2742-2014 OI Krein, Sarah/0000-0003-2111-8131 NR 49 TC 15 Z9 15 U1 1 U2 11 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 MAR-APR PY 2006 VL 43 IS 2 BP 227 EP 238 DI 10.1682/JRRD.2005.06.0106 PG 12 WC Rehabilitation SC Rehabilitation GA 070TT UT WOS:000239548200011 PM 16847789 ER PT J AU Welsh, AH Zhou, XH AF Welsh, AH Zhou, XH TI Estimating the retransformed mean in a heteroscedastic two-part model SO JOURNAL OF STATISTICAL PLANNING AND INFERENCE LA English DT Article DE extra zeros; health care costs; heteroscedastic regression model; retransformation; skewed data; smearing; two-part model ID SAMPLES AB Two distribution-free estimators are proposed to estimate the mean of a dependent variable after fitting a semiparametric two-part heteroscedastic regression model to a transformation of the dependent variable. We show that the proposed estimators are consistent and have asymptotic normal distributions. We also compare their finite-sample performance in a simulation study. Finally, we illustrate the proposed methods in a real-world example of predicting in-patient health care costs. (c) 2004 Elsevier B.V. All rights reserved. C1 Univ Washington, Dept Biostat, Sch Publ Hlth, Seattle, WA 98195 USA. Univ Southampton, Fac Math Studies, Southampton SO17 1BJ, Hants, England. VA Puget Sound Hlth Care Syst, NW HSR&D Ctr Excellence 152, Seattle, WA 98108 USA. RP Zhou, XH (reprint author), Univ Washington, Dept Biostat, Sch Publ Hlth, F600 Hlth Sci,POB 357232, Seattle, WA 98195 USA. EM azhou@u.washington.edu NR 15 TC 17 Z9 17 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-3758 J9 J STAT PLAN INFER JI J. Stat. Plan. Infer. PD MAR 1 PY 2006 VL 136 IS 3 BP 860 EP 881 DI 10.1016/j.jspi.2004.07.009 PG 22 WC Statistics & Probability SC Mathematics GA 989TT UT WOS:000233697500015 ER PT J AU Sawicki, MP AF Sawicki, MP TI Knocking out answers to diabetes: Role of SSTR5 SO JOURNAL OF SURGICAL RESEARCH LA English DT Article ID SOMATOSTATIN; GENE; SECRETION; ABLATION; RECEPTOR; MICE C1 Greater Los Angeles VA Med Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Sawicki, MP (reprint author), Greater Los Angeles VA Med Ctr, CHS 72-215,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM msawicki@mednet.ucla.edu NR 11 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 0022-4804 J9 J SURG RES JI J. Surg. Res. PD MAR PY 2006 VL 131 IS 1 BP 131 EP 132 DI 10.1016/j.jss.2005.09.015 PG 2 WC Surgery SC Surgery GA 018NM UT WOS:000235771200019 PM 16297405 ER PT J AU Collins, TC Suarez-Almazor, M Bush, RL Petersen, NJ AF Collins, TC Suarez-Almazor, M Bush, RL Petersen, NJ TI Gender and peripheral arterial disease SO JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE LA English DT Article ID ADULTS; POPULATION; PREVALENCE; MORTALITY; QUALITY; WOMEN AB Objective: The aim of this study is to determine gender differences in the risk factor profile and leg symptoms of peripheral arterial disease ( PAD). Methods: We identified men and women with PAD from a cohort of patients within a primary care clinic setting. We screened patients 50 years of age and older. We diagnosed PAD based on an ankle-brachial index (ABI) level of less than 0.9; the ABI is the ratio of ankle and arm systolic blood pressure measurements. Patients completed 4 questionnaires, one of which was used to ascertain leg symptoms related to compromised blood flow, the San Diego Claudication Questionnaire (SDCQ). Additional questionnaires were used to determine the patient's medical history, walking impairment, and health-related quality of life. Results: We enrolled 403 patients stratified by race and gender including 55 white women, 82 African American women, and 71 Hispanic women. There were no significant differences by gender in the prevalence of disease. The prevalence of PAD was 9.1% in white women, 21.9% in African American women, and 14.1% in Hispanic women (P = .11). Risk factors for PAD were the same for women and men (ie, diabetes mellitus, current smoking, and use of blood pressure medication). Walking impairment subscale scores were lower for women with PAD when compared with women without PAD and to men with disease. Scores for physical function and general health were lower for women versus men with PAD. Conclusions: The prevalence of PAD, a common disease within primary care clinics, does not vary by gender. Women with PAD are at greater risk for a compromise in daily function and quality of life. Future research is needed to prevent walking impairment and improve limb functioning in patients, particularly women, with PAD. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. RP Collins, TC (reprint author), Dept Vet Affairs, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM tcollins@bcm.tmc.edu NR 22 TC 34 Z9 35 U1 1 U2 2 PU AMER BOARD FAMILY MEDICINE PI LEXINGTON PA 2228 YOUNG DR, LEXINGTON, KY 40505 USA SN 1557-2625 J9 J AM BOARD FAM MED JI J. Am. Board Fam. Med. PD MAR-APR PY 2006 VL 19 IS 2 BP 132 EP 140 PG 9 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 046IG UT WOS:000237804300004 PM 16513901 ER PT J AU Friedlander, AH Norman, DC AF Friedlander, AH Norman, DC TI Geriatric alcoholism - Pathophysiology and dental implications SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Review DE alcoholism; aging; metabolism ID TUMOR-NECROSIS-FACTOR; SUBSTANCE USE DISORDERS; LATE-LIFE; LIVER-DISEASE; ORAL HYGIENE; OLDER-ADULTS; RISK-FACTORS; PERIODONTAL-DISEASE; TREATMENT ADHERENCE; GENERAL-POPULATION AB Background.. The authors reviewed the clinical features, epidemiology, diagnosis, medical treatment, orofacial findings and dental treatment of geriatric patients with alcoholism. Types of Studies Reviewed. The authors conducted MEDLINE searches for the period 1995 through 2004 using the terms "alcoholism," "geriatric," "pathophysiology," "treatment" and "dentistry." They selected reports published in English in peer-reviewed journals for further review. Results. Physiological changes associated with aging permit the harmful effects of drinking alcohol to arise at lower levels of consumption than in younger people. Excessive use of alcohol exacerbates the medical and emotional problems associated with aging and predisposes the person to adverse drug reactions with medications controlling these illnesses. Clinical Implications. The incidence of dental disease in this population is extensive because of diminished salivary flow and a disinterest in performing appropriate oral hygiene techniques. Concurrent abuse of tobacco products worsens dental disease and heightens the risk of developing oral cancer. Identification of patients who abuse alcohol, a cancer-screening examination, preventive dental education, and use of saliva substitutes and anticaries agents are indicated. Clinicians must take precautions when performing surgery and when prescribing or administering analgesics, antibiotics or sedative agents that are likely to have an adverse interaction with alcohol. C1 VA Greater Los Angeles Healthcare Syst, Grad Med Educ, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Grad Med Educ, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 100 TC 8 Z9 12 U1 4 U2 10 PU AMER DENTAL ASSN PI CHICAGO PA 211 E CHICAGO AVE, CHICAGO, IL 60611 USA SN 0002-8177 J9 J AM DENT ASSOC JI J. Am. Dent. Assoc. PD MAR PY 2006 VL 137 IS 3 BP 330 EP 338 PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 022UO UT WOS:000236081800024 PM 16570466 ER PT J AU Casarett, D Van Ness, PH O'Leary, JR Fried, TR AF Casarett, D Van Ness, PH O'Leary, JR Fried, TR TI Are patient preferences for life-sustaining treatment really a barrier to hospice enrollment for older adults with serious illness? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hospice; end-of-life care; hospice preferences ID RANDOMIZED CONTROLLED-TRIAL; HEALTH-CARE PROXIES; OF-LIFE; NURSING-HOMES; PALLIATIVE CARE; END; PHYSICIANS; COMPLETION; DECISIONS; CANCER AB OBJECTIVES: To determine whether patient preferences are a barrier to hospice enrollment. DESIGN: Prospective cohort study. SETTING: Fifteen ambulatory primary care and specialty clinics and three general medicine inpatient units. PARTICIPANTS: Two hundred three seriously ill patients with cancer (n=65, 32%), congestive heart failure (n=77, 38%), and chronic obstructive pulmonary disease (n=61, 30%) completed multiple interviews over a period of up to 24 months. MEASUREMENTS: Preferences for high- and low-burden life-sustaining treatment and site of death and concern about being kept alive by machines. RESULTS: Patients were more likely to enroll in hospice after interviews at which they said that they did not want low-burden treatment (3 patients enrolled/16 interviews at which patients did not want low-burden treatment vs 47 patients enrolled/841 interviews at which patients wanted low-burden treatment; relative risk (RR)=3.36, 95% confidence interval (CI)=1.17-9.66), as were interviews at which patients said they would not want high-burden treatment (5/28 vs 45/826; RR=3.28, 95% CI=1.14-7.62), although most patients whose preferences were consistent with hospice did not enroll before the next interview. In multivariable Cox regression models, patients with noncancer diagnoses who desired low-burden treatment (hazard ratio (HR)=0.46, 95% CI=0.33-0.68) were less likely to enroll in hospice, and those who were concerned that they would be kept alive by machines were more likely to enroll (HR=5.46, 95% CI=1.86-15.88), although in patients with cancer, neither preferences nor concerns about receiving excessive treatment were associated with hospice enrollment. Preference for site of death was not associated with hospice enrollment. CONCLUSION: Overall, few patients had treatment preferences that would make them eligible for hospice, although even in patients whose preferences were consistent with hospice, few enrolled. Efforts to improve end-of-life care should offer alternatives to hospice that do not require patients to give up life-sustaining treatment, as well as interventions to improve communication about patients' preferences. C1 Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Div Geriatr Med, Philadelphia, PA 19104 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06510 USA. Yale Univ, Sch Med, Program Aging, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. Dept Vet Affairs Connecticut Healthcare Syst, Clin Epidemiol Res Ctr, New Haven, CT USA. RP Casarett, D (reprint author), 3615 Chestnut St, Philadelphia, PA 19104 USA. EM Casarett@mail.med.upenn.edu FU NIA NIH HHS [K02 AG20113, R01 AG019769, K02 AG020113-01, K02 AG020113, R01 AG019769-01A1, R01 AG19769] NR 44 TC 33 Z9 33 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 MAR PY 2006 VL 54 IS 3 BP 472 EP 478 DI 10.1111/j.1532-5415.2005.00628.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 017ZB UT WOS:000235731000012 PM 16551315 ER PT J AU Min, LC Elliott, MN Wenger, NS Saliba, D AF Min, LC Elliott, MN Wenger, NS Saliba, D TI Higher vulnerable elders survey scores predict death and functional decline in vulnerable older people SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE mortality; functional decline; screening tool ID MORTALITY; COMMUNITY; ASSOCIATION; POPULATION; CARE; IMPAIRMENT; DEMENTIA; OUTCOMES; FAILURE; PROGRAM AB OBJECTIVES: To examine whether the Vulnerable Elders Survey (VES-13) score predicts risk of death and functional decline in vulnerable older adults. DESIGN: Longitudinal evaluation with mean follow-up of 11 months (range 8-14 months). SETTING: Two managed care organizations in the United States. PARTICIPANTS: Four hundred twenty community-dwelling older people identified as having moderate to high risk of death and functional decline based on a VES-13 score of 3 or higher. These older people were enrolled in the Assessing Care of Vulnerable Elders observational study. MEASUREMENTS: Baseline: VES-13 score, sex, income, cognitive score, and number of medical diagnoses. Outcome measures: functional decline and death. RESULTS: VES-13 scores strongly predicted death and functional decline (P <.001, area under the receiver operating curve=0.66). The estimated combined risk of death and decline rose with VES-13 score, increasing from 23% for older people with a VES-13 score of 3 to 60% for those with a score of 10. Other measures (sex, comorbidity) were not significant predictors of death or decline over this period after controlling for VES-13 score. CONCLUSION: The VES-13 score is useful as a screening tool to detect risk of health deterioration in already vulnerable older populations, and higher scores reflect greater risk over a short follow-up period. C1 Univ Calif Los Angeles, Dept Med, Div Geriatr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90095 USA. RAND, Santa Monica, CA USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Min, LC (reprint author), Univ Calif Los Angeles, Dept Med, Div Geriatr, 10945 Le Conte Ave,Suite 2339,Box 951687, Los Angeles, CA 90095 USA. EM lmin@mednet.ucla.edu NR 29 TC 70 Z9 70 U1 2 U2 3 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 MAR PY 2006 VL 54 IS 3 BP 507 EP 511 DI 10.1111/j.1532-5415.2005.00615.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 017ZB UT WOS:000235731000018 PM 16551321 ER PT J AU Rosen, J Mittal, V Degenholtz, H Castle, N Mulsant, BH Hulland, S Nace, D Rubin, F AF Rosen, Jules Mittal, Vikas Degenholtz, Howard Castle, Nick Mulsant, Benoit H. Hulland, Shelley Nace, David Rubin, Fred TI Ability, incentives, and management feedback: Organizational change to reduce pressure ulcers in a nursing home SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE nursing home; pressure ulcer; quality improvement; organization ID BRADEN-SCALE; SORE RISK; QUALITY; PREVENTION AB Objective: Quality improvement (QI) processes in nursing homes are highly variable and often ineffective. This study evaluated an innovative QI process to reduce pressure ulcers (PUs) in a nursing home with a high rate of PUs. Design: This was a 48-week, longitudinal study comparing the incidence of PUs during 12-week baseline and intervention and post-intervention periods. Setting: Not-for-profit, 136-bed nursing home in urban Western Pennsylvania. Patients or Other Participants: All residents and all staff at the nursing home participated in this study. Interventions: The intervention consisted of 3 components: Ability enhancement, incentivization, and management feedback. To enhance ability, all staff members completed a computer-based interactive video education program on PU prevention and were mandated to use penlights to promote early detection. Incentivization included $75 for each staff member if the desired reduction in PU incidence was achieved. Management feedback provided real-time information of staff"s adherence to the mandated training. Main Outcome Measures: Outcome measures consisted of staff's adherence to mandated training and the incidence of new PUs during the baseline period compared to the intervention and post-intervention periods. Results: Management responded to noncompliance with training with both rewards and stepped discipline. Adherence to protocol, as measured by training compliance, was 100%. There was a significant reduction (P < .05) in the incidence of stage 2 or worse PUs during the intervention period. During the post-intervention periods, the effect was lost. Conclusion: An innovative QI initiative resulted in a significant decrease in PUs in 1 facility. This intervention was not sustainable when the 3 components of the QI intervention were no longer actively maintained. C1 Univ Pittsburgh, Sch Med, WPIC, Dept Psychiat, Pittsburgh, PA 15241 USA. Univ Pittsburgh, Katz Grad Sch Business, Pittsburgh, PA 15241 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA 15241 USA. VA Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Internal Med, Pittsburgh, PA USA. RP Rosen, J (reprint author), Univ Pittsburgh, Sch Med, WPIC, Dept Psychiat, 3811 OHara St, Pittsburgh, PA 15241 USA. EM rosenji@upmc.edu RI Nace, David/D-2638-2014 OI Degenholtz, Howard/0000-0003-1986-7360 FU AHRQ HHS [HS11976]; NIMH NIH HHS [MH52247, MH01613] NR 25 TC 17 Z9 18 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD MAR PY 2006 VL 7 IS 3 BP 141 EP 146 DI 10.1016/j.jamda.2005.08.003 PG 6 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 081JV UT WOS:000240314800002 PM 16503306 ER PT J AU Berner, ES Houston, TK Ray, MN Allison, JJ Heudebert, GR Chatham, WW Kennedy, JI Glandon, GL Norton, PA Cawford, MA Maisiak, RS AF Berner, ES Houston, TK Ray, MN Allison, JJ Heudebert, GR Chatham, WW Kennedy, JI Glandon, GL Norton, PA Cawford, MA Maisiak, RS TI Improving ambulatory prescribing safety with a handheld decision support system: A randomized controlled trail SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; GASTROINTESTINAL TOXICITY; RHEUMATOID-ARTHRITIS; PROSPECTIVE VALIDATION; SIMPLE QUESTIONNAIRE; CONTROLLED-TRIAL; RISK; PERFORMANCE; PATIENT; THROMBOEMBOLISM AB Objective: To evaluate the effectiveness of a personal digital assistant (PDA)-based clinical decision support system (CDSS) on nonsteroidal anti-inflammatory drug (NSAID) prescribing safety in the outpatient setting. Design: The design was a randomized, controlled trial conducted in a university-based resident clinic. Internal medicine residents received a PDA-based CDSS suite. For intervention residents, the CDSS included a prediction rule for NSAID-related gastrointestinal risk assessment and treatment recommendations. Unannounced standardized patients (SPs) trained to portray musculoskeletal symptoms presented to study physicians. Safety outcomes were assessed from the prescriptions given to the SPs. Each prescription was reviewed by a committee of clinicians blinded to participant, intervention group assignment, and baseline or follow-up status. Measurements: Prescriptions were judged as safe or unsafe. The main outcome measure was the differential change in unsafe prescribing of NSAIDs for the intervention versus the control group. Results: At baseline, the mean proportion of cases per physician with unsafe prescriptions for the two groups was similar (0.27 vs. 0.29, p > 0.05). Controlling for baseline performance, intervention participants prescribed more safely than controls after receiving the CDSS (0.23 vs. 0.45 [F = 4.24, p < 0.05]). With the CDSS, intervention participants documented more complete assessment of patient gastrointestinal risk from NSAIDs. Conclusion: Participants provided with a PDA-based CDSS for NSAID prescribing made fewer unsafe treatment decisions than participants without the CDSS. C1 Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness Res, Birmingham, AL USA. RP Berner, ES (reprint author), Univ Alabama, Dept Hlth Serv Adm, 1675 Univ Blvd,Room 544, Birmingham, AL 35294 USA. EM eberner@uab.edu RI Houston, Thomas/F-2469-2013 OI Berner, Eta/0000-0003-4319-2949 FU AHRQ HHS [R18 HS011820, R18 HS 11820] NR 52 TC 47 Z9 47 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD MAR-APR PY 2006 VL 13 IS 2 BP 171 EP 179 DI 10.1197/jamia.M1961 PG 9 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 023HQ UT WOS:000236118000008 PM 16357350 ER PT J AU Heinzerling, KG Etzioni, DA Hurley, B Holtom, P Bluthenthal, RN Asch, SM AF Heinzerling, KG Etzioni, DA Hurley, B Holtom, P Bluthenthal, RN Asch, SM TI Hospital utilization for injection drug use-related soft tissue infections in urban versus rural counties in California SO JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE LA English DT Article DE hospital utilization; injection drug use; Medicaid; soft tissue infection; urban; rural ID SAN-FRANCISCO; UNITED-STATES; RISK-FACTORS; ABSCESSES; SKIN; PREVALENCE AB Drug related-soft tissue infections (DR-STIs) are a significant source of hospital utilization in inner-city urban areas where injection drug use is common but the magnitude of hospital utilization for DR-STIs outside of inner-city urban areas is not known. We described the magnitude and characteristics of hospital utilization for DR-STIs in urban versus rural counties in California. All discharges from all nonfederal hospitals in California in 2000 with ICD-9 codes for a soft tissue infection and for drug dependence/abuse were abstracted from the California Office of Statewide Health Planning and Development discharge database. There were 4,152 DR-STI discharges in 2000 from hospitals in 49 of California's 58 counties. Residents of 12 large metropolitan counties accounted for 3,598 discharges (87% of total). The majority of DR-STI discharges were from urban safety net hospitals with county indigent programs and Medicaid as the expected payment source and opiate related discharge diagnoses. Hospital utilization for DR-STIs in California is highest in large urban metropolitan counties, although DR-STI discharges are widespread. Increased access to harm reduction services and drug treatment may reduce government health care expenditures by preventing unnecessary hospital utilization for DR-STIs. C1 Univ Calif Los Angeles, Dept Family Med, Sch Med, Los Angeles, CA 90025 USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Surg, Sch Med, Los Angeles, CA 90025 USA. Univ So Calif, Keck Sch Med, Los Angeles, CA 90089 USA. RAND, Hlth Program, Santa Monica, CA 90406 USA. RAND, Drug Policy Res Ctr, Santa Monica, CA 90406 USA. RP Heinzerling, KG (reprint author), Univ Calif Los Angeles, Dept Family Med, Sch Med, 11075 Santa Monica Blvd,Suite 200, Los Angeles, CA 90025 USA. EM heinzk@ucla.edu OI Bluthenthal, Ricky/0000-0003-3491-1702 FU NIDA NIH HHS [K23 DA023558] NR 18 TC 7 Z9 7 U1 1 U2 2 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 MAR PY 2006 VL 83 IS 2 BP 176 EP 181 DI 10.1007/s11524-005-9021-6 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 039OO UT WOS:000237316300006 PM 16736367 ER PT J AU Spurgeon, SEF Hsieh, YC Rivadinera, A Beer, TM Mori, M Garzotto, M AF Spurgeon, SEF Hsieh, YC Rivadinera, A Beer, TM Mori, M Garzotto, M TI Classification and regression tree analysis for the prediction of aggressive prostate cancer on biopsy SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostate-specific antigen; risk; biopsy ID DIGITAL RECTAL EXAMINATION; RADICAL PROSTATECTOMY; NATURAL-HISTORY; ANTIGEN; MEN; PROBABILITY; NOMOGRAM; DISEASE; GRADE; RISK AB Purpose: Prostate cancer screening allows early cancer detection but not all patients benefit from subsequent therapy. Thus, identifying patients who are likely to harbor aggressive cancer could significantly decrease the number of prostate biopsies performed. Materials and Methods: Data were collected on 1,563 consecutive referred men with serum PSA 10 ng/ml or less who underwent an initial prostate biopsy. Predictors of aggressive cancer (Gleason sum 7 or greater) were identified using CART analysis. Model building was done in a randomly selected training set (70% of the data) and validation was completed using the remaining data. Results: Cancer was detected in 406 men (26.1%). Gleason 7 or greater cancer was found in 130 men (8.3%). CART created a decision tree that identified certain groups at risk for aggressive cancer, namely 1) PSAD greater than 0.165 ng/ml/cc, and 2) PSAD greater than 0.058 to 0.165 ng/rnl/cc or less, age greater than 57.5 years and prostate volume greater than 22.7 cc. The incidence of aggressive prostate cancer was 1.1% when PSAD was 0.058 ng/ml/cc or less in the validation set. The sensitivity and specificity of CART for identifying men with aggressive cancer were 100% and 31.8% for model building data, and 91.5% and 33.5% for the validation data set, respectively. Conclusions: CART identified groups at risk for aggressive prostate cancer. Application of this CART could decrease unnecessary biopsies by 33.5% when only a diagnosis of high grade prostate cancer would lead to subsequent therapy. C1 Portland Vet Affairs Med Ctr, Urol Sect, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, Portland, OR USA. Oregon Hlth & Sci Univ, Div Urol, Portland, OR USA. Oregon Hlth & Sci Univ, Inst Canc, Biostat Shared Resource, Portland, OR USA. RP Garzotto, M (reprint author), Portland Vet Affairs Med Ctr, Urol Sect, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM garzotto@ohsu.edu NR 20 TC 8 Z9 9 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD MAR PY 2006 VL 175 IS 3 BP 918 EP 922 DI 10.1016/S0022-5347(05)00353-8 PN 1 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 011SW UT WOS:000235289400027 PM 16469580 ER PT J AU Chen, JWY Wasterlain, CG AF Chen, JWY Wasterlain, CG TI Status epilepticus: pathophysiology and management in adults SO LANCET NEUROLOGY LA English DT Review ID CONVULSIVE STATUS EPILEPTICUS; REFRACTORY STATUS EPILEPTICUS; SUSTAINING STATUS EPILEPTICUS; TEMPORAL-LOBE EPILEPSY; NONCONVULSIVE STATUS EPILEPTICUS; SPONTANEOUS RECURRENT SEIZURES; CHILDHOOD STATUS EPILEPTICUS; LIMBIC STATUS EPILEPTICUS; NEURON-SPECIFIC ENOLASE; ACID-INDUCED SEIZURES AB As in Clark and Prout's classic work, we identify three phases of generalised convulsive status epilepticus, which we call impending, established, and subtle. We review physiological and subcellular changes that might play a part in the transition from single seizures to status epilepticus and in the development of time-dependent pharmacoresistance. We review the principles underlying the treatment of status epilepticus and suggest that prehospital treatment is beneficial, that therapeutic drugs should be used in rapid sequence according to a defined protocol, and that refractory status epilepticus should be treated with general anaesthesia. We comment on our preference for drugs with a short elimination half-life and discuss some therapeutic choices. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Wasterlain, CG (reprint author), Univ Calif Los Angeles, Geffen Sch Med, Dept Neurol, Los Angeles, CA 90073 USA. EM wasteria@ucla.edu FU NINDS NIH HHS [NS13515, NS42708] NR 163 TC 189 Z9 197 U1 1 U2 18 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1474-4422 EI 1474-4465 J9 LANCET NEUROL JI Lancet Neurol. PD MAR PY 2006 VL 5 IS 3 BP 246 EP 256 DI 10.1016/S1474-4422(06)70374-X PG 11 WC Clinical Neurology SC Neurosciences & Neurology GA 016PS UT WOS:000235632900019 PM 16488380 ER PT J AU Liu, F Xu, DX Ferguson, MS Chu, BC Saam, T Takaya, N Hatsukami, TS Yuan, C Kerwin, WS AF Liu, F Xu, DX Ferguson, MS Chu, BC Saam, T Takaya, N Hatsukami, TS Yuan, C Kerwin, WS TI Automated in vivo segmentation of carotid plaque MRI with morphology-enhanced probability maps SO MAGNETIC RESONANCE IN MEDICINE LA English DT Article DE in vivo; carotid artery; multi-contrast MR; plaque composition; naive-Bayesian network ID LEVEL SET APPROACH; QUANTITATIVE ASSESSMENT; ACCURACY; IMAGES; ATHEROSCLEROSIS; MODEL AB MRI is a promising noninvasive technique for characterizing atherosclerotic plaque composition in vivo, with an end-goal of assessing plaque vulnerability. Because of limitations arising from acquisition time, achievable resolution, contrast-to-noise ratio, patient motion, and the effects of blood flow, automatically identifying plaque composition remains a challenging task in vivo. In this article, a segmentation method using maximum a posteriori probability Bayesian theory is presented that divides axial, multi-contrast-weighted images into regions of necrotic core, calcification, loose matrix, and fibrous tissue. Key advantages of the method are that it utilizes morphologic information, such as local wall thickness, and coupled active contours to limit the impact from noise and artifacts associated with in vivo imaging. In experiments involving 142 sets of multi-contrast images from 26 subjects undergoing carotid endarterectomy, segmented areas of each of these tissues per slice agreed with histologically confirmed areas with correlations (R-2) of 0.78, 0.83, 0.41, and 0.82, respectively. In comparison, manually identifying areas blinded to histology yielded correlations of 0.71, 0.76, 0.33, and 0.78, respectively. These results show that in vivo automatic segmentation of carotid MRI is feasible and comparable to or possibly more accurate than manual review for quantifying plaque composition. Magn Reson Med 55: 659-668, 2006. Published 2006 Wiley-Liss, lnc. C1 Univ Washington, Vasc Imaging Lab, Seattle, WA 98109 USA. Univ Washington, Dept Radiol, Seattle, WA 98109 USA. VA Puget Sound Hlth Care Syst, Dept Surg, Seattle, WA USA. RP Univ Washington, Vasc Imaging Lab, 815 Mercer St,Box 358050, Seattle, WA 98109 USA. EM feil@u.washington.edu FU NHLBI NIH HHS [R01-HL056784, R44-HL070576] NR 27 TC 80 Z9 84 U1 0 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0740-3194 EI 1522-2594 J9 MAGN RESON MED JI Magn. Reson. Med. PD MAR PY 2006 VL 55 IS 3 BP 659 EP 668 DI 10.1002/mrm.20814 PG 10 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 019TA UT WOS:000235858400025 PM 16470594 ER PT J AU Fishman, JM Casarett, D AF Fishman, JM Casarett, D TI Mass media and medicine: When the most trusted media mislead SO MAYO CLINIC PROCEEDINGS LA English DT Editorial Material ID CULTIVATION; PERSPECTIVE; TELEVISION C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Annenberg Sch Commun, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Ctr Bioeth, Div Geriatr Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Fishman, JM (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 711 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM jfishman@cceb.med.upenn.upenn.edu NR 17 TC 6 Z9 6 U1 0 U2 0 PU MAYO CLINIC PROCEEDINGS PI ROCHESTER PA 660 SIEBENS BLDG MAYO CLINIC, ROCHESTER, MN 55905 USA SN 0025-6196 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD MAR PY 2006 VL 81 IS 3 BP 291 EP 293 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 018CG UT WOS:000235740700002 PM 16529129 ER PT J AU Mansouri, A Muller, FL Liu, YH Ng, R Faulkner, J Hamilton, M Richardson, A Huang, TT Epstein, CJ Van Remmen, H AF Mansouri, A Muller, FL Liu, YH Ng, R Faulkner, J Hamilton, M Richardson, A Huang, TT Epstein, CJ Van Remmen, H TI Alterations in mitochondrial function, hydrogen peroxide release and oxidative damage in mouse hind-limb skeletal muscle during aging SO MECHANISMS OF AGEING AND DEVELOPMENT LA English DT Article DE mitochondrial function; hydrogen peroxide generation; oxidative damage; skeletal muscle ID FREE-RADICAL PRODUCTION; CALORIC RESTRICTION; HEART-MITOCHONDRIA; PROTEIN COMPLEXES; KNOCKOUT MICE; AGE; GENERATION; OXYGEN; RAT; DNA AB Mitochondrial function, hydrogen peroxide generation and oxidative damage were measured in hind-limb skeletal muscle from young (6-8 month) and old (27-29 month) wildtype and heterozygous Mn-superoxide dismutase (MnSOD) knockout mice (Sod2(+/-)). The reduction in MnSOD activity in the Sod2(+/-) mice makes these mice a good model to examine the implications of life-long elevated endogenous mitochondrial oxidative stress on mitochondrial function. ATP production was reduced approximately 30% with age in skeletal muscle mitochondria isolated from wildtype mice, and reduced 40-45% in mitochondria from both young and old Sod2(+/-) mice compared to the young wildtype mice. Release of hydrogen peroxide from skeletal muscle mitochondria increased 40-50% with age in both wildtype and Sod2(+/-) but was not higher ill mitochondria from Sod2(+/-) mice. Activities of electron transport Complexes I and V were decreased 25-30% in both young and old Sod2(+/-) mice compared to wildtype mice, and were 25-30% lower in mitochondria from old wildtype and old Sod2(+/-) mice. DNA oxidative damage (oxo8dG levels) increased more than 45% with age and over 130% in the young Sod(+/-) mice compared to the wildtype mice. These data show that mitochondrial oxidative stress in mouse skeletal muscle is increased with age, leading to alterations in mitochondrial function. In addition, increased oxidative stress generated by reduced activity of MnSOD does not exacerbate these alterations during aging. (c) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev Studies, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. Univ Michigan, Inst Gerontol, Ann Arbor, MI 48109 USA. Stanford Univ, Palo Alto, CA 94304 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94143 USA. RP Van Remmen, H (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. EM vanremmen@uthscsa.edu OI Mansouri, Abdellah/0000-0003-3856-5771 FU NIA NIH HHS [5T3-AG021890-02, AG-08938, P01 AG20591] NR 45 TC 125 Z9 127 U1 0 U2 6 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0047-6374 J9 MECH AGEING DEV JI Mech. Ageing Dev. PD MAR PY 2006 VL 127 IS 3 BP 298 EP 306 DI 10.1016/j.mad.2005.11.004 PG 9 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 019TU UT WOS:000235860400010 PM 16405961 ER PT J AU Kertesz, SG Larson, MJ Cheng, DM Tucker, JA Winter, M Mullins, A Saitz, R Samet, JH AF Kertesz, SG Larson, MJ Cheng, DM Tucker, JA Winter, M Mullins, A Saitz, R Samet, JH TI Need and non-need factors associated with addiction treatment utilization in a cohort of homeless and housed urban poor SO MEDICAL CARE LA English DT Article; Proceedings Paper CT 66th Annual Meeting of the College-on-Problems-of-Drug-Dependence CY JUN 14, 2004 CL San Juan, PR SP Coll Problems Drug Dependence DE homelessness; substance abuse; utilization; longitudinal ID SUBSTANCE-ABUSE TREATMENT; HELP-SEEKING; MEDICAL-CARE; BEHAVIORAL-MODEL; SEVERITY INDEX; MENTAL-HEALTH; ALCOHOL; ADULTS; OUTCOMES; DETOXIFICATION AB Background: Research on addiction treatment utilization in indigent samples mainly has been retrospective, without measures of addictive consequences, social network influences, and motivation. Prospective assessment of factors influencing utilization could inform policy and clinical care. Objective: We sought to identify factors associated with utilization of addiction treatment and mutual help groups among substance-dependent persons with high rates of homelessness. Research and Methods: This was a prospective cohort of patients detoxified from alcohol or drugs at baseline who were followed for 2 years in a randomized clinical trial of linkage to primary care (n = 274). Outcomes included utilization of Inpatient/Residential, Outpatient, Any Treatment, and Mutual Help Groups. Predictor variables in longitudinal regression analyses came from the literature and clinical experience, organized according to theoretical categories of Need, and non-Need (eg, Predisposing and Enabling). Results: Many subjects used Inpatient/Residential (72%), Outpatient (62%), Any Treatment (88%) or Mutual Help Groups (93%) at least once. In multivariable analyses, addictive consequences (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.12-1.71), motivation (OR 1.32, 95% CI 1.09-1.60), and female gender (OR 1.80, 95% CI 1.13-2.86) were associated with most treatment types (ORs are for Any Treatment). Homelessness was associated with Residential/Inpatient (for Chronically Homeless vs. Housed, OR 1.75, 95% CI 1.04-2.94). Living with one's children (OR 0.51, 95% CI 0.31-0.84) and substance-abusing social environment (OR 0.65, 95% CI 0.43-0.98) were negatively associated with Any Treatment. Conclusions: In this cohort of substance-dependent persons, addictive consequences, social network variables, and motivation were associated with treatment utilization. Non-need factors, including living with one's children and gender, also were significant. C1 Univ Alabama, Sch Med, Div Prevent Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Med, Div Gen Internal 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, Boston, MA USA. Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02215 USA. Univ Alabama, Sch Publ Hlth, Dept Hlth Behav, Birmingham, AL 35294 USA. Boston Univ, Sch Publ Hlth, Data Coordinating Ctr, Boston, MA 02215 USA. Wright Inst, Berkeley, CA USA. Boston Univ, Sch Med, Boston Med Ctr, Gen Internal Med Sect, Boston, MA 02215 USA. Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02215 USA. Boston Univ, Sch Publ Hlth, Youth Alcohol Prevent Ctr, Boston, MA 02215 USA. Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA 02215 USA. RP Kertesz, SG (reprint author), Univ Alabama, Sch Med, Div Prevent Med, 1530 3rd Ave S,MT608, Birmingham, AL 35294 USA. EM skertesz@uab.edu OI Kertesz, Stefan/0000-0001-6101-8421 FU NCRR NIH HHS [M01-RR00533]; NIDA NIH HHS [K23-DA15847]; PHS HHS [R01-10019, R01-10870] NR 49 TC 20 Z9 20 U1 1 U2 7 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 MAR PY 2006 VL 44 IS 3 BP 225 EP 233 DI 10.1097/01.mlr.0000199649.19464.8f PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 018VJ UT WOS:000235792600005 PM 16501393 ER PT J AU Glassman, PA Belperio, P Simon, B Lanto, A Lee, M AF Glassman, PA Belperio, P Simon, B Lanto, A Lee, M TI Exposure to automated drug alerts over time - Effects on clinicians' knowledge and perceptions SO MEDICAL CARE LA English DT Article DE drug therapy; computer assisted; medication errors; attitude of health personnel; attitude to computers; medical record systems; computerized ID PHYSICIAN ORDER ENTRY; INTERVENTION; BENEFITS; BARRIERS; SYSTEMS; ERRORS AB Objective: We tested whether interval exposure to an automated drug alert system that included approximately 2000 drug-drug interaction alerts increased recognition of selected interacting drug pairs. We also examined other perceptions about computerized order entry. Research Design: We administered cross-sectional surveys in 2000 and 2002 that included more than 260 eligible clinicians in each time period. Subjects: We studied clinicians practicing in ambulatory settings within a Southern California Veterans Affairs Healthcare System and who responded to both surveys (97 respondents). Measures: We sought to measure (1) recognition of selected drug-drug and drug-condition interactions and (2) other benefits and barriers to using automated drug alerts. Results: Clinicians correctly categorized similar percentages of the 7 interacting drug-drug pairs at baseline and follow-up (53% vs. 54%, P = 0.51) but improved their overall recognition of the 3 contraindicated drug-drug pairs (51% vs. 60%, P = 0.01). No significant changes from baseline to follow-up were found for the 8 interacting drug-condition pairs (60% vs. 62%, P = 0.43) or the 4 contraindicated drug-condition pairs (52% vs. 56%, P = 0.24). More providers preferred using order entry at follow-up than baseline (63% vs. 45%, P < 0.001). Signal-to-noise ratio remained the biggest reported problem at follow-up and baseline (54 vs. 57%, P = 0.75). In 2002, clinicians reported seeing a median of 5 drug alerts per week (representing approximately 12.5% of prescriptions entered), with a median 5% reportedly leading to an action. Conclusions: Interval exposure to automated drug alerts had little to no effect on recognition of selected drug-drug interactions. The primary perceived barrier to effective utilization of drug alerts remained the same over time. C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA 90073 USA. VA HSR&D Ctr Excellence Study Healthcare Provider, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. VA Ctr Qual Management Publ Hlth, Palo Alto, CA USA. RP Glassman, PA (reprint author), VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, 111G,W Los Angeles Campus,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Peter.Glassman@med.va.gov NR 22 TC 39 Z9 41 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD MAR PY 2006 VL 44 IS 3 BP 250 EP 256 DI 10.1097/01.mlr.0000199849.08389.91 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 018VJ UT WOS:000235792600008 PM 16501396 ER PT J AU Reger, MA Watson, GS Frey, WH Baker, LD Cholerton, B Keeling, ML Belongia, DA Fishel, MA Plymate, SR Schellenberg, GD Cherrier, MM Craft, S AF Reger, MA Watson, GS Frey, WH Baker, LD Cholerton, B Keeling, ML Belongia, DA Fishel, MA Plymate, SR Schellenberg, GD Cherrier, MM Craft, S TI Effects of intranasal insulin on cognition in memory-impaired older adults: Modulation by APOE genotype SO NEUROBIOLOGY OF AGING LA English DT Article DE cognition; Alzheimer's disease; diabetes; memory; glucose ID CENTRAL-NERVOUS-SYSTEM; GROWTH-FACTOR-I; APOLIPOPROTEIN-E GENOTYPE; AMYLOID PRECURSOR PROTEIN; CENTRAL CHOLINERGIC MECHANISM; BLOOD-BRAIN-BARRIER; OBESE ZUCKER RATS; ALZHEIMERS-DISEASE; CEREBROSPINAL-FLUID; HABITUATION RESPONSE AB Raising insulin acutely in the periphery and in brain improves verbal memory. Intranasal insulin administration, which raises insulin acutely in the CNS without raising plasma insulin levels, provides an opportunity to determine whether these effects are mediated by central insulin or peripheral processes. Based on prior research with intravenous insulin, we predicted that the treatment response would differ between subjects with (epsilon 4+) and without (epsilon 4-) the APOE-epsilon 4 allele. On separate mornings, 26 memory-impaired subjects (13 with early Alzheimer's disease and 13 with amnestic mild cognitive impairment) and 35 normal controls each underwent three intranasal treatment conditions consisting of saline (placebo) or insulin (20 or 40 1U). Cognition was tested 15 min post-treatment, and blood was acquired at baseline and 45 min after treatment. Intranasal insulin treatment did not change plasma insulin or glusose levels. Insulin treatment facilitated recall on two measures of verbal memory in memory-impaired epsilon 4- adults. These effects were stronger for niernory-impaired epsilon 4- subjects than for memory-impaired epsilon 4+ subjects and normal adults. Unexpectedly, memory-impaired epsilon 4+ subjects showed poorer recall following insulin administration on one test of memory. These findings suggest that intranasal insulin administration may have therapeutic benefit without the risk of peripheral hypoglycemia and provide further evidence for apolipoprotein E (APOE) related differences in insulin metabolism. (c) 2005 Elsevier Inc. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Pharmacol, Seattle, WA 98195 USA. Reg Hosp, Alzheimers Res Ctr, St Paul, MN 55101 USA. Univ Minnesota, Dept Pharmaceut, Minneapolis, MN 55455 USA. RP Craft, S (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 1660 S Columbian Way,S182-GRECC, Seattle, WA 98108 USA. EM scraft@u.washington.edu OI Frey II, William/0000-0002-6373-0794 FU NIA NIH HHS [P50 AG 05136] NR 70 TC 273 Z9 286 U1 3 U2 19 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD MAR PY 2006 VL 27 IS 3 BP 451 EP 458 DI 10.1016/j.neurobiolaging.2005.03.016 PG 8 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 018HQ UT WOS:000235755400010 PM 15964100 ER PT J AU Dracheva, S Davis, KL Chin, B Woo, DA Schmeidler, J Haroutunian, V AF Dracheva, S Davis, KL Chin, B Woo, DA Schmeidler, J Haroutunian, V TI Myelin-associated mRNA and protein expression deficits in the anterior cingulate cortex and hippocampus in elderly schizophrenia patients SO NEUROBIOLOGY OF DISEASE LA English DT Article DE oligodendrocytes; myelin; gene expression; PCR; schizophrenia; postmortem; anterior cingulate cortex; hippocampus ID 2',3'-CYCLIC NUCLEOTIDE 3'-PHOSPHODIESTERASE; CENTRAL-NERVOUS-SYSTEM; DEMENTED OLD PEOPLE; PREFRONTAL CORTEX; OLIGODENDROCYTE DYSFUNCTION; TEMPORAL CORTEX; HUMAN BRAIN; IN-VIVO; ABNORMALITIES; RECEPTOR AB Microarray and other studies have reported oligodendrocyte and myelin-related (OMR) deficits in schizophrenia. Here, we employed a quantitative approach to determine the magnitude of OMR gene expression deficits and their brain-region specificity. In addition, we examined how expression levels among the studied OMR genes are interrelated. mRNA of MAG, CNP, SOX10, CLDN11, and PMP22, but not MBP and MOBP, was reduced in the hippocampus and anterior cingulate cortex but not in the putamen of patients with schizophrenia. Expression of the only protein examined (CNP) was decreased in the hippocampus but not in the putamen. Correlation and factor analyses revealed that mRNA levels for genes that did exhibit differential expression in schizophrenia (MAG, CNP, SOX10, CLDN11, and PMP2), as opposed to those that did not (MOBP and MBP), loaded on separate factors. Thus, OMR gene and protein expression deficits in schizophrenia are brain-region specific, and the affected components may share regulatory elements. (C) 2005 Elsevier Inc. All rights reserved. C1 Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. RP Haroutunian, V (reprint author), Bronx Vet Adm Med Ctr, 3F-02,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Vahram.Haroutunian@mssm.edu FU NCRR NIH HHS [M01-RR-00071]; NIMH NIH HHS [MH064673, MH45212] NR 49 TC 110 Z9 117 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 0969-9961 J9 NEUROBIOL DIS JI Neurobiol. Dis. PD MAR PY 2006 VL 21 IS 3 BP 531 EP 540 DI 10.1016/j.nbd.2005.08.012 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 020HJ UT WOS:000235899100009 PM 16213148 ER PT J AU Higuchi, M Kudo, T Suzuki, S Evans, TT Sasaki, R Wada, Y Shirakawa, T Sawyer, JR Gotoh, A AF Higuchi, M Kudo, T Suzuki, S Evans, TT Sasaki, R Wada, Y Shirakawa, T Sawyer, JR Gotoh, A TI Mitochondrial DNA determines androgen dependence in prostate cancer cell lines SO ONCOGENE LA English DT Article DE mitochondrial DNA; prostate cancer; hormone dependence ID FACTOR-KAPPA-B; NEUROGASTROINTESTINAL ENCEPHALOMYOPATHY; SACCHAROMYCES-CEREVISIAE; MULTIPLE DELETIONS; MUTATOR PHENOTYPE; POINT MUTATIONS; MTDNA; ACTIVATION; EXPRESSION; CARCINOMA AB Prostate cancer progresses from an androgen-dependent to androgen-independent stage after androgen ablation therapy. Mitochondrial DNA plays a role in cell death and metastatic competence. Further, heteroplasmic large-deletion mitochondrial DNA is very common in prostate cancer. To investigate the role of mitochondrial DNA in androgen dependence of prostate cancers, we tested the changes of normal and deleted mitochondrial DNA in accordance with the progression of prostate cancer. We demonstrated that the androgen-independent cell line C4-2, established by inoculation of the androgen-dependent LNCaP cell line into castrated mice, has a greatly reduced amount of normal mitochondrial DNA and an accumulation of large-deletion DNA. Strikingly, the depletion of mitochondrial DNA from androgen-dependent LNCaP resulted in a loss of androgen dependence. Reconstitution of normal mitochondrial DNA to the mitochondrial DNA-depleted clone restored androgen dependence. These results indicate that mitochondrial DNA determines androgen dependence of prostate cancer cell lines. Further, mitochondrial DNA-deficient cells formed tumors in castrated athymic mice, whereas LNCaP did not. The accumulation of large deletion and depletion of mitochondrial DNA may thus play a role in the development of androgen independence, leading to progression of prostate cancers. C1 Univ Arkansas Med Sci, Dept Biochem & Mol Biol, Little Rock, AR 72205 USA. VA Med Ctr, Houston, TX USA. Dept Neurol, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Kobe Univ, Sch Med, Dept Radiol, Chuo Ku, Kobe, Hyogo 657, Japan. Kobe Univ, Sch Med, Dept Clin Genet, Chuo Ku, Kobe, Hyogo 657, Japan. Kobe Univ, Sch Med, Dept Urol, Chuo Ku, Kobe, Hyogo 657, Japan. Kobe Univ, Sch Med, Int Ctr Med Res, Chuo Ku, Kobe, Hyogo 657, Japan. Univ Arkansas Med Sci, Dept Pathol, Little Rock, AR 72205 USA. RP Higuchi, M (reprint author), Univ Arkansas Med Sci, Dept Biochem & Mol Biol, 4301 W Markham Slot 516, Little Rock, AR 72205 USA. EM mhiguchi@uams.edu RI Suzuki, Seigo/G-5378-2012 FU NCI NIH HHS [CA100846, R01 CA100846-06, R01 CA100846-02, R01 CA100846-04, R01 CA100846, R01 CA100846-01A1, R01 CA100846-03, R01 CA100846-05] NR 44 TC 52 Z9 52 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD MAR PY 2006 VL 25 IS 10 BP 1437 EP 1445 DI 10.1038/sj.onc.1209190 PG 9 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 020EE UT WOS:000235890400001 PM 16278679 ER PT J AU Gallagher, RM AF Gallagher, RM TI Health system studies of pain in older adults: Can we save the "golden years"? SO PAIN MEDICINE LA English DT Editorial Material C1 Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Gallagher, RM (reprint author), Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. NR 2 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 MAR-APR PY 2006 VL 7 IS 2 BP 101 EP 102 DI 10.1111/j.1526-4637.2006.00136.x PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 024UE UT WOS:000236220900001 PM 16634721 ER PT J AU Turner, EH Loftis, JM Blackwell, AD AF Turner, EH Loftis, JM Blackwell, AD TI Serotonin a la carte: Supplementation with the serotonin precursor 5-hydroxytryptophan SO PHARMACOLOGY & THERAPEUTICS LA English DT Review DE serotonin; antidepressants; 5-HTP; tryptophan; depression; selective serotonin re-uptake inhibitor ID TRYPTOPHAN-HYDROXYLASE ISOFORM; POSITRON-EMISSION-TOMOGRAPHY; SEASONAL AFFECTIVE-DISORDER; ALPHA-INDUCED CHANGES; RAT-LIVER CELLS; INTERFERON-ALPHA; MAJOR DEPRESSION; INDOLEAMINE 2,3-DIOXYGENASE; ANTIDEPRESSANT ACTION; SLEEP-DEPRIVATION AB This paper reviews the preclinical and clinical evidence regarding the use of the dietary supplement 5-hydroxytryptophan (5-HTP) for the treatment of depression. In the absence of supplementation with exogenous 5-HTP, the amount of endogenous 5-HTP available for serotonin synthesis depends on the availability of tryptophan and on the activity of various enzymes, especially tryptophan hydroxylase, indoleamine 2,3-dioxygenase, and tryptophan 2,3-dioxygenase (TDO). Factors affecting each of these are reviewed. The amount of 5-HTP reaching the central nervous system (CNS) is affected by the extent to which 5-HTP is converted to serotonin in the periphery. This conversion is controlled by the enzyme amino acid decarboxylase, which, in the periphery, can be blocked by peripheral decarboxylase inhibitors (PDIs) such as carbidopa. Preclinical and clinical evidence for the efficacy of 5-HTP for depression is reviewed, with emphasis on double-blind, placebo-controlled (DB-PC) trials. Safety issues with 5-HTP are also reviewed, with emphasis on eosinophilia myalgia syndrome (EMS) and serotonin syndrome. Published by Elsevier Inc. C1 Portland VA Med Ctr, Mood Disorders Ctr, Portland, OR 97239 USA. Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Univ Oregon, Dept Anthropol, Eugene, OR 97403 USA. RP Turner, EH (reprint author), Portland VA Med Ctr, Mood Disorders Ctr, P3MHDC,3710 SW Us Vet Hosp Rd, Portland, OR 97239 USA. EM Erick.turner@med.va.gov RI Blackwell, Aaron/B-5258-2008; Turner, Erick/A-4848-2008 OI Blackwell, Aaron/0000-0002-5871-9865; Turner, Erick/0000-0002-3522-3357 NR 121 TC 83 Z9 87 U1 5 U2 40 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0163-7258 J9 PHARMACOL THERAPEUT JI Pharmacol. Ther. PD MAR PY 2006 VL 109 IS 3 BP 325 EP 338 DI 10.1016/j.pharmthera.2005.06.004 PG 14 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 013KW UT WOS:000235409200002 PM 16023217 ER PT J AU Hammad, SM Taha, TA Nareika, A Johnson, KR Lopes-Virella, MF Obeid, LM AF Hammad, SM Taha, TA Nareika, A Johnson, KR Lopes-Virella, MF Obeid, LM TI Oxidized LDL immune complexes induce release of sphingosine kinase in human U937 monocytic cells SO PROSTAGLANDINS & OTHER LIPID MEDIATORS LA English DT Article DE sphingosine kinase; sphingosine 1 phosphate; LDL immune complex; oxidized LDL; macrophage ID LOW-DENSITY-LIPOPROTEIN; SMOOTH-MUSCLE-CELLS; INFLAMMATORY CELLS; INDUCED APOPTOSIS; PLASMA-MEMBRANE; ACTIVATION; MACROPHAGES; 1-PHOSPHATE; ANTIBODIES; RECEPTOR AB The transformation of rnacrophages into foam cells is a critical event in the development of atherosclerosis. The most studied aspect of this process is the uptake of modified LDL through the scavenger receptors. Another salient aspect is the effect of modified LDL immune complexes on macrophages activation and foam cell formation. Macrophages internalize oxidized LDL immune complexes (oxLDL-IC) via the Fc-gamma receptor and transform into activated foam cells. In this study we examined the effect of oxLDL-IC on sphingosine kinase 1 (SK1), an enzyme implicated in mediating pro-survival and inflammatory responses through the generation of the signaling molecule sphingosine-1-phosphate (S1P). Intriguingly, oxLDL-IC, but not oxLDL alone, induced an immediate translocation and release of SK1 into the conditioned medium as evidenced by fluorescence confocal microscopy. Immunoblot analysis of cell lysates and conditioned medium revealed a decrease in intracellular SK1 protein levels accompanied by a concomitant increase in extracellular SK1 levels. Furthermore, measurement of S1P formation showed that the activity of cell-associated SK decreased in response to oxLDL-IC compared to oxLDL alone, whereas the activity of SK increased extracellularly. Blocking oxLDL-IC binding to Fc-gamma receptors resulted in decreased levels of extracellular S1P. The data also show that cell survival of human U937 cells exposed to oxLDL-IC increased compared to oxLDL alone. Exogenously added S1P further increased cell survival induced by oxLDL-IC. Taken together, these findings indicate that S1P may be generated extracellularly in response to modified LDL immune complexes and may therefore promote cell survival and prolong cytokine release by activated macrophages. (C) 2006 Elsevier Inc. All rights reserved. C1 Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Gen Internal Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Dept Vet Affairs, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. RP Hammad, SM (reprint author), Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, 114 Doughty St,630B,POB 250776, Charleston, SC 29425 USA. EM hammadsm@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NHLBI NIH HHS [HL55782]; NIGMS NIH HHS [GM62887] NR 53 TC 28 Z9 31 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1098-8823 J9 PROSTAG OTH LIPID M JI Prostaglandins Other Lipid Mediat. PD MAR PY 2006 VL 79 IS 1-2 BP 126 EP 140 DI 10.1016/j.prostaglandins.2005.12.004 PG 15 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 027NS UT WOS:000236422900010 PM 16516816 ER PT J AU Tomisawa, Y Ogasawara, YS Maesawa, C Masuda, T Kurebayashi, J Hershman, NJM Ohta, K Wakabayashi, G AF Tomisawa, Y Ogasawara, YS Maesawa, C Masuda, T Kurebayashi, J Hershman, NJM Ohta, K Wakabayashi, G TI Cyclooxygenase-2 inhibition by celecoxib reduces proliferation and induces apoptosis in human papillary cell carcinoma cell line SO PROSTAGLANDINS & OTHER LIPID MEDIATORS LA English DT Meeting Abstract CT 9th International Conference Eicosanoids CY SEP 11-14, 2005 CL San Francisco, CA C1 Iwate Med Univ, Sch Med, Dept Surg 1, Morioka, Iwate 0208505, Japan. Iwate Med Univ, Sch Med, Dept Pathol 2, Morioka, Iwate 0208505, Japan. Kawasaki Med Univ, Dept Breast & Thyroid Surg, Okayama 7010192, Japan. Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Yamanashi Med Univ, Dept Internal Med 3, Yamanashi 4093898, Japan. 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 1098-8823 J9 PROSTAG OTH LIPID M JI Prostaglandins Other Lipid Mediat. PD MAR PY 2006 VL 79 IS 1-2 BP 185 EP 186 PG 2 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 027NS UT WOS:000236422900172 ER PT J AU Huckans, MS Blackwell, AD Harms, TA Hauser, P AF Huckans, MS Blackwell, AD Harms, TA Hauser, P TI Management of hepatitis C disease among VA patients with schizophrenia and substance use disorders SO PSYCHIATRIC SERVICES LA English DT Article ID DEPRESSION AB Objective: Rates of hepatitis C (HCV) infection, testing, and treatment were compared among patients with schizophrenia, a substance use disorder, or co-occurring schizophrenia or schizoaffective disorder and a substance use disorder and a control group. Methods: Information about 293,445 patients of the Northwest Veterans Healthcare Administration was obtained. Results: The substance use disorder group constituted 13.6 percent of the sample; the schizophrenia group, 1.6 percent; and the co-occurring-disorders group, 1.4 percent. Respectively, these groups were approximately four, two, and six times as likely as the control group to receive HCV testing and about seven, two, and eight times as likely to be infected. The rate of interferon (IFN) therapy was significantly lower for the substance use group and the group with co-occurring disorders. However, the magnitude of the differences was not substantial, suggesting that these high-risk groups were not excluded from IFN therapy. C1 Portland VA Med Ctr, Behav Hlth & Neurosci Div, NW Hepatitis C Resource Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Univ Oregon, Dept Anthropol, Eugene, OR 97403 USA. RP Huckans, MS (reprint author), Portland VA Med Ctr, Behav Hlth & Neurosci Div, NW Hepatitis C Resource Ctr, 3710 SW US Vet Hosp Rd,P3MHDC, Portland, OR 97239 USA. EM marilyn.huckans@med.va.gov RI Blackwell, Aaron/B-5258-2008 OI Blackwell, Aaron/0000-0002-5871-9865 NR 10 TC 18 Z9 19 U1 0 U2 0 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 EI 1557-9700 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD MAR PY 2006 VL 57 IS 3 BP 403 EP 406 DI 10.1176/appi.ps.57.3.403 PG 4 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 019TE UT WOS:000235858800018 PM 16525001 ER PT J AU Grubaugh, AL Frueh, BC Elhai, JD Monnier, J Knapp, RG Magruder, KM AF Grubaugh, AL Frueh, BC Elhai, JD Monnier, J Knapp, RG Magruder, KM TI Racial differences in psychiatric symptom patterns and service use in VA primary care clinics SO PSYCHIATRIC SERVICES LA English DT Article ID VETERANS; HEALTH; PTSD AB The purpose of this study was to assess racial differences in psychopathology and service use in a sample of African-American and Caucasian veterans. Methods: African-American (N=253) and Caucasian (N=460) veterans from primary care clinics at four Department of Veterans Affairs (VA) medical centers were compared on rates of trauma, posttraumatic stress disorder (PTSD), other psychiatric diagnoses, functional status, and use of VA services and benefits. A cross-sectional, epidemiologic design incorporating self-report measures, structured interviews, and chart reviews was used. Results: With the exception of substance abuse or dependence diagnoses and use of substance abuse treatment and urgent care services, few racial differences emerged. Conclusion: Overall, the findings suggest that African-American and Caucasian veterans, including those with PTSD, do not differ significantly in psychopathology or in their use of VA benefits and services. C1 Med Univ S Carolina, Div Publ Psychiat, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Dept Vet Affairs, Med Ctr, Charleston, SC 29425 USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD 57069 USA. Med Univ S Carolina, Dept Bioinformat & Epidemiol, Charleston, SC 29425 USA. RP Grubaugh, AL (reprint author), Med Univ S Carolina, Div Publ Psychiat, Dept Psychiat & Behav Sci, 67 President St,POB 250861, Charleston, SC 29425 USA. EM grubaugh@musc.edu NR 10 TC 13 Z9 13 U1 2 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD MAR PY 2006 VL 57 IS 3 BP 410 EP 413 DI 10.1176/appi.ps.57.3.410 PG 4 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 019TE UT WOS:000235858800020 PM 16525003 ER PT J AU Stone, AM AF Stone, AM TI Prescribing behavior and marketing practices SO PSYCHIATRIC SERVICES LA English DT Letter C1 Philadelphia VA Med Ctr, PTSD Clin Team, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. RP Stone, AM (reprint author), Philadelphia VA Med Ctr, PTSD Clin Team, Philadelphia, PA USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD MAR PY 2006 VL 57 IS 3 BP 419 EP 419 DI 10.1176/appi.ps.57.3.419 PG 1 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 019TE UT WOS:000235858800024 PM 16525009 ER PT J AU Stelzner, M Chen, DC AF Stelzner, M Chen, DC TI To make a new intestinal mucosa SO REJUVENATION RESEARCH LA English DT Article; Proceedings Paper CT 2nd Conference on Strategies for Engineered Negligible Senescence (SENS) CY SEP, 2005 CL Cambridge, ENGLAND ID ENGINEERED SMALL-INTESTINE; EPITHELIAL ORGANOID UNITS; STEM-CELL TRANSPLANTATION; SMALL-BOWEL; TISSUE; NEOINTESTINE; NEOMUCOSA; SCAFFOLDS; MODEL AB A number of clinical conditions are caused by disorders affecting the mucosal lining of the gastrointestinal tract. Some patients suffer from a loss of mucosal surface area due to congenital defects or due to surgical resections ("short bowel syndrome"). Other patients have inborn or acquired defects of certain mucosal functions (e.g., glucose-galactose malabsorption, bile acid malabsorption). Many patients with these mucosal disorders could be more effectively treated if healthy mucosa were available in larger quantities as a replacement or functional supplement. We therefore developed methods to transplant mucosal stem cells from one part of the intestine to another and to make bioengineered intestinal mucosa. We generated an animal model of bile acid malabsorption using rats that underwent resection of the distal 25% of their small intestine (ileum). This resulted in significant losses of bile acids with the fecal excretions in these animals. We subsequently harvested ileal stem cell clusters from neonatal donors, removed the mucosa from a segment of proximal intestine (jejunum), and implanted the stem cell clusters into the debrided segment of jejunum. After four weeks, the animals had developed a functional "neomucosa." We inserted the "neo-ileal" segment into continuity as a substitute ileum. Postoperative measurements of fecal bile acid excretion showed that we were able to reverse the malabsorption syndrome in this model. This was the first reported neo-mucosa-based treatment of a malabsorption syndrome in vivo. We subsequently studied different biodegradable PGA and PLLA scaffoldings to generate bioengineered intestinal mucosa. We implanted these materials into omentum of rats and were able to identify a PGA/PLLA hybrid material on which engraftment rates of 36% of the available surface area could be achieved. Most recently, we developed a novel technique that permits direct observation of cell-biomaterial interactions after implantation into omentum or intestine in vivo. This method will help to optimize engraftment conditions for stem cell clusters on biomaterials. C1 Vet Adm Greater Los Angeles, Surg Serv 10H2, Los Angeles, CA 90073 USA. RP Stelzner, M (reprint author), Vet Adm Greater Los Angeles, Surg Serv 10H2, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Matthias.Stelzner@va.gov NR 16 TC 6 Z9 6 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1549-1684 J9 REJUV RES JI Rejuv. Res. PD SPR PY 2006 VL 9 IS 1 BP 20 EP 25 DI 10.1089/rej.2006.9.20 PG 6 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 035OJ UT WOS:000237010600004 PM 16608391 ER PT J AU Tsai, AG Christie, JD Gaughan, CA Palma, WR Margolis, ML AF Tsai, AG Christie, JD Gaughan, CA Palma, WR Margolis, ML TI Change in forced expiratory time and spirometric performance during a single pulmonary function testing session SO RESPIRATORY CARE LA English DT Article DE pulmonary function test; forced expiratory time ID AIR-FLOW OBSTRUCTION; AIRWAYS OBSTRUCTION; BRONCHODILATOR; DISEASE; REVERSIBILITY; PARAMETERS; SELECTION; THERAPY; ASTHMA AB BACKGROUND: Among patients with obstructive lung disease, the correlation between clinical improvement and bronchodilator response is poor. Forced expiratory time (FET) may explain some discrepancy, but FET has received little attention. METHODS: We analyzed change in FET during the 3 initial satisfactory flow-volume loops in 102 consecutive patients, 37 with normal spirometry and 65 with airflow obstruction referred to a Veterans Administration pulmonary function testing (PFT) laboratory over 5 months. Patients included both PFT-naive and PFT-experienced individuals. We also evaluated the relationship between FET and spirometric performance (sum of forced expiratory volume in the first second and forced vital capacity) and the effect of inhaled bronchodilator on FET among patients with airflow obstruction. RESULTS: Normals and patients with airflow obstruction showed significant increments in FET and in spirometric performance during the 3 initial successive pre-bronchodilator attempts (p < 0.001 for both groups). This was true for PFT-naive and PFT-experienced individuals. There were significant associations between increments in FET and improvements in spirometric performance in all subgroups. After inhaled bronchodilator there was a further FET increment among patients with airflow obstruction (p = 0.009), but there was no significant difference between bronchodilator responders and nonresponders. CONCLUSIONS: Patients with normal pulmonary function and those with obstruction develop longer FET during the initial phases of spirometric testing, regardless of previous PFT experience. Longer FET is associated with better spirometric performance. Bronchodilator administration is associated with modest prolongation of FET, but change in FET did not help identify bronchodilator responders. C1 Hosp Univ Penn, Div Gen Internal Med, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Div Pulm, Philadelphia, PA 19104 USA. Hosp Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Pulm Funct Lab, Philadelphia, PA USA. RP Margolis, ML (reprint author), Philadelphia Vet Affairs Med Ctr, Div Pulm, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM mitchell.margolis@med.va.gov FU PHS HHS [2-T32-HP-010026] NR 24 TC 5 Z9 6 U1 0 U2 0 PU DAEDALUS ENTERPRISES INC PI IRVING PA 9425 N MAC ARTHUR BLVD, STE 100, IRVING, TX 75063-4706 USA SN 0020-1324 J9 RESPIR CARE JI Respir. Care PD MAR PY 2006 VL 51 IS 3 BP 246 EP 251 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 020JT UT WOS:000235905600001 PM 16533413 ER PT J AU Lin, SKV Kuna, ST Bogen, DK AF Lin, SKV Kuna, ST Bogen, DK TI A novel device for measuring long-term oxygen therapy adherence: A preliminary validation SO RESPIRATORY CARE LA English DT Article DE adherence; compliance; monitor; long-term oxygen therapy ID SLEEP APNEA/HYPOPNEA SYNDROME; NASAL CPAP; CONCENTRATOR AB INTRODUCTION: Current methods for measuring patient adherence to long-term oxygen therapy fail to measure the actual amount of time the patient is inhaling oxygen and the pattern of oxygen use within the day. We have developed a novel oxygen-adherence monitor to address these limitations, and this report introduces the monitor and provides preliminary data validating its use. METHODS: This battery-powered monitor attaches to the oxygen source And detects respiratory-related pressure fluctuations transmitted through the nasal cannula. The monitor takes a measurement over a 25-second period, at 4-min intervals. It detects And stores data on 4 different states that describe,the patient's actual use of the oxygen source and nasal cannula: source-off/cannula-off, source-off/cannula-on, source-on/cannula-off, and source-on/cannula-on. We studied the monitor's performance with 10 patients with chronic obstructive pulmonary disease, during A directly-observed sequence of using and not using supplemental oxygen via nasal cannula, while sitting and walking. RESULTS: The monitor correctly detected 122 out of 129 measurements Among all participants, yielding a 95% detection accuracy. CONCLUSIONS A monitor that objectively measures oxygen inhalation, rather than. oxygen expenditure, may help improve the management of patients on long-term oxygen therapy. C1 Univ Penn, Dept Bioengn, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Pulm Allergy & Crit Care Div, Philadelphia, PA USA. Univ Penn, Ctr Sleep & Resp Neurobiol, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Lin, SKV (reprint author), Univ Penn, Dept Bioengn, 120 Hayden Hall,3320 Smith Walk, Philadelphia, PA 19104 USA. EM sunkai.lin@gmail.com NR 19 TC 1 Z9 2 U1 0 U2 1 PU DAEDALUS ENTERPRISES INC PI IRVING PA 9425 N MAC ARTHUR BLVD, STE 100, IRVING, TX 75063-4706 USA SN 0020-1324 J9 RESPIR CARE JI Respir. Care PD MAR PY 2006 VL 51 IS 3 BP 266 EP 271 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 020JT UT WOS:000235905600004 PM 16533416 ER PT J AU Palevsky, PM AF Palevsky, PM TI Dialysis modality and dosing strategy in acute renal failure SO SEMINARS IN DIALYSIS LA English DT Article ID CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; CONTINUOUS ARTERIOVENOUS HEMODIAFILTRATION; CONTINUOUS VENOVENOUS HEMOFILTRATION; REPLACEMENT THERAPY; PROPHYLACTIC DIALYSIS; REQUIRING DIALYSIS; RANDOMIZED-TRIAL; INTERMITTENT; HEMODIALYSIS AB Many fundamental aspects of the management of renal replacement therapy (RRT) in acute renal failure (ARF) remain unresolved. While data from multiple studies support the initiation of RRT, in the absence of other indications, when the BUN has reached a level of approximately 90-100 mg/dl, there are conflicting data regarding the benefit of earlier initiation of renal support. The relative efficacy of the various RRT modalities is uncertain. Despite growing utilization, a survival benefit or greater recovery of renal function has not been demonstrated for continuous renal replacement therapy (CRRT) as compared to conventional intermittent hemodialysis (IHD). Optimal dosing strategies are also poorly defined. While there is increasing evidence that more intensive renal support is associated with better outcomes in ARF, an optimal Kt/V-urea and treatment frequency for IHD remain to be established. Similarly, although data suggest that continuous venovenous hemofiltration (CVVH) should be dosed at no less than 35 ml/kg/hr (postdilution), confirmation of this dosing strategy and validation for other modalities of CRRT are required. C1 VA Pittsburgh Healthcare Syst, Univ Dr Div, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Univ Dr Div, Renal Sect, Room 7E123 111F-U, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Palevsky, Paul/0000-0002-7334-5400 NR 55 TC 20 Z9 22 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD MAR-APR PY 2006 VL 19 IS 2 BP 165 EP 170 DI 10.1111/j.1525-139X.2006.00144.x PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 017ME UT WOS:000235696900014 PM 16551296 ER PT J AU Kushida, CA Littner, MR Hirshkowitz, M Morgenthaler, TI Alessi, CA Bailey, D Boehlecke, B Brown, TM Coleman, J Friedman, L Kapen, S Kapur, VK Kramer, M Lee-Chiong, T Owens, J Pancer, JP Swick, TJ Wise, MS AF Kushida, Clete A. Littner, Michael R. Hirshkowitz, Max Morgenthaler, Timothy I. Alessi, Cathy A. Bailey, Dennis Boehlecke, Brian Brown, Terry M. Coleman, Jack, Jr. Friedman, Leah Kapen, Sheldon Kapur, Vishesh K. Kramer, Milton Lee-Chiong, Teofilo Owens, Judith Pancer, Jeffrey P. Swick, Todd J. Wise, Merrill S. TI Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders SO SLEEP LA English DT Article DE sleep related breathing disorder; obstructive sleep apnea; continuous positive airway pressure; CPAP; sleep-disordered breathing; bilevel positive airway pressure; BPAP ID LONG-TERM COMPLIANCE; PLACEBO-CONTROLLED TRIAL; APNEA-HYPOPNEA SYNDROME; NOCTURNAL NASAL VENTILATION; SPLIT-NIGHT POLYSOMNOGRAPHY; PROSPECTIVE PARALLEL TRIAL; AMBULATORY BLOOD-PRESSURE; APNEA/HYPOPNEA SYNDROME; CPAP THERAPY; APNOEA/HYPOPNOEA SYNDROME AB Positive airway pressure (PAP) devices are used to treat patients with sleep related breathing disorders (SRBD) including obstructive sleep apnea (OSA). Currently, PAP devices come in three forms: (1) continuous positive airway pressure (CPAP), (2) bilevel positive airway pressure (BPAP), and (3) automatic self-adjusting positive airway pressure (APAP). After a patient is diagnosed with OSA, the current standard of practice involves performing full, attended polysomnography during which positive pressure is adjusted to determine optimal pressure for maintaining airway patency. This titration is used to find a fixed single pressure for subsequent nightly usage. A task force of the Standards of Practice Committee of the American Academy of Sleep Medicine reviewed the available literature. Based on this review, the Standards of Practice Committee developed these practice parameters as a guideline for using CPAP and BPAP appropriately (an earlier review and practice parameters for APAP was published in 2002). Major conclusions and current recommendations are as follows: 1) A diagnosis of OSA must be established by an acceptable method. 2) CPAP is effective for treating OSA. 3) Full-night, attended studies performed in the laboratory are the preferred approach for titration to determine optimal pressure; however, split-night, diagnostic-titration studies are usually adequate. 4) CPAP usage should be monitored objectively to help assure utilization. 5) Initial CPAP follow-up is recommended during the first few weeks to establish utilization pattern and provide remediation if needed. 6) Longer-term follow-up is recommended yearly or as needed to address mask, machine, or usage problems. 7) Heated humidification and a systematic educational program are recommended to improve CPAP utilization.8) Some functional outcomes such as subjective sleepiness improve with positive pressure treatment in patients with OSA. 9) CPAP and BPAP therapy are safe; side effects and adverse events are mainly minor and reversible. 10) BPAP may be useful in treating some forms of restrictive lung disease or hypoventilation syndromes associated with hypercapnia. C1 Stanford Univ, Ctr Excellence Sleep Disorders, Stanford, CA USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Sepulveda, CA USA. Baylor Coll Med, Houston, TX USA. VA Med Ctr, Houston, TX USA. Mayo Clin, Mayo Sleep Disorders Ctr, Rochester, MN USA. Univ Calif Los Angeles, Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ N Carolina, Chapel Hill, NC USA. St Joseph Mem Hosp, Murphysboro, IL USA. Middle Tennessee ENT, Murfreesboro, TN USA. Stanford Univ, Sch Med, Stanford, CA USA. VA Med Ctr, Detroit, MI USA. Wayne State Univ, Detroit, MI USA. Univ Washington, Sleep Disorder Ctr, Seattle, WA USA. Maimoides Med Ctr, Psychiat Dept, Brooklyn, NY USA. NYU, Sch Med, New York, NY USA. Sleep Clin, Natl Jewish Med & Res Ctr, Denver, CO USA. Rhode Isl Hosp, Dept Pediat, Providence, RI USA. RP Kushida, CA (reprint author), Stanford Sleep Disorders Clin, 401 Quarry Rd,Suite 3301, Stanford, CA 94305 USA. EM clete@stanford.edu RI Kapur, Vishesh/K-1054-2014 OI Kapur, Vishesh/0000-0002-5417-1097; Morgenthaler, Timothy/0000-0002-2614-3793 NR 94 TC 269 Z9 276 U1 2 U2 9 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAR 1 PY 2006 VL 29 IS 3 BP 375 EP 380 PG 6 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 078SL UT WOS:000240123600014 PM 16553024 ER PT J AU Kim, CY O'Rourke, RW Chang, EY Jobe, BA AF Kim, Charles Y. O'Rourke, Robert W. Chang, Eugene Y. Jobe, Blair A. TI Unsedated small-caliber upper endoscopy: An emerging diagnostic and therapeutic technology SO SURGICAL INNOVATION LA English DT Article DE small-caliber endoscopy; transnasal evaluation; diagnostic upper endoscopy ID ESOPHAGOGASTRODUODENOSCOPY EGD; CONVENTIONAL EGD; TRANSNASAL ESOPHAGOGASTRODUODENOSCOPY; GASTROINTESTINAL ENDOSCOPY; RANDOMIZED-TRIAL; ESOPHAGOSCOPY; PLACEMENT; TOLERANCE; SEDATION; RATES AB Although conventional esophagogastroduodenoscopy has become widespread in its applications and availability, it is constrained by the requirement for patient sedation. This requirement contributes to morbidity, time lost from work, and additional resource utilization in personnel and facilities. Small-caliber endoscopy is an emerging technology that enables transnasal evaluation of the upper gastrointestinal tract in a unsedated patient. This procedure can be performed in a wider range of settings, including the clinic setting where a dedicated conscious sedation suite is not available and can be incorporated into the office visit. The applications of small-caliber endoscopy include general diagnostic upper endoscopy, screening and surveillance of Barrett esophagus, and intraoperative diagnostics or postoperative evaluation of the upper gastrointestinal tract. Therapeutic applications include the placement of nasoduodenal feeding tubes, esophageal pH catheters, and impedance catheters. When used in the sedated patient, small-caliber endoscopy can also facilitate esophageal stricture dilation and transnasal placement of a percutaneous endoscopic gastrostomy tube. This review discusses the techniques, equipment, and applications of small-caliber endoscopy of the upper gastrointestinal tract. C1 Portland VA Med Ctr, Surg Serv P3GS, Dept Surg, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, Surg Serv P3GS, Dept Surg, POB 1034, Portland, OR 97207 USA. EM jobeb@ohsu.edu FU NCI NIH HHS [R03 CA105959-01]; NIDDK NIH HHS [K23 DK066165-01] NR 22 TC 11 Z9 12 U1 0 U2 0 PU WESTMINSTER PUBL INC PI GLEN HEAD PA 708 GLEN COVE AVE, GLEN HEAD, NY 11545 USA SN 1553-3506 J9 SURG INNOV JI Surg. Innov. PD MAR PY 2006 VL 13 IS 1 BP 31 EP 39 DI 10.1177/155335060601300106 PG 9 WC Surgery SC Surgery GA 148ZH UT WOS:000245115400006 PM 16708153 ER PT J AU Ramanathan, V Nguyen, PT Nguyen, PV Khan, A Musher, D AF Ramanathan, V Nguyen, PT Nguyen, PV Khan, A Musher, D TI Successful medical management of recurrent emphysematous pyelonephritis SO UROLOGY LA English DT Article ID NONNEUROGENIC NEUROGENIC BLADDER; RENAL-FAILURE; KIDNEY AB Emphysematous pyelonephritis is characterized by infection and gas formation in the renal parenchyma. This rare disorder tends to occur more frequently in patients with diabetes mellitus and urinary tract obstruction. In this case report, we describe a nondiabetic patient with Hinman syndrome who developed recurrent emphysematous pyelonephritis that was successfully treated with antibiotics on both occasions. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. RP Ramanathan, V (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, 2002 Holcombe Blvd,111-J, Houston, TX 77030 USA. EM ramanath@bcm.edu NR 16 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI Urology PD MAR PY 2006 VL 67 IS 3 DI 10.1016/j.urology.2005.09.059 PG 3 WC Urology & Nephrology SC Urology & Nephrology GA 027PV UT WOS:000236428400054 ER PT J AU Bibbins-Domingo, K Ali, S Wu, AH Whooley, MA AF Bibbins-Domingo, K Ali, S Wu, AH Whooley, MA TI NT-proBNP: An independent predictor of heart failure SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P111 BP E333 EP E333 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100172 ER PT J AU Bibbins-Domingo, K Ali, S Wu, AHB Schiller, NB Whooley, MA AF Bibbins-Domingo, K Ali, S Wu, AHB Schiller, NB Whooley, MA TI NT-proBNP: An independent predictor of cardiovascular events SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P110 BP E333 EP E333 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100171 ER PT J AU Dublin, S French, B Glazer, NL Wiggins, KL Lumley, TS Psaty, BM Smith, NL Heckbert, SR AF Dublin, S French, B Glazer, NL Wiggins, KL Lumley, TS Psaty, BM Smith, NL Heckbert, SR TI Obesity is associated with increased risk of new-onset atrial fibrillation SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst 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 LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P193 BP E349 EP E350 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100249 ER PT J AU Fried, LF Shlipak, MG Sarnak, M Katz, R Cushman, M Kuller, LH Newman, AB AF Fried, LF Shlipak, MG Sarnak, M Katz, R Cushman, M Kuller, LH Newman, AB TI Longitudinal change in inflammatory markers and change in kidney function in an elderly cohort SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Tufts New England Med Ctr, Boston, MA USA. Univ Washington, Seattle, WA 98195 USA. Univ Vermont, Burlington, VT USA. Univ Pittsburgh, Pittsburgh, PA USA. RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150 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 FEB 28 PY 2006 VL 113 IS 8 MA P134 BP E338 EP E338 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100195 ER PT J AU Glazer, NL Dublin, S Smith, NL French, B Jackson, LA Siscovick, DS Psaty, BM Heckbert, SR AF Glazer, NL Dublin, S Smith, NL French, B Jackson, LA Siscovick, DS Psaty, BM Heckbert, SR TI Newly detected atrial fibrillation and compliance with antithrombotic guidelines SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 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 FEB 28 PY 2006 VL 113 IS 8 MA P9 BP E313 EP E313 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100073 ER PT J AU Halanych, JH Safford, MM Lewis, CE Kiefe, CI AF Halanych, JH Safford, MM Lewis, CE Kiefe, CI TI The association between socioeconomic position and perceived racial discrimination: The CARDIA study SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P342 BP E380 EP E380 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100393 ER PT J AU Ix, JH Shlipak, MG Brandenburg, VM Ali, S Ketteler, M Whooley, MA AF Ix, JH Shlipak, MG Brandenburg, VM Ali, S Ketteler, M Whooley, MA TI Association between human fetuin-A and the metabolic syndrome: Data from the Heart and Soul Study SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. Rhein Westfal TH Aachen, Univ Hosp, D-5100 Aachen, Germany. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P167 BP E344 EP E344 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100224 ER PT J AU Ix, JH Shlipak, MG Chertow, GM Ali, S Schiller, NB Whooley, MA AF Ix, JH Shlipak, MG Chertow, GM Ali, S Schiller, NB Whooley, MA TI Cystatin C, left ventricular hypertrophy, and diastolic dysfunction: Data from the Heart and Soul Study SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 6 Z9 6 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P127 BP E337 EP E337 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100188 ER PT J AU Lovasi, GS Lemaitre, RN Siscovick, DS Lumley, TS Bis, JC Dublin, S Smith, NL Heckbert, SR Psaty, BM AF Lovasi, GS Lemaitre, RN Siscovick, DS Lumley, TS Bis, JC Dublin, S Smith, NL Heckbert, SR Psaty, BM TI Amount of leisure-time physical activity and risk of nonfatal myocardial infarction SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P261 BP E363 EP E364 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100315 ER PT J AU Safford, MM Halanych, JH Allison, JJ Kirk, K Kiefe, CI AF Safford, MM Halanych, JH Allison, JJ Kirk, K Kiefe, CI TI Uncontrolled hypertension: Are African Americans getting better care? SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P329 BP E377 EP E377 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100380 ER PT J AU Safford, MM Halanych, JI Lewis, CE Levine, D Houser, S Howard, G AF Safford, MM Halanych, JI Lewis, CE Levine, D Houser, S Howard, G TI Racial differences in intensity of hypertension treatment: The reasons for geographic and racial disparities in stroke study SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA 35 BP E309 EP E309 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100060 ER PT J AU Shlipak, MG Sarnak, M Fried, L Newman, A Katz, R Siscovick, D Psaty, B Kestenbaum, B Stehman-Breen, C AF Shlipak, MG Sarnak, M Fried, L Newman, A Katz, R Siscovick, D Psaty, B Kestenbaum, B Stehman-Breen, C TI The burden of preclinical kidney disease in the elderly SO CIRCULATION LA English DT Meeting Abstract CT 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY MAR 02-05, 2006 CL Phoenix, AZ SP Amer Heart Assoc, Natl Heart, Lung & Blood Inst C1 Tufts Univ, Boston, MA 02111 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Pittsburgh, Pittsburgh, PA USA. Univ Washington, Seattle, WA 98195 USA. Amgen Corp, Thousand Oaks, CA 91320 USA. RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150 NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 28 PY 2006 VL 113 IS 8 MA P115 BP E334 EP E334 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 016KW UT WOS:000235620100176 ER PT J AU McMurtray, AM Chen, AK Shapira, JS Chow, TW Mishkin, F Miller, BL Mendez, MF AF McMurtray, AM Chen, AK Shapira, JS Chow, TW Mishkin, F Miller, BL Mendez, MF TI Variations in regional SPECT hypoperfusion and clinical features in frontotemporal dementia SO NEUROLOGY LA English DT Article ID FRONTAL-LOBE DEGENERATION; ALZHEIMERS-DISEASE; PICKS-DISEASE; DIAGNOSTIC-CRITERIA; TEMPORAL VARIANTS; SOCIAL-BEHAVIOR; CONSENSUS; DISORDERS; SYMPTOMS AB Objective: To characterize the presenting clinical features for frontotemporal dementia (FTD) and contrast them with the degree of frontal and temporal hypoperfusion on SPECT imaging. Methods: The authors evaluated 74 patients who eventually met Consensus Criteria for the FTD form of frontotemporal lobar degeneration (excluding primary progressive aphasia and semantic dementia) on 2-year follow-up. On first presentation, these patients had undergone both an FTD Inventory for 12 features based on core and supportive Consensus Criteria and SPECT imaging. The initial clinical diagnostic features were contrasted with variations in regional SPECT hypoperfusion. Results: The patients with FTD had more hypoperfusion in the right frontal lobe than in other regions; the subgroup of 25 patients who met Consensus Criteria from the first presentation had the most right frontal hypoperfusion. Frontal lobe involvement was associated with significant apathy, whereas temporal lobe involvement was associated with hypomania-like behavior. Right frontal lobe hypoperfusion further predicted loss of insight, environmental dependency, and stereotyped behaviors. Other associations included left frontal hypoperfusion with a decline in personal hygiene and left temporal hypoperfusion with compulsions and mental rigidity. Conclusions: On first presentation, frontotemporal dementia (FTD) is disproportionately a right frontal disease evident on behavioral measures and on SPECT. Nonetheless, patients with FTD can initially present with further regional differences in clinical diagnostic features, such as apathy with bifrontal hypoperfusion and hypomania-like behaviors with anterior temporal involvement. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Toronto, Toronto, ON, Canada. Harbor UCLA Med Ctr, Los Angeles, CA 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, 691-1163AF,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU NIA NIH HHS [P01 AG019724, AG19724-01] NR 43 TC 56 Z9 57 U1 2 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 FEB 28 PY 2006 VL 66 IS 4 BP 517 EP 522 DI 10.1212/01.wnl.0000197983.39436.e7 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 016UF UT WOS:000235645200016 PM 16505304 ER PT J AU Kim, TW Kertesz, SG Horton, NJ Tibbetts, N Samet, JH AF Kim, TW Kertesz, SG Horton, NJ Tibbetts, N Samet, JH TI Episodic homelessness and health care utilization in a prospective cohort of HIV-infected persons with alcohol problems SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; MEDICAL-CARE; SUBSTANCE-ABUSE; ANTIRETROVIRAL THERAPY; SHELTER UTILIZATION; SERVICE UTILIZATION; CASE-MANAGEMENT; URBAN HOMELESS; HOUSING STATUS; SAN-FRANCISCO AB Background: Because individuals with HIV/AIDS often have complex medical and social needs, the impact of housing status on medical service utilization is difficult to isolate from the impact of conditions that may worsen during periods of homelessness such as depression and substance abuse. We examine whether episodes of homelessness are independently associated with suboptimal medical utilization even when accounting for concurrent addiction severity and depression. Methods: We used data from a 30-month cohort of patients with HIV/AIDS and alcohol problems. Housing status, utilization ( ambulatory visits, emergency department (ED) visits, and hospitalizations) and other features were assessed with standardized research interviews at 6-month intervals. Multivariable longitudinal regression models calculated incidence rate ratios (IRR) comparing utilization rates during 6-month intervals ( homeless versus housed). Additional models assessed whether addiction severity and depressive symptoms could account for utilization differences. Results: Of the 349 subjects, 139 (39%) reported homelessness at least once during the study period; among these subjects, the median number of nights homeless per 6-month interview period was 30. Homelessness was associated with higher ED utilization ( IRR = 2.17; 95% CI = 1.72 - 2.74) and hospitalizations ( IRR = 2.30; 1.70 - 3.12), despite no difference in ambulatory care utilization ( IRR = 1.09; 0.89 - 1.33). These associations were attenuated but remained significant when adjusting for addiction severity and depressive symptoms. Conclusion: In patients with HIV/AIDS and alcohol problems, efforts to improve housing stability may help to mitigate intensive medical utilization patterns. C1 Boston Univ, Sch Med, Dept Med, Sect Gen Internal Med,Clin Addict Res & Educ Unit, Boston, MA 02118 USA. Univ Alabama, Sch Med, Dept Med, Div Prevent Med, Birmingham, AL USA. Deep S Ctr Effectiveness, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Smith Coll, Dept Math, Northampton, MA 01063 USA. DM STAT Inc, Medford, MA USA. Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA USA. RP Kim, TW (reprint author), Boston Univ, Sch Med, Dept Med, Sect Gen Internal Med,Clin Addict Res & Educ Unit, Boston, MA 02118 USA. EM theresa.kim@bmc.org; skertesz@mail.dopm.uab.edu; nhorton@felix.smith.edu; nicole.campagnoni@dmstat.com; jsamet@bu.edu RI Horton, Nicholas/A-2493-2008 OI Samet, Jeffrey/0000-0002-0897-3400; Horton, Nicholas/0000-0003-3332-4311; Kim, Theresa/0000-0001-6043-0721 FU NCRR NIH HHS [M01 RR000533, M01-RR00533]; NIAAA NIH HHS [R01-AA10870, R01 AA010870, R01-AA11785, R01-AA13766]; NIDA NIH HHS [K23 DA015487, K23-DA15487, R25 DA013582, R25-DA 13582] NR 49 TC 27 Z9 27 U1 1 U2 10 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 FEB 27 PY 2006 VL 6 AR 19 DI 10.1186/1472-6963-6-19 PG 10 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 029QY UT WOS:000236580700001 PM 16504167 ER PT J AU Bent, S Padula, A Avins, AL AF Bent, S Padula, A Avins, AL TI Brief communication: Better ways to question patients about adverse medical events - A randomized, controlled trial SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID CONSORT STATEMENT; CLINICAL-TRIAL AB Background: There is no standard method of identifying adverse events in clinical trials. Objective: To determine whether 3 different methods of questioning patients about adverse events in a clinical trial affect the frequency of reported events. Design: Randomized, single-blind, controlled trial. Setting: A Veterans Administration medical center, San Francisco, California. Participants: Men 50 years of age or older who had benign prostatic hyperplasia. Measurement: Frequency of self-reported medical problems. Intervention: The authors randomly assigned 214 men who were undergoing a 1-month, single-blind, placebo run-in period during an existing clinical trial to 3 groups to test different self-administered methods of assessing medical problems at the end of the run-in period. The first group was asked an open-ended question; the second group was asked an open-ended, defined question; and the third group was given a checklist of 53 common side effects. Results: All 214 patients completed the study. Patients assigned to the checklist group reported a total of 238 adverse events; in comparison, patients who were asked an open-ended question or an open-ended, defined question reported 11 and 14 adverse events, respectively (P < 0.001). The percentage of patients reporting any adverse event was also much higher in the group assigned to the checklist (77%) than in the first group (14%) or second group (13%) (P< 0.001). Limitations: The study included only relatively healthy, well-educated, middle-aged men and assessed only self-reported medical problems after the participants had taken placebo for 1 month. All personnel overseeing the study were aware of the group assignments. Conclusions: Different methods of collecting patient data regarding adverse events lead to large differences in the reported rates of adverse events in clinical trials, potentially reducing the validity of comparisons between the side effect profiles of drugs and other interventions. C1 San Francisco Vet Adm Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Bent, S (reprint author), San Francisco Vet Adm Med Ctr, 111-A1,4150 Clermont St, San Francisco, CA 94121 USA. EM bent@itsa.ucsf.edu FU NIDDK NIH HHS [R01 DK056199, 1 R01 DK56199-01]; PHS HHS [1 K08 ATO1338-01] NR 13 TC 87 Z9 89 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 FEB 21 PY 2006 VL 144 IS 4 BP 257 EP 261 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 015HS UT WOS:000235543100004 PM 16490911 ER PT J AU Dhaliwal, AS Deswal, A Pritchett, AM Bozkur, B AF Dhaliwal, AS Deswal, A Pritchett, AM Bozkur, B TI How much reduction is needed in BNP levels to reduce future clinical events with treatment during hospitalization for heart failure? SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 55th Annual Scientific Session of the American-College-of-Cardiology CY MAR 11-14, 2006 CL Atlanta, GA SP Amer Coll Cardiol C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 21 PY 2006 VL 47 IS 4 SU A BP 72A EP 73A PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 015CV UT WOS:000235530400313 ER PT J AU Dhaliwal, AS Zhang, QE Deswal, A Pritchett, AM Mann, DL Bozkurt, B AF Dhaliwal, AS Zhang, QE Deswal, A Pritchett, AM Mann, DL Bozkurt, B TI A simple multi-biomarker model does not predict outcomes better than single biomarkers in heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 55th Annual Scientific Session of the American-College-of-Cardiology CY MAR 11-14, 2006 CL Atlanta, GA SP Amer Coll Cardiol C1 DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 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 FEB 21 PY 2006 VL 47 IS 4 SU A BP 89A EP 89A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 015CV UT WOS:000235530400384 ER PT J AU Ristow, B Ali, S Whooley, MA Schiller, NB AF Ristow, B Ali, S Whooley, MA Schiller, NB TI End diastolic pulmonary regurgitation gradient predicts adverse cardiovascular outcomes: Data from the heart and soul study SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 55th Annual Scientific Session of the American-College-of-Cardiology CY MAR 11-14, 2006 CL Atlanta, GA SP Amer Coll Cardiol C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 21 PY 2006 VL 47 IS 4 SU A BP 98A EP 98A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 015CV UT WOS:000235530400420 ER PT J AU Saleh, JR Ebrahimi, R Shah, AP Wadhani, N Toggart, EJ AF Saleh, JR Ebrahimi, R Shah, AP Wadhani, N Toggart, EJ TI Statins in acute coronary syndrome: A meta-analysis SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 55th Annual Scientific Session of the American-College-of-Cardiology CY MAR 11-14, 2006 CL Atlanta, GA SP Amer Coll Cardiol C1 Univ Calif Los Angeles, W Los Angeles VA, Los Angeles, 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 21 PY 2006 VL 47 IS 4 SU A BP 212A EP 212A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 015CV UT WOS:000235530401230 ER PT J AU Ho, PM Rumsfeld, JS Masoudi, FA McClure, DL Plomondon, ME Steiner, JF Magid, DJ AF Ho, PM Rumsfeld, JS Masoudi, FA McClure, DL Plomondon, ME Steiner, JF Magid, DJ TI The impact of medication non-adherence on hospitalization and mortality among patients with diabetes SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 55th Annual Scientific Session of the American-College-of-Cardiology CY MAR 11-14, 2006 CL Atlanta, GA SP Amer Coll Cardiol C1 Denver VA Med Ctr, Denver, CO USA. Kaiser Permanente, Denver, CO USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 21 PY 2006 VL 47 IS 4 SU A BP 264A EP 264A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 015CV UT WOS:000235530401449 ER PT J AU Heidenreich, PA Spertus, JA Jones, PG Weintraub, WS Rumsfeld, JS Rathore, SS Peterson, ED Masoudi, FA Krumholz, HM Havranek, EP Conard, MW Williams, RE AF Heidenreich, PA Spertus, JA Jones, PG Weintraub, WS Rumsfeld, JS Rathore, SS Peterson, ED Masoudi, FA Krumholz, HM Havranek, EP Conard, MW Williams, RE CA Cardiovascular Outcomes Res Cons TI Health status identifies heart failure outpatients at risk for hospitalization or death SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID QUALITY-OF-LIFE; READMISSION; PREDICTOR AB OBJECTIVES We tested the hypothesis that one health status measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ), provides prognostic information independent of other clinical data in outpatients with heart failure (HF). BACKGROUND Health status measures are used to describe a patient's clinical condition and have been shown to predict mortality in Some Populations. Their prognostic value may be particularly useful among patients with HF for identifying candidates for disease management in whom increased care may reduce hospitalizations and prevent death. METHODS We evaluated 505 HF patients from 13 outpatient clinics who had all ejection fraction < 40% using the KCCQ summary score. Proportional hazards regression was used to evaluate the association between the KCCQ summary score (range, 0 to 100; higher scores indicate better health status) and the primary outcome of death or HF admission, adjusting for baseline patient characteristics, 6-min walk distance, and B-type natriuretic peptide (BNP). RESULTS The mean age was 61 years, 76% of patients were male, 51% had an ischemic HF etiology, and 5% were New York Heart Association functional class IV. At 12 months, among the 9% of patients with a KCCQ-score < 25, 37% had been admitted for HF and 20% had died, compared with 7% (HF admissions) and 5% (death) of those with a KCCQ-score = >= 75 (33% of patients, p < 0.0001 for both comparisons). In sequential multivariable models adjusting for clinical variables, 6-min walk, and BNP levels, the KCCQ score remained significantly associated with survival free of HF hospitalization. CONCLUSIONS A low KCCQ score is an independent predictor of poor prognosis in outpatients with HF. C1 Palo Alto VA Hlth Care Syst, Palo Alto, CA 94304 USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. Emory Univ, Atlanta, GA 30322 USA. Denver VA Med Ctr, Denver, CO USA. Yale Univ, New Haven, CT USA. Duke Univ, Med Ctr, Durham, NC USA. Denver Hlth Med Ctr, Denver, CO USA. Northwestern Univ, Evanston, IL USA. RP Heidenreich, PA (reprint author), Palo Alto VA Hlth Care Syst, 3801 Miranda Ave, Palo Alto, CA 94304 USA. EM heiden@stanford.edu OI Heidenreich, Paul/0000-0001-7730-8490 FU NIGMS NIH HHS [GM07205] NR 14 TC 125 Z9 126 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 21 PY 2006 VL 47 IS 4 BP 752 EP 756 DI 10.1016/j.jacc.2005.11.021 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 013QB UT WOS:000235422900011 PM 16487840 ER PT J AU Gordon, HS Street, RL Sharf, BF Kelly, PA Souchek, J AF Gordon, HS Street, RL Sharf, BF Kelly, PA Souchek, J TI Racial differences in trust and lung cancer patients' perceptions of physician communication SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article; Proceedings Paper CT 28th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 11-14, 2005 CL New Orleans, LA SP Soc General Internal Med ID PRIMARY-CARE PHYSICIANS; ETHNIC DISPARITIES; AFRICAN-AMERICANS; HEALTH-CARE; OUTCOMES; STYLE; CONSULTATIONS; CHEMOTHERAPY; SATISFACTION; RELIABILITY AB Purpose Black patients report lower trust in physicians than white patients, but this difference is poorly studied. We examined whether racial differences in patient trust are associated with physician-patient communication about lung cancer treatment. Patients and Methods Data were obtained for 103 patients (22% black and 78% white) visiting thoracic surgery or oncology clinics in a large Southern Veterans Affairs hospital for initial treatment recommendation for suspicious pulmonary nodules or lung cancer. Questionnaires were used to determine patients' perceptions of the quality of the physicians' communication and were used to assess patients' previsit and postvisit trust in physician and trust in health care system. Patients responded on a 10-point scale. Results Previsit trust in physician was statistically similar in black and white patients (mean score, 8.2 v 8.3, respectively; P = .80), but black patients had lower postvisit trust in physician than white patients (8.0 v 9.3, respectively; P = .02). Black patients, compared with white patients, judged the physicians' communication as less informative (7.3 v 8.5, respectively; P = .03), less supportive (8.1 v 9.3, respectively; P = .03), and less partnering (6.4 v 8.2, respectively; P = .001). In mixed linear regression analysis, controlling for clustering of patients by physician, patients' perceptions of physicians' communication were statistically significant (P < .005) predictors of postvisit trust, although patient race, previsit trust, and patient and visit characteristics were not significant (P > .05) predictors. Conclusion Perceptions that physician communication was less supportive, less partnering, and less informative accounted for black patients' lower trust in physicians. Our findings raise concern that black patients may have lower trust in their physicians in part because of poorer physician-patient communication. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Dept Internal Med, Houston, TX 77030 USA. Texas A&M Univ, Dept Commun, College Stn, TX 77843 USA. RP Gordon, HS (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM hgordon@bcm.tmc.edu RI Gordon, Howard/E-4420-2010 OI Gordon, Howard/0000-0002-6712-5954 FU AHRQ HHS [P01 HS10876] NR 46 TC 153 Z9 154 U1 2 U2 10 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 FEB 20 PY 2006 VL 24 IS 6 BP 904 EP 909 DI 10.1200/JCO.2005.03.1955 PG 6 WC Oncology SC Oncology GA 014HF UT WOS:000235469700014 PM 16484700 ER PT J AU Blutt, SE Warfield, KL O'Neal, CM Estes, MK Conner, ME AF Blutt, SE Warfield, KL O'Neal, CM Estes, MK Conner, ME TI Host, viral, and vaccine factors that determine protective efficacy induced by rotavirus and virus-like particles (VLPs) SO VACCINE LA English DT Article DE virus-like particles; rotavirus; protective immunity ID SECRETING CELL RESPONSES; CHIMERIC VP6 PROTEIN; INTRANASAL IMMUNIZATION; IMMUNE-RESPONSES; GNOTOBIOTIC PIGS; 2/6-ROTAVIRUS-LIKE PARTICLES; INDEPENDENT PROTECTION; ANTIBODY-RESPONSES; CAPSID PROTEINS; MICE AB Critical factors that are important in protection from rotavirus infection have remained elusive. We demonstrate here that inbred mice (C57BL/6 and BALB/c) exhibit differences in: (1) susceptibility to and (2) VLP-induced protection from rotavirus infection. Comparing protection induced by 2/4/6/7-VLPs with inactivated and live rotavirus, intranasally induced protection was dependent on dsRNA or minor structural proteins and correlated with intestinal antibody, while orally induced protection required immunization with replicating virus. Combination oral/intranasal vaccination did not improve VLP protective efficacy. These studies indicate that host, viral, and vaccine factors determine the level of protective efficacy induced by VLPs. (c) 2005 Elsevier Ltd. All rights reserved. C1 Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. Michael E Debakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Conner, ME (reprint author), Baylor Coll Med, Dept Mol Virol & Microbiol, 1 Baylor Plaza, Houston, TX 77030 USA. EM mconner@bcm.tmc.edu FU NIAID NIH HHS [AI24998, AI10604]; NIDDK NIH HHS [DK56338] NR 48 TC 30 Z9 31 U1 0 U2 3 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD FEB 20 PY 2006 VL 24 IS 8 BP 1170 EP 1179 DI 10.1016/j.vaccine.2005.08.090 PG 10 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 016VD UT WOS:000235647900015 PM 16191453 ER PT J AU Wang, C Hayes, B Vestling, MM Takayama, K AF Wang, C Hayes, B Vestling, MM Takayama, K TI Transposome mutagenesis of an integral membrane transporter in Corynebacterium matruchotii SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE trehalose corynomycolates; Corynomycolic acid; ATP-binding cassette transporter; Tn5 mutagenesis; MALDI mass spectrometry; Mycobacterium tuberculosis ID MYCOBACTERIUM-TUBERCULOSIS; MYCOLIC ACIDS; CELL-WALL; BIOSYNTHESIS; TREHALOSE AB A transposon-5 insertion library of Corynebacterium matruchotii ATCC14266 was generated and screened for mutants with altered corynomycolic acid content. One of these designated 319 mutants showed an interruption of a gene encoding an integral membrane protein. MALDI mass spectra of trehalose monocorynomycolate (TMCM), trehalose dicorynomycolate, and methyl corynomycolates derived from cell wall arabinogalactan-corynomycolate showed that these lipids from the mutant contained a lower amount of shortchain (C-24 to C-34) and much greater amount of long-chain (primarily C-36:2) corynomycolic acids than the wild type. An analysis of mRNA demonstrated that the integral membrane protein and ATP-binding cassette transporter are transcriptionally coupled. These results suggested that the proteins/enzymes encoded by the membrane transporter gene locus preferably move short-chain corynomycolic acids from the cytoplasm across the membrane bilayer to the periplasmic space where the synthesis of TMCM is thought to occur. This is the first evidence linking corynomycolic acid to a transporter gene locus. published by Elsevier Inc. C1 William S Middleton Mem Vet Adm Med Ctr, Mycobacteriol Res Lab, Madison, WI 53705 USA. Univ Wisconsin, Dept Chem, Madison, WI 53706 USA. Univ Wisconsin, Sch Med, Dept Med Microbiol & Immunol, Madison, WI 53706 USA. Univ Wisconsin, Dept Bacteriol, Madison, WI 53706 USA. RP Takayama, K (reprint author), William S Middleton Mem Vet Adm Med Ctr, Mycobacteriol Res Lab, 2500 Overlook Terrace, Madison, WI 53705 USA. EM Kuni.Takayama@med.va.gov NR 16 TC 10 Z9 10 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 FEB 17 PY 2006 VL 340 IS 3 BP 953 EP 960 DI 10.1016/j.bbrc.2005.12.097 PG 8 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 009DR UT WOS:000235092000030 PM 16403458 ER PT J AU Spencer, BA Babey, SH Etzioni, DA Ponce, NA Brown, ER Yu, HJ Chawla, N Litwin, MS AF Spencer, BA Babey, SH Etzioni, DA Ponce, NA Brown, ER Yu, HJ Chawla, N Litwin, MS TI A population-based survey of prostate-specific antigen testing among California men at higher risk for prostate carcinoma SO CANCER LA English DT Article DE prostate carcinoma; prostate-specific antigen; screening; high risk; African American ID AFRICAN-AMERICAN MEN; CANCER SCREENING PRACTICES; RADICAL PROSTATECTOMY; MORTALITY-RATES; RELATIVE RISK; UNITED-STATES; WHITE MEN; TRENDS; UPDATE; METAANALYSIS AB BACKGROUND. Despite the lack of evidence demonstrating a survival benefit from prostate-specific antigen (PSA) screening, its use has become widespread, organizations have encouraged physicians to discuss early detection of prostate carcinoma, and two higher risk groups have been recognized. In the current study, the authors examined whether African-American men and men who had a family history of prostate carcinoma underwent PSA testing preferentially, and patterns of test use were examined according to age, race, and other factors. METHODS. Data regarding self-reported PSA test use in the past year among men age 50 years and older Without a history of prostate carcinoma (n = 8713 men) were analyzed from the 2001 California Health Interview Survey. RESULTS. The overall rate of PSA use was 43.0%. Older age, higher socioeconomic status, having a usual Source of healthcare, and a family history of prostate carcinoma were the strongest predictors of testing. Higher risk African-American men age 50 years and older were no more likely to be tested than white men. Men at higher risk who had a family history of prostate carcinoma were more likely to have been tested than men who had no such family history. CONCLUSIONS. Rates of PSA use among higher risk men who had a family history of prostate carcinoma were higher compared with the rates among men without such a family history. However, PSA testing rates among higher risk African-American men were no different than the rates among lower risk white men, Suggesting that some risk factors for prostate carcinoma (but not others) are associated with preferential testing. Testing in all groups was associated with access to care variables, highlighting the importance of removing barriers to preventive healthcare services. C1 Univ Calif Los Angeles, Dept Urol, David Geffen Sch Med, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Dept Urol, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles Ctr Hlth Policy Res, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Surg, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Hlth Serv, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Spencer, BA (reprint author), Univ Calif Los Angeles, Dept Urol, David Geffen Sch Med, Box 951738, Los Angeles, CA 90095 USA. EM spencerb@ucla.edu OI Ponce, Ninez/0000-0001-5151-6718 FU NCI NIH HHS [N02PC95057] NR 44 TC 34 Z9 34 U1 1 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD FEB 15 PY 2006 VL 106 IS 4 BP 765 EP 774 DI 10.1002/cncr.21673 PG 10 WC Oncology SC Oncology GA 012FU UT WOS:000235324400006 PM 16419068 ER PT J AU Zhao, R Xiang, N Domann, FE Zhong, WX AF Zhao, R Xiang, N Domann, FE Zhong, WX TI Expression of p53 enhances selenite-induced superoxide production and apoptosis in human prostate cancer cells SO CANCER RESEARCH LA English DT Article ID SE-METHYLSELENOCYSTEINE; ADENOCARCINOMA CELLS; MEDIATED APOPTOSIS; OXIDATIVE STRESS; REDOX MECHANISM; PREVENTION; PROTEIN; GLUTATHIONE; MORTALITY; SELENOMETHIONINE AB Although the anticancer effects of selenium have been shown in clinical, preclinical, and laboratory studies, the underlying mechanism(s) remains unclear. Our previous study showed that sodium selenite induced LNCaP human prostate cancer cell apoptosis in association with production of reactive oxygen species, alteration of cell redox state, and mitochondrial damage. In the present study, we showed that selenite-induced apoptosis was superoxide mediated and p53 dependent via mitochondrial pathways. In addition, we also showed that superoxide production by selenite was p53 dependent. Our study showed that wild-type p53-expressing LNCaP cells were more sensitive to selenite-induced apoptosis than p53-null PC3 cells. Selenite treatment resulted in high levels of superoxide production in LNCaP cells but only low levels in PC3 cells. LNCaP cells also showed sequential increases in levels of phosphorylated p53 (serine 15), total p53, Bax, and p21(Waf1) proteins following selenite treatment. The effects of selenite were suppressed by pretreatment with a synthetic superoxide dismutase mimic or by knockdown of p53 via RNA interference. LNCaP cells treated with selenite also showed p53 translocation to mitochondria, cytochrome c release into the cytosol, and activation of caspase-9. On the other hand, restoration of wild-type p53 expression in PC3 cells increased cellular sensitivity to selenite and resulted in increased superoxide production, caspase-9 activation, and apoptosis following selenite treatment. These results suggest that selenite induces apoptosis by producing superoxide to activate p53 and to induce p53 mitochondrial translocation. Activation of p53 in turn synergistically enhances superoxide production and apoptosis induced by selenite. C1 Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Ctr Clin Sci, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI USA. Univ Iowa, Free Rad & Radiat Biol Program, Iowa City, IA USA. RP Zhong, WX (reprint author), Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Ctr Clin Sci, K4-868,Box 8550,600 Highland Ave, Madison, WI 53792 USA. EM wzhong3@wisc.edu OI Domann, Frederick/0000-0002-0489-2179 FU NCI NIH HHS [CA1114281, R01 CA114281] NR 47 TC 74 Z9 79 U1 0 U2 15 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 FEB 15 PY 2006 VL 66 IS 4 BP 2296 EP 2304 DI 10.1158/0008-5472.CAN-05-2216 PG 9 WC Oncology SC Oncology GA 013CM UT WOS:000235387200054 PM 16489034 ER PT J AU Yan, HJ Frost, P Shi, YJ Hoang, B Sharma, S Fisher, M Gera, J Lichtenstein, A AF Yan, HJ Frost, P Shi, YJ Hoang, B Sharma, S Fisher, M Gera, J Lichtenstein, A TI Mechanism by which mammalian target of rapamycin inhibitors sensitize multiple myeloma cells to dexamethasone-induced apoptosis SO CANCER RESEARCH LA English DT Article ID MESSENGER-RNA TRANSLATION; SITE-MEDIATED TRANSLATION; CYCLIN D1; ENHANCED SENSITIVITY; IMMUNOPHILIN FKBP51; SQUIRREL-MONKEY; AKT ACTIVITY; PROTEIN; RESISTANCE; KINASE AB Mammalian target of rapamycin (mTOR) inhibitors curtail cap-dependent translation. However, they can also induce post-translational modifications of proteins. We assessed both effects to understand the mechanism by which mTOR inhibitors like rapamycin sensitize multiple myeloma cells to dexamethasone-induced apoptosis. Sensitization was achieved in multiple myeloma cells irrespective of their PTEN or p53 status, enhanced by activation of AKT, and associated with stimulation of both intrinsic and extrinsic pathways of apoptosis. The sensitizing effect was not due to post-translational modifications of the RAFTK kinase, Jun kinase, p38 mitogen-activated protein kinase, or BAD. Sensitization was also not associated with a rapamycin-mediated increase in glucocorticoid receptor reporter expression. However, when cap-dependent translation was prevented by transfection with a mutant 4E-BP1 construct, which is resistant to mTOR-induced phosphorylation, cells responded to dexamethasonc with enhanced apoptosis, mirroring the effect of coexposure to rapamycin. Thus, sensitization is mediated by inhibition of cap-dependent translation. A high-throughput screening for translational efficiency identified several antiapoptotic proteins whose translation was inhibited by rapamycin. Immunoblot assay confirmed rapamycin-induced down-regulated expressions of XIAP, CIAP1, HSP-27, and BAG-3, which may play a role in the sensitization to apoptosis. Studies in a xenograft model showed synergistic in vivo antimyeloma effects when dexamethasone was combined with the mTOR inhibitor CCI-779. Synergistic effects were associated with an enhanced multiple myeloma cell apoptosis in vivo. This study supports the strategy of combining dexamethasone with mTOR inhibitors in multiple myeloma and identifies a mechanism by which the synergistic effect is achieved. C1 Univ Calif Los Angeles, Greater Los Angeles VA Healthcare Ctr, Dept Med, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Greater Los Angeles VA Healthcare Ctr, Dept Pathol, Sch Med, Los Angeles, CA USA. Jonsson Comprehens Canc Ctr, Los Angeles, CA 90034 USA. RP Lichtenstein, A (reprint author), Univ Calif Los Angeles, Med Ctr, W Los Angeles VA, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM alan.lichtenstein@med.va.gov OI Frost, Patrick/0000-0003-3348-5983 FU NCI NIH HHS [CA 111448, CA 96920] NR 47 TC 81 Z9 87 U1 1 U2 4 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 FEB 15 PY 2006 VL 66 IS 4 BP 2305 EP 2313 DI 10.1158/0008-5472.CAN-05-2447 PG 9 WC Oncology SC Oncology GA 013CM UT WOS:000235387200055 PM 16489035 ER PT J AU Lee, SJ Lindquist, K Segal, MR Covinsky, KE AF Lee, SJ Lindquist, K Segal, MR Covinsky, KE TI Development and validation of a prognostic index for 4-year mortality in older adults SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CORONARY-HEART-DISEASE; ADMINISTRATIVE DATA; PREDICTIVE MODEL; UNITED-STATES; COMORBIDITY; COMMUNITY; HEALTH; RISK; HOSPITALIZATION; PREVENTION AB Context Both comorbid conditions and functional measures predict mortality in older adults, but few prognostic indexes combine both classes of predictors. Combining easily obtained measures into an accurate predictive model could be useful to clinicians advising patients, as well as policy makers and epidemiologists interested in risk adjustment. Objective To develop and validate a prognostic index for 4-year mortality using information that can be obtained from patient report. Design, Setting, and Participants Using the 1998 wave of the Health and Retirement Study (HRS), a population-based study of community-dwelling US adults older than 50 years, we developed the prognostic index from 11 701 individuals and validated the index with 8009. Individuals were asked about their demographic characteristics, whether they had specific diseases, and whether they had difficulty with a series of functional measures. We identified variables independently associated with mortality and weighted the variables to create a risk index. Main Outcome Measure Death by December 31, 2002. Results The overall response rate was 81%. During the 4-year follow-up, there were 1361 deaths (12%) in the development cohort and 1072 deaths (13%) in the validation cohort. Twelve independent predictors of mortality were identified: 2 demographic variables (age: 60-64 years, 1 point; 65-69 years, 2 points; 70-74 years, 3 points; 75-79 years, 4 points; 80-84 years, 5 points, >85 years, 7 points and male sex, 2 points), 6 comorbid conditions (diabetes, 1 point; cancer, 2 points; lung disease, 2 points; heart failure, 2 points; current tobacco use, 2 points; and body mass index <25, 1 point), and difficulty with 4 functional variables (bathing, 2 points; walking several blocks, 2 points; managing money, 2 points, and pushing large objects, 1 point. Scores on the risk index were strongly associated with 4-year mortality in the validation cohort, with 0 to 5 points predicting a less than 4% risk, 6 to 9 points predicting a 15% risk, 10 to 13 points predicting a 42% risk, and 14 or more points predicting a 64% risk. The risk index showed excellent discrimination with a c statistic of 0.84 in the development cohort and 0.82 in the validation cohort. Conclusion This prognostic index, incorporating age, sex, self-reported comorbid conditions, and functional measures, accurately stratifies community-dwelling older adults into groups at varying risk of mortality. C1 San Francisco Vet Affairs Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Lee, SJ (reprint author), San Francisco Vet Affairs Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. EM sei.lee@va.gov FU AHRQ HHS [K02-HS00006]; NIA NIH HHS [R01AG023626, U01AG09740] NR 46 TC 316 Z9 321 U1 2 U2 16 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 15 PY 2006 VL 295 IS 7 BP 801 EP 808 DI 10.1001/jama.295.7.801 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 011YZ UT WOS:000235306700025 PM 16478903 ER PT J AU Ma, QL Lim, GP Harris-White, ME Yang, FS Ambegaokar, SS Glabe, CG Teter, B Frautschy, SA Cole, GM AF Ma, QL Lim, GP Harris-White, ME Yang, FS Ambegaokar, SS Glabe, CG Teter, B Frautschy, SA Cole, GM TI Antibodies against beta-amyloid reduce A beta oligomers, glycogen synthase kinase-3 beta activation and tau phosphorylation in vivo and in vitro SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE Alzheimer's disease; passive immunization; immunoneutralization; amyloid; neurofibrillary tangles ID LONG-TERM POTENTIATION; ALZHEIMERS-DISEASE; TRANSGENIC MICE; MOUSE MODEL; INDUCED NEURODEGENERATION; HIPPOCAMPAL-NEURONS; PRECURSOR PROTEIN; PEPTIDE; PATHOLOGY; LITHIUM AB Although active and passive immunization against the beta-amyloid peptide (A beta) of amyloid plaque-bearing transgenic mice markedly reduces amyloid plaque deposition and improves cognition, the mechanisms of neuroprotection and impact on toxic oligomer species are not understood. We demonstrate that compared to control IgG2b, passive immunization with intracerebroventricular (icv) anti-A beta (1-15) antibody into the AD HuAPPsw (Tg2576) transgenic mouse model reduced specific oligomeric forms of A beta, including the dodecamers; that correlate with cognitive decline. Interestingly, the reduction of soluble A beta oligomers, but not insoluble A beta, significantly correlated with reduced tau phosphorylation by glycogen synthase kinase-3 beta (GSK-3 beta), a major tau kinase implicated previously in mediating A beta toxicity. A conformationally-directed antibody against amyloid oligomers (larger than tetramer) also reduced A beta oligomer-induced activation of GSK3 beta and protected human neuronal SH-SY5Y cells from A beta oligomer-induced neurotoxicity, supporting a role for A beta oligomers in human tau kinase activation. These data suggest that antibodies that are highly specific for toxic oligomer subspecies may reduce toxicity via reduction of GSK-3 beta, which could be an important strategy for Alzheimer's disease (AD) therapeutics. (c) 2005Wiley-Liss, Inc. C1 Greater Los Angeles Vet Affairs Healthcare Syst, VA Med Ctr, Geriatr Res & Clin Ctr, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Irvine, Dept Mol Biol & Biochem, Irvine, CA 92717 USA. RP Cole, GM (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, VA Med Ctr, Geriatr Res & Clin Ctr, Alzheimer Res 151,Bldg 7,Rm A102,16111 Plummer St, Sepulveda, CA 91343 USA. EM gmcole@ucla.edu FU NIA NIH HHS [P50 AG016570, R01 AG010685, R01 AG021975, R01 AG022080, R01 AG10685]; NINDS NIH HHS [R01 NS043946, R01 NS43946] NR 60 TC 93 Z9 101 U1 1 U2 11 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 FEB 15 PY 2006 VL 83 IS 3 BP 374 EP 384 DI 10.1002/jnr.20734 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 015BX UT WOS:000235528000003 PM 16385556 ER PT J AU Holsehneider, DP Yang, J Sadler, TR Nguyen, PT Givrad, TK Maarek, JMI AF Holsehneider, DP Yang, J Sadler, TR Nguyen, PT Givrad, TK Maarek, JMI TI Mapping cerebral blood flow changes during auditory-cued conditioned fear in the nontethered, nonrestrained rat SO NEUROIMAGE LA English DT Review DE brain mapping; functional neuroimaging; fear conditioning; cerebral blood flow; statistical parametric mapping; medial prefrontal cortex; amygdala; hippocampus; striatum; septum; periaqueductal gray ID MEDIAL PREFRONTAL CORTEX; PHASEOLUS-VULGARIS-LEUKOAGGLUTININ; DIFFERENT ANTEROGRADE AMNESIAS; MIDBRAIN PERIAQUEDUCTAL GRAY; FOS-LIKE IMMUNOREACTIVITY; LATERAL AMYGDALA NEURONS; FREELY MOVING RATS; CONTEXTUAL FEAR; DORSAL HIPPOCAMPUS; VENTRAL HIPPOCAMPUS AB Conditioned fear (CF) is one of the most frequently used behavioral paradigms; however, little work has mapped changes in cerebral perfusion during CF in the rat-the species which has dominated CF research. Adult rats carrying an implanted minipump were exposed to a tone (controls, n = 8) or a tone conditioned in association with footshocks (CS group, n = 9). During reexposure to the tone 24 h later, animals were injected intravenously by remote activation with [C-14]-iodoantipyrine using the pump. Significant group differences in regional CBF-related tissue radioactivity (CBF-TR) were determined by region-of-interest analysis of brain autoradiographs, as well as in the reconstructed, three-dimensional brain by statistical parametric mapping (SPM). CS animals demonstrated significantly greater, fear-enhanced increases in CBF-TR in auditory cortex than controls. The lateral amygdala was activated, whereas the basolateral/basomedial and central amygdala were deactivated. In the hippocampus and medial prefrontal cortex, CBF-TR increased significantly ventrally but not dorsally. Significant activations were noted in medial striatum and the thalamic midline and intralaminar nuclei. However, the ventrolateral/dorsolateral striatum and its afferents from motor and somatosensory cortex were deactivated, consistent with the behavioral immobility seen during CF. Significant activations were also noted in the lateral septum, periaqueductal gray, and deep mesencephalic nucleus/tegmental tract. Our results show that auditory stimuli endowed with aversive properties through conditioning result in significant redistribution of cerebral perfusion. SPM is a useful tool in the brain mapping of complex rodent behaviors, in particular the changes in activation patterns in limbic, thalamic, motor, and cortical circuits during CF. