FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Adelson, DW Kosoyan, HP Wang, YH Steinberg, JZ Tache, Y AF Adelson, David W. Kosoyan, Hovsep P. Wang, Yuhua Steinberg, Justin Z. Tache, Yvette TI Gastric vagal efferent inhibition evoked by intravenous CRF is unrelated to simultaneously recorded vagal afferent activity in urethane-anesthetized rats SO JOURNAL OF NEUROPHYSIOLOGY LA English DT Article ID CORTICOTROPIN-RELEASING-FACTOR; DORSAL MOTOR NUCLEUS; IMMERSION-RESTRAINT STRESS; ACUTE LIVER-INJURY; IN-VITRO; SUBDIAPHRAGMATIC VAGUS; ABDOMINAL-SURGERY; MESSENGER-RNAS; RECEPTORS; NEURONS AB Corticotropin-releasing factor (CRF) injected peripherally or released in response to stressful challenges to the organism reduces gastric tone and contractility, in part by vagal pathways. However, information on the changes in gastric vagal impulse activity evoked by peripheral CRF administration is entirely lacking. Using a novel "dual recording" method in urethane-anesthetized rats, vagal efferent (VE) and afferent (VA) impulse activities were recorded simultaneously from separate, fine bundles dissected from the ventral gastric vagus nerve branch innervating the glandular stomach. Activity records for 38 VA single units (SUs) and 33 VE SUs were sorted from multiunit records obtained from 13 preparations. Intravenous (iv) administration of saline had no effect on multiunit VE activity, whereas CRF (1 mu g/kg, iv) immediately inhibited VE activity, reaching a nadir of 54 +/- 8.0% of preinjection levels at 3.0 min postinjection. CRF (1 mu g/kg, iv) inhibited 25/33 (75.8%) VE SUs and excited three of 33 (9.1%) VE SUs. In contrast to potent effects on VE activity, iv CRF did not alter multiunit VA activity. Single-unit analysis, however, revealed five of 38 (13.1%) VA SUs excited by iv CRF at widely varying latencies (suggesting an indirect mode of action) and one inhibited VA SU. VA SUs excited after iv CRF did not respond during gastric distention and vice versa. These experiments are the first to use simultaneous recording of gastric VA and VE units. The data demonstrate a predominantly inhibitory influence of iv CRF on VE outflow to the hindstomach, not driven by gastric vagovagal reflex activity. C1 Univ Calif Los Angeles, W Los Angeles VAMC, VAGLAHS, Digest Dis Res Ctr,CURE, Los Angeles, CA 90073 USA. RP Adelson, DW (reprint author), Univ Calif Los Angeles, W Los Angeles VAMC, VAGLAHS, Digest Dis Res Ctr,CURE, Bldg 115,Rm 325,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dadelson@ucla.edu OI Adelson, David/0000-0002-4623-6030 FU NIDDK NIH HHS [DK-41301, R01 DK-33061, R21 DK-074736] NR 65 TC 7 Z9 7 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-3077 J9 J NEUROPHYSIOL JI J. Neurophysiol. PD APR PY 2007 VL 97 IS 4 BP 3004 EP 3014 DI 10.1152/jn.01143.2006 PG 11 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 188OT UT WOS:000247929900039 PM 17314242 ER PT J AU Stella, SL Hu, WD Vila, A Brecha, NC AF Stella, Salvatore L., Jr. Hu, Wanda D. Vila, Alejandro Brecha, Nicholas C. TI Adenosine inhibits voltage-dependent Ca2+ influx in cone photorecevtor terminals of the tiger salamander retina SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE FM 4-64; synaptored-C2; fluo-4; VAMP; piccolo ID ENDOGENOUS ADENOSINE; SYNAPTIC-TRANSMISSION; ROD PHOTORECEPTORS; MAMMALIAN RETINA; CALCIUM INFLUX; GANGLION-CELLS; RAT RETINA; RECEPTORS; RELEASE; NEURONS AB Endogenous adenosine has already been shown to inhibit transmitter release from the rod synapse by suppressing Ca2+, influx through voltage-gated Ca2+, channels. However, it is not clear how adenosine modulates the cone synapse. Cone photoreceptors, like rod photoreceptors, also possess L-type Ca2+, channels that regulate the release of L-glutamate. To assess the impact of adenosine on Ca2+, influx though voltage-gated Ca2+ channels in cone terminals, whole-cell perforated-patch clamp recording and Ca2+ imaging with fluo-4 were used on isolated cones and salamander retinal slices. Synaptic markers (VAMP and piccolo) and activity-clependent dye labeling revealed that tiger salamander cone terminals contain a broad, vesicle-filled cytoplasmic extension at the base of the somatic compartment, which is unlike rod terminals that contain one or more thin axons, each terminating in a large bulbous synaptic terminal. The spatiotemporal Ca2+ responses of the cone terminals do not differ significantly from the Ca2+ responses of the soma or inner segment like that observed in rods. Whole-cell recording of cone Ica and Ca2+ imaging of synaptic terminals in cones demonstrate that adenosine inhibited both Ica and the depolarization-evoked Ca2+ increase in cone terminals in a dose-dependent manner from 1 to 50 mu M, with an EC50 of 15.6 mu M. These results indicate that, as in rods, adenosine's ability to suppress voltage-dependent Ca2+ channels at the cone synapse will limit the amount of L-glutamate released. Therefore, adenosine has an inhibitory effect on L-glutamate release at the first synapse, which likely favors elevated adenosine levels in the dark or during dark-adapted conditions. (c) 2007 Wiley-Liss, Inc. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, 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, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Stella, SL (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, 10833 Le Conte Ave,Box 951763,CHS 73-323, Los Angeles, CA 90095 USA. EM sstella@mednet.ucla.edu OI Stella Jr., Salvatore/0000-0003-1971-2537 FU NEI NIH HHS [R56 EY004067, EY 04067, R01 EY015573, EY 15573, R01 EY004067]; NIDDK NIH HHS [P30 DK041301, DK 41301] NR 52 TC 12 Z9 12 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD APR PY 2007 VL 85 IS 5 BP 1126 EP 1137 DI 10.1002/jnr.21210 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 157NK UT WOS:000245726700021 PM 17304584 ER PT J AU Goldstein, NE Fischberg, D AF Goldstein, Nathan E. Fischberg, Daniel TI Update in hospice and palliative care 2005 SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Review ID TRIAL C1 CUNY Mt Sinai Sch Med, Dept Geriatr, New York, NY 10029 USA. James J Peters VA Med Ctr, Bronx, NY USA. Queens Med Ctr, Pain & Palliat Care Dept, Honolulu, HI USA. RP Goldstein, NE (reprint author), CUNY Mt Sinai Sch Med, Dept Geriatr, 1 Gustave Levy Pl,Box 1070, New York, NY 10029 USA. EM Nathan.Goldstein@mssm.edu NR 6 TC 0 Z9 0 U1 0 U2 1 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD APR PY 2007 VL 10 IS 2 BP 476 EP 482 DI 10.1089/jpm.2006.0167 PG 7 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 165AJ UT WOS:000246275900031 ER PT J AU Zemnick, C Woodhouse, SA Gewanter, RM Raphael, M Piro, JD AF Zemnick, Candice Woodhouse, Shermian A. Gewanter, Richard M. Raphael, Michael Piro, John D. TI Rapid prototyping technique for creating a radiation shield SO JOURNAL OF PROSTHETIC DENTISTRY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Prosthodontic-Society CY FEB, 2006 CL Chicago, IL SP Amer Prosthodont Soc ID DEVELOPING FACIAL PROSTHESES; MOHS MICROGRAPHIC SURGERY; COMPUTED-TOMOGRAPHY; CAD/CAM TECHNIQUES; FABRICATION; STEREOLITHOGRAPHY; SURFACE; DESIGN; INTEGRATION; TECHNOLOGY AB Radiation therapy for the treatment of head and neck skin cancer poses challenges because of the inherently uneven tissue topography of the face and the need to protect surrounding unaffected tissues. The use of a customized radiation shield that combines tissue-equivalent bolus material with protective material addresses these issues. This article describes a technique using rapid prototyping to design and fabricate an extraoral radiation shield. This innovative application provides an expedient, standardized approach for delivering radiotherapy to the face, which is not only more comfortable for the patient, but allows more precise treatment delivery. C1 Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. Columbia Univ, Div Prosthodont, Coll Dent Med, New York, NY USA. Columbia Univ, Coll Phys & Surg, Dept Radiat Oncol, New York, NY USA. Direct Dimens Inc, Owings Mills, MD USA. RP Zemnick, C (reprint author), Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. EM cbz2001@columbia.edu NR 26 TC 10 Z9 10 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-3913 J9 J PROSTHET DENT JI J. Prosthet. Dent. PD APR PY 2007 VL 97 IS 4 BP 236 EP 241 DI 10.1016/j.prosdent.2007.02.005 PG 6 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 169KU UT WOS:000246591900009 PM 17499094 ER PT J AU Tufts, JB Molis, MR AF Tufts, Jennifer B. Molis, Michelle R. TI Perception of roughness by listeners with sensorineural hearing loss SO JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA LA English DT Article ID MUSICAL TENSION; DISSONANCE; NOISES; PITCH AB The perception of auditory roughness presumably results from imperfect spectral or temporal resolution. Sensorineural hearing loss, by affecting spectral resolution, may therefore alter roughness perception. In this study, normal-hearing and hearing-impaired listeners estimated the roughness of amplitude-modulated tones varying in carrier frequency, modulation rate, and modulation depth. Their judgments were expected to reflect effects of impaired spectral resolution. Instead, their judgments were similar, in most respects, to those of normally-hearing listeners, except at very slow modulation rates. Results suggest that mild-to-moderate sensorineural hearing loss increases the roughness of slowly fluctuating signals. (c) 2007 Acoustical Society of America. C1 Univ Connecticut, Dept Commun Sci, Storrs, CT 06269 USA. Portland VA Med Ctr, Natl Ctr Rehabilitat Auditory Res, Portland, OR 97207 USA. RP Tufts, JB (reprint author), Univ Connecticut, Dept Commun Sci, 850 Balton Ave,Unit 1085, Storrs, CT 06269 USA. EM jennifer.tufts@uconn.edu; michelle.molis@va.gov FU NIDCD NIH HHS [DC 00626] NR 13 TC 4 Z9 4 U1 0 U2 3 PU ACOUSTICAL SOC AMER AMER INST PHYSICS PI MELVILLE PA STE 1 NO 1, 2 HUNTINGTON QUADRANGLE, MELVILLE, NY 11747-4502 USA SN 0001-4966 J9 J ACOUST SOC AM JI J. Acoust. Soc. Am. PD APR PY 2007 VL 121 IS 4 BP EL161 EP EL167 DI 10.1121/1.2710744 PG 7 WC Acoustics; Audiology & Speech-Language Pathology SC Acoustics; Audiology & Speech-Language Pathology GA 156ZE UT WOS:000245687600066 PM 17471762 ER PT J AU Friedlander, AH Yagiela, JA Mahler, ME Rubin, R AF Friedlander, Arthur H. Yagiela, John A. Mahler, Michael E. Rubin, Robert TI The pathophysiology, medical management and dental implications of adult attention-deficit/hyperactivity disorder SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Article DE attention-deficit/hyperactivity disorder; drug interactions; attention; dental care for disabled ID DEFICIT HYPERACTIVITY DISORDER; ADVERSE DRUG-INTERACTIONS; PSYCHIATRIC COMORBIDITY; PSYCHOSOCIAL TREATMENTS; CHILDHOOD-ONSET; SUBSTANCE-ABUSE; BRAIN ACTIVITY; UNITED-STATES; PRIMARY-CARE; DOUBLE-BLIND AB Background. Few published reports in the dental literature have focused on adult attention-deficit/hypersctivity disorder (ADHD) and its dental implications. Types of Studies Reviewed. The authors conducted a MEDLINE search for the period 2000 through 2005 using the terms "adult" and "attention-deficit" to define ADHD's pathology, medical treatment and dental implications. Results. ADHD is a development condition that affects slightly more than 4% of the adult U.S. population. Its symptoms include inattention, hyperactivity and impulsivity that can cause personal, social, occupational and leisure-time dysfunction. Medications used to treat the disorder include stimulants, selective noradrenergic uptake inhibitors and tricyclic antidepressants. Clinical Implications. The oral health of people with ADHD may be compromised by inattention and impulsivity that impair home care regimens and can lead to cigarette addiction, which may cause oral cancer and damage to periodontium, and excessive ingestion of caffeinated sugar-laden soft drinks that promote dental caries. To safely care for this patient population, dentists must be familiar with the stimulant and nonstimulant medications used to treat adult ADHD, because these drugs can cause adverse orofacial and systemic reactions and interact adversely with dental therapeutic agents. C1 VA Greater Los Angeles Healthcare Syst, Neurobehav Clin, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Dept Psychiat & Mental Hlth, Los Angeles, CA 90073 USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Clin, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov RI Reis, Aline/G-9573-2012 NR 74 TC 9 Z9 11 U1 2 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 APR PY 2007 VL 138 IS 4 BP 475 EP 482 PG 8 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 158AM UT WOS:000245763100020 PM 17403737 ER PT J AU Braun, U McCullough, L Kunik, M AF Braun, U. McCullough, L. Kunik, M. TI Racial/ethnic differences in the use of mental health services in seriously ill veterans. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 DeBakey VA Med Ctr, HSRD CoE, Houston, TX USA. BCM, Houston, TX USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S199 EP S199 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500585 ER PT J AU Burnett, J Coverdale, J Kelly, PA Pickens, S Dyer, C AF Burnett, J. Coverdale, J. Kelly, P. A. Pickens, S. Dyer, C. TI Variables that predict depression in a sample of self-neglecting geriatric outpatients. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Consortium Res Elder Self Neglect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Harris Cty Hosp Dist, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S189 EP S189 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500556 ER PT J AU Day, H AF Day, H. TI Identifying barriers and solutions to effective nursing physician communication: A qualitative study. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S38 EP S38 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500109 ER PT J AU Devadoss, R Green, GL Carter, DN Latini, DM Kaniu-Mwaniki, P Barker, JC Sands, LP Chren, M Walter, LC Knight, SJ AF Devadoss, R. Green, G. L. Carter, D. N. Latini, D. M. Kaniu-Mwaniki, P. Barker, J. C. Sands, L. P. Chren, M. Walter, L. C. Knight, S. J. TI Understanding treatment related symptom outcomes among prostate cancer patients. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 SUNY Syracuse, Upstate Med Univ, Syracuse, NY USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Baylor Coll Med, Houston Ctr Quality Care & Utilizat Studies, Houston, TX 77030 USA. Michael E De Bakey Vet Affairs Med Ctr, Houston, TX USA. Purdue Univ, W Lafayette, IN 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S59 EP S59 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500171 ER PT J AU Dyer, CB Burnett, J Pickens, S Vogel, M Regev, T Kim, L Kelly, PA AF Dyer, C. B. Burnett, J. Pickens, S. Vogel, M. Regev, T. Kim, L. Kelly, P. A. TI The self-neglect severity Scale: A sensitive screening tool. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Consortium Res Elder Self Neglect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Haris Cty Hosp Dist, Houston, TX USA. ME Debakey Vet Affairs Med Ctr, Houston, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S201 EP S201 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500590 ER PT J AU Edes, T Tompkins, H AF Edes, T. Tompkins, H. TI Quality measure of reduction of inpatient days during home based primary care (HBPC). SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 US Dept Vet Affairs, Washington, DC 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S6 EP S7 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500019 ER PT J AU Fermin, E Sanchez-Reilly, S Wittenberg-Lyles, E AF Fermin, E. Sanchez-Reilly, S. Wittenberg-Lyles, E. TI Evaluating the impact of interdisciplinary family meetings among caregivers of older adults. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriatr Soc C1 Univ Texas Hlth Sci Ctr San Antonio, GRECC, San Antonio, TX 78285 USA. So Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas San Antonio, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S59 EP S60 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500172 ER PT J AU Jamshed, N Martin, J Josephson, K Khan-Hudson, A Vandenberg, T Martinez, S Alessi, C AF Jamshed, N. Martin, J. Josephson, K. Khan-Hudson, A. Vandenberg, T. Martinez, S. Alessi, C. TI Functional recovery and cognitive impairment among older people receiving rehabilitation in a nursing home. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 VA Greater Los Angeles, GRECC, North Hills, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S215 EP S215 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500630 ER PT J AU Kinard, TN Sanchez-Reilly, S Lee, S AF Kinard, T. N. Sanchez-Reilly, S. Lee, S. TI Functional assessment among geriatric cancer patients. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S208 EP S209 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500611 ER PT J AU LoConte, N Gleason, C Gunter-Hunt, G Carlsson, C Siebers, M AF LoConte, N. Gleason, C. Gunter-Hunt, G. Carlsson, C. Siebers, M. TI Screening for and prevalence of firearm access and driving among veterans with dementia. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Wisconsin, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Ctr Gerontol & Hlth Care Res, Madison, WI USA. NR 0 TC 0 Z9 0 U1 1 U2 4 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 APR PY 2007 VL 55 IS 4 SU S BP S104 EP S104 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500305 ER PT J AU McGory, ML Jain, S Sekeris, E Leonardi, MJ Shekelle, PG Ko, CY AF McGory, M. L. Jain, S. Sekeris, E. Leonardi, M. J. Shekelle, P. G. Ko, C. Y. TI Does physician specialty influence quality measure development for elderly surgical patients? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU 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 APR PY 2007 VL 55 IS 4 SU S BP S217 EP S217 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500635 ER PT J AU Pickens, S Burnett, J Naik, A Dyer, CB AF Pickens, S. Burnett, J. Naik, A. Dyer, C. B. TI Characterizing elders who self-neglect based on the Kohlman evaluation of living skills. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Baylor Coll Med, Houston, TX 77030 USA. DeBakey Vet Affairs Med Ctr, Houston, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S160 EP S160 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500471 ER PT J AU Ruzicka, SA Sanchez-Reilly, S AF Ruzicka, S. A. Sanchez-Reilly, S. TI The impact of a geriatric palliative consultation service in a tertiary setting: A pilot study. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Texas, Hlth Sci Ctr, Sch Nursing, San Antonio, TX 78285 USA. South Texas Vet Hlth Care Syst, GRECC, San Antonio, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S151 EP S151 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500445 ER PT J AU Sanchez-Reilly, S Zeber, J Copeland, L Pugh, M Wolff, P Karnad, A AF Sanchez-Reilly, S. Zeber, J. Copeland, L. Pugh, M. Wolff, P. Karnad, A. TI Cancer among "oldest of the old": Prevalence rates, medical comorbidities, and treatment modalities. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. South Texas Vet Hlth Care Syst, San Antonio, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S205 EP S205 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500601 ER PT J AU Sanchez-Reilly, S Wittenberg-Lyles, E AF Sanchez-Reilly, S. Wittenberg-Lyles, E. TI Evaluating ACP communication. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriatr Soc C1 Univ Texas Hlth Sci Ctr San Antonio, GRECC, San Antonio, TX 78285 USA. Univ Texas San Antonio, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S129 EP S130 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500381 ER PT J AU Seitan, L Sanchez-Reilly, S Wittenberg-Lyles, E Lee, S AF Seitan, L. Sanchez-Reilly, S. Wittenberg-Lyles, E. Lee, S. TI The impact of a geriatric consult service on caregiver's perception of inpatient care. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriatr Soc C1 Univ Cent Del Caribe, Sch Med, Bayamon, PR 78285 USA. Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. Univ Texas San Antonio, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S161 EP S161 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500473 ER PT J AU Shah, FA Boockvar, K AF Shah, F. A. Boockvar, K. TI Drug prescribing practices during patient transfer. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Mt Sinai Sch Med, Dept Geriatr, New York, NY USA. James J Peters VA Med Ctr, Dept Geriatr, Bronx, NY 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S147 EP S147 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500432 ER PT J AU Shanley, E Tio-Matos, I Merriam, GR AF Shanley, E. Tio-Matos, I. Merriam, G. R. TI Half a century of estrogen use in a nonagenarian: 54 years of cardioprotection? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 VA Puget Sound, Tacoma, WA USA. Univ Washington, Seattle, WA 98195 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S117 EP S117 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500342 ER PT J AU Shanley, E Falzgraf, S AF Shanley, E. Falzgraf, S. TI Bochdalek hernia: An uncommon cause for a common symptom in elders. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 VA Puget Sound, Tacoma, 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S116 EP S116 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500341 ER PT J AU Smiechowska, JK Asnicar, MA Taffet, GE Smith, RG Garcia, JM AF Smiechowska, J. K. Asnicar, M. A. Taffet, G. E. Smith, R. G. Garcia, J. M. TI Ghrelin effects on body weight and body composition in cisplatin induced cachexia. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 Baylor Coll Med, Huffington Ctr Aging, Houston, TX 77030 USA. DeBakey Vet Affairs Med Ctr, Houston, TX USA. Hartford Fdn, Ctr Excellence Geriatricse, Houston, TX 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S166 EP S166 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500488 ER PT J AU Steinman, MA Rosenthal, GE Landefeld, CS AF Steinman, M. A. Rosenthal, G. E. Landefeld, C. S. TI Are drugs-to-avoid criteria an accurate diagnostic tool for problem prescribing? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Iowa City VA Healthcare Syst, Iowa City, IA USA. Univ Iowa, Iowa City, IA 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 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S7 EP S7 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500021 ER PT J AU Sun, B Hoffman, JR Mangione, CM Mower, WR AF Sun, B. Hoffman, J. R. Mangione, C. M. Mower, W. R. TI Older age predicts short-term, serious events after syncope. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Scientific Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriat Soc C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S122 EP S122 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500359 ER PT J AU Villarreal, D Ross, J Sanchez-Reilly, S Wittenberg-Lyles, E Lee, S AF Villarreal, D. Ross, J. Sanchez-Reilly, S. Wittenberg-Lyles, E. Lee, S. TI Breaking barriers: An interdisciplinary educational intervention to improve pain among older adults. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract CT Annual Meeting of the American-Geriatrics-Society CY MAY 02-06, 2007 CL Seattle, WA SP Amer Geriatr Soc C1 Univ Texas Hlth Sci Ctr San Antonio, GRECC, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas San Antonio, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD APR PY 2007 VL 55 IS 4 SU S BP S187 EP S188 PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 157WQ UT WOS:000245752500551 ER PT J AU Ikonomidis, JS Jones, JA Barbour, JR Stroud, RE Clark, LL Kaplan, BS Zeeshan, A Bavaria, JE Gorman, JH Spinale, FG Gorman, RC AF Ikonomidis, John S. Jones, Jeffery A. Barbour, John R. Stroud, Robert E. Clark, Leslie L. Kaplan, Brooke S. Zeeshan, Ahmed Bavaria, Joseph E. Gorman, Joseph H., III Spinale, Francis G. Gorman, Robert C. TI Expression of matrix metalloproteinases and endogenous inhibitors within ascending aortic aneurysms of patients with bicuspid or tricuspid aortic valves SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Association-for-Thoracic-Surgery CY APR 29-MAY 03, 2006 CL Philadelphia, PA SP Amer Assoc Thorac Surg ID ACTIVATION; THROMBUS; CANCER; VIVO; WALL AB Objective: The mechanisms contributing to ascending thoracic aortic aneurysms associated with bicuspid aortic valves may differ from ascending thoracic aortic aneurysms with tricuspid aortic valves. Matrix metalloproteinases and their endogenous inhibitors have been causally linked to ascending thoracic aortic aneurysm formation. This study tested the hypothesis that specific and different matrix metalloproteinase and tissue inhibitors of metalloproteinase profiles would be observed in ascending thoracic aortic aneurysm samples from patients with bicuspid aortic valves versus tricuspid aortic valves. Methods: Ascending thoracic aortic aneurysm samples taken from patients with bicuspid aortic valve ( n = 53) and patients with tricuspid aortic valve ( n = 46) were assessed for representative subtypes of all matrix metalloproteinase classes and all 4 known tissue inhibitors of metalloproteinases. Levels were compared [ optical density units, median ( interquartile range)] both to reference control ascending aortic samples ( n = 26) and within each valve group by aneurysm diameter ( <= 3.9 cm, 4.0-5.9 cm and >= 6.0 cm). Results: Different and specific matrix metalloproteinase and tissue inhibitors of metalloproteinase profiles were observed in the ascending thoracic aortic aneurysm groups. In bicuspid aortic valves, matrix metalloproteinase-2 increased by 34% when compared with either tricuspid aortic valves or control (P <.05), and matrix metalloproteinase-14 decreased by 59% compared with tricuspid aortic valves ( P <.05). In tricuspid aortic valve samples, tissue inhibitors of metalloproteinase-2 decreased by 35% when compared with either tricuspid aortic valves or control (P <.05), and matrix metalloproteinase-13 increased by 140% in the 4.0- to 5.9- cm diameter range ( P <.05). Conclusions: A unique matrix metalloproteinase and tissue inhibitor of metalloproteinase portfolio was observed in ascending thoracic aortic aneurysms from patients with bicuspid aortic valve compared with patients with tricuspid aortic valve. These differences, suggesting disparate mechanisms of extracellular matrix remodeling, may provide unique biochemical targets for ascending thoracic aortic aneurysm prognostication and treatment in these 2 groups of patients. C1 Med Univ S Carolina, Div Cardiothorac Surg, Dept Cardiothorac Surg, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Univ Penn, Div Cardiothorac Surg, Philadelphia, PA 19104 USA. RP Ikonomidis, JS (reprint author), Med Univ S Carolina, Div Cardiothorac Surg, Dept Cardiothorac Surg, Ralph H Johnson Vet Affairs Med Ctr, Suite 409 CSB,96 Jonathan Lucas St, Charleston, SC 29425 USA. EM ikonomij@musc.edu FU NHLBI NIH HHS [HL 059165-07, R01 HL075488-01] NR 26 TC 92 Z9 93 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD APR PY 2007 VL 133 IS 4 BP 1028 EP 1036 DI 10.1016/j.jtcvs.2006.10.083 PG 9 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 149AI UT WOS:000245118100027 PM 17382648 ER PT J AU Graff, JN Mori, M Li, H Garzotto, M Penson, D Potosky, AL Beer, TM AF Graff, Julie N. Mori, Motomi Li, Hong Garzotto, Mark Penson, David Potosky, Arnold L. Beer, Tomasz M. TI Predictors of overall and cancer-free survival of patients with localized prostate cancer treated with primary androgen suppression therapy: Results from the prostate cancer outcomes study SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; androgen antagonists; mortality; nomograms ID QUALITY-OF-LIFE; RADICAL PROSTATECTOMY; DEPRIVATION THERAPY; HORMONAL-THERAPY; RADIATION-THERAPY; PRACTICE PATTERNS; CARCINOMA; TRIAL; MEN AB Purpose: Primary androgen suppression therapy for clinically localized prostate cancer is increasingly common in the United States despite a lack of supportive evidence for its use. We determined which demographic and clinical factors predict overall and cancer specific survival with this treatment strategy in patients enrolled in the Prostate Cancer Outcomes Study. Materials and Methods: In 1994 to 1995 the Prostate Cancer Outcomes Study recruited 3,533 men diagnosed with prostate cancer. Clinical and treatment information was abstracted from medical records and demographic characteristics were obtained from patient surveys 6, 12, 24 and 60 months after diagnosis. Overall and cancer specific mortality was analyzed through December 2002 using the Kaplan-Meier method and Cox regression. Results: A total of 276 patients had organ confined (cTl-2) prostatic adenocarcinoma and received primary androgen suppression therapy within 1 year of diagnosis. Median followup for censored patients was 7.6 years (range 1.1 to 8.1). Five-year overall and cancer specific survival was 66% (95% CI 59-72) and 91% (95% CI 86-94), respectively. Independent predictors of shorter overall survival were patient age 75 years or older, prostate specific antigen 20 ng/ml or greater, Gleason score 7 or greater and abnormal digital rectal examination. Gleason score 7 or greater, prostate specific antigen 20 ng/ml or greater and a low comorbidity index were independent predictors of shorter cancer specific survival. Conclusions: The use of primary androgen suppression therapy in the Prostate Cancer Outcomes Study data set resulted in 91% 5-year cancer specific survival. Advanced age, and factors that reflect tumor burden and biology were predictive of overall survival, while cancer specific survival was predicted by tumor factors and the burden of comorbid conditions. A nomogram for predicting overall survival at 5 years was constructed. C1 Oregon Hlth & Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Div Urol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Biostat Shared Resource, Inst Canc, Portland, OR 97239 USA. Portland VA Med Ctr, Urol Sect, Portland, OR USA. Univ So Calif, Dept Urol, Norris Canc Ctr, Los Angeles, CA 90089 USA. Univ So Calif, Dept Prevent Med, Norris Canc Ctr, Los Angeles, CA 90089 USA. NCI, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. RP Beer, TM (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Hematol & Med Oncol, Mail Code CR-145,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM beert@ohsu.edu FU NCI NIH HHS [N01PC67010, N01PC67005, N01PC67009, N01PC67006, N01PC67007, N01PC67000] NR 20 TC 12 Z9 12 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD APR PY 2007 VL 177 IS 4 BP 1307 EP 1312 DI 10.1016/j.juro.2006.11.054 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 148QV UT WOS:000245090600030 PM 17382720 ER PT J AU Streblow, DN van Cleef, KWR Kreklywich, CN Meyer, C Smith, P Defilippis, V Grey, F Fruh, K Searles, R Bruggeman, C Vink, C Nelson, JA Orloff, SL AF Streblow, Daniel N. van Cleef, Koen W. R. Kreklywich, Craig N. Meyer, Christine Smith, Patricia Defilippis, Victor Grey, Finn Fruh, Klaus Searles, Robert Bruggeman, Cathrien Vink, Cornelis Nelson, Jay A. Orloff, Susan L. TI Rat cytomegalovirus gene expression in cardiac allograft recipients is tissue specific and does not parallel the profiles detected in vitro SO JOURNAL OF VIROLOGY LA English DT Article ID COUPLED RECEPTOR GENE; MURINE CYTOMEGALOVIRUS; HEART-TRANSPLANTS; CHRONIC REJECTION; INFECTIOUS VIRUS; SALIVARY-GLANDS; PROTEIN; TRANSCRIPTION; CELLS; VIVO AB Rat cytomegalovirus (RCMV) is a beta-herpesvirus with a 230-kbp genome containing over 167 open reading frames (ORFs). RCMV gene expression is tightly regulated in cultured cells, occurring in three distinct kinetic classes (immediate early, early, and late). However, the extent of viral-gene expression in vivo and its relationship to the in vitro expression are unknown. In this study, we used RCW-specific DNA microarrays to investigate the viral transcriptional profiles in cultured, RCMV-infected endothelial cells, fibroblasts, and aortic smooth muscle cells and to compare these profiles to those found in tissues from RCMV-infected rat heart transplant recipients. In cultured cells, RCMV expresses approximately 95% of the known viral ORFs with few differences between cell types. By contrast, in vivo viral-gene expression in tissues from rat heart allograft recipients is highly restricted. In the tissues studied, a total of 80 viral genes expressing levels twice above background (5,000 to 10,000 copies per mu g total RNA) were detected. In each tissue type, there were a number of genes expressed exclusively in that tissue. Although viral mRNA and genomic DNA levels were lower in the spleen than in submandibular glands, the number of individual viral genes expressed was higher in the spleen (60 versus 41). This finding suggests that the number of viral genes expressed is specific to a given tissue and is not dependent upon the viral load or viral mRNA levels. Our results demonstrate that the profiles, as well as the amplitude, of viral-gene expression are tissue specific and are dramatically different from those in infected cultured cells, indicating that RCMV gene expression in vitro does not reflect viral-gene expression in vivo. C1 Oregon Hlth & Sci Univ, Vaccine & Gene Therapy Inst, Beaverton, OR 97006 USA. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Beaverton, OR 97006 USA. Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97239 USA. Univ Maastricht, Dept Med Microbiol, Maastricht, Netherlands. RP Streblow, DN (reprint author), Oregon Hlth & Sci Univ, Vaccine & Gene Therapy Inst, 505 SW 185th St, Beaverton, OR 97006 USA. EM streblow@ohsu.edu FU NHLBI NIH HHS [HL65754, R01 HL071695, R01 HL083194, R01 HL065754, HL71695, HL083194, R01 HL066238, HL 66238-01]; NIAID NIH HHS [AI21640, R01 AI021640] NR 30 TC 21 Z9 21 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD APR PY 2007 VL 81 IS 8 BP 3816 EP 3826 DI 10.1128/JVI.02425-06 PG 11 WC Virology SC Virology GA 157BF UT WOS:000245692900016 PM 17251289 ER PT J AU Carnes, M Bigby, J AF Carnes, Molly Bigby, Judyann TI Jennifer fever in academic medicine SO JOURNAL OF WOMENS HEALTH LA English DT Editorial Material C1 Univ Wisconsin, Dept Med, Madison, WI 53715 USA. William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI USA. Women Vet Hlth Program, Madison, WI USA. Brigham & Womens Hosp, Dept Med, Harvard Med Sch Ctr Excellence Womens Hlth, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA USA. RP Carnes, M (reprint author), Univ Wisconsin, Dept Med Psychiat & Ind & Syst Engn, Ctr Womens Hlth Res, WISELI, 700 Regent St,Suite 301, Madison, WI 53715 USA. EM mlcarnes@wisc.edu FU NIGMS NIH HHS [R01 GM088477] NR 5 TC 1 Z9 1 U1 0 U2 2 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1540-9996 J9 J WOMENS HEALTH JI J. Womens Health PD APR PY 2007 VL 16 IS 3 BP 299 EP 301 DI 10.1089/jwh.2007.E072 PG 3 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 158GB UT WOS:000245778600002 PM 17439375 ER PT J AU Bredy, TW Wu, H Crego, C Zellhoefer, J Sun, YE Barad, M AF Bredy, Timothy W. Wu, Hao Crego, Cortney Zellhoefer, Jessica Sun, Yi E. Barad, Mark TI Histone modifications around individual BDNF gene promoters in prefrontal cortex are associated with extinction of conditioned fear SO LEARNING & MEMORY LA English DT Article ID PROTEIN-SYNTHESIS; NEUROTROPHIC FACTOR; VALPROIC ACID; MEMORY EXTINCTION; RAT HIPPOCAMPUS; MOUSE MODEL; AMYGDALA; REQUIRES; CONSOLIDATION; MICE AB Extinction of conditioned fear is an important model both of inhibitory learning and of behavior therapy for human anxiety disorders. Like other forms of learning, extinction learning is long-lasting and depends on regulated gene expression. Epigenetic mechanisms make an important contribution to persistent changes in gene expression; therefore, in these studies, we have investigated whether epigenetic regulation of gene expression contributes to fear extinction. Since brain-derived neurotrophic factor ( BDNF) is crucial for synaptic plasticity and for the maintenance of long-term memory, we examined histone modifications around two BDNF gene promoters after extinction of cued fear, as potential targets of learning-induced epigenetic regulation of gene expression. Valproic acid ( VPA), used for some time as an anticonvulsant and a mood stabilizer, modulates the expression of BDNF, and is a histone deacetylase ( HDAC) inhibitor. Here, we report that extinction of conditioned fear is accompanied by a significant increase in histone H4 acetylation around the BDNF P4 gene promoter and increases in BDNF exon I and IV mRNA expression in prefrontal cortex, that VPA enhances long-term memory for extinction because of its HDAC inhibitor effects, and that VPA potentiates the effect of weak extinction training on histone H4 acetylation around both the BDNF P1 and P4 gene promoters and on BDNF exon IV mRNA expression. These results suggest a relationship between histone H4 modification, epigenetic regulation of BDNF gene expression, and long-term memory for extinction of conditioned fear. In addition, they suggest that HDAC inhibitors may become a useful pharmacological adjunct to psychotherapy for human anxiety disorders. C1 Semel Inst Neurosci & Human Behav, Brain Res Inst, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Barad, M (reprint author), Semel Inst Neurosci & Human Behav, Brain Res Inst, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. EM mbarad@mednet.ucla.edu RI Wu, Hao/G-4145-2013 OI Wu, Hao/0000-0002-1256-6891 NR 45 TC 278 Z9 291 U1 3 U2 35 PU COLD SPRING HARBOR LAB PRESS, PUBLICATIONS DEPT PI WOODBURY PA 500 SUNNYSIDE BLVD, WOODBURY, NY 11797-2924 USA SN 1072-0502 J9 LEARN MEMORY JI Learn. Mem. PD APR PY 2007 VL 14 IS 4 BP 268 EP 276 DI 10.1101/lm.500907 PG 9 WC Neurosciences; Psychology, Experimental SC Neurosciences & Neurology; Psychology GA 162BI UT WOS:000246060900006 PM 17522015 ER PT J AU Zhang, QW Safford, M Miller, D Crystal, S Rajan, M Tseng, CL Pogach, L AF Zhang, Quanwu Safford, Monika Miller, Donald Crystal, Stephen Rajan, Mangala Tseng, Chin-Lin Pogach, Leonard TI Short-term statin exposure is associated with reduced all-cause mortality in persons with diabetes SO MEDICAL CARE LA English DT Article; Proceedings Paper CT 63rd Annual Meeting of the American-Diabetes-Association CY JUN 13-17, 2003 CL NEW ORLEANS, LA SP Amer Diabet Assoc DE statins; mortality; diabetes ID CORONARY-HEART-DISEASE; PLACEBO-CONTROLLED TRIAL; OF-VETERANS-AFFAIRS; LOWERING TREATMENT; CHOLESTEROL LEVELS; RANDOMIZED-TRIALS; ELDERLY PATIENTS; PRAVASTATIN; METAANALYSIS; THERAPY AB Background: The survival benefit of statins in nontrial populations of persons with diabetes is unknown. Objective: We sought to determine all-cause mortality in fiscal year 2001 (FYOI) after statin initiation in FY 99 and/or FYOO in individuals with diabetes in the Veterans Healthcare Administration (VHA). Methods: Using a retrospective longitudinal cohort analysis, we analyzed 201,102 veterans with diabetes from 104 VHA facilities with medical, pharmacy, and laboratory information from VHA and Medicare databases. Patients with statin exposure, defined as ha, medication possession coverage > 50% of eligible days in FY99 and/or FY00, were characterized as initiators if no statin prescription was found in FY98. Otherwise, they were characterized as continuing users. We defined 4 statin exposure groups: FY99 only, FY00 only, both FY99 and 00, and neither year. All-cause mortality was determined in FY01 Propensity score matched comparisons were used to corroborate results from mixed effects logistic models. Results: FYOI mortality was no different between FY99-only initiators and the nonexposure group (odds ratio [OR] = 1.08, P = 0.429). In contrast, FY00-only and FY99-00 initiator groups showed odds ratio of 0.75 (P < 0.0001) and 0.71 (P < 0.0001), respectively. There was a similar benefit for continuing users. Propensity analysis demonstrated consistent findings. Increased statin adherence from > 50% to > 75% was associated with increased benefit (OR = 0.71, P < 0.0001 versus OR = 0.62, P = 0.0002). Conclusions: One to 2-year statin exposure is associated with a 25% to 29% risk reduction in all-cause mortality of the subsequent year in a high-risk diabetes cohort. C1 Ctr Healthcare Knowledge Management, Dept Vet Affairs New Jersey Healthcare Syst, E Orange, NJ 07018 USA. Birmingham VA Med Ctr, Deep S Ctr Effect, Birmingham, AL USA. Univ Alabama, Birmingham, AL USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. Bedford Vet Affairs Med, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Rutgers State Univ, New Brunswick, NJ USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. RP Pogach, L (reprint author), Ctr Healthcare Knowledge Management, Dept Vet Affairs New Jersey Healthcare Syst, 385 Tremont Ave, E Orange, NJ 07018 USA. EM Leonard.Pogach@med.va.gov NR 28 TC 6 Z9 6 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD APR PY 2007 VL 45 IS 4 BP 308 EP 314 DI 10.1097/01.mlr.0000250227.94196.f0 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 157EO UT WOS:000245701600007 PM 17496714 ER PT J AU Monkul, ES Hatch, JP Nicoletti, MA Spence, S Brambilla, P Lacerda, ALT Sassi, R Mallinger, AG Keshavan, MS Soares, JC AF Monkul, E. S. Hatch, J. P. Nicoletti, M. A. Spence, S. Brambilla, P. Lacerda, A. L. T. Sassi, R. B. Mallinger, A. G. Keshavan, M. S. Soares, J. C. TI Fronto-limbic brain structures in suicidal and non-suicidal female patients with major depressive disorder SO MOLECULAR PSYCHIATRY LA English DT Article DE suicide; depression; mood disorders; affective disorders; magnetic resonance imaging; limbic system ID SUBGENUAL PREFRONTAL CORTEX; ORBITOFRONTAL CORTEX; BIPOLAR DISORDER; MOOD DISORDERS; ANATOMICAL MRI; AMYGDALA ENLARGEMENT; DECISION-MAKING; UNIPOLAR; VOLUMES; ABNORMALITIES AB Our knowledge about the neurobiology of suicide is limited. It has been proposed that suicidal behavior generally requires biological abnormalities concomitant with the personality trait of impulsivity/aggression, besides an acute psychiatric illness or psychosocial stressor. We investigated fronto-limbic anatomical brain abnormalities in suicidal and non-suicidal adult female patients with unipolar depression. Our sample consisted of seven suicidal unipolar patients, 10 non-suicidal unipolar patients and 17 healthy female comparison subjects. The criterion for suicidality was one or more documented lifetime suicide attempts. A 1.5T GE Signa Imaging System running version Signa 5.4.3 software was used to acquire the magnetic resonance imaging images. All anatomical structures were measured blindly, with the subjects' identities and group assignments masked. We used analysis of covariance with age and intracranial volume as covariates and the Tukey-Kramer procedure to compare suicidal patients, non-suicidal patients and healthy comparison subjects. Suicidal patients had smaller right and left orbitofrontal cortex gray matter volumes compared with healthy comparison subjects. Suicidal patients had larger right amygdala volumes than non-suicidal patients. Abnormalities in the orbitofrontal cortex and amygdala in suicidal patients may impair decision-making and predispose these patients to act more impulsively and to attempt suicide. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Program, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78229 USA. Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Dokuz Eylul Univ, Sch Med, Dept Psychiat, Izmir, Turkey. Univ Udine, Dept Pathol & Expt & Clin Med, Sect Psychiat, I-33100 Udine, Italy. Univ Fed Sao Paulo, Dept Psychiat, LiNC, Sao Paulo, Brazil. Sci Inst IRCCS E Medea, Udine, Italy. Univ Sao Paulo, Inst Psychiat, BR-05508 Sao Paulo, Brazil. Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15260 USA. Wayne State Univ, Sch Med, Dept Psychiat & Behav Sci, Detroit, MI 48202 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOOD CNS Program, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI Lacerda, Acioly/A-7052-2010; brambilla, paolo/B-4184-2010 OI Lacerda, Acioly/0000-0002-9370-0449; brambilla, paolo/0000-0002-4021-8456 FU NCRR NIH HHS [RR020571]; NIMH NIH HHS [MH 30915, MH 01736] NR 43 TC 114 Z9 120 U1 0 U2 5 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 APR PY 2007 VL 12 IS 4 BP 360 EP 366 DI 10.1038/sj.mp.4001919 PG 7 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 151TH UT WOS:000245313200006 PM 17389903 ER PT J AU Shlipak, MG AF Shlipak, Michael G. TI Cystatin C as a marker of glomerular filtration rate in chronic kidney disease: influence of body composition SO NATURE CLINICAL PRACTICE NEPHROLOGY LA English DT Editorial Material DE chronic kidney disease; cystatin C; glomerular filtration rate; lean mass ID SERUM CREATININE; IMPACT C1 San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Shlipak, MG (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu NR 5 TC 10 Z9 10 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1745-8323 J9 NAT CLIN PRACT NEPHR JI Nat. Clin. Pract. Nephrol. PD APR PY 2007 VL 3 IS 4 BP 188 EP 189 DI 10.1038/ncpneph0404 PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 150KI UT WOS:000245215300004 PM 17290239 ER PT J AU Katsel, P Li, C Haroutunian, V AF Katsel, Pavel Li, Celeste Haroutunian, Vahram TI Gene expression alterations in the sphingolipid metabolism pathways during progression of dementia and Alzheimer's disease: A shift toward ceramide accumulation at the earliest recognizable stages of Alzheimer's disease? SO NEUROCHEMICAL RESEARCH LA English DT Article DE Alzheimer's disease; dementia; ceramide; glycosphingolipid; sphingolipid metabolism; postmortem; gene expression; microarray; brain regions ID AMYLOID-BETA-PEPTIDE; CORONARY-ARTERY-DISEASE; LOW-DENSITY-LIPOPROTEIN; NEUTRAL SPHINGOMYELINASE; SIGNAL-TRANSDUCTION; APOLIPOPROTEIN-E; NEUROFIBRILLARY TANGLES; EXECUTIVE FUNCTION; CEREBRAL-ISCHEMIA; COGNITIVE DECLINE AB There is mounting evidence linking A beta(42) generation in Alzheimer's disease (AD) with sphingomyelin catabolism. Using microarray technology to study 17 brain regions from subjects with varying severity of AD and dementia we detected multiple gene expression abnormalities of the key enzymes that control sphingolipid metabolism. These changes were correlated with the progression of clinical dementia. The upregulation of gene expression of the enzymes controlling synthesis de novo of Cer and the downregulation of the enzymes involved in glycosphingolipid synthesis was evident as early in disease progression as in mild dementia. Together these changes suggest a shift in sphingolipid metabolism towards accumulation of Cer, depletion of glycosphingolipids and the reduction of synthesis of the anti-apoptosis signaling lipid-sphingosine 1-phosphate as a function of disease progression. This disrupted balance within the sphingolipid metabolism may trigger signaling events promoting neurodegeneration across cortical regions. This potential mechanism may provide a link between lipid metabolism disturbance and AD. C1 Vet Adm Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. RP Katsel, P (reprint author), Vet Adm Med Ctr, Dept Psychiat, Room 4F-20,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM pavel.katsel@mssm.edu FU NIA NIH HHS [AG 02219] NR 68 TC 109 Z9 110 U1 0 U2 1 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0364-3190 J9 NEUROCHEM RES JI Neurochem. Res. PD APR PY 2007 VL 32 IS 4-5 BP 845 EP 856 DI 10.1007/s11064-007-9297-x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 149GG UT WOS:000245134500031 PM 17342407 ER PT J AU Dyk, K Sano, M AF Van Dyk, Kathleen Sano, Mary TI The impact of nutrition on cognition in the elderly SO NEUROCHEMICAL RESEARCH LA English DT Review DE Alzheimer's Disease; Dementia Cognitive Impairment; nutrition ID INCIDENT ALZHEIMER-DISEASE; RANDOMIZED CONTROLLED-TRIAL; DIETARY FATTY-ACIDS; VITAMIN-E; POSTMENOPAUSAL WOMEN; SERUM VITAMIN-B-12; FOLATE STATUS; DOUBLE-BLIND; OLD-AGE; RISK AB The possibility that nutritional manipulation may protect against cognitive decline and dementia is an inviting prospect. However data supporting a beneficial effect of a particular dietary pattern is limited. Although studies have demonstrated a health benefit to dietary plans that are high in fiber, whole grains, natural sugar and fish while maintaining lower intake in meat dairy and poultry, the ability to identify the most salient factors of these diets have been unsuccessful. Several aspects of diet have been studied in detail and provided support for potential mechanisms for improving cognition. Clinical trials have explored these mechanisms through supplementation studies with minimal benefits being observed. Continuing work to hone the mechanisms and refine our knowledge of dietary benefits is described. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. James J Peters VAMC, Bronx, NY 10468 USA. RP Sano, M (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustave L Levy Pl,Box 1230, New York, NY 10029 USA. EM Mary.sano@mssm.edu OI Van Dyk, Kathleen/0000-0003-1500-930X NR 66 TC 0 Z9 0 U1 1 U2 8 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0364-3190 J9 NEUROCHEM RES JI Neurochem. Res. PD APR PY 2007 VL 32 IS 4-5 BP 893 EP 904 DI 10.1007/s11064-006-9241-5 PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 149GG UT WOS:000245134500034 ER PT J AU Kochunov, P Thompson, PM Lancaster, JL Bartzokis, G Smith, S Coyle, T Royall, DR Laird, A Fox, PT AF Kochunov, P. Thompson, P. M. Lancaster, J. L. Bartzokis, G. Smith, S. Coyle, T. Royall, D. R. Laird, A. Fox, P. T. TI Relationship between white matter fractional anisotropy and other indices of cerebral health in normal aging: Tract-based spatial statistics study of aging SO NEUROIMAGE LA English DT Article ID MYELINATED NERVE-FIBERS; MAPPING CORTICAL CHANGE; DIFFUSION-TENSOR; GRAY-MATTER; ALZHEIMERS-DISEASE; HUMAN BRAIN; IN-VIVO; NEUROPSYCHIATRIC DISORDERS; STRUCTURAL INTEGRITY; PROBABILISTIC ATLAS AB White matter (WM) fractional anisotropy (FA) is thought to be related to WM integrity and decline in FA is often used as an index of decreasing WM health. However, the relationship of FA to other structural indices of cerebral health has not been well studied. We hypothesized that the decline in WM health will be associated with changes in several other indices of cerebral health. In this manuscript we studied the correlation between whole-brain/hemispheric/corpus callosum FA and gray matter (GM) thickness, sulcal span, and the volume of T2-hyperintense WM in a group of 31 healthy aging individuals (12 males/19 females) aged 57-82 years old. Individual subjects' FA measures were calculated from diffusion tracing imaging (DTI) data using tract-based spatial statistics-an approach specifically designed and validated for voxel-wise multi-subject FA analysis. Age-controlled correlation analysis showed that whole-brain average FA values were significantly and positively correlated with the subject's average GM thickness and negatively correlated with hyperintense WM volume. Intra-hemispheric correlations between FA and other measures of cerebral health had generally greater effect sizes than inter-hemispheric correction, with correlation between left FA and left GM thickness being the most significant (r=0.6, p < 0.01). Regional analysis of FA values showed that late-myelinating fiber tracts of the genu of corpus callosum had higher association with other cerebral health indices. These data are consistent with the hypothesis that late-myelinating regions of the brain bear the brunt of age-related degenerative changes. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Res Imaging Ctr, San Antonio, TX 78284 USA. Univ Calif Los Angeles, David Geffen Sch Med, Lab Neuroimaging, Dept Neurol,Div Brain Mapping, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. Univ Oxford, Ctr Funct MRI Brain, Oxford, England. Univ Texas, Dept Psychol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. RP Kochunov, P (reprint author), Univ Texas, Hlth Sci Ctr, Res Imaging Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM kochunov@uthscsa.edu RI Lancaster, Jack/F-2994-2010; Kochunov, Peter/E-4711-2010; Laird, Angela/B-5800-2010; Fox, Peter/B-4725-2010 OI Fox, Peter/0000-0002-0465-2028; Smith, Stephen/0000-0001-8166-069X FU NCRR NIH HHS [RR019771]; NIA NIH HHS [AG021431, P50 AG 16570]; NIBIB NIH HHS [EB01651]; NIDA NIH HHS [P20 MH/ DA52176]; NIMH NIH HHS [MH066029]; NLM NIH HHS [LM05639] NR 62 TC 130 Z9 131 U1 0 U2 9 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 APR 1 PY 2007 VL 35 IS 2 BP 478 EP 487 DI 10.1016/j.neuroimage.2006.12.021 PG 10 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 151LY UT WOS:000245293100004 PM 17292629 ER PT J AU Xu, GL Liu, XF Meyer, JS Yin, Q Zhang, RL AF Xu, Gelin Liu, Xinfeng Meyer, John Stirling Yin, Qin Zhang, Renliang TI Cognitive performance after carotid angioplasty and stenting with brain protection devices SO NEUROLOGICAL RESEARCH LA English DT Article DE angioplasty; carotid stenosis; cognition; psychometrics; stroke ID PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; TRANSCRANIAL DOPPLER; ENDARTERECTOMY; IMPAIRMENT; RECONSTRUCTION; PERFUSION; DEMENTIA; STENOSIS; DISEASE; SURGERY AB Objective: Neuropsychological outcomes after carotid endarterectomy (CEA) have been investigated extensively. However, cognitive impacts of carotid angioplasty and stenting (CAS), an emerging alternative to CEA, have not been studied. This study is aimed at investigating pattern and degree of cognitive changes after CAS among patients with high-grade carotid stenosis. Patients and methods: Fifty-four patients with high-grade carotid artery stenosis and received elective CAS were followed. Sixty-six patients with similar medical conditions requiring carotid angiography (CAG) were enrolled as controls. Cognitive functions among patients in both groups were evaluated at baseline and follow-ups utilizing a battery of neuropsychometric tests. Results were analysed by inter-group and within-group comparisons. Results: There were no statistically significant differences between CAS and CAG patients regarding demographic characteristics, risk factors for stroke and baseline cognitive performance (p > 0.05). CAS patients performed significantly better than CAG patients in Rey auditory verbal learning tests (RAVLT) at week 1 (41.2 +/- 5.2 versus 37.4 +/- 4.0, p < 0.001) and week 12 follow-ups (43.3 +/- 7.7 versus 37.3 +/- 4.5, p < 0.001). Comparison of z score also indicated CAS patients improved significantly more than CAG patients in RAVLT at both weeks 1 (1.08 +/- 1.29 versus 0.25 +/- 0.99, p < 0.001) and 12 follow-ups (1.62 +/- 1.95 versus 0.05 +/- 1.02, p < 0.001). Conclusion: CAS patients demonstrated improvement in verbal memory after procedures. Correction of cerebral hypoperfusion and reduction of artery-to-artery embolization after CAS are postulated responsible for the cognitive improvement. C1 Nanjing Univ, Sch Med, Jinling Hosp, Dept Neurol, Nanjing 210002, Jiangsu, Peoples R China. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Michael E DeBakey Vet Adm Med Ctr, Cerebrovasc Res Lab, Houston, TX USA. RP Xu, GL (reprint author), Nanjing Univ, Sch Med, Jinling Hosp, Dept Neurol, 305 E Zhongshan Rd, Nanjing 210002, Jiangsu, Peoples R China. EM gelinxu@gmail.com OI Xu, Gelin/0000-0002-6194-0341 NR 29 TC 27 Z9 34 U1 0 U2 2 PU MANEY PUBLISHING PI LEEDS PA STE 1C, JOSEPHS WELL, HANOVER WALK, LEEDS LS3 1AB, W YORKS, ENGLAND SN 0161-6412 J9 NEUROL RES JI Neurol. Res. PD APR PY 2007 VL 29 IS 3 BP 251 EP 255 DI 10.1179/016164107X159216 PG 5 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 165JJ UT WOS:000246301100006 PM 17178010 ER PT J AU Vestri, HS Maianu, L Moellering, DR Garvey, WT AF Vestri, Helliner S. Maianu, Lidia Moellering, Douglas R. Garvey, W. Timothy TI Atypical antipsychotic drugs directly impair insulin action in adipocytes: Effects on glucose transport, lipogenesis, and antilipolysis SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE second-generation antipsychotics; adipocyte; insulin resistance; lipolysis; glucose transport; obesity ID PRIMARY CULTURED ADIPOCYTES; CLOZAPINE; RAT; SCHIZOPHRENIA; RESISTANCE; RECEPTORS; BRAIN; METABOLITES; RISPERIDONE; MECHANISMS AB Treatment with second-generation antipsychotics (SGAs) has been associated with weight gain and the development of diabetes mellitus, although the mechanisms are unknown. We tested the hypothesis that SGAs exert direct cellular effects on insulin action and substrate metabolism in adipocytes. We utilized two cultured cell models including 3T3-L1 adipocytes and primary cultured rat adipocytes, and tested for effects of SGAs risperidone (RISP), clozapine (CLZ), olanzapine (OLZ), and quetiapine (QUE), together with conventional antipsychotic drugs butyrophenone (BUTY), and trifluoperazine (TFP), over a wide concentration range from 1 to 500 mu M. The effects of antipsychotic drugs on basal and insulin-stimulated rates of glucose transport were studied at 3 h, 15 h, and 3 days. Both CLZ and OLZ (but not RISP) at doses as low as 5 mu M were able to significantly decrease the maximal insulin-stimulated glucose transport rate by similar to 40% in 3T3-L1 cells, whereas CLZ and RISP reduced insulin-stimulated glucose transport rates in primary cultured rat adipocytes by similar to 50-70%. Conventional drugs (BUTY and TFP) did not affect glucose transport rates. Regarding intracellular glucose metabolism, both SGAs (OLZ, QUE, RISP) and conventional drugs (BUTY and TFP) increased basal and/or insulin-stimulated glucose oxidation rates, whereas rates of lipogenesis were increased by CLZ, OLZ, QUE, and BUTY. Finally, rates of lipolysis in response to isoproterenol were reduced by the SGAs (CLZ, OLZ, QUE, RISP), but not by BUTY or TFP. These experiments demonstrate that antipsychotic drugs can differentially affect insulin action and metabolism through direct cellular effects in adipocytes. However, only SGAs were able to impair the insulin-responsive glucose transport system and to impair lipolysis in adipocytes. Thus, SGAs directly induce insulin resistance and alter lipogenesis and lipolysis in favor of progressive lipid accumulation and adipocyte enlargement. These effects of SGAs on adipocytes could explain, in part, the association of SGAs with weight gain and diabetes. C1 Univ Alabama, Dept Nutr Sci, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Vestri, HS (reprint author), Univ Alabama, Dept Nutr Sci, Webb 244,1675 Univ Blvd, Birmingham, AL 35294 USA. EM helliner@uab.edu FU NIDDK NIH HHS [DK-38765] NR 38 TC 85 Z9 88 U1 0 U2 7 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD APR PY 2007 VL 32 IS 4 BP 765 EP 772 DI 10.1038/sj.npp.1301142 PG 8 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 146SV UT WOS:000244955900003 PM 16823387 ER PT J AU McNeely, MJ Fujimoto, WY Leonetti, DL Tsai, EC Boyko, EJ AF McNeely, Marguerite J. Fujimoto, Wilfred Y. Leonetti, Donna L. Tsai, Elaine C. Boyko, Edward J. TI The association between birth weight and visceral fat in middle-age adults SO OBESITY LA English DT Article DE risk factors; type 2 diabetes; body composition; Asian Americans ID DIABETES-MELLITUS; BODY-COMPOSITION; YOUNG MEN; ADIPOSITY; OBESITY; GROWTH; RISK; CHILDHOOD; COHORT; FETAL AB Objective: Low birth weight, a proxy for fetal underdevelopment, is associated with increased risk of developing type 2 diabetes during adulthood. Low birth weight is also associated with central obesity, but little is known about the association between birth weight and visceral adiposity. The purpose of this study is to test the hypothesis that lower birth weight is associated with increased amounts of visceral fat in middle-age adults. Research Methods and Procedures: This is an observational study of 91 adults (58 men and 33 women) 40 +/- 6 years of age (mean standard deviation). Ethnicity was either Japanese American (79%) or non-Hispanic white (21%). Birth weight was obtained from State Departments of Health. Measurements included smoking status, BMI, and visceral (intra-abdominal) fat measured by computed tomography. Results: Visceral fat was not associated with birth weight after adjustment for age, sex, ethnicity, BMI, or smoking status (p = 0.76). There was no evidence that the association between birth weight and visceral fat varied by age, sex, or ethnicity. Discussion: We found no evidence that low birth weight is associated with increased visceral fat in middle-age adults. C1 Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA 98105 USA. Univ Washington, Dept Anthropol, Seattle, WA 98105 USA. Vet Affairs Puget Sound Hlth Care Syst, Vet Affairs Epidemiol Res & Informat Ctr, Seattle, WA USA. RP McNeely, MJ (reprint author), Univ Washington, Dept Med, Div Gen Internal Med, 4311 11th Ave NE,Suite 230, Seattle, WA 98105 USA. EM mcneely@u.washington.edu OI Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR-00037]; NHLBI NIH HHS [HL-49293]; NICHD NIH HHS [R24 HD042828-10, R24 HD042828]; NIDDK NIH HHS [DK-17047, DK-31170] NR 20 TC 11 Z9 11 U1 0 U2 0 PU NORTH AMER ASSOC STUDY OBESITY PI SILVER SPRING PA 8630 FENTON ST, SUITE 918, SILVER SPRING, MD 20910 USA SN 1071-7323 J9 OBESITY JI Obesity PD APR PY 2007 VL 15 IS 4 BP 816 EP 819 DI 10.1038/oby.2007.596 PG 4 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 157OI UT WOS:000245729300004 PM 17426314 ER PT J AU Grady, D Cohen, B Tice, J Krisof, M Olyaie, A Sawaya, GF AF Grady, Deborah Cohen, Beth Tice, Jeffrey Krisof, Margaret Olyaie, Azin Sawaya, George F. TI Ineffectiveness of sertraline for treatment of menopausal hot flushes - A Randomized controlled trial SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID POSTMENOPAUSAL WOMEN; BREAST-CANCER; DOUBLE-BLIND; FLASHES; VENLAFAXINE; PAROXETINE; ESTROGEN; METAANALYSIS; INSTRUMENT; FLUOXETINE AB OBJECTIVE: To estimate the effect of the selective serotonin reuptake inhibitor sertraline on hot flush frequency and severity in perimenopausal and postmenopausal women. METHODS: We performed a randomized, blinded, placebo-controlled trial in women aged 40 to 60 years with 14 or more hot flushes per week (N=99). Women were randomly assigned initially to daily oral sertraline (50 mg) or identical placebo for 2 weeks. if no substantial side effects were noted, the dose was increased to two tablets daily (100 mg sertraline or placebo) and continued for an additional 4 weeks. Hot flush frequency and severity were recorded on a daily diary. Hot flush score was calculated as frequency multiplied by severity. Participants also completed questionnaires addressing quality of life, menopausal symptoms, sleep quality, sexual function, mood, and side effects. RESULTS: After 6 weeks of treatment, hot flush frequency decreased similarly in both the placebo (38%) and sertraline (39%) groups (P=.94). Mean hot flush scores also decreased similarly in both groups (41% and 42%, respectively, P=.86). Compared with placebo, women in the sertraline group were more likely to report gastrointestinal complaints, dry mouth, and dizziness. Treatment with sertraline also resulted in greater worsening of scores on the Medical Outcomes Study (MOS) Short Form 36 standardized physical component and the global Female Sexual Function Index. Results were similar in women at least 80% adherent to study medication. CONCLUSION: Treatment with sertraline did not improve hot flush frequency or severity in generally healthy perimenopausal and postmenopausal women, but was associated with bothersome side effects. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00283192. C1 Univ Calif San Francisco, Womens Hlth Clin Res Ctr, San Francisco, CA 94115 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Grady, D (reprint author), Univ Calif San Francisco, Womens Hlth Clin Res Ctr, 1635 Divisadero St,Suite 600, San Francisco, CA 94115 USA. EM Deborah.Grady@ucsf.edu NR 24 TC 53 Z9 55 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD APR PY 2007 VL 109 IS 4 BP 823 EP 830 DI 10.1097/01.AOG.0000258278.73505.fa PG 8 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 195AI UT WOS:000248384500006 PM 17400842 ER PT J AU Groeneveld, PW Matta, MA Suh, JJ Yang, FF Shea, JA AF Groeneveld, Peter W. Matta, Mary A. Suh, Janice J. Yang, Feifei Shea, Judy A. TI Quality of life among implantable cardioverter-defibrillator recipients in the primary prevention therapeutic era SO PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY LA English DT Article DE defibrillators; implantable; quality of life ID HEART-FAILURE; TRIAL; ICD; MORBIDITY; MORTALITY; ATTITUDES; ANXIETY; SHOCKS AB Background: Although patients receiving implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden cardiac death are the fastest growing segment of the ICD recipient population, the quality-of-life (QOL) effects of the ICD among primary prevention patients are not well understood. The purpose of this study was to measure and compare the health-related QOL among primary and secondary prevention ICD recipients, and to determine predictive factors for high or low QOL in each group. Methods: Forty-five primary prevention and 75 secondary prevention ICD recipients receiving routine care in electrophysiology clinics within the University of Pennsylvania Health System were assessed using several well-validated general and ICD-specific QOL instruments. Results: Between primary and secondary prevention patients, there were no significant differences in EuroQol 5D (medians: 0.84 vs 0.84, P = 0.71), Health Utilities Index (medians: 0.88 vs 0.85, P = 0.95), Short Form-12 aggregate physical summary (means: 45 vs 46, P = 0.64), and Short Form-12 aggregate mental summary (means: 46 vs 47, P = 0.93) scores. Both primary and secondary prevention patients viewed their devices favorably according to the Florida Patient Acceptance Survey scale, with no significant differences between group means (80 vs 83, P = 0.71). However, substantial fractions of both primary and secondary prevention recipients had particular concerns about lifting (40%), sexual activity (19%), and driving (14%). Conclusions: QOL does not significantly differ between primary prevention and secondary prevention ICD recipients. Device recipients had comparable QOL to published, nationwide QOL estimates among non-ICD patients of similar age. The ICD was highly acceptable to most primary and secondary prevention patients. C1 Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Groeneveld, PW (reprint author), 1229 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM peter.groeneveld@va.gov NR 32 TC 35 Z9 35 U1 2 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0147-8389 J9 PACE JI PACE-Pacing Clin. Electrophysiol. PD APR PY 2007 VL 30 IS 4 BP 463 EP 471 DI 10.1111/j.1540-8159.2007.00694.x PG 9 WC Cardiac & Cardiovascular Systems; Engineering, Biomedical SC Cardiovascular System & Cardiology; Engineering GA 156IZ UT WOS:000245642600004 PM 17437568 ER PT J AU Quinones, MP Estrada, CA Jimenez, F Martinez, H Willmon, O Kuziel, WA Ahuja, SK Ahuja, SS AF Quinones, M. P. Estrada, C. A. Jimenez, F. Martinez, H. Willmon, O. Kuziel, W. A. Ahuja, S. K. Ahuja, S. S. TI CCL2-independent role of CCR2 in immune responses against Leishmania major SO PARASITE IMMUNOLOGY LA English DT Article DE chemokine; immunology; infection; parasite ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; CHEMOKINE RECEPTOR 2; RHEUMATOID-ARTHRITIS; DEFICIENT MICE; RECRUITMENT; INFECTION; DISEASE; CELLS; ATHEROSCLEROSIS AB The chemokine CCL2 (MCP-1) and its receptor CCR2 modulate leucocyte migration and T helper differentiation. CCL2 or CCR2 knockout (KO) mice have divergent phenotypes following infection with the intracellular parasite Leishmania major (L. major). Compared to wild-type (WT) mice, intra-dermally infected CCR2 KO mice in the L. major-resistant C57BL/6j background become susceptible and fail to generate protective Th1 responses. In contrast, subcutaneously infected CCL2 KO mice in the L. major-susceptible BALB/c background are resistant and exhibit reduced pathogenic Th2 responses. Here we explore two variables that may account for this contrasting outcome, namely background strain and route of infection. We found that the CCR2-null state, both in the BALB/c and the C57BL/6j background, was associated with increased susceptibility to intradermal or subcutaneous L. major infection. Notably, the CCL2-null state did not change the ability of C57BL/6j mice to mount protective responses following intradermal infection. Dual genetic inactivation of CCR2 and CCL2 in the L. major-resistant C57BL/6j background resulted in a shift to a susceptible phenotype analogous to that of CCR2 KO in the C57BL/6j background. We concluded that CCL2-independent effects of CCR2 are indispensable for the control of L. major infection and the generation of protective immune responses. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Prot Design Labs Inc, Fremont, CA USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Vet Adm Ctr Res AIDS & HIV Infect 1, San Antonio, TX USA. RP Ahuja, SS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, MC 7870,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM ahuja@uthscsa.edu FU NIAID NIH HHS [AI48644]; OMH OASH HHS [D52MP03115-01-0] NR 34 TC 14 Z9 14 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0141-9838 J9 PARASITE IMMUNOL JI Parasite Immunol. PD APR PY 2007 VL 29 IS 4 BP 211 EP 217 DI 10.1111/j.1365-3024.2006.00935.x PG 7 WC Immunology; Parasitology SC Immunology; Parasitology GA 147ER UT WOS:000244986700005 PM 17371458 ER PT J AU Kelly, PA Haidet, P AF Kelly, P. Adam Haidet, Paul TI Physician overestimation of patient literacy: A potential source of health care disparities SO PATIENT EDUCATION AND COUNSELING LA English DT Article; Proceedings Paper CT Annual Research and Teaching Forum of the American-Academy-on-Physician-and-Patient CY OCT, 2004 CL Indianapolis, IN SP Amer Acad Phys & Patient DE literacy; health disparities; patient-provider relationship; health knowledge; minority groups; measurement ID DIABETES PATIENTS; COMMUNICATION; ASSOCIATION AB Objective: To investigate physician overestimation of patient literacy level in a primary care setting. Methods: The study sample consisted of 12 non-academic primary care physicians and 100 patients from a U.S. Department of Veterans Affairs Hospital in Houston, Texas. Patient literacy level was measured on a 1-4 scale using the Rapid Estimate of Adult Literacy in Medicine (REALM). Physicians rated each patient's literacy level on a corresponding scale. Chi-square was used to test for association of patient race/ ethnicity and gender with: (1) patient REALM level and (2) discrepancy between patient REALM level and physician rating of patient literacy level. Results: Patient REALM level was not statistically significantly associated with patient race/ethnicity or gender. Physicians overestimated the REALM level for 54% of African American, 11% of white non-Hispanic, and 36% of other race/ethnicity patients (p < .01). Conclusion: Physicians commonly overestimate patients' literacy levels, and this apparently occurs more often with minority patients, and particularly with African Americans, than with white non-Hispanic patients. This discordance in estimation of patient's literacy level may be a source of disparities in health care. (c) 2006 Elsevier Ireland Ltd. All rights reserved. C1 Baylor Coll Med, US Dept Vet Affairs, Houston, TX 77030 USA. RP Kelly, PA (reprint author), Michael E DeBakey VA Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM pakelly@bcm.edu NR 17 TC 107 Z9 109 U1 3 U2 14 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0738-3991 J9 PATIENT EDUC COUNS JI Patient Educ. Couns. PD APR PY 2007 VL 66 IS 1 BP 119 EP 122 DI 10.1016/j.pec.2006.10.007 PG 4 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 154DR UT WOS:000245487500017 PM 17140758 ER PT J AU Chan, PLS Nutt, JG Holford, NHG AF Chan, Phylinda L. S. Nutt, John G. Holford, Nicholas H. G. TI Levodopa slows progression of Parkinson's disease. External validation by clinical trial simulation SO PHARMACEUTICAL RESEARCH LA English DT Article DE clinical trial simulation; DATATOP; disease progress model; ELLDOPA; Parkinson's disease; protective treatment ID BENEFIT FOLLOWING WITHDRAWAL; 1ST 4 YEARS; SINEMET CR; L-DOPA; PHARMACOKINETICS; STANDARD; BROMOCRIPTINE; MULTICENTER; MORTALITY; CARBIDOPA AB To externally validate the model predictions of a DATATOP cohort analysis through application of clinical trial simulation with the study design of the ELLDOPA trial. The stochastic pharmacokinetic-pharmacodynamic and disease progress model was developed from the large DATATOP cohort of patients followed for 8 years. ELLDOPA was designed to detect a difference between placebo and levodopa treated arms in the total Unified Parkinson's Disease Rating Scale (UPDRS) taken at baseline and following 2 weeks levodopa washout after 40 weeks of treatment. The total UPDRS response was simulated with different assumptions on levodopa effect (symptomatic with/without disease modifying capability) and washout speed of symptomatic effect. The observed results of ELLDOPA were similar to the model predictions assuming levodopa slows disease progression and has a slow washout of symptomatic effect. This simulation work confirmed the conclusion of the DATATOP analysis finding that levodopa slows disease progression. The simulation results also showed that a dose-related increased rate of progression in Parkinson's disease, obscured by symptomatic benefit, is very unlikely. Finally, the simulation results also shown that 2 weeks washout period was not adequate to completely eliminate the symptomatic benefits of levodopa. C1 Univ Auckland, Dept Pharmacol & Clin Pharmacol, Fac Med & Hlth Sci, Auckland 1, New Zealand. Portland VA Med Ctr, Dept Neurol & Physiol & Pharmacol, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Holford, NHG (reprint author), Univ Auckland, Dept Pharmacol & Clin Pharmacol, Fac Med & Hlth Sci, Private Bag 92019, Auckland 1, New Zealand. EM n.holford@auckland.ac.nz OI Holford, Nick/0000-0002-4031-2514 NR 33 TC 38 Z9 39 U1 0 U2 3 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0724-8741 J9 PHARM RES JI Pharm. Res. PD APR PY 2007 VL 24 IS 4 BP 791 EP 802 DI 10.1007/s11095-006-9202-3 PG 12 WC Chemistry, Multidisciplinary; Pharmacology & Pharmacy SC Chemistry; Pharmacology & Pharmacy GA 145UF UT WOS:000244890100018 PM 17308968 ER PT J AU Borello-France, DF Handa, VL Brown, MB Goode, P Kreder, K Scheufele, LL Weber, AM AF Borello-France, Diane F. Handa, Victoria L. Brown, Morton B. Goode, Patricia Kreder, Karl Scheufele, Laura L. Weber, Anne M. CA Pelvic Floor Disorders Network TI Pelvic-floor muscle function in women with pelvic organ prolapse SO PHYSICAL THERAPY LA English DT Article; Proceedings Paper CT 26th Annual Meeting of the American-Urogynecologic-Society CY SEP 15-17, 2005 CL Atlanta, GA SP Amer Urogynecol Soc ID LOWER URINARY-TRACT; CONTINENCE-SOCIETY; SEXUAL FUNCTION; INCONTINENCE; STRENGTH; POPULATION; STANDARDIZATION; TERMINOLOGY; SYMPTOMS AB Background and Purpose The purpose of this study was to determine whether pelvic organ prolapse severity, pelvic symptoms, quality of life, and sexual function differ based on pelvic-floor muscle function in women planning to have prolapse surgery. Subjects and Methods Three hundred seventeen women without urinary stress incontinence who were enrolled in a multicenter surgical trial were examined to determine pelvic-floor muscle function (by Brink scale score). The subjects were 61.6 +/- 10.2 ((X) over bar +/- - SD) years of age. Thirteen percent of the subjects had stage II (to the hymen) pelvic organ prolapse, 68% had stage III (beyond the hymen) prolapse, and 19% had stage IV (complete vaginal eversion) prolapse. Subjects with lowest (3-6) and highest (10-12) Brink scale scores were compared on prolapse severity, pelvic symptoms and bother, quality of life, and sexual function. Results Subjects with the highest Brink scores (n=75) had less advanced prolapse, smaller genital hiatus measurements, and less urinary symptom burden compared with those with the lowest Brink scores (n=56). The results indicated that pelvic-floor muscle function was not associated with condition-specific quality of life or sexual function. Discussion and Conclusion Although modestly clinically significant, better pelvic-floor muscle function was associated with less severe prolapse and urinary symptoms. C1 Duquesne Univ, Dept Phys Therapy, Pittsburgh, PA 15282 USA. Johns Hopkins Univ, Baltimore, MD USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. Univ Alabama, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Clin Program, Birmingham, AL USA. Univ Iowa, Dept Urol, Iowa City, IA 52242 USA. Johns Hopkins Bayview Med Ctr, Baltimore, MD USA. NICHHD, Pelv Floor Disorders Network, NIH, Bethesda, MD 20892 USA. RP Borello-France, DF (reprint author), Duquesne Univ, Dept Phys Therapy, 111 Hlth Sci Bldg, Pittsburgh, PA 15282 USA. EM borellofrance@duq.edu FU NICHD NIH HHS [U10 HD41248, U10 HD41269, U10 HD41261, U10 HD41268, U10 HD041261, U10 HD41267, U10 HD41263, U10 HD41250, U01 HD41249] NR 32 TC 11 Z9 12 U1 0 U2 3 PU AMER PHYSICAL THERAPY ASSOC PI ALEXANDRIA PA 1111 N FAIRFAX ST, ALEXANDRIA, VA 22314 USA SN 0031-9023 J9 PHYS THER JI Phys. Ther. PD APR PY 2007 VL 87 IS 4 BP 399 EP 407 DI 10.2522/ptj.20060160 PG 9 WC Orthopedics; Rehabilitation SC Orthopedics; Rehabilitation GA 150NM UT WOS:000245223500004 PM 17341510 ER PT J AU Bromley, E AF Bromley, Elizabeth TI Barriers to the appropriate clinical use of medications that improve the cognitive deficits of schizophrenia SO PSYCHIATRIC SERVICES LA English DT Review ID QUALITY-OF-LIFE; FOLLOW-UP; ECOLOGICAL VALIDITY; ALZHEIMERS-DISEASE; NEUROPSYCHOLOGICAL DEFICITS; 1ST-EPISODE SCHIZOPHRENIA; VOCATIONAL-REHABILITATION; NEUROCOGNITIVE DEFICITS; COMPROMISED INTELLECT; SUPPORTED EMPLOYMENT AB A high priority has been placed on developing medications to treat the cognitive deficits associated with schizophrenia, but less attention has been given to planning for appropriate use of these medications in practice. The cognitive deficits of schizophrenia present several complexities as a treatment target that may limit a clinician's ability to prescribe cognitive enhancers to the patients who need them and to monitor for improvements in outcomes. In this review the neuropsychological evidence regarding cognition and functioning is discussed with a view toward how this evidence might guide clinicians' prescribing practices. Three challenges regarding the use of cognitive enhancers in schizophrenia are discussed. First, laboratory constructs of cognition are not equivalent to cognitive skills and behaviors seen in the clinic. The evidence generated in clinical trials of cognitive enhancers may have uncertain ecological validity. Second, objective scores on cognitive tests often do not match clinicians' and patients' perceptions of cognitive deficits. Mismatch between objective and subjective assessments of cognition may complicate the monitoring of medication. Third, although reductions in disability are desired outcomes of cognitive enhancement, clinicians may not be able to rely on assessments of patients' functional status to determine whether cognition medications are effective. In summary, data on the clinical meaning of neuropsychological constructs, careful selection of outcome measures for randomized clinical trials, and effectiveness trials could help ensure that cognition-enhancing medications can be appropriately prescribed in usual practice settings to the patients who can benefit from them. C1 Univ Calif Los Angeles, Semel Inst, Hlth Serv Res Ctr, Los Angeles, CA 90024 USA. RP Bromley, E (reprint author), W Los Angeles Vet Affairs Med Ctr, MIRECC, 11301 Wilshire Blvd,Bldg 210A, Los Angeles, CA 90073 USA. EM ebromley@ucla.edu NR 106 TC 7 Z9 7 U1 4 U2 7 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 APR PY 2007 VL 58 IS 4 BP 475 EP 481 DI 10.1176/appi.ps.58.4.475 PG 7 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 154JQ UT WOS:000245503400010 PM 17412848 ER PT J AU Shi, LZ Ascher-Svanum, H Zhu, BJ Faries, D Montgomery, W Marder, SR AF Shi, Lizheng Ascher-Svanum, Haya Zhu, Baojin Faries, Douglas Montgomery, William Marder, Stephen R. TI Characteristics and use patterns of patients taking first-generation depot antipsychotics or oral antipsychotics for schizophrenia SO PSYCHIATRIC SERVICES LA English DT Article ID MEDICATION COMPLIANCE; ADHERENCE; CARE; STRATEGIES; DISORDERS; GUIDELINE; OUTCOMES; SYSTEM; COSTS; SCALE AB Objective: Investigators compared patient characteristics and antipsychotic use patterns between individuals with schizophrenia treated in usual care with first-generation depot antipsychotics and those treated with oral antipsychotics (first- or second-generation or both). Methods: Analyses used data from the U. S. Schizophrenia Care and Assessment Program, a large, prospective study of treatment for schizophrenia conducted July 1997 through September 2003. Participants were assessed at enrollment and every six months thereafter with patient self-report, validated psychiatric measures, and systematic extraction of medical records. Individuals treated with a first- generation depot antipsychotic at any time during the three-year study (N=569) were compared with those treated with only oral antipsychotics (N=1,617) on characteristics at enrollment and medication use pattern during the year after enrollment. Results: Compared with patients receiving only oral antipsychotics, participants treated with depot medications ( haloperidol or fluphenazine decanoate) were more likely to be African American (p <.001); less likely to be a veteran (p=. 