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ So Calif, Dept Cell & Neurobiol, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Psychiat & Behav Sci, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Neurol, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Pathol, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Dept Biomed Engn, Keck Sch Med, Los Angeles, CA 90089 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. RP Holsehneider, DP (reprint author), Univ So Calif, Dept Cell & Neurobiol, Keck Sch Med, 1333 San Pablo St,BMT 403,MC 9112, Los Angeles, CA 90089 USA. EM holschne@usc.edu FU NCCIH NIH HHS [R24 AT002681, 1R24AT002681]; NIBIB NIH HHS [R01 EB000300, 8R01 EB-00300]; NINDS NIH HHS [1R01 NS050171, R01 NS050171] NR 134 TC 29 Z9 30 U1 0 U2 4 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1053-8119 J9 NEUROIMAGE JI Neuroimage PD FEB 15 PY 2006 VL 29 IS 4 BP 1344 EP 1358 DI 10.1016/j.neuroimage.2005.08.038 PG 15 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 015EJ UT WOS:000235534400033 PM 16216535 ER PT J AU Ellenbogen, KA Levine, JH Berger, RD Daubert, JP Winters, SL Greenstein, E Shalaby, A Schaechter, A Subacius, H Kadish, A AF Ellenbogen, KA Levine, JH Berger, RD Daubert, JP Winters, SL Greenstein, E Shalaby, A Schaechter, A Subacius, H Kadish, A CA DEFINITE Investigators TI Are implantable cardioverter defibrillator shocks a surrogate for sudden cardiac death in patients with nonischemic cardiomyopathy? SO CIRCULATION LA English DT Article DE sudden death; arrhythmia; heart arrest; syncope; defibrillation ID IDIOPATHIC DILATED CARDIOMYOPATHY; NONSUSTAINED VENTRICULAR-TACHYCARDIA; SYNCOPE; STIMULATION; ISCHEMIA; ORIGIN; RISK AB Background-Ventricular tachyarrhythmias long enough to cause implantable cardioverter defibrillator (ICD) shocks are generally thought to progress to cardiac arrest. In previous ICD trials, shocks have been considered an appropriate surrogate for sudden cardiac death (SCD) because the number of shocks has been thought to be equivalent to the mortality excess in patients without ICDs. The practice of equating ICD shocks with mortality is controversial and has not been validated critically. Methods and Results-The Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation ( DEFINITE) trial was a prospective, randomized, multicenter trial of ICD therapy in 458 patients with nonischemic cardiomyopathy. Patients were randomized to receive standard medical therapy (STD) or STD plus an ICD. Shock electrograms were reviewed, and the cause of death was evaluated by a separate blinded events committee. There were 15 SCD or cardiac arrests in the STD group and only 3 in the ICD arm. In contrast, of the 229 patients randomized to an ICD, 33 received 70 appropriate ICD shocks. Patients in the ICD arm were more likely to have an arrhythmic event ( ICD shock plus SCD) than patients in the STD arm ( hazard ratio 2.12, 95% CI 1.153 to 3.893, P=0.013). The number of arrhythmic events when one includes syncope as a potential arrhythmic event was similar in both groups ( hazard ratio 1.20, 95% CI 0.774 to 1.865, P=0.414). Approximately the same number of total events was noted in each arm when we compared syncope plus SCD/cardiac arrest in the STD arm with SCD plus ICD shocks plus syncope in the ICD arm. Conclusions-Appropriate ICD shocks occur more frequently than SCD in patients with nonischemic cardiomyopathy. This suggests that episodes of nonsustained ventricular tachycardia frequently terminate spontaneously in such patients. C1 Virginia Commonwealth Univ, Med Coll Virginia, Dept Med, Richmond, VA 23298 USA. St Francis Mem Hosp, Roslyn, NY USA. Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA. Univ Rochester, Rochester, NY USA. Morristown Mem Hosp, Morristown, NJ USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NW Mem Hosp, Bluhm Cardiovasc Inst, Clin Trials Unit, Chicago, IL 60611 USA. RP Ellenbogen, KA (reprint author), Virginia Commonwealth Univ, Med Coll Virginia, Dept Med, POB 980053, Richmond, VA 23298 USA. EM kellenbogen@pol.net OI Subacius, Haris/0000-0003-4061-1220 NR 15 TC 170 Z9 172 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 14 PY 2006 VL 113 IS 6 BP 776 EP 782 DI 10.1161/CIRCULATIONAHA.105.561571 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 012DU UT WOS:000235319200008 PM 16461817 ER PT J AU Tyler, KL Pape, J Goody, RJ Corkill, M Kleinschmidt-DeMasters, BK AF Tyler, KL Pape, J Goody, RJ Corkill, M Kleinschmidt-DeMasters, BK TI CSF findings in 250 patients with serologically confirmed West Nile virus meningitis and encephalitis SO NEUROLOGY LA English DT Article ID BACTERIAL-MENINGITIS; UNITED-STATES; NEW-YORK; INFECTION AB Objective: To provide a large, comprehensive evaluation of the CSF findings in patients with serologically confirmed West Nile virus (WNV), CNS disease, and their correlation with outcome. Methods: CSF samples from 334 WNV-infected hospitalized patients were analyzed. Information was available and extracted from the medical records of 250 of these patients, and CSF parameters correlated with clinical and epidemiologic features of disease ( e. g., patient age, sex, outcome). Results: Patients with meningitis had a mean of 226 cells/mm(3), and those with encephalitis had a mean of 227 cells/mm(3). Three percent of meningitis patients and 5% of encephalitis patients had fewer than 5 cells/mm(3), and approximately 8% of both groups had more than 500 cells/mm(3). Patients with meningitis had a mean of 41% neutrophils, and those with encephalitis had 45%. Forty-five percent of meningitis patients and 37% of encephalitis patients had at least 50% neutrophils in their initial CSF specimen. Neither the mean percent neutrophils nor their distribution differed significantly between groups. Forty-seven percent of encephalitis patients and 16% of meningitis patients had CSF protein of 100 mg/dL or greater (p < 0.01). Although specific CSF parameters, including nucleated cell count and protein concentration, correlated significantly with outcome, multivariate analysis suggested that their total predictive value was modest. Age was an additional predictor of outcome independent of CSF variables in all patients. Conclusions: Serologically confirmed West Nile virus meningitis and encephalitis produce similar degrees of CSF pleocytosis and are frequently associated with substantial CSF neutrophilia. Patients with encephalitis have higher CSF protein concentrations and are more likely to have adverse outcomes, including admission to long-term care facilities or even death after their acute illness. CSF findings were only a modest predictor of disease outcome, with patient age adding important independent prognostic information. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, 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, Neurol Serv, Denver, CO USA. Colorado Dept Publ Hlth & Environm, Denver, CO USA. Exempla Lutheran Hosp, Dept Pathol, Denver, CO USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, 4200 E 9th Ave, Denver, CO 80262 USA. EM ken.tyler@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 NR 17 TC 49 Z9 53 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD FEB 14 PY 2006 VL 66 IS 3 BP 361 EP 365 DI 10.1212/01.wnl.0000195890.70898.1f PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 012ON UT WOS:000235348600013 PM 16382032 ER PT J AU Au, DH Udris, EM Fihn, SD McDonell, MB Curtis, JR AF Au, DH Udris, EM Fihn, SD McDonell, MB Curtis, JR TI Differences in health care utilization at the end of life among patients with chronic obstructive pulmonary disease and patients with lung cancer SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID OF-LIFE; ADVANCE DIRECTIVES; DATABASES; HOSPITALS; PROGNOSIS; COSTS; COPD AB Background: We sought to examine health care resource utilization in the last 6 months of life among patients who died with chronic obstructive pulmonary disease (COPD) compared with those who died with lung cancer and to examine geographic variations in care. Methods: We performed a retrospective cohort study of patients diagnosed as having COPD or lung cancer, who were seen in 1 of 7 Veteran Affairs medical centers primary care clinics and who died during the study period. Our outcome of interest was health care resource utilization in the last 6 months of life. Results: In the last 6 months of life, patients with COPD were more likely to visit their primary care providers but had fewer hospital admissions compared with patients with lung cancer. Patients with COPD had twice the odds of being admitted to an intensive care unit (ICU), 5 times the odds of remaining there 2 weeks or longer, and received fewer opiates and benzodiazepine prescriptions compared with patients with lung cancer. There were geographic variations in the use of ICUs for patients with COPD but not for those with lung cancer. Total health care costs were $4000 higher for patients with COPD because of ICU utilization. Conclusions: In the last 6 months of life, patients with COPD were more likely to have had a primary care visit and been admitted to an ICU but less likely to receive palliative medications compared with patients with lung cancer. We found significant geographic variability in ICU utilization but only for patients with COPD. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. RP Au, DH (reprint author), Hlth Serv Res Dev MS 152, Div Pulm & Crit Care Med, 1660 S Columbian Way, Seattle, WA 98108 USA. EM dau@u.washington.edu NR 24 TC 81 Z9 84 U1 3 U2 11 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 13 PY 2006 VL 166 IS 3 BP 326 EP 331 DI 10.1001/archinte.166.3.326 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 011SP UT WOS:000235288700009 PM 16476873 ER PT J AU Shrank, WH Hoang, TY Ettner, SL Glassman, PA Nair, K DeLapp, D Dirstine, J Avorn, J Asch, SM AF Shrank, WH Hoang, TY Ettner, SL Glassman, PA Nair, K DeLapp, D Dirstine, J Avorn, J Asch, SM TI The implications of choice - Prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditions SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID INCENTIVE-BASED FORMULARIES; DRUG UTILIZATION; MANAGED CARE; ANTIHYPERTENSIVE THERAPY; PRESCRIPTION DRUGS; INHALED STEROIDS; BENEFIT PLANS; ASTHMA; DISCONTINUATION; PERSISTENCE AB Background: A large proportion of Americans are enrolled in 3-tier pharmacy benefit plans. We studied whether patients enrolled in such plans who receive generic or preferred brand-name agents when initiating chronic therapy were more adherent to treatment than those who received nonpreferred brand-name medications. Methods: We analyzed pharmacy claims filled between October 1, 2001, and October 1, 2003, from a large health plan for 6 classes of chronic medications: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, calcium channel blockers, oral contraceptives, orally inhaled corticosteroids, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors. We measured adherence as the proportion of days covered (PDC) in each drug class during the first year of therapy. We evaluated how the formulary status of the initial prescription (generic, preferred, or nonpreferred) influenced PDC and adequate adherence, defined as PDC greater than 80%, over the subsequent year. Results: A total of 7532 new prescriptions were filled in 1 of the classes evaluated: 1747 (23.2%) for nonpreferred medications, 4376 (58.1%) for preferred drugs, and 1409 (18.7%) for generic drugs. After controlling for patient sociodemographic characteristics and drug class, PDC was 12.6% greater for patients initiated on generic medications vs nonpreferred medications (58.8% vs 52.2%; P<.001). The PDC was 8.8% greater for patients initiated on preferred vs nonpreferred medications (56.8% vs 52.2%; P<.001). Patients initiated on generic and preferred medications had 62% and 30% greater odds, respectively, of achieving adequate adherence compared with those who received nonpreferred medications. Conclusion: In 3-tier pharmacy benefit plans, prescribing generic or preferred medications within a therapeutic class is associated with improvements in adherence to therapy. C1 Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02120 USA. Harvard Univ, Sch Med, Boston, MA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. Univ Colorado, Hlth Sci Ctr, Dept Pharm, Denver, CO USA. Anthem Blue Cross & Blue Shield, Denver, CO USA. Anthem Prescript Management, Denver, CO USA. RP Shrank, WH (reprint author), Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremont St,Suite 3030, Boston, MA 02120 USA. EM wshrank@partners.org RI Mendoza, Elvia/A-9361-2012 NR 39 TC 189 Z9 193 U1 2 U2 12 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 13 PY 2006 VL 166 IS 3 BP 332 EP 337 DI 10.1001/archinte.166.3.332 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 011SP UT WOS:000235288700010 PM 16476874 ER PT J AU Mareninova, OA Sung, KF Hong, P Lugea, A Pandol, SJ Gukovsky, I Gukovskaya, AS AF Mareninova, OA Sung, KF Hong, P Lugea, A Pandol, SJ Gukovsky, I Gukovskaya, AS TI Cell death in pancreatitis - Caspases protect from necrotizing pancreatitis SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TUMOR-NECROSIS-FACTOR; RECEPTOR-INTERACTING PROTEIN; ACINAR-CELLS; INDUCED APOPTOSIS; INFLAMMATORY MEDIATORS; SIGNALING COMPLEX; APAF-1 APOPTOSOME; CYTOCHROME-C; KINASE RIP; ACTIVATION AB Mechanisms of cell death in pancreatitis remain unknown. Parenchymal necrosis is a major complication of pancreatitis; also, the severity of experimental pancreatitis correlates directly with necrosis and inversely with apoptosis. Thus, shifting death responses from necrosis to apoptosis may have a therapeutic value. To determine cell death pathways in pancreatitis and the possibility of necrosis/apoptosis switch, we utilized the differences between the rat model of cerulein pancreatitis, with relatively high apoptosis and low necrosis, and the mouse model, with little apoptosis and high necrosis. We found that caspases were greatly activated during cerulein pancreatitis in the rat but not mouse. Endogenous caspase inhibitor X-linked inhibitor of apoptosis protein (XIAP) underwent complete degradation in the rat but remained intact in the mouse model. Furthermore, XIAP inhibition with embelin triggered caspase activation in the mouse model, implicating XIAP in caspase blockade in pancreatitis. Caspase inhibitors decreased apoptosis and markedly stimulated necrosis in the rat model, worsening pancreatitis parameters. Conversely, caspase induction with embelin stimulated apoptosis and decreased necrosis in mouse model. Thus, caspases not only mediate apoptosis but also protect from necrosis in pancreatitis. One protective mechanism is through degradation of receptor-interacting protein (RIP), a key mediator of "programmed" necrosis. We found that RIP was cleaved (i.e. inactivated) in the rat but not the mouse model. Caspase inhibition restored RIP levels; conversely, caspase induction with embelin triggered RIP cleavage. Our results indicate key roles for caspases, XIAP, and RIP in the regulation of cell death in pancreatitis. Manipulating these signals to change the pattern of death responses presents a therapeutic strategy for treatment of pancreatitis. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. Chang Gung Mem Hosp, Dept HepatoGastroenterol, Taipei 333, Taiwan. RP Gukovskaya, AS (reprint author), Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,Bldg 258,Rm 340, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NIDDK NIH HHS [DK59936] NR 78 TC 159 Z9 171 U1 0 U2 7 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 10 PY 2006 VL 281 IS 6 BP 3370 EP 3381 DI 10.1074/jbc.M511276200 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 009QV UT WOS:000235128200045 PM 16339139 ER PT J AU Bent, S Kane, C Shinohara, K Neuhaus, J Hudes, ES Goldberg, H Avins, AL AF Bent, S Kane, C Shinohara, K Neuhaus, J Hudes, ES Goldberg, H Avins, AL TI Saw palmetto for benign prostatic hyperplasia SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID DOUBLE-BLIND; CONTROLLED-TRIAL; SERENOA-REPENS; FINASTERIDE; EFFICACY; MEN; DOXAZOSIN; EXTRACT; INDEX AB BACKGROUND: Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration. METHODS: In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects. RESULTS: There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups. CONCLUSIONS: In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. C1 San Francisco VAMC, Dept Med, Gen Internal Med Sect, San Francisco, CA 94121 USA. San Francisco VAMC, Urol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Osher Ctr Integrat Med, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, Div Gen Internal Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Family Practice, San Francisco, CA 94143 USA. Kaiser Permanente No Calif, Oakland, CA USA. RP Bent, S (reprint author), San Francisco VAMC, 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]; NIDDK NIH HHS [1 R01 DK56199-01] NR 39 TC 184 Z9 192 U1 0 U2 5 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 FEB 9 PY 2006 VL 354 IS 6 BP 557 EP 566 DI 10.1056/NEJMoa053085 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 010HF UT WOS:000235177500005 PM 16467543 ER PT J AU Higashi, T Wenger, N Shekelle, P AF Higashi, T Wenger, N Shekelle, P TI Quality of care for vulnerable older patients - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Kyoto Univ, Dept Epidemiol & Healthcare Res, Kyoto 6068501, Japan. RAND Corp, Santa Monica, CA 90407 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. RP Higashi, T (reprint author), Kyoto Univ, Dept Epidemiol & Healthcare Res, Kyoto 6068501, Japan. NR 0 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 FEB 7 PY 2006 VL 144 IS 3 BP 219 EP 220 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 008XS UT WOS:000235074800013 ER PT J AU Caunt, CJ Finch, AR Sedgley, KR Oakley, L Luttrell, LM McArdle, CA AF Caunt, CJ Finch, AR Sedgley, KR Oakley, L Luttrell, LM McArdle, CA TI Arrestin-mediated ERK activation by gonadotropin-releasing hormone receptors - Receptor-specific activation mechanisms and compartmentalization SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PROTEIN-COUPLED RECEPTORS; MAP KINASE KINASE; DYNAMIN-DEPENDENT INTERNALIZATION; SIGNAL-REGULATED KINASE; GROWTH-FACTOR RECEPTOR; BETA-ARRESTIN; NUCLEAR TRANSLOCATION; RAPID DESENSITIZATION; C-SRC; CELLS AB Activation of seven-transmembrane region receptors typically causes their phosphorylation with consequent arrestin binding and desensitization. Arrestins also act as scaffolds, mediating signaling to Raf and ERK and, for some receptors, inhibiting nuclear translocation of ERK. GnRH receptors (GnRHRs) act via G(q/11) to stimulate the phospholipase C/Ca2+/protein kinase C (PKC) cascade and the Raf/MEK/ERK cassette. Uniquely, type I mammalian GnRHRs lack the C-tails that are found in other seven-\transmembrane region receptors ( including nonmammalian GnRHRs) and are implicated in arrestin binding. Here we have compared ERK signaling by human GnRHRs (hGnRHRs) and Xenopus GnRHRs (XGnRHRs). In HeLa cells, XGnRHRs underwent rapid and arrestin-dependent internalization and caused arrestin/green fluorescent protein (GFP) translocation to the membrane and endosomes, whereas hGnRHRs did not. Internalized XGnRHRs were co-localized with arrestin-GFP, whereas hGnRHRs were not. Both receptors mediated transient ERK phosphorylation and nuclear translocation (revealed by immunohistochemistry or by imaging of co-transfected ERK2-GFP), and for both, ERK phosphorylation was reduced by PKC inhibition but not by inhibiting epidermal growth factor receptor autophosphorylation. In the presence of PKC inhibitor, Delta arrestin-(319 - 418) blocked XGnRHR-mediated, but not hGnRHR- mediated, ERK phosphorylation. When receptor number was varied, hGnRHRs activated phospholipase C and ERK more efficiently than XGnRHRs but were less efficient at causing ERK2-GFP translocation. At high receptor number, XGnRHRs and hGnRHRs both caused ERK2-GFP translocation to the nucleus, but at low receptor number, XGnRHRs caused ERK2-GFP translocation, whereas hGnRHRs did not. Thus, experiments with XGnRHRs have revealed the first direct evidence of arrestin-mediated (probably G protein-independent) GnRHR signaling, whereas those with hGnRHRs imply that scaffolds other than arrestins can determine GnRHR effects on ERK compartmentalization. C1 Univ Bristol, Henry Wellcome Labs Integrat Neurosci & Endocrino, Bristol BS1 3NY, Avon, England. Med Univ S Carolina, Dept Med Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. RP McArdle, CA (reprint author), Univ Bristol, Henry Wellcome Labs Integrat Neurosci & Endocrino, Whitson St, Bristol BS1 3NY, Avon, England. EM craig.mcardle@bris.ac.uk OI McArdle, Craig/0000-0003-4836-5351 FU Medical Research Council [G9721484]; Wellcome Trust NR 47 TC 43 Z9 45 U1 1 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 FEB 3 PY 2006 VL 281 IS 5 BP 2701 EP 2710 DI 10.1074/jbc.M507242200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 006XT UT WOS:000234931800036 PM 16314413 ER PT J AU Miller, PM Spies, C Neumann, T Javors, MA Hoyumpa, AM Roache, J Webb, A Kashi, M Sharkey, FE Anton, RF Egan, BM Basile, J Nguyen, S Fleming, MF Dillie, KS AF Miller, PM Spies, C Neumann, T Javors, MA Hoyumpa, AM Roache, J Webb, A Kashi, M Sharkey, FE Anton, RF Egan, BM Basile, J Nguyen, S Fleming, MF Dillie, KS TI Alcohol biomarker screening in medical and surgical settings SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol biomarkers; %CDT; GGT ID CARBOHYDRATE-DEFICIENT TRANSFERRIN; STAGE LIVER-DISEASE; DISORDERS IDENTIFICATION TEST; UPPER DIGESTIVE-TRACT; PRIMARY-HEALTH-CARE; LABORATORY MARKERS; UNIT STAY; CONSUMPTION; SERUM; ABUSE AB This article highlights the proceedings of a symposium presented at the 28th Annual Meeting or the Research Society oil Alcoholism in Santa Barbara, CA, Oil June 28 2005, organized and chaired by Peter Miller. The presentations included (1) Screening for Alcohol Use Disorders in Surgical and Trauma Patients, presented by Claudia Spies; (2) Are Serum Levels or %CDT and GGT Related to Severity of Liver Biopsy Inflammation, Fibrosis, and Steatohepatitis in Patients with Hepatitis C? by Martin Javors; (3) Biochemical Alcohol Screening in the Treatment of Hypertension, presented by Peter Miller; and (4) The Cost-Effectiveness of a New Biomarker, CDT, in a Primary Care Sample, by Michael Fleming. Presentations were discussed by Raymond Anton. C1 Med Univ S Carolina, Ctr Drug & Alcohol Studies, Charleston, SC 29425 USA. Med Univ S Carolina, Div Gen Internal Med, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. Univ Med, Charite Hosp, Dept Anesthesiol & Intens Care Med, Berlin, Germany. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Houston, TX USA. Univ Texas, Hlth Sci Ctr, Dept Pharmacol, Houston, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, Houston, TX USA. Univ Wisconsin, Dept Family Med, Madison, WI USA. RP Miller, PM (reprint author), Med Univ S Carolina, Ctr Drug & Alcohol Studies, 67 President St,POB 250861, Charleston, SC 29425 USA. EM millerpm@musc.edu NR 55 TC 14 Z9 15 U1 3 U2 3 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 FEB PY 2006 VL 30 IS 2 BP 185 EP 193 DI 10.1111/j.1530-0277.2006.00029.x PG 9 WC Substance Abuse SC Substance Abuse GA 009RX UT WOS:000235131200004 PM 16441267 ER PT J AU Metz, DC Comer, GM Soffer, E Forsmark, CE Cryer, B Chey, W Pisegna, JR AF Metz, DC Comer, GM Soffer, E Forsmark, CE Cryer, B Chey, W Pisegna, JR TI Three-year oral pantoprazole administration is effective for patients with Zollinger-Ellison syndrome and other hypersecretory conditions SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID MANAGEMENT; OMEPRAZOLE; LANSOPRAZOLE; DEFINITION; GASTRINOMA; RESECTION; EFFICACY; THERAPY; SAFETY; TUMORS AB Background Zollinger-Ellison syndrome and idiopathic hypersecretion are gastrointestinal hypersecretory conditions requiring long-term maintenance. Aims The safety and efficacy data for short-term (6-month) treatment of Zollinger-Ellison syndrome and idiopathic hypersecretion with oral pantoprazole were previously published. This study extends the initial observations to 3 years. Methods The primary efficacy end point for this report was the control of gastric acid secretion in the last hour before the next dose of oral pantoprazole (acid output of < 10 mmol/h; < 5 mmol/h in subjects with prior acid-reducing surgery). Dose titration was permitted to a maximum of 240 mg per 24 h. Results Twenty-four subjects completed the study. The acid output of 28 of 34 subjects was controlled at initial enrolment. The mean acid output rates were < 10 mmol/h throughout the 36 months of treatment for 90-100% of the patients. The majority of the patients were controlled with b.d. doses of 40 or 80 mg pantoprazole at 36 months (acid output was controlled in 24 of 24 subjects). Pantoprazole was generally well tolerated with minimal adverse events reported. Conclusion Maintenance oral pantoprazole therapy up to 3 years at dosages of 40-120 mg b.d. was effective and well tolerated in patients with Zollinger-Ellison syndrome and other hypersecretory conditions. C1 Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90073 USA. Univ Penn, Med Ctr, Dept Med, Div Gastroenterol, Philadelphia, PA 19104 USA. Wyeth Res, Collegeville, PA USA. Univ Florida, Div Gastroenterol, Gainesville, FL USA. Dallas Vet Affairs Med Ctr, Div Gastroenterol, Dallas, TX USA. Rochester Inst Digest Dis & Sci, Rochester, NY USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. RP Pisegna, JR (reprint author), Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 24 TC 14 Z9 15 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD FEB 1 PY 2006 VL 23 IS 3 BP 437 EP 444 DI 10.1111/j.1365-2036.2006.02762.x PG 8 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 003EH UT WOS:000234663900011 PM 16423003 ER PT J AU Einhorn, LH Brames, MJ Heinrich, MC Corless, CL Madani, A AF Einhorn, LH Brames, MJ Heinrich, MC Corless, CL Madani, A TI Phase II study of imatinib mesylate in chemotherapy refractory germ cell tumors expressing KIT SO AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS LA English DT Article DE KIT; germ cell tumor; imatinib ID TESTICULAR CANCER; C-KIT; EFFICACY; IFOSFAMIDE; PACLITAXEL; CISPLATIN; THERAPY; SAFETY; KINASE; TRIAL AB Objective: This phase II study was conducted to determine the activity of imatinib (gleevec) in heavily pretreated patients with KIT-positive metastatic germ cell tumor. Materials and Methods: From June 2002 through April 2005, 18 patients with refractory germ cell tumors were tested for KIT expression by immunohistochemistry. All patients screened were deemed to be incurable with further standard chemotherapy or surgery. Six patients were eligible and treated with imatinib 600 mg/d orally. Results: There were no complete or partial remissions. Five of 6 patients had progressive disease and 1 patient had stable disease with a > 50% decline in serum alpha-fetoprotein for 3 months before developing further progression. Conclusion: In this small sample size, there was no evidence of significant antitumor activity of imatinib in patients with KIT-positive refractory germ cell tumors. C1 Indiana Univ, Dept Med, Div Hematol Oncol, Indianapolis, IN USA. Walther Canc Inst, Indianapolis, IN USA. Oregon Hlth & Sci Univ, Inst Canc, Dept Med, Div Hematol Oncol, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR USA. Hematol & Oncol Assoc So Michigan, Jackson, MI USA. RP Einhorn, LH (reprint author), 535 Barnhill Dr Room 473, Indianapolis, IN 46202 USA. EM leinhorn@iupui.edu NR 15 TC 46 Z9 47 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0277-3732 J9 AM J CLIN ONCOL-CANC JI Am. J. Clin. Oncol.-Cancer Clin. Trials PD FEB PY 2006 VL 29 IS 1 BP 12 EP 13 DI 10.1097/01.coc.0000195086.47548.ef PG 2 WC Oncology SC Oncology GA 012GI UT WOS:000235325900004 PM 16462496 ER PT J AU Weintraub, D Cary, MS Stern, MB Taraborelli, D Katz, IR AF Weintraub, D Cary, MS Stern, MB Taraborelli, D Katz, IR TI Daily affect in Parkinson disease is responsive to life events and motor symptoms SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Parkinson disease; positive affect; negative affect ID DEPRESSION; METHYLPHENIDATE; POPULATION AB The aims of this study were to examine the daily affective experiences of patients with Parkinson disease (PD) and to determine their association with daily events and motor symptoms. Specifically, it was intended to test the hypothesis that PD, even in the absence of depression, is associated with anhedonia. Method: Nondepressed male subjects with PD (N=24) and a comparison group of healthy elderly males (N=23) completed daily affect rating scales and, for the patients with PD, a supplemental self-assessment questionnaire of PD-related symptoms for 4 consecutive weeks. The effect of daily events and PD- related symptoms on daily affect was examined using linear and logistic mixed regression models. Results: Overall, patients with PD reported significantly less positive and more negative affect than healthy peers over time. There were similar, and expected, associations between negative events and affect in both groups. Although patients with PD reported far fewer positive events than control subjects, they reported as great an improvement in affect in response to them. Regarding self-reported PD-related symptoms, only increasing severity of core motor symptoms was independently associated with worse affect. Conclusions: Although the conclusions of this study are tempered by a comparison group that is not optimal, our results suggest that patients with PD do not demonstrate anhedonia in response to positive life events. The gross intergroup difference in daily events suggests the potential value of interventions that emphasize daily engagement in positive experiences to improve positive affective tone. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. RP Weintraub, D (reprint author), 3535 Market St,Rm 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [K23MH067894] NR 20 TC 10 Z9 10 U1 0 U2 0 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 FEB PY 2006 VL 14 IS 2 BP 161 EP 168 DI 10.1097/01.JGP.0000192494.96543.f4 PG 8 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 011HT UT WOS:000235259600010 PM 16473981 ER PT J AU Weintraub, D Oehlberg, KA Katz, IR Stern, MB AF Weintraub, D Oehlberg, KA Katz, IR Stern, MB TI Test characteristics of the 15-item geriatric depression scale and Hamilton Depression Rating Scale in Parkinson disease SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE Parkinson disease; depression; Geriatric Depression Scale ID NONMOTOR SYMPTOMS; SHORT VERSIONS; PERFORMANCE; PREVALENCE; INSTRUMENT; COMMUNITY; INVENTORY; VALIDITY; GDS-15 AB Objective: The objective of this study was to compare the sensitivity, specificity, and diagnostic accuracy of the 15-item Geriatric Depression Scale (GDS-15) and the Hamilton Depression Rating Scale (HDRS) in patients with Parkinson disease (PD). Method: A convenience sample of 148 outpatients with idiopathic PD receiving specialty care completed the GDS-15 and were administered the HDRS and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) depression module by a research psychiatrist or trained research assistant. Receiver-operating characteristic (ROC) curves were plotted for the GDS-15 and HDRS scores with a SCID diagnosis of a depressive disorder as the state variable. Results: Thirty-two subjects (22%) were diagnosed with a depressive disorder. The discriminant validity of the GDS-15 and HDRS were both high (ROC area under the curve: 0.92 and 0.91, respectively), with greatest dichotomization for the GDS-15 at a cutoff of 4/5 (87% accuracy, 88% sensitivity, 85% specificity) and the HDRS at a cutoff of 9/10 (83% accuracy, 88% sensitivity, 78% specificity). Conclusions: The GDS-15 performs well as a screening instrument and in distinguishing depressed from nondepressed patients in PD. Its test characteristics are comparable to the HDRS. Because it is a brief instrument and can be self-administered, it is an excellent depression screening tool in this population. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. RP Weintraub, D (reprint author), 3535 Market St,Rm 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [K23 MH067894, K23MH067894] NR 35 TC 97 Z9 97 U1 3 U2 7 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 FEB PY 2006 VL 14 IS 2 BP 169 EP 175 DI 10.1097/01.JGP.0000192488.66049.4b PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 011HT UT WOS:000235259600011 PM 16473982 ER PT J AU Leverich, GS Altshuler, LL Frye, MA Suppes, T McElroy, SL Keck, PE Kupka, RW Denicoff, KD Nolen, WA Grunze, H Martinez, MI Post, RM AF Leverich, GS Altshuler, LL Frye, MA Suppes, T McElroy, SL Keck, PE Kupka, RW Denicoff, KD Nolen, WA Grunze, H Martinez, MI Post, RM TI Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and Bupropion as adjuncts to mood stabilizers SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID DOUBLE-BLIND; I DEPRESSION; ANTIDEPRESSANT DISCONTINUATION; NETWORK I; DISORDER; 1-YEAR; OUTPATIENTS; LAMOTRIGINE; METHODOLOGY; QUETIAPINE AB Objective: The authors examined the comparative risks of switches in mood polarity into hypomania or mania during acute and continuation trials of adjunctive antidepressant treatment of bipolar depression. Method: One hundred fifty-nine patients with bipolar I disorder or bipolar II disorder participated in a total of 228 acute (10-week) randomized trials of bupropion, sertraline, or venlafaxine as an adjunct to a mood stabilizer. Patients in 87 of these trials entered continuation treatment for up to 1 year. Antidepressant response and the occurrence of subthreshold brief hypomania (emergence of brief hypomania [at least 1 but < 7 days] or recurrent brief hypomania) and threshold switches (emergence of full-duration hypomania [>= 7 days] or mania) were blindly assessed by using clinician-rated daily reports of mood-associated dysfunction on the National Institute of Mental Health Life Chart Method. Results: Threshold switches into full-duration hypomania and mania occurred in 11.4% and 7.9%, respectively, of the acute treatment trials and in 21.8% and 14.9%, respectively, of the continuation trials. The rate of threshold switches was higher in the 169 trials in patients with bipolar I disorder (30.8%) than the 59 trials in patients with bipolar II disorder (18.6%). The ratio of threshold switches to subthreshold brief hypomanias was higher in both the acute (ratio=3.60) and continuation trials (ratio=3.75) of venlafaxine than in the acute and continuation trials of bupropion (ratios=0.85 and 1.17, respectively) and sertraline (ratios=1.67 and 1.66, respectively). In only 37 (16.2%) of the original 228 acute antidepressant trials, or in only 23.3% of the patients, was there a sustained antidepressant response in the continuation phase in the absence of a threshold switch. Conclusions: Adjunctive treatment with antidepressants in bipolar depression was associated with substantial risks of threshold switches to full-duration hypomania or mania in both acute and long-term continuation treatment. Of the three antidepressants included in the study, venlafaxine was associated with the highest relative risk of such switching and bupropion with the lowest risk. C1 NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. Univ Cincinnati, Coll Med, Psychopharmacol Res Program, Dept Psychiat, Cincinnati, OH 45221 USA. Cincinnati VA Med Ctr, Mental Hlth Care Line & Gen Clin Res Ctr, Cincinnati, OH USA. Altrecht Inst Mental Hlth Care, Utrecht, Netherlands. Univ Groningen Hosp, Dept Psychiat, NL-9700 RB Groningen, Netherlands. Univ Munich, Psychiat Clin, Munich, Germany. RP NIMH, Biol Psychiat Branch, Bldg 10,Room 3S239,10 Ctr Dr,MSC-1272, Bethesda, MD 20892 USA. EM levericg@mail.nih.gov RI Nolen, Willem/E-9006-2014 FU NIMH NIH HHS [R01 MH079261] NR 40 TC 245 Z9 249 U1 0 U2 14 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X EI 1535-7228 J9 AM J PSYCHIAT JI Am. J. Psychiat. PD FEB PY 2006 VL 163 IS 2 BP 232 EP 239 DI 10.1176/appi.ajp.163.2.232 PG 8 WC Psychiatry SC Psychiatry GA 008HO UT WOS:000235031000013 PM 16449476 ER PT J AU Altshuler, LL Suppes, T Black, DO Nolen, WA Leverich, G Keck, PE Frye, MA Kupka, R McElroy, SL Grunze, H Kitchen, CMR Post, R AF Altshuler, LL Suppes, T Black, DO Nolen, WA Leverich, G Keck, PE Frye, MA Kupka, R McElroy, SL Grunze, H Kitchen, CMR Post, R TI Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second-generation antidepressants SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID MANIA; INDUCTION; SCALE AB Objectives: The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder. Method: In a 10-week trial, 184 outpatients with bipolar depression (134 with bipolar I disorder, 48 with bipolar II disorder, two with bipolar disorder not otherwise specified) were treated with one of three antidepressants as an adjunct to mood stabilizers. The patients' switch rates were assessed. Switch was defined as a Young Mania Rating Scale (YMRS) score > 13 or a Clinical Global Impression (CGI) mania score >= 3 (mildly ill). Results: Depressed subjects with bipolar II disorder had a significantly lower acute switch rate into hypomania/mania when either YMRS or CGI criteria were used to define switch. Conclusions: These data suggest that depressed patients with bipolar II disorder are less vulnerable than those with bipolar I disorder to switch into hypomania/mania when treated with an antidepressant adjunctive to a mood stabilizer. C1 Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90024 USA. Univ Texas, SW Med Ctr, Dept Psychiat, VA Greater Los Angeles Healthcare Syst,W Los Ange, Dallas, TX 75230 USA. Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75230 USA. Univ Groningen, Med Ctr, Dept Psychiat, Groningen, Netherlands. NIMH, Biol Psychiat Branch, NIH, Bethesda, MD 20892 USA. Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program,Mental Hlth Care Line, Cincinnati, OH USA. Cincinnati VA Med Ctr, Cincinnati, OH USA. Altrech Inst Mental Hlth Care, Utrecht, Netherlands. Univ Munich, Dept Psychiat, D-8000 Munich, Germany. Univ Calif Los Angeles, Sch Publ Hlth, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP 300 UCLA Med Plaza,Suite 1544,Box 957057, Los Angeles, CA 90095 USA. EM laltshuler@mednet.ucla.edu RI Nolen, Willem/E-9006-2014 FU NIMH NIH HHS [R01 MH079261] NR 17 TC 105 Z9 109 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 EI 1535-7228 J9 AM J PSYCHIAT JI Am. J. Psychiat. PD FEB PY 2006 VL 163 IS 2 BP 313 EP 315 DI 10.1176/appi.ajp.163.2.313 PG 3 WC Psychiatry SC Psychiatry GA 008HO UT WOS:000235031000024 PM 16449487 ER PT J AU Burman, W Benator, D Vernon, A Khan, A Jones, B Silva, C Lahart, C Weis, S King, B Mangura, B Weiner, M El-Sadr, W AF Burman, W Benator, D Vernon, A Khan, A Jones, B Silva, C Lahart, C Weis, S King, B Mangura, B Weiner, M El-Sadr, W CA Tuberculosis Trials Consortium TI Acquired rifamycin resistance with twice-weekly treatment of HIV-related tuberculosis SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE antiretroviral therapy; HIV; rifabutin; rifamycin resistance; tuberculosis ID HUMAN-IMMUNODEFICIENCY-VIRUS; DIAGNOSED PULMONARY TUBERCULOSIS; MYCOBACTERIUM-TUBERCULOSIS; INFECTED PATIENTS; ANTIRETROVIRAL THERAPY; RIFABUTIN; RELAPSE; RIFAMPICIN; MORTALITY; MORBIDITY AB Rationale. Rifabutin was recommended in place of rifampin during treatment of HIV-related tuberculosis (TB) to facilitate concomitant potent antiretroviral therapy, but this approach has not been evaluated in a prospective study. Objective: To evaluate the activity of intermittent rifabutin-based therapy. Methods: Patients with culture-confirmed TB were treated under direct supervision with 2 mo of rifabutin, isoniazid, pyrazinamide, and ethambutol (given daily, thrice-weekly, or twice-weekly per the local tuberculosis control program), followed by 4 mo of twice-weekly rifabutin plus isoniazid. Measurements: Culture-positive treatment failure or relapse. Main Results: A total of 169 eligible patients were enrolled. Most had advanced HIV disease; the median CD4 cell count and HIV-RNA level were 90 cells/mm(3) (interquartile range, 35-175) and 5.3 log(10) copies/ml (interquartile range, 4.8-5.7), respectively. Nine (5.3%) patients had culture-positive treatment failure (n = 3) or relapse (n = 6). Eight of these nine (89%) cases had isolates with acquired rifamycin resistance. Treatment failure or relapse was associated with baseline CD4 lymphocyte count, being 12.3% (9/73; 95% confidence interval, 6.5-22.0%) among patients with CD4 < 100 cells/mm(3) versus 0% (0/65; 95% confidence interval, 0.0-4.5%) among those with higher CD4 lymphocyte counts (p < 0.01). One hundred thirty-seven (81%) patients received antiretroviral therapy during TB treatment. Adverse events were common, but only two patients (1%) permanently discontinued study drugs. Conclusions: Intermittent rifabutin-based therapy for HIV-related TB; was well tolerated, but there was a high risk of treatment failure or relapse with acquired rifamycin resistance among patients with low CD4 lymphocyte counts. C1 Denver Publ Hlth, Denver, CO 80204 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. Vet Affairs Med Ctr, Washington, DC 20422 USA. George Washington Univ, Med Ctr, Washington, DC 20037 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Univ So Calif, Med Ctr, Los Angeles, CA USA. Baylor Coll Med, Houston, TX 77030 USA. Univ N Texas, Hlth Sci Ctr, Ft Worth, TX USA. Tarrant Cty Publ Hlth Dept, Ft Worth, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Natl TB Ctr, Newark, NJ 07103 USA. Harlem Hosp Med Ctr, New York, NY USA. Columbia Univ Coll Phys & Surg, New York, NY 10032 USA. RP Burman, W (reprint author), Denver Publ Hlth, 605 Bannock St, Denver, CO 80204 USA. EM bburman@dhha.org NR 35 TC 96 Z9 101 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 FEB 1 PY 2006 VL 173 IS 3 BP 350 EP 356 DI 10.1164/rccm.200503-417OC PG 7 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 007IJ UT WOS:000234962000016 PM 16109981 ER PT J AU Tan, RJ Lee, JS Manni, ML Fattman, CL Tobolewski, JM Zheng, MQ Kolls, JK Martin, TR Oury, TD AF Tan, RJ Lee, JS Manni, ML Fattman, CL Tobolewski, JM Zheng, MQ Kolls, JK Martin, TR Oury, TD TI Inflammatory cells as a source of airspace extracellular superoxide dismutase after pulmonary injury SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article DE inflammation; neutrophils; pneumonia; proteolysis; superoxide dismutase ID LUNG INJURY; EC-SOD; MOUSE LUNG; HYPEROXIA; EXPOSURE; LOCALIZATION; PURIFICATION; NEUTROPHILS; FIBROSIS; ASBESTOS AB Extracellular superoxide dismutase (EC-SOD) is an antioxidant abundant in the lung. Previous studies demonstrated depletion of lung parenchymal EC-SOD in mouse models of interstitial lung disease coinciding with an accumulation of EC-SOD in airspaces. EC-SOD sticks to the matrix by a proteolytically sensitive heparin-binding domain; therefore, we hypothesized that interstitial inflammation and matrix remodeling contribute to proteolytic redistribution of EC-SOD from lung parenchyma into the airspaces. To determine if inflammation limited to airspaces leads to EC-SOD redistribution, we examined a bacterial pneumonia model. This model led to increases in airspace polymorphonuclear leukocytes staining strongly for EC-SOD. EC-SOD accumulated in airspaces at 24 h without depletion of EC-SOD from lung parenchyma. This led us to hypothesize that airspace EC-SOD was released from inflammatory cells and was not a redistribution of matrix EC-SOD. To test this hypothesis, transgenic mice with lung-specific expression of human EC-SOD were treated with asbestos or bleomycin to initiate an interstitial lung injury. in these studies, EC-SOD accumulating in airspaces was entirely the mouse isoform, demonstrating an extrapulmonary source (inflammatory cells) for this EC-SOD. We also demonstrate that EC-SOD knockout mice possess greater lung inflammation in response to bleomycin and bacteria when compared with wild types. We conclude that the source of accumulating EC-SOD in airspaces in interstitial lung disease is inflammatory cells and not the lung and that interstitial processes such as those found in pulmonary fibrosis are required to remove EC-SOD from lung matrix. C1 Univ Pittsburgh, Med Ctr, Dept Pathol, Dept Med,Div Pulm Allergy & Crit Care Med, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Med Ctr, Dept Pediat, Pittsburgh, PA 15261 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. RP Oury, TD (reprint author), Univ Pittsburgh, Med Ctr, Dept Pathol, Dept Med,Div Pulm Allergy & Crit Care Med, 7th Floor,Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA. EM tdoury@pitt.edu FU NHLBI NIH HHS [HL073996, HL65892, HL70178, HL73996, R01 HL063700, R01HL063700-05, R01HL079142]; NIEHS NIH HHS [5F30ES013621-02]; NIGMS NIH HHS [GM37696] NR 31 TC 24 Z9 24 U1 0 U2 0 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1044-1549 J9 AM J RESP CELL MOL JI Am. J. Respir. Cell Mol. Biol. PD FEB PY 2006 VL 34 IS 2 BP 226 EP 232 DI 10.1165/rcmb.2005-0212OC PG 7 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 009MI UT WOS:000235115700013 PM 16224105 ER PT J AU Grant, EG El-Saden, SM Madrazo, BL Baker, JD Kliewer, MA AF Grant, EG El-Saden, SM Madrazo, BL Baker, JD Kliewer, MA TI Innominate artery occlusive disease: Sonographic findings SO AMERICAN JOURNAL OF ROENTGENOLOGY LA English DT Article DE angiography; cardiovascular disease; Doppler sonography; innominate artery; subclavian steal syndrome ID SUBCLAVIAN STEAL; RENAL-ARTERY; STENOSIS; DIAGNOSIS AB OBJECTIVE. The objective of this study was to report the sonographic abnormalities in a group of patients with angiographically proven innominate artery stenosis and occlusion. MATERIALS AND METHODS. A review of all cerebrovascular sonograms at our institutions was undertaken to identify patients with complete or partial flow reversal in the right vertebral artery and reversal or midsystolic deceleration of flow in any one of the three major segments of the right carotid system (common, internal, or external carotid artery). The distribution and appearance of these abnormalities was evaluated, and the presence or absence of tardus-parvus waveforms was noted in any segment of the right carotid artery. Additionally, a left to right common carotid peak systolic velocity ratio (LCCA/RCCA) was calculated and compared to published normal values. All patients had correlative contrast or MR angiography. Correlation was made between the severity of stenosis as determined by angiographic images and waveform aberrations as well as the more objective LCCA/RCCA ratios. RESULTS. Twelve patients were identified as having the abnormalities described above in the right vertebral and carotid arteries. Doppler waveforms from the tight vertebral artery revealed that eight of the 12 patients had complete reversal of flow at rest. Bidirectional flow was found in the remaining four as manifested by the presence of marked midsystolic deceleration. In the carotid arteries, one patient had complete reversal of flow in all segments of the right carotid system. Waveforms with midsystolic deceleration were identified in at least one of the carotid arteries of the remaining I I patients: common carotid artery (8/11 = 73%), internal carotid artery (10/11 = 91%), external carotid artery (3/11 = 27%). The average LCCA/RCCA was 3.1 with a range of 1.7 to 5.7 (normal = 0.7-1.3). All patients had severe innominate artery disease (from 70% to occlusion) by contrast angiography or MR angiography. There was no correlation between the angiographically determined degree of stenosis and the Doppler findings. CONCLUSION. A distinctive pattern of hemodynamic alterations occurs in the right vertebral and carotid arteries of patients with severe innominate artery disease. Findings include reversed or bidirectional flow in the fight vertebral artery, the presence of midsystolic deceleration in any of the branches of the right carotid system, and elevated LCCA/RCCA ratio. C1 W Los Angeles VA Med Ctr, Dept Radiol, Los Angeles, CA USA. Miami Univ, Sch Med, Miami, FL USA. W Los Angeles VA Med Ctr, Dept Vasc Surg, Los Angeles, CA USA. Univ Wisconsin, Sch Med, Madison, WI USA. RP Grant, EG (reprint author), Univ So Calif, Dept Radiol, Keck Sch Med, 1500 San Pablo St, Los Angeles, CA 90033 USA. NR 19 TC 11 Z9 12 U1 0 U2 0 PU AMER ROENTGEN RAY SOC PI RESTON PA 1891 PRESTON WHITE DR, SUBSCRIPTION FULFILLMENT, RESTON, VA 22091 USA SN 0361-803X J9 AM J ROENTGENOL JI Am. J. Roentgenol. PD FEB PY 2006 VL 186 IS 2 BP 394 EP 400 DI 10.2214/AJR.04.1000 PG 7 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 005ME UT WOS:000234825900017 PM 16423944 ER PT J AU Simon, JA Lin, F Vittinghoff, E Bittner, V AF Simon, JA Lin, F Vittinghoff, E Bittner, V CA HERS Res Grp TI The relation of postmenopausal hormone therapy to serum uric acid and the risk of coronary heart disease events: The Heart and Estrogen-Progestin Replacement Study (HERS) SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE cardiovascular risk factors; estrogens; hormones; uric acid ID ANTURANE REINFARCTION TRIAL; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; FOLLOW-UP; ESSENTIAL-HYPERTENSION; ATHEROSCLEROSIS RISK; DIABETES-MELLITUS; HONOLULU HEART; WOMEN; MEN AB PURPOSE: To determine whether baseline serum uric acid (UA) levels and estrogen-progestin (E + P)associated change in serum UA in postmenopausal women with coronary disease are associated with recurrent coronary heart disease (CHD) events. METHODS: 2763 postmenopausal women enrolled in the Heart and Estrogen-Progestin Replacement Study (HERS) were randomly assigned to take conjugated E + P or placebo in a secondary CHD prevention study. The primary outcome for these analyses was nonfatal myocardial infarction or CHD death during a mean follow up of 4.1 years. RESULTS: The baseline serum UA for the cohort was 5.4 mg/dl and, compared with placebo, E + P on average lowered serum UA levels slightly (0.2 mg/dl) at one year of follow up (p < 0.0001). Baseline serum UA levels were associated in simple proportional hazards models with CHD events; each standard deviation increase (1.3 mg/dl) was associated with a 22% increased risk of primary CHD events (p =.0001). This association, however, was no longer statistically significant after multivariable adjustment (p = 0.36). There was no association between on-study change in serum UA level and any CHD outcome. CONCLUSION: Treatment with E + P lowered serum UA levels slightly, but neither baseline UA nor charge in UA affected CHD risk. C1 San Francisco VA Med Ctr, Gen Internal Med Sect, Med Serv, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, Div Clin Res, San Francisco, CA 94143 USA. Univ Alabama, Div Cardiovasc Dis, Birmingham, AL 35294 USA. RP Simon, JA (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, Med Serv, 4150 Clement St, San Francisco, CA 94121 USA. EM jasimon@itsa.ucsf.edu OI Bittner, Vera/0000-0001-9456-850X NR 58 TC 22 Z9 24 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD FEB PY 2006 VL 16 IS 2 BP 138 EP 145 DI 10.1016/j.annepidem.2005.04.003 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 015LR UT WOS:000235553400010 PM 16039873 ER PT J AU Netscher, DT Richards, WT AF Netscher, DT Richards, WT TI Rational treatment for multiple digit congenital absence - Case report of nonvasculorized toe phalangeal transfers and distraction lengthening for symbrachydactyly SO ANNALS OF PLASTIC SURGERY LA English DT Article DE symbrachydactyly; toe phalangeal transfer; digital lengthening ID HAND; RECONSTRUCTION; DEFORMITIES; TRANSPLANTATION; OSTEOGENESIS; ANOMALIES; THUMB AB A case is discussed in which a young male was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits when lie was an infant. This initial surgical procedure was later followed by webspace deepening and Ultimately by distraction lengthening of the digits. At 8 years of age, lie has a very functional hand with mobile metacarpophalangeal joints in all reconstructed fingers. In fact, lie uses this reconstructed right hand as his dominant extremity. The case is discussed in context of phalangeal growth potential, specific indications for this type of reconstruction, and final long-term outcome. This case also helps to recommend rational treatment protocols for similar congenital hand anomalies. C1 Baylor Coll Med, Plast Surg Serv, Dept Vet Affairs Med Ctr, Div Plast Surg, Houston, TX 77030 USA. RP Netscher, DT (reprint author), 6624 Fannin,Suite 2730, Houston, TX 77030 USA. EM Netscher@bcm.tmc.edu NR 31 TC 4 Z9 5 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0148-7043 J9 ANN PLAS SURG JI Ann. Plast. Surg. PD FEB PY 2006 VL 56 IS 2 BP 211 EP 215 DI 10.1097/01.sap.0000194244.25602.c5 PG 5 WC Surgery SC Surgery GA 009HU UT WOS:000235103300023 PM 16432336 ER PT J AU Taylor, SL Fremont, A Jain, AK McLaughlin, R Peterson, E Ferguson, TB Lurie, N AF Taylor, SL Fremont, A Jain, AK McLaughlin, R Peterson, E Ferguson, TB Lurie, N TI Racial and ethnic disparities in care: The perspectives of cardiovascular surgeons SO ANNALS OF THORACIC SURGERY LA English DT Article ID PHYSICIANS; IMPACT; RACE AB Background. Although racial/ethnic disparities in care are well documented, particularly for cardiac care, we know little about what cardiac surgeons think about them. For educational efforts to be effective in helping physicians address disparities, they must consider providers' knowledge and beliefs about the underlying causes of the disparities. Methods. We conducted a survey in 2004 to assess cardiologists' and cardiac surgeons' knowledge of racial/ethnic disparities in cardiovascular care and their perceptions about the underlying causes. Respondents were recruited from the membership of four cardiovascular professional associations. This paper focuses on cardiovascular surgeons' responses (n = 208). Results. Forty-four percent of cardiovascular surgeons thought that, among patients with cardiac risk factors, black patients were not as likely as white patients to receive cardiac diagnostic tests and procedures. Additionally, 30% thought that black patients were not as likely as white patients to receive therapeutic tests and procedures. However, only 13% agreed that cardiac care disparities occur "often" or "somewhat often" based on patients' race/ethnicity, independent of their insurance and education. Only 3% thought disparities were likely to occur in their clinical setting. Respondents appeared more likely to endorse patient factors (eg, health behaviors or treatment adherence) than system or provider (eg, miscommunication or continuity of care) factors as reasons for disparities. Conclusions. Although some surgeons acknowledge that racial/ethnic disparities in cardiac care occur, very few agree that they occur often, independent of patients' characteristics. Educational efforts tailored to local care settings, such as reviewing quality of care data on patients of different races/ethnicities within a clinic/hospital, may effectively inform all physicians of these disparities. C1 RAND Corp, Santa Monica, CA 90407 USA. RAND Corp, Washington, DC USA. Univ Calif Los Angeles, W Los Angeles VAMC, Div Med, Los Angeles, CA USA. Duke Univ, Durham, NC USA. Amer Coll Cardiol, Bethesda, MD USA. Louisiana State Univ, New Orleans, LA USA. Soc Thorac Surg, Chicago, IL USA. RP Taylor, SL (reprint author), RAND Corp, 1776 Main St,M5S,POB 2138, Santa Monica, CA 90407 USA. EM staylor@rand.org RI Fremont, Allen/A-7752-2009 NR 14 TC 21 Z9 21 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD FEB PY 2006 VL 81 IS 2 BP 531 EP 536 DI 10.1016/j.athoracsur.2005.08.004 PG 6 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 009VV UT WOS:000235142400020 PM 16427845 ER PT J AU McNeil, MR Matthews, CT Hula, WD Doyle, PJ Fossett, TRD AF McNeil, MR Matthews, CT Hula, WD Doyle, PJ Fossett, TRD TI Effects of visual-manual tracking under dual-task conditions on auditory language comprehension and story retelling in persons with aphasia SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 35th Annual Clinical Aphasiology Conference CY MAY 31-JUN 04, 2005 CL Sanibel Isl, FL ID RESOURCE-ALLOCATION; DIVIDED ATTENTION; PERFORMANCE; INDIVIDUALS; FMRI AB Background: Two recent studies (McNeil et al., 2004, 2005) evaluated non-brain-injured (N-BI) elderly persons' dual-task performance oil a story retell procedure (SRP) and a visual-manual line-tracking task. Results of both studies demonstrated a unidirectional cost whereby the difficulty of the language task had an effect on tracking performance; however, the difficulty of the tracking task had no effect on language comprehension as indexed by story retelling. Aims: The specific aim of this investigation was to assess the effects of performing a concurrent visual-manual tracking task on the comprehension of stories in persons with aphasia (PWA). Methods & Procedures: The current study evaluated the performance trading in these tasks in PWA using similar dual-task procedures as those employed ill the McNeil et al (2004 2005) studies. Specifically, two tracking difficulty levels were used to assess concurrent costs under a single difficulty level of the SRP. Outcomes & Results: The results of this study replicate, in PWA, the null effect of tracking, difficulty on story retell performance that was found in the two earlier studies in N-BI elderly persons. Contrary to predictions, there was no significant effect of tracking difficulty on story retell performance. There was also no significant difference between story comprehension or visual manual-tracking tasks performed alone or in the competing conditions. Conclusions: The results of this study do not support the hypothesis that a deficit in allocating processing resources in PWA would result in a concurrent cost of tracking difficulty on story comprehension. The results are discussed relative to the limitations of the story retell procedure for indexing potential dual-task effects and relative to the possible structure of the shared cognitive architecture used in these specific dual-tasks. C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP McNeil, MR (reprint author), Univ Pittsburgh, Dept Commun Sci & Disorders, 4033 Forbes Tower, Pittsburgh, PA 15260 USA. EM mcneil@pitt.edu NR 26 TC 4 Z9 4 U1 0 U2 1 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD FEB-APR PY 2006 VL 20 IS 2-4 BP 167 EP 174 DI 10.1080/02687030500472660 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 047PA UT WOS:000237890000007 ER PT J AU Doyle, PJ Matthews, C Mikolic, JM Hula, W McNeil, MR AF Doyle, PJ Matthews, C Mikolic, JM Hula, W McNeil, MR TI Do measures of language impairment predict patient-reported communication difficulty and distress as measured by the Burden of Stroke Scale (BOSS)? SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 35th Annual Clinical Aphasiology Conference CY MAY 31-JUN 04, 2005 CL Sanibel Isl, FL ID SOCIAL SUPPORT; PSYCHOLOGICAL DISTRESS; FUNCTIONAL STATUS; MENTAL-HEALTH; LIFE; OUTCOMES; SURVIVORS; THERAPY; IMPACT; CANCER AB Background: Patient-reported measures of Communication difficulty and communication-related distress may be used to obtain efficient and valid indices of the functional consequences of aphasia and its treatment on the daily lives of many community-dwelling stroke survivors. However, they have not been employed to evaluate treatment outcomes or to examine hypotheses specifying their relationship to commonly employed measures of speech and language impairment in persons with aphasia. Aims: This study examined whether the Shortened Porch Index of Communicative Abilities. (SPICA) (Disimoni, Keith, & Darley, 1980), 55-item Revised Token Test (55-item RTT) (Arvedson, McNeil, & West, 1986), and BDAE Severity Rating Scale (Good-lass, Kaplan, & Barressi, 2001) scores obtained at 3 months post-onset (MPO) predicted patient-reported communication difficulty and distress as measured by the Burden of Stroke Scale (BOSS) (Doyle et al., 2004) at 12 MPO. Methods & Procedures: A sample of 37 adults with mild to moderate aphasia (M SPICA %ile = 70.4) were identified from a larger sample (n = 178) of community-dwelling stroke survivors who participated in a longitudinal investigation designed to examine the psychometric properties of the BOSS. Speech and language data obtained from the sub-sample of participants with aphasia were retrospectively examined in two sequential regression models in which the 3-MPO test scores served as the predictor variables of interest, and 12-MPO BOSS Communication Difficulty and Communication Distress Scores served as dependent variables. Results: Among the speech and language measures examined, only 3-month BDAE Severity Ratings contributed significantly to the prediction of 12-month patient-reported communication difficulty and distress as measured by the BOSS. Conclusions: The findings suggest that performance-based measures of speech and language impairment such as the SPICA and 55-item RTT may not accurately predict the day-to-day communication difficulty and distress experienced by community-dwelling stroke survivors with mild to moderate aphasia. Replication of these findings in a prospectively designed study employing a larger more representative sample, and more comprehensive assessment instruments is needed to substantiate the relationship between performance-based measures of language impairment and patient-reported communication difficulty and distress in adults with aphasia. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. RP Doyle, PJ (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr,132A-H, Pittsburgh, PA 15206 USA. EM patrick.doyle@med.va.gov NR 52 TC 4 Z9 4 U1 0 U2 0 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD FEB-APR PY 2006 VL 20 IS 2-4 BP 349 EP 361 DI 10.1080/02687030500475135 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA 047PA UT WOS:000237890000021 ER PT J AU Comer, SD Sullivan, MA Yu, E Rothenberg, JL Kleber, HD Kampman, K Dackis, C O'Brien, CP AF Comer, SD Sullivan, MA Yu, E Rothenberg, JL Kleber, HD Kampman, K Dackis, C O'Brien, CP TI Injectable, sustained-release naltrexone for the treatment of opioid dependence - A randomized, placebo-controlled trial SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article; Proceedings Paper CT 66th Annual Meeting of the College-on-Problems-of-Drug-Dependence CY JUN 14, 2004 CL San Juan, PR SP Coll Problems Drug Dependence ID NARCOTIC-ANTAGONISTS; ALCOHOL DEPENDENCE; METHADONE PATIENTS; HEROIN; BUPRENORPHINE; OVERDOSE; MORPHINE; HUMANS; DEPOT; HEPATOTOXICITY AB Context: Oral naltrexone can completely antagonize the effects produced by opioid agonists. However, poor compliance with naltrexone has been a major obstacle to the effective treatment of opioid dependence. Objective: To evaluate the safety and efficacy of a sustained release depot formulation of naltrexone in treating opioid dependence. Design and Setting: Randomized, double-blind, placebo-controlled, 8-week trial conducted at 2 medical centers. Participants: Sixty heroin-dependent adults. Interventions: Participants were stratified by sex and years of heroin use (>= 5 vs < 5) and then were randomized to receive placebo or 192 or 384 mg of depot naltrexone. Doses were administered at the beginning of weeks 1 and 5. All participants received twice-weekly relapse prevention therapy, provided observed urine samples, and completed other assessments at each visit. Main Outcome Measures: Retention in treatment and percentage of opioid-negative urine samples. Results: Retention in treatment was dose related, with 39%, 60%, and 68% of patients in the placebo, 192 mg of naltrexone, and 384 mg of naltrexone groups, respectively, remaining in treatment at the end of 2 months. Time to dropout had a significant main effect of dose, with mean time to dropout of 27, 36, and 48 days for the placebo, 192 mg of naltrexone, and 384 mg of naltrexone groups, respectively. The percentage of urine samples negative for opioids, methadone, cocaine, benzodiazepines, and amphetamine varied significantly as a function of dose. When the data were recalculated without the assumption that missing urine samples were positive, a main effect of group was not found for any drugs tested except cocaine, where the percentage of cocaine-negative urine samples was lower in the placebo group. Adverse events were minimal and generally mild. This formulation of naltrexone was well tolerated and produced a robust, dose-related increase in treatment retention. Conclusion: These data provide new evidence of the feasibility, efficacy, and tolerability of long-lasting antagonist treatments for opioid dependence. C1 Columbia Univ, New York State Psychiat Inst, Div Subst Abuse, New York, NY 10032 USA. Columbia Univ, Dept Psychiat, Coll Phys & Surg, New York, NY 10032 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Dept Behav Hlth, Philadelphia, PA USA. RP Comer, SD (reprint author), Columbia Univ, New York State Psychiat Inst, Div Subst Abuse, 1051 Riverside Dr,Unit 120, New York, NY 10032 USA. EM sdc10@columbia.edu FU NCI NIH HHS [P60 CA05186]; NIDA NIH HHS [N01DA-3-8829, N01DA-1-8817, P50 DA009236, P50 DA09236, P60 DA005186] NR 48 TC 169 Z9 178 U1 1 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD FEB PY 2006 VL 63 IS 2 BP 210 EP 218 DI 10.1001/archpsyc.63.2.210 PG 9 WC Psychiatry SC Psychiatry GA 009YZ UT WOS:000235150900012 PM 16461865 ER PT J AU Evans, CT LaVela, SL Smith, B Miskevics, S Weaver, FM Goldstein, B AF Evans, CT LaVela, SL Smith, B Miskevics, S Weaver, FM Goldstein, B TI Influenza diagnosis and treatment in veterans with spinal cord injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE antiviral agents; influenza; rehabilitation; spinal cord injuries AB Objective: To assess influenza diagnosis and treatment behaviors and prescribing practices for antiviral medications among spinal cord injury (SCI) practitioners. Design: Anonymous cross-sectional survey of practitioners and retrospective review of administrative diagnostic and prescription databases. Setting: Department of Veterans Affairs health care facilities. Participants: One hundred practitioners participated (response rate, 65%). Interventions: Not applicable. Main Outcome Measures: Strategies for diagnosing and treating influenza and type of antivirals prescribed. Results: Ninety-seven percent of practitioners reported using clinical symptoms to diagnose a patient with influenza. The most common treatments included symptom relievers (94%), followed by antivirals (21%). Antivirals reportedly used included amantadine (64%), rimantadine (36%), oseltamivir (32%), and zanamivir (11%). Twenty-one prescriptions for antivirals were identified during the influenza season and all were for amantadine. Conclusions: Despite recommendations by the U.S. Centers for Disease Control and Prevention and high risks of respiratory complications after SCI, antiviral medications and diagnostic tests for influenza are seldom used in the treatment of influenza in this population. Research is needed to identify barriers to diagnosing and administering antivirals in people with SCI. C1 Vet Affairs Edward Hines Jr Hosp, Dept Vet Affairs, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Hlth Serv & Policy Res, Chicago, IL 60611 USA. VA Puget Sound Healthcare Syst, Spinal Cord Injury & Disorders Strateg Healthcare, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Evans, CT (reprint author), Vet Affairs Edward Hines Jr Hosp, Dept Vet Affairs, Midwest Ctr Hlth Serv & Policy Res, 151H,5th & Roosevelt Rd,POB 5000,Rm D302, Hines, IL 60141 USA. EM Charlesnika.Evans@va.gov NR 9 TC 3 Z9 3 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 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD FEB PY 2006 VL 87 IS 2 BP 291 EP 293 DI 10.1016/j.apmr.2005.10.008 PG 3 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 013CJ UT WOS:000235386900023 PM 16442987 ER PT J AU Georges, GE Maris, MB Maloney, DG Sandmaier, BM Sorror, ML Shizura, JA Niederwieser, DW Agura, ED Bruno, B McSweeney, PA Pulsipher, MA Chauncey, TR Storer, BE Storb, RF AF Georges, GE Maris, MB Maloney, DG Sandmaier, BM Sorror, ML Shizura, JA Niederwieser, DW Agura, ED Bruno, B McSweeney, PA Pulsipher, MA Chauncey, TR Storer, BE Storb, RF TI Nonmyeloablative unrelated donor (URD) hematopoietic cell transplantation (HCT) for the treatment of patients (PTS) with poor-risk, relapsed or refractory multiple myeloma SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Meeting Abstract CT 32nd Annual Meeting of the American-Society-for-Blood-and-Marrow-Transplantation CY FEB 16-20, 2006 CL Honolulu, HI SP Amer Soc Blood & Marrow Transplantat C1 Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Washington, Seattle, WA 98195 USA. Rocky Mt Canc Ctr, Denver, CO USA. Stanford Univ, Palo Alto, CA 94304 USA. Univ Leipzig, D-7010 Leipzig, Germany. Baylor Univ, Med Ctr, Dallas, TX USA. Univ Turin, I-10124 Turin, Italy. Univ Utah, Salt Lake City, UT USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 1 Z9 1 U1 0 U2 1 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD FEB PY 2006 VL 12 IS 2 SU 1 MA 46 BP 19 EP 19 DI 10.1016/j.bbmt.2005.11.061 PG 1 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 012MU UT WOS:000235344100047 ER PT J AU McKibbin, T Burzynski, JA Twombly, RG Ochoa, JL Tsai, TW Callander, NS Freytes, CO AF McKibbin, T Burzynski, JA Twombly, RG Ochoa, JL Tsai, TW Callander, NS Freytes, CO TI Paclitaxel followed by filgrastim for peripheral blood stem cell (PBSC) mobilization in patients with hematologic malignancies who experienced prior mobilization failures SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Meeting Abstract CT 32nd Annual Meeting of the American-Society-for-Blood-and-Marrow-Transplantation CY FEB 16-20, 2006 CL Honolulu, HI SP Amer Soc Blood & Marrow Transplantat C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD FEB PY 2006 VL 12 IS 2 SU 1 MA 270 BP 96 EP 96 DI 10.1016/j.bbmt.2005.11.293 PG 1 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 012MU UT WOS:000235344100271 ER PT J AU Sampogna, F Chren, MM Melchi, CF Pasquini, P Tabolli, S Abeni, D AF Sampogna, F Chren, MM Melchi, CF Pasquini, P Tabolli, S Abeni, D CA Improve Study Grp TI Age, gender, quality of life and psychological distress in patients hospitalized with psoriasis SO BRITISH JOURNAL OF DERMATOLOGY LA English DT Article DE age; gender; psoriasis; psychological distress; quality of life ID SELF-ADMINISTERED PSORIASIS; PSYCHIATRIC MORBIDITY; SKIN DISEASES; DERMATOLOGICAL OUTPATIENTS; ATOPIC-DERMATITIS; STRESS INVENTORY; SEVERITY INDEX; BODY-IMAGE; IMPACT; VALIDITY AB Background Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. Methods The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-assessed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and >= 65 years, in subsets of patients based on clinical and sociodemographic characteristics. Results We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. Conclusions These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women. C1 IRCCS, IDI, Hlth Serv Res Unit, I-00167 Rome, Italy. IRCCS, IDI, Dermatol Unit VIII, I-00167 Rome, Italy. IRCCS, IDI, Epidemiol Unit, I-00167 Rome, Italy. San Francisco Vet Affairs Med Ctr, HSR&D Res Enhancement Award Program, San Francisco, CA USA. Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA. RP Sampogna, F (reprint author), IRCCS, IDI, Hlth Serv Res Unit, Via Monti Creta 104, I-00167 Rome, Italy. EM f.sampogna@idi.it OI Abeni, Damiano/0000-0002-0167-7617 NR 44 TC 77 Z9 83 U1 2 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0007-0963 J9 BRIT J DERMATOL JI Br. J. Dermatol. PD FEB PY 2006 VL 154 IS 2 BP 325 EP 331 DI 10.1111/j.1365-2133.2005.06909.x PG 7 WC Dermatology SC Dermatology GA 003RN UT WOS:000234699400019 PM 16433804 ER PT J AU Potter, MJ Szabo, SM Sarraf, D Michels, R Schmidt-Erfurth, U AF Potter, MJ Szabo, SM Sarraf, D Michels, R Schmidt-Erfurth, U TI Photodynamic therapy for subretinal neovascularization in type 2A idiopathic juxtafoveolar telangiectasis SO CANADIAN JOURNAL OF OPHTHALMOLOGY-JOURNAL CANADIEN D OPHTALMOLOGIE LA English DT Article; Proceedings Paper CT Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology CY APR 24-29, 2004 CL Ft Lauderdale, FL SP Assoc Res Vis & Ophthalmol DE idiopathic juxtafoveolar retinal telangiectasis; subretinal neovascularization; photodynamic therapy; verteporfin ID RETINAL TELANGIECTASIS; MEMBRANE; VERTEPORFIN AB Background: Photodynamic therapy (PDT) with verteporfin is now the standard of care worldwide for the treatment of choroidal neovascularization, but has been used only rarely in those with subretinal neovascular membranes (SRNVM) due to type 2A idiopathic juxtafoveolar retinal telangiectasis (IJT). We performed a retrospective study to examine the outcome of patients treated with PDT for SRNVM secondary to IJT. Methods: Retrospective interventional case series of 7 eyes of 6 IJT patients with SRNVMs treated with PDT Ophthalmic examination and fluorescein angiography were performed before treatment, with retreatment every 3 months as needed. The main outcome was the proportion of patients avoiding vision loss (change of +/- 4 letters, or better). Results: Baseline Snellen acuity ranged from 20/40 to 20/400 (median 20/80). Mean follow-up was 21 months. Patients received 2.4 treatments on average. Five of 7 patients avoided vision loss; acuity improved in 3 eyes (a I line improvement), stayed the same in 2 eyes ( 4 letters) and decreased in 2 eyes ( >= I line decrease) over time. Median final acuity was 20/80. Five of 7 eyes had final acuities of >= 20/200. No leakage was observed in any eyes following cessation of treatment. Interpretation: Previously reported outcomes for SRNVM in type 2A IJT, in both natural history and after laser or surgical treatment, have been uniformly poor. PDT may be considered for these patients due to its excellent safety profile and clinically favorable outcomes in this study. C1 Univ British Columbia, Dept Ophthalmol, Vancouver, BC V5Z 1M9, Canada. Univ Calif Los Angeles, Jules Stein Eye Inst, Kaiser Permanente, King Drew Med Ctr, Los Angeles, CA 90024 USA. Greater Los Angles VA Healthcare Ctr, Los Angeles, CA USA. Univ Vienna, Dept Ophthalmol, Vienna, Austria. Univ Eye Hosp, Lubeck, Germany. RP Potter, MJ (reprint author), Sect B-2550 Willow St, Vancouver, BC V5Z 3N9, Canada. EM mpotter@interchange.ubc.ca NR 10 TC 18 Z9 19 U1 0 U2 0 PU CANADIAN OPHTHAL SOC PI OTTAWA PA 1525 CARLING AVE SUITE 610, OTTAWA, ONTARIO K1Z 8R9, CANADA SN 0008-4182 J9 CAN J OPHTHALMOL JI Can. J. Opthalmol.-J. Can. Opthalmol. PD FEB PY 2006 VL 41 IS 1 BP 34 EP 37 PG 4 WC Ophthalmology SC Ophthalmology GA 021FK UT WOS:000235968900004 PM 16462869 ER PT J AU Kazhdan, I Long, L Montellano, R Cavazos, DA Marciniak, RA AF Kazhdan, I Long, L Montellano, R Cavazos, DA Marciniak, RA TI Targeted gene therapy for breast cancer with truncated Bid SO CANCER GENE THERAPY LA English DT Article DE breast cancer; tumor targeting; tBid ID REVERSE-TRANSCRIPTASE PROMOTER; ANTI-APOPTOSIS GENE; SURVIVIN MESSENGER-RNA; TELOMERASE ACTIVITY; BAX GENE; IN-VIVO; EXPRESSION; CELLS; HTERT; ACTIVATION AB We studied the efficiency of the proapoptotic factor tBid, targeted to tumor cells using the promoters of the hTERT, Survivin and Muc1 genes, in killing breast cancer cells. tBid is the active fragment of the proapoptotic protein Bid and is generated in response to death receptor activation. When placed under control of a strong CMV promoter, tBid was highly efficient in killing breast cancer cells. When expression of tBid was driven by tumor-specific promoters, the magnitude of killing was significant in cell lines with high levels of promoter activity. For successful gene therapy with targeted tBid, it is therefore crucial to be able to predict promoter activity prior to selection of the therapeutic construct. To test whether gene expression could serve as a predictor, we correlated expression of Survivin, hTERT and Muc1 genes with the activity of the corresponding promoters in a panel of breast cancer cell lines. Expression of the Muc1 gene correlated well with the activity of its promoter and the resultant tumor cell killing. For the hTERT and Survivin promoters, however, promoter activity did not correlate well with the expression of the corresponding genes. The implications and possible mechanism of these discrepancies are discussed. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Med Oncol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Kazhdan, I (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Med Oncol, 7703 Floyd Curl Dr,MC7884, San Antonio, TX 78229 USA. EM kazhdan@uthscsa.edu FU NCI NIH HHS [5 K12 CA01723-10] NR 52 TC 13 Z9 14 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0929-1903 J9 CANCER GENE THER JI Cancer Gene Ther. PD FEB PY 2006 VL 13 IS 2 BP 141 EP 149 DI 10.1038/sj.cgt.7700867 PG 9 WC Biotechnology & Applied Microbiology; Oncology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Oncology; Genetics & Heredity; Research & Experimental Medicine GA 003JS UT WOS:000234678600004 PM 16110313 ER PT J AU Mims, MP Hayes, TG Zheng, SY Leal, SM Frolov, A Ittmann, MM Wheeler, TM Prchal, JT AF Mims, MP Hayes, TG Zheng, SY Leal, SM Frolov, A Ittmann, MM Wheeler, TM Prchal, JT TI Mitochondrial DNA G10398A polymorphism and invasive breast cancer in African-American women SO CANCER RESEARCH LA English DT Letter ID MTDNA C1 Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Mims, MP (reprint author), Baylor Coll Med, Houston, TX 77030 USA. NR 3 TC 40 Z9 40 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD FEB 1 PY 2006 VL 66 IS 3 BP 1880 EP 1880 DI 10.1158/0008-5472.CAN-05-3774 PG 1 WC Oncology SC Oncology GA 009FD UT WOS:000235095900078 PM 16452251 ER PT J AU Kim, IA Shin, JH Kim, IH Kim, JH Kim, JS Wu, HG Chie, EK Ha, SW Park, CI Kao, GD AF Kim, IA Shin, JH Kim, IH Kim, JH Kim, JS Wu, HG Chie, EK Ha, SW Park, CI Kao, GD TI Histone deacetylase inhibitor-mediated radiosensitization of human cancer cells: Class differences and the potential influence of p53 SO CLINICAL CANCER RESEARCH LA English DT Article ID CARCINOMA-CELLS; REPAIR ACTIVITY; DNA-REPAIR; CLASS-I; APOPTOSIS; EXPRESSION; ENHANCEMENT; PROLIFERATION; EPIGENETICS; ACTIVATION AB Histone deacetylase inhibitors (HDI) are emerging as potentially useful components of the anticancer armamentarium and as useful tools to dissect mechanistic pathways. HDIs that globally inhibit histone deacetylases (HDAC) have radiosensitizing effects, but the relative contribution of specific HDAC classes remains unclear. Newly characterized HDIs are now available that preferentially inhibit specific HDAC classes, including SK7041 (inhibits class I HDACs) and splitomicin (inhibits class III HDACs). We investigated in human cancer cells the relative radiosensitizations that result from blocking specific HDAC classes. We found that trichostatin A (TSA; inhibitor of both class I and II HDACs) was the most effective radiosensitizer, followed by the class I inhibitor SK7041, whereas splitomicin (inhibitor of class III) had least effect. Interestingly, radiosensitization by TSA in cell lines expressing p53 was more pronounced than in isogenic lines lacking p53. Radiosensitization of cells expressing p53 by TSA was reduced by pifithrin-alpha, a small-molecule inhibitor of p53. In contrast, the radiosensitization by TSA of cells expressing low levels of p53 was enhanced by transfection of wild-type p53- expressing vector or pretreatment with leptomycin B, an inhibitor of nuclear export that increased intracellular levels of p53. These effects on radiosensitization were respectively muted or not seen in cells treated with SK7041 or splitomicin. To our knowledge, this may be among the first systematic investigations of the comparative anticancer effects of inhibiting specific classes of HDACs, with results suggesting differences in the degrees of radiosensitization, which in some cell lines may be influenced by p53 expression. C1 Seoul Natl Univ, Coll Med, Dept Radiat Oncol, Seoul 110744, South Korea. Seoul Natl Univ, Coll Med, Canc Res Inst, Seoul 110744, South Korea. Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA 19104 USA. RP Kim, IH (reprint author), Seoul Natl Univ, Coll Med, Dept Radiat Oncol, 28 Yongon Dong, Seoul 110744, South Korea. EM ihkim@snu.ac.kr RI Chie, Eui Kyu/J-5677-2012; Kim, In Ah/J-5426-2012; Kim, Jae Sung/J-5429-2012; Ha, Sung Whan/J-5699-2012; Wu, Hong Gyun/J-5547-2012 OI Kim, Jin Ho/0000-0002-7918-1072 NR 52 TC 59 Z9 60 U1 0 U2 3 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 FEB 1 PY 2006 VL 12 IS 3 BP 940 EP 949 DI 10.1158/1078-0432.CCR-05-1230 PN 1 PG 10 WC Oncology SC Oncology GA 010NR UT WOS:000235201900034 PM 16467109 ER PT J AU Kudolo, GB Wang, W Elrod, R Barrientos, J Haase, A Blodgett, J AF Kudolo, GB Wang, W Elrod, R Barrientos, J Haase, A Blodgett, J TI Short-term ingestion of Ginkgo biloba extract does not alter whole body insulin sensitivity in non-diabetic, pre-diabetic or type 2 diabetic subjects - A randomized double-blind placebo-controlled crossover study SO CLINICAL NUTRITION LA English DT Article DE Ginkgo biloba; insulin resistance; Type 2 diabetes ID PLATELET-ACTIVATING-FACTOR; BETA-CELL FUNCTION; RESISTANCE SYNDROME; GLUCOSE-TOLERANCE; MELLITUS; HYPERTENSION; DISEASE; EGB-761; METAANALYSIS; INDIVIDUALS AB Background Et Aims: Ingestion of Ginkgo biloba Extract (EGb 761) may increase pancreatic beta-cell function in both healthy subjects with normal glucose tolerance (NGT) as well as patients with Type 2 Diabetes mellitus (T2DM). Since hyperinsulinemia is a hallmark of T2DM, it is important to verify that increased insulin production is not due to increased insulin resistance. Method: NGT subjects (n = 10; age, 44.2 +/- 13.9 years old), impaired glucose tolerance (IGT) (n = 8; age 51.3 +/- 6.6 years old) and T2DM subjects (n = 8, 51.6 +/- 15.2 years old) completed a randomized, double-blind, placebo-controlled crossover study. After ingesting either EGb 761 (120mg/day as a single dose) or placebo during each 3-month arm, a 2-step euglycemic insulin clamp was performed. Results: At the low insulin infusion rate (10mU/m(2)/min) the glucose metabolic rates (M values) were 3.5 +/- 1.5 vs. 3.0 +/- 0.5mg/kg (P=0.16), 3.0 +/- 0.4 vs. 2.8 +/- 0.8mg/kg (P=0.19) and 2.6 +/- 0.7 vs. 2.4 +/- 0.5mg/kg (P=0.09) for the placebo and EGb 761 cycles, in the NGT, IGT and T2DM subjects, respectively. At the high insulin infusion rate (40 mU/m(2)/min) the M values were 7.3 +/- 2.3 vs. 8.1 +/- 2.5mg/kg (P=0.07), 6.2 +/- 1.6vs. 6.5 +/- 2.1 mg/kg (P=0.32) and 3.6 +/- 1.6vs. 3.5 +/- 1.0 mg/kg (P=0.34) for placebo vs. EGb 761 cycles, in the NGT, IGT and T2DM subjects, respectively. Conclusion: The ingestion of 120mg of EGb 761 as a single for 3 months did not produce insulin resistance in the non-diabetic or pre-diabetic subjects or exacerbate the disease in the T2DM subjects. (c) 2005 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Clin Lab Sci, San Antonio, TX 78229 USA. Audie L Murphy Vet Affairs Hosp, San Antonio, TX 78284 USA. RP Kudolo, GB (reprint author), Univ Texas, Hlth Sci Ctr, Dept Clin Lab Sci, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM Kudolo@uthscsa.edu FU NCCIH NIH HHS [R01-AT-00832]; NCRR NIH HHS [M01-RR-01346] NR 43 TC 10 Z9 13 U1 1 U2 3 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0261-5614 J9 CLIN NUTR JI Clin. Nutr. PD FEB PY 2006 VL 25 IS 1 BP 123 EP 134 DI 10.1016/j.clnu.2005.10.001 PG 12 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 027SN UT WOS:000236436000014 PM 16293352 ER PT J AU Glynn, SM AF Glynn, Shirley M. TI Kingdon and Turkington's cognitive therapy of schizophrenia SO COGNITIVE AND BEHAVIORAL PRACTICE LA English DT Book Review ID BEHAVIORAL THERAPY C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. RP Glynn, SM (reprint author), VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 12 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 1077-7229 J9 COGN BEHAV PRACT JI Cogn. Behav. Pract. PD FEB PY 2006 VL 13 IS 1 BP 105 EP 106 DI 10.1016/j.cbpra.2006.01.003 PG 2 WC Psychology, Clinical SC Psychology GA 174HQ UT WOS:000246933300015 ER PT J AU Heinzerling, KG Kral, AH Flynn, NM Anderson, RL Scott, A Gilbert, ML Asch, SM Bluthenthal, RN AF Heinzerling, KG Kral, AH Flynn, NM Anderson, RL Scott, A Gilbert, ML Asch, SM Bluthenthal, RN TI Unmet need for recommended preventive health services among clients of California syringe exchange programs: Implications for quality improvement SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE preventive services; quality of care; syringe exchange programs; injection drug use; HIV; hepatitis C ID INJECTION-DRUG-USERS; HEPATITIS-C VIRUS; SUBSTANCE-ABUSE TREATMENT; NEW-YORK-CITY; METHADONE-MAINTENANCE TREATMENT; RANDOMIZED CONTROLLED-TRIAL; PRIMARY MEDICAL-CARE; HIV RISK BEHAVIOR; SAN-FRANCISCO; B-VIRUS AB Background: Comprehensive preventive services are recommended for injection drug users (IDU), including screening tests, vaccinations, risk reduction counseling, and sterile syringes. Syringe exchange programs (SEP) may facilitate receipt of preventive services by IDUs, but whether SEP clients receive recommended preventive care is not known. We explained use of recommended preventive services by clients of 23 SEPs throughout California. Methods: Five hundred and sixty SEP clients were recruited from 23 SEPs throughout California between March and September 2003. Receipt of 10 recommended preventive Services and Source of care (SEP versus non-SEP providers) was ascertained from client interviews. Results: Oil average, SEP clients received only 13 % of recommended preventive services and 49% of clients received none of the recommended services. 017 services that were received, 76% were received from SEPs. In multivariate analysis, use of drug treatment and more frequent SEP visits were associated with receipt of recommended preventive services by clients. Conclusions: SEPs are often the only source of preventive care for their IDU clients. Still, SEP clients fail to receive most recommended preventive services. Interventions to increase use of preventive services and improve the quality of preventive care received by IDUs, Such as increased access to drug treatment and SEPs, are needed. (c) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Calif Los Angeles, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. Univ Calif San Francisco, Dept Family & Community Med, San Francisco, CA 94143 USA. Univ Calif Davis, Dept Internal Med, Div Infect Dis, Sacramento, CA 95817 USA. RAND, Hlth Program, Santa Monica, CA USA. RAND, Drug Policy Res Ctr, Santa Monica, CA USA. Charles R Drew Univ Med & Sci, Drew Ctr AIDS Res Educ & Serv, Dept Psychiat, Los Angeles, CA 90059 USA. RP Heinzerling, KG (reprint author), Univ Calif Los Angeles, Robert Wood Johnson Clin Scholars Program, 911 Broxton Ave,3rd Floor, Los Angeles, CA 90024 USA. EM heinzk@ucla.edu OI Bluthenthal, Ricky/0000-0003-3491-1702 FU NIDA NIH HHS [R01DA14210] NR 94 TC 24 Z9 24 U1 5 U2 7 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 FEB 1 PY 2006 VL 81 IS 2 BP 167 EP 178 DI 10.1016/j.drugalcdep.2005.06.008 PG 12 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 004WJ UT WOS:000234783000008 PM 16043308 ER PT J AU Aujesky, D Roy, PM Le Manach, CP Verschuren, F Meyer, G Obrosky, DS Stone, RA Cornuz, J Fine, MJ AF Aujesky, D Roy, PM Le Manach, CP Verschuren, F Meyer, G Obrosky, DS Stone, RA Cornuz, J Fine, MJ TI Validation of a model to predict adverse outcomes in patients with pulmonary embolism SO EUROPEAN HEART JOURNAL LA English DT Article DE pulmonary embolism; prognosis; mortality ID MOLECULAR-WEIGHT HEPARIN; DEEP-VEIN THROMBOSIS; OUTPATIENT TREATMENT; UNFRACTIONATED HEPARIN AB Aims To validate a model for quantifying the prognosis of patients with pulmonary embolism (PE). The model was previously derived from 10 534 US patients. Methods and results We validated the model in 367 patients prospectively diagnosed with PE at 117 European emergency departments. We used baseline data for the model's 11 prognostic variables to stratify patients into five risk classes (I-V). We compared 90-day mortality within each risk class and the area under the receiver operating characteristic curve between the validation and the original derivation samples. We also assessed the rate of recurrent venous thrombo-embolism and major bleeding within each risk class. Mortality was 0% in Risk Class I, 1.0% in Class II, 3.1% in Class III, 10.4% in Class IV, and 24.4% in Class V and did not differ between the validation and the original derivation samples. The area under the curve was larger in the validation sample (0.87 vs. 0.78, P=0.01). No patients in Classes I and II developed recurrent thrombo-embolism or major bleeding. Conclusion The model accurately stratifies patients with PE into categories of increasing risk of mortality and other relevant complications. Patients in Risk Classes I and II are at low risk of adverse outcomes and are potential candidates for outpatient treatment. C1 Univ Lausanne, Div Gen Internal Med, Univ Outpatient Clin, Lausanne, Switzerland. Univ Lausanne, Clin Epidemiol Ctr, Lausanne, Switzerland. Univ Angers, Dept Emergency Med, Angers, France. Univ Catholique Louvain, Clin Univ St Luc, Dept Emergency Med, B-1200 Brussels, Belgium. Univ Paris 05, Hop Europeen Georges Pompidou, Dept Resp Care, Paris, France. Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. VA Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. RP Aujesky, D (reprint author), CHU Vaudois, Serv Med Interne, BH10-622, CH-1011 Lausanne, Switzerland. EM drahomir.aujesky@chuv.ch FU NHLBI NIH HHS [1 R21 HL075521-01A1] NR 23 TC 144 Z9 150 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0195-668X J9 EUR HEART J JI Eur. Heart J. PD FEB PY 2006 VL 27 IS 4 BP 476 EP 481 DI 10.1093/eurheartj/ehi588 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 011OO UT WOS:000235278100020 PM 16207738 ER PT J AU Reue, K Donkor, J AF Reue, Karen Donkor, Jimmy TI Lipin: a determinant of adiposity, insulin sensitivity and energy balance SO FUTURE LIPIDOLOGY LA English DT Review DE adipocyte differentiation; alternative mRNA splicing; animal model; energy expenditure; insulin sensitivity; lipodystrophy; obesity ID QUANTITATIVE TRAIT LOCUS; DYSTROPHY FLD MUTATION; SERUM LEPTIN LEVELS; GENE-EXPRESSION; MAMMALIAN TARGET; RAPAMYCIN; PROTEIN; MOUSE; DIFFERENTIATION; SUSCEPTIBILITY AB Lipodystrophy and obesity represent extreme ends of the adiposity spectrum, and both are associated with conditions such as insulin resistance, diabetes and atherosclerosis. This points to a key role for adipose tissue in metabolic homeostasis and has spurred efforts to identify genes involved in adipose tissue development and function. Lipin is one such gene. Variations in lipin expression levels in mouse models produce wide variations in adiposity ranging from lipodystrophy in lipin-deficient mice, to obesity in mice with enhanced lipin expression in either adipose tissue or muscle. These effects reflect important roles for lipin in key metabolic processes including cell differentiation and lipid storage in adipose tissue, and energy utilization in muscle. This review summarizes the work to date on lipin, focusing on its effects on adipose tissue mass and energy balance, insulin sensitivity and cellular function. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Health Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Med Sci Training Program, Los Angeles, CA 90024 USA. RP Reue, K (reprint author), Univ Calif Los Angeles, Dept Human Genet, 695 Charles E Young Dr S Gonda, Los Angeles, CA 90095 USA. EM reuek@ucla.edu NR 32 TC 5 Z9 5 U1 0 U2 1 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 1746-0875 J9 FUTURE LIPIDOL JI Future Lipidol. PD FEB PY 2006 VL 1 IS 1 BP 91 EP 101 DI 10.2217/17460875.1.1.91 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 208YB UT WOS:000249354000017 ER PT J AU Auslander, JN Lieberman, DA Sonnenberg, A AF Auslander, JN Lieberman, DA Sonnenberg, A TI Endoscopic procedures and diagnoses are not influenced by seasonal variations SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID PEPTIC-ULCER; COLORECTAL-CANCER; UNITED-STATES; HOSPITAL ADMISSIONS; DUODENAL-ULCER; DISEASE; COLONOSCOPY; MORTALITY; SCOTLAND AB Background: The occurrences of various GI diseases are thought to be influenced by seasonal variations. The present study was clone to test the hypothesis that seasonal variations in endoscopic diagnoses reflect underly ing patterns in the performance of endoscopic procedures. Methods: The Clinical Outcomes Research Initiative (CORI) uses a Computerized endoscopic report generator to collect endoscopic data from 73 diverse practice sites throughout the United States. We used the CORI database to analyze the date-specific occurrence of EGD and colonoscopy, as well as the endoscopic diagnoses of gastric ulcer, duodenal ulcer, and colorectal cancer. Time trends are analyzed by autocorrelation and by linear and nonlinear regression. Results: Between January 2000 and December 2003, the number of EGDs and colonoscopies increased 2.5- and 4.1-fold, respectively. The rate of duodenal ulcer fell from 21.2 (15.6-27.5) to 19.0 (15.8-22.8) per 1000 EGDS. The rate of gastric ulcer fell from 42.6 (33.3-50.1) to 33.4 (29.5-38.7) per 1000 EGDs. The rate of colorectal cancer fell from 109.9 (98.3-122.8) to 72.2 (67.4-77.2) per 1000 colonoscopies. The time trends of neither endoscopic procedures nor endoscopic diagnoses revealed any seasonal variation or other cyclic pattern. Conclusions: The performance of endoscopic procedures is unaffected by any seasonal variation. C1 Portland VA Med Ctr, Gastroenterol Sect, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Div Gastroenterol, Portland, OR USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, Gastroenterol Sect, P3-GI,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. FU NIDDK NIH HHS [5-R33-DK061778-03, 2-U01-DK057132-06A1] NR 26 TC 4 Z9 4 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 FEB PY 2006 VL 63 IS 2 BP 267 EP 272 DI 10.1016/j.gie.2005.08.052 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 010KT UT WOS:000235194300014 PM 16427933 ER PT J AU Gum, AM Arean, PA Hunkeler, E Tang, LQ Katon, W Hitchcock, P Steffens, DC Dickens, J Unutzer, J AF Gum, AM Arean, PA Hunkeler, E Tang, LQ Katon, W Hitchcock, P Steffens, DC Dickens, J Unutzer, J CA IMPACT Investigators TI Depression treatment preferences in older primary care patients SO GERONTOLOGIST LA English DT Article DE treatment preferences; depression; primary core; collaborative care; counseling ID QUALITY IMPROVEMENT PROGRAMS; RANDOMIZED CONTROLLED TRIAL; LATE-LIFE; MAJOR DEPRESSION; CONSENSUS STATEMENT; AFRICAN-AMERICAN; HEALTH-CARE; MANAGEMENT; OUTCOMES; UPDATE AB Purpose: For depressed older primary care patients, this study aimed to examine (a) characteristics associated with depression treatment preferences; (b) predictors of receiving preferred treatment; and (c) whether receiving preferred treatment predicted satisfaction and depression outcomes. Design and Methods: Data are from 1,602 depressed older primary care patients who participated in a multisite, randomized clinical trial comparing usual care to collaborative care, which offered medication and counseling for up to 12 months. Baseline assessment included demographics, depression, health information, prior depression treatment, potential barriers, and treatment preferences (medication, counseling). At 12 months, services received, satisfaction, and depression outcomes were assessed. Results: More patients preferred counseling (57%) than medication (43%). Previous experience with a treatment type was the strongest predictor of preference. In addition, medication preference was predicted by male gender and diagnosis of major depression (vs dysthymia). The collaborative care model greatly improved access to preferred treatment, especially for counseling (74% vs 33% in usual care). Receipt of preferred treatment did not predict satisfaction or depression outcomes; these outcomes were most strongly impacted by treatment condition. Implications: Many depressed older primary care patients desire counseling, which is infrequently available in usual primary care. Discussion of treatment preferences should include an assessment of prior treatment experiences. A collaborative care model that increases collaboration between primary care and mental health professionals can increase access to preferred treatment. If preferred treatment is not available, collaborative care still results in good satisfaction and depression outcomes. C1 Univ S Florida, Dept Aging & Mental Hlth, Tampa, FL 33612 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Kaiser Permanente No Calif, Div Res, Oakland, CA USA. Univ Calif Los Angeles, Ctr Hlth Serv Res, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Indiana Univ, Dept Psychiat, Indianapolis, IN 46204 USA. RP Gum, AM (reprint author), Univ S Florida, Dept Aging & Mental Hlth, 13301 Bruce B Downs Blvd,MHC 1400, Tampa, FL 33612 USA. EM agum@fmhi.usf.edu NR 43 TC 126 Z9 128 U1 5 U2 13 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD FEB PY 2006 VL 46 IS 1 BP 14 EP 22 PG 9 WC Gerontology SC Geriatrics & Gerontology GA 012BH UT WOS:000235312700002 PM 16452280 ER PT J AU Fisher, SE Burgio, LD Thorn, BE Hardin, JM AF Fisher, SE Burgio, LD Thorn, BE Hardin, JM TI Obtaining self-report data from cognitively impaired elders: Methodological issues and clinical implications for nursing home pain assessment SO GERONTOLOGIST LA English DT Article; Proceedings Paper CT 55th Annual Meeting of the Gerontological-Society-of-America CY NOV 22-26, 2002 CL BOSTON, MA SP Gerontol Soc Amer DE clinical assessment; dementia; pain; self report methodology; nursing home; geriatric pain measure ID MINI-MENTAL-STATE; QUALITY-OF-LIFE; ANALGESIC MEDICATION; NORMATIVE DATA; DATA SET; RESIDENTS; 3MS; MANAGEMENT; DEMENTIA; PRESCRIPTION AB Purpose: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Design and Methods: Using a modification of the Geriatric Pain Measure (GPM-M2), we interviewed 61 residents from two nursing homes (Mini-Mental State Examination score, M = 15 +/- 7) once a week for A consecutive weeks. We collected additional data by means of chart review, cognitive status assessments, and surveys of certified nursing assistants. We used descriptive and correlational analyses to address our primary aims. Results: Eighty-nine percent of residents completed all four scheduled interviews. Cognitive status was not significantly correlated with number of nonresponses and prompts for yes-no questions, but it was significantly correlated with nonresponses and prompts for Likert-scole questions (r = -.48, p <.001 and r = -.59, p <.001, respectively). Completion time for the 17-item pain measure (M = 13 min) was not predicted by cognitive status. Residents' scores on the GPM-M2 were significantly correlated with number of chronic pain-associated diagnoses, r = .37, p <.01, and internal consistency was excellent, alpha = 0.87 - 0.91. Residents' GPM-M2 scores were stable over time, r = .74-.80, p <.0001, for all comparisons. Implications: Using explicit protocols and reporting procedural data allows researchers and clinicians to better understand and apply results of self-report studies with cognitively impaired elders. Results suggest that many nursing home residents can provide consistent and reliable self-report pain data, given appropriate time and assistance. C1 Univ Alabama, Dept Psychol, Tuscaloosa, AL 35487 USA. Univ Alabama, Ctr Mental Hlth & Aging, Tuscaloosa, AL 35487 USA. Univ Alabama, Dept Informat Syst Stat & Management Sci, Tuscaloosa, AL 35487 USA. RP Fisher, SE (reprint author), VA Pittsburgh Healthcare Syst, Behav Hlth Serv Line 116A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM sfisher@bama.ua.edu FU CMHS SAMHSA HHS [H79 SM 54569-01]; NINR NIH HHS [R03 NR008517] NR 41 TC 18 Z9 18 U1 1 U2 2 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 0016-9013 J9 GERONTOLOGIST JI Gerontologist PD FEB PY 2006 VL 46 IS 1 BP 81 EP 88 PG 8 WC Gerontology SC Geriatrics & Gerontology GA 012BH UT WOS:000235312700009 PM 16452287 ER PT J AU Million, M Wang, L Wang, Y Adelson, DW Yuan, PQ Maillot, C Coutinho, SV Mcroberts, JA Bayati, A Mattsson, H Wu, V Wei, JY Rivier, J Vale, W Mayer, EA Tache, Y AF Million, M Wang, L Wang, Y Adelson, DW Yuan, PQ Maillot, C Coutinho, SV Mcroberts, JA Bayati, A Mattsson, H Wu, V Wei, JY Rivier, J Vale, W Mayer, EA Tache, Y TI CRF2 receptor activation prevents colorectal distension induced visceral pain and spinal ERK1/2 phosphorylation in rats SO GUT LA English DT Article ID CORTICOTROPIN-RELEASING-FACTOR; IRRITABLE-BOWEL-SYNDROME; STRESS-RELATED ALTERATIONS; GENE-RELATED PEPTIDE; RECTAL DISTENSION; MOTOR FUNCTION; COMPETITIVE ANTAGONISTS; AFFERENT-FIBERS; DORSAL-HORN; MAP KINASE AB Background and aims: Activation of corticotropin releasing factor 1 ( CRF1) receptors is involved in stress related responses and visceral pain, while activation of CRF2 receptors dampens the endocrine and some behavioural stress responses. We hypothesised that CRF2 receptor activation may influence visceral pain induced by colorectal distension ( CRD) in conscious rats, and assessed the possible sites and mechanisms of action. Methods: Male Sprague-Dawley rats were exposed to CRDs ( 60 mm Hg, 10 minutes twice, with a 10 minute rest interval). Visceromotor responses ( VMR) were measured by electromyography or visual observation. Spinal ( L6-S1) extracellular signal regulated kinase 1/2 ( ERK 1/2) activation following in vivo CRD and CRF2 receptor gene expression in the T13-S1 dorsal root ganglia ( DRG) and spinal cord were determined. Inferior splanchnic afferent ( ISA) activity to CRD ( 0.4 ml, 20 seconds) was assessed by electrophysiological recording in an in vitro ISA nerve-inferior mesenteric artery ( intra-arterial)-colorectal preparation. Results: In controls, VMR to the second CRD was mean 31 ( SEM 4)% higher than that of the first ( p < 0.05). The selective CRF2 agonist, human urocortin 2 ( hUcn 2, at 10 and 20 mu g/kg), injected intravenous after the first distension, prevented sensitisation and reduced the second response by 8 ( 1)% and 30 ( 5)% ( p, 0.05) compared with the first response, respectively. RT-PCR detected CRF2 receptor gene expression in the DRG and spinal cord. CRD ( 60 mm Hg for 10 minutes) induced phosphorylation of ERK 1/2 in neurones of lumbosacral laminae I and IIo and the response was dampened by intravenous hUcn 2. CRD, in vitro, induced robust ISA spike activity that was dose dependently blunted by hUcn 2 ( 1-3 mu g, intra-arterially). The CRF2 receptor antagonist, astressin(2)-B ( 200 mu g/kg subcutaneously or 20 mg intra-arterially) blocked the hUcn 2 inhibitory effects in vivo and in vitro. Conclusions: Peripheral injection of hUcn 2 blunts CRD induced visceral pain, colonic afferent, and spinal L6-S1 ERK 1/2 activity through CRF2 receptor activation in rats. C1 Univ Calif Los Angeles, CURE, Digest Dis Res Ctr,Div Digest Dis, VA Greater Los Angeles Healthcare Syst,Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis, VA Greater Los Angeles Healthcare Syst,Dept Med, Los Angeles, CA USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, La Jolla, CA 92037 USA. AstraZeneca R&D, Molndal, Sweden. RP Million, M (reprint author), 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 [DK41301, DK-57238-01A1S1, DK26741, P-50 DK64539, P01 DK026741, P30 DK041301, P50 DK064539, R01 DK-33061, R01 DK-57238] NR 52 TC 78 Z9 80 U1 0 U2 2 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 FEB PY 2006 VL 55 IS 2 BP 172 EP 181 DI 10.1136/gut.2005.051391 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 001RH UT WOS:000234553500010 PM 15985561 ER PT J AU Graham, DY AF Graham, DY TI Helicobacter 2006: A note from the editor SO HELICOBACTER LA English DT Editorial Material ID PYLORI INFECTION; INFLAMMATION C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX USA. NR 8 TC 6 Z9 7 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1083-4389 J9 HELICOBACTER JI Helicobacter PD FEB PY 2006 VL 11 IS 1 BP 1 EP 1 DI 10.1111/j.0083-8703.2006.00378.x PG 1 WC Gastroenterology & Hepatology; Microbiology SC Gastroenterology & Hepatology; Microbiology GA 003QW UT WOS:000234697700001 ER PT J AU Yates, J Keeble, W Pals, G Ameziane, N van Spaendonk, R Olson, S Akkari, Y Pasquini, R Bagby, G AF Yates, Jane Keeble, Winifred Pals, Gerard Ameziane, Najim van Spaendonk, Rosalina Olson, Susan Akkari, Yassmine Pasquini, Ricardo Bagby, Grover TI Novel Inactivating Mutations of FANCC in Brazilian Patients with Fanconi Anemia SO HUMAN MUTATION LA English DT Article DE Fanconi; Fanconi anemia; FANCC; splice site mutation; mitomycin C; chromosome instability AB We have identified three novel FANCC mutations, a truncating single base insertion in exon 4 (c.455_456dupA), a point mutation in exon 13 (c.1390C>T), and a splice site mutation leading to deletion of exon 9, in two Brazilian FA-C patients, each a compound heterozygote. Using complementation analyses, we confirmed that two of these mutations inactivate the function of the FANCC protein. Published 2006 Wiley-Liss, Inc. C1 [Yates, Jane; Keeble, Winifred; Bagby, Grover] OHSU Canc Inst, Portland, OR 97239 USA. [Olson, Susan; Akkari, Yassmine; Bagby, Grover] OHSU Canc Inst, Dept Mol & Med Genet, Sch Med, Portland, OR 97239 USA. [Bagby, Grover] Oregon Hlth & Sci Univ, Dept Med, Sch Med, Portland, OR 97201 USA. [Yates, Jane; Keeble, Winifred; Bagby, Grover] Portland VA Med Ctr, Portland, OR USA. [Pals, Gerard; Ameziane, Najim; van Spaendonk, Rosalina] Vrije Univ Amsterdam Med Ctr, Dept Genet, Amsterdam, Netherlands. [Pasquini, Ricardo] Hosp Clin Fed Univ Parana, Curitiba, Parana, Brazil. RP Bagby, G (reprint author), OHSU Canc Inst, CR145,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM grover@ohsu.edu OI Bagby, Grover/0000-0001-6830-2046 FU NIH [P01 HL148546, R01 HL72321-01]; Fanconi Anemia Research Fund; Department of Veterans Affairs FX This study was supported in part by grants from NIH (P01 HL148546, R01 HL72321-01), the Fanconi Anemia Research Fund, and the Department of Veterans Affairs. NR 19 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1059-7794 EI 1098-1004 J9 HUM MUTAT JI Hum. Mutat. PD FEB PY 2006 VL 27 IS 2 DI 10.1002/humu.9402 PG 8 WC Genetics & Heredity SC Genetics & Heredity GA V39QS UT WOS:000209426100008 PM 16429406 ER PT J AU Lyden, PD Krieger, D Yenari, M Dietrich, WD AF Lyden, Patrick D. Krieger, Derk Yenari, Miclori Dietrich, W. Dalton TI Therapeutic hypothermia for acute stroke SO INTERNATIONAL JOURNAL OF STROKE LA English DT Review ID CEREBRAL-ARTERY OCCLUSION; TRANSIENT GLOBAL-ISCHEMIA; DELAYED POSTISCHEMIC HYPOTHERMIA; MILD RESUSCITATIVE HYPOTHERMIA; TISSUE-PLASMINOGEN ACTIVATOR; PERMANENT FOCAL ISCHEMIA; DAMAGE COOL AID; MODERATE HYPOTHERMIA; SHIVERING THRESHOLD; FOREBRAIN ISCHEMIA AB Hypothermia is the most potent neuroprotective therapy available. Clinical use of hypothermia is limited by technology and homeostatic mechanisms that maintain core body temperature. Recent advances in intravascular cooling catheters and successful trials of hypothermia for cardiac arrest revivified interest in hypothermia for stroke, resulting in Phase 1 clinical trials and plans for further development. Given the recent spate of neuroprotective therapy failures, we sought to clarify whether clinical trials of therapeutic hypothermia should be mounted in stroke patients. We reviewed the preclinical and early clinical trials of hypothermia for a variety of indications, the putative mechanisms for neuroprotection with hypothermia, and offer several hypotheses that remain to be tested in clinical trials. Therapeutic hypothermia is promising, but further Phase 1 and Phase 2 development efforts are needed to ensure that cooling of stroke patients is safe, before definitive efficacy trials. C1 Univ Calif San Diego, Stroke Ctr, San Diego, CA 92103 USA. Univ Calif San Diego, Neurol & Res Serv, San Diego Vet Adm Med Ctr, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA. Cleveland Clin Fdn, Sect Stroke & Neurol Crit Care, Cleveland, OH 44195 USA. Univ Calif San Francisco, Sch Med, Dept Neurol, San Francisco, CA 94143 USA. San Francisco Vet Adm Med Ctr, Dept Neurol, San Francisco, CA USA. Univ Miami, Sch Med, Dept Neurol Surg, Miami, FL 33136 USA. RP Lyden, PD (reprint author), Univ Calif San Diego, Stroke Ctr, OPC 3rd Floor,Suite 3,200 W Arbor Dr, San Diego, CA 92103 USA. EM plyden@ucsd.edu NR 119 TC 56 Z9 60 U1 0 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1747-4930 J9 INT J STROKE JI Int. J. Stroke PD FEB PY 2006 VL 1 IS 1 BP 9 EP 19 DI 10.1111/j.1747-4949.2005.00011.x PG 11 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 178DK UT WOS:000247201200004 PM 18706063 ER PT J AU Gupta, RS Carrion-Carire, V Weiss, KB AF Gupta, RS Carrion-Carire, V Weiss, KB TI The widening black/white gap in asthma hospitalizations and mortality SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Article DE asthma; disparities; hospitalizations; mortality ID HEALTH-INSURANCE PROGRAM; CHILDHOOD ASTHMA; EMERGENCY-DEPARTMENT; ETHNIC DISPARITIES; URBAN CHILDREN; UNITED-STATES; PRIMARY-CARE; GUIDELINES; REDUCTION; MEDICAID AB Background: Large racial differences in asthma morbidity and mortality have prompted research on new interventions, public awareness, and health policy efforts in the past decade. Objective: We sought to characterize recent trends in US asthma hospitalization and mortality for black and white children and adults during the period from 1980 through 2002. Methods: We conducted a successive representative national cohort study of US residents ages 5 to 34 years using data from the National Hospital Discharge Survey and the US vital statistics system. Outcome measures included black/white (B/W) asthma hospitalization and mortality rates, rate ratios, and rate differences. Results: For asthma hospitalizations from 1980 through 2002, children ages 5 to 18 years had a 50% increase in the B/W rate ratio, and the rate difference increased from 22.8 to 28.3 hospitalizations per 10,000 population. For young adults ages 19 to 34 years, the B/W rate ratio increased from 2.3 to 2.8, and the rate difference decreased front 9.6 to 7.9 hospitalizations per 10,000 population. For asthma mortality front 1980 through 2001, children ages 5 to 19 years had a large increase in the B/W rate ratio from 4.5 to 5.6 and in the rate difference from 5.6 to 8.1 deaths per 1,000,000 population. There did not appear to be a significant change in the B/W differences for adults ages 20 to 34 years. Conclusions: For children, there have been notable increases in asthma B/W differences in hospitalizations and mortality since 1980, whereas for adults the increase has been smaller. National efforts to improve asthma care over the past decade do not appear to have reduced this B/W gap. When treating children with asthma, it is important to consider the racial-ethnic factors that might lead to avoidable hospitalizations and premature mortality. C1 Inst Healthcare Studies, Chicago, IL 60611 USA. Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med, Chicago, IL USA. Childrens Mem Hosp, Smith Child Hlth Res Program, Chicago, IL USA. Vet Affairs Edward Hines Jr Hosp, US Dept Vet Affairs, Midwest Ctr Hlth Serv & Policy Res, Hines, IL USA. RP Gupta, RS (reprint author), Inst Healthcare Studies, 339 E Chicago Ave,Room 712, Chicago, IL 60611 USA. EM r-gupta@northwestern.edu RI Dalla Zuanna, Teresa/G-3133-2015 FU AHRQ HHS [T32HS00078-07] NR 41 TC 86 Z9 87 U1 0 U2 3 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 BP 351 EP 358 DI 10.1016/j.jaci.2005.11.047 PG 8 WC Allergy; Immunology SC Allergy; Immunology GA 017IM UT WOS:000235687300018 PM 16461136 ER PT J AU Bermant, C Pratt, A Opsahl, M Sanchez, H Bush, RK AF Bermant, C Pratt, A Opsahl, M Sanchez, H Bush, RK TI Production of a cDNA library to Harmonia axyridis multicolor lady beetle SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 62nd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 03-07, 2006 CL Miami Beach, FL SP Amer Acad Allergy, Asthma & Immunol C1 William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 SU S MA 1195 BP S310 EP S310 DI 10.1016/j.jaci.2005.12.1222 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 019VR UT WOS:000235865302273 ER PT J AU Esch, RF Bush, RK Peden, D Lockey, RF AF Esch, RF Bush, RK Peden, D Lockey, RF TI Sublingual-oral administration of standardized allergenic extracts/vaccines: Safety and dosing studies SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 62nd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 03-07, 2006 CL Miami Beach, FL SP Amer Acad Allergy, Asthma & Immunol C1 Greer Labs, Lenoir, NC USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Univ N Carolina, Chapel Hill, NC USA. Univ S Florida, Tampa, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 SU S MA 348 BP S89 EP S89 DI 10.1016/j.jaci.2005.12.357 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 019VR UT WOS:000235865300348 ER PT J AU Hsu, RT Crawford, WW Klaustermeyer, WB AF Hsu, RT Crawford, WW Klaustermeyer, WB TI Patients with intermittent asthma account for a substantial portion of asthma-related hospital emergency department visits SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 62nd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 03-07, 2006 CL Miami Beach, FL SP Amer Acad Allergy, Asthma & Immunol C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Kaiser Permanente, Harbor City, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 SU S MA 1067 BP S276 EP S276 DI 10.1016/j.jaci.2005.12.1144 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 019VR UT WOS:000235865302145 ER PT J AU Knuffman, JE Sanchez, H Opsahl, MA Sorkness, RL Bush, RK AF Knuffman, JE Sanchez, H Opsahl, MA Sorkness, RL Bush, RK TI Effects of allergen challenge on a chronic animal model of Alternaria sensitivity SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 62nd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 03-07, 2006 CL Miami Beach, FL SP Amer Acad Allergy, Asthma & Immunol C1 Univ Wisconsin, Madison, WI USA. Univ Wisconsin Hosp & Clin, William S Middleton Mem Vet Adm Hosp, Madison, WI 53792 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 SU S MA 443 BP S113 EP S113 DI 10.1016/j.jaci.2005.12.454 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 019VR UT WOS:000235865300443 ER PT J AU Randhawa, IS Yanni, G AF Randhawa, IS Yanni, G TI Cartilage-Hair Hypoplasia syndrome: A pediatric case report of nonalcoholic steatohepatitis and liver failure SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 62nd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY MAR 03-07, 2006 CL Miami Beach, FL SP Amer Acad Allergy, Asthma & Immunol C1 Univ Calif Los Angeles, W Los Angeles VA, Los Angeles, CA USA. Loma Linda Univ, Med Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD FEB PY 2006 VL 117 IS 2 SU S MA 1127 BP S292 EP S292 DI 10.1016/j.jaci.2005.12.1101 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 019VR UT WOS:000235865302205 ER PT J AU Shelburne, SA Montes, M Hamill, RJ AF Shelburne, SA Montes, M Hamill, RJ TI Immune reconstitution inflammatory syndrome: more answers, more questions SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE HIV; HAART; paradoxical reaction; restoration ID ACTIVE ANTIRETROVIRAL THERAPY; HIV-INFECTED PATIENTS; RESTORATION DISEASE; COMBINATION THERAPY; PROTEASE-INHIBITOR; RISK-FACTORS; INITIATION; TUBERCULOSIS; AIDS; TYPE-1 AB The institution of highly active antiretroviral therapy (HAART) in HIV-infected patients restores protective immune responses against a wide variety of pathogens and dramatically decreases mortality. In a subset of patients receiving HAART, immune reconstitution is associated with a pathological inflammatory response leading to substantial short-term morbidity and even mortality. The past several years have seen marked advances in our clinical understanding of the immune reconstitution inflammatory syndrome (IRIS), but many questions remain. This article summarizes recent data on clinical risk factors for the development of IRIS. A consistent finding from multiple groups is that IRIS develops in a substantial percentage of HIV-infected patients who have an underlying opportunistic infection and receive HAART. As the use of HAART stands to markedly increase over the next several years, optimal care of patients receiving HAART will need to incorporate monitoring for and treating complications of IRIS. C1 Baylor Coll Med, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Sect Infect Dis 111G, Houston, TX 77030 USA. RP Hamill, RJ (reprint author), Baylor Coll Med, Dept Med, Infect Dis Sect, 1 Baylor Plaza, Houston, TX 77030 USA. EM richard.hamill@med.va.gov FU NCRR NIH HHS [K12 RR17665] NR 33 TC 147 Z9 157 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD FEB PY 2006 VL 57 IS 2 BP 167 EP 170 DI 10.1093/jac/dki444 PG 4 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 007KJ UT WOS:000234967400002 PM 16354748 ER PT J AU Morgan, AL Masoudi, FA Havranek, EP Jones, PG Peterson, PN Krumholz, HM Spertus, JA Rumsfeld, JS AF Morgan, AL Masoudi, FA Havranek, EP Jones, PG Peterson, PN Krumholz, HM Spertus, JA Rumsfeld, JS CA CORC TI Difficulty taking medications, depression, and health status in heart failure patients SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE heart failure; quality of life; depression ID CASE-FINDING INSTRUMENTS; QUALITY-OF-LIFE; MYOCARDIAL-INFARCTION; TREATMENT ADHERENCE; ELDERLY PATIENTS; RISK; DISEASE; SYMPTOMS; MORTALITY; DEATH AB Background: Little is known about medication nonadherence in heart failure populations. We evaluated the association between I aspect of medication nonadherence, patient-reported difficulty taking medications as directed, and health status among heart failure outpatients, and then examined whether this association was explained by depression. Methods and Results: A total of 522 outpatients with left ventricular ejection fraction < 0.40 completed clinical evaluation, Kansas City Cardiomyopathy Questionnaire (KCCQ), Medical Outcomes Study-Depression questionnaire, and categorized their difficulty taking medications (5-level Likert-scale question). Multivariable regression was used to evaluate the cross-sectional association between difficulty taking medications and health status, with incremental adjustment for medical history and depressive symptoms. Patients with difficulty taking medications (n = 64; 12.2%) had worse health status (8.2 +/- 2.7 point lower mean KCCQ summary scores; P =.008) and more depressive symptoms (43.8% versus 27.1%; P =.006). Adjusting for demographic and clinical factors had little effect on the association between difficulty taking medications and health status (8.0 +/- 3.2 point lower KCCQ scores; P=.01); however, the relationship was attenuated with adjustment for depressive symptoms (4.7 +/- 2.9 point lower KCCQ scores; P = 11). Conclusions: Among heart failure outpatients, difficulty taking medications is associated with worse health status. This association appears to be explained, in part, by coexistent depression. Future studies should evaluate interventions such as depression treatment to improve medication adherence and health status. C1 Denver VA Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver Hlth Med Ctr, Denver, CO USA. UMKC, Mid Amer Heart Inst, Kansas City, MO USA. Yale Univ, Med Ctr, New Haven, CT USA. RP Rumsfeld, JS (reprint author), Denver VA Med Ctr, 1055 Clermont St, Denver, CO 80220 USA. FU NIA NIH HHS [K08-AG01011] NR 34 TC 57 Z9 57 U1 3 U2 4 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD FEB PY 2006 VL 12 IS 1 BP 54 EP 60 DI 10.1016/j.cardfail.2005.08.004 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 021VH UT WOS:000236013500005 PM 16500581 ER PT J AU Li, WJ Luo, YM Zhang, F Signore, AP Gobbel, GT Simon, RP Chen, J AF Li, WJ Luo, YM Zhang, F Signore, AP Gobbel, GT Simon, RP Chen, J TI Ischemic preconditioning in the rat brain enhances the repair of endogenous oxidative DNA damage by activating the base-excision repair pathway SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE DNA damage and repair; neuroprotection; neuronal survival; oxidative stress; tolerance to ischemia ID FOCAL CEREBRAL-ISCHEMIA; CYCLIN-DEPENDENT KINASES; APOPTOSIS-INDUCING FACTOR; ELEMENT-BINDING PROTEIN; NEURONAL CELL-DEATH; POLYMERASE-BETA; ALKYLATING AGENT; MAMMALIAN-CELLS; STRAND BREAKS; POLY(ADP-RIBOSE) POLYMERASE AB The development of ischemic tolerance in the brain, whereby a brief period of sublethal 'preconditioning' ischemia attenuates injury from subsequent severe ischemia, may involve the activation of multiple intracellular signaling events that promote neuronal survival. In this study, the potential role of inducible DNA base-excision repair (BER), an endogenous adaptive response that prevents the detrimental effect of oxidative DNA damage, has been studied in the rat model of ischemic tolerance produced by three episodes of ischemic preconditioning (IP). This paradigm of IP, when applied 2 and 5 days before 2-h middle cerebral artery occlusion (MCAO), significantly decreased infarct volume in the frontal-parietal cortex 72 h later. Correlated with this protective effect, IP markedly attenuated the nuclear accumulations of several oxidative DNA lesions, including 8-oxodG, AP sites, and DNA strand breaks, after 2-h MCAO. Consequently, harmful DNA damage-responsive events, including NAD depletion and p53 activation, were reduced during postischemic reperfusion in preconditioned brains. The mechanism underlying the decreased DNA damage in preconditioned brain was then investigated by measuring BER activities in nuclear extracts. Beta-polymerase-mediated BER activity was markedly increased after IP, and this activation occurred before ( 24 h) and during the course of ischemic tolerance ( 48 to 72 h). In similar patterns, the activities for AP site and 8-oxodG incisions were also upregulated after IP. The upregulation of BER activities after IP was likely because of increased expression of repair enzymes beta-polymerase, AP endonuclease, and OGG1. These results suggest that the activation of the BER pathway may contribute to IP-induced neuroprotection by enhancing the repair of endogenous oxidative DNA damage after ischemic injury. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Neurosurg, Pittsburgh, PA 15213 USA. Oregon Hlth Sci Univ, Dept Neurol Physiol & Pharmacol, Portland, OR 97201 USA. RS Dow Neurobiol Labs, Legacy Res, Portland, OR USA. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 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 FU NINDS NIH HHS [NS35965, NS36736, NS38560, NS45048] NR 77 TC 50 Z9 54 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD FEB PY 2006 VL 26 IS 2 BP 181 EP 198 DI 10.1038/sj.jcbfm.9600180 PG 18 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 021HZ UT WOS:000235975600004 PM 16001017 ER PT J AU Griffen, SC Oostema, K Stanhope, KL Graham, J Styne, DM Glaser, N Cummings, DE Connors, MH Havel, PJ AF Griffen, SC Oostema, K Stanhope, KL Graham, J Styne, DM Glaser, N Cummings, DE Connors, MH Havel, PJ TI Administration of lispro insulin with meals improves glycemic control, increases circulating leptin, and suppresses ghrelin, compared with regular/NPH insulin in female patients with type 1 diabetes SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID BODY-WEIGHT REGULATION; GLUCOSE-METABOLISM; ENERGY HOMEOSTASIS; ADIPOCYTE HORMONES; ADOLESCENT GIRLS; ACYLATED PEPTIDE; PLASMA LEPTIN; ACTIVE FORM; FOOD-INTAKE; SHORT-TERM AB Context: Overweight and obesity are overrepresented in adolescents with type 1 diabetes mellitus (T1DM). Exogenous insulin administration often poorly reproduces normal insulin patterns and may less effectively regulate leptin and ghrelin, two hormones involved in the control of appetite and adiposity. Objective: The objective of the study was to determine whether insulin regimens that better replicate normal insulin patterns and augment postprandial nutrient disposal may help normalize leptin and ghrelin and improve body weight regulation. Design, Setting, and Participants: Ten young women with T1DM were studied in this 2-wk prospective, balanced crossover-design study at the University of California, Davis. Intervention: Participants received either a single injection of regular + NPH insulin (R + N) or two mealtime injections of Lispro insulin in randomized order on 2 separate days. Meal composition and total insulin administered were the same on both treatment days. Main Outcome Measures: Plasma glucose, insulin, leptin, and ghrelin concentrations were monitored over the 10-h study period. Results: Lispro produced two distinct mealtime peaks of insulin, compared with one prolonged rise with R + N. Lispro reduced postprandial hyperglycemia and total glucose area under the curve. Leptin increased more on the Lispro (2.7 +/- 0.7 vs. 0.7 +/- 0.5 ng/ml, P = 0.02). Ghrelin was more suppressed after lunch with Lispro ( P = 0.004). Conclusions: Injection of Lispro insulin with meals produces more physiological insulin patterns, better glucose control, and improved leptin and ghrelin regulation than R + N. More closely mimicking normal insulin, leptin, and ghrelin responses to meals with fast-acting insulin may have implications for body weight regulation in T1DM. C1 Univ Calif Davis, Dept Endocrinol, Davis, CA 95616 USA. Univ Calif Davis, Dept Pediat, Davis, CA 95616 USA. Univ Calif Davis, Sch Med, Davis, CA 95616 USA. Univ Calif Davis, Dept Nutr, Davis, CA 95616 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Endocrinol, Seattle, WA 98108 USA. RP Griffen, SC (reprint author), Univ Calif Davis, Med Ctr, Patient Support & Serv Bldg,Suite G-400,4150 V St, Sacramento, CA 95817 USA. EM scgriffen@ucdavis.edu FU NCRR NIH HHS [RR 019975]; NHLBI NIH HHS [HL 075675]; NIDDK NIH HHS [DK 58108, DK 002619, DK 35747, DK 50129] NR 40 TC 21 Z9 23 U1 0 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 FEB PY 2006 VL 91 IS 2 BP 485 EP 491 DI 10.1210/jc.2005-1338 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 010CC UT WOS:000235161200021 PM 16317063 ER PT J AU Liao, JC Mastali, M Gau, V Suchard, MA Moller, AK Bruckner, DA Babbitt, JT Li, Y Gornbein, J Landaw, EM McCabe, ERB Churchill, BM Haake, DA AF Liao, JC Mastali, M Gau, V Suchard, MA Moller, AK Bruckner, DA Babbitt, JT Li, Y Gornbein, J Landaw, EM McCabe, ERB Churchill, BM Haake, DA TI Use of electrochemical DNA biosensors for rapid molecular identification of uropathogens in clinical urine specimens SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID NUCLEIC-ACID AMPLIFICATION; 16S RIBOSOMAL-RNA; ESCHERICHIA-COLI; TRACT-INFECTIONS; UROLOGIC DISEASES; AMERICA PROJECT; AMPEROMETRIC DETECTION; RESOURCE USE; PCR; BACTERIA AB We describe the first species-specific detection of bacterial pathogens in human clinical fluid samples using a microfabricated electrochemical sensor array. Each of the 16 sensors in the array consisted of three single-layer gold electrodes-working, reference, and auxiliary. Each of the working electrodes contained one representative from a library of capture probes, each specific for a clinically relevant bacterial urinary pathogen. The library included probes for Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Entero-cococcits spp., and the Klebsiella-Enterobacter group. A bacterial 16S rRNA target derived from single-step bacterial lysis was hybridized both to the biotin-modified capture probe on the sensor surface and to a second, fluorescein-modified detector probe. Detection of the target-probe hybrids was achieved through binding of a horseradish peroxidase (HRP)-conjugated anti-fluorescein antibody to the detector probe. Amperometric measurement of the catalyzed HRP reaction was obtained at a fixed potential of -200 mV between the working and reference electrodes. Species-specific detection of as few as 2,600 uropathogenic bacteria in culture, inoculated urine, and clinical urine samples was achieved within 45 ruin from the beginning of sample processing. In a feasibility study of this amperometric detection system using blinded clinical urine specimens, the sensor array had 100% sensitivity for direct detection of gram-negative bacteria without nucleic acid purification or amplification. Identification was demonstrated for 98% of gram-negative bacteria for which species-specific probes were available. When combined with a microfluidics-based sample preparation module, the integrated system could serve as a point-of-care device for rapid diagnosis of urinary tract infections. C1 VA Greater LA Healthcare, Div Infect Dis, Los Angeles, CA 90073 USA. GenFluides Inc, Montery Pk, CA 91754 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 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 Biomath, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. RP Haake, DA (reprint author), VA Greater LA Healthcare, Div Infect Dis, 111F, Los Angeles, CA 90073 USA. EM dhaake@ucla.edu RI Liao, Joseph/J-5874-2015 FU NIBIB NIH HHS [EB00127, R01 EB000127] NR 52 TC 133 Z9 134 U1 6 U2 38 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD FEB PY 2006 VL 44 IS 2 BP 561 EP 570 DI 10.1128/JCM.44.2.561-570.2006 PG 10 WC Microbiology SC Microbiology GA 012MV UT WOS:000235344200042 PM 16455913 ER PT J AU Allen, NL Leeth, RR Finan, KR Tishler, DS Vickers, SM Wilcox, CM Hawn, MT AF Allen, NL Leeth, RR Finan, KR Tishler, DS Vickers, SM Wilcox, CM Hawn, MT TI Outcomes of cholecystectomy after endoscopic sphincterotomy for choledocholithiasis SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-of-American-Gastrointestinal-Endoscopic-Surgeons (SAGES) CY MAR 31-APR 03, 2004 CL Denver, CO SP Soc Amer Gastrointestinal Endoscop Surg DE cholecystectomy; choledocholithiasis; endoscopic; sphincterotomy; outcomes ID BILE-DUCT STONES; GALLBLADDER IN-SITU; TERM-FOLLOW-UP; LAPAROSCOPIC CHOLECYSTECTOMY; ACUTE CHOLECYSTITIS; 10-YEAR EXPERIENCE; PROSPECTIVE TRIAL; RANDOMIZED TRIAL; MANAGEMENT; RISK AB Laparoscopic cholecystectomy (LC) for treatment of symptomatic common bile duct stones (CBDS) after endoscopic sphincterotomy (ES) is associated with increased conversion and complications compared with other indications. We examined factors associated with conversion and complications of LC after ES. A retrospective study of 32 patients undergoing ES for CBDS followed by cholecystectomy was undertaken. Surgical outcomes for this group were compared with a control population of 499 LCs for all other indications. Factors associated with open cholecystectomy and complications in the ES group were analyzed. Patients undergoing LC preceded by ES had a significantly higher complication (odds ratio [OR] 7.97; 95% CI, 2.84-22.5) and conversion rate (OR = 3.45; 95% CI, 1.56-7.66) compared with LC for all other indications. Pre-ES serum bilirubin greater than 5 mg/dL was predictive of conversion (positive predictive value = 63 %, P < 0.005). Patients with symptomatic CBDS that undergo LC after ES have higher complication and conversion rates than patients undergoing LC without ES. Pre-ES serum bilirubin is useful in identifying patients who may not have a successful laparoscopic approach at cholecystectomy. C1 Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. Univ Alabama, Dept Gastroenterol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Hawn, MT (reprint author), Univ Alabama, Dept Surg, KB 417,1530 3rd Ave S, Birmingham, AL 35294 USA. EM mhawn@uab.edu NR 17 TC 17 Z9 18 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD FEB PY 2006 VL 10 IS 2 BP 292 EP 296 DI 10.1016/j.gassur.2005.05.013 PG 5 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 013DB UT WOS:000235388700025 PM 16455464 ER PT J AU Givens, JL Datto, CJ Ruckdeschel, K Knott, K Zubritsky, C Oslin, DW Nyshadham, S Vanguri, P Barg, FK AF Givens, JL Datto, CJ Ruckdeschel, K Knott, K Zubritsky, C Oslin, DW Nyshadham, S Vanguri, P Barg, FK TI Older patients' aversion to antidepressants - A qualitative study SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 28th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 11-14, 2005 CL New Orleans, LA SP Soc Gen Internal Med DE antidepressants; patient preferences; qualitative research; geriatrics ID PRIMARY-CARE PATIENTS; RANDOMIZED CONTROLLED-TRIAL; GERIATRIC DEPRESSION; GENERAL-PRACTICE; MENTAL-ILLNESS; HEALTH-CARE; LATE-LIFE; DISORDERS; MEDICINES; ADHERENCE AB BACKGROUND: Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE: To explore attitudes toward antidepressants in a sample of depressed, community-dwelling elders who were offered treatment. DESIGN: Cross-sectional, qualitative study utilizing semi-structured interviews. PARTICIPANTS: Primary care patients age 60 years and over with depression, from academic and community primary care practices of the University of Pennsylvania Health System and the Philadelphia Department of Veterans Affairs. Patients participated in either the Prevention of Suicide in Primary Care Elderly: Collaborative Trial or the Primary Care Research in Substance Abuse and Mental Health for the Elderly Trial. Sixty-eight patients were interviewed and responses from 42 participants with negative attitudes toward medication for depression were analyzed. MEASUREMENTS: Interviews were audiotaped, transcribed, and entered into a qualitative software program for coding and analysis. A multidisciplinary team of investigators coded the transcripts and identified key features of narratives expressing aversion to antidepressants. RESULTS: Four themes characterized resistance to antidepressants: (1) fear of dependence; (2) resistance to viewing depressive symptoms as a medical illness; (3) concern that antidepressants will prevent natural sadness; (4) prior negative experiences with medications for depression. CONCLUSIONS: Many elders resisted the use of antidepressants. Patients expressed concerns that seem to reflect their concept of depression as well as their specific concerns regarding antidepressants. These findings may enhance patient-provider communication about depression treatment in elders. C1 Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. Univ Penn, Sch Arts & Sci, Philadelphia, PA 19104 USA. Univ Penn, Dept Family Practice & Community Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Anthropol, Philadelphia, PA 19104 USA. RP Givens, JL (reprint author), 1226 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM jagivens@mail.med.upenn.edu FU CMHS SAMHSA HHS [1UD1SM53033]; NIMH NIH HHS [5P30MH52129, P30 MH066270, P30-MH066270] NR 40 TC 60 Z9 63 U1 3 U2 13 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 FEB PY 2006 VL 21 IS 2 BP 146 EP 151 DI 10.1111/j.1525-1497.2005.00296.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 019WK UT WOS:000235867800011 PM 16336620 ER PT J AU Saha, S AF Saha, S TI The relevance of cultural distance between patients and physicians to racial disparities in health care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID OF-VETERANS-AFFAIRS; PERCEPTIONS; PERFORMANCE; QUALITY; RATINGS; STYLE; RACE C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Dept Med, Gen Internal Med Sect, Portland, OR USA. RP Saha, S (reprint author), Portland VAMC P3MED, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM sahas@ohsu.edu NR 23 TC 5 Z9 5 U1 3 U2 5 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 FEB PY 2006 VL 21 IS 2 BP 203 EP 205 DI 10.1007/s11606-006-0262-1 PG 3 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 019WK UT WOS:000235867800023 PM 16606385 ER PT J AU Fihn, SD AF Fihn, SD TI Moving implementation science forward SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, HSR&D 152, Seattle, WA 98108 USA. RP Fihn, SD (reprint author), VA Puget Sound Hlth Care Syst, HSR&D 152, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 4 TC 5 Z9 5 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 FEB PY 2006 VL 21 SU 2 BP S65 EP S66 DI 10.1111/j.1525-1497.2006.00365.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600011 PM 16637963 ER PT J AU Hagedorn, H Hogan, M Smith, JL Bowman, C Curran, GM Espadas, D Kimmel, B Kochevar, L Legro, MW Sales, AE AF Hagedorn, H Hogan, M Smith, JL Bowman, C Curran, GM Espadas, D Kimmel, B Kochevar, L Legro, MW Sales, AE TI Lessons learned about implementing research evidence into clinical practice - Experiences from VA QUERI SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art of Implementation Conference CY AUG 30-SEP 01, 2004 CL Washington, DC SP Dept Vet Affairs, Off Res & Dev, Hlth Serv Res & Dev Serv DE implementation research; quality improvement; evidence-based medicine; guidelines ID QUALITY IMPROVEMENT; MEDICAL-RECORD; VETERANS AB The mission of the Veterans Health Administration's [VHA) quality enhancement research initiative (QUERI) is to enhance the quality of VHA health care by implementing clinical research findings into routine care. This paper presents lessons that QUERI investigators have learned through their initial attempts to pursue the QUERI mission. The lessons in this paper represent those that were common across multiple QUERI projects and were mutually agreed on as having substantial impact on the success of implementation. While the lessons are consistent with commonly recognized ingredients of successful implementation efforts, the examples highlight the fact that, even with a thorough knowledge of the literature and thoughtful planning, unexpected circumstances arise during implementation efforts that require flexibility and adaptability. The findings stress the importance of utilizing formative evaluation techniques to identify barriers to successful implementation and strategies to address these barriers. C1 VA Med Ctr, Subst Use Disorders QUERI, Minneapolis, MN 55417 USA. VA Ann Arbor Healthcare Syst, Diabet Mellitus QUERI, Ann Arbor, MI USA. Cent Arkansas Vet Healthcare Syst, Mental Hlth QUERI, Little Rock, AR USA. VA San Diego Healthcare Syst, HIV QUERI, San Diego, CA USA. Houston VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Minneapolis VA Med Ctr, Colerectal Canc QUERI, Minneapolis, MN USA. VA Puget Sound Healthcare Syst, Spinal Cord Injury QUERI, Seattle, WA USA. VA Puget Sound Healthcare Syst, Ischem Heart Dis QUERI, Seattle, WA USA. RP Hagedorn, H (reprint author), VA Med Ctr, Subst Use Disorders QUERI, 1 Vet Dr 116A9, Minneapolis, MN 55417 USA. EM Hildi.Hagedorn@va.gov RI Sales, Anne/D-9678-2012 OI Sales, Anne/0000-0001-9360-3334 NR 17 TC 40 Z9 41 U1 1 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2006 VL 21 SU 2 BP S21 EP S24 DI 10.1111/j.1525-1497.2006.00358.x PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600004 PM 16637956 ER PT J AU Kiefe, CI Sales, A AF Kiefe, CI Sales, A TI A state-of-the-art conference on implementing evidence in health care - Reasons and recommendations SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID CONCEPTUAL-FRAMEWORK; QUALITY; VETERANS; DISSEMINATION; SYSTEM C1 Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Kiefe, CI (reprint author), Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. EM ckiefe@mail.dopm.uab.edu RI Sales, Anne/D-9678-2012 NR 29 TC 9 Z9 9 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 FEB PY 2006 VL 21 SU 2 BP S67 EP S70 DI 10.1007/s11606-006-0278-6 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600012 PM 16637964 ER PT J AU Kochevar, LK Yano, EM AF Kochevar, LK Yano, EM TI Understanding health care organization needs and context - Beyond performance gaps SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art of Implementation Conference CY AUG 30-SEP 01, 2004 CL Washington, DC SP Dept Vet Affairs, Off Res & Dev, Hlth Serv Res & Dev Serv DE needs assessment; quality improvement; methods; systems analysis ID FAULT-DIAGNOSIS; DYNAMIC-SYSTEMS; INTERVENTIONS; METHODOLOGY; QUALITY; DESIGN AB Significant efforts have been invested in improving our understanding of how to accelerate and magnity the impact of research on clinical practice. While approaches to fostering translation of research into practice are numerous, none appears to be superior and the evidence for their effectiveriess is mixed. Lessons learned from formative evaluation have given us a greater-appreciation of the contribution of context to successful implementation of quality improvement interventions. While formative evaluation is a powerful tool for addressing context effects during implementation, lessons learned from the social sciences (including management and operations research, sociology, and public health) show us that there are also powerful preimple-mentation. tools available to us. This paper discusses how we might integrate these tools into implementation research. We provide a theoretical framework for our need to understand organizational contexts and how organizational characteristics can alert us to situations where preimplementation tools will prove most valuable. C1 Minneapolis VA Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN 55417 USA. Minneapolis VA Med Ctr, VA Colerectal Canc QUERI, Minneapolis, MN 55417 USA. VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Kochevar, LK (reprint author), Minneapolis VA Med Ctr, Ctr Chron Dis Outcomes Res, 2E-152,1 Vet Dr, Minneapolis, MN 55417 USA. EM laura.kochevar@med.va.gov NR 44 TC 37 Z9 39 U1 2 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 FEB PY 2006 VL 21 SU 2 BP S25 EP S29 DI 10.1111/j.1525-1497.2006.00359.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600005 PM 16637957 ER PT J AU Rubenstein, LV Pugh, J AF Rubenstein, LV Pugh, J TI Strategies for promoting organizational and practice change by advancing implementation research SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art of Implementation Conference CY AUG 30-SEP 01, 2004 CL Washington, DC SP Dept Vet Affairs, Off Res & Dev, Hlth Serv Res & Dev Serv DE health services research; quality of care; implementation; organizational change; clinical practice ID QUALITY IMPROVEMENT PROGRAM; HEALTH-CARE-SYSTEM; PATIENT OUTCOMES; MANAGED CARE; OF-CARE; INTERVENTIONS; DIFFUSION; FRAMEWORK; SERVICES; LESSONS AB BACKGROUND: The persistence of a large quality gap between what we know about how to produce high quality clinical care and what the public receives has prompted interest in developing more effective methods to get evidence into practice. Implementation research aims to supply such methods. PURPOSE: This article proposes a set of recommendations aimed at establishing a common understanding of what implementation research is, and how to foster its development. METHODS: We developed the recommendations in the context of a translation research conference hosted by the VA for VA and non-VA health services researchers. IMPACTS: Healthcare organizations, journals, researchers and academic institutions can use these recommendations to advance the field of implementation science and thus increase the impact of clinical and health services research on the health and health care of the public. C1 Vet Adm Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Gen Med, San Antonio, TX 78285 USA. RP Rubenstein, LV (reprint author), VA Med Ctr 152, 16111 Plummer St, Sepulveda, CA 91343 USA. EM lisar@rand.org OI Pugh, Jacqueline/0000-0003-4933-141X NR 42 TC 91 Z9 92 U1 1 U2 9 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2006 VL 21 SU 2 BP S58 EP S64 DI 10.1111/j.1525-1497.2006.00364.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600010 PM 16637962 ER PT J AU Sales, A Smith, J Curran, G Kochevar, L AF Sales, A Smith, J Curran, G Kochevar, L TI Models, strategies, and tools - Theory in implementing evidence-based findings into health care practice SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art of Implementation Conference CY AUG 30-SEP 01, 2004 CL Washington, DC SP Dept Vet Affairs, Off Res & Dev, Hlth Serv Res & Dev Serv DE evidence-based medicine; organizational change; professional practice; behavior ID SOCIAL COGNITIVE THEORY; NO MAGIC BULLETS; QUALITY IMPROVEMENT; CONCEPTUAL-FRAMEWORK; GENERAL-PRACTICE; REASONED ACTION; DISSONANCE; INTERVENTIONS; BEHAVIOR; PROGRAM AB This paper presents a case for careful consideration of theory in planning to implement evidence-based practices into clinical care. As described, theory should be tightly linked to strategic planning through careful choice or creation of an implementation framework. Strategies should be linked to specific interventions and/or intervention components to be implemented, and the choice of tools should match the interventions and overall strategy, linking back to the original theory and framework. The thesis advanced is that in most studies where there is an attempt to implement planned change in clinical processes, theory is used loosely. An example of linking theory to intervention design is presented from a Mental Health Quality Enhancement Research Initiative effort to increase appropriate use of antipsychotic medication among patients with schizophrenia in the Veterans Health Administration. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence 152, Seattle, WA 98108 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Little Rock VA Med Ctr, Little Rock, AR USA. Univ Arkansas, Dept Psychiat, Little Rock, AR 72204 USA. Minneapolis VA Med Ctr, Minneapolis, MN USA. RP Sales, A (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence 152, 1660 S Columbian Way, Seattle, WA 98108 USA. EM ann.sales@med.va.gov RI Sales, Anne/D-9678-2012 OI Sales, Anne/0000-0001-9360-3334 NR 70 TC 58 Z9 58 U1 1 U2 15 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 FEB PY 2006 VL 21 SU 2 BP S43 EP S49 DI 10.1111/j.1525-1497.2006.00362.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600008 PM 16637960 ER PT J AU Stetler, CB Legro, MW Wallace, CM Bowman, C Guihan, M Hagedorn, H Kimmel, B Sharp, ND Smith, JL AF Stetler, CB Legro, MW Wallace, CM Bowman, C Guihan, M Hagedorn, H Kimmel, B Sharp, ND Smith, JL TI The role of formative evaluation in implementation research and the QUERI experience SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art of Implementation Conference CY AUG 30-SEP 01, 2004 CL Washington, DC SP Dept Vet Affairs, Off Res & Dev, Hlth Serv Res & Dev Serv DE process assessment (health care); evaluation methodology; evaluation studies ID DISEASE PREVENTION PROGRAMS; QUALITY IMPROVEMENT; HEALTH-PROMOTION; COMPLEX INTERVENTIONS; FRAMEWORK; SCIENCE AB This article describes the importance and role of 4 stages of formative evaluation in our growing understanding of how to implement research findings into practice in order to improve the quality of clinical care. It reviews limitations of traditional approaches to implementation research and presents a rationale for new thinking and use of new methods. Developmental, implementation-focused, progress-focused, and interpretive evaluations are then defined and illustrated with examples from Veterans Health Administration Quality Enhancement Research Initiative projects. This article also provides methodologic details and highlights challenges encountered in actualizing formative evaluation within implementation research. C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. VA San Diego Healthcare Syst, San Diego, CA USA. Edward Hines Jr VA Healthcare Syst, Hines, IL USA. Minneapolis VA Med Ctr, Minneapolis, MN USA. Baylor Coll Med, Houston, TX 77030 USA. Vet Affairs Med Ctr, Houston, TX 77030 USA. Cent Arkansas Vet Healthcare Syst, Little Rock, AR USA. RP Stetler, CB (reprint author), 321 Middle St, Amherst, MA 01002 USA. EM cheryl.stetler@the-spa.com NR 61 TC 130 Z9 130 U1 2 U2 17 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 FEB PY 2006 VL 21 SU 2 BP S1 EP S8 DI 10.1111/j.1525-1497.2006.00355.x PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 024QH UT WOS:000236210600001 PM 16637954 ER PT J AU Aqel, RA Zoghbi, GJ AF Aqel, RA Zoghbi, GJ TI Radiation therapy-related cardiovascular disease SO JOURNAL OF HEART AND LUNG TRANSPLANTATION LA English DT Letter ID CORONARY-ARTERY-DISEASE; HODGKINS-DISEASE; CARDIAC-DISEASE; CHEST IRRADIATION; HEART-DISEASE; FOLLOW-UP C1 Birmingham Vet Affairs Med Ctr, Div Cardiovasc Dis, Birmingham, AL USA. Univ Alabama, Dept Internal Med, Div Cardiovasc Dis, Birmingham, AL USA. RP Aqel, RA (reprint author), Birmingham Vet Affairs Med Ctr, Div Cardiovasc Dis, Birmingham, AL USA. NR 12 TC 2 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1053-2498 J9 J HEART LUNG TRANSPL JI J. Heart Lung Transplant. PD FEB PY 2006 VL 25 IS 2 BP 257 EP 258 DI 10.1016/j.healun.2005.04.010 PG 2 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery; Transplantation SC Cardiovascular System & Cardiology; Respiratory System; Surgery; Transplantation GA 012ZO UT WOS:000235379600022 PM 16446234 ER PT J AU Musher, DM AF Musher, DM TI Pneumococcal serotypes and virulence SO JOURNAL OF INFECTIOUS DISEASES LA English DT Letter ID STREPTOCOCCUS-PNEUMONIAE; INVASIVE DISEASE C1 Baylor Coll Med, Med Serv, Infect Dis Sect, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol, Houston, TX 77030 USA. Baylor Coll Med, Dept Microbiol, Houston, TX 77030 USA. RP Musher, DM (reprint author), Baylor Coll Med, Med Serv, Infect Dis Sect, Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 10 TC 1 Z9 1 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB 1 PY 2006 VL 193 IS 3 BP 477 EP 477 DI 10.1086/499283 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 005NL UT WOS:000234831000021 PM 16388500 ER PT J AU Purnell, JQ Bland, LB Garzotto, M Lemmon, D Wersinger, EM Ryan, CW Brunzell, JD Beer, TM AF Purnell, JQ Bland, LB Garzotto, M Lemmon, D Wersinger, EM Ryan, CW Brunzell, JD Beer, TM TI Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer SO JOURNAL OF LIPID RESEARCH LA English DT Article DE estradiol; apolipoprotein; inflammation; androgen deprivation therapy ID ANDROGEN DEPRIVATION THERAPY; HORMONE REPLACEMENT THERAPY; RANDOMIZED CONTROLLED-TRIAL; CORONARY-HEART-DISEASE; POSTMENOPAUSAL WOMEN; PLASMA-LIPOPROTEINS; ESTRAMUSTINE PHOSPHATE; PARENTERAL ESTROGEN; SERUM-CHOLESTEROL; BODY-COMPOSITION AB Androgen deprivation therapy (ADT) for prostate cancer is now used in earlier disease stages and as adjuvant treatment. Recognizing and reducing the toxicity of this therapy, including worsened lipid levels and cardiovascular disease (CVD) risks, has become an important clinical concern. Oral estrogen therapy induces hypogonadism and mitigates many side effects of ADT, but has a high thrombosis risk. Transdermal estrogen therapy (TDE) has a lower thrombosis risk than oral estrogen and may improve CVD risk compared with ADT. This prospective pilot study of 18 men with androgen-independent prostate cancer receiving ADT measured effects of TDE on lipid and inflammatory CVD risk factors before and after 8 weeks of TDE ( estradiol 0.6 mg/day). During treatment, estradiol levels rose 17-fold; total cholesterol, LDL cholesterol, and apolipoprotein B levels decreased. HDL2 cholesterol increased, with no changes in triglyceride or VLDL cholesterol levels. Dense LDL cholesterol decreased and LDL buoyancy increased in association with a decrease in HL activity. Highly sensitive C-reactive protein levels and other inflammatory markers did not worsen. Compared with ADT, short-term TDE therapy of prostate cancer improves lipid levels without deterioration of CVD-associated inflammatory markers and may, on longer-term follow-up, improve CVD and mortality rates.-Purnell, J. Q., L. B. Bland, M. Garzotto, D. Lemmon, E. M. Wersinger, C. W. Ryan, J. D. Brunzell, and T. M. Beer. Effects of transdermal estrogen on levels of lipids, lipase activity, and inflammatory markers in men with prostate cancer. C1 Oregon Hlth Sci Univ, Dept Med, Div Endocrinol Diabet & Clin Nutr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Ctr Study Weight Regulat, Portland, OR 97239 USA. Portland VA Med Ctr, Div Urol, Portland, OR 97239 USA. Portland VA Med Ctr, Div Hematol & Med Oncol, Portland, OR 97239 USA. Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. RP Purnell, JQ (reprint author), Oregon Hlth Sci Univ, Dept Med, Div Endocrinol Diabet & Clin Nutr, Portland, OR 97239 USA. EM purnellj@ohsu.edu FU NCRR NIH HHS [M01 RR00334]; NHLBI NIH HHS [R01 HL-64322]; NIDDK NIH HHS [R03-DK-61996, K23-DK-02689]; PHS HHS [03-3839-504384] NR 55 TC 15 Z9 17 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD FEB PY 2006 VL 47 IS 2 BP 349 EP 355 DI 10.1194/jlr.M500276-JLR200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 005SS UT WOS:000234844700011 PM 16299398 ER PT J AU Schneider, PL Bramstedt, KA AF Schneider, PL Bramstedt, KA TI When psychiatry and bioethics disagree about patient decision making capacity (DMC) SO JOURNAL OF MEDICAL ETHICS LA English DT Article ID CONSULTATION-LIAISON PSYCHIATRY; CLINICAL ETHICS AB The terms "competency'' and "decision making capacity'' (DMC) are often used interchangeably in the medical setting. Although competency is a legal determination made by judges, "competency'' assessments are frequently requested of psychiatrists who are called to consult on hospitalised patients who refuse medical treatment. In these situations, the bioethicist is called to consult frequently as well, sometimes as a second opinion or "tie breaker''. The psychiatric determination of competence, while a clinical phenomenon, is based primarily in legalism and can be quite different from the bioethics approach. This discrepancy highlights the difficulties that arise when a patient is found to be "competent'' by psychiatry but lacking in DMC by bioethics. Using a case, this dilemma is explored and guidance for reconciling the opinions of two distinct clinical specialties is offered. C1 Univ Calif Los Angeles, Sch Med, Bioeth Comm, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Cleveland Clin Fdn, Dept Bioeth, Cleveland, OH 44195 USA. RP Schneider, PL (reprint author), Univ Calif Los Angeles, Sch Med, Bioeth Comm, Vet Adm Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Paul.Schneider@med.va.gov NR 7 TC 15 Z9 16 U1 0 U2 5 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0306-6800 J9 J MED ETHICS JI J. Med. Ethics PD FEB 1 PY 2006 VL 32 IS 2 BP 90 EP 93 DI 10.1136/jme.2005.013136 PG 4 WC Ethics; Medical Ethics; Social Issues; Social Sciences, Biomedical SC Social Sciences - Other Topics; Medical Ethics; Social Issues; Biomedical Social Sciences GA 007XF UT WOS:000235004000007 PM 16446413 ER PT J AU Oshima, M Maruta, T Ohtani, M Deitiker, PR Mosier, DR Atassi, MZ AF Oshima, M Maruta, T Ohtani, M Deitiker, PR Mosier, DR Atassi, MZ TI Vaccination with a MHC class II peptide in Alum and inactive pertussis strongly ameliorates clinical MG in C57BL/6 mice SO JOURNAL OF NEUROIMMUNOLOGY LA English DT Article DE antigen presentation; autoimmunity; MHC; immunotherapy; EAMG ID AUTOIMMUNE MYASTHENIA-GRAVIS; RECEPTOR-ALPHA-SUBUNIT; CALIFORNICA ACETYLCHOLINE-RECEPTOR; T-CELL RECOGNITION; IN-VITRO; SYNTHETIC PEPTIDES; EPITOPE; CHAIN; SUPPRESSION; LYMPHOCYTES AB We have investigated the efficacy of immunization against peptides from predisposing MHC class II molecules in human-compatible adjuvants for ameliorating experimental autoimmune myasthenia gravis (EAMG). C57BL/6 mice were immunized three times with the peptide I-A beta(b)62-76 in Alum + killed pertussis organisms (PT) prior to two injections with tAChR. The treatment greatly reduced the occurrence and severity of clinical MG relative to controls that received saline/Alum + PT or none. It also reduced antibody and T-cell responses against tAChR. The results have important implications for the possible immunotherapy of MG by targeting disease-associated MHC. (c) 2005 Elsevier B.V. All rights reserved. C1 Baylor Coll Med, Dept Biochem & Mol Biol, Houston, TX 77030 USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Dept Immunol, Houston, TX 77030 USA. ME DeBakey VA Med Ctr, Neurol & Med Res Serv, Houston, TX 77030 USA. RP Oshima, M (reprint author), Baylor Coll Med, Dept Biochem & Mol Biol, 1 Baylor Plaza, Houston, TX 77030 USA. EM moshima@bcm.tmc.edu NR 46 TC 5 Z9 5 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-5728 J9 J NEUROIMMUNOL JI J. Neuroimmunol. PD FEB PY 2006 VL 171 IS 1-2 BP 8 EP 16 DI 10.1016/j.jneuroim.2005.09.015 PG 9 WC Immunology; Neurosciences SC Immunology; Neurosciences & Neurology GA 009LW UT WOS:000235114500002 PM 16271400 ER PT J AU Bohnen, NI Kaufer, DI Hendrickson, R Ivanco, LS Lopresti, BJ Constantine, GM Mathis, CA Davis, JG Moore, RY DeKosky, ST AF Bohnen, NI Kaufer, DI Hendrickson, R Ivanco, LS Lopresti, BJ Constantine, GM Mathis, CA Davis, JG Moore, RY DeKosky, ST TI Cognitive correlates of cortical cholinergic denervation in Parkinson's disease and parkinsonian dementia SO JOURNAL OF NEUROLOGY LA English DT Article DE acetylcholinesterase; cognitive; dementia; Parkinson's disease; positron emission tomography ID CEREBRAL ACETYLCHOLINESTERASE ACTIVITY; POSITRON-EMISSION-TOMOGRAPHY; ALZHEIMERS-DISEASE; IN-VIVO; NUCLEUS BASALIS; MEYNERT; BRAIN; DYSFUNCTION; PROPIONATE; DEFICITS AB We recently reported findings that loss of cortical acetylcholinesterase (AChE) activity is greater in parkinsonian dementia than in Alzheimer's disease (AD). In this study we determined cognitive correlates of in vivo cortical AChE activity in patients with parkinsonian dementia (PDem, n = 11), Parkinson's disease without dementia (PD, n = 13), and in normal controls (NC, n = 14) using N-C-11]methyl-piperidin-4-yl propionate ([C-11]PMP) AChE positron emission tomography (PET). Cortical AChE activity was significantly reduced in the PDem (-20.9%) and PD (-12.7 %) subjects (P < 0.001) when compared with the control subjects. Analysis of the cognitive data within the patient groups demonstrated that scores on the WAIS-III Digit Span, a test of working memory and attention, had most robust correlation with cortical AChE activity (R = 0.61, p < 0.005). There were also significant correlations between cortical AChE activity and other tests of attentional and executive functions, such as the Trail Making and Stroop Color Word tests. There was no significant correlation between cortical AChE activity and duration of motor disease (R = -0.01, ns) or severity of parkinsonian motor symptoms (R = 0.14, ns). We conclude that cortical cholinergic denervation in PD and parkinsonian dementia is associated with decreased performance on tests of attentional and executive functioning. C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Radiol, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Math & Stat, Pittsburgh, PA 15213 USA. RP Bohnen, NI (reprint author), Univ Pittsburgh, Dept Neurol, Liliane S Kaufmann Bldg,Suite 811,3471 5th Ave, Pittsburgh, PA 15213 USA. EM nbohnen@pitt.edu RI Bohnen, Nicolaas/A-1312-2007; Mathis, Chester/A-8607-2009 FU NIA NIH HHS [AG05133] NR 43 TC 140 Z9 146 U1 2 U2 15 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 FEB PY 2006 VL 253 IS 2 BP 242 EP 247 DI 10.1007/s00415-005-0971-0 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 013ZP UT WOS:000235448800016 PM 16133720 ER PT J AU Lopez, OL Becker, JT Jagust, WJ Fitzpatrick, A Carlson, MC DeKosky, ST Breitner, J Lyketsos, CG Jones, B Kawas, C Kuller, LH AF Lopez, OL Becker, JT Jagust, WJ Fitzpatrick, A Carlson, MC DeKosky, ST Breitner, J Lyketsos, CG Jones, B Kawas, C Kuller, LH TI Neuropsychological characteristics of mild cognitive impairment subgroups SO JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY LA English DT Article ID CARDIOVASCULAR HEALTH; MEMORY IMPAIRMENT; ALZHEIMERS-DISEASE; DEMENTIA; PREVALENCE; POPULATION; CLASSIFICATION; QUESTIONNAIRE; PERFORMANCE; DECLINE AB Objective: To describe the neuropsychological characteristics of mild cognitive impairment (MCI) subgroups identified in the Cardiovascular Health Study (CHS) cognition study. Methods: MCI was classified as MCI-amnestic type (MCI-AT): patients with documented memory deficits but otherwise normal cognitive function; and MCI-multiple cognitive deficits type (MCI-MCDT): impairment of at least one cognitive domain (not including memory), or one abnormal test in at least two other domains, but who had not crossed the dementia threshold. The MCI subjects did not have systemic, neurological, or psychiatric disorders likely to affect cognition. Results: MCI-AT (n = 10) had worse verbal and non-verbal memory performance than MCI-MCDT (n = 28) or normal controls (n = 374). By contrast, MCI-MCDT had worse language, psychomotor speed, fine motor control, and visuoconstructional function than MCI-AT or normal controls. MCI-MCDT subjects had memory deficits, though they were less pronounced than in MCI-AT. Of the MCI-MCDT cases, 22 (78.5%) had memory deficits, and 6 (21.5%) did not. MCI-MCDT with memory disorders had more language deficits than MCI-MCDT without memory disorders. By contrast, MCI-MCDT without memory deficits had more fine motor control deficits than MCI-MCDT with memory deficits. Conclusions: The most frequent form of MCI was the MCI-MCDT with memory deficits. However, the identification of memory impaired MCI groups did not reflect the true prevalence of MCI in a population, as 16% of all MCI cases and 21.5% of the MCI-MCDT cases did not have memory impairment. Study of idiopathic amnestic and non-amnestic forms of MCI is essential for an understanding of the aetiology of MCI. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Univ Calif Berkeley, Dept Neurol, Berkeley, CA 94720 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Mental Hyg, Baltimore, MD USA. Johns Hopkins Univ, Dept Psychiat, Baltimore, MD USA. Wake Forest Univ, Dept Psychiat, Winston Salem, NC 27109 USA. Univ Calif Irvine, Dept Neurol, Irvine, CA 92717 USA. RP Lopez, OL (reprint author), 3501 Forbes Ave,Suite 830,Oxford Bldg, Pittsburgh, PA 15213 USA. EM lopezol@upmc.edu FU NHLBI NIH HHS [N01-HC-15103, N01-HC-35129, N01-HC-85079, N01-HC-85086]; NIA NIH HHS [AG15928, AG20098, R01 AG015928, R01 AG020098, R56 AG020098]; NIMH NIH HHS [MH07033] NR 51 TC 88 Z9 91 U1 2 U2 6 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0022-3050 J9 J NEUROL NEUROSUR PS JI J. Neurol. Neurosurg. Psychiatry PD FEB PY 2006 VL 77 IS 2 BP 159 EP 165 DI 10.1136/jnnp.2004.045567 PG 7 WC Clinical Neurology; Psychiatry; Surgery SC Neurosciences & Neurology; Psychiatry; Surgery GA 011QY UT WOS:000235284400008 PM 16103044 ER PT J AU Rattan, R Giri, S Singh, AK Singh, I AF Rattan, R Giri, S Singh, AK Singh, I TI Rho/ROCK pathway as a target of tumor therapy SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE statin; Rho GTPases; tumor; apoptosis; ROCK ID LOVASTATIN-INDUCED APOPTOSIS; 3-HYDROXY-3-METHYLGLUTARYL-COENZYME-A REDUCTASE INHIBITORS; SMOOTH-MUSCLE-CELLS; PROTEIN-KINASE; GLIOMA-CELLS; RHO-GTPASES; HEPATOCELLULAR-CARCINOMA; ACTIN CYTOSKELETON; GROWTH-INHIBITION; INDUCE APOPTOSIS AB This study emphasizes the importance of Rho/ROCK pathway in lovastatin-induced apoptosis as replenishment with exogenous isoprenoid, geranylgeranylpyrophosphate (GGPP), resulted in inhibition of apoptosis in cultured tumor cells. Treatment of C6 glioma cells with Toxin B and exoenzyme C3 resulted in cell death suggesting the role of geranylgeranylated protein(s) in the survival of glioma cells. Relative apoptotic death observed in cells transfected with dominant negative constructs of RhoA, Rac, and cdc42 imply Rho A as playing the major role in cell survival. Furthermore, the inhibition of Rho A kinase (ROCK), a direct downstream effector of Rho A, by Y-27632 or dominant negative of ROCK, induced apoptosis in glioma cells. These findings indicate that RhoA/ROCK pathway is involved negatively in the regulation of glioma cell death pathway. Moreover, in vivo studies of lovastatin treatment in animals implanted with C6 glioma cell tumors also resulted in smaller tumor size and induced apoptosis in the tumor tissue. The implantation of stably transfected C6 glioma cells with expression vector of C3 exoenzyme, dominant negative of RhoA and ROCK, resulted in significant smaller tumor mass, further establishing the importance of geranylgeranylated proteins, specifically RhoA and its downstream effecter ROCK, in cell survival and tumor genesis (C) 2005 Wiley-Liss, Inc. C1 Med Univ S Carolina, Childrens Res Inst, Dept Pediat, Charleston, SC 29425 USA. Ralph Johnson Vet Affairs Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. RP Singh, I (reprint author), Med Univ S Carolina, Childrens Res Inst, Dept Pediat, 173 Ashley Ave,509, Charleston, SC 29425 USA. EM singhi@musc.edu FU NCRR NIH HHS [C06 RR018823]; NINDS NIH HHS [NS-22576, NS-40144, NS-34741, NS 37766, NS-40810] NR 68 TC 50 Z9 58 U1 2 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 FEB 1 PY 2006 VL 83 IS 2 BP 243 EP 255 DI 10.1002/jnr.20707 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 013UC UT WOS:000235434300008 PM 16385577 ER PT J AU Higami, Y Barger, JL Page, GP Allison, DB Smith, SR Prolla, TA Weindruch, R AF Higami, Y Barger, JL Page, GP Allison, DB Smith, SR Prolla, TA Weindruch, R TI Energy restriction lowers the expression of genes linked to inflammation, the cytoskeleton, the extracellular matrix, and angiogenesis in mouse adipose tissue SO JOURNAL OF NUTRITION LA English DT Article DE microarray; energy restriction; dietary restriction; aging ID HEPATIC INSULIN-RESISTANCE; CALORIC RESTRICTION; VISCERAL FAT; ADIPSIN EXPRESSION; ADIPOCYTE DIFFERENTIATION; LEPTIN RESISTANCE; DEFICIENT MICE; CATHEPSIN-S; OBESITY; PROTEIN AB Using high-density oligonucleotide microarrays, we examined the actions of energy restriction (ER) on the expression of > 11,000 genes in epididymal white adipose tissue (WAT) of 10- to 11-mo-old male C57B16 mice. Four groups were studied: controls not subjected to food restriction (CO), food-restricted 18 h before being killed (FR), short-term ER for 23 d (SER), and long-term ER for 9 mo (LER). As we reported previously, compared with CO mice, FR and SER minimally influenced the gene expression profiles; however, 345 transcripts of 6266 genes determined to be expressed in WAT were significantly altered by LER. We focus here on the 109 (31%) of these genes that were involved in either inflammation (56 genes), cytoskeleton (16 genes), extracellular matrix (23 genes), or angiogenesis (14 genes). Among these 109 genes, 104 transcripts (95%) were downregulated by LER. Western blotting for heat shook protein 47 and osteonectin, and immunohistochemical staining for hypoxia inducible factor (HIF-1 alpha), supportec the microarray data that LER downregulated the expressions of these genes. Additionally, a 75% reduction in adipocyte size with LER reflected the change in the expression of genes involved in cell morphology. Our findings provide evidence that LER suppresses the expression of genes encoding inflammatory molecules in WAT while promoting structural remodeling of the cytoskeleton, extracellular matrix, and vasculature. These alterations may play an important role in the protection against WAT-derived inflammation and in lifespan extension by LER. C1 Univ Wisconsin, Dept Med, Madison, WI 53705 USA. Wisconsin Natl Primate Res Ctr, Madison, WI 53715 USA. Nagasaki Univ, Dept Pathol & Gerontol, Sch Biomed Sci, Nagasaki 8528523, Japan. Univ Alabama, Sect Stat Genet, Dept Biostat, Birmingham, AL 35249 USA. Pennington Biomed Res Ctr, Baton Rouge, LA 70808 USA. Univ Wisconsin, Dept Genet, Madison, WI 53706 USA. Univ Wisconsin, Dept Med Genet, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Educ & Clin Ctr, Madison, WI 53705 USA. RP Weindruch, R (reprint author), Univ Wisconsin, Dept Med, Madison, WI 53705 USA. EM rhweindr@wisc.edu OI Allison, David/0000-0003-3566-9399 FU NIA NIH HHS [R01 AG18922, T32AG00213] NR 67 TC 72 Z9 76 U1 2 U2 9 PU AMER SOCIETY NUTRITIONAL SCIENCE PI BETHESDA PA 9650 ROCKVILLE PIKE, RM L-2407A, BETHESDA, MD 20814 USA SN 0022-3166 J9 J NUTR JI J. Nutr. PD FEB PY 2006 VL 136 IS 2 BP 343 EP 352 PG 10 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 006JU UT WOS:000234894600002 PM 16424110 ER PT J AU Minzenberg, MJ Fisher-Irving, M Poole, JH Vinogradov, S AF Minzenberg, MJ Fisher-Irving, M Poole, JH Vinogradov, S TI Reduced self-referential source memory performance is associated with interpersonal dysfunction in borderline personality disorder SO JOURNAL OF PERSONALITY DISORDERS LA English DT Article ID AUDITORY HALLUCINATIONS; SCHIZOPHRENIA; SYMPTOMATOLOGY; DEPRESSION; INVENTORY; HOSTILITY; SCALES; ITEM AB Source memory is impaired in schizophrenia, and this deficit is related to symptoms of interpersonal antagonism such as suspiciousness and hostility. The present study evaluated source memory in borderline personality disorder (BPD) and its relation to interpersonal antagonism. Forty-one noninpatient adults with BPD according to the DSM-IV and 26 healthy control subjects performed a verbal source memory test requiring completion of sentences with and without emotional content ("Hot" vs. "Cold" sentences). Subjects also completed self-report measures of suspiciousness and interpersonal antagonism (Buss-Durkec Hostility Inventory) and depression (Beck Depression Inventory). The BPD group showed no significant difference from the control group in self-referential source memory, recognition memory, response bias, and performance enhancement for items with emotion content. However, in the BPD group, poorer self-referential source memory was significantly related to Hostility measures including suspiciousness, but not with Depression scores. In contrast, generic item recognition memory was unrelated to Hostility. Heterogeneity in source memory function may be specifically related to some of the hallmark interpersonal disturbances of BPD, independent of the effects of general negative affect or general memory impairment. C1 Univ Calif Davis, Med Ctr, Davis, CA 95616 USA. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RP Minzenberg, MJ (reprint author), Univ Calif Davis Hlth Syst, Imaging Res Ctr, 4701 X St, Sacramento, CA 95817 USA. EM michael.minzenberg@ucdmc.ucdavis.edu NR 39 TC 5 Z9 6 U1 3 U2 7 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0885-579X J9 J PERS DISORD JI J. Pers. Disord. PD FEB PY 2006 VL 20 IS 1 BP 42 EP 54 DI 10.1521/pedi.2006.20.1.42 PG 13 WC Psychiatry SC Psychiatry GA 020PL UT WOS:000235921900005 PM 16563078 ER PT J AU Bearden, CE Glahn, DC Monkul, ES Barrett, J Najt, P Kaur, S Sanches, M Villarreal, V Bowden, C Soares, JC AF Bearden, CE Glahn, DC Monkul, ES Barrett, J Najt, P Kaur, S Sanches, M Villarreal, V Bowden, C Soares, JC TI Sources of declarative memory impairment in bipolar disorder: Mnemonic processes and clinical features SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article DE bipolar disorder; clinical state; declarative memory; cognition; gender ID PREFRONTAL CORTEX; MOOD DISORDERS; NEUROPSYCHOLOGICAL FUNCTION; NEUROCOGNITIVE FUNCTION; COGNITIVE IMPAIRMENT; EUTHYMIC PATIENTS; VERBAL MEMORY; HIPPOCAMPAL FUNCTION; GENDER-DIFFERENCES; ATTENTION-DEFICIT AB Background: There is mounting evidence that declarative memory processes are impaired in patients with bipolar disorder. However, predictors of the observed impairment are not well understood. This study seeks to: (i) better characterize the nature of declarative memory impairment in bipolar disorder, and (ii) determine the relationship between clinical variables and memory function in bipolar disorder. Methods: 49 adult patients with bipolar disorder in varying mood states and 38 demographically matched healthy participants completed a comprehensive neurocognitive battery assessing general cognitive functioning, processing speed, and declarative memory. The California verbal learning test was used to characterize learning and memory functions. Results: Although patients with bipolar disorder utilized a similar semantic clustering strategy to healthy controls, they recalled and recognized significantly fewer words than controls, suggesting impaired encoding of verbal information. In contrast, lack of rapid forgetting suggests relative absence of a storage deficit in bipolar patients. While severity of mood symptomatology and illness duration were not associated with task performance, gender and family history significantly affected memory function. Conclusions: Results suggest that declarative memory impairments in bipolar patients: (1) are consistent with deficits in learning, but do not appear to be related to different organizational strategies during learning, and (2) do not appear to be secondary to clinical state, but rather may be associated with the underlying pathophysiology of the illness. (c) 2005 Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Schizophrenia & Related Disorders, San Antonio, TX 78284 USA. Dokuz Eylul Univ, Sch Med, Dept Psychiat, Izmir, Turkey. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Bearden, CE (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, 300 Bldg Med Plaza,Suite 2265, Los Angeles, CA 90095 USA. EM cbearden@mednet.ucla.edu FU NCRR NIH HHS [M01-RR-01346]; NIMH NIH HHS [MH01736] NR 72 TC 48 Z9 50 U1 0 U2 4 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 FEB PY 2006 VL 40 IS 1 BP 47 EP 58 DI 10.1016/j.jpsychires.2005.08.006 PG 12 WC Psychiatry SC Psychiatry GA 014GA UT WOS:000235466200005 PM 16199055 ER PT J AU Hula, W Doyl, PJ McNeil, MR Mikolic, JM AF Hula, W Doyl, PJ McNeil, MR Mikolic, JM TI Rasch modeling of revised token test performance: Validity and sensitivity to change SO JOURNAL OF SPEECH LANGUAGE AND HEARING RESEARCH LA English DT Article; Proceedings Paper CT 34th Annual Clinical Aphasiology Conference CY 2004 CL Park City, UT DE assessment; aphasia; auditory comprehension; spoken language comprehension assessment; standardized assessment ID SENTENCE COMPREHENSION; SCALE; APHASIA; IMPACT; SCIENCE AB The purpose of this research was to examine the validity of the 55-item Revised Token Test (RTT) and to compare traditional and Rasch-based scores in their ability to detect group differences and change over time. The 55-item RTT was administered to 108 left- and right-hemisphere stroke survivors, and the data were submitted to Rasch analysis. Traditional and Rasch-based scores for a subsample of 60 stroke survivors were submitted to analyses of variance with group (left hemisphere with aphasia vs. right hemisphere) and time post onset (3 vs. 6 months post onset) as factors. The 2 scoring methods were compared using an index of relative precision. Forty-eight items demonstrated acceptable model fit. Misfitting items came primarily from Subtest IX. The Rasch model accounted for 71% of the variance in the responses to the remaining items. Intersubtest patterns of item difficulty were well predicted by item content, but unexpected within-subtest differences were found. Both traditional and Rasch person scores demonstrated significant group differences, but only the latter demonstrated statistically significant change over time. Analysis of relative precision, however, failed to confirm a significant difference between the 2 methods. The findings generally support the RTT's validity, but a minority of items appears to respond to a different construct. Also, within-subtest differences in item difficulty suggest the need for further examination of variability in impaired language performance. Finally, the results suggest an equivocal advantage for Rasch scores in detecting change over time. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. RP Hula, W (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr,132A-H, Pittsburgh, PA 15206 USA. EM william.hula@med.va.gov NR 85 TC 13 Z9 13 U1 1 U2 4 PU AMER SPEECH-LANGUAGE-HEARING ASSOC PI ROCKVILLE PA 10801 ROCKVILLE PIKE, ROCKVILLE, MD 20852-3279 USA SN 1092-4388 J9 J SPEECH LANG HEAR R JI J. Speech Lang. Hear. Res. PD FEB PY 2006 VL 49 IS 1 BP 27 EP 46 DI 10.1044/1092-4388(2006/003) PG 20 WC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation SC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation GA 030JZ UT WOS:000236632000003 PM 16533071 ER PT J AU Henry, JA Schechter, MA Zaugg, TL Griest, S Jastreboff, PJ Vernon, JA Kaelin, C Meikle, MB Lyons, KS Stewart, BJ AF Henry, James A. Schechter, Martin A. Zaugg, Tara L. Griest, Susan Jastreboff, Pawel J. Vernon, Jack A. Kaelin, Christine Meikle, Mary B. Lyons, Karen S. Stewart, Barbara J. TI Outcomes of clinical trial: Tinnitus masking versus tinnitus retraining therapy SO JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY LA English DT Article DE clinical trial; hearing disorders; military veterans; rehabilitation; tinnitus ID HANDICAP QUESTIONNAIRE; MANAGEMENT AB A controlled clinical study was conducted to evaluate prospectively the clinical efficacy of tinnitus masking (TM) and tinnitus retraining therapy (TRT) in military veterans having clinically significant tinnitus. Qualifying patients were placed into the two groups in an alternating manner (to avoid selection bias), and treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index) and the verbally administered TRT interview forms. Findings are presented from the three written questionnaires, and from two of the interview questions (percentage time aware of, and annoyed by, tinnitus). Outcomes were analyzed on an intent-to-treat basis, using a multilevel modeling approach. Of the 123 patients enrolled, 118 were included in the analysis. Both groups showed significant declines (improvements) on these measures, with the TRT decline being significantly greater than for TM. The greater declines in TRT compared to TM occurred most strongly in patients who began treatment with a "very big" tinnitus problem. When patients began treatment with a,"moderate" tinnitus problem, the benefits of TRT compared to TM were more modest. C1 [Henry, James A.; Schechter, Martin A.; Zaugg, Tara L.; Griest, Susan; Jastreboff, Pawel J.; Kaelin, Christine] Portland VA Med Ctr, VA RR&D Natl Ctr Rehabilitat Auditory Res, Portland, OR USA. [Griest, Susan; Vernon, Jack A.; Meikle, Mary B.] Oregon Hlth & Sci Univ, Dept Otolaryngol, Portland, OR 97201 USA. [Schechter, Martin A.] Portland VA Med Ctr, VA Audiol Clin, Portland, OR USA. [Jastreboff, Pawel J.] Emory Univ, Tinnitus & Hyperacusis Ctr, Dept Otolaryngol, Atlanta, GA 30322 USA. [Lyons, Karen S.; Stewart, Barbara J.] Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97201 USA. RP Henry, JA (reprint author), VA Med Ctr NCRAR, PO Box 1034, Portland, OR 97207 USA. EM james.henry@med.va.gov NR 48 TC 61 Z9 64 U1 1 U2 16 PU AMER ACAD AUDIOLOGY PI RESTON PA 11730 PLAZA DR, STE 300, RESTON, VA 20190 USA SN 1050-0545 EI 2157-3107 J9 J AM ACAD AUDIOL JI J. Am. Acad. Audiol. PD FEB PY 2006 VL 17 IS 2 BP 104 EP 132 DI 10.3766/jaaa.17.2.4 PG 29 WC Audiology & Speech-Language Pathology; Otorhinolaryngology SC Audiology & Speech-Language Pathology; Otorhinolaryngology GA 241UE UT WOS:000251680500004 PM 16640064 ER PT J AU Hutt, E Pepper, GA Vojir, C Fink, R Jones, KR AF Hutt, E Pepper, GA Vojir, C Fink, R Jones, KR TI Assessing the appropriateness of pain medication prescribing practices in nursing homes SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE pain management; nursing home; dementia; quality of care ID NONMALIGNANT PAIN; OLDER-ADULTS; MANAGEMENT; CANCER; RESIDENTS; INTERVENTION; PREVALENCE; CARE; OSTEOARTHRITIS; OUTPATIENTS AB OBJECTIVES: To test a tool for screening the quality of nursing home (NH) pain medication prescribing. DESIGN: Validity and reliability of measurement tool developed for a pre/postintervention with untreated comparison group. SETTING: Six treatment NHs and six comparison NHs in rural and urban Colorado. PARTICIPANTS: NH staff, physicians, and repeated 20% random sample of each home's residents (N=2,031). INTERVENTION: Nurse and physician education; NH internal pain team to champion better pain management using a pain vital sign, consultations, and rounds. MEASUREMENTS: An expert panel reviewed the Pain Medication Appropriateness Scale (PMAS) for content validity. Research assistants interviewed NH residents, assessed them for pain using standardized instruments, and reviewed their medical records for prescriptions and use of pain and adjuvant medication. Construct validity was assessed by comparing the PMAS of residents in pain with the PMAS of those not in pain and comparing scores in homes in which the intervention was more effective with those in which it was less effective, using the Fisher exact and Student t tests. Interrater and test-retest reliability were measured. RESULTS: The mean total PMAS was 64% of optimal. Fewer than half of residents with predictably recurrent pain were prescribed scheduled pain medication; 23% received at least one high-risk medication. PMAS scores were better for residents not in pain (68% vs 60%, P=.004) and in homes where nurses' knowledge of pain assessment and management improved or stayed the same during the intervention (69% vs 61%, P=.03). CONCLUSION: The PMAS is useful for assessing pain medication prescribing in NHs and elucidates why so many residents have poorly controlled pain. C1 Univ Colorado, Denver VA Med Ctr 151, Denver, CO 80220 USA. Univ Colorado, Dept Med, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Sch Nursing, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. Univ Utah, Coll Nursing, Salt Lake City, UT 84112 USA. Yale Univ, Sch Nursing, New Haven, CT 06536 USA. RP Hutt, E (reprint author), Univ Colorado, Denver VA Med Ctr 151, 1055 Clermont St, Denver, CO 80220 USA. EM Evelyn.Hutt@uchsc.edu FU AHRQ HHS [U18-HS11093] NR 46 TC 32 Z9 32 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 FEB PY 2006 VL 54 IS 2 BP 231 EP 239 DI 10.1111/j.1532-5415.2005.00582.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 009FZ UT WOS:000235098300005 PM 16460373 ER PT J AU Barton, C Miller, B Yaffe, K AF Barton, Cynthia Miller, Bruce Yaffe, Kristine TI Improved evaluation and management of cognitive impairment: Results of a comprehensive intervention in long.-term care SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE cognitive impairment; dementia; long-term care ID NURSING-HOME PLACEMENT; QUALITY STANDARDS SUBCOMMITTEE; ACADEMY-OF-NEUROLOGY; MINIMUM DATA SET; ALZHEIMERS-DISEASE; DOUBLE-BLIND; PRACTICE PARAMETER; CONTROLLED-TRIAL; DEMENTIA; DONEPEZIL AB Objectives: Although as many as 50% of patients in long-term care have dementia, it is often not diagnosed and therefore, undertreated. We determined whether an intervention could improve the diagnosis and management of patients with cognitive impairment (CI) in long-term care. Design, Setting, and Participants: The assessment phase consisted of a record review of 60 consecutively admitted patients to the San Francisco VA Nursing Home Care Unit (NHCU). Cognitive impairment was determined by admission MMSE <= 24, indication of cognitive problem on MDS, or chart diagnosis of dementia. The evaluation consisted of a repeat chart review of 60 additional consecutively admitted patients. Intervention: The intervention consisted of low-cost and easy-to-implement educational activities (training, focus groups), strategies to document cognitive status, and consultation with dementia experts. Measurements/results: The 2 cohorts of 60 patients did not differ on demographics or on other characteristics (P >.25 for all). Prior to the intervention, of the 23 patients with Cl, 52% had an identified etiology, 35% had a physician management plan, and 22% had a multidisciplinary care plan. Postintervention, of the 22 patients with Cl, 91% had an identified etiology (P =.007), 86% had a physician plan (P =.001), and 59% had a multidisciplinary plan (P =.016). Conclusions: Initial results confirmed the underdiagnosis and undertreatment of Cl in our long-term care facility. Our intervention with educational programs, increased documentation of cognitive status, and consultation resulted in increased identification of etiology and improved plans for management of patients with Cl. C1 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Barton, C (reprint author), Univ Calif San Francisco, Dept Neurol, Box 116A,4150 Clement St, San Francisco, CA 94121 USA. EM cfb756@itsa.ucsf.edu FU NIA NIH HHS [R01 AG 021918-02] NR 34 TC 15 Z9 15 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD FEB PY 2006 VL 7 IS 2 BP 84 EP 89 DI 10.1016/j.jamda.2005.06.008 PG 6 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 081JU UT WOS:000240314700004 PM 16461249 ER PT J AU Woods, TD Patel, A AF Woods, TD Patel, A TI A critical review of patent foramen ovale detection using saline contrast echocardiography: When bubbles lie SO JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY LA English DT Review ID ATRIAL SEPTAL ANEURYSM; TO-LEFT SHUNT; RECURRENT CEREBROVASCULAR EVENTS; CRYPTOGENIC STROKE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; PARADOXICAL EMBOLISM; TRANSTHORACIC ECHOCARDIOGRAPHY; PLATYPNEA-ORTHODEOXIA; MEDICAL-TREATMENT; HEART-DISEASE AB Saline and indocyanine green dye were the first agents noted to produce a contrast effect when injected peripherally during M-mode echocardiographic imaging, although it was subsequently found that almost any type of injected solution would have this effect. These first-generation contrast agents were limited to opacification of right heart structures, and they prompted subsequent development of agents that traverse pulmonary circulation. Although opacification limited to right heart structures is considered a limitation of these first-generation agents, this is an advantage when attempting to identify the presence of right-to-left shunt. First-generation air contrast is considered the gold standard for identification of patent foramen ovale (PFO). However, PFO investigators have used varying criteria to define abnormal contrast studies. There are also multiple mechanisms by which saline contrast studies may produce both false-positive and false-negative results for presence of PFO. There is mounting experimental evidence that PFO is associated with cerebral ischemia and migraine headache, with a resulting evolution of devices for percutaneous closure of these shunts. Echocardiographic physicians must be aware of potential pitfalls of the air contrast technique to avoid exposing patients to unnecessary risk of closure devices, and missing the potential benefit of shunt closure in appropriately selected patients. C1 Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA. William S Middleton Mem Vet Adm Med Ctr, Serv Cardiol, Madison, WI 53705 USA. RP Woods, TD (reprint author), Med Coll Wisconsin, Dept Med, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. EM twoods@mcw.edu NR 52 TC 72 Z9 73 U1 0 U2 2 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0894-7317 J9 J AM SOC ECHOCARDIOG JI J. Am. Soc. Echocardiogr. PD FEB PY 2006 VL 19 IS 2 BP 215 EP 222 DI 10.1016/j.echo.2005.09.023 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 012DV UT WOS:000235319300016 PM 16455428 ER PT J AU Pejovic, T Liu, HY Cappuccini, F Cain, JM Bagby, GC AF Pejovic, T Liu, HY Cappuccini, F Cain, JM Bagby, GC TI Fanconi pathway dysfunction in ovarian cancer: Tissue specific cytogenetic instability in ovarian epithelial cells in high risk women. SO JOURNAL OF THE SOCIETY FOR GYNECOLOGIC INVESTIGATION LA English DT Meeting Abstract CT 53rd Annual Scientific Meeting of the Society-for-Gynecologic-Investigation CY MAR 22-25, 2006 CL Toronto, CANADA SP Soc Gynecolog Investigation C1 Oregon Hlth & Sci Univ, Portland, OR USA. Portland VA Med Ctr, NW VA Canc Res Ctr, Portland, OR 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 1071-5576 J9 J SOC GYNECOL INVEST JI J. Soc. Gynecol. Invest. PD FEB PY 2006 VL 13 IS 2 SU S MA 373 BP 187A EP 187A PG 1 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 017KZ UT WOS:000235693800372 ER PT J AU Freedland, SJ Platz, EA Presti, JC Aronson, WJ Amling, CL Kane, CJ Terris, MK AF Freedland, SJ Platz, EA Presti, JC Aronson, WJ Amling, CL Kane, CJ Terris, MK TI Obesity, serum prostate specific antigen and prostate size: Implications for prostate cancer detection SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostatectomy; obesity; prostate-specific antigen ID BODY-MASS INDEX; FOLLOW-UP; HYPERPLASIA; BIOPSY; RISK; MEN; ANTHROPOMETRY; POPULATION; PREDICTOR; INSULIN AB Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and prostate weight in a cohort of men undergoing RP. Materials and Methods: We evaluated the association of BMI with prostate weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database. Results: On multivariate analysis increasing BMI was associated with increasing prostate weight but only in men younger than 63 years and not in men 63 years or older (p-trend < 0.001 and 0.44, respectively). In men younger than 63 years mean multivariate adjusted prostate weight +/- SE in those with a BMI of less than 25 vs 30 to 34.9 kg/m(2) was 33.8 +/- 1.4 vs 41.4 +/- 1.6 gm. There was no significant association between BMI and preoperative PSA (p-trend = 0.70). Conclusions: In a cohort of men undergoing RP obesity was associated with larger prostate size but only in younger men. There was no association between BMI and PSA. Assuming equal PSA, the degree of prostatic enlargement observed in younger obese men in this study would be expected to result in a modest decrease in the odds of detecting prostate cancer in a contemporary series of PSA screened men due to the decreased sensitivity of cancer detection related to larger prostate size. Obesity may appear protective for prostate cancer in younger men due to technical issues unrelated to cancer biology. C1 Johns Hopkins Univ, Sch Med, Dept Urol, Baltimore, MD USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. Johns Hopkins Med Inst, Sidney Kimmel Comprehens Canc Ctr, Baltimore, MD 21205 USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Vet Adm Med Ctr, Dept Surg, Palo Alto, CA USA. Univ Calif Los Angeles, Sch Med, Dept Surg, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Urol, Los Angeles, CA USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Vet Adm Med Ctr, Dept Surg, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Med Coll Georgia, Dept Surg, Vet Adm Med Ctr, Augusta, GA 30912 USA. Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. RP Freedland, SJ (reprint author), Johns Hopkins Sch Med, Div Urol, Box 3850, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Terris, Martha/0000-0002-3843-7270 FU NCI NIH HHS [P50 CA92131-01A1, P50CA58236, R01CA100938] NR 21 TC 96 Z9 97 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD FEB PY 2006 VL 175 IS 2 BP 500 EP 504 DI 10.1016/S0022-5347(05)00162-X PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 001XO UT WOS:000234576200022 PM 16406980 ER PT J AU Rigberg, DA McGory, ML Zingmond, DS Maggard, MA Agustin, M Lawrence, PF Ko, CY AF Rigberg, DA McGory, ML Zingmond, DS Maggard, MA Agustin, M Lawrence, PF Ko, CY TI Thirty-day mortality statistics underestimate the risk of repair of thoracoabdominal aortic aneurysms: A statewide experience SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 59th Annual Meeting of the Society-for-Vascular-Surgery CY JUN 16-19, 2005 CL Chicago, IL SP Soc Vasc Surg ID UNITED-STATES; IMMEDIATE; ACCURACY; SURGERY AB Objective: The purpose of this study was to determine the 30-day and 365-day mortality for the repair of thoracoabdominal aortic aneurysms (TAA), when stratified by age, in the general population. These data provide clinicians with information more applicable to an individual patient than mortality figures from a single institutional series. Methods. Data were obtained from the California Office of Statewide Health Planning and Development (OSHPD) for the years 1991 to 2002. These data were linked to the state death certificate file, allowing for continued information oil the status of the patients after hospital discharge. All patients undergoing elective and ruptured TAA repair as coded by International Classification of Diseases, 9th Clinical Modification (ICD-9, CM) in California were identified. Patients aged < 50 or > 90 years old were excluded. We determined 30- and 365-day mortality and stratified our findings by decade of patient age (eg, 50 to 59). Demographics of elective and ruptured cases were also compared. Results: We identified 1010 patients (797 elective, 213 ruptured) who underwent TAA repair. Mean patient ages were 70.0 (elective) and 72.1 years (ruptured). Men comprised 62% of elective and 68% of ruptured aneurysm patients, and 80% (elective) and 74% (ruptured) were white. Overall elective patient mortality was 19% at 30 days and 31% at 365 days. There was a steep increase in mortality with increasing age, such that elective 365-day mortality increased from about 18% for patients 50 to 59 years old to 40% for patients 80 to 89 years old. The elective case 31-day to 365-day mortality ranged from 7.8% for the youngest patients to 13.5%. Mortality for ruptured cases was 48.4% at 30 days and 61.5% at 365 days, and these rates also increased with age. Conclusions: Our observed 30-day mortality for TAA repairs is consistent with previous reports; however, mortality at 1 year demonstrates a significant risk beyond the initial perioperative period, and this risk increases with age. These data reflect surgical mortality for TAA repair in the general population and may provide more useful data for surgeons and patients contemplating TAA surgery. C1 Univ Calif Los Angeles, Sch Med, Ctr Surg Outcomes & Qual, W Los Angeles Vet Adm Med Ctr, Los Angeles, CA 90024 USA. RP Rigberg, DA (reprint author), GONDA Goldschmied Vasc Ctr, Div Vasc Surg, 200 UCLA Med Plaza,Suite 510-6, Los Angeles, CA 90095 USA. EM drigberg@mednet.ucla.edu NR 21 TC 177 Z9 181 U1 1 U2 3 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 FEB PY 2006 VL 43 IS 2 BP 217 EP 222 DI 10.1016/j.jvs.2005.10.070 PG 6 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 014PN UT WOS:000235492300003 PM 16476589 ER PT J AU Rigberg, DA Zingmond, DS McGory, ML Maggard, MA Agustin, M Lawrence, PF Ko, CY AF Rigberg, DA Zingmond, DS McGory, ML Maggard, MA Agustin, M Lawrence, PF Ko, CY TI Age stratified, perioperative, and one-year mortality after abdominal aortic aneurysm repair: A statewide experience SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 33rd Annual Symposium of the Society-for-Clinical-Vascular-Surgery CY MAR 09-13, 2005 CL Coral Gables, FL SP Soc Clin Vasc Surg ID UNITED-STATES; STENT-GRAFT; OPERATIVE MORTALITY; SURGERY; MORBIDITY; INTACT; ENDOGRAFT; VOLUME; TRIAL; RATES AB Objective: The purpose of this study was to determine the in-hospital, 30-day, and 365-day mortality for the open repair of abdominal aortic aneurysms (AAAs), when stratified by age, in the general population. Age stratification could provide clinicians with information more applicable to an individual patient than overall mortality figures. Methods: In a retrospective analysis, data were obtained from the California Office of Statewide Health Planning and Development (OSHPD) for the years 1995 to 1999. Out-of-hospital mortality was determined via linkage to the state death registry. All patients undergoing AAA repair as coded by International Classification of Diseases, 9th Revision (ICD-9) procedure code 38.44 and diagnosis codes 441.4 (intact) and 441.3/441.5 (ruptured) in California were identified. Patients < 50 years of age were excluded. We determined in-hospital, 30-day, and 365-day mortality, and stratified our findings by patient age. Multivariate logistic regression was used to determine predictors of mortality in the intact and ruptured AAA cohorts. Results: We identified 12,406 patients (9,778 intact, 2,628 ruptured). Mean patient age was 72.4 +/- 7.2 years (intact) and 73.9 +/- 8.2 (ruptured). Men comprised 80.9% of patients, and 90.8% of patients were white. Overall, intact AAA patient mortality was 3.8% in-hospital, 4% at 30 days, and 8.5% at 365 days. There was a steep increase in mortality with increasing age, such that 365-day mortality increased from 2.9% for patients 51 to 60 years old to 15% for patients 81 to 90 years old. Mortality from day 31 to 365 was greater than both in-hospital and 30-day mortality for all but the youngest intact AAA patients. Perioperative (in-hospital and 30-day) mortality for ruptured cases was 45%, and mortality at 1 year was 54%. Conclusions. There is continued mortality after the open repair of AAAs during postoperative days 31 to 365 that, for many patients, is greater than the perioperative death rate. This mortality increases dramatically with age for both intact and ruptured AAA repair. C1 Univ Calif Los Angeles, Sch Med, Ctr Surg Outcomes & Qual, W Los Angeles Vet Adm Med Ctr, Los Angeles, CA USA. RP Rigberg, DA (reprint author), GONDA Goldschmied Vasc Ctr, Div Vasc Surg, 200 UCLA Med Plaza,Suite 510-6, Los Angeles, CA 90095 USA. EM drigberg@mednet.ucla.edu NR 32 TC 23 Z9 24 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD FEB PY 2006 VL 43 IS 2 BP 224 EP 229 DI 10.1016/j.jvs.2005.10.071 PG 6 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 014PN UT WOS:000235492300006 PM 16476591 ER PT J AU Henao, EA Hodge, MD Felkai, DD McCollum, CH Noon, GP Lin, PH Lumsden, AB Bush, RL AF Henao, EA Hodge, MD Felkai, DD McCollum, CH Noon, GP Lin, PH Lumsden, AB Bush, RL TI Contrast-enhanced Duplex surveillance after cndovascular abdominal aortic aneurysm repair: Improved efficacy using a continuous infusion technique SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 59th Annual Meeting of the Society-for-Vascular-Surgery CY JUN 16-19, 2005 CL Chicago, IL SP Soc Vasc Surg ID ENDOLUMINAL AAA REPAIR; COMPUTED-TOMOGRAPHY; ULTRASOUND SCAN; BLOOD-FLOW; FOLLOW-UP; ENDOLEAKS; AGENT; EXPOSURE; US AB Introduction: Currently, postoperative endoleak Surveillance after endovascular aortic aneurysm repair (EVAR) is primarily done by computed tomography (CT). The purpose of this study was to determine the efficacy of contrast-enhanced ultrasonography scans to detect endoleaks by using a novel infusion method and compare these findings with those of CT angiography (CTA). Methods: Twenty male patients (mean age, 70.4 years) underwent surveillance utilizing both CTA and contrast-enhanced color Duplex imaging. One 3-mL vial of Optison (Perfluten Protein A microspheres for injection) and 57 mL normal saline, for a total of 60 mL, were administered to each patient as a continuous infusion at 4 mL/min via a peripheral vein. Each Study was optimized with harmonic imaging, and a reduced mechanical index of 0.4 to 0.5, compression of I to 3, and a focal zone below the aorta to minimize microsphere rupture. One minute was allowed from the time of infusion to the appearance of contrast in the endograft. Flow was evaluated within the lumen of the graft and its components, as was the presence or absence of endoleaks. Findings were compared with standard color-flow Duplex imaging and CT utilizing CTA reconstruction protocols. Results: All patients evaluated had modular endografts implanted for elective aneurysm repair. Contrast-enhanced duplex scans identified nine endoleaks: one type I and eight type II. No additional endoleaks were seen on CTA. However, CTA failed to recognize three type II endoleaks seen by contrast-enhanced ultrasound. The continuous infusion method allowed for longer and more detailed imaging. An average of 46.8 mL of the contrast infusion solution was used per patient. Conclusions. Contrast enhanced Duplex ultrasonography accurately demonstrates endoleaks after EVAR and may be considered as a primary surveillance modality. Continuous infusion permits longer imaging time. C1 Baylor Coll Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Henao, EA (reprint author), Care of Corke J, 1 Baylor Plaza,404D, Houston, TX 77030 USA. EM surgmax@hotmail.com NR 22 TC 50 Z9 52 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 FEB PY 2006 VL 43 IS 2 BP 259 EP 263 DI 10.1016/j.jvs.2005.09.045 PG 5 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 014PN UT WOS:000235492300014 PM 16476596 ER PT J AU Silberfein, EJ Lin, PH Bush, RL Zhou, W Lumsden, AB AF Silberfein, EJ Lin, PH Bush, RL Zhou, W Lumsden, AB TI Aortic endograft infection due to Pasteurella multocida following a rabbit bite SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID PROSTHETIC JOINT INFECTION; GRAFT INFECTION; VASCULAR GRAFT; ANEURYSM AB Abdominal aortic endograft infection is a serious complication after an endovascular abdominal aortic aneurysm repair. Pasteurella multocida, a gram-negative bacterium, is a commonly found organism in the mouth flora of many house pets. We report a case of an aortic endograft infection caused by P multocida after a rabbit bite. Successful treatment was performed by extra-anatomic revascularization followed by endograft removal. C1 Houston VAMC, Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Houston VAMC, Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Houston VAMC, Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. RP Lin, PH (reprint author), Houston VAMC, Baylor Coll Med, Dept Surg, 2002 Holcomb Blvd, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 15 TC 21 Z9 21 U1 0 U2 3 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD FEB PY 2006 VL 43 IS 2 BP 393 EP 395 DI 10.1016/j.jvs.2005.10.067 PG 3 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 014PN UT WOS:000235492300042 PM 16476621 ER PT J AU Copeland, LA Zeber, JE Rosenheck, RA Miller, AL AF Copeland, LA Zeber, JE Rosenheck, RA Miller, AL TI Unforeseen inpatient mortality among veterans with schizophrenia SO MEDICAL CARE LA English DT Article DE aging; comorbidity; health services; mortality; schizophrenia; veterans ID SYSTEM SERVICE USE; MENTAL-DISORDERS; MYOCARDIAL-INFARCTION; PSYCHIATRIC-PATIENTS; MEDICAL-SERVICES; CARE; QUALITY; OUTPATIENTS; DISEASE; AFFAIRS AB Background: Patients with schizophrenia have co-occurring medical conditions, like other patients, but may lack the capacity to provide good self-care or to work with their providers to ensure appropriate medical treatment. We hypothesized that death among patients with schizophrenia occurs more frequently after minimal care of comorbid conditions. Methods: All patients who died in veterans affairs (VA) hospitals during FY02 were categorized as to type of death: unforeseen (age < 80 years, 1-2 inpatient days past year), cancer, organ failure (heart, lungs, kidneys), frailty (dementias, hip fractures, dehydration, etc.), or other deaths. Logistic regression explored factors in unforeseen death. Results: During the year, 27,798 patients died in VA facilities; 3% had schizophrenia (n = 943). Roughly two-thirds of all deaths were from cancer or organ failure, 11% frailty, 9% other, and 8% met criteria for unforeseen death. Among patients with schizophrenia however, 20% fell into the unforeseen death category. In an adjusted model, schizophrenia was associated with a 2-fold increased risk of unforeseen death compared with any other category (odds ratio = 2.4, 95% confidence interval 1.6-3.4). Unforeseen death was less likely among patients with substance abuse diagnoses in the year before death and more likely when patients had no outpatient medical care. Conclusions: VA patients with schizophrenia were more likely to die as inpatients with little previous-year care compared with other inpatient decedents without schizophrenia. Outreach efforts may be necessary to engage patients with schizophrenia in treatment of potentially life-threatening conditions. C1 S Texas Vet Hlth Care Syst, VERDICT HSR&D, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Vet Affairs Connecticut Healthcare Syst, NE Program Evaluat Ctr, West Haven, CT USA. Yale Univ, Sch Med, New Haven, CT USA. RP Copeland, LA (reprint author), S Texas Vet HCS ALMD, VERDICT Ctr, 7400 Merton Minter 11C6, San Antonio, TX 78229 USA. EM copelandl@uthscsa.edu OI Copeland, Laurel/0000-0002-9478-0209 NR 28 TC 22 Z9 22 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2006 VL 44 IS 2 BP 110 EP 116 DI 10.1097/01.mlr.0000196973.99080.fb PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 007EE UT WOS:000234950400003 PM 16434909 ER PT J AU MacLean, CH Louie, R Shekelle, PG Roth, CP Saliba, D Higashi, T Adams, J T Chang, J Kamberg, CJ Solomon, DH Young, RT Wenger, NS AF MacLean, CH Louie, R Shekelle, PG Roth, CP Saliba, D Higashi, T Adams, J T Chang, J Kamberg, CJ Solomon, DH Young, RT Wenger, NS TI Comparison of administrative data and medical records to measure the quality of medical care provided to vulnerable older patients SO MEDICAL CARE LA English DT Article DE quality of care; performance; administrative data ID OF-CARE; AMBULATORY CARE; ELDERS; BENEFICIARIES; INFORMATION; IMPROVEMENT; COMMUNITY; ACCURACY; VALIDITY; PROJECT AB Background: Administrative data are used to determine performance for publicly reported in health plan "report cards," accreditation status, and reimbursement. However, it is unclear how performance based on administrative data and medical records compare. Methods: We compared applicability, eligibility, and performance on 182 measures of health care quality using medical records and administrative data during a 13-month period for a random sample of 399 vulnerable older patients enrolled in managed care. Results: Of 182 quality indicators (QIs) spanning 22 conditions, 145 (80%) were applicable only to medical records and 37 (20%) to either medical records or administrative data. Among 48 QIs specific to geriatric conditions, all were applicable to medical records; 2 of these also were applicable to administrative data. Eligibility for the 37 QIs that were applicable to both medical records and administrative data was similar for both data sources (94% agreement, K = 0.74). With the use of medical records, 152 of the 182 the QIs that were applicable to medical records were triggered and yielded an overall performance of 55%. Using administrative data, 30 of the 37 QIs that were applicable to administrative data were triggered and yielded overall performance of 83% (P < 0.05 vs. medical records). Restricting to QIs applicable to both data sources, overall performance was 84% and 83% (P = 0.21) for medical records and administrative data, respectively. Conclusions: The number and spectrum of QIs that can be measured for vulnerable elderly patients is far greater for medical records than for administrative data. Although summary estimates of health care quality derived from administrative data and medical records do not differ when using identical measures, summary scores from these data sources vary substantially when the totality of care that can be measured by each data source is measured. C1 RAND Hlth, Santa Monica, CA 90407 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RAND Hlth, Arlington, VA USA. Univ Calif Los Angeles, Div Rheumatol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Gen Internal Med, Los Angeles, CA 90024 USA. RP MacLean, CH (reprint author), RAND Hlth, 1776 Main St,M-26, Santa Monica, CA 90407 USA. EM maclean@rand.org FU BHP HRSA HHS [PE-19001] NR 32 TC 28 Z9 28 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2006 VL 44 IS 2 BP 141 EP 148 DI 10.1097/01.mlr.0000196960.12860.de PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 007EE UT WOS:000234950400007 PM 16434913 ER PT J AU Liu, F Pore, N Kim, M Voong, KR Dowling, M Maity, A Kao, GD AF Liu, F Pore, N Kim, M Voong, KR Dowling, M Maity, A Kao, GD TI Regulation of histone deacetylase 4 expression by the SP family of transcription factors SO MOLECULAR BIOLOGY OF THE CELL LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; CELL-CYCLE ARREST; END RULE PATHWAY; GENE-EXPRESSION; SKELETAL-MUSCLE; NUCLEAR EXPORT; RECEPTOR GENE; N-COR; DIHYDROFOLATE-REDUCTASE; UBIQUITIN CONJUGATION AB Histone deacetylases mediate critical cellular functions but relatively little is known about mechanisms controlling their expression, including expression of HDAC4, a class II HDAC implicated in the modulation of cellular differentiation and viability. Endogenous HDAC4 mRNA, protein levels and promoter activity were all readily repressed by mithramycin, suggesting regulation by GC-rich DNA sequences. We validated consensus binding sites for Sp1/Sp3 transcription factors in the HDAC4 promoter through truncation studies and targeted mutagenesis. Specific and functional binding by Sp1/Sp3 at these sites was confirmed with chromatin immunoprecipitation (ChIP) and electromobility shift assays (EMSA). Cotransfection of either Sp1 or Sp3 with a reporter driven by the HDAC4 promoter led to high activities in SL2 insect cells (which lack endogenous Sp1/Sp3). In human cells, restored expression of Sp1 and Sp3 up-regulated HDAC4 protein levels, whereas levels were decreased by RNA-interference-mediated knockdown of either protein. Finally, variable levels of Sp1 were in concordance with that of HDAC4 in a number of human tissues and cancer cell lines. These studies together characterize for the first time the activity of the HDAC4 promoter, through which Sp1 and Sp3 modulates expression of HDAC4 and which may contribute to tissue or cell-line-specific expression of HDAC4. C1 Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Kao, GD (reprint author), Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA 19104 USA. EM Kao@xrt.upenn.edu FU NCI NIH HHS [CA093638, CA107956, R01 CA093638, R01 CA107956] NR 85 TC 27 Z9 27 U1 0 U2 0 PU AMER SOC CELL BIOLOGY PI BETHESDA PA 8120 WOODMONT AVE, STE 750, BETHESDA, MD 20814-2755 USA SN 1059-1524 J9 MOL BIOL CELL JI Mol. Biol. Cell PD FEB PY 2006 VL 17 IS 2 BP 585 EP 597 DI 10.1091/mbc.E05-08-0775 PG 13 WC Cell Biology SC Cell Biology GA 009MX UT WOS:000235117300004 PM 16280357 ER PT J AU Lien, YC Lin, SM Nithipongvanitch, R Oberley, TD Noel, T Zhao, Q Daosukho, C St Clair, DK AF Lien, YC Lin, SM Nithipongvanitch, R Oberley, TD Noel, T Zhao, Q Daosukho, C St Clair, DK TI Tumor necrosis factor receptor deficiency exacerbated Adriamycin-induced cardiomyocytes apoptosis: an insight into the Fas connection SO MOLECULAR CANCER THERAPEUTICS LA English DT Article ID MANGANESE SUPEROXIDE-DISMUTASE; DOXORUBICIN-INDUCED APOPTOSIS; CYTOCHROME-C RELEASE; INDUCED CARDIOMYOPATHY; MEDIATED APOPTOSIS; CARDIAC MYOCYTES; MITOCHONDRIAL DYSFUNCTION; INDUCED CARDIOTOXICITY; OLIGOMERIZES BAK; TRANSGENIC MICE AB Cardiomyopathy is a major dose-limiting factor for applications of Adriamycin, a potent chemotherapeutic agent. The present study tested the hypothesis that increased tumor necrosis factor (TNF)-alpha signaling via its receptors protects against Adriamycin-induced cardiac injury. We used mice in which both TNF receptor I and II have been selectively inactivated (DKO) with wild-type mice as controls. Morphometric studies of cardiac tissue following Adriamycin treatment revealed greater ultrastructural damage in cardiomyocyte mitochondria from DKO mice. Biochemical studies of cardiac tissues showed cytochrome c release and the increase in proapoptotic protein levels, suggesting that lack of TNF-alpha receptor I and II exacerbates Adriamycin-induced cardiac injury. The protective role of TNF receptor I and II was directly confirmed in isolated primary cardiomyocytes. Interestingly, following Adriamycin treatment, the levels of Fas decreased in the wild-type mice. In contrast, DKO mice had an increase in Fas levels and its downstream target, mitochondrial truncated Bid. These results suggested that TNF-alpha receptors play a critical role in cardioprotection by suppression of the mitochondrial-mediated associated cell death pathway. C1 Univ Kentucky, Grad Ctr Toxicol, Lexington, KY 40536 USA. Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Pathol & Lab Med Serv, Madison, WI USA. Mahidol Univ, Fac Med Technol, Bangkok, Thailand. RP St Clair, DK (reprint author), Univ Kentucky, Grad Ctr Toxicol, 454 Hlth Sci Res Bldg, Lexington, KY 40536 USA. EM dstcl00@uky.edu FU NCI NIH HHS [CA 80152, CA 94853] NR 43 TC 17 Z9 22 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 FEB PY 2006 VL 5 IS 2 BP 261 EP 269 DI 10.1158/1535-7163.MCT-05-0390 PG 9 WC Oncology SC Oncology GA 017VM UT WOS:000235721400009 PM 16505099 ER PT J AU Qin, W Peng, Y Ksiezak-Reding, H Ho, L Stetka, B Lovati, E Pasinetti, GM AF Qin, W Peng, Y Ksiezak-Reding, H Ho, L Stetka, B Lovati, E Pasinetti, GM TI Inhibition of cyclooxygenase as potential novel therapeutic strategy in N141I presenilin-2 familial Alzheimer's disease SO MOLECULAR PSYCHIATRY LA English DT Article DE COX-2; PS2; apoptosis; GSK-3 beta; b-catenin ID RANDOMIZED CONTROLLED-TRIAL; TRANSGENIC MOUSE MODEL; WNT SIGNALING PATHWAY; CELL-CYCLE ACTIVITY; BETA-CATENIN; EPIDEMIOLOGIC EVIDENCE; EXPRESSION; APOPTOSIS; PLACEBO; PHOSPHORYLATION AB The present study was designed to further explore the potential cause/effect relationship between the expression of both the N141I presenilin (PS) 2 mutant familial Alzheimer's disease (FAD) gene and cyclooxgenase (COX) in respect to the mechanism associated with programmed cell death in Alzheimer's disease (AD). We found that expression of mutant N141I PS2 resulting in apoptotic cell death in H4 neuronal cells coincided with >4-fold induction in the expression of the inducible form of COX-2, but not the constitutive COX-1. Moreover, we found that the expression of the N141I PS2 FAD gene strongly promoted (>2-fold) glycogen synthase kinase (GSK)-3 beta activity coincidental with a reduction in the level of beta-catenin translocated from the cytoplasmic to the nuclear compartment. Most interestingly, we found that inhibition of COX-2-mediated generation of prostaglandin (PG)-E-2 in H4 neuronal cells with the preferential COX-2 inhibitor nimesulide protects against N141I PS2-mediated apoptotic cell death coincidental with an inhibition of GSK-3 beta activity and subsequent normalization of beta-catenin cellular distribution. The clinical relevance of this finding was confirmed by the evidence that COX-2 protein and PG-E-2 concentrations were selectively increased >2-fold in the cerebral cortex of subjects harboring the N141I PS2 FAD mutation relative to wild-type PS2 AD cases. This study demonstrates for the first time that COX-2 may be a downstream effector of mutant N141I PS2-mediated apoptotic cell death and that inhibition of COX-2 may neuroprotect in AD through modulation of a GSK-3 beta-beta-catenin-mediated response. The study provides support for the potential pharmacogenomic identification of N141I PS2 FAD cases that might preferentially benefit from inhibition of COX-2 during the progression of clinical dementia. C1 Mt Sinai Sch Med, Dept Psychiat, Neuroinflammat Res Labs, New York, NY 10029 USA. Mt Sinai Sch Med, Bronx Vet Affairs Med Ctr, GRECC, Bronx, NY USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Dept Psychiat, Neuroinflammat Res Labs, Box 1230,1 Gustave L Levy Pl, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu FU NIA NIH HHS [AG13799, P50 AG05136] NR 38 TC 17 Z9 18 U1 0 U2 2 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 FEB PY 2006 VL 11 IS 2 BP 172 EP 181 DI 10.1038/sj.mp.4001773 PG 10 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 007FJ UT WOS:000234953700011 PM 16331303 ER PT J AU Zhao, LX Ma, QL Calon, F Harris-White, ME Yang, FS Lim, GP Morihara, T Ubeda, OJ Ambegaokar, S Hansen, JE Weisbart, RH Teter, B Frautschy, SA Cole, GM AF Zhao, LX Ma, QL Calon, F Harris-White, ME Yang, FS Lim, GP Morihara, T Ubeda, OJ Ambegaokar, S Hansen, JE Weisbart, RH Teter, B Frautschy, SA Cole, GM TI Role of p21-activated kinase pathway defects in the cognitive deficits of Alzheimer disease SO NATURE NEUROSCIENCE LA English DT Article ID AMYLOID PRECURSOR PROTEIN; MENTAL-RETARDATION; SYNAPTIC PLASTICITY; MISSENSE MUTATION; DENDRITIC SPINES; ACTIN DYNAMICS; DOWN-SYNDROME; MEMORY LOSS; LIM-KINASE; DREBRIN AB Defects in dendritic spines are common to several forms of cognitive deficits, including mental retardation and Alzheimer disease. Because mutation of p21-activated kinase ( PAK) can lead to mental retardation and because PAK-cofilin signaling is critical in dendritic spine morphogenesis and actin dynamics, we hypothesized that the PAK pathway is involved in synaptic and cognitive deficits in Alzheimer disease. Here, we show that PAK and its activity are markedly reduced in Alzheimer disease and that this is accompanied by reduced and redistributed phosphoPAK, prominent cofilin pathology and downstream loss of the spine actin-regulatory protein drebrin, which cofilin removes from actin. We found that beta-amyloid ( A beta) was directly involved in PAK signaling deficits and drebrin loss in A beta oligomer-treated hippocampal neurons and in the Appswe transgenic mouse model bearing a double mutation leading to higher A beta production. In addition, pharmacological PAK inhibition in adult mice was sufficient to cause similar cofilin pathology, drebrin loss and memory impairment, consistent with a potential causal role of PAK defects in cognitive deficits in Alzheimer disease. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Laval, Med Ctr, Mol Endocrinol & Oncol Res Ctr, Quebec City, PQ G1V 4G2, Canada. Univ Laval, Fac Pharm, Ste Foy, PQ G1K 7P4, Canada. Educ & Clin Ctr, Sepulveda, CA 91343 USA. Osaka Univ, Sch Med, Div Psychiat & Behav Proteom, Dept Post Genom & Dis, Suita, Osaka 565, Japan. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. RP Cole, GM (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, Sepulveda, CA 91343 USA. EM gmcole@ucla.edu FU NIA NIH HHS [AG16793, AG022080, AG10415, AG10685, P01 AG16570, P50 AG 16570, P50 AG016570, P50 AG05142, R01 AG010685, R01 AG013741, R01 AG13741]; NINDS NIH HHS [NS43946] NR 50 TC 181 Z9 188 U1 2 U2 7 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1097-6256 J9 NAT NEUROSCI JI Nat. Neurosci. PD FEB PY 2006 VL 9 IS 2 BP 234 EP 242 DI 10.1038/nn1630 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 007SN UT WOS:000234990100019 PM 16415866 ER PT J AU Vitiello, MV Moe, KE Merriam, GR Mazzoni, G Buchner, DH Schwartz, RS AF Vitiello, MV Moe, KE Merriam, GR Mazzoni, G Buchner, DH Schwartz, RS TI Growth hormone releasing hormone improves the cognition of healthy older adults SO NEUROBIOLOGY OF AGING LA English DT Article DE aging; elderly; cognition; GHRH; GH; IGF-I; cognitive function ID FACTOR-I; HUMAN-BRAIN; ALZHEIMERS-DISEASE; DEFICIENT ADULTS; AGE; MEN; INSULIN-LIKE-GROWTH-FACTOR-1; DECREASES; RECEPTORS; INCREASES AB Declines in the activity of the somatotrophic axis have been implicated in the age-related changes observed in a number of physiological functions, including cognition. Such a-e-related changes may be arrested or partially reversed by hormonal Supplementation. We examined the effect of 6 months treatment with daily growth hormone releasing hormone (GHRH) or placebo oil the cognition Of a group of 89 healthy older (68.0 +/- 0.7) adults. GHRH resulted in improved performance on WAIS-R performance IQ (p<0.01) WAIS-R Picture arrangement (p<0.01), finding A's (p<0.01), verbal sets (p<0.01) and single-dual task (p<0.04). GHRH-based improvements were independent of gender. estrogen Status or baseline cognitive capacity. These results demonstrate that the age-related decline in the somatotrophic axis may be related to age-related decline in cognition. Further they indicate that supplementation of this neuro-hormonal axis may partially ameliorate such cognitive declines in healthy normal older adults and potentially in individuals with impaired cognitive function (i.e., mild cognitive impairment and Alzheimer's disease). (C) 2005 Elsevier Inc. All rights reserved. C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Seton Hall Univ, Dept Psychol, S Orange, NJ 07079 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. RP Vitiello, MV (reprint author), Univ Washington, Dept Psychiat & Behav Sci, BB-1520D Hlth Sci Bldg,Box 356560,1959 NE Pacific, Seattle, WA 98195 USA. EM vitiello@u.washington.edu OI Vitiello, Michael/0000-0002-9776-0473 FU NCRR NIH HHS [M01-RR-00037]; NIA NIH HHS [AG10943]; NIMH NIH HHS [K02-MH01158, MH53575] NR 28 TC 32 Z9 33 U1 2 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD FEB PY 2006 VL 27 IS 2 BP 318 EP 323 DI 10.1016/j.neurobiolaging.2005.01.010 PG 6 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 004WD UT WOS:000234782400015 PM 16399214 ER PT J AU Yin, W Cao, GD Johnnides, MJ Signore, AP Luo, YM Hickey, RW Chen, J AF Yin, W Cao, GD Johnnides, MJ Signore, AP Luo, YM Hickey, RW Chen, J TI TAT-mediated delivery of Bcl-xL protein is neuroprotective against neonatal hypoxic-ischemic brain injury via inhibition of caspases and AIF SO NEUROBIOLOGY OF DISEASE LA English DT Article DE protein transduction; hypoxia; ischemia; apoptosis; cerebral ID APOPTOSIS-INDUCING FACTOR; CEREBRAL-ARTERY OCCLUSION; NEURONAL CELL-DEATH; RAT-BRAIN; IN-VIVO; INFLAMMATORY MEDIATORS; TRANSDUCTION DOMAIN; DNA FRAGMENTATION; FUSION PROTEIN; CYTOCHROME-C AB Systemic delivery of recombinant Bcl-xL fusion protein containing the TAT protein transduction domain attenuated neonatal brain damage following hypoxic ischemia (H-I). Within 30 min after intraperitoneal injection of TAT-Bcl-xL protein into 7-day-old rats, substantially enhanced levels of Bcl-xL were found in several brain regions. Administration of TAT-Bcl-xL at the conclusion of the H-I insult decreased cerebral tissue loss in a dose-dependent manner measured I and 8 weeks later. Neuroprotection provided by TAT-Bcl-xL was significantly greater than that of the pan-caspase inhibitor BAF, suggesting that protection is only partially attributable to caspase inhibition by TAT-Bcl-xL. TAT-Bcl-xL not only inhibited caspases-3 and -9 activities after H-I but also prevented nuclear translocation of AIF. Taken together, these results substantiate the feasibility of peripheral delivery of an anti-apoptotic factor into the brain of neonatal animals to reduce H-I-induced brain injury. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Pittsburgh Inst Neurodegenerat Dis, Pittsburgh, PA 15261 USA. Childrens Hosp Pittsburgh, Div Pediat Emergency Med, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15261 USA. RP Univ Pittsburgh, Sch Med, Dept Neurol, S-507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu FU NINDS NIH HHS [NS45048, NS43802, NS36736] NR 58 TC 64 Z9 69 U1 1 U2 1 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0969-9961 EI 1095-953X J9 NEUROBIOL DIS JI Neurobiol. Dis. PD FEB PY 2006 VL 21 IS 2 BP 358 EP 371 DI 10.1016/j.nbd.2005.07.015 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 008KW UT WOS:000235040600010 PM 16140540 ER PT J AU Pekary, AE Stevens, SA Sattin, A AF Pekary, AE Stevens, SA Sattin, A TI Rapid modulation of TRH and TRH-like peptide levels in rat brain and peripheral tissues by corticosterone SO NEUROCHEMISTRY INTERNATIONAL LA English DT Article DE corticosterone; TRH; limbic system; cortex; pancreas; reproductive system ID THYROTROPIN-RELEASING-HORMONE; ALPHA-AMIDATING MONOOXYGENASE; NECROSIS-FACTOR-ALPHA; GLUCOCORTICOIDS STIMULATE; INTERFERON-GAMMA; GENE-EXPRESSION; CELL APOPTOSIS; ADRENAL-CORTEX; IN-VITRO; KAPPA-B AB Disturbance of glucocorticoid signaling has been implicated in several neuropsychiatric disorders including unipolar and bipolar depression and anxiety induced by maternal deprivation. Antidepressants have been shown to be neuroprotective and able to reverse damage to glia and neurons. Thyrotropin-releasing hormone (TRH) is an endogenous antidepressant that reduces the expression of glycogen synthase kinase-3 beta (GSK-3 beta), an enzyme that hyperphosphorylates tau and is implicated in bipolar depression, diabetes and Alzheimer's disease. In order to understand the potential role of TRH and TRH-like peptides both as mediators of the depressogenic effects of glucocorticoids and as potential therapeutics for neuropsychiatric disease, 300 a male Sprague-Dawley rats were injected i.p. with 4 mg corticosterone/0.5 ml 50% DMSO + 50% ethanol and sacrificed 0, 2, 4 and 8 h later. Levels of TRH and TRH-like peptides were measured in various brain regions involved in mood regulation and pancreas and reproductive tissues that mediate the metabolic and reproductive impairments associated with high glucocorticoid levels. Significant increases, ranging from 2- to 12-fold, in TRH or TRH-like peptide levels were observed in almost all brain regions studied at 4 h after corticosterone injection. In cerebellum, TRH and TRH-like peptides increased 4-14-fold by 8 h. TRH-like peptide levels fell 86-98% at 4 h after treatment in testis. TRH, derived only from Leydig cells, was not affected. TRH and TRH-like peptides increased 2-4-fold at 8 h in pancreas. TRH and TRH-like peptide concentrations in prostate were not affected by corticosterone up to 8 h after injection. The 4 h needed to detect a highly significant change in the TRH and TRH-like peptide levels in brain and peripheral tissues is consistent with the mediation of most corticosterone-effects via alterations in gene transcription. Published by Elsevier Ltd. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Biobehav Sci, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Pekary, AE (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, Bldg 114,Room 229,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM eugene.pekary@med.va.gov NR 71 TC 18 Z9 18 U1 1 U2 8 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0197-0186 J9 NEUROCHEM INT JI Neurochem. Int. PD FEB PY 2006 VL 48 IS 3 BP 208 EP 217 DI 10.1016/j.neuint.2005.10.003 PG 10 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 016BX UT WOS:000235596700007 PM 16293347 ER PT J AU Suchomelova, L Baldwin, RA Kubova, H Thompson, KW Sankar, R Wasterlain, CG AF Suchomelova, L Baldwin, RA Kubova, H Thompson, KW Sankar, R Wasterlain, CG TI Treatment of experimental status epilepticus in immature rats: Dissociation between anticonvulsant and antiepileptogenic effects SO PEDIATRIC RESEARCH LA English DT Article ID HYPOXIA-INDUCED SEIZURES; INDUCED NEURONAL INJURY; PILOCARPINE MODEL; POSTTRAUMATIC SEIZURES; DEVELOPING BRAIN; TOPIRAMATE; EPILEPTOGENESIS; EPILEPSY; EXPRESSION; PREVENTION AB We Studied the effects of treating Status epilepticus (SE) induced by lithium and pilocarpine at postnatal day 15 (P15) or 28 (P28), on the severity of acute SE and of SE-induced epileptogenesis. Rats received topiramate (10 or 50 mg/kg IP) or diazepam C (5 mg/kg, IP) 20, 40 or 70 min after pilocarpine, and three months after SE 24-h video/EEG recordings were obtained for one (P28) Or two weeks (P15) continuously. In P15 rats, topiramate did not modify the course of SE, yet treatment at 20 or 40 min completely prevented the development of spotaneous recurrent seisures (SRS) while later treatment (70 min) was partially effective in reducing the severity and frequency of SRS. Diazepam was effective against acute SE at all time points tested. Early (20 min) but not late treatment with diazepam had the effect of reducing the frequency and severity of SRS. In P28 rats, both drugs reduced the cumulative seizure time. Early treatment (20 min) with either drug reduced the incidence of chronic epilepsy. Late treatment (40/70 min) did not alter the incidence of SRS, but decreased their frequency. This study demonstrates that, in the treatment of SE, anticonvulsant and antiepileptogenic effects call be dissociated in a development-specific manner: topiramate was antiepileplogenic without being in effective anticonvulsant in P15 animals at the doses tested. Diazepam, on the other hand, was a better anticonvulsant than in antiepileptogenic agent in the P15 animals at the dose tested. Such effects were not seen in the older animals. C1 Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90073 USA. Acad Sci Czech Republ, Inst Physiol, CR-14220 Prague, Czech Republic. RP Suchomelova, L (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, 11 301 Wilshire Blvd,Bldg 114,Rm 139, Los Angeles, CA 90073 USA. EM lsuchomc@ucla.edu RI Kubova, Hana/C-4210-2012 OI Kubova, Hana/0000-0002-2016-7428 FU NINDS NIH HHS [NS13515, NS045911, NS046516] NR 40 TC 51 Z9 51 U1 1 U2 3 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD FEB PY 2006 VL 59 IS 2 BP 237 EP 243 DI 10.1203/01.pdr.0000196333.16608.30 PG 7 WC Pediatrics SC Pediatrics GA 004PG UT WOS:000234764100014 PM 16439585 ER PT J AU Wilkinson, CW AF Wilkinson, CW TI Roles of acetylation and other post-translational modifications in melanocortin function and interactions with endorphins SO PEPTIDES LA English DT Review DE MSH; acetylation; pro-opiomelanocortin; endorphin ID MELANOCYTE-STIMULATING-HORMONE; AGOUTI-RELATED PROTEIN; GAMMA-MSH PEPTIDES; CENTRAL-NERVOUS-SYSTEM; PROOPIOMELANOCORTIN-DERIVED PEPTIDES; ANTERIOR LOBE CORTICOTROPES; INTRACELLULAR FREE CALCIUM; INCREASED SECRETORY DRIVE; BETA-ENDORPHIN; ALPHA-MSH AB Phylogenetic, developmental, anatomic, and stimulus-specific variations in post-translational processing of POMC are well established. For melanocortins, the role of alpha-N-acetylation and the selective activities of alpha, beta, and gamma forms are of special interest. Acetylation may shift the predominant activity of POMC products between endorphinergic and melanocortinergic actions-which are often in opposition. This review addresses: (1) variations in POMC processing; (2) the influence of acetylation on the functional activity of alpha-MSH; (3) state- and stimulus-dependent effects on the proportional distribution of forms of melanocortins and endorphins; (4) divergent effects of alpha-MSH and beta-endorphin administration; (5) potential roles of beta- and gamma-MSH. Published by Elsevier Inc. C1 VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Wilkinson, CW (reprint author), VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, S-182 GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM wilkinso@u.washington.edu NR 147 TC 33 Z9 33 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD FEB PY 2006 VL 27 IS 2 BP 453 EP 471 DI 10.1016/j.peptides.2005.05.029 PG 19 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 014NR UT WOS:000235487400024 PM 16280185 ER PT J AU Turner, AP Kivlahan, DR Rimmele, CT Bombardier, CH AF Turner, AP Kivlahan, DR Rimmele, CT Bombardier, CH TI Does preinjury alcohol use or blood alcohol level influence cognitive functioning after traumatic brain injury? SO REHABILITATION PSYCHOLOGY LA English DT Article DE alcohol; traumatic brain injury; cognition; rehabilitation; BAL ID DISORDERS IDENTIFICATION TEST; SPINAL-CORD-INJURY; SUBSTANCE-ABUSE; NATURAL-HISTORY; SELF-REPORTS; INTOXICATION; DRINKING; VALIDITY; ETHANOL; STATE AB Objective: To examine the relations among preinjury alcohol use patterns and admission blood alcohol level (BAL) and postinjury cognitive functioning among individuals with recent TBI. Design: Cohort survey with chart review and follow-up cognitive assessment. Setting: Acute inpatient rehabilitation program in a Level I trauma center. Participants: 124 consecutive initial admissions meeting inclusion criteria. Measures: Admission BAL, preinjury alcohol consumption, consequences, and symptoms of dependence, as well as initial injury severity and subsequent cognitive functioning. Results: Higher BAL at hospital admission was related to greater initial injury severity (lower Glasgow Coma Scale score). Preinjury alcohol consumption and admission BAL were not consistently related to any postinjury assessment of cognition. Conclusion: Alcohol use at the time of injury may exacerbate the initial severity of TBI. Cognitive functioning soon after injury does not appear to be related to any preinjury drinking behavior. C1 VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. VA Puget Cound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. RP Turner, AP (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv, S-117,1660 S Columbian Way, Seattle, WA 98108 USA. EM aaron.turner@med.va.gov OI Turner, Aaron/0000-0001-6897-8003 NR 49 TC 5 Z9 5 U1 3 U2 5 PU EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 0090-5550 EI 1939-1544 J9 REHABIL PSYCHOL JI Rehabil. Psychol. PD FEB PY 2006 VL 51 IS 1 BP 78 EP 86 DI 10.1037/0090-5550.51.1.78 PG 9 WC Psychology, Clinical; Rehabilitation SC Psychology; Rehabilitation GA 022FH UT WOS:000236040000011 ER PT J AU Schumacher, HR Chen, LX AF Schumacher, HR Chen, LX TI Newer therapeutic approaches: Gout SO RHEUMATIC DISEASE CLINICS OF NORTH AMERICA LA English DT Article ID SERUM URIC-ACID; PURINE SELECTIVE INHIBITOR; MYOCARDIAL-INFARCTION; XANTHINE-OXIDASE; CARDIOVASCULAR-DISEASE; INDUCED HYPERURICEMIA; RENAL-FUNCTION; RISK-FACTOR; URATE; ALLOPURINOL AB Newer approaches to the treatment of gout have included modifications and further attention to aspects of current therapies, and development of interesting new therapies. Colchicine prophylaxis appears to be needed longer than previously recognized after introduction of a urate-lowering agent. Diet has received attention, though most dietary effects are small. New agents under investigation include pegylated formulations of uricase and a new potent xanthine oxidase inhibitor, febuxostat. Some cardiovascular drugs have been shown to be uricosuric. C1 Philadelphia Vet Affairs Med Ctr, Div Rheumatol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Penn Presbyterian Med Ctr, Philadelphia, PA USA. RP Schumacher, HR (reprint author), Philadelphia Vet Affairs Med Ctr, Div Rheumatol, 151K,Univ & Woodlands Ave, Philadelphia, PA 19104 USA. EM schumacr@mail.med.upenn.edu NR 62 TC 11 Z9 16 U1 1 U2 7 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-857X J9 RHEUM DIS CLIN N AM JI Rheum. Dis. Clin. North Am. PD FEB PY 2006 VL 32 IS 1 BP 235 EP + DI 10.1016/j.rdc.2005.10.003 PG 11 WC Rheumatology SC Rheumatology GA 025ZV UT WOS:000236307400017 PM 16504833 ER PT J AU Khanna, D Arnold, EL Pencharz, JN Grossman, JM Traina, SB Lal, A MacLean, CH AF Khanna, D Arnold, EL Pencharz, JN Grossman, JM Traina, SB Lal, A MacLean, CH TI Measuring process of arthritis care: The Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis SO SEMINARS IN ARTHRITIS AND RHEUMATISM LA English DT Review DE rheumatoid arthritis; quality of care; quality measures; process of care ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; CORTICOSTEROID-INDUCED OSTEOPOROSIS; GLUCOCORTICOID-INDUCED OSTEOPOROSIS; RANDOMIZED CONTROLLED-TRIAL; LOW-DOSE METHOTREXATE; BONE-MINERAL DENSITY; TOTAL HIP-ARTHROPLASTY; 5-YEAR FOLLOW-UP; FEE-FOR-SERVICE; DOUBLE-BLIND AB OBJECTIVE To describe the scientific evidence that supports each of the explicit process measures in the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis. METHODS For each of the 27 measures in the Arthritis Foundation's Quality Indicator set, a comprehensive literature review was performed for evidence that linked the process of care defined in the indicator with relevant clinical outcomes and to summarize practice guidelines relevant to the indicators. RESULTS Over 7500 titles were identified and reviewed. For each of the indicators the scientific evidence to support or refute the quality indicator was summarized. We found direct evidence that supported a process-outcome link for 15 of the indicators, an indirect link for 7 of the indicators, and no evidence to support or refute a link for 5. The processes of care described in the indicators for which no supporting/refuting data were found have been assumed to be so essential to care that clinical trails assessing their importance have not, and probably never will be, performed. The process of care described in all but 2 of the indicators is recommended in 1 or more practice guidelines. CONCLUSION There are sufficient scientific evidence and expert consensus to support the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis, which defines a minimal standard of care that can be used to assess health care quality for patients with rheumatoid arthritis. C1 RAND, Hlth, Santa Monica, CA 90407 USA. Univ Cincinnati, Div Immunol, Cincinnati, OH 45221 USA. VAMC, Cincinnati, OH USA. Univ Calif Los Angeles, Div Rheumatol, Los Angeles, CA 90024 USA. Toronto Gen Hosp, Toronto Gen Res Inst, Toronto, ON, Canada. Univ Toronto, Fac Med, Inst Med Sci, Toronto, ON, Canada. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Greater Los Angeles Vet Adm Hlth Care Syst, Los Angeles, CA 90024 USA. RP MacLean, CH (reprint author), RAND, Hlth, 1776 Main St, Santa Monica, CA 90407 USA. EM maclean@rand.org NR 194 TC 29 Z9 29 U1 0 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0049-0172 J9 SEMIN ARTHRITIS RHEU JI Semin. Arthritis Rheum. PD FEB PY 2006 VL 35 IS 4 BP 211 EP 237 DI 10.1016/j.semarthit.2005.08.004 PG 27 WC Rheumatology SC Rheumatology GA 015GV UT WOS:000235540800003 PM 16461068 ER PT J AU Kushida, CA Morgenthaler, TI Littner, MR Alessi, CA Bailey, D Coleman, J Friedman, L Hirshkowitz, M Kapen, S Kramer, M Lee-Chiong, T Owens, J Pancer, JP AF Kushida, Clete A. Morgenthaler, Timothy I. Littner, Michael R. Alessi, Cathy A. Bailey, Dennis Coleman, Jack, Jr. Friedman, Leah Hirshkowitz, Max Kapen, Sheldon Kramer, Milton Lee-Chiong, Teofilo Owens, Judith Pancer, Jeffrey P. TI Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005 SO SLEEP LA English DT Article DE practice parameters; practice guidelines; standards of practice; snoring; obstructive sleep apnea syndrome; oral appliances; dental devices ID CARDIOVASCULAR-DISEASE AB These practice parameters are an update of the previously published recommendations regarding use of oral appliances in the treatment of snoring and Obstructive Sleep Apnea (OSA). Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the overall care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Follow-up polysomnography or an attended cardiorespiratory (Type 3) sleep study is needed to verify efficacy, and may be needed when symptoms of OSA worsen or recur. Patients with OSA who are treated with oral appliances should return for follow-up office visits with the dental specialist at regular intervals to monitor patient adherence, evaluate device deterioration or maladjustment, and to evaluate the health of the oral structures and integrity of the occlusion. Regular follow up is also needed to assess the patient for signs and symptoms of worsening OSA. Research to define patient characteristics more clearly for OA acceptance, success, and adherence is needed. C1 Stanford Univ, Ctr Excellence Sleep Disorders, Stanford, CA 94305 USA. Mayo Clin, Mayo Sleep Disorders Ctr, Rochester, MN USA. VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Sepulveda, CA USA. Middle Tennessee ENT, Murfreesboro, TN USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. VA Med Ctr, Detroit, MI USA. Wayne State Univ, Detroit, MI USA. Maimonides Hosp, Dept Psychiat, Brooklyn, NY 11219 USA. NYU, Sch Med, New York, NY USA. Natl Jewish Med & Res Ctr, Sleep Clin, Denver, CO USA. Rhode Isl Hosp, Dept Pediat, Providence, RI USA. RP Kushida, CA (reprint author), Stanford Univ, Ctr Excellence Sleep Disorders, Stanford, CA 94305 USA. OI Morgenthaler, Timothy/0000-0002-2614-3793 NR 8 TC 277 Z9 294 U1 2 U2 10 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD FEB 1 PY 2006 VL 29 IS 2 BP 240 EP 243 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 078SK UT WOS:000240123500016 PM 16494092 ER PT J AU Matsumori, Y Northington, FJ Hong, SHM Kayama, T Sheldon, A Vexler, ZS Ferriero, DM Weinstein, PR Liu, JL AF Matsumori, Y Northington, FJ Hong, SHM Kayama, T Sheldon, A Vexler, ZS Ferriero, DM Weinstein, PR Liu, JL TI Reduction of caspase-8 and-9 cleavage is associated with increased c-FLIP and increased binding of Apaf-1 and Hsp70 after neonatal hypoxic/ischemic injury in mice overexpressing Hsp70 SO STROKE LA English DT Article DE apoptosis; mitochondria; stress proteins ID PROGRAMMED CELL-DEATH; CYTOCHROME-C; HYPOXIA-ISCHEMIA; BRAIN-DAMAGE; IN-VIVO; APOPTOSIS; RAT; HEAT-SHOCK-PROTEIN-70; ACTIVATION; PROCASPASE-9 AB Background and Purpose - Caspase-8 and caspase-9 are essential proteases of the extrinsic and intrinsic apoptotic pathways, respectively. We investigated whether neuroprotection associated with overexpression of heat-shock protein 70 (Hsp70), a natural cellular antiapoptotic protein, is mediated by caspase-8 and caspase-9 signaling in the neonatal mouse brain after hypoxia/ ischemia (H/I) injury. Methods - Postnatal day 7 transgenic mice overexpressing rat Hsp70 (Hsp70 Tg) and their wild-type (Wt) littermates underwent unilateral common carotid artery ligation followed by 30 minutes of exposure to 8% O-2. The expression of apoptotic proteins was quantified by Western blot analysis, and the specific interaction between Hsp70 and apoptotic protease activating factor 1 (Apaf-1) was determined by coimmunoprecipitation. Results - Hsp70 overexpression reduced cytosolic translocation of cytochrome c without affecting the levels of Apaf-1 and pro - caspase-9 24 hours after H/I. The expression of these apoptotic proteins in the naive neonatal brains was also not affected by Hsp70 overexpression. Reduced caspase-9 cleavage occurred in Hsp70 Tg mice compared with Wt littermates 24 hours after H/I and correlated with increased binding of Hsp70 and Apaf-1. Increased cellular Fas-associated death domain-like interleukin-1 beta-converting enzyme inhibitory protein (FLIP) expression and decreased caspase-8 cleavage were also observed in Hsp70 Tg compared with Wt mice 24 hours after H/I. Conclusions - Our results suggest that the extrinsic and intrinsic apoptotic pathways mediate the neuroprotective effects of Hsp70 overexpression in neonatal H/I, specifically by upregulating FLIP and sequestering Apaf-1, leading to reduced cleavage of caspase-8 and caspase-9. C1 Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Yamagata Univ, Sch Med, Dept Neurol Surg, Yamagata 99023, Japan. Johns Hopkins Univ, Sch Med, Dept Pediat, Eudowood Neonatal Pulm Div, Baltimore, MD 21205 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94143 USA. RP Liu, JL (reprint author), Univ Calif San Francisco, Dept Neurol Surg 112C, 4150 Clement St, San Francisco, CA 94121 USA. EM miro@itsa.ucsf.edu RI Liu, Jialing/A-8627-2012 OI Liu, Jialing/0000-0003-4420-4382 FU NINDS NIH HHS [NS33997, NS35902, NS44025, NS45059, P50 NS035902, R01 NS040469, R01 NS044025, R01 NS40469, R21 NS051576] NR 26 TC 46 Z9 58 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 FEB PY 2006 VL 37 IS 2 BP 507 EP 512 DI 10.1161/01.STR.0000199057.00365.20 PG 6 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 005NJ UT WOS:000234829800077 PM 16397188 ER PT J AU Tang, XN Xu, LJ Qiao, YL Giffard, R Yenari, MA AF Tang, XN Xu, LJ Qiao, YL Giffard, R Yenari, MA TI Microglia-derived reactive oxygen species potentiate blood-brain barrier disruption after stroke SO STROKE LA English DT Meeting Abstract CT International Stroke Conference CY FEB 16-18, 2006 CL Kissimmee, FL SP Amer Stroke Assoc C1 UCSF, San Francisco VAMC, San Francisco, CA USA. Stanford Univ, Stanford, CA 94305 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2006 VL 37 IS 2 BP 630 EP 630 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 005NJ UT WOS:000234829800143 ER PT J AU Tang, XN Blankenberg, F Cheng, DY Yenari, MA AF Tang, XN Blankenberg, F Cheng, DY Yenari, MA TI Imaging apoptosis by Tc-99m-labeled annexin V spect after stroke SO STROKE LA English DT Meeting Abstract CT International Stroke Conference CY FEB 16-18, 2006 CL Kissimmee, FL SP Amer Stroke Assoc C1 UCSF, San Francisco, CA USA. San Francisco VAMC, San Francisco, CA USA. Stanford Univ, Stanford, CA 94305 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2006 VL 37 IS 2 BP 645 EP 645 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 005NJ UT WOS:000234829800215 ER PT J AU Chu, BC Ferguson, M Underhill, H Takaya, N Small, R Hatsukami, TS Yuan, C AF Chu, BC Ferguson, M Underhill, H Takaya, N Small, R Hatsukami, TS Yuan, C TI Multicontrast weighted, high-resolution MRI characterization of carotid ulceration/rupture and thrombus: An MRI-histology study SO STROKE LA English DT Meeting Abstract CT International Stroke Conference CY FEB 16-18, 2006 CL Kissimmee, FL SP Amer Stroke Assoc C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2006 VL 37 IS 2 BP 650 EP 650 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 005NJ UT WOS:000234829800237 ER PT J AU Khan, M Elango, C Singh, AK Johnson, RH Singh, I AF Khan, M Elango, C Singh, AK Johnson, RH Singh, I TI Ceramide participates in the penumbral damage in a rat model of experimental stroke by a mechanism involving c-Jun N-Terminal kinase and reactive oxygen species SO STROKE LA English DT Meeting Abstract CT International Stroke Conference CY FEB 16-18, 2006 CL Kissimmee, FL SP Amer Stroke Assoc 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 LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2006 VL 37 IS 2 BP 731 EP 731 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 005NJ UT WOS:000234829800645 ER PT J AU Gelfenbeyn, M Goodkin, R Kliot, M AF Gelfenbeyn, M Goodkin, R Kliot, M TI Sterile recurrent spinal epidural abscess in a patient with Crohn's disease: a case report SO SURGICAL NEUROLOGY LA English DT Article DE spinal epidural abscess; Crohn's disease; case report ID EXTRADURAL ABSCESS; BACTERIAL-MENINGITIS; MANAGEMENT; DIAGNOSIS; COMPLICATION; DRAINAGE AB Background: The frequency of SEA is increasing. There are several well-established predisposing factors. Case Description: Our case presents certain unusual features that include an association with CD, persistent sterile cultures, and multiple recurrences of lesions at adjacent levels. Conclusions: A review of the literature showed only 13 case reports of SEA in patients with CD with an additional patient mentioned in one series. Recurrence of SEA at the same location was reported only twice. The diagnostic workup and treatment modalities pertinent to this case are discussed. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Gelfenbeyn, M (reprint author), Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. NR 39 TC 8 Z9 8 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-3019 J9 SURG NEUROL JI Surg. Neurol. PD FEB PY 2006 VL 65 IS 2 BP 178 EP 184 DI 10.1016/j.surneu.2005.05.028 PG 7 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 012ZQ UT WOS:000235379800015 PM 16427419 ER PT J AU Tetzlaff, MT Teh, BS Timme, TL Fujita, T Satoh, T Tabata, KI Mai, WY Vlachaki, MT Amato, RJ Kadmon, D Miles, BJ Ayala, G Wheeler, TM Aguilar-Cordova, E Thompson, TC Butler, EB AF Tetzlaff, MT Teh, BS Timme, TL Fujita, T Satoh, T Tabata, KI Mai, WY Vlachaki, MT Amato, RJ Kadmon, D Miles, BJ Ayala, G Wheeler, TM Aguilar-Cordova, E Thompson, TC Butler, EB TI Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer SO TECHNOLOGY IN CANCER RESEARCH & TREATMENT LA English DT Article DE radiation therapy; gene therapy; prostate cancer; therapeutic index ID THYMIDINE KINASE GENE; DOUBLE-SUICIDE GENE; INTENSITY-MODULATED RADIOTHERAPY; TK PLUS GCV; TRANSGENE EXPRESSION SENSITIZES; UNFAVORABLE-PROGNOSIS CARCINOMA; ORTHOTOPIC MOUSE MODEL; TUMOR-SUPPRESSOR GENE; PHASE-III TRIAL; REPLICATION-COMPETENT AB The advances in radiotherapy (3D-CRT, IMRT) have enabled high doses of radiation to be delivered with the least possible associated toxicity. However, the persistence of cancer (local recurrence after radiotherapy) despite these increased doses as well as distant failure suggesting the existence of micro-metastases, especially in the case of higher risk disease, have underscored the need for continued improvement in treatment strategies to manage local and micro-metastatic disease as definitively as possible. This has prompted the idea that an increase in the therapeutic index of radiotherapy might be achieved by combining it with in situ gene therapy. The goal of these combinatorial therapies is to maximize the selective pressure against cancer cell growth while minimizing treatment-associated toxicity. Major efforts utilizing different gene therapy strategies have been employed in conjunction with radiotherapy. We reviewed our and other published clinical trials utilizing this combined radio-genetherapy approach including their associated pre-clinical in vitro and in vivo models. The use of in situ gene therapy as an adjuvant to radiation therapy dramatically reduced cell viability in vitro and tumor growth in vivo. No significant worsening of the toxicities normally observed in single-modality approaches were identified in Phase I/II clinical studies. Enhancement of both local and systemic T-cell activation was noted with this combined approach suggesting anti-tumor immunity. Early clinical outcome including biochemical and biopsy data was very promising. These results demonstrate the increased therapeutic efficacy achieved by combining in situ gene therapy with radiotherapy in the management of local prostate cancer. The combined approach maximizes tumor control, both local-regional and systemic through radio-genetherapy induced cytotoxicity and anti-tumor immunity. C1 Baylor Coll Med, Dept Radiol, Sect Radiat Oncol, Houston, TX 77030 USA. Baylor Coll Med, Scott Dept Urol, Houston, TX 77030 USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Methodist Hosp, Dept Radiat Oncol, Houston, TX 77030 USA. Methodist Hosp, GU Oncol Program, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. RP Teh, BS (reprint author), Baylor Coll Med, Dept Radiol, Sect Radiat Oncol, Houston, TX 77030 USA. EM bteh@bcm.tmc.edu FU PHS HHS [P50-58204] NR 95 TC 5 Z9 7 U1 1 U2 1 PU ADENINE PRESS PI SCHENECTADY PA 2066 CENTRAL AVE, SCHENECTADY, NY 12304 USA SN 1533-0346 J9 TECHNOL CANCER RES T JI Technol. Cancer Res. Treat. PD FEB PY 2006 VL 5 IS 1 BP 23 EP 36 PG 14 WC Oncology SC Oncology GA 013MN UT WOS:000235413500004 PM 16417399 ER PT J AU Xu, JM Hershman, JM AF Xu, JM Hershman, JM TI Histone deacetylase inhibitor depsipeptide represses nicotinamide N-methyltransferase and hepatocyte nuclear factor-1 beta gene expression in human papillary thyroid cancer cells SO THYROID LA English DT Article ID PARKINSONS-DISEASE; GROWTH-INHIBITION; CARCINOMA CELLS; TRANSCRIPTION; FK228; IDENTIFICATION; ACTIVATION; MARKER; P53; HOMEOPROTEIN AB Nicotinamide N-methyltransferase (NNMT) catalyzes N-methylation of nicotinamide and other structural analogues. NNMT gene expression is enhanced in many papillary thyroid cancer cells and activated by hepatocyte nuclear factor (HNF)-1 beta. In this work, we studied the effects of depsipeptide, a histone deacetylase inhibitor, on NNMT gene expression in BHP 18-21 papillary thyroid cancer cells. Depsipeptide reduced NNMT mRNA level in a dose-dependent and time-dependent manner as determined by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). In contrast, expression of the sodium iodide symporter (NIS), a gene with differentiated function, was enhanced in the treated cells. NNMT protein level determined by Western blot analysis and NNMT catalytic activity was also reduced significantly in the depsipeptide-treated cells. To study the mechanism of NNMT gene repression by depsipeptide, effects of depsipeptide on NNMT promoter activity were determined by luciferase reporter gene assay. NNMT promoter activity was significantly reduced in the HNF-1 beta-positive BHP 18-21 cells but not in the HNF-1 beta-negative BHP 14-9 papillary cancer cells. A mutant reporter construct with mutations in a HNF-1 site in the NNMT basal promoter region did not respond to depsipeptide in both HNF-1 beta-positive and -negative cells. Depsipeptide reduced steady-state HNF-1 beta mRNA level, depleted nuclear HNF-1,6 protein levels, and abolished activity of DNA binding to the HNF-1 site in the NNMT promoter region. Protein synthesis inhibitor cycloheximide and proteasome inhibitor MG-132 enhanced HNF-1 beta stability in the depsipeptide-treated cells. In summary, depsipeptide represses NNMT and HNF-1 beta gene expression in some papillary thyroid cancer cells. The repression of NNMT by depsipeptide is at the transcription level through downregulation of transcription activator HNF-1 beta. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Endocrinol & Diabet Div, Los Angeles, CA USA. RP Hershman, JM (reprint author), VA Greater Los Angeles Healthcare Syst, Endocrinol Div 111D, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jhershman@ucla.edu NR 49 TC 9 Z9 9 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1050-7256 J9 THYROID JI Thyroid PD FEB PY 2006 VL 16 IS 2 BP 151 EP 160 DI 10.1089/thy.2006.16.151 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 025HM UT WOS:000236256100005 PM 16676400 ER PT J AU Yasar, AS Monkul, ES Sassi, RB Axelson, D Brambilla, P Nicoletti, MA Hatch, JP Keshavan, M Ryan, N Birmaher, B Soares, JC AF Yasar, AS Monkul, ES Sassi, RB Axelson, D Brambilla, P Nicoletti, MA Hatch, JP Keshavan, M Ryan, N Birmaher, B Soares, JC TI MRI study of corpus callosum in children and adolescents with bipolar disorder SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE mood disorders; neuroimaging; white matter ID UNIPOLAR AB This structural magnetic resonance imaging study examined the length, areas, and circularity of the corpus callosum (CC) in 16 children and adolescents with bipolar disorder and 21 healthy controls. Bipolar disorder patients had lower circularity of the CC splenium compared with healthy controls. No significant differences in CC length or area were observed, suggesting that reported CC abnormalities appear late in the course of bipolar disorder. (c) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Program, San Antonio, TX 78229 USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Ctr Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA USA. Univ Verona, Dept Med & Publ Hlth, Sect Psychiat, I-37100 Verona, Italy. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78284 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Program, 7703 Floyd Curl Dr,MC-7792, 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 [RR020571]; NIMH NIH HHS [MH 01736, MH 30915, MH 55123, MH 59929] NR 15 TC 30 Z9 30 U1 2 U2 5 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD JAN 30 PY 2006 VL 146 IS 1 BP 83 EP 85 DI 10.1016/j.pscychresns.2005.09.004 PG 3 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 029EE UT WOS:000236541100010 PM 16337778 ER PT J AU Caetano, SC Hatch, JP Brambilla, P Sassi, RB Nicolletti, M Malinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC AF Caetano, SC Hatch, JP Brambilla, P Sassi, RB Nicolletti, M Malinger, AG Frank, E Kupfer, DJ Keshavan, MS Soares, JC TI Anatomical MRI study of hippocampus and amygdala in patients with current and remitted major depression (vol 132, pg 141, 2004) SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Correction C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, BR-01051 Sao Paulo, Brazil. Univ Udine, Sect Psychiat, Dept Pathol & Expt & Clin Med, I-33100 Udine, Italy. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 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, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010; Caetano, Sheila/H-5010-2012 OI brambilla, paolo/0000-0002-4021-8456; Caetano, Sheila/0000-0001-8403-7078 NR 1 TC 0 Z9 0 U1 0 U2 2 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD JAN 30 PY 2006 VL 146 IS 1 BP 103 EP 103 DI 10.1016/j.pscychresns.2005.10.001 PG 1 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 029EE UT WOS:000236541100013 ER PT J AU MacLean, CH Newberry, SJ Mojica, WA Khanna, P Issa, AM Suttorp, MJ Lim, YW Traina, SB Hilton, L Garland, R Morton, SC AF MacLean, CH Newberry, SJ Mojica, WA Khanna, P Issa, AM Suttorp, MJ Lim, YW Traina, SB Hilton, L Garland, R Morton, SC TI Effects of omega-3 fatty acids on cancer risk - A systematic review SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID DIETARY-FAT INTAKE; BREAST-CANCER; PROSTATE-CANCER; COLON-CANCER; LUNG-CANCER; COLORECTAL-CANCER; ENTERAL IMMUNONUTRITION; METHODOLOGICAL QUALITY; NETHERLANDS-COHORT; PANCREATIC-CANCER AB Context Omega-3 fatty acids are purported to reduce the risk of cancer. Studies have reported mixed results. Objective To synthesize published and unpublished evidence to determine estimates of the effect of omega-3 fatty acids on cancer risk in prospective cohort studies. Data Sources Articles published from 1966 to October 2005 identified through MEDLINE, PREMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and CAB Health; unpublished literature sought through letters to experts in the neutraceutical industry. Study Selection A total of 38 articles with a description of effects of consumption of omega-3 fatty acids on tumor incidence, prospective cohort study design, human study population; and description of effect of omega-3 among groups with different levels of exposure in the cohort were included. Two reviewers independently reviewed articles using structured abstraction forms; disagreements were resolved by consensus. Data Extraction Two reviewers independently abstracted detailed data about the incidence of cancer, the type of cancer, the number and characteristics of the patients, details on the exposure to omega-3 fatty acids, and the elapsed time between the intervention and outcome measurements. Data about the methodological quality of the study were also abstracted. Data Synthesis Across 20 cohorts from 7 countries for 11 different types of cancer and using up to 6 different ways to categorize omega-3 fatty acid consumption, 65 estimates of the association between omega-3 fatty acid consumption were reported. Among these, only 8 were statistically significant. The high degree of heterogeneity across these studies precluded pooling of data. For breast cancer 1 significant estimate was for increased risk (incidence risk ratio [RR], 1.47; 95% confidence interval [CI], 1.10-1.98) and 3 were for decreased risk (RR, 0.68-0.72); 7 other estimates did not show a significant association. For colorectal cancer, there was 1 estimate of decreased risk (RR, 0.49; 95% Cl, 0.27-0.89) and 17 estimates without association. For lung cancer one of the significant associations was for increased cancer risk (IRR, 3.0; 95% Cl, 1.2-7.3), the other was for decreased risk (RR, 0.32; 95% Cl, 0.13-0.76), and 4 other estimates were not significant. For prostate cancer, there was 1 estimate of decreased risk (RR, 0.43; 95% Cl, 0.22-0.83) and 1 of increased risk (RR, 1.98; 95% Cl, 1.34-2.93) for advanced prostate cancer; 15 other estimates did not show a significant association. The study that assessed skin cancer found an increased risk (RR, 1.13; 95% CI, 1.01-1.27). No significant associations between omega-3 fatty acid consumption and cancer incidence were found for aerodigestive cancer, bladder cancer, lymphoma, ovarian cancer, pancreatic cancer, or stomach cancer. Conclusions A large body of literature spanning numerous cohorts from many countries and with different demographic characteristics does not provide evidence to suggest a significant association between omega-3 fatty acids and cancer incidence. Dietary supplementation with omega-3 fatty acids is unlikely to prevent cancer. C1 So Calif Evidence Based Practice Ctr, Santa Monica, CA USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Wright State Univ, Sch Med, Dayton, OH USA. RP MacLean, CH (reprint author), RAND Corp, 1776 Main St,M4W, Santa Monica, CA 90407 USA. EM maclean@rand.org FU PHS HHS [290-02-0003] NR 60 TC 280 Z9 290 U1 10 U2 39 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 25 PY 2006 VL 295 IS 4 BP 403 EP 415 DI 10.1001/jama.295.4.403 PG 13 WC Medicine, General & Internal SC General & Internal Medicine GA 005QJ UT WOS:000234838600021 PM 16434631 ER PT J AU Aujesky, D Obrosky, DS Stone, RA Auble, TE Perrier, A Cornuz, J Roy, PM Fine, MJ AF Aujesky, D Obrosky, DS Stone, RA Auble, TE Perrier, A Cornuz, J Roy, PM Fine, MJ TI A prediction rule to identify low-risk patients with pulmonary embolism SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID DEEP-VEIN THROMBOSIS; MOLECULAR-WEIGHT HEPARIN; RIGHT-VENTRICULAR DYSFUNCTION; OUTPATIENT TREATMENT; UNFRACTIONATED HEPARIN; VENOUS THROMBOEMBOLISM; PROGNOSTIC VALUE; TROPONIN-T; TOTAL HIP; ADMISSION AB Background: A simple prognostic model could help identify patients with pulmonary embolism who are at low risk of death and are candidates for outpatient treatment. Methods: We randomly allocated 15 531 retrospectively identified inpatients who had a discharge diagnosis of pulmonary embolism from 186 Pennsylvania hospitals to derivation (67%) and internal validation (33%) samples. We derived our rule to predict 30-day mortality using classification tree analysis and patient data routinely available at initial examination as potential predictor variables. We used data from a European prospective study to externally validate the rule among 221 inpatients with pulmonary embolism. We determined mortality and nonfatal adverse medical outcomes across derivation and validation samples. Results: Our final model consisted of 10 patient factors (age >= 70 years: history of cancer, heart failure, chronic lung disease, chronic renal disease, and cerebrovascular disease; and clinical variables of pulse rate >= 110 beats/min, systolic blood pressure < 100 mm Hg, altered mental status, and arterial oxygen saturation <90%). Patients with none of these factors were defined as low risk. The 30-day mortality rates for low-risk patients were 0.6%, 1.5%, and 0% in the derivation, internal validation, and external validation samples, respectively. The rates of nonfatal adverse medical outcomes were less than 1% among low-risk patients across all study samples. Conclusions: This simple prediction rule accurately identifies patients with pulmonary embolism who are at low risk of short-term mortality and other adverse medical outcomes. Prospective validation of this rule is important before its implementation as a decision aid for outpatient treatment. C1 Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA USA. VA Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Lausanne, Univ Outpatient Clin, Dept Internal Med, Lausanne, Switzerland. Univ Lausanne, Clin Epidemiol Ctr, Lausanne, Switzerland. Univ Geneva, Dept Internal Med, Div Gen Internal Med, Geneva, Switzerland. Univ Angers, Dept Emergency Med, Angers, France. RP Aujesky, D (reprint author), CHU Vaudois, Serv Med Interne, BH 10-622, CH-1011 Lausanne, Switzerland. EM aujesky@swissonline.ch RI Perrier, Arnaud/M-2263-2014 FU NHLBI NIH HHS [1 R21 HL075521-01A1] NR 44 TC 104 Z9 109 U1 1 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 23 PY 2006 VL 166 IS 2 BP 169 EP 175 DI 10.1001/archinte.166.2.169 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 004RH UT WOS:000234769400005 PM 16432084 ER PT J AU Metlay, JP Fishman, NO Joffe, M Edelstein, PH AF Metlay, JP Fishman, NO Joffe, M Edelstein, PH TI Impact of pediatric vaccination with pneumococcal conjugate vaccine on the risk of bacteremic pneumococcal pneumonia in adults SO VACCINE LA English DT Article; Proceedings Paper CT 4th International Symposium on Pneumococci and Pneumococcal Diseases CY MAY 09-13, 2004 CL Helsinki, FINLAND DE pneumococcal infections; pneumococcal vaccines; bacteremia; herd immunity ID POLYSACCHARIDE VACCINE; DISEASE; CARRIAGE AB Invasive pneumococcal disease in adults may be declining, reflecting a form of herd protection from a new pediatric pneumococcal conjugate vaccine. Our aim was to determine whether vaccination of children protects adults in the same home from bacteremic pneumococcal pneumonia. We conducted a case-control study with 43 participating hospitals across a five-county region in Pennsylvania. Eligible cases were adults with bacteremic pneumococcal pneumonia identified by the microbiology laboratories at participating hospitals. Controls were healthy adults from the region identified through random digit dialing. Cases and controls were interviewed by telephone. We analyzed vaccine protection in those adults who reported living in homes with at least one child <= 6 years of age. From April 2002 through June 2004, there was a significant decline in the proportion of adult pneumococcal bacteremia due to any of the seven serotypes in the conjugate vaccine (p = 0.006). Within this time period, 17% of cases and controls reported living in homes with at least one child <= 6 years of age. In adjusted analysis, vaccination of the youngest child in the home was associated with an 80% reduction in the odds of bacteremic pneumococcal pneumonia among adults with children in the home (OR= 0.2, 95% Cl 0.1-0.8). We conclude that introduction of a pneumococcal conjugate vaccine for children has reduced the population rate of adult pneumococcal bacteremia due to vaccine serotypes and is associated with a reduced risk of bacteremic pneumococcal pneumonia for adults with children in the home. (c) 2005 Elsevier Ltd. All rights reserved. C1 Vet Affairs Med Ctr, Dept Vet Affairs, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Biostat & Epidemiol, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Educ & Res Therapeut, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Pathol & Lab Med, Sch Med, Philadelphia, PA 19104 USA. RP Metlay, JP (reprint author), Vet Affairs Med Ctr, Dept Vet Affairs, 9th Floor, Philadelphia, PA 19104 USA. EM jmetlay@cceb.med.upenn.edu FU NIAID NIH HHS [R01 AI 46645] NR 18 TC 31 Z9 34 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD JAN 23 PY 2006 VL 24 IS 4 BP 468 EP 475 DI 10.1016/j.vaccine.2005.07.095 PG 8 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 008OZ UT WOS:000235051600010 PM 16125826 ER PT J AU Liu, Y Teeter, MM DuRand, CJ Neve, KA AF Liu, Y Teeter, MM DuRand, CJ Neve, KA TI Identification of a Zn2+-binding site on the dopamine D-2 receptor SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE allosteric modulation; zinc ion-binding site; dopamine D-2 receptor; site-directed mutagenesis ID BINDING-SITE; BETA(2)-ADRENERGIC RECEPTOR; ALLOSTERIC MODULATION; OPIOID RECEPTOR; ZINC; ACTIVATION; MECHANISMS; SODIUM; INHIBITION; PROTEINS AB Zinc (II) modulates the function of many integral membrane proteins. To identify the Zn2+-binding site responsible for allosteric modulation of the D-2 dopamine receptor, we first demonstrated that the binding site is likely located in extracellular loops or in transmembrane regions that are accessible from the extracellular milieu. We mutated every histidine in these regions to alanine; two mutants, H394A and H399A, exhibited a reduced response to Zn2+. Combined mutation of H394 and H399 caused a larger effect of zinc than did either single mutation. Mutation of other potential Zn2+-binding residues predicted to be in proximity to H394 or H399 did not substantially alter the potency of Zn2+. The double mutant H394A/H399A was similar to D-2 in affinity for [H-3]spiperone and ability to inhibit cyclic AMP accumulation. We conclude that binding of Zn2+ to H394 and H399 on the dopamine D, receptor contributes to allosteric regulation of antagonist binding. (c) 2005 Elsevier Inc. All rights reserved. C1 Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Univ Calif Davis, Dept Psychiat, Davis, CA 95616 USA. Univ Calif Davis, Dept Chem, Davis, CA 95616 USA. Boston Coll, Dept Chem, Chestnut Hill, MA 02467 USA. RP Neve, KA (reprint author), Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. EM nevek@ohsu.edu OI Neve, Kim/0000-0003-0109-7345 NR 38 TC 14 Z9 15 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 JAN 20 PY 2006 VL 339 IS 3 BP 873 EP 879 DI 10.1016/j.bbrc.2005.11.110 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 000CT UT WOS:000234439200023 PM 16332354 ER PT J AU Munhall, AC Johnson, SW AF Munhall, AC Johnson, SW TI Dopamine-mediated actions of ephedrine in the rat substantia nigra SO BRAIN RESEARCH LA English DT Article DE ephedrine; substantia nigra; dopamine; brain slice; neurophysiology; microelectrode ID VENTRAL TEGMENTAL AREA; POTASSIUM CONDUCTANCE; ZONA COMPACTA; D2 RECEPTORS; IN-VITRO; NEURONS; AMPHETAMINE; RELEASE; TRANSMISSION; SEROTONIN AB Although ephedrine is a centrally active stimulant, its effect on midbrain dopamine neurons is not known. To study the effect of ephedrine on dopamine-containing cells, current-clamp microelectrode recordings were made from substantia nigra pars compacta (SNC) neurons in horizontal brain slice preparations. Ephedrine (100-1000 mu M) slowed spontaneous firing and produced a modest concentration-dependent hyperpolarization of membrane potential (EC50 279 mu M), with a concomitant net decrease in membrane resistance. These effects were blocked by the D-2-like dopamine antagonist sulpiride (1 mu M). Electrically evoked inhibitory synaptic potentials mediated by GABA(B) receptors were reduced 28% by ephedrine. However, ephedrine did not reduce fast synaptic potentials mediated by GABA(A) or ionotropic glutamate receptors. Inhibition of the GABA(B) response appeared to be mediated by a postsynaptic mechanism because ephedrine also reduced baclofen-induced hyperpolarization by 28%. Both ephedrine-induced hyperpolarization and inhibition of baclofen-induced hyperpolarization were abolished when slices were superfused with the tyrosine hydroxylase inhibitor alpha-methyl-para-tyrosine (AMPT). Despite perfusion with AMPT, the ability of ephedrine to cause hyperpolarization was restored after perfusing the slice with dopamine (30 mu M). Taken together, these results suggest that ephedrine causes hyperpolarization and suppresses GABAB receptor-mediated effects by releasing endogenous dopamine. However, the high concentrations required to observe these effects in vitro suggest that biologically relevant central effects of ephedrine are more likely to be mediated either by non-dopamine systems, such as those involving noradrenaline, or by dopamine systems outside the SNC. (c) 2005 Elsevier B.V. All rights reserved. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R&D 61,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM johnsost@ohsu.edu FU NIMH NIH HHS [MH40416] NR 34 TC 9 Z9 9 U1 1 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JAN 19 PY 2006 VL 1069 IS 1 BP 96 EP 103 DI 10.1016/j.brainres.2005.11.044 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 018IZ UT WOS:000235759000011 PM 16386715 ER PT J AU Larson, EB Wang, L Bowen, JD McCormick, WC Teri, L Crane, P Kukull, W AF Larson, EB Wang, L Bowen, JD McCormick, WC Teri, L Crane, P Kukull, W TI Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID PHYSICAL-ACTIVITY; ALZHEIMERS-DISEASE; COGNITIVE PERFORMANCE; APOLIPOPROTEIN-E; AEROBIC FITNESS; HEALTH; PEOPLE; ADULTS; RECOMMENDATION; IMPAIRMENT AB Background: Alzheimer disease and other dementing disorders are major sources of morbidity and mortality in aging societies. Proven strategies to delay onset or reduce risk for dementing disorders would be greatly beneficial. Objective: To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease. Design: Prospective cohort study. Setting: Group Health Cooperative, Seattle, Washington. Participants: 1740 persons older than age 65 years without cognitive impairment who scored above the 25th percentile on the Cognitive Ability Screening Instrument (CASI) in the Adult Changes in Thought study and who were followed biennially to identify incident dementia. Measurements: Baseline measurements, including exercise frequency, cognitive function, physical function, depression, health conditions, lifestyle characteristics, and other potential risk factors for dementia (for example, apolipoprotein E EURO4); biennial assessment for dementia. Results: During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease). The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% Cl, 0.44 to 0.86; P = 0.004). The interaction between exercise and performance-based physical function was statistically significant (P = 0.013). The risk reduction associated with exercise was greater in those with lower performance levels. Similar results were observed in analyses restricted to participants with incident Alzheimer disease. Limitations: Exercise was measured by self-reported frequency. The study population had a relatively high proportion of regular exercisers at baseline. Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons. C1 Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. RP Larson, EB (reprint author), Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, 1730 Minor Ave,Suite 1600, Seattle, WA 98101 USA. EM larson.e@ghc.org RI Crane, Paul/C-8623-2014 OI Kukull, Walter/0000-0001-8761-9014; Crane, Paul/0000-0003-4278-7465 FU NIA NIH HHS [AG06781] NR 44 TC 543 Z9 572 U1 13 U2 122 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JAN 17 PY 2006 VL 144 IS 2 BP 73 EP 81 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 004AX UT WOS:000234725500003 PM 16418406 ER PT J AU Rumsfeld, JS Epstein, AJ AF Rumsfeld, JS Epstein, AJ TI Racial disparities in cardiovascular procedure outcomes - Turn down the volume SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Editorial Material ID BYPASS GRAFT-SURGERY; QUALITY; MORTALITY; PATIENT; CARE; RACE C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Sect Cardiol,Div Cardiol, Denver, CO 80220 USA. Yale Sch Publ Hlth, Div Hlth Policy & Adm, New Haven, CT USA. RP Rumsfeld, JS (reprint author), Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Sect Cardiol,Div Cardiol, Cardiol 111B,1055 Clermont St, Denver, CO 80220 USA. EM John.Rumsfeld@med.va.gov NR 17 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JAN 17 PY 2006 VL 47 IS 2 BP 425 EP 426 DI 10.1016/j.jacc.2005.10.025 PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 003FM UT WOS:000234667100026 PM 16412872 ER PT J AU Kepe, V Barrio, JR Huang, SC Ercoli, L Siddarth, P Shoghi-Jadid, K Cole, GM Satyamurthy, N Cummings, JL Small, GW Phelps, ME AF Kepe, V Barrio, JR Huang, SC Ercoli, L Siddarth, P Shoghi-Jadid, K Cole, GM Satyamurthy, N Cummings, JL Small, GW Phelps, ME TI Serotonin 1A receptors in the living brain of Alzheimer's disease patients SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article DE [F-18]MPPF; brain 5-HT1A receptors; neuronal loss; positron emission tomography ID MILD COGNITIVE IMPAIRMENT; NEUROFIBRILLARY TANGLES; 5-HT1A RECEPTOR; NEURONAL LOSS; HIPPOCAMPAL-FORMATION; ENTORHINAL CORTEX; PYRAMIDAL NEURONS; PET; TOMOGRAPHY; PLAQUES AB 4-[F-18]fluoro-N-{2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl}-N-(2-pyridinyl)benzamide, a selective serotonin 1A (5-HT1A) molecular imaging probe, was used in conjunction with positron emission tomography (PET) for quantification of 5-HT1A receptor densities in the living brains of Alzheimer's disease patients (ADs) (n = 8), subjects with mild cognitive impairment (n = 6), and controls (n = 5). ADs had receptor densities significantly decreased in both hippocampi (binding potential: controls 1.62 +/- 0.07; ADs 1.18 +/- 0.26) and also in raphe nuclei (controls 0.63 +/- 0.09; ADs 0.37 +/- 0.20). When volume losses are included, 5-HT1A losses are even more severe (i.e., average mean decreases of 24% in mild cognitive impairment patients and 49% in ADs). A strong correlation of 5-HT1A receptor decreases in hippocampus with worsening of clinical symptoms (Mini Mental State Exam scores) was also found. Moreover, these decreases in 5-HT1A receptor measures correlate with decreased glucose utilization as measured with 2-deoxy-2-[F-18]fluoro-D-glucose PET in the brains of ADs (standardized uptake values; globally: controls 0.89 +/- 0.04, ADs 0.72 +/- 0.04; posterior cingulate gyrus: controls 1.05 +/- 0.09, ADs 0.79 +/- 0.11). They also inversely correlate with increased neuropathological loads measured with 2-(1-{6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl)ethylidene)malononitrile PET in several neocortical regions in the same subjects. The in vivo observations were confirmed independently by in vitro digital autoradiography with 4-[F-18]fluoro-N-{2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl)-N-(2-pyridinyl)benz-amide and 2-(1-(6-[(2-[F-18]fluoroethyl)(methyl)amino]-2-naphthyl)ethylidene)malononitrile on brain tissue specimens from two ADs and three nondemented subjects. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst & Geriatr, North Hills, CA 91343 USA. RP Barrio, JR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA 90095 USA. EM jbarrio@mednet.ucla.edu; mphelps@mednet.ucla.edu RI Shoghi, Kooresh/H-7398-2014 OI Shoghi, Kooresh/0000-0003-3204-457X FU NIA NIH HHS [P50 AG005142, AG05142] NR 45 TC 136 Z9 139 U1 0 U2 1 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD JAN 17 PY 2006 VL 103 IS 3 BP 702 EP 707 DI 10.1073/pnas.0510237103 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 004BU UT WOS:000234727800037 PM 16407119 ER PT J AU Cheng, CA Chen, JS Patel, RP AF Cheng, CA Chen, JS Patel, RP TI Unlabeled uses of botulinum toxins: A review, part 1 SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Review DE botulinum toxin A; botulinum toxins; drugs; mechanism of action; skeletal; muscle relaxants; toxicity ID TENSION-TYPE HEADACHE; RANDOMIZED CONTROLLED-TRIAL; ESSENTIAL HAND TREMOR; DOUBLE-BLIND; ESOPHAGEAL ACHALASIA; PALMAR HYPERHIDROSIS; PNEUMATIC DILATATION; FOCAL HYPERHIDROSIS; BALLOON DILATION; PLACEBO AB Purpose. Efficacy and safety data regarding the unlabeled uses of botulinum toxins are reviewed, and the pharmacology, adverse effects, and characteristics of commercially available botulinum toxins are discussed. Summary. More than 300 articles have been published on the use of botulinum toxins, particularly botulinum toxin type A, to treat conditions characterized by excessive smooth or skeletal muscle spasticity. Botulinum toxins are synthesized by Clostridium botulinum and cause temporary local paralysis of the injected muscle by inhibiting acetylcholine release at the neuromuscular junction. While botulinum toxins have Food and Drug Administration-approved labeling to treat a limited number of spasticity disorders, including cervical dystonia and blepharospasm, the toxins have more than 50 reported therapeutic uses. Among these uses, the most rigorously studied indications include achalasia, essential tremors, palmar hyperhidrosis, chronic anal fissures, headache prophylaxis, and limb spasticity. The main adverse effects of the toxins are pain and erythema at the injection site, although unintended paralysis of muscles adjacent to the site of toxin injection may also occur. Conclusion. Clinical studies support the use of botulinum toxins for certain conditions, although more studies are needed to establish the role of the drug relative to conventional therapies and to determine patient predictors of response. Although botulinum toxins are generally well tolerated, a patient-specific risk-benefit assessment should precede any decision to use them for unlabeled indications. C1 Univ Calif San Francisco, Drug Informat & Anal Serv, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Blue Shield Calif, San Francisco, CA USA. RP Cheng, CA (reprint author), Univ Calif San Francisco, Drug Informat & Anal Serv, 521 Parnassus Ave,C-152,Box 0622, San Francisco, CA 94143 USA. EM chengc@pharmacy.ucsf.edu NR 42 TC 24 Z9 24 U1 0 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 JAN 15 PY 2006 VL 63 IS 2 BP 145 EP 152 DI 10.2146/ajhp050137 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 006MN UT WOS:000234901700007 PM 16390928 ER PT J AU Trivedi, MA Schmitz, TW Ries, ML Torgerson, BM Sager, MA Hermann, BP Asthana, S Johnson, SC AF Trivedi, Mehul A. Schmitz, Taylor W. Ries, Michele L. Torgerson, Britta M. Sager, Mark A. Hermann, Bruce P. Asthana, Sanjay Johnson, Sterling C. TI Reduced hippocampal activation during episodic encoding in middle-aged individuals at genetic risk of Alzheimer's Disease: a cross-sectional study SO BMC MEDICINE LA English DT Review ID MILD COGNITIVE IMPAIRMENT; APOLIPOPROTEIN-E GENOTYPE; E EPSILON-4 ALLELE; CEREBRAL GLUCOSE-METABOLISM; VOXEL-BASED MORPHOMETRY; E TYPE-4 ALLELE; BRAIN ACTIVATION; MEMORY PERFORMANCE; NOVELTY DETECTION; ELDERLY SUBJECTS AB Background: The presence of the apolipoprotein E ( APOE) epsilon 4 allele is a major risk factor for the development of Alzheimer's disease ( AD), and has been associated with metabolic brain changes several years before the onset of typical AD symptoms. Functional MRI ( fMRI) is a brain imaging technique that has been used to demonstrate hippocampal activation during measurement of episodic encoding, but the effect of the epsilon 4 allele on hippocampal activation has not been firmly established. Methods: The present study examined the effects of APOE genotype on brain activation patterns in the medial temporal lobe ( MTL) during an episodic encoding task using a well-characterized novel item versus familiar item contrast in cognitively normal, middle-aged ( mean = 54 years) individuals who had at least one parent with AD. Results: We found that epsilon 3/4 heterozygotes displayed reduced activation in the hippocampus and MTL compared to epsilon 3/3 homozygotes. There were no significant differences between the groups in age, education or neuropsychological functioning, suggesting that the altered brain activation seen in epsilon 3/4 heterozygotes was not associated with impaired cognitive function. We also found that participants' ability to encode information on a neuropsychological measure of learning was associated with greater activation in the anterior MTL in the epsilon 3/3 homozygotes, but not in the epsilon 3/4 heterozygotes. Conclusion: Together with previous studies reporting reduced glucose metabolism and AD-related neuropathology, this study provides convergent validity for the idea that the MTL exhibits functional decline associated with the APOE epsilon 4 allele. Importantly, these changes were detected in the absence of meaningful neuropsychological differences between the groups. A focus of ongoing work in this laboratory is to determine if these findings are predictive of subsequent cognitive decline. C1 William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53706 USA. Univ Wisconsin, Sch Med, Dept Neurol, Madison, WI 53706 USA. RP Johnson, SC (reprint author), William S Middleton Mem Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM mt2@medicine.wisc.edu; tws@medicine.wisc.edu; mlr@medicine.wisc.edu; bmt@medicine.wisc.edu; masager@facstaff.wisc.edu; hermann@neurology.wisc.edu; sa@medicine.wisc.edu; scj@medicine.wisc.edu FU NIA NIH HHS [AG021155, R01 AG021155] NR 103 TC 73 Z9 74 U1 5 U2 10 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1741-7015 J9 BMC MED JI BMC Med. PD JAN 13 PY 2006 VL 4 AR 1 DI 10.1186/1741-7015-4-1 PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 145KH UT WOS:000244863200001 PM 16412236 ER PT J AU Jackson, LA Nelson, JC Whitney, CG Neuzil, KM Benson, P Malais, D Baggs, J Mullooly, J Black, S Shay, DK AF Jackson, LA Nelson, JC Whitney, CG Neuzil, KM Benson, P Malais, D Baggs, J Mullooly, J Black, S Shay, DK TI Assessment of the safety of a third dose of pneumococcal polysaccharide vaccine in the Vaccine Safety Datalink population SO VACCINE LA English DT Article DE pneumococcal vaccine; pneumococcal polysaccharide vaccine; vaccine safety AB There is little information on the safety of administration of a third dose of pneumococcal polysaccharide vaccine (PPV). The authors conducted a retrospective assessment of 316,995 adult members of three health maintenance organizations who had received one, two, or three PPV doses. Medical encounters associated with diagnosis codes potentially indicative of an injection site reaction in the week following a first, second, or third PPV dose were identified. These presumptive events occurred in 0.3% (911/279504) of the first PPV group, 0.7% (257/36888) of the second PPV group, and 0.5% (3/603) of the third PPV group (p > 0.5 for both comparisons with the third PPV group). These findings do not suggest that a third PPV dose is associated with an increased risk of medically attended injection site reactions compared with a first or second PPV dose. (c) 2005 Elsevier Ltd. All rights reserved. C1 Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. Kaiser Permanente NW Ctr Hlth Res, Portland, OR USA. Kaiser Permanente, Vaccine Study Ctr, Oakland, CA USA. RP Jackson, LA (reprint author), Ctr Hlth Studies, 1730 Minor Ave,Ste 1600, Seattle, WA 98101 USA. EM jackson.1@ghc.org OI Shay, David/0000-0001-9619-4820; Baggs, James/0000-0003-0757-4683 NR 5 TC 14 Z9 14 U1 1 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD JAN 12 PY 2006 VL 24 IS 2 BP 151 EP 156 DI 10.1016/j.vaccine.2005.07.066 PG 6 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 004UM UT WOS:000234777800006 PM 16122845 ER PT J AU Busuttil, RA Rubio, M Dolle, MET Campisi, J Vijg, J AF Busuttil, RA Rubio, M Dolle, MET Campisi, J Vijg, J TI Mutant frequencies and spectra depend on growth state and passage number in cells cultured from transgenic lacZ-plasmid reporter mice SO DNA REPAIR LA English DT Article DE lacZ-plasmid mouse embryonic fibroblasts; ultraviolet (UV); mutation; quiescence; proliferation ID IN-VIVO MUTATIONS; SOMATIC MUTATIONS; MURINE CELLS; MOUSE MODEL; REPAIR; FIBROBLASTS; IMMORTALIZATION; ACCUMULATION; REPLICATION; EXPRESSION AB Transgenic mice harboring the lacZ gene within a plasmid that can be recovered and amplified in Escherichia coli, to establish mutant frequencies and spectra, have provided crucial insights into the relationships between mutations, cancer and aging in vivo. Here, we use embryonic fibroblasts from transgenic lacZ-plasmid reporter mice to determine the relationship between cell proliferation in culture and mutations induced by ultraviolet (UV) light. A single dose of 2.5 J/m(2) of UVC to actively proliferating cells caused an approximately eightfold increase in mutant frequency 24 h after irradiation. Identically treated quiescent cells showed a two-fold increase in mutant frequency. Thus, whereas proliferation facilitated the acquisition of mutations, it was not an absolute requirement. Characterization of the UV-induced mutations indicated that the lower mutant frequency in quiescent cells was due mainly to a reduction in point mutations; size-change mutations, indicative of translocations or deletions, were relatively unaffected by the growth state of the cells. To investigate long-term genomic stability after UVC-induced damage, we monitored the lacZ locus in irradiated cells passaged for many generations in culture. The results indicated the emergence of jackpot mutations of rapidly changing frequency, most likely reflecting the successive emergence and decline of dominant cell clones during long-term culture. These findings show that the lacZ-plasmid locus is a valid reporter for studying induced mutations in short-term cultures of both quiescent and proliferating fibroblasts. In long-term cultures, the locus is less suitable for studying induced mutations owing to the instability of the cell population. (C) 2005 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78245 USA. Univ Calif Berkeley, Lawrence Berkeley Lab, Div Life Sci, Berkeley, CA 94720 USA. Natl Inst Publ Hlth & Environm, NL-3720 BA Bilthoven, Netherlands. Buck Inst Age Res, Novato, CA USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Inst Longev & Aging Studies, STCBM Bldg,Suite 2-200,15355 Lambda, San Antonio, TX 78245 USA. EM vijg@uthscsa.edu FU NIA NIH HHS [AG20438, AG17242] NR 24 TC 19 Z9 19 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1568-7864 J9 DNA REPAIR JI DNA Repair PD JAN 5 PY 2006 VL 5 IS 1 BP 52 EP 60 DI 10.1016/j.dnarep.2005.07.006 PG 9 WC Genetics & Heredity; Toxicology SC Genetics & Heredity; Toxicology GA 004VG UT WOS:000234780000006 PM 16126462 ER PT J AU Kilbourne, AM McGinnis, GF Belnap, BH Klinkman, M Thomas, M AF Kilbourne, AM McGinnis, GF Belnap, BH Klinkman, M Thomas, M TI The role of clinical information technology in depression care management SO ADMINISTRATION AND POLICY IN MENTAL HEALTH LA English DT Article DE chronic diseases; depression; information systems; major depressive disorder; quality improvement ID RANDOMIZED CONTROLLED-TRIAL; ELECTRONIC MEDICAL-RECORD; QUALITY IMPROVEMENT; TRANSLATING EVIDENCE; CHRONIC ILLNESS; HEALTH-CARE; STRATEGIES; TELEPHONE; COMPUTER; SYMPTOMS AB We examine the literature on the growing application of clinical information technology in managing depression care and highlight lessons learned from Robert Wood Johnson Foundation's national program "Depression in Primary Care-Incentives Demonstrations." Several program sites are implementing depression care registries. Key issues discussed about implementing registries include using a simple yet functional format, designing registries to track multiple conditions versus depression alone (i.e., patient-centric versus disease-centric registries) and avoiding violations of patient privacy with the advent of more advanced information technologies (e.g., web-based formats). Finally, we discuss some implications of clinical information technology for healthcare practices and policy makers. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Michigan, Dept Family Med, Ann Arbor, MI 48109 USA. Colorado Access, Denver, CO USA. Univ Colorado Hlth Sci Syst, Denver, CO USA. RP Kilbourne, AM (reprint author), VA Pittsburgh Ctr Hlth Equ Res & Promot 151C, Univ Dr C, Pittsburgh, PA 15240 USA. EM Amy.Kilbourne@med.va.gov NR 36 TC 7 Z9 7 U1 2 U2 2 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0894-587X J9 ADM POLICY MENT HLTH JI Adm. Policy. Ment. Health PD JAN PY 2006 VL 33 IS 1 BP 54 EP 64 DI 10.1007/s10488-005-4236-0 PG 11 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 043NB UT WOS:000237606800009 PM 16215661 ER PT J AU Jarvik, LF Matsityatna, SS AF Jarvik, LF Matsityatna, SS TI Two decades of research in Alzheimer disease: Looking back to the first volume of ADAD SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Editorial Material DE Alzheimer disease; research progress; retrospective ID CHILDREN AB During the first two decades of the life of this Journal (ADAD) much progress has been made in our understanding of Alzheimer disease (AD). Advancing knowledge, however, has been accompanied by increasing appreciation of the complexity and heterogeneity of this disease. Prevention and cure continue to elude us as the number of afflicted and the cost of their care continues to increase. New techniques together with long-term prospective follow-up studies, as well as utilization of data accumulated in existing data bases, are needed to mode the field forward. We expect that during the next two decades, as new information accrues, reports published in ADAD will continue to contribute to the dissemination and elucidation of critical issues in Alzheimer research. C1 Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Jarvik, LF (reprint author), Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, 760 Westwood Plaza, Los Angeles, CA 90095 USA. EM ljarvik@ucla.edu NR 13 TC 2 Z9 2 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PD JAN-MAR PY 2006 VL 20 IS 1 BP 3 EP 5 DI 10.1097/01.wad.0000202412.54976.1e PG 3 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 020OX UT WOS:000235920300002 PM 16493229 ER PT J AU Rumsfeld, JS Magid, DJ Peterson, ED Plomondon, ME Petersen, LA Grunwald, GK Every, NR Sales, AE AF Rumsfeld, JS Magid, DJ Peterson, ED Plomondon, ME Petersen, LA Grunwald, GK Every, NR Sales, AE TI Outcomes after acute coronary syndrome admission to primary versus tertiary Veterans Affairs medical centers: The Veterans Affairs Access to Cardiology study SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; QUALITY-OF-LIFE; ARTERY-DISEASE; FUNCTIONAL STATUS; ELDERLY-PATIENTS; UNSTABLE ANGINA; UNITED-STATES; HOSPITALS; REVASCULARIZATION; CATHETERIZATION AB Background There is a concern that patients with acute coronary syndrome (ACS) admitted to primary care hospitals (without on-site cardiac procedures) may be at risk for worse outcomes compared with patients admitted to tertiary care hospitals. In addition to mortality, one way to assess patient outcomes is via health status and rehospitalization rates. We compared the health status and rehospitalization of patients with ACS admitted to primary versus tertiary care Veterans Affairs hospitals. Methods This was a cohort study of 2132 patients with ACS admitted to 21 Veterans Affairs hospitals (12 primary care and 9 tertiary care) from 1998 to 1999. Primary outcomes were 7-month health status as measured by the Seattle Angina Questionnaire and rehospitalization. Hierarchical multivariable regression was used to evaluate the association between admission to a primary (vs tertiary) care hospital and these outcomes. Discharge medications and 7-month cardiac procedure rates were also compared. Results There were no significant differences in discharge medication rates between primary and tertiary hospital patients. Forty-two percent of the patients admitted to a primary care hospital was transferred to a tertiary care hospital during index admission. Primary hospital patients had significantly lower 7-month rates of cardiac catheterization (36% vs 51%, P<.001) and percutaneous coronary intervention (11% vs 20%, P<.001), but there were no differences in coronary artery bypass graft surgery rates. After risk adjustment, there were no significant differences in 7-month angina frequency (odds ratio [OR] 0.98, 95% CI 0.78-1.22), physical limitation (OR 0.97, 95% CI 0.77-1.23), quality of life (OR 1.12, 95% CI 0.89-1.40), or rehospitalization (OR 1.07, 95% CI 0.54-2.14) between the 2 groups. Conclusions These results suggest that an integrated health care system can achieve similar intermediate-term health status and rehospitalization outcomes for patients with ACS irrespective of the site of admission despite the lower rates of cardiac procedures for the primary care hospital patients. C1 Denver VA Med Ctr, Cardiol & Hlth Serv Res, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Colorado Permanente Med Grp, Clin Res Unit, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Duke Clin Res Inst, Durham, NC USA. Duke Univ, Med Ctr, Durham, NC USA. Houston VA Med Ctr, Hlth Serv Res, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Rumsfeld, JS (reprint author), Denver VA Med Ctr, Cardiol & Hlth Serv Res, Cardiol 111B,1055 Clermont St, Denver, CO 80220 USA. EM john.rumsfeld@med.va.gov RI Sales, Anne/D-9678-2012 OI Sales, Anne/0000-0001-9360-3334 NR 27 TC 1 Z9 1 U1 0 U2 1 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD JAN PY 2006 VL 151 IS 1 BP 32 EP 38 DI 10.1016/j.ahj.2005.03.012 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 000TK UT WOS:000234485100005 PM 16368288 ER PT J AU Legner, VJ Doerner, D McCormick, WC Reilly, DF AF Legner, VJ Doerner, D McCormick, WC Reilly, DF TI Clinician agreement with perioperative cardiovascular evaluation guidelines and clinical outcomes SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID MAJOR NONCARDIAC SURGERY; CARDIAC RISK; PREOPERATIVE ASSESSMENT; VASCULAR-SURGERY; AMERICAN-COLLEGE; AORTIC-SURGERY; COMPLICATIONS; MEDICINE; INDEX AB The American College of Cardiology/American Heart Association (ACC/AHA) published guidelines for preoperative cardiac risk stratification in 1996. Although clinician practice may differ from the guidelines, it remains unclear whether deviation from these guidelines affects clinical outcomes. This study sought to determine if discordance between clinician practice and the ACC/AHA guidelines affects perioperative cardiac outcomes. Eight hundred twenty-three patients who underwent 864 consecutive preoperative evaluations performed from 1995 to 1997 at a tertiary care academic medical center were prospectively followed. Clinician recommendations for preoperative cardiac testing were compared with ACC/AHA guideline recommendations. Frequencies of perioperative cardiac complications were compared between concordant and discordant testing recommendations. There were 33 perioperative cardiac complications (3.8%). Overall, there was no difference in the frequency of complications when there was discordance with the ACC/AHA guidelines compared with concordance (4.1% vs 3.7%, p = 0.81). The ACC/AHA guidelines recommended cardiac testing for 236 patients (27.3%). Clinicians ordered testing in half of those cases (n = 112). There was a lower frequency of cardiac complications when clinicians did not perform testing as recommended by the ACC/AHA guidelines (3.2% vs 10.7%, p = 0.02). Conversely, clinicians ordered cardiac testing in 45 patients (7%) when not recommended by the guidelines. Patients in this group had a trend toward more cardiac complications (6.7% vs 2.4%, p = 0.09). In conclusion, the failure of clinicians to follow the ACC/AHA guidelines when perioperative testing was recommended did not result in a higher frequency of cardiac complications. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Washington, Sch Med, Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Div Gerontol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Div Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Div Gen Internal Med, Seattle, WA 98195 USA. RP Legner, VJ (reprint author), Univ Washington, Sch Med, Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. EM legner@u.washington.edu NR 19 TC 6 Z9 6 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 JAN 1 PY 2006 VL 97 IS 1 BP 118 EP 122 DI 10.1016/j.amjcard.2005.07.115 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 002BU UT WOS:000234587200024 PM 16377295 ER PT J AU Ioannou, GN Boyko, EJ Lee, SP AF Ioannou, GN Boyko, EJ Lee, SP TI The prevalence and predictors of elevated serum aminotransferase activity in the United States in 1999-2002 SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID OVERWEIGHT AB OBJECTIVES: The presence of elevated serum aminotransferase activity is a sign of possible underlying liver disease. We aimed to describe the prevalence and associations of elevated serum aminotransferase activity in a recent, nationally representative U.S. survey. METHODS: We described the prevalence and predictors of elevated alanine aminotransferase (ALT > 43 IU/L) or elevated aspartate aminotransferase (AST > 40 IU/L) activity among 6,823 participants of the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2002. We compared our findings to the results already published based on the NHANES conducted between 1988 and 1994. RESULTS: In NHANES 1999-2002, the prevalences of elevated ALT, AST, or either ALT or AST were 8.9%, 4.9%, and 9.8%, respectively, in the entire population and 7.3%, 3.6%, and 8.1%, respectively, after excluding participants who tested positive for hepatitis C virus (HCV) antibody or reported excessive alcohol consumption. Strong predictors of elevated ALT activity included increasing waist circumference and body mass index, alcohol consumption, male sex, Mexican American ethnicity, decreasing age, and presence of HCV antibody. In NHANES 1988-1994, which employed a different assay methodology, the prevalences of elevated aminotransferases were approximately half of the prevalences we describe in NHANES 1999-2002, but the predictors of elevated ALT activity were similar. CONCLUSIONS: The current prevalence of elevated ALT activity in the United States (8.9%) is more than double that of previously available estimates. This prevalence is very high (7.3%) even among persons without viral hepatitis C or excessive alcohol consumption and is strongly associated with risk factors for nonalcoholic fatty liver disease. C1 VA Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA USA. Univ Washington, Dept Med, Div Gastroenterol, Seattle, WA USA. Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA. RP Ioannou, GN (reprint author), VA Puget Sound Hlth Care Syst, Res Enhancement Award Program, S-111-Gastro 1660 S Columbian Way, Seattle, WA 98108 USA. RI Lee, Sum Ping/C-4333-2009 OI Boyko, Edward/0000-0002-3695-192X NR 12 TC 143 Z9 148 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JAN PY 2006 VL 101 IS 1 BP 76 EP 82 DI 10.1111/j.1572-0241.2006.00341.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 999SY UT WOS:000234412000015 PM 16405537 ER PT J AU Bian, J Dow, WH Matchar, DB AF Bian, J Dow, WH Matchar, DB TI Medicare HMO penetration and mortality outcomes of ischemic stroke SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH MAINTENANCE ORGANIZATIONS; ACUTE MYOCARDIAL-INFARCTION; CARE MARKET SHARE; MANAGED CARE; SYSTEMS; SPECIALTIES; QUALITY; PLANS; RATES; COST AB objective: To examine associations between Medicare health maintenance organization (HMO) penetration and stroke mortality outcomes among older persons. Study Design: Panel analysis of nationally representative secondary data from 1993 to 1998. Methods: The first analysis sample included ischemic stroke hospitalizations among older persons in the Nationwide Inpatient Sample; the second included county-level ischemic stroke deaths in the National Vital Statistics System. The 2 samples were merged with the HMO enrollment data and the 2001 Area Resource File. The 2 outcomes were inhospital death status and county-level population ischemic stroke death rates among older persons; the 2 utilization variables were length of hospital stay for ischemic stroke and proportion of ischemic stroke deaths occurring in hospitals. The 3 key explanatory variables were county-level Medicare total, independent practice association, and nonindependent practice association HMO penetration. Ordinary least squares analysis with hospital or county fixed effects was used in estimation. Results: Medicare HMO penetration was not associated with the 2 ischemic stroke mortality outcomes (P > .05). Increases in Medicare total and independent practice association HMO penetration were associated with a significant shift in a higher proportion of stroke deaths from hospitals to nursing homes or residences (P < .05). Medicare HMO penetration was negatively associated with length of stay, although this was not statistically significant (P > .05). Conclusions: Increased Medicare HMO penetration was associated with a shift in ischemic stroke deaths from hospitals to nonhospital settings. The effect of Medicare HMO penetration on quality of stroke care needs further research. C1 Univ Alabama, Div Prevent Med, Birmingham, AL 35295 USA. Univ Calif Berkeley, Deep S Ctr Effectiveness, Birmingham VA Med Ctr, Berkeley, CA 94720 USA. Univ Calif Berkeley, Sch Publ Hlth, Div Hlth Policy & Management, Berkeley, CA 94720 USA. Duke Univ, Duke Ctr Clin Hlth Policy Res, Durham, NC USA. RP Bian, J (reprint author), Univ Alabama, Div Prevent Med, MT 640,1530 3rd Ave S, Birmingham, AL 35295 USA. EM jbian@uab.edu OI Dow, William/0000-0002-4080-1668 FU AHRQ HHS [T32 HS00032] NR 33 TC 2 Z9 2 U1 0 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 JAN PY 2006 VL 12 IS 1 BP 58 EP 64 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 004WA UT WOS:000234782100006 PM 16402889 ER PT J AU Berfield, AK Chait, A Oram, JF Zager, RA Johnson, AC Abrass, CK AF Berfield, AK Chait, A Oram, JF Zager, RA Johnson, AC Abrass, CK TI IGF-1 induces rat glomerular mesangial cells to accumulate triglyceride SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE chronic kidney disease; cholesterol; peroxisome proliferator-activated receptor; foam cells ID LOW-DENSITY-LIPOPROTEIN; GROWTH-FACTOR-I; SMOOTH-MUSCLE-CELLS; PROLIFERATOR-ACTIVATED RECEPTORS; MACROPHAGE SCAVENGER RECEPTORS; CHOLESTEROL EFFLUX; RENAL-DISEASE; OXIDIZED LDL; LIPID-ACCUMULATION; ZUCKER RATS AB Rat glomerular mesangial cells ( MC) become lipid-laden foam cells when they are exposed to IGF-1. IGF-1 increased accumulation of triglyceride (TG) 2.5-fold in MC after 7 days. TG accumulation resulted from enhanced macropinocytosis and decreased efflux secondary to a 40-50% reduction in peroxisome proliferator-activated receptor ( PPAR)-delta (PPAR-delta). There was no evidence of primary or secondary changes in cholesterol or TG synthesis, increased uptake by LDL or scavenger receptors, or reduced efflux via ATP-binding cassette A-1. Although the lipid moiety taken up can be influenced by the concentration of cholesterol or TG in the medium, in standard medium MC preferentially accumulate TG. TG-rich MC foam cells fail to contract in response to angiotensin II (Berfield AK, Andress DL, and Abrass CK. Kidney Int 62: 1229 1237, 2002); however, their migratory response to IGF binding protein-5 is unaffected. This differs from cholesterol loading, which impairs both phagocytosis and migration. These findings have important implications for understanding the mechanisms that contribute to lipid accumulation in MC and the functional consequences of different forms of foam cells. These observations are relevant to understanding vascular disease and progressive renal diseases that are accelerated by abnormalities in lipid metabolism. C1 Univ Washington, Sch Med, Dept Med, Div Endocrinol & Metab, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. RP Abrass, CK (reprint author), Univ Washington, Sch Med, Dept Med, Div Endocrinol & Metab, 1660 S Columbian Way, Seattle, WA 98108 USA. EM cabrass@u.washington.edu FU NIDDK NIH HHS [R01-DK-9771-05, DK-02456, R37-DK-38432] NR 81 TC 12 Z9 12 U1 0 U2 0 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 JAN PY 2006 VL 290 IS 1 BP F138 EP F147 DI 10.1152/ajprenal.00054.2005 PG 10 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 991YJ UT WOS:000233850500016 PM 16077083 ER PT J AU Lee, DBN Huang, E Ward, HJ AF Lee, DBN Huang, E Ward, HJ TI Tight junction biology and kidney dysfunction SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Review DE kidney disease; zonula occludens ID ACUTE-RENAL-FAILURE; TRANSCRIPTION FACTOR SNAIL; CELL-CELL ADHESION; EPITHELIAL-MESENCHYMAL TRANSITIONS; CHRONIC INTERSTITIAL NEPHRITIS; GLOMERULAR SLIT DIAPHRAGM; POLARITY PROTEIN PAR6; RHO-FAMILY GTPASES; E-CADHERIN; ATP DEPLETION AB Tight junction biology and kidney dysfunction. Am J Physiol Renal Physiol 290: F20-F34, 2006; doi:10.1152/ajprenal.00052.2005.- The epithelial tight junction (TJ) has three major functions. As a "gate," it serves as a regulatory barrier separating and maintaining biological fluid compartments of different composition. As a " fence," it generates and maintains the apicobasal polarity of cells that form the confluent epithelium. Finally, the TJ proteins form a trafficking and signaling platform that regulates cell growth, proliferation, differentiation, and dedifferentiation. Six examples are selected that illustrate the emerging link between TJ dysfunction and kidney disease. First, the glomerular slit diaphragm (GSD) is evolved, in part, from the TJ and, on maturation, exhibits all three functions of the TJ. GSD dysfunction leads to proteinuria and, in some instances, podocyte dedifferentiation and proliferation. Second, accumulating evidence supports epithelial-mesenchymal transformation (EMT) as a major player in renal fibrosis, the final common pathway that leads to end-stage renal failure. EMT is characterized by a loss of cell-cell contact and apicobasal polarity, which are hallmarks of TJ dysfunction. Third, in autosomal dominant polycystic kidney disease, mutations of the polycystins may disrupt their known interactions with the apical junction complex, of which the TJ is a major component. This can lead to disturbances in epithelial polarity regulation with consequent abnormal tubulogenesis and cyst formation. Fourth, evidence for epithelial barrier and polarity dysregulation in the pathogenesis of ischemic acute renal failure will be summarized. Fifth, the association between mutations of paracellin-1, the first TJ channel identified, and clinical disorders of magnesium and calcium wasting and bovine renal fibrosis will be used to highlight an integral TJ protein that can serve multiple TJ functions. Finally, the role of WNK4 protein kinase in shunting chloride across the TJ of the distal nephron will be addressed. C1 VA Med Ctr, Dept Med 111, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Ctr Med, Div Nephrol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Med, Vet Affairs Greater Los Angeles Healthcare Syst, VISN 22, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, King Drew Med Ctr, Los Angeles, CA 90059 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90059 USA. RP Lee, DBN (reprint author), VA Med Ctr, Dept Med 111, 16111 Plummer St, Sepulveda, CA 91343 USA. EM dbnlee@ucla.edu FU NHLBI NIH HHS [T32-HL-07656]; NIDDK NIH HHS [T32-DK-07789, 1R01DK/HD-51948] NR 184 TC 95 Z9 98 U1 0 U2 8 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 JAN PY 2006 VL 290 IS 1 BP F20 EP F34 DI 10.1152/ajprenal.00052.2005 PG 15 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 991YJ UT WOS:000233850500004 PM 16339962 ER PT J AU Tian, W Fu, Y Wang, DH Cohen, DM AF Tian, W Fu, Y Wang, DH Cohen, DM TI Regulation of TRPV1 by a novel renally expressed rat TRPV1 splice variant SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE transient receptor potential channel ID VANILLOID RECEPTOR; CAPSAICIN RECEPTOR; CATION CHANNEL; VR1; ACTIVATION; MUTATIONS; SUGGESTS; MEDIATE; CLONING; RNAS AB Regulation of TRPV by a novel renally expressed rat TRPV1 splice variant. Am J Physiol Renal Physiol 290: F117-F126, 2006. First published August 9, 2005; doi:10.1152/ajprenal.00143.2005.- The capsaicin receptor and transient receptor potential channel TRPV1 senses heat, protons, and vanilloid agonists in peripheral sensory ganglia. Abundant data have suggested the presence of potentially novel splice variants in the kidney. We report a novel rat TRPV1 splice variant, TRPV1(VAR), cloned from kidney papilla. TRPV1VAR cDNA was identified in multiple kidney tissues. Its sequence was fully compatible with potential splice donor and acceptor sites in the rat TRPV1 gene. TRPV1VAR is predicted to encode a truncated form of TRPV1 consisting of the NH(2)-terminal 248 residues of TRPV1 ( all within the NH(2)-terminal intracellular domain) followed by five non-consensus amino acids (Arg-Glu-Ala-Met-Trp) and a stop codon. The variant utilizes the same consensus Kozak sequence as canonical TRPV1. A band of the appropriate molecular mass was identified in rat kidney papillary ( but not medullary) lysates immunoblotted with an antibody directed against the NH(2) terminus of TRPV1, whereas an antibody recognizing the TRPV1 COOH terminus failed to detect it. Upon heterologous expression in HEK 293 cells, TRPV1(VAR) potentiated the ability of cotransfected TRPV1 to confer calcium influx in response to resiniferatoxin. TRPV1(VAR) did not influence expression or cell surface localization of cotransfected TRPV1. TRPV1(VAR) protein product associated with the NH2 terminus of canonical TRPV1. Interestingly, when expressed in the COS-7 epithelial cell line, TRPV1(VAR) functioned in a dominant-negative acting capacity, partially blocking TRPV1-dependent resiniferatoxin responsiveness. We conclude that TRPV1(VAR) is one of perhaps several TRPV1 splice variants expressed in rat kidney and that it may serve to modulate TRPV1 responsiveness in some tissues. C1 Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Michigan State Univ, Dept Med Pharmacol & Toxicol, E Lansing, MI 48824 USA. RP Cohen, DM (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Mailcode PP262,3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM cohend@ohsu.edu NR 35 TC 25 Z9 27 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 JAN PY 2006 VL 290 IS 1 BP F117 EP F126 DI 10.1152/ajprenal.00143.2005 PG 10 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 991YJ UT WOS:000233850500014 PM 16091583 ER PT J AU Reoux, JP Oreskovich, MR AF Reoux, JP Oreskovich, MR TI A comparison of two versions of the clinical institute withdrawal assessment for alcohol: The CIWA-Ar and CIWA-AD SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID BENZODIAZEPINES; MANAGEMENT; DETOXIFICATION; CARE AB Scores from two versions of the Clinical Institute Withdrawal Assessment for Alcohol, the CIWA-Ar and CIWA-AD, were compared in 135 alcohol detoxification episodes. The paired mean score for withdrawal severity was statistically higher with the CIWA-AD (p < 0.001), but the mean difference of 0.45 (95% CI: 0.38-0.53, t=11.74) is not likely to be clinically significant. The difference in the total score between the two scales was 1 point or less 82.6% of the time, and nearly all (97.7%) of the CIWA-AD scores were within 3 points of the paired CIWA-Ar score ( range -6 to +6). C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Reoux, JP (reprint author), VAPSHCS-116ATC,1660 S Columbian Way, Seattle, WA 98108 USA. EM joe.reoux@med.va.gov NR 16 TC 8 Z9 8 U1 1 U2 3 PU ROUTLEDGE JOURNALS, 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. PY 2006 VL 15 IS 1 BP 85 EP 93 DI 10.1080/10550490500419136 PG 9 WC Substance Abuse SC Substance Abuse GA 007TE UT WOS:000234991900012 PM 16449097 ER PT J AU Parchman, ML Romero, RL Pugh, JA AF Parchman, ML Romero, RL Pugh, JA TI Encounters by patients with type 2 diabetes - Complex and demanding: An observational study SO ANNALS OF FAMILY MEDICINE 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 DE diabetes mellitus; type 2; primary health care; quality of health care ID PRIMARY-CARE PRACTICE; COMPETING DEMANDS; QUALITY; VISITS; MANAGEMENT; SERVICES; DISEASES; CENTERS; MODEL; TIME AB PURPOSE We wanted to examine the relationships between quality of diabetes care delivered, the type and length of encounter, and time to the next follow-up encounter. METHODS The content of the physician-patient encounter was directly observed in 20 primary care clinics for 211 patients with type 2 diabetes mellitus. The quality of diabetes care was measured as the percentage of the 5 following services delivered during the encounter if they had not been offered in the previous year: foot examination, referral for an eye examination, a glycosylated hemoglobin (HbA(1c)) measurement, a lipid panel, and a urine microalbumin test. RESULTS All indicated services were performed in 33% of encounters. Compared with encounters for an acute illness, patients visiting for chronic disease follow-up were 4.8 (95% CI, 1.95%-12.01%) times more likely to receive 100% of all indicated services. Length of encounter was associated with percentage of services delivered, but only during chronic disease follow-up encounters (P =.02). Encounters during which 100% of all indicated services were delivered had a mean length of 19.4 minutes. The time to the next scheduled encounter was shorter if fewer services were delivered during the observed encounter (P =.009). CONCLUSIONS Competing demands during primary care encounters require patient and physician to prioritize services delivered and defer indicated services to subsequent visits. Current models of patient care in primary care settings are inadequate to address the multitude of tasks facing clinicians, especially among patients with complex chronic illnesses. Innovative approaches and new models are needed to improve the quality of diabetes care. C1 S Texas Vet Hlth Care Syst, VERDICT Hlth Serv Res Ctr, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78285 USA. RP Parchman, ML (reprint author), S Texas Vet Hlth Care Syst, VERDICT Hlth Serv Res Ctr, 11C6,7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM parchman@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU AHRQ HHS [K08 HS013008-02] NR 28 TC 47 Z9 47 U1 1 U2 3 PU ANNALS FAMILY MEDICINE PI LEAWOOD PA 11400 TOMAHAWK CREEK PARKWAY, LEAWOOD, KS 66211-2672, UNITED STATES SN 1544-1709 J9 ANN FAM MED JI Ann. Fam. Med. PD JAN-FEB PY 2006 VL 4 IS 1 BP 40 EP 45 DI 10.1370/afm.422 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 013UU UT WOS:000235436200007 PM 16449395 ER PT J AU Greenberg, RN Mullane, K van Burik, JAH Raad, I Abzug, MJ Anstead, G Herbrecht, R Langston, A Marr, KA Schiller, G Schuster, M Wingard, JR Gonzalez, CE Revankar, SG Corcoran, G Kryscio, RJ Hare, R AF Greenberg, RN Mullane, K van Burik, JAH Raad, I Abzug, MJ Anstead, G Herbrecht, R Langston, A Marr, KA Schiller, G Schuster, M Wingard, JR Gonzalez, CE Revankar, SG Corcoran, G Kryscio, RJ Hare, R TI Posaconazole as salvage therapy for zygomycosis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID CELL TRANSPLANT RECIPIENTS; INVASIVE FUNGAL-INFECTIONS; CARE CANCER CENTER; B LIPID COMPLEX; AMPHOTERICIN-B; IMMUNOCOMPROMISED PATIENTS; RECEIVING VORICONAZOLE; MUCORMYCOSIS; ITRACONAZOLE; EPIDEMIOLOGY AB Zygomycosis, an infection that is associated with significant morbidity and mortality, is becoming common in immunocompromised patients. Posaconazole is a new extended-spectrum azole antifungal that has demonstrated in vitro and in vivo activity against zygomycetes. This report provides the results from the first 24 patients with active zygomycosis who were enrolled in two open-label, nonrandomized, multicentered compassionate trials that evaluated oral posaconazole as salvage therapy for invasive fungal infections. Posaconazole was usually given as an oral suspension of 200 mg four times a day or 400 mg twice a day. Eleven (46%) of the infections were rhinocerebral. Duration of posaconazole therapy ranged from 8 to 1,004 days (mean, 292 days; median, 182 days). Rates of successful treatment (complete cure and partial response) were 79% in 19 subjects with zygomycosis refractory to standard therapy and 80% in 5 subjects with intolerance to standard therapy. Overall, 19 of 24 subjects (79%) survived infection. Survival was also associated with surgical resection of affected tissue and stabilization or improvement of the subjects' underlying illnesses. Failures either had worsening of underlying illnesses or requested all therapy withdrawn; none of the failures received more than 31 days of posaconazole. Posaconazole oral solution was well tolerated and was discontinued in only one subject due to a drug rash. Posaconazole appears promising as an oral therapy for zygomycosis in patients who receive required surgery and control their underlying illness. C1 Univ Kentucky, Sch Med, Dept Med, Lexington, KY 40536 USA. Dept Vet Affairs Med Ctr, Med Serv, Lexington, KY USA. Univ Chicago, Sch Med, Chicago, IL 60637 USA. Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. MD Anderson Canc Ctr, Houston, TX USA. Univ Colorado, Denver, CO 80202 USA. Childrens Hosp, Denver, CO 80218 USA. S Texas Vet Healthcare Syst, Dept Med, San Antonio, TX USA. Hop Hautepierre, Strasbourg, France. Emory Univ Hosp, Atlanta, GA 30322 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Hosp Univ Penn, Philadelphia, PA 19104 USA. Univ Florida, Gainesville, FL 32611 USA. Georgetown Univ Hosp, Lombardi Canc Ctr, Washington, DC USA. Dallas VA Med Ctr, Dallas, TX USA. Amgen Inc, Regulatory Affairs, Thousand Oaks, CA USA. Univ Kentucky, Dept Stat & Publ Hlth, Lexington, KY 40506 USA. Schering Plough Res Inst, Kenilworth, NJ USA. RP Greenberg, RN (reprint author), Univ Kentucky, Sch Med, Dept Med, Room MN 672,800 Rose St, Lexington, KY 40536 USA. EM RNgree01@uky.edu RI Herbrecht, Raoul/D-3471-2013; Young, Jo-Anne/G-2617-2013 OI Young, Jo-Anne/0000-0003-4182-341X; Herbrecht, Raoul/0000-0002-9381-4876 NR 50 TC 266 Z9 285 U1 2 U2 4 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 JAN PY 2006 VL 50 IS 1 BP 126 EP 133 DI 10.1128/AAC.50.1.126-133.2006 PG 8 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 007RT UT WOS:000234988000016 PM 16377677 ER PT J AU Johnson, VA Hazelwood, JD Andersen, J Miller, AB Liu, T Alston-Smith, B Brosgart, CL Rooney, JF Polsky, B Peters, MG AF Johnson, V. A. Hazelwood, J. D. Andersen, J. Miller, A. B. Liu, T. Alston-Smith, B. Brosgart, C. L. Rooney, J. F. Polsky, B. Peters, M. G. TI Tenofovir disoproxil fumarate (TDF) and adefovir dipivoxil (ADV) are effective in chronic hepatitis B virus (HBV) infection in subjects who are co-infected with HIV: HBV and HIV drug resistance results of ACTG Protocol A5127 SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT 15th International HIV Drug Resistance Workshop CY JUN 13-17, 2006 CL Sitges, SPAIN C1 Univ Alabama, Sch Med, Birmingham, AL 02115 USA. Birmingham VA Med Ctr, Birmingham, AL 20892 USA. Harvard Univ, Sch Publ Hlth, Boston, MA 94404 USA. NIAID, NIH, Bethesda, MD USA. Gilead Sci Inc, Foster City, CA USA. St Lukes Roosevelt Hosp, Div Infect Dis, New York, NY 94143 USA. Columbia Univ, Coll Phys & Surg, New York, NY USA. Univ Calif San Francisco, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT MEDICAL PRESS LTD PI LONDON PA 2-4 IDOL LANE, LONDON EC3R 5DD, ENGLAND SN 1359-6535 J9 ANTIVIR THER JI Antivir. Ther. PY 2006 VL 11 IS 5 BP S11 EP S11 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 076UY UT WOS:000239984700029 ER PT J AU Kelly, PA AF Kelly, PA TI Automated essay scoring: A cross-disciplinary perspective SO APPLIED PSYCHOLOGICAL MEASUREMENT LA English DT Book Review C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. RP Kelly, PA (reprint author), Baylor Coll Med, VA Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. NR 4 TC 1 Z9 1 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0146-6216 J9 APPL PSYCH MEAS JI Appl. Psychol. Meas. PD JAN PY 2006 VL 30 IS 1 BP 66 EP 68 DI 10.1177/0146621605278217 PG 3 WC Social Sciences, Mathematical Methods; Psychology, Mathematical SC Mathematical Methods In Social Sciences; Psychology GA 998TX UT WOS:000234343900008 ER PT J AU Peirce, TR Bray, NJ Williams, NM Norton, N Moskvina, V Preece, A Haroutunian, V Buxbaum, JD Owen, MJ O'Donovan, MC AF Peirce, TR Bray, NJ Williams, NM Norton, N Moskvina, V Preece, A Haroutunian, V Buxbaum, JD Owen, MJ O'Donovan, MC TI Convergent evidence for 2 ',3 '-cyclic nucleotide 3 '-phosphodiesterase as a possible susceptibility gene for schizophrenia SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID BIPOLAR DISORDER; HUMAN BRAIN; DNA POOLS; MYELINATION; ASSOCIATION; EXPRESSION; POLYMORPHISMS; DYSFUNCTION; POSTMORTEM; LINKAGE AB Context: Convergent data make 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP) a candidate gene for schizophrenia. Reduced expression has been reported in the schizophrenic brain. The CNP gene maps to a region to which we have reported linkage to schizophrenia. Mice in which the CNP gene has been knocked out display central nervous system pathological characteristics reminiscent of some features observed in schizophrenia. 2',3'Cyclic nucleotide 3'-phosphodiesterase is used as a marker of myelin-forming cells and is detectable in cells of oligodendrocyte lineage throughout life. Because CNP is thought to be important for oligodendrocyte function, altered expression has been interpreted as supportive of the hypothesis that altered oligodendrocyte function may be an etiological factor in schizophrenia. However, it is unclear whether the observed changes in the schizophrenic brain are primary or secondary. Objectives: To determine if CNP expression is influenced by DNA polymorphisms and to verify if these polymorphisms are associated with schizophrenia. Design: Allele-specific messenger RNA expression assay and genetic association studies. Setting: Unrelated subjects were ascertained from secondary psychiatric inpatient and outpatient services. Participants: We used brain tissue from 60 anonymous individuals with no known psychiatric disorder; a case-control sample of 708 white individuals from the United Kingdom meeting DSM-IV criteria for schizophrenia matched for age, sex, and ethnicity to 711 blood donor controls; and a pedigree with DNA from 6 affected siblings and 1 parent, showing evidence for linkage to CNP. Main Outcome Measures: Association between allele and gene expression. Association between allele and schizophrenia. Results: The exonic single nucleotide polymorphism rs2070106 was associated with CNP expression (P <.001). Compatible with underexpression of CNP messenger RNA in schizophrenia, the lower-expressing A allele was significantly associated with schizophrenia (P=.04) in the case-control sample. All affected individuals in the linked pedigree were homozygous for the lower-expression allele, providing independent support for the association (P=.03). Conclusions: Our data support the hypothesis that reduced CNP expression in the schizophrenic brain is relevant to disease etiology and therefore provide support for the general hypothesis that altered oligodendrocyte function is an etiological factor in schizophrenia. C1 Univ Cardiff Wales, Sch Med, Dept Med Psychol, Cardiff CF14 4XN, Wales. Univ Cardiff Wales, Sch Med, Biostat & Bioinformat Unit, Cardiff CF14 4XN, Wales. Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Affairs Med Ctr, Mental Illness Res Ctr, New York, NY USA. Bronx Vet Affairs Med Ctr, Mental Illness Educ Ctr, New York, NY USA. Bronx Vet Affairs Med Ctr, Mental Illness Clin Ctr, New York, NY USA. RP Owen, MJ (reprint author), Univ Cardiff Wales, Sch Med, Dept Med Psychol, Heath Pk, Cardiff CF14 4XN, Wales. EM owenmj@groupwise.cf.ac.uk RI turton, miranda/F-4682-2011 OI O'Donovan, Michael/0000-0001-7073-2379; Buxbaum, Joseph/0000-0001-8898-8313; Escott-Price, Valentina/0000-0003-1784-5483 FU Medical Research Council [G9810900] NR 25 TC 78 Z9 82 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD JAN PY 2006 VL 63 IS 1 BP 18 EP 24 DI 10.1001/archpsyc.63.1.18 PG 7 WC Psychiatry SC Psychiatry GA 000DK UT WOS:000234440900002 PM 16389193 ER PT J AU Bartzokis, G Lu, PH Geschwind, DH Edwards, N Mintz, J Cummings, JL AF Bartzokis, G Lu, PH Geschwind, DH Edwards, N Mintz, J Cummings, JL TI Apolipoprotein E genotype and age-related myelin breakdown in healthy individuals - Implications for cognitive decline, and dementia SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID INDUCED INTRAMYELINIC EDEMA; E EPSILON-4 ALLELE; MATTER STRUCTURAL INTEGRITY; PRIMATE CEREBRAL-CORTEX; TRAUMATIC BRAIN-INJURY; CENTRAL-NERVOUS-SYSTEM; E TYPE-4 ALLELE; ALZHEIMERS-DISEASE; WHITE-MATTER; RHESUS-MONKEY AB Context: Apolipoprotein E (APOE) genotype is the most influential Alzheimer disease (AD) risk factor after advanced age. The APOE4 alleles decrease and the APOE2 alleles increase age at onset of AD. Human and nonhuman primate data suggest that in midlife, the structural integrity of myelin sheaths begins breaking down, with an accelerating age-related trajectory most evident in the brain's later-myelinating association regions. This may result in a progressive "disconnection" of widely distributed neural networks that may underlie the age risk factor for AD. Objective: To assess, using magnetic resonance imaging, whether the shift in age at onset of AD observed with the APOE genotype is associated with the trajectory of age-related myelin breakdown. Design: Cross-sectional. Setting: Metropolitan university medical center. Participants: Healthy individuals (N=104) aged 55 to 75 years who underwent genotyping for APOE. Main Outcome Measures: Calculated transverse relaxation rates, an indirect measure of white matter structural integrity, for late-myelinating frontal lobe white matter (Fwm) and early- and later-myelinating regions of the corpus callosum, the splenium (Swm) and the genu (Gwm). Results: The presence of the protective APOE2 allele was associated with significantly higher relaxation rates in Fwm and Gwm but not in Swln. Furthermore, APOE status impacted the trajectory of age-related myelin breakdown in late-myelinating regions (Fwm and Gwm) but not in Swm. In Fwm and Gwm, APOE4+ individuals had a steeper slope of decline in relaxation rates with age than APOE2+ individuals; those with APOE3/3 alleles had an intermediate slope. Conclusions: In later-myelinating regions, the severity and rate of myelin breakdown in healthy older individuals are associated with APOE status and support the hypothesis that this process may contribute to age at onset of AD. Combining APOE status with noninvasive measures of myelin breakdown may be useful in assessing treatment strategies for the primary prevention of AD. C1 Univ Calif Los Angeles, David Geffen Sch Med, Alzheimers Dis Ctr, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Div Brain Mapping,Lab Neuroimaging, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Psychiat, Los Angeles, CA USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Alzheimers Dis Ctr, Dept Neurol, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013; Mintz, Jim/N-7385-2014 OI Mintz, Jim/0000-0002-8299-5851 FU NIA NIH HHS [P50 AG 16570]; NIMH NIH HHS [MH51928, MH6357-01A1, MH066029-01A2] NR 98 TC 66 Z9 68 U1 3 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD JAN PY 2006 VL 63 IS 1 BP 63 EP 72 DI 10.1001/archpsyc.63.1.63 PG 10 WC Psychiatry SC Psychiatry GA 000DK UT WOS:000234440900007 PM 16389198 ER PT J AU Berger, DH AF Berger, DH TI Interdisciplinary work flow assessment and redesign decreases operating room turnover time and allows for additional caseload - Invited critique SO ARCHIVES OF SURGERY LA English DT Editorial Material C1 Michael E DeBakey Vet Affairs Med Ctr, Surg Serv, Houston, TX 77030 USA. RP Berger, DH (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Surg Serv, Mail Stop 1120CL,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dhb@bcm.tmc.edu NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD JAN PY 2006 VL 141 IS 1 BP 70 EP 70 DI 10.1001/archsurg.141.1.70 PG 1 WC Surgery SC Surgery GA 000WR UT WOS:000234493600013 ER PT J AU McClain, MT Poole, BD Bruner, BF Kaufman, KM Harley, JB James, JA AF McClain, MT Poole, BD Bruner, BF Kaufman, KM Harley, JB James, JA TI An altered immune response to Epstein-Barr nuclear antigen 1 in pediatric systemic lupus erythematosus SO ARTHRITIS AND RHEUMATISM LA English DT Article ID VIRUS INFECTION; PEPTIDE IMMUNIZATION; HUMORAL AUTOIMMUNITY; B-LYMPHOCYTES; SM B/B'; EPITOPE; AUTOANTIBODIES; TRANSFORMATION; RECOGNITION; ANTIBODIES AB Objective. New examples support the concept that host immune responses to pathogenic organisms can act as the nidus for autoimmunity. Two such examples implicate the Epstein-Barr virus (EBV) in systemic lupus erythematosus (SLE), i.e., data consistent with SLE anti-Sm and anti-60-kd Ro autoantibodies emerging from distinct humoral immune responses to Epstein-Barr nuclear antigen I (EBNA-1). We undertook this study to further test whether the humoral immune response to EBNA-1 is a risk factor for pediatric SLE. Methods. Sera from pediatric lupus patients and healthy matched controls were tested for anti-EBNA-1 by Western blotting and enzyme-linked immunosorbent assay (ELISA). To define the fine specificity of their anti-EBNA-1 humoral immune response, fragments of EBNA-1 and the maximally overlapping unique octapeptides of EBNA-1 were tested by modified ELISAs Results. All 36 pediatric SLE patient sera tested recognized EBNA-1, while sera from only 25 of 36 matched EBV-positive controls targeted EBNA-1 (P < 0.005). Epitope mapping revealed that the humoral anti-EBNA-1 response in pediatric SLE was distinct from and less restricted than that in matched normal individuals. Meanwhile, no significant differences between SLE patient sera and control sera were observed in the responses to other herpesviruses or in binding to sequential epitopes from cytomegalovirus immediate-early antigen or EBNA-2. Conclusion. Anti-EBNA-1 antibodies are associated with pediatric-onset SLE. Furthermore, an altered humoral immune response to EBNA-1, characteristic of SLE, has been found and may be an important SLE susceptibility factor. C1 Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK 73104 USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP James, JA (reprint author), Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM jamesj@omrf.ouhsc.edu FU NCRR NIH HHS [RR 020143, RR 15577]; NIAID NIH HHS [AI 24717, AI 51347]; NIAMS NIH HHS [AR 01981, AR 048140, AR 049084, AR 31584, AR 42460, AR 45084, QAR 45451]; NIDCR NIH HHS [DE 015223] NR 40 TC 63 Z9 67 U1 0 U2 3 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 JAN PY 2006 VL 54 IS 1 BP 360 EP 368 DI 10.1002/art.21682 PG 9 WC Rheumatology SC Rheumatology GA 002IO UT WOS:000234605200044 PM 16385527 ER PT J AU Bland, LB Beer, TM Garzatto, M AF Bland, LB Beer, TM Garzatto, M TI Phase II study of transdermal estradiol in androgen-independent prostate carcinoma - Author Reply SO CANCER LA English DT Letter ID TUBULIN ISOTYPE EXPRESSION C1 Oregon Hlth Sci Univ, Dept Urol & Renal Transplantat, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Hematol & Med Oncol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Inst Canc, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Urol Sect, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Urol & Renal Transplantat, Portland, OR 97201 USA. RP Bland, LB (reprint author), Oregon Hlth Sci Univ, Dept Urol & Renal Transplantat, Portland, OR 97201 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD JAN 1 PY 2006 VL 106 IS 1 BP 235 EP 235 DI 10.1002/cncr.21529 PG 1 WC Oncology SC Oncology GA 998ZK UT WOS:000234358200031 ER PT J AU Zhang, L Sharma, S Hershman, JM Brent, GA Dubinett, SM Huang, M AF Zhang, L Sharma, S Hershman, JM Brent, GA Dubinett, SM Huang, M TI Iodide sensitizes genetically modified non-small cell lung cancer cells to ionizing radiation SO CANCER GENE THERAPY LA English DT Article DE lung cancer; iodide; radiation; gene therapy ID JUNCTIONAL-INTERCELLULAR COMMUNICATION; SYMPORTER GENE; SODIUM/IODIDE SYMPORTER; RADIO-SENSITIZATION; THYROID-CELLS; THERAPY; EXPRESSION; TRANSPORT; SYSTEM; MECHANISMS AB While external ionizing radiation has been used for treating non-small cell lung cancer (NSCLC), improved efficacy of this modality would be an important advance. Ectopic expression of the sodium iodide symporter (NIS) and thyroperoxidase (TPO) genes in NSCLC cells facilitated concentration of iodide in NSCLC cells, which markedly induced apoptosis in vitro and in vivo. Preincubation of the NIS/TPO-modified NSCLC cells in iodide followed by ionizing radiation generates bystander tumoricidal effects and potently enhances tumor cell killing. This iodide-induced bystander effect is associated with enhanced gap junction intercellular communication (GJIC) activity and increased connexin-43 (Cx43) expression. Thus, iodide may serve as an enhancer to markedly improve the efficacy of radiation therapy in combined therapeutic modalities. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm & Crit Care Med, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Endocrinol & Metab, Los Angeles, CA 90095 USA. 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, Dept Pathol, Los Angeles, CA 90095 USA. RP Huang, M (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Pulm Med, 37-131 CHS,Mail Code 169017, Los Angeles, CA 90095 USA. EM minhuang@mednet.ucla.edu FU NCI NIH HHS [R01 CA085686, P50 CA90388] NR 37 TC 5 Z9 9 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0929-1903 J9 CANCER GENE THER JI Cancer Gene Ther. PD JAN PY 2006 VL 13 IS 1 BP 74 EP 81 DI 10.1038/sj.cgt.7700875 PG 8 WC Biotechnology & Applied Microbiology; Oncology; Genetics & Heredity; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Oncology; Genetics & Heredity; Research & Experimental Medicine GA 995LY UT WOS:000234103000009 PM 16052231 ER PT J AU Schittenhelm, MM Shiraga, S Schroeder, A Corbin, AS Griffith, D Lee, FY Bokemeyer, C Deininger, MWN Druker, BJ Heinrich, MC AF Schittenhelm, MM Shiraga, S Schroeder, A Corbin, AS Griffith, D Lee, FY Bokemeyer, C Deininger, MWN Druker, BJ Heinrich, MC TI Dasatinib (BMS-354825), a dual SRC/ABL kinase inhibitor, inhibits the kinase activity of wild-type, juxtamembrane, and activation loop mutant KIT Isoforms associated with human malignancies SO CANCER RESEARCH LA English DT Article ID GASTROINTESTINAL STROMAL TUMORS; RECEPTOR TYROSINE KINASE; LIGAND-INDEPENDENT ACTIVATION; CHRONIC MYELOID-LEUKEMIA; PROTOONCOGENE C-KIT; MAST-CELL LEUKEMIA; BETA-CATENIN GENE; IN-VITRO; STI-571 INHIBITION; IMATINIB STI571 AB Activating mutations of the activation loop of KIT are associated with certain human neoplasms, including the majority of patients with systemic mast cell disorders, as well as cases of seminoma, acute myelogenous leukemia (AML), and gastrointestinal stromal tumors (GISTs). The small-molecule tyrosine kinase inhibitor imatinib mesylate is a potent inhibitor of wild-type (WT) KIT and certain mutant KIT isoforms and has become the standard of care for treating patients with metastatic GIST. However, KIT activation loop mutations involving codon D816 that are typically found in AML, systemic mastocytosis, and semitioma are insensitive to imatinib mesylate (IC50 > 5-10 mu mol/L), and acquired KIT activation loop mutations can be associated with imatinib mesylate resistance in GIST. Dasatinib (formerly BMS-354825) is a small-molecule, ATP-competitive inhibitor of SRC and ABL tyrosine kinases with potency in the low nanomolar range. Some small-molecule SRC/ABL inhibitors also have potency against WT KIT kinase. Therefore, we hypothesized that dasatinib might inhibit the kinase activity of both WT and mutant KIT isoforms. We report. herein that dasatinib potently inhibits WT KIT and juxtamembrane domain mutant KIT autophosphorylation and KIT-dependent activation of downstream pathways important for cell viability and cell survival, such as Ras/mitogen-activated protein kinase, phosphoinositide 3-kinase/Akt, and Janus-activated kinase/signal transducers and activators of transcription. Furthermore, dasatinib is a potent inhibitor of imatinib-resistant KIT activation loop mutants and induces apoptosis in mast cell anti leukemic cell lines expressing these mutations (potency against KIT D816Y >> D81613 > D816V). Our studies suggest. that dasatinib may have clinical efficacy against human neoplasms that. tire associated with gain-of-function KIT mutations. C1 Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Med, Div Hematol Oncol, Portland, OR 97201 USA. Bristol Myers Squibb Co, Oncol Drug Discovery, Princeton, NJ USA. Univ Hamburg, Med Ctr Eppendorf, Dept Med, Hamburg, Germany. Howard Hughes Med Inst, Chevy Chase, MD USA. RP Heinrich, MC (reprint author), Portland Vet Affairs Med Ctr, R&D-19,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM heinrich@ohsu.edu FU NCI NIH HHS [P30 CA69533] NR 47 TC 314 Z9 322 U1 3 U2 17 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JAN 1 PY 2006 VL 66 IS 1 BP 473 EP 481 DI 10.1158/0008-5472.CAN-05-2050 PG 9 WC Oncology SC Oncology GA 001JN UT WOS:000234529500057 PM 16397263 ER PT J AU Sharma, SD Katiyar, SK AF Sharma, SD Katiyar, SK TI Dietary grape-seed proanthocyanidin inhibition of ultraviolet B-induced immune suppression is associated with induction of IL-12 SO CARCINOGENESIS LA English DT Article ID TEA POLYPHENOL (-)-EPIGALLOCATECHIN-3-GALLATE; DELAYED-TYPE HYPERSENSITIVITY; ANTIGEN-PRESENTING CELLS; CONTACT HYPERSENSITIVITY; SKIN-CANCER; SYSTEMIC SUPPRESSION; IN-VIVO; INDUCED IMMUNOSUPPRESSION; TRANSPLANT RECIPIENTS; OXIDATIVE STRESS AB We have shown previously that dietary grape seed proanthocyanidins (GSPs) inhibit UVB-induced photocarcinogenesis in mice. As UVB-induced immune suppression has been implicated in the development of skin cancer risk, we investigated whether dietary GSPs can modulate the effects of UVB on the immune system. We found that the UVB-induced (180 mJ/cm(2)) ear swelling response (inflammatory reaction) was significantly lower in mice fed with a GSP-supplemented (0.5 and 1.0%, w/w) diet than mice fed with the standard AIN76A diet. Dietary GSPs markedly inhibited UVB-induced (180 mJ/cm(2)) suppression of contact hypersensitivity responses in a local model of immunosuppression but had only moderate inhibitory effect in a systemic model of immunosuppression. Dietary GSPs reduced the UVB-induced increase in immunosuppressive cytokine interleukin (IL)-10 in skin and draining lymph nodes compared with mice that did not receive GSPs. In contrast, GSPs enhanced the production of immunostimulatory cytokine IL-12 in the draining lymph nodes. Intraperitoneal injection of GSPs-fed mice with a neutralizing anti-IL-12 antibody abrogated the protective effects of the GSPs against UVB-induced suppression of the contact hypersensitivity response. These data indicate for the first time that GSPs modulate UVB-induced immunosuppression and suggest that this may be one of the possible mechanisms by which they prevent photocarcinogenesis in mice. C1 Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. Univ Alabama, Skin Dis Res Ctr, Birmingham, AL 35294 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 [CA104428]; NIAMS NIH HHS [AR050948-01] NR 43 TC 32 Z9 44 U1 1 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0143-3334 J9 CARCINOGENESIS JI Carcinogenesis PD JAN PY 2006 VL 27 IS 1 BP 95 EP 102 DI 10.1093/carcin/bgi169 PG 8 WC Oncology SC Oncology GA 997BF UT WOS:000234219300009 PM 15987716 ER PT J AU Ma, TS Hayes, TG Levine, GN Carabello, BA AF Ma, TS Hayes, TG Levine, GN Carabello, BA TI Malignant pleural/pericardial effusion with tamponade and life-threatening reversible myocardial depression in a case of an initial presentation of lung adenocarcinoma SO CARDIOLOGY LA English DT Article DE myopericarditis; pericardial effusion; lung neoplasm; cardiac metastasis; cardiac tamponade ID NONBACTERIAL THROMBOTIC ENDOCARDITIS; WOMAN; PERICARDIUM; METASTASES; CARCINOMA; CANCER; TUMORS; HEART AB We present a case of a middle-aged woman in cardiac tamponade. Following pericardiocentesis that removed 1,500 ml of hemorrhagic fluid, the patient exhibited cardiogenic shock; LVEF, at its nadir, on inotrope, was less than 20%. Ventricular function slowly improved, with inotropic support, to the normal range by the 25th day of hospitalization. Cardiac failure in malignancy has often been attributed to multi-system failure; this case showed a hereto unrecognized clinical phenomenon 'malignancy-associated myopericarditis'. While the direct link of cause and effect cannot be made with certainty, the case should be instructive to other clinicians who encounter similar life-threatening presentations of cardiac decompensation in malignancy. Copyright (c) 2006 S. Karger AG, Basel. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Cardiol Sect, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Sect Hematol & Oncol, Houston, TX USA. RP Ma, TS (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Cardiol Sect, 2002 Holocombe Blvd, Houston, TX 77030 USA. EM tma@bcm.tmc.edu NR 14 TC 2 Z9 2 U1 2 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0008-6312 J9 CARDIOLOGY JI Cardiology PY 2006 VL 105 IS 1 BP 30 EP 33 DI 10.1159/000088344 PG 4 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 982ZR UT WOS:000233201400007 PM 16179783 ER PT J AU Esteghamati, A Abbasi, M Nakhjavani, M Yousefizadeh, A Basa, AP Afshar, H AF Esteghamati, Alireza Abbasi, Mehrshad Nakhjavani, Manouchehr Yousefizadeh, Abbas Basa, Amelita P. Afshar, Hamid TI Prevalence of diabetes and other cardiovascular risk factors in an Iranian population with acute coronary syndrome SO CARDIOVASCULAR DIABETOLOGY LA English DT Article AB Background: Coronary artery disease is the leading cause of death in industrialized countries and most patients with diabetes die from complications of atherosclerosis. The objective of this study was to determine the presence of diabetes mellitus and other conventional coronary heart disease risk factors (cigarette smoking, hypertension and hyperlipidemia) in patients with acute coronary events in an Iranian population. Methods: The study included 514 patients with unstable angina or myocardial infarction (MI) out of 720 patients admitted to CCU ward of a general hospital from March 2003 to March 2005. History of diabetes, hypertension and cigarette smoking, demographic indices, coronary heart disease and diabetes mellitus treatment, myocardial enzymes, serum triglycerides (TG) and cholesterol and fasting and non fasting blood glucose levels and HbA1C of diabetics were recorded of admission sheets. The data were structured to appropriate one way ANOVA, T tests, and chi square test with SPSS 13 product for windows. Results: Out of all patients 35.8% were female, 30% were diabetics (Duration 13.4 +/- 8.7 years), 42% were smoker and 91% were hypertensive. Twenty four percent had MI and 76% had unstable angina. MI was significantly higher in diabetic patients (36.4% vs. 19.2%, P < 0.001). Location and extension of MI and myocardial enzymes did not differ between diabetics and non-diabetic patients. Diabetic patients were older than non diabetics (65 +/- 11.6 vs. 59.7 +/- 12.5 years, p < 0.05). Five (66.7%) out of 9 patients with fatal MI were diabetics (Odds Ratio = 2.98). Age, duration of diabetes and HbA1c levels, did not differ between diabetic patients with or without MI. Hypertension and current smoking was significantly higher in patients with MI compared to patients with unstable angina (p < 0.05). Serum TG, HDL-C, LDL-C and total cholesterol level did not differ between patients with MI and unstable angina. Diabetic patients compare to non diabetic patients were more hypertensive (96% vs. 88.7%, p < 0.005) and had higher serum triglyceride (TG over 200 mg/dl, 35.1% vs. 26.4, p < 0.05). Diabetes was more frequent among women than men (36.4% vs. 26.4%, p < 0.05). Women were older than men (65 +/- 11.6 vs. 59.2 +/- 13 years, p < 0.005) and had higher total serum cholesterol (200 +/- 41.8 vs. 192 +/- 42.5 mg/dl, p < 0.05) and HDL-C levels (49.7 +/- 22 vs. 40 +/- 13 mg/dl, p < 0.005). Ninety seven percent of all patients had at least one of cardiovascular risk factors (hypertension, smoking, diabetes, high cholesterol and low HDL-cholesterol levels). Conclusion: In this study 19 out of 20 patients with acute coronary event have at least one of conventional cardiac risk factors. Diabetes and hypertension are leading risk factors, which may directly or indirectly interfere and predict more serious complications of coronary heart disease. C1 [Abbasi, Mehrshad] Univ Tehran Med Sci, Endocrine Dept, Vali Asr Hosp, Tehran 1419733147, Iran. [Esteghamati, Alireza] Univ Tehran Med Sci, Fac Med, Tehran 1419733147, Iran. [Nakhjavani, Manouchehr] Univ Tehran Med Sci, Div Endocrine, Vali Asr Hosp, Tehran 1419733147, Iran. [Yousefizadeh, Abbas] Bank Melli Hosp, Dept Internal Med, Tehran, Iran. [Basa, Amelita P.] Baylor Coll Med, Endocrine Dept, VA Med Ctr, Houston, TX 77030 USA. [Afshar, Hamid] Alton Ochsner Med Fdn & Ochsner Clin, Dept Cardiol, New Orleans, LA 70121 USA. RP Abbasi, M (reprint author), Univ Tehran Med Sci, Endocrine Dept, Vali Asr Hosp, Keshavarz Blvd, Tehran 1419733147, Iran. EM Esteghamati@sina.tums.ac.ir; mehrshad_abbasi@Yahoo.com; nakhjavanim@sina.tums.ac.ir; Abbasyousefizadeh@yahoo.com; amyloubasa@yahoo.com; hamidafshar@yahoo.com RI Abbasi, Mehrsahd/J-4064-2012 OI Abbasi, Mehrsahd/0000-0001-5011-897X NR 31 TC 28 Z9 30 U1 2 U2 4 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1475-2840 J9 CARDIOVASC DIABETOL JI Cardiovasc. Diabetol. PY 2006 VL 5 AR 15 DI 10.1186/1475-2840-5-15 PG 6 WC Cardiac & Cardiovascular Systems; Endocrinology & Metabolism SC Cardiovascular System & Cardiology; Endocrinology & Metabolism GA V23DE UT WOS:000208322700015 PM 16842631 ER PT J AU Tan, HM Jiang, XH Yang, F Li, ZH Liao, D Trial, J Magera, MJ Durante, W Yang, XF Wang, H AF Tan, HM Jiang, XH Yang, F Li, ZH Liao, D Trial, J Magera, MJ Durante, W Yang, XF Wang, H TI Hyperhomocysteinemia inhibits post-injury reendothelialization in mice SO CARDIOVASCULAR RESEARCH LA English DT Article DE homocysteine; carotid injury; reendothelialization ID CYSTATHIONINE BETA-SYNTHASE; RAT CAROTID-ARTERY; ENDOTHELIAL-CELLS; NEOINTIMA FORMATION; GROWTH-FACTOR; MOUSE MODEL; ACCELERATES REENDOTHELIALIZATION; S-ADENOSYLHOMOCYSTEINE; VASCULAR DYSFUNCTION; OXIDATIVE STRESS AB Objective: Hyperhomocysteinemia (HHcy) is a risk factor for cardiovascular disease and has been reported to inhibit endothelial cell (EC) growth. Notwithstanding, precisely how HHcy regulates EC growth in vivo remains unknown. In this study, we established a mouse model of endothelial injury and reendothelialization and examined the role and mechanism of HHcy in endothelial repair. Methods and results: A mouse model of carotid artery air-dry endothelium denudation and reendothelialization was established and used to evaluate post-injury endothelial repair in mice with the gene deletion of cystathionine-beta-synthase (CBS). Moderate and severe HHcy were induced in CBS+/+ and CBS-/+ mice through a high-methionine diet. Post-injury reendothelialization, which correlated with increased post-injury neointima formation, was impaired in severe HHcy mice. To elucidate the underlying mechanism, we examined circulating endothelial progenitor cells (EPC) in HHcy mice and studied the effect of homocysteine (Hcy) on proliferation, migration, and adhesion of human umbilical vein endothelial cells (HUVEC). The peripheral EPC population was not significantly altered in HHcy mice. Hey had a profound inhibitory effect on EC proliferation and migration at physiologically relevant concentrations and inhibited EC adhesion at concentrations of 200 mu M and higher. Conclusion: We have established a convenient and accurate mouse model of carotid injury in which the reendothelialization process can be precisely quantified. In addition, we have observed impaired reendothelialization and increased neointimal formation in severe HHcy mice. The capacity of Hey to inhibit proliferation and migration of EC may be responsible for impaired reendothelialization and contribute to arteriosclerosis in HHcy. (c) 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved. C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pharmacol, Houston, TX 77030 USA. Sun Yat Sen Univ, Sch Med, Guangzhou, Peoples R China. Mayo Clin, Rochester, MN 55905 USA. RP Wang, H (reprint author), Baylor Coll Med, VA Med Ctr, 2002 Holocombe Blvd, Houston, TX 77030 USA. EM hongw@bcm.tmc.edu FU NHLBI NIH HHS [R01 HL077288, HL36045, HL59976, HL67033, HL74925, HL77288, K02 HL074925, R01 HL036045, R01 HL059976, R01 HL067033] NR 43 TC 38 Z9 40 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0008-6363 J9 CARDIOVASC RES JI Cardiovasc. Res. PD JAN PY 2006 VL 69 IS 1 BP 253 EP 262 DI 10.1016/j.cardiores.2005.08.016 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 004HT UT WOS:000234743300029 PM 16226235 ER PT J AU McNulty, E Cohen, J Chou, T Shunk, K AF McNulty, E Cohen, J Chou, T Shunk, K TI A "grapple hook" technique using a deflectable tip catheter to facilitate complex proximal circumflex interventions SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE percutaneous coronary intervention; chronic total occlusion; angulation ID CHRONIC TOTAL OCCLUSIONS; SIROLIMUS-ELUTING STENT; CORONARY ANGIOPLASTY; DETERMINANTS; IMMEDIATE; OUTCOMES; SUCCESS AB We present two patients with angulated, proximal left circumflex lesions, one a chronic total occlusion and one an acute subtotal occlusion. In both cases, use of the deflectable tip Venture Catheter (Velocimed, Minneapolis, MN) facilitated guide wire passage and successful percutaneous coronary intervention (PCI) after prior attempts at guide wire passage with standard wires were unsuccessful. (c) 2005 Wiley-Liss, Inc. C1 Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, Dept Cardiol, San Francisco, CA 94121 USA. RP McNulty, E (reprint author), Univ Calif San Francisco, Sch Med, San Francisco Vet Affairs Med Ctr, Dept Cardiol, 111C,4150 Clement St, San Francisco, CA 94121 USA. EM Edward.mcnulty2@med.va.gov NR 12 TC 11 Z9 11 U1 0 U2 2 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 JAN PY 2006 VL 67 IS 1 BP 46 EP 48 DI 10.1002/ccd.20547 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 003TW UT WOS:000234705500011 PM 16331693 ER PT J AU Zhang, BX Ma, XY Shu, ZJ Yeh, CK Swerdlow, RH Katz, MS AF Zhang, BX Ma, XY Shu, ZJ Yeh, CK Swerdlow, RH Katz, MS TI Differential regulation of intracellular calcium oscillations by mitochondria and gap junctions SO CELL BIOCHEMISTRY AND BIOPHYSICS LA English DT Article DE intracellular Ca2+; mitochondria; gap junction; calcium oscillation; p0 NT2 cells ID CA2+ INFLUX; INOSITOL 1,4,5-TRISPHOSPHATE; SYMPATHETIC NEURONS; INSULIN-SECRETION; CYTOSOLIC CA2+; ACINAR-CELLS; STORE; ENTRY; HEMICHANNELS; ASTROCYTES AB Fluctuations of intracellular Ca2+ ([Ca2+](i)) regulate a variety of cellular functions. The classical Ca2+ transport pathways in the endoplasmic reticulum (ER) and plasma membrane are essential to [Ca2+], oscillations. Although mitochondria have recently been shown to absorb and release Ca2+ during G protein-coupled receptor (GPCR) activation, the role of mitochondria in [Ca2+](i) oscillations remains to be elucidated. Using fluo-3-loaded human teratocarcinoma NT2 cells, we investigated the regulation of [Ca2+](i) oscillations by mitochondria. Both the muscarinic GPCR agonist carbachol and the ER Ca2+-adenosine triphosphate inhibitor thapsigargin (Tg) induced [Ca2+](i) oscillations in NT2 cells. The [Ca2+](i) oscillations induced by carbachol were unsynchronized among individual NT2 cells; in contrast, Tg-induced oscillations were synchronized. Inhibition of mitochondrial functions with either mitochondrial blockers or depletion of mitochondrial DNA eliminated carbachol-but not Tg-induced [Ca2+](i) oscillations. Furthermore, carbachol-induced [Ca2+](i) oscillations were partially restored to mitochondrial DNA-depleted NT2 cells by introduction of exogenous mitochondria. Treatment of NT2 cells with gap junction blockers prevented Tg-induced but not carbachol-induced [Ca2+](i) oscillations. These data suggest that the distinct patterns of [Ca2+](i) oscillations induced by GPCR and Tg are differentially modulated by mitochondria and gap junctions. C1 S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182, Audie L Murphy Div, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78229 USA. Univ Virginia, Hlth Sci Ctr, Dept Neurol, Charlottesville, VA 22908 USA. RP Zhang, BX (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 binxz@yahoo.com FU NHLBI NIH HHS [023565N/HL75011] NR 50 TC 2 Z9 4 U1 0 U2 0 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 1085-9195 J9 CELL BIOCHEM BIOPHYS JI Cell Biochem. Biophys. PY 2006 VL 44 IS 2 BP 187 EP 203 DI 10.1385/CBB:44:2:187 PG 17 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 043FS UT WOS:000237586000002 PM 16456221 ER PT J AU Chen, DC Avansino, JR Agopian, VG Hoagland, VD Woolman, JD Pan, S Ratner, BD Stelzner, M AF Chen, David C. Avansino, Jeffrey R. Agopian, Vatche G. Hoagland, Vicki D. Woolman, Jacob D. Pan, Sheng Ratner, Buddy D. Stelzner, Matthias TI Comparison of polyester scaffolds for bioengineered intestinal mucosa SO CELLS TISSUES ORGANS LA English DT Article DE intestinal stem cell; polyglycolic acid; polylactic acid; tissue-engineered small intestine; polyester scaffolds ID SHORT-BOWEL SYNDROME; EPITHELIAL ORGANOID UNITS; STEM-CELLS; PORE-SIZE; TRANSPLANTATION; MANAGEMENT; RAT; REGENERATION; CHILDREN; ADHESION AB Introduction: Biodegradable polyester scaffolds have proven useful for growing neointestinal tissue equivalents both in vitro and in vivo. These scaffolds allow cells to attach and grow in a 3-dimensional space while nutrient flow is maintained throughout the matrix. The purpose of this study was to evaluate different biopolymer constructs and to determine mucosal engraftment rates and mucosal morphology. Hypothesis: We hypothesized that different biopolymer constructs may vary in their ability to provide a good scaffolding onto which intestinal stem cell organoids may be engrafted. Study Design: Eight different microporous biodegradable polymer tubes composed of polyglycolic acid (PGA), polylactic acid, or a combination of both, using different fabrication techniques were seeded with intestinal stem cell clusters obtained from neonatal rats. Three different seeded polymer constructs were subsequently placed into the omentum of syngeneic adult recipient rats (n = 8). Neointestinal grafts were harvested 4 weeks after implantation. Polymers were microscopically evaluated for the presence of mucosal growth, morphology, scar formation and residual polymer. Results: Mucosal engraftment was observed in 7 out of 8 of the polymer constructs. A maximal surface area engraftment of 36% (range 5-36%) was seen on nonwoven, randomly entangled, small fiber PGA mesh coated with aerosolized 5% poly-L-lactic acid. Villous and crypt development, morphology and created surface area were best on PGA nonwoven mesh constructs treated with poly-L-lactic acid. Electrospun microfiber PGA had poor overall engraftment with little or no crypt or villous formation. Conclusion: Intestinal organoids can be engrafted onto biodegradable polyester scaffoldings with restitution of an intestinal mucosal layer. Variability in polymer composition, processing techniques and material properties (fiber size, luminal dimensions and pore size) affect engraftment success. Future material refinements should lead to improvements in the development of a tissue-engineered intestine. Copyright (c) 2007 S. Karger AG, Basel. C1 Univ Calif Los Angeles, Dept Surg, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90024 USA. Univ Washington, Dept Surg, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Bioengn, Seattle, WA 98195 USA. RP Agopian, VG (reprint author), Univ Calif Los Angeles, Dept Surg, VA Greater Los Angeles Hlth Care Syst, 10833 Conte Ave, Los Angeles, CA 90024 USA. EM vagopian@mednet.ucla.edu NR 32 TC 15 Z9 15 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1422-6405 J9 CELLS TISSUES ORGANS JI Cells Tissues Organs PY 2006 VL 184 IS 3-4 BP 154 EP 165 DI 10.1159/000099622 PG 12 WC Anatomy & Morphology; Cell Biology; Developmental Biology SC Anatomy & Morphology; Cell Biology; Developmental Biology GA 156LL UT WOS:000245649400006 PM 17409741 ER PT J AU Cheng, E Chen, A Vassar, S Lee, M Cohen, SN Vickrey, B AF Cheng, E Chen, A Vassar, S Lee, M Cohen, SN Vickrey, B TI Comparison of secondary prevention care after myocardial infarction and stroke SO CEREBROVASCULAR DISEASES LA English DT Article DE secondary prevention; stroke; transient ischemic attack; cardiovascular disease; quality of health care ID AMERICAN-HEART-ASSOCIATION; ATHEROSCLEROTIC CARDIOVASCULAR-DISEASE; ISCHEMIC-STROKE; RISK-FACTORS; HEALTH; PROFESSIONALS; STATEMENT; QUALITY; ATTACK; GUIDELINES AB Background: Whether secondary prevention of atherosclerosis is performed as frequently after cerebrovascular events ( stroke or transient ischemic attack) as after cardiac events ( myocardial infarction or angina) is unknown. Methods: We compared the receipt of six secondary preventive care processes among 943 persons with a prior cardiac event to that among 523 persons with a prior cerebrovascular event using a representative sample of the US population. Results: The cardiac event group had higher rates for three care processes: antithrombotic medication use in the past year (83-77%, p = 0.01), ever advised to exercise more (66-52%, p < 0.001), and ever advised to eat fewer high-fat or high-cholesterol foods ( 70-54%, p < 0.001). Conclusions: Compared to the cardiac event group, the quality of care of the cerebrovascular event group is lower and should be improved. C1 VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90073 USA. Univ So Calif, Dept Pediat, Keck Sch Med, Los Angeles, CA 90089 USA. Univ Calif Los Angeles, Dept Neurol, Hlth Serv Res Program, David Geffen Sch Med, Los Angeles, CA USA. Sunrise Hosp & Med Ctr, Stroke Prevent Program, Las Vegas, NV USA. RP Cheng, E (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Neurol, 11301 Wilshire Blvd,Bldg 500,ML 127, Los Angeles, CA 90073 USA. EM eric.cheng@med.va.gov NR 26 TC 9 Z9 9 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1015-9770 J9 CEREBROVASC DIS JI Cerebrovasc. Dis. PY 2006 VL 21 IS 4 BP 235 EP 241 DI 10.1159/000091220 PG 7 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 015WA UT WOS:000235580800004 PM 16446536 ER PT J AU Jin, M Wener, MH Bankson, DD AF Jin, M Wener, MH Bankson, DD TI Evaluation of automated sex hormone binding globulin immunoassays SO CLINICAL BIOCHEMISTRY LA English DT Article DE SHBG; sex hormone binding globulin; sex steroid binding globulin; SSBG; testosterone; free testosterone; bioavailable testosterone; method comparison ID BIOAVAILABLE TESTOSTERONE; SERUM AB Background: Sex hormone binding globulin (SHBG) is an important regulator of testosterone and estradiol. Study design: We validated the Diagnostic Products Corporation (DPC) and Roche Diagnostic SHBG immunoassays on the DPC Immulite 2000 and Roche Modular E170 analyzers. Results: The coefficient of variation for SHBG kits from both manufacturers was in the range of 3.9-7.7% (between-run) and 0.95-5.0% (within-run), free of interference from hemoglobin, bilirubin, lipid, and rheumatoid factor, and linear up to at least 170 nM SHBG. The results of the two methods, however, were biased by up to 29% depending on the SHBG concentration. Conclusion: The SHBG assays perform well but standardization is needed. Published by The Canadian Society of Clinical Chemists. C1 Vet Affairs Puget Sound Hlth Care Syst, Dept Pathol & Lab Med, Clin Chem & STAT Labs, Seattle, WA 98108 USA. Univ Washington, Dept Lab Med, Seattle, WA 98195 USA. RP Bankson, DD (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Dept Pathol & Lab Med, Clin Chem & STAT Labs, 1660 S Columbian Way S-113, Seattle, WA 98108 USA. EM daniel.bankson@med.va.gov RI Perez , Claudio Alejandro/F-8310-2010 OI Perez , Claudio Alejandro/0000-0001-9688-184X NR 9 TC 4 Z9 4 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0009-9120 J9 CLIN BIOCHEM JI Clin. Biochem. PD JAN PY 2006 VL 39 IS 1 BP 91 EP 94 DI 10.1016/j.clinbiochem.2005.10.012 PG 4 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 005AH UT WOS:000234793600014 PM 16325792 ER PT J AU Davila, JA El-Serag, HB AF Davila, JA El-Serag, HB TI Racial differences in survival of hepatocellular carcinoma in the United States: A population-based study SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID TRENDS AB Background & Aims: Survival after hepatocellular carcinoma (HCC) diagnosis is generally dismal, but there are patients with more favorable outcomes. Racial variation in survival of patients with HCC could be associated with observed differences in survival; however this has not been previously examined. Methods: During 1987-2001, HCC patients were identified from 9 Surveillance, Epidemiology, and End-Results registries. One- and 3-year survival rates were calculated and compared by race. Models were constructed to examine the effects of race on the mortality risk. Results: Asians had the highest 1- and 3-year observed and relative survival, followed by whites, Hispanics, and blacks. Compared with whites, Asians (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.11-1.69) were more likely to receive local or surgical therapy, whereas blacks (OR, 0.62; 95% CI, 0.49-0.78) and Hispanics (OR, 0.81; 95% CI, 0.60-1.09) were less likely to receive therapy. Adjusting for differences in receipt of therapy, stage of HCC, year of diagnosis, and other demographics, Asians (hazard rate [HR], 0.84; 95% CI, 0.78-0.91) maintained a lower mortality risk compared with whites. In adjusted models, Hispanics (HR, 1.13; 95% CI, 1.03-1.24) maintained a higher mortality risk, whereas the mortality risk for blacks became nonsignificant different from whites (HR, 1.06; 95% CI, 0.99-1.14). Last, a 22% improvement in survival was observed between 1987-1991 and 1997-2001, which was mostly explained by increased receipt of local or surgical therapy. Conclusions: We observed significant racial variation in survival. These variations in survival are partly explained by a lower likelihood of receipt of therapy and more advanced HCC at diagnosis among blacks and Hispanics. C1 Michael E DeBakey Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Gastroenterol Sect, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 14 TC 55 Z9 56 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD JAN PY 2006 VL 4 IS 1 BP 104 EP 110 DI 10.1053/S1542-3565(05)00745-7 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 007TI UT WOS:000234992300019 PM 16431312 ER PT J AU Loftis, J Pagel, R Bussell, C Menasco, D Hauser, P AF Loftis, Jennifer Pagel, Rebecca Bussell, Cara Menasco, Daniel Hauser, Peter TI Pegylated interferon-alpha does not induce sickness behavior in prairie votes. SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 6th Annual Meeting of the Federation-of-Clinical-Immunology-Societies CY JUN 01-05, 2006 CL San Francisco, CA SP Federat Clin Immunol Soc 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 ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PY 2006 VL 119 SU S BP S130 EP S130 DI 10.1016/j.clim.2006.04.305 PG 1 WC Immunology SC Immunology GA 048CD UT WOS:000237924300347 ER PT J AU Muder, RR Brennen, C Rihs, JD Wagener, MM Obman, A Stout, JE Yu, VL AF Muder, RR Brennen, C Rihs, JD Wagener, MM Obman, A Stout, JE Yu, VL TI Isolation of Staphylococcus aureus from the urinary tract: Association of isolation with symptomatic urinary tract infection and subsequent staphylococcal bacteremia SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID TERM-CARE FACILITY; CONTROLLED TRIAL; BACTERIURIA; RESIDENTS; SUSCEPTIBILITY; COLONIZATION; CATHETERS; FEVER; WOMEN AB Background. Staphylococcus aureus is frequently isolated from urine samples obtained from long-term care patients. The significance of staphylococcal bacteriuria is uncertain. We hypothesized that S. aureus is a urinary pathogen and that colonized urine could be a source of future staphylococcal infection. Methods. We performed a cohort study of 102 patients at a long-term care Veterans Affairs facility for whom S. aureus had been isolated from clinical urine culture. Patients were observed via urine and nasal cultures that were performed every 2 months. We determined the occurrence of (1) symptomatic urinary tract infection concurrent with isolation of S. aureus (by predetermined criteria), (2) staphylococcal bacteremia concomitant with isolation of S. aureus from urine, and (3) subsequent episodes of staphylococcal infection. Results. Of 102 patients, 82% had undergone recent urinary catheterization. Thirty-three percent of patients had symptomatic urinary tract infection at the time of initial isolation of S. aureus, and 13% were bacteremic. Eight-six percent of the initial urine isolates were methicillin-resistant S. aureus. Seventy-one patients had follow-up culture data; 58% of cultures were positive for S. aureus at >= 2 months (median duration of staphylococcal bacteriuria, 4.3 months). Sixteen patients had subsequent staphylococcal infections, occurring up to 12 months after initial isolation of S. aureus; 8 late-onset infections were bacteremic. In 5 of 8 patients, the late blood isolate was found to have matched the initial urine isolate by pulsed-field gel electrophoresis typing. Conclusions. S. aureus is a cause of urinary tract infection among patients with urinary tract catheterization. The majority of isolates are methicillin-resistant S. aureus. S. aureus bacteriuria can lead to subsequent invasive infection. The efficacy of antistaphylococcal therapy in preventing late-onset staphylococcal infection in patients with persistent staphylococcal bacteriuria should be tested in controlled trials. C1 VA Pittsburgh Healthcare Syst, Infect Dis Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. RP Muder, RR (reprint author), VA Pittsburgh Healthcare Syst, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. EM Robert.Muder@med.va.gov NR 25 TC 45 Z9 46 U1 1 U2 7 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 JAN 1 PY 2006 VL 42 IS 1 BP 46 EP 50 DI 10.1086/498518 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 989UH UT WOS:000233698900013 PM 16323090 ER PT J AU Anzueto, A Niederman, MS Pearle, J Restrepo, MI Heyder, A Choudhri, SH AF Anzueto, A Niederman, MS Pearle, J Restrepo, MI Heyder, A Choudhri, SH CA Community Acquired Pneumonia Recov TI Community-acquired pneumonia recovery in the elderly (CAPRIE): Efficacy and safety of moxifloxacin therapy versus that of levofloxacin therapy SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 101st International Conference of the American-Thoracic-Society CY MAY 20-25, 2005 CL San Diego, CA SP Amer Thorac Soc, Fogarty AIDS Int Training & Res Program ID CLOSTRIDIUM-DIFFICILE; CLARITHROMYCIN; POPULATION; GUIDELINES; MANAGEMENT; PROGNOSIS; ADULTS; TRIAL AB Background. Limited prospective data are available for elderly patients with community-acquired pneumonia (CAP). This study aimed to determine the efficacy and safety of moxifloxacin versus that of levofloxacin for the treatment of CAP in hospitalized elderly patients (age, >= 65 years). Methods. We conducted a prospective, double-blind, randomized, controlled trial. Eligible patients were stratified by CAP severity before randomization to receive treatment with either intravenous/oral moxifloxacin (400 mg daily) or intravenous/oral levofloxacin (500 mg daily) for 7-14 days. Clinical response at test-of-cure (the primary efficacy end point was between days 5 and 21 after completion of therapy), and clinical response during therapy (between days 3 and 5 after the start of therapy) and bacteriologic response were secondary end points. Results. The safety population included 394 patients ( 195 in the moxifloxacin group and 199 in the levofloxacin group). The population eligible for clinical efficacy analysis (i.e., the clinically valid population) included 281 patients (141 in the moxifloxacin group and 140 in the levofloxacin group); 51.3% were male, and the mean age (+/- SD) was years. Cure rates at test-of-cure for the clinically valid population were 92.9% in the 77.4 +/- 7.7 moxifloxacin arm and 87.9% in the levofloxacin arm (95% confidence interval [CI], -1.9 to 11.9; P=.2). Clinical recovery by days 3-5 after the start of treatment was 97.9% in the moxifloxacin arm vs. 90.0% in the levofloxacin arm (95% CI, 1.7-14.1; P=.01). In the moxifloxacin group, cure rates were 92.6% for patients with mild or moderate CAP and 94.7% for patients with severe CAP, compared with cure rates of 88.6% and 84.6%, respectively, in the levofloxacin group (significant). Cure rates in the moxifloxacin arm were 90.0% for patients aged 65-74 years and 94.5% for patients aged >= 75 years, compared with 85.0% and 90.0%, respectively, in the levofloxacin arm (significant). There were no statistically significant differences between the treatment groups Ppnot with regard to drug-related adverse events. Conclusions. Intravenous/ oral moxifloxacin therapy was efficacious and safe for hospitalized elderly patients with CAP, achieving > 90% cure in all severity and age subgroups, and was associated with faster clinical recovery than intravenous/oral levofloxacin therapy, with a comparable safety profile. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Healthcare Syst, Dept Med, Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX USA. Winthrop Univ Hosp, Dept Med, Mineola, NY 11501 USA. Calif Res Med Grp, Fullerton, CA USA. Carolina Res Specialists, Elizabeth City, NC USA. Bayer Pharmaceut, West Haven, CT USA. RP Anzueto, A (reprint author), 111E,7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM Anzueto@uthscsa.edu NR 22 TC 57 Z9 65 U1 0 U2 4 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 JAN 1 PY 2006 VL 42 IS 1 BP 73 EP 81 DI 10.1086/498520 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 989UH UT WOS:000233698900018 PM 16323095 ER PT J AU Abramson, JS Neuzil, KM Tamblyn, SE AF Abramson, JS Neuzil, KM Tamblyn, SE TI Annual universal influenza vaccination: Ready or not? SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID CHILDREN; SCHOOLCHILDREN AB Influenza causes annual worldwide epidemics of respiratory disease. Currently, the United States and many other countries recommend influenza vaccination for persons who are at high risk for influenza-related complications. This commentary explores the potential benefits of a policy advocating universal annual influenza vaccination and outlines obstacles that need to be overcome to make such a recommendation feasible. The 5-year experience of a free influenza vaccination program for everyone >= 6 months of age in the Canadian province of Ontario is reviewed. C1 Wake Forest Univ, Sch Med, Dept Pediat, Winston Salem, NC 27157 USA. Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98195 USA. Univ Western Ontario, Dept Epidemiol & Biostat, Fac Med & Dent, London, ON, Canada. RP Abramson, JS (reprint author), Wake Forest Univ, Sch Med, Dept Pediat, Med Ctr Blvd, Winston Salem, NC 27157 USA. EM jabrams@wfubmc.edu NR 15 TC 11 Z9 14 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 JAN 1 PY 2006 VL 42 IS 1 BP 132 EP 135 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 989UH UT WOS:000233698900027 PM 16323103 ER PT J AU Gallagher, RM AF Gallagher, RM TI Management of neuropathic pain - Translating mechanistic advances and evidence-based research into clinical practice SO CLINICAL JOURNAL OF PAIN LA English DT Article DE neuropathic pain; management; evidence-based ID LIDOCAINE PATCH 5-PERCENT; CHRONIC POSTHERPETIC NEURALGIA; DOUBLE-BLIND; DIABETIC-NEUROPATHY; RANDOMIZED-TRIAL; EFFICACY; GABAPENTIN; CAPSAICIN; ANTIDEPRESSANTS; HYPOTHESES AB The concept of rational polypharmacy is now well established in the field of pain management. This concept has evolved in concert with progress in understanding the pathophysiologic mechanisms of pain diseases and disorders and how medications affect these processes. Other clinical factors must be considered in formulating the pain management strategy most likely to succeed in both controlling pain and improving function in a given patient. This article will review how pain diagnosis, pain mechanisms, pain phenomenology, medication efficacy, and risk profile influence medication selection in pain medicine practice, with a selective focus on the treatment of neuropathic pain. In addition, the role of psychosocial factors as they affect pain managernent will be discussed. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Anesthesiol, Philadelphia, PA 19104 USA. RP Gallagher, RM (reprint author), Univ Penn, Vet Affairs Med Ctr, Woodland Ave, Philadelphia, PA 19014 USA. EM rgallagh@mail.med.upenn.edu NR 31 TC 18 Z9 22 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0749-8047 J9 CLIN J PAIN JI Clin. J. Pain PD JAN PY 2006 VL 22 IS 1 SU S BP S2 EP S8 DI 10.1097/01.ajp.0000193827.07453.d6 PG 7 WC Anesthesiology; Clinical Neurology SC Anesthesiology; Neurosciences & Neurology GA 001TB UT WOS:000234558200002 PM 16344609 ER PT J AU Gallagher, RM AF Gallagher, RM TI Analgesic selection in the management of chronic pain - Linking mechanisms & evidence-based research to clinical practice SO CLINICAL JOURNAL OF PAIN LA English DT Editorial Material C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19014 USA. Univ Penn, Dept Anesthesiol, Philadelphia, PA 19014 USA. Univ Penn, Vet Affairs Med Ctr, Philadelphia, PA 19014 USA. RP Gallagher, RM (reprint author), Univ Penn, Vet Affairs Med Ctr, Woodland Ave, Philadelphia, PA 19014 USA. EM rgallagh@mail.med.upenn.edu NR 1 TC 1 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0749-8047 J9 CLIN J PAIN JI Clin. J. Pain PD JAN PY 2006 VL 22 IS 1 SU S BP S1 EP S1 DI 10.1097/01.ajp.0000193828.45571.06 PG 1 WC Anesthesiology; Clinical Neurology SC Anesthesiology; Neurosciences & Neurology GA 001TB UT WOS:000234558200001 PM 16344608 ER PT J AU Palevsky, PM AF Palevsky, Paul M. TI Epidemiology of acute renal failure: The tip of the iceberg SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Editorial Material ID MORTALITY; INSUFFICIENCY C1 VA Pittsburgh Healthcare Syst, Univ Dr Div, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Univ Dr Div, Renal Sect, Room 7E123 111F-U, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Palevsky, Paul/0000-0002-7334-5400 NR 12 TC 29 Z9 31 U1 0 U2 1 PU AMERICAN SOCIETY NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD JAN PY 2006 VL 1 IS 1 BP 6 EP 7 DI 10.2215/CJN.01521005 PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 106DA UT WOS:000242080000003 PM 17699185 ER PT J AU Dransfield, MT Lock, BJ Graver, RI AF Dransfield, Mark Thomas Lock, Brion Jacob Graver, Robert I., Jr. TI Improving the lung cancer resection rate in the US Department of Veterans Affairs Health System SO CLINICAL LUNG CANCER LA English DT Article DE diagnosis; non-small-cell lung cancer; practice organization; thoracic surgery ID POSITRON-EMISSION-TOMOGRAPHY; STAGE-I; SURGICAL RESECTION; CELL; CARCINOMA; SURVIVAL; MANAGEMENT; DIAGNOSIS; PROGNOSIS; SURGERY AB BACKGROUND: The optimal treatment for non-small-cell lung cancer (NSCLC) is surgical resection; however, most patients are ineligible because of advanced disease. Although resection rates of 25%, have been reported nationally, rates in the Veterans Affairs (VA) system appear lower, perhaps because of limited access to specialized care. We hypothesized that, since the introduction of a specialized Lung Mass Clinic in 1999, the resection rate at the Birmingham VA Medical Center would be comparable with US benchmarks. We also sought to identify the medical and nonmedical factors that influenced the use of surgery. PATIENTS AND METHODS: We reviewed the electronic medical records of all veterans seen in the Lung Mass Clinic from 1999 to 2003 and identified patients with NSCLC. Demographics, comorbidities, diagnostic methods, times to diagnosis/resection, and postoperative survival were recorded. Reasons for nonresection were documented and tabulated, and differences between the resected and nonresected subgroups were examined. RESULTS: One hundred fifty-six patients with NSCLC were identified, and 31 (20%) underwent resection. There were no differences in age, ethnicity, or sex between those undergoing resection and those denied surgery. Patients who underwent resection were less likely to have chronic obstructive pulmonary disease and had better pulmonary function. Eighty-four percent of those who did not undergo resection had advanced disease, poor pulmonary function, or had refused therapy. Although the median time to resection was longer than expected (104 days), overall survival was comparable with other reports (65% at 3 years). CONCLUSION: Since the inception of the Lung Mass Clinic, the resection rate at Birmingham VA Medical Center has improved. The primary limitation to resection was late presentation and not preoperative delays. C1 Birmingham Vet Affairs Med Ctr, Div Pulm Allergy & Crit Care Med, Birmingham, AL 35294 USA. Univ Alabama, Birmingham, AL 35294 USA. RP Dransfield, MT (reprint author), Birmingham Vet Affairs Med Ctr, Div Pulm Allergy & Crit Care Med, 215 THT,1900 Univ Blvd, Birmingham, AL 35294 USA. EM mdransfield99@msn.com NR 27 TC 20 Z9 20 U1 0 U2 0 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 JAN PY 2006 VL 7 IS 4 BP 268 EP 272 PG 5 WC Oncology SC Oncology GA 106CK UT WOS:000242078400006 PM 16512981 ER PT J AU Mularski, RA Grazer, RE Santoni, L Strother, JS Bizovi, KE AF Mularski, RA Grazer, RE Santoni, L Strother, JS Bizovi, KE TI Treatment advice on the Internet leads to a life-threatening adverse reaction: Hypotension associated with niacin overdose SO CLINICAL TOXICOLOGY LA English DT Article DE niacin; nicotinic acid; overdose; poisoning; critical care; Internet; dietary supplement; over-the-counter; hypotension; schizophrenia ID ALTERNATIVE MEDICAL THERAPIES; FULMINANT HEPATIC-FAILURE; NICOTINIC-ACID THERAPY; ADVISING PATIENTS; UNITED-STATES; COMPLEMENTARY; SCHIZOPHRENIA; PHYSICIAN; TRENDS AB We describe a case of massive oral niacin overdose that resulted in severe persistent hypotension without the manifestation of cutaneous flushing. This case is the highest overdose of niacin reported in the literature to date and the first time severe persistent hypotension has been attributed to niacin. A 56-year-old male with a history of schizophrenia presented to the emergency department after orally ingesting 11,000 mg of niacin. The patient cited an Internet resource that recommended high-dose niacin for therapy of schizophrenia as the reason for his ingestion. He stopped his psychiatric medications several weeks prior to his niacin overdose. At presentation, the patient was alert and normothermic. His pulse was 68 beats per minute and his blood pressure was initially 92/41 mmHg. Hypotension with a blood pressure of 58/40 developed over the next few hours and persisted despite intravenous infusion of over 4 liters of normal saline. The physical exam was otherwise unremarkable, specifically without signs of an allergic reaction or cutaneous flushing. He required intravenous dopamine infusion for 12 hours to support a mean arterial blood pressure greater than 60 mmHg. Evaluation for other etiologies of hypotension was unrevealing. Serum niacin levels were 8.2 ug/mL and 5.6 ug/mL at 48 and 96 hours post ingestion, respectively, giving an apparent T1/2 of 87 hours. Massive overdose of niacin appears to be capable of causing severe, persistent hypotension in the absence of cutaneous flushing. In this case, the ingestion of a dietary supplement based on Internet advice led to a severe adverse reaction. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RAND Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90073 USA. Oregon Hlth Sci Univ, Dept Emergency Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. RP Mularski, RA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd Mailcode 111G, Los Angeles, CA 90073 USA. EM rmularsk@ucla.edu NR 36 TC 6 Z9 6 U1 6 U2 7 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0731-3810 J9 CLIN TOXICOL JI Clin. Toxicol. PY 2006 VL 44 IS 1 BP 81 EP 84 DI 10.1080/15563650500394928 PG 4 WC Toxicology SC Toxicology GA 011OY UT WOS:000235279100012 PM 16496499 ER PT J AU Espeland, MA Dotson, K Jaramillo, SA Kahn, SE Harrison, B Montez, M Foreyt, JP Montgomery, B Knowler, WC AF Espeland, M. A. Dotson, K. Jaramillo, S. A. Kahn, S. E. Harrison, B. Montez, M. Foreyt, J. P. Montgomery, B. Knowler, W. C. CA Look Ahead Res Grp TI Consent for genetics studies among clinical trial participants: findings from Action for Health in Diabetes (Look AHEAD) SO CLINICAL TRIALS LA English DT Article ID INFORMED CONSENT; RECRUITMENT; POPULATION; SAMPLES; COHORT AB Background: Increasingly, genetic specimens are collected to expand the value of clinical trials through study of genetic effects on disease incidence, progression or response to interventions. Purpose and methods: We describe the experience obtaining IRB-approved DNA consent forms across the 19 institutions in the Action for Health in Diabetes (Look AHEAD), a clinical trial examining the effect of a lifestyle intervention for weight loss on the risk of serious cardiovascular events among individuals with type 2 diabetes. We document the rates participants provided consent for DNA research, identify participant characteristics associated with consent, and discuss implications for genetics research. Results: IRB approval to participate was obtained from 17 of 19 institutions. The overall rate of consent was 89.6% among the 15 institutions that had completed consenting at the time of our analysis, which was higher than reported for other types of cohort studies. Consent rates were associated with factors expected to be associated with weight loss and cardiovascular disease and to affect the distribution of candidate genes. Non-consent occurred more frequently among participants grouped as African-American, Hispanic, female, more highly educated or not dyslipidemic. Limitations: The generalizabilty of results is limited by the inclusion/exclusion criteria of the trial. Conclusions: Barriers to obtaining consent to participate in genetic studies may differ from other recruitment settings. Because of the potentially complex associations between personal characteristics related to adherence, outcomes and gene distributions, differential rates of consent may introduce biases in estimates of genetic relationships. C1 Wake Forest Univ, Sch Med, Dept Biostat Sci, Winston Salem, NC 27157 USA. VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NIDDK, Bethesda, MD USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Baylor Coll Med, Behav Med Res Ctr, Houston, TX 77030 USA. NIDDK, Diabet Epidemiol & Clin Res Sect, Phoenix, AZ USA. RP Espeland, MA (reprint author), Wake Forest Univ, Sch Med, Dept Biostat Sci, Med Ctr Blvd, Winston Salem, NC 27157 USA. EM mespelan@wfubmc.edu OI Kriska, Andrea/0000-0002-3522-0869; Kahn, Steven/0000-0001-7307-9002; Redmon, J. Bruce/0000-0002-1883-9467 FU Intramural NIH HHS; NCRR NIH HHS [M01 RR000051, M01 RR000056, M01 RR000056 44, M01 RR000211, M01 RR00051, M01 RR001066, M01 RR002719, M01-RR-01066, M01-RR-02719, M01RR00211-40]; NIDDK NIH HHS [U01 DK057151, DK 046204, DK56990, DK56992, DK57002, DK57008, DK57078, DK57131, DK57135, DK57136, DK57149, DK57151, DK57154, DK57171, DK57177, DK57178, DK57182, DK57219, P30 DK046204, P30 DK048520, P30DK48520, U01 DK056990, U01 DK056992, U01 DK057002, U01 DK057008, U01 DK057078, U01 DK057131, U01 DK057135, U01 DK057136, U01 DK057136-09, U01 DK057149, U01 DK057154, U01 DK057171, U01 DK057177, U01 DK057178, U01 DK057182, U01 DK057219] NR 25 TC 21 Z9 21 U1 0 U2 3 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1740-7745 J9 CLIN TRIALS JI Clin. Trials PY 2006 VL 3 IS 5 BP 443 EP 456 DI 10.1177/1740774506070727 PG 14 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 109TK UT WOS:000242331500004 PM 17060218 ER PT J AU Brandt, DK Hind, JA Robbins, J Lindblad, AS Gensler, G Gill, G Baum, H Lilienfeld, D Logemann, JA AF Brandt, Diane K. Hind, Jacqueline A. Robbins, JoAnne Lindblad, Anne S. Gensler, Gary Gill, Gary Baum, Herb Lilienfeld, David Logemann, Jeri A. CA Commun Sciences Disorders Clinical TI Challenges in the design and conduct of a randomized study of two interventions for liquid aspiration SO CLINICAL TRIALS LA English DT Article ID PRACTICAL CLINICAL-TRIALS; INFORMED-CONSENT; OLDER-PEOPLE; RISK-FACTORS; ELDERLY PATIENTS; PNEUMONIA; CARE; MORTALITY; DISEASE; RECOMMENDATIONS AB Background. Liquid aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of liquid aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease. Methods. Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities. Results. In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, supplementing site staff to identify potential study participants using a 'circuit rider' approach, continued recruitment of new sites and staff throughout the course of the trial, adapting forms and procedures and managing within economic constraints in a changing trial environment. Limitations. Many of the challenges faced by the researchers were not anticipated when the study began. Successful strategies are described for these unanticipated difficulties, based on retrospective evaluation. Conclusions. Successful conduct of clinical trials in long-term care environments that are heavily impacted by changes extraneous to the trial design and with staff typically new to clinical trials is possible but success depends on logistical flexibility. C1 EMMES Corp, Rockville, MD USA. Univ Wisconsin, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53705 USA. ORC Macro, Calverton, MD USA. Prot Design Labs Inc, Fremont, CA USA. Northwestern Univ, Chicago, IL 60611 USA. RP Brandt, DK (reprint author), CSDRG Stat & Data Ctr, Commun Sci & Disorders Clin Trials Res Grp, 401 N Washington St,Suite 700, Rockville, MD 20850 USA. EM dbrandt@emmes.com OI Tuite, Paul/0000-0003-1413-7924 FU NIDCD NIH HHS [DC03206] NR 54 TC 12 Z9 12 U1 1 U2 10 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1740-7745 J9 CLIN TRIALS JI Clin. Trials PY 2006 VL 3 IS 5 BP 457 EP 468 DI 10.1177/1740774506070731 PG 12 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 109TK UT WOS:000242331500005 PM 17060219 ER PT J AU O'Mahony, DS Liles, WC Altemeier, WA Dhanireddy, S Frevert, CW Liggitt, D Martin, TR Matute-Bello, G AF O'Mahony, D. Shane Liles, W. Conrad Altemeier, William A. Dhanireddy, Shireesha Frevert, Charles W. Liggitt, Denny Martin, Thomas R. Matute-Bello, Gustavo TI Mechanical ventilation interacts with endotoxemia to induce extrapulmonary organ dysfunction SO CRITICAL CARE LA English DT Article ID RESPIRATORY-DISTRESS-SYNDROME; LIPOPOLYSACCHARIDE-BINDING PROTEIN; EPITHELIAL-CELL APOPTOSIS; MITOCHONDRIAL DYSFUNCTION; INFLAMMATORY RESPONSE; EXPERIMENTAL-MODEL; CRITICAL ILLNESS; FAS CD95; IN-VIVO; LUNG AB Introduction Multiple organ dysfunction syndrome ( MODS) is a common complication of sepsis in mechanically ventilated patients with acute respiratory distress syndrome, but the links between mechanical ventilation and MODS are unclear. Our goal was to determine whether a minimally injurious mechanical ventilation strategy synergizes with low-dose endotoxemia to induce the activation of pro-inflammatory pathways in the lungs and in the systemic circulation, resulting in distal organ dysfunction and/or injury. Methods We administered intraperitoneal Escherichia coli lipopolysaccharide (LPS; 1 mu g/g) to C57BL/6 mice, and 14 hours later subjected the mice to 6 hours of mechanical ventilation with tidal volumes of 10 ml/kg ( LPS + MV). Comparison groups received ventilation but no LPS ( MV), LPS but no ventilation ( LPS), or neither LPS nor ventilation (phosphate-buffered saline; PBS). Results Myeloperoxidase activity and the concentrations of the chemokines macrophage inflammatory protein-2 (MIP-2) and KC were significantly increased in the lungs of mice in the LPS + MV group, in comparison with mice in the PBS group. Interestingly, permeability changes across the alveolar epithelium and histological changes suggestive of lung injury were minimal in mice in the LPS + MV group. However, despite the minimal lung injury, the combination of mechanical ventilation and LPS resulted in chemical and histological evidence of liver and kidney injury, and this was associated with increases in the plasma concentrations of KC, MIP-2, IL-6, and TNF-alpha. Conclusion Non-injurious mechanical ventilation strategies interact with endotoxemia in mice to enhance pro-inflammatory mechanisms in the lungs and promote extra-pulmonary end-organ injury, even in the absence of demonstrable acute lung injury. C1 Univ Washington, Sch Med, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Div Allergy & Infect Dis, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Comparat Med, Seattle, WA 98195 USA. RP Matute-Bello, G (reprint author), Univ Washington, Sch Med, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. EM matuteb@u.washington.edu FU NHLBI NIH HHS [P50 HL073996, K08 HL070840, K08-HL70840, P50 HL73996] NR 28 TC 43 Z9 46 U1 0 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1466-609X J9 CRIT CARE JI Crit. Care PY 2006 VL 10 IS 5 AR R136 DI 10.1186/cc5050 PG 9 WC Critical Care Medicine SC General & Internal Medicine GA 185NS UT WOS:000247718300012 PM 16995930 ER PT J AU Fagerlie, SR Bagby, GC AF Fagerlie, SR Bagby, GC TI Immune defects in Fanconi anemia SO CRITICAL REVIEWS IN IMMUNOLOGY LA English DT Review DE aplastic anemia; immunodeficiency; T cell; tumor surveillance; chromosomal instability ID TUMOR-NECROSIS-FACTOR; DEPENDENT PROTEIN-KINASE; GROUP-C GENE; DOUBLE-STRANDED-RNA; HEMATOPOIETIC PROGENITOR CELLS; INDUCED APOPTOTIC RESPONSES; HUMAN-PAPILLOMAVIRUS HPV; NF-KAPPA-B; NATURAL-KILLER; INTERFERON-GAMMA AB Fanconi anemia (FA) is a genetic disorder characterized by sensitivity to DNA cross-linking agents, multiple congenital anomalies, progressive bone marrow failure, and an increased prevalence of malignancy. The nature of chromosomal instability in FA is better understood today than in the past, but the molecular pathogenesis of bone marrow failure in this disease has not been clarified. Although there is documented evidence that FA hematopoietic stem cells (HSC) have inherent defects that reduce their survival, the potential influence of auxiliary cells on the ability of the FA bone marrow microenvironment to maintain and support HSC in unknown. Historically, FA has not been represented as a disease that affects the lymphoid compartment. In this article we review the results of studies that suggest that the FA immune system is dysfunctional and may contribute to the pathogenesis of both FA bone marrow failure and neoplastic disease. C1 Fred Hutchinson Canc Res Ctr, Div Clin Res, Transplantat Biol Program, Seattle, WA 98109 USA. Oregon Hlth Sci Univ, Inst Canc, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Fagerlie, SR (reprint author), Fred Hutchinson Canc Res Ctr, Div Clin Res, Transplantat Biol Program, D1-100,1100 Fairview Ave N, Seattle, WA 98109 USA. EM sfagerli@fhcre.org OI Bagby, Grover/0000-0001-6830-2046 FU NCI NIH HHS [T32 CA080416] NR 137 TC 20 Z9 20 U1 0 U2 3 PU BEGELL HOUSE INC PI NEW YORK PA 145 MADISON AVE, STE 601, NEW YORK, NY 10016-7892 USA SN 1040-8401 J9 CRIT REV IMMUNOL JI Crit. Rev. Immunol. PY 2006 VL 26 IS 1 BP 81 EP 96 PG 16 WC Immunology SC Immunology GA 011DP UT WOS:000235248400004 PM 16472069 ER PT J AU Afshar-Kharghan, V Thiagarajan, P AF Afshar-Kharghan, V Thiagarajan, P TI Leukocyte adhesion and thrombosis SO CURRENT OPINION IN HEMATOLOGY LA English DT Article DE leukocyte adhesion; microvesicles; selectins; thrombosis; tissue factor ID TISSUE-FACTOR; P-SELECTIN; PLATELET ACTIVATION; CATHEPSIN-G; ESSENTIAL THROMBOCYTHEMIA; POLYCYTHEMIA-VERA; BLOOD-COAGULATION; FIBRIN DEPOSITION; FACTOR-VIIA; IN-VITRO AB Purpose of the review. The consequences of arterial thrombosis such as myocardial infarction, stroke and peripheral vascular occlusion are the leading causes of morbidity and mortality. A high leukocyte count and an elevation in inflammatory markers are identified as significant risk factors for thrombosis. Leukocytes form the front line in defense against infection and are the first cells arriving at the site of inflammation. This review summarizes the cellular and molecular mechanisms by which adherent leukocytes can induce a prothrombotic state. Recent findings. Circulating tissue factor has been recognized as a potential prothrombotic factor initiating thrombosis after vascular injury, The tissue factor is present on microvesicles originated from activated leukocytes. Leukocytes generate tissue factor containing microvesicles following stimulation with cytokines and following platelet adhesion via P-selectin. Additionally, activated leukocytes release several mediators, such as cathepsin G and elastase, which can activate both the coagulation cascade and platelets. Furthermore, new roles for leukocytes have been identified in vascular injury in sickle cell anemia, in vascular occlusion following the rupture of atherosclerotic plaque, and in thrombotic complications of myeloproliferative diseases. Summary. Leukocyte adhesion to endothelium and platelets plays an important role in the activation of the coagulation cascade. An excessive activation of leukocytes during the inflammatory process may induce a systemic procoagulant state. Elucidation of critical steps in activation of coagulation by leukocytes may offer a new therapeutic target for antithrombotic therapy based on blocking leukocyte adhesion. C1 Baylor Coll Med, Dept Pathol & Med Thrombosis Res, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Thiagarajan, P (reprint author), VA Med Ctr, Mail Stop 113,2002 Holcombe Blvd, Houston, TX 77030 USA. EM perumalt@bcm.tmc.edu OI Thiagarajan, Perumal/0000-0003-2186-7036 FU NHLBI NIH HHS [HL 65096] NR 49 TC 59 Z9 64 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 1065-6251 J9 CURR OPIN HEMATOL JI Curr. Opin. Hematol. PD JAN PY 2006 VL 13 IS 1 BP 34 EP 39 DI 10.1097/01.moh.0000190107.54790.de PG 6 WC Hematology SC Hematology GA 995CZ UT WOS:000234078800006 PM 16319685 ER PT J AU Martinez, V Tache, Y AF Martinez, V. Tache, Y. TI CRF1 receptors as a therapeutic target for irritable bowel syndrome SO CURRENT PHARMACEUTICAL DESIGN LA English DT Review DE CRF; CRF receptors; CRF antagonists; IBS; stress; gastrointestinal; colon ID CORTICOTROPIN-RELEASING-FACTOR; CENTRAL-NERVOUS-SYSTEM; UROCORTIN-LIKE IMMUNOREACTIVITY; STRESS-RELATED ALTERATIONS; LOCUS-COERULEUS NEURONS; PITUITARY-ADRENAL AXIS; COLONIC MOTOR FUNCTION; FACTOR MESSENGER-RNA; LONG-EVANS RATS; CRH-1-RECEPTOR ANTAGONIST R121919 AB The characterization of the corticotropin-releasing factor (CRF) family of neuroendocrine regulatory peptides, the cloning and pharmacological characterization of two CRF receptor subtypes (CRF1 and CRF2), and the development of selective CRF receptor antagonists provided new insight to unravel the mechanisms of stress and the potential involvement of the CRF system in different pathophysiological conditions, including functional gastrointestinal disorders, mainly irritable bowel syndrome (IBS), and psychopathologies such as anxiety/depression. Compelling pre-clinical data showed that brain CRF administration mimics acute stress-induced colonic responses and enhances colorectal distension-induced visceral pain in rats through CRF1 receptors. Similarly, peripheral CRF reduced the pain threshold to colonic distension and increased colonic motility in humans and rodents. These observations mimic the manifestations of IBS, characterized by abdominal bloating/discomfort and altered bowel habits, Moreover, CRF-CRF1 pathways have been implicated in the development of anxiety/depression. These psychopathologies, together with stressful life events, have high comorbidity with IBS, and are considered significant components of the disease. From these observations, CRF1 receptors have been suggested as a target to treat IBS. Peripherally acting CRF1 antagonists might directly improve IBS symptoms, as related to motility, secretion and immune response. On the other hand, central actions will be beneficial as to prevent the psychopathologies that co-exist with IBS and as a way to modulate the central processing of stress- and visceral pain-related signals. Here, we review the pre-clinical and clinical data supporting these assumptions, and address the efforts done at a pharmaceutical level to develop effective therapies targeting CRF1 receptors for functional gastrointestinal disorders. C1 Univ Calif Los Angeles, Dept Med, W Los Angeles VA Med Ctr, Div Diges Dis,CURE,DDRCVA Greater Los Angeles Hea, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Ctr Neurovisceral Sci & Womens Hlth, W Los Angeles VA Med Ctr,Div Digest Dis, Los Angeles, CA 90073 USA. AstraZeneca R&D, Integrat Pharmacol Gastrointestinal Biol, Molndal, Sweden. RP Tache, Y (reprint author), Univ Calif Los Angeles, Dept Med, W Los Angeles VA Med Ctr, Div Diges Dis,CURE,DDRCVA Greater Los Angeles Hea, Bldg 115,Rm 117,11301 Wilshire blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu RI Martinez, Vicente/N-1189-2014 FU NIAMS NIH HHS [P50 AR-049550]; NIDDK NIH HHS [DK-41301, R01 DK-33061, R01 DK-57236] NR 246 TC 60 Z9 66 U1 0 U2 4 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1381-6128 J9 CURR PHARM DESIGN JI Curr. Pharm. Design PY 2006 VL 12 IS 31 BP 4071 EP 4088 DI 10.2174/138161206778743637 PG 18 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 097ZG UT WOS:000241488300007 PM 17100612 ER PT J AU Kramer, JH Nelson, A Johnson, JK Yaffe, K Glenn, S Rosen, HJ Miller, BL AF Kramer, Joel H. Nelson, Adam Johnson, Julene K. Yaffe, Kristine Glenn, Shenly Rosen, Howard J. Miller, Bruce L. TI Multiple cognitive deficits in amnestic mild cognitive impairment SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE amnestic mild cognitive impairment; Alzheimer's disease; executive function; fluency ID ALZHEIMERS-DISEASE; EXECUTIVE DEFICITS; DEMENTIA; OUTCOMES; STAGE AB Objective: To determine if more widespread cognitive deficits are present in a narrowly defined group of patients with the amnestic form of mild cognitive impairment (MCI). Methods: From a larger sample of patients clinically diagnosed as meeting the criteria of Petersen et al. for amnestic MCI, we selected 22 subjects who had Clinical Dementia Rating scores of zero on all domains besides memory and orientation. These MCI subjects with presumably isolated memory impairments were compared to 35 age-matched normal controls and 33 very mild Alzheimer's disease ( AD) patients on a battery of neuropsychological tests. Result: In addition to the expected deficits in episodic memory, the amnestic MCI group performed less well than the controls but better than the AD group on design fluency, category fluency, a set shifting task and the Stroop interference condition. Over half the amnestic MCI group ( vs. none of the normal controls) scored at least 1 standard deviation below control means on 4 or more of the nonmemory cognitive tasks. Conclusions: Isolated memory impairment may be fairly uncommon in clinically diagnosed amnestic MCI patients, even when the criteria for amnestic MCI are fairly narrow. Additional cognitive impairments are likely to include fluency and executive functioning. These more diffuse deficits argue for comprehensive cognitive assessments, even when the patient and family are reporting only memory decline, and are consistent with the increase in attention paid to the heterogeneity of MCI. Copyright (C) 2006 S. Karger AG, Basel. C1 Univ Calif San Francisco, Med Clin, Mem & Aging Ctr, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Kramer, JH (reprint author), Univ Calif San Francisco, Med Clin, Mem & Aging Ctr, Box 1207,350 Parnassus,Suite 706, San Francisco, CA 94143 USA. EM kramer@itsa.ucsf.edu FU NIA NIH HHS [L30 AG024692, P30 AG010129, P50 AG005142, P50 AG016570, AG16570, P50-AG05142, R01 AG022538, R01 AG022538-02, AG10129] NR 32 TC 84 Z9 88 U1 1 U2 6 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2006 VL 22 IS 4 BP 306 EP 311 DI 10.1159/000095303 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 107JQ UT WOS:000242167400007 PM 16931884 ER PT J AU Yaffe, K Petersen, RC Lindquist, K Kramer, J Miller, B AF Yaffe, Kristine Petersen, Ron C. Lindquist, Karla Kramer, Joel Miller, Bruce TI Subtype of mild cognitive impairment and progression to dementia and death SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE mild cognitive impairment; mild cognitive impairment subtypes; risk of mortality ID ALZHEIMER-DISEASE; DECLINE AB Background: Mild cognitive impairment (MCI) represents a common cognitive state between normal cognitive aging and dementia. There is limited information about the heterogeneity of MCI and how this heterogeneity may influence the clinical course of MCI. We determined the longitudinal course of subtypes of MCI and assessed the rate of progression to dementia and to death. Methods: As part of the Alzheimer's Disease Research Centers of California, we studied 327 patients with MCI ( 250 with amnestic MCI, 34 with single nonmemory MCI, and 43 with multiple domain MCI) who were followed longitudinally. We determined if subtype of MCI was independently associated with time to dementia diagnosis and time to death using Cox proportional hazard models, and type of dementia using Fisher's exact test. Results: Mean age of the patients with MCI was 72.9 +/- 9.3 years and mean Mini-Mental State Examination score was 25.7 +/- 4.3. After a mean follow-up of 3.1 years, 199 (65%) progressed to dementia and 80 (24%) died. After multivariate adjustment, compared to those with amnestic MCI, patients with single nonmemory or multiple subtype MCI were less likely to receive a diagnosis of dementia (HR = 0.60; 95% CI 0.35 - 1.05 and HR = 0.71; 95% CI 0.44 - 1.14) but more likely to die HR = 2.57; 95% CI 1.13 - 5.84 and HR = 1.73; 95% CI 0.72 - 4.18), but these results were of borderline statistical significance. There were significant differences in the type of dementia diagnosed across MCI subtypes ( p = 0.006). Among the patients who progressed to Alzheimer's disease, 76% had prior amnestic MCI; of the patients who progressed to vascular dementia, 50% had prior amnestic MCI; all patients who progressed to a frontal dementia syndrome had single nonmemory MCI previously. Conclusions: The majority of patients with MCI progressed to dementia and a significant proportion died. Subtype of MCI may influence rates of progression to death and to dementia and has a major influence on subsequent type of dementia diagnosis. Copyright (C) 2006 S. Karger AG, Basel. C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Mayo Clin, Dept Neurol, Rochester, MN USA. RP Yaffe, K (reprint author), Univ Calif San Francisco, Dept Psychiat, Box 181,4150 Clement St, San Francisco, CA 94121 USA. EM kristine.yaffe@ucsf.edu FU NIA NIH HHS [P01 AG019724, P50 AG023501, R01 AG021918] NR 20 TC 127 Z9 133 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2006 VL 22 IS 4 BP 312 EP 319 DI 10.1159/000095427 PG 8 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 107JQ UT WOS:000242167400008 PM 16940725 ER PT J AU McMurtray, A Clark, DG Christine, D Mendez, MF AF McMurtray, A Clark, DG Christine, D Mendez, MF TI Early-onset dementia: Frequency and causes compared to late-onset dementia SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE dementia, early onset, late onset; Alzheimer's disease ID FRONTOTEMPORAL LOBAR DEGENERATION; PRESENILE-DEMENTIA; VASCULAR DEMENTIA; PREVALENCE; YOUNG; ASCERTAINMENT; POPULATION; MINNESOTA; ROCHESTER; SCOTLAND AB Background: Research on the epidemiology of dementia has focused on the elderly. Few investigations have studied differences in etiologic frequencies between early-onset dementia (EOD), with onset at an age of less than 65 years old, and the more common late-onset disorder. Objectives: To determine relative frequencies and characteristics of EOD versus late-onset dementia (LOD; age of onset 6 65 years) diagnosed in a large memory disorders program over a 4-year period. Methods: We reviewed medical records, including an extensive neurobehavioral and neurological evaluation, of all patients seen at a large Veteran's Affairs Medical Center Memory Disorders clinic between 2001 and 2004 and assessed demographic variables, final diagnoses, presence of dementia, and differential diagnosis of dementing illnesses. Results: Among 1,683 patients presenting for evaluation of an acquired decline in memory or cognition, 948 (56%) met established clinical criteria for a dementing illness. About 30% (n = 278) of these had an age of onset of <65 years, compared to 670 with LOD. Patients were predominantly male (98%). Compared to the late-onset group, the EOD patients were less severely impaired on presentation, but they did not differ in gender distribution or educational background. The EOD group had significantly more dementia attributed to traumatic brain injury, alcohol, human immunodeficiency virus (HIV), and frontotemporal lobar degeneration compared to the LOD patients. In contrast, the LOD group had significantly more Alzheimer's disease compared to the EOD group. Conclusions: This study, conducted at a Veterans Affairs Hospital, is the largest series to date on EOD, and found a previously unexpectedly large number of patients below the age of 65 with cognitive deficits and impaired functioning consequent to head trauma, alcohol abuse, and HIV. These findings highlight the differential distribution and importance of preventable causes of dementia in the young. Copyright (C) 2006 S. Karger AG, Basel. C1 VA Greater Los Angeles Healthcare Syst, Neurobehav Unit, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA. RP McMurtray, A (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit, 116AF,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM amcmurtray@mednet.ucla.edu NR 27 TC 71 Z9 76 U1 3 U2 17 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2006 VL 21 IS 2 BP 59 EP 64 DI 10.1159/000089546 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 002ZL UT WOS:000234651300001 PM 16276111 ER PT J AU Issa, AM Mojica, WA Morton, SC Traina, S Newberry, SJ Hilton, LG Garland, RH MacLean, CH AF Issa, AM Mojica, WA Morton, SC Traina, S Newberry, SJ Hilton, LG Garland, RH MacLean, CH TI The efficacy of omega-3 fatty acids on cognitive function in aging and dementia: A systematic review SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE omega-3 fatty acids; treatment of dementia; Alzheimer's disease; cognitive function in normal aging ID ALZHEIMER-DISEASE; METHODOLOGICAL QUALITY; FATTY-ACIDS; RISK; FISH; CONSUMPTION; COHORT AB We systematically reviewed the published literature on the effects of omega - 3 fatty acids on measures of cognitive function in normal aging, incidence and treatment of dementia. Computerized databases were searched for published literature to identify potentially relevant studies with the intent to conduct a meta-analysis. We screened 5,865 titles, reviewed 497 studies of which 49 underwent a detailed review, and found 5 studies that pertained to our objectives. We included controlled clinical trials and observational studies, including prospective cohort, case-control, and case series designs; we excluded case reports. We had no language restrictions. We abstracted data on the effects of omega - 3 fatty acids and on study design, relevant outcomes, study population, source, type, amount, and duration of omega - 3 fatty acid consumption, and parameters of methodological quality. A single cohort study has assessed the effects of omega - 3 fatty acids on cognitive function with normal aging and found no association for fish or total omega - 3 consumption. In four studies that assessed the effects of omega - 3 fatty acids on incidence and treatment of dementia, a trend in favor of omega - 3 fatty acids (fish and total omega - 3 consumption) toward reducing risk of dementia and improving cognitive function was reported. The available data are insufficient to draw strong conclusions about the effects of omega - 3 fatty acids on cognitive function in normal aging or on the incidence or treatment of dementia. However, limited evidence suggests a possible association between omega - 3 fatty acids and reduced risk of dementia. Copyright (C) 2006 S. Karger AG, Basel. C1 RAND Hlth, So Calif Evidence Based Practice Ctr, Santa Monica, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. RP Issa, AM (reprint author), RAND Corp, Div Hlth, 1776 Main St, Santa Monica, CA 90401 USA. EM aissa1@ucla.edu NR 21 TC 49 Z9 50 U1 4 U2 20 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2006 VL 21 IS 2 BP 88 EP 96 DI 10.1159/000090224 PG 9 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 002ZL UT WOS:000234651300005 PM 16340205 ER PT J AU Monkul, ES Nicoletti, MA Spence, D Sassi, RB Axelson, D Brambilla, P Hatch, JP Keshavan, M Ryan, N Birmaher, B Soares, JC AF Monkul, E. Serap Nicoletti, Mark A. Spence, David Sassi, Roberto B. Axelson, David Brambilla, Paolo Hatch, John P. Keshavan, Matcheri Ryan, Neal Birmaher, Boris Soares, Jair C. TI MRI study of thalamus volumes in juvenile patients with bipolar disorder SO DEPRESSION AND ANXIETY LA English DT Article DE thalamus; bipolar disorder; mood disorders; affective disorders; neuroimaging; MRI; children ID ACETYL-L-ASPARTATE; MOOD DISORDERS; TRANSPORTER BINDING; HUMAN BRAIN; I DISORDER; SCHIZOPHRENIA; ABNORMALITIES; MATTER; MANIA; PET AB In vivo imaging studies suggest functional abnormalities of the thalamus in adult patients with bipolar disorder, but the presence of anatomical abnormalities is controversial. Our objective in this study was to compare the thalamus volumes of children and adolescents with bipolar disorder versus healthy controls to determine whether any morphological abnormalities exist early in illness course. We studied 16 patients with bipolar disorder according to DSM-IV criteria (mean age +/- SD = 15.5 +/- 3.4 years) and 21 healthy control subjects (mean age +/- SD = 16.9 +/- 3.8 years). Blinded examiners measured thalamic gray matter volumes with a semiautomated technique. Analysis of covariance, with age, gender, and intracranial brain volume as covariates, revealed no significant differences in left and right thalamic volumes between patients with bipolar disorder and healthy controls. Our findings indicate there are no significant differences in thalamus size between children and adolescents with bipolar disorder and healthy comparison subjects, in contrast to available findings for schizophrenia and first-break psychosis. Any differences in thalamus size that may exist between patients with bipolar disorder and healthy controls must amount to small effect sizes. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Progam, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Dokuz Eylul Univ, Sch Med, Dept Psychiat, Izmir, Turkey. Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Dept Psychiat, Med Ctr, Western Psychiat Inst & Clin, Pittsburgh, PA USA. Univ Udine, Dept Pathol & Expt Clin Med, Sect Psychiat, I-33100 Udine, Italy. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78229 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Progam, 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 [RR 020571]; NIMH NIH HHS [MH 01736, MH 30915, MH 59929, MH55123] NR 35 TC 12 Z9 13 U1 3 U2 5 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1091-4269 J9 DEPRESS ANXIETY JI Depress. Anxiety PY 2006 VL 23 IS 6 BP 347 EP 352 DI 10.1002/da.20161 PG 6 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 091FM UT WOS:000241012200004 PM 16688738 ER PT J AU Harris, BS Spruill, L Edmonson, AM Rackley, MS Benson, DW O'Brien, TX Gourdie, RG AF Harris, BS Spruill, L Edmonson, AM Rackley, MS Benson, DW O'Brien, TX Gourdie, RG TI Differentiation of cardiac Purkinje fibers requires precise spatiotemporal regulation of Nkx2-5 expression SO DEVELOPMENTAL DYNAMICS LA English DT Article DE heart conduction system; Nkx2-5; Purkinje fibers; development; atrioventricular block ID CONGENITAL HEART-DISEASE; MYOSIN HEAVY-CHAIN; CONDUCTION SYSTEM; GENE-EXPRESSION; AVIAN HEART; MUTATIONS; LINEAGE; ADULT; MOUSE; CARDIOMYOCYTES AB Nkx2-5 gene mutations cause cardiac abnormalities, including deficits of function in the atrioventricular conduction system (AVCS). In the chick, Nkx2-5 is elevated in Purkinje fiber AVCS cells relative to working cardiomyocytes. Here, we show that Nkx2-5 expression rises to a peak as Purkinje fibers progressively differentiate. To disrupt this pattern, we overexpressed Nkx2-5 from embryonic day 10, as Purkinje fibers are recruited within developing chick hearts. Overexpression of Nkx2-5 caused inhibition of slow tonic myosin heavy chain protein (sMHC), a late Purkinje fiber marker but did not affect Cx40 levels. Working cardiomyocytes overexpressing Nkx2-5 in these hearts ectopically up-regulated Cx40 but not sMHC. Isolated embryonic cardiomyocytes overexpressing Nkx2-5 also displayed increased Cx40 and suppressed sMHC. By contrast, overexpression of a human NKX2-5 mutant did not effect these markers in vivo or in vitro, suggesting one possible mechanism for clinical phenotypes. We conclude that a prerequisite for normal Purkinje fiber maturation is precise regulation of Nkx2-5 levels. C1 Med Univ S Carolina, Dept Cell Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Anat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Gazes Cardiac Res Inst, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Med Res Serv, Charleston, SC USA. Cincinnati Childrens Hosp, Med Ctr, Dept Mol & Cardiovasc Biol, Cincinnati, OH USA. RP Gourdie, RG (reprint author), Med Univ S Carolina, Dept Cell Biol & Anat, 171 Ashley Ave, Charleston, SC 29425 USA. EM gourdier@musc.edu FU NCRR NIH HHS [P20 RR016434, P20RR016434]; NHLBI NIH HHS [HL56728, P01 HL036059, R01 HL056728-09, HL36059, R01 HL056728]; NICHD NIH HHS [HD39946, P01 HD039946] NR 44 TC 17 Z9 18 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1058-8388 J9 DEV DYNAM JI Dev. Dyn. PD JAN PY 2006 VL 235 IS 1 BP 38 EP 49 DI 10.1002/dvdy.20580 PG 12 WC Anatomy & Morphology; Developmental Biology SC Anatomy & Morphology; Developmental Biology GA 995AW UT WOS:000234073300006 PM 16245335 ER PT J AU Lara-Castro, C Luo, NL Wallace, P Klein, RL Garvey, WT AF Lara-Castro, C Luo, NL Wallace, P Klein, RL Garvey, WT TI Adiponectin multimeric complexes and the metabolic syndrome trait cluster SO DIABETES LA English DT Article ID PLASMA-PROTEIN ADIPONECTIN; NUCLEAR-MAGNETIC-RESONANCE; BODY-FAT DISTRIBUTION; INSULIN SENSITIVITY; ENERGY-EXPENDITURE; HUMANS; RESISTANCE; CELL; ACRP30/ADIPONECTIN; LEPTIN AB Adiponectin circulates in human plasma mainly as a 180-kDa low molecular weight (LMW) hexamer and a high molecular weight (HMW) multimer of similar to 360 kDa. We comprehensively examined the relationships between circulating levels of total adiponectin, adiponectin multimers, and the relative distribution (i.e., ratio) of multimeric forms with key features of the metabolic syndrome. Total adiponectin (r = 0.45), HMW (r = 0.47), LMW (r = 0.31), and HMW-to-total adiponectin ratio (r = 0.29) were significantly correlated with insulin-stimulated glucose disposal rate. Similarly, total (r = -0.30), HMW (r = -0.38), and HMW-to-total adiponectin ratio (r = -0.34) were correlated with central fat distribution but not with total fat mass or BMI. Regarding energy metabolism, although there were no effects on resting metabolic rate, total (r = 0.41) and HMW (r = 0.44) were associated with increasing rates of fat oxidation. HMW-to-total adiponectin ratio increased as a function of total adiponectin, and it was HMW quantity (not total or HMW-to-total adiponectin ratio or LMW) that was primarily responsible for all of these relationships. Impact on nuclear magnetic resonance lipoprotein subclasses was assessed. HMW and total adiponectin were correlated with decreases in large VLDL (r = -0.44 and -0.41); decreases in small LDL (r = -0.41 and -0.36) and increases in large LDL (r = 0.36 and 0.30) particle concentrations accompanied by increased LDL particle size (r = 0.47 and 0.39); and increases in large HDL (r = 0.45 and 0.37) and HDL particle size (r = 0.53 and 0.47). Most of these correlations persisted after adjustment for metabolic covariables. In conclusion, first, serum adiponectin is associated with increased insulin sensitivity, reduced abdominal fat, and high basal lipid oxidation; however, it is HAM quantity, not total or HMW-to-total adiponectin ratio, that is primarily responsible for these relationships. Second, reduced quantities of HMW independently recapitulate the lipoprotein subclass profile associated with insulin resistance after correcting for glucose disposal rate and BMI. Finally, HMW adiponectin is an important factor in explaining the metabolic syndrome. C1 Univ Alabama, Dept Nutr Sci, Birmingham, AL 35294 USA. Med Univ S Carolina, Dept Med, Div Endocrinol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Lara-Castro, C (reprint author), Univ Alabama, Dept Nutr Sci, 1675 Webb Nutr Sci Bldg,Room 244, Birmingham, AL 35294 USA. EM larac@uab.edu FU NCRR NIH HHS [M01 RR 00032]; NHLBI NIH HHS [P01 HL 55782]; NIDDK NIH HHS [DK 38765, P30 DK 56336] NR 35 TC 312 Z9 321 U1 2 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 JAN PY 2006 VL 55 IS 1 BP 249 EP 259 DI 10.2337/diabetes.55.01.06.db05-1105 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 998WB UT WOS:000234349500031 PM 16380500 ER PT J AU Garrow, D Egede, LE AF Garrow, D Egede, LE TI Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes SO DIABETES CARE LA English DT Article ID NATIONAL-SURVEY; UNITED-STATES; PREVALENCE; COSTS AB OBJECTIVE - To assess the association between complementary and alternative medicine (CAM) use, preventive care practices, and use of conventional medical services among adults with diabetes. RESEARCH DESIGN AND METHODS - We analyzed data on 2,474 adults with diabetes. We created an overall CAM-use category based on use of any of the following: diets, herbs, chiropractic care, yoga, relaxation, acupuncture, ayuverda, biofeedback, chelation, energy healing, Reiki therapy, hypnosis, massage, naturopathy, and homeopathy. We used multiple logistic regression to assess the effect of CAM use on preventive care practices (receipt of influenza and pneumonia vaccines) and use of conventional medical services (number of primary care and emergency department visits). STATA was used for statistical analysis to account for the complex survey design. RESULTS - A total of 48% of adults with diabetes used some form of CAM. CAM use was independently associated with receipt of pneumonia vaccination (odds ratio 1.56 [95% CI 1.26-1.94]) but not significantly associated with receipt of influenza vaccination (1.17 [0.921.48]). CAM use was independently associated with visiting the emergency department (1.34 [1.06-1.70]), having six or more primary care visits (1.44 [1.14-1.83]), and having eight or more primary care visits (1.66 [1.22-2.25]). CONCLUSIONS - in contrast to the findings of previous studies, CAM use appears to be associated with increased likelihood of receipt of preventive care services and increased emergency department and primary care visits. CAM use may not be a barrier to use of conventional medical services in adults with diabetes. C1 Med Univ S Carolina, Ctr Hlth Care Res, Dept Med, Div Gen Internal Med, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Egede, LE (reprint author), Med Univ S Carolina, Ctr Hlth Care Res, Dept Med, Div Gen Internal Med, 135 Cannon St,Suite 403, Charleston, SC 29425 USA. EM egedel@musc.edu NR 23 TC 50 Z9 50 U1 4 U2 16 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 JAN PY 2006 VL 29 IS 1 BP 15 EP 19 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 998VZ UT WOS:000234349300003 PM 16373889 ER PT J AU Egede, LE Michel, Y AF Egede, LE Michel, Y TI Medical mistrust diabetes management, and glycemic indigent population with self control in an type 2 diabetes SO DIABETES CARE LA English DT Article ID AFRICAN-AMERICAN; PHYSICIAN SCALE; TRUST; CARE; RELIABILITY; VALIDATION; TESTS C1 Med Univ S Carolina, Div Gen Internal Med, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Med Univ S Carolina, Coll Nursing, Charleston, SC 29425 USA. RP Egede, LE (reprint author), Med Univ S Carolina, Div Gen Internal Med, Dept Med, 135 Cannon St,Suite 403, Charleston, SC 29425 USA. EM egedel@musc.edu FU AHRQ HHS [5K08HS11418] NR 13 TC 10 Z9 10 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JAN PY 2006 VL 29 IS 1 BP 131 EP 132 DI 10.2337/diacare.29.01.06.dc05-1642 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 998VZ UT WOS:000234349300022 PM 16373908 ER PT J AU Watson, GS Reger, MA Baker, LD McNeely, MJ Fujimoto, WY Kahn, SE Boyko, EJ Leonetti, DL Craft, S AF Watson, GS Reger, MA Baker, LD McNeely, MJ Fujimoto, WY Kahn, SE Boyko, EJ Leonetti, DL Craft, S TI Effects of exercise and nutrition on memory in Japanese Americans with impaired glucose tolerance SO DIABETES CARE LA English DT Article ID LIFE-STYLE; DIABETES-MELLITUS; GLYCEMIC CONTROL; INSULIN; DISEASE; RISK C1 Geriatr Res Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Res & Dev Serv, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP Watson, GS (reprint author), S-182-GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM gswatson@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR00037]; NIDDK NIH HHS [DK02654, DK17047, DK35816, DK48152] NR 13 TC 9 Z9 9 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 JAN PY 2006 VL 29 IS 1 BP 135 EP 136 DI 10.2337/diacare.29.01.06.dc05-1889 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 998VZ UT WOS:000234349300024 PM 16373910 ER PT J AU Yao, JK Leonard, S Reddy, R AF Yao, Jeffrey K. Leonard, Sherry Reddy, Ravinder TI Altered glutathione redox state in schizophrenia SO DISEASE MARKERS LA English DT Article DE glutathione; glutathione disulfide; glutathione peroxidase; glutathione reductase; cigarette smoking; age; postmortem caudate; schizophrenia ID PERFORMANCE LIQUID-CHROMATOGRAPHY; INDUCED OXIDATIVE STRESS; CIGARETTE-SMOKE; NITRIC-OXIDE; BRAIN; PHASE; PEROXYNITRITE; QUANTITATION; DEPLETION; RADICALS AB Altered antioxidant status has been reported in schizophrenia. The glutathione (GSH) redox system is important for reducing oxidative stress. GSH, a radical scavenger, is converted to oxidized glutathione (GSSG) through glutathione peroxidase (GPx), and converted back to GSH by glutathione reductase (GR). Measurements of GSH, GSSG and its related enzymatic reactions are thus important for evaluating the redox and antioxidant status. In the present study, levels of GSH, GSSG, GPx and GR were assessed in the caudate region of postmortem brains from schizophrenic patients and control subjects (with and without other psychiatric disorders). Significantly lower levels of GSH, GPx, and GR were found in schizophrenic group than in control groups without any psychiatric disorders. Concomitantly, a decreased GSH:GSSG ratio was also found in schizophrenic group. Moreover, both GSSG and GR levels were significantly and inversely correlated to age of schizophrenic patients, but not control subjects. No significant differences were found in any GSH redox measures between control subjects and individuals with other types of psychiatric disorders. There were, however, positive correlations between GSH and GPx, GSH and GR, as well as GPx and GR levels in control subjects without psychiatric disorders. These positive correlations suggest a dynamic state is kept in check during the redox coupling under normal conditions. By contrast, lack of such correlations in schizophrenia point to a disturbance of redox coupling mechanisms in the antioxidant defense system, possibly resulting from a decreased level of GSH as well as age-related decreases of GSSG and GR activities. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Pharm, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. VA Denver Hlth Care Syst, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. RP Yao, JK (reprint author), VA Pittsburgh Healthcare Syst, Bldg 13,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM jkyao@pitt.edu FU NIDA NIH HHS [DA09457]; NIMH NIH HHS [MH58141, MH64118] NR 44 TC 162 Z9 165 U1 1 U2 4 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 0278-0240 J9 DIS MARKERS JI Dis. Markers PY 2006 VL 22 IS 1-2 BP 83 EP 93 PG 11 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental; Pathology SC Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine; Pathology GA 212GK UT WOS:000249581800007 PM 16410648 ER PT J AU Loftis, JM Matthews, AM Hauser, P AF Loftis, JM Matthews, AM Hauser, P TI Psychiatric and substance use disorders in individuals with hepatitis C - Epidemiology and management SO DRUGS LA English DT Review ID INTERFERON-ALPHA THERAPY; INJECTING DRUG-USERS; RIBAVIRIN COMBINATION THERAPY; CHRONIC VIRAL-HEPATITIS; VIRUS-INFECTION; LIVER-DISEASE; PLUS RIBAVIRIN; DEPRESSIVE SYMPTOMS; RATING-SCALE; FOLLOW-UP AB Hepatitis C virus (HCV) infection is a major health concern in the US strategies are complicated by the extremely high rate of psychiatric and substance use disorders in those who have HCV. The majority of new and existing cases of HCV are related to injection drug use and, in this population, the prevalence of psychiatric comorbidity is high. Optimally, all patients with HCV should be screened for psychiatric and substance use disorders before initiation of antiviral therapy. If a patient screens positive, he or she should be referred to a mental healthcare provider or addiction specialist, assessed for the presence of a psychiatric or substance use disorder, and appropriately treated prior to initiation of antiviral (i.e. interferon) therapy. Although interferon-based therapies can lead to severe neuropsychiatric adverse effects, including in rare instances suicide, evidence suggests that many patients with comorbid psychiatric and substance use diagnoses can be treated safely and effectively using comanagement strategies. However, most patients with HCV are not treated with antiviral therapy. Therefore, we must expand our definition of HCV 'treatment' to include treatment of the comorbid psychiatric and substance use disorders that accompany HCV infection and precede antiviral therapy. This paper reviews the epidemiology and management of psychiatric and substance use disorders in patients with HCV, the issue of psychiatric and substance use disorders as contraindications for antiviral therapy, and current treatment strategies for HCV patients with these comorbid conditions. C1 Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR USA. Portland VAMC, Portland VA Mood Disorders Ctr, Oporto, Portugal. Portland VAMC, NW Hepatitis C Resource Ctr, Portland, OR USA. Portland VAMC, JENS Lab, Portland, OR USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR USA. Oregon Hlth Sci Univ, Dept Internal Med, Portland, OR USA. RP Hauser, P (reprint author), Oregon Hlth Sci Univ, Dept Psychiat, 3710 SW US Vet Hosp Rd,P3MH Adm, Portland, OR 97239 USA. EM peter.hauser2@med.va.gov NR 156 TC 52 Z9 53 U1 0 U2 4 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 0012-6667 J9 DRUGS JI Drugs PY 2006 VL 66 IS 2 BP 155 EP 174 DI 10.2165/00003495-200666020-00003 PG 20 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA 017OM UT WOS:000235702900003 PM 16451091 ER PT J AU Kaiser, RM Schmader, KE Pieper, CF Lindblad, CI Ruby, CM Hanlon, JT AF Kaiser, Robert M. Schmader, Kenneth E. Pieper, Carl F. Lindblad, Catherine I. Ruby, Christine M. Hanlon, Joseph T. TI Therapeutic failure-related hospitalisations in the frail elderly SO DRUGS & AGING LA English DT Article ID ADVERSE DRUG-REACTIONS; ADMISSIONS; EMERGENCY; EVENTS; DEFINITIONS; PREVENTION; MANAGEMENT AB Background and objective: Although therapeutic failure may be a common cause of drug-related morbidity in older adults, few studies have focused on this problem. The study objective was to determine the frequency and types of, and the factors associated with, therapeutic failure leading to hospitalisation in frail, elderly patients, using a new instrument named the Therapeutic Failure Questionnaire (TFQ). Methods: The sample included 106 frail, hospitalised elderly patients enrolled in a I-year-long health service intervention trial at I I Veterans Affairs Medical Centres. The TFQ was developed by a team of clinicial geriatricians and tested for reliability by two clinical pharmacists and a geriatrician on a sample of 32 patients. To establish validity, a geriatrician retrospectively reviewed the computerised medication records and clinical charts for these patients and applied the TFQ to determine probable therapeutic failures at the time of hospital admission. Results: Inter- and intra-rater reliability for the TFQ were very good (kappa = 0.82 for both). Overall, 11% of patients had one or more probable therapeutic failures (TFQ scores between 4 and 7) leading to hospitalisation. Cardiopulmonary disease was a common 'indicator' of therapeutic failure and was often the result of non-adherence. The only factor associated with therapeutic failure occurrence was severe chronic kidney disease (crude odds ratio 5.87; 95% CI 1.20, 28.69; p = 0.01). Conclusions: The TFQ was able to identify several cases of probable therapeutic failure leading to hospitalisation in frail, elderly patients. Non-adherence to effective therapies for chronic serious cardiopulmonary disease was a common cause of therapeutic failure and represents a target for interventions to reduce hospitalisation. Further research on the occurrence, risk factors for and types of therapeutic failure is needed in a larger cohort of older non-veterans. C1 Univ Pittsburgh, Dept Geriatr Med, Sch Med, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res, Pittsburgh, PA USA. Univ Miami, Miller Sch Med, Div Gerontol & Geriatr Med, Miami, FL 33152 USA. Univ Miami, Geriatr Inst, Miami, FL 33152 USA. Miami VA Healthcare Syst, Geriatr Res Educ & Clin Ctr, Miami, FL USA. Duke Univ, Med Ctr, Aging Ctr, Durham, NC USA. Duke Univ, Med Ctr, Sch Med, Durham, NC 27710 USA. Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Durham, NC USA. Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC USA. Univ Minnesota, Coll Pharm, Minneapolis, MN 55455 USA. Vet Affairs Med Ctr, Minneapolis, MN USA. Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA. RP Hanlon, JT (reprint author), Univ Pittsburgh, Dept Geriatr Med, Sch Med, Kaufman Med Bldg Suite 514,3471 5th Ave, Pittsburgh, PA 15213 USA. EM hanlonj@dom.pitt.edu FU NIA NIH HHS [P30-AG024827, R01-AG-14158, P30 AG024827, R01-AG-15432]; NIAID NIH HHS [K24-AI-51324] NR 21 TC 17 Z9 19 U1 0 U2 0 PU ADIS INT LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1170-229X EI 1179-1969 J9 DRUG AGING JI Drugs Aging PY 2006 VL 23 IS 7 BP 579 EP 586 DI 10.2165/00002512-200623070-00004 PG 8 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 097YL UT WOS:000241485900004 PM 16930086 ER PT J AU Pugh, MJV Foreman, PJ Berlowitz, DR AF Pugh, Mary Jo V. Foreman, Perry J. Berlowitz, Dan R. TI Prescribing antiepileptics for the elderly - Differences between guideline recommendations and clinical practice SO DRUGS & AGING LA English DT Article ID NEWLY-DIAGNOSED EPILEPSY; NURSING-HOME RESIDENTS; TONIC CLONIC SEIZURES; DOUBLE-BLIND; DRUG-USE; LAMOTRIGINE MONOTHERAPY; UNTREATED EPILEPSY; CARBAMAZEPINE; THERAPY; AGE AB The incidence of epilepsy in patients aged > 60 years is higher than in any other period of life. Yet, until recently, what was known about the treatment of older patients with epilepsy has been inferred from studies in younger patients. A growing body of clinical evidence focused exclusively on the elderly suggests that, while some issues are similar for older and younger adults, older patients with epilepsy may require even more attention regarding antiepileptic drug (AED) selection than younger patients. This article reviews published guidelines and recommendations to identify explicit recommendations for use of specific AEDs in the elderly, and assesses the extent to which those recommendations have been adopted in clinical practice. We found that while one systematically derived guideline stated that lamotrigine may be a good choice for older patients because of its favourable adverse effect profile, only clinical recommendations based on expert opinion explicitly identified AEDs that are more and less appropriate for use in the elderly. Examination of published studies describing recent AED-prescribing patterns suggests that clinical recommendations have been, at best, slowly adopted. This observation is exemplified by the fact that older patients newly diagnosed with epilepsy are still prescribed phenobarbital - a drug identified as suboptimal in 1985. In order to better understand the delay in adopting clinical recommendations, we examine these findings in light of diffusion of innovations theory, a theory that has been used to understand dissemination of other new medical technologies. According to this theory, while it is too early to suggest that use of second-generation AEDs in the elderly has been delayed, the continued use of phenobarbital in older patients newly diagnosed with epilepsy represents a serious delay in adoption of recent guidelines. Delays may be related to lack of knowledge by primary care clinicians and emergency room physicians (who frequently treat older patients with epilepsy), lack of 'opinion leaders' in primary care and perhaps general neurology, clinicians' focus on seizure control as the primary endpoint in treating patients with epilepsy, and difficulties in changing long-standing prescribing patterns. Research targeting barriers to more appropriate prescribing is needed to determine appropriate strategies for changing AED prescribing practices in the elderly. C1 S Texas Vet Healthcare Syst, San Antonio, TX 78023 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Michael E DeBakey VA Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. ENRM VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. RP Pugh, MJV (reprint author), S Texas Vet Healthcare Syst, 7400 Merton Minter St, San Antonio, TX 78023 USA. EM pughm@uthscsa.edu OI Pugh, Mary Jo/0000-0003-4196-7763 NR 73 TC 18 Z9 18 U1 5 U2 7 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1170-229X J9 DRUG AGING JI Drugs Aging PY 2006 VL 23 IS 11 BP 861 EP 875 DI 10.2165/00002512-200623110-00002 PG 15 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 118SN UT WOS:000242962100002 PM 17109565 ER PT J AU Leung, WK Chan, FKL Graham, DY AF Leung, WK Chan, FKL Graham, DY TI Ulcers and gastritis SO ENDOSCOPY LA English DT Article ID HELICOBACTER-PYLORI INFECTION; MUCOSA; COHORT C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. Chinese Univ Hong Kong, Prince Wales Hosp, Fac Med, Inst Digest Dis, Hong Kong, Hong Kong, Peoples R China. Chinese Univ Hong Kong, Prince Wales Hosp, Fac Med, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Rm 3A-320 111D,2002 Holocombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu RI Leung, Wai Keung/B-8140-2011; Chan, Francis K. L./F-4851-2010 OI Chan, Francis K. L./0000-0001-7388-2436 NR 12 TC 2 Z9 2 U1 0 U2 0 PU GEORG THIEME VERLAG KG PI STUTTGART PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY SN 0013-726X J9 ENDOSCOPY JI Endoscopy PD JAN PY 2006 VL 38 IS 1 BP 2 EP 4 DI 10.1055/s-2005-921129 PG 3 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 003EF UT WOS:000234663700002 PM 16429346 ER PT J AU Licht, EA McMurtray, AM Wallis, RA Panizzon, K Saul, RE Fujikawa, DG Mendez, MF AF Licht, Eliot A. McMurtray, Aaron M. Wallis, Roi Ann Panizzon, Kimberley Saul, Ron E. Fujikawa, Denson G. Mendez, Mario F. TI MRI abnormalities as markers for epileptiform activity in cognitively impaired and demented patients SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 50 EP 50 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385500140 ER PT J AU Rowan, AJ Ramsay, RE Macias, F AF Rowan, A. James Ramsay, R. Eugene Macias, Flavia CA VA Cooperative Study 428 Study G TI In the elderly, seizure control and antiepileptic drug tolerance decrease with increasing age SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Bronx Vet Adm Med Ctr, New York, NY USA. Mt Sinai Sch Med, New York, NY USA. VA Med Ctr, Miami, FL USA. Univ Miami, Sch Med, Miami, FL USA. RI Ramsay, R. Eugene/D-4491-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 198 EP 198 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501036 ER PT J AU Higgs, MH Robbins, CA Spain, WJ AF Higgs, Matthew H. Robbins, Carol A. Spain, William J. TI Stochastic bursting in neocortical layer 2/3 pyramidal neurons SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Univ Washington, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 216 EP 216 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501088 ER PT J AU Niquet, J Lopez-Meraz, ML Wasterlain, C Suchomelova, L AF Niquet, Jerome Lopez-Meraz, Maria-Leonor Wasterlain, Claude Suchomelova, Lucie TI Hyperthermia aggravates status epilepticus induced-neuronal injury in the immature brain SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Vet Affairs Greater Los Angeles Healthcare Syst, Epilepsy Res Lab 151, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 224 EP 225 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501113 ER PT J AU Peng, ZC Huang, CS Houser, CR AF Peng, Zechun Huang, Christine S. Houser, Carolyn R. TI Transitory activation of extracellular signal-regulated kinase (ERK) by spontaneous seizures in a mouse model of temporal lobe epilepsy SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 231 EP 231 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501133 ER PT J AU Wallis, RA Panizzon, KL AF Wallis, Roi Ann Panizzon, Kimberly L. TI Neuroprotective efficacy of the mitochondrial ATP-sensitive potassium channel opener, chromakalim against depolarization injury to Ca1 pyramidal neurons in rat hippocampal slices SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Healthcare Syst, North Hills, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 238 EP 238 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501151 ER PT J AU Zhao, SP Shinmei, SS Aviles, ER Fujikawa, DG AF Zhao, Shuangping Shinmei, Steve S. Aviles, Ernesto R., Jr. Fujikawa, Denson G. TI Translocation of mitochondrial cytochrome C, apoptosis-inducing factor and endonuclease G to the nuclei of seizure-induced necrotic neurons SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 VA Greater Los Angeles Healthcare Syst, North Hills, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 242 EP 242 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501164 ER PT J AU Pugh, MJV Knoefel, JE Cramer, JA Berlowitz, DR AF Pugh, Mary Jo V. Knoefel, Jan E. Cramer, Joyce A. Berlowitz, Dan R. TI Profound comorbidity in older patients with epilepsy SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Vet Healthcare Syst New Mexico, Albuquerque, NM USA. S Texas Vet Healthcare Syst, VERDICT, San Antonio, TX USA. Yale Univ, New Haven, CT USA. Bedford VA Hosp, CHQOER, Bedford, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 281 EP 282 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501279 ER PT J AU Bower, CM Cheng, EM Spencer, SS Vassar, S Vickrey, BG AF Bower, Christine M. Cheng, Eric M. Spencer, Susan S. Vassar, Stefanie Vickrey, Barbara G. TI Preoperative expectations for resective epilepsy surgery SO EPILEPSIA LA English DT Meeting Abstract CT 60th Annual Meeting of the American-Epilepsy-Society CY DEC 01-05, 2006 CL San Diego, CA SP Amer Epilepsy Soc C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Greater Los Angeles VA Med Ctr, Dept Neurol, Los Angeles, CA USA. Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06510 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PY 2006 VL 47 SU 4 BP 340 EP 340 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 096OA UT WOS:000241385501444 ER PT S AU Offner, H Polanczyk, M AF Offner, Halina Polanczyk, Magdalena BE Bradlow, HL Carruba, G TI A potential role for estrogen in experimental autoimmune encephalomyelitis and multiple sclerosis SO ESTROGENS AND HUMAN DISEASES SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Estrogens and Human Diseases CY MAY 15-21, 2006 CL Erice, ITALY SP Ettore Majorana Fdn, Ctr Sci Culture DE estrogen; estrogen receptors; Treg; FoxP3; immunoregulation; neuroprotection; EAE; multiple sclerosis ID REGULATORY T-CELLS; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; IMMUNOLOGICAL SELF-TOLERANCE; CENTRAL-NERVOUS-SYSTEM; MYELIN PROTEOLIPID PROTEIN; BV8S2 TRANSGENIC MICE; RECEPTOR-ALPHA; GENE-EXPRESSION; FEMALE MICE; GENDER DIFFERENCES AB The extensive literature and the work from our laboratory illustrate the large number of complex processes affected by estrogen that might contribute to the striking ability of 17-beta estradiol (E2) and its derivatives to inhibit clinical and histological signs of experimental autoimmune encephalomyelitis (EAE) in mice. These effects require sustained exposure to relatively low doses of exogenous hormone and offer better protection when initiated prior to induction of EAE. The E2 mediates inhibition of encephalitogenic T cells, inhibition of cell migration into central nervous system tissue, and neuroprotective effects that promote axon and myelin survival. E2 effects on EAE are mediated through Esr-1 (alpha receptor for E2) but not Esr-2 (beta receptor for E2), as are its anti-inflammatory and neuroprotective effects. A novel finding is that E2 upregulated the expression of FoxP3 that contributes to the activity of CD4 + CD25 + T regulatory cells (Treg). The protective effects of E2 in EAE suggest its use as a therapy for multiple sclerosis (MS). Possible risks may be minimized by using sub-pregnancy levels of exogenous E2 that produced synergistic effects when used in combination with another immunoregulatory therapy. Alternatively, one might envision using E2 derivatives alone or in combination therapies in both male and female MS patients. C1 Portland VA Med Ctr, Neuroimmunol Res R&D 31, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Anesthesiol & Perioperat Med, Portland, OR 97239 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu NR 113 TC 53 Z9 58 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 978-1-57331-669-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1089 BP 343 EP 372 DI 10.1196/annals.1386.021 PG 30 WC Oncology; Endocrinology & Metabolism; Multidisciplinary Sciences SC Oncology; Endocrinology & Metabolism; Science & Technology - Other Topics GA BFU92 UT WOS:000244736800029 PM 17261780 ER PT J AU Marklund, N Fulp, CT Shimizu, S Puri, R McMillan, A Strittmatter, SM McIntosh, TK AF Marklund, N Fulp, CT Shimizu, S Puri, R McMillan, A Strittmatter, SM McIntosh, TK TI Selective temporal and regional alterations of Nogo-A and small proline-rich repeat protein 1A (SPRR1A) but not Nogo-66 receptor (NgR) occur following traumatic brain injury in the rat SO EXPERIMENTAL NEUROLOGY LA English DT Review DE Nogo-A; Nogo-66 receptor; small proline-rich repeat protein 1A (SPRR1A); traumatic brain injury; oligodendrocytes ID CENTRAL-NERVOUS-SYSTEM; LATERAL FLUID-PERCUSSION; SPINAL-CORD-INJURY; MYELIN-ASSOCIATED GLYCOPROTEIN; MESSENGER-RNA EXPRESSION; OLIGODENDROCYTE PRECURSOR CELLS; INHIBITS NEURITE OUTGROWTH; RETINAL GANGLION-CELLS; AXON REGENERATION; WHITE-MATTER AB Axons show a poor regenerative capacity following traumatic central nervous system (CNS) injury, partly due to the expression of inhibitors of axonal outgrowth, of which Nogo-A is considered the most important. We evaluated the acute expression of Nogo-A, the Nogo-66 receptor (NgR) and the novel small proline-rich repeat protein 1A (SPRR1A, previously undetected in brain), following experimental lateral fluid percussion (FP) brain injury in rats. Immunoflourescence with antibodies against Nogo-A, NgR and SPRR1A was combined with antibodies against the neuronal markets NeuN and microtubule-associated protein (MAP)-2 and the oligodendrocyte market RIP, while Western blot analysis was performed for Nogo-A and NgR. Brain injury produced a significant increase in Nogo-A expression in injured cortex, ipsilateral external capsule and reticular thalamus from days 1-7 post-injury (P < 0.05) compared to controls. Increased expression of Nogo-A was observed in both RIP- and NeuN positive (+) cells in the ipsilateral cortex, in NeuN (+) cells in the CA3 region of the hippocampus and reticular thalamus and in RIP (+) cells in white matter tracts. Alterations in NgR expression were not observed following traumatic brain injury (TBI). Brain injury increased the extent of SPRR1A expression in the ipsilateral cortex and the CA3 at all post-injury time-points in NeuN (+) cells. The marked increases in Nogo-A and SPRR1A in several important brain regions suggest that although inhibitors of axonal growth may be upregulated, the injured brain is also capable of expressing proteins promoting axonal outgrowth following TBI. (c) 2005 Elsevier Inc. All rights reserved. C1 Univ Penn, Sch Med, Dept Neurosurg, Traumat Brain Injury Lab, Philadelphia, PA 19104 USA. Univ Uppsala Hosp, Dept Neurosurg, SE-75185 Uppsala, Sweden. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06520 USA. RP Marklund, N (reprint author), Univ Uppsala Hosp, Dept Neurosurg, SE-75685 Uppsala, Sweden. EM niklas.marklund@neurokir.uu.se; ss4662@drexel.edu; Stephen.Strittmatter@yale.edu; tkm53@comcast.net RI Strittmatter, Stephen/F-5739-2011 OI Strittmatter, Stephen/0000-0001-8188-3092 FU NIMH NIH HHS [MH T32-17168]; NINDS NIH HHS [R01 NS042304, NS P50-08803, NS R01-40978, R01 NS039962, R01 NS039962-10, R01 NS042304-08, R01 NS056485, R01 NS056485-04, R37 NS033020, R37 NS033020-15] NR 110 TC 36 Z9 38 U1 1 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0014-4886 J9 EXP NEUROL JI Exp. Neurol. PD JAN PY 2006 VL 197 IS 1 BP 70 EP 83 DI 10.1016/j.expneurol.2005.08.029 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 001LI UT WOS:000234534200008 PM 16321384 ER PT J AU Goodwin, SC Bradley, LD Lipman, JC Stewart, EA Nosher, JL Sterling, KM Barth, MH Siskin, GP Shlansky-Goldberg, RD AF Goodwin, SC Bradley, LD Lipman, JC Stewart, EA Nosher, JL Sterling, KM Barth, MH Siskin, GP Shlansky-Goldberg, RD CA UAE versus Myomectomy Study Grp TI Uterine artery embolization versus myomectomy: a multicenter comparative study SO FERTILITY AND STERILITY LA English DT Article DE embolization; fibroid; leiomyoma ID FIBROID EMBOLIZATION; ABDOMINAL MYOMECTOMY; SYMPTOMATIC LEIOMYOMATA; TRIAL; HYSTERECTOMY; MENORRHAGIA; REDUCTION; SUCCESS AB Objective: To determine whether there is significant quality of life score improvement after uterine artery embolization (UAE) and to compare UAE and myomectomy outcomes. Design: Prospective cohort controlled study. Setting: Sixteen medical centers in the United States. Patient(s): One hundred forty-nine UAE patients and 6.0 myomectomy patients. Patients were assigned to myomectomy or UAE on the basis of a best treatment decision made by the patient and her physician. All patients were observed for 6 months. The UAE patients also had follow-up examinations at 1 year. Intervention(s): Myomectomy or UAE. Main Outcome Measure(s): Quality of life score changes, menstrual bleeding score changes, uterine size differences, time off, and adverse events. Result(s): Both groups experienced statistically significant improvements in the uterine fibroid quality of life score, menstrual bleeding, uterine volume, and overall postoperative quality of life. The mean hospital stay was 1 day for the UAE patients, compared with 2.5 days for the myomectomy patients. The UAE and myomectomy patients returned to their normal activities in 15 days and 44 days, respectively, and returned to work in 10 days and 37 days, respectively. At least one adverse event occurred in 40.1% of the myomectomy patients, compared with 22.1% in the UAE group. Conclusion(s): The uterine fibroid quality of life score was significantly improved in both groups. No significant differences were observed in bleeding improvement, uterine volume reduction, uterine fibroid quality of life score improvement, and overall quality of life score improvement between groups. Patients receiving UAE required fewer days off work, fewer hospital days, and experienced fewer adverse events. C1 Dept Vet Affairs, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Cleveland Clin Fdn, Dept Gynecol, Cleveland, OH 44195 USA. Radiol Associates Atlanta, Atlanta, GA USA. Brigham & Womens Hosp, Dept Gynecol, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA USA. Robert Wood Johnson Med Ctr, Dept Radiol, New Brunswick, NJ USA. Inova Alexandria Hosp, Dept Radiol, Alexandria, VA USA. Methodist Hosp, Dept Radiol, Houston, TX 77030 USA. Albany Med Ctr, Albany, NY USA. Hosp Univ Penn, Div Intervent Radiol, Philadelphia, PA 19104 USA. RP Goodwin, SC (reprint author), Vet Adm Greater Los Angeles Hlth Care Syst, Imaging Serv, 11301 Wilshire Blvd,Mail Code 114, Los Angeles, CA 90073 USA. EM scott.goodwin@med.va.gov OI Shlansky-Goldberg, Richard/0000-0003-3371-0570 NR 37 TC 64 Z9 73 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0015-0282 J9 FERTIL STERIL JI Fertil. Steril. PD JAN PY 2006 VL 85 IS 1 BP 14 EP 21 DI 10.1016/j.fertnstert.2005.05.074 PG 8 WC Obstetrics & Gynecology; Reproductive Biology SC Obstetrics & Gynecology; Reproductive Biology GA 006QX UT WOS:000234913100003 PM 16412720 ER PT J AU Goodwin, SC AF Goodwin, SC TI Uterine artery embolization: a legitimate option for the treatment of uterine fibroids SO FERTILITY AND STERILITY LA English DT Editorial Material ID LEIOMYOMAS; MANAGEMENT AB As compared with hysterectomy and myomectomy, uterine artery embolization is a safe and efficacious therapy. It should be offered as a legitimate alternative for the treatment of symptomatic fibroids. C1 Vet Adm Greater Los Angeles Hlth Care Syst, Imaging Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA USA. RP Goodwin, SC (reprint author), Vet Adm Greater Los Angeles Hlth Care Syst, Imaging Serv, 11301 Wilshire Blvd,Mail Code 114, Los Angeles, CA 90073 USA. EM scott.goodwin@med.va.gov NR 9 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0015-0282 J9 FERTIL STERIL JI Fertil. Steril. PD JAN PY 2006 VL 85 IS 1 BP 48 EP 48 DI 10.1016/j.fertnstert.2005.09.009 PG 1 WC Obstetrics & Gynecology; Reproductive Biology SC Obstetrics & Gynecology; Reproductive Biology GA 006QX UT WOS:000234913100010 ER PT J AU Reusch, JE Gliwa, C Gunther, J Pedler, M Mcdonald, T O'Brien, K Schauer, I AF Reusch, Jane E. B. Gliwa, Catherine Gunther, Jodean Pedler, Michelle Mcdonald, Tom O'Brien, Kevin Schauer, Irene TI Divergent impact of LDL and oxidized LDL on CREB activation and downregulation SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract CT 13th Annual Meeting of the Society-for-Free-Radical-Biology-and-Medicine CY NOV 15-19, 2006 CL Denver, CO SP Soc Free Rad Biol & Med C1 Denver VAMC, Denver, CO USA. Univ Colorado, Boulder, CO 80309 USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PY 2006 VL 41 SU 1 BP S42 EP S42 PG 1 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 103OC UT WOS:000241895600119 ER PT J AU Richardson, A AF Richardson, A. TI Quantitative assessment of the post-translational modification of proteins in aging SO FREE RADICAL RESEARCH LA English DT Meeting Abstract CT 13th Biennial Meeting of the Society-for-Free-Radical-Research-International CY AUG 15-19, 2006 CL Davos, SWITZERLAND SP Soc Free Rad Res Int C1 Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1071-5762 J9 FREE RADICAL RES JI Free Radic. Res. PY 2006 VL 40 SU 1 BP S49 EP S49 PG 1 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 086EG UT WOS:000240656000056 ER PT J AU Zheng, Z Yenari, MA AF Zheng, Z Yenari, MA TI The application of HSP70 as a target for gene therapy SO FRONTIERS IN BIOSCIENCE LA English DT Review DE cerebral ischemia; heat shock protein; gene therapy; HSP70; stroke ID HEAT-SHOCK PROTEINS; FOCAL CEREBRAL-ISCHEMIA; ALPHA-SYNUCLEIN AGGREGATION; PEPTIDE-BINDING DOMAIN; SIMPLEX-VIRUS VECTORS; TRANSCRIPTION FACTOR; IN-VIVO; TRANSGENIC MICE; KINASE-C; RAT HEAT-SHOCK-PROTEIN-70 AB The 70-kDa heat shock proteins (HSP70s) are well-studied and characterized heat shock proteins (HSPs). They constitute essential components of a quality control system of protein synthesis, and function as molecular chaperones to prevent proteins from misfolding and aggregating during both de novo synthesis and under conditions of stress. Moreover, it is now well established that HSP70s play important cytoprotective roles in various pathological settings. Recognition of molecular chaperone and cytoprotective functions of HSP70s is fostering active investigations into the potential of HSP70s as therapeutic targets at the laboratory level. Gaining insight into these recent advances may have profound implications in the development of HSP70-based clinical studies. C1 Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94131 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA 94131 USA. RP Yenari, MA (reprint author), Univ Calif San Francisco, Dept Neurol, 4150 Clement St, San Francisco, CA 94131 USA. EM yenari@alum.mit.edu FU NINDS NIH HHS [NS40516] NR 117 TC 12 Z9 13 U1 0 U2 3 PU FRONTIERS IN BIOSCIENCE INC PI MANHASSET PA C/O NORTH SHORE UNIV HOSPITAL, BIOMEDICAL RESEARCH CENTER, 350 COMMUNITY DR, MANHASSET, NY 11030 USA SN 1093-9946 J9 FRONT BIOSCI JI Front. Biosci. PD JAN 1 PY 2006 VL 11 BP 699 EP 707 DI 10.2741/1828 PG 9 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 973MX UT WOS:000232528000054 PM 16146762 ER PT J AU Naliboff, BD Mayer, EA AF Naliboff, BD Mayer, EA TI Brain imaging in IBS: Drawing the line between cognitive and non-cognitive processes SO GASTROENTEROLOGY LA English DT Editorial Material ID IRRITABLE-BOWEL-SYNDROME; PAIN; ACTIVATION; PERCEPTION; RESPONSES; PLACEBO; FIBROMYALGIA; STIMULATION; MECHANISMS; SYSTEM C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Physiol, Los Angeles, CA USA. RP Naliboff, BD (reprint author), VA Greater Los Angeles Healthcare Syst, W Los Angeles,Bldg 115,Room 223,11301 Wilshire Bl, Los Angeles, CA 90073 USA. EM naliboff@ucla.edu NR 27 TC 20 Z9 22 U1 1 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2006 VL 130 IS 1 BP 267 EP 270 DI 10.1053/j.gastro.2005.1.1.034 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 001HW UT WOS:000234525200031 PM 16401488 ER PT J AU Seltman, AK Kahrilas, PJ Chang, EY Mori, M Hunter, JG Jobe, BA AF Seltman, AK Kahrilas, PJ Chang, EY Mori, M Hunter, JG Jobe, BA TI Endoscopic measurement of cardia circumference as an indicator of GERD SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID LOWER ESOPHAGEAL SPHINCTER; GASTROESOPHAGEAL-REFLUX DISEASE; HIATAL-HERNIA; GASTRIC DISTENSION; RELAXATION; COMPETENCE; MECHANISM; VALVE; LENGTH AB Background: It is theorized that repeated gastric distention leads to dilatation of the cardia and the development of GERD. We hypothesize that cardia circumference correlates with the presence and the severity of GERD, and we developed software to measure cardia circumference from static endoscopic images. Our aims were to validate the software and to quantify cardia circumference along the spectrum of GERD. Methods: Software-based measurements were compared with actual measurements in animal and mechanical models. A retrospective review of an endoscopic database and patient charts produced 273 subjects, grouped as follows: controls, GERD, <= 3-cm Barrett's esophagus, or > 3-cm Barrett's esophagus. A blinded abstractor measured cardia circumference by using images from the database. Results: Software and actual measurements correlated closely and were reproducible among observers. Median cardia circumference for each group was the following: control, 31.8 mm; GERD, 37.8 mm; <= 3-cm Barrett's esophagus, 38.4 mm; and > 3-cm Barren's esophagus, 45.0 mm (p < 0.001). By using 34.3 mm as a cutoff, cardia circumference was 85.3% sensitive and 89.6% specific for the diagnosis of GERD. Conclusions: There was a direct relationship between cardia circumference and the presence of GERD. This finding augments our understanding of the anatomic contributions of the esophagogastric junction in the pathogenesis of GERD. Cardia measurement may prove to be a useful diagnostic tool. C1 Portland VA Med Ctr, Surg Serv, Portland, OR 97207 USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, Surg Serv, P3Surg,POB 1034, Portland, OR 97207 USA. FU NCI NIH HHS [5P30 CA69533-04, R03 CA150959-01]; NIDCD NIH HHS [R01 DC00646]; NIDDK NIH HHS [2U01DK057132-06A1, K23 DK066165-01] NR 35 TC 14 Z9 14 U1 0 U2 1 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 JAN PY 2006 VL 63 IS 1 BP 22 EP 31 DI 10.1016/j.gie.2005.07.030 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 999UC UT WOS:000234415000005 PM 16377311 ER PT J AU Gopal, DV Chang, EY Kim, CY Sandone, C Pfau, PR Frick, TJ Hunter, JG Kahrilas, PJ Jobe, BA AF Gopal, DV Chang, EY Kim, CY Sandone, C Pfau, PR Frick, TJ Hunter, JG Kahrilas, PJ Jobe, BA TI EUS characteristics of Nissen fundoplication: normal appearance and mechanisms of failure SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT 14th World Congress of the International-Association-of-Surgeons-and-Gastroenterologists CY SEP 09-12, 2004 CL Zurich, SWITZERLAND SP Int Assoc Surg & Gastroenterologists ID GASTROESOPHAGEAL-REFLUX DISEASE; LAPAROSCOPIC ANTIREFLUX SURGERY; FOLLOW-UP; MANAGEMENT; COMPLICATIONS; OPERATIONS; APPRAISAL; SYMPTOMS AB Background: In patients who develop symptoms after Nissen fundoplication, the precise mechanism of failure can be difficult to determine. Current testing modalities do not demonstrate sufficient anatomic detail to definitively determine the mechanism. This observational study establishes that EUS can determine fundoplication integrity and hiatal anatomic relationships after Nissen fundoplication. Methods: EUS was performed on the native esophagogastric junction and after Nissen fundoplication in two swine. The EUS characteristics of a properly performed fundoplication were determined. Subsequently; complications of Nissen fundoplication were created, and EUS was performed on each. The EUS criteria of each mechanism of failure were defined. Results: EUS provided sufficient axial resolution to distinguish the esophagus, the fundoplication, and the surrounding hiatal structures within a single image. US of the native esophagogastric junction discerned the length of intra-abdominal esophagus, esophagogastric junction, crura, and anterior hiatus, and, thus; the point of entry into the abdominal cavity. EUS of Nissen fundoplication revealed a 5-layered pattern in a 360 degrees configuration. These layers represent the following: (1) the esophageal wall, (2) the space between the esophagus and the fundoplication, (3) the inner gastric wall of the fundoplication, (4) the gastric lumen, and (5) the outer gastric wall of the fundoplication. A slipped repair was identified by the presence of an echogenic gastric serosa within the fundoplication. A tight fundoplication results in attenuation of the gastric walls, thickening of the esophageal wall, and loss of the 5-layer pattern secondary to obliteration of the potential spaces of the gastric lumen. Dehiscence of the fundoplication was evidenced by a less than 360 degrees 5-layer pattern. Conclusions: EUS of hiatal anatomic relationships is feasible and provides detailed information regarding the integrity and the position of a Nissen fundoplication. EUS may enable a precise determination of the anatomic causes of failure after antireflux surgery. C1 Portland VA Med Ctr, Surg Serv, Portland, OR 97207 USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, Surg Serv, P3Surg,POB 1034, Portland, OR 97207 USA. FU NCI NIH HHS [R03 CA105959-01]; NIDCD NIH HHS [R01 DC00646]; NIDDK NIH HHS [K23 DK066165-01] NR 23 TC 6 Z9 6 U1 0 U2 2 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 JAN PY 2006 VL 63 IS 1 BP 35 EP 44 DI 10.1016/j.gie.2005.08.044 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 999UC UT WOS:000234415000007 PM 16377313 ER PT J AU Ciechanowski, P Russo, J Katon, W Simon, G Ludman, E Von Korff, M Young, B Lin, E AF Ciechanowski, P Russo, J Katon, W Simon, G Ludman, E Von Korff, M Young, B Lin, E TI Where is the patient? The association of psychosocial factors and missed primary care appointments in patients with diabetes SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE attachment theory; attachment style; depression; health care utilization; missed appointment; no-show appointments ID CORONARY-HEART-DISEASE; HEALTH-CARE; ATTACHMENT THEORY; ADULT ATTACHMENT; SELF-CARE; DEPRESSIVE SYMPTOMS; MAJOR DEPRESSION; GLYCEMIC CONTROL; NON-ATTENDANCE; ADHERENCE AB Objective: Missed appointments are associated with poorer health outcomes. We predicted that compared to secure attachment style, fearful and dismissing attachment styles would be associated with greater number of missed primary care visits in patients with diabetes. Methods: In patients with diabetes from nine health maintenance organization primary care clinics, we collected data on attachment style and major depression status, and determined the number of missed primary care appointments from automated data. We used Poisson and logistic regression analyses to determine if attachment style was associated with the number of missed primary care same day appointments, scheduled office visits and scheduled preventive care visits, after adjusting for demographics, clinical characteristics, appointment frequency and clustering by clinic. We included major depression as a potential effect modifier. Results: Among 3923 patients with diabetes, prevalence rates of attachment styles were 43.9% for secure, 35.8% for dismissing, 8.1% for preoccupied and 12.2% for fearful attachment style. Major depression was present in 12.4% of patients. Among patients without major depression, there were more missed scheduled office visits (RR= 1.46, 95% CI = 1.18-1.81) among those with dismissing compared to secure attachment style. The likelihood ofhaving missed same day appointments was lower for those with fearful attachment style relative to those with secure attachment style in nondepressed patients compared to patients with fearful and secure attachment style with major depression ( P < .01). Conclusions: Attachment styles characterized by low levels of collaboration are associated with more missed primary care appointments compared to secure attachment style in patients with diabetes. These associations are moderated by depression status. (c) 2006 Elsevier Inc. All tights reserved. C1 Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98104 USA. Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. RP Ciechanowski, P (reprint author), Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. EM pavelcie@u.washington.edu FU NIDDK NIH HHS [K23 DK60652-01]; NIMH NIH HHS [MH 016473, MH 4-1739] NR 50 TC 35 Z9 35 U1 1 U2 11 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 JAN-FEB PY 2006 VL 28 IS 1 BP 9 EP 17 DI 10.1016/j.genhosppsych.2005.07.004 PG 9 WC Psychiatry SC Psychiatry GA 006YT UT WOS:000234934600003 PM 16377360 ER PT J AU Zhang, H Loriaux, P Eng, J Campbell, D Keller, A Moss, P Bonneau, R Zhang, N Zhou, Y Wollscheid, B Cooke, K Yi, EC Lee, H Peskind, ER Zhang, J D Smith, R Aebersold, R AF Zhang, Hui Loriaux, Paul Eng, Jimmy Campbell, David Keller, Andrew Moss, Pat Bonneau, Richard Zhang, Ning Zhou, Yong Wollscheid, Bernd Cooke, Kelly Yi, Eugene C. Lee, Hookeun Peskind, Elaine R. Zhang, Jing D Smith, Richard Aebersold, Ruedi TI UniPep - a database for human N-linked glycosites: a resource for biomarker discovery SO GENOME BIOLOGY LA English DT Article ID HUMAN PLASMA PROTEOME; TANDEM MASS-SPECTROMETRY; IMMUNOAFFINITY SUBTRACTION; QUANTITATIVE-ANALYSIS; HYDRAZIDE CHEMISTRY; SERUM PROTEOME; ACCURATE MASS; SPECTRAL DATA; PROTEINS; CANCER AB There has been considerable recent interest in proteomic analyses of plasma for the purpose of discovering biomarkers. Profiling N-linked glycopeptides is a particularly promising method because the population of N- linked glycosites represents the proteomes of plasma, the cell surface, and secreted proteins at very low redundancy and provides a compelling link between the tissue and plasma proteomes. Here, we describe UniPep http://www.unipep.org-a database of human N-linked glycosites - as a resource for biomarker discovery. C1 Inst Syst Biol, Seattle, WA 98103 USA. NYU, Ctr Comparat Funct Genom, New York, NY USA. Univ Zurich, ETH, Inst Mol Syst Biol, CH-8006 Zurich, Switzerland. Univ Zurich, Fac Sci, CH-8006 Zurich, Switzerland. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Harborview Med Ctr, Seattle, WA 98104 USA. Pacific NW Natl Lab, Div Biol Sci, Richland, WA 99352 USA. Pacific NW Natl Lab, Environm Mol Sci Lab, Richland, WA 99352 USA. RP Zhang, H (reprint author), Inst Syst Biol, Seattle, WA 98103 USA. EM hzhang@systemsbiology.org RI Eng, Jimmy/I-4202-2012; Smith, Richard/J-3664-2012; Wollscheid, Bernd/E-8909-2010; Eng, Jimmy/C-6556-2017 OI Eng, Jimmy/0000-0001-6352-6737; Smith, Richard/0000-0002-2381-2349; Wollscheid, Bernd/0000-0002-3923-1610; Eng, Jimmy/0000-0001-6352-6737; Lee, Hookeun/0000-0002-0696-8421 FU NCI NIH HHS [U01-CA-111244, R21 CA114852, R21-CA-114852, U01 CA111244]; NCRR NIH HHS [P41 RR018522, RR18522]; NHLBI NIH HHS [N01-HV-28179, N01HV28179] NR 46 TC 69 Z9 70 U1 2 U2 10 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1474-760X J9 GENOME BIOL JI Genome Biol. PY 2006 VL 7 IS 8 AR r73 DI 10.1186/gb-2006-7-8-r73 PG 12 WC Biotechnology & Applied Microbiology; Genetics & Heredity SC Biotechnology & Applied Microbiology; Genetics & Heredity GA 095QN UT WOS:000241322800018 PM 16901351 ER PT J AU Rubin, RT Miller, TH Rhodes, ME Czambel, RK AF Rubin, RT Miller, TH Rhodes, ME Czambel, RK TI Growth hormone responses to low-dose physostigmine in elderly vs. young women and men SO GERONTOLOGY LA English DT Article DE growth hormone; cholinergic; physostigmine; aging; cortisol; sexual diergism ID ADRENAL CORTICAL RESPONSES; ADRENOCORTICAL AXIS RESPONSES; ALZHEIMERS-DISEASE; SEXUAL DIERGISM; GH SECRETION; CHOLINERGIC SYSTEM; MAJOR DEPRESSIVES; PYRIDOSTIGMINE; AGE; RELEASE AB Background: Growth hormone (GH) secretion is a sensitive measure of CNS cholinergic neurotransmission, and GH decreases considerably with age. Cholinesterase inhibitors, which increase acetylcholine concentrations, have been used in elderly subjects to investigate the neuroendocrine effects of aging and Alzheimer's disease. However, there have been only a few studies of a potential sex difference in GH responses to cholinesterase inhibitors in elderly subjects, with mixed results. Objective: We therefore administered low-dose physostigmine (PHYSO), a cholinesterase inhibitor, to normal, non-hormone-replaced, elderly women and men, to ascertain a potential sex difference in GH response. We hypothesized: ( 1) elderly women and men would have similar hormone responses, because of relatively low circulating estrogen in the women, and ( 2) the elderly women would have significantly lower baseline GH and GH responses to cholinergic challenge than the young women we studied previously. Methods: Normal elderly women and men >= 65 years of age meeting stringent inclusion and exclusion criteria were studied on three test days, 4 - 7 days apart, by serial blood sampling for several hours for baseline GH, followed by administration of low-dose PHYSO ( first and third days) or saline (second day) at 18: 00 h. Frequent blood sampling was continued for several hours. Plasma GH and hypothalamo-pituitaryadrenal cortical hormones were measured in each sample. Results: PHYSO administration produced no side effects in about half the elderly subjects and mild side effects in the other half, with no significant female-male differences and no significant relationship between the presence or absence of side effects and GH response. PHYSO significantly increased GH compared to saline, to a similar degree in the elderly women and men. The elderly women had a significantly greater GH response to PHYSO than did the young women, whereas GH responses were similar in the elderly and young men. Conclusions: These results indicate similar GH responses to low-dose PHYSO in elderly women compared to elderly men, and a significantly greater GH response in elderly women compared to young women. A likely mechanism is increased sensitivity of central cholinergic systems that inhibit somatostatin and/or enhance GHRH release from the hypothalamus. Copyright (c) 2006 S. Karger AG, Basel. C1 VA Greater LA Healthcare Syst, Dept Psychiat & Mental Hlth, Los Angeles, CA 90073 USA. Drexel Univ, Allegheny Gen Hosp, Coll Med, Ctr Res Neurosci, Pittsburgh, PA USA. RP Rubin, RT (reprint author), VA Greater LA Healthcare Syst, Dept Psychiat, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM robert.rubin@med.va.gov FU NIMH NIH HHS [MH28380] NR 47 TC 2 Z9 4 U1 0 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0304-324X J9 GERONTOLOGY JI Gerontology PY 2006 VL 52 IS 2 BP 76 EP 84 DI 10.1159/000090952 PG 9 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 018PA UT WOS:000235776100002 PM 16508314 ER PT J AU Pekary, AE AF Pekary, Albert Eugene BE Kastin, AJ TI Thyrotrophin-Releasing Hormone: New Functions for an Ancient Peptide SO HANDBOOK OF BIOLOGICALLY ACTIVE PEPTIDES LA English DT Article; Book Chapter ID GLYCOGEN-SYNTHASE KINASE-3-BETA; XENOPUS-LAEVIS; TRH RECEPTORS; RAT-BRAIN; CLONING; CDNA; EXPRESSION; SUBTYPE; INHIBITOR; NEURONS AB Thyrotrophin-releasing hormone (TRH) was the first of the hypothalamic releasing factors to be fully characterized. It consists of the tripeptide pGlu-His-Pro-NH2 that is derived from a precursor protein with multiple copies of the precursor sequence Lys-Arg-Gln-His-Pro-Gly-(Lys/Arg)-Arg. Pre-proTRH is distributed throughout the animal kingdom, occurring in species lacking a pituitary. In addition to its neuroendocrine release from the hypothalamus of mammals, resulting in secretion of TSH and PRL from the anterior pituitary, it functions as a neurotransmitter, neuromodulator, and neuroprotective agent in the central and peripheral nervous systems. Unlike hypothalamic preproTRH mRNA levels and TRH content that are subject to thyroid hormone negative feedback inhibition, extrahypothalamic brain TRH biosynthesis and release are unresponsive to thyroid hormone status. TRH suppresses glycogen synthase kinase-3 beta (GSK-3 beta) expression, a process that may lead to treatments for Alzheimer's disease, depression, bipolar disorder, and diabetes. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Pekary, AE (reprint author), VA Greater Los Angeles Healthcare Syst, Bldg 114,Rm 229, Los Angeles, CA 90073 USA. NR 42 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-046379-7 PY 2006 BP 629 EP 634 DI 10.1016/B978-012369442-3/50092-1 PG 6 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BCR53 UT WOS:000311102400091 ER PT J AU Martinez, V Tache, Y AF Martinez, Vicente Tache, Yvette BE Kastin, AJ TI Calcitonin Gene-Related Peptide and Gastrointestinal Function SO HANDBOOK OF BIOLOGICALLY ACTIVE PEPTIDES LA English DT Article; Book Chapter ID CGRP ANTAGONISTS; GASTRIC-MUCOSA; BINDING-SITES; DIABETIC-RATS; SUBSTANCE-P; CAPSAICIN; RECEPTOR; AFFERENTS; LOCALIZATION; INFLAMMATION AB Calcitonin gene-related peptide (CGRP) is a 37-amino-acid peptide present in nerve terminals of extrinsic afferents and in intrinsic enteric neurons throughout the gastrointestinal tract. Following its release, the peptide acts locally on specific receptors (CGRP(1)) located in enteric neurons, smooth muscle, endocrine cells, and vascular structures. The stimulation of CGRP(1) receptors elicits wide-ranging effects on gut function, including inhibition of gastric acid secretion and gut motility, increased gastric mucosal blood flow and mucosal resistance to injury, and modulation of visceral nociception. These observations suggest that CGRP plays an important role in the maintenance of gastrointestinal homeostasis and might be involved in pathophysiological alterations associated with secretory, motor, inflammatory, and sensory disturbances. C1 [Martinez, Vicente] AstraZeneca R&D, Integrat Pharmacol GI Biol, SE-43183 Molndal, Sweden. [Tache, Yvette] VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. RP Martinez, V (reprint author), AstraZeneca R&D, Integrat Pharmacol GI Biol, SE-43183 Molndal, Sweden. RI Martinez, Vicente/N-1189-2014 NR 34 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-046379-7 PY 2006 BP 1005 EP 1011 DI 10.1016/B978-012369442-3/50141-0 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BCR53 UT WOS:000311102400140 ER PT J AU Germano, PM Pisegna, JR AF Germano, Patrizia M. Pisegna, Joseph R. BE Kastin, AJ TI Pituitary Adenylate Cyclase Activating Polypeptide (PACAP) SO HANDBOOK OF BIOLOGICALLY ACTIVE PEPTIDES LA English DT Article; Book Chapter ID VASOACTIVE-INTESTINAL-PEPTIDE; DESCENDING RELAXATION PHASE; GUINEA-PIG; SIGNAL-TRANSDUCTION; I RECEPTOR; HYPOTHALAMIC POLYPEPTIDE; PERISTALTIC REFLEX; CIRCULAR MUSCLE; SPLICE VARIANTS; BINDING-SITES AB Pituitary adenylate cyclase activating polypeptide (PACAP) is expressed in the enteric nervous system of the gastrointestinal tract, where it functions to increase secretory activity and motility. Studies focusing on the role of PACAP in the gastrointestinal (GI) tract have identified it is as a key regulator in gastric acid secretion. Receptors for PACAP (PAC1) are expressed on the enterochromaffinlike (ECL) cells of the gastric corpus, where they regulate the release of histamine. PACAP is expressed in both gastric and colonic neurons, where it regulates gastrointestinal physiology. PACAP has also been demonstrated to regulate immune function in the GI tract and may be a key regulator of the inflammatory response associated with conditions such as inflammatory bowel disease. Receptors for PACAP have been discovered on tumors of the GI tract, and their stimulation is involved with growth of colonic tumors. C1 [Germano, Patrizia M.] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Los Angeles, CA 90073 USA. [Pisegna, Joseph R.] Univ Calif Los Angeles, Div Gastroenterol & Hepatol, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Los Angeles, CA 90073 USA. RP Germano, PM (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Los Angeles, CA 90073 USA. NR 41 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-046379-7 PY 2006 BP 1091 EP 1096 DI 10.1016/B978-012369442-3/50153-7 PG 6 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA BCR53 UT WOS:000311102400152 ER PT B AU Link, JM Jones, RE Offner, H Vandenbark, AA AF Link, Jason M. Jones, Richard E. Offner, Halina Vandenbark, Arthur A. BE Tatlisumak, T Fisher, M TI Experimental models for demyelinating diseases SO HANDBOOK OF EXPERIMENTAL NEUROLOGY: METHODS AND TECHNIQUES IN ANIMAL RESEARCH LA English DT Article; Book Chapter ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; MYELIN BASIC-PROTEIN; T-CELL-RECEPTOR; CENTRAL-NERVOUS-SYSTEM; INCOMPLETE FREUNDS-ADJUVANT; LYMPH-NODE CELLS; PROTEOLIPID PROTEIN; MULTIPLE-SCLEROSIS; LEWIS RATS C1 [Link, Jason M.; Jones, Richard E.; Offner, Halina] Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. [Vandenbark, Arthur A.] Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, Tykeson Multiple Sclerosis Res Lab, Dept Neurol, Portland, OR 97239 USA. RP Link, JM (reprint author), Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, R&D 31,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. NR 74 TC 0 Z9 0 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI CAMBRIDGE PA THE PITT BUILDING, TRUMPINGTON ST, CAMBRIDGE CB2 1RP, CAMBS, ENGLAND BN 978-0-521-83814-6 PY 2006 BP 393 EP 410 DI 10.1017/CBO9780511541742.023 D2 10.1017/CBO9780511541742 PG 18 WC Neurosciences; Veterinary Sciences SC Neurosciences & Neurology; Veterinary Sciences GA BXT09 UT WOS:000297007700023 ER PT J AU Young, AJ Rodriguez, KL AF Young, AJ Rodriguez, KL TI The role of narrative in discussing end-of-life care: Eliciting values and goals from text, context, and subtext SO HEALTH COMMUNICATION LA English DT Article ID PATIENT AB This article reports a qualitative study of elderly veterans' perceptions of and preferences for end-of-life care. At a large urban Veterans Affairs (VA) hospital, we asked 30 veterans and 30 health care providers to define 4 terms in the VA form of the advance directive: life-sustaining treatment, terminal condition, state of permanent unconsciousness, and decision-making capacity. The veterans commonly used narratives to construct meaning, and analysis showed that the resulting texts had both a subtext (the values and goals driving the narrative) and a context (life experiences that filter and shape the current interpretation). We found that all 3 components-text, subtext, and context-are crucial to understanding the central theme of an individual's narrative and the decision-making processes associated with it. In this article we examine 1 lengthy narrative using Chafe's (1994) notion of intonation units. We then present a series of short narratives to demonstrate 3 subthemes that emerged from the data: quality of life versus quantity of life, benefit of treatment versus cost of treatment, and, most common, control versus lack of control. Our goal was to demonstrate the centrality and usefulness of storytelling in the patient-provider interaction when listeners are willing to consider the subtext and context of the story and its role in the decision-making process. As demonstrated in this study, deciphering people's stories gives us insight into their values, the mental constructs that drive their decision making, and the goals that they have for their own health care. C1 Univ Memphis, Dept Commun, Memphis, TN 38152 USA. Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Young, AJ (reprint author), Univ Memphis, Dept Commun, 143 Theatre & Commun Bldg, Memphis, TN 38152 USA. EM aj.young@memphis.edu NR 15 TC 10 Z9 10 U1 0 U2 3 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 USA SN 1041-0236 J9 HEALTH COMMUN JI Health Commun. PY 2006 VL 19 IS 1 BP 49 EP 59 DI 10.1207/s15327027hc1901_6 PG 11 WC Communication; Health Policy & Services SC Communication; Health Care Sciences & Services GA 010AJ UT WOS:000235154900006 PM 16519592 ER PT J AU Jensen, DM AF Jensen, DM TI Outcomes, effectiveness, tolerability, and direct costs of prophylactic variceal treatments SO HEPATOLOGY LA English DT Letter ID CIRRHOSIS; LIGATION; PROPRANOLOL; CIRRHOTICS; HEMORRHAGE; NADOLOL; RISK C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Jensen, DM (reprint author), VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 9 TC 2 Z9 2 U1 1 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JAN PY 2006 VL 43 IS 1 BP 197 EP 198 DI 10.1002/hep.21007 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 000KH UT WOS:000234460000029 ER PT J AU Musani, SK Zhang, HG Hsu, HC Yi, NJ Gorman, BS Allison, DB Mountz, JD AF Musani, Solomon K. Zhang, Huang-Ge Hsu, Hui-Chen Yi, Nengjun Gorman, Bernard S. Allison, David B. Mountz, John D. TI Principal component analysis of quantitative trait loci for immune response to adenovirus in mice SO HEREDITAS LA English DT Article ID MEDIATED GENE-TRANSFER; NECROSIS-FACTOR-ALPHA; TRANSGENE EXPRESSION; IL-10-DEFICIENT MICE; KUPFFER CELLS; THERAPY; TUMOR; VECTORS; INTERLEUKIN-12; ACTIVATION AB Data on the duration of transgene expression in the liver, the presence of cytotoxic T lymphocytes (CTLs) against adenovirus, and serum cytokines from 18 strains of C57BL/6xDBA/2 (BxD) recombinant inbred mice were analyzed. Our aim was to detect quantitative trait loci (QTLs) that may have causal relationship with the duration of adenovirus-mediated transgene expression in the liver. Information from beta-galactosidase (LacZ) expression; CTL production; and serum levels of gamma interferon, tumor necrosis factor-alpha, and interleukin-6 30 days after intravenous injection of liver LacZ were summarized by principal component analysis and analyzed using maximum likelihood interval mapping implemented in the QTL cartographer software. Two principal component (PC) scores explained 82.5% of the phenotypic variance in the original variables and identified QTLs not identified by analysis of individual traits. The distribution of original variables among PCs was such that variables in PC1 were predominantly cytokines with little CTL response whereas LacZ and CTL were the predominant contributors to PC2 with practically no contribution from cytokines. PC1 was significantly associated with two QTLs on chromosomes 7 and 9 located at 57.5 cM and 41.01 cM, respectively. Five QTLs were significantly associated with PC2 on chromosomes 12 (23.01 and 31.01 cM) and 15 (29.21, 36.01, and 56.31 cM). These results illustrate the use of principal component analysis in mapping QTLs using multiple correlated traits. C1 Univ Alabama, Dept Med, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA. Univ Alabama, Dept Biostat, Sect Stat Genet, Birmingham, AL 35294 USA. Nassau Community Coll, Garden City, NY 11530 USA. Univ Alabama, Dept Nutr Sci, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Mountz, JD (reprint author), Univ Alabama, Dept Med, Div Clin Immunol & Rheumatol, 701 S 19th St,Room 473,LHRB Birmingham, Birmingham, AL 35294 USA. EM jdmountz@.uab.edu OI Allison, David/0000-0003-3566-9399 FU NHLBI NIH HHS [1T32HL072757-01]; NIA NIH HHS [R01-AG11653]; NIAID NIH HHS [R01-AI42900]; NIDDK NIH HHS [5 P30 DK56336-04]; NIEHS NIH HHS [5R01ES009912-05] NR 48 TC 5 Z9 5 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0018-0661 J9 HEREDITAS JI Hereditas PY 2006 VL 143 IS 1 BP 189 EP 197 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 125WO UT WOS:000243474400027 PM 17362354 ER PT B AU Lieberman, D AF Lieberman, D. BE VanCutsem, E Schmiegel, W Rustgi, AK Zeitz, M TI Colorectal cancer screening: cost-effectiveness and adverse events SO Highlights in Gastrointestinal Oncology SE FALK SYMPOSIUM LA English DT Proceedings Paper CT Falk Symposium 149 on Highlights in Gastrointestinal Oncology CY OCT 01-02, 2005 CL Berlin, GERMANY ID FECAL-OCCULT-BLOOD; COMPUTED TOMOGRAPHIC COLONOGRAPHY; CONTRAST BARIUM ENEMA; AVERAGE-RISK; ASYMPTOMATIC ADULTS; FLEXIBLE SIGMOIDOSCOPY; VIRTUAL COLONOSCOPY; NATIONAL-SURVEY; TASK-FORCE; RECOMMENDATIONS C1 Oregon Hlth Sci Univ, Div Gastroenterol, Portland VA Med Ctr, Portland, OR 97239 USA. RP Lieberman, D (reprint author), Oregon Hlth Sci Univ, Div Gastroenterol, Portland VA Med Ctr, P3-G1,POB 1034, Portland, OR 97239 USA. NR 46 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS BN 1-4020-5108-5 J9 FALK SYMP PY 2006 VL 149 BP 91 EP 103 PG 13 WC Oncology; Gastroenterology & Hepatology SC Oncology; Gastroenterology & Hepatology GA BFB98 UT WOS:000240945400010 ER PT J AU Eccles, MP Mittman, BS AF Eccles, Martin P. Mittman, Brian S. TI Welcome to Implementation Science SO IMPLEMENTATION SCIENCE LA English DT Editorial Material AB Implementation research is the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care. This relatively new field includes the study of influences on healthcare professional and organisational behaviour. Implementation Science will encompass all aspects of research in this field, in clinical, community and policy contexts. This online journal will provide a unique platform for this type of research and will publish a broad range of articles - study protocols, debate, theoretical and conceptual articles, rigorous evaluations of the process of change, and articles on methodology and rigorously developed tools - that will enhance the development and refinement of implementation research. No one discipline, research design, or paradigm will be favoured. Implementation Science looks forward to receiving manuscripts that facilitate the continued development of the field, and contribute to healthcare policy and practice. C1 [Eccles, Martin P.] Newcastle Univ, Ctr Hlth Serv Res, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. [Mittman, Brian S.] VA Greater Angeles Healthcare Syst, VA Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. [Mittman, Brian S.] Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Eccles, MP (reprint author), Newcastle Univ, Ctr Hlth Serv Res, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. EM Martin.Eccles@newcastle.ac.uk; Brian.Mittman@va.gov NR 8 TC 159 Z9 160 U1 3 U2 17 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PY 2006 VL 1 AR 1 DI 10.1186/1748-5908-1-1 PG 3 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V99JR UT WOS:000206717500001 ER PT J AU Hysong, SJ Best, RG Pugh, JA AF Hysong, Sylvia J. Best, Richard G. Pugh, Jacqueline A. TI Audit and feedback and clinical practice guideline adherence: Making feedback actionable SO IMPLEMENTATION SCIENCE LA English DT Article AB Background: As a strategy for improving clinical practice guideline (CPG) adherence, audit and feedback (A&F) has been found to be variably effective, yet A&F research has not investigated the impact of feedback characteristics on its effectiveness. This paper explores how high performing facilities (HPF) and low performing facilities (LPF) differ in the way they use clinical audit data for feedback purposes. Method: Descriptive, qualitative, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low adherence to six CPGs, as measured by external chart review audits. One-hundred and two employees involved with outpatient CPG implementation across the six facilities participated in one-hour semi-structured interviews where they discussed strategies, facilitators and barriers to implementing CPGs. Interviews were analyzed using techniques from the grounded theory method. Results: High performers provided timely, individualized, non-punitive feedback to providers, whereas low performers were more variable in their timeliness and non-punitiveness and relied on more standardized, facility-level reports. The concept of actionable feedback emerged as the core category from the data, around which timeliness, individualization, non-punitiveness, and customizability can be hierarchically ordered. Conclusion: Facilities with a successful record of guideline adherence tend to deliver more timely, individualized and non-punitive feedback to providers about their adherence than facilities with a poor record of guideline adherence. Consistent with findings from organizational research, feedback intervention characteristics may influence the feedback's effectiveness at changing desired behaviors. C1 [Hysong, Sylvia J.] Michael E DeBakey VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Hysong, Sylvia J.] Baylor Coll Med, Dept Med, Hlth Serv Res Sect, Houston, TX 77030 USA. [Best, Richard G.] Lockheed Martin Informat Technol, Healthcare Solut Div, San Antonio, TX USA. [Pugh, Jacqueline A.] S Texas Vet Hlth Care Syst, Vet Evidence Based Res Disseminat & Implementat, San Antonio, TX USA. [Pugh, Jacqueline A.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. RP Hysong, SJ (reprint author), Michael E DeBakey VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. EM sylvia.hysong@med.va.gov; rbest@satx.rr.com; pugh@uthscsa.edu RI Hysong, Sylvia/B-8420-2008 OI Hysong, Sylvia/0000-0002-9063-5207; Pugh, Jacqueline/0000-0003-4933-141X FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (VA HSRD) [CPI 99-129] FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (VA HSR&D) (CPI 99-129). Dr. Hysong is a health services researcher at the Houston Center for Quality of Care and Utilization Studies, a VA HSR&D Center of Excellence, and she is an Instructor of Medicine at Baylor College of Medicine in Houston. This research was conducted during her tenure at the Veterans Evidence-Based Research Dissemination and Implementation Center (VERDICT), a VA HSR&D Research Enhancement Award Program. Dr. Best is a Senior Healthcare Consultant at Lockheed Martin Information Systems; this research was conducted during his tenure at VERDICT. Dr. Pugh is the director of VERDICT, a Professor of Internal Medicine at the University of Texas Health Science Center at San Antonio, TX, and a staff physician at the South Texas Veterans Health Care System, where VERDICT is housed. All three authors' salaries were supported, in part, by the Department of Veterans Affairs. The views expressed in this article are solely those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, Baylor College of Medicine, Lockheed Corporation, or the University of Texas. NR 28 TC 82 Z9 82 U1 1 U2 8 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PY 2006 VL 1 AR 9 DI 10.1186/1748-5908-1-9 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V99JR UT WOS:000206717500009 PM 16722539 ER PT J AU Magnabosco, JL AF Magnabosco, Jennifer L. TI Innovations in mental health services implementation: a report on state-level data from the US Evidence-Based Practices Project SO IMPLEMENTATION SCIENCE LA English DT Article AB Background: The Evidence-Based Practice (EBP) Project has been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date, Project findings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project. Methods: Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 - Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation. Results: One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation. Conclusion: Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan, implement and sustain such efforts. This paper offers a classification scheme and list of innovative implementation activities and strategies. The classification scheme offers potential value for future studies that seek to assess the effects of various implementation processes, and helps establish widely accepted standards and criteria that can be used to assess the value of innovative activities and strategies. C1 VA Greater Angeles Healthcare Syst, VA Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. RP Magnabosco, JL (reprint author), VA Greater Angeles Healthcare Syst, VA Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. EM jlmagnabosco@mindspring.com FU MacArthur Foundation Network on Mental Health Policy Research FX The author would like to thank the John D. and Catherine T. MacArthur Foundation Network on Mental Health Policy Research for funding the preparation of data analyses and writing of the manuscript associated with this phase of the EBP Project, and the following colleagues from the MacArthur Foundation Network on Mental Health Policy Research for their collegiality, contributions to the acquisition of site visit data and writing of site visit reports, and comments on an earlier version of this manuscript: Howard Goldman, Audrey Burnam, Joseph Morrissey, Pam Hyde, Kimberly Roussin Isett, Brenda Coleman-Beattie, Vijay Ganju, Charlie Rapp, and Katie Falls. The author would especially like to thank Howard Goldman for his guidance and support. The author also would like to thank Cynthia Gammage for technical assistance in preparing this manuscript. NR 55 TC 32 Z9 32 U1 2 U2 8 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PY 2006 VL 1 AR 13 DI 10.1186/1748-5908-1-13 PG 11 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V99JR UT WOS:000206717500013 PM 16734913 ER PT J AU Stetler, CB Legro, MW Rycroft-Malone, J Bowman, C Curran, G Guihan, M Hagedorn, H Pineros, S Wallace, CM AF Stetler, Cheryl B. Legro, Marcia W. Rycroft-Malone, Joanne Bowman, Candice Curran, Geoffrey Guihan, Marylou Hagedorn, Hildi Pineros, Sandra Wallace, Carolyn M. TI Role of "external facilitation" in implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration SO IMPLEMENTATION SCIENCE LA English DT Article AB Background: Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other interventions, especially to other change agent roles when used in multi-faceted implementation projects. Researchers who are part of the Quality Enhancement Research Initiative (QUERI) are actively exploring various approaches and processes, including facilitation, to enable implementation of best practices in the Veterans Health Administration health care system - the largest integrated healthcare system in the United States. This paper describes a systematic, retrospective evaluation of implementation-related facilitation experiences within QUERI, a quality improvement program developed by the US Department of Veterans Affairs. Methods: A post-hoc evaluation was conducted through a series of semi-structured interviews to examine the concept of facilitation across several multi-site QUERI implementation studies. The interview process is based on a technique developed in the field of education, which systematically enhances learning through experience by stimulating recall and reflection regarding past complex activities. An iterative content analysis approach relative to a set of conceptually-based interview questions was used for data analysis. Findings: Findings suggest that facilitation, within an implementation study initiated by a central change agency, is a deliberate and valued process of interactive problem solving and support that occurs in the context of a recognized need for improvement and a supportive interpersonal relationship. Facilitation was described primarily as a distinct role with a number of potentially crucial behaviors and activities. Data further suggest that external facilitators were likely to use or integrate other implementation interventions, while performing this problem-solving and supportive role. Preliminary Conclusions: This evaluation provides evidence to suggest that facilitation could be considered a distinct implementation intervention, just as audit and feedback, educational outreach, or similar methods are considered to be discrete interventions. As such, facilitation should be well-defined and explicitly evaluated for its perceived usefulness within multi-intervention implementation projects. Additionally, researchers should better define the specific contribution of facilitation to the success of implementation in different types of projects, different types of sites, and with evidence and innovations of varying levels of strength and complexity. C1 [Legro, Marcia W.; Pineros, Sandra; Wallace, Carolyn M.] VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. [Rycroft-Malone, Joanne] Univ Wales, Ctr Hlth Related Res, Reader Hlth Serv Res, Bangor, Gwynedd, Wales. [Bowman, Candice] Hlth Serv Res & Dev, QUERI HIV, VA San Diego Healthcare Syst, San Diego, CA 92161 USA. [Curran, Geoffrey] Ctr Mental Healthcare & Outcomes Res, Cent Arkansas Vet Healthcare Syst, N Little Rock, AR 72114 USA. [Guihan, Marylou] Jr VA Hosp, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. [Hagedorn, Hildi] Minneapolis VA Med Ctr, Minneapolis, MN 55417 USA. RP Stetler, CB (reprint author), 321 Middle St, Amherst, MA 01002 USA. EM Cheryl.Stetler@comcast.net; mlegro@earthlink.net; j.rycroft-malone@bangor.ac.uk; Candice.Bowman@va.gov; CURRAN.GEOFFREYM@va.gov; Marylou.guihan@va.gov; Hildi.Hagedorn@va.gov; Sandra.Pineros@va.gov; Carolyn.Wallace1@va.gov FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service FX Nancy Sharp, PhD, VA Puget Sound Health Care System is acknowledged for her support of and feedback regarding this exploration. NR 20 TC 89 Z9 89 U1 0 U2 10 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1748-5908 J9 IMPLEMENT SCI JI Implement. Sci. PY 2006 VL 1 AR 23 DI 10.1186/1748-5908-1-23 PG 15 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V99JR UT WOS:000206717500023 PM 17049080 ER PT J AU Ahearn, EP Mussey, M Johnson, C Krohn, A Krahn, D AF Ahearn, EP Mussey, M Johnson, C Krohn, A Krahn, D TI Quetiapine as an adjunctive treatment for post-traumatic stress disorder: an 8-week open-label study SO INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY LA English DT Article DE post-traumatic stress disorder; quetiapine ID BORDERLINE PERSONALITY-DISORDER; COMBAT-RELATED PTSD; MAJOR DEPRESSION; SELECTIVE ACTIVATION; ANXIOLYTIC ACTIVITY; OLANZAPINE; RISPERIDONE; RESISTANT; SYMPTOMS; SCALE AB This study evaluated the effectiveness of quetiapine for subjects with post-traumatic stress disorder (PTSD) who were already on a stable dose of a selective serotonin reuptake inhibitor (SSRI) but had significant PTSD symptoms. Fifteen subjects were enrolled in an 8-week open-label trial for PTSD in which quetiapine was added to an SSRI. Subjects were on a stable dose of the SSRI for at least 6 weeks before study entry and had a Clincian-Administered PTSD Scale (CAPS) score of greater than or equal to 50 at study baseline. The mean age of subjects was 49 years (eight men and seven women). The average duration of PTSD was 29 years, one-third of subjects had combat-related PTSD, and two-thirds had noncombat PTSD. The mean dose prescribed in the study was 216 mg per day. The initial median CAPS score was 80, indicating severe PTSD. The addition of a modest dose of quetiapine provided significant relief from PTSD symptoms with a 42% overall improvement in PTSD symptoms based on the CAPS and significant improvement along each dimension of symptoms: re-experiencing (Z = - 3.24, P = 0.0012), hyperarousal (Z = -3.30, P = 0.001) and avoidance (Z = -2.13, P = 0.03). Subjects rated themselves as 45% improved on average on the Davidson Trauma Scale and reported a 44% decrease in their level of disability and impairment as reflected by the Sheehan Disability Scale. Subjects with PTSD who had significant PTSD symptoms when on an SSRI benefited from the addition of quetiapine. Patients improved significantly on all three clusters of PTSD symptoms: re-experiencing, hyperarousal and avoidance. C1 Univ Wisconsin, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. RP Ahearn, EP (reprint author), Univ Wisconsin, William S Middleton Mem Vet Hosp, 2500 Overlook Terrace, Madison, WI 53705 USA. EM eileen.ahearn@med.va.gov NR 52 TC 28 Z9 28 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0268-1315 J9 INT CLIN PSYCHOPHARM JI Int. Clin. Psychopharmacol. PD JAN PY 2006 VL 21 IS 1 BP 29 EP 33 DI 10.1097/01.yic.0000182116.49887.ae PG 5 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 996QK UT WOS:000234189100004 PM 16317314 ER PT J AU Hong, O Ronis, DL Lusk, SL Kee, GS AF Hong, OiSaeng Ronis, David L. Lusk, Sally L. Kee, Gwang-Soog TI Efficacy of a computer-based hearing test and tailored hearing protection intervention SO INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE LA English DT Article DE tailored intervention; computer-based; hearing protection; construction worker ID CONSTRUCTION WORKERS USE; HEALTH-PROMOTION MODEL; EXPERT-SYSTEM INTERVENTION; INDICATORS; BEHAVIORS; PEOPLE AB Advances in computer technology and accessibility enable researchers to provide individually tailored interventions for behavioral change. Using multimedia technology, this study developed and tested a computer-based heating test and a tailored intervention. The purpose of this study was to evaluate, using a randomized experimental design, the efficacy of the intervention to increase workers' use of hearing protection. The tailored intervention developed by the research team showed more significant short-term effect measured immediately after the intervention than the control intervention. For the long-term effect measured I year after the intervention, both tailored and control groups showed significant increase in their reported use (7% vs. 6%)from preintervention to postintervention, but no significant difference between the two groups. The change accomplished in this study was small progress toward the desired level of 100% use of hearing protection to prevent noise-induced hearing loss. This finding showed that changing workers' hearing protection behavior is difficult. C1 Univ Michigan, Occupat Hlth Nursing Program, Sch Nursing, Ann Arbor, MI 48109 USA. Univ Michigan, US Dept Vet Affairs, Ann Arbor, MI 48109 USA. RP Hong, O (reprint author), Univ Michigan, Occupat Hlth Nursing Program, Sch Nursing, 400 N Ingalls,Room 3182, Ann Arbor, MI 48109 USA. EM oshong@umich.edu FU NIOSH CDC HHS [5R01OH04034-01A1] NR 40 TC 16 Z9 17 U1 0 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1070-5503 J9 INT J BEHAV MED JI Int. J. Behav. Med. PY 2006 VL 13 IS 4 BP 304 EP 314 DI 10.1207/s15327558ijbm1304_5 PG 11 WC Psychology, Clinical SC Psychology GA 137FF UT WOS:000244277700004 PM 17228988 ER PT J AU Morgello, S Holzer, CE Ryan, E Young, C Naseer, M Castellon, SA Frol, AB Atkinson, JH Gelman, BB Grant, I Singer, EJ AF Morgello, S. Holzer, C. E., III Ryan, E. Young, C. Naseer, M. Castellon, S. A. Frol, A. B. Atkinson, J. Hampton Gelman, B. B. Grant, I. Singer, E. J. TI Interrater reliability of the psychiatric research interview for substance and mental disorders in an HIV-infected cohort: experience of the National NeuroAIDS Tissue Consortium SO INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH LA English DT Article DE interrater reliability; PRISM; HIV ID HUMAN-IMMUNODEFICIENCY-VIRUS; STRUCTURED CLINICAL INTERVIEW; TEST-RETEST RELIABILITY; MOOD DISORDERS; HOMOSEXUAL MEN; DRUG-USERS; PSYCHOPATHOLOGY; AIDS; PREVALENCE; VALIDITY AB The interrater reliability of the Psychiatric Research Interview for Substance and Mental Disorders (PRISM) was assessed in a multicentre study. Four sites of the National NeuroAIDS Tissue Consortium performed blinded reratings of audio-taped PRISM interviews of 63 HIV-infected patients. Diagnostic modules for substance-use disorders and major depression were evaluated. Seventy-six per cent of the patient sample displayed one or more substance-use disorder diagnoses and 54% had major depression. Kappa coefficients for lifetime histories of substance abuse or dependence (cocaine, opiates, alcohol, cannabis, sedative, stimulant, hallucinogen) and major depression ranged from 0.66 to 1.00. Overall the PRISM was reliable in assessing both past and current disorders except for current cannabis disorders when patients had concomitant cannabinoid prescriptions for medical therapy. The reliability of substance-induced depression was poor to fair although there was a low prevalence of this diagnosis in our group. We conclude that the PRISM yields reliable diagnoses in a multicentre study of substance-experienced, HIV-infected individuals. Copyright (c) 2006 John Wiley & Sons, Ltd. C1 Mt Sinai Sch Med, New York, NY USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. Univ Calif San Diego, San Diego, CA 92103 USA. Univ Calif Los Angeles, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. VA San Diego Healthcare Syst, San Diego, CA USA. RP Morgello, S (reprint author), Mt Sinai Med Ctr, Box 1134,1 Gustave L Levy Pl, New York, NY 10029 USA. EM susan.morgello@mssm.edu FU NCRR NIH HHS [M01-RR-00071]; NIMH NIH HHS [R24MH59724, R24MH59745]; NINDS NIH HHS [R24NS38841, R24NS45491] NR 27 TC 22 Z9 22 U1 5 U2 5 PU WHURR PUBLISHERS LTD PI LONDON PA 19B COMPTON TERRACE, LONDON N1 2UN, ENGLAND SN 1049-8931 J9 INT J METH PSYCH RES JI Int. J. Methods Psychiatr. Res. PY 2006 VL 15 IS 3 BP 131 EP 138 DI 10.1002/mpr.189 PG 8 WC Psychiatry SC Psychiatry GA 087JX UT WOS:000240739800004 PM 17019897 ER PT J AU Lu, S Ren, CX Liu, Y Epner, DE AF Lu, S Ren, CX Liu, Y Epner, DE TI PI3K-Akt signaling is involved in the regulation of p21(WAF/CIP) expression and androgen-independent growth in prostate cancer cells SO INTERNATIONAL JOURNAL OF ONCOLOGY LA English DT Article DE prostate cancer; androgen receptor; androgen-independent growth; signal transduction ID INHIBITOR P21 GENE; RECEPTOR GENE; DEPRIVATION THERAPY; PROGNOSTIC-SIGNIFICANCE; FREQUENT INACTIVATION; PROGRAMMED DEATH; TYROSINE KINASE; BETA-CATENIN; AKT ACTIVITY; PROTEIN AB The purpose of this study is to investigate the role of PI3K-Akt signaling in prostate cancer cell growth and androgen receptor (AR)-mediated gene expression. Androgen-dependent LNCaP cells and their androgen-independent counterpart, LNCaP-AI cells, were used. We found that PI3K-Akt signaling is elevated in LNCaP-AI cells compared to that in LNCaP cells and is involved in androgen-independent growth. More importantly, PI3K-Akt signaling enhances AR activity and is involved in the induction of AR target genes, such as p21(WAF/CIP), a gene with anti-apoptosis activity and associated with androgen-independent growth in human prostate cancer. A receptor tyrosine kinase inhibitor also inhibits the PI3K-Akt signaling and compromises AR activity and cell growth. These findings suggest that the PI3K-Akt cell growth survival pathway and its downstream-regulated gene, p21(WAF/CIP), are targets for developing novel therapies against prostate cancer, especially those androgen-independent diseases. C1 Univ Cincinnati, Coll Med, Dept Pathol & Lab Med, Cincinnati, OH 45267 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX 77030 USA. RP Lu, S (reprint author), Univ Cincinnati, Coll Med, Dept Pathol & Lab Med, 231 Albert Sabin Way,POB 670529, Cincinnati, OH 45267 USA. EM shan.lu@uc.edu NR 59 TC 27 Z9 29 U1 0 U2 1 PU SPANDIDOS PUBL LTD PI ATHENS PA POB 18179, ATHENS, 116 10, GREECE SN 1019-6439 J9 INT J ONCOL JI Int. J. Oncol. PD JAN PY 2006 VL 28 IS 1 BP 245 EP 251 PG 7 WC Oncology SC Oncology GA 996UU UT WOS:000234201400028 PM 16328002 ER PT J AU Mendez, MF AF Mendez, Mario F. TI The accurate diagnosis of early-onset dementia SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article DE dementia; Alzheimer's disease; vascular dementia; frontotemporal dementia; traumatic brain injury ID ISCHEMIC VASCULAR DEMENTIA; ALZHEIMERS-DISEASE; FRONTOTEMPORAL DEMENTIA; PRESENILE-DEMENTIA; PREVALENCE; FEATURES; POPULATION; CRITERIA; HEALTH; ASCERTAINMENT AB Early-onset dementia (EOD, < 65 years at onset) is a relatively common and frequently misdiagnosed condition. One reason for misdiagnosis is that EOD has a more varied differential diagnosis than late-onset dementia (LOD). For example, Alzheimer's disease (AD), the preponderant LOD, makes up only about one-third of EODs; the rest are due to vascular dementias, frontotemporal lobar degenerations, traumatic head injury, alcohol-related dementia, and a great many other conditions. Another reason for misdiagnosis is that early-onset AD may have predominant cognitive deficits other than memory loss and a potential familial inheritance with spastic paraparesis, seizures, or myoclonus. A third reason is that EOD often presents with neuropsychiatric features out-of-proportion to any cognitive deficits. Despite these obstacles, it is important to accurately diagnose EODs, particularly because they differ in management and course. Clinicians can successfully diagnose most EODs with careful cognitive and family histories, mental status and neurological examinations, and neuroimaging. C1 VA Greater Los Angeles Healthcare Syst, Neurobiol Unit, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobiol Unit, 116AF,Bldg 500,3S,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@ucla.edu NR 50 TC 57 Z9 57 U1 3 U2 17 PU BAYWOOD PUBL CO INC PI AMITYVILLE PA 26 AUSTIN AVE, PO BOX 337, AMITYVILLE, NY 11701 USA SN 0091-2174 J9 INT J PSYCHIAT MED JI Int. J. Psychiatr. Med. PY 2006 VL 36 IS 4 BP 401 EP 412 DI 10.2190/Q6J4-R143-P630-KW41 PG 12 WC Psychiatry SC Psychiatry GA 150VY UT WOS:000245248900002 PM 17407994 ER PT J AU Park, JL Cesaretti, JA Kao, J Stone, NN Stock, RG AF Park, J. L. Cesaretti, J. A. Kao, J. Stone, N. N. Stock, R. G. TI Vardenafil is more efficacious than tadalafil for patient's who requested an alternative to sildenafil following prostate brachytherapy SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Meeting Abstract CT 48th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY NOV 05-09, 2006 CL Philadelphia, PA SP Amer Soc Therapeut Radiol & Oncol C1 James J Peters Vet Adm, Bronx, NY USA. Mt Sinai Sch Med, New York, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0360-3016 J9 INT J RADIAT ONCOL JI Int. J. Radiat. Oncol. Biol. Phys. PY 2006 VL 66 IS 3 SU S MA 2593 BP S540 EP S540 DI 10.1016/j.ijrobp.2006.07.1006 PG 1 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 094EF UT WOS:000241221602105 ER PT J AU Post, JB Wilkes, BM Michelis, MF AF Post, James B. Wilkes, Barry M. Michelis, Michael F. TI Iron deficiency in patients with chronic kidney disease: potential role for intravenous iron therapy independent of erythropoietin SO INTERNATIONAL UROLOGY AND NEPHROLOGY LA English DT Article DE anemia iron-deficiency; chronic; dialysis; erythropoietin; ferritin; kidney failure ID CHRONIC-RENAL-FAILURE; RECOMBINANT-HUMAN-ERYTHROPOIETIN; LEFT-VENTRICULAR HYPERTROPHY; HEMODIALYSIS-PATIENTS; MAINTENANCE HEMODIALYSIS; PREDIALYSIS PATIENTS; DIALYSIS PATIENTS; HEMATOCRIT LEVEL; SUPPLEMENTATION; ABSORPTION AB The prevalence of iron deficiency and its contribution to the anemia of end stage renal disease has been extensively studied, but much less is known about the role of iron deficiency in the pathogenesis of the anemia of chronic kidney disease in predialysis patients. All new hemodialysis patients entering a single hemodialysis unit between July 1999 and April 2002 were included in the study. The admission laboratory tests and the Health Care Financing Administration (HCFA) 2728 form were examined to determine the prevalence of erythropoietin use, anemia (Hb < 11 g/dl), and iron deficiency (ferritin < 100 ng/ml and transferrin saturation % < 20%). In a second part of the study, the effect of intravenous iron gluconate replacement in patients with stage III & IV chronic kidney disease was examined. Anemia was present in 68% of all patients starting hemodialysis. Iron deficiency was a common feature occurring in 29% of patients taking erythropoietin (49% of all patients) and 26% of patients without erythropoietin (51 % of all patients). Following the administration of intravenous iron gluconate to four patients, there was a significant rise in hemoglobin levels from 10.6 +/- 0.19 to 11.7 +/- g/dl (p=0.02). Conclusion: Iron deficiency is common in predialysis patients. Replenishing iron stores in anemic patients with chronic kidney disease significantly increases hemoglobin levels and should be considered as an integral part of the therapy for treating anemia in the predialysis population. C1 James J Peters Hosp, Dept Vet Affairs, Bronx, NY 10468 USA. Lenox Hill Hosp, Div Nephrol, New York, NY 10021 USA. RP Post, JB (reprint author), James J Peters Hosp, Dept Vet Affairs, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM james.post@med.va.gov OI Michelis, Michael F/0000-0003-4677-1559 NR 24 TC 8 Z9 12 U1 0 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0301-1623 J9 INT UROL NEPHROL JI Int. Urol. Nephrol. PY 2006 VL 38 IS 3-4 BP 719 EP 723 DI 10.1007/s11255-006-0035-0 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 150KN UT WOS:000245215800070 PM 17106764 ER PT J AU Luetkemeyer, A Hare, CB Stansell, J Tien, PC Charlesbois, E Lum, P Havlir, D Peters, M AF Luetkemeyer, A Hare, CB Stansell, J Tien, PC Charlesbois, E Lum, P Havlir, D Peters, M TI Clinical presentation and course of acute hepatitis c infection in HIV-infected patients SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE acute hepatitis C; HIV; pegylated interferon; men who have sex with men ID HUMAN-IMMUNODEFICIENCY-VIRUS; ALPHA-2A PLUS RIBAVIRIN; RANDOMIZED CONTROLLED-TRIAL; SEXUAL TRANSMISSION; NATURAL-HISTORY; HOMOSEXUAL-MEN; INTERFERON-ALPHA-2B; COINFECTION; PREVALENCE; TERM AB Hepatitis C virus (HCV) has become a significant source of morbidity and mortality in HIV-infected patients. However, little is known about the clinical presentation and course of acute HCV infection in this population. This study reports the outcomes of acute HCV infection in 9 HIV-infected men. Sex with men was the only reported risk factor for HCV infection in 6 of the subjects. Clinical presentation of acute HCV ranged from incidentally discovered elevated transaminases to severe liver dysfunction requiring hospitalization. At the time of HCV diagnosis, 8 of 9 patients had CD4(+) counts > 250 cells/mm(3), and 6 had HIV vital loads of <= 5000 copies/mL. Eight patients were receiving antiretroviral therapy. outcome of these acute HCV infections varied. Five patients experienced virologic clearance, 2 in whom virus cleared spontaneously and 3 who were treated with pegylated interferon and ribavirin. Four patients developed chronic infection, one of whom had a relapse during HCV treatment and 3 of whom Were untreated. All 4 patients to whom HCV therapy was administered experienced significant anemia or neutropenia, necessitating close reduction or Support with growth factors. Prompt recognition of acute HCV infection May minimize antiretroviral treatment interruption and will allow early treatment, which may improve virologic clearance. Unexplained transaminase elevations in HIV-infected patients, including men who have sex with men, should trigger an evaluation for acute HCV infection. C1 Univ Calif San Francisco, San Francisco Gen Hosp, HIV AIDS Div, San Francisco, CA 94110 USA. Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, Div Gastroenterol, San Francisco, CA 94143 USA. RP Luetkemeyer, A (reprint author), Univ Calif San Francisco, San Francisco Gen Hosp, HIV AIDS Div, Box 0874,Bldg 80,995 Potrero Ave, San Francisco, CA 94110 USA. EM aluetkemeyer@php.ucsf.edu FU NIAID NIH HHS [P30 AI027763, K24-AI51982, K24 AI051982]; NIDDK NIH HHS [P30 DK26743, P30 DK026743]; NIMH NIH HHS [T32 MH019105, T32 MH-19105] NR 37 TC 80 Z9 83 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD JAN 1 PY 2006 VL 41 IS 1 BP 31 EP 36 DI 10.1097/01.qai.0000191281.77954.27 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 000CM UT WOS:000234438500005 PM 16340470 ER PT J AU Goetz, MB Holodniy, M Poulton, JS Rodriguez, FH Rigsby, MO AF Goetz, MB Holodniy, M Poulton, JS Rodriguez, FH Rigsby, MO TI Utilization and access to Antiretroviral genotypic resistance testing and results within the US department of veterans affairs SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV infections; genotype; drug resistance; veterans; data collection ID HUMAN-IMMUNODEFICIENCY-VIRUS; HIV DRUG-RESISTANCE; EXPERT ADVICE; RECOMMENDATIONS; TYPE-1; CARE AB We Sought to characterize variation in the use of HIV genotypic resistance tests and how results were reported. Methods: Clinicians and laboratory managers at all Veterans Affairs (VA) medical centers were asked to complete a survey in March 2003 regarding HIV resistance testing practices. Results: Surveys from 13 1 of 150 sites were returned. Forty-eight percent of HIV clinicians indicated that US Department of Health and Human Services guidelines were the usual basis for ordering tests. Although between 12% and 31% of respondents indicated that they always, sometimes, seldom, or never ordered resistance tests in patients with acute or chronic HIV infection, > 70% ordered tests it) adherent patients with treatment failure. Among the 32 centers with > 200 patients in care, 13 +/- 8 (mean standard deviation) tests were performed per 100 patients in care during 2002. Forty-nine percent of clinicians said that tests were helpful, but only 33% expressed confidence in using test results. Only 40% of sites entered results in the VA electronic medical record. Conclusion: Ordering patterns for HIV resistance tests differed significantly among VA sites. A minority of clinicians indicated confidence in the use of test results. A consistent system to capture and present complete results was absent. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Infect Dis Sect 111F, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Vet Affairs Palo Alto Healthcare Syst, AIDS Res Ctr, Palo Alto, CA USA. Stanford Univ, Div Infect Dis & Geog Med, Stanford, CA 94305 USA. Publ Healthcare Strateg Healthcare Grp, Dept Vet Affairs, Washington, DC USA. Vet Affairs Connecticut Healthcare Syst, West Haven, CT USA. Yale Univ, Dept Med, Infect Dis Sect, New Haven, CT 06520 USA. Louisiana State Univ, Sch Med, Vet Affairs Med Ctr, Pathol & Lab Med Serv, New Orleans, LA 70112 USA. Louisiana State Univ, Sch Med, Dept Pathol, New Orleans, LA 70112 USA. RP Goetz, MB (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Infect Dis Sect 111F, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM matthew.goetz@med.va.gov OI Goetz, Matthew/0000-0003-4542-992X NR 21 TC 2 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD JAN 1 PY 2006 VL 41 IS 1 BP 59 EP 62 DI 10.1097/01.qai.0000187445.76579.08 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 000CM UT WOS:000234438500009 PM 16340474 ER PT J AU Davison, JW Sweeney, ML Bush, KR Correale, TMD Calsyn, DA Reoux, JP Sloan, KL Kivlahan, DR AF Davison, John W. Sweeney, Marie L. Bush, Kristen R. Correale, Tania M. Davis Calsyn, Donald A. Reoux, Joseph P. Sloan, Kevin L. Kivlahan, Daniel R. TI Outpatient treatment engagement and abstinence rates following inpatient opioid detoxification SO JOURNAL OF ADDICTIVE DISEASES LA English DT Article DE opioid detoxification; outpatient treatment; chronic opiold dependence; antagonist; naltrexone ID DRUG-ABUSE TREATMENT; METHADONE-MAINTENANCE; CONTROLLED-TRIAL; OUTCOMES; DEPENDENCE; ADDICTS; OPIATE; NALTREXONE; SERVICES; RELAPSE AB Many patients with chronic opioid dependence are referred to drug-free outpatient treatment following inpatient detoxification even though successful outpatient treatment engagement and abstinence from opioids occur only in a minority of cases. This retrospective cohort analysis of medical records documents the post-discharge outcome in a treatment setting that maximizes the support during transition to abstinence-oriented outpatient care, with comprehensive social, medical and mental health services, including the availability of naltrexone. Participants were male veterans (N = 112) admitted at an urban VA medical center. Most patients (78%) successfully completed acute detoxification, 49% initiated naltrexone, and 76% accepted a VA aftercare plan. At 90-day follow-up, only 22% remained in aftercare, and < 3% had toxicology-verified abstinence from opioids. At one-year follow-up, 1 out of 5 had been readmitted for detoxification and 4.5% had died. Most patients successfully detoxified from opioids, but very few remained engaged and stabilized in abstinence-oriented outpatient treatment. C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. VA Ctr Excellence Substance Abuse Treatment & Edu, Seattle, WA 98108 USA. Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98108 USA. Univ Washington, VA Ctr Excellence Substance Abuse Treatment & Edu, Seattle, WA 98195 USA. Univ Washington, Inst Alcohol & Drug Abuse, Seattle, WA 98195 USA. Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. RP Davison, JW (reprint author), Dept Vet Affairs, Publ Hlth Strateg Hlth Care Grp 13B, 810 Vermont Ave NW, Washington, DC 20420 USA. EM John.Davison@va.gov NR 31 TC 3 Z9 3 U1 1 U2 2 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 1055-0887 J9 J ADDICT DIS JI J. Addict. Dis. PY 2006 VL 25 IS 4 BP 27 EP 35 DI 10.1300/J069v25n04_03 PG 9 WC Substance Abuse SC Substance Abuse GA 116YN UT WOS:000242839800003 PM 17088223 ER PT J AU Xie, AL Skatrud, JB Puleo, DS Dempsey, JA AF Xie, AL Skatrud, JB Puleo, DS Dempsey, JA TI Influence of arterial O-2 on the susceptibility to posthyperventilation apnea during sleep SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE apnea threshold ID CONGESTIVE-HEART-FAILURE; OXYGEN-SENSING NEURONS; CARBON-DIOXIDE; VENTILATORY RESPONSE; MECHANICAL VENTILATION; RESPIRATORY RESPONSE; STEP CHANGES; HYPOXIA; CO2; CHEMORECEPTOR AB To investigate the contribution of the peripheral chemoreceptors to the susceptibility to posthyperventilation apnea, we evaluated the time course and magnitude of hypocapnia required to produce apnea at different levels of peripheral chemoreceptor activation produced by exposure to three levels of inspired P-O2. We measured the apneic threshold and the apnea latency in nine normal sleeping subjects in response to augmented breaths during normoxia ( room air), hypoxia ( arterial O-2 saturation = 78-80%), and hyperoxia ( inspired O-2 fraction = 50 - 52%). Pressure support mechanical ventilation in the assist mode was employed to introduce a single or multiple numbers of consecutive, sighlike breaths to cause apnea. The apnea latency was measured from the end inspiration of the first augmented breath to the onset of apnea. It was 12.2 +/- 1.1 s during normoxia, which was similar to the lung-to-ear circulation delay of 11.7 s in these subjects. Hypoxia shortened the apnea latency (6.3 +/- 0.8 s; P < 0.05), whereas hyperoxia prolonged it ( 71.5 +/- 13.8 s; P < 0.01). The apneic threshold end-tidal P-CO2 ( PETCO2) was defined as the PETCO2 at the onset of apnea. During hypoxia, the apneic threshold PETCO2 was higher ( 38.9 +/- 1.7 Torr; P < 0.01) compared with normoxia ( 35.8 +/- 1.1; Torr); during hyperoxia, it was lower ( 33.0 +/- 0.8 Torr; P < 0.05). Furthermore, the difference between the eupneic PETCO2 and apneic threshold PETCO2 was smaller during hypoxia ( 3.0 +/- 1.0 Torr P < 001) and greater during hyperoxia ( 10.6 +/- 0.8 Torr; P < 0.05) compared with normoxia ( 8.0 +/- 0.6 Torr). Correspondingly, the hypocapnic ventilatory response to CO2 below the eupneic PETCO2 was increased by hypoxia (3.44 +/- 0.63 l (.) min(-1) (.) Torr(-1); P < 0.05) and decreased by hyperoxia ( 0.63 +/- 0.04 l (.) min(-1) (.) Torr(-1); P < 0.05) compared with normoxia ( 0.79 +/- 0.05 l (.) min(-1) (.) Torr(-1)). These findings indicate that posthyperventilation apnea is initiated by the peripheral chemoreceptors and that the varying susceptibility to apnea during hypoxia vs. hyperoxia is influenced by the relative activity of these receptors. C1 William S Middleton Mem Vet Adm Med Ctr, Pulm Physiol Lab, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Populat & Hlth Sci, Madison, WI 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 NR 52 TC 27 Z9 27 U1 0 U2 0 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 JAN PY 2006 VL 100 IS 1 BP 171 EP 177 DI 10.1152/japplphysiol.00440.2005 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 993SC UT WOS:000233974200028 PM 16179400 ER PT J AU Levine, AJ Hardy, DJ Miller, E Castellon, SA Longshore, D Hinkin, CH AF Levine, AJ Hardy, DJ Miller, E Castellon, SA Longshore, D Hinkin, CH TI The effect of recent stimulant use on sustained attention in HIV-Infected adults SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article ID ABSTINENT COCAINE ABUSERS; IMMUNODEFICIENCY-VIRUS-INFECTION; AIDS DEMENTIA COMPLEX; CEREBRAL VOLUME LOSS; NEUROPSYCHOLOGICAL CONSEQUENCES; COGNITIVE FUNCTION; WORKING-MEMORY; DRUG-ABUSE; PERFORMANCE; DEFICITS AB Evidence suggests that stimulant use may exacerbate the deleterious cognitive effects of HIV, and that it has similar neuropathological consequences. In the current study, we examined the effect of recent stimulant use on sustained attention in adults infected with HIV. The sample consisted of 23 non-drug users and 17 stimulant users (cocaine and/or methamphetamine), all who were HIV-positive. Drug use was determined via urine toxicology. Sustained attention was assessed with the Conners' Continuous Performance Task - second edition (CPT-II). Groups were compared on overall performance variables, as well as patterns of performance across time. Compared to the non-drug users, stimulant users showed a gradual increase in reaction time variability and omission errors. Stimulant users' scores indicated impaired vigilance relative to an age and gender-matched normative sample. The groups were equivalent on other measures of attention, global neuropsychological functioning, mood, and demographic variables. The results indicate that recent stimulant use among HIV-infected adults adversely affects sustained attention. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Loyola Marymount Univ, Dept Psychol, Los Angeles, CA 90045 USA. RP Levine, AJ (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Inst Neuropsychiat, 760 Westwood Pl,Room C8-747, Los Angeles, CA 90024 USA. EM ajlevine@mednet.ucla.edu OI Miller, Eric/0000-0002-0650-714X FU NIDA NIH HHS [R01 DA013799, R01 DA13799]; NIMH NIH HHS [R01 MH58552, R01 MH058552] NR 63 TC 24 Z9 25 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1380-3395 J9 J CLIN EXP NEUROPSYC JI J. Clin. Exp. Neuropsychol. PD JAN PY 2006 VL 28 IS 1 BP 29 EP 42 DI 10.1080/13803390490918066 PG 14 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 014XX UT WOS:000235515100003 PM 16448974 ER PT J AU Pope, JW Kern, RS AF Pope, JW Kern, RS TI An "Errorful" learning deficit in schizophrenia? SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article ID YOUNG NONPSYCHOTIC SCHIZOPHRENICS; SEVERE MENTAL-ILLNESS; NEUROCOGNITIVE DEFICITS; MEMORY; REHABILITATION; IMPAIRMENT AB Disturbances in learning are prominent in schizophrenia. The present study examined the effect of committing mistakes (errors) on learning in schizophrenia. Subjects included schizophrenia and schizoaffective disorder patients (n = 36) and healthy adults (n = 22) who were administered a word-stem completion task under "errorfree" (no guessing) and "errorful" (guessing) conditions. The data were analyzed using a 2 (group) x 2 (order) x 2 (condition) repeated-measures ANOVA and by comparing standard residualized scores between patients and controls. The results from the ANOVA revealed a significant group x condition interaction with patients showing greater impairment relative to controls on the errorful versus errorfree condition. Similarly, contrasts of standard residualized scores revealed patients' scores on the errorful condition to be deviant from that of healthy adults. The findings implicate problems in the ability to self-correct and suggest that rehabilitation efforts incorporating errorless learning methods may benefit persons with schizophrenia. C1 Fuller Grad Sch Psychol, Pasadena, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Dept Vet Affairs VISN 22 Mental Illness Res Educ, Los Angeles, CA USA. RP Kern, RS (reprint author), VA Greater Los Angeles Healthcare Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM rkern@ucla.edu NR 34 TC 19 Z9 19 U1 4 U2 4 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1380-3395 J9 J CLIN EXP NEUROPSYC JI J. Clin. Exp. Neuropsychol. PD JAN PY 2006 VL 28 IS 1 BP 101 EP 110 DI 10.1080/13803390490918138 PG 10 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 014XX UT WOS:000235515100008 PM 16448979 ER PT J AU Green, MF AF Green, Michael F. TI Cognitive impairment and functional outcome in schizophrenia and bipolar disorder SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Roundtable Meeting on Improving Cognitive Function and Functional Outcome in Severe Mental Illness CY JAN 13, 2006 CL Dallas, TX ID NEUROCOGNITIVE DEFICITS; CLINICAL-TRIALS; MATRICS; BATTERY AB A considerable amount of evidence supports the relationship between cognitive impairment and functional outcomes in schizophrenia. Cognitive impairment is considered a core feature of schizophrenia that includes problems in speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These deficits can also serve as an endophenotype for the illness in studies of genetics. Cognition is considered a reasonable treatment target in individuals with schizophrenia, partly because cognitive deficits contribute to poor functional outcomes. Similarly, evidence is beginning to emerge that cognitive impairment may also be a core feature of bipolar disorder. In addition, cognitive deficits adversely affect functional outcomes in bipolar disorder. This evidence suggests that cognition can be considered a reasonable target for intervention in both schizophrenia and bipolar disorder. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Green, MF (reprint author), 300 ULCA Plaza,Rm 2263, Los Angeles, CA 90095 USA. EM mgreen@ucla.edu NR 20 TC 197 Z9 207 U1 3 U2 29 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PY 2006 VL 67 SU 9 BP 3 EP 8 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 076WM UT WOS:000239988900001 PM 16965182 ER PT J AU Marder, SR AF Marder, Stephen R. TI Drug initiatives to improve cognitive function SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Roundtable Meeting on Improving Cognitive Function and Functional Outcome in Severe Mental Illness CY JAN 13, 2006 CL Dallas, TX ID SEVERELY IMPAIRED SCHIZOPHRENIA; ANTIPSYCHOTIC-DRUGS; CLINICAL-TRIALS; MATRICS; REMEDIATION; SYMPTOMS; SUBTYPE; BATTERY AB Unlike for other chronic illnesses, the development of new medications for the treatment of schizophrenia has been relatively dormant since the 1950s. Recently, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) program was established by the National Institute of Mental Health (NIMH) in order to facilitate the development of treatments for cognitive impairment and functional outcome in schizophrenia. Although effective medications for managing the positive symptoms of schizophrenia have permitted many patients to live in the community, these medications often fail to improve social and vocational function. As a result, some experts believe that research into new treatments should focus instead on the functional outcomes of patients by improving cognitive abilities and social competence. The MATRICS program brought together scientists from academia, government, and industry to discuss ways of promoting the development of new treatments for schizophrenia and gain consensus on treatment targets. The initiatives that have come out of the MATRICS program include focusing on adjunct medications, addressing regulatory issues with the U.S. Food and Drug Administration, determining the best way to measure functional outcomes, classifying symptoms, developing a battery of cognitive tests for assessing outcomes in clinical trials, and ranking promising targets for new treatment development. C1 Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA USA. W Los Angeles VA Healthcare Ctr, Los Angeles, CA USA. RP Marder, SR (reprint author), 11301 Wilshire Blvd,MIRECC 210A, Los Angeles, CA 90073 USA. EM marder@ucla.edu NR 29 TC 27 Z9 30 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 PY 2006 VL 67 SU 9 BP 31 EP 35 PG 5 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 076WM UT WOS:000239988900006 PM 16965187 ER PT J AU Fonseca, M Soares, JC Hatch, JP Santin, AP Kapczinski, F AF Fonseca, M Soares, JC Hatch, JP Santin, AP Kapczinski, F TI An open trial of adjunctive escitalopram in bipolar depression SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID ANTIDEPRESSANT-INDUCED MANIA; OBSESSIVE-COMPULSIVE DISORDER; DOUBLE-BLIND; I DEPRESSION; RATING-SCALE; FLUOXETINE; PLACEBO; OUTPATIENTS; IMIPRAMINE; OLANZAPINE AB Objective: This study was designed to evaluate the efficacy and safety of a highly potent and selective serotonergic antidepressant, escitalopram, in the treatment of bipolar depression. Method: Twenty outpatients with DSM-IV bipolar depression types I and II were enrolled in a 12-week open trial of escitalopram, 10 mg daily, adjunctive to their ongoing mood stabilizer. Assessments were carried Out using the Hamilton Rating Scale for Depression (HAM-D), the Young Mania Rating Scale (YMRS), and the Clinical Global Impressions for Severity (CGI-S) and Improvement (CGI-I) scales. The study was conducted from August 2003 to February 2004. Results: Escitalopram was associated with significant improvement as measured by the HAM-D total score, which showed a mean reduction from baseline (mean = 20.9, SD = 4.2) to endpoint (mean = 8.9, SD = 3.6; p < .001) of 12 points. The mean CGI-S score decreased by 3.3 points (baseline: mean = 4.8, SD = 0.7; week 12: mean = 1.5, SD = 0.6; p < .001). Adverse events emerged in 75% of the patients (N = 15), usually of mild-to-moderate severity. Four dropouts took place due to manic switch (N = 1), hypomanic symptoms (N = 2), and hospitalization due to the emergence of suicidal ideation and psychosis (N = 1). Conclusion: These findings suggest that escitalopram in association with mood stabilizers may be an effective and reasonably well-tolerated treatment for patients with moderate-to-severe bipolar depression. The switch rate was similar to what is described in the literature for the selective serotonin reuptake inhibitors. Randomized controlled trials of escitalopram in bipolar depression are warranted. C1 Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychiat, San Antonio, TX 78229 USA. Fed Univ Rio Grande Sul, Psychiat Res Unit, Porto Alegre, RS, Brazil. S Texas Vet Hlth Care Syst, Psychiat Serv, Audie L Murphys Div, San Antonio, TX USA. Fed Univ Rio Grande, Sch Med, Clin Hosp, Psychait Serv, Porto Alegre, RS, Brazil. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX USA. RP Fonseca, M (reprint author), Univ Texas, Hlth Sci Ctr, Div Mood & Anxiety Disorders, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM fonsecam2@uthscsa.edu RI Kapczinski, Flavio/D-3175-2013; Kapczinski, Flavio/J-5803-2014 NR 38 TC 10 Z9 10 U1 1 U2 3 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD JAN PY 2006 VL 67 IS 1 BP 81 EP 86 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 009ZA UT WOS:000235151000012 PM 16426092 ER PT J AU Ancoli-Israel, S Martin, JL AF Ancoli-Israel, Sonia Martin, Jennifer L. TI Insomnia and Daytime Napping in Older Adults SO JOURNAL OF CLINICAL SLEEP MEDICINE LA English DT Review DE Elderly; insomnia; daytime sleepiness; napping AB Insomnia, daytime sleepiness, and napping are all highly prevalent among the elderly, reflecting changes in sleep architecture, sleep efficiency, sleep quality, and circadian sleep-wake cycles. Insomnia is sometimes associated with subjective daytime sleepiness, as well as other clinical and socioeconomic consequences. The daytime sleepiness will at times lead to napping. Although napping is viewed as a common age-related occurrence, little is known about its benefits or consequences. Factors reported to be contributors to daytime napping include sleep-maintenance difficulty and sleep fragmentation with consequent daytime sleepiness, nighttime use of long-acting sedating agents, daytime use of sedating medications, and dementia. However, a correlation between sleep disturbance and daytime napping has not been consistently observed. Whether napping is beneficial, neutral, or detrimental is an important issue, in light of conflicting findings regarding the impact of daytime napping on nighttime sleep and recent reports of an association between napping and adverse clinical outcomes, including increased mortality risk. Further research is needed to determine whether there is a cause-and-effect relationship between napping and insomnia, and between napping and adverse clinical outcomes, and to explore the clinical implications of improving insomnia and reducing daytime napping. Clinical evaluations of hypnotic agents should assess efficacy for both improving insomnia symptoms (particularly sleep-maintenance difficulty, in the case of elderly patients) and reducing daytime sleepiness that would lead to inadvertent napping. C1 [Ancoli-Israel, Sonia] Univ Calif San Diego, San Diego, CA 92103 USA. [Ancoli-Israel, Sonia] VASDHS, San Diego, CA USA. [Martin, Jennifer L.] VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr, Los Angeles, CA USA. [Martin, Jennifer L.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Ancoli-Israel, S (reprint author), Univ Calif San Diego, Psychiat, 3350 La Jolla Village Dr, San Diego, CA 92161 USA. EM sancoliisrael@ucsd.edu FU NIA [AG08415, 5 P60 AG10415]; NCI [A85264, M01 RR00827] FX Funding support was provided by NIA AG08415, NCI A85264, M01 RR00827, and NIA 5 P60 AG10415. The authors would like to acknowledge Amy Yamamoto and H. Heith Durrence of Sepracor, Inc., for their assistance in the preparation of earlier drafts of this manuscript. NR 83 TC 33 Z9 33 U1 3 U2 6 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 1550-9389 EI 1550-9397 J9 J CLIN SLEEP MED JI J. Clin. Sleep Med. PY 2006 VL 2 IS 3 BP 333 EP 342 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA V44VF UT WOS:000209775800015 PM 17561549 ER PT J AU Guarino, CM Ko, CY Baker, LC Klein, DJ Quiter, ES Escarce, JJ AF Guarino, CM Ko, CY Baker, LC Klein, DJ Quiter, ES Escarce, JJ TI Impact of instructional practices on student satisfaction with attendings' teaching in the inpatient component of internal medicine clerkships SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE medical education; Internal Medicine clerkship; medical student satisfaction ID PERCEPTIONS; EDUCATION AB OBJECTIVE: To determine the prevalence and influence of specific attending teaching practices on student evaluations of the quality of attendings' teaching in the inpatient component of Internal Medicine clerkships. DESIGN: Nationwide survey using a simple random sample. SETTING: One hundred and twenty-one allopathic 4-year medical schools in the United States. PARTICIPANTS: A total of 2,250 fourth-year medical students. MEASUREMENTS AND MAIN RESULTS: In the spring of 2002, student satisfaction with the overall quality of teaching by attendings in the inpatient component of Internal Medicine clerkships was measured on a 5-point scale from very satisfied to very dissatisfied (survey response rate, 68.3%). Logistic regression was used to determine the association of specific teaching practices with student evaluations of the quality of their attendings' teaching. Attending physicians' teaching practices such as engaging students in substantive discussions (odds ratio (OR) =3.0), giving spontaneous talks and prepared presentations (OR=1.6 and 1.8), and seeing new patients with the team (OR=1.2) were strongly associated with higher student satisfaction, whereas seeming rushed and eager to finish rounds was associated with lower satisfaction (OR=0.6). CONCLUSION: Findings suggest that student satisfaction with attendings' teaching is high overall but there is room for improvement. Specific teaching behaviors used by attendings affect student satisfaction. These specific behaviors could be taught and modified for use by attendings and clerkship directors to enhance student experiences during clerkships. C1 RAND Corp, Santa Monica, CA 90407 USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA USA. Stanford Univ, Sch Med, Dept Hlth Res & Policy, Palo Alto, CA 94304 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. RP Guarino, CM (reprint author), RAND Corp, MSN,1776 Main St, Santa Monica, CA 90407 USA. EM cassie@rand.org OI Baker, Laurence/0000-0001-5032-794X NR 10 TC 13 Z9 14 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 JAN PY 2006 VL 21 IS 1 BP 7 EP 12 DI 10.1111/j.1525-1497.2005.0253.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 010CD UT WOS:000235163600002 PM 16423117 ER PT J AU Oslin, DW Ross, J Sayers, S Murphy, J Kane, V Katz, IR AF Oslin, DW Ross, J Sayers, S Murphy, J Kane, V Katz, IR TI Screening, assessment, and management of depression in VA primary care clinics - The Behavioral Health Laboratory SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE depression; primary care; adult; elderly ID RANDOMIZED CONTROLLED-TRIAL; TELEPHONE ASSESSMENT; COST-EFFECTIVENESS; RELIABILITY; POPULATION; PROGRAM; PREVALENCE; INTERVIEWS; SEVERITY; DEMENTIA AB OBJECTIVES: The purpose of this project was to assess the utility and feasibility of a telephone-based systematic clinical assessment service, the Behavioral Health Laboratory (BHL), in the context of primary care. The BHL is a clinical service that provides primary care providers with an assessment and a summary of mental health and substance abuse (MH/SA) symptoms and provides treatment decision support, including triage to specialty MH/SA services. The BHL was implemented to assist in the evaluation of patients who screened positively for depression at an annual clinical appointment or who were identified through routine care. METHODS: Results from systematic screening of primary care patients were extracted during a period of 6 months prior to implementation of the BHL and after implementation of the BHL. Descriptive results of the 580 evaluations conducted during this time were available. RESULTS: Results suggest an association between the implementation of the BHL and an increase in the proportion of patients screened for depression in primary care. In addition, there was an increase in the proportion of patients who screened positively (2.8% vs 7.0%). The BHL was successful in providing a comprehensive assessment for 78% of those referred. Significant co-occurring mental illness and substance misuse were found among those assessed. CONCLUSIONS., Introducing the BHL into primary care was associated with an apparent change in clinical practice in primary care at the Philadelphia VA Medical Center. Not only were more patients identified. the broad-based approach of the BHL identified significant comorbidity with alcohol misuse, illicit drugs. and suicidal ideation, symptoms likely to have been missed in routine clinical practice. The BHL offers a practical, low-cost method of assessment. monitoring, and treatment planning for patients identified in primary care with MH/SA needs. C1 Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Ctr Study Addict, Philadelphia, PA 19104 USA. Univ Penn, Hlth Syst, Div Gen Internal Med, Dept Med, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. VISN 4 Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. RP Oslin, DW (reprint author), Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, 3535 Market St,Room 3002, Philadelphia, PA 19104 USA. EM oslin@mail.med.upenn.edu FU NIMH NIH HHS [K08 MH001599, K08MH01599, P30 MH066270, P30 MH66270] NR 30 TC 84 Z9 86 U1 2 U2 6 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 JAN PY 2006 VL 21 IS 1 BP 46 EP 50 DI 10.1111/j.1525-1497.2005.00267.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 010CD UT WOS:000235163600007 PM 16423122 ER PT J AU Tanner, CE Eckstrom, E Desai, SS Joseph, CL Ririe, MR Bowen, JL AF Tanner, CE Eckstrom, E Desai, SS Joseph, CL Ririe, MR Bowen, JL TI Uncovering frustrations - A qualitative needs assessment of academic general internists as geriatric care providers and teachers SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE geriatrics; general internal medicine; medical education; faculty development; qualitative methods; curriculum development ID MEDICINE; FACULTY AB BACKGROUND: General internists commonly provide medical care for older adults and geriatric education to trainees, but lack the necessary knowledge and skills to fulfill these tasks. OBJECTIVE: Assess the geriatric training needs of academic general internists in 3 hospital systems in Portland, OR. DESIGN: Ten focus groups and 1 semi-structured interview. Interview transcripts were analyzed using thematic analysis. a well-recognized qualitative technique. PARTICIPANTS: A convenience sample of 22 academic general internists and 8 geriatricians from 3 different teaching hospitals. MEASUREMENTS: We elicited stories of frustration and success in caring for elderly patients and in teaching about their care. We asked geriatricians to recount their experiences as consultants to general internists and to comment on the training of Internists in geriatrics. RESULTS: In addition to deficits in their medical knowledge and skills. our Internists reported frustration with the process of delivering care to older adults. In particular, they felt ill prepared to guide care transitions for patients, use multidisciplinary teams effectively. and were frustrated with health care system issues. Additionally. general internists' approach to medical care, which largely relies on the medical model, is different from that of geriatricians, which focuses more on social and functional issues. CONCLUSIONS: Although our findings may not be broadly representative, improving our general internists' abilities to care for the elderly and to teach learners how to do the same should address deficits in medical knowledge and skills, barriers to the processes of delivering care, and philosophical approaches to care. Prioritizing and quantifying these needs and measuring the effectiveness of curricula to address them are areas for future research. C1 Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR USA. Legacy Hlth Syst, Portland, OR USA. RP Bowen, JL (reprint author), Oregon Hlth Sci Univ, Portland VA Med Ctr, 3181 SW Sam Jackson Pk Rd,Mail Code L475, Portland, OR USA. EM bowenj@ohsu.edu NR 11 TC 15 Z9 15 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 JAN PY 2006 VL 21 IS 1 BP 51 EP 55 DI 10.1111/j.1525-1497.2005.00281.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 010CD UT WOS:000235163600008 PM 16423123 ER PT J AU Haidet, P Stein, HF AF Haidet, P Stein, HF TI The role of the student-teacher relationship in the formation of physicians - The hidden curriculum as process SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 9th Biannual Regenstreif Conference CY SEP 29-OCT 01, 2004 CL Marshall, IN SP Regenstreif Inst Inc, Regenstreif Fdn, Feitzer Inst DE education; medical; culture; professional role; students; medical; relationship-centered care ID MEDICAL-EDUCATION; INTERVIEWING SKILLS; INFORMAL CURRICULUM; HUMAN DIMENSIONS; CENTERED CARE; PROFESSIONALISM; IDENTIFICATION; COMMUNICATION; ACQUISITION; ENVIRONMENT AB Relationship-Centered Care acknowledges the central importance of relationships in medical care. In a similar fashion, relationships hold a central position in medical education. and are critical for achieving favorable learning outcomes. However, there is little empirical work in the medical literature that explores the development and meaning of relationships in medical education. In this essay, we explore the growing body of work on the culture of medical school, often termed the "hidden curriculum." We suggest that relationships are a critical mediating factor in the hidden curriculum. We explore evidence from the educational literature with respect to the student-teacher relationship, and the relevance that these studies hold for medical education. We conclude with suggestions for future research on student-teacher relationships in medical education settings. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Oklahoma, Sch Med, Dept Family & Prevent Med, Oklahoma City, OK USA. RP Haidet, P (reprint author), 2002 Holcombe Blvd,152, Houston, TX 77030 USA. EM phaidet@bcm.tmc.edu NR 71 TC 111 Z9 114 U1 2 U2 18 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 JAN PY 2006 VL 21 SU 1 BP S16 EP S20 DI 10.1111/j.1525-1497.2006.00304.x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 007OW UT WOS:000234980000004 PM 16405704 ER PT J AU El-Serag, HB Siegel, AB Davila, JA Shaib, YH Cayton-Woody, M McBride, R McGlynn, KA AF El-Serag, HB Siegel, AB Davila, JA Shaib, YH Cayton-Woody, M McBride, R McGlynn, KA TI Treatment and outcomes of treating of hepatocellular carcinoma among Medicare recipients in the United States: A population-based study SO JOURNAL OF HEPATOLOGY LA English DT Article DE outcomes; SEER-Medicare; resection; transplant; treatment; HCC ID SURVIVAL AB Background/Aims: There are several treatment alternatives available for patients diagnosed with hepatocellular carcinoma (HCC). Yet, neither the extent to which potentially curative or palliative therapy is used to treat HCC, nor the determinants of using such therapies are known. Further, it is unclear how effective different modalities are for treating HCC. Methods: We used the linked SEER-Medicare dataset to identify patients diagnosed with HCC between 1992 and 1999. We identified 2963 patients with continuous Medicare enrollment who were not enrolled in a Medicare-HMO. HCC treatments were categorized as potentially curative therapy (resection, transplant, local ablation), or palliative (trans-arterial chemoembolization (TACE), chemotherapy), and no therapy. Demographic (age, sex, race, geographic region), clinical (comorbidity, risk factors and severity of liver disease) and tumor factors (tumor size, extent of disease) were examined as potential determinants of therapy, as well as survival in univariate and multivariable analyses. Survival curves were also generated and compared among the different treatment modalities. Results: The median age at diagnosis was 74 years (range: 32-105), and most patients (91%) were older than 65 years. Approximately 68% were White, 10% Black, 4% Hispanic, 8% Asian, and 9% were of other race. Thirteen percent of the patients received potentially curative therapy (transplant 0.9%, resection 8.2%, local ablation 4.1%), 4% received TACE,57% received other palliative therapy, and 26% received no specific therapy. Only 34% of 513 patients with single lesions, and 34% of 143 patients with lesions < 3.0 cm received potentially curative therapy. However, 19.2% of patients with unfavorable tumor features (lesion > 10.0 cm) received such therapy. Among patients who received potentially curative therapy (n = 392), resection was the most common procedure (n = 243,62%) followed by local ablation (n = 122, 31%) and finally transplantation (n = 27, 7%). In regression analyses, geographic variations in the extent and type of curative therapy persisted after adjusting for demographic, clinical, and tumor features. Median overall survival was 104 days following HCC diagnosis with the longest survival in the transplant group (852 days) and the shortest survival in the group with no treatment (58 days). In the survival analysis, transplantation led to the longest survival, followed by resection. Neither ablation nor TACE yielded prolonged survival (3 year survival was less than 10%). Conclusions: In this predominantly 65 years and older Medicare population, there are marked geographic variations in the management of HCC that seem to be at least as important as clinical and tumor-related features in determining the extent and type of HCC therapy. There is underutilization of potentially curative therapy, even among those with favorable tumor features. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. C1 Baylor Coll Med, Sect Hlth Serv Res, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Gastroenterol Sect, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Columbia Univ, Coll Phys & Surg, Div Canc Epidemiol & Genet, NCI,DHHS, New York, NY USA. Columbia Univ, Coll Phys & Surg, Dept Med, New York, NY USA. Columbia Univ, Coll Phys & Surg, Herbert Irving Comprehens Canc Ctr, New York, NY USA. Columbia Univ, Coll Phys & Surg, Mailman Sch Publ Hlth, New York, NY USA. RP El-Serag, HB (reprint author), Baylor Coll Med, Sect Hlth Serv Res, Houston Vet Affairs Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 13 TC 140 Z9 140 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD JAN PY 2006 VL 44 IS 1 BP 158 EP 166 DI 10.1016/j.jhep.2005.10.002 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 000FG UT WOS:000234445700026 PM 16290309 ER PT J AU Landefeld, CS AF Landefeld, C. Seth TI Care of hospitalized older patients - Opportunities for hospital-based physicians SO JOURNAL OF HOSPITAL MEDICINE LA English DT Article DE geriatric syndromes; geriatrics; healthcare improvement; hospital care; hospitalized older persons; patient safety; quality of care ID ADDITIONAL BASIC SCIENCE; RANDOMIZED CONTROLLED-TRIAL; CATHETER-RELATED BACTERIURIA; CLINICAL MEDICINE; FUNCTIONAL OUTCOMES; REGIONAL-VARIATIONS; ELDERLY PATIENTS; ADVERSE EVENTS; UNITED-STATES; HIP FRACTURE AB BACKGROUND: Half of patients admitted to hospital for reasons unrelated to childbirth are age 65 years or older. Nonetheless, few hospital-based physicians have received training in geriatric medicine, and few geriatricians practice in the hospital. This paper describes the state of the science of hospital care for older patients, and identifies opportunities and barriers to improving their care. METHODS: General medical journals from 1980 to the present were selectively reviewed to identify original articles on the treatment of specific diseases and syndromes on hospitalized persons age 65 years or older. Information was synthesized to describe the course of these patients during and after hospitalization, and to identify effective management strategies and gaps in knowledge. RESULTS: Older persons in hospitals pose substantial clinical challenges: they have high rates of cognitive impairment, delirium, disability, and difficulty walking, and they often require increased attention, longer lengths of stay, and higher hospital costs than younger patients with the same diagnoses. Disease-specific interventions have not been studied extensively in those older than 75 years. Multicomponent interventions can reduce short-term rates of disability and delirium without increasing costs, but they have not been widely disseminated. Interventions to treat or prevent other common conditions in hospitalized older patients have not been proven effective. CONCLUSIONS: Fundamental discoveries in the science of hospital medicine are needed to prevent or treat geriatric syndromes, to treat common diseases in the very old, and to put into practice what is known. Hospital-based physicians can address these gaps in knowledge and practice with geriatricians, building from their shared perspectives on the care of the aged in complex health systems. C1 [Landefeld, C. Seth] Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. [Landefeld, C. Seth] Univ Calif San Francisco, Ctr Aging, San Francisco, CA 94143 USA. [Landefeld, C. Seth] San Francisco VA Med Ctr, Qual Scholars Program, San Francisco, CA USA. [Landefeld, C. Seth] San Francisco VA Med Ctr, Geriatr & Extended Care Serv, San Francisco, CA USA. RP Landefeld, CS (reprint author), UCSF, Box 1265,Suite 380,3333 Calif St, San Francisco, CA 94118 USA. FU NIA NIH HHS [AG 00912, AG 10418] NR 68 TC 14 Z9 14 U1 2 U2 5 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD JAN-FEB PY 2006 VL 1 IS 1 BP 42 EP 47 DI 10.1002/jhm.11 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 291PQ UT WOS:000255209700009 PM 17219470 ER PT J AU Bogaert, Y Grippa, J Nemenoff, R Reusch, JEB AF Bogaert, Y Grippa, J Nemenoff, R Reusch, JEB TI Type 1 collagen regulates vascular smooth muscle cell phenotype by down-regulation of CREB and serum response factor through an Akt-dependent mechanism SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Denver VAMC, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 85 BP S94 EP S94 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500098 ER PT J AU Gerchman, F Tong, J Utzschneider, KM McNeely, MJ Hull, RL Zraika, S Udayasankar, J Leonetti, DJ Boyko, EJ Fujimoto, WY Kahn, SE AF Gerchman, F Tong, J Utzschneider, KM McNeely, MJ Hull, RL Zraika, S Udayasankar, J Leonetti, DJ Boyko, EJ Fujimoto, WY Kahn, SE TI Increased visceral adiposity is associated with decreased glomerular filtration rate by a mechanism independent of glucose tolerance. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 156 BP S107 EP S107 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500169 ER PT J AU Goel, A Brooks-Worrell, B Palmer, JP AF Goel, A Brooks-Worrell, B Palmer, JP TI Assessment of regulatory T cells in phenotypic type 2 diabetes patients SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 305 BP S132 EP S132 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500318 ER PT J AU Heppe, D Gunter, J Pedler, M Reusch, JEB AF Heppe, D Gunter, J Pedler, M Reusch, JEB TI Vascular regulation of protein kinase in insulin resistance. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Denver VAMC, Denver, CO USA. Univ Colorado, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 464 BP S159 EP S159 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500477 ER PT J AU Kao, KC Hong, S Taylor, CE Nouvong, A Masih, S Perell, KL Fang, MA AF Kao, KC Hong, S Taylor, CE Nouvong, A Masih, S Perell, KL Fang, MA TI Laterally wedged shoe inserts as an intervention for medial knee osteoarthritis SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Calif State Univ Fullerton, Dept Kinesiol & Hlth Sci, Fullerton, CA USA. NR 0 TC 0 Z9 0 U1 2 U2 3 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 302 BP S132 EP S132 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500315 ER PT J AU Kulig, CC Beresford, TP Everson, XGT AF Kulig, CC Beresford, TP Everson, XGT TI Lack of detectable levels of fatty acid ethyl esters in plasma of abstinent liver transplant recipients. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 263 BP S125 EP S125 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500276 ER PT J AU Njoku, CJ Patrick, KS Oates, JC AF Njoku, CJ Patrick, KS Oates, JC TI Urine F2-isoprostanes are reduced in lupus nephritis. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Med Univ S Carolina, Ralph H Johnson VAMC, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 247 BP S300 EP S300 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301501246 ER PT J AU Rome, ME Stella, SL Brecha, NC AF Rome, ME Stella, SL Brecha, NC TI Gamma-aminobutyric acid receptor physiology in cone bipolar cells of the mammalian retina. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 358 BP S141 EP S142 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500371 ER PT J AU Shimizu, T Shinmei, SS Fujikawa, DG AF Shimizu, T Shinmei, SS Fujikawa, DG TI Seizure-induced neuronal necrosis is a caspase-independent process. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 364 BP S143 EP S143 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500377 ER PT J AU Tong, J Utzschneider, KM Carr, DB Hull, RL Udayasankar, J Gerchman, F Zraika, S Knopp, RH Kahn, SE AF Tong, J Utzschneider, KM Carr, DB Hull, RL Udayasankar, J Gerchman, F Zraika, S Knopp, RH Kahn, SE TI Parasympathetic innervation may mediate the effect of age and gender on body fat distribution in humans. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 326 BP S136 EP S136 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500339 ER PT J AU Tylee, TS Cummings, DE AF Tylee, TS Cummings, DE TI Inhibition of hypothalamic protein kinase A signaling attenuates ghrelin-induced feeding in rats. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 319 BP S134 EP S135 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500332 ER PT J AU Tylee, TS Cummings, DE AF Tylee, TS Cummings, DE TI Inhibition of hypothalamic protein kinase A signaling attenuates ghrelin-induced feeding in rats SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 52 BP S88 EP S88 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500065 ER PT J AU Utzschneider, KM Tong, J Gerchman, F Udayasankar, J Montgomery, B Kahn, SE Puget, VA AF Utzschneider, KM Tong, J Gerchman, F Udayasankar, J Montgomery, B Kahn, SE Puget, VA TI The early insulin response during an oral glucose tolerance test exhibits marked day-to-day variability in free-living adults. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 155 BP S106 EP S106 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500168 ER PT J AU Wander, PL Raskind, MA Zabetian, CP Warren, DJ Kumata, J Peskind, ER AF Wander, PL Raskind, MA Zabetian, CP Warren, DJ Kumata, J Peskind, ER TI Prazosin improves nightmares and sleep disturbance and does not worsen daytime symptoms in posttraumatic stress disorder. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Experimental Biology 2004 Annual Meeting CY APR 17-21, 2004 CL Washington, DC C1 Univ Washington, Sch Med, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA USA. Univ Washington, Dept Neurol, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Geriatr Ctr, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU B C DECKER INC PI HAMILTON PA 20 HUGHSON ST SOUTH, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD JAN PY 2006 VL 54 IS 1 SU S MA 511 BP S167 EP S167 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 011XH UT WOS:000235301500524 ER PT J AU Winterbottom, LM Fong, AM Benkstein, KL Liang, BB Snodgrass, LS Parks-Huitron, H AF Winterbottom, LM Fong, AM Benkstein, KL Liang, BB Snodgrass, LS Parks-Huitron, H TI Impact of a clinical pharmacy consult service on guideline adherence and management of gabapentin for neuropathic pain SO JOURNAL OF MANAGED CARE PHARMACY LA English DT Article DE gabapentin; neuropathic pain; clinical pharmacy; formulary management ID RANDOMIZED CONTROLLED-TRIAL; POSTHERPETIC NEURALGIA; DOUBLE-BLIND; DIABETIC-NEUROPATHY; DRUGS AB OBJECTIVE: Our objectives were to (1) determine whether a computerized clinical pharmacy approval and follow-up consult process for ordering new prescriptions for gabapentin for the treatment of neuropathic pain decreased the number of patients without documented treatment benefit while increasing follow-up and documentation of effectiveness, and (2) describe gabapentin use patterns at a Veterans Affairs (VA) Medical Center, including the use of first-line therapies prior to gabapentin therapy for neuropathic pain. METHODS: The clinical pharmacy intervention included review of (1) the indication for gabapentin; (2) the required use and failure or contraindication of 3 first-line therapies: nonsteroidal ant-inflammatory drugs (NSAIDs), tricyclic antidepressants (TCAs), and capsaicin cream; (3) the initial pain assessment; and (4) patient follow-up in 4 to 6 weeks, with repeat pain assessment. A retrospective chart review was performed for all patients who received a new prescription for gabapentin from October 2002 to April 2003 at the Portland VA Medical Center (PVAMC). The outcomes of interest for the provider group versus the clinical pharmacy managed group included follow-up at 6 weeks or less versus follow-up at more than 6 weeks, documentation of treatment benefit, how many of the 3 first-line therapies were tried before gabapentin, and whether the gabapentin therapy was discontinued. RESULTS: There were 237 patients who received a new prescription for gabapentin between October 2002 and April 2003. Of these gabapentin prescriptions, 61% (n=144) were prescribed for neuropathic pain. Of the new gabapentin prescriptions for neuropathic pain, 61% (n=88) were made from approved clinical pharmacy consults, 38% (n=54) were ordered without a clinical pharmacy consult, and 38% (n=2) were not included because the patient received the drug despite denial by the clinical pharmacy consult. The rate of follow-up to assess documentation of benefit of therapy with gabapentin was 87% (n=62) in the clinical pharmacy consult group compared with 51% (n=27) in the provider-managed group (chi(2) = 18.07, P < 0.001). Of the patients who were assessed by follow-up, 89% (n=55) of the clinical pharmacy consult group received follow-up within 6 weeks versus 52% (n=14) of the provider-managed group (X-2 = 12.63, P < 0.001). Compared with the patients managed by clinical pharmacists, 43% (n=23) of the gabapentin patients in the provider-managed group had no evidence of prior use of any of the 3 agents required by the gabapentin neuropathic pain guideline, 55% (n=29) had evidence of prior use of 1 or 2 first-line agents, and only 2% (n=1) had evidence of prior use of all 3 required first-line agents, versus 100% (n=71) of the patients managed by clinical pharmacy consult. There was no difference in the rate of continuation of gabapentin therapy in the group of patients who received clinical pharmacy consults (65%) compared with the provider-managed group (68%, chi(2)=0.11, P=0.718). Of the 148 pharmacy consults for new gabapentin prescriptions that were completed during the 7-month period from October 2002 through April 2003, 60 (40%) were denied, which resulted in the lack of gabapentin use in these 60 patients. CONCLUSIONS: A clinical pharmacy intervention as part of the management of a treatment guideline for appropriate gabapentin use promotes documentation of drug therapy effectiveness in neuropathic pain and prevention of gabapentin use prior to a trial with alternative first-line therapies. C1 Dept Vet Affairs Med Ctr, Portland, OR 97239 USA. Portland Vet Affairs Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. PVAMC, Portland Ctr Evaluat Clin Serv, Portland, OR USA. RP Winterbottom, LM (reprint author), Dept Vet Affairs Med Ctr, Portland, OR 97239 USA. EM lisa.winterbottom@med.va.gov NR 39 TC 2 Z9 2 U1 1 U2 5 PU ACADEMY MANAGED CARE PHARMACY PI ALEXANDRIA PA 100 N PITT ST, 400, ALEXANDRIA, VA 22314-3134 USA SN 1083-4087 J9 J MANAG CARE PHARM JI J. Manag. Care Pharm. PD JAN-FEB PY 2006 VL 12 IS 1 BP 61 EP 69 PG 9 WC Health Care Sciences & Services; Pharmacology & Pharmacy SC Health Care Sciences & Services; Pharmacology & Pharmacy GA 030BU UT WOS:000236609100005 PM 16420109 ER PT J AU Signore, AP Weng, ZF Hastings, T Van Laar, AD Liang, QH Lee, YJ Chen, J AF Signore, AP Weng, ZF Hastings, T Van Laar, AD Liang, QH Lee, YJ Chen, J TI Erythropoietin protects against 6-hydroxydopamine-induced dopaminergic cell death SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE neuroprotection; Parkinson's disease; serinethreonine kinase ( Akt); substantia nigra pars compacta ID ENDOPLASMIC-RETICULUM STRESS; NF-KAPPA-B; PARKINSONS-DISEASE; IN-VIVO; CEREBRAL-ISCHEMIA; SUBSTANTIA-NIGRA; SIGNAL-TRANSDUCTION; NEUROTROPHIC FACTOR; BRAIN-INJURY; KINASE-B AB Parkinson's disease (PD) is a neurodegenerative disorder characterized by the death of midbrain dopaminergic neurons. In the present study, erythropoietin, a trophic factor that has both hematopoietic and neural protective characteristics, was investigated for its capacity to protect dopaminergic neurons in experimental Parkinson's disease. Using both the dopaminergic cell line, MN9D, and primary dopamine neurons, we show that erythropoietin (1-3 U/mL) is neuroprotective against the dopaminergic neurotoxin, 6-hydroxydopamine. Protection was mediated by the erythropoietin receptor, as neutralizing anti-erythropoietin receptor antibody abrogated the protection. Activation of Akt/protein kinase B (PKB), via the phosphoinositide 3-kinase pathway, is a critical mechanism in erythropoietin-induced protection, while activation of extracellular signal-regulated kinase (ERK)1/2 contributes only moderately. Indeed, transfection of constitutively active Akt/PKB into dopaminergic cells was sufficient to protect against cell death. Furthermore, erythropoietin diminished markers of apoptosis in MN9D cells, including caspase 9 and caspase 3 activation and internucleosomal DNA fragmentation, suggesting that erythropoietin interferes with the apoptosis-execution process. When erythropoietin was administered to mice unilaterally lesioned with 6-hydroxydopamine, it prevented the loss of nigral dopaminergic neurons and maintained striatal catecholamine levels for at least 8 weeks. Erythropoietin-treated mice also had significantly reduced behavioral asymmetries. These studies suggest that erythropoietin can be an effective neuroprotective agent for dopaminergic neurons, and may be useful in reversing behavioral deficits associated with Parkinson's disease. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Pharmacol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Inst Neurodegenerat Disorders, Pittsburgh, PA 15213 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 FU NINDS NIH HHS [NS45048, NS43802, NS44076, NS44178] NR 66 TC 53 Z9 61 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JAN PY 2006 VL 96 IS 2 BP 428 EP 443 DI 10.1111/j.1471-4159.2005.03587.x PG 16 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 994JX UT WOS:000234029100013 PM 16336625 ER PT J AU Mendez, MF McMurtray, A Chen, AK Shapira, JS Mishkin, F Miller, BL AF Mendez, MF McMurtray, A Chen, AK Shapira, JS Mishkin, F Miller, BL TI Functional neuroimaging and presenting psychiatric features in frontotemporal dementia SO JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY LA English DT Article ID ALZHEIMERS-DISEASE; PICKS-DISEASE; NEUROPSYCHIATRIC FEATURES; LOBAR DEGENERATION; SEMANTIC DEMENTIA; TEMPORAL VARIANTS; FRONTAL VARIANT; SOCIAL-BEHAVIOR; CRITERIA; DYSFUNCTION AB Background: Frontotemporal dementia (FTD) is a behavioural syndrome caused by degeneration of the frontal and anterior temporal lobes. Behavioural disturbances include psychiatric features. Whether patients with FTD present with psychiatric features varies with the initial neuroanatomical variability of FTD. Objective: To identify presenting psychiatric changes not part of diagnostic criteria of FTD and contrast them with the degree of hemispheric asymmetry and frontal and temporal hypoperfusion on single photon emission computed tomography ( SPECT) imaging. Methods: 74 patients who met consensus criteria for FTD were evaluated at a two year follow up. All had brain SPECT on initial presentation. Results of an FTD psychiatric checklist were contrasted with ratings of regional hypoperfusion. Results: The regions of predominant hypoperfusion did not correlate with differences on FTD demographic variables but were associated with presenting psychiatric features. Dysthymia and anxiety were associated with right temporal hypoperfusion. "Moria'' or frivolous behaviour also occurred with temporal lobe changes, especially on the right. The only significant frontal lobe feature was the presence of a peculiar physical bearing in association with right frontal hypoperfusion. Conclusions: Patients with FTD may present with psychiatric changes distinct from the behavioural diagnostic criteria for this disorder. Early temporal involvement is associated with frivolous behaviour and right temporal involvement is associated with emotional disturbances. In contrast, those with right frontal disease may present with alterations in non-verbal behaviour. C1 VA Greater Los Angeles Healthcare, Neurobehav, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Harbor UCLA Med Ctr, Los Angeles, CA USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare, Neurobehav, 116AF,Bldg 500,3S,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu FU NIA NIH HHS [AG19724-01, P01 AG019724] NR 37 TC 47 Z9 47 U1 0 U2 1 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0022-3050 J9 J NEUROL NEUROSUR PS JI J. Neurol. Neurosurg. Psychiatry PD JAN PY 2006 VL 77 IS 1 BP 4 EP 7 DI 10.1136/jnnp.2005.072496 PG 4 WC Clinical Neurology; Psychiatry; Surgery SC Neurosciences & Neurology; Psychiatry; Surgery GA 997EJ UT WOS:000234227500004 PM 16043457 ER PT J AU Kleinschmidt-DeMasters, BK Rojiani, AM Filley, CM AF Kleinschmidt-DeMasters, BK Rojiani, AM Filley, CM TI Central and extrapontine myelinolysis: Then... and now SO JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY LA English DT Review DE alcoholism; central pontine myelinolysis; extrapontine myelinolysis; hyponatremia; lateral pontine myelinolysis; osmotic demyelination; pathogenesis; white matter ID CENTRAL PONTINE MYELINOLYSIS; ELECTROLYTE-INDUCED DEMYELINATION; CENTRAL-NERVOUS-SYSTEM; LIVER-TRANSPLANT RECIPIENTS; RAPID CORRECTION; SERUM SODIUM; OSMOTIC MYELINOLYSIS; PITUITARY SURGERY; ORGANIC OSMOLYTES; MR FINDINGS AB In this review, we emphasize neuropathologic and neurobehavioral aspects of central Pontine and extrapontine myclinolysis (CPM/EPM), also known as the osmotic demyelination syndrome. The literature is reviewed from the time of the initial report in 1959 and from key developments that have occurred more recently. Particular consideration is given to pathogenic mechanisms as revealed by recent animal studies. The role of white matter Pathology in neurobehavioral dysfunction is also considered. The "then" and "now" of CPM and EPM tell 2 different stories. Yet, in many respects, this expansion of information over the past nearly 50 years simply represents a continuum, as well as recognition, of the vast gaps that still persist in our understanding of this disorder. C1 Univ Colorado, Ctr Hlth Sci, Dept Pathol, Denver, CO 80262 USA. Univ Colorado, Ctr Hlth Sci, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Ctr Hlth Sci, Dept Neurosurg, Denver, CO 80262 USA. Denver Vet Affairs med Ctr, Denver, CO USA. Univ S Florida, Dept Interdisciplinary Oncol, Tampa, FL USA. Univ S Florida, Dept Pathol & Neuropathol, Tampa, FL USA. RP Kleinschmidt-DeMasters, BK (reprint author), Univ Colorado, Ctr Hlth Sci, Dept Pathol, B-216,4200 E 9th Ave, Denver, CO 80262 USA. EM bk.demasters@uchsc.edu NR 96 TC 52 Z9 60 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-3069 J9 J NEUROPATH EXP NEUR JI J. Neuropathol. Exp. Neurol. PD JAN PY 2006 VL 65 IS 1 BP 1 EP 11 DI 10.1097/01.jnen.0000196131.72302.68 PG 11 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 005PQ UT WOS:000234836700001 PM 16410743 ER PT J AU Tyor, WR Rao, V Sas, A Bimonte, H Ranga, U Prasad, V AF Tyor, William R. Rao, Vasu Sas, Andrew Bimonte, Heather Ranga, Uday Prasad, Vinayaka TI Clade CHIV-1 encephalitis in SCID mice results in less cognitive dysfunction than clade B SO JOURNAL OF NEUROVIROLOGY LA English DT Meeting Abstract CT 7th International Symposium on NeuroVirology CY MAY 31-JUN 03, 2006 CL Philadelphia, PA SP NIMH, NINDS, NIDA, Drexel Univ Coll Med, Inst Mol Med Infect Dis, Drexel Univ, Dept Microbiol Immunology, Office Dean, Temple Univ Sch Med, Sbarro Inst Canc Res & Mol Med, Natl Multiple Sclerosis Soc, Journal NeuroVirology C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Charleston, SC USA. Albert Einstein Coll Med, Bronx, NY 10467 USA. Univ Arizona, Tempe, AZ USA. Jawaharlal Nehru Ctr Adv Sci Res, Bangalore, Karnataka, India. NR 0 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1355-0284 J9 J NEUROVIROL JI J. Neurovirol. PY 2006 VL 12 SU 1 MA P195 BP 82 EP 82 PG 1 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 059US UT WOS:000238758300196 ER PT J AU Christianson, MA Schwartz, MW Suzuki, N AF Christianson, Matthew A. Schwartz, Michael W. Suzuki, Norman TI Determinants of insulin availability in parenteral nutrition solutions SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID ADSORPTION; INFUSION AB Background: Management of hyperglycemia in patients receiving parenteral nutrition (PN) often includes the addition of regular insulin to the PN solution. A literature review has shown insulin availability in such solutions to range from 10% to 95%. This discrepancy iri availability may be due to differences in the composition of the PN solution, the final concentration of insulin, or the assay method used to determine insulin concentrations. The purpose of this study was to evaluate insulin recovery from a standard PN solution used at our medical center. Methods: Solutions were manually prepared in our pharmacy according to standard practice. Multivitamins and trace elements were added to 1 of 2 L of solution each day. Each of 3 simulated patients received 2 L of solution per day for 3 consecutive days. Samples from each bottle were drawn at baseline, 1 hour after the start of infusion, and 1 hour before the end of infusion and were subsequently analyzed for immunoreactive insulin levels by radioimmunoassay. Results: Recovery of insulin from solutions containing multivitamins and trace elements was much greater (95%) than from those without (5%). Conclusions: The presence of multivitamins and trace elements is a major determinant of insulin availability in PN solutions. Additional research is necessary to determine the mechanism mediating this effect and to assess its clinical significance. C1 VA Puget Sound Hlth Care Syst, Dept Vet Affairs, Serv Pharm, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Harborview Med Ctr, Seattle, WA USA. RP Christianson, MA (reprint author), VA Puget Sound Hlth Care Syst, Dept Vet Affairs, Serv Pharm, S-119Phar,1660 S Columbian Way, Seattle, WA 98108 USA. EM matthew.christianson@med.va.gov RI Schwartz, Michael/H-9950-2012 NR 12 TC 5 Z9 7 U1 1 U2 2 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD JAN-FEB PY 2006 VL 30 IS 1 BP 6 EP 9 DI 10.1177/014860710603000106 PG 4 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 195WR UT WOS:000248443500003 PM 16387892 ER PT J AU Raymond, JR Gelasco, AK Turner, JH AF Raymond, J. R. Gelasco, A. K. Turner, J. H. TI Calmodulin interacts with and modulates 5-HT1a and 5-HT2a receptors SO JOURNAL OF PHARMACOLOGICAL SCIENCES LA English DT Meeting Abstract CT 6th IUPHAR Satellite Meeting on Serotonin CY JUN 27-30, 2006 CL Hokkaido Univ, Sapporo, JAPAN SP Serotonin Club HO Hokkaido Univ DE 5-HT/serotonin; calmodulin; phosphorylation; G protein C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JAPANESE PHARMACOLOGICAL SOC PI KYOTO PA EDITORIAL OFF, KANTOHYA BLDG GOKOMACHI-EBISUGAWA NAKAGYO-KU, KYOTO, 604, JAPAN SN 1347-8613 J9 J PHARMACOL SCI JI J. Pharmacol. Sci. PY 2006 VL 101 SU 1 BP 58 EP 58 PG 1 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 059UU UT WOS:000238758500056 ER PT J AU Shen, BJ Myers, HF McCreary, CP AF Shen, BJ Myers, HF McCreary, CP TI Psychosocial predictors of cardiac rehabilitation quality-of-life outcomes SO JOURNAL OF PSYCHOSOMATIC RESEARCH LA English DT Article DE cardiac rehabilitation; coronary heart disease; hostility; quality of life; social support; depression ID CORONARY-HEART-DISEASE; COOK-MEDLEY HOSTILITY; MYOCARDIAL-INFARCTION; ARTERY-DISEASE; SOCIAL SUPPORT; DEPRESSIVE SYMPTOMS; CONSTRUCT-VALIDITY; NEGATIVE EMOTIONS; FUNCTIONAL STATUS; HEALTH AB This study investigated hostility, social support, coping, depression, and their contributions to concurrent and posttreatment quality of life (QoL) among a group of patients participating in a 6-week cardiac rehabilitation program. Method: Both direct and mediational relationships among psychosocial factors, QoL baseline, and QoL outcome were examined using structural equation modeling analysis, while age, education, and severity of illness (risk for future event) were controlled. Results: The final model was well supported (chi(2)=64.88, df=56, P >.05; CFI=.99, RMSEA=.04). Results indicated that baseline QoL, hostility, and depressive symptom severity directly and independently predicted QoL outcome, while depression and hostility were also associated with baseline QoL. Hostility, social support, and maladaptive coping also contributed to baseline and follow-up QoL by their associations with depression. Conclusion: Psychosocial characteristics were interrelated, and they predicted postrehabilitation QoL outcome directly or indirectly through depression symptom severity (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Miami, Dept Psychol, Coral Gables, FL 33124 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Greater Los Angeles VA Hlth Ctr, Los Angeles, CA USA. RP Shen, BJ (reprint author), Univ Miami, Dept Psychol, POB 248185, Coral Gables, FL 33124 USA. EM bshen@miami.edu NR 60 TC 27 Z9 29 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3999 J9 J PSYCHOSOM RES JI J. Psychosomat. Res. PD JAN PY 2006 VL 60 IS 1 BP 3 EP 11 DI 10.1016/j.jpsychores.2005.06.069 PG 9 WC Psychiatry SC Psychiatry GA 012DH UT WOS:000235317900002 PM 16380304 ER PT J AU Turner, AP Martin, C Williams, RM Goudreau, K Bowen, JD Hatzakis, M Whitham, RH Bourdette, DN Walker, L Haselkorn, JK AF Turner, Aaron P. Martin, Christine Williams, Rhonda M. Goudreau, Kelly Bowen, James D. Hatzakis, Michael, Jr. Whitham, Ruth H. Bourdette, Dennis N. Walker, Lynne Haselkorn, Jodie K. TI Exploring educational needs of multiple sclerosis care providers: Results of a care-provider survey SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE cognition; depression; disease-modifying agents; education; fatigue; multiple sclerosis; multiple sclerosis diagnosis; pain; sexual function; spasticity ID CONTINUING MEDICAL-EDUCATION AB Our objective was to survey experienced multiple sclerosis (MS) care providers, determine their ongoing professional educational needs, and develop future education programs. We asked providers across a variety of disciplines to identify the areas in which clinical consultation and continuing medical education (CME) would most improve their ability to provide care to individuals with MS; their preferred education modalities; and their confidence in providing care related to disease-modifying agents (DMAs), fatigue, depression, spasticity, and bladder management. At a national meeting of MS professionals, 152 MS care providers completed a self-report survey that was designed for this cross-sectional cohort study. Areas of greatest interest for clinical consultation and CME were identical and included cognition, fatigue, DMA use, spasticity, pain, sex, diagnosis of MS, and depression. Participants expressed a preference for live and interactive CME modalities. Confidence in providing specific disease-related care sometimes differed between Veterans Health Administration (VHA) and non-VHA providers. The results indicate that clinical consultations and CME should be targeted to the topics of greatest interest identified by providers and delivered in a live or interactive modality whenever possible. C1 VA Puget Sound Hlth Care Syst, Rehabil Care Serv S117, Dept Vet Affairs, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Maryland, Dept Neurol, College Pk, MD 20742 USA. VAMC, Baltimore, MD USA. VAMC, Portland, OR USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. RP Turner, AP (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv S117, Dept Vet Affairs, 1660 S Columbian Way, Seattle, WA 98108 USA. EM Aaron.Turner@med.va.gov OI Turner, Aaron/0000-0001-6897-8003 NR 15 TC 2 Z9 2 U1 0 U2 0 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 JAN-FEB PY 2006 VL 43 IS 1 BP 25 EP 33 DI 10.1682/JRRD.2004.11.0139 PG 9 WC Rehabilitation SC Rehabilitation GA 060SI UT WOS:000238821500004 PM 16847769 ER PT J AU Wallin, MT Wilken, JA Turner, AP Williams, RM Kane, R AF Wallin, Mitchell T. Wilken, Jeffrey A. Turner, Aaron P. Williams, Rhonda M. Kane, Robert TI Depression and multiple sclerosis: Review of a lethal combination SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Review DE assessment; depression; morbidity; mortality; multiple sclerosis; outcome; prevention; review; suicide; treatment ID QUALITY-OF-LIFE; EXPRESSIVE GROUP-PSYCHOTHERAPY; COGNITIVE-BEHAVIOR THERAPY; RANDOMIZED CLINICAL-TRIAL; BRAIN MRI LESIONS; MAJOR DEPRESSION; SOCIAL SUPPORT; INTERFERON-BETA; PRIMARY-CARE; MULTIDIMENSIONAL ASSESSMENT AB Depression is the most frequent psychiatric disorder in multiple sclerosis (MS) patients. The etiology of depression is multifactorial and likely associated with psychosocial stress, focal demyelinating lesions, and immune dysfunction. Proper diagnosis and severity assessment are critical prior to initiation of therapy. Patients with suicidal ideation should be referred for immediate psychiatric consultation and be closely monitored. While more therapeutic trials for depression in MS are needed, MS patients have been shown to respond to current antidepressant medications and psychotherapy. Unfortunately, patients with MS and major depression or suicidal thoughts are often underassessed and therefore not diagnosed. Unlike other aspects of MS, depression is treatable. Early intervention in depression can prevent declines in quality of life and even death from suicide. This article reviews the unique features, assessment, and treatment of depression in MS. MS care providers should vigilantly assess depression and suicide risk in their patients. C1 Dept Vet Affairs Med Ctr, Neurol Serv 127, Washington, DC 20422 USA. Georgetown Univ, Dept Neurol, Washington, DC USA. Maryland VA Healthcare Syst, Multiple Sclerosis Ctr Excellence E, Baltimore, MD USA. Univ Maryland, Dept Psychol, College Pk, MD 20742 USA. VA Puget Sound Hlth Care Syst, MSCoE W, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Wallin, MT (reprint author), Dept Vet Affairs Med Ctr, Neurol Serv 127, 50 Irving St NW, Washington, DC 20422 USA. EM mitchell.wallin@med.va.gov OI Turner, Aaron/0000-0001-6897-8003 NR 137 TC 38 Z9 41 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 JAN-FEB PY 2006 VL 43 IS 1 BP 45 EP 61 DI 10.1682/JRRD.2004.09.0117 PG 17 WC Rehabilitation SC Rehabilitation GA 060SI UT WOS:000238821500006 PM 16847771 ER PT J AU Lovera, J Bagert, B Smoot, KH Wild, K Frank, R Bogardus, K Oken, BS Whitham, RH Bourdette, DN AF Lovera, Jesus Bagert, Bridget Smoot, Kyle H. Wild, Katherine Frank, Rachel Bogardus, Kristin Oken, Barry S. Whitham, Ruth H. Bourdette, Dennis N. TI Correlations of Perceived Deficits Questionnaire of Multiple Sclerosis Quality of Life Inventory with Beck Depression Inventory and neuropsychological tests SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE Beck Depression Inventory; California Verbal Learning Test; cognition disorders; depression; multiple sclerosis; neuropsychological tests; Paced Auditory Serial Addition Test; Perceived Deficits Questionnaire; quality of life; questionnaires ID COGNITIVE DYSFUNCTION; PERFORMANCE; METAMEMORY; IMPAIRMENT AB The Perceived Deficits Questionnaire (PDQ) is a part of the Multiple Sclerosis (MS) Quality of Life Inventory that assesses self-perceived cognitive difficulties. We used baseline data from 49 MS subjects participating in a clinical trial to evaluate the correlation of the PDQ with two measures of cognitive impairment, the Paced Auditory Serial Addition Test (PASAT) and the California Verbal Learning Test, 2nd edition (CVLT-II), total score, and one measure of depression, the Beek Depression Inventory-Amended (BDI-IA). The PDQ correlated significantly (r - 0.42; 95% confidence interval [CI], 0.15 to 0.62; p = 0.003) with the BDI-IA scores but not with either the PASAT (r = - 0.22; 95% Cl, - 0.48 to 0.06; p = 0.2) or the CVLT-II total (r = - 0. 17; 95% CI, -0.43 to 0. 12; p = 0.25). A subset of 38 of these subjects who scored worse than 0.5 standard deviation below the mean on the PASAT or CVLT-II received a more extensive neuropsychological battery of tests. No significant correlations were found between any of these tests and the PDQ. These results suggest that self-perceived cognitive dysfunction relates more to depression than to objective cognitive dysfunction. C1 Portland VA Med Ctr, Dept Vet Affairs Multiple Sclerosis Ctr Excellenc, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Neurol, Sch Med, Portland, OR 97201 USA. Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Cambridge, MA 02138 USA. RP Lovera, J (reprint author), Portland VA Med Ctr, Dept Vet Affairs Multiple Sclerosis Ctr Excellenc, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM loveraj@ohsu.edu RI Bagert, Bridget/A-5499-2011 FU NCCIH NIH HHS [P50 AT00066-01] NR 24 TC 28 Z9 28 U1 1 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 JAN-FEB PY 2006 VL 43 IS 1 BP 73 EP 82 DI 10.1682/JRRD.2004.09.0118 PG 10 WC Rehabilitation SC Rehabilitation GA 060SI UT WOS:000238821500008 PM 16847773 ER PT J AU Campbell, DG Turner, AP Williams, RM Hatzakis, M Bowen, JD Rodriquez, A Haselkorn, JK AF Campbell, Duncan G. Turner, Aaron P. Williams, Rhonda M. Hatzakis, Michael, Jr. Bowen, James D. Rodriquez, Arthur Haselkorn, Jodie K. TI Complementary and alternative medicine use in veterans with multiple sclerosis: Prevalence and demographic associations SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE acupuncture; alternative medicine; chiropractic treatment; complementary therapies; herbal medications; logistic model; massage therapy; multiple sclerosis; naturopathy; traditional healthcare ID UNITED-STATES; MILITARY VETERANS; MENTAL-DISORDERS; NATIONAL-SURVEY; PRIMARY-CARE; THERAPIES; PATTERNS; GUIDELINES; UTILITY; MS AB The present study explored complementary and alternative medicine (CAM) use in veterans with multiple sclerosis (MS). We administered self-report questionnaires to 451 veterans who received healthcare from Veterans Health Administration facilities. CAM use among veterans with MS was widespread; 37% of respondents reported current or past use. Roughly 33% of CAM users reported using multiple interventions, and 40% of respondents desired interventions that they were not already using. Logistic regression suggested that CAM use was more likely among participants with graduate-level education, poor self-reported health over the past year, and a progressive relapsing MS subtype. Participants who used traditional medical services were also more likely to use CAM, which suggests that CAM services are used in addition to, as opposed to in place of, traditional services. As others have proposed, these results suggest that care providers who work with persons with MS would be well served to understand, routinely screen for, and make use of CAM when appropriate. C1 VA Puget Sound Healthcare Syst, Rehabil Care Serv, Seattle, WA 98108 USA. Dept Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Div Neurol, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. RP Turner, AP (reprint author), VA Puget Sound Healthcare Syst, Rehabil Care Serv, S-117,1660 S Columbian Way, Seattle, WA 98108 USA. EM Aaron.Turner@med.va.gov OI Turner, Aaron/0000-0001-6897-8003 NR 37 TC 18 Z9 18 U1 4 U2 8 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 JAN-FEB PY 2006 VL 43 IS 1 BP 99 EP 109 DI 10.1682/JRRD.2004.08.0110 PG 11 WC Rehabilitation SC Rehabilitation GA 060SI UT WOS:000238821500011 PM 16847776 ER PT J AU Wallen, ES Mulloy, KB AF Wallen, Erik S. Mulloy, Karen B. TI Computer-based training for safety: Comparing methods with older and younger workers SO JOURNAL OF SAFETY RESEARCH LA English DT Article DE computer-based teaming; adult teaming; occupational safety and health training; aging; multimedia ID COGNITIVE LOAD THEORY; ADULT AGE-DIFFERENCES; WORKING-MEMORY; SPLIT-ATTENTION; TEXT; PERFORMANCE; INFORMATION; EFFICIENCY; TASK AB Introduction: Computer-based safety training is becoming more common and is being delivered to an increasingly aging workforce. Aging results in a number of changes that make it more difficult to learn from certain types of computer-based training. Instructional designs derived from cognitive teaming theories may overcome some of these difficulties. Methods: Three versions of computer-based respiratory safety training were shown to older and younger workers who then took a high and a low level teaming test. Results: Younger workers did better overall. Both older and younger workers did best with the version containing text with pictures and audio narration. Discussion: Computer-based training with pictures and audio narration may be beneficial for workers over 45 years of age. Impact on Industry: Computer-based safety training has advantages but workers of different ages may benefit differently. Computer-based safety programs should be designed and selected based on their ability to effectively train older as well as younger learners. (c) 2006 National Safety Council and Elsevier Ltd. All rights reserved. C1 Univ New Mexico 1, Dept Internal Med, Albuquerque, NM 87131 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Mulloy, KB (reprint author), Univ New Mexico 1, Dept Internal Med, MSC10-5550, Albuquerque, NM 87131 USA. EM kmulloy@salud.unm.edu NR 51 TC 14 Z9 15 U1 4 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-4375 J9 J SAFETY RES JI J. Saf. Res. PY 2006 VL 37 IS 5 BP 461 EP 467 DI 10.1016/j.jsr.2006.08.003 PG 7 WC Ergonomics; Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary; Transportation SC Engineering; Public, Environmental & Occupational Health; Social Sciences - Other Topics; Transportation GA 123FF UT WOS:000243281000005 PM 17137597 ER PT J AU Cooper, RA AF Cooper, RA TI James J. Peters Memorial Lecture - Carrying the torch: A call to build on the progress of the past 25 years SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Editorial Material ID SPINAL-CORD-INJURY; REHABILITATION; MEDICINE C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, Pittsburgh, PA 15206 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper+@pitt.edu NR 17 TC 2 Z9 2 U1 0 U2 0 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2006 VL 29 IS 1 BP 5 EP 9 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 027KG UT WOS:000236413900003 PM 16572559 ER PT J AU Cooper, RA AF Cooper, RA TI Wheelchair standards: It's all about quality assurance and evidence-based practice SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Editorial Material ID ELECTRIC-POWERED WHEELCHAIRS; ANSI/RESNA STANDARDS; DURABILITY C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn & Phys Med & Rehabil, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu NR 12 TC 10 Z9 10 U1 0 U2 0 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2006 VL 29 IS 2 BP 93 EP 94 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 044BW UT WOS:000237648100002 PM 16739552 ER PT J AU Waites, KB Canupp, KC Roper, JF Camp, SM Chen, YY AF Waites, Ken B. Canupp, Kay C. Roper, James F. Camp, Susan M. Chen, Yuying TI Evaluation of 3 methods of bladder irrigation to treat bacteriuria in persons with neurogenic bladder SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE neurogenic bladder; spinal cord injuries; bacteriuria; urinary tract infection; irrigation; acetic acid; neomycin-polymyxin ID SPINAL-CORD-INJURY; URINARY-TRACT-INFECTION; INTERMITTENT CATHETERIZATION; INDWELLING CATHETERS; CIPROFLOXACIN; PROPHYLAXIS; PREVENTION; LESION AB Background/Objective: We conducted a randomized, double-blind comparison of twice daily bladder irrigation using 1 of 3 different solutions in community-residing persons with neurogenic bladder who used indwelling catheters to evaluate efficacy in treatment of bacteriuria. Methods: Eighty-nine persons with bacteriuria were randomized to irrigate their bladders twice daily for 8 weeks with 30 mL of (a) sterile saline, (b) acetic acid, or (c) neomycin-polymyxin solution. Urinalysis, cultures, and antimicrobial susceptibility tests were performed at baseline and weeks 2, 4, and 8 to determine the extent to which each of the solutions affected numbers and types of bacteria, urinary pH, urinary leukocytes, and generation of antimicrobial-resistant organisms. Results: Bladder irrigation was well tolerated with the exception of 3 participants who had bladder spasms. None of the 3 irrigants had a detectable effect on the degree of bacteriuria or pyuria in 52 persons who completed the study protocol. A significant increase in urinary pH occurred in all 3 groups. No significant development of resistance to oral antimicrobials beyond what was observed at baseline was detected. Conclusions: Bladder irrigation was generally well tolerated for 8 weeks. No advantages were detected for neomycin-polymyxin or acetic acid over saline in terms of reducing the urinary bacterial load and inflammation. We cannot recommend bladder irrigation as a means of treatment for bacteriuria in persons with neurogenic bladder. C1 Univ Alabama, Dept Pathol, Birmingham, AL 35249 USA. Univ Alabama, Dept Phys Med & Rehabil, Birmingham, AL 35249 USA. Birmingham Vet Affairs Med Ctr, Phys Med & Rehabil Serv, Birmingham, AL USA. RP Waites, KB (reprint author), Univ Alabama, Dept Pathol, WP 230,619 19th St S, Birmingham, AL 35249 USA. EM waites@path.uab.edu NR 24 TC 18 Z9 18 U1 2 U2 3 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2006 VL 29 IS 3 BP 217 EP 226 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 060SH UT WOS:000238821400007 PM 16859225 ER PT J AU LaVela, SL Weaver, FM Goldstein, B Chen, K Miskevics, S Rajan, S Gater, DR AF LaVela, Sherri L. Weaver, Frances M. Goldstein, Barry Chen, Ke Miskevics, Scott Rajan, Suparna Gater, David R., Jr. TI Diabetes mellitus in individuals with spinal cord injury or disorder SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; diabetes mellitus; self-care; Behavioral Factor Surveillance System; prevalence; veterans affairs ID VETERANS; COMPLICATIONS; POPULATION; OUTCOMES; ALCOHOL; DISEASE AB Background/Objective: To examine diabetes prevalence, care, complications, and characteristics of veterans with a spinal cord injury or disorder (SCI/D). Methods: A national survey of veterans with an SCI/D was conducted using Behavioral Risk Factor Surveillance System (BRFSS) survey questions. Data were compared with national Centers for Disease Control and Prevention BRFSS data for veteran and nonveteran general populations. Results: Overall prevalence of diabetes in individuals with an SCI/D was 20% (3 times higher than in the general population). Veterans with an SCI/D and veterans, in general, had a higher prevalence of diabetes across all age groups; however, those with an SCI/D who were 45 to 59 years of age had a higher prevalence than other veterans. One fourth of the persons with an SCI/D and diabetes reported that diabetes affected their eyes or that they had retinopathy (25%), and 41% had foot sores that took more than 4 weeks to heal. More veterans, both with (63%) and without an SCI/D (60%), took a class on how to manage their diabetes than the general population (50%). Veterans with an SCI/D and diabetes were more likely to report other chronic conditions and poorer quality of life than those without diabetes. Conclusions: Diabetes prevalence is greater among veterans with an SCI/D compared with the civilian population, but is similar to that of other veterans, although it may occur at a younger age in those with an SCI/D. Veterans with an SCI/D and diabetes reported more comorbidities, more slow-healing foot sores, and poorer quality of life than those without diabetes. Efforts to prevent diabetes and to provide early intervention in persons with SCI/D are needed. C1 Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Qual Enhancement Res Initiat, Midw Ctr Hlth Serv & Policy Res, Dept Vet Affairs, Hines, IL 60141 USA. Univ Illinois, Sch Publ Hlth, Ctr Res Hlth & Aging, Chicago, IL USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Chicago, IL 60611 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Michigan, Dept Phys Med & Rehabil, Ann Arbor, MI 48109 USA. VA Ann Arbor Healthcare Syst, Dept Vet Affairs, Ann Arbor, MI USA. RP LaVela, SL (reprint author), Vet Affairs Edward Hines Jr Hosp, Spinal Cord Injury Qual Enhancement Res Initiat, Midw Ctr Hlth Serv & Policy Res, Dept Vet Affairs, POB 5000 151H, Hines, IL 60141 USA. EM Sherri.LaVela@va.gov RI Gater, David/F-3418-2011 OI Gater, David/0000-0002-6714-619X NR 36 TC 36 Z9 36 U1 0 U2 2 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2006 VL 29 IS 4 BP 387 EP 395 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 092ZV UT WOS:000241137800005 PM 17044389 ER PT J AU Kilbourne, AM Salloum, I Dausey, D Cornelius, JR Conigliaro, J Xu, XY Pincus, HA AF Kilbourne, AM Salloum, I Dausey, D Cornelius, JR Conigliaro, J Xu, XY Pincus, HA TI Quality of care for substance use disorders in patients with serious mental illness SO JOURNAL OF SUBSTANCE ABUSE TREATMENT LA English DT Article DE mental disorders; substance use disorders; psychotic disorders; quality of care; quality indicators AB We assessed the quality of care for substance use disorders (SUDs) among 8,083 patients diagnosed with serious mental illness from the VA mid-Atlantic region. Using data from the National Patient Care Database (2001-2002), we assessed the percentage of patients receiving a diagnosis of SUD, percentage beginning SUD treatment 14 days or earlier after diagnosis, and percentage receiving continued SUD care 30 days or less. Overall, 1,559 (19.3%) were diagnosed with an SUD. Of the 1,559, 966 (62.0%) initiated treatment and 847 (54.3%) received continued care. Although patients diagnosed with bipolar disorder were more likely to receive a diagnosis of SUD than those diagnosed with schizophrenia or schizoaffective disorder (22.7%, 18.9%, and 17.7%, respectively; chi(2) = 26.02, df = 2, p < .001), they were less likely to initiate (49.1%, 70.7%, and 68.6%, respectively; chi(2) = 59.29, df = 2, p < .001) or continue treatment (39.9%, 63.2%, and 62.2%, respectively; chi(2) = 72.25, df = 2, p < .001). Greater efforts are needed to diagnose and treat SUDs in patients with serious mental illness, particularly for those with bipolar disorder. (c) 2006 Elsevier Inc. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, RAND, Hlth Inst, Pittsburgh, PA 15213 USA. Univ Kentucky, Med Ctr, Lexington, KY USA. RP Kilbourne, AM (reprint author), VA Pittsburgh Ctr Hlth Equ Res & Promot, 151-C,Univ Dr C, Pittsburgh, PA 15240 USA. EM amy.kilbourne@med.va.gov FU NIAAA NIH HHS [R01 AA 11292, R21 AA 014396] NR 11 TC 7 Z9 7 U1 2 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0740-5472 J9 J SUBST ABUSE TREAT JI J. Subst. Abus. Treat. PD JAN PY 2006 VL 30 IS 1 BP 73 EP 77 DI 10.1016/j.jsat.2005.10.003 PG 5 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 007KC UT WOS:000234966700007 PM 16377454 ER PT J AU Samii, A Ryan-Dykes, P Tsukuda, RA Zink, C Franks, R Nichol, WP AF Samii, A Ryan-Dykes, P Tsukuda, RA Zink, C Franks, R Nichol, WP TI Telemedicine for delivery of health care in Parkinson's disease SO JOURNAL OF TELEMEDICINE AND TELECARE LA English DT Article AB We have used telemedicine at the Seattle Veterans Administration Medical Center to deliver follow-up care to patients with Parkinson's disease (PD). Patients were located at eight facilities which were 67-2400 km from the medical centre. Each facility had videoconferencing equipment (connected by Internet Protocol at 384 kbit/s), and computer terminals that could access the patient's electronic medical record. Over a three-year period, we used telemedicine for 100 follow-up visits on 34 PD patients. Visits lasted 30-60 min. Patients and providers were satisfied with the use of the technology. Savings amounted to approximately 1500 attendant travel hours, 100,000 travel kilometres, and US$37,000 in travel and lodging costs. For the first 82 telemedicine visits, the video quality was inadequate for scoring all components of the motor Unified Parkinson Disease Rating Scale (UPDRS). For the last 18 visits, a different videoconferencing unit produced better video quality, which was satisfactory for motor UPDRS measurements, except for components that required physical contact with the patient (rigidity and retropulsion testing). Our experience shows that telemedicine can be used effectively for follow-up visits with selected PD patients who are unable to travel. C1 VAPSHCS, Dept Neurol, Seattle, WA 98108 USA. VAPSHCS, Seattle PADRECC, Seattle, WA 98108 USA. Portland VA Med Ctr, Portland PADRECC, Portland, OR USA. VA Puget Sound Hlth Care Syst, Clin Informat, Seattle, WA USA. RP Samii, A (reprint author), VAPSHCS, Dept Neurol, Mailstop 127,1660 S Columbian Way, Seattle, WA 98108 USA. EM asamii@u.washington.edu NR 5 TC 32 Z9 32 U1 0 U2 5 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 1357-633X J9 J TELEMED TELECARE JI J. Telemed. Telecare PY 2006 VL 12 IS 1 BP 16 EP 18 DI 10.1258/135763306775321371 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 011AF UT WOS:000235239300003 PM 16438773 ER PT J AU Morales, K Wittink, M Datto, C DiFilippo, S Cary, M TenHave, T Katz, IR AF Morales, K Wittink, M Datto, C DiFilippo, S Cary, M TenHave, T Katz, IR TI Simvastatin causes changes in affective processes in elderly volunteers SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE simvastatin; cholesterol; affect; depression; diaries ID LOW SERUM-CHOLESTEROL; QUALITY-OF-LIFE; COA REDUCTASE INHIBITORS; DEPRESSIVE SYMPTOMS; MENTAL-DISORDER; HEART-DISEASE; STATINS; PREVALENCE; METABOLISM; MORTALITY AB OBJECTIVES: To test for simvastatin-induced changes in affect and affective processes in elderly volunteers. DESIGN: Randomized, clinical trial. SETTING: The Geriatric Behavioral Psychopharmacology Laboratory at the University of Pennsylvania. PARTICIPANTS: Eighty older volunteers, average age 70, with high normal/mildly elevated serum cholesterol. INTERVENTION: Simvastatin up to 20 mg/d or placebo for 15 weeks. MEASUREMENTS: Daily diary records of positive and negative affects and of events and biweekly measures of depressive symptoms. Affect ratings were obtained using the Lawton positive and negative affect scales; independent raters coded the valences of events. RESULTS: Thirty-one of 39 subjects assigned to placebo and 33 of 41 receiving simvastatin completed the study. During biweekly assessments, four subjects on simvastatin and one on placebo experienced depressive symptoms, as manifest by Center for Epidemiological Studies Depression scale scores greater than 16 (exact P=.36). Diary data demonstrated significant effects on affective processes. For positive affect, there was a significant medication-by-time interaction that reflected decreases in positive affect in subjects receiving simvastatin, greatest in those patients whose final total cholesterol levels were below 148 mg/dL. For negative affect, there were significant medication-by-event, and medication-by-event-by-time interactions, reflecting a time-limited increase in the apparent effect of negative events. CONCLUSION: Simvastatin has statistically significant effects on affect and affective processes in elderly volunteers. The decrease in positive affect may be significant clinically and relevant to the quality of life of many patients. C1 Univ Penn, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Dept Family Practice & Community Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia Dept, Mental Illness Res Educ & Clin Ctr, Philadelphia, PA USA. RP Katz, IR (reprint author), Univ Penn, Sect Geriatr Psychiat, 3535 Market St,Room 3001, Philadelphia, PA 19104 USA. EM katzi@mail.med.upenn.edu FU NIMH NIH HHS [P30 MH66270, R01 MH58349] NR 49 TC 24 Z9 26 U1 1 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 JAN PY 2006 VL 54 IS 1 BP 70 EP 76 DI 10.1111/j.1532-5412.2005.00542.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 999QF UT WOS:000234404300010 PM 16420200 ER PT J AU Barnhill, JG Fye, CL Williams, DW Reda, DJ Harris, CL Clegg, DO AF Barnhill, Jamie G. Fye, Carol L. Williams, David W. Reda, Domenic J. Harris, Crystal L. Clegg, Daniel O. TI Chondroitin product selection for the glucosamine/chondroitin arthritis intervention trial SO JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION LA English DT Article DE dietary supplements; chondroitin; glucosamine/chondroitin arthritis intervention trial; osteoarthritis; product selection AB Objective: To select a high-quality chondroitin dosage form and/ or an appropriate source of sodium chondroitin for the National Institutes of Health's Glucosamine/ Chondroitin Arthritis Intervention Trial ( GAIT). Design: Controlled experimental trials. Setting: Laboratory. Patients or Participants: Not applicable. Interventions: Commercially available chondroitin products were reviewed, and purified sodium chondroitin from two suppliers was evaluated through tests ( infrared and near-infrared identification, moisture content, pH, optical rotation, color and clarity of aqueous solutions prepared from the powders, protein contamination, total residue following ignition and nitrogen content, determination of sodium chondroitin molecular weight, disaccharide analysis, and measurement of chondroitin, sodium, and total glycosaminoglycan content) and an onsite supplier audit. Main Outcome Measures: Purity, potency, and quality of sodium chondroitin powders. Results: No commercially available chondroitin product was deemed appropriate for use in GAIT. Samples of sodium chondroitin powder from two suppliers exhibited similar disaccharide and glycosaminoglycan content. Each contained approximately 2% hyaluronic acid and 8%-9% unsulfated disaccharide. Potency was inconsistent across groups, which might have resulted from different analytical methods and choice of reference standard. Mean potency obtained by five separate methods ranged from 82.2% to 95.5% for one supplier, 92.5% to 110.1% for another, and 95.1% to 112.5% for a commercially obtained reference standard. Critical issues raised by the results include choice of reference standard, selection of assay method, and the consistent appearance of an unidentifiable contaminant present in all three lots from one supplier. Conclusion: This blinded study determined methods to identify acceptable agents and provided results, which, in addition to regulatory compliance supplier audits, formed the basis for chondroitin product selection in GAIT. C1 US Dept Vet Affairs, Biopharmaceut Pharmacokinet Lab Sect, Cooperat Studies Program, Clin Res Pharm Coordinating Ctr, Albuquerque, NM USA. Univ New Mexico, Coll Pharm, Albuquerque, NM 87131 USA. SMART, Good Clin Practice Review Grp, VA Cooperat Studies Program, Albuquerque, NM USA. Glucosamine Chondroitin Arthritis Intervent Trail, Hines, IL USA. Coordinating Ctr, VA Cooperat Studies Program, Hines, IL USA. Clin Res Pharm Coordinating Ctr, Biopharmaceut Pharmacokinet Lab, VA Cooperat Studies Program, Albuquerque, NM 87106 USA. Univ Utah, Sch Med, Div Rheumatol, Salt Lake City, UT USA. RP Barnhill, JG (reprint author), Clin Res Pharm Coordinating Ctr, Biopharmaceut Pharmacokinet Lab, VA Cooperat Studies Program, 2401 Ctr Ave,SE, Albuquerque, NM 87106 USA. EM jamie.barnhill@csp.research.med.va.gov FU NIAMS NIH HHS [AR92236] NR 13 TC 24 Z9 25 U1 1 U2 7 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 JAN-FEB PY 2006 VL 46 IS 1 BP 14 EP 24 DI 10.1331/154434506775268616 PG 11 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA V43YX UT WOS:000202971500006 PM 16529337 ER PT J AU Shlipak, MG Fyr, CLW Chertow, GM Harris, TB Kritchevsky, SB Tylavsky, FA Satterfield, S Cummings, SR Newman, AB Fried, LF AF Shlipak, Michael G. Fyr, Christina L. Wassel Chertow, Glenn M. Harris, Tamara B. Kritchevsky, Stephen B. Tylavsky, Frances A. Satterfield, Suzanne Cummings, Steven R. Newman, Anne B. Fried, Linda F. TI Cystatin C and mortality risk in the elderly: The health, aging, and body composition study SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID GLOMERULAR-FILTRATION-RATE; CORONARY-HEART-DISEASE; EARLY RENAL IMPAIRMENT; OLDER-ADULTS; KIDNEY-FUNCTION; CARDIOVASCULAR EVENTS; CLINICAL EVALUATION; MARKER; INSUFFICIENCY; CREATININE AB Kidney dysfunction is known to decrease life expectancy in the elderly. Cystatin C is a novel biomarker of kidney function that may have prognostic utility in older adults. The association of cystatin C with mortality was evaluated in a biracial cohort of black and white ambulatory elderly and compared with that of serum creatinine concentrations. The Health, Aging and Body Composition study is a cohort of well-functioning elderly that was designed to evaluate longitudinal changes in weight, body composition, and function. A total of 3075 participants who were aged 70 to 79 yr and had no disability were recruited at sites in Memphis, TN, and Pittsburgh, PA, between April 1997 and June 1998 with a follow-up of 6 yr. At entry, the mean cystatin C was 1.05 mg/L and the mean creatinine was 1.06 mg/dl. After 6 yr of follow-up, 557 participants had died. The mortality rates in each ascending cystatin C quintile were 1.7, 2.7, 2.9, 3.1, and 5.4%/yr. After adjustment for demographic risk factors, comorbid health conditions, and inflammatory biomarkers (C-reactive protein, IL-6. and TNF-alpha), each quintile of cystatin C was significantly associated with increased mortality risk compared with the lowest: Hazard ratios (HR; 95% confidence intervals) quintile 1, -1.0 (referent); quintile 2, -1.74 (1.21 to 2.50); quintile 3, -1.51 (1.05 to 2.18); quintile 4, -1.49 (1.04 to 2.13); and quintile 5, -2.18 (1.53 to 3.10). These associations did not differ by gender or race. Results were consistent for cardiovascular and other-cause mortality, but not cancer mortality. Creatinine quintiles were not associated with mortality after multivariate adjustment (HR: 1.0 [referent], 1.00 [0.72 to 1.39], 0.95 [0.68 to 1.32], 1.11 [0.79 to 1.57], 1.16 [0.86 to 1.58]). Cystatin C is a strong, independent risk factor for mortality in the elderly. Future studies should investigate whether cystatin C has a role in clinical medicine. C1 Univ Calif San Francisco, Gen Internal Med Sect, VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA. NIA, Lab Epidemiol Demog & Biometry, Intramural Res Program, Bethesda, MD 20892 USA. Wake Forest Bowman Gray Sch Med, J Paul Sticht Ctr Aging & Rehabil, Winston Salem, NC USA. Univ Tennessee, Dept Prevent Med, Memphis, TN 38163 USA. Calif Pacific Med Ctr, Inst Res, San Francisco, CA USA. Univ Pittsburgh, Dept Epidemiol, Grad Sch Publ Hlth, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. RP Shlipak, MG (reprint author), Univ Calif San Francisco, Gen Internal Med Sect, VA Med Ctr, 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; Kritchevsky, Stephen/0000-0003-3336-6781 FU NHLBI NIH HHS [R01 HL073208-01]; NIA NIH HHS [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106] NR 27 TC 138 Z9 142 U1 1 U2 5 PU AMERICAN SOCIETY NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD JAN PY 2006 VL 17 IS 1 BP 254 EP 261 DI 10.1681/ASN.2005050545 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 106SB UT WOS:000242120000032 PM 16267155 ER PT J AU Wierenga, CE Maher, LM Moore, AB White, KD McGregor, K Soltysik, DA Peck, KK Gopinath, KS Singletary, F Gonzalez-Rothi, LJ Briggs, RW Crosson, B AF Wierenga, CE Maher, LM Moore, AB White, KD McGregor, K Soltysik, DA Peck, KK Gopinath, KS Singletary, F Gonzalez-Rothi, LJ Briggs, RW Crosson, B TI Neural substrates of syntactic mapping treatment: An fMRI study of two cases SO JOURNAL OF THE INTERNATIONAL NEUROPSYCHOLOGICAL SOCIETY LA English DT Article DE neuroplasticity; rehabilitation; aphasia; functional neuroimaging; linguistics; cerebrovascular accident ID EVENT-RELATED FMRI; TEMPORAL-SPATIAL STRATEGY; THEMATIC ROLE ASSIGNMENT; SENTENCE COMPREHENSION; SPEECH PRODUCTION; BRAIN PLASTICITY; BROCAS AREA; POSTSTROKE APHASIA; TREATMENT PROGRAM; RIGHT-HEMISPHERE AB Two patients (G01, J02) with chronic nonfluent aphasia and sentence production deficits received syntactic mapping treatment to improve sentence production. The patients had dramatically different outcomes in that improved syntax production generalized to nontreatment tasks for G01, but not for JO2. To learn how treatment influenced the neural substrates for syntax production, both patients underwent pre- and posttreatment functional magnetic resonance imaging (fMRI) of sentence generation. G01 showed more robust activity posttreatment than pretreatment in Broca's area; ventral temporal activity decreased slightly from pre- to posttreatment. Comparison of J02's pretreatment and posttreatment images revealed little change, although activity was more diffuse pre- than posttreatment. Findings suggest that for G01, rehabilitation led to engagement of an area (Broca's area) used minimally during the pretreatment scan, whereas for J02, rehabilitation may have led to more efficient use of areas already involved in sentence generation during the pretreatment scan. fMRI findings are discussed in the context of sentence-production outcome and generalization. C1 Univ Florida, Hlth Sci Ctr, Dept Clin & Hlth Psychol, Gainesville, FL 32610 USA. Malcom Randall VA Med Ctr, Brain Rehabil Res Ctr, Dept Vet Affairs Rehabil Res & Dev, Gainesville, FL USA. Univ Florida, Dept Neurol, Gainesville, FL 32611 USA. Univ Florida, Dept Radiol & Nucl Med, Gainesville, FL 32611 USA. Univ Florida, Dept Psychol, Gainesville, FL 32611 USA. Univ Florida, Dept Radiol, Gainesville, FL 32611 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Crosson, B (reprint author), Univ Florida, Hlth Sci Ctr, Dept Clin & Hlth Psychol, Box 100165, Gainesville, FL 32610 USA. EM bcrosson@phhp.ufl.edu RI Crosson, Bruce/L-3128-2013; Maher, Lynn/L-7074-2015 OI SOLTYSIK, DAVID/0000-0002-6597-5226; McGregor, Keith/0000-0003-3654-351X FU NIDCD NIH HHS [P50-DC03888] NR 76 TC 18 Z9 20 U1 3 U2 5 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH ST, NEW YORK, NY 10011-4211 USA SN 1355-6177 J9 J INT NEUROPSYCH SOC JI J. Int. Neuropsychol. Soc. PD JAN PY 2006 VL 12 IS 1 BP 132 EP 146 DI 10.1017/S135561770606019X PG 15 WC Clinical Neurology; Neurosciences; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 012BS UT WOS:000235313800016 PM 16433953 ER PT J AU Conhaim, RL Watson, KE Heisey, DM Leverson, GE Harms, BA AF Conhaim, RL Watson, KE Heisey, DM Leverson, GE Harms, BA TI Hemorrhage causes interalveolar perfusion maldistribution in the lungs of anesthetized rats SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article; Proceedings Paper CT 63rd Annual Meeting of the American-Association-for-the-Surgery-of-Trauma CY SEP 29-OCT 02, 2004 CL Maui, HI SP Amer Assoc Surg Trauma DE blood loss; pulmonary blood flow; pulmonary microcirculation; dispersion index analysis; perfusion heterogeneity ID INJURY; MICROVESSELS AB Background: Lung injury often occurs following hemorrhage and we hypothesized that this might be due to the effects of hemorrhage on perfusion distribution among alveoli. To test this, we measured interalveolar perfusion distribution in anesthetized, spontaneously breathing rats subjected to blood losses of 0%, 10%, 20%, or 30% of calculated blood volume Methods: We measured interalveolar perfusion distribution by analyzing trapping patterns of 4-mu m diameter fluorescent latex particles infused into the pulmonary circulation. The particles (2 X 10(8)) were infused I hour after each animal had been bled, and the lungs were then removed and air-dried. Using a confocal fluorescence microscope, we collected images of the particles in eight sections of each lung. Each image encompassed 3,360 x 3,360 x 100 mu m (approximately 5,000 alveoli), and included 3-4,000 particles. Particle distributions in the images were measured using the method of dispersion index (DI) analysis. A DI value of zero corresponds to a statistically random distribution; the more DI exceeds zero, the more the distribution is clustered or inhomogenous Results: The largest DI values for the four groups were: 0%, 0.69 +/- 0.41; 10%, 0.57 +/- 0.58; 20%, 0.72 +/- 0.34; 30%, 1.38 +/- 0.41. The 30% blood loss group had a max DI value approximately twofold greater than those of the other three (P < 0.0001). Conclusions. Our results suggest that interalveolar perfusion distribution becomes markedly maldistributed at blood losses of 30%. This contributes to ventilation-perfusion mismatching, and may be a precipitating event for lung injury following hemorrhage. C1 Univ Wisconsin, Sch Med, Dept Surg, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Conhaim, RL (reprint author), Univ Wisconsin, Sch Med, Dept Surg, BX3236,600 Highland Ave, Madison, WI 53792 USA. EM conhaim@surgery.wisc.edu NR 16 TC 9 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-6061 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD JAN PY 2006 VL 60 IS 1 BP 158 EP 162 DI 10.1097/01.ta.0000203110.03258.d0 PG 5 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 008UN UT WOS:000235066300034 PM 16456450 ER PT J AU Greene, KL Elkin, EP Karapetian, A DuChane, J Carroll, PR Kane, CJ AF Greene, KL Elkin, EP Karapetian, A DuChane, J Carroll, PR Kane, CJ CA Capsure Investigators TI Prostate biopsy tumor extent but not location predicts recurrence after radical prostatectomy: Results from CAPSURE SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; biopsy; recurrence; prostatectomy ID POSITIVE SURGICAL MARGINS; BEAM RADIATION-THERAPY; NEEDLE-BIOPSY; ANTIGEN RECURRENCE; PATHOLOGICAL STAGE; SEARCH DATABASE; CANCER; CORES; PERCENTAGE; DISEASE AB Purpose: Prostate cancer biopsy information is important for patient risk assessment. Although the number and extent of positive biopsies have been used to predict recurrence, the impact of positive biopsy location and contiguity is less clear. We compared the ability of positive prostate biopsy location and pattern with number and percent positive biopsies to predict recurrence after RP. Materials and Methods: From CaPSURE we identified 2,037 men treated with RP from 1992 to 2002 for whom detailed biopsy information and 2 or more followup PSA values were available. Treatment failure was defined as 2 consecutive PSA values of 0.2 ng/ml or higher, or a second treatment delivered more than 6 months after RP. Biopsy tumor volume (number and percent positive sites), location of disease (anatomical site, laterality), and contiguity of positive biopsies were entered into Cox proportional hazards models to predict risk of disease recurrence while controlling for Gleason grade, PSA and T stage. Results: Higher number and percent of positive biopsy cores were associated with prostate cancer recurrence, risk stratification category and Gleason grade, p < 0.0001, HR 1.09 (Cl 1.02 to 1.16) and 1.01 (CI 1.00 to 1.01), respectively. Number of biopsy cores taken, laterality, contiguity and positive biopsy location were not associated with disease recurrence. Conclusions: The number and the percentage of biopsies positive for cancer correlated with treatment failure after radical prostatectomy. Contiguity, laterality and location were not associated with recurrence. C1 Univ Calif San Francisco, Dept Urol, Ctr Comprehens Canc, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Kane, CJ (reprint author), Univ Calif San Francisco, Dept Urol, Ctr Comprehens Canc, 1600 Divisadero St,Rm A631, San Francisco, CA 94143 USA. EM ckane@urol.ucsf.edu FU PHS HHS [P50 C89520] NR 20 TC 18 Z9 18 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JAN PY 2006 VL 175 IS 1 BP 125 EP 129 DI 10.1016/S0022-5347(05)00009-1 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 994AD UT WOS:000234001100030 PM 16406887 ER PT J AU Beer, TM Bland, LB Bussiere, JR Neiss, MB Wersinger, EM Garzotto, M Ryan, CW Janowsky, JS AF Beer, TM Bland, LB Bussiere, JR Neiss, MB Wersinger, EM Garzotto, M Ryan, CW Janowsky, JS TI Testosterone loss and estradiol administration modify memory in men SO JOURNAL OF UROLOGY LA English DT Article DE prostatic neoplasms; estradiol; testosterone; memory ID PROSTATE-CANCER; COGNITIVE FUNCTION; OLDER MEN; WORKING-MEMORY; ESTROGEN; SUPPRESSION; PERFORMANCE; CARCINOMA; HORMONES; THERAPY AB Purpose: Little is known about the effect of androgen deprivation therapy on the brain despite the fact that sex steroid receptors are abundant in cortical brain regions that mediate memory and other cognitive functions. We characterized the impact of androgen deprivation and of subsequent estradiol therapy on the long-term and working memory of patients with prostate cancer. Materials and Methods: Long-term memory (immediate and delayed paragraph recall tests), working memory (SOP and Trails tests) and Profile of Mood States were assessed at baseline and 4 weeks later in 18 patients with androgen independent prostate cancer beginning second line hormonal therapy with transdermal estradiol 0.6 mg/24 hours. The same assessments were performed in 2 age matched control groups of 18 patients with prostate cancer undergoing androgen deprivation continuing on hormonal therapy and 17 community dwelling healthy men. Results: Immediate and delayed verbal memory were significantly worse in patients with prostate cancer on androgen deprivation than in age matched healthy controls. In addition, men with prostate cancer took more time to complete the Trails A task, indicating slower processing speed, but did not differ significantly from healthy controls in working memory tasks. In individual repeated measures analyses, verbal memory performance improved with estradiol therapy but did not change in the 2 control groups. Conclusions: Sex steroid loss and replacement have effects on specific cognitive processes in older men. Furthermore, estrogen has the potential to reverse the neurotoxic effects on memory performance caused by androgen deprivation. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Dept Med, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, 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, Div Hematol & Med Oncol, Dept Med, Mail Code CR145,3181 SW San Jackson Pk Rd, Portland, OR 97239 USA. EM beert@ohsu.edu FU NCRR NIH HHS [5 M01 RR00334, 5 M01 RR00334-33S2]; NIA NIH HHS [AG18843]; PHS HHS [03-3839-504384] NR 20 TC 62 Z9 63 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JAN PY 2006 VL 175 IS 1 BP 130 EP 135 DI 10.1016/S0022-5347(05)00049-2 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 994AD UT WOS:000234001100032 PM 16406889 ER PT J AU Burgio, KL Goode, PS Urban, DA Umlauf, MG Locher, JL Bueschen, A Redden, DT AF Burgio, KL Goode, PS Urban, DA Umlauf, MG Locher, JL Bueschen, A Redden, DT TI Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: A randomized, controlled trial SO JOURNAL OF UROLOGY LA English DT Article DE bladder; urinary incontinence; biofeedback (psychology); prostatectomy; pelvic floor ID QUALITY-OF-LIFE; LOCALIZED PROSTATE-CANCER; RADICAL PROSTATECTOMY; URINARY-INCONTINENCE; MEN; RELIABILITY; INVENTORY; OUTCOMES; WOMEN AB Purpose: We tested the effectiveness of preoperative biofeedback assisted behavioral training for decreasing the duration and severity of incontinence, and improving quality of life in the 6 months following radical prostatectomy. Materials and Methods: We performed a prospective, randomized, controlled trial comparing preoperative behavioral training to usual care. The volunteer sample included 125 men 53 to 68 years old who elected radical prostatectomy for prostate cancer. Patients were stratified according to age and tumor differentiation, and randomized to 1 preoperative session of biofeedback assisted behavioral training plus daily home exercise or a usual care control condition, consisting of simple postoperative instructions to interrupt the urinary stream. The main outcome measurements were duration of incontinence (time to continence), as derived from bladder diaries, incontinence severity (the proportion with severe/continual leakage), pad use, Incontinence Impact Questionnaire, psychological distress (Hopkins Symptom Checklist) and health related quality of life (Medical Outcomes Study Short Form Health Survey). Results: Preoperative behavioral training significantly decreased time to continence (p = 0.03) and the proportion of patients with severe/continual leakage at the 6-month end point (5.9% vs 19.6%, p = 0.04). There were also significant differences between the groups for self-reported urine loss with coughing (22.0% vs 51.1%, p = 0.003), sneezing (26.0% vs 48.9%, p = 0.02) and getting up from lying down (14.0% vs 31.9%, p = 0.04). No differences were found on return to work and usual activities or quality of life measures. Conclusions: Preoperative behavioral training can hasten the recovery of urine control and decrease the severity of incontinence following radical prostatectomy. C1 Univ Alabama, Sch Med, Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Dept Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Med, Birmingham, AL USA. Univ Alabama, Sch Med, Dept Surg, Birmingham, AL USA. Univ Alabama, Sch Med, Ctr Aging, Birmingham, AL USA. Univ Alabama, Sch Med, Sch Nursing, Birmingham, AL USA. Univ Alabama, Sch Med, Sch Publ Hlth, Birmingham, AL USA. RP Burgio, KL (reprint author), Birmingham Vet Affairs Med Ctr, GRECC, 11G,700 19th St S, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu RI Umlauf, Mary/A-5021-2015 FU NIDDK NIH HHS [R01 DK50283] NR 20 TC 78 Z9 81 U1 1 U2 17 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD JAN PY 2006 VL 175 IS 1 BP 196 EP 201 DI 10.1016/S0022-5347(05)00047-9 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 994AD UT WOS:000234001100053 PM 16406909 ER PT J AU Williams, BR Baker, PS Allman, RM Roseman, JM AF Williams, Beverly Rosa Baker, Patricia Sawyer Allman, Richard M. Roseman, Jeffrey M. TI The feminization of bereavement among community-dwelling older adults SO JOURNAL OF WOMEN & AGING LA English DT Article DE bereavement; feminization; older adults ID WOMENS HEALTH; DEPRESSIVE SYMPTOMS; PARENTAL BEREAVEMENT; GENDER-DIFFERENCES; PHYSICAL-ACTIVITY; SOCIAL NETWORKS; LIFE SPOUSAL; WIDOWHOOD; SUPPORT; MEN AB We examined gender differences in frequency and sociodemographic predictors of spousal, non-spousal family, and friendship bereavement events among community-dwelling older adults using data from the UAB Study of Aging. Analysis involved a 30-month observation period of 893 subjects. There were significant differences between women and men for all types of loss. Significant differences were also found in the sociodemographic predictors of loss between and within gender categories. This study revealed the extent to which older women disproportionately bear the burden of loss and points to the need for greater attention to bereavement as a women's issue. C1 Birningham VA Med Ctr, Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, Birmingham, AL 35233 USA. Univ Alabama, Ctr Aging, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Epidemiol, Birmingham, AL 35294 USA. RP Williams, BR (reprint author), Birningham VA Med Ctr, Birmingham Atlanta VA Geriatr Res Educ & Clin Ctr, GRECC 11G,700 19th St S, Birmingham, AL 35233 USA. EM bwilliams@aging.uab.edu; pbaker@uab.edu; rallman@uab.edu; bush@uab.edu FU NIA NIH HHS [R01 AG015062, R01 AG15062] NR 50 TC 11 Z9 11 U1 3 U2 5 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 0895-2841 J9 J WOMEN AGING JI J. Women Aging PY 2006 VL 18 IS 3 BP 3 EP 18 DI 10.1300/J074v18n03_02 PG 16 WC Gerontology; Women's Studies SC Geriatrics & Gerontology; Women's Studies GA 106PS UT WOS:000242113800002 PM 17000616 ER PT J AU Andress, DL AF Andress, DL TI Vitamin D in chronic kidney disease: A systemic role for selective vitamin D receptor activation SO KIDNEY INTERNATIONAL LA English DT Review DE vitamin D; vitamin D receptor activation; chronic kidney disease; cardiovascular disease ID CHRONIC-RENAL-FAILURE; SMOOTH-MUSCLE-CELLS; CD4(+) T-CELLS; CORONARY-ARTERY CALCIFICATION; CHRONIC-HEMODIALYSIS PATIENTS; BONE MORPHOGENETIC PROTEIN-2; HORMONE-RELATED PEPTIDE; VASCULAR CALCIFICATION; PARATHYROID-HORMONE; SECONDARY HYPERPARATHYROIDISM AB Hyperparathyroidism occurs in most patients during the progression of chronic kidney disease (CKD) and one of its initiating events, reduced serum levels of 1,25-dihydroxyvitamin D, results from a decrease in renal 1 alpha hydroxylase activity, which converts 25-hydroxyvitamin D to its activated form. The combination of persistently high parathyroid hormone (PTH) and low 1,25-dihydroxyvitamin D is associated with bone loss, cardiovascular disease, immune suppression and increased mortality in patients with end-stage kidney failure. Recent studies in dialysis patients suggest that paricalcitol, a selective activator of the vitamin D receptor (VDR), is associated with a more favorable efficacy to side effect profile than calcitriol, with less morbidity and better survival. One hypothesis derived from such studies suggests that systemic activation of VDRs may have direct effects on the cardiovascular system to decrease mortality in CKD. Although current guidelines for regulating serum calcium, phosphate and PTH recommend specific interventions at the various stages of CKD to prevent or postpone irreversible parathyroid disease and decrease cardiovascular morbidity and mortality, emerging data suggest that vitamin D therapy may prolong survival in this patient population by mechanisms that are independent of calcium, phosphate and PTH. It is suggested that a re-evaluation of current treatment recommendations is needed and that future research should focus on mechanisms that distinguish potential tissue specific benefits of selective VDR activators in patients with CKD. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Div Nephrol, Dept Med, Seattle, WA 98108 USA. RP Andress, DL (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Div Nephrol, Dept Med, Mailstop 111A,1660 S Columbian Way, Seattle, WA 98108 USA. EM dandress@u.washington.edu NR 117 TC 199 Z9 213 U1 1 U2 9 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JAN PY 2006 VL 69 IS 1 BP 33 EP 43 DI 10.1038/sj.ki.5000045 PG 11 WC Urology & Nephrology SC Urology & Nephrology GA 999JX UT WOS:000234386700016 PM 16374421 ER PT J AU Thornburg, KL Bagby, SP Giraud, GD AF Thornburg, Kent L. Bagby, Susan P. Giraud, George D. BE Neill, JD TI Maternal Adaptation to Pregnancy SO KNOBIL AND NEILL'S PHYSIOLOGY OF REPRODUCTION, VOLS 1 AND 2, 3RD EDITON LA English DT Article; Book Chapter ID GLOMERULAR-FILTRATION-RATE; INTERSTITIAL HYDROSTATIC-PRESSURE; BASAL METABOLIC-RATE; ANGIOTENSIN-ALDOSTERONE SYSTEM; INSTRUMENTED CONSCIOUS RATS; ATRIAL-NATRIURETIC-PEPTIDE; PLASMA-VOLUME EXPANSION; ADULT-BLOOD PRESSURE; GRAVID ANIMAL-MODELS; RENAL HEMODYNAMICS C1 [Thornburg, Kent L.; Giraud, George D.] Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Heart Res Ctr, Portland, OR 97201 USA. [Thornburg, Kent L.; Bagby, Susan P.; Giraud, George D.] Oregon Hlth & Sci Univ, Dept Med, Heart Res Ctr, Portland, OR 97201 USA. [Giraud, George D.] Portland VA Med Ctr, Portland, OR USA. RP Thornburg, KL (reprint author), Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Heart Res Ctr, Portland, OR 97201 USA. OI Thornburg, Kent/0000-0002-5561-4785 NR 220 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-053527-2 PY 2006 BP 2899 EP 2923 PG 25 WC Reproductive Biology SC Reproductive Biology GA BCW96 UT WOS:000311804003004 ER PT J AU Hofstetter, J Suckow, MA Hickman, DL AF Hofstetter, John Suckow, Mark A. Hickman, Debra L. BE Suckow, MA Weisbroth, SH Franklin, CL TI Morphophysiology SO LABORATORY RAT, 2ND EDITION SE American College of Laboratory Animal Medicine Series LA English DT Article; Book Chapter ID TASTE BUD DISTRIBUTION; MINOR SALIVARY-GLANDS; PRECORNEAL TEAR FILM; BROWN ADIPOSE-TISSUE; AGE-RELATED-CHANGES; ALBINO-RAT; SKELETAL-MUSCLE; POSTNATAL-DEVELOPMENT; INTRAOCULAR-PRESSURE; SURFACE AREA C1 [Hofstetter, John] Indiana Univ Sch Med, Indianapolis, IN 46202 USA. [Hickman, Debra L.] Portland VA Med Ctr, Portland, OR 97239 USA. [Suckow, Mark A.] Univ Notre Dame, Freiman Life Sci Ctr 400, Notre Dame, IN 46556 USA. RP Hofstetter, J (reprint author), Indiana Univ Sch Med, 1120 South Dr,Fesler Hall 302, Indianapolis, IN 46202 USA. OI Suckow, Mark/0000-0001-7317-697X NR 215 TC 9 Z9 9 U1 1 U2 3 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-045432-0 J9 AM COLL LAB PY 2006 BP 93 EP 125 DI 10.1016/B978-012074903-4/50007-8 PG 33 WC Veterinary Sciences; Zoology SC Veterinary Sciences; Zoology GA BCT73 UT WOS:000311378400006 ER PT B AU Mietzner, SM Stout, JE Shannon, JL Yu, VL Wareing, DR AF Mietzner, Sue M. Stout, Janet E. Shannon, Jaclynn L. Yu, Victor L. Wareing, David R. BE Cianciotto, NP Kwaik, YA Edelstein, PH Fields, BS Geary, DF Harrison, TG Joseph, CA Ratcliff, RM Stout, JE Swanson, MS TI Evaluation of the dynal biotech Legionella immunomagnetic separation method versus conventional culture for the isolation of Legionella pneumophila serogroup 1 from water samples SO LEGIONELLA: STATE OF THE ART 30 YEARS AFTER ITS RECOGNITION LA English DT Proceedings Paper CT 6th International Conference on Legionella CY OCT 16-20, 2005 CL Chicago, IL ID NOSOCOMIAL LEGIONNAIRES-DISEASE; SYSTEMS C1 VA Pittsburgh Healthcare Syst, Dept Infect Dis, Pittsburgh, PA 15240 USA. RP Mietzner, SM (reprint author), VA Pittsburgh Healthcare Syst, Dept Infect Dis, Pittsburgh, PA 15240 USA. NR 6 TC 0 Z9 0 U1 1 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N STREET NW, WASHINGTON, DC 20036-2904 USA BN 978-1-55581-390-1 PY 2006 BP 449 EP 452 PG 4 WC Infectious Diseases SC Infectious Diseases GA BFS09 UT WOS:000244175400107 ER PT B AU Stout, JE AF Stout, Janet E. BE Cianciotto, NP Kwaik, YA Edelstein, PH Fields, BS Geary, DF Harrison, TG Joseph, CA Ratcliff, RM Stout, JE Swanson, MS TI Controlling Legionella in hospital water systems: Facts versus folklore SO LEGIONELLA: STATE OF THE ART 30 YEARS AFTER ITS RECOGNITION LA English DT Proceedings Paper CT 6th International Conference on Legionella CY OCT 16-20, 2005 CL Chicago, IL ID NOSOCOMIAL LEGIONNAIRES-DISEASE; ENVIRONMENTAL CULTURES; POTABLE WATER; DISINFECTION; PREVENTION; PNEUMOPHILA; CATALONIA; BACTERIA; EFFICACY; SPAIN C1 VA Pittsburgh Healthcare Syst, Dept Infect Dis, Pittsburgh, PA 15240 USA. RP Stout, JE (reprint author), VA Pittsburgh Healthcare Syst, Dept Infect Dis, Pittsburgh, PA 15240 USA. NR 31 TC 1 Z9 1 U1 1 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N STREET NW, WASHINGTON, DC 20036-2904 USA BN 978-1-55581-390-1 PY 2006 BP 469 EP 472 PG 4 WC Infectious Diseases SC Infectious Diseases GA BFS09 UT WOS:000244175400113 ER PT J AU Scott, BL Sandmaier, BM Storer, B Maris, MB Sorror, ML Maloney, DG Chauncey, TR Storb, R Deeg, HJ AF Scott, BL Sandmaier, BM Storer, B Maris, MB Sorror, ML Maloney, DG Chauncey, TR Storb, R Deeg, HJ TI Myeloablative vs nonmyeloablative allogeneic transplantation for patients with myelodysplastic syndrome or acute myelogenous leukemia with multilineage dysplasia: a retrospective analysis SO LEUKEMIA LA English DT Article DE myelodysplastic syndrome; hemopoietic cell transplantation; nonmyeloablative transplantation; secondary leukemia ID HEMATOPOIETIC-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; GRAFT-VERSUS-LEUKEMIA; HEMATOLOGIC MALIGNANCIES; UNRELATED DONORS; THERAPY; ENGRAFTMENT; DISEASES; OLDER; HCT AB Transplant outcome was analyzed in 150 patients with myelo-dysplastic syndrome (MDS) or acute myelogenous leukemia transformed from MDS (tAML) conditioned with nonmyeloablative or myeloablative regimens. A total of 38 patients received nonmyeloablative regimens of 2Gy total body irradiation alone (n = 2) or with fludarabine (n = 36), 90mg/m(2). A total of 112 patients received a myeloablative regimen of busulfan, 16 mg/kg ( targeted to 800-900 ng/ml), and cyclophosphamide 120 mg/kg. Nonmyeloablative patients were older ( median age 62 vs 52 years, P < 0.001), more frequently had progressed to tAML ( 53 vs 31%, P = 0.06), had higher risk disease by the International Prognostic Scoring System ( 53 vs 30%, P = 0.004), had higher transplant specific comorbidity indices ( 68 vs 42%, P = 0.01) and more frequently had durable complete responses to induction chemotherapy ( 58 vs 14%). Three-year overall survival (27%/48% ( P = 0.56)), progression-free survival (28%/44%, ( P = 0.60)), and nonrelapse mortality (41%/34%, ( P = 0.94)) did not differ significantly between nonmyeloblative/ myeloablative conditioning. Overall (HR = 0.9, P = 0.84) and progression-free survivals (HR = 1, P = 0.93) were similar for patients with chemotherapy-induced remissions irrespective of conditioning intensity. Graft vs leukemia effects may be more important than conditioning intensity in preventing progression in patients in chemotherapy-induced remissions at the time of transplantation. Randomized prospective studies are needed to further address the optimal choice of transplant conditioning intensity in myeloid neoplasms. 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. RP Deeg, HJ (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,D1-100,POB 19024, Seattle, WA 98109 USA. EM jdeeg@fhcrc.org FU NCI NIH HHS [CA15704, CA18029, CA78902, P01 CA078902]; NHLBI NIH HHS [HL36444] NR 15 TC 148 Z9 152 U1 1 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0887-6924 J9 LEUKEMIA JI Leukemia PD JAN PY 2006 VL 20 IS 1 BP 128 EP 135 DI 10.1038/sj.leu.2404010 PG 8 WC Oncology; Hematology SC Oncology; Hematology GA 993LW UT WOS:000233956600018 PM 16270037 ER PT J AU Murray, JP Liotti, M Ingmundson, PT Mayberg, HS Pu, YL Zamarripa, F Liu, YJ Woldorff, MG Gao, JH Fox, PT AF Murray, JP Liotti, M Ingmundson, PT Mayberg, HS Pu, YL Zamarripa, F Liu, YJ Woldorff, MG Gao, JH Fox, PT TI Children's brain Activations while viewing televised violence revealed by fMRI SO MEDIA PSYCHOLOGY LA English DT Article ID POSITRON-EMISSION-TOMOGRAPHY; FACIAL EXPRESSIONS; HUMAN AMYGDALA; RIGHT-HEMISPHERE; EMOTION; RETRIEVAL; RECOGNITION; ATTENTION; MEMORY; PET AB Though social and behavioral effects of TV violence have been studied extensively, the brain systems involved in TV violence viewing in children are, at present, not known. In this study, 8 children viewed televised violent and nonviolent video sequences while brain activity was measured with functional magnetic resonance imaging. Both violent and nonviolent viewing activated regions involved in visual motion, visual object and scenes, and auditory listening. However, viewing TV violence selectively recruited a network of right hemisphere regions including precuneus, posterior cingulate, amygdala, inferior parietal, and prefrontal and premotor cortex. Bilateral activations were apparent in hippocampus, parahippo-campus, and pulvinar. TV violence viewing transiently recruits a network of brain regions involved in the regulation of emotion, arousal and attention, episodic memory encoding and retrieval, and motor programming. This pattern of brain activations may explain the behavioral effects observed in many studies, especially the finding that children who are frequent viewers of TV violence are more likely to behave aggressively. Such extensive viewing may result in a large number of aggressive scripts stored in long-term memory in the posterior cingulate, which facilitates rapid recall of aggressive scenes that serve as a guide for overt social behavior. C1 Kansas State Univ, Sch Family Studies & Human Serv, Manhattan, KS 66506 USA. Harvard Univ, Childrens Hosp, Sch Med, Mind Sci Fdn, Boston, MA 02115 USA. Harvard Univ, Childrens Hosp, Sch Med, Ctr Media & Child Hlth, Boston, MA 02115 USA. Simon Fraser Univ, Burnaby, BC V5A 1S6, Canada. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. Emory Univ, Sch Med, Atlanta, GA 30322 USA. Univ Chicago, Sch Med, Chicago, IL 60637 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Univ Florida, Sch Med, Gainesville, FL 32611 USA. Duke Univ, Durham, NC 27706 USA. RP Murray, JP (reprint author), Kansas State Univ, Sch Family Studies & Human Serv, Manhattan, KS 66506 USA. EM jpm@ksu.edu RI Fox, Peter/B-4725-2010 OI Fox, Peter/0000-0002-0465-2028 NR 56 TC 25 Z9 25 U1 0 U2 14 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1521-3269 EI 1532-785X J9 MEDIA PSYCHOL JI Media Psychol. PY 2006 VL 8 IS 1 BP 25 EP 37 DI 10.1207/S1532785XMEP0801_3 PG 15 WC Communication; Film, Radio, Television; Psychology, Applied SC Communication; Film, Radio & Television; Psychology GA 012PZ UT WOS:000235352800003 ER PT J AU Johnson, ML Pietz, K Battleman, DS Beyth, RJ AF Johnson, ML Pietz, K Battleman, DS Beyth, RJ TI Therapeutic goal attainment in patients with hypertension and dyslipidemia SO MEDICAL CARE LA English DT Article ID DENSITY-LIPOPROTEIN-CHOLESTEROL; BLOOD-PRESSURE; CARDIOVASCULAR-DISEASE; RANDOMIZED-TRIALS; DIABETES-MELLITUS; CLINICAL-PRACTICE; HEART-DISEASE; RISK-FACTORS; GUIDELINES; MANAGEMENT AB Background: Recent guidelines emphasize the need to assess and treat overall risk for cardiovascular disease through the concomitant management of multiple risk factors. We sought to ascertain treatment patterns and attainment of therapeutic goals in patients with isolated and concomitant hypertension and dyslipidemia, both with and without diabetes mellitus (DM) and symptomatic cardiovascular disease. Methods: Inception cohorts of more than 41,000 newly diagnosed hypertension and dyslipidemia patients from 6 medical centers of the south-central Veterans Affairs health care system were evaluated. Treatment patterns and goal attainment for low-density lipoprotein cholesterol (LDL-C; Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults guidelines: < 160, < 130, or <= 100 mg/dL depending on risk factors) and blood pressure (BP; Joint National Committee 6: < 140/90 or < 130/85 mm Hg depending on risk factors) were measured at I year. Separate analyses were conducted in patients with and without DM and symptomatic cardiovascular disease. Results: Treatment rates in patients with and without DM and symptomatic disease ranged from 46.6% to 71.3% in patients with hypertension only, from 31.5% to 64.1% in patients with dyslipidemia only, and from 64.3% to 91.3% in patients with both conditions. Among asymptomatic patients, 40.6% of nondiabetics and 20.6% of patients with DM with isolated hypertension reached BP targets. Attainment of LDL-C goals was slightly higher and reached 52.8% among patients with DM with concomitant hypertension. Among symptomatic patients, attainment of all goals was < 40% for all groups. The proportion of asymptomatic patients with concomitant disease reaching goal for both BP and LDL-C was 24.4% among nondiabetics and 15.4% among patients with DM; these proportions decreased to 13.6% and 13.4% respectively, among patients with symptomatic cardiovascular disease. Conclusions: The majority of patients were receiving pharmacological treatment of hypertension and dyslipidemia, yet attainment of therapeutic goals was generally < 50%. Further work is needed to determine factors related to improvement in management and outcomes of patients with multiple cardiovascular risk factors. C1 VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Dept Med, Houston, TX USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA USA. Univ Florida, Rehabil Outcomes Res Ctr, NF SG Vet Hlth Syst, Gainesville, FL 32611 USA. Univ Florida, Div Geriatr, Gainesville, FL USA. Pfizer Inc, Pfizer Global Outcomes Res, New York, NY USA. RP Johnson, ML (reprint author), VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM mjohnson@bcm.tmc.edu NR 34 TC 32 Z9 33 U1 3 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JAN PY 2006 VL 44 IS 1 BP 39 EP 46 DI 10.1097/01.mlr.0000188982.25397.37 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 998TN UT WOS:000234342600006 PM 16365611 ER PT J AU Mendez, MF AF Mendez, MF TI What frontotemporal dementia reveals about the neurobiological basis of morality SO MEDICAL HYPOTHESES LA English DT Article ID ANTISOCIAL PERSONALITY-DISORDER; POSITRON-EMISSION-TOMOGRAPHY; FRONTAL-LOBE DAMAGE; PREFRONTAL CORTEX; ACQUIRED SOCIOPATHY; SOCIAL COGNITION; DECISION-MAKING; CRIMINAL BEHAVIOR; TEMPORAL VARIANT; BRAIN AB There is evidence that moral behavior is a product of evolution and an innate aspect of the human brain. Functional magnetic resonance studies in normals, investigations of psychopaths, and acquired sociopathy from brain lesions suggest a neurobiology of moral behavior. Reports of sociopathy among patients with frontotemporal dementia (FTD) have provided a further opportunity to clarify the neurobiology of morality. They confirm a morality network that includes the ventromedial frontal cortex, the orbitofrontal cortex, and the amygdalae. The right ventromedial region is critical for the emotional tagging of moral situations, the orbitofrontal cortex responds to social cues and mitigates impulsive reactions, and the amygdalae are necessary for threat detection and moral learning. Alterations in moral behavior in FTD may result from a loss of the emotional label of moral dilemmas, coupled with disinhibited responses. More investigations are needed to fully understand how the brain mediates moral or ethical behavior. (c) 2006 Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. RP Mendez, MF (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Ctr, Neurobehav Unit, Dept Neurol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@UCLA.edu NR 84 TC 29 Z9 29 U1 5 U2 13 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2006 VL 67 IS 2 BP 411 EP 418 DI 10.1016/j.mehy.2006.01.048 PG 8 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 057WD UT WOS:000238625000039 PM 16540253 ER PT J AU Setubal, JC Reis, M Matsunaga, J Haake, DA AF Setubal, JC Reis, M Matsunaga, J Haake, DA TI Lipoprotein computational prediction in spirochaetal genomes 10.1099/mic.0.28317-0 SO MICROBIOLOGY-SGM LA English DT Article ID SURFACE-EXPOSED LIPOPROTEIN; LYME-DISEASE SPIROCHETE; BORRELIA-BURGDORFERI; BACTERIAL LIPOPROTEINS; ESCHERICHIA-COLI; TREPONEMA-PALLIDUM; SEQUENCE-ANALYSIS; SIGNAL PEPTIDES; PROTEIN; PATHOGENESIS AB Lipoproteins are of great interest in understanding the molecular pathogenesis of spirochaetes. Because spirochaete lipobox sequences exhibit more plasticity than those of other bacteria, application of existing prediction algorithms to emerging sequence data has been problematic. In this paper a novel lipoprotein prediction algorithm is described, designated SpLip, constructed as a hybrid of a lipobox weight matrix approach supplemented by a set of lipoprotein signal peptide rules allowing for conservative amino acid substitutions. Both the weight matrix and the rules are based on a training set of 28 experimentally verified spirochaetal lipoproteins. The performance of the SpLip algorithm was compared to that of the hidden Markov model-based LipoP program and the rules-based algorithm Psort for all predicted protein-coding genes of Leptospira interrogans sv. Copenhageni, L. interrogans sv. Lai, Borrelia burgdorferi, Borrelia garinii, Treponema pallidum and Treponema denticola. Psort sensitivity (13-35 %) was considerably less than that of SpLip (93-100 %) or LipoP (50-84 %) due in part to the requirement of Psort for Ala or Gly at the -1 position, a rule based on E. coli lipoproteins. The percentage of false-positive lipoprotein predictions by the LipoP algorithm (8-30 %) was greater than that of SpLip (0-1 %) or Psort (4-27 %), due in part to the lack of rules in LipoP excluding unprecedented amino acids such as Lys and Arg in the -1 position. This analysis revealed a higher number of predicted spirochaetal lipoproteins than was previously known. The improved performance of the SpLip algorithm provides a more accurate prediction of the complete lipoprotein repertoire of spirochaetes. The hybrid approach of supplementing weight matrix scoring with rules based on knowledge of protein secretion biochemistry may be a general strategy for development of improved prediction algorithms. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Virginia Tech, Virginia Bioinformat Inst, Blacksburg, VA 24060 USA. Univ Estadual Campinas, Lab Bioinformat, Inst Computac, BR-13084071 Campinas, SP, Brazil. Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90095 USA. RP Haake, DA (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, 111F, Los Angeles, CA 90073 USA. EM dhaake@ucla.edu RI Setubal, Joao/C-7305-2012; Reis, Marcelo/K-4075-2012 OI Setubal, Joao/0000-0001-9174-2816; Reis, Marcelo/0000-0002-3754-9115 FU NIAID NIH HHS [AI-34431, R01 AI034431, R01 AI034431-09, R21 AI034431, R29 AI034431] NR 36 TC 112 Z9 115 U1 0 U2 4 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING RG7 1AG, BERKS, ENGLAND SN 1350-0872 J9 MICROBIOL-SGM JI Microbiology-(UK) PD JAN PY 2006 VL 152 BP 113 EP 121 DI 10.1099/mic.0.28317-0 PN 1 PG 9 WC Microbiology SC Microbiology GA 004HA UT WOS:000234741400013 PM 16385121 ER PT J AU Thompson, SK Chang, EY Jobe, BA AF Thompson, SK Chang, EY Jobe, BA TI Clinical review: Healing in gastrointestinal anastomoses, Part I SO MICROSURGERY LA English DT Review ID EXPERIMENTAL COLONIC ANASTOMOSES; MECHANICAL BOWEL PREPARATION; EXPERIMENTAL INTESTINAL ANASTOMOSES; ACUTE WOUND FAILURE; COLLAGEN-SYNTHESIS; COLORECTAL SURGERY; BREAKING STRENGTH; BURSTING STRENGTH; RATS; RESECTION AB Gastrointestinal healing is a topic rarely reviewed in the literature, yet it is of paramount importance to the surgeon. Failure of anastomotic healing may lead to life-threatening complications, additional surgical procedures, increased length of stay, increased cost, long-term disability, and reduced quality of life for the patient. The goal of this article is to review the biological response to wounded tissue, to outline discrete differences between skin and gastrointestinal healing, to discuss local and systemic factors important to gastrointestinal healing, and to compare methods of measuring collagen content and strength of the newly formed anastomosis. Part II of this review will focus on techniques and therapies available to optimize anastornotic healing. (c) 2006 Wiley-Liss, Inc. C1 Portland VA Med Ctr, P3GS Surg Serv, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, P3GS Surg Serv, POB 1034, Portland, OR 97207 USA. EM jobeb@ohsu.edu NR 27 TC 68 Z9 73 U1 0 U2 3 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0738-1085 J9 MICROSURG JI Microsurgery PY 2006 VL 26 IS 3 BP 131 EP 136 DI 10.1002/micr.20197 PG 6 WC Surgery SC Surgery GA 030UN UT WOS:000236660500002 PM 16518804 ER PT J AU Enestvedt, CK Thompson, SK Chang, EY Jobe, BA AF Enestvedt, CK Thompson, SK Chang, EY Jobe, BA TI Clinical review: Healing in gastrointestinal anastomoses, Part II SO MICROSURGERY LA English DT Review ID ENDOTHELIAL GROWTH-FACTOR; ADDITIONAL MICROVASCULAR ANASTOMOSIS; INTRATHORACIC ESOPHAGEAL-CARCINOMA; LASER-DOPPLER FLOWMETRY; GASTRIC TUBE; BLOOD-FLOW; PREOPERATIVE EMBOLIZATION; INTESTINAL ANASTOMOSES; INDUCED ANGIOGENESIS; COLON INTERPOSITION AB Complications arising from gastrointestinal anastomosis failures are a major source of morbidity and mortality. This review examines the effects of local blood flow on anastomotic healing, and discusses strategies for improving perfusion. Disruption of blood supply plays a significant role in the development of anastornotic leakage. Several methods have been suggested to improve perfusion. Omental pedicles have been employed as buttresses to promote angiogenesis, but efficacy in preventing anastornotic dehiscence has not been established. The administration of exogenous pharmacologic agents (such as vascular endothelial growth factor) is another potential strategy, although the oncological safety of this approach has been questioned. Two techniques which show promise in reducing anastornotic leakage rates include the vascular augmentation of grafts at risk for ischemia (supercharging) and ischemic conditioning (utilizing the delay phenomenon). Further studies of these strategies are needed to establish their efficacy and safety for routine use in gastrointestinal anastomoses. (c) 2006 Wiley-Liss, Inc. C1 Portland VA Med Ctr, P3GS Surg Serv, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. RP Jobe, BA (reprint author), Portland VA Med Ctr, P3GS Surg Serv, POB 1034, Portland, OR 97207 USA. EM jobeb@ohsu.edu NR 49 TC 25 Z9 30 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0738-1085 J9 MICROSURG JI Microsurgery PY 2006 VL 26 IS 3 BP 137 EP 143 DI 10.1002/micr.20198 PG 7 WC Surgery SC Surgery GA 030UN UT WOS:000236660500003 PM 16518802 ER PT J AU Sherman, SE Joseph, AM Yano, EM Simon, BF Arikian, N Rubenstein, LV Parkerton, P Mittman, BS AF Sherman, SE Joseph, AM Yano, EM Simon, BF Arikian, N Rubenstein, LV Parkerton, P Mittman, BS TI Assessing the institutional approach to implementing smoking cessation practice guidelines in veterans health administration facilities SO MILITARY MEDICINE LA English DT Article ID PRIMARY-CARE; QUALITY AB National smoking cessation guidelines include recommended strategies for providers and health care organizations, but they offer little guidance on how to structure care. We conducted a cross-sectional survey at 40 Veterans Health Administration facilities, to describe the structure of smoking cessation care, to assess adherence to national guidelines, and to assess facilities' preferred approach to providing smoking cessation treatment. We categorized sites as those using a primary care approach (most smokers treated by the primary care provider) versus a specialty approach (medication restricted to smoking cessation clinics, to which most patients were referred). Nearly all sites reported systematic screening for smoking and counseling of smokers, usually by both nursing staff members and the primary care provider. Most sites used a specialty approach, restricting medication access to smokers attending a cessation program. Future research should evaluate whether this approach provides adequate access and responsiveness to patient preferences for the full population of smokers in primary care. C1 Vet Adm Greater Los Angeles Healthcare Syst, Vet Adm Hlth Serv Res & Dev, Ctr Excellence Study Healthcare Provider Behav, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Vet Adm Med Ctr, Ctr Chron Dis Outcome Res, Vet Integrated Serv Network 13, Minneapolis, MN 55417 USA. Univ Minnesota, Dept Med, Minneapolis, MN 55417 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90095 USA. RAND Corp, Santa Monica, CA 90407 USA. RP Sherman, SE (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Vet Adm Hlth Serv Res & Dev, Ctr Excellence Study Healthcare Provider Behav, Sepulveda, CA 91343 USA. NR 22 TC 15 Z9 15 U1 2 U2 2 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD JAN PY 2006 VL 171 IS 1 BP 80 EP 87 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 019JV UT WOS:000235832300018 PM 16532880 ER PT J AU Thompson, SM Cai, X Dinocourt, C Nestor, MW AF Thompson, Scott M. Cai, Xiang Dinocourt, Celine Nestor, Michael W. BE Pitkanen, A Schwartzkroin, PA Moshe, SL TI The Use of Brain Slice Cultures for the Study of Epilepsy SO MODELS OF SEIZURES AND EPILEPSY LA English DT Article; Book Chapter ID HIPPOCAMPUS IN-VITRO; EXCITATORY SYNAPTIC-TRANSMISSION; TEMPORAL-LOBE EPILEPSY; LONG-TERM POTENTIATION; SEIZURE-LIKE ACTIVITY; SEMLIKI-FOREST-VIRUS; CA1 PYRAMIDAL CELLS; RAT HIPPOCAMPUS; EPILEPTIFORM ACTIVITY; ORGANOTYPIC CULTURES C1 [Thompson, Scott M.] Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Los Angeles, CA 90024 USA. [Cai, Xiang; Dinocourt, Celine; Nestor, Michael W.] Univ Maryland, Dept Physiol, Baltimore, MD 21201 USA. RP Thompson, SM (reprint author), Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Los Angeles, CA 90024 USA. NR 99 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-045702-4 PY 2006 BP 45 EP 58 DI 10.1016/B978-012088554-1/50007-4 PG 14 WC Neurosciences SC Neurosciences & Neurology GA BCT46 UT WOS:000311355400007 ER PT J AU Mazarati, AM Thompson, KW Suchomelova, L Sankar, R Shirasaka, Y Nissinen, J Pitkanen, A Bertram, E Wasterlain, CG AF Mazarati, Andrey M. Thompson, Kerry W. Suchomelova, Lucie Sankar, Raman Shirasaka, Yukiyoshi Nissinen, Jari Pitkanen, Asla Bertram, Edward Wasterlain, Claude G. BE Pitkanen, A Schwartzkroin, PA Moshe, SL TI Status Epilepticus: Electrical Stimulation Models SO MODELS OF SEIZURES AND EPILEPSY LA English DT Article; Book Chapter ID SUSTAINING STATUS EPILEPTICUS; LIMBIC STATUS EPILEPTICUS; TEMPORAL-LOBE EPILEPSY; DEEP PREPYRIFORM CORTEX; SPONTANEOUS SEIZURES; ANTIEPILEPTIC DRUGS; DEVELOPING BRAIN; NEURONAL DEATH; ANIMAL-MODELS; RAT MODEL C1 [Mazarati, Andrey M.; Thompson, Kerry W.; Suchomelova, Lucie; Shirasaka, Yukiyoshi] Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Los Angeles, CA 90095 USA. [Bertram, Edward] Univ Virginia, Dept Neurol, Charlottesville, VA USA. [Nissinen, Jari; Pitkanen, Asla] Univ Kuopio, AI Virtanen Inst Mol Sci, Dept Neurobiol, FIN-70211 Kuopio, Finland. [Sankar, Raman] Univ Calif Los Angeles, Brain Res Inst, Dept Neurol, Los Angeles, CA 90024 USA. [Sankar, Raman] Univ Calif Los Angeles, Brain Res Inst, Dept Pediat, Los Angeles, CA 90024 USA. RP Mazarati, AM (reprint author), Univ Calif Los Angeles, W Los Angeles VA Med Ctr, Los Angeles, CA 90095 USA. NR 70 TC 10 Z9 10 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-045702-4 PY 2006 BP 449 EP 464 DI 10.1016/B978-012088554-1/50038-4 PG 16 WC Neurosciences SC Neurosciences & Neurology GA BCT46 UT WOS:000311355400038 ER PT J AU Green, LK AF Green, LK TI Granulomatous inflammation in cytopathology: A review of 154 cases SO MODERN PATHOLOGY LA English DT Meeting Abstract CT 95th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY FEB 11-17, 2006 CL Atlanta, GA SP US & Canadian Acad Pathol C1 Houston VAMC, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0893-3952 J9 MODERN PATHOL JI Mod. Pathol. PD JAN PY 2006 VL 19 SU 1 MA 257 BP 58A EP 58A PG 1 WC Pathology SC Pathology GA 995IR UT WOS:000234094500257 ER PT J AU Kasuganti, D Green, L Reddy, VB Kluskens, L Gattuso, P AF Kasuganti, D Green, L Reddy, VB Kluskens, L Gattuso, P TI Hematologic malignancies involving body cavities: Diagnostic and prognostic implications in 116 cases SO MODERN PATHOLOGY LA English DT Meeting Abstract CT 95th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY FEB 11-17, 2006 CL Atlanta, GA SP US & Canadian Acad Pathol C1 Rush Univ, Med Ctr, Chicago, IL 60612 USA. Houston VAMC, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0893-3952 J9 MODERN PATHOL JI Mod. Pathol. PD JAN PY 2006 VL 19 SU 1 MA 267 BP 61A EP 61A PG 1 WC Pathology SC Pathology GA 995IR UT WOS:000234094500267 ER PT J AU Martin, FC Handforth, A AF Martin, Fredricka C. Handforth, Adrian TI Carbenoxolone and mefloquine suppress tremor in the harmaline mouse model of essential tremor SO MOVEMENT DISORDERS LA English DT Article DE essential tremor; harmaline; gap junction; connexin; carbenoxolone; mefloquine ID POSITRON EMISSION TOMOGRAPHY; NEURONAL GAP-JUNCTIONS; LONG-CHAIN ALCOHOLS; INFERIOR OLIVE; PHARMACOLOGICAL-PROPERTIES; CEREBELLAR DYSFUNCTION; NERVOUS-SYSTEM; RAT-BRAIN; IN-VIVO; EXPRESSION AB Excessive olivo-cerebellar synchrony is implicated in essential tremor. Because synchrony in some networks is mediated by gap junctions, we examined whether the gap junction blockers heptanol, octanol, carbenoxolone, and mefloquine suppress tremor in the mouse harmaline model, and performed an open-treatment clinical study of mefloquine for essential tremor. Digitized motion was used to quantify tremor in mice administered harmaline, 20 mg/kg s.c. In mice the broad-spectrum gap junction blockers heptanol, octanol (350 mg/kg i.p. each), and carbenoxolone (20 mg/kg) suppressed harmaline tremor. Mefloquine (50 mg/kg), which blocks gap junctions containing connexin 36, robustly suppressed harmaline tremor. Glycyrrhizic acid (related to carbenoxolone) and chloroquine (related to mefloquine), which do not block gap junctions, failed to suppress harmaline tremor in mice. Clinically, tremor was assessed with standard rating scales, and subjects asked to take 62.5, 125, and 250 mg mefloquine weekly for 12 weeks at each dose. None of the four human subjects showed a meaningful tremor reduction with mefloquine, likely because clinical levels were below those required for efficacy. In view of recent genetic evidence, the anti-tremor mechanism of these compounds is uncertain but may represent a novel therapeutic target, possibly involving gap junctions other than those containing connexin 36. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Serv Neurol, Los Angeles, CA USA. RP Handforth, A (reprint author), 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM charles.handforth@med.va.gov NR 69 TC 29 Z9 31 U1 0 U2 3 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. PY 2006 VL 21 IS 10 BP 1641 EP 1649 DI 10.1002/mds.20940 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 101MQ UT WOS:000241745300011 PM 16773639 ER PT J AU Yishak, AA Costacou, T Virella, G Zgibor, J Fried, L Walsh, M Evans, RW Lopes-Virella, M Kagan, VE Otvos, J Orchard, TJ AF Yishak, AA Costacou, T Virella, G Zgibor, J Fried, L Walsh, M Evans, RW Lopes-Virella, M Kagan, VE Otvos, J Orchard, TJ TI Novel predictors of overt nephropathy in subjects with type 1 diabetes. A nested case control study from the Pittsburgh Epidemiology of Diabetes Complications cohort SO NEPHROLOGY DIALYSIS TRANSPLANTATION LA English DT Article DE adhesion molecules; antioxidants; diabetic nephropathy; immune complexes; lipids ID CORONARY-ARTERY-DISEASE; OXIDIZED LDL; ANTIOXIDANTS; PROGRESSION AB Background. Predictors of diabetic nephropathy are only partly known and traditional risk factors do not adequately explain disease risk. We thus examined novel risk factors for overt nephropathy (ON) in type 1 diabetes. Methods. The EDC is a prospective study of childhood-onset type 1 diabetes. When first seen (1986-1988), mean age was 28 and diabetes duration 19 years. In the subsequent 10 years, 56 of 485 subjects without ON in 1986-88 developed ON. An age, duration (+/- 3 years), and sex-matched control was identified for 47 cases. Forty-two matched pairs had available stored plasma samples obtained prior to ON onset in cases, and complete standard risk factor data. Results. Cases had a higher baseline albumin excretion rate (AER), HbA(1), pulse rate, non-HDL cholesterol, fibrinogen, small LDL and lower eGDR and LDL particle size compared to controls (all P values < 0.05). Multiple measures of immune complexes were increased in cases (P < 0.05), whereas borderline elevations were seen for total antioxidant reserve (P = 0.06) and retinol (P = 0.08). Multivariably, other than AER, LDL particle size and IgG-IC were predictive beyond the standard predictors. Conclusion. Besides AER, the immunecomplexes and lipoprotein subclasses may provide additional information in the assessment of ON risk in type 1 diabetes. C1 Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Environm & Occupat Hlth, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA 15213 USA. Vet Pittsburgh Hlth Care Syst Pittsburgh, Pittsburgh, PA USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Dept Med, Charleston, SC USA. LipoSci Inc, Raleigh, NC USA. RP Orchard, TJ (reprint author), Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Diabet & Lipid Res Bldg,3512 5th Ave, Pittsburgh, PA 15213 USA. EM tjo@pitt.edu OI orchard, trevor/0000-0001-9552-3215 FU NIDDK NIH HHS [DK34818] NR 19 TC 19 Z9 19 U1 0 U2 2 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 JAN PY 2006 VL 21 IS 1 BP 93 EP 100 DI 10.1093/ndt/gfi103 PG 8 WC Transplantation; Urology & Nephrology SC Transplantation; Urology & Nephrology GA 000BO UT WOS:000234436100021 PM 16144851 ER PT J AU Odden, MC Whooley, MA Shlipak, MG AF Odden, Michelle C. Whooley, Mary A. Shlipak, Michael G. TI Depression, stress, and quality of life in persons with chronic kidney disease: The Heart and Soul Study SO NEPHRON CLINICAL PRACTICE LA English DT Article DE chronic kidney disease; kidney disease, depression; kidney disease, stress; kidney disease, quality of life ID STAGE RENAL-DISEASE; HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; SINGLE-ITEM; HEALTH; INSUFFICIENCY; SYMPTOMS; ASSOCIATION; MORTALITY; ISCHEMIA AB Background: The effect of mild chronic kidney disease (CKD) on depression, stress, quality of life (QOL), and health status is not well understood. We compared these outcomes in subjects with and without CKD. Methods: We performed a cross- sectional study of 967 outpatients enrolled in the Heart and Soul Study. CKD was defi ned as a measured creatinine clearance <60 ml/min. Outcome measures included depressive symptoms measured using the Patient Health Questionnaire (PHQ), stress measured using the Perceived Stress Scale (PSS), and QOL and overall health rated as excellent, very good, good, fair, or poor. Results: The prevalence of depressive symptoms (17 vs. 19%, p = 0.4) or perceived stress (11 vs. 16%, p = 0.09) did not vary signifi cantly by CKD. The prevalence of fair or poor QOL was not signifi cantly different in subjects with CKD, compared with those without CKD (24 vs. 23%, p = 0.65). Age-adjusted analyses revealed a signifi cant association of CKD with QOL (p = 0.003), however, this association no longer reached statistical significance after adjustment for confounders (p = 0.06). Subjects with CKD were more likely to report poor or fair overall health than subjects without CKD (42 vs. 34%, p = 0.03). After multivariate adjustment, CKD remained signifi cantly associated with worse overall health (OR = 1.65, 95% Cl 1.21 - 2.24, p = 0.001), and modestly associated with QOL ( OR = 1.31, 95% Cl 0.99-1.75, p = 0.06), but had no association with depression (p = 0.48) or stress (p = 0.24). Conclusion: In this study of persons with coronary artery disease, subjects with CKD had reduced overall health and modestly reduced QOL; however, mental health was similar in those with and without CKD. These fi ndings suggest that self-assessed overall health may decline at earlier stages of renal dysfunction than mental health outcomes or QOL. C1 San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Shlipak, MG (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, 4150 Clement St,111A-1, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu FU NHLBI NIH HHS [R01 HL079235, R01 HL079235-01A1] NR 34 TC 28 Z9 30 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1660-2110 J9 NEPHRON CLIN PRACT JI Nephron. Clin. Pract. PY 2006 VL 103 IS 1 BP C1 EP C7 DI 10.1159/000090112 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 163PS UT WOS:000246174100001 PM 16340237 ER PT J AU Watson, GS Bernhardt, T Reger, MA Cholerton, BA Baker, LD Peskind, ER Asthana, S Plymate, SR Frolich, L Craft, S AF Watson, GS Bernhardt, T Reger, MA Cholerton, BA Baker, LD Peskind, ER Asthana, S Plymate, SR Frolich, L Craft, S TI Insulin effects on CSF norepinephrine and cognition in Alzheimer's disease SO NEUROBIOLOGY OF AGING LA English DT Article DE aging; Alzheimer's disease; attention; amnestic mild cognitive impairment; cerebrospinal fluid; insulin; lumbar puncture; norepinephrine; memory ID APOLIPOPROTEIN-E GENOTYPE; LOCUS-COERULEUS; MEMORY; MODULATION; BRAIN AB We assessed the effects of induced hyperinsulinemia on plasma and cerebrospinal fluid (CSF) levels of norepinephrine (NE) and on cognition for patients with Alzheimer's disease (AD) and normal older adults. For normal adults, insulin increased plasma and CSF NE levels; also, recall for paraphrased details of a story improved as CSF NE levels increased. Mental control was positively correlated with CSF levels of NE for patients. These findings demonstrate that raising peripheral insulin levels can modulate CNS NE levels and suggest that insulin-stimulated increases in NE may modulate cognitive functions. (C) 2005 Elsevier Inc. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Heidelberg, Cent Inst Mental Hlth, D-6800 Mannheim, Germany. Univ Wisconsin, Sch Med, Ctr Geriatr Res Educ & Clin, William S Middleton Mem Hosp,Dept Med, Madison, WI USA. RP Craft, S (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC, S-182-GRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM scraft@u.washington.edu FU NIA NIH HHS [T32 AG000258, R01 AG10880] NR 16 TC 50 Z9 51 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD JAN PY 2006 VL 27 IS 1 BP 38 EP 41 DI 10.1016/j.neurobiolaging.2004.11.011 PG 4 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 998YM UT WOS:000234355800006 PM 16298239 ER PT J AU Williams, DL Goldstein, G Minshew, NJ AF Williams, DL Goldstein, G Minshew, NJ TI The profile of memory function in children with autism SO NEUROPSYCHOLOGY LA English DT Article DE autism; memory assessment; discriminant analysis; principal components analysis ID PERVASIVE DEVELOPMENTAL DISORDERS; WORKING-MEMORY; IMPAIRED MEMORY; DIAGNOSTIC INTERVIEW; INFANTILE-AUTISM; COMPREHENSION; RECOGNITION; INTACT; FACE; INDIVIDUALS AB A clinical memory test was administered to 38 high-functioning children with autism and 38 individually matched normal controls, 8-16 years of age. The resulting profile of memory abilities in the children with autism was characterized by relatively poor memory for complex visual and verbal information and spatial working memory with relatively intact associative learning ability, verbal working memory, and recognition memory. A stepwise discriminant function analysis of the subtests found that the Finger Windows subtest, a measure of spatial working memory, discriminated most accurately between the autism and normal control groups. A principal components analysis indicated that the factor structure of the subtests differed substantially between the children with autism and controls, suggesting differing organizations of memory ability. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Autism Res Program, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Healthcare Syst, Res Serv, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15260 USA. RP Minshew, NJ (reprint author), Univ Pittsburgh, Sch Med, Dept Psychiat, Autism Res Program, Webster Hall,Suite 300,3811 OHara St, Pittsburgh, PA 15213 USA. EM minshewnj@upmc.edu FU NICHD NIH HHS [HD35469, P01 HD035469, U19 HD035469]; NINDS NIH HHS [R01 NS033355] NR 56 TC 103 Z9 105 U1 1 U2 24 PU AMER PSYCHOLOGICAL ASSOC/EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0894-4105 J9 NEUROPSYCHOLOGY JI Neuropsychology PD JAN PY 2006 VL 20 IS 1 BP 21 EP 29 DI 10.1037/0894-4105.20.1.21 PG 9 WC Psychology, Clinical; Neurosciences; Psychology SC Psychology; Neurosciences & Neurology GA 011UK UT WOS:000235293700003 PM 16460219 ER PT J AU Yehuda, R Yang, RK Golier, JA Grossman, RA Bierer, LM Tischler, L AF Yehuda, R Yang, RK Golier, JA Grossman, RA Bierer, LM Tischler, L TI Effect of sertraline on glucocorticoid sensitivity of mononuclear leukocytes in post-traumatic stress disorder SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE sertraline; SSRI; antidepressants; glucocorticoid receptors; lysozyme activity; post-traumatic stress disorder; mononuclear leukocytes ID RECEPTOR FUNCTION; COMBAT VETERANS; P-GLYCOPROTEIN; MESSENGER-RNA; MULTIDRUG-RESISTANCE; ANTIDEPRESSANT DRUGS; MAJOR DEPRESSION; PLASMA-CORTISOL; DEXAMETHASONE; GENE AB This study examined the effects of sertraline (SER) on glucocorticoid sensitivity in mononuclear leukocytes (MNL) from eight subjects with current post-traumatic stress disorder (PTSD) and nine comparison subjects. In all, 60 ml of blood was withdrawn by venipuncture at 0800, and MNL were isolated from blood and divided into two portions: the first contained live cells incubated with a series of concentrations of dexamethasone (DEX); the second contained cells incubated with similar concentrations of DEX+2 mu M SER. Group difference in the concentrations of DEX required to inhibit lysozyme activity by 50% were evaluated under conditions of DEX-only and DEX+SER using analysis of covariance (ANCOVA). A significant Group x Condition interaction reflected that SER altered the lysozyme IC50-DEX in the direction of decreasing sensitivity to glucocorticoids in PTSD while having no uniform effect in cells from comparison subjects. The data provide support for the idea that glucocorticoid receptors might be more responsive to antidepressants in PTSD than in persons without PTSD. Insofar as increased sensitivity to glucocorticoids has been linked with PTSD, the actions of SER on the lysozyme IC50-DEX suggest that this medication may target a biologic alteration associated with PTSD pathophysiology. C1 Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, Bronx, NY USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. RP Yehuda, R (reprint author), Bronx Vet Affairs, Psychiat 116A,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov NR 53 TC 15 Z9 15 U1 8 U2 9 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JAN PY 2006 VL 31 IS 1 BP 189 EP 196 DI 10.1038/sj.npp.1300862 PG 8 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 023MX UT WOS:000236132000019 PM 16123752 ER PT J AU Minzenberg, MJ Grossman, R New, AS Mitropoulou, V Yehuda, R Goodman, M Reynolds, DA Silverman, JM Coccaro, EF Marcus, S Siever, LJ AF Minzenberg, MJ Grossman, R New, AS Mitropoulou, V Yehuda, R Goodman, M Reynolds, DA Silverman, JM Coccaro, EF Marcus, S Siever, LJ TI Blunted hormone responses to ipsapirone are associated with trait impulsivity in personality disorder patients SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE serotonin; 5-HT1A receptor; cortisol; prolactin; impulsivity; borderline personality disorder ID POSITRON-EMISSION-TOMOGRAPHY; 5-HT1A RECEPTOR FUNCTION; META-CHLOROPHENYLPIPERAZINE; SEROTONIN RECEPTORS; AGGRESSIVE-BEHAVIOR; TOURETTES-SYNDROME; ANXIETY DISORDERS; DEPRESSION; CORTISOL; CHALLENGE AB Impulsive aggression is associated with central serotonergic dysfunction. Animal models particularly implicate the 5-HT1A receptor in this behavior. We tested the hypothesis that central 5-HT1A receptor function is impaired in impulsive aggressive personality disorder patients. A total of 52 individuals with DSM-III-R personality disorders, all medically healthy adult outpatients without concurrent psychiatric medication treatment, underwent serial plasma cortisol, prolactin, and temperature measurements before and after ipsapirone 20 mg oral administration. Subjects completed self-report measures of impulsivity, hostility, depression and anxiety, and childhood maltreatment. Stepwise regression analysis revealed impulsivity alone among symptom measures to be associated with significantly decreased peak cortisol and prolactin responses. Diagnoses of borderline personality disorder (BPD) and intermittent explosive disorder-revised (IED-R) were associated with significantly increased and decreased cortisol responses, respectively. However, post hoc analyses indicated that impulsivity was significantly negatively correlated with cortisol responses in the BPD group, and may mediate the association of both BPD and IED-R with altered cortisol responses. Temperature response was associated with neither diagnostic nor symptom measures. Neither diagnostic nor dimensional measures of depression or anxiety, nor severity of childhood maltreatment, were significantly associated with cortisol, prolactin, or temperature responses. Impulsivity is related to impaired function at (or downstream to) postsynaptic 5-HT1A receptors, and this relationship may be partly responsible for the association of impaired serotonergic function with diagnoses such as BPD and IED-R. In addition, D-2 receptor dysfunction may play a role in impulsivity, whereas 5-HT1A cell-body autoreceptor function may be spared in these disorders. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. Bronx Vet Affairs Med Ctr, OOMH, Dept Psychiat, Bronx, NY 10468 USA. Baystate Med Ctr, Dept Psychiat, Springfield, MA USA. Univ Chicago, Pritzker Sch Med, Dept Psychiat, Chicago, IL 60637 USA. Mt Sinai Sch Med, Dept Biomath, New York, NY USA. RP Minzenberg, MJ (reprint author), Bronx Vet Affairs Med Ctr, OOMH, Dept Psychiat, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM michael.minzenberg@mssm.edu FU NIMH NIH HHS [R01-MH56606-01A2]; PHS HHS [R03 MR 5869701] NR 47 TC 11 Z9 11 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 JAN PY 2006 VL 31 IS 1 BP 197 EP 203 DI 10.1038/sj.npp.1300853 PG 7 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 023MX UT WOS:000236132000020 PM 16123761 ER PT J AU Taub, E Uswatte, G AF Taub, Edward Uswatte, Gitendra TI Constraint-Induced Movement therapy: Answers and questions after two decades of research SO NEUROREHABILITATION LA English DT Editorial Material ID RANDOMIZED CLINICAL-TRIAL; UPPER EXTREMITY; LEARNED NONUSE; CHRONIC STROKE; FORCED USE; REHABILITATION AB Constraint-Induced Movement therapy or CI therapy is a behavioral approach to neurorehabilitation based on a program of neuroscience experiments conducted with deafferented monkeys. Over the last 20 years, a large body of evidence has accumulated to support the efficacy of CI therapy for rehabilitating hemiparetic arm use in individuals with chronic stroke. Given the persuasive evidence for its efficacy to date, other research questions have risen to the forefront. How cost-effective is CI therapy? What are optimal training and other treatment parameters? What patient characteristics moderate the effects of CI therapy? The papers gathered in this special issue address many of these topics. C1 Univ Alabama, Sch Social & Behav Sci, Dept Psychol, Birmingham, AL 35294 USA. Univ Alabama, Sch Hlth Related Profess, Dept Phys Therapy, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Res Serv, Birmingham, AL USA. RP Taub, E (reprint author), Univ Alabama, Sch Social & Behav Sci, Dept Psychol, 1530 3rd Ave S,CPM712, Birmingham, AL 35294 USA. EM etaub@uab.edu RI Uswatte, Gitendra/C-4913-2009 FU NICHD NIH HHS [HD34273] NR 18 TC 51 Z9 52 U1 0 U2 7 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2006 VL 21 IS 2 BP 93 EP 95 PG 3 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 076WP UT WOS:000239989200001 PM 16917156 ER PT J AU Mennemeyer, ST Taub, E Uswatte, G Pearson, S AF Mennemeyer, Stephen T. Taub, Edward Uswatte, Gitendra Pearson, Sonya TI Employment in households with stroke after Constraint-Induced Movement therapy SO NEUROREHABILITATION LA English DT Article DE stroke; rehabilitation; cost benefit analysis; employment ID UPPER-EXTREMITY; REHABILITATION; CARE; RELIABILITY; MORTALITY; AUTOCITE; VALIDITY; PATIENT; HEALTH; FAMILY AB Randomized controlled clinical studies show that Constraint-Induced Movement therapy ( CI therapy) improves impaired arm function in patients with stroke. Little is known about how this therapy affects employment of patients or their caregivers. Individuals more than 1-year post-stroke ( N = 121) were retrospectively surveyed about their activities and employment prior to stroke, after stroke but before CI therapy and after CI therapy. They were also asked if someone had stopped working to be a caregiver and if that person had resumed employment. Before stroke, 48% of patients had been employed; this fell to 22% after stroke and did not significantly rise after CI therapy with most of the newly unemployed moving into a permanent retirement status before starting CI therapy. Among the CI therapy patients, one-quarter ( 29/121) reported that someone had limited their employment to take care of them following their stroke. After CI therapy, more than 60% ( 18/29) of caregivers returned to employment. Our preliminary finding regarding return to work by caregivers of stroke patients post-CI therapy warrants further study using prospective methods and randomized, controlled designs. C1 Univ Alabama, Sch Publ Hlth, Dept Hlth Care Org & Policy, Birmingham, AL 35294 USA. Univ Alabama, Dept Psychol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Mennemeyer, ST (reprint author), Univ Alabama, Sch Publ Hlth, Dept Hlth Care Org & Policy, 330 RPHB,1530 3rd Ave S, Birmingham, AL 35294 USA. EM smenneme@uab.edu RI Uswatte, Gitendra/C-4913-2009 FU NICHD NIH HHS [R01 HD034273, HD 34273] NR 32 TC 6 Z9 6 U1 0 U2 1 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2006 VL 21 IS 2 BP 157 EP 165 PG 9 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 076WP UT WOS:000239989200007 PM 16917162 ER PT J AU Niquet, J Seo, DW Allen, SG Wasterlain, CG AF Niquet, J. Seo, D. -W. Allen, S. G. Wasterlain, C. G. TI Hypoxia in presence of blockers of excitotoxicity induces a caspase-dependent neuronal necrosis SO NEUROSCIENCE LA English DT Article DE apoptosis; cytochrome c; MK-801; NBQX; ATP; mitochondrial membrane potential ID TRANSIENT CEREBRAL-ISCHEMIA; D-ASPARTATE RECEPTORS; CELL-DEATH; MOLECULAR-MECHANISMS; CYTOCHROME-C; BRAIN-INJURY; APOPTOSIS; INHIBITION; ACTIVATION; GLUTAMATE AB When excitotoxic mechanisms are blocked, severe or prolonged hypoxia and hypoxia-ischemia can still kill neurons, by a mechanism which is poorly understood. We studied this "non-excitotoxic hypoxic death" in primary cultures of rat dentate gyrus neurons. Many neurons subjected to hypoxia in the presence of blockers of ionotropic glutamate receptors developed the electron microscopic features of necrosis. They showed early mitochondrial swelling, loss of mitochondrial membrane potential and cytoplasmic release of cytochrome c, followed by activation of caspase-9, and by caspase-9-dependent activation of caspase-3. Caspase inhibitors were neuroprotective. These results suggest that "nonexcitotoxic hypoxic neuronal death" requires the activation in many neurons of a cell death program originating in mitochondria and leading to necrosis. Published by Elsevier Ltd on behalf of IBRO. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Epilepsy Res Lab 151, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, 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. Sungkyunkwan Univ, Sch Med, Dept Neurol, Samsung Med Ctr, Seoul, South Korea. RP Niquet, J (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Epilepsy Res Lab 151, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jniquet@ucla.edu FU NINDS NIH HHS [NS13515] NR 24 TC 11 Z9 11 U1 0 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2006 VL 141 IS 1 BP 77 EP 86 DI 10.1016/j.neuroscience.2006.03.073 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 063PZ UT WOS:000239033300009 PM 16697116 ER PT J AU Lauriat, TL Dracheva, S Chin, B Schmeidler, J McInnes, LA Haroutunian, V AF Lauriat, TL Dracheva, S Chin, B Schmeidler, J McInnes, LA Haroutunian, V TI Quantitative analysis of glutamate transporter mRNA expression in prefrontal and primary visual cortex in normal and schizophrenic brain SO NEUROSCIENCE LA English DT Article DE quantitative PCR; EAAT2; GLT1; gene expression; antipsychotic; RT-PCR ID AMINO-ACID TRANSPORTER; IN-SITU HYBRIDIZATION; RAT CEREBRAL-CORTEX; AMYOTROPHIC-LATERAL-SCLEROSIS; 2 SPLICE VARIANTS; GENE-EXPRESSION; ELDERLY-PATIENTS; COMPARATIVE IMMUNOCYTOCHEMISTRY; RECEPTOR EXPRESSION; ALZHEIMERS-DISEASE AB Abnormalities of the glutamatergic system in schizophrenia have been identified in numerous studies, but little is known about the role of glutamate transporters and their messenger RNA (mRNA) expression. In addition, the abundances of the two major isoforms of human excitatory amino acid transporter 2 (EAAT2) or its rat ortholog, glutamate transporter 1, have never been compared in a quantitative manner. Using quantitative reverse transcription-polymerase chain reaction, we established that the expression of the EAAT1, EAAT2a, EAAT2b, and EAAT3 transcripts was not different in the dorsolateral prefrontal and primary visual cortices of persons with schizophrenia relative to matched controls. EAAT2a expression was about 25-fold and 10-fold higher than EAAT2b in human and rat brain, respectively. The data provided no evidence of an effect of antipsychotic medications on the mRNA expression of the glutamate transporters. However, because most of the schizophrenic subjects in the cohort had been treated with antipsychotics for many years, it is still possible that changes in transporter expression were masked by medication effects. (c) 2005 Published by Elsevier Ltd on behalf of IBRO. C1 Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Biomath, New York, NY 10029 USA. RP Haroutunian, V (reprint author), Bronx Vet Affairs Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM vahram.haroutunian@mssm.edu OI Lauriat, Tara/0000-0003-0729-9386 NR 73 TC 23 Z9 26 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PY 2006 VL 137 IS 3 BP 843 EP 851 DI 10.1016/j.neuroscience.2005.10.003 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 009OG UT WOS:000235121000011 PM 16297566 ER PT J AU Burgio, KL Goode, PS Richter, HE Locher, JL Roth, DL AF Burgio, Kathryn L. Goode, Patricia S. Richter, Holly E. Locher, Julie L. Roth, David L. TI Global ratings of patient satisfaction and perceptions of improvement with treatment for urinary incontinence: Validation of three global patient ratings SO NEUROUROLOGY AND URODYNAMICS LA English DT Article DE behavior therapy; outcomes assessment; patient satisfaction; urinary incontinence; validation study ID RANDOMIZED CONTROLLED-TRIAL; AUTOLOGOUS FASCIA LATA; OLDER WOMEN; LONG-TERM; DISSATISFACTION; QUESTIONNAIRES; SERVICES; EFFICACY; SUCCESS AB Aims: To test the validity of three patient global ratings, satisfaction, perception of improvement, and estimated percent improvement, for measuring outcomes of behavioral treatment for urinary incontinence. Methods: This report is a secondary analysis of data from three randomized controlled trials testing behavioral interventions for incontinence. Participants were 359 community-dwelling women, aged 40-92 years, with stress, urge, or mixed urinary incontinence. All participants received an 8-week program of clinic-based or self-administered behavioral training. Subjective outcomes included a patient satisfaction question (PSQ), global perception of improvement (GPI), and estimated percent improvement (EPI). Convergent validity was tested by examining the relationship between each measure and reduction of incontinence (bladder diary), change on the incontinence impact questionnaire (IIQ), and desire for another treatment. Discriminant validity was explored by examining the relationship of the global ratings to five measures not expected to be related to outcome (age, race, BMI, education level, and change in perceived pain). Results: All three patient global ratings were significantly associated with each other (P < 0.0001), with diary measures of reduction of incontinence episodes (P < 0.0001), and change in the IIQ (P < 0.005), and inversely associated with desire for another treatment (P < 0.0001). All three patient ratings were not significantly associated with age, race, BMI, education level, or change in perceived pain. Conclusion: Patient global ratings of satisfaction, perception of improvement, and estimated percent improvement. have acceptable convergent and discriminant validity for measuring outcomes in studies of behavioral treatment for urinary incontinence. C1 Birmingham Atlanta GRECC, Dept Vet Affairs Med Ctr, Birmingham, AL USA. Univ Alabama, Sch Med, Birmingham, AL USA. Univ Alabama, Ctr Aging, Birmingham, AL USA. Univ Alabama, Sch Publ Hlth, Birmingham, AL 35294 USA. RP Burgio, KL (reprint author), Birmingham VA Med Ctr, GRECC, 11G,700 19th St S, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu FU NIA NIH HHS [AG R01 08010]; NIDDK NIH HHS [R01 DK49472]; PHS HHS [KO4 00431] NR 32 TC 64 Z9 64 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0733-2467 J9 NEUROUROL URODYNAM JI Neurourol. Urodyn. PY 2006 VL 25 IS 5 BP 411 EP 417 DI 10.1002/nau.20243 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 073TD UT WOS:000239764600003 PM 16652380 ER PT S AU Reusch, JEB Watson, PA Pugazhenthi, S AF Reusch, Jane E. B. Watson, Peter A. Pugazhenthi, Subbiah BE Friedman, JE TI Disruption of CREB regulated of gene expression in diabetes SO NEW TRANSCRIPTION FACTORS AND THEIR ROLE IN DIABETES AND ITS THERAPY SE Advances in Molecular and Cellular Endocrinology LA English DT Article; Book Chapter ID SMOOTH-MUSCLE-CELLS; ELEMENT-BINDING PROTEIN; CAMP-RESPONSE ELEMENT; FACTOR-ALPHA-RECEPTOR; ARTERIAL-WALL THICKNESS; PANCREATIC BETA-CELLS; GROWTH-FACTOR; TRANSCRIPTION FACTOR; CYCLIC-AMP; IN-VIVO AB Cardiovascular disease it is the leading cause of death in diabetes. In light of this, diabetes has recently been named and a cardiovascular disease equivalent. The molecular mechanisms that place persons with diabetes at excess vascular risk are numerous, including dyslipidemia, hypertension, hyperglycemia chronic inflammation and oxidative stress. These different factors place the diabetic vasculature in a state of chronic metabolic stress and this stress leads to vascular dysfunction. Our laboratory has focused on gaining a better understanding of the impact of diabetes and insulin resistance (IR) upon vascular smooth muscle cell gene regulation. Specifically, we have observed that the transcription factor CREB (cAMP response element binding protein) is critical for the maintenance of healthy quiescent (contractile and non-proliferative) vascular smooth muscle cell (SMC) function. In rodent models of diabetes and IR there is decreased expression of CREB protein in the vasculature. Loss of vascular CREB expression is associated with simultaneous increased expression of pro-atherogenic transcriptional regulators, such as NF-kB and C/EBP delta (CCAAT enhancer binding protein). This imbalance promotes SMC activation (proliferation, migration, matrix production and apoptosis) and may be important for excess vascular disease in diabetes. The evidence for CREB regulation of SMC function and its disruption in models of diabetes and atherosclerosis will be discussed in this chapter. In addition to macrovascular disease, many other target organs are injured by the metabolic stress of diabetes including pancreatic beta cells (which contribute to disease progression) and cardiac and neuronal cells (which contribute to complications). We have identified a pattern of changes in gene regulation, loss of CREB function and augmentation of stress induced gene expression, that may contribute to the multi-organ dysfunction observed in diabetes. C1 [Reusch, Jane E. B.; Watson, Peter A.; Pugazhenthi, Subbiah] Univ Colorado, Hlth Sci Ctr, Vet Affairs Med Ctr, Div Endocrinol, Denver, CO 80202 USA. [Reusch, Jane E. B.; Watson, Peter A.] Denver VA Med Ctr, Denver, CO USA. RP Reusch, JEB (reprint author), Univ Colorado, Hlth Sci Ctr, Vet Affairs Med Ctr, Div Endocrinol, Denver, CO 80202 USA. NR 96 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER NORTH HOLLAND PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1569-2566 BN 978-0-08-046355-1 J9 ADV MOL CELL ENDOCR PY 2006 VL 5 BP 211 EP 231 DI 10.1016/S1569-2566(06)05011-3 PG 21 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA BCV16 UT WOS:000311560500012 ER PT J AU Huerta, S Li, ZP Livingston, EH AF Huerta, S Li, ZP Livingston, EH TI Outcome of portal injuries following bariatric operations SO OBESITY SURGERY LA English DT Article DE portal injuries; morbid obesity; gastric bypass; lethal complications; liver transplantation ID ROUX-EN-Y; PREOPERATIVE WEIGHT-LOSS; SEVERELY OBESE-PATIENTS; GASTRIC BYPASS; SUPER-OBESE; LIVER-TRANSPLANTATION; VEIN THROMBOSIS; UNITED-STATES; MORTALITY; MORBIDITY AB Background: Portal vein thrombosis is rare following Roux-en-Y gastric bypass (RYGBP). Its natural history is dependent on the etiology of the thrombosis. Iatrogenic injuries at bariatric operations resulting in portal vein thrombosis are lethal complications typically necessitating a liver transplant, whereas postoperative portal vein thrombosis without an injury to the portal vein has a benign course. There are currently no data on management or prognostic factors of portal vein thrombosis after bariatric operations. Methods: 3 patients referred for liver transplantation secondary to portal vein injury following bariatric surgery between 2000 and 2003 are presented. Results: 2 super-obese (BMI >= 50 kg/M2) and 1 morbidly obese (BMI 44 kg/M2) patients sustained portal vein injuries during bariatric surgery (RYGBP 2, VBG 1) by experienced bariatric surgeons. In each case, the portal injury was identified and repaired. Thrombosis followed reconstruction in all 3 patients. All 3 underwent emergency liver transplantation, but died of sepsis and multi-organ failure following transplantation. Review of the literature found no cases of traumatic portal vein injuries following bariatric operations and 2 cases of postoperative portal vein thrombosis: 1 following LRYGBP (BMI 46) and one after a Lap-Band (BMI 41). Conclusion: Injury to the portal vein resulting from difficulty in discerning the anatomy of the intra-abdominal structures in the morbidly obese, is a lethal complication of bariatric surgery. Super-obese patients submitting to bariatic surgery should lose weight, undergo a two-stage bariatric procedure, or undergo laparoscopic RYGBP to minimize the risk of portal injury. Postoperative portal vein thrombosis has a benign course and can be managed conservatively. C1 Univ Texas, SW Med Ctr, VA N Texas Hlth Care Syst, Dallas, TX 75230 USA. VA Greater Los Angeles Syst, Los Angeles, CA USA. RP Huerta, S (reprint author), 4500 Lancaster Rd, Dallas, TX 75216 USA. EM Sergio.Huerta@UTSouthwestern.edu NR 28 TC 9 Z9 9 U1 0 U2 2 PU F D-COMMUNICATIONS INC PI TORONTO PA 3100 BAYVIEW AVE, UNIT 4, TORONTO, ONTARIO M2N 5L3, CANADA SN 0960-8923 J9 OBES SURG JI Obes. Surg. PD JAN PY 2006 VL 16 IS 1 BP 105 EP 109 DI 10.1381/096089206775222203 PG 5 WC Surgery SC Surgery GA 006WG UT WOS:000234927800021 PM 16417768 ER PT J AU Friedlander, AH Golub, MS AF Friedlander, AH Golub, MS TI The significance of carotid artery atheromas on panoramic radiographs in the diagnosis of occult metabolic syndrome SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS LA English DT Article ID CORONARY-HEART-DISEASE; NUTRITION EXAMINATION SURVEY; 3RD NATIONAL-HEALTH; INSULIN-RESISTANCE; CARDIOVASCULAR-DISEASE; SUBCLINICAL ATHEROSCLEROSIS; ASSOCIATION CONFERENCE; DIABETES-MELLITUS; CHOLESTEROL; PREVALENCE AB Objective. Metabolic syndrome (MetS), the co-occurrence of abdominal obesity, hypertriglyceridemia, reduced HDL cholesterol, hypertension, and insulin resistance promotes carotid atherosclerosis and stroke. The objective of this study was to determine if the presence of calcified atheromas detected on panoramic radiographs of individuals free of overt vascular disease may herald occult MetS. Study design. Ninety-four individuals (mean age 65.6 years) with a calcified atheroma detected by a VA dental clinic were evaluated. A like-aged group was used for comparative analysis. Results. Fifteen percent of individuals (mean age 64 years) with an atheroma had occult MetS. Mean waist circumference was 116 cm, BMI 32.7 kg/m(2), triglycerides 250 mg/dL, HDL cholesterol 35 mg/dL, blood pressure 147/87 mm Hg, and glucose 117 mg/dL. Only 6% of controls had occult MetS but this difference in prevalence was not proven to be statistically significant (P = .059). Conclusion. Some individuals with a calcified atheroma may have undiagnosed MetS and should be referred to their physician because aggressive management may preclude a stroke. C1 VA Greater Los Angeles Healthcare Syst, Grad Med Educ, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Grad Med Educ, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 40 TC 14 Z9 15 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD JAN PY 2006 VL 101 IS 1 BP 95 EP 101 DI 10.1016/j.tripleo.2005.04.027 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 997ZP UT WOS:000234287900015 PM 16360613 ER PT J AU Seshamani, M Ruiz, C Schwartz, SK Mirza, N AF Seshamani, M Ruiz, C Schwartz, SK Mirza, N TI Cymetra (TM) injections to treat leakage around a tracheoesophageal puncture SO ORL-JOURNAL FOR OTO-RHINO-LARYNGOLOGY AND ITS RELATED SPECIALTIES LA English DT Article; Proceedings Paper CT Meeting of the Eastern Section of the Triological-Society CY JAN, 2005 CL Washington, DC SP Triol Soc, Eastern Sect DE voice prosthesis; tracheoesophageal puncture; laryngectomy; leakage; Cymetra ID VOICE; REHABILITATION; RESTORATION AB Tracheoesophageal puncture (TEP) is a commonly used method of voice restoration following total laryngectomy, but leakage around the prosthesis is prevalent. Several treatments for leakage have been proposed in the literature, but with varying success. This paper examines the efficacy of Cymetra (TM) to help shrink the TEP site and stop leakage. Six patients with leaking TEP sites refractory to downsizing and/or cautery were selected for the study. Injection sites were determined based on the primary sites of leakage. Cymetra was rehydrated with 1.0% lidocaine saline solution and injected via a 23-gauge needle a few millimeters deep to the mucosa, approximately 2 mm from the edge. The patients were followed for up to 13 months. Following 1 trial of Cymetra injection, 4 patients achieved successful results. Only 1 patient has not yet achieved full resolution of leakage. Cymetra may provide a safer and more effective option for resolution of leakage than other methods currently employed. Copyright (c) 2006 S. Karger AG, Basel. C1 Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Seshamani, M (reprint author), Univ Penn, Sch Med, Box 265,3450 Hamilton Walk, Philadelphia, PA 19104 USA. EM meena.seshamani@marshallscholarship.org NR 6 TC 8 Z9 9 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0301-1569 J9 ORL J OTO-RHINO-LARY JI ORL-J. Oto-Rhino-Laryngol. Relat. Spec. PY 2006 VL 68 IS 3 BP 146 EP 148 DI 10.1159/000091277 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 015VX UT WOS:000235580500005 PM 16449823 ER PT J AU Vaughan, N James, T McDermott, D Griest, T Fausti, S AF Vaughan, N James, T McDermott, D Griest, T Fausti, S TI A 5-year prospective study of diabetes and hearing loss in a veteran population SO OTOLOGY & NEUROTOLOGY LA English DT Article DE diabetes; hearing loss; hemoglobin A1c; insulin; pure-tone threshold ID INNER-EAR; MELLITUS; MICROANGIOPATHY; AGE AB Hypothesis: Veterans with diabetes will have significantly greater hearing loss than nondiabetic veterans. Background: The association between diabetes and hearing loss remains unclear despite the volume of research that has been devoted to the question. Often, differences in hearing thresholds between diabetic and nondiabetic patients are confounded by age and noise exposure. Methods: In this 5-year prospective study, 342 diabetic veterans and 352 nondiabetic veterans from the Portland VA Medical Center in Oregon were tested on a variety of audiometric measures, including pure-tone thresholds. Results: Age and noise exposure were accounted for in the analyses. There was a trend toward greater hearing loss in diabetic patients 60 years of age and younger across the frequency range. These differences were statistically significant only in the highest frequencies tested (10, 12.5, 14, and 16 kHz). The effects of both diabetes and noise exposure on high-frequency hearing thresholds were dependent on age. For patients older than 60 years, the mean thresholds were not significantly different. Conclusion: These results suggest that diabetic patients 60 years old or younger may show early high-frequency hearing loss similar to early presbycusis. After age 60, difference in hearing loss between diabetic and nondiabetic patients was reduced. C1 Portland VA Med Ctr, Natl Ctr Rehabil Auditory Res, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Vaughan, N (reprint author), Portland VA Med Ctr, Natl Ctr Rehabil Auditory Res, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM Nancy.Vaughan@med.va.gov NR 14 TC 37 Z9 42 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA SN 1531-7129 J9 OTOL NEUROTOL JI Otol. Neurotol. PD JAN PY 2006 VL 27 IS 1 BP 37 EP 43 DI 10.1097/01.mao.0000194812.69556.74 PG 7 WC Clinical Neurology; Otorhinolaryngology SC Neurosciences & Neurology; Otorhinolaryngology GA 004AO UT WOS:000234724600008 PM 16371845 ER PT J AU Koropchak, CM Pollak, KI Arnold, RM Alexander, SC Skinner, CS Olsen, MK Jeffreys, AS Rodriguez, KL Abernethy, AP Tulsky, JA AF Koropchak, Celine M. Pollak, Kathryn I. Arnold, Robert M. Alexander, Stewart C. Skinner, Celette Sugg Olsen, Maren K. Jeffreys, Amy S. Rodriguez, Keri L. Abernethy, Amy P. Tulsky, James A. TI Studying communication in oncologist-patient encounters: The SCOPE trial SO PALLIATIVE MEDICINE LA English DT Article DE patient-provider relationship; physician-patient communication; oncologist ID CANCER-PATIENTS; PRIMARY-CARE; SKILLS; DEPRESSION; QUALITY; MODEL AB Study objective: Most oncologists have not received adequate training in physician-patient communication, and existing effective courses tend to be time and resource intensive. We are developing and testing a tailored CD-ROM educational intervention that includes feedback on oncologists' own audio-recorded conversations with their advanced cancer patients. In this report, we describe the study methods and identify challenges to implementation and how these were overcome. Study design: A three-phase, randomized, controlled trial. In Phase 1, we audio-recorded oncologist-patient clinic encounters. In Phase 2, oncologists were randomly assigned to a communication CD-ROM intervention or control. Phase 3 consisted of audio-recording all participating oncologists conversing with a new sample of patients, two to 12 months after the intervention, to assess its effectiveness. Setting: Oncology clinics at Duke University Medical Center (DUMC) and the Durham Veterans Affairs Medical Center (DVAMC) in Durham, NC, and the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, PA. Participants: Medical, radiation and gynecological oncologists and their patients with advanced cancer. Intervention: A tailored CD-ROM that contains an interactive educational interface with reference materials and video-clips of model conversations, along with the oncologists' own Phase 1 audio-recorded conversations. Conclusion: We present challenges and solutions to oncologist recruitment, identifying appropriate patients with advanced cancer, adapting to clinic flow, and developing a self-administered communications intervention. C1 Duke Univ, Med Ctr, Ctr Palliat Care, Durham, NC 27705 USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Duke Univ, Med Ctr, Duke Comprehens Canc Ctr, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Community & Family Med, Durham, NC 27710 USA. Univ Pittsburgh, Inst Canc, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Inst Doctor Patient Commun, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Inst Enhance Palliat Care, Pittsburgh, PA 15260 USA. Durham VA Med Ctr, Ctr Hlth Serv Res, Durham, NC USA. Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27706 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. RP Koropchak, CM (reprint author), Duke Univ, Med Ctr, Ctr Palliat Care, Box 2720,2424 Erwin Rd,Suite 1105, Durham, NC 27705 USA. EM korop001@mc.duke.edu FU NCI NIH HHS [R01 CA-100387-01] NR 29 TC 27 Z9 27 U1 0 U2 5 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0269-2163 J9 PALLIATIVE MED JI Palliat. Med. PY 2006 VL 20 IS 8 BP 813 EP 819 DI 10.1177/0269216306070657 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health; Medicine, General & Internal SC Health Care Sciences & Services; Public, Environmental & Occupational Health; General & Internal Medicine GA 122UA UT WOS:000243251300011 PM 17148536 ER PT J AU Schneider, A Lamb, J Barmada, MM Cuneo, A Money, ME Whitcomb, DC AF Schneider, Alexander Lamb, Janette Barmada, M. Michael Cuneo, Anthony Money, Mary E. Whitcomb, David C. TI Keratin 8 mutations are not associated with familial, sporadic and alcoholic pancreatitis in a population from the United States SO PANCREATOLOGY LA English DT Article DE keratin 8; hereditary pancreatitis; alcoholic pancreatitis; chronic pancreatitis ID TROPICAL CALCIFIC PANCREATITIS; CATIONIC TRYPSINOGEN GENE; SERINE-PROTEASE INHIBITOR; CYSTIC-FIBROSIS GENE; SPINK1/PSTI MUTATIONS; LIVER-DISEASE; KAZAL TYPE-1; POLYMORPHISMS; BANGLADESH; HEALTH AB Background and Aims: Genetic predispositions play a major role in the development of chronic pancreatitis. Recently, a mutation in the keratin 8 gene (G62C) was reported to be associated with chronic pancreatitis in Italy. We determined whether mutations in the keratin 8 gene are associated with familial, sporadic and alcoholic recurrent acute or chronic pancreatitis in a population from the United States. Methods: We investigated the relevant genomic region of the keratin 8 gene in 80 patients with familial pancreatitis without a cationic trypsinogen (PRSS1) gene mutation from 52 different families, 21 patients with familial hereditary pancreatitis and a PRSS1 mutation from 20 different families, 126 patients with sporadic pancreatitis without a PRSS1 mutation, 61 patients with alcoholic pancreatitis and 271 controls by direct DNA sequencing. Results: We found the heterozygous G62C mutation in n = 3/80 patients ( n = 2/52 patients from different families, 3.8%) with familial pancreatitis without PRSS1 mutation and in n = 3/126 patients (2.4%) with sporadic pancreatitis. We detected an adjacent heterozygous I63V mutation in n = 2/80 patients ( n = 2/52 patients from different families, 3.8%) with familial pancreatitis without PRSS1 mutation and in n = 1/61 patients (1.6%) with alcoholic pancreatitis. We found the G62C mutation in n = 2/271 controls (0.7%) and the I63V mutation in n = 2/271 controls ( 0.7%). There were no statistically signifi cant differences in the genotype frequencies between patients and controls ( p >0.05). Screening of additional available family members revealed that these variants did not segregate with the disease phenotype. There was no statistically signifi cant difference in the frequency of these keratin 8 variants between patients with chronic pancreatitis and controls ( p >0.05). Conclusion: These keratin 8 variants are not associated with familial, sporadic or alcoholic pancreatitis. Copyright (C) 2006 S. Karger AG, Basel and IAP. C1 Univ Pittsburgh, UPMC Presbyterian, Ctr Genom Sci, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Care Syst, Dept Med, Div Gastroenterol, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Dept Human Genet, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Dept Cell Biol & Physiol, Pittsburgh, PA USA. Washington Cty Hosp, Hagerstown, MD USA. Univ Heidelberg Hosp, Dept Med 2, D-68135 Mannheim, Germany. RP Whitcomb, DC (reprint author), Univ Pittsburgh, UPMC Presbyterian, Ctr Genom Sci, 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] NR 22 TC 7 Z9 9 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1424-3903 J9 PANCREATOLOGY JI Pancreatology PY 2006 VL 6 IS 1-2 BP 103 EP 108 DI 10.1159/000090029 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 136XF UT WOS:000244256700014 PM 16327287 ER PT J AU Caroff, SN Martine, R Kleiner-Fisman, G Eisa, M Lorry, A Gallop, R Stern, MB Duda, JE AF Caroff, SN Martine, R Kleiner-Fisman, G Eisa, M Lorry, A Gallop, R Stern, MB Duda, JE TI Treatment of levodopa-induced dyskinesias with donepezil SO PARKINSONISM & RELATED DISORDERS LA English DT Letter DE dyskinesias; donepezil; Parkinson's disease; levodopa; cholinesterase inhibitors ID DOPA-INDUCED DYSKINESIAS; PARKINSONS-DISEASE; MOVEMENT-DISORDERS; PHYSOSTIGMINE C1 Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Neurol, Philadelphia, PA 19104 USA. Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06510 USA. W Chester Univ, Dept Math & Appl Stat, W Chester, PA 19380 USA. RP Caroff, SN (reprint author), Vet Affairs Med Ctr, Dept Psychiat, 116A,Univ Ave, Philadelphia, PA USA. NR 12 TC 5 Z9 5 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PY 2006 VL 12 IS 4 BP 261 EP 263 DI 10.1016/j.parkreldis.2005.10.003 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 054SJ UT WOS:000238398600010 PM 16364675 ER PT J AU Weintraub, D Morales, KH Duda, JE Moberg, PJ Stern, MB AF Weintraub, Daniel Morales, Knashawn H. Duda, John E. Moberg, Paul J. Stern, Matthew B. TI Frequency and correlates of co-morbid psychosis and depression in Parkinson's disease SO PARKINSONISM & RELATED DISORDERS LA English DT Article DE Parkinson's disease; depression; psychosis; co-morbidity ID RATING-SCALE; RISK-FACTORS; TEACHING TAPE; MOTOR SECTION; HALLUCINATIONS; PREVALENCE; DELUSIONS AB Though both psychosis and depression are common in Parkinson's disease (PD), it is not clear if an association between the two disorders exists. One hundred and thirty PD patients were divided into four groups based on a comprehensive psychiatric assessment: (1) no depression or psychosis (47.7%); (2) psychosis only (16.2%); (3) depression only (26.2%); and (4) psychosis and depression (10.0%). Co-morbid psychosis and depression did not occur more frequently than expected by chance (P = .77). Psychosis was associated with dopamine agonist use (P = .02), depression with mild-cognitive impairment (P = .03), and their co-occurrence with higher daily levodopa dosages (P < .01). These results suggest that psychosis and depression in PD are distinct neurobehavioral disorders. (c) 2006 Elsevier Ltd. All rights reserved. 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, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Weintraub, D (reprint author), Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [K23 MH067894, K23 MH067894-04]; PHS HHS [067894] NR 31 TC 21 Z9 21 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PY 2006 VL 12 IS 7 BP 427 EP 431 DI 10.1016/j.parkreldis.2006.03.006 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 099OW UT WOS:000241605700004 PM 16797214 ER PT J AU Furuno, JP Metlay, JP Harnett, JP Wilson, J Langenberg, P McGregor, JC Zhu, JK Perencevich, EN AF Furuno, JP Metlay, JP Harnett, JP Wilson, J Langenberg, P McGregor, JC Zhu, JK Perencevich, EN TI Population antibiotic susceptibility for Streptococcus pneumoniae and treatment outcomes in common respiratory tract infections SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE Streptococcus pneumoniae; ecological analysis; respiratory tract infection; antibiotic resistance; outcomes ID ACUTE OTITIS-MEDIA; BACTEREMIC PNEUMOCOCCAL PNEUMONIA; ANTIMICROBIAL RESISTANCE; UNITED-STATES; MANAGED CARE; CLINICAL OUTCOMES; ACUTE SINUSITIS; IMPACT; TRENDS; EXACERBATIONS AB Purpose Antibiotic-resistant Streptococcus pneumoniae potentially threatens the successful treatment of common respiratory tract infections (RTls); however, the relationship between antibiotic resistance and treatment outcomes remains unclear. We aimed to test the hypothesis that higher in vitro penicillin and erythromycin nonsusceptibility levels among clinical isolates of S. pneumoniae are associated with higher risk of treatment failure in suppurative acute otitis media (AOM), acute sinusitis, and acute exacerbation of chronic bronchitis (AECB). Methods We conducted a population-level analysis using treatment outcomes data from a national, managed-care claims database, and antibiotic susceptibility data from a national repository of antimicrobial susceptibility results between 1997 and 2000. Treatment outcomes in patients with suppurative AOM, acute sinusitis, or AECB receiving selected macrolides or beta-lactams were assessed. Associations between RTI-specific treatment outcomes and antibiotic nonsusceptibility were determined using Spearman correlation coefficients with condition-specific paired outcome and susceptibility data for each region and each year. Results There were 649 552 available RTI outcomes and 7252 susceptibility tests performed on S. pneumoniae isolates. There were no statistically significant trends across time for resolution proportions following treatment by either beta-lactams or macrolides among any of the RTIs. Correlation analyses found no statistically significant association between S. pneumoniae susceptibility and RTI treatment outcomes apart from a significant positive association between of erythromycin nonsusceptibility in ear isolates and macrolide treatment resolution for suppurative AOM. Conclusion On the population level, in vitro S. pneumoniae nonsusceptibility to macrolide or beta-lactam antibiotics was not associated with treatment failure in conditions of probable S. pneumoniae etiology. Copyright (c) 2005 John Wiley & Sons, Ltd. C1 Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Baltimore, MD 21201 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Pfizer Inc, US Outcomes Res Grp, New York, NY USA. NIH, Natl Ctr Minor Hlth & Hlth Disparities, Bethesda, MD 20892 USA. Univ Maryland, Med Ctr, Baltimore, MD 21201 USA. VA Maryland Healthcare Syst, Baltimore, MD USA. RP Furuno, JP (reprint author), Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, 100 N Greene St,Lower Level, Baltimore, MD 21201 USA. RI McGregor, Jessina/A-7625-2008 NR 39 TC 6 Z9 8 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD JAN PY 2006 VL 15 IS 1 BP 1 EP 9 DI 10.1002/pds.1135 PG 9 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 006CO UT WOS:000234872900001 PM 16136615 ER PT J AU Pawlyk, AC Sanford, LD Brennan, FX Morrison, AR Ross, RJ AF Pawlyk, AC Sanford, LD Brennan, FX Morrison, AR Ross, RJ TI Corticotropin-releasing factor microinjection into the central nucleus of the amygdala alters REM sleep SO PHARMACOLOGICAL REPORTS LA English DT Article DE amygdala; corticotropin-releasing factor; stress; psychological; sleep; REM ID FACTOR-RECEPTOR; STRESS; RAT; IMMOBILIZATION; LOCALIZATION; EMOTION; BRAIN; CRH AB Psychological stressors have a prominent effect on rapid eye movement sleep (REMS) in humans and animals. We hypothesized that the stress-related neurochemical corticotropin-releasing factor (CRF), acting in the amygdala, could initiate neural events that lead to REMS alterations. Therefore, we made bilateral microinjections of three different doses of CRF into the central nucleus of the amygdala (CeA) in five rats. Only the lowest dose of CRF (1 ng) induced a change in sleep, specifically REMS, during the 4-h post-injection period. Thus, REMS alterations following psychological stress may depend, in part, on CRF release in the CeA. C1 Univ Penn, Sch Vet Med, Dept Anim Biol, Lab Study Brain Sleep, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Behav Hlth Serv 116 MHC, Philadelphia, PA 19104 USA. Eastern Virginia Med Sch, Dept Anat & Pathol, Norfolk, VA 23501 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. RP Ross, RJ (reprint author), Univ Penn, Sch Vet Med, Dept Anim Biol, Lab Study Brain Sleep, Philadelphia, PA 19104 USA. EM ross_r@mail.trc.upenn.edu FU NHLBI NIH HHS [HL7953]; NIMH NIH HHS [MH42903] NR 20 TC 12 Z9 12 U1 0 U2 1 PU POLISH ACAD SCIENCES INST PHARMACOLOGY PI KRAKOW PA SMETNA 12, 31-343 KRAKOW, POLAND SN 1734-1140 J9 PHARMACOL REP JI Pharmacol. Rep. PD JAN-FEB PY 2006 VL 58 IS 1 BP 125 EP 130 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 029HY UT WOS:000236554200017 PM 16531640 ER PT J AU Tache, Y Million, M AF Tache, Yvette Million, Mulugeta BE Johnson, LR TI Central Corticotropin-Releasing Factor and the Hypothalamic-Pituitary-Adrenal Axis in Gastrointestinal Physiology SO PHYSIOLOGY OF THE GASTROINTESTINAL TRACT, VOLS 1 AND 2, 4TH EDITION LA English DT Article; Book Chapter ID GASTRIC-ACID-SECRETION; IRRITABLE-BOWEL-SYNDROME; CENTRAL-NERVOUS-SYSTEM; STRESS-RELATED ALTERATIONS; EDINGER-WESTPHAL NUCLEUS; COLONIC MOTOR FUNCTION; FACTOR CRF RECEPTOR; MESSENGER-RNA EXPRESSION; WATER-AVOIDANCE STRESS; DORSAL VAGAL COMPLEX C1 [Tache, Yvette; Million, Mulugeta] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. [Tache, Yvette; Million, Mulugeta] Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Med,Div Digest Dis, Los Angeles, CA 90095 USA. [Tache, Yvette; Million, Mulugeta] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Tache, Y (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, CURE Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 275 TC 9 Z9 10 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS BN 978-0-08-045615-7 PY 2006 BP 791 EP 816 PG 26 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA BCR99 UT WOS:000311229600032 ER PT J AU Montrose, MH Akiba, Y Takeuchi, K Kaunitz, JD AF Montrose, Marshall H. Akiba, Yasutada Takeuchi, Koji Kaunitz, Jonathan D. BE Johnson, LR TI Gastroduodenal Mucosal Defense SO PHYSIOLOGY OF THE GASTROINTESTINAL TRACT, VOLS 1 AND 2, 4TH EDITION LA English DT Article; Book Chapter ID DUODENAL BICARBONATE SECRETION; PROSTAGLANDIN-E-RECEPTOR; TRANSMEMBRANE CONDUCTANCE REGULATOR; GASTRIC EPITHELIAL-CELLS; NITRIC-OXIDE SYNTHASE; INTESTINAL TREFOIL FACTOR; NECTURUS ANTRAL MUCOSA; PANCREATIC-DUCT CELLS; GENE-RELATED PEPTIDE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS C1 [Montrose, Marshall H.] Univ Cincinnati, Dept Mol & Cellular Physiol, Cincinnati, OH 45267 USA. [Akiba, Yasutada] W Los Angeles VAMC, Brentwood Biomed Res Inst, Los Angeles, CA 90073 USA. [Takeuchi, Koji] Kyoto Pharmaceut Univ, Dept Pharmacol & Expt Therapeut, Yamashina Ku, Kyoto 607, Japan. [Kaunitz, Jonathan D.] Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. [Kaunitz, Jonathan D.] W Los Angeles VAMC, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. RP Montrose, MH (reprint author), Univ Cincinnati, Dept Mol & Cellular Physiol, Med Sci Bldg,Room 4253,231 Albert Sabin Way, Cincinnati, OH 45267 USA. NR 425 TC 9 Z9 9 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS BN 978-0-08-045615-7 PY 2006 BP 1259 EP 1291 PG 33 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA BCR99 UT WOS:000311229600052 ER PT S AU Marmar, CR McCaslin, SE Metzler, TJ Best, S Weiss, DS Fagan, J Liberman, A Pole, N Otte, C Yehuda, R Mohr, D Neylan, T AF Marmar, Charles R. McCaslin, Shannon E. Metzler, Thomas J. Best, Suzanne Weiss, Daniel S. Fagan, Jeffery Liberman, Akiva Pole, Nnamdi Otte, Christian Yehuda, Rachel Mohr, David Neylan, Thomas BE Yehuda, R TI Predictors of posttraumatic stress in police and other first responders SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE police; PTSD; risk; first responders; peritraumatic ID EMERGENCY SERVICES PERSONNEL; CRITICAL INCIDENT EXPOSURE; OF-LIFE OUTCOMES; VIETNAM VETERANS; ACOUSTIC STARTLE; PTSD SYMPTOMS; RISK-FACTORS; FOLLOW-UP; DISORDER; OFFICERS AB We provide an overview of previous research conducted by our group on risk and resilience factors for PTSD symptoms in police and other first responders. Based on our work, the findings of other investigators on individual differences in risk for PTSD, and drawing on preclinical studies fear conditioning and extinction, we propose a conceptual model for the development of PTSD symptoms emphasizing the role of vulnerability and resilience to peritraumatic panic reactions. We tested this conceptual model in a cross-sectional sample of police officers (n = 715). Utilizing an hierarchical linear regression model we were able to explain 39.7% of the variance in PTSD symptoms. Five variables remained significant in the final model; greater peritraumatic distress (beta = 0.240, P <.001), greater peritraumatic dissociation (beta = 0.174, P <.001), greater problem-solving coping (beta = 0.103, P <.01), greater routine work environment stress (beta = 0.182,P <.001), and lower levels of social support (beta = -0.246,P <.001). These results were largely consistent with the proposed conceptual model. Next steps in this line of research will be to test this model prospectively in a sample of 400 police academy recruits assessed during training and currently being followed for the first 2 years of police service. C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94121 USA. Columbia Univ, New York, NY 10027 USA. Natl Inst Justice, Washington, DC 20531 USA. Univ Michigan, Ann Arbor, MI 48109 USA. Univ Hamburg, Hosp Eppendorf, D-20246 Hamburg, Germany. Mt Sinai Sch Med, Div Traumat Stress Studies, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Marmar, CR (reprint author), San Francisco Vet Affairs Med Ctr, 4150 Clement St,116 P, San Francisco, CA 94121 USA. EM Charles.marmar@med.va.gov FU NIMH NIH HHS [R01-MH56350] NR 49 TC 97 Z9 98 U1 5 U2 31 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 1 EP 18 DI 10.1196/annals.1364.001 PG 18 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600001 PM 16891557 ER PT S AU Golier, JA Harvey, PD Legge, J Yehuda, R AF Golier, Julia A. Harvey, Philip D. Legge, Juliana Yehuda, Rachel BE Yehuda, R TI Memory performance in older trauma survivors - Implications for the longitudinal course of PTSD SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE trauma; memory; aging; neuropsychology; geriatric ID POSTTRAUMATIC-STRESS-DISORDER; CHILDHOOD SEXUAL-ABUSE; INTIMATE PARTNER VIOLENCE; HIPPOCAMPAL VOLUME; COMBAT VETERANS; HOLOCAUST SURVIVORS; COGNITIVE DEFICITS; PYRAMIDAL NEURONS; VIETNAM VETERANS; EXPLICIT MEMORY AB Impaired declarative memory performance and smaller hippocampal volume have been observed in young and middle-aged adults with chronic posttraumatic stress disorder (PTSD). These alterations may put trauma survivors with PTSD at greater risk for cognitive decline in later life. This article focuses on the emerging literature on neuropsychological impairment in aging trauma survivors, in particular, elderly combat veterans and survivors of the Holocaust. In veterans and in Holocaust survivors, PTSD was associated with substantial impairments in learning, free and cued recall, and recognition memory compared to the respective nonexposed subjects; however, in neither group was PTSD associated with impaired retention or "rapid forgetting." Additionally, PTSD was not associated with smaller right or left hippocampal volume in either cohort. PTSD is associated with considerable cognitive burden with age. Longitudinal studies of older subjects are warranted to examine whether PTSD is associated with accelerated aging or progressive memory loss. C1 James J Peters VA Med Ctr, OOMH, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY 10029 USA. RP Golier, JA (reprint author), James J Peters VA Med Ctr, OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Julia.golier@med.va.gov NR 49 TC 35 Z9 35 U1 1 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 54 EP 66 DI 10.1196/annals.1364.006 PG 13 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600006 PM 16891562 ER PT S AU Yehuda, R AF Yehuda, Rachel BE Yehuda, R TI Advances in understanding neuroendocrine alterations in PTSD and their therapeutic implications SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE posttraumatic stress disorder; cortisol; neuroendocrine alterations; novel therapeutic strategies; hypothalamic-pituitary-adrenal axis ID POSTTRAUMATIC-STRESS-DISORDER; DEXAMETHASONE-SUPPRESSION TEST; CORTICOTROPIN-RELEASING HORMONE; PITUITARY-ADRENAL AXIS; URINARY CORTISOL EXCRETION; PERIPHERAL MONONUCLEAR LEUKOCYTES; GLUCOCORTICOID-RECEPTOR RESPONSE; BORDERLINE PERSONALITY-DISORDER; MAJOR DEPRESSIVE DISORDER; VEHICLE ACCIDENT VICTIMS AB The findings from investigations of the neuroendocrinology of posttraumatic stress disorder (PTSD) have highlighted alterations that have not historically been associated with pathologic processes, and have, accordingly, raised several questions about the nature of the findings and their relationship to PTSD. The most infamous of these observations-low cortisol levels-has been the subject of much discussion and scrutiny because the finding has been both counterintuitive, and not uniformly reproducible. This fact notwithstanding, novel therapeutic approaches to the treatment of PTSD are in large part predicated on the assumption that glucocorticoid levels may be lower in PTSD. This article summarizes important neuroendocrine observations in cortisol and provides strategies for understanding what has emerged over the past two decades, to be a complex and sometimes contradictory literature. C1 Mt Sinai Sch Med, Div Traumat Stress Studies, New York, NY 10029 USA. James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Yehuda, R (reprint author), Bronx VA OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@med.va.gov; rachel.yehuda@med.va.gov FU NIMH NIH HHS [R01MH249555, R01MH064675] NR 144 TC 150 Z9 153 U1 1 U2 9 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 137 EP 166 DI 10.1196/annals.1364.012 PG 30 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600012 PM 16891568 ER PT S AU Yehuda, R Flory, JD Southwick, S Charney, DS AF Yehuda, Rachel Flory, Janine D. Southwick, Steven Charney, Dennis S. BE Yehuda, R TI Developing an agenda for translational studies of resilience and vulnerability following trauma exposure SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE resilience; PTSD; trauma; translational research; brain; neuroendocrine markers ID POSTTRAUMATIC-STRESS-DISORDER; PITUITARY-ADRENOCORTICAL REGULATION; CORTICOTROPIN-RELEASING FACTOR; NEUROPEPTIDE-Y CONCENTRATIONS; STAGE BREAST-CANCER; DEHYDROEPIANDROSTERONE-SULFATE; SOCIAL SUPPORT; DEXAMETHASONE SUPPRESSION; MAJOR DEPRESSION; URINARY CORTISOL AB Here we outline a translational research agenda for studies of resilience, defined as the process of adapting well in the face of adversity or trauma. We argue that an individual differences approach to the study of resilience, in which the full range of behavioral and biological responses to stress exposure is examined can be applied across human samples (e.g., people who have developed psychopathology versus those who have not; people who have been exposed to trauma versus those who have not) and even, in some cases, across species. We delineate important psychological resilience-related factors including positive affectivity and optimism, cognitive flexibility, coping, social support, emotion regulation, and mastery. Key brain regions associated with stress-related psychopathology have been identified with animal models of fear (e.g., extinction and fear conditioning; memory reconsolidation) and we describe how these regions can be studied in humans using neuroirnaging technology. Finally, we cite recent research identifying neuroendocrine markers of resilience and recovery in humans (e.g., neuropeptide Y [NPY], dehydroepiandrosterone [DHEA]) that can also be measured, in some cases, in other species. That exposure to adversity or trauma does not necessarily lead to impairment and the development of psychopathology in all people is an important observation. Understanding why this is so will provide clues for the development of therapeutic interventions for those people who do develop stress-related psychopathology, or even for the prevention of adverse outcomes. C1 Mt Sinai Sch Med, New York, NY 10029 USA. James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. Yale Univ, Sch Med, New Haven, CT 06510 USA. Vet Affairs Connecticut, New Haven, CT 06510 USA. RP Yehuda, R (reprint author), Bronx VA OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov; Rachel.Yehuda@med.va.gov NR 94 TC 112 Z9 114 U1 4 U2 18 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 379 EP 396 DI 10.1196/annals.1364.028 PG 18 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600028 PM 16891584 ER PT S AU Tischler, L Brand, SR Stavitsky, K Labinsky, E Newmark, R Grossman, R Buchsbaum, MS Yehuda, R AF Tischler, Lisa Brand, Sarah R. Stavitsky, Karina Labinsky, Ellen Newmark, Randall Grossman, Robert Buchsbaum, Monte S. Yehuda, Rachel BE Yehuda, R TI The relationship between hippocampal volume and declarative memory in a population of combat veterans with and without PTSD SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE post-traumatic stress disorder; memory; trauma exposure; hippocampal volume; CVLT ID POSTTRAUMATIC-STRESS-DISORDER AB Both reduced hippocampal volume and cognitive alterations have been found in posttraumatic stress disorder (PTSD). The purpose of this article was to examine the relationship between hippocampal volume, combat exposure, symptom severity, and memory performance in a sample of combat veterans with and without a history of PTSD. Subjects were 33 male veteran volunteers (16 PTSD+, 17 PTSD-) who underwent an MRI and neuropsychological testing with the California Verbal Learning Test (CVLT), a measure of declarative memory. Relationships between hippocampal volume (i.e., right + left hippocampal volume/whole brain volume) and performance on the CVLT were determined using partial correlational analysis controlled for age and Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) vocabulary scores. Percent hippocampal volume for the entire sample was positively associated with several aspects of memory performance as reflected by the CVLT. In the PTSD+ group, CVLT performance was negatively correlated with lifetime, but not current CAPS symptoms. CVLT performance appears to be strongly correlated with hippocampal volume in a group of trauma survivors with and without PTSD. Insofar as CVLT performance in the PTSD group was negatively associated with worst episode, but not to current PTSD symptoms, memory performance in combat veterans may reflect some aspect of risk related to the magnitude of the psychological response to trauma, rather than current symptoms that may be interfering with cognitive performance. It will be of interest to study cognitive abilities that may relate to the likelihood of specific PTSD symptoms and to track changes in CVLT performance and hippocampal volume over time in persons with and without a history of trauma exposure. C1 James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY 10029 USA. RP Yehuda, R (reprint author), Bronx VA OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov; Rachel.Yehuda@med.va.gov NR 17 TC 34 Z9 37 U1 1 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 405 EP 409 DI 10.1196/annals.1364.031 PG 5 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600031 PM 16891587 ER PT S AU Grossman, R Yehuda, R Golier, J McEwen, B Harvey, P Maria, NS AF Grossman, Robert Yehuda, Rachel Golier, Julia McEwen, Bruce Harvey, Philip Maria, Nelly Sta. BE Yehuda, R TI Cognitive effects of intravenous hydrocortisone in subjects with PTSD and healthy control subjects SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE Annals of the New York Academy of Sciences LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad & Sci DE posttraumatic stress disorder; cortisol; cognitive function; working memory; declarative memory; attention; hypothalamicpituitary-adrenal axis ID POSTTRAUMATIC-STRESS-DISORDER; GLUCOCORTICOID-RECEPTOR NUMBER; URINARY CORTISOL EXCRETION; LONG-TERM POTENTIATION; CA3 PYRAMIDAL NEURONS; HIPPOCAMPAL VOLUME; DECLARATIVE MEMORY; PLASMA-CORTISOL; COMBAT VETERANS; WORKING-MEMORY AB On the basis of peripheral (nonbrain) neuroendocrine findings in subjects with posttraumatic stress disorder (PTSD), it has been hypothesized that these individuals also have a greater central (brain) sensitivity to glucocorticoids. In nonpsychiatric subjects, it has been found that working and declarative memory performance is selectively impaired by acute glucocorticoid administration. We hypothesized that subjects with PTSD, as compared to nonpsychiatric controls, would show greater impairments in verbal declarative memory and working memory, but not attention, following exogenous glucocorticoid administration. These data are part of a larger study using functional neuroimaging and peripheral HPA axis measures in these same subjects. Subjects underwent a 0.5-mg dexamethasone suppression test and measurement of basal cortisol, basal plasma lymphocyte glucocorticoid receptor number, and postdexamethasone cortisol on a separate day. Under double-blind randomized crossover conditions, 17-mg hydrocortisone or placebo was administered by intravenous (i.v.) bolus to 15 medication-free PTSD subjects (4 female) and 12 nonpsychiatric control subjects (4 female) matched by age, sex, and education level. Participants then underwent positron emission tomography (PET) scanning and 90 min after the initial drug/placebo administration, cognitive testing was then performed. By repeated measures ANCOVA (covaried for baseline performance on that neuropsychological test), neither attention tasks of digit span forward nor backward showed significant change. However, there were significant drug (F = 17.644, df = 1,25 P < 0.001), group (F = 4.383, df 1,25 P = 0.048), and drug by group interactions (F = 4.756, df 1,25 P = 0.040) for verbal declarative memory. By t-test, there was not a difference in baseline performance on this measure between subject groups. The subject group with PTSD experienced a greater decline in verbal declarative memory performance following hydrocortisone administration. For working memory, there were significant group (F = 6.048, df = 1,25 P = 0.022) and drug by group interactions (F = 6.048, df = 1,25 P = 0.022) for verbal declarative memory. By t-test, there was not a difference in baseline performance on this measure between subject groups. The hydrocortisone administration led to impairment in working memory in the group of subjects with PTSD, but not in the control subject group. Exploratory correlations between percent cortisol suppression following dexamethasone and baseline plasma lymphocyte glucocorticoid receptor number with declarative and working memory measures among subject groups separately and in a combined way revealed a negative correlation between lymphocyte glucocorticoid receptor density and working memory (r = -0.54, df = 25, P = 0.008). Brain sensitivity to glucocorticoids appears to be greater in subjects with PTSD. Heightened vulnerability of declarative memory in subjects with PTSD may indicate hippocampal involvement, whereas working memory vulnerability suggests additional brain regions (prefrontal, cingulate, temporal, and parietal cortices) and neurotransmitter systems (dopamine and serotonin) particularly sensitive to glucocorticoids in persons with PTSD. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. Rockefeller Res Inst, Dept Neuroendocrinol, New York, NY USA. Univ Pittsburgh, Med Ctr, Dept Psychol, Pittsburgh, PA USA. RP Grossman, R (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1230, New York, NY 10029 USA. EM robertgrossman@yahoo.com FU NCRR NIH HHS [5M01RR0071]; NIMH NIH HHS [R01MH49555, 1K08MH01543-01A1] NR 42 TC 31 Z9 31 U1 1 U2 4 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN STREET, MALDEN 02148, MA USA SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 410 EP 421 DI 10.1196/annals.1364.032 PG 12 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600032 PM 16891588 ER PT S AU McCaslin, SE Inslicht, SS Neylan, TC Metzler, TJ Otte, C Lenoci, M Henn-Haase, C Best, S Yehuda, R Marmar, CR AF McCaslin, Shannon E. Inslicht, Sabra S. Neylan, Thomas C. Metzler, Thomas J. Otte, Christian Lenoci, Maryann Henn-Haase, Clare Best, Suzanne Yehuda, Rachel Marmar, Charles R. BE Yehuda, R TI Association between alexithymia and neuroendocrine response to psychological stress in police academy recruits SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE alexithymia; neuroendocrine; stress; posttraumatic stress disorder ID SCALE AB Alexithymia has been associated with both posttraumatic stress disorder and neuroendocrine responses to stress. This study examined the relationship of alexithymia to salivary cortisol and 3-methoxy4-hydroxy-phenylglycol (MHPG) in a sample of police academy recruits exposed to a video stress challenge. Alexithymia scores were negatively associated with catecholamine response to the video challenge but no association was found between alexithymia scores and cortisol reactivity. C1 Univ Calif San Francisco, PTSD Res Program, VAMC, San Francisco, CA 94121 USA. Dept Psychiat, San Francisco, CA 94121 USA. Univ Hosp Hamburg Eppendorf, D-20246 Hamburg, Germany. Mt Sinai Sch Med, Div Traumat Stress Studies, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP McCaslin, SE (reprint author), Univ Calif San Francisco, PTSD Res Program, VAMC, 4150 Clement St 116P, San Francisco, CA 94121 USA. EM Shannon.McCaslin@va.gov NR 7 TC 2 Z9 2 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 425 EP 427 DI 10.1196/annals.1364.034 PG 3 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600034 PM 16891590 ER PT S AU Inslicht, SS Marmar, CR Neylan, TC Metzler, TJ Hart, SL Otte, C McCaslin, SE Larkin, GL Hyman, KB Baum, A AF Inslicht, Sabra S. Marmar, Charles R. Neylan, Thomas C. Metzler, Thomas J. Hart, Stacey L. Otte, Christian McCaslin, Shannon E. Larkin, Gregory Luke Hyman, Kelly B. Baum, Andrew BE Yehuda, R TI Increased cortisol in women with intimate partner violence-related posttraumatic stress disorder SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE posttraumatic stress disorder; cortisol; HPA axis; platelet catecholamines; epinephrine; norepinephrine; intimate partner violence ID VICTIMS AB Intimate partner violence (IPV) is a chronic and recurrent traumatic stressor associated with PTSD; however, its biological correlates are not well understood. This study examined diurnal salivary cortisol and platelet catecholamines in women with lifetime IPV-related PTSD and in women exposed to IPV who did not develop PTSD. Cortisol was elevated in women with lifetime PTSD compared to controls. No differences were found for platelet catecholamines. C1 Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94121 USA. Univ Hosp Hamburg Eppendorf, D-20246 Hamburg, Germany. Univ Texas, SW Med Ctr, Dallas, TX 75390 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15213 USA. RP Inslicht, SS (reprint author), Vet Affairs Med Ctr, 4150 Clement St 116P, San Francisco, CA 94121 USA. EM Sabra.Inslicht@med.va.gov RI Hart, Stacey/E-4819-2011 OI LARKIN, GREGORY LUKE/0000-0002-8655-7824 NR 6 TC 22 Z9 22 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 428 EP 429 DI 10.1196/annals.1364.035 PG 2 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600035 PM 16891591 ER PT S AU Golier, JA Legge, J Yehuda, R AF Golier, Julia A. Legge, Juliana Yehuda, Rachel BE Yehuda, R TI The ACTH response to dexamethasone in Persian Gulf War veterans SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE PTSD; Gulf War; medically unexplained illness; ACTH; cortisol; dexamethasone ID POSTTRAUMATIC-STRESS-DISORDER; PITUITARY-ADRENAL AXIS; PHYSICAL HEALTH; PLASMA-CORTISOL; SUPPRESSION; SURVIVORS; ABUSE; PTSD; EXPOSURE; ILLNESS AB The basis of postdeployment health symptoms in Gulf War veterans remains poorly understood. Alterations in the feedback regulation of the hypothalamic-pituitary-adrenal (HPA) axis have been demonstrated in posttraumatic stress disorder (PTSD) and other bodily disorders related to stress. The objective of this article was to examine whether similar HPA axis alterations are related to Gulf War deployment, postdeployment health symptoms, or PTSD. Plasma adrenocorticotropic hormone (ACTH) was measured on consecutive mornings at 08:00 h before and after a low dose of oral dexamethasone (DEX) at 23:00 h in Gulf War veterans with PTSD (n = 14), Gulf War veterans without PTSD (n = 11), and healthy veterans never deployed to a war zone (n = 12). Both Gulf War veterans with PTSD and Gulf War veterans without PTSD had significantly lower post-DEX ACTH levels than the nonexposed veterans, in the absence of group differences in basal ACTH or DEX levels. Among Gulf War veterans, post-DEX ACTH levels were significantly associated with musculoskeletal symptoms. Gulf War deployment and postdeployment health symptoms appear to be associated with alterations in feedback regulation of the pituitary gland that suggests a possible common link between postdeployment health symptoms and other chronic stress-related conditions. C1 James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY 10029 USA. RP Golier, JA (reprint author), Bronx Vet Adm Med Ctr, COMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Julia.golier@med.va.gov NR 25 TC 9 Z9 9 U1 2 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 448 EP 453 DI 10.1196/annals.1364.040 PG 6 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600040 PM 16891596 ER PT S AU Brand, SR Engel, SM Canfield, RL Yehuda, R AF Brand, Sarah R. Engel, Stephanie M. Canfield, Richard L. Yehuda, Rachel BE Yehuda, R TI The effect of maternal PTSD following in utero trauma exposure on behavior and temperament in the 9-month-old infant SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE maternal PTSD; infant behavior; 9/11; cortisol ID POSTTRAUMATIC-STRESS-DISORDER; CORTISOL AB In view of evidence of in utero glucocorticoid programming, and our prior observation of lower cortisol levels in 9-month-old infants of mothers with posttraumatic stress disorder (PTSD) compared to mothers without PTSD, we undertook an examination of the effect of in utero maternal stress, as determined by PTSD symptom severity, and maternal cortisol levels on behavioral outcomes in the infant. Methods: Ninety-eight pregnant women directly exposed to the World Trade Center (WTC) collapse on 9/11 provided salivary cortisol samples and completed a PTSD symptom questionnaire and a behavior rating scale to measure infant temperament, including distress to limitations, and response to novelty. Results: Mothers who developed PTSD in response to 9/11 had lower morning and evening salivary cortisol levels, compared to mothers who did not develop PTSD. Maternal morning cortisol levels were inversely related to their rating of infant distress and response to novelty (i.e., loud noises, new foods, unfamiliar people). Also, mothers who had PTSD rated their infants as having greater distress to novelty than did mothers without PTSD (t = 2.77, df = 61, P = 0.007). Conclusion: Longitudinal studies are needed to determine how the association between maternal PTSD symptoms and cortisol levels and infant temperament reflect genetic and/or epigenetic mechanisms of intergenerational transmission. C1 James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY 10029 USA. Cornell Univ, Ithaca, NY 14853 USA. RP Yehuda, R (reprint author), Bronx VA OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov; Rachel.Yehuda@med.va.gov FU NIEHS NIH HHS [P42 ES07384]; NIMH NIH HHS [5R01 MH64675-03, R01 MH64675-01] NR 7 TC 49 Z9 56 U1 0 U2 15 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 454 EP 458 DI 10.1196/annals.1364.041 PG 5 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600041 PM 16891597 ER PT S AU Labinsky, E Blair, W Yehuda, R AF Labinsky, Ellen Blair, William Yehuda, Rachel BE Yehuda, R TI Longitudinal assessment of dissociation in holocaust survivors with and without PTSD and nonexposed aged Jewish adults SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE PTSD; dissociation; holocaust; aging; longitudinal ID SCALE; RELIABILITY; VALIDITY AB The trajectory of posttraumatic stress disorder (PTSD) and PTSD-related symptoms in relation to aging is not well understood. We previously observed higher levels of dissociation as measured by the Dissociative Experiences Scale (DES) among older Holocaust survivors with, compared to those without, PTSD, though scores on the DES in Holocaust survivors were markedly lower than those that had been reported for younger cohorts. We undertook a longitudinal evaluation of dissociation in Holocaust survivors. Twenty-six Holocaust survivors with current PTSD, 30 Holocaust survivors without current PTSD, and 19 nonexposed were evaluated at the initial evaluation and subsequently 8.11 years later. Repeated measures analysis of variance (ANOVA) on the DES scores from these times demonstrated a significant main effect for time and a significant group by time interaction, reflecting a marked decline in Holocaust survivors, particularly those with PTSD. Controlling for age obliterated the effect of time, but not the group by time interaction. A similar pattern was shown with The Clinician Administered PTSD Scale (CAPS) scores. Different symptoms related to PTSD show different trajectories of change with age, with dissociation appearing to be less prominent with age. C1 Mt Sinai Sch Med, New York, NY 10029 USA. James J Peterson Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. RP Labinsky, E (reprint author), Mt Sinai Sch Med, 1 Gustave L Levy Pl,Box 1228, New York, NY 10029 USA. EM Ellen.Labinsky@msnyuhealth.org FU NCRR NIH HHS [M01 RR00071]; NIMH NIH HHS [R01 MH64675-01] NR 5 TC 12 Z9 12 U1 1 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 459 EP 462 DI 10.1196/annals.1364.042 PG 4 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600042 PM 16891598 ER PT S AU Yehuda, R Labinsky, E Tischler, L Brand, SR Lavin, Y Blair, W Bierer, LM Goodman, RZ Grossman, RA AF Yehuda, Rachel Labinsky, Ellen Tischler, Lisa Brand, Sarah R. Lavin, Yonit Blair, William Bierer, Linda M. Goodman, Rachel Z. Grossman, Robert A. BE Yehuda, R TI Are adult offspring reliable informants about parental PTSD? A validation study SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE parental PTSD; Holocaust; offspring AB We developed a short questionnaire-Parental PTSD Questionnaire-(PPQ), designed to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parents. Fifty-eight adult offspring of Holocaust survivors (23 men and 35 women) completed the questionnaire about a parent who was independently evaluated by a trained clinician using the Clinician Administered PTSD Scale (CAPS). Only 5.2% of the offspring reported, "not knowing" if their parent had experienced 10 or fewer symptoms, while 56.9% provided estimates for all 17 items. There were no significant differences between lifetime frequencies of the individual symptoms as endorsed on the PPQ compared to the CAPS when subjects with completed PPQs were compared with CAPS. Interrater reliability between offspring and clinician was highly significant for each of the items when evaluated separately so as to include data for subjects who endorsed not knowing if a certain symptom had been present. Further studies are warranted to examine the psychometric properties of this measure. C1 James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov; Rachel.Yehuda@med.va.gov NR 1 TC 13 Z9 14 U1 1 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 484 EP 487 DI 10.1196/annals.1364.047 PG 4 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600047 PM 16891603 ER PT S AU Bierer, LM Tischler, L Labinsky, E Cahill, S Foa, E Yehuda, R AF Bierer, Linda M. Tischler, Lisa Labinsky, Ellen Cahill, Shawn Foa, Edna Yehuda, Rachel BE Yehuda, R TI Clinical correlates of 24-h cortisol and norepinephrine excretion among subjects seeking treatment following the World Trade Center attacks on 9/11 SO PSYCHOBIOLOGY OF POSTTRAUMATIC STRESS DISORDER: A DECADE OF PROGRESS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Meeting on Psychobiology of Post-Traumatic Stress Disorder CY SEP 11-13, 2005 CL New York, NY SP New York Acad Sci DE 24-h cortisol; norepinephrine; 9/11; PTSD ID POSTTRAUMATIC-STRESS-DISORDER; DEPRESSION; SEVERITY AB Whereas trauma-associated arousal has been linked fairly consistently with elevations in both glucocorticoids and catecholamines, neuroendocrine correlates of hyperarousal in the context of posttraumatic stress disorder (PTSD) have been more variable. Further, neuroendocrine predictors of the development of PTSD following trauma have been related to prior exposure, and data from several laboratories suggests that hyperarousal may develop in a neuroendocrine milieu of relatively diminished basal glucocorticoid secretion. Methods: In this article we examined 24-h cortisol and norepinephrine excretion in 42 treatment-seeking survivors of the 9/11 World Trade Center (WTC) attacks, 32 of whom met criteria for PTSD, and 15 of whom met criteria for major depression, at the time of evaluation; 14 of the 15 subjects meeting criteria for major depression also suffered from PTSD. Results: PTSD subjects' 24-h cortisol excretion (46.3 +/- 20.0 mu L/dL) was lower than that of the non-PTSD cohort (72.2 +/- 22.4 mu L/dL; t = 3.18, df = 37, P = 0.003), and 24-h urinary cortisol was negatively correlated with the experience of the WTC attacks as a Criterion-A event (r = -0.427, P = 0.007), and with self-rated avoidance (r = -0.466, P = 0.003) and total score (r = -0.398, P = 0.012) on the PTSD Symptom Scale (PSS). In contrast, 24-h norepinephrine excretion was not associated with the development of PTSD or with PTSD-related symptoms, but was negatively correlated with days since 9/11 at the time of evaluation (r = -0.393, P = 0.015). Discussion: The latter finding suggests a relationship of norepinephrine to a dimension of stress-related arousal not captured by the symptom-rating scales chosen for this study to reflect symptoms related to PTSD and other neuropsychiatric disorders, but instead, of one to that of the sudden multidimensional life disruption suffered by the WTC C1 CUNY Mt Sinai Sch Med, New York, NY 10029 USA. James J Peters Vet Affairs Med Ctr, Bronx, NY 10468 USA. Univ Penn, Philadelphia, PA 19104 USA. RP Yehuda, R (reprint author), Bronx Vet Adm Med Ctr, Bronx, NY USA. EM rachel.yehuda@med.va.gov; rachel.yehuda@med.va.gov NR 8 TC 24 Z9 24 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-619-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1071 BP 514 EP 520 DI 10.1196/annals.1364.055 PG 7 WC Multidisciplinary Sciences; Clinical Neurology; Psychiatry SC Science & Technology - Other Topics; Neurosciences & Neurology; Psychiatry GA BFB20 UT WOS:000240653600054 PM 16891610 ER PT J AU Meissner, HH Hoo, GWS Khonsary, SA Mandelkern, M Brown, CV Santiago, SM AF Meissner, HH Hoo, GWS Khonsary, SA Mandelkern, M Brown, CV Santiago, SM TI Idiopathic pulmonary fibrosis: Evaluation with positron emission tomography SO RESPIRATION LA English DT Article DE pulmonary fibrosis; idiopathic interstitial pneumonia; positron emission tomography; usual interstitial pneumonitis ID RESOLUTION COMPUTED-TOMOGRAPHY; INTERSTITIAL LUNG-DISEASE; ALVEOLITIS; ACTIVATION; PNEUMONIA; DIAGNOSIS; MODEL AB Background: The pathogenesis of interstitial lung disease remains under investigation, but may be related to increased inflammatory or cellular activity. This activity may be detectable with physiologic imaging. Objectives: We investigated the role of physiologic imaging using F-18-2-fluoro-2-deoxy-D-glucose ((18)FDG)-positron emission tomography ( PET) scans in idiopathic pulmonary fibrosis (IPF). Methods: Seven male patients with histologically confirmed IPF underwent (18)FDG-PET scans. Scans were analyzed qualitatively and interpreted as positive or negative. Patients also underwent pulmonary function tests and computed tomography (CT) scans. Results: The average total lung capacity was 71 +/- 22% predicted ( mean +/- SD) and diffusing capacity for carbon monoxide was 44 +/- 14% predicted. All had changes consistent with IPF on chest CT and 2 patients had ground glass attenuation. Six of seven patients (86%) had a positive (18)FDG-PET scan. Changes in the (18)FDG-PET scan were seen in 1 patient corresponding to changes in clinical status. Conclusions: Our findings suggest that (18)FDG-PET scans may be helpful in the evaluation of IPF. Increased activity suggests active disease and changes in response to therapy. Copyright (C) 2006 S. Karger AG, Basel. C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Div Pulm & Crit Care Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Div Nucl Med, Los Angeles, CA USA. RP Santiago, SM (reprint author), W Los Angeles VA Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Silverio.santiago@med.va.gov NR 24 TC 31 Z9 32 U1 0 U2 1 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0025-7931 J9 RESPIRATION JI Respiration PY 2006 VL 73 IS 2 BP 197 EP 202 DI 10.1159/000088062 PG 6 WC Respiratory System SC Respiratory System GA 023LD UT WOS:000236127300013 PM 16141712 ER PT J AU Eisenstein, EM Eisenstein, D AF Eisenstein, E. M. Eisenstein, D. TI A behavioral homeostasis theory of habituation and sensitization: II. Further developments and predictions SO REVIEWS IN THE NEUROSCIENCES LA English DT Article DE habituation; sensitization; learning; instinct; circadian; homeostasis; dementia; evolution ID GALVANIC SKIN-RESPONSE; SYNAPTIC PLASTICITY; KAIC PHOSPHORYLATION; MAIN CHARACTERISTICS; APLYSIA-CALIFORNICA; ALARM CALLS; PHASE-ANGLE; CONDUCTANCE; COCKROACH; MICROORGANISMS AB Habituation may be viewed as a decremental behavioral change to iterative stimuli of little immediate relevance. It is observed from protozoa to humans, indicating its evolutionary significance /24,25/. If habituation is interpreted as the process of filtering out unimportant repetitive stimuli, then how should sensitization be interpreted? The 'behavioral homeostasis theory' of these two behaviors is based on the notion that organisms at a high level of 'alertness' prior to experiencing a new iterative stimulus will show a large initial response followed by a decrement (habituation) if the stimulus is of little significance. Conversely, the same organism at a low level of 'alertness' will show a small initial response to the same stimulus followed by an increase in 'alertness' and a larger response to the next stimulus (sensitization) in order to receive enough information to assess its significance. Circadian rhythmicity is hypothesized to play a role in determining 'alertness' to a new iterative stimulus at any given time. The level of responsiveness in initial habituaters and sensitizers, as an asymptote is approached, is a balance between being too 'alert' to an unimportant stimulus and missing other significant stimuli, and being too 'un-alert' and missing a change in the relevance of the present iterative stimulus. The concept of 'behavioral homeostasis' includes behaviors beyond habituation and sensitization across phylogeny. It includes instinctive as well as learned, and group as well as individual behavior. Such behavioral homeostatic processes to optimize detection and assessment of constantly occurring external stimuli are critical for organism survival. Clinical implications of this theory are also examined. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Eisenstein, EM (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM edward.eisenstein@med.va.gov NR 71 TC 17 Z9 17 U1 2 U2 9 PU FREUND & PETTMAN PUBLISHERS PI EAST YORKSHIRE PA ENHOLMES HALL, PATRINGTON, EAST YORKSHIRE HU12 OPR, ENGLAND SN 0334-1763 J9 REV NEUROSCIENCE JI Rev. Neurosci. PY 2006 VL 17 IS 5 BP 533 EP 557 PG 25 WC Neurosciences SC Neurosciences & Neurology GA 117OJ UT WOS:000242882300004 PM 17180878 ER PT J AU Dracheva, S Davis, KL Chin, B Woo, DA Haroutunian, V AF Dracheva, S Davis, KL Chin, B Woo, DA Haroutunian, V TI Myelin-associated MRNA and protein expression deficits in the anterior cingulate cortex and hippocampus of schizophrenia patients: Possible link with SOX10 methylation status SO SCHIZOPHRENIA RESEARCH LA English DT Meeting Abstract CT 13th Biennial Winter Workshop on Schizophrenia Research CY FEB 04-10, 2006 CL Davos, SWITZERLAND C1 CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. EM stella.dracheva@mssm.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JAN PY 2006 VL 81 SU S BP 46 EP 46 PG 1 WC Psychiatry SC Psychiatry GA 015AQ UT WOS:000235524700104 ER PT J AU Theberge, J Jakary, A AF Theberge, J Jakary, A TI Comment on "N-acetylaspartate reductions in the mediodorsal and anterior thalamus in men with schizophrenia verified by tissue volume corrected proton MRSI" (Schizophr Res 76, 173-185, 2005) SO SCHIZOPHRENIA RESEARCH LA English DT Letter ID GLUTAMINE C1 Harvard Univ, Sch Med, McLean Hosp, Dept Psychiat,Brain Imaging Ctr, Belmont, MA 02478 USA. San Francisco VA Med Ctr, No Calif Inst Res & Educ, San Francisco, CA 94121 USA. RP Theberge, J (reprint author), Harvard Univ, Sch Med, McLean Hosp, Dept Psychiat,Brain Imaging Ctr, 115 Mill St, Belmont, MA 02478 USA. EM jtheberge@mclean.harvard.edu; angela.jakary@med.va.gov RI Theberge, Jean/A-3087-2008 OI Theberge, Jean/0000-0001-7578-4469 NR 4 TC 0 Z9 0 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD JAN 1 PY 2006 VL 81 IS 1 BP 119 EP 120 DI 10.1016/j.schres.2005.09.014 PG 2 WC Psychiatry SC Psychiatry GA 004TI UT WOS:000234774700013 PM 16298108 ER PT S AU Abe, E AF Abe, Etsuko BE Zaidi, M TI Function of BMPs and BMP antagonists in adult bone SO SKELETAL DEVELOPMENT AND REMODELING IN HEALTH, DISEASE, AND AGING SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Skeletal Development and Remodeling in Health, Disease and Aging CY MAY 18-21, 2005 CL New York, NY SP NY Acad Sci, Alliance Better Bone Hlth, Procter & Gamble Pharmaceut, Sanofi Aventis, Novartis Pharmaceut, Roche Pharmaceut, Merck & Co DE BMP; BMP antagonist; Wnt; catenin; osteoblast; bone remodeling ID MORPHOGENETIC PROTEINS; BETA-CATENIN; OSTEOBLAST DIFFERENTIATION; CELL-DIFFERENTIATION; TWISTED-GASTRULATION; NEGATIVE REGULATOR; SMAD-BINDING; TGF-BETA; NOGGIN; WNT AB The expression and function of BMPs and BMPs in bone tissues have been studied for a long time because of their remarkable activities. However, their biological functions in normal bone-remodeling in adults were not fully understood until recently. Advanced technologies using gene manipulation were used to study their roles in adulthood. In addition, findings of new BMP antagonists and the effect of Wnt-canonical pathways on bone features also provided new insights in bone studies. C1 CUNY Mt Sinai Sch Med, Dept Med, Div Endocrinol, Mt Sinai Bone Program, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. RP Abe, E (reprint author), CUNY Mt Sinai Sch Med, Dept Med, Div Endocrinol, Mt Sinai Bone Program, 1 Gustave L Levy Pl,Box 1055, New York, NY 10029 USA. EM etsuko.abe@mssm.edu NR 59 TC 39 Z9 42 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-583-4 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1068 BP 41 EP 53 DI 10.1196/annals.1346.007 PG 13 WC Multidisciplinary Sciences; Orthopedics SC Science & Technology - Other Topics; Orthopedics GA BFA92 UT WOS:000240548200005 PM 16831904 ER PT S AU Roodman, GD AF Roodman, G. David BE Zaidi, M TI Regulation of osteoclast differentiation SO SKELETAL DEVELOPMENT AND REMODELING IN HEALTH, DISEASE, AND AGING SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Skeletal Development and Remodeling in Health, Disease and Aging CY MAY 18-21, 2005 CL New York, NY SP NY Acad Sci, Alliance Better Bone Hlth, Procter & Gamble Pharmaceut, Sanofi Aventis, Novartis Pharmaceut, Roche Pharmaceut, Merck & Co DE osteoclasts; differentiation; autocrine; paracrine; cytokines ID KAPPA-B LIGAND; MESSENGER-RNA EXPRESSION; HUMAN MARROW CULTURES; GIANT-CELL TUMORS; LARGE T-ANTIGEN; BCL-X-L; BONE-RESORPTION; RECEPTOR ACTIVATOR; ANNEXIN-II; PARATHYROID-HORMONE AB The osteoclast (OCL) is derived from the cells in monocyte-macrophage lineage. The earliest identifiable OCL precursor is the granulocyte-macrophage colony-forming unit (CFU-GM), which gives rise to granulocytes, monocytes, and OCL. CFU-GM-derived cells then differentiate to committed OCL precursors, which are post-mitotic cells, and fuse to form multinucleated OCL. A variety of factors both positively and negatively regulate OCL formation and activity. These include growth factors, such as macrophage colony-simulating factor, which simulates the proliferation and prevents apoptosis of early OCL precursors, and RANK ligand (RANKL), which is the primary mediator of OCL formation. Most factors that induce OCL differentiation, such as PTHrP, IL-11, and prostaglandins, do so by inducing expression of RANKL on, the surface of immature osteoblasts. Osteoprotegerin is a decoy receptor that blocks RANKL activity. In addition, OCL produce autocrine-paracrine factors that regulate OCL formation, such as IL-6, which is produced at high levels by OCL in Paget's disease and increases OCL formation. We screened human and murine OCL cDNA libraries to identify autocrine-paracrine factors that regulate OCL activity. We identified annexin-II, MIP-1 alpha, ADAM8, eosinophil chemotactic factor, and OCL inhibitor factors 1 and 2 as factors involved in OCL formation. Most recently, we have identified the receptor for ADAM8, alpha(9)beta(1) integrin, which appears to be critical for normal OCL activity. OCL differentiation is controlled by exogenous hormones and cytokines as well as autocrine-paracrine factors that positively or negatively regulate OCL proliferation and differentiation. C1 Univ Pittsburgh, Sch Med Hematol Oncol, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Roodman, GD (reprint author), Univ Pittsburgh, Sch Med Hematol Oncol, VA Pittsburgh Healthcare Syst, R&D 151-U,Room 2E-113,Univ Dr C, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu NR 52 TC 114 Z9 122 U1 0 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-583-4 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1068 BP 100 EP 109 DI 10.1196/annals.1346.013 PG 10 WC Multidisciplinary Sciences; Orthopedics SC Science & Technology - Other Topics; Orthopedics GA BFA92 UT WOS:000240548200011 PM 16831910 ER PT S AU Garcia-Palacios, V Chung, HY Choi, SJ Kurihara, N Lee, YW Ehrlich, LA Collins, R Roodman, GD AF Garcia-Palacios, Veronica Chung, Ho Yeon Choi, Sun Jin Kurihara, Noriyoshi Lee, Yun Won Ehrlich, Lori A. Collins, Robert Roodman, G. David BE Zaidi, M TI Eosinophil chemotactic factor-L (ECF-L) enhances osteoclast formation by increasing ICAM-1 expression SO SKELETAL DEVELOPMENT AND REMODELING IN HEALTH, DISEASE, AND AGING SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Skeletal Development and Remodeling in Health, Disease and Aging CY MAY 18-21, 2005 CL New York, NY SP NY Acad Sci, Alliance Better Bone Hlth, Procter & Gamble Pharmaceut, Sanofi Aventis, Novartis Pharmaceut, Roche Pharmaceut, Merck & Co DE ECF-L; osteoclasts; ICAM-1 ID INTERCELLULAR-ADHESION MOLECULE-1; FUNCTION-ASSOCIATED ANTIGEN-1; FACTOR RECEPTOR FAMILY; DIFFERENTIATION; PROTEIN; LECTIN; IDENTIFICATION; INFLAMMATION; INVOLVEMENT; PRECURSORS AB Eosinophil chemotactic factor-L (ECF-L) is a novel stimulator of osteoclast (OCL) formation that acts at the differentiation/fusion stage of OCL formation, and is a cofactor for RANK ligand (RANKL). We examined the effects of ECF-L on the intracellular signaling pathways utilized by RANKL, and on the expression of ICAM-1/LFA-1 to determine its mechanism of action. RAW 264.7 and bone marrow cells were treated with RANKL and/or ECF-L Fe protein to determine their effect on NF-kappa B and AP-1 activity. ECF-L by itself only modestly increased NF-kappa B binding and JNK activity in RAW 264.7 cells, which were further enhanced by RANKL. In contrast, ECF-L Fe increased LFA-1 alpha and ICAM-1 mRNA levels 1.8-fold in mouse marrow cultures, and anti-ICAM-1 almost completely inhibited OCL formation induced by 10(-10) M 1,25-(OH)(2)D-3, and ECF-L Fc. Furthermore, ECF-L Fc did not enhance OCL formation by ICAM-I knockout (KO) cells. Increased expression of ICAM-I by ECF-L appears to be critical for its effects on OCL formation. C1 Univ Pittsburgh, Dept Med Hematol Oncol, Pittsburgh, PA USA. Sungkyunkwan Univ, Dept Med, Seoul, South Korea. Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Roodman, GD (reprint author), 111-H,Univ Dr C, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu FU NIAID NIH HHS [AI-32177]; NIAMS NIH HHS [R01-AR41336] NR 14 TC 1 Z9 1 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-583-4 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1068 BP 240 EP 243 DI 10.1196/annals.1346.048 PG 4 WC Multidisciplinary Sciences; Orthopedics SC Science & Technology - Other Topics; Orthopedics GA BFA92 UT WOS:000240548200025 PM 16831924 ER PT S AU Rajendren, G Zhou, H Moonga, BS Zaidi, M Sun, L AF Rajendren, Gopalan Zhou, Hang Moonga, Baljit S. Zaidi, Mone Sun, Li BE Zaidi, M TI Restoration of bone mass in Hpg mouse by preoptic area grafting SO SKELETAL DEVELOPMENT AND REMODELING IN HEALTH, DISEASE, AND AGING SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Skeletal Development and Remodeling in Health, Disease and Aging CY MAY 18-21, 2005 CL New York, NY SP NY Acad Sci, Alliance Better Bone Hlth, Procter & Gamble Pharmaceut, Sanofi Aventis, Novartis Pharmaceut, Roche Pharmaceut, Merck & Co DE osteoporosis; hypogonadism; gonadotropin-releasing hormone ID HYPOGONADAL FEMALE MICE; HORMONE DEFICIENCY; BRAIN GRAFTS; CELLS; MEN AB Hereditary hypogonadism in the hpg mouse, caused by a deletion mutation in the gonadotropin-releasing hormone (GnRH) gene, is associated with sterility, absent ovarian development, and undetectable circulating sex steroids. Eight-month-old female hpg mice had a significantly reduced bone mineral density (BMD) at the lumbar spine, femur, and tibia. In addition, the mice showed significant reductions in liver and kidney weight, with virtually nonexistent ovaries. Successfully transplanted hpg mice with preoptic area grafts contained GnRH-positive neurons, consistent with our previous experience, and the host median eminence was innervated by GnRH immunoreactive fibers. A return of reproductive function was evident from increased ovarian weight and vaginal cornification. Of note was that grafted hpg mice showed a complete reversal to baseline of their BMD measured at all three sites. This establishes that the low bone mass that occurs in old hpg mice can be fully and rapidly ameliorated by preoptic area grafting. C1 Mt Sinai Bone Program, Dept Med, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, New York, NY 10029 USA. RP Sun, L (reprint author), Mt Sinai Sch Med, Endocrinol 1055,1 Gustave L Levy Pl, New York, NY 10029 USA. EM mone.zaidi@mssm.edu; mone.zaidi@mssm.edu FU NIA NIH HHS [R01 AG14197, AG23176]; NIDDK NIH HHS [DK70526] NR 13 TC 6 Z9 9 U1 1 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-583-4 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1068 BP 341 EP 347 DI 10.1196/annals.1346.050 PG 7 WC Multidisciplinary Sciences; Orthopedics SC Science & Technology - Other Topics; Orthopedics GA BFA92 UT WOS:000240548200036 PM 16831935 ER PT J AU Alessi, CA Martin, JL Webber, AP Alam, T Josephson, KR Harker, JO AF Alessi, C. A. Martin, J. L. Webber, A. P. Alam, T. Josephson, K. R. Harker, J. O. TI More daytime sleeping among older people undergoing post-acute rehabilitation predicts worse functional recovery SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, GRECC, Sepulveda, CA USA. Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S BP A111 EP A112 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700331 ER PT J AU Berka, C Westbrook, PR Lumicao, MN Olmstead, R Levendowski, DJ Davis, G Eric, S Braich, K Ramsey, CK AF Berka, C. Westbrook, P. R. Lumicao, M. N. Olmstead, R. DJ, Levendowski Davis, G. Eric, S. Braich, K. Ramsey, C. K. TI Influence of sleep-disordered breathing on neurocognitive functions pre- and posttreatment with CPAP SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Adv Brain Monitoring Inc, Carlsbad, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 616 BP A208 EP A209 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700620 ER PT J AU Boehmer, LN Mitchell, TM Zhou, Q Siegel, JM AF Boehmer, L. N. Mitchell, T. M. Zhou, Q. Siegel, J. M. TI Prokineticin-2 affects sleep rhythms SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Calif Los Angeles, Braiin Res Inst, Los Angeles, CA USA. VA GLAHS Sepulveda, North Hills, CA USA. Univ Calif Irvine, Irvine, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 50 BP A17 EP A17 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700052 ER PT J AU Braich, K Berka, C Westbrook, PR Lumicao, MN Olmstead, R Levendowski, DJ Davis, G Ramsey, CK Eric, S AF Braich, K. Berka, C. Westbrook, P. R. Lumicao, M. N. Olmstead, R. Levendowski, D. J. Davis, G. Ramsey, C. K. Eric, S. TI Evaluation of subjective measures of sleepiness in obstructive sleep APNEA patients pre- and post-treatment with CPAP and comparison to healthy controls SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Adv Brain Monitoring Inc, Carlsbad, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 576 BP A195 EP A196 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700580 ER PT J AU Gvilia, I McGinty, D Szymusiak, R AF Gvilia, I McGinty, D. Szymusiak, R. TI Accumulation of rapid eye movement sleep propensity in the rat: A role for wakefulness SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. I Beritashvili Inst Physiol, Tbilisi, Rep of Georgia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 342 BP A116 EP A117 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700343 ER PT J AU Gvilia, I Turner, A McGinty, D Szymusiak, R AF Gvilia, I. Turner, A. McGinty, D. Szymusiak, R. TI Expression of c-fos in the preoptic area during different levels of sleep drive SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA USA. I Beritashvili Inst Physiol, Tbilisi, Rep of Georgia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 5 BP A2 EP A2 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700007 ER PT J AU Herbst, ED Metzler, T McCaslin, S Inslicht, S Neylan, T AF Herbst, E. D. Metzler, T. McCaslin, S. Inslicht, S. Neylan, T. TI Adaptation effects to sleep studies in participants with and without chronic posttraumatic stress disorder SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Calif San Francisco, San Francisco Vet Adm Med Ctr, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 972 BP A332 EP A333 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916701349 ER PT J AU Juergens, TM AF Juergens, T. M. TI Anxiety and depression on the tolerance of a continuous positive airway pressure (CPAP) mask in split-night sleep studies SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Wisconsin Hosp, Dept Psychiat, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 982 BP A336 EP A336 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916701359 ER PT J AU Juergens, TM Young, T AF Juergens, T. M. Young, T. TI The interaction of ApoE allele status and sleep disordered breathing on cognitive function SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Wisconsin Hosp & Clin, Dept Geriatr Psychiat, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Dept Psychiat, Madison, WI USA. Univ Wisconsin, Dept Populat Hlth Sci, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 335 BP A113 EP A113 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700335 ER PT J AU Lyamin, O Siegel, J AF Lyamin, O. Siegel, J. TI Cetacean sleep behavior varies with body size SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Calif Los Angeles, Dept Psychiat, North Hills, CA USA. Univ Calif Los Angeles, VA GLAHS Sepulveda, North Hills, CA USA. Utrish Dolphinarium, Moscow, Russia. NR 0 TC 1 Z9 1 U1 1 U2 7 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 115 BP A38 EP A38 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700117 ER PT J AU Pryaslova, J Lyamin, O AF Pryaslova, J. Lyamin, O. TI Behavioral sleep in the walrus SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. VA GLAHS Sepulveda, North Hills, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 113 BP A37 EP A38 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916700115 ER PT J AU Weaver, EM Maynard, C AF Weaver, E. M. Maynard, C. TI Sleep apnea mortality in middle-aged versus geriatric veterans SO SLEEP LA English DT Meeting Abstract CT 20th Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 17-22, 2006 CL Salt Lake City, UT SP Associated Process Sleep Soc C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER ACADEMY SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CENTER STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2006 VL 29 SU S MA 637 BP A215 EP A215 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 047ZH UT WOS:000237916701014 ER PT B AU Welsh, CH Fugit, RV AF Welsh, Carolyn H. Fugit, Randolph V. BA LeeChiong, T BF LeeChiong, T TI MEDICATIONS THAT CAN CAUSE INSOMNIA SO SLEEP: A COMPREHENSIVE HANDBOOK LA English DT Article; Book Chapter ID SLEEP; TOXICITY C1 [Welsh, Carolyn H.; Fugit, Randolph V.] Denver Vet Affairs Med Ctr, Denver, CO USA. RP Welsh, CH (reprint author), Denver Vet Affairs Med Ctr, Denver, CO USA. NR 21 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE PUBL PI OXFORD PA OSNEY MEAD, OXFORD OX2 0EL, ENGLAND BN 978-0-471-75172-4 PY 2006 BP 103 EP 109 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA BZE26 UT WOS:000301234900015 ER PT J AU Martin, JL Alessi, CA AF Martin, Jennifer L. Alessi, Cathy A. BA LeeChiong, T BF LeeChiong, T TI SLEEP IN INSTITUTIONALIZED OLDER ADULTS SO SLEEP: A COMPREHENSIVE HANDBOOK LA English DT Article; Book Chapter ID NURSING-HOME PATIENTS; ACTIVITY RHYTHM DISTURBANCES; ALZHEIMERS-DISEASE; CIRCADIAN-RHYTHMS; INTERVENTION; AGITATION; LIGHT; WAKEFULNESS; RESIDENTS; IMPROVE C1 [Martin, Jennifer L.; Alessi, Cathy A.] Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Martin, JL (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 23 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE PUBL PI OXFORD PA OSNEY MEAD, OXFORD OX2 0EL, ENGLAND BN 978-0-471-75172-4 PY 2006 BP 615 EP 619 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA BZE26 UT WOS:000301234900081 ER PT J AU Rodriguez, KL Young, AJ AF Rodriguez, KL Young, AJ TI Patients' and healthcare providers' understandings of life-sustaining treatment: Are perceptions of goals shared or divergent? SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE USA; end-of-life care; life-sustaining treatment; advance care planning; healthcare preferences; qualitative research; veterans ID ADVANCE DIRECTIVES; OF-LIFE; MODELS AB In this cross-sectional qualitative study, researchers performed in-depth, semistructured interviews with 30 pairs of patients and their primary care providers in an outpatient clinic of a large, urban Veterans Affairs (VA) medical center in the United States. During audiotaped interviews to assess their understanding of advance directive concepts, participants were asked what "life-sustaining treatment" means to them and why they think of it in the way they do. The findings indicate that patients and providers in the United States tend to view and discuss life-sustaining treatment in terms of four goals for end-of-life care: (1) extending the length of life, (2) improving the quality of life, (3) maintaining or improving specific biological functions, and (4) assisting the body for a temporary period of time. Patients thought providers were more concerned with extending the length of life than with quality-based outcomes, and patients often discussed life-sustaining treatment as acceptable means for short-term but not long-term use. Many providers indicated that they struggle with conflicting quality-based and physiologic care goals. The findings highlight the importance of eliciting patient preferences not only for specific types of treatment, such as cardiopulmonary resuscitation, but also for end-of-life care goals or desired health-related outcomes, such as maximizing the quantity of life. The findings also suggest that advance directives and patient-provider discussions that focus on acceptable health states and valued life activities may be better suited to patients' end-of-life care goals than those that focus on specific medical interventions. Published by Elsevier Ltd. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. RP Rodriguez, KL (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Univ Dr C,Bldg 28,Room 1A129, Pittsburgh, PA 15240 USA. EM keri.rodriguez@med.va.gov NR 31 TC 24 Z9 24 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD JAN PY 2006 VL 62 IS 1 BP 125 EP 133 DI 10.1016/j.scoscimed.2005.05.023 PG 9 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 995VG UT WOS:000234131900012 PM 15993530 ER PT J AU Colley, BJ O'Brien, TX AF Colley, Byron Judson, III O'Brien, Terrence X. TI Cardiac tamponade: Still being newly described SO SOUTHERN MEDICAL JOURNAL LA English DT Editorial Material C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Off Res & Dev, Charleston, SC USA. RP O'Brien, TX (reprint author), Med Univ S Carolina, Dept Med, 135 Rutledge Ave,Suite 1201,POB 250952, Charleston, SC 29425 USA. EM obriente@musc.edu NR 6 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0038-4348 J9 SOUTH MED J JI South.Med.J. PD JAN PY 2006 VL 99 IS 1 BP 4 EP 4 DI 10.1097/01.smj.0000197043.02035.ec PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 095NK UT WOS:000241314400003 PM 16466106 ER PT J AU Barnwell, SS Earleywine, M AF Barnwell, Sara Smucker Earleywine, Mitch TI Simultaneous alcohol and cannabis expectancies predict simultaneous use SO SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY LA English DT Article AB Background: Simultaneous use of alcohol and cannabis predicts increased negative consequences for users beyond individual or even concurrent use of the two drugs. Given the widespread use of the drugs and common simultaneous consumption, problems unique to simultaneous use may bear important implications for many substance users. Cognitive expectancies offer a template for future drug use behavior based on previous drug experiences, accurately predicting future use and problems. Studies reveal similar mechanisms underlying both alcohol and cannabis expectancies, but little research examines simultaneous expectancies for alcohol and cannabis use. Whereas research has demonstrated unique outcomes associated with simultaneous alcohol and cannabis use, this study hypothesized that unique cognitive expectancies may underlie simultaneous alcohol and cannabis use. Results: This study examined a sample of 2600 (66% male; 34% female) Internet survey respondents solicited through advertisements with online cannabis-related organizations. The study employed known measures of drug use and expectancies, as well as a new measure of simultaneous drug use expectancies. Expectancies for simultaneous use of alcohol and cannabis predicted simultaneous use over and above expectancies for each drug individually. Discussion: Simultaneous expectancies may provide meaningful information not available with individual drug expectancies. These findings bear potential implications on the assessment and treatment of substance abuse problems, as well as researcher conceptualizations of drug expectancies. Policies directing the treatment of substance abuse and its funding ought to give unique consideration to simultaneous drug use and its cognitive underlying factors. C1 [Barnwell, Sara Smucker] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Earleywine, Mitch] SUNY Albany, Dept Psychol, Albany, NY 12222 USA. RP Barnwell, SS (reprint author), VA Greater Los Angeles Healthcare Syst, Mail Code 116B,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM smucker@usc.edu; MEarleywine@albany.edu NR 31 TC 8 Z9 8 U1 2 U2 3 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1747-597X J9 SUBST ABUSE TREAT PR JI Subst/ Abus. Treatment Prev. Pol. PY 2006 VL 1 AR 29 DI 10.1186/1747-597X-1-29 PG 9 WC Substance Abuse SC Substance Abuse GA V99JS UT WOS:000206717600028 PM 17034634 ER PT J AU Kertesz, SG Madan, A Wallace, D Schumacher, JE Milby, JB AF Kertesz, Stefan G. Madan, Alok Wallace, Dennis Schumacher, Joseph E. Milby, Jesse B. TI Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons SO SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY LA English DT Article AB Background: Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results: Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996-1998) were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e. g. depression) and anxiety-related disorders (e. g. post-traumatic stress disorder). Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p = 0.12). Conclusion: Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population. C1 [Kertesz, Stefan G.; Schumacher, Joseph E.] Univ Alabama, Sch Med, Div Prevent Med, Birmingham, AL 35294 USA. [Kertesz, Stefan G.] Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL 35294 USA. [Madan, Alok] Univ N Carolina, Sch Med, Dept Psychiat, Chapel Hill, NC 27599 USA. [Wallace, Dennis] Rho Fed Syst Inc, Chapel Hill, NC 27517 USA. [Milby, Jesse B.] Univ Alabama, Dept Psychol, Div Prevent Med, Birmingham, AL 35294 USA. RP Kertesz, SG (reprint author), Univ Alabama, Sch Med, Div Prevent Med, 1530 3rd Ave S MT 608, Birmingham, AL 35294 USA. EM skertesz@uab.edu; madal_99@yahoo.com; dwallace@rhoworld.com; jschumacher@mail.dopm.uab.edu; jmilby@uab.edu FU NIDA NIH HHS [K23 DA015487, K23-DA-15487, R01-DA-08475] NR 42 TC 7 Z9 9 U1 1 U2 5 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1747-597X J9 SUBST ABUSE TREAT PR JI Subst/ Abus. Treatment Prev. Pol. PY 2006 VL 1 AR 27 DI 10.1186/1747-597X-1-27 PG 8 WC Substance Abuse SC Substance Abuse GA V99JS UT WOS:000206717600026 PM 16965639 ER PT J AU Zhou, W Lin, PH Bush, RL Terramani, TT Matsuura, JH Cox, M Peden, E Guerrero, M Silberfein, EJ Dardik, A Rosenthal, D Lumsden, AB AF Zhou, W Lin, PH Bush, RL Terramani, TT Matsuura, JH Cox, M Peden, E Guerrero, M Silberfein, EJ Dardik, A Rosenthal, D Lumsden, AB TI In situ reconstruction with cryopreserved arterial allografts for management of mycotic aneurysms or aortic prosthetic graft infections: a multi-institutional experience SO TEXAS HEART INSTITUTE JOURNAL LA English DT Article DE aneurysm, infected/surgery; bacterial infections/complications/surgery; arteries/transplantation; blood vessel prosthesis/adverse effects; cryopreservation; prosthesis-related infections/surgery; staphylococcal infections/surgery; surgical wound intection/surgery; reoperation; transplantation, homologous ID SURGICAL-MANAGEMENT; REPLACEMENT; HOMOGRAFTS; MODEL AB We designed this study to evaluate a multi-institutional experience regarding the efficacy of cryopreserved aortic allografts in the treatment of infected aortic prosthetic grafts or mycotic aneurysms. We reviewed clinical data of all patients from 4 institutions who underwent in situ aortic reconstruction with cryopreserved allografts for either infected aortic prosthetic graft or mycotic aneurysms from during a 6-year period. Relevant clinical variables and treatment outcomes were analyzed. A total of 42 patients (37 men; overall mean age 63 +/- 13 years, range 41-74 years) were identified during this study period. Treatment indications included 34 primary aortic graft infections (81%), 6 mycotic aneurysms (22%), and 2 aortoenteric erosions (5%). Transabdominal and thoracoabdominal approaches were used in 38 (90%) and 4 patients (10%), respectively. Staphylococcus aureus was the most commonly identified organism (n=27,64%). Although there was no intraoperative death, the 30-day operative mortality was 17% (n=7). There were 21 (50%) nonfatal complications, including local wound infection (n=8), lower-extremity deep venous thrombosis (n=5), amputation (n=6), and renal failure requiring hemodialysis (n=2). The average length of hospital stay was 16.4 +/- 7 days. During a mean follow-up period of 12.5 months, reoperation for allograft revision was necessary in 1 patient due to graft thrombosis (6%). The overall treatment mortality rate was 21% (n=9). In situ aortic reconstruction with cryopreserved allografts is an acceptable treatment method in patients with infected aortic prosthetic graft or mycotic aneurysms. Our,,, study showed that mid-term graft-related complications such as reinfection or aneurysmal degeneration were uncommon. C1 Baylor Coll Med, Houston VAMC, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Dept Surg, Houston, TX 77030 USA. Emory Univ, Sch Med, Dept Surg, Div Vasc Surg, Atlanta, GA 30322 USA. Med Coll Georgia, Atlanta Med Ctr, Dept Surg, Div Vasc Surg, Atlanta, GA USA. Yale Univ, Sch Med, Dept Surg, Div Vasc Surg, New Haven, CT 06510 USA. RP Lin, PH (reprint author), Baylor Coll Med, Houston VAMC, Div Vasc Surg & Endovasc Therapy, 20002 Holcombe Blvd 112, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 25 TC 41 Z9 42 U1 0 U2 0 PU TEXAS HEART INST PI HOUSTON PA PO BOX 20345, HOUSTON, TX 77225-0345 USA SN 0730-2347 J9 TEX HEART I J JI Tex. Heart Inst. J. PY 2006 VL 33 IS 1 BP 14 EP 18 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 022UC UT WOS:000236080500004 PM 16572862 ER PT B AU Hoffman, TJ Rold, TL Figueroa, SD Sieckman, GL Garrison, GC Winkelmann, CT Smith, CJ Perry, MC Volkert, WA AF Hoffman, T. J. Rold, T. L. Figueroa, S. Daibes Sieckman, G. L. Garrison, G. C. Winkelmann, C. T. Smith, C. J. Perry, M. C. Volkert, W. A. GP Medimond TI The gastrin releasing peptide receptor (BB2r) as a potential target for diagnostic and therapeutic radiopharmaceuticals SO UICC World Cancer Congress, Proceedings LA English DT Proceedings Paper CT World Cancer Congress of the International-Union-Against-Cancer (UICC) CY JUL 08-12, 2006 CL Washington, DC SP Int Union Against Canc ID PROSTATE-CANCER CELLS C1 Univ Missouri, Ellis Fischel Canc Ctr, Dept Internal Med, Dept Radiol & Vet Pathobiol,US Dept Vet Affairs, Columbia, MO 65201 USA. RP Hoffman, TJ (reprint author), Univ Missouri, Ellis Fischel Canc Ctr, Dept Internal Med, Dept Radiol & Vet Pathobiol,US Dept Vet Affairs, Columbia, MO 65201 USA. NR 7 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 978-88-7587-318-9 PY 2006 BP 63 EP 67 PG 5 WC Oncology SC Oncology GA BGE15 UT WOS:000246257800013 ER PT B AU Hoffman, TJ Figueroa, SD Rold, TL Sieckman, GL Winkelmann, CT Ma, L Garrison, JC Volkert, WA AF Hoffman, T. J. Figueroa, S. D. Rold, T. L. Sieckman, G. L. Winkelmann, C. T. Ma, L. Garrison, J. C. Volkert, W. A. GP Medimond TI Molecular and anatomic imaging in tumor targeted radiopharmaceutical drug development SO UICC World Cancer Congress, Proceedings LA English DT Proceedings Paper CT World Cancer Congress of the International-Union-Against-Cancer (UICC) CY JUL 08-12, 2006 CL Washington, DC SP Int Union Against Canc C1 Univ Missouri, Dept Internal Med, Dept Radiol, US Dept Vet Affairs, Columbia, MO 65201 USA. RP Hoffman, TJ (reprint author), Univ Missouri, Dept Internal Med, Dept Radiol, US Dept Vet Affairs, Columbia, MO 65201 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU MEDIMOND S R L PI 40128 BOLOGNA PA VIA MASERATI 5, 40128 BOLOGNA, 00000, ITALY BN 978-88-7587-318-9 PY 2006 BP 69 EP 73 PG 5 WC Oncology SC Oncology GA BGE15 UT WOS:000246257800014 ER PT S AU Lieu, SN Oh, DS Pisegna, JR Germano, PM AF Lieu, Song N. Oh, David S. Pisegna, Joseph R. Germano, Patricia M. BE Vaudry, H Laburthe, M TI Neuroendocrine tumors express PAC1 receptors SO VIP, PACAP, AND RELATED PEPTIDES: FROM GENE TO THERAPY SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 7th International Symposium on VIP, PACAP and Related Peptides CY SEP 11-14, 2005 CL Rouen, FRANCE SP Conseil Reg Haute-Normandie, Agglomerat Rouen, Inst Fed Rech Multidisciplinaires Peptides, Inst Natl Sante Rech Med, Municipal Rouen, Sci Act Haute-Normandie, Tech Chime-Biol Sante, Univ Paris 7, Univ Rouen DE BON; carcinoid tumor; PACAP ID CYCLASE-ACTIVATING POLYPEPTIDE; VASOACTIVE-INTESTINAL-PEPTIDE; ADENYLATE-CYCLASE; FUNCTIONAL EXPRESSION; SIGNAL-TRANSDUCTION; SPLICE VARIANTS; CANCER CELLS; I RECEPTOR; ANTAGONIST; SECRETION AB Neuroendocrine tumors (NETs) of the gastrointestinal tract can be grossly divided into two general types: carcinoid and pancreatic endocrine tumors. The former develop in the luminal intestine whereas the latter occur within the pancreas. To ascertain whether pituitary adenylate cyclase-activating polypeptide (PACAP) has a biological effect on the regulation of secretion or growth, we studied the well-established NET cell line, BON. BON cells have been shown previously to contain chromogranin A, neurotensin, and serotonin. In response to mechanical stimulation, BON cells have been demonstrated to release serotonin. The current article demonstrates that the high-affinity PAC1 receptor is expressed on the NET cell line BON. These results indicate that PACAP may regulate the biological release of peptides and serotonin from BON cells and that, like in solid tumors, PACAP could potentially stimulate the growth of BON cells. C1 Univ Calif Los Angeles, CURE, David Geffen Sch Med,Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. RP Germano, PM (reprint author), Univ Calif Los Angeles, CURE, David Geffen Sch Med,Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Bldg 115,Rm 313,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM pgermano@ucla.edu FU NIDDK NIH HHS [DK37240] NR 14 TC 5 Z9 7 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 1-57331-550-8 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2006 VL 1070 BP 399 EP 404 DI 10.1196/annals.1317.052 PG 6 WC Biochemistry & Molecular Biology; Multidisciplinary Sciences; Neurosciences SC Biochemistry & Molecular Biology; Science & Technology - Other Topics; Neurosciences & Neurology GA BEZ57 UT WOS:000240364200056 PM 16888199 ER PT J AU Grubaugh, AL Monnier, J Magruder, KM Knapp, RG Frueh, BC AF Grubaugh, Anouk L. Monnier, Jeannine Magruder, Kathryn M. Knapp, Rebecca G. Frueh, B. Christopher TI Female veterans seeking medical care at Veterans Affairs primary care clinics: Psychiatric and medical illness burden and service use SO WOMEN & HEALTH LA English DT Article DE primary care; female veterans; PTSD; service use; psychiatric status; medical functioning ID NEUROPSYCHIATRIC INTERVIEW MINI; MENTAL-HEALTH-SERVICES; NATIONAL SAMPLE; WOMEN VETERANS; VA; PREVALENCE; DISORDERS; OUTPATIENTS; SYMPTOMS; ABUSE AB Objective: To examine rates of medical and psychiatric disorders among 187 female veterans recruited at four Veterans Affairs Medical Centers (VAMCs), the recognition of such disorders by VAMC care providers, and the use of relevant medical and mental health services by women both within and outside of the VA setting. Methods: We used a cross-sectional, epidemiological design incorporating self-report measures, structured interviews, and chart reviews to obtain relevant information for analyses. Results: Forty-four percent (43.9%) of women met criteria for at least one psychiatric disorder; 34.0% of these women met criteria for two or more additional psychiatric diagnoses, and concordance rates between interview and chart diagnoses were low. Ninety-five percent (95.2%) of women had a medical condition noted in their charts; 86.6% had two or more additional medical conditions, and a significant number of women had both medical and psychiatric diagnoses. Forty-four percent (43.9%) of women with an identified mental health condition received specialized mental health care by the VA in the past year. Conclusions: Findings from this study suggest that female veterans treated in VAMCs had significant medical and psychiatric problems, and these women might not be getting their health care needs adequately met through the VA health care system. In fight of our findings, we discuss relevant implications and future directions for research. C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Grubaugh, AL (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, POB 250861, Charleston, SC 29425 USA. EM grubaugh@musc.edu; monnierj@musc.edu; magrudkm@musc.edu; knappr@musc.edu; fruehbc@musc.edu NR 28 TC 27 Z9 27 U1 1 U2 3 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 0363-0242 J9 WOMEN HEALTH JI Women Health PY 2006 VL 43 IS 3 BP 41 EP 62 DI 10.1300/J013v43n03_03 PG 22 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 112RF UT WOS:000242543900003 PM 17194677 ER PT J AU Seelig, MD Gelberg, L Tavrow, P Lee, M Rubenstein, LV AF Seelig, MD Gelberg, L Tavrow, P Lee, M Rubenstein, LV TI Determinants of physician unwillingness to offer medical abortion using mifepristone SO WOMENS HEALTH ISSUES LA English DT Article ID EARLY-PREGNANCY TERMINATION; UNITED-STATES; VAGINAL MISOPROSTOL; RANDOMIZED-TRIAL; SURGICAL ABORTION; 200 MG; INTERNISTS; PROVIDERS; SERVICES AB Purpose. We sought to identify factors associated with contemplating versus not contemplating offering medical abortion with mifepristone among physicians not opposed to it. Methods. We analyzed data from a Kaiser Family Foundation survey of a nationally representative sample of 790 American obstetrician/gynecologists and primary care physicians. Our study sample consisted of 419 physicians who were not personally opposed to medical abortion and could be classified as not actively considering (precontemplation) or actively considering (contemplation) offering mifepristone. We conducted multivariate logistic regression to predict being unlikely to offer mifepristone (i.e., in the precontemplation stage of change). Principal findings. In 2001, 1 year after U.S. Food and Drug Administration (FDA) approval, 5% of physicians surveyed were offering mifepristone. Among the 750 physicians not offering mifepristone, 57% were not opposed. Of those not opposed, 74% reported that they were unlikely to offer mifepristone in the next year (precontemplation) as compared to 23% who might offer it (contemplation). Independent predictors of being in the precontemplation stage were being a primary care versus OB/GYN physician (odds ratio [OR] 3.29, p =.02), being in private versus hospital-based practice (OR 2.40, p =.03), and lacking concerns about FDA regulations (OR 2.06, P =.01) or violence and protests (OR 1.93, p =.03) as barriers to offering mifepristone. Conclusions. For precontemplation-stage physicians, the most efficient strategy for increasing the availability of medical abortion may be to design programs that emphasize clinical benefits and feasibility to stimulate interest in the procedure. For contemplation-stage physicians, the optimum approach may be one that helps to overcome barriers associated with FDA regulations and concerns about violence and protests. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Family Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Community Hlth Sci, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA USA. VA Greater Los Angeles, HSR&D Ctr Excellence, Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Internal Med, Los Angeles, CA USA. RP Seelig, MD (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Family Med, 10880 Wilshire Blvd,Suite 1800, Los Angeles, CA 90024 USA. EM mseelig@mednet.ucla.edu NR 48 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 1049-3867 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD JAN-FEB PY 2006 VL 16 IS 1 BP 14 EP 21 DI 10.1016/j.whi.2005.12.001 PG 8 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 018XW UT WOS:000235799100003 PM 16487920 ER PT J AU Bean-Mayberry, BA Chang, CCH McNeil, MA Scholle, SH AF Bean-Mayberry, BA Chang, CCH McNeil, MA Scholle, SH TI Ensuring high-quality primary care for women: Predictors of success SO WOMENS HEALTH ISSUES LA English DT Article ID PHYSICIAN GENDER; PATIENT SATISFACTION; PREVENTIVE SERVICES; HEALTH CENTERS; DELIVERY; CANCER; ATTRIBUTES; DOCTORS; BREAST AB Background. Provider gender, provider specialty, and clinic setting affect quality of primary care delivery for women, but previous research has not examined these factors in combination. The purpose of this study is to determine whether separate or combined effects of provider gender, availability of gynecologic services from the provider, and women's clinic setting improve patient ratings of primary care. Methods. Women veterans receiving care in women's clinics or traditional primary care at 10 Veteran's Affair (VA) medical centers completed a mailed questionnaire (N = 1321, 61%) rating four validated domains of primary care (preference for provider, communication, coordination, and accumulated knowledge). For each domain, summary scores were calculated and dichotomized into perfect score (maximum score) versus other. Multiple logistic regressions were used to estimate the probability of a perfect score in each domain while controlling for patient characteristics and site. Results. Female provider was significantly associated with perfect ratings for communication and coordination. Providing gynecologic care was significantly associated with perfect ratings for male and female providers. Patients who used a women's clinic and had a female provider who gave gynecologic care had perfect or nearly perfect ratings for preference for provider, communication, and accumulated knowledge. Conclusion. Gynecologic services are linked to patient ratings of primary care separate from and in synergy with the effect of female provider. Male and female providers should consider offering routine gynecologic services or working in coordination with a setting that provides gynecologic services. Health care evaluations should assess scope of services for provider and practice. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Div Gen Med, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Natl Comm Qual Assurance, Washington, DC USA. RP Bean-Mayberry, BA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 151-C, Pittsburgh, PA 15240 USA. EM Bevanne.Bean-Mayberry@med.va.gov NR 32 TC 18 Z9 18 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1049-3867 J9 WOMEN HEALTH ISS JI Womens Health Iss. PD JAN-FEB PY 2006 VL 16 IS 1 BP 22 EP 29 DI 10.1016/j.whi.2005.12.002 PG 8 WC Public, Environmental & Occupational Health; Women's Studies SC Public, Environmental & Occupational Health; Women's Studies GA 018XW UT WOS:000235799100004 PM 16487921 ER PT J AU Bailey, JN AF Bailey, JN TI Including endophenotypes as covariates in variance component heritability and linkage analysis SO BMC GENETICS LA English DT Article; Proceedings Paper CT 14th Genetic Analysis Workshop CY SEP 07-19, 2004 CL Noordwijkerhout, NETHERLANDS ID TRAITS AB The purpose of these analyses was to determine if incorporating or adjusting for covariates in genetic analyses helped or hindered in genetic analyses, specifically heritability and linkage analyses. To study this question, two types of covariate models were used in the simulated Genetic Analysis Workshop 14 dataset in which the true gene locations are known. All four populations of one replicate were combined for the analyses. The first model included typical covariates of sex and cohort (population) and the second included the typical covariates and also those related endophenotypes that are thought to be associated with the trait (phenotypes A, B, C, D, E, F, G, H, I, J, K, and L). A final best fit model produced in the heritability analyses was used for linkage. Linkage for disease genes D1, D3, and D4 were localized using models with and without the covariates. The use of inclusion of covariates did not appear to have any consistent advantage or disadvantage for the different phenotypes in regards to gene localization or false positive rate. C1 Univ Calif Los Angeles, Sch Med, Inst Neuropsychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Epilepsy Genet Genom Labs, Comprehens Epilepsy Program, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst W Los, Los Angeles, CA USA. RP Bailey, JN (reprint author), Univ Calif Los Angeles, Sch Med, Inst Neuropsychiat, Los Angeles, CA 90024 USA. EM jbailey@mednet.ucla.edu NR 6 TC 1 Z9 1 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1471-2156 J9 BMC GENET JI BMC Genet. PD DEC 30 PY 2005 VL 6 SU 1 AR S49 DI 10.1186/1471-2156-6-S1-S49 PG 4 WC Genetics & Heredity SC Genetics & Heredity GA 023CR UT WOS:000236103400049 PM 16451660 ER PT J AU Farrar, CE Huang, CS Clarke, SG Houser, CR AF Farrar, CE Huang, CS Clarke, SG Houser, CR TI Increased cell proliferation and granule cell number in the dentate gyrus of protein repair-deficient mice SO JOURNAL OF COMPARATIVE NEUROLOGY LA English DT Article DE isoaspartyl; neurogenesis; PCMT1; insulin receptor; IGF-I receptor; doublecortin ID CENTRAL-NERVOUS-SYSTEM; FACTOR-I RECEPTOR; INDUCED STATUS EPILEPTICUS; ADULT-RAT HIPPOCAMPUS; INSULIN-RECEPTOR; O-METHYLTRANSFERASE; DAMAGED PROTEINS; IGF-I; ISOASPARTYL PEPTIDES; INDUCED NEUROGENESIS AB Recent studies have demonstrated that mice lacking protein L-isoaspartate (D-aspartate) O-methyltransferase (Pcmt1-/- mice) have alterations in the insulin-like growth factor-I (IGF-I) and insulin receptor pathways within the hippocampal formation as well as other brain regions. However, the cellular localization of these changes and whether the alterations might be associated with an increase in cell number within proliferative regions, such as the dentate gyrus, were unknown. In this study, stereological methods were used to demonstrate that these mice have an increased number of granule cells in the granule cell layer and hilus of the dentate gyrus. The higher number of granule cells was accompanied by a greater number of cells undergoing mitosis in the dentate gyrus, suggesting that an increase in neuronal cell proliferation occurs in this neurogenic zone of adult Pcmt1- / - mice. In support of this, increased doublecortin labeling of immature neurons was detected in the subgranular zone of the dentate gyrus. In addition, double immunofluorescence studies demonstrated that phosphorylated IGF-1/insulin receptors in the subgranular zone were localized on immature neurons, suggesting that the- increased activation of one or both of these receptors in Pcmt1-/- mice could contribute to the growth and survival of these cells. We propose that deficits in the repair of isoaspartyl protein damage leads to alterations in metabolic and growth-receptor pathways, and that this model may be particularly relevant for studies of neurogenesis that is stimulated by cellular damage. C1 Univ Calif Los Angeles, Dept Neurobiol, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Chem & Biochem, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90095 USA. RP Houser, CR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, 73-235 CHS, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU BLRD VA [I01 BX000404]; NIA NIH HHS [AG18000]; NIGMS NIH HHS [GM26020]; NINDS NIH HHS [NS046524] NR 84 TC 16 Z9 16 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9967 J9 J COMP NEUROL JI J. Comp. Neurol. PD DEC 26 PY 2005 VL 493 IS 4 BP 524 EP 537 DI 10.1002/cne.20780 PG 14 WC Neurosciences; Zoology SC Neurosciences & Neurology; Zoology GA 991QW UT WOS:000233829700004 PM 16304629 ER PT J AU Casarett, D Fishman, JM MacMoran, HJ Pickard, A Asch, DA AF Casarett, D Fishman, JM MacMoran, HJ Pickard, A Asch, DA TI Epidemiology and prognosis of coma in daytime television dramas SO BRITISH MEDICAL JOURNAL LA English DT Article ID PERSISTENT VEGETATIVE STATE; SOAP-OPERA; HEAD-INJURY; BREAST-CANCER; BRAIN-DAMAGE; EDUCATION; ATTITUDES; BEHAVIOR; PROGRAM; ADULTS AB Objective To determine how soap operas Portray, and possibly misrepresent, the likelihood of recovery for patients in coma. Design Retrospective cohort study Setting Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005. Subjects 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis. Results Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P < 0.001). On the day that patients regained consciousness, most (49/57; 86%) had no evidence of limited function, cognitive deficit, or residual disability needing rehabilitation. Compared with meta-analysis data, patients in this sample had a much better than expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% 7%; both P < 0.001). Conclusions The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery. C1 Philadelphia VA Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr Med, Philadelphia, PA 19104 USA. RP Casarett, D (reprint author), Philadelphia VA Med Ctr, Ctr Hlth Equity Res & Promot, 9 E,3900 Woodland Ave, Philadelphia, PA 19104 USA. EM casarett@mail.med.upenn.edu NR 38 TC 11 Z9 11 U1 0 U2 2 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0959-8146 J9 BRIT MED J JI Br. Med. J. PD DEC 24 PY 2005 VL 331 IS 7531 BP 1537 EP 1539 DI 10.1136/bmj.331.7531.1537 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 998WT UT WOS:000234351300025 PM 16373744 ER PT J AU Papadakis, MA Teherani, A Banach, MA Knettler, TR Rattner, SL Stern, DT Veloski, JJ Hodgson, CS AF Papadakis, MA Teherani, A Banach, MA Knettler, TR Rattner, SL Stern, DT Veloski, JJ Hodgson, CS TI Disciplinary action by medical boards and prior behavior in medical school SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID UNPROFESSIONAL BEHAVIOR; MEASURING PROFESSIONALISM; STUDENTS; PERFORMANCE; COMPETENCE; EDUCATION AB Background: Evidence supporting professionalism as a critical measure of competence in medical education is limited. In this case-control study, we investigated the association of disciplinary action against practicing physicians with prior unprofessional behavior in medical school. We also examined the specific types of behavior that are most predictive of disciplinary action against practicing physicians with unprofessional behavior in medical school. Methods: The study included 235 graduates of three medical schools who were disciplined by one of 40 state medical boards between 1990 and 2003 (case physicians). The 469 control physicians were matched with the case physicians according to medical school and graduation year. Predictor variables from medical school included the presence or absence of narratives describing unprofessional behavior, grades, standardized-test scores, and demographic characteristics. Narratives were assigned an overall rating for unprofessional behavior. Those that met the threshold for unprofessional behavior were further classified among eight types of behavior and assigned a severity rating (moderate to severe). Results: Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical school (odds ratio, 3.0; 95 percent confidence interval, 1.9 to 4.8), for a population attributable risk of disciplinary action of 26 percent. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility (odds ratio, 8.5; 95 percent confidence interval, 1.8 to 40.1) and severely diminished capacity for self-improvement (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.2). Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school (1 percent and 7 percent population attributable risk, respectively), but the association with these variables was less strong than that with unprofessional behavior. Conclusions: In this case-control study, disciplinary action among practicing physicians by medical boards was strongly associated with unprofessional behavior in medical school. Students with the strongest association were those who were described as irresponsible or as having diminished ability to improve their behavior. Professionalism should have a central role in medical academics and throughout one's medical career. C1 Univ Calif San Francisco, Sch Med, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Federat State Med Boards, Dallas, TX USA. Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA. Univ Michigan, Sch Med, Vet Affairs Ann Arbor Healthcare Syst, Ann Arbor, MI USA. Univ Colorado, Denver, CO 80202 USA. Hlth Sci Ctr, Denver, CO USA. RP Papadakis, MA (reprint author), Univ Calif San Francisco, Sch Med, S-245,Box 0454, San Francisco, CA 94143 USA. EM papadakm@medsch.ucsf.edu RI Stern, David/E-8678-2016 OI Stern, David/0000-0001-9278-7303 NR 31 TC 312 Z9 318 U1 3 U2 31 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 22 PY 2005 VL 353 IS 25 BP 2673 EP 2682 DI 10.1056/NEJMsa052596 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 995IQ UT WOS:000234094400008 PM 16371633 ER PT J AU Berlowitz, DR Cushman, WC Glassman, P AF Berlowitz, DR Cushman, WC Glassman, P TI Hypertension in adults across age groups SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Bedford VA Hosp, Bedford, MA 01730 USA. Memphis VA Med Ctr, Memphis, TN USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Berlowitz, DR (reprint author), Bedford VA Hosp, Bedford, MA 01730 USA. EM dberlow@bu.edu NR 5 TC 5 Z9 5 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 21 PY 2005 VL 294 IS 23 BP 2970 EP 2971 DI 10.1001/jama.294.23.2970 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 995GB UT WOS:000234087700015 PM 16414940 ER PT J AU Armstrong, K Weber, B Ubel, PA Peters, N Holmes, J Schwartz, JS AF Armstrong, K Weber, B Ubel, PA Peters, N Holmes, J Schwartz, JS TI Individualized survival curves improve satisfaction with cancer risk management decisions in women with BRCA1/2 mutations SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID HORMONE REPLACEMENT THERAPY; RANDOMIZED CONTROLLED-TRIAL; HEREDITARY BREAST-CANCER; SURGICAL ADJUVANT BREAST; ESTROGEN PLUS PROGESTIN; PROPHYLACTIC OOPHORECTOMY; POSTMENOPAUSAL WOMEN; CARRIERS; PREVENTION; TAMOXIFEN AB Purpose Women with BRCA 1/2 mutations are faced with complex decisions about breast and ovarian cancer risk management. This study was conducted to determine the effect of a tailored decision support system (DSS) that provides individualized survival and cancer incidence curves specific to expected outcomes of alternative management strategies. Patients and Methods This was a double-blind, randomized controlled trial of 32 women with BRCA 1/2 mutations. Primary outcome measures were decision satisfaction, cancer anxiety, perceptions of cancer risk given alternative management strategies, and management decisions. Results Twenty-seven women completed a 6-week follow-up. Women in the intervention arm (n = 13) reported significantly higher decision satisfaction at follow-up than women in the control arm (n = 14; adjusted mean difference, 9.7; P < .0005). The effect of the DSS was greater among women with low cancer anxiety at baseline than women with high cancer anxiety at baseline (P = .01 for interaction). However, the DSS did not significantly alter cancer anxiety at follow-up, perceptions of cancer risk given alternative management strategies, or management decisions. Conclusion The presentation of individualized survival and incidence curves for alternative management options improves satisfaction about cancer risk management decisions among women with BRCA1/2 mutations without increasing anxiety or changing management decisions. The benefit of the DSS is greatest among women with relatively low cancer-related anxiety at baseline. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Abramson Family Canc Res Inst, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. Vet Affairs Hlth Serv Res & Dev, Ctr Practice Management & Outcomes Res, Ann Arbor, MI USA. RP Armstrong, K (reprint author), 1204 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM karmstro@mail.med.upenn.edu NR 40 TC 19 Z9 19 U1 3 U2 8 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD DEC 20 PY 2005 VL 23 IS 36 BP 9319 EP 9328 DI 10.1200/JCO.2005.06.119 PG 10 WC Oncology SC Oncology GA 997FL UT WOS:000234230400040 PM 16361631 ER PT J AU Rodriguez, JD Royall, D Daum, LT Kagan-Hallet, K Chambers, JP AF Rodriguez, JD Royall, D Daum, LT Kagan-Hallet, K Chambers, JP TI Amplification of Herpes simplex type 1 and Human Herpes type 5 viral DNA from formalin-fixed Alzheimer brain tissue SO NEUROSCIENCE LETTERS LA English DT Article DE Alzheimer's; herpes; formalin-fixed; brain ID PARAFFIN-EMBEDDED TISSUES; POLYMERASE-CHAIN-REACTION; VIRUS TYPE-1; DISEASE BRAINS; FORMALDEHYDE; FIXATIVES; PCR AB It is known that nucleic acids from formalin-fixed tissues are not nearly as good templates for DNA amplification as those extracted from fresh tissues. However, specimens stored in most pathologic archives are initially fixed in formalin. The possibility of an infectious etiology of several diseases including Alzheimer's underscores the usefulness of archived tissue in assessing the association of infectious agents with specific pathology. In this report, we describe in detail a method resulting in robust amplification of HSV1 and Human Herpes type (HHV) 5 viral DNA targets using formalin-fixed Alzheimer brain frontal and temporal tissue as source of amplification template. Herpes simplex type 2 viral DNA was not detected in the limited samples examined in this study. Amplicons were verified by sequence analysis. Brain tissue stored in formalin longer than 1 year prior to post-formalin-fixation analysis gave rise to significantly shorter amplicons consistent with the observation that template DNA integrity decreases significantly with increasing time of storage in formalin. Thus, this report should be useful in PCR-based investigations assessing the regional presence of viral DNAs in formalin-fixed brain tissue. (C) 2005 Elsevier Ireland Ltd. All rights reserved. C1 Univ Texas, Dept Biol, San Antonio, TX 78249 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Dept Pathol, San Antonio, TX 78229 USA. RP Chambers, JP (reprint author), Univ Texas, Dept Biol, 6900 N Loop 1604 W,SB Rm 1-01-28, San Antonio, TX 78249 USA. EM james.chambers@utsa.edu FU NIGMS NIH HHS [GM 00819] NR 15 TC 4 Z9 4 U1 1 U2 2 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 DEC 16 PY 2005 VL 390 IS 1 BP 37 EP 41 DI 10.1016/j.neulet.2005.07.052 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 970RN UT WOS:000232327400008 PM 16118038 ER PT J AU Clearfield, M Downs, JR Lee, M Langendorfer, A McConathy, W Gotto, AM AF Clearfield, M Downs, JR Lee, M Langendorfer, A McConathy, W Gotto, AM TI Implications from the Air Force/Texas Coronary Atherosclerosis Prevention Study for the Adult Treatment Panel III guidelines SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID DENSITY LIPOPROTEIN CHOLESTEROL; METABOLIC SYNDROME; APOLIPOPROTEIN-B; FOLLOW-UP; EVENTS; RISK; AFCAPS/TEXCAPS; ASSOCIATIONS; PREDICTOR; DISEASE AB The Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) first reported its results in 1998, before the 2001 publication of the National Cholesterol Education Program-Adult Treatment Panel III guidelines (NCEP-ATP III) and 2004 update. Our objective was to investigate the impact of these guidelines on the AFCAPS/TexCAPS cohort. The main outcome measures were the event rates of first acute major coronary events (AMCEs), which were reduced 39% by lovastatin (95% confidence interval [CI] 21% to 53%, p <0.001) in the 65% of the cohort eligible for drug therapy and by 34% (95% CI -9% to 60%, p = 0.108) in the remaining 35% for whom drug therapy was considered optional. The evaluation of other guideline components included a 44% (95% CI 27% to 58%, p <0.001) reduction in AMCEs in subjects with baseline high-density lipoprotein cholesterol <40 mg/dl and a 41% (95% CI 19% to 57%) reduction in AMCEs in subjects with the metabolic syndrome. In the recent update, patients who had a moderately high risk of coronary heart disease and a baseline low-density lipoprotein cholesterol level of 100 to 130 mg/dl could be considered for therapy with a medication to lower the low-density lipoprotein cholesterol level to <100 mg/dl. A total of 334 subjects (5.1%) were in this group, in whom lovastatin reduced the risk of AMCEs by 68% (95% CI 12% to 88%, p = 0.027). However, 21% of the AMCEs were missed by the guidelines. Metabolic syndrome was noted in 48% of these subjects and may help define those in whom treatment with a medication is now considered optional. In conclusion, the ability of the ATP III guidelines and its update has markedly improved our ability to define coronary heart disease risk; however, other components of the guidelines, such as non-high-density lipoprotein cholesterol and the optional low-density lipoprotein cholesterol target goal of < 100 mg/dl, still require additional evaluation. (C) 2005 Elsevier Inc. All rights reserved. C1 Univ N Texas, Hlth Sci Ctr, Dept Internal Med, Ft Worth, TX 76107 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Merck Res Labs, Rahway, NJ USA. Cornell Univ, Weill Med Coll, New York, NY USA. RP Clearfield, M (reprint author), Univ N Texas, Hlth Sci Ctr, Dept Internal Med, Ft Worth, TX 76107 USA. EM mclearfi@hsc.unt.edu NR 18 TC 18 Z9 20 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 DEC 15 PY 2005 VL 96 IS 12 BP 1674 EP 1680 DI 10.1016/j.amjcard.2005.07.079 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 997BR UT WOS:000234220500012 PM 16360356 ER PT J AU Goodman, FDC Glassman, P AF Goodman, FDC Glassman, P TI Evaluating potentially aberrant outpatient prescriptions for extended-release oxycodone SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article C1 Dept Vet Affairs, Pharm Benefits Management Strateg Healthcare Grp, Vet Hlth Adm, Hines, IL 60141 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Goodman, FDC (reprint author), Dept Vet Affairs, Pharm Benefits Management Strateg Healthcare Grp, Vet Hlth Adm, 1st Ave & Cermak Rd,Bldg 17,Room 139, Hines, IL 60141 USA. EM francine.goodman@med.va.gov NR 12 TC 7 Z9 7 U1 0 U2 0 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD DEC 15 PY 2005 VL 62 IS 24 BP 2604 EP 2608 DI 10.2146/ajhp040618 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 995QX UT WOS:000234120000006 PM 16333058 ER PT J AU Jones, A Kwow, CK Kelley, ME Ibrahim, SA AF Jones, A Kwow, CK Kelley, ME Ibrahim, SA TI Racial disparity in knee arthroplasty utilization in the veterans health administration SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article ID QUALITY-OF-LIFE; OSTEOARTHRITIS; METAANALYSIS; REPLACEMENT C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15240 USA. Emory Univ, Sch Publ Hlth, Atlanta, GA 30322 USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. EM said.ibrahim2@med.va.gov NR 13 TC 26 Z9 26 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 DEC 15 PY 2005 VL 53 IS 6 BP 979 EP 981 DI 10.1002/art.21596 PG 3 WC Rheumatology SC Rheumatology GA 995FL UT WOS:000234086100025 PM 16342110 ER PT J AU Busuttil, RA Garcia, AM Cabrera, C Rodriguez, A Suh, Y Kim, WH Huang, TT Vijg, J AF Busuttil, RA Garcia, AM Cabrera, C Rodriguez, A Suh, Y Kim, WH Huang, TT Vijg, J TI Organ-specific increase in mutation accumulation and apoptosis rate in CuZn-superoxide dismutase-deficient mice SO CANCER RESEARCH LA English DT Article ID TRANSGENIC MICE; DAMAGE; AGE; BRAIN; LIVER AB Reactive oxygen species have been implicated as a cause of cancer and aging in mammals. Mice deficient for the antioxidant enzyme CuZn-superoxide dismutase (Sod1) have a decreased life span and an elevated incidence of liver cancer. To test the hypothesis that the cancer-prone phenotype in such mice is due to accelerated spontaneous mutation accumulation, we crossed these mutants with mice harboring a neutral lacZ mutation reporter gene. At 2 months of age, the lacZ mutation frequency in the liver of the hybrid animals was already twice as high as in littermate controls of the same age. This difference in mutation frequency increased to > 3-fold at 6 months of age, after which it did not increase any further. Characterization of the mutation spectra in liver of the Sod1-null mice indicated mainly GC-to-TA transversions and GC-to-AT transitions, signature mutations of oxidative stress. The accelerated mutation accumulation in liver was accompanied by an increased frequency of apoptotic cells, as indicated by an increase in both terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling- and caspase 3-stained cells at 6 and 12 months of age. In kidney, an elevated mutation frequency above controls of similar to 2.5-fold was found not earlier than at 6 months. No increased mutation accumulation was observed in brain or spleen. These results support the hypothesis, that oxidative stress is an important causal factor of cancer in mammals. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78240 USA. Univ Texas, Hlth Sci Ctr, Dept Mol Med, San Antonio, TX 78240 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. Seoul Natl Univ, Coll Med, Seoul, South Korea. Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA. Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Palo Alto Vet Affairs Hlth Care Syst, Palo Alto, CA 94304 USA. RP Vijg, J (reprint author), Univ Texas, Hlth Sci Ctr, Dept Physiol, 7703 Floyd Curl Dr, San Antonio, TX 78240 USA. EM vijg@uthscsa.edu RI Kim, Wooho/G-3703-2011 FU NIA NIH HHS [AG20438, AG024400, AG17242] NR 16 TC 46 Z9 48 U1 0 U2 4 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD DEC 15 PY 2005 VL 65 IS 24 BP 11271 EP 11275 DI 10.1158/0008-5472.CAN-05-2980 PG 5 WC Oncology SC Oncology GA 996FF UT WOS:000234159100008 PM 16357131 ER PT J AU Schittenhelm, MM Oechsle, K Kollmannsberger, C Honecker, F Weber, DA Tillner, J Corless, C Heinrich, MC Bokemeyer, C AF Schittenhelm, MM Oechsle, K Kollmannsberger, C Honecker, F Weber, DA Tillner, J Corless, C Heinrich, MC Bokemeyer, C TI Association of EGFR and KRAS mutation status and clinical response to the anti-epidermal growth factor receptor (EGFR) monoclonal antibody matuzumab (M, EMD-72000) and paclitaxel (P) in a phase I study of patients (pts) with advanced non-small cell lung C. SO CLINICAL CANCER RESEARCH LA English DT Meeting Abstract CT AACR/NCI/EORTC International Conference on Molecular Targets and Cancer Therapeutics CY NOV 14-18, 2005 CL Philadelphia, PA SP AACR, NCI, EORTC, AMGEN, AstraZeneca, Britol-Myers Squibb Co, Pfizer, Sanofi Aventis, Bayer Hlth Car Pharmaceut, Lilly, Genentech, GSK GlaxoSmithKline, Johnson &Johnson, MERCK, NOVARTIS ONCOL, Centocor, OSI Oncol, Schering-Plough, BTG, Servier, RADPHARM, Cvitkovic & Associes C1 Univ Tubingen Hosp, Dept Hematol Oncol, Tubingen, Germany. OHSU, Canc Inst Portland, Portland, OR USA. Univ Hamburg, Hosp Eppendorf, Dept Hematol Oncol, D-20246 Hamburg, Germany. Merck KGaA, Darmstadt, Germany. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD DEC 15 PY 2005 VL 11 IS 24 SU S BP 8992S EP 8993S PN 2 PG 2 WC Oncology SC Oncology GA 999IJ UT WOS:000234382700118 ER PT J AU Rattan, R Giri, S Singh, AK Singh, I AF Rattan, R Giri, S Singh, AK Singh, I TI AICAR (5-aminoimidazole-4-carboxamide-1-beta-4-ribofuranoside) inhibits cancer cell proliferation in vitro and in vivo via AMP-activated protein kinase (AMPIK). SO CLINICAL CANCER RESEARCH LA English DT Meeting Abstract CT AACR/NCI/EORTC International Conference on Molecular Targets and Cancer Therapeutics CY NOV 14-18, 2005 CL Philadelphia, PA SP AACR, NCI, EORTC, AMGEN, AstraZeneca, Britol-Myers Squibb Co, Pfizer, Sanofi Aventis, Bayer Hlth Car Pharmaceut, Lilly, Genentech, GSK GlaxoSmithKline, Johnson &Johnson, MERCK, NOVARTIS ONCOL, Centocor, OSI Oncol, Schering-Plough, BTG, Servier, RADPHARM, Cvitkovic & Associes C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph Johnson Vet Affairs Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD DEC 15 PY 2005 VL 11 IS 24 SU S BP 9110S EP 9110S PN 2 PG 1 WC Oncology SC Oncology GA 999IJ UT WOS:000234382701165 ER PT J AU Brown, DA Chicco, AJ Jew, KN Johnson, MS Lynch, JM Watson, PA Moore, RL AF Brown, DA Chicco, AJ Jew, KN Johnson, MS Lynch, JM Watson, PA Moore, RL TI Cardioprotection afforded by chronic exercise is mediated by the sarcolemmal, and not the mitochondrial, isoform of the K(ATP) channel in the rat SO JOURNAL OF PHYSIOLOGY-LONDON LA English DT Article ID ISCHEMIA-REPERFUSION INJURY; SENSITIVE POTASSIUM CHANNELS; INFARCT SIZE; IN-VIVO; PRECONDITIONING PROTECTS; MYOCARDIAL-INFARCTION; CONSCIOUS RABBITS; BETA-OXIDATION; CORONARY FLOW; H9C2 CELLS AB This study was conducted to examine the role of myocardial ATP-sensitive potassium (K(ATP)) channels in exercise-induced protection from ischaemia-reperfusion (I-R) injury. Female rats were either sedentary (Sed) or exercised for 12 weeks (Tr). Hearts were excised and underwent a 1-2 h regional I-R protocol. Prior to ischaemia, hearts were subjected to pharmacological blockade of the sarcolemmal K(ATP) channel with HMR 1098 (SedHMR and TrHMR), mitochondrial blockade with 5-hydroxydecanoic acid (5HD; Sed5HD and Tr5HD), or perfused with buffer containing no drug (Sed and Tr). Infarct size was significantly smaller in hearts from Tr animals (35.4 +/- 2.3 versus 44.7 +/- 3.0% of the zone at risk for Tr and Sed, respectively). Mitochondrial K(ATP) blockade did not abolish the training-induced infarct size reduction (30.0 +/- 3.4 versus 38.0 +/- 2.6 in Tr5HD and Sed5HD, respectively); however, sarcolemmal K(ATP) blockade completely eradicated the training-induced cardioprotection. Infarct size was 71.2 +/- 3.3 and 64.0 +/- 2.4% of the zone at risk for TrHMR and Sed HMR. The role of sarcolemmal K(ATP) channels in Tr-induced protection was also supported by significant increases in both subunits of the sarcolemmal K(ATP) channel following training. LV developed pressure was better preserved in hearts from Tr animals, and was not influenced by addition of HMR 1098. 5HD decreased pressure development regardless of training status, from 15 min of ischaemia through the duration of the protocol. This mechanical dysfunction was likely to be due to a 5HD-induced increase in myocardial Ca(2+) content following I-R. The major findings of the present study are: (1) unlike all other known forms of delayed cardioprotection, infarct sparing following chronic exercise was not abolished by 5HD; (2) pharmacological blockade of the sarcolemmal K(ATP) channel nullified the cardioprotective benefits of exercise training; and (3) increased expression of sarcolemmal K(ATP) channels was observed following chronic training. C1 Univ Colorado, Cardiovasc Inst, Dept Integrat Physiol, Boulder, CO 80309 USA. Univ Colorado, Dept Med, Div Endocrinol, Denver, CO 80112 USA. Denver Hlth Sci Ctr, Denver, CO 80112 USA. Denver VA Med Ctr, Denver, CO 80112 USA. RP Moore, RL (reprint author), Univ Colorado, Cardiovasc Inst, Dept Integrat Physiol, Boulder, CO 80309 USA. EM russell.moore@colorado.edu RI Moore, Russell/D-1040-2013 OI Moore, Russell/0000-0002-6727-8985 FU NHLBI NIH HHS [HL72790, HL40306, R01 HL040306, R01 HL072790]; NIGMS NIH HHS [GM066728-01, R25 GM066728] NR 71 TC 69 Z9 71 U1 0 U2 5 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0022-3751 J9 J PHYSIOL-LONDON JI J. Physiol.-London PD DEC 15 PY 2005 VL 569 IS 3 BP 913 EP 924 DI 10.1113/jphysiol.2005.095729 PG 12 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 991JC UT WOS:000233808300018 PM 16223762 ER PT J AU Tsao, JCI Dobalian, A Stein, JA AF Tsao, JCI Dobalian, A Stein, JA TI Illness burden mediates the relationship between pain and illicit drug use in persons living with HIV SO PAIN LA English DT Article DE pain; substance use; illicit drug use; HIV; AIDS ID AMBULATORY AIDS PATIENTS; NATIONAL PROBABILITY SAMPLES; LOW-PREVALENCE DISEASES; QUALITY-OF-LIFE; SERVICES UTILIZATION; UNITED-STATES; INFECTED INDIVIDUALS; SUBSTANCE-ABUSE; HEALTH SURVEY; DISORDERS AB We investigated predictive and concurrent relationships among reported pain, HIV/AIDS illness burden, and substance use history in 2267 participants in the longitudinal HIV Cost and Services Utilization Study (HCSUS). Substance use history was classified as screening positive for current illicit drug use (N = 253), past drug use (N = 617), and non-user (N = 1397) at baseline. To control for demographic correlates, age, sex and socioeconomic status (SES) were included as predictors. Covariance structure models indicated greater pain at baseline among participants acknowledging current substance use. Pain at baseline was also directly predicted by greater HIV/AIDS illness burden, lower SES, and older age. At 6 months, pain was directly predicted by prior pain, worse concurrent HIV/AIDS illness burden and female sex. At 12 months, pain was predicted by older age, prior pain, and concurrent HIV/AIDS illness. It was also modestly but significantly predicted by current substance use at baseline. In addition to the direct effects on pain, there were significant indirect effects of demographic and drug use variables on pain mediated through HIV/AIDS illness burden and prior pain. There were significant and positive indirect effects of current and past drug use, greater age, and lower SES on pain at all three time periods. Pain at 6 months and pain at 12 months were also indirectly impacted by previous illness burden. Our results indicate that HIV+persons who screened positive for current use of a range of illicit substances experienced greater HIV/AIDS illness burden which in turn predicted increased pain. (c) 2005 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Pediat Pain Program, Dept Pediat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv,Ctr Excellence Study Healthcare Pro, VA Greater Los Angeles Healthcare Syst HSR&D, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. RP Tsao, JCI (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Pediat Pain Program, Dept Pediat, 10940 Wilshire Blvd,Suite 1450, Los Angeles, CA 90024 USA. EM jtsao@mednet.ucla.edu FU AHRQ HHS [U01 HS008578, U01HS08578]; NIDA NIH HHS [R03 DA017026, DA01070, DA017026, P01 DA001070] NR 42 TC 17 Z9 18 U1 3 U2 6 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-3959 J9 PAIN JI Pain PD DEC 15 PY 2005 VL 119 IS 1-3 BP 124 EP 132 DI 10.1016/j.pain.2005.09.023 PG 9 WC Anesthesiology; Clinical Neurology; Neurosciences SC Anesthesiology; Neurosciences & Neurology GA 998YN UT WOS:000234355900014 PM 16297562 ER PT J AU Shin, JM Grundler, G Senn-Bilfinger, J Simon, WA Sachs, G AF Shin, JM Grundler, G Senn-Bilfinger, J Simon, WA Sachs, G TI Functional consequences of the oligomeric form of the membrane-bound gastric H,K-ATPase SO BIOCHEMISTRY LA English DT Article ID K+-COMPETITIVE INHIBITOR; PROTON PUMP INHIBITORS; SUBSTITUTED IMIDAZO<1,2-A>PYRIDINES; ANTIULCER AGENTS; SARCOPLASMIC-RETICULUM; ADENOSINE-TRIPHOSPHATASE; CATALYTIC CYCLE; H+/K+-ATPASE; BINDING-SITE; BETA-SUBUNIT AB Cross-linking and two-dimensional crystallization studies have suggested that the membrane-bound gastric H,K-ATPase might be a dimeric alpha,beta-heterodimer. Effects of an oligomeric structure on the characteristics of E-1, E-2, and phosphoenzyme conformations were examined by measuring binding stoichiometries of acid-stable phosphorylation (EP) from [gamma-P-32]ATP or (32)p(i) or of binding of [gamma-P-32]ATP and of a K+-competitive imidazonaphthyridine (INT) inhibitor to an enzyme preparation containing similar to 5 nmol of ATPase/mg of protein. At < 10 mu M MgATP, E-1 [ATP]center dot Mg center dot(H+):E-2 is formed at a high-affinity site, and is then converted to E1P center dot Mg center dot(H+):E-2 and then to E2P center dot Mg:E-1 with luminal proon extrusion. Maximal acid-stable phosphorylation yielded 2.65 nmol/mg of protein. Luminal K+-dependent dephosphorylation returns this conformation to the E, form. At high MgATP concentrations (> 0.1 mM), the oligomer forms E2P center dot Mg:E,[ATP]center dot Mg center dot(H+). The sum of the levels of maximal EP formation and ATP binding was 5.3 nmol/mg. The maximal amount of [H-3]INT bound was 2.6 nmol/mg in the presence of MuATP, Mg2+, Mg-P-i, or Mg-vanadate with complete inhibition of activity. K+ displaced INT only in nigericin-treated vesicles, and thus, INT binds to the luminal surface of the E2 form. INT-bound enzyme also formed 2.6 nmol of EP/mg at high ATP concentrations by formation of E-2 center dot Mg center dot(INT)(exo):E-1[ATP]center dot Mg center dot(H+) which is converted to E-2 center dot Mg center dot(INT)(exo):E1P center dot Mg center dot(H+)(cyto), but this E1P form was K+-insensitive.Bindina of the inhibitor fixes half the oligomer in the E2 form with full inhibition of activity, while the other half of the oligomer is able to form E1P only when the inhibitor is bound. It appears that the catalytic subunits of the oligomer during turnover in intact gastric vesicles are restricted to a reciprocal E-1:E-2 configuration. C1 VA Greater Los Angeles Healthcare Syst, Membrane Biol Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. ALTANA Pharma AG, Constance, Germany. RP VA Greater Los Angeles Healthcare Syst, Membrane Biol Lab, 11301 Wilshire Blvd,Bldg 113,Rm 324, Los Angeles, CA 90073 USA. EM jaishin@ucla.edu FU NIDDK NIH HHS [DK58333, DK53462, DK17294, DK46917] NR 66 TC 17 Z9 18 U1 1 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD DEC 13 PY 2005 VL 44 IS 49 BP 16321 EP 16332 DI 10.1021/bi051342q PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 992QH UT WOS:000233898400039 PM 16331993 ER PT J AU Gopal, R Glasheen, JJ Miyoshi, TJ Prochazka, AV AF Gopal, R Glasheen, JJ Miyoshi, TJ Prochazka, AV TI Burnout and internal medicine resident work-hour restrictions SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID FAMILY-PRACTICE RESIDENTS; PATIENT-CARE; STRESS; SLEEP AB Background: Burnout is very common in internal medicine residents. Effective July 2003, all residents were restricted to work less than an average of 80 hours per week and no more than 30 hours of continuous duty for patient care and educational obligations. We evaluated rates of burn-out in internal medicine residents before and after the implementation of the new work-hour restriction. Methods: University of Colorado Health Science Center internal medicine residents were surveyed in May 2003 and May 2004. The survey contained the Maslach Burnout Inventory, organized into 3 subscales (ie, emotional exhaustion, depersonalization, and personal accomplishment); the Primary Care Evaluation of Mental Disorders depression screen; and self-reported quality of care and education. Results: The response rate was 87% (121 of 139 residents) and 74% (106 of 143 residents) in 2003 and 2004, respectively. Self-reported hours worked decreased from a mean of 74.6 to 67.1 (P=.003). In 2004, 13% fewer residents experienced high emotional exhaustion (42% vs 29%; P=.03). There was a trend toward fewer residents with high depersonalization (61% vs 55%; P=.13) and fewer residents with a positive depression screen (51% vs 41%; P=.11). Personal accomplishment did not change. The assessment of self-reported quality of care did not significantly change from 2003 to 2004. Residents reported attending fewer educational conferences per month (18.99 vs 15.56; P=.01). Overall residency satisfaction decreased 6 mm on a 100-mm visual analogue score (P=.02). Conclusions: Burnout continues to be a major problem. Reducing hours may be the first step to reduce burnout but may also affect education and quality of care. C1 Denver Vet Affairs Med Ctr, Dept Med, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Dept Internal Med, Aurora, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Family Med, Aurora, CO USA. RP Gopal, R (reprint author), Denver Vet Affairs Med Ctr, Dept Med, Box 11B,1055 Clermont St, Denver, CO 80220 USA. EM Ravi.Gopal@med.va.gov NR 30 TC 135 Z9 139 U1 0 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD DEC 12 PY 2005 VL 165 IS 22 BP 2595 EP 2600 DI 10.1001/archinte.165.22.2595 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 992KW UT WOS:000233883800010 PM 16344416 ER EF