005); had more psychiatric hospitalizations in the year before enrollment (p <.001); and were more likely to have been arrested (p <.001), to use alcohol and illicit substances (p <.001), and to show higher psychopathology, particularly psychotic symptoms and disorganized thinking (p <.01 for both). In the year after enrollment, participants treated with depot medications had a high mean medication possession ratio (91%), and most of the medication regimens (68%) were augmented with oral antipsychotics for prolonged durations (median of 144 days). Conclusion: Patients with schizophrenia treated with first-generation depot antipsychotics differed from those treated with only oral antipsychotics. Findings suggest that first- generation depot antipsychotics might address some unmet needs of a unique subgroup of patients with schizophrenia. C1 Tulane Univ, Sch Publ Hlth & Trop Med, Dept Hlth Syst Management, New Orleans, LA 70112 USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Shi, LZ (reprint author), Tulane Univ, Sch Publ Hlth & Trop Med, Dept Hlth Syst Management, 1440 Canal St,Suite 1900, New Orleans, LA 70112 USA. EM lshi1@tulane.edu NR 34 TC 62 Z9 62 U1 0 U2 2 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 APR PY 2007 VL 58 IS 4 BP 482 EP 488 DI 10.1176/appi.ps.58.4.482 PG 7 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 154JQ UT WOS:000245503400011 PM 17412849 ER PT J AU Niv, N Cohen, AN Sullivan, G Young, AS AF Niv, Noosha Cohen, Amy N. Sullivan, Greer Young, Alexander S. TI The MIRECC version of the global assessment of functioning scale: Reliability and validity SO PSYCHIATRIC SERVICES LA English DT Article ID IV AXIS-V; DSM-IV; QUALITY-ASSURANCE; OUTCOMES; GAF; SCHIZOPHRENIA; INTERVIEW; RATINGS; SYSTEM; CARE AB Objective: This study examined the reliability and convergent, discriminant, and predictive validity of the Mental Illness Research, Education, and Clinical Center (MIRECC) version of the Global Assessment of Functioning (GAF) scale. The MIRECC GAF measures occupational functioning, social functioning, and symptom severity on three subscales. Methods: MIRECC GAF ratings were obtained for 398 individuals with schizophrenia or schizoaffective disorder who were receiving treatment at three Veterans Affairs mental health clinics. Assessments were completed by using the Positive and Negative Syndrome Scale and the Quality of Life Interview at baseline and nine months later. Results: All three MIRECC GAF subscales exhibited very high levels of reliability. The occupational and symptom subscales showed good convergent and discriminant validity. The social subscale was related to measures of social functioning and, to a greater degree, symptom severity. The occupational and social subscales significantly predicted their respective domains at the nine-month follow-up. The symptom subscale predicted negative symptoms at follow-up; however, it did not predict positive symptoms or cognitive disorientation. Instead, the social subscale was predictive of cognitive disorientation at follow-up. When the standard GAF was routinely administered by clinicians, scores demonstrated little validity. Conclusions: The three MIRECC GAF subscales can be scored reliably, and they have good concurrent and predictive validity. Further work is needed on brief measures of patient functioning, especially measures of social functioning. C1 W Los Angeles VA, Vet Affairs Desert Pacific Mental Illness Res Edu, MIRECC, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. MIRECC, Vet Affairs S Cent, Little Rock, AR USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. RP Niv, N (reprint author), W Los Angeles VA, Vet Affairs Desert Pacific Mental Illness Res Edu, MIRECC, 11301 Wilshire Blvd210A, Los Angeles, CA 90073 USA. EM noosha23@yahoo.com RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NIMH NIH HHS [MH-068639] NR 22 TC 30 Z9 30 U1 2 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD APR PY 2007 VL 58 IS 4 BP 529 EP 535 DI 10.1176/appi.ps.58.4.529 PG 7 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 154JQ UT WOS:000245503400018 PM 17412856 ER PT J AU Balshi, SF Wolfinger, GJ Balshi, TJ AF Balshi, Stephen F. Wolfinger, Glenn J. Balshi, Thomas J. TI An examination of immediately loaded dental implant stability in the diabetic patient using resonance frequency analysis (RFA) SO QUINTESSENCE INTERNATIONAL LA English DT Article DE bone-implant interface; diabetes; immediate loading; implant stability; resonance frequency analysis; Teeth in a Day ID MELLITUS AB Objectives: To evaluate the stability of 18 immediately loaded Branemark System dental implants in an insulin-controlled, diabetic, 71-year old patient over the first 30 months after surgery, and to correlate this data with implant stability in healthy patients. Method and Materials: Stability measurements were taken using resonance frequency analysis on all implants at surgery placement and at 5 postsurgical examinations (1, 2, 3, 6, and 30 months). Results: All 18 implants remained in function after 2.5 years of follow-up. The mean stability of the implants decreased 12.7% during the first 30 days, a value twice as much as seen in the general population. After the first 30 days, the stability of the implants increased slightly over the next 60 days. After 30 months of follow-up, the mean implant stability continued to increase, however, not to a value equal to that of the initial measurement taken at the time of implant placement. Conclusion: Despite the metabolic differences seen in diabetic patients, an immediate loading protocol can be successful and result in osseointegration. C1 Prosthodont Intermedica, Inst Facial Esthet, Ft Washington, PA 19034 USA. CM Ceram USA, Mahwah, NJ USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Balshi, SF (reprint author), Prosthodont Intermedica, Inst Facial Esthet, 467 Penn Ave,Suite 201, Ft Washington, PA 19034 USA. EM balshi2@aol.com NR 26 TC 10 Z9 11 U1 0 U2 0 PU QUINTESSENCE PUBLISHING CO INC PI HANOVER PARK PA 4350 CHANDLER DRIVE, HANOVER PARK, IL 60133 USA SN 0033-6572 J9 QUINTESSENCE INT JI Quintessence Int. PD APR PY 2007 VL 38 IS 4 BP 271 EP 279 PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 157BU UT WOS:000245694400002 PM 17432781 ER PT J AU MacMorris, M Kumar, M Lasda, E Larsen, A Kraemer, B Blumenthal, T AF MacMorris, Margaret Kumar, Madhur Lasda, Erika Larsen, Alison Kraemer, Brian Blumenthal, Thomas TI A novel family of C. elegans snRNPs contains proteins associated with trans-splicing SO RNA-A PUBLICATION OF THE RNA SOCIETY LA English DT Article DE trans-splicing; operons; Caenorhabditis; SL snRNP; SmY ID SPLICED LEADER RNA; NUCLEAR RIBONUCLEOPROTEIN-PARTICLES; CAENORHABDITIS-ELEGANS; SL2; ORGANIZATION; EXPRESSION; OPERONS; CSTF-64; FORM; SUUM AB In many Caenorhabditis elegans pre-mRNAs, the RNA sequence between the 5' cap and the first 3' splice site is replaced by trans-splicing a short spliced leader (SL) from the Sm snRNP, SL1. C. elegans also utilizes a similar Sm snRNP, SL2, to trans-splice at sites between genes in polycistronic pre-mRNAs from operons. How do SL1 and SL2 snRNPs function in different contexts? Here we show that the SL1 snRNP contains a complex of SL75p and SL21p, which are homologs of novel proteins previously reported in the Ascaris SL snRNP. Interestingly, we show that the SL2 snRNP does not contain these proteins. However, SL75p and SL26p, a paralog of SL21p, are components of another Sm snRNP that contains a novel snRNA species, Sm Y. Knockdown of SL75p is lethal. However, knockdown of either SL21p or SL26p alone leads to cold-sensitive sterility, whereas knockdown of both SL21p and SL26p is lethal. This suggests that these two proteins have overlapping functions even though they are associated with different classes of snRNP. These phenotypic relationships, along with the association of SL26p with SL75p, imply that, like the SL1 RNA/Sm/SL75p/SL21p complex, the Sm Y/Sm/SL75p/SL26p complex is associated with trans-splicing. C1 Univ Colorado, Dept Mol Cellular & Dev Biol, Boulder, CO 80309 USA. Univ Colorado, Sch Med, Dept Biochem & Mol Genet, Aurora, CO 80045 USA. Univ Colorado, Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Boulder, CO 80309 USA. RP Blumenthal, T (reprint author), Univ Colorado, Dept Mol Cellular & Dev Biol, Boulder, CO 80309 USA. EM tom.blumenthal@colorado.edu FU NIA NIH HHS [P01 AG17586, P01 AG017586]; NIGMS NIH HHS [R01 GM42432, R01 GM042432] NR 27 TC 28 Z9 32 U1 0 U2 2 PU COLD SPRING HARBOR LAB PRESS, PUBLICATIONS DEPT PI WOODBURY PA 500 SUNNYSIDE BLVD, WOODBURY, NY 11797-2924 USA SN 1355-8382 J9 RNA JI RNA-Publ. RNA Soc. PD APR PY 2007 VL 13 IS 4 BP 511 EP 520 DI 10.1261/rna.426707 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 149QI UT WOS:000245161300008 PM 17283210 ER PT J AU Morgenthaler, T Alessi, C Friedman, L Owens, J Kapur, V Boehlecke, B Brown, T Chesson, A Coleman, J Lee-Chiong, T Pancer, J Swick, TJ AF Morgenthaler, Timothy Alessi, Cathy Friedman, Leah Owens, Judith Kapur, Vishesh Boehlecke, Brian Brown, Terry Chesson, Andrew, Jr. Coleman, Jack Lee-Chiong, Teofilo Pancer, Jeffrey Swick, Todd J. TI Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: An update for 2007 SO SLEEP LA English DT Review DE circadian rhythms; actigraphy; advanced sleep phase syndrome; delayed sleep phase syndrome; shift work disorder ID NURSING-HOME RESIDENTS; PLACEBO-CONTROLLED TRIAL; BRIGHT LIGHT TREATMENT; RESTLESS LEGS SYNDROME; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; FULL-TERM INFANTS; ALZHEIMERS-DISEASE; CIRCADIAN-RHYTHMS; MORNINGNESS-EVENINGNESS; POSTMENOPAUSAL WOMEN AB Background: Actigraphy is increasingly used in sleep research and the clinical care of patients with sleep and circadian rhythm abnormalities. The following practice parameters update the previous practice parameters published in 2003 for the use of actigraphy in the study of sleep and circadian rhythms. Methods: Based upon a systematic grading of evidence, members of the Standards of Practice Committee, including those with expertise in the use of actigraphy, developed these practice parameters as a guide to the appropriate use of actigraphy, both as a diagnostic tool in the evaluation of sleep disorders and as an outcome measure of treatment efficacy in clinical settings with appropriate patient populations. Recommendations: Actigraphy provides an acceptably accurate estimate of sleep patterns in normal, healthy adult populations and inpatients suspected of certain sleep disorders. More specifically, actigraphy is indicated to assist in the evaluation of patients with advanced sleep phase syndrome (ASPS), delayed sleep phase syndrome (DSPS), and shift work disorder. Additionally, there is some evidence to support the use of actigraphy in the evaluation of patients suspected of jet lag disorder and non-24hr sleep/wake syndrome (including that associated with blindness). When polysomnography is not available, actigraphy is indicated to estimate total sleep time in patients with obstructive sleep apnea. In patients with insomnia and hypersomnia, there is evidence to support the use of actigraphy in the characterization of circadian rhythms and sleep patterns/ disturbances. In assessing response to therapy, actigraphy has proven useful as an outcome measure in patients with circadian rhythm disorders and insomnia. In older adults (including older nursing home residents), in whom traditional sleep monitoring can be difficult, actigraphy is indicated for characterizing sleep and circadian patterns and to document treatment responses. Similarly, in normal infants and children, as well as special pediatric populations, actigraphy has proven useful for delineating sleep patterns and documenting treatment responses. Conclusions: Recent research utilizing actigraphy in the assessment and management of sleep disorders has allowed the development of evidence-based recommendations for the use of actigraphy in the clinical setting. Additional research is warranted to further refine and broaden its clinical value. C1 Mayo Clin, Rochester, MN USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst Sepulveda, Los Angeles, CA USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Brown Univ, Rhode Isl Hosp, Providence, RI 02903 USA. Univ Washington, Seattle, WA 98195 USA. Univ N Carolina, Chapel Hill, NC 27515 USA. St Joseph Mem Hosp, Murphysboro, IL USA. LSU Hlth Sci Ctr, Shreveport, LA USA. Murfreesboro Med Ctr, Murfreesboro, TN USA. Natl Jewish Med & Res Ctr, Denver, CO USA. Houston Sleep Ctr, Houston, TX USA. RP Morgenthaler, T (reprint author), Amer Acad Sleep Med, Stand Practice Comm, 1 Westbrook Corp Ctr,Suite 920, Westchester, IL 60154 USA. EM aasm@aasmnet.org RI Kapur, Vishesh/K-1054-2014 OI Kapur, Vishesh/0000-0002-5417-1097; Morgenthaler, Timothy/0000-0002-2614-3793 NR 117 TC 455 Z9 462 U1 9 U2 57 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 APR 1 PY 2007 VL 30 IS 4 BP 519 EP 529 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 160UA UT WOS:000245966600018 PM 17520797 ER PT J AU Basile, JN AF Basile, Jan N. TI Fixed-dose combination therapy in the treatment of hypertension: Ready for prime time SO SOUTHERN MEDICAL JOURNAL LA English DT Editorial Material ID BLOOD-PRESSURE C1 Med Univ S Carolina, Div Gen Internal Med Geriatr, Ralph H Johnson VA Med Ctr, Primary Care Serv Line, Charleston, SC 29401 USA. RP Basile, JN (reprint author), Med Univ S Carolina, Div Gen Internal Med Geriatr, Ralph H Johnson VA Med Ctr, Primary Care Serv Line, 109 Bee St, Charleston, SC 29401 USA. EM jan.basile@med.va.gov NR 7 TC 2 Z9 2 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 APR PY 2007 VL 100 IS 4 BP 343 EP 344 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 172AX UT WOS:000246777600003 PM 17458389 ER PT J AU Wong, E Rosen, LS Mulay, M VanVugt, A Dinolfo, M Tomoda, C Sugawara, M Hershman, JM AF Wong, Elaine Rosen, Lee S. Mulay, Marilyn VanVugt, Andy Dinolfo, Melissa Tomoda, Chisato Sugawara, Masahiro Hershman, Jerome M. TI Sunitinib induces hypothyroidism in advanced cancer patients and may inhibit thyroid peroxidase activity SO THYROID LA English DT Article ID TYROSINE KINASE INHIBITOR; ENDOTHELIAL GROWTH-FACTOR; IN-VIVO; ANGIOGENESIS; SU11248 AB Objective: Sunitinib is a novel tyrosine kinase inhibitor with antitumor and antiangiogenic effects. An observed higher than expected rate of hypothyroidism in sunitinib-treated patients prompted assessment of the incidence of hypothyroidism. Design: Patients taking sunitinib had their thyroid function tests (TFTs) assessed via chart review. To explore potential effects on the thyroid, we examined the antiperoxidase activity of sunitinib by in vitro testing its effect on guaiacol oxidation and protein iodination by lactoperoxidase. Main outcome: Of the 89 patients who took sunitinib, 49 patients were excluded from analysis for several reasons. Of the remaining 40 patients, 21 (53%, 24% of the original 89) developed elevated thyrotropin (TSH) after a median of 5 months ( range 1 - 36 months). Median TSH was 21.4 mU/L ( range 4.6 - 174 mU/L). In vitro, sunitinib had antiperoxidase activity that was about one-fourth the potency of propylthiouracil. Conclusions: Of the 40 patients who had TFTs assessed after starting sunitinib, 53% developed elevated TSH. We recommend that all patients treated with sunitinib be monitored for hypothyroidism. The mechanism of the antithyroid effect appears to be inhibition of peroxidase activity. Further research is needed to confirm the mechanism by which sunitinib induces hypothyroidism. C1 Vet Adm Greater Los Angeles Healthcare Syst, Dept Endocrinol & Diabet, Los Angeles, CA USA. Premiere Oncol, Los Angeles, CA USA. RP Hershman, JM (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,111-D, Los Angeles, CA 90073 USA. EM jerome.hershman@va.gov NR 14 TC 113 Z9 115 U1 0 U2 4 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 APR PY 2007 VL 17 IS 4 BP 351 EP 355 DI 10.1089/thy.2006.0308 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 165AN UT WOS:000246276300010 PM 17465866 ER PT J AU Markland, AD Thompson, IM Ankerst, DP Higgins, B Kraus, SR AF Markland, Alayne D. Thompson, Ian M. Ankerst, Donna P. Higgins, Betsy Kraus, Stephen R. TI Lack of disparity in lower urinary tract symptom severity between community-dwelling non-Hispanic white, Mexican-American, and African-American men SO UROLOGY LA English DT Article ID BENIGN PROSTATIC HYPERPLASIA; NUTRITION EXAMINATION SURVEY; CHRONIC-RENAL-FAILURE; 3RD NATIONAL-HEALTH; NATURAL-HISTORY; ASSOCIATION; PROGRESSION; PREVALENCE; DISEASE; BLACK AB OBJECTIVES To determine whether disparities exist in the reporting of lower urinary tract symptoms (LUTS) in non-Hispanic white (NHW), Mexican-American (MA), and African-American (AA) men. METHODS Data were collected from a prospective, community-based cohort assembled to study risk factors associated with prostate cancer. Measures included demographics, pros tate-specific antigen (PSA), body mass index (BMI), and family history of prostate cancer. Lower urinary tract symptom severity was assessed in 2804 men (1485 NHW, 964 MA, 355 AA) without prostate cancer according to the American Urological Association Symptom Index. RESULTS No significant difference (P = 0.998) was seen in the prevalence of moderate or severe LUTS in NHW (34%), MA (34%), and AA (33%) men. No differences were found in either obstructive or irritative symptoms among the three groups. Age, PSA level, BMI, and family history did not affect symptom severity. CONCLUSIONS Rates of moderate to severe LUTS symptoms in this cohort were similar to those in other community-based populations of NHW men. Lower rates of moderate or severe symptoms were noted in AA men than previously reported. Mexican-American men had similar degrees of LUTS as the general population, and with their increased risk for diabetes and renal disease, in-depth study of this population is warranted. C1 Univ Texas, Hlth Sci Ctr, Dept Urol, San Antonio, TX 78229 USA. Univ Alabama, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Birmingham, AL USA. San Antonio Canc Inst, San Antonio Ctr Biomarkers Risk Prostate Canc, San Antonio, TX USA. RP Kraus, SR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Urol, 7703 Floyd Curl Dr,MC 7845, San Antonio, TX 78229 USA. EM krauss@uthscsa.edu FU NCI NIH HHS [U01 CA086402, 5U01CA86402-04, U01 CA086402-05] NR 20 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 0090-4295 J9 UROLOGY JI Urology PD APR PY 2007 VL 69 IS 4 BP 697 EP 702 DI 10.1016/j.urology.2007.01.024 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 167TK UT WOS:000246474800023 PM 17445654 ER PT J AU King, CR Freedland, SJ Terris, MK Aronson, WJ Kane, CJ Amling, CL Presti, JC AF King, Christopher R. Freedland, Stephen J. Terris, Martha K. Aronson, William J. Kane, Christopher J. Amling, Christopher L. Presti, Joseph C., Jr. TI Optimal timing, cutoff, and method of calculation of preoperative prostate-specific antigen velocity to predict relapse after prostatectomy: A report from SEARCH SO UROLOGY LA English DT Article ID RADICAL PROSTATECTOMY; PSA VELOCITY; DOUBLING TIME; CANCER; INTERVAL AB OBJECTIVES Preoperative prostate-specific antigen (PSA) velocity (PSAV), the rate of PSA rise preceding diagnosis, predicts for relapse and cancer death after prostatectomy or radiotherapy. We studied the timing, cutoff levels, and method of calculation to better define its usefulness. METHODS The rates of biochemical relapse were examined in 471 patients who underwent radical prostatectomy (RP) with previous PSA history available. PSAV was calculated by two methods, as the difference between two PSAs divided by time, or as the slope of all available PSAs within that interval. Kaplan-Meier relapse-free survival was compared among the groups with various intervals and cutoff levels in their preoperative PSAV definition. Univariate and multivariate analysis examined all preoperative factors and PSAV for their association with relapse. RESULTS The two methods of PSAV calculation yielded values within 5% of each other (R-2 = 0.91). A PSA history that precedes RP by at least 12 months is necessary. A PSAV cutoff level of 2 ng/mL/yr or less versus greater than 2 ng/mL/yr appeared optimal for a PSA interval spanning 12 to 24 months before RP (P = 0.008). PSAV using a longer interval (24 to 36 months) before RP appeared more sensitive, with a cutoff of I ng/mL/yr or less versus greater than 1 ng/mL/yr (P = 0.029) and 2 ng/mL/yr or less versus greater than 2 ng/mL/yr (P = 0.0041) associated with relapse. A preoperative PSAV of 2 ng/mL/yr or less versus greater than 2 ng/mL/yr was an independent factor associated with the risk of relapse after RP. CONCLUSIONS The results of our study have shown that preoperative PSAV is independently associated with relapse after RP. However, a minimum interval of 12 months before RP is needed, and a PSAV cutoff level of 2 ng/mL/yr appears optimal. A simple two-point method of calculating PSAV is reliable. UROLOGY 69: 732-737, 2007.(C) 2007 Elsevier Inc. C1 Stanford Univ, Sch Med, Dept Radiat Oncol, Div Urol Oncol, Stanford, CA 94305 USA. Vet Affairs Med Ctr, Dept Surg, Urol Sect, Durham, NC USA. Duke Univ, Sch Med, Div Urol Surg, Durham, NC USA. Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. Vet Affairs Med Ctr, Dept Surg, Augusta, GA USA. Univ Calif Los Angeles, Dept Urol, Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Dept Surg, Los Angeles, CA USA. Univ Calif San Francisco, Dept Urol, Sch Med, San Francisco, CA 94143 USA. Vet Affairs Med Ctr, Urol Sect, Dept Surg, San Francisco, CA 94121 USA. Univ Alabama, Dept Urol, Birmingham, AL USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Stanford Univ, Sch Med, Dept Urol, Div Urol Oncol, Stanford, CA 94305 USA. Vet Affairs Med Ctr, Dept Surg, Urol Sect, Palo Alto, CA 94304 USA. RP King, CR (reprint author), Stanford Univ, Sch Med, Dept Radiat Oncol, Div Urol Oncol, 875 Blake Wilbur Dr, Stanford, CA 94305 USA. EM crking@stanford.edu OI Terris, Martha/0000-0002-3843-7270 NR 12 TC 17 Z9 17 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 APR PY 2007 VL 69 IS 4 BP 732 EP 737 DI 10.1016/j.urology.2007.01.019 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 167TK UT WOS:000246474800029 PM 17445660 ER PT J AU Nathan, RV AF Nathan, Ramesh V. TI Suspected immune reconstitution inflammatory syndrome associated with the proliferation of Kaposi's sarcoma during HAART SO AIDS LA English DT Letter ID ANTIRETROVIRAL THERAPY; PROTEASE INHIBITOR; REGRESSION C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Infect Dis, Los Angeles, CA 90073 USA. RP Nathan, RV (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Infect Dis, Los Angeles, CA 90073 USA. NR 8 TC 8 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD MAR 30 PY 2007 VL 21 IS 6 BP 775 EP 775 DI 10.1097/QAD.0b013e3280ad3da6 PG 1 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 156HA UT WOS:000245637500020 PM 17413703 ER PT J AU Sharma, A Masri, J Jo, OD Bernath, A Martin, J Funk, A Gera, J AF Sharma, Anushree Masri, Janine Jo, Oak D. Bernath, Andrew Martin, Jheralyn Funk, Alexander Gera, Joseph TI Protein kinase C regulates internal initiation of translation of the GATA-4 mRNA following vasopressin-induced hypertrophy of cardiac myocytes SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID RIBOSOME ENTRY SITES; TRANS-ACTING FACTORS; GENE-EXPRESSION; TRANSCRIPTION FACTORS; MEDIATED TRANSLATION; IN-VITRO; PRESSURE-OVERLOAD; AKT ACTIVITY; CYCLIN D1; PHOSPHORYLATION AB GATA-4 is a key member of the GATA family of transcription factors involved in cardiac development and growth as well as in cardiac hypertrophy and heart failure. Our previous studies suggest that GATA-4 protein synthesis may be translationally regulated. We report here that the 518-nt long 5'-untransiated region (5'-UTR) of the GATA-4 mRNA, which is predicted to form stable secondary structures (-65 kcal/mol) such as to be inhibitory to cap-dependent initiation, confers efficient translation to monocistronic reporter mRNAs in cell-free extracts. Moreover, uncapped GATA-4 5'-UTR containing monocistronic reporter mRNAs continue to be well translated while capped reporters are insensitive to the inhibition of initiation by cap-analog, suggesting a capin-dependent mechanism of initiation. Utilizing a dicistronic luciferase mRNA reporter containing the GATA-4 5'-UTR within the intercistrionic region, we demonstrate that this leader sequence confers functional internal ribosome entry site (IRES) activity. The activity of the GATA-4 IRES is unaffected in trans - differentiating P19CL6 cells, however, is strongly stimulated immediately following arginine-vasopressin exposure of H9c2 ventricular myocytes. IRES activity is then maintained at submaximal levels during hypertrophic growth of these cells. Supraphysiological Ca(2+) levels diminished stimulation of IRES activity immediately following exposure to vasopressin and inhibition of protein kinase C activity utilizing a pseudosubstrate peptide sequence blocked IRES activity during hypertrophy. Thus, our data suggest a mechanism for GATA-4 protein synthesis under conditions of reduced global cap-dependent translation, which is maintained at a submaximal level during hypertrophic growth and point to the regulation of GATA-4 IRES activity by sarco(ER)reticular Ca(2+) stores and PKC. C1 Greater Los Angels Vet Affairs Healthcare Syst, Dept Res & Dev, Los Angeles, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90048 USA. RP Gera, J (reprint author), Greater Los Angels Vet Affairs Healthcare Syst, Dept Res & Dev, Los Angeles, CA 91343 USA. EM gera@ucla.edu FU NCI NIH HHS [CA109312] NR 57 TC 13 Z9 15 U1 2 U2 5 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 MAR 30 PY 2007 VL 282 IS 13 BP 9505 EP 9516 DI 10.1074/jbc.M608874200 PG 12 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 153HA UT WOS:000245421700023 PM 17284439 ER PT J AU Zhao, JB Wecht, JM Zhang, YF Wen, XL Zeman, R Bauman, WA Cardozo, C AF Zhao, Jingbo Wecht, Jill M. Zhang, Yuanfei Wen, Xialing Zeman, Richard Bauman, William A. Cardozo, Christopher TI iNOS expression in rat aorta is increased after spinal cord transection: A possible cause of orthostatic hypotension in man SO NEUROSCIENCE LETTERS LA English DT Article DE orthostatic hypotension; nitric oxide; inducible nitric oxide synthase; spinal cord injury ID NITRIC-OXIDE SYNTHASE; HEAD-UP TILT; SIMULATED MICROGRAVITY; TETRAPLEGIC MAN; INJURY; GENE; INTOLERANCE AB Orthostatic hypotension commonly occurs in persons with spinal cord injury (SCI), limiting rehabilitation and independence. Findings of increased production of nitric oxide (NO) by inducible nitric oxide synthase (iNOS) after exposure to simulated microgravity suggest that increased iNOS expression contributes to OH in persons with SCI. To test this possibility, male Wistar rats underwent surgical transection of the spinal cord (T 10) or sham-SCI surgery followed by euthanasia 3, 7 or 14 days later. Expression in thoracic aortic of inducible (iNOS), endothelial (eNOS) and neuronal (nNOS) NOS was then determined. In SCI rats, expression of iNOS mRNA was decreased at 3 days, had returned to normal levels of expression at 7 days and was increased at 14 days post-SCI (1.8-fold). In contrast, levels of eNOS mRNA were increased at 3 days (1.4-fold), then declined over time reaching levels by day 14 that were reduced compared to sham-SCI (0.23-fold). There were no significant effects of SCI on nNOS expression. These findings suggest a possible role for increased iNOS expression in the pathogenesis of OH in persons with SCI. (c) 2007 Elsevier Ireland Ltd. All rights reserved. C1 James J Peters VA Med Ctr, VA RR&D Ctr Excellence, Ctr Excellence Med Consequences Spinal Cord Injur, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. Mt Sinai Sch Med, Dept Rehabil Med, New York, NY USA. New York Med Coll, Dept Cell Biol & Anat, Valhalla, NY 10595 USA. RP Cardozo, C (reprint author), James J Peters VA Med Ctr, VA RR&D Ctr Excellence, Ctr Excellence Med Consequences Spinal Cord Injur, Room 1E-02, Bronx, NY 10468 USA. EM chris.cardozo@mssm.edu RI Zeman, Richard/A-9295-2009 NR 30 TC 5 Z9 6 U1 1 U2 4 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 MAR 30 PY 2007 VL 415 IS 3 BP 210 EP 214 DI 10.1016/j.neulet.2007.01.025 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 158CM UT WOS:000245768600004 PM 17287083 ER PT J AU Reichenberg, A Smith, C Schmeidler, J Silverman, JM AF Reichenberg, Abraham Smith, Christopher Schmeidler, James Silverman, Jeremy M. TI Birth order effects on autism symptom domains SO PSYCHIATRY RESEARCH LA English DT Article DE pervasive developmental disorders; autism diagnostic interview; speech; siblings; first vs. second born ID PERVASIVE DEVELOPMENTAL DISORDER; MULTIPLEX FAMILIES; NONVERBAL IQ; INDIVIDUALS; INTERVIEW; PARENTS AB Autism is predominantly genetically determined. Evidence supports familiality of the main sets of behavioral characteristics that define the syndrome of autism; however, possible non-genetic effects have also been suggested. The present study compared levels of autism symptom domains, as measured by the Autism Diagnostic Interview, and useful phrase speech scores between 106 pairs of first- and second-born siblings from multiply affected families. In addition, the intercorrelations between the measures were compared between siblings. The overall mean repetitive behavior total score was significantly higher (worse) in first-born than in second-born siblings. In contrast, first-born siblings had significantly lower (better) useful phrase speech than their younger siblings. Autism social and non-verbal communication scores were significantly correlated in first- and in second-born siblings. However, there was a significant difference in the coefficients between first- and second-born siblings. Performance on the non-verbal communication domain was also significantly and positively correlated with useful phrase speech score in both first- and second-born siblings. It is unclear at this time whether these results are of biologic origin. Nevertheless, the findings suggest that genetic studies in autism using specific levels of familial autism traits as phenotypes should take into account their intercorrelations and birth order effects embedded in the instrument. (c) 2006 Elsevier Ireland Ltd. All rights reserved. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Adm Med Ctr, Psychiat Serv, Bronx, NY USA. Mt Sinai Sch Med, Dept Biomath Sci, New York, NY USA. RP Reichenberg, A (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1230,1 Gustave L Levy Pl, New York, NY 10029 USA. EM avi.reichenberg@mssm.edu NR 16 TC 12 Z9 12 U1 1 U2 9 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD MAR 30 PY 2007 VL 150 IS 2 BP 199 EP 204 DI 10.1016/j.psychres.2004.09.012 PG 6 WC Psychiatry SC Psychiatry GA 157HH UT WOS:000245708900011 PM 17289158 ER PT J AU Kahn, SE Viberti, G AF Kahn, Steven E. Viberti, Giancarlo CA ADOPT Steering Comm TI Glycemic durability of monotherapy for diabetes - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Kings Coll London Sch Med, London SE1 9RT, England. RP Kahn, SE (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. EM skahn@u.washington.edu NR 5 TC 1 Z9 1 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 29 PY 2007 VL 356 IS 13 BP 1380 EP 1380 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 150MN UT WOS:000245221000033 ER PT J AU Adams, SG Smith, PK Allan, PF Anzueto, A Pugh, JA Cornell, JE AF Adams, Sandra G. Smith, Paulla K. Allan, Patrick F. Anzueto, Antonio Pugh, Jacqueline A. Cornell, John E. TI Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management SO ARCHIVES OF INTERNAL MEDICINE LA English DT Review ID RANDOMIZED CONTROLLED TRIAL; RESPIRATORY HEALTH WORKER; SELF-MANAGEMENT; PATIENT EDUCATION; COPD PATIENTS; CLINICAL-TRIALS; CHRONIC ILLNESS; PROGRAM; METAANALYSIS; IMPACT AB Background: Implementation of the chronic care model (CCM) has been shown to be an effective preventative strategy to improve outcomes in diabetes mellitus, depression, and congestive heart failure, but data are lacking regarding the effectiveness of this model in preventing complications in patients with chronic obstructive pulmonary disease. Methods: We searched the MEDLINE, CINAHL, and Cochrane databases from inception to August 2005 and included English-language articles that enrolled adults with chronic obstructive pulmonary disease and (1) contained intervention(s) with CCM component(s), (2) included a comparison group or measures at 2 points (before/after), and (3) had relevant outcomes. Two reviewers independently extracted data. Results: Symptoms, quality of life, lung function, and functional status were not significantly different between the intervention and control groups. However, pooled relative risks (95% confidence intervals) for emergency/unscheduled visits and hospitalizations for the group that received at least 2 CCM components were 0.58 (0.42-0.79) and 0.78 (0.66-0.94), respectively. The weighted mean difference (95% confidence interval) for hospital stay was -2.51 (-3.40 to -1.61) days shorter for the group that received 2 or more components. There were no significant differences for those receiving only 1 CCM component. Conclusions: Limited published data exist evaluating the efficacy of CCM components in chronic obstructive pulmonary disease management. However, pooled data demonstrated that patients with chronic obstructive pulmonary disease who received interventions with 2 or more CCM components had lower rates of hospitalizations and emergency/unscheduled visits and a shorter length of stay compared with control groups. The results of this review highlight the need for well-designed trials in this population. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Div Pulm Dis Crit Care Med, San Antonio, TX 78285 USA. VERDICT, San Antonio, TX USA. Wilford Hall USAF Med Ctr, S Texas Vet Hlth Care Syst & Pulm Med, Geriatr Res Educ & Clin Ctr, San Antonio, TX USA. RP Adams, SG (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Pulm Dis Sect, 111E,7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM adamssg@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X NR 63 TC 167 Z9 172 U1 1 U2 19 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 MAR 26 PY 2007 VL 167 IS 6 BP 551 EP 561 DI 10.1001/archinte.167.6.551 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 149UQ UT WOS:000245172800005 PM 17389286 ER PT J AU Griffin, WC Middaugh, LD Becker, HC AF Griffin, William C., III Middaugh, Lawrence D. Becker, Howard C. TI Voluntary ethanol drinking in mice and ethanol concentrations in the nucleus accumbens SO BRAIN RESEARCH LA English DT Article DE alcohol; mouse; self-administration; lick; nucleus accumbens ID C57BL/6J MICE; EXTRACELLULAR DOPAMINE; MICRODIALYSIS PROBES; CONSUMPTION; NALTREXONE; REINFORCEMENT; WITHDRAWAL; GLUTAMATE; EXPOSURE; CUES AB The present study determined ethanol concentrations in the nucleus accumbens (NAcc) of C57BL/6J (136) mice voluntarily drinking ethanol using an established limited access paradigm. Lickometer circuits were employed to monitor the temporal pattern of consummatory behavior, and serial samples were collected from the NAcc using in vivo microdialysis techniques. Ethanol in the dialysate was measured by gas chromatography with flame ionization detection. During dialysis, mice preferentially consumed sufficient amounts of sweetened ethanol (similar to 3 g/kg ethanol) to produce low millimolar levels of ethanol in dialysates from the NAcc; water intake was negligible. overall, there was a positive relationship between total amount of ethanol consumed during the 2 h drinking session and cumulative (as well as peak) ethanol levels in NAcc. Additionally, and the total number of licking responses was positively correlated with the total amount of ethanol consumed. Moreover, the change in NAcc ethanol levels was temporally linked to the pattern of ethanol drinking, with periods of high licking responses on the ethanol tube preceding peak brain ethanol levels. The results indicate that the voluntary consumption of ethanol by B6 mice in a limited access time frame elevates ethanol concentration in NAcc dialysates in a manner consistent with the pattern of ethanol consumption. (c) 2007 Elsevier B.V. All rights reserved. C1 Med Univ S Carolina, Ctr Drug & Alcohol Program, Charleston Alcohol Res Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Griffin, WC (reprint author), Med Univ S Carolina, Ctr Drug & Alcohol Program, Charleston Alcohol Res Ctr, POB 250861, Charleston, SC 29425 USA. EM griffinw@musc.edu FU NIAAA NIH HHS [P50AA10761] NR 29 TC 11 Z9 11 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD MAR 23 PY 2007 VL 1138 BP 208 EP 213 DI 10.1016/j.brainres.2006.12.071 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 150QI UT WOS:000245230900022 PM 17275791 ER PT J AU Boockvar, K Meier, D AF Boockvar, Kenneth Meier, Diane TI Frail older adults and palliative care - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 James J Peters VA Med Ctr, Bronx, NY USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. RP Boockvar, K (reprint author), James J Peters VA Med Ctr, Bronx, NY USA. EM kenneth.boockvar@mssm.edu OI Boockvar, Kenneth/0000-0003-1165-5558 NR 2 TC 1 Z9 1 U1 0 U2 1 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 MAR 21 PY 2007 VL 297 IS 11 BP 1194 EP 1195 DI 10.1001/jama.297.11.1194-c PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 147XO UT WOS:000245039300021 ER PT J AU Ross, JS Lackner, JE Lurie, P Gross, CP Wolfe, S Krumholz, HM AF Ross, Joseph S. Lackner, Josh E. Lurie, Peter Gross, Cary P. Wolfe, Sidney Krumholz, Harlan M. TI Pharmaceutical company payments to physicians - Early experiences with disclosure laws in Vermont and Minnesota SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACADEMIC MEDICAL-CENTERS; INDUSTRY; DRUG; HOUSESTAFF AB Context Recent legislation in 5 states and the District of Columbia mandated state disclosure of payments made to physicians by pharmaceutical companies. In 2 of these states, Vermont and Minnesota, payment disclosures are publicly available. Objectives To determine the accessibility and quality of the data available in Vermont and Minnesota and to describe the prevalence and magnitude of disclosed payments. Design and Setting Cross-sectional analysis of publicly available data from July 1, 2002, through June 30, 2004, in Vermont and from January 1, 2002, through December 31, 2004, in Minnesota. Main Outcome Measures Accessibility and quality of disclosure data and the number, value, and type of payments of $100 or more to physicians. Results Access to payment data required extensive negotiation with the Office of the Vermont Attorney General and manual photocopying of individual disclosure forms at Minnesota's State Board of Pharmacy. In Vermont, 61% of payments were not released to the public because pharmaceutical companies designated them as trade secrets and 75% of publicly disclosed payments were missing information necessary to identify the recipient. In Minnesota, 25% of companies reported in each of the 3 years. In Vermont, among 12 227 payments totaling $2.18 million publicly disclosed, there were 2416 payments of $100 or more to physicians; total, $1.01 million; median payment, $177 (range, $100-$20 000). In Minnesota, among 6946 payments totaling $30.96 million publicly disclosed, there were 6238 payments of $100 or more to physicians; total, $22.39 million; median payment, $1000 (range, $100-$922239). Physician-specific analyses were possible only in Minnesota, identifying 2388 distinct physicians who received payment of $100 or more; median number of payments received, 1 (range, 1-88) and the median amount received, $1000 (range, $100-$1178203). Conclusions The Vermont and Minnesota laws requiring disclosure of payments do not provide easy access to payment information for the public and are of limited quality once accessed. However, substantial numbers of payments of $100 or more were made to physicians by pharmaceutical companies. C1 Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. Publ Citizen, Hlth Res Grp, Washington, DC USA. Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Med, Gen Internal Med Sect, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adv, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. RP Ross, JS (reprint author), Mt Sinai Sch Med, Dept Geriatr & Adult Dev, 1 Gustave L Levy Pl,POB 1070, New York, NY 10029 USA. EM joseph.ross@mssm.edu NR 17 TC 50 Z9 50 U1 0 U2 1 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 MAR 21 PY 2007 VL 297 IS 11 BP 1216 EP 1223 DI 10.1001/jama.297.11.1216 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 147XO UT WOS:000245039300025 PM 17374816 ER PT J AU Casarett, DJ Quill, TE AF Casarett, David J. Quill, Timothy E. TI "I'm not ready for hospice": Strategies for timely and effective hospice discussions SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID OBSTRUCTIVE PULMONARY-DISEASE; MALIGNANT BOWEL OBSTRUCTION; TERMINALLY-ILL PATIENTS; PATIENT PREFERENCES; PALLIATIVE CARE; ADVANCED CANCER; NURSING-HOMES; HEART-FAILURE; SURVIVAL; LIFE AB Hospice programs offer unique benefits for patients who are near the end of life and their families, and growing evidence indicates that hospice can provide high-quality care. Despite these benefits, many patients do not enroll in hospice, and those who enroll generally do so very late in the course of their illness. Some barriers to hospice referral arise from the requirements of hospice eligibility, which will be difficult to eliminate without major changes to hospice organization and financing. However, the challenges of discussing hospice create other barriers that are more easily remedied. The biggest communication barrier is that physicians are often unsure of how to talk with patients clearly and directly about their poor prognosis and limited treatment options (both requirements of hospice referral) without depriving them of hope. This article describes a structured strategy for discussing hospice, based on techniques of effective communication that physicians use in other "bad news" situations. This strategy can make hospice discussions both more compassionate and more effective. C1 Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Rochester, Med Ctr, Ctr Eth Humanities & Palliat Care, Rochester, NY 14642 USA. RP Casarett, DJ (reprint author), 3615 Chestnut St, Philadelphia, PA 19104 USA. EM casarett@mail.med.upenn.edu NR 52 TC 54 Z9 55 U1 3 U2 10 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 MAR 20 PY 2007 VL 146 IS 6 BP 443 EP 449 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 150CC UT WOS:000245192200006 PM 17371889 ER PT J AU Heinrich, MC Corless, CL AF Heinrich, Michael C. Corless, Christopher L. TI KIT mutations and imatinib dose effects in patients with gastrointestinal stromal tumors - Reply SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Letter ID RESISTANCE C1 Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Heinrich, MC (reprint author), Portland VA Med Ctr, Portland, OR 97201 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 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 MAR 20 PY 2007 VL 25 IS 9 BP 1147 EP 1148 DI 10.1200/JCO.2006.09.9408 PG 3 WC Oncology SC Oncology GA 152GD UT WOS:000245348600032 ER PT J AU Caperton, L Murphey, P Yamazaki, Y McMahan, CA Walter, CA Yanagimachi, R McCarrey, JR AF Caperton, Lee Murphey, Patricia Yamazaki, Yukiko McMahan, C. Alex Walter, Christi A. Yanagimachi, Ryuzo McCarrey, John R. TI Assisted reproductive technologies do not alter mutation frequency or spectrum SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article DE genetic integrity; in vitro fertilization; infertility; mutagenesis; embryology ID INTRACYTOPLASMIC SPERM INJECTION; IN-VITRO FERTILIZATION; PREIMPLANTATION MOUSE EMBRYOS; BECKWITH-WIEDEMANN-SYNDROME; LACI GENE; TESTICULAR SPERMATOZOA; IMPRINTING DEFECTS; MUTANT FREQUENCIES; ROUND SPERMATIDS; TRANSGENIC MICE AB Assisted reproductive technologies (ARTs) have now contributed to the birth of > 3 million babies worldwide, but concerns remain regarding the safety of these methods. We have used a transgenic mouse model to examine the effects of ARTs on the frequency and spectrum of point mutations in midgestation mouse fetuses produced by either natural reproduction or various methods of ART, including preimplantation culture, embryo transfer, in vitro fertilization, intracytoplasmic sperm injection, and round spermatid injection. Our results show that there is no significant difference in the frequency or spectrum of de novo point mutations found in naturally conceived fetuses and fetuses produced by in vitro fertilization, intracytoplasmic sperm injection, or round spermatid injection. These results, based on analyses of a transgenic mouse system, indicate that with respect to maintenance of genetic integrity, ARTs appear to be safe. C1 Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. Univ Texas San Antonio, San Antonio, TX 78249 USA. Univ Hawaii, John A Burns Sch Med, Honolulu, HI 96813 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Yanagimachi, R (reprint author), Univ Texas Hlth Sci Ctr San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM yana@hawaii.edu; john.mccarrey@utsa.edu FU NICHD NIH HHS [R01 HD042772, HD 42772] NR 47 TC 28 Z9 29 U1 0 U2 4 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 MAR 20 PY 2007 VL 104 IS 12 BP 5085 EP 5090 DI 10.1073/pnas.0611642104 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 150YY UT WOS:000245256700058 PM 17360354 ER PT J AU Shouse, MN Scordato, JC Farber, PR de Lanerolle, N AF Shouse, Margaret N. Scordato, John C. Farber, Paul R. de Lanerolle, Nihal TI The alpha 2 adrenoreceptor agonist clonidine suppresses evoked and spontaneous seizures, whereas the alpha 2 adrenoreceptor antagonist idazoxan promotes seizures in amygdala-kindled kittens SO BRAIN RESEARCH LA English DT Article DE norepinephrine; clonidine; idazoxan; spontaneous seizures; microinfusion; amygdala kindling; kittens ID TEMPORAL-LOBE EPILEPSY; LOCUS-COERULEUS; NOREPINEPHRINE DEPLETION; AUDIOGENIC-SEIZURES; BINDING-SITES; RAT-BRAIN; SLEEP; MICROINFUSION; NORADRENALINE; STIMULATION AB Microinfusion of alpha 2 adrenoreceptor agonists and antagonists into amygdala has contrasting effects on evoked and spontaneous seizure susceptibility in amygdala-kindled kittens. Subjects were 14 preadolescent kittens between 3 and 4 months old at the beginning of kindling. The same protocol was followed except that half the kittens received microinfusions (1 mu l) of the alpha 2 agonist clonidine (CLON; 1.32 nmol), and half received the alpha 2 antagonist idazoxan (IDA; 0.33 nmol). Infusions were made over 1 min through needles inserted into cannulae adjacent to stimulating electrodes in the kindled amygdala, and evoked seizures were tested 10-12 min later. The results were: (1) CLON elevated seizure thresholds obtained once at the beginning and end of kindling, but only when compared to sham control values (needle insertion only) in the same animals; IDA significantly reduced thresholds. (2) CLON retarded and IDA accelerated kindling rate, defined as the number of afterdischarges (ADs) required to achieve the first stage 6 seizure or generalized tonic-clonic convulsion (GTC). These effects were most pronounced on the emergence of seizure "generalization" stages (36) from "focal" seizure stages (1-2). (3) CLON prevented onset of spontaneous seizures, whereas IDA precipitated onset of spontaneous seizures in 100% of the animals before or during the 5-week post-kindling follow-up during which seizures were evoked once each work day. The study confirms previous findings in kindled rodents to show that CLON and IDA can have opposing effects on kindling development in kittens and is the first report to show contrasting effects on spontaneous epileptogenesis in kindled animals as well. (c) 2006 Elsevier B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. Yale Univ, Sch Med, Dept Neurosurg, New Haven, CT 06520 USA. RP Shouse, MN (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. EM nshouse@ucla.edu NR 47 TC 5 Z9 5 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD MAR 16 PY 2007 VL 1137 IS 1 BP 58 EP 68 DI 10.1016/j.brainres.20006.12.033 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 145EY UT WOS:000244849300007 PM 17214976 ER PT J AU Block, K Gorin, Y Hoover, P Williams, P Chelmicki, T Clark, RA Yoneda, T Abboud, HE AF Block, Karen Gorin, Yves Hoover, Paul Williams, Paul Chelmicki, Tomasz Clark, Robert A. Yoneda, Toshiyuki Abboud, Hanna E. TI NAD(P)H Oxidases regulate HIF-2 alpha protein expression SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TUMOR-SUPPRESSOR GENE; HYPOXIA-INDUCIBLE FACTOR-1-ALPHA; RENAL-CARCINOMA CELLS; GROWTH SUPPRESSION; NADPH OXIDASES; UP-REGULATION; CANCER CELLS; OXYGEN; ACTIVATION; NOX4 AB Biallelic inactivation of the von Hippel-Lindau tumor suppressor gene (VHL) is linked to the development of hereditary and sporadic renal cell carcinoma (RCC). In the absence of VHL, the alpha subunits of heterodimeric hypoxia-inducible transcription factors (HIT-1 alpha and HIF-2 alpha) are stabilized. Reactive oxygen species, generated by NAD(P)H oxidases, are involved in signaling cascades of malignant growth. We show that in VHL-deficient cells p22(phox), Nox4 protein levels and NADPH-dependent superoxide generation are increased. Reintroduction of VHL into the VHL-deficient cells down-regulates the expression of p22(phox) and NADPH-dependent superoxide generation. Inhibition of the 26 S proteasome in VHL-expressing cells increased p22(phox) protein levels, which correlated with an increase of NADPH-dependent superoxide generation. We also show that p22(phox) co-immunoprecipitates with VHL in vivo. Moreover, p22(phox) is a target of ubiquitination. Importantly, in VHL-deficient cells, diphenyleneiodonium chloride (DPI), an inhibitor of Nox oxidases, decreased the expression of HIF-2a. Down-regulation of Nox1, Nox4, and p22(phox) expression by small interfering RNA also decreased HIF-2 alpha protein expression and inhibited Akt and 4E-BP1 phosphorylation, suggesting that a translational mechanism is involved in maintaining HIF-2 alpha in VHL-deficient cells. Colony formation by RCC 786-O in soft agar was markedly inhibited by DPI. Moreover, DPI significantly inhibited RCC 786-O tumor formation in athymic mice. Collectively, the data demonstrate that VHL protein exerts its tumor suppressor action, at least partially, via inhibition of p22(phox)-based Nox4/Nox1 NADPH oxidase-dependent reactive oxygen species generation. C1 Univ Texas, Hlth Sci Ctr, George OBrien Kidney Res Ctr, Dep Med,Div Nephrol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, George OBrien Kidney Res Ctr, Dep Med,Div Endocrinol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Block, K (reprint author), Univ Texas, Hlth Sci Ctr, George OBrien Kidney Res Ctr, Dep Med,Div Nephrol, MC 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM block@uthscsa.edu RI Bell, Tiffany/F-4403-2010 OI Gorin, Yves/0000-0003-4048-6925 NR 31 TC 66 Z9 70 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAR 16 PY 2007 VL 282 IS 11 BP 8019 EP 8026 DI 10.1074/jbc.M611569200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 148ND UT WOS:000245081000033 PM 17200123 ER PT J AU Smith, JP Dong, MH Kaunitz, JD AF Smith, Jason P. Dong, Mamie H. Kaunitz, Jonathan D. TI Evaluation of a pharmacist-managed hepatitis C care clinic SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article DE ambulatory care; antivirals; clinical pharmacists; combined therapy; economics; hematopoietic agents; hepatitis C; peginterferon alfa 2-a; peginterferon alfa 2-b; ribavirin; toxicity ID UNITED-STATES VETERANS; PLUS RIBAVIRIN; ANTIVIRAL THERAPY; VIRUS-INFECTION AB Purpose. A description of an effort to create a more time, labor, and cost-efficient method for the management of patients with hepatitis C virus (HCV) infection in Department of Veterans Affairs (VA) hospitals is provided; this pilot study also revealed the outcomes of a pharmacist-managed clinic for these patients in comparison to established standards of care. Methods. A retrospective analysis was performed on data obtained from patients who were referred to the clinic between October 2002 and March 2004 and who had a clinical pharmacist as their primary treatment provider. The patients' medical records were searched for demographic information, disease characteristics, treatment information, treatment and safety information, and virological response. Results. Thirty-one patients were evaluated, and 27 were offered antiviral therapy in the hepatitis C care clinic between October 2002 and March 2004. Of the 27 patients who had sufficient data for analysis, there was a sustained response rate of 63% (17 of 27) overall after treatment with peginterferon and ribavirin combination therapy. Only 3 patients (11%) stopped therapy early secondary to adverse effects, whereas 8 (30%) were managed with growth factors. Conclusion. VA patients managed by a clinical pharmacist for the treatment of chronic HCV infection demonstrated similar treatment outcomes compared with the results from earlier studies with VA patients managed with traditional care. Further studies are warranted to investigate the role of the pharmacist in the management of patients with HCV infection. C1 W Los Angeles Vet Affairs Med Ctr, Greater Los Angeles Vet Affairs VA Healthcare Sys, Dept Pharm, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. RP Smith, JP (reprint author), W Los Angeles Vet Affairs Med Ctr, Greater Los Angeles Vet Affairs VA Healthcare Sys, Dept Pharm, 11301 Wilshire Blvd,Bldg 500,Suite 4046A, Los Angeles, CA 90073 USA. EM jason.smith2@va.gov NR 23 TC 13 Z9 14 U1 0 U2 1 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 MAR 15 PY 2007 VL 64 IS 6 BP 632 EP 636 DI 10.2146/ajhp060153 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 152OR UT WOS:000245371800014 PM 17353572 ER PT J AU Feng, S Agoulnik, IU Bogatcheva, NV Kamat, AA Kwabi-Addo, B Li, R Ayala, G Ittmann, MM Agoulnik, AI AF Feng, Shu Agoulnik, Irina U. Bogatcheva, Natalia V. Kamat, Aparna A. Kwabi-Addo, Bernard Li, Rile Ayala, Gustavo Ittmann, Michael M. Agoulnik, Alexander I. TI Relaxin promotes prostate cancer progression SO CLINICAL CANCER RESEARCH LA English DT Article ID TRANSGENIC MOUSE; UP-REGULATION; H2 RELAXIN; GROWTH; RECEPTORS; CELLS; DIFFERENTIATION; TUMOR; MICE; OVEREXPRESSION AB Purpose: To understand the role of relaxin peptide in prostate cancer, we analyzed the expression of relaxin and its receptor in human prostate cancer samples, the effects of relaxin signaling on cancer cell phenotype in vitro, and the effects of increased serum relaxin concentrations on cancer progression in vivo. Experimental Design: The relaxin and its receptor leucine-rich repeat containing G protein coupled receptor 7 (LGR7) expression were studied by quantitative reverse transcription-PCR (11 benign and 44 cancer tissue samples) and by relaxin immunohistochemistry using tissue microarrays containing 10 normal and 69 cancer samples. The effects of relaxin treatment and enclogenous relaxin/LGR7 suppression via short interfering RNA in PC-3 and LNCaP cells were analyzed in vitro. The effect of transgenic relaxin overexpression [Tg(Rln1)] on cancer growth and survival was evaluated in autochthonous transgenic adenocarcinoma of the mouse prostate (TRAMP). Results:The relaxin mRNA expression was significantly higher in recurrent prostate cancer samples. In tissue microarrays of the 10 normal tissues, 8 had low staining in epithelial cells, whereas only 1 of 9 high-grade prostatic intraepithelial neoplasia lesions had low expression (P = 0.005) and only 29 of 65 cancers had low expression (P = 0.047). Stimulation with relaxin increased cell proliferation, invasiveness, and adhesion in vitro. The suppression of relaxin/LGR7 via short interfering RNAs decreased cell invasiveness by 90% to 95% and growth by 10% to 25% and increased cell apoptosis 0.6 to 2.2 times. The Tg (Rln1) TRAMP males had shorter median survival time, associated with the decreased apoptosis of tumor cells, compared with non-Tg(R/n1) TRAMP animals. Conclusions: Relaxin signaling plays a role in prostate cancer progression. C1 Baylor Coll Med, Dept Obstet & Gynecol, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Gynecol Oncol, Houston, TX 77030 USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX USA. RP Agoulnik, AI (reprint author), Baylor Coll Med, Dept Obstet & Gynecol, 1 Baylor Plaza,Suite 207D, Houston, TX 77030 USA. EM agoulnik@bcm.edu RI Kwabi-Addo, Bernard/A-6993-2016 OI Kwabi-Addo, Bernard/0000-0003-3692-6350; Agoulnik, Irina/0000-0003-4889-0324; Agoulnik, Alexander/0000-0001-6587-6845 FU NCI NIH HHS [5 P50 CA58204, R21 CA118362, R21 CA118362-01A1] NR 32 TC 63 Z9 65 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 MAR 15 PY 2007 VL 13 IS 6 BP 1695 EP 1702 DI 10.1158/1078-0432.CCR-06-2492 PG 8 WC Oncology SC Oncology GA 147VV UT WOS:000245031800013 PM 17363522 ER PT J AU Johnson, S Schriever, C Galang, M Kelly, CP Gerding, DN AF Johnson, Stuart Schriever, Christopher Galang, Minerva Kelly, Ciaran P. Gerding, Dale N. TI Interruption of recurrent Clostridium difficile - Associated diarrhea episodes by serial therapy with vancomycin and rifaximin SO CLINICAL INFECTIOUS DISEASES LA English DT Editorial Material ID IN-VITRO ACTIVITY; DISEASE AB Eight women who each experienced 4-8 episodes of Clostridium difficile-associated diarrhea were given a 2-week course of rifaximin therapy when they were asymptomatic, immediately after completing their last course of vancomycin therapy. Seven of the 8 patients experienced no further diarrhea recurrence. The patient who had a recurrence responded to a second course of rifaximin therapy, but rifaximin-resistant C. difficile was recovered after treatment. A controlled trial for treating recurrent Clostridium difficile associated diarrhea appears to be warranted. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Med Ctr, Maywood, IL 60153 USA. Beth Israel Deaconess Hosp, Boston, MA USA. Harvard Univ, Boston, MA 02115 USA. RP Johnson, S (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. EM sjohnson@lumc.edu NR 12 TC 176 Z9 184 U1 2 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 MAR 15 PY 2007 VL 44 IS 6 BP 846 EP 848 DI 10.1086/511870 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 136RT UT WOS:000244242500015 PM 17304459 ER PT J AU Cheng, EM Swarztrauber, K Siderowf, AD Eisa, MS Lee, M Vassar, S Jacob, E Vickrey, BG AF Cheng, Eric M. Swarztrauber, Kari Siderowf, Andrew D. Eisa, Mahmood S. Lee, Martin Vassar, Stefanie Jacob, Erin Vickrey, Barbara G. TI Association of specialist involvement and quality of care for Parkinson's disease SO MOVEMENT DISORDERS LA English DT Article DE Parkinson's disease; quality of care; indicators; movement-disorder specialist ID VULNERABLE ELDERS/; STANDARDS SUBCOMMITTEE; PRACTICE PARAMETER; MEDICAL-CARE; INDICATORS; LIFE; MANAGEMENT; AGREEMENT; VARIABLES; NEUROLOGY AB Because Parkinson's disease (PD) has multiple neurological symptoms and often complex treatments, the quality of PD care may be higher when a specialist is involved. We examined the medical records, from 1998 to 2004, of 401 Los Angeles veterans with Parkinson's disease to determine whether care met key indicators of PD care quality. All care following a visit to a movement-disorder specialist or general neurologist was classified as specialty care. We compared adherence to each indicator by level of specialist involvement through logistic regression models. Over the study period, 10 indicators of PD care quality were triggered 2,227 times. Overall, movement disorder specialist involvement (78%) was associated with higher adherence to indicators than did general neurologist involvement (70%, P = 0.006) and nonneurologist involvement (52%, P < 0.001). The differences between movement disorder specialist and nonneurologist involvement were especially large for four indicators: treatment of wearing-off, assessments of falls, depression, and hallucinations. There is significant room for improving aspects of PD care quality among patients who do not have the involvement of a specialist. Quality of care interventions should involve specialists in management of motor symptoms and incorporate methods for routine assessment of nomnotor PD symptoms. (c) 2007 Movement Disorder Society. C1 VA Greater Los Angeles Healthcare Syst, Dept Neurol, Parkinsons Dis Res Educ & Clin Ctr PADRECC, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Prov Hlth Syst, Prov Med Grp, Newberg, OR USA. Philadelphia VA Med Ctr, PADRECC, Philadelphia, PA USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Yale Univ, Dept Neurol, New Haven, CT USA. Neurol Neurosurg & Spine Clin S Georgia, Valdosta, GA USA. VA Greater Los Angeles Healthcare Syst, VA Ctr Study Healthcare Provider Behav, Los Angeles, CA 90073 USA. RP Cheng, EM (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Neurol, Parkinsons Dis Res Educ & Clin Ctr PADRECC, 11301 Wilshire Blvd,B500,ML 127, Los Angeles, CA 90073 USA. EM Eric.Cheng@va.gov NR 26 TC 29 Z9 29 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD MAR 15 PY 2007 VL 22 IS 4 BP 515 EP 522 DI 10.1002/mds.21311 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 153CG UT WOS:000245408700013 PM 17260340 ER PT J AU Seal, KH Bertenthal, D Miner, CR Sen, S Marmar, C AF Seal, Karen H. Bertenthal, Daniel Miner, Christian R. Sen, Saunak Marmar, Charles TI Bringing the war back home - Mental health disorders among 103 788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; NATIONAL COMORBIDITY SURVEY; CARE; VIETNAM; PREVALENCE; ATTRITION; SERVICES AB Background: Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have endured high combat stress and are eligible for 2 years of free military service-related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities. Methods: US veterans separated from OEF/OIF military service and first seen at VA health care facilities between September 30, 2001 ( US invasion of Afghanistan), and September 30, 2005, were included. Mental health diagnoses and psychosocial problems were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The prevalence and clinical circumstances of and subgroups at greatest risk for mental health disorders are described herein. Results: Of 103 788 OEF/OIF veterans seen at VA health care facilities, 25 658 (25%) received mental health diagnosis(es); 56% of whom had 2 or more distinct mental health diagnoses. Overall, 32 010 (31%) received mental health and/or psychosocial diagnoses. Mental health diagnoses were detected soon after the first VA clinic visit (median of 13 days), and most initial mental health diagnoses (60%) were made in nonmental health clinics, mostly primary care settings. The youngest group of OEF/OIF veterans (age, 18-24 years) were at greatest risk for receiving mental health or posttraumatic stress disorder diagnoses compared with veterans 40 years or older. Conclusions: Co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of OEF/OIF veterans seen at VA facilities. Targeted early detection and intervention beginning in primary care settings are needed to prevent chronic mental illness and disability. C1 San Francisco VA Med Ctr, Div Gen Internal Med, Hlth Serv Res & Dev Res Enhancement Award Program, 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. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. RP Seal, KH (reprint author), San Francisco VA Med Ctr, Div Gen Internal Med, Hlth Serv Res & Dev Res Enhancement Award Program, Box 111A-1,4150 Clement St, San Francisco, CA 94121 USA. EM karen.seal@va.gov NR 27 TC 477 Z9 483 U1 5 U2 35 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 MAR 12 PY 2007 VL 167 IS 5 BP 476 EP 482 DI 10.1001/archinte.167.5.476 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 145GX UT WOS:000244854400011 PM 17353495 ER PT J AU Colston, JT Boylston, WH Feldman, MD Jenkinson, CP de la Rosa, SD Barton, A Trevino, RJ Freeman, GL Chandrasekar, B AF Colston, James T. Boylston, William H. Feldman, Marc D. Jenkinson, Chris P. de la Rosa, Sam D. Barton, Amanda Trevino, Rodolfo J. Freeman, Gregory L. Chandrasekar, Bysani TI Interleukin-18 knockout mice display maladaptive cardiac hypertrophy in response to pressure overload SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE interleukins; myocardial hypertrophy; Akt; signal transduction; mouse; pressure overload ID NF-KAPPA-B; TRANSVERSE AORTIC CONSTRICTION; TUMOR-NECROSIS-FACTOR; SIGNALING PATHWAY; HYPOXIC INJURY; IN-VIVO; EXPRESSION; IL-18; CARDIOMYOCYTES; HEART AB Interleukin (IL)-18 is a cardiotropic proinflammatory cytokine chronically elevated in the serum of patients with cardiac hypertrophy (LVH). The purpose of this study was to examine the role of IL-18 in pressure-overload hypertrophy using wild type (WT) and IL-18 -/- (null) mice. Adult male C57B1/6 mice underwent transaortic constriction (TAC) for 7 days or sham surgery. Heart weight/body weight ratios showed blunted hypertrophy in IL-18 null TAC mice compared to WT TAC animals. Microarray analyses indicated differential expression of hypertrophy-related genes in WT versus IL-18 nulls. Northern, Western, and EMSA analyses showed Akt and GATA4 were increased in WT but unchanged in IL-18 null mice. Our results demonstrate blunted hypertrophy with reduced expression of contractile-, hypertrophy-, and remodeling-associated genes following pressure overload in IL-18 null mice, and suggest that TL-18 plays a critical role in the hypertrophic response. (c) 2007 Elsevier Inc. All rights reserved. C1 S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. RP Chandrasekar, B (reprint author), S Texas Vet Hlth Care Syst, San Antonio, TX USA. EM chandraseka@uthscsa.edu FU NHLBI NIH HHS [HL68020, R01 HL068020, R21 HL079926, HL077926]; NIA NIH HHS [T32 AG021890]; NIDDK NIH HHS [R01 DK079195] NR 31 TC 30 Z9 33 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 MAR 9 PY 2007 VL 354 IS 2 BP 552 EP 558 DI 10.1016/j.bbrc.2007.01.030 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 133YO UT WOS:000244050000037 PM 17250807 ER PT J AU Li, W Li, Y Guan, SX Fan, JH Cheng, CF Bright, AM Chinn, C Chen, M Woodley, DT AF Li, Wei Li, Yong Guan, Shengxi Fan, Jianhua Cheng, Chieh-Fang Bright, Alexandra M. Chinn, Cindi Chen, Mei Woodley, David T. TI Extracellular heat shock protein-90 alpha: linking hypoxia to skin cell motility and wound healing SO EMBO JOURNAL LA English DT Article DE cell motility; HIF-1; hypoxia; secreted Hsp90; wound healing ID HUMAN DERMAL FIBROBLASTS; HUMAN KERATINOCYTE MOTILITY; HEAT-SHOCK PROTEINS; SIGNAL-TRANSDUCTION; INDUCIBLE FACTOR-1; GENE-EXPRESSION; CANCER-THERAPY; MIGRATION; OXYGEN; INDUCTION AB Hypoxia is a microenvironmental stress in wounded skin, where it supports wound healing by promoting cell motility. The mechanism of the hypoxia action remained speculative. Here, we provide evidence that hypoxia promotes human dermal fibroblast (HDF) migration by inducing secretion of heat shock protein-90alpha (hsp90 alpha) into the extracellular environment through hypoxia-inducible factor-1alpha (HIF-1 alpha). The secreted hsp90 alpha in turn executes hypoxia's pro-motility effect. Expression of an activated HIF-1 alpha mimicked, whereas expression of an inactive HIF-1 alpha or suppression of endogenous HIF-1 alpha blocked, hypoxia- induced hsp90a secretion and HDF migration. Interestingly, the hypoxia-HIF-1 pathway-induced hsp90a secretion required neither changes in the steady-state mRNA level nor in the promoter activity of hsp90a. Recombinant hsp90a fully duplicated the hypoxia effect on HDFs. Inhibition of extracellular hsp90a function completely blocked the hypoxia-HIF-1 pathway-stimulated HDF migration. More intriguingly, topical application of hsp90a accelerated wound healing in mice. This study has demonstrated a novel mechanism of hypoxia > HIF-1 > hsp90 alpha secretion > skin cell migration > wound healing, and identified extracellular hsp90 alpha as a potential therapeutic agent for skin wounds. C1 Univ So Calif, Keck Sch Med, Dept Dermatol, Los Angeles, CA 90033 USA. Greater Los Angeles Vet Adm Hlth Syst, Los Angeles, CA USA. Fourth Mil Med Univ, Dept Plast Surg, Xijing Hosp, Xian, Shaanxi, Peoples R China. RP Li, W (reprint author), Univ So Calif, Keck Sch Med, Dept Dermatol, 1303 N Miss Rd, Los Angeles, CA 90033 USA. EM wli@usc.edu FU NIAMS NIH HHS [AR46538, GM/AR67100-01, R01 AR046538] NR 48 TC 125 Z9 135 U1 0 U2 8 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0261-4189 J9 EMBO J JI Embo J. PD MAR 7 PY 2007 VL 26 IS 5 BP 1221 EP 1233 DI 10.1038/sj.emboj.7601579 PG 13 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 143JE UT WOS:000244716000003 PM 17304217 ER PT J AU Walter, LC Konety, BR AF Walter, Louise C. Konety, Badrinath R. TI PSA screening and elderly men - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID CANCER C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA. RP Walter, LC (reprint author), San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. EM louise.walter@ucsf.edu NR 3 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 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 7 PY 2007 VL 297 IS 9 BP 949 EP 949 DI 10.1001/jama.297.9.949-b PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 143CP UT WOS:000244697900016 ER PT J AU Kerlikowske, K Ichikawa, L Miglioretti, DL Buist, DSM Vacek, PM Smith-Bindman, R Yankaskas, B Carney, PA Ballard-Barbash, R AF Kerlikowske, Karla Ichikawa, Laura Miglioretti, Diana L. Buist, Diana S. M. Vacek, Pamela M. Smith-Bindman, Rebecca Yankaskas, Bonnie Carney, Patricia A. Ballard-Barbash, Rachel TI Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID PARENCHYMAL PATTERNS; FAMILY-HISTORY; SCREENING MAMMOGRAPHY; UNITED-STATES; TAMOXIFEN; AGE; WOMEN; ASSOCIATION; POPULATION; PREVENTION AB Background Whether a change over time in clinically measured mammographic breast density influences breast cancer risk is unknown. Methods From January 1993 to December 2003, data that included American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) breast density categories (1-4 in order of increasing density) were collected prospectively on 301955 women aged 30 and older who were not using postmenopausal hormone replacement therapy and underwent at least two screening mammography examinations; 2639 of the women were diagnosed with breast cancer within 1 year of the last examination. Women's first and last BI-RADS breast density (average 3.2 years apart) and logistic regression were used to model the odds of having invasive breast cancer or ductal carcinoma in situ diagnosed within 12 months of the last examination by change in BI-RADS category. Rates of breast cancer adjusted for age, mammography registry, and time between screening examinations were estimated from this model. All statistical tests were two-sided. Results The rate (breast cancers per 1000 women) of breast cancer was higher if BI-RADS breast density category increased from 1 to 2 (5.6, 95% confidence interval [CI] = 4.7 to 6.9) or 1 to 3 (9.9, 95% Cl = 6.4 to 15.5) compared to when it remained at BI-RADS density of 1 (3.0, 95% Cl = 2.3 to 3.9; P <.001 for trend). Similar and statistically significant trends between increased or decreased density and increased or decreased risk of breast cancer, respectively, were observed for women whose breast density category was initially 2 or 3 and changed categories. BI-RADS density of 4 on the first examination was associated with a high rate of breast cancer (range 9.1-13.4) that remained high even if breast density decreased. Conclusion An increase in BI-RADS breast density category within 3 years may be associated with an increase in breast cancer risk and a decrease in density category with a decrease in risk compared to breast cancer risk in women in whom breast density category remains unchanged. Two longitudinal measures of BI-RADS breast density may better predict a woman's risk of breast cancer than a single measure. C1 Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Vet Affairs, Gen Internal Med Sect, San Francisco, CA 94143 USA. Grp Hlth Ctr Hlth Studies, Seattle, WA USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Vermont, Coll Med, Dept Med Biostat, Burlington, VT USA. Univ Vermont, Coll Med, Dept Pathol, Burlington, VT 05405 USA. Univ N Carolina, Dept Radiol, Chapel Hill, NC USA. Oregon Hlth Sci Univ, Dept Family Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. NCI, Appl Res Program, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. RP Kerlikowske, K (reprint author), San Francisco VA Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM karla.kerlikowske@ucsf.edu FU NCI NIH HHS [U01CA69976, P01 CA107584, R01 CA080888, U01 CA086076, U01 CA086076-06, U01 CA086082, U01CA63731, U01CA63736, U01CA63740, U01CA70013, U01CA70040, U01CA86076, U01CA86082] NR 51 TC 116 Z9 116 U1 1 U2 5 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0027-8874 J9 J NATL CANCER I JI J. Natl. Cancer Inst. PD MAR 7 PY 2007 VL 99 IS 5 BP 386 EP 395 DI 10.1093/jnci/djk066 PG 10 WC Oncology SC Oncology GA 145PV UT WOS:000244877900011 PM 17341730 ER PT J AU Han, JK Feliciano, Z AF Han, Janet K. Feliciano, Zenaida TI Is outpatient implantation of biventricular devices safe? SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 56th Annual Scientific Session of the American-College-of-Cardiology CY MAR 24-27, 2007 CL New Orleans, LA SP Amer Coll Cardiol C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, 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 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 MAR 6 PY 2007 VL 49 IS 9 SU A BP 18A EP 18A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 142LQ UT WOS:000244651800072 ER PT J AU Dhaliwal, A Bozkurt, B DeBakey, ME AF Dhaliwal, Amandeep Bozkurt, Biykem DeBakey, Michael E. TI Higher percent BNP reduction is required in blacks than whites to reduce event free survival in heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 56th Annual Scientific Session of the American-College-of-Cardiology CY MAR 24-27, 2007 CL New Orleans, LA SP Amer Coll Cardiol C1 VA 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 MAR 6 PY 2007 VL 49 IS 9 SU A BP 91A EP 92A PG 2 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 142LQ UT WOS:000244651800376 ER PT J AU Ebrahimi, R Feit, F Manoukian, S Lincoff, AM Dyke, C Gersh, B Mehran, R Moses, J Stone, G AF Ebrahimi, Ramin Feit, Frederick Manoukian, Steven Lincoff, A. Michael Dyke, Cornelius Gersh, Bernard Mehran, Roxana Moses, Jeffery Stone, Gregg TI Outcome in acute coronary syndrome patients managed surgically based on clopidogrel exposure and delay to surgery: A report from the ACUITY trial SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 56th Annual Scientific Session of the American-College-of-Cardiology CY MAR 24-27, 2007 CL New Orleans, LA SP Amer Coll Cardiol C1 Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. Columbia Univ, Ctr 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2007 VL 49 IS 9 SU A BP 252A EP 252A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 142LQ UT WOS:000244651801482 ER PT J AU Ebrahimi, R Manoukian, S Feit, F Lincoff, AM Dyke, C Gersh, B Mehran, R Moses, J Stone, G AF Ebrahimi, Ramin Manoukian, Steven Feit, Frederick Lincoff, A. Michael Dyke, Cornelius Gersh, Bernard Mehran, Roxana Moses, Jeffery Stone, Gregg TI Upstream therapy with bivalirudin is as safe and effective as heparin for patients with acute coronary syndrome undergoing coronary artery bypass surgery: A report from the ACUITY trial. SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 56th Annual Scientific Session of the American-College-of-Cardiology CY MAR 24-27, 2007 CL New Orleans, LA SP Amer Coll Cardiol C1 Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. Columbia Univ, Ctr 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 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD MAR 6 PY 2007 VL 49 IS 9 SU A BP 253A EP 253A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 142LQ UT WOS:000244651801484 ER PT J AU Zabalgoitia, M Reagan, RF Stec, DE Rimoldi, JM Valente, AJ Chandrasekar, B AF Zabalgoitia, Miguel Reagan, Raymond F. Stec, David E. Rimoldi, John M. Valente, Anthony J. Chandrasekar, Bysani TI Carbon monoxide donors or heme oxygenase-1 overexpression block interleukin-18-mediated NF-kB-PTEN-dependent human cardiac endothelial cell death SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Meeting Abstract CT 56th Annual Scientific Session of the American-College-of-Cardiology CY MAR 24-27, 2007 CL New Orleans, LA SP Amer Coll Cardiol C1 So Texas Vet Hlth Care Syst, Dept Vet Affairs, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU 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 MAR 6 PY 2007 VL 49 IS 9 SU A BP 378A EP 378A PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 142LQ UT WOS:000244651802434 ER PT J AU Escamilla, MA Ontiveros, A Nicolini, H Raventos, H Mendoza, R Medina, R Munoz, R Levinson, D Peralta, JM Dassori, A Almasy, L AF Escamilla, M. A. Ontiveros, A. Nicolini, H. Raventos, H. Mendoza, R. Medina, R. Munoz, R. Levinson, D. Peralta, J. M. Dassori, A. Almasy, L. TI A genome-wide scan for schizophrenia and psychosis susceptibility loci in families of Mexican and Central American ancestry SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article DE schizophrenia; genetics; Mexico; Latino; Mexican-American; Central American ID COSTA-RICAN POPULATION; LINKAGE DISEQUILIBRIUM; DIAGNOSTIC INTERVIEW; VULNERABILITY LOCUS; BIPOLAR DISORDER; GENE; HETEROGENEITY; CHROMOSOME-18; RELIABILITY; PEDIGREES AB Schizophrenia is a complex psychiatric disorder, likely to be caused in part by multiple genes. In this study, linkage analyses were performed to identify chromosomal regions most likely to be associated with schizophrenia and psychosis in multiplex families of Mexican and Central American origin. Four hundred and fifty-nine individuals from 99 families, containing at least two siblings with hospital diagnoses of schizophrenia or schizoaffective disorder, were genotyped. Four hundred and four microsatellite markers were genotyped for all individuals and multipoint non-parametric linkage analyses were performed using broad (any psychosis) and narrow (schizophrenia and schizoaffective disorder) models. Under the broad model, three chromosomal regions (1pter-p36, 5q35, and 18p11) exhibited evidence of linkage with non-parametric lod (NPL) scores greater than 2.7 (equivalent to empirical P values of less than 0.001) with the peak multipoint NPL = 3.42 (empirical P value 0.00003), meeting genomewide evidence for significant linkage in the 1pter-p36 region. Under the narrow model, the same three loci showed (nonsignificant) evidence of linkage. These linkage findings (lpter-p36, 18p11, and 5q35) highlight where genes for psychosis and schizophrenia are most likely to be found in persons of Mexican and Central American ancestry, and correspond to recent linkages of schizophrenia or psychosis in other populations which were formed in part from emigrants from the Spanish empire of the 15th and 16th centuries. (c) 2006 Wiley-Liss, Inc. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Inst Informat Invest Mental Hlth, INFOSAME, Sch Med, Ctr Invest,Div Hlth Sci,ITESM, Monterrey, NL, Mexico. Med & Family Res Grp, Mexico City, DF, Mexico. Univ Costa Rica, Ctr Res Mol Biol, San Jose, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Torrance, CA 90509 USA. S Texas Vet Hlth Syst, Dept Psychiat, San Antonio, TX USA. Family Hlth Ctr San Diego, San Diego, CA USA. Stanford Univ, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA. SW Fdn Biomed Res, San Antonio, TX 78284 USA. RP Escamilla, MA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM escamillam@uthsesa.edu OI Raventos, Henriette/0000-0001-9423-8308; Nicolini, Humberto/0000-0003-2494-0067 FU NIMH NIH HHS [MH60881] NR 41 TC 27 Z9 27 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1552-4841 J9 AM J MED GENET B JI Am. J. Med. Genet. B PD MAR 5 PY 2007 VL 144B IS 2 BP 193 EP 199 DI 10.1002/ajmg.b.30411 PG 7 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 143NL UT WOS:000244729000006 PM 17044102 ER PT J AU Zraika, S Hull, RL Udayasankar, J Utzschneider, KM Tong, J Gerchman, F Kahn, SE AF Zraika, Sakeneh Hull, Rebecca L. Udayasankar, Jayalakshmi Utzschneider, Kristina M. Tong, Jenny Gerchman, Fernando Kahn, Steven E. TI Glucose- and time-dependence of islet amyloid formation in vitro SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE islet amyloid; human islet amyloid polypeptide; islets; beta-cell; insulin secretion; cell viability; amylin; mouse model; diabetes ID TRANSGENIC MOUSE MODEL; BETA-CELL APOPTOSIS; DIABETES-MELLITUS; POLYPEPTIDE IAPP; MICE; PATHOGENESIS; SECRETION; PANCREAS; FIBRILS AB Islet amyloid contributes to the loss of beta-cell mass in type 2 diabetes. To examine the roles of glucose and time on amyloid formation, we developed a rapid in vitro model using isolated islets from human islet amyloid polypeptide (hIAPP) transgenic mice. Islets from hIAPP transgenic and non-transgenic mice were cultured for up to 7 days with either 5.5, 11.1, 16.7 or 33.3 mmol/l glucose. At various time-points throughout the culture period, islets were harvested for determination of amyloid and beta-cell areas, and for measures of cell viability, insulin content, and secretion. Following culture of hIAPP transgenic islets in 16.7 or 33.3 mmol/l glucose, amyloid formation was significantly increased compared to 5.5 or 11.1 mmol/l glucose culture. Amyloid was detected as early as day 2 and increased in a time-dependent manner so that by day 7, a decrease in the proportion of beta-cell area in hIAPP transgenic islets was evident. When compared to non-transgenic islets after 7-day culture in 16.7 mmol/l glucose, hIAPP transgenic islets were 24% less viable, had decreased beta-cell area and insulin content, but displayed no change in insulin secretion. Thus, we have developed a rapid in vitro model of light microscopy-visible islet amyloid formation that is both glucose- and time-dependent. Formation of amyloid in this model is associated with reduced cell viability and beta-cell loss but adequate functional adaptation. It thus enables studies investigating the mechanism(s) underlying the amyloid-associated loss of beta-cell mass in type 2 diabetes. (c) 2007 Elsevier Inc. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98108 USA. RP Zraika, S (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. EM zraikas@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087 FU NIDDK NIH HHS [K01 DK074404, DK-17047, P30 DK017047, DK-74404] NR 27 TC 23 Z9 25 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 MAR 2 PY 2007 VL 354 IS 1 BP 234 EP 239 DI 10.1016/j.bbrc.2006.12.187 PG 6 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 135DH UT WOS:000244133800039 PM 17222388 ER PT J AU Schillace, RV Pisenti, N Pattamanuch, N Galligan, S Marracci, GH Bourdette, DN Carr, DW AF Schillace, R. V. Pisenti, N. Pattamanuch, N. Galligan, S. Marracci, G. H. Bourdette, D. N. Carr, D. W. TI Lipoic acid stimulates cAMP production in T lymphocytes and NK cells SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE lipoic acid; cAMP; lymphocyte; NK cell ID EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS; PROSTANOID RECEPTORS; SPINAL-CORD; MIGRATION; BLOOD; ACTIVATION; EXPRESSION; EP2 AB The anti-oxidant lipoic acid (LA) potently suppresses clinical and pathologic disease in the animal model of multiple sclerosis, experimental autoimmune encephalomyelitis, by inhibiting the migration of pathogenic T cells to the spinal cord. The mechanism by which this occurs is largely unknown. In this report we demonstrate that LA induces increases in cyclic AMP, a known immunosuppressant, in human T cells. The increase in cAMP is associated with increased adenylyl eyclase activity and is partially blocked by prostanoid receptor antagonists. We present evidence that LA also stimulates cAMP production in natural killer (NK) cells. This novel mechanism of action is highly relevant to the immunomodulatory effects of LA and provides further support for the study of LA as a therapeutic agent for multiple sclerosis and other autoimmune diseases. (c) 2007 Elsevier Inc. All rights reserved. C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Endocrinol, Portland, OR 97239 USA. RP Carr, DW (reprint author), VAMC, RD-8 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM carrd@ohsu.edu FU NCCIH NIH HHS [P50AT00066-01, P50 AT000066] NR 18 TC 27 Z9 29 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 MAR 2 PY 2007 VL 354 IS 1 BP 259 EP 264 DI 10.1016/j.bbrc.2006.12.195 PG 6 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 135DH UT WOS:000244133800043 PM 17210133 ER PT J AU Fujikawa, DG Shinmei, SS Zhao, SP Aviles, ER AF Fujikawa, Denson G. Shinmei, Steve S. Zhao, Shuangping Aviles, Ernesto R., Jr. TI Caspase-dependent programmed cell death pathways are not activated in generalized seizure-induced neuronal death SO BRAIN RESEARCH LA English DT Article DE caspase-8; caspase-9; cell death; DNA laddering; necrosis; seizures ID INTERNUCLEOSOMAL DNA CLEAVAGE; INDUCED STATUS EPILEPTICUS; NMDA RECEPTOR ANTAGONIST; ACUTE NECROTIC INSULTS; HYPOXIA-ISCHEMIA; ENDONUCLEASE-G; APOPTOTIC NEURODEGENERATION; CYSTEINE PROTEASES; LIMBIC SEIZURES; MUTANT MICE AB Activation of the caspase-dependent cell death pathways has been shown in focal seizures, but whether this occurs in prolonged generalized seizures is not known. We investigated whether the initiator caspase in the extrinsic pathway, caspase-8, or the intrinsic pathway, caspase-9, is activated during the first 24 h following lithium-pilocarpine-induced status epilepticus, when neuronal death is maximal and widespread. The thymuses of rats given methamphetamine were used as positive controls for caspase-3-activated cellular apoptosis. Following methamphetamine treatment, caspase-9 but not caspase-8 was activated in thymocytes. However, 6 or 24 h following status epilepticus, none of 26 brain regions studied showed either caspase-8 or -9 activation by immunohistochemistry, western blotting and enzyme activity assays. Our results provide evidence against the activation of the extrinsic and intrinsic caspase pathways in generalized seizures, which produce morphologically necrotic neurons with internucleosomal DNA cleavage (DNA laddering), a programmed process. In contrast, there is increasing evidence that caspase-independent programmed mechanisms play a prominent role in seizure-induced neuronal death. Published by Elsevier B.V. C1 VA Greater Los Angeles Healthcare Syst, Expt Neurol Lab, North Hills, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. RP Fujikawa, DG (reprint author), VA Greater Los Angeles Healthcare Syst, Expt Neurol Lab, 151B4,16111 Plummer St, North Hills, CA 91343 USA. EM dfujikaw@ucla.edu NR 76 TC 25 Z9 27 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD MAR 2 PY 2007 VL 1135 IS 1 BP 206 EP 218 DI 10.1016/j.brainres.2006.12.029 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 141BR UT WOS:000244551900024 PM 17204252 ER PT J AU Lu, H Wu, JY Beswick, EJ Ohno, T Odenbreit, S Haas, R Reyes, VE Kita, M Graham, DY Yamaoka, Y AF Lu, Hong Wu, Jeng Yih Beswick, Ellen J. Ohno, Tomoyuki Odenbreit, Stefan Haas, Rainer Reyes, Victor E. Kita, Masakazu Graham, David Y. Yamaoka, Yoshio TI Functional and intracellular signaling differences associated with the Helicobacter pylori AlpAB adhesin from Western and East Asian strains SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID GASTRIC EPITHELIAL-CELLS; NF-KAPPA-B; OUTER-MEMBRANE PROTEINS; CAG PATHOGENICITY ISLAND; HISTIDINE-DECARBOXYLASE PROMOTER; INFLAMMATION-ASSOCIATED CANCER; INTERLEUKIN-8 PRODUCTION; TYROSINE PHOSPHORYLATION; ACTIVATOR PROTEIN-1; EXPRESSION AB Following adhesion of Helicobacterpylori to gastric epithelial cells, intracellular signaling leads to cytokine production, which causes H. pylori-related gastric injury. Two adjacent homologous genes (alpA and alpB), which encode H. pylori outer membrane proteins, are thought to be associated with adhesion and cytokine induction. We co-cultured gastric epithelial cells with wild type H. pylori strains and their corresponding alpA/alpB-deleted mutants (Delta alpAB). Results were confirmed by complementation. Flow cytometry confirmed that AlpAB was involved in cellular adhesion. Deletion of alpAB reduced interleukin (IL)-6 induction in gastric epithelial cells. Deletion of alpAB reduced IL-8 induction with East Asian but not with Western strains. All AlpAB-positive strains tested activated the extracellular signal-regulated kinase, c-Fos, and cAMP-responsive element-binding protein. Activation of the Jun-N-terminal kinase, c-Jun, and NF-kappa B was exclusive to AlpAB from East Asian strains. Delta alpAB mutants poorly colonized the stomachs of C57BL/6 mice and were associated with lower mucosal levels of KC and IL-6. Our results suggest that AlpAB may induce gastric injury by mediating adherence to gastric epithelial cells and by modulating proinflammatory intracellular signaling cascades. Known geographical differences in H. pylori-related clinical outcomes may relate to differential effects of East Asian and Western types of AlpAB on NF-kappa B-related proinflammatory signaling pathways. C1 Baylor Coll Med, Dept Med Gastroenterol, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Digest Dis, Dept Gastroenterol,Renji Hosp, Shanghai 200001, Peoples R China. Kaohsiung Med Univ Hosp, Div Gastroenterol, Dept Internal Med, Kaohsiung 807, Taiwan. Univ Texas, Med Branch, Dept Pediat, Galveston, TX 77555 USA. Univ Texas, Med Branch, Dept Microbiol & Immunol, Galveston, TX 77555 USA. Univ Munich, Max Von Pettenkofer Inst Hyg & Med Microbiol, D-80336 Munich, Germany. Kyoto Prefectural Univ Med, Dept Microbiol, Kyoto 6028566, Japan. RP Yamaoka, Y (reprint author), Baylor Coll Med, Dept Med Gastroenterol, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu RI Wu, Jeng-Yih/D-4520-2009 FU NIDDK NIH HHS [P30 DK056338, DK50669, DK56338, DK62813, R01 DK050669, R01 DK062813, R01 DK062813-03] NR 41 TC 36 Z9 41 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAR 2 PY 2007 VL 282 IS 9 BP 6242 EP 6254 DI 10.1074/jbc.M611178200 PG 13 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 145LS UT WOS:000244867200030 PM 17202133 ER PT J AU Moye, PK Pesik, N Terndrup, T Roe, J Weissman, N Kiefe, C Houston, TK AF Moye, Philip Kevin Pesik, Nicki Terndrup, Thomas Roe, Jedd Weissman, Norman Kiefe, Catarina Houston, Thomas K. TI Bioterrorism training in US emergency medicine residencies: Has it changed since 9/11? SO ACADEMIC EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT 12th Annual National Research Service Award Trainees Conference CY JUN, 2006 CL Seattle, WA DE bioterrorism; residency; education; emergency medicine; experiential learning ID CARDIAC LIFE-SUPPORT; FACULTY-DEVELOPMENT; SKILLS; PROGRAMS AB Objectives: To assess the change in prevalence of bioterrorism training among emergency medicine (EM) residencies from 1998 to 2005, to characterize current training, and to identify characteristics of programs that have implemented more intensive training methods. Methods: This was a national cross sectional survey of the 133 U.S. EM residencies participating in the 2005 National Resident Matching Program; comparison with a baseline survey from 1998 was performed. Types of training provided were assessed, and programs using experiential methods were identified. Results: Of 112 programs (84.2%) responding, 98% reported formal training in bioterrorism, increased from 53% (40/76) responding in 1998. In 2005, most programs with bioterrorism training (65%) used at least three methods of instruction, mostly lectures (95%) and disaster drills (80%). Fewer programs used experiential methods such as field exercises or bioterrorism-specific rotations (35% and 13%, respectively). Compared with other programs, residency programs with more complex, experiential methods were more likely to teach bioterrorism-related topics at least twice a year (83% vs. 59%; p = 0.018), to teach at least three topics (60% vs. 40%; p = 0.02), and to report funding for bioterrorism research and education (74% vs. 45%; p = 0.007). Experiential and nonexperiential programs were similar in program type (university or nonuniversity), length of program, number of residents, geographic location, and urban or rural setting. Conclusions: Training of EM residents in bioterrorism preparedness has increased markedly since 1998. However, training is often of low intensity, relying mainly on nonexperiential instruction such as lectures. Although current recommendations are that training in bioterrorism include experiential learning experiences, the authors found the rate of these experiences to be low. C1 Univ Alabama, Dept Emergency Med, Birmingham, AL 35294 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL USA. Univ Alabama, Dept Med, Div Prevent Med, Birmingham, AL USA. Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA USA. William Beaumont Hosp, Dept Emergency Med, Royal Oak, MI 48072 USA. Birmingham VA Med Ctr, Deep S Ctr Effectiveness Res, Birmingham, AL USA. Univ Alabama, Dept Med, Hlth Serv & Outcomes Res Training Program, Birmingham, AL 35294 USA. RP Moye, PK (reprint author), Univ Alabama, Dept Emergency Med, Birmingham, AL 35294 USA. EM kmoye@uabmc.edu RI Houston, Thomas/F-2469-2013 NR 25 TC 10 Z9 10 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1069-6563 J9 ACAD EMERG MED JI Acad. Emerg. Med. PD MAR PY 2007 VL 14 IS 3 BP 221 EP 227 DI 10.1197/j.aem.2006.10.102 PG 7 WC Emergency Medicine SC Emergency Medicine GA 142FS UT WOS:000244635400006 PM 17264202 ER PT J AU Cummings, DE Naleid, AM Lattemann, DPF AF Cummings, David E. Naleid, Amy M. Lattemann, Dianne P. Figlewicz TI Ghrelin: a link between energy homeostasis and drug abuse? SO ADDICTION BIOLOGY LA English DT Editorial Material ID STIMULATES LOCOMOTOR-ACTIVITY; CONDITIONED PLACE PREFERENCE; TRANSPORTER MESSENGER-RNA; RAT NUCLEUS-ACCUMBENS; DOPAMINE RELEASE; INTRAVENTRICULAR INSULIN; COCAINE-SEEKING; ALCOHOL; LEPTIN; FOOD C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111 Endo, Seattle, WA 98108 USA. EM davidec@u.washington.edu FU NIDDK NIH HHS [DK40963, P01 DK68384, R01 DK61516] NR 37 TC 18 Z9 19 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1369-1600 J9 ADDICT BIOL JI Addict. Biol. PD MAR PY 2007 VL 12 IS 1 BP 1 EP 5 DI 10.1111/j.1369-1600.2007.00053.x PG 5 WC Biochemistry & Molecular Biology; Substance Abuse SC Biochemistry & Molecular Biology; Substance Abuse GA 139FF UT WOS:000244417000001 PM 17407491 ER PT J AU Bugg, JM DeLosh, EL Davalos, DB Davis, HP AF Bugg, Julie M. DeLosh, Edward L. Davalos, Deana B. Davis, Hasker P. TI Age differences in Stroop interference: Contributions of general slowing and task-specific deficits SO AGING NEUROPSYCHOLOGY AND COGNITION LA English DT Article ID OLDER-ADULTS; COLOR-WORD; WORKING-MEMORY; PERFORMANCE; INHIBITION; ATTENTION; SPEED AB This study examined the contributions of general slowing and task-specific deficits to age-related changes in Stroop interference. Nine hundred thirty-eight participants aged 20 to 89 years completed an abbreviated Stroop color-naming task and a subset of 281 participants also completed card-sorting, simple reaction time, and choice reaction time tasks. Age-related increases in incongruent color-naming latency and card-sorting perseverative errors were observed. Hierarchical regression analyses showed that the processing speed measures accounted for significant variance on both dependent measures, but that there was also a significant residual effect of age. An additional regression analysis showed that some of the variance in incongruent color-naming, after controlling for processing speed, was shared with the variance in perseverative errors. Overall, findings suggest that the age difference in Stroop interference is partially attributable to general slowing, but is also attributable to age-related changes in task-specific processes such as inhibitory control. C1 Colorado State Univ, Ft Collins, CO 80523 USA. Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver, CO USA. Univ Colorado, Colorado Springs, CO 80907 USA. RP Bugg, JM (reprint author), Washington Univ, Dept Psychol, Campus Box 1125,1 Brooking Dr, St Louis, MO 63130 USA. EM jbugg@artsci.wustl.edu NR 28 TC 31 Z9 31 U1 5 U2 13 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 1382-5585 J9 AGING NEUROPSYCHOL C JI Aging Neuropsychol. Cogn. PD MAR PY 2007 VL 14 IS 2 BP 155 EP 167 DI 10.1080/138255891007065 PG 13 WC Psychology, Developmental; Psychology, Experimental SC Psychology GA 155QA UT WOS:000245591800004 ER PT J AU Hinkin, CH Barclay, TR Castellon, SA Levine, AJ Durvasula, RS Marion, SD Myers, HF Longshore, D AF Hinkin, Charles H. Barclay, Terry R. Castellon, Steven A. Levine, Andrew J. Durvasula, Ramani S. Marion, Sarah D. Myers, Hector F. Longshore, Douglas TI Drug use and medication adherence among HIV-1 infected individuals SO AIDS AND BEHAVIOR LA English DT Article DE HIV infection; AIDS; medication adherence; drug use; methamphetamine; cocaine ID ACTIVE ANTIRETROVIRAL THERAPY; SELF-REPORTED ADHERENCE; HIV-INFECTED PERSONS; CRACK COCAINE USE; METHAMPHETAMINE DEPENDENCE; PROTEASE INHIBITORS; VIRAL SUPPRESSION; PATIENT-ADHERENCE; SUBSTANCE USE; ADULTS AB This longitudinal study examined the impact of drug use and abuse on medication adherence among 150 HIV-infected individuals, 102 who tested urinalysis positive for recent illicit drug use. Medication adherence was tracked over a 6-month period using an electronic monitoring device (MEMS caps). Over the 6-month study drug-positive participants demonstrated significantly worse medication adherence than did drug-negative participants (63 vs. 79%, respectively). Logistic regression revealed that drug use was associated with over a fourfold greater risk of adherence failure. Stimulant users were at greatest risk for poor adherence. Based upon within-participants analyses comparing 3-day adherence rates when actively using versus not using drugs, this appears to be more a function of state rather than trait. These data suggest that it is the acute effects of intoxication, rather than stable features that may be characteristic of the drug-using populace, which leads to difficulties with medication adherence. C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Calif State Univ Los Angeles, Los Angeles, CA 90032 USA. Point Loma Univ, San Diego, CA USA. Charles R Drew Univ Med & Sci, Res Ctr Ethn Hlth & Behav, Los Angeles, CA 90059 USA. RP Hinkin, CH (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, 760 Westwood Plaza,Room C8-747, Los Angeles, CA 90024 USA. EM chinkin@ucla.edu FU NIDA NIH HHS [R01 DA013799, R01 DA013799-04, R01 DA13799]; NIMH NIH HHS [T32 MH019535] NR 58 TC 131 Z9 136 U1 2 U2 11 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1090-7165 J9 AIDS BEHAV JI AIDS behav. PD MAR PY 2007 VL 11 IS 2 BP 185 EP 194 DI 10.1007/s10461-006-9152-0 PG 10 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 140CO UT WOS:000244480700003 PM 16897351 ER PT J AU Mayben, JK Kramer, JR Kallen, MA Franzini, L Lairson, DR Giordano, TP AF Mayben, Jennifer K. Kramer, Jennifer R. Kallen, Michael A. Franzini, Luisa Lairson, David R. Giordano, Thomas P. TI Predictors of delayed HIV diagnosis in a recently diagnosed cohort SO AIDS PATIENT CARE AND STDS LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; FUNCTIONAL HEALTH LITERACY; UNITED-STATES; ANTIRETROVIRAL THERAPY; COST-EFFECTIVENESS; CARE; INFECTION; URBAN; SEX; ADHERENCE AB Delayed diagnosis of HIV is associated with a worse prognosis despite highly active anti-retroviral therapy. Many persons with HIV infection are diagnosed late in the disease process. We conducted a study of 119 persons recently diagnosed with HIV infection to determine the association of health literacy and other factors with delayed diagnosis. Patients were recruited from four publicly funded facilities in Houston, Texas. Health literacy was measured with the Test of Functional Health Literacy in Adults (TOFHLA). Delayed diagnosis was assessed by CD4 cell count at diagnosis. Sixty-five percent of patients had CD4 cell counts 350 cells/mm(3) or less. Twenty-eight percent had inadequate health literacy, but literacy was not associated with CD4 cell count. Thirty-eight percent were tested because they "felt sick." In multivariable analysis, female gender (p = 0.005), reason tested other than "felt sick" (p < 0.001), and marijuana use (p = 0.004) and other illicit drug use (p = 0.01) were predictors of having a higher CD4 cell count at diagnosis. These results confirm that late diagnosis of HIV is common among users of public health care facilities. Expanded routine testing for HIV infection is needed with attention directed to men and persons who may not recognize that they are at risk for contracting HIV infection. C1 Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Houston Ctr Qual Care & Utilizat Studies, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Univ Texas, Hlth Sci Ctr, Sch Publ Hlth, Houston, TX USA. RP Giordano, TP (reprint author), Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. EM tpg@bcm.tmc.edu FU NIMH NIH HHS [K23MH067505]; PHS HHS [T32HP10031] NR 36 TC 26 Z9 26 U1 2 U2 3 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD MAR PY 2007 VL 21 IS 3 BP 195 EP 204 DI 10.1089/apc.2006.0097 PG 10 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 156LX UT WOS:000245651100006 PM 17428187 ER PT J AU Williams, EC Horton, NJ Samet, JH Saitz, R AF Williams, Emily C. Horton, Nicholas J. Samet, Jeffrey H. Saitz, Richard TI Do brief measures of readiness to change predict alcohol consumption and consequences in primary care patients with unhealthy alcohol use? SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE alcohol; alcohol use; readiness to change ID BEHAVIORAL-COUNSELING INTERVENTIONS; CHANGE QUESTIONNAIRE; EXCESSIVE DRINKERS; SMOKING-CESSATION; SELF-EFFICACY; CAGE; METAANALYSIS; VALIDATION; DRINKING; SAMPLE AB Background: Assessing readiness to change is recommended as part of brief interventions for patients with unhealthy alcohol use. However, the utility and predictive validity of readiness measures have not been well established. Methods: In a prospective cohort study, we assessed primary care patients with unhealthy alcohol use (past-month drinking of risky amounts, or any amount and an affirmative response to CAGE alcohol screening questionnaire) and reassessed them 6 months later. At study entry, we assessed readiness to change using 1 multi-item measure of stage of change, and 5 single-item measures (readiness per se, importance of changing, confidence in ability to change, intention to cut down, intention to abstain). Outcomes included alcohol consumption and alcohol-related consequences. Multivariable regression models were fit for each measure of readiness and each outcome. Results: Of 312 patients with unhealthy alcohol use, 228 (73%) were assessed at study entry and 6 months later and had complete data. Among readiness measures, only confidence and intention to abstain (1 point changes on single-item measures) were associated with consumption 6 months later: less heavy episodic drinking [adjusted odds ratio (AOR) 0.88, 95% CI 0.80-0.98 and AOR 0.79, 0.64-0.98, respectively], and less drinking of risky amounts (AOR 0.89, 0.79-1.00 and AOR 0.78, 0.62-0.98, respectively). Intention to abstain was also associated with more abstinence (AOR 1.43, 1.09-1.88). Single-item measures of readiness, importance, and intention to cut down were significantly associated with higher odds of alcohol consequences. Greater confidence (single item) was associated with a lower odds of any consequences (AOR 0.88, 0.79-0.98). Conclusions: Greater readiness, as measured by several brief assessments, was associated with more consequences and was not predictive of consumption. However, assessing confidence in the ability to change one's alcohol use may have a role in predicting subsequent decreases in both consumption and consequences in primary care patients. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA 98101 USA. Univ Washington, Dept Med, Grad Sch Publ Hlth, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Grad Sch Publ Hlth, Seattle, WA 98195 USA. Smith Coll, Dept Math & Stat, Northampton, MA 01063 USA. Boston Univ, Sch Med, Clin Addict Res & Educ Unit, Sect Gen Internal Med,Dept Med, Boston, MA 02118 USA. Med Ctr, Boston, MA USA. Boston Univ, Sch Publ Hlth, Youth Alcohol Prevent Ctr, Boston, MA USA. Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA. Boston Univ, Sch Publ Hlth, Dept Social & Behav Sci, Boston, MA USA. RP Williams, EC (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM emwilli@u.washington.edu RI Horton, Nicholas/A-2493-2008 OI Samet, Jeffrey/0000-0002-0897-3400; Horton, Nicholas/0000-0003-3332-4311; /0000-0002-2535-1427 NR 66 TC 34 Z9 34 U1 1 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAR PY 2007 VL 31 IS 3 BP 428 EP 435 DI 10.1111/j.1530-0277.2006.00324.x PG 8 WC Substance Abuse SC Substance Abuse GA 134QE UT WOS:000244097900009 PM 17295727 ER PT J AU Au, DH Kivlahan, DR Bryson, CL Blough, D Bradley, KA AF Au, David H. Kivlahan, Daniel R. Bryson, Chris L. Blough, David Bradley, Katharine A. TI Alcohol screening scores and risk of hospitalizations for GI conditions in men SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcoholism; alcohol screening; epidemiology; hemorrhage; pancreatitis; hepatitis ID PRIMARY-CARE PATIENTS; BEHAVIORAL-COUNSELING INTERVENTIONS; IDENTIFICATION TEST AUDIT; PROBLEM DRINKING; USE DISORDERS; GENERAL-POPULATION; LIVER-DISEASE; HEALTH-STATUS; SELF-REPORTS; CONSUMPTION AB Background: Alcohol misuse is a common cause of liver disease, upper gastrointestinal (GI) bleeding, and pancreatitis, but it is not known whether alcohol screening questionnaires can identify patients at increased risk for hospitalizations due to these conditions. Objective: To evaluate the association of alcohol screening scores with the risk of subsequent hospitalization for alcohol-related GI conditions. Design: Retrospective cohort study. Participants: Male general medicine outpatients from 7 Veterans Affairs (VA) medical centers who returned mailed questionnaires. Measurements: The CAGE questionnaire (0-4 points) and the Alcohol Use Disorders Identification Test-Consumption questions (AUDIT-C; 0-12 points) were included on mailed surveys. The main outcome, "GI hospitalization," was a primary VA or Medicare discharge diagnosis indicating liver disease, upper GI bleeding, or pancreatitis. Results: Among 31,311 patients followed, a median of 3.75 years, patients with CAGE scores >= 2 points or AUDIT-C scores >= 6 points were at a significantly increased risk for GI hospitalizations. Adjusted hazard ratios (HRadj) ranged from 1.6 (95% CI 1.2-2.0) for CAGE score 2, to 1.7 (1.4-2.2) for CAGE 4, and from 1.4 (1.01-2.0) for AUDIT-C scores from 6 to 7, to 2.7 (1.9-3.8) for AUDIT-C scores from 10 to 12. Secondary analyses demonstrated that the association was the strongest among patients less than 50 years of age who reported drinking in the past year. Conclusions: Brief alcohol screening questionnaires predict subsequent hospitalizations for alcohol-related GI conditions. C1 Ctr Excellence Subst Abuse Treatment & Educ, VA Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. Hlth Serv Res & Dev, Seattle, WA USA. Primary & Specialty Med Care Serv, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Pharm, Seattle, WA 98195 USA. RP Bradley, KA (reprint author), Ctr Excellence Subst Abuse Treatment & Educ, VA Puget Sound Hlth Care Syst, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM willi@u.washington.edu FU NIAAA NIH HHS [K23 AA00313] NR 56 TC 39 Z9 39 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD MAR PY 2007 VL 31 IS 3 BP 443 EP 451 DI 10.1111/j.1530-0277.2006.00325.x PG 9 WC Substance Abuse SC Substance Abuse GA 134QE UT WOS:000244097900011 PM 17295729 ER PT J AU Kressin, NR Glickman, ME Peterson, ED Whittle, J Orner, MB Petersen, LA AF Kressin, Nancy R. Glickman, Mark E. Peterson, Eric D. Whittle, Jeff Orner, Michelle B. Petersen, Laura A. TI Functional status outcomes among white and African-American cardiac patients in an equal access system SO AMERICAN HEART JOURNAL LA English DT Article ID CORONARY-ARTERY BYPASS; HEALTH-CARE-SYSTEM; QUALITY-OF-LIFE; RACIAL-DIFFERENCES; VETERANS-AFFAIRS; DISEASE; REVASCULARIZATION; ANGIOGRAPHY; DISPARITIES; SURGERY AB Background Racial disparities exist in invasive cardiac procedure use and, sometimes, in subsequent functional status outcomes. We explored whether racial differences in functional outcomes occur in settings where differences in access and treatment are minimized. Methods We conducted a prospective observational cohort study of 1022 white and African-American cardiac patients with positive nuclear imaging studies in 5 VA hospitals. Patients' functional status was assessed at baseline, 6, and 12 months later using the Seattle Angina Questionnaire and the SF-12, controlling for, treatment received, clinical, sociodemographic, and psychological, characteristics. Results There were no significant baseline effects of race on functional status, after adjusting for sociodemographics, comorbid conditions, maximal medical therapy, severity of ischemia on nuclear imaging study, personal attitudes, and beliefs. Although there were no race differences in percutaneous transluminal coronary angioplasty use, there was a trend of African Americans being less likely to undergo coronary artery bypass graft, after 6 months (1.4% vs 6.5%) and I year (1.9 vs 6.9%). After adjustment, the decline in the SF 12 Physical Component Summary from baseline to 6 months was, on average, 2.4 points less for African Americans than for whites, and at 12 months, Anginal Stability improved 8.4 points more for African Americans. The relative strength and direction of both findings persisted after removing covariates that might be confounded with race, and African Americans decreased less than whites on Physical Limitations, and improved more on Treatment Satisfaction, Anginal Frequency, and Disease Perceptions. Conclusions in a setting where differences in access are minimized, so are racial differences in functional status outcomes. C1 VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA 01730 USA. Boston Univ, Sch Med, Gen Internal Med Sect, Boston, MA 02215 USA. Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC 27706 USA. Zablocki Vet Adm Med Ctr, Primary Care Div, Milwaukee, WI 53295 USA. Med Coll Wisconsin, Dept Med, Div Gen Internal Med, Milwaukee, WI 53226 USA. Houston VA Med Ctr, Div Hlth Policy & Qual, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Sect Hlth Serv Res, Dept Med, Houston, TX 77030 USA. RP Kressin, NR (reprint author), VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, 200 Springs Rd,Bldg 70,152, Bedford, MA 01730 USA. EM nkressin@bu.edu OI Kressin, Nancy/0000-0003-2767-4286; Glickman, Mark/0000-0003-3993-2801 NR 39 TC 10 Z9 10 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD MAR PY 2007 VL 153 IS 3 BP 418 EP 425 DI 10.1016/j.ahj.2006.11.019 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 143ZF UT WOS:000244764200013 PM 17307422 ER PT J AU Bresnahan, S Eastwood, JA AF Bresnahan, Sandra Eastwood, Jo-Ann TI Confounding T-wave inversion SO AMERICAN JOURNAL OF CRITICAL CARE LA English DT Article ID NONCARDIAC SURGERY; COMMITTEE; MORTALITY; UPDATE AB In the medical community, the nonspecific finding of T-wave inversion warrants further investigation. An electrocardiogram may be an essential component of a surgical risk evaluation. Patients who show a T-wave inversion on a preoperative electrocardiogram require further investigation to distinguish between pathological and benign T-wave inversion. Optimizing patients' safety during the perioperative experience is the ultimate clinical outcome. C1 [Eastwood, Jo-Ann] Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. [Bresnahan, Sandra] Univ Calif Los Angeles, Anesthesia Preop Clin, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Bresnahan, S (reprint author), Mail Code 111,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sandra.bresnahan@va.gov NR 14 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CRITICAL CARE NURSES PI ALISO VIEJO PA 101 COLUMBIA, ALISO VIEJO, CA 92656 USA SN 1062-3264 J9 AM J CRIT CARE JI Am. J. Crit. Care PD MAR PY 2007 VL 16 IS 2 BP 137 EP 140 PG 4 WC Critical Care Medicine; Nursing SC General & Internal Medicine; Nursing GA 271SS UT WOS:000253809600008 PM 17322013 ER PT J AU Thakkar, K Gilger, MA Shulman, RJ El Serag, HB AF Thakkar, Kalpesh Gilger, Mark A. Shulman, Robert J. El Serag, Hashem B. TI EGD in children with abdominal pain: A systematic review SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Review ID HELICOBACTER-PYLORI INFECTION; UPPER GASTROINTESTINAL ENDOSCOPY; FIBEROPTIC ENDOSCOPY; ADOLESCENTS; CHILDHOOD; INFANTS; DISEASE; REFLUX; DYSPEPSIA; DIAGNOSIS AB BACKGROUND: We performed a systematic review to examine the diagnostic yield (endoscopic and histologic) of esophagogastroduodenoscopy (EGD) for the evaluation of abdominal pain of unclear etiology in children. We also examined the effect of EGD on change in treatment, quality of life, change in abdominal pain, and cost-effectiveness. METHODS: All full-length articles published in English during 1966-2005 were included if: (a) participants had abdominal pain without known underlying gastrointestinal disease, (b) participants underwent EGD primarily for the evaluation of abdominal pain, (c) findings of the EGD were reported, (d) participants were under 18 yr, and (e) sample size greater than 50. RESULTS: Eighteen articles examining 1,871 patients fulfilled the inclusion and exclusion criteria. All were observational and most (13) were prospective. Only three studies were performed in the United States and of those two were prospective. The largest study examined about 400 procedures and 13 studies examined less than 100 procedures. One case of inflammatory bowel disease and 67 duodenal or gastric ulcers were reported, thus diagnostic yield was achieved in 3.6% of cases. The prevalence of nonspecific histological gastrointestinal inflammatory lesions varied between 23% and 93%. Six articles attempted to correlate endoscopic or histologic findings with treatment management decisions. No articles attempted to describe quality of life or cost-effectiveness. None of the studies analyzed the association of alarm symptoms or signs to diagnostic yield. CONCLUSIONS: The diagnostic yield of EGD in children with unclear abdominal pain is low; however, existing studies are inadequate. The effect of EGD on change in treatment, quality of life, improvement of abdominal pain, and cost-effectiveness is unknown. The predictors of significant findings are unclear. Our findings suggest that a large multicenter study examining clinical factors, biopsy reports, and addressing patient outcomes is needed to further clarify the value of EGD in children with abdominal pain. C1 Baylor Coll Med, Sect Pediat Gastroenterol Hepatol & Nutr, Houston, TX 77030 USA. Baylor Coll Med, USDA ARS, Childrens Nutr Res Ctr, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP Thakkar, K (reprint author), 6621 Fannin St CCC 1010, Houston, TX 77030 USA. NR 49 TC 14 Z9 14 U1 0 U2 1 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 MAR PY 2007 VL 102 IS 3 BP 654 EP 661 DI 10.1111/j.1572-0241.2007.01051.x PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 140PF UT WOS:000244517000029 PM 17222318 ER PT J AU Ahmed, A Lefante, CM Alam, N AF Ahmed, Ali Lefante, Christina M. Alam, Nazmul TI Depression and nursing home admission among hospitalized older adults with coronary artery disease: A propensity score analysis SO AMERICAN JOURNAL OF GERIATRIC CARDIOLOGY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; HEART-FAILURE; MAJOR DEPRESSION; ELDERLY PATIENTS; COMMON OUTCOMES; RELATIVE RISK; MORTALITY; HEALTH; PREDICTORS; SYMPTOMS AB Admission to a nursing home is considered a Poor outcome for community-dwelling older adults. The objective of this study was to determine whether depression increased the risk of nursing home admission. Using the National Hospital Discharge Survey 2001-2003 datasets, the authors identified 28,172 community-dwelling older adults, 65 years and older, discharged alive with a primary discharge diagnosis of coronary artery disease. The objective of this study was to determine the association between depression and subsequent nursing home admissions in these patients. Propensity scores for depression, calculated for each patient using a multivariable logistic. regression model, were used to match 686 depressed patients with 2058 nondepressed patients who had similar propensity scores. Logistic regression analyses were used to determine the association between depression and nursing home admission. Patients had a mean age SD of 77 +/- 8 years, and 61% were women. Compared with 9% of nondepressed patients, 13% of depressed patients were admitted to nursing homes (relative risk, 1.42; 95% confidence interval, 1.12-1.78). When adjusted for various demographic, clinical, and care-related covariates, the association became somewhat stronger (adjusted relative risk, 1.55; 95% confidence interval, 1.21-1.99). In ambulatory older adults hospitalized with coronary artery disease, a secondary diagnosis of depression was associated with a significantly increased risk of nursing home admission. C1 Univ Alabama, Div Gerontol & Geriatr Med, Sch Med, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL 35294 USA. Univ Alabama, Ctr Heart Failure Res, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Sect Geriatr, Birmingham, AL USA. Louisiana State Univ, Hlth Sci Ctr, New Orleans Sch Publ Hlth, Dept Epidemiol, New Orleans, LA USA. RP Ahmed, A (reprint author), Univ Alabama, Div Gerontol & Geriatr Med, Sch Med, Dept Med, 1530 3rd Ave S,CH-19,Suite 219, Birmingham, AL 35294 USA. EM aahmed@uab.edu RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 FU NHLBI NIH HHS [P50 HL077100, R01 HL085561, 1-R01-HL085561-01, R01 HL085561-01, P50-HL077100]; NIA NIH HHS [1-K23-AG19211-01, 1-K23-AG19211-04, K23 AG019211-01A2, K23 AG019211, K23 AG019211-04] NR 44 TC 5 Z9 5 U1 0 U2 0 PU LE JACQ LTD PI DARIEN PA 3 PARKLANDS DRIVE, DARIEN, CT 06820 USA SN 1076-7460 J9 AM J GERIATR CARDIOL JI Am. J. Geriatr. Cardiol. PD MAR-APR PY 2007 VL 16 IS 2 BP 76 EP 83 DI 10.1111/j.1076-7460.2007.05519.x PG 8 WC Cardiac & Cardiovascular Systems; Geriatrics & Gerontology SC Cardiovascular System & Cardiology; Geriatrics & Gerontology GA 144WE UT WOS:000244826300003 PM 17380615 ER PT J AU Martin, BK Breitner, JCS Evans, D Lyketsos, CG Meinert, CL AF Martin, Barbara K. Breitner, John C. S. Evans, Denis Lyketsos, Constantine G. Meinert, Curtis L. TI The trialist, meta-analyst, and journal editor: Lessons from ADAPT SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material C1 Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Rush Univ, Med Ctr, Dept Internal Med, Chicago, IL 60612 USA. Johns Hopkins Sch Med, Dept Psychiat, Baltimore, MD USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. RP Martin, BK (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. NR 5 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAR PY 2007 VL 120 IS 3 BP 192 EP 193 DI 10.1016/j.amjmed.2006.12.010 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 143WF UT WOS:000244756400002 PM 17349436 ER PT J AU Rosman, AS Korsten, MA AF Rosman, Alan S. Korsten, Mark A. TI Meta-analysis comparing CT colonography, air contrast barium enema, and colonoscopy SO AMERICAN JOURNAL OF MEDICINE LA English DT Review DE CT colonography; barium enema; colonoscopy; summary receiver operating characteristic curve; meta-analysis ID COMPUTED-TOMOGRAPHIC COLONOGRAPHY; VIRTUAL COLONOSCOPY; COLORECTAL-CANCER; CONVENTIONAL COLONOSCOPY; DIAGNOSTIC-TEST; COLON-CANCER; PATIENT ACCEPTANCE; AVERAGE-RISK; POLYPS; NEOPLASIA AB INTRODUCTION: Published studies have reported a wide range of sensitivities and specificities for computed tomographic (CT) colonography for polyp detection, generating controversy regarding its diagnostic accuracy. METHODS: A meta-analysis of published studies comparing the accuracies of CT colonography and colonoscopy for polyp detection was performed. The pooled per-patient sensitivities and specificities were calculated at various thresholds for polyp size. Summary receiver operating characteristic (sROC) curves were also constructed. RESULTS: Thirty studies were included in the meta-analysis of CT colonography. The pooled per-patient sensitivity of CT colonography was higher for polyps greater than 10 mm (0.82, 95% confidence interval [CI], 0.76- 0.88) compared with polyps 6 to 10 mm (0.63, 95% CI, 0.52- 0.75) and polyps 0 to 5 mm (0.56, 95% CI, 0.42- 0.70). Similarly, the exact area under the sROC curve (area +/- standard error) was higher using a threshold greater than 10 mm (0.898 +/- 0.063) compared with thresholds of greater than 5 mm and any size (0.884 +/- 0.033 and 0.822 +/- 0.059, respectively). There were no significant differences in the diagnostic characteristics of 2-dimensional versus 3-dimensional CT colonography. At a threshold greater than 5 mm, the exact area under the sROC curve was significantly higher for endoscopic colonoscopy compared with CT colonography (0.998 +/- 0.006 vs 0.884 +/- 0.033, P <.005). CONCLUSIONS: CT colonography has a reasonable sensitivity and specificity for detecting large polyps but was less accurate than endoscopic colonoscopy for smaller polyps. Thus, CT colonography may not be a reasonable alternative in situations in which a small polyp may be clinically relevant. (c) 2007 Elsevier Inc. All rights reserved. C1 James J Peters VA Med Ctr, Gastroenterol Sect, Bronx, NY 10468 USA. James J Peters VA Med Ctr, Program Med, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Rosman, AS (reprint author), James J Peters VA Med Ctr, Gastroenterol Sect, Suite F,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Alan.Rosman@Med.VA.Gov NR 74 TC 68 Z9 71 U1 2 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAR PY 2007 VL 120 IS 3 BP 203 EP U4 DI 10.1016/j.amjmed.2006.05.061 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 143WF UT WOS:000244756400004 PM 17349438 ER PT J AU Breitner, J Evans, D Lyketsos, C Martin, B Meinert, C AF Breitner, John Evans, Denis Lyketsos, Constantine Martin, Barbara Meinert, Curtis TI ADAPT trial data SO AMERICAN JOURNAL OF MEDICINE LA English DT Letter C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Rush Univ, Rush Inst Healthy Aging, Chicago, IL 60612 USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Ctr Clin Trials, Baltimore, MD 21205 USA. RP Breitner, J (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA USA. FU NIA NIH HHS [U01 AG015477-05S3, U01 AG015477-05S2] NR 2 TC 6 Z9 6 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD MAR PY 2007 VL 120 IS 3 BP E3 EP E3 DI 10.1016/j.amjmed.2006.09.022 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 143WF UT WOS:000244756400022 PM 17349430 ER PT J AU Tam, DY Vagefi, MR Naseri, A AF Tam, Diamond Y. Vagefi, M. Reza Naseri, Ayman TI The clear corneal tongue: A mechanism for wound incompetence after phacoemulsification SO AMERICAN JOURNAL OF OPHTHALMOLOGY LA English DT Article ID CATARACT-SURGERY; ENDOPHTHALMITIS; INCISION; TUNNEL AB PURPOSE: To describe a mechanism for wound incompe, tence after phacoemulsification with corneal incisions resulting in early postoperative wound leakage. DESIGN: Observational case series. METHODS: Three patients who had uneventful phacoemulsification through a clear corneal incision were identified because of a postoperative wound leak. A corneal tongue, consisting of an everted triangular flap of posterior corneal stroma, the Descemet membrane, and endothelium, was observed in the wounds of all cases. RESULTS: One wound leak resolved after pressure patching. The other two necessitated wound revisions. None of the patients developed endophthalmitis. CONCLUSIONS: In phacoemulsification with corneal incisions, an everted flap of posterior corneal tissue, a corneal tongue, may prevent normal anatomical apposition of the surgical wound edges leading to potential wound incompetence. This event may increase the risk of endophthalmitis after clear corneal phacoemulsification. C1 San Francisco VA Med Ctr, Dept Ophthalmol, San Francisco, CA 94121 USA. RP Naseri, A (reprint author), San Francisco VA Med Ctr, Dept Ophthalmol, San Francisco, CA 94121 USA. EM Ayman.Naseri@va.gov NR 7 TC 7 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 0002-9394 J9 AM J OPHTHALMOL JI Am. J. Ophthalmol. PD MAR PY 2007 VL 143 IS 3 BP 526 EP 528 DI 10.1016/j.ajo.2006.09.061 PG 3 WC Ophthalmology SC Ophthalmology GA 141CZ UT WOS:000244555700029 PM 17317406 ER PT J AU Fischer, L Gukovskaya, AS Penninger, JM Mareninova, OA Friess, H Gukovsky, I Pandol, SJ AF Fischer, L. Gukovskaya, A. S. Penninger, J. M. Mareninova, O. A. Friess, H. Gukovsky, I. Pandol, S. J. TI Phosphatidylinositol 3-kinase facilitates bile acid-induced Ca2+ responses in pancreatic acinar cells SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE sarco( endo) plasmic reticulum Ca2+-ATPase; taurolithocholic acid 3-sulfate; taurochenodeoxycholate; cholecystokinin; pancreatitis ID RAT HEPATOCYTES; ENZYME ACTIVATION; CALCIUM; RELEASE; OBSTRUCTION; CA2+-ATPASE; RETICULUM; SEVERITY; SIGNALS; STORES AB Bile acids are known to induce Ca2+ signals in pancreatic acinar cells. We have recently shown that phosphatidylinositol 3-kinase (PI3K) regulates changes in free cytosolic Ca2+ concentration ([Ca2+](i)) elicited by CCK by inhibiting sarco(endo) plasmic reticulum Ca2+-ATPase (SERCA). The present study sought to determine whether PI3K regulates bile acid-induced [Ca2+](i) responses. In pancreatic acinar cells, pharmacological inhibition of PI3K with LY-294002 or wortmannin inhibited [Ca2+](i) responses to taurolithocholic acid 3-sulfate (TLC-S) and taurochenodeoxycholate (TCDC). Furthermore, genetic deletion of the PI3K gamma-isoform also decreased [Ca2+](i) responses to bile acids. Depletion of CCK-sensitive intracellular Ca2+ pools or application of caffeine inhibited bile acid-induced [Ca2+](i) signals, indicating that bile acids release Ca2+ from agonist-sensitive endoplasmic reticulum (ER) stores via an inositol (1,4,5)-trisphosphate-dependent mechanism. PI3K inhibitors increased the amount of Ca2+ in intracellular stores during the exposure of acinar cells to bile acids, suggesting that PI3K negatively regulates SERCA-dependent Ca2+ reloading into the ER. Bile acids inhibited Ca2+ reloading into ER in permeabilized acinar cells. This effect was augmented by phosphatidylinositol (3,4,5)-trisphosphate (PIP3), suggesting that both bile acids and PI3K act synergistically to inhibit SERCA. Furthermore, inhibition of PI3K by LY-294002 completely inhibited trypsinogen activation caused by the bile acid TLC-S. Our results indicate that PI3K and its product, PIP3, facilitate bile acid-induced [Ca2+](i) responses in pancreatic acinar cells through inhibition of SERCA-dependent Ca2+ reloading into the ER and that bile acid- induced trypsinogen activation is mediated by PI3K. The findings have important implications for the mechanism of acute pancreatitis since [Ca2+](i) increases and trypsinogen activation mediate key pathological processes in this disorder. C1 W Los Angeles Vet Affairs Healthcare Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90073 USA. Austrian Acad Sci, Inst Mol Biotechnol, Vienna, Austria. RP Gukovskaya, AS (reprint author), W Los Angeles Vet Affairs Healthcare Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 258,Rm 340, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu RI Penninger, Josef/I-6860-2013 OI Penninger, Josef/0000-0002-8194-3777 FU NIAAA NIH HHS [P50-AA-11999]; NIDDK NIH HHS [DK-59508, DK-59936] NR 37 TC 28 Z9 30 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD MAR PY 2007 VL 292 IS 3 BP G875 EP G886 DI 10.1152/ajpgi.00558.2005 PG 12 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 144HN UT WOS:000244787200020 PM 17158252 ER PT J AU Sullivan, CN Raboin, SJ Gulley, S Sinzobahamvya, NT Green, GM Reeve, JR Sayegh, AI AF Sullivan, Cherese N. Raboin, Shannon J. Gulley, Stephen Sinzobahamvya, Ntwenzi T. Green, Gary M. Reeve, Joseph R., Jr. Sayegh, Ayman I. TI Endogenous cholecystokinin reduces food intake and increases Fos-like immunoreactivity in the dorsal vagal complex but not in the myenteric plexus by CCK1 receptor in the adult rat SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE camostat; vagotomy; devazepide ID GLUCAGON-LIKE PEPTIDE-1; BRAIN-STEM; C-FOS; GASTROINTESTINAL-TRACT; INTESTINAL NUTRIENTS; CENTRAL ORGANIZATION; EXOCRINE PANCREAS; BINDING-SITES; NEURONS; EXPRESSION AB Endogenous cholecystokinin reduces food intake and increases Fos-like immunoreactivity in the dorsal vagal complex but not in the myenteric plexus by CCK1 receptor in the adult rat. Am J Physiol Regul Integr Comp Physiol 292: R1071 - R1080, 2007. First published November 2, 2006; doi:10.1152/ajpregu. 00490.2006. - We hypothesized that endogenous CCK reduces food intake by activating the dorsal vagal complex (DVC) and the myenteric neurons of the gut. To test this hypothesis, adult rats were given camostat mesilate; a nonnutrient releaser of endogenous CCK, by orogastric gavage, and Fos-like immunoreactivity (Fos-LI) was quantified in the DVC and the myenteric plexus. The results for endogenous CCK were compared with those for exogenous CCK-8. Exogenous CCK-8 reduced food intake and stimulated Fos-LI in the DVC and in myenteric neurons of the duodenum and jejunum. In comparison, endogenous CCK reduced food intake and increased DVC Fos-LI but did not increase Fos-LI in the myenteric plexus. Similar to CCK-8, devazepide, a specific CCK1 receptor antagonist, and not L365,260, a specific CCK2 receptor antagonist, attenuated the reduction of food intake by camostat. In addition, Fos-LI in the DVC in response to both exogenous CCK-8 and camostat administration was significantly attenuated by vagotomy, as well as by blocking CCK1 receptors. These results demonstrate for the first time that reduction of food intake in adult rats by endogenous CCK released by a nonnutrient mechanism requires CCK1 receptors, the vagus nerve, and activation of the DVC, but not the myenteric plexus. C1 Tuskegee Univ, Coll Vet Med, Dept Biomed Sci, Gastroenterol Lab, Tuskegee, AL 36088 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Univ Calif Los Angeles, CURE, Los Angeles, CA USA. Univ Calif Los Angeles, Digest Dis Res Ctr, Vet Adm Greater Los Angeles Healthcare Syst, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Div Digest Dis, Sch Med, Los Angeles, CA USA. RP Sullivan, CN (reprint author), Tuskegee Univ, Coll Vet Med, Dept Biomed Sci, Gastroenterol Lab, Tuskegee, AL 36088 USA. EM sayeghai@tuskegee.edu FU NIDDK NIH HHS [R01 DK 33850, DK 41301]; NIGMS NIH HHS [S06 GM 08091-31] NR 55 TC 25 Z9 26 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD MAR PY 2007 VL 292 IS 3 BP R1071 EP R1080 DI 10.1152/ajpregu.00490.2006 PG 10 WC Physiology SC Physiology GA 143LC UT WOS:000244722100003 PM 17082351 ER PT J AU Zhang, WK Meng, H Li, ZH Shu, ZJ Ma, XY Zhang, BX AF Zhang, Wanke Meng, Hua Li, Zhen-Hua Shu, Zhenju Ma, Xiuye Zhang, Bin-Xian TI Regulation of STIM1, store-operated Ca2+ influx, and nitric oxide generation by retinoic acid in rat mesangial cells SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE diabetes; protein downregulation; glomerular hyperfiltration; proteasome; lactacystin; eNOS ID PROTEIN-KINASE-C; GLOMERULAR ENDOTHELIAL-CELLS; ACTIVATED RECEPTOR-GAMMA; DIABETIC-NEPHROPATHY; HIGH GLUCOSE; TGF-BETA; EXTRACELLULAR-MATRIX; PLASMA-MEMBRANE; CALCIUM INFLUX; EXPRESSION AB It has been shown that store- operated Ca2+ influx ( SOC) plays critical roles in the activation of endothelial nitric oxide ( NO) synthase ( eNOS) and generation of NO in endothelial cells. Recent studies indicate stromal interaction molecule 1 ( STIM1) is the molecule responsible for SOC activation following Ca2+ depletion in the ER. Retinoic acids ( RA) have beneficial effects in the treatment of renal diseases. The mechanism of the RA action is still largely unknown. In the current study, we used primary cultured rat mesangial cells to examine the effect of RA on SOC and STIM1. In these cells, BK caused concentration- dependent [ Ca2+](i) mobilization. Treatment of the cells with RA, while it had no effect on the initial peak, reduced the plateau phase of BK- mediated [ Ca2+](i) response, indicating the inhibition of SOC by RA. The level of STIM1 protein but not mRNA in RA- treated cells was significantly reduced. RA treatment did not affect TGF-beta- mediated gradual Ca2+ influx which occurred by superoxide anion- mediated mechanism, indicating RA treatment specifically inhibited SOC in mesangial cells. RT- PCR and Western blot analysis demonstrated that eNOS was expressed in rat mesangial cells grown in media containing 11 and 30 but not 5.5 mM glucose. Downregulation of STIM1 protein and BK- induced SOC by RA treatment or STIM1 dsRNA were associated with abolished NO production. The 26S proteasome inhibitor lactacystin blocked the RA- mediated downregulation of BK- induced SOC, suggesting that ubiquitin- proteasome pathway may be involved in RA- mediated STIM1 protein downregulation in rat mesangial cells. Our data suggest that glucose- induced eNOS expression and NO production in mesangial cells may contribute to hyperfiltration in diabetes and RA may exert beneficial effects by downregulation of STIM1 and SOC in mesangial cells. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78285 USA. RP Zhang, BX (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr, GRECC 182,7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM zhangb2@uthscsa.edu FU NHLBI NIH HHS [R01-HL-75011] NR 55 TC 15 Z9 15 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 MAR PY 2007 VL 292 IS 3 BP F1054 EP F1064 DI 10.1152/ajprenal.00286.2006 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 143LE UT WOS:000244722300018 PM 17090780 ER PT J AU Sun, BC Hoffman, JR Mower, WR AF Sun, Benjamin C. Hoffman, Jerome R. Mower, William R. TI Evaluation of a modified prediction instrument to identify significant pediatric intracranial injury after blunt head trauma SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID NEW-ORLEANS CRITERIA; COMPUTED-TOMOGRAPHY; CLINICAL PREDICTORS; DECISION INSTRUMENT; CHILDREN; RULE; CT; CONSCIOUSNESS; ABNORMALITY; INDICATORS AB Study objective: We evaluate the effect of a modification of the University of California-Davis Pediatric Head Injury Rule on the ability of the decision instrument for pediatric head injury to predict clinically important intracranial injury in an external cohort. Methods: We analyzed data prospectively recorded in 1,666 pediatric patients enrolled in the derivation set of the National Emergency X-Radiography Utilization Study II (NEXUS II). Treating physicians at 21 emergency departments recorded the presence or absence of clinical predictors on all patients who received a head computed tomography (CT) scan after experiencing blunt head trauma. Predictors included 3 exact elements of the University of California-Davis Rule (abnormal mental status, signs of skull fracture, and scalp hematoma in children : 2 years of age), some with different wording, and 2 modified elements with new definitions (the presence of high-risk vomiting or severe headache, rather than any vomiting or headache). Results: A significant intracranial injury was identified by CT in 138 (8.3%) patients. Sensitivity of the modified instrument to detect significant intracranial injury was 90.4% (95% confidence interval [CI] 85.4% to 95.4%); 13 children with such an injury were misclassified as low risk, Specificity of the modified instrument was 42.7% (95% Cl 40.1% to 45.3%). Conclusion: In the NEXUS II cohort, a modified version of the University of California-Davis Rule misclassified a substantial proportion of pediatric patients with clinically important blunt head injury. Although we cannot evaluate the exact University of California-Davis Rule, we demonstrate that using stricter definitions of "headache" and "vomiting" and different wording than in the original study may have unintended or negative consequences. We emphasize the importance of careful attention to precise definitions of clinical predictors when a decision instrument is used. C1 Univ Calif Los Angeles, Ctr Emergency Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Robert Wood Johnson Clin Scolars Program, Los Angeles, CA 90024 USA. RP Sun, BC (reprint author), W Los Angeles VA Med Ctr, MAil Stop 111,Bldg 500,Wing 3E,11301 Wilshire Blv, Los Angeles, CA 90073 USA. EM bsun@post.harvard.edu FU AHRQ HHS [R01 HS09699] NR 27 TC 24 Z9 24 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD MAR PY 2007 VL 49 IS 3 BP 325 EP 332 DI 10.1016/j.annemergmed.2006.08.032 PG 8 WC Emergency Medicine SC Emergency Medicine GA 142GI UT WOS:000244637000014 PM 17210207 ER PT J AU Werner, RM Asch, DA AF Werner, Rachel M. Asch, David A. TI Clinical concerns about clinical performance measurement SO ANNALS OF FAMILY MEDICINE LA English DT Editorial Material DE health care quality; access; and evaluation; quality improvement; primary health care; patient-centered care ID QUALITY-OF-CARE; HEALTH-CARE; PHYSICIANS; VA AB Performance measurement has become one of the foundations of current efforts.,, to improve health care quality and has successfully increased compliance with practice guidelines in many settings. Despite the successes of performance measurement, many physicians remain apprehensive about its use because performance measurement "gets in the way of" delivering good care. There are several reasons clinicians might feel this way. First, performance measurement is increasingly being extended to areas that have only a small clinical benefit and thus risk diverting attention from other more important but unmeasured aspects of care. Second, most performance measurement systems provide no priority for following guidelines likely to yield a large clinical benefit compared with guidelines likely to yield at best a small clinical benefit. Third, performance measures focus physicians' attention narrowly on compliance with those measures rather than more broadly on the needs of the individual patient. Because performance measures are evaluated at the level of the indicator, they may crowd out quality at the level of the patient that is equally important but that cannot be easily measured. Performance measures play an important role in improving health care quality and will undoubtedly continue to do so; however, they are only one part of the solution to improving health care quality. Good performance is not necessarily good care, and pressure to improve performance can come at the sacrifice of good care. in its current state, performance measurement is better suited to improving measured care than improving the care of individual patients. C1 Univ Penn, Div Gen Internal Med, Sch Med, 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 USA. RP Werner, RM (reprint author), Univ Penn, Div Gen Internal Med, Sch Med, 1230 Blockley Hall 423 Guardian Dr, Philadelphia, PA 19104 USA. EM rwerner@mail.med.upenn.edu NR 22 TC 29 Z9 29 U1 2 U2 4 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 MAR-APR PY 2007 VL 5 IS 2 BP 159 EP 163 DI 10.1370/afm.645 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 161FU UT WOS:000246000700011 PM 17389541 ER PT J AU Haidet, P AF Haidet, Paul TI Jazz and the 'art' of medicine: Improvisation in the medical encounter SO ANNALS OF FAMILY MEDICINE LA English DT Editorial Material DE physician-patient relations; primary health care; patient-centered care; education; medical; humanities; music; communication; curriculum; theoretical models; behavioral medicine; health care delivery; health services research ID DOCTOR-PATIENT COMMUNICATION; PRIMARY-CARE PHYSICIANS; BAD-NEWS; INTERVIEW; SATISFACTION; BEHAVIOR; SKILLS; CLUES AB Improvisation is an important aspect of patient-physician communication. It is also a defining feature of jazz music performance. This essay uses examples from jazz to illustrate principles of improvisation that relate to an individual communication act (ie, building space into one's communication), a physician's communicative style (ie, developing one's voice), and the communicative process of the medical encounter (ie, achieving ensemble). At all 3 levels, the traditions of jazz improvisation can inform efforts to research and teach medical interviewing by fostering a contextualized view of patient-physician communication. C1 Baylor Coll Med, Houston, TX 77030 USA. RP Haidet, P (reprint author), VA Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM phaidet@bcm.tmc.edu NR 55 TC 39 Z9 39 U1 6 U2 13 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 MAR-APR PY 2007 VL 5 IS 2 BP 164 EP 169 DI 10.1370/afm.624 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 161FU UT WOS:000246000700012 PM 17389542 ER PT J AU Makrygiannakis, D Hermansson, M Ulfgren, AK Nicholas, AP Zendman, AJ Eklund, A Grunewald, J Skold, M Klareskog, L Catrina, AI AF Makrygiannakis, D. Hermansson, M. Ulfgren, A-K. Nicholas, A. P. Zendman, A. J. Eklund, A. Grunewald, J. Skold, M. Klareskog, L. Catrina, A. Irinel TI Smoking upregulates peptidylarginine 2 enzyme expression and citrullination SO ANNALS OF THE RHEUMATIC DISEASES LA English DT Meeting Abstract CT 27th European Workshop for Rheumatology Research CY FEB 22-24, 2007 CL Florence, ITALY C1 Karolinska Univ Hosp, Dept Rheumatol, Stockholm, Sweden. Karolinska Univ Hosp, Dept Resp Med, Stockholm, Sweden. Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. Radboud Univ Nijmegen, Dept Biochem, Nijmegen, Netherlands. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0003-4967 J9 ANN RHEUM DIS JI Ann. Rheum. Dis. PD MAR 1 PY 2007 VL 66 SU 1 MA 035 BP A16 EP A16 PG 1 WC Rheumatology SC Rheumatology GA 138BN UT WOS:000244337600051 ER PT J AU Wagner, MT Wymer, JH Carlozzi, NE Bachman, D Walker, A Mintzer, J AF Wagner, Mark T. Wymer, Joy H. Carlozzi, Noelle E. Bachman, David Walker, Aljoeson Mintzer, Jacobo CA Alzheimer Study Grp TI Preliminary examination of progression of Alzheimer's disease in a rural Southern African American cohort SO ARCHIVES OF CLINICAL NEUROPSYCHOLOGY LA English DT Article DE African American; Alzheimer disease; dementia; neuropsychological assessment; cerebrovascular disease ID NEUROPSYCHOLOGICAL TEST-PERFORMANCE; MILD COGNITIVE IMPAIRMENT; NEUROPSYCHIATRIC INVENTORY; ISCHEMIC SCORE; UNITED-STATES; RISK-FACTORS; DEMENTIA; DIAGNOSIS; ADULTS; CERAD AB African Americans are at significantly increased risk for the development of Alzheimer's disease (AD), yet are seriously underrepresented in research trials. Preliminary experiences on a large scale, multi-site, 5-year longitudinal trial investigating the psychometric expression and progression of AD targeting an aging Southern rural cohort of African Americans are reported. Sixty-five participants, ranging from asymptomatic to severely demented, underwent extensive individual diagnostic and psychometric evaluation. Results indicated that cultural factors strongly influenced the data. Recruitment with asymptomatic volunteers were found to have greater educational attainment than other participant groups. Psychomotor measures showed greater impairment in African Americans compared to Caucasians suggesting increased cerebrovascular burden. African Americans' performance on the Boston Naming Test and the Wechsler Test of Adult Reading tests were significantly different than performance of Caucasian groups. The findings demonstrated that a better understanding of sociocultural factors associated with AD in the African American population may facilitate the development of primary and secondary preventions, especially when considering the role of cerebrovascular comorbidity which is a modifiable risk factor. (C) 2007 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. C1 Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Wagner, MT (reprint author), Med Univ S Carolina, Dept Neurosci, CSB Room 307,96 Jonathon Lucas St, Charleston, SC 29425 USA. EM wagnermt@musc.edu NR 69 TC 2 Z9 2 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0887-6177 J9 ARCH CLIN NEUROPSYCH JI Arch. Clin. Neuropsychol. PD MAR PY 2007 VL 22 IS 3 BP 405 EP 414 DI 10.1016/j.acn.2007.01.014 PG 10 WC Psychology, Clinical; Psychology SC Psychology GA 196IO UT WOS:000248475100014 PM 17296283 ER PT J AU Anderson, CA Bosque, P Filley, CM Arciniegas, DB Kleinschmidt-DeMasters, BK Pape, WJ Tyler, KL AF Anderson, C. Alan Bosque, Patrick Filley, Christopher M. Arciniegas, David B. Kleinschmidt-DeMasters, B. K. Pape, W. John Tyler, Kenneth L. TI Colorado surveillance program for chronic wasting disease transmission to humans - Lessons from 2 highly suspicious but negative cases SO ARCHIVES OF NEUROLOGY LA English DT Article ID CREUTZFELDT-JAKOB-DISEASE; MULE DEER; PRIONS; ELK; BARRIERS AB Objective: To describe 2 patients with rapidly progressive dementia and risk factors for exposure to chronic wasting disease (CWD) in whom extensive testing negated the possible transmission of CWD. Design/Methods: We describe the evaluation of 2 young adults with initial exposure histories and clinical presentations that suggested the possibility of CWD transmission to humans. Patients: A 52-year-old woman with possible laboratory exposure to CWD and a 25-year-old man who had consumed meat from a CWD endemic area. Interventions: Clinical evaluation, neuropathological examination, and genetic testing. Results: Neuropathological and genetic assessment in the 2 patients proved the diagnoses of early-onset Alzheimer disease and a rare genetic prion disease. Conclusion: No convincing cases of CWD transmission to humans have been detected in our surveillance program. C1 Univ Colorado, Sch Med, Dept Neurol, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Psychiat, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Pathol, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Med, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Microbiol, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Immunol, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Denver Hlth Med Ctr, Denver, CO USA. Colorado Dept Publ Hlth & Environm, Denver, CO USA. RP Anderson, CA (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, B-182,4200 E 9th Ave, Denver, CO 80262 USA. EM al.anderson@uchsc.edu RI Arciniegas, David/A-3792-2009 OI Tyler, Kenneth/0000-0003-3294-5888 NR 19 TC 10 Z9 12 U1 1 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD MAR PY 2007 VL 64 IS 3 BP 439 EP 441 DI 10.1001/archneur.64.3.439 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 145GZ UT WOS:000244854600021 PM 17353391 ER PT J AU van Drongelen, S Boninger, ML Impink, BG Khalaf, T AF van Drongelen, Stefan Boninger, Michael L. Impink, Bradley G. Khalaf, Tagreed TI Ultrasound imaging of acute biceps tendon changes after wheelchair sports SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE rehabilitation; shoulder; tendon injuries; ultrasonography; wheelchairs ID ROTATOR CUFF TEARS; UPPER EXTREMITY; SHOULDER JOINT; 2 SPEEDS; ULTRASONOGRAPHY; PARAPLEGIA; PROPULSION; PATHOLOGY; USERS; PAIN AB Objectives: To investigate acute changes in the biceps tendon after a high-intensity wheelchair propulsion activity and to determine whether these changes are related to subject characteristics. Design: The biceps tendon was imaged with ultrasound before and after wheelchair basketball or quad rugby. The average diameter of the tendon was calculated as well as the echogenicity ratio (the pixel intensity ratio of the biceps tendon to a reference just superficial to the tendon sheath). Setting: National Veterans Wheelchair Games in 2004 and 2005. Participants: Forty-two subjects who participated in wheelchair basketball or quad rugby at the Veterans Games. Interventions: Not applicable. Main Outcome Measures: Biceps tendon diameter and biceps echogenicity. Results: The echogenicity ratio of the tendon significantly decreased from 1.97 to 1.73 after the event (P=.038). The diameter of the biceps tendon increased from 4.60 to 4.82mm (P=.178). Also, it was found that the change in tendon diameter positively correlated with the time of play (P=.004). Conclusions: Acute changes in biceps tendon properties after exercise were found and likely represent edema, a first sign of overuse injury. The significance of continuous activity was shown by the fact that subjects who had more playing time showed a larger increase in tendon diameter. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Swiss Parapleg Res, Nottwil, Switzerland. Mayo Clin, Coll Med, Dept Phys Med & Rehabil, Rochester, MN USA. RP Boninger, ML (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. EM boninger@pitt.edu RI van Drongelen, Stefan/J-4983-2015 OI van Drongelen, Stefan/0000-0001-5961-1015; Boninger, Michael/0000-0001-6966-919X NR 32 TC 20 Z9 20 U1 1 U2 6 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD MAR PY 2007 VL 88 IS 3 BP 381 EP 385 DI 10.1016/j.apmr.2006.11.024 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 142AU UT WOS:000244621600018 PM 17321833 ER PT J AU Turner, JH Garnovskaya, MN Raymond, JR AF Turner, Justin H. Garnovskaya, Maria N. Raymond, John R. TI Serotonin 5-HT1A receptor stimulates c-Jun N-terrninal kinase and induces apoptosis in Chinese hamster ovary fibroblasts SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH LA English DT Article DE 5-hydroxytryptamine; serotonin; apoptosis; programmed cell death; G protein; phosphorylation ID ACTIVATED PROTEIN-KINASE; BAY X 3702; TERMINAL KINASE; MEDIATED INHIBITION; PARKINSONS-DISEASE; SIGNALING PATHWAYS; CAUSES SUPPRESSION; CULTURED NEURONS; RAT HIPPOCAMPUS; CELL-SURVIVAL AB The 5-HTlA receptor is a prototypical member of the large and diverse scrotonin receptor family. One key role of this receptor is to stimulate cell proliferation and differentiation via the extracellular signal regulated protein kinase (ERK) mitogen activated protein (MAP) kinase. There are few reports on the ability of the 5-HTlA receptor to modulate other MAP kinases such as c-Jun N-terminal kinase (JNK), which is activated by various extracellular stimuli, resulting in cell growth, differentiation, and programmed cell death. We report here for the first time that the 5-HTlA receptor stimulates JNK. JNK stimulation was Pertussis toxin-sensitive and was mediated by Rho family low molecular weight GTPases. The 5-HTlA receptor also increased apoptosis, which was mimicked by the MEK inhibitor PD98059, and blocked by the JNK inhibitor SP600125. These results suggest that the 5-HTlA receptor stimulates both ERK-dependent anti-apoptotic pathways and JNK-dependent pro-apoptotic pathways in CHO cells. (c) 2006 Published by Elsevier B.V. C1 Ralph H Johnson VA Med Ctr, Med & Res Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. RP Raymond, JR (reprint author), 179 Ashley Ave,Colcock Hall Off Provost, Charleston, SC 29425 USA. EM raymondj@musc.edu FU NIDDK NIH HHS [DK52448]; NIGMS NIH HHS [GM08716, GM63909] NR 61 TC 16 Z9 17 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-4889 J9 BBA-MOL CELL RES JI Biochim. Biophys. Acta-Mol. Cell Res. PD MAR PY 2007 VL 1773 IS 3 BP 391 EP 399 DI 10.1016/j.bbamcr.2006.12.003 PG 9 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 147LS UT WOS:000245005100011 PM 17208318 ER PT J AU Mani, G Feldman, MD Patel, D Agrawal, CM AF Mani, Gopinath Feldman, Marc D. Patel, Devang Agrawal, C. Mauli TI Coronary stents: A materials perspective SO BIOMATERIALS LA English DT Review DE stent; surface treatment; surface modification; drug delivery ID DRUG-ELUTING STENTS; MUSCLE-CELL-PROLIFERATION; BALLOON-EXPANDABLE-STENT; IMMERSION ION-IMPLANTATION; TITANIUM-NITRIDE-OXIDE; 316L STAINLESS-STEEL; CARBON-COATED STENTS; LONG-TERM STABILITY; ARTERY-DISEASE; SURFACE MODIFICATION AB The objective of this review is to describe the suitability of different biomaterials as coronary stents. This review focuses on the following topics: (1) different materials used for stents, (2) surface characteristics that influence stent-biology interactions, (3) the use of polymers in stents, and (4) drug-eluting stents, especially those that are commercially available. (c) 2006 Elsevier Ltd. All rights reserved. C1 Univ Texas, Coll Engn, Dept Biomed Engn, San Antonio, TX 78249 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Cardiol, San Antonio, TX 78229 USA. Dept Vet Affairs S Texas Hlth Care Syst, San Antonio, TX 78229 USA. RP Agrawal, CM (reprint author), Univ Texas, Coll Engn, Dept Biomed Engn, 1 UTSA Circle, San Antonio, TX 78249 USA. EM mauli.agrawal@utsa.edu NR 272 TC 389 Z9 411 U1 16 U2 182 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0142-9612 J9 BIOMATERIALS JI Biomaterials PD MAR PY 2007 VL 28 IS 9 BP 1689 EP 1710 DI 10.1016/j.biomaterials.2006.11.042 PG 22 WC Engineering, Biomedical; Materials Science, Biomaterials SC Engineering; Materials Science GA 135RE UT WOS:000244169900011 PM 17188349 ER PT J AU Clegg, LX Reichman, ME Hankey, BF Miller, BA Lin, YD Johnson, NJ Schwartz, SM Bernstein, L Chen, VW Goodman, MT Gomez, SL Graff, JJ Lynch, CF Lin, CC Edwards, BK AF Clegg, Limin X. Reichman, Marsha E. Hankey, Benjamin F. Miller, Barry A. Lin, Yi D. Johnson, Norman J. Schwartz, Stephen M. Bernstein, Leslie Chen, Vivien W. Goodman, Marc T. Gomez, Scarlett L. Graff, John J. Lynch, Charles F. Lin, Charles C. Edwards, Brenda K. TI Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies SO CANCER CAUSES & CONTROL LA English DT Article DE National Longitudinal Mortality Study; NLMS; race; ethnicity and immigrant status; surveillance; epidemiology; End Results; SEER ID NATIONAL DEATH INDEX; END RESULTS PROGRAM; UNITED-STATES; AMERICAN-INDIANS; BREAST-CANCER; BIRTHPLACE; SURVEILLANCE; SELF; EPIDEMIOLOGY; WOMEN AB Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute are based on medical records and administrative information. Although SEER data have been used extensively in health disparities research, the quality of information concerning race, Hispanic ethnicity, and immigrant status has not been systematically evaluated. The quality of this information was determined by comparing SEER data with self-reported data among 13,538 cancer patients diagnosed between 1973-2001 in the SEER-National Longitudinal Mortality Study linked database. The overall agreement was excellent on race (kappa = 0.90, 95% CI = 0.88-0.91), moderate to substantial on Hispanic ethnicity (kappa = 0.61, 95% CI = 0.58-0.64), and low on immigrant status (kappa = 0.21. 95% CI = 0.10, 0.23). The effect of these disagreements was that SEER data tended to under-classify patient numbers when compared to self-identifications, except for the non-Hispanic group which was slightly over-classified. These disagreements translated into varying racial-, ethnic-, and immigrant status-specific cancer statistics, depending on whether self-reported or SEER data were used. In particular, the 5-year Kaplan-Meier survival and the median survival time from all causes for American Indians/Alaska Natives were substantially higher when based on self-classification (59% and 140 months, respectively) than when based on SEER classification (44% and 53 months, respectively), although the number of patients is small. These results can serve as a useful guide to researchers contemplating the use of population-based registry data to ascertain disparities in cancer burden. In particular, the study results caution against evaluating health disparities by using birthplace as a measure of immigrant status and race information for American Indians/Alaska Natives. C1 US Dept Vet Affairs, Off Healthcare Inspect, Off Inspector Gen, Washington, DC 20001 USA. NCI, Surveillance Res Program, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. Monash Univ, Sch Med, Melbourne, Vic 3004, Australia. US Bur Census, Suitland, MD USA. Fred Hutchinson Canc Res Ctr, Program Epidemiol, Div Publ Hlth Sci, Seattle, WA 98104 USA. Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90089 USA. LSU Sch Publ Hlth, Louisiana Tumor Registry, New Orleans, LA USA. Univ Hawaii, Canc Res Ctr, Honolulu, HI 96822 USA. No Calif Canc Ctr, Fremont, CA USA. Wayne State Univ, Karmanos Canc Inst, Detroit, MI 48202 USA. Univ Iowa, State Hlth Registry Iowa, Iowa City, IA 52242 USA. RP Clegg, LX (reprint author), US Dept Vet Affairs, Off Healthcare Inspect, Off Inspector Gen, 801 I St,NW,Room 1018, Washington, DC 20001 USA. EM Lin.clegg@va.gov NR 43 TC 95 Z9 99 U1 0 U2 3 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0957-5243 J9 CANCER CAUSE CONTROL JI Cancer Causes Control PD MAR PY 2007 VL 18 IS 2 BP 177 EP 187 DI 10.1007/s10552-006-0089-4 PG 11 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 134EL UT WOS:000244065700007 PM 17219013 ER PT J AU Diaz, A Barria, P Niederman, M Restrepo, MI Dreyse, J Fuentes, G Couble, B Saldias, F AF Diaz, Alejandro Barria, Paulina Niederman, Michael Restrepo, Marcos I. Dreyse, Jorge Fuentes, Gino Couble, Bernardita Saldias, Fernando TI Etiology of community-acquired pneumonia in hospitalized patients in Chile - The increasing prevalence of respiratory viruses among classic pathogens SO CHEST LA English DT Article DE bacterial pneumonia; community; etiology; viruses ID PNEUMOCOCCAL PNEUMONIA; ADULT PATIENTS; STREPTOCOCCUS-PNEUMONIAE; PROGNOSTIC-FACTORS; EPITHELIAL-CELLS; GUIDELINES; MANAGEMENT; MULTICENTER; DIAGNOSIS; SEVERITY AB Background and study objectives: The range and relative impact of microbial pathogens, particularly viral pathogens, as a cause of community-acquired pneumonia (CAP) in hospitalized adults has not received much attention. The aim of this study was to determine the microbial etiology of CAP in adults and to identify the risk factors for various specific pathogens. Methods: We prospectively studied 176 patients (mean [+/- SD] age, 65.8 +/- 18.5 years) who had hospitalized for CAP to identify the microbial etiology. For each patient, sputum and blood cultures were obtained as well as serology testing for Mycoplasina pneumoniae and Chlamydophila pneumoniae, urinary antigen testing for Legionella pneumophila and Streptococcus pneumoniae, and a nasopharyngeal swab for seven respiratory viruses. Results: Microbial etiology was determined in 98 patients (55%). S pneumoniae (49 of 98 patients; 50%) and respiratory viruses (32%) were the most frequently isolated pathogen groups. Pneumococcal pneumonia was associated with tobacco smoking of > 10 pack-years (odds ratio [OR] 2.6; 95% confidence interval [CI], 1.2 to 5.4; p = 0.01). Respiratory viruses were isolated more often in fall or winter (28%; p = 0.011), and as an exclusive etiology tended to be isolated in patients : 65 years of age (20%; p = 0.07). Viral CAP was associated with antimicrobial therapy prior to hospital admission (OR, 4.5; 95% CI, 1.4 to 14.6). Conclusions: S pneumoniae remains the most frequent pathogen in adults with CAP and should be covered with empirical antimicrobial treatment. Viruses were the second most common etiologic agent and should be tested for, especially in fall or winter, both in young and elderly patients who are,hospitalized with CAP. C1 Pontificia Univ Catolica Chile, Dept Enfermedades Resp, Santiago, Chile. Winthrop Univ Hosp, Dept Med, Mineola, NY 11501 USA. S Texas Vet Hlth Care Syst, Dept Med, Div Pulm Crit Care Med & Infect Dis, San Antonio, TX USA. RP Diaz, A (reprint author), 20 Bonner Ave, Somerville, MA 02143 USA. EM alediazf@hotmail.com RI Restrepo, Marcos/H-4442-2014 NR 37 TC 59 Z9 69 U1 0 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAR PY 2007 VL 131 IS 3 BP 779 EP 787 DI 10.1378/chest.06-1800 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 148KI UT WOS:000245072900024 PM 17356093 ER PT J AU Mandell, LA Wunderink, RG Anzueto, A Bartlett, JG Campbell, GD Dean, NC Dowell, SF File, TM Musher, DM Niederman, MS Torres, A Whitney, CG AF Mandell, Lionel A. Wunderink, Richard G. Anzueto, Antonio Bartlett, John G. Campbell, G. Douglas Dean, Nathan C. Dowell, Scott F. File, Thomas M., Jr. Musher, Daniel M. Niederman, Michael S. Torres, Antonio Whitney, Cynthia G. TI Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults SO CLINICAL INFECTIOUS DISEASES LA English DT Review ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; INVASIVE PNEUMOCOCCAL DISEASE; RANDOMIZED CONTROLLED-TRIAL; LOW-RISK PATIENTS; VENTILATOR-ASSOCIATED PNEUMONIA; URINARY ANTIGEN TEST; NEURAMINIDASE INHIBITOR OSELTAMIVIR; DIAGNOSTIC FIBEROPTIC BRONCHOSCOPY; STAPHYLOCOCCUS-AUREUS INFECTIONS; TRANSTHORACIC NEEDLE ASPIRATION AB Improving the care of adult patients with community-acquired pneumonia (CAP) has been the focus of many different organizations, and several have developed guidelines for management of CAP. Two of the most widely referenced are those of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS). In response to confusion regarding differences between their respective guidelines, the IDSA and the ATS convened a joint committee to develop a unified CAP guideline document. The guidelines are intended primarily for use by emergency medicine physicians, hospitalists, and primary care practitioners; however, the extensive literature evaluation suggests that they are also an appropriate starting point for consultation by specialists. Substantial overlap exists among the patients whom these guidelines address and those discussed in the recently published guidelines for health care-associated pneumonia (HCAP). Pneumonia in nonambulatory residents of nursing homes and other long-term care facilities epidemiologically mirrors hospital-acquired pneumonia and should be treated according to the HCAP guidelines. However, certain other patients whose conditions are included in the designation of HCAP are better served by management in accordance with CAP guidelines with concern for specific pathogens. C1 McMaster Univ, Henderson Hosp, Div Infect Dis, Hamilton, ON L8V 1C3, Canada. McMaster Univ, Sch Med, Hamilton, ON L8V 1C3, Canada. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78285 USA. Michael E DeBakey VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD 21218 USA. Univ Mississippi, Sch Med, Div Pulm Crit Care & Sleep Med, Jackson, MS 39216 USA. LDS Hosp, Div Pulm & Crit Care Med, Salt Lake City, UT USA. Univ Utah, Salt Lake City, UT USA. Ctr Dis Control & Prevent, Atlanta, GA USA. NW Ohio Univ, Coll Med, Rootstown, OH USA. Summa Hlth Syst, Akron, OH USA. SUNY Stony Brook, Stony Brook, NY 11794 USA. Winthrop Univ Hosp, Dept Med, Mineola, NY 11501 USA. Univ Barcelona, Fac Med, Inst Invest Biomed August Pi & Sunyer, Hosp Clin Barcelona,Cap Serv Pneumol & Allergia R, Barcelona 7, Spain. RP Mandell, LA (reprint author), McMaster Univ, Henderson Hosp, Div Infect Dis, 5th Fl,Wing 40,Rm 503,711 Concess St, Hamilton, ON L8V 1C3, Canada. EM lmandell@mcmaster.ca OI Wunderink, Richard/0000-0002-8527-4195 NR 335 TC 2306 Z9 2576 U1 41 U2 225 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAR 1 PY 2007 VL 44 SU 2 BP S27 EP S72 DI 10.1086/511159 PG 46 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 132FT UT WOS:000243929000001 PM 17278083 ER PT J AU Atherton, S Church, V Locke, C Tjoelker, R AF Atherton, Sherri Church, Victoria Locke, Christy Tjoelker, Rita TI Clinical nurse specialists: Bridging the gap between evidence and practice using evidence-based fact sheets SO CLINICAL NURSE SPECIALIST LA English DT Meeting Abstract C1 Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0887-6274 J9 CLIN NURSE SPEC JI Clin. Nurse Spec. PD MAR-APR PY 2007 VL 21 IS 2 BP 102 EP 102 DI 10.1097/00002800-200703000-00012 PG 1 WC Nursing SC Nursing GA 140AX UT WOS:000244475600011 ER PT J AU Shacter, HE Gee, RE Long, JA AF Shacter, Hannah E. Gee, Rebekah E. Long, Judith A. TI Variation in availability of emergency contraception in pharmacies SO CONTRACEPTION LA English DT Article DE emergency contraception; health policy; women's health; pharmacy availability ID CONSCIENTIOUS OBJECTION AB Objective: The availability of emergency contraception (EC) depends on pharmacy stocking practices and pharmacist willingness to dispense the medication. We aimed to describe the availability of EC in areas governed by different state policies regarding pharmacist behavior. Study Design: A telephone survey was conducted between October I and December 31, 2005, of every pharmacy listed in the metropolitan areas of Atlanta, Philadelphia and Boston. We asked whether pharmacies could fill a prescription for EC within 24 h and, if not, why not. Results: We interviewed pharmacists at 1085 pharmacies (response rate of 75%). Overall, 23% were unable to fill a prescription for EC within 24 It. The rate of being unable to fill was 35% in Atlanta, 23% in Philadelphia and 4% in Boston (p <.001). Refusal rates were low: 4% overall; 8% in Atlanta; 3% in Philadelphia and 0% in Boston. Conclusions: Variation in state policy predicted the availability of EC. The most common reason for not being able to fill a prescription within 24 h was not having the medication in stock. (c) 2007 Elsevier Inc. All rights reserved. C1 Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Robert Wood Johnson Fdn, Clin Scholars Program, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Shacter, HE (reprint author), Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA 19104 USA. EM hshacter@gmail.com NR 17 TC 12 Z9 13 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0010-7824 J9 CONTRACEPTION JI Contraception PD MAR PY 2007 VL 75 IS 3 BP 214 EP 217 DI 10.1016/j.contraception.2006.11.005 PG 4 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 141BB UT WOS:000244550100011 PM 17303492 ER PT J AU Amory, JK Page, ST Anawalt, BD Matsumoto, AM Bremner, WJ AF Amory, John K. Page, Stephanie T. Anawalt, Bradley D. Matsumoto, Alvin M. Bremner, William J. TI Acceptability of a combination testosterone gel and depomedroxyprogesterone acetate male contraceptive regimen SO CONTRACEPTION LA English DT Article DE spermatogenesis; sexual function; male hormonal contraception; testosterone gel ID MALE HORMONAL CONTRACEPTION; NORMALIZES ANDROGEN LEVELS; NORETHISTERONE ENANTHATE; SEXUAL FUNCTION; TRANSDERMAL TESTOSTERONE; BODY-COMPOSITION; CLINICAL-TRIAL; NORMAL MEN; UNDECANOATE; SPERMATOGENESIS AB Background: Testosterone (T) gel, administered transdermally in combination with injections of depornedroxyprogesterone acetate (DMPA) every 3 months, results in effective suppression of spermatogenesis in 90% of men. Men's attitudes regarding the daily self-administration of T-gel and the impact of such a regimen on sexual function, however, are unknown. Therefore, we questioned subjects enrolled in a combination T-gel plus DMPA male contraceptive trial regarding the acceptability of T-gel for male contraception and the impact of the T-geu DMPA regimen on sexual function and satisfaction during treatment. Study Design: Thirty-eight healthy men, ages 18-55, were treated with T-gel (100 mg daily) + DMPA (300 mg every 3 months) for 24 weeks. Sexual function was assessed using a validated questionnaire at baseline, after 12 and 24 weeks of treatment and 12 weeks into recovery. The overall acceptability of the method and attitudes regarding the daily self-administration of T-gel were assessed by a questionnaire 12 weeks into recovery. Results: Fifty percent of subjects were either satisfied or very satisfied with the T-gel-based contraceptive regimen, and 45% indicated they would use the regimen if it were commercially available. The T-gel was found to be easy to use by 76% of men, but a third of subjects felt that T-gel administration interfered with their daily routine. Sexual function was largely preserved during treatment; however, slight decreases in sexual function were noted during recovery. Conclusions: The experimental male hormonal contraceptive regimen of T-gel + DMPA is acceptable to approximately one half of study volunteers, most of whom would use the method if it were commercially available. Given its appeal to a significant proportion of men, additional studies using T-gel and DMPA for male contraception are warranted. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA 98108 USA. RP Amory, JK (reprint author), Univ Washington, Dept Med, Box 326429, Seattle, WA 98195 USA. FU NIA NIH HHS [K23 AG027238, K23 AG027238-03]; NICHD NIH HHS [K23 HD45386, U54 HD12629, U54 HD42454] NR 21 TC 19 Z9 19 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0010-7824 J9 CONTRACEPTION JI Contraception PD MAR PY 2007 VL 75 IS 3 BP 218 EP 223 DI 10.1016/j.contraception.2006.11.003 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 141BB UT WOS:000244550100012 PM 17303493 ER PT J AU Rondon-Berrios, H Palevsky, PM AF Rondon-Berrios, Helbert Palevsky, Paul M. TI Treatment of acute kidney injury: an update on the management of renal replacement therapy SO CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION LA English DT Review DE acute kidney injury; hemodialysis; hemofiltration; renal replacement therapy ID CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; CONTINUOUS ARTERIOVENOUS HEMODIAFILTRATION; CONTINUOUS VENOVENOUS HEMODIAFILTRATION; FAILURE REQUIRING DIALYSIS; RANDOMIZED-TRIAL; INTERMITTENT HEMODIALYSIS; CONTINUOUS HEMOFILTRATION; CARDIAC-SURGERY; RECOVERY AB Purpose of review Renal replacement therapy remains the cornerstone of management for the patient with severe acute kidney injury. Although the technology for providing renal replacement therapy has markedly advanced over the past few decades, fundamental issues regarding its management, including timing of initiation, selection of modality and dosing of therapy, remain unresolved. Recent findings Although several retrospective and observational studies of the timing of initiation of renal replacement therapy have suggested improved survival with early initiation of treatment, the design of these studies does not allow definitive conclusions. Recent randomized trials have not demonstrated any benefit with regard to survival or recovery of renal function with continuous renal replacement therapy compared with intermittent hemodialysis. Increased intensity of renal support appears to be associated with improved survival; however more definitive studies are ongoing. Summary The optimal management of renal replacement therapy in patients with acute kidney injury remains uncertain. Appropriately designed studies evaluating timing of initiation of therapy need to be undertaken. Current data suggest that modality of therapy does not impact outcome. More intensive renal support may be associated with improved outcomes; however several large randomized controlled trials assessing this question are ongoing. C1 VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, Room 7E123 111F-U,Univ Dr Div, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Palevsky, Paul/0000-0002-7334-5400; Rondon-Berrios, Helbert/0000-0002-7109-146X NR 51 TC 25 Z9 27 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1062-4821 J9 CURR OPIN NEPHROL HY JI Curr. Opin. Nephrol. Hypertens. PD MAR PY 2007 VL 16 IS 2 BP 64 EP 70 DI 10.1097/MNH.0b013e32802ef4a5 PG 7 WC Urology & Nephrology; Peripheral Vascular Disease SC Urology & Nephrology; Cardiovascular System & Cardiology GA 139WS UT WOS:000244464000002 PM 17293679 ER PT J AU Albrecht, J Werth, VP AF Albrecht, Joerg Werth, Victoria P. TI Development of the CLASI as an outcome instrument for cutaneous lupus erythematosus SO DERMATOLOGIC THERAPY LA English DT Article DE cutaneous lupus erythematosus; patient outcome assessment; reproducibility of results; validity ID QUALITY-OF-LIFE; DISEASE SEVERITY; ATOPIC-DERMATITIS; SKIN-DISEASE; SURFACE-AREA; INDEX; PSORIASIS; RELIABILITY; IMPACT; ECZEMA AB Skin involvement is a frequent presenting manifestation of systemic lupus erythematosus (SLE). Cutaneous lupus erythematosus (CLE), frequently occurring without SLE, may be even more common than SLE. Until recently, clinical instruments to measure skin involvement in CLE did not exist, hampering clinical research in this field. In this paper the present authors describe outcome instruments for SLE and outline the considerations underlying the design and validation of an outcome instrument for CLE, the cutaneous lupus disease area and severity index. These studies serve as a model for development and validation of standardized instruments that can be applied to other cutaneous diseases, particularly autoimmune diseases, in order to facilitate epidemiologic studies and clinical trials. C1 Univ Penn, Dept Dermatol, Philadelphia, PA 19119 USA. John H Stroger Jr Hosp Cook Cty, Dept Med, Div Dermatol, Chicago, IL USA. Philadelphia VA Med Ctr, Philadelphia VA Dermatol, Philadelphia, PA USA. RP Werth, VP (reprint author), Univ Penn, Dept Dermatol, 2 Rhodes,3600 Spruce St, Philadelphia, PA 19119 USA. EM werth@mail.med.upenn.edu NR 32 TC 25 Z9 27 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1396-0296 J9 DERMATOL THER JI Dermatol. Ther. PD MAR-APR PY 2007 VL 20 IS 2 BP 93 EP 101 DI 10.1111/j.1529-8019.2007.00117.x PG 9 WC Dermatology SC Dermatology GA 172GQ UT WOS:000246792500004 PM 17537137 ER PT J AU Cnop, M Vidal, J Hull, RL Utzschneider, KM Carr, DB Schraw, T Scherer, PE Boyko, EJ Fujimoto, WY Khan, SE AF Cnop, Miriam Vidal, Josep Hull, Rebecca L. Utzschneider, Kristina M. Carr, Darcy B. Schraw, Todd Scherer, Philipp E. Boyko, Edward J. Fujimoto, Wilfred Y. Khan, Steven E. TI Progressive loss of beta-cell function leads to worsening glucose tolerance in first-degree relatives of subjects with type 2 diabetes SO DIABETES CARE LA English DT Article ID POLYCYSTIC-OVARY-SYNDROME; LIFE-STYLE INTERVENTION; INSULIN-RESISTANCE; HIGH-RISK; FASTING GLUCOSE; FOLLOW-UP; MELLITUS; SENSITIVITY; SECRETION; DYSFUNCTION AB OBJECTIVE - The relative roles of insulin resistance and beta-cell dysfunction in the pathogenesis of impaired glucose tolerance (IGT) and type 2 diabetes are debated. First-degree relatives of individuals with type 2 diabetes are at increased risk of developing hyperglycemia. RESEARCH DESIGN AND METHODS - We evaluated the evolution of insulin sensitivity, beta-cell function, glucose effectiveness, and glucose tolerance over 7 years in 33 nondiabetic, first-degree relatives of type 2 diabetic individuals using frequently sampled tolbutamide-modified intravenous and oral glucose tolerance tests. RESULTS - Subjects gained weight, and their waist circumference increased (P < 0.05). Insulin sensitivity, the acute insulin response to glucose, and glucose effectiveness did not change significantly. However, when we accounted for the modulating effect of insulin sensitivity on insulin release, beta-cell function determined as the disposition index decreased by 22% (P < 0.05). This decrease was associated with declines in intravenous and oral glucose tolerance (P < 0.05 and P < 0.001, respectively). Of the subjects with normal glucose tolerance at the first assessment, we compared those who progressed to IGT with those who did not. The disposition index was 50% lower in the progressors than in the nonprogressors at follow-up (P < 0.05). CONCLUSIONS - The decline in glucose tolerance over time in first-degree relatives of type 2 diabetic individuals is strongly related to the loss of beta-cell function. Thus, early interventions to slow the decline in beta-cell function should be considered in high-risk individuals. C1 VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Univ Washington, Div Maternal Fetal Med, Dept Obstet & Gynecol, Seattle, WA 98195 USA. Albert Einstein Coll Med, Dept Cell Biol, Ctr Diabet Res & Training, New York, NY USA. Albert Einstein Coll Med, Dept Med, Ctr Diabet Res & Training, New York, NY USA. VA Puget Sound Hlth Care Syst, Div Gen Internal Med, Dept Med, Seattle, WA 98108 USA. RP Khan, SE (reprint author), VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu OI Cnop, Miriam/0000-0002-5112-1692; Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR-16066, RR-37]; NIDDK NIH HHS [DK-02654, DK-026687, DK-17047] NR 33 TC 83 Z9 90 U1 1 U2 3 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 2007 VL 30 IS 3 BP 677 EP 682 DI 10.2337/dc06-1834 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 146NM UT WOS:000244941200036 PM 17327340 ER PT J AU Anzueto, A Bishal, WR Pottumarthy, S AF Anzueto, Antonio Bishal, William R. Pottumarthy, Sudha TI Role of oral extended-spectrum cephems in the treatment of acute exacerbation of chronic bronchitis SO DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE LA English DT Article DE AECB; oral cephems ID OBSTRUCTIVE PULMONARY-DISEASE; RESISTANT STREPTOCOCCUS-PNEUMONIAE; ACUTE BACTERIAL EXACERBATIONS; RESPIRATORY-TRACT PATHOGENS; CEFDITOREN-PIVOXIL; ALEXANDER PROJECT; UNITED-STATES; CEFDINIR; SUSCEPTIBILITY; INFECTIONS AB Risk stratification is the recommended approach for treatment of acute exacerbation of chronic bronchitis (AECB) to optimize the chances of clinical success. The suggested oral therapy for "simple or uncomplicated" AECB, which is predominantly a result of infection due to Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae, includes advanced macrolides and 2nd- or 3rd-generation cephalosporins, in addition to the older 1st-line agents (aminopenicillins, doxycycline, trimethoprim/sulfamethoxazole, and erythromycin). In light of increasing resistance of H. influenzae and S. pneumoniae to the older agents, the specific directed structural modification of the cephalosporin nucleus resulted in the development of extended-spectrum 3rd-generation oral cephems with enhanced beta-lactamase stability and improved activity against Gram-positive pathogens (penicillin-susceptible S. pneumoniae and oxacillin-susceptible Staphylococcus aureus). Analysis of results of double-blind randomized clinical trials assessing efficacy of the extended-spectrum oral cephems published since 2000 demonstrates that both cefdinir and cefditoren have similar point estimates of success in comparison to their comparators (cefuroxime, cefprozil, or Loracarbef), when either the clinical cure or the bacteriologic response was analyzed. Thus, oral extended-spectrum 3rd-generation cephems, which retain antimicrobial efficacy against the traditional respiratory pathogens despite changing resistance patterns, offer excellent coverage against the key pathogens involved in simple or uncomplicated AECB. (c) 2007 Elsevier Inc. All rights reserved. C1 Houston Dept Hlth & Human Serv, Houston, TX 77054 USA. Johns Hopkins Univ, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21231 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. S Texas Vet Healthcare Syst, San Antonio, TX 78284 USA. RP Pottumarthy, S (reprint author), Houston Dept Hlth & Human Serv, Houston, TX 77054 USA. EM sudha.pottumarthy@cityofhouston.net NR 43 TC 11 Z9 12 U1 0 U2 0 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 2007 VL 57 IS 3 SU S BP 31S EP 38S DI 10.1016/j.diagmicrobio.2006.12.003 PG 8 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 151KU UT WOS:000245289800005 PM 17349461 ER PT J AU Bagic, A Boudreau, EA Greenfield, J Sato, S AF Bagic, Anto Boudreau, Eilis A. Greenfield, Jacquelyn Sato, Susumu TI Electro-clinical evolution of refractory non-convulsive status epilepticus caused by West Nile virus encephalitis SO EPILEPTIC DISORDERS LA English DT Article DE West Nile virus (WNV); seizure; status epilepticus; encephalitis; arbovirus; chronic lymphocytic leukemia; nonconvulsive status epilepticus ID PROPOFOL INFUSION SYNDROME; ST-LOUIS ENCEPHALITIS; INFECTION; EPIDEMIC; CHILDREN; EEG; PATHOPHYSIOLOGY; PATHOGENESIS; ACIDOSIS; OUTBREAK AB West Nile virus (WNV) has re-emerged with a much wider geographic distribution and a higher incidence than ever. In spite of some recent reports on the neurological manifestations and EEG changes caused by WNV encephalitis, there are few data on the incidence of seizures, status epilepticus or post-encephalitic epilepsy. There is also no systematic review of EEG changes caused by WNV encephalitis that is based on a large series of patients. Here, we review the pertinent literature, and report the electroclinical evolution and therapeutic complexity of a patient with WNV encephalitis who developed refractory, non-convulsive status epilepticus. C1 NINDS, EEG Stn, NIH, Bethesda, MD 20892 USA. Portland VA Med Ctr, HSRDP, Portland, OR USA. RP Bagic, A (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, Suite 811,Kaufmann Med Bldg,3471 5th Ave, Pittsburgh, PA 15213 USA. EM bagica@upmc.edu NR 33 TC 7 Z9 7 U1 1 U2 1 PU JOHN LIBBEY EUROTEXT LTD PI MONTROUGE PA 127 AVE DE LA REPUBLIQUE, 92120 MONTROUGE, FRANCE SN 1294-9361 J9 EPILEPTIC DISORD JI Epileptic Disord. PD MAR PY 2007 VL 9 IS 1 BP 98 EP 103 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 145IG UT WOS:000244857900015 PM 17307720 ER PT J AU Guerra, CE Shea, JA AF Guerra, Carmen E. Shea, Judy A. TI Health literacy and perceived health status in Latinos and African Americans SO ETHNICITY & DISEASE LA English DT Article DE African Americans; comorbidity; continental population groups; ethnic groups; health; health literacy; health status; Hispanic Americans; minority groups; quality of life ID SELF-RATED HEALTH; PREDICTING MORTALITY; REPORTED HEALTH; LOW-INCOME; CARE; COMORBIDITY; VALIDITY; PERCEPTION; OUTCOMES; ADULTS AB Objective: To determine the association between functional health literacy and physical and mental health status in a sample of Latinos and African Americans. Methods: A cross-sectional study that used a demographics questionnaire, the Short Test of Functional Health Literacy in Adults (S-TOFHLA), the physical component summary (PCS-12) and mental component summary (MCS-1 2) scales of the SF-1 2, and the Charlson Comorbidity Index in a sample of 1301 Medicaid and/or Medicare Latino and African American adult patients at four community clinics and one university-based general medicine practice in Philadelphia. Results: When stratified by inadequate, marginal, and adequate functional health literacy levels and compared to SF-12 population norm scores of 50.0, the mean (standard deviation [SD]) PCS-12 scores were 38.8 (11.2), 38.5 (11.1), 42.7 (11.4), respectively (P <.0001); the mean (SD) MCS-12 scores were 43.3 (11.2), 43.5 (10.4), 44.3 (11.7), respectively (P=39). After adjusting for sociodemographic confounders and Charlson Index score, functional health literacy was not significantly associated with physical or mental health status (P >.50 and P=.41, respectively). Conclusion: Functional health literacy is not independently associated with perceived physical health status or mental health status in a sample of ethnic minorities. C1 Univ Penn, Sch Med, Div Gen Internal Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Guerra, CE (reprint author), Univ Penn, Sch Med, Div Gen Internal Med, Dept Med, 1221 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM carmen.guerra@uphs.upenn.edu FU AHRQ HHS [R01 HS10299]; NCI NIH HHS [K01-CA097925] NR 53 TC 17 Z9 17 U1 4 U2 7 PU INT SOC HYPERTENSION BLACKS-ISHIB PI ATLANTA PA 100 AUBURN AVE NE STE 401, ATLANTA, GA 30303-2527 USA SN 1049-510X J9 ETHNIC DIS JI Ethn. Dis. PD SPR PY 2007 VL 17 IS 2 BP 305 EP 312 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189SV UT WOS:000248009700019 PM 17682363 ER PT J AU Elias, FN Yuen, TJ Olson, SL Sangeorzan, BJ Ledoux, WR AF Elias, Fady N. Yuen, Tracy J. Olson, Soren L. Sangeorzan, Bruce J. Ledoux, William R. TI Correction of clawed hallux deformity: Comparison of the Jones procedure and FHL transfer in a cadaver model SO FOOT & ANKLE INTERNATIONAL LA English DT Article DE biomechanics; foot; hallux abnormalities; pressure; surgery; toes ID FOOT PRESSURE; TENDON; MANAGEMENT; ETIOLOGY; RISK AB Background: A clawed hallux is defined as extension of the first metatarsophalangeal (MTP) joint combined with flexion of the interphalangeal JP) joint. Two operative procedures, the modified Jones procedure and flexor hallucis longus (FHL) transfer, are indicated for correction. The purpose of this study were to evaluate the overall effectiveness of these two procedures in correcting both the clawed hallux deformity and its mechanical consequences and to compare their effect on postoperative plantar pressures. Methods: The modified Jones procedure and FHL transfer were done on cadaver specimens that were tested before and after surgery in a specialized footloading frame. We quantified the angular correction of the MTP and the IP joints, as well as the plantar pressures under the head of the first metatarsal and the hallux. Results: Both surgeries were equally effective in correcting the angular deformity at the MTP and IP joints (p = 0.037 and 0.0020, respectively). A significant reduction in the plantar pressure (p = 0.015) beneath the first metatarsal was observed with both the modified Jones procedure and the FHL transfer. Overall, there was no significant difference between preoperative and postoperative pressures beneath the hallux (p = 0.5); however, for the FHL overpull group there was significantly less pressure beneath the hallux after surgery (p = 0.014). Conclusions: The two surgeries produced similar results, but the FHL transfer does not require fusion of the hallux, which is considered an undesirable comorbidity of the modified Jones procedure. C1 VA Puget Sound, Seattle, WA 98108 USA. RR&D Ctr Excellence Limb Loss Prevent & Prosthet, Dept Vet Affairs, Seattle, WA USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA. Univ Washington, Dept Engn Mech, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA Puget Sound, Ms 151,1600 S Columbian Way, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 15 TC 6 Z9 6 U1 0 U2 1 PU AMER ORTHOPAEDIC FOOT & ANKLE SOC, INC PI SEATTLE PA 2517 EASTLAKE AVE EAST, STE 200, SEATTLE, WA 98102 USA SN 1071-1007 J9 FOOT ANKLE INT JI Foot Ankle Int. PD MAR PY 2007 VL 28 IS 3 BP 369 EP 376 DI 10.3113/FAI.2007.0369 PG 8 WC Orthopedics SC Orthopedics GA 140WF UT WOS:000244536700014 PM 17371661 ER PT J AU Kudo, T Lu, H Wu, JY Ohno, T Wu, MJ Genta, RM Graham, DY Yamaoka, Y AF Kudo, Takahiko Lu, Hong Wu, Jeng-Yih Ohno, Tomoyuki Wu, Michael J. Genta, Robert M. Graham, David Y. Yamaoka, Yoshio TI Pattern of transcription factor activation in Helicobacter pylori-infected Mongolian gerbils SO GASTROENTEROLOGY LA English DT Article ID NF-KAPPA-B; GASTRIC EPITHELIAL-CELLS; TRANSIENT FOREBRAIN ISCHEMIA; PROMOTER ACTIVATION; CYTOKINE EXPRESSION; MUCOSAL CYTOKINE; CAGA GENE; INFLAMMATION; CANCER; PROTEINS AB Background & Aims: Helicobacter pylori interact with epithelial cells resulting in activation of cellular signaling pathways leading to an inflammatory response. The pattern and timing of transcription factor activation in H pylori-infected gastric mucosa remain unclear. We investigated the roles of transcription factors in the gastric mucosa of H pylori-infected gerbils over the course of the infection. Methods: Six-week-old male Mongolian gerbils were inoculated orally with H pylori TN2GF4 or isogenic cagE mutants and examined at 1, 3, 9, and 18 months. We examined the expression of 54 transcription factors using DNA/protein arrays and electrophoretic mobility shift assays. Phosphorylation status of mitogen-activated protein kinases and I kappa B were evaluated by immunoblot and immunohistochemistry. Results: Ten transcription factors were up-regulated by H pylori infection. Six of these factors, including activator protein-1 (AP-1) and cAMP responsive element binding protein (CREB), reached maximal levels at 3 months and were strongly correlated with cellular inflammation and ulceration. Phosphorylation of extracellular signal-regulated kinase correlated with activation of AP-1 and CREB. Levels of nuclear factor-kappa B and interferon-stimulated responsive element (ISRE) peaked at 18 months and correlated with the presence of severe atrophy and with phosphorylation of Jun-N-terminal kinase (JNK), p38, and I kappa B. Conclusions: The gastric mucosal transcription factors induced by H pylori infection differed according to the phase and outcome of infection; AP-1 and CREB levels were early responders related to inflammation and ulceration, whereas NF-kappa B and ISRE were late responders related to atrophy. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Digest Dis, Renji Hosp,Dept Gastroenterol, Shanghai 200030, Peoples R China. Kaohsiung Med Univ Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung, Taiwan. Vet Affairs N Texas Hlth Care Syst, Pathol & Lab Serv, Dallas, TX USA. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, 111D,Rm 3A-320,2002 Holcombe Blvd, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu RI Wu, Jeng-Yih/D-4520-2009 FU NIDDK NIH HHS [DK62813, R01 DK062813, R01 DK062813-03, DK56338, P30 DK056338] NR 40 TC 27 Z9 27 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD MAR PY 2007 VL 132 IS 3 BP 1024 EP 1038 DI 10.1053/j.gastro.2007.01.009 PG 15 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 149YH UT WOS:000245182300026 PM 17383425 ER PT J AU Pandol, SJ Saluja, AK Imrie, CW Banks, PA AF Pandol, Stephen J. Saluja, Ashok K. Imrie, Clement W. Banks, Peter A. TI Acute pancreatitis: Bench to the bedside SO GASTROENTEROLOGY LA English DT Review ID NF-KAPPA-B; PLATELET-ACTIVATING-FACTOR; PROTEIN-KINASE-C; SYSTEMIC INFLAMMATORY RESPONSE; ACUTE NECROTIZING PANCREATITIS; HEAT-SHOCK-PROTEIN; ACID ETHYL-ESTER; TAUROCHOLATE-INDUCED PANCREATITIS; WATER-IMMERSION STRESS; TUMOR-NECROSIS-FACTOR C1 VA Greater Los Angeles Hlth Care Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Univ Minnesota, Dept Surg, Minneapolis, MN 55455 USA. Glasgow Royal Infirm, Glasgow G4 0SF, Lanark, Scotland. Brigham & Womens Hosp, Dept Med, Div Gastroenterol, Boston, MA 02115 USA. RP Pandol, SJ (reprint author), VA Greater Los Angeles Hlth Care Syst, Dept Med, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA USA. EM Stephen.pandol@va.gov OI Imrie, Clem/0000-0002-1190-7084 FU NIDDK NIH HHS [DK 072439, DK 058694] NR 258 TC 269 Z9 296 U1 3 U2 22 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD MAR PY 2007 VL 132 IS 3 BP 1127 EP 1151 DI 10.1053/j.gastro.2007.01.055 PG 25 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 149YH UT WOS:000245182300034 PM 17383433 ER PT J AU Williams, JW Gerrity, M Holsinger, T Dobscha, S Gaynes, B Dietrich, A AF Williams, John W., Jr. Gerrity, Martha Holsinger, Tracey Dobscha, Steve Gaynes, Bradley Dietrich, Allen TI Systematic review of multifaceted interventions to improve depression care SO GENERAL HOSPITAL PSYCHIATRY LA English DT Review DE depressive disorder; care management; literature synthesis ID RANDOMIZED CONTROLLED-TRIAL; LATE-LIFE DEPRESSION; DISEASE MANAGEMENT PROGRAMS; DISSEMINATING QUALITY IMPROVEMENT; LONG-TERM OUTCOMES; COST-EFFECTIVENESS; COLLABORATIVE CARE; MAJOR DEPRESSION; CHRONIC ILLNESS; ANTIDEPRESSANT TREATMENT AB Objective: Depression is a prevalent high-impact illness with poor outcomes in primary care settings. We performed a systematic review to determine to what extent multifaceted interventions improve depression outcomes in primary care and to define key elements, patients who are likely to benefit and resources required for these interventions. Method: We searched Medline, HealthSTAR, CINAHL, PsycINFO and a specialized registry of depression trials from 1966 to February 2006; reviewed bibliographies of pertinent articles; and consulted experts. Searches were limited to the English language. We included 28 randomized controlled trials that: (a) involved primary care patients receiving acute-phase treatment; (b) tested a multicomponent intervention involving a patient-directed component; and (c) reported effects on depression severity. Pairs of investigators independently abstracted information regarding (a) setting and subjects, (b) components of the intervention and (c) outcomes. Results: Twenty of 28 interventions improved depression outcomes over 3-12 months (an 18.4% median absolute increase in patients with 50% improvement in symptoms; range, 8.3-46%). Sustained improvements at 24-57 months were demonstrated in three studies addressing acute-phase and continuation-phase treatments. All interventions involved care management and required additional resources or staff reassignment to implement; interventions were delivered exclusively or predominantly by telephone in 16 studies. The most commonly used intervention features were: patient education and self-management, monitoring of depressive symptoms and treatment adherence, decision support for medication management, a patient registry and mental health supervision of care managers. Other intervention features were highly variable. Conclusion: There is strong evidence supporting the short-term benefits of care management for depression; critical elements for successful programs are emerging. (c) 2007 Elsevier Inc. All rights reserved. C1 Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27705 USA. Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Portland, OR 97239 USA. Univ N Carolina, Dept Psychiat, Chapel Hill, NC USA. Dartmouth Coll Sch Med, Dept Community & Family Med, Hanover, NH USA. RP Williams, JW (reprint author), Durham VA Med Ctr, Ctr Hlth Serv Res Primary Care, Durham, NC USA. EM Jw.williams@duke.edu OI Gaynes, Bradley/0000-0002-8283-5030 NR 107 TC 151 Z9 153 U1 5 U2 18 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 MAR-APR PY 2007 VL 29 IS 2 BP 91 EP 116 DI 10.1016/j.genhosppsych.2006.12.003 PG 26 WC Psychiatry SC Psychiatry GA 146AG UT WOS:000244906300002 PM 17336659 ER PT J AU Butt, AA Justice, AC Skanderson, M Rigsby, MO Good, CB Kwoh, CK AF Butt, Adeel A. Justice, Amy C. Skanderson, Melissa Rigsby, Michael O. Good, Chester B. Kwoh, C. Kent TI Rate and predictors of treatment prescription for hepatitis C SO GUT LA English DT Article ID INTERFERON-ALPHA-2B PLUS RIBAVIRIN; HIV-INFECTED VETERANS; VIRUS-INFECTION; PEGINTERFERON ALPHA-2A; HEPATOCELLULAR-CARCINOMA; RANDOMIZED-TRIAL; COINFECTION; RISK; COMBINATION; PREVALENCE AB Background: The true treatment rate for hepatitis C virus (HCV) in veterans is unknown. Aim: To determine the treatment prescription rates and predictors of treatment prescription for HCV in a large national population. Methods: The Department of Veterans Affairs National Patient Care Database (NPCD) was used to identify all HCV-infected people between the fiscal years 1999 and 2003 using the International classification of diseases, 9th revision codes. Demographic information, medical and psychiatric comorbidities, and drug and alcohol use diagnoses were retrieved. Pharmacy data were retrieved from the Department of Veterans Affairs Pharmacy Benefits Management (PBM) database. Logistic regression analysis was used to determine the predictors of treatment for HCV in HCV. Results: 113 927 veterans in the Department of Veterans Affairs care with a diagnosis of HCV were identified. The treatment prescription rate for HCV was 11.8%. Patients not prescribed treatment were older, more likely to be from minority races, have more alcohol and drug misuse, and have medical and psychiatric comorbid conditions. In a multivariate logistic regression model, the following factors were predictive of non-treatment for HCV: increasing age ( odds ratio ( OR) 0.77 for each 5-year increase in age; 95% confidence interval (CI) 0.76 to 0.78); black race ( OR 0.64; 95% CI 0.6 to 0.68); Hispanic race ( OR 0.88; 95% CI 0.8 to 0.96); alcohol abuse and dependence ( OR 0.62; 95% CI 0.59 to 0.65); drug abuse and dependence ( OR 0.78; 95% CI 0.74 to 0.82); anaemia ( OR 0.18; 95% CI 0.16 to 0.21); hepatitis B infection ( OR 0.72; 95% CI 0.62 to 0.83); coronary artery disease ( OR 0.9; 95% CI 0.85 to 0.97); stroke ( OR 0.75; 95% CI 0.67 to 0.85); bipolar disorder ( OR 0.64; 95% CI 0.58 to 0.70); major depression ( OR 0.72; 95% CI 0.67 to 0.77); mild depression ( OR 0.56; 95% CI 0.53 to 0.59); and schizophrenia ( OR 0.71; 95% CI 0.65 to 0.77). The following factors were associated with a higher likelihood of treatment prescription for HCV: liver cirrhosis ( OR 1.6; 95% CI 1.5 to 1.7); and diabetes ( OR 1.07; 95% CI 1.02 to 1.12). Conclusions: A small number of HCV-infected veterans were prescribed treatment for HCV. Non-treatment is associated with increasing age, non-white race, drug and alcohol abuse, and dependence and comorbid illnesses. Reasons for non-treatment need further study. C1 Univ Pittsburgh, Med Ctr, Sch Med, VA Pittsburgh Healthcare Syst,Ctr Hlth Equ Res &, Pittsburgh, PA 15213 USA. Yale Univ, Sch Med, New Haven, CT 06520 USA. VA Connecticut Healthcare Syst, West Haven, CT USA. RP Butt, AA (reprint author), Univ Pittsburgh, Med Ctr, Sch Med, VA Pittsburgh Healthcare Syst,Ctr Hlth Equ Res &, 3601 5th Ave,Suite 3A,Falk Med Bldg, Pittsburgh, PA 15213 USA. EM butta@dom.pitt.edu FU NIDA NIH HHS [DA016175-01A1, K23 DA016175] NR 31 TC 104 Z9 104 U1 4 U2 8 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 MAR PY 2007 VL 56 IS 3 BP 385 EP 389 DI 10.1136/gut.2006.099150 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 143IT UT WOS:000244714700017 PM 17005764 ER PT J AU Dicianno, BE Spaeth, DM Cooper, RA Fitzgerald, SG Boninger, ML Brown, KW AF Dicianno, Brad E. Spaeth, Donald M. Cooper, Rory A. Fitzgerald, Shirley G. Boninger, Michael L. Brown, Karl W. TI Force control strategies while driving electric powered wheelchairs with isometric and movement-sensing joysticks SO IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING LA English DT Article DE assistive technology; biological motor systems; force control; isometric joystick; movement disorders; rehabilitation; wheelchairs ID POSITION; MODEL AB Innovations to control interfaces for electric powered wheelchairs (EPWs) could benefit 220 000 current users and over 125 000 individuals who desire mobility but cannot use a conventional motion sensing joystick (MSJ). We developed a digital isometric joystick (IJ) with sophisticated signal processing and two control functions. In a prior study, subjects' driving accuracy with our IJ was comparable to using an MSJ. However, we observed subjects using excessive force on the IJ possibly because its rigid post provides no positional feedback. Thus, this paper examines the time-series data recorded in the previous study to characterize subjects' force control strategies since weakness is a concern. Eleven EPW users with upper limb impairments drove an EPW using an IJ with two different control functions and an MSJ in a Fitts' law paradigm. Subjects relied upon positional feedback from the MSJ and used appropriate force. In contrast, subjects using the IJ with either control function applied significantly higher force than necessary (p < 0.0001 and p = 0.0058). Using higher average force was correlated with quicker trial times but not associated with accuracy. Lack of positional feedback may result in use of excess isometric force. Modifying control functions, adjusting gain, or providing additional training or feedback might address this problem. C1 HERL, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. Ctr Excellence Wheelchairs & Associated Rehabil E, VA Pittsburgh Hlth Care Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. RP Dicianno, BE (reprint author), HERL, Pittsburgh, PA 15206 USA. EM diciannob@herlpitt.org; spaethd@herlpitt.org; rcooper@pitt.edu; sgf9@pitt.edu; boninger@pitt.edu; brownk@herlpitt.org OI Boninger, Michael/0000-0001-6966-919X; Dicianno, Brad/0000-0003-0738-0192 FU NICHD NIH HHS [K12HD01097] NR 27 TC 14 Z9 14 U1 2 U2 4 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI PISCATAWAY PA 445 HOES LANE, PISCATAWAY, NJ 08855-4141 USA SN 1534-4320 EI 1558-0210 J9 IEEE T NEUR SYS REH JI IEEE Trans. Neural Syst. Rehabil. Eng. PD MAR PY 2007 VL 15 IS 1 BP 144 EP 150 DI 10.1109/TNSRE.2007.891394 PG 7 WC Engineering, Biomedical; Rehabilitation SC Engineering; Rehabilitation GA 149ZA UT WOS:000245184200020 PM 17436887 ER PT J AU Beenhouwer, DO Yoo, EM Lai, CW Rocha, MA Morrison, SL AF Beenhouwer, David O. Yoo, Esther M. Lai, Chun-Wei Rocha, Miguel A. Morrison, Sherie L. TI Human immunoglobulin G2 (IgG2) and IgG4, but not IgG1 or IgG3, protect mice against Cryptococcus neoformans infection SO INFECTION AND IMMUNITY LA English DT Article ID ANTICAPSULAR MONOCLONAL-ANTIBODIES; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; HUMAN IMMUNOGLOBULIN G1; FC-RECEPTOR; CAPSULAR POLYSACCHARIDE; RHEUMATOID-ARTHRITIS; PASSIVE-IMMUNIZATION; COMPLEMENT; ISOTYPE; BINDING AB The encapsulated yeast Cryptococcus neoformans is a significant cause of meningitis and death in patients with AIDS. Some murine monoclonal antibodies (MAbs) against the glucuronoxylomannan (GXM) component of the C neoformans capsular polysaccharide can prolong the lives of infected mice, while others have no effect or can even shorten survival. To date, no one has systematically compared the efficacies of antibodies with the same variable regions and different human constant regions with their unique combination of effector functions in providing protection against murine C neoformans infection. In the present study, we examined the efficacies of anti-GXM MAbs of the four human immunoglobulin G (IgG) subclasses, which have identical variable regions but differ in their capacities to bind the three types of Fc receptors for IgG (Fc gamma R), their abilities to activate complement, and their half-lives. IgG2 and IgG4 anti-GXM prolonged the lives of infected BALB/c mice, IgG3 anti-GXM did not affect animal survival, while mice treated with IgG1 anti-GXM died earlier than mice treated with phosphate-buffered saline or irrelevant isotype-matched MAbs. All NIAbs decreased serum GXM in infected animals. Effector pathways traditionally believed to be important in defense against microbes, such as opsonophagocytosis and complement binding, negatively correlated with antibody efficacy. It is generally accepted that human IgG1 has the most favorable combination of effector functions for therapeutic use against infections. Therefore, our findings have significant implications for humanization of the mouse IgG1 currently in clinical trials for cryptococcal meningitis and for the design of antibody therapeutics to treat other infectious diseases as well. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. RP Beenhouwer, DO (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Div Infect Dis, 111F,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dbeenhou@ucla.edu FU NIAID NIH HHS [AI51415, R01 AI051415, R37 AI029470, AI29470] NR 73 TC 45 Z9 47 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD MAR PY 2007 VL 75 IS 3 BP 1424 EP 1435 DI 10.1128/IAI.01161-06 PG 12 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 143PD UT WOS:000244733900039 PM 17220317 ER PT J AU Cornia, PB Takahashi, TA Lipsky, BA AF Cornia, Paul B. Takahashi, Traci A. Lipsky, Benjamin A. TI Evaluating and treating diabetic foot infections SO INFECTIONS IN MEDICINE LA English DT Article DE diabetic foot infection; diabetic foot ulcer; antibiotic therapy ID RESISTANT STAPHYLOCOCCUS-AUREUS; OSTEOMYELITIS; ULCERS; DIAGNOSIS; ISCHEMIA; DISEASE; REVASCULARIZATION; PREVALENCE; MANAGEMENT; AMPUTATION AB In diabetic foot infections, ulceration of a neuropathic foot is typically the inciting event, followed by infection of the wound. Key components of the initial evaluation include assessing for signs of systemic infection, determining the extent of tissue involvement, and evaluating for peripheral arterial perfusion. Antibiotic therapy is usually initiated empirically. Regardless of the severity of infection, empiric regimens should always have activity against the most commonly encountered pathogens, staphylococci and streptococci. Moderate to severe infections necessitate broader-spectrum agents with activity against commonly isolated Gram-negative bacilli and, in some cases, methicillin-resistant Staphylococcus aureus and Enterococcus species. Therapy should be modified based on results of cultures of properly obtained wound specimens. Most patients also need some surgical intervention as well as proper wound care. C1 Univ Washington, Sch Med, Div Gen Internal Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Serv, Seattle, WA USA. RP Cornia, PB (reprint author), Univ Washington, Sch Med, Div Gen Internal Med, Seattle, WA 98195 USA. RI Lipsky, Benjamin/B-4645-2013 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 51 TC 0 Z9 0 U1 2 U2 3 PU UBM MEDICA PI NORWALK PA 535 CONNECTICUT AVE, STE 300, NORWALK, CT 06854 USA SN 0749-6524 J9 INFECT MED JI Infect. Med. PD MAR PY 2007 VL 24 IS 3 BP 124 EP 129 PG 6 WC Infectious Diseases SC Infectious Diseases GA 148DU UT WOS:000245055500008 ER PT J AU Littman, AJ Vitiello, MV Foster-Schubert, K Ulrich, CM Tworoger, SS Potter, JD Weigle, DS McTiernan, A AF Littman, A. J. Vitiello, M. V. Foster-Schubert, K. Ulrich, C. M. Tworoger, S. S. Potter, J. D. Weigle, D. S. McTiernan, A. TI Sleep, ghrelin, leptin and changes in body weight during a 1-year moderate-intensity physical activity intervention SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article DE physical activity; randomized trial; ghrelin; leptin; sleep; weight change ID INSOMNIA RATING-SCALE; FOOD-INTAKE; SHORT-TERM; OBESITY; DURATION; OVERWEIGHT; APPETITE; ADULTS; RISK; POPULATION AB Objective: To investigate cross-sectional and longitudinal relationships among exercise, sleep, ghrelin and leptin. Methods: We randomly assigned 173 post-menopausal sedentary overweight ( body mass index >= 24.0 kg/m(2) and > 33% body fat) women aged 50-75 years living in western Washington State to either a facility- and home-based moderate-intensity physical activity intervention or a stretching control group. Fasting plasma ghrelin, leptin, measured height, weight and self-reported sleep were assessed at baseline and 12 months. Results: There were no consistent cross-sectional patterns between self-reported sleep measures and ghrelin or leptin at baseline. The weight loss differences between exercisers and stretchers were greater for those who slept less at follow-up than at baseline compared to those whose sleep duration did not change (-3.2 kg, 95% confidence interval (CI) -5.8, -0.5). Improvements in sleep quality were associated with significantly greater differences between exercisers and stretchers for ghrelin increases ( improved vs same sleep quality: +115 pg/ml, 95% CI +25, +206) and leptin decreases ( improved vs worsened sleep quality: -5.7 ng/ml, 95% CI -9.5, -1.5). Conclusion: There was only limited evidence that changes in sleep duration or quality modified exercise-induced changes in weight, ghrelin or leptin. Moreover, the observed differences were not in the directions hypothesized. Future longitudinal studies including population-based samples using objective measures of sleep and long follow-up may help to clarify these relationships. C1 Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98109 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Sch Med, Seattle, WA 98104 USA. Univ Washington, Sch Med, Dept Med, Div Med Endocrinol & Nutr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Brigham & Womens Hosp, Channing Lab, Dept Med, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Univ Washington, Harborview Med Ctr, Div Endocrinol, Seattle, WA 98104 USA. RP Littman, AJ (reprint author), Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1100 Fairview Ave N M4 B402,POB 19024, Seattle, WA 98109 USA. EM alittman@fhcrc.org OI Potter, John/0000-0001-5439-1500; Tworoger, Shelley/0000-0002-6986-7046; Vitiello, Michael/0000-0002-9776-0473 FU NCI NIH HHS [R25 CA94880, T32 CA090001] NR 37 TC 39 Z9 39 U1 1 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD MAR PY 2007 VL 31 IS 3 BP 466 EP 475 DI 10.1038/sj.ijo.0803438 PG 10 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 140CL UT WOS:000244480100011 PM 16909130 ER PT J AU Baeten, JM McClelland, RS Wener, MH Bankson, DD Lavreys, L Mandaliya, K Bwayo, JJ Kreiss, JK AF Baeten, Jared M. McClelland, R. Scott Wener, Mark H. Bankson, Daniel D. Lavreys, Ludo Mandaliya, Kishorchandra Bwayo, Job J. Kreiss, Joan K. TI Relationship between markers of HIV-1 disease progression and serum beta-carotene concentrations in Kenyan women SO INTERNATIONAL JOURNAL OF STD & AIDS LA English DT Article DE beta-carotene; HIV-1; acute phase response; vitamin A; micronutrient deficiency; nutritional assessment; nutritional status ID HUMAN-IMMUNODEFICIENCY-VIRUS; VITAMIN-A STATUS; RANDOMIZED-TRIAL; CARDIOVASCULAR-DISEASE; VERTICAL TRANSMISSION; LUNG-CANCER; CELL COUNTS; VIRAL LOAD; INFECTION; SUPPLEMENTATION AB Observational studies have suggested that low serum beta-carotene concentrations may influence HIV-1 disease progression. However, randomized trials have not demonstrated beneficial effects of beta-carotene supplementation. To understand this discrepancy, we conducted a cross-sectional study among 400 HIV-1-seropositive women in Mombasa, Kenya, to correlate serum beta-carotene concentrations with several measures of HIV-1 disease severity. beta-Carotene concentrations were significantly associated with biologic markers of HIV-1 disease progression (CD4 count, HIV-1 plasma viral load, serum C-reactive protein [CRP] concentration, and serum albumin level). In multivariate analysis, beta-carotene concentrations below the median were associated with elevated CRP (>1 0 mg/l, adjusted odds ratio [aOR] 3.32, 95% confidence interval [CI] 1.99-6.53, P < 0.001) and higher HIV-1 plasma viral load (for each log(10) copies/mL increase, aOR 1.38, 95% CI 1.01-1.88, P = 0.04). In the context of negative findings from randomized trials of beta-carotene supplementation in HIV-1-seropositive individuals, these results suggest that low beta-carotene concentrations primarily reflect more active HIV-1 infection rather than a deficiency amenable to intervention. C1 Univ Washington, Seattle HIV Prevent Trials Unit, Dept Med, Seattle, WA 98104 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98104 USA. Univ Washington, Dept Lab Med, Seattle, WA 98104 USA. Vet Affairs Puget Sound Hlth Care Syst, Pathol & Lab Med Serv, Seattle, WA USA. Coast Prov Gen Hosp, Mombasa, Kenya. Univ Nairobi, Dept Med Microbiol, Nairobi, Kenya. RP Baeten, JM (reprint author), Univ Washington, Seattle HIV Prevent Trials Unit, Dept Med, UW Box 359927,901 Boren Ave,Suite 1300, Seattle, WA 98104 USA. EM jbaeten@u.washington.edu FU FIC NIH HHS [D43-TW00007]; NIAID NIH HHS [AI43844, AI39996]; NIDDK NIH HHS [DK35816] NR 31 TC 10 Z9 10 U1 0 U2 1 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 0956-4624 J9 INT J STD AIDS JI Int. J. STD AIDS PD MAR PY 2007 VL 18 IS 3 BP 202 EP 206 DI 10.1258/095646207780132541 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 155OK UT WOS:000245587000014 PM 17362556 ER PT J AU Lo Re, V Kostman, JR Gross, R Reddy, KR Mounzer, K Zemel, BS Rennert, H Stieritz, DD Putt, M Frank, I Strom, BL AF Lo Re, Vincent, III Kostman, Jay R. Gross, Robert Reddy, K. Rajender Mounzer, Karam Zemel, Babette S. Rennert, Hanna Stieritz, Donald D. Putt, Mary Frank, Ian Strom, Brian L. TI Incidence and risk factors for weight loss during dual HIV/hepatitis C virus therapy SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT 22nd International Conference on Pharmacoepidemiology and Therapeutic Risk Management CY AUG 24-27, 2006 CL Lisbon, PORTUGAL DE hepatitis C virus; hepatitis C virus therapy; HIV; HIV/hepatitis C virus coinfection; weight loss ID CHRONIC HEPATITIS-C; HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-INFECTED PATIENTS; REVERSE-TRANSCRIPTASE INHIBITORS; ALPHA-2A PLUS RIBAVIRIN; MITOCHONDRIAL TOXICITY; ANTIRETROVIRAL-THERAPY; PEGYLATED INTERFERON-ALPHA-2B; LIPODYSTROPHY; LIVER AB Background: Clinical observations suggest that patients with HIV/hepatitis C virus (HCV) may lose body weight during dual therapy, but this has not been confirmed analytically. Objectives: To determine if the incidence and degree of weight loss among patients with HIV/HCV receiving highly active antiretroviral therapy (HAART) and pegylated (PEG)-interferon plus ribavirin were greater than in (1) HCV-monoinfected patients receiving PEG-interferon plus ribavirin and (2) HIV-monoinfected patients receiving HAART. Risk factors for weight loss among patients with HIV/HCV were also examined. Methods: A retrospective cohort study was performed among HIV/HCV-coinfected, HCV-monoinfected and HIV-monoinfected patients. Body weights were assessed up to 6 months before and up to 12 months after initiation of HCV therapy (HIV/HCV-coinfected and HCV-monoinfected subjects) and over 18 months on HAART (HIV-monoinfected subjects). The primary outcome was clinically significant weight loss (>= 5% of baseline weight). Results: Of 192 subjects, 63 had HIV/HCV, 64 had HCV alone, and 65 had HIV alone. Clinically significant weight loss occurred in 48 (76%) subjects with HIV/HCV versus 25 (39%) subjects with HCV (P < 0.001) and 2 (3%) subjects with HIV (P < 0.001), yielding adjusted hazard ratios (HRs) of 2.76 (95% confidence interval [CI]: 1.67 to 4.55) and 38.5 (95% CI: 8.5 to 174.7), respectively Receipt of more than 2 nucleoside reverse transcriptase inhibitors increased the risk of clinically significant weight loss (adjusted HR = 8.17, 95% CI: 2.37 to 28.20). Conclusions: The incidence of weight loss is greater in dually treated patients with HIV/HCV than in treated HCV- or HFV-monoinfected patients. Prospective studies should evaluate additional risk factors for weight loss and changes in body composition to elucidate the mechanism for this weight loss. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Div Infect Dis,Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Gastroenterol, Dept Med, Philadelphia, PA 19104 USA. Philadelphia FIGHT, Jonathan Lax Treatment Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Pathol & Lab Med Serv, Philadelphia, PA USA. RP Lo Re, V (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Div Infect Dis,Dept Med, 711 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM vincent.lore@uphs.upenn.edu RI Zemel, Babette/D-1117-2009; Lo Re, Vincent/N-7817-2015 FU AHRQ HHS [HS 10399]; NIAID NIH HHS [P30 AI 45008, T32 AI 055435, U01 AI 32783]; NIDDK NIH HHS [F32 DK 069080]; NIMH NIH HHS [K08 MH 01584] NR 34 TC 6 Z9 6 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD MAR 1 PY 2007 VL 44 IS 3 BP 344 EP 350 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 141WT UT WOS:000244610400015 PM 17179767 ER PT J AU Wright, TM Myrick, H Malcolm, R Randall, P Boyle, E Henderson, S Anton, R AF Wright, Tara M. Myrick, Hugh Malcolm, Robert Randall, Patrick Boyle, Elizabeth Henderson, Scott Anton, Raymond TI Impact of lifetime alcohol quit attempts and medicated detoxifications on time to relapse during an index alcohol detoxification SO JOURNAL OF ADDICTION MEDICINE LA English DT Article; Proceedings Paper CT 159th Annual Meeting of the American-Psychiatric-Association CY MAY 20-25, 2006 CL Toronto, CANADA SP Amer Psychiat Assoc DE alcohol; drinking history; alcohol withdrawal; detoxifications; relapse ID SUBSEQUENT WITHDRAWAL SEIZURES; COMPULSIVE DRINKING SCALE; KINDLING HYPOTHESIS; SEVERITY; CARBAMAZEPINE; RELIABILITY; CONSUMPTION; INSTRUMENT; EPISODES; HISTORY AB Previous work has shown that multiple medication-treated alcohol detoxifications are associated with poorer treatment outcomes during subsequent detoxifications. Little is known about the impact of nonmedicated attempts to stop drinking outside the realm of these medically supervised detoxifications on acute detoxification outcomes. This study included 58 subjects enrolled in an outpatient detoxification study. Subjects were asked why and how often they quit alcohol for 3 days or longer during their drinking lifetime using concepts derived from the Cognitive Lifetime Drinking History. The effect of previous attempts at abstinence (both medicated and nonmedicated) on time to relapse during an index detoxification was examined. After the index detoxification, older individuals relapsed later than younger individuals and the number of previous medicated detoxifications rather than total lifetime quit attempts per se was related to quicker relapse. Contrary to expectation, those who reported fewer previous nonmedicated quit attempts tended to relapse sooner than those who reported more past quit attempts. This study supports and extends previous work that suggests that the number of previous medicated detoxifications, rather than the total number of past attempts at abstinence, predicts higher and sooner risk for early relapse drinking during outpatient alcohol detoxification. C1 [Wright, Tara M.; Myrick, Hugh; Malcolm, Robert; Randall, Patrick; Boyle, Elizabeth; Henderson, Scott; Anton, Raymond] Med Univ S Carolina, Dept Psychiat & Behav Sci, Ctr Drug & Alcohol Program, Charleston, SC 29425 USA. [Myrick, Hugh] Ralph H Johnson Dept Vet Affairs Med Ctr, Res & Dev Serv, Charleston, SC USA. RP Wright, TM (reprint author), Med Univ S Carolina, Inst Psychiat 4N, 67 President St, Charleston, SC 29425 USA. EM wright@musc.edu NR 31 TC 5 Z9 5 U1 4 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1932-0620 J9 J ADDICT MED JI J. Addict. Med. PD MAR PY 2007 VL 1 IS 1 BP 15 EP 20 DI 10.1097/ADM.0b013e318044ce4f PG 6 WC Substance Abuse SC Substance Abuse GA 303FW UT WOS:000256027400004 PM 21768927 ER PT J AU Cluver, JS Miller, PM Anton, RF AF Cluver, Jeffrey S. Miller, Peter M. Anton, Raymond F. TI Case studies of the utility of serum carbohydrate-deficient transferrin (%CDT) in the clinical management of alcoholics SO JOURNAL OF ADDICTION MEDICINE LA English DT Article DE %CDT; alcohol; biomarkers ID GAMMA-GLUTAMYL-TRANSFERASE; BIOMARKER; MARKERS; SAMPLE AB A laboratory test that measures the percentage of carbohydrate-deficient transferrin (%CDT) has been approved by the FDA for the detection of heavy alcohol use. This biomarker has unique properties and has proven to be a useful tool in multiple clinical settings. It can be used for screening and monitoring purposes in patients with suspected or known alcohol use disorders. We review the use of this test in the management of 5 patients seen in the mental health and substance abuse clinics at a Department of Veterans Affairs Medical Center. C1 [Cluver, Jeffrey S.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. [Cluver, Jeffrey S.; Miller, Peter M.; Anton, Raymond F.] Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. RP Cluver, JS (reprint author), Ralph H Johnson Vet Affairs Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM cluverj@musc.edu NR 17 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1932-0620 J9 J ADDICT MED JI J. Addict. Med. PD MAR PY 2007 VL 1 IS 1 BP 44 EP 47 DI 10.1097/ADM.0b013e3180473c00 PG 4 WC Substance Abuse SC Substance Abuse GA 303FW UT WOS:000256027400009 PM 21768932 ER PT J AU Micek, MA Bradley, KA Braddock, CH Maynard, C McDonell, M Fihn, SD AF Micek, Mark A. Bradley, Katharine A. Braddock, Clarence H., III Maynard, Charles McDonell, Mary Fihn, Stephan D. TI Complementary and alternative medicine use among veterans affairs outpatients SO JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE LA English DT Letter ID UNITED-STATES; MILITARY VETERANS; ADULTS; TRENDS; CARE C1 Univ Washington, Dept Hlth Serv, Sch Publ Hlth & Community Med, Seattle, WA 98105 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Epidemiol Res & Informat Ctr, Dept Hlth Serv, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Stanford Univ, Dept Gen Internal Med, Palo Alto, CA 94304 USA. Univ Washington, Sch Publ Hlth & Community Med, Seattle, WA 98195 USA. RP Micek, MA (reprint author), Univ Washington, Dept Hlth Serv, Sch Publ Hlth & Community Med, 1107 NE 45th St,Suite 427, Seattle, WA 98105 USA. EM mmicek@u.washington.edu RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 FU NIAAA NIH HHS [K23AA00313] NR 11 TC 10 Z9 10 U1 2 U2 3 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1075-5535 J9 J ALTERN COMPLEM MED JI J. Altern. Complement Med. PD MAR PY 2007 VL 13 IS 2 BP 190 EP 193 DI 10.1089/acm.2006.6147 PG 4 WC Integrative & Complementary Medicine SC Integrative & Complementary Medicine GA 151LS UT WOS:000245292400005 PM 17388760 ER PT J AU Amory, JK Page, ST Anawalt, BD Matsumotol, AM Bremner, WJ AF Amory, John K. Page, Stephanie T. Anawalt, Bradley D. Matsumotol, Alvin M. Bremner, William J. TI Elevated serum INSL3 is associated with failure to completely suppress spermatogenesis in men receiving male hormonal contraception SO JOURNAL OF ANDROLOGY LA English DT Meeting Abstract CT 32nd Annual Meeting of the American-Society-of-Andrology CY APR 18-24, 2007 CL Tampa, FL SP Amer Soc Androl C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD MAR-APR PY 2007 SU S MA 22 BP 46 EP 46 PG 1 WC Andrology SC Endocrinology & Metabolism GA 142LX UT WOS:000244652500025 ER PT J AU Jonker, SS Zhang, LB Louey, S Giraud, GD Thornburg, KL Faber, JJ AF Jonker, Sonnet S. Zhang, Lubo Louey, Samantha Giraud, George D. Thornburg, Kent L. Faber, J. Job TI Myocyte enlargement, differentiation, and proliferation kinetics in the fetal sheep heart SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE hyperplasia; hypertrophy; terminal differentiation; apoptosis ID CARDIAC MYOCYTES; RAT HEART; MYOCARDIAL APOPTOSIS; CARDIOPLEGIC ARREST; CELL-PROLIFERATION; MOUSE HEART; STEM-CELLS; CARDIOMYOCYTES; FETUS; CORTISOL AB The generation of new myocytes is an essential process of in utero heart growth. Most, or all, cardiac myocytes lose their capacity for proliferation during the perinatal period through the process of terminal differentiation. An increasing number of studies focus on how experimental interventions affect cardiac myocyte growth in the fetal sheep. Nevertheless, fundamental questions about normal growth of the fetal heart remain unanswered. In this study, we determined that during the last third of gestation the hearts of fetal sheep grew primarily by four processes. 1) Myocyte proliferation contributed substantially to daily cardiac mass gain, and the number of cardiac myocytes continued to increase to term. 2) The (hitherto unrecognized) contribution to cardiac growth by the increase in myocyte size associated with the transition from mononucleation to binucleation (terminal differentiation) became considerable from similar to 115 days of gestational age (dGA) until term (145dGA). Because binucleation became the more frequent outcome of myocyte cell cycle activity after similar to 115dGA, the number of binucleated myocytes increased at the expense of the number of mononucleated myocytes. Both the interval between nuclear divisions and the duration of cell cycle activity in myocytes decreased substantially during this same period. Finally, cardiac growth was in part due to enlargement of 3) mononucleated and 4) binucleated myocytes, which grew in cross-sectional diameter but not length during the last third of gestation. These data on normal cardiac growth may enable a more detailed understanding of the consequences of experimental and pathological interventions in prenatal life. C1 Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Heart Res Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. Loma Linda Univ, Sch Med, Dept Pharmacol, Ctr Perinatal Biol, Loma Linda, CA 92350 USA. RP Jonker, SS (reprint author), Univ Iowa, CBRB 1270, 285 Newton Rd, Iowa City, IA 52242 USA. EM sonnet-jonker@uiowa.edu OI Jonker, Sonnet/0000-0002-1097-2562 FU NHLBI NIH HHS [HL-067745]; NICHD NIH HHS [HD-034430] NR 53 TC 58 Z9 58 U1 0 U2 3 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 MAR PY 2007 VL 102 IS 3 BP 1130 EP 1142 DI 10.1152/japplphysiol.00937.2006. PG 13 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 143LF UT WOS:000244722400043 PM 17122375 ER PT J AU Wen, Y Feng, J Scott, DR Marcus, EA Sachs, G AF Wen, Yi Feng, Jing Scott, David R. Marcus, Elizabeth A. Sachs, George TI The HP0165-HP0166 two-component system (ArsRS) regulates acid-induced expression of HP1186 alpha-carbonic anhydrase in Helicobacter pylori by activating the pH-dependent promoter SO JOURNAL OF BACTERIOLOGY LA English DT Article ID BACTERIAL PROMOTERS; MUTATIONAL ANALYSIS; UREASE EXPRESSION; ALLELIC EXCHANGE; GENE-EXPRESSION; RNA-POLYMERASE; RESISTANCE; ADAPTATION; INDUCTION; GENOME AB The periplasmic a-carbonic anhydrase of Helicobacter pylori is essential for buffering the periplasm at acidic pH. This enzyme is an integral component of the acid acclimation response that allows this neutralophile to colonize the stomach. Transcription of the HP1186 alpha-carbonic anhydrase gene is upregulated in response to low environmental pH. A binding site for the HP0166 response regulator (ArsR) has been identified in the promoter region of the HP1186 gene. To investigate the mechanism that regulates the expression of HP1186 in response to low pH and the role of the HP0165-HP0166 two-component system (ArsRS) in this acid-inducible regulation, Northern blot analysis was performed with RNAs isolated from two different wild-type H. pylori strains (26695 and 43504) and mutants with HP0165 histidine kinase (ArsS) deletions, after exposure to either neutral pH or low pH (pH 4.5). ArsS-dependent upregulation of HP1186 alpha-carbonic anhydrase in response to low pH was found in both strains. Western blot analysis of H. pylori membrane proteins confirmed the regulatory role of ArsS in HP1186 expression in response to low pH. Analysis of the HP1186 promoter region revealed two possible transcription start points (TSP1 and TSP2) located 43 and 11 bp 5' of the ATG start codon, respectively, suggesting that there are two promoters transcribing the HP1186 gene. Quantitative primer extension analysis showed that the promoter from TSP, (43 bp 5' of the ATG start codon) is a pH-dependent promoter and is regulated by ArsRS in combating environmental acidity, whereas the promoter from TSP2 may be responsible for control of the basal transcription of HP1186 alpha-carbonic anhydrase. C1 Univ Calif Los Angeles, Membrane Biol Lab, Dept Physiol, David Geffen Sch Med, Los Angeles, CA 90073 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 [R01 DK046917, DK46917, DK53462, DK58333] NR 56 TC 25 Z9 29 U1 1 U2 3 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 2007 VL 189 IS 6 BP 2426 EP 2434 DI 10.1128/JB.01492-06 PG 9 WC Microbiology SC Microbiology GA 147EG UT WOS:000244985600025 PM 17220228 ER PT J AU Martini, SR Kent, TA AF Martini, Sharyl R. Kent, Thomas A. TI Hyperglycemia in acute ischemic stroke: a vascular perspective SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Review DE acute; glucose; hyperglycemia; outcome; reperfusion; stroke ID NITRIC-OXIDE SYNTHASE; PLASMINOGEN-ACTIVATOR INHIBITOR-1; FOCAL CEREBRAL-ISCHEMIA; SMOOTH-MUSCLE-CELLS; PROTEIN-KINASE-C; NF-KAPPA-B; GLUCAGON-LIKE PEPTIDE-1; HUMAN ENDOTHELIAL-CELLS; HIGH GLUCOSE-CONCENTRATIONS; BLOOD-GLUCOSE AB Admission hyperglycemia complicates approximately one- third of acute ischemic strokes and is associated with a worse clinical outcome. Both human and animal studies have showed that hyperglycemia is particularly detrimental in ischemia/ reperfusion. Decreased reperfusion blood flow has been observed after middle cerebral artery occlusion in acutely hyperglycemic animals, suggesting the vasculature as an important site of hyperglycemic reperfusion injury. This paper reviews biochemical and molecular pathways in the vasculature that are rapidly affected by hyperglycemia and concludes that these changes result in a pro- vasoconstrictive, pro- thrombotic and proinflammatory phenotype that renders the vasculature vulnerable to reperfusion injury. Understanding these pathways should lead to the development of rational therapies that reduce hyperglycemic reperfusion injury and thus improve outcome in this large subset of acute ischemic stroke patients. C1 Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Stroke Program, Houston, TX USA. RP Kent, TA (reprint author), Baylor Coll Med, Dept Neurol, 2002 Holcombe Blvd MS127, Houston, TX 77030 USA. EM tkent@bcm.tmc.edu OI Kent, Thomas/0000-0002-9877-7584 FU NINDS NIH HHS [R01 NS 42078-01A1] NR 160 TC 93 Z9 106 U1 0 U2 4 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 MAR PY 2007 VL 27 IS 3 BP 435 EP 451 DI 10.1038/sj.jcbfm.9600355 PG 17 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 138TX UT WOS:000244387100001 PM 16804552 ER PT J AU Aravagiri, M Marder, SR Pollock, B AF Aravagiri, Manickam Marder, Stephen R. Pollock, Bruce TI Determination of ziprasidone in human plasma by liquid chromatography-electrospray tandem mass spectrometry and its application to plasma level determination in schizophrenia patients SO JOURNAL OF CHROMATOGRAPHY B-ANALYTICAL TECHNOLOGIES IN THE BIOMEDICAL AND LIFE SCIENCES LA English DT Article DE ziprasidone; LC-MS-MS; schizophrenia patients; plasma analysis; ziprasidone levels ID ANTIPSYCHOTIC-DRUG ZIPRASIDONE; METABOLISM; EXTRACTION; CP-88,059; EXCRETION; WEIGHT; AGENT AB An accurate, rapid and simple liquid chromatography-tandem mass spectrometry (LC-MS-MS) assay method was developed for the determination of ziprasidone (ZIP) in the plasma of schizophrenia patients. A simple one step liquid-liquid extraction with 20% methylene dichloride in pentane was used to isolate ZIP and the internal standard from the plasma matrix. The compounds were separated on a C-18 column by an isocratic elution and the eluted compounds were analyzed by a triple quadrupole mass spectrometer with a Turbolon spray interface using the positive ion atmospheric pressure electrospray ionization method and detected using multiple reaction monitoring mode. The ZIP standard calibration curve was linear over the range of 0.25-500 ng/ml when 0.5 ml of plasma was used for the analysis (r(2) > 0.998). The intra-assay (within-day) and inter-assay (between-day) variations were less than 12% for the spiked standard curve and quality control samples. The absolute extraction efficiency was 82% for ZIP and 68% for INS-RSP. The analysis time for each sample was less than 3 min and useful for high turnaround plasma level determinations. This LC-MS-MS assay method for ZIP is highly specific, sensitive, accurate and rapid and is currently being used for the plasma level determination of ZIP in schizophrenia patients treated with various daily oral doses of ZIP. The data showed large inter-individual variations. (c) 2006 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. Univ Pittsburgh, Geriatr Psychopharmacol Program, Pittsburgh, PA 15260 USA. Univ Toronto, Rotman Res Inst, Toronto, ON M4X 1K9, Canada. RP Aravagiri, M (reprint author), Univ Calif Los Angeles, Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. EM kannan@ucla.edu FU NIMH NIH HHS [MH064173, N01MH90001, MH41573] NR 21 TC 18 Z9 20 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1570-0232 J9 J CHROMATOGR B JI J. Chromatogr. B PD MAR 1 PY 2007 VL 847 IS 2 BP 237 EP 244 DI 10.1016/j.jchromb.2006.10.024 PG 8 WC Biochemical Research Methods; Chemistry, Analytical SC Biochemistry & Molecular Biology; Chemistry GA 152UN UT WOS:000245387600022 PM 17098485 ER PT J AU Fox, E Daskal, FC Stocking, C AF Fox, Ellen Daskal, Frona C. Stocking, Carol TI Ethics consultants' recommendations for life-prolonging treatment of patients in persistent vegetative state: A follow-up study SO JOURNAL OF CLINICAL ETHICS LA English DT Article ID MEDICAL ASPECTS; GOALS C1 US Dept Vet Affairs, Natl Ctr Eth Hlth Care, Washington, DC USA. Univ Chicago, MacLean Ctr Clin Med Eth, Chicago, IL 60637 USA. RP Fox, E (reprint author), US Dept Vet Affairs, Natl Ctr Eth Hlth Care, Washington, DC USA. EM Foxe2@comcast.net NR 9 TC 3 Z9 4 U1 1 U2 3 PU UNIV PUBLISHING GROUP PI HAGERSTOWN PA 138 W WASHINGTON ST, STE 403-405, HAGERSTOWN, MD 21740 USA SN 1046-7890 J9 J CLIN ETHIC JI J. Clin. Ethics PD SPR PY 2007 VL 18 IS 1 BP 64 EP 71 PG 8 WC Ethics; Social Sciences, Biomedical SC Social Sciences - Other Topics; Biomedical Social Sciences GA 170QG UT WOS:000246678400010 PM 17546936 ER PT J AU Caroff, SN Walker, P Campbell, EC Lorry, A Petro, C Lynch, K Gallop, R AF Caroff, Stanley N. Walker, Patricia Campbell, E. Cabrina Lorry, Alan Petro, Christopher Lynch, Kevin Gallop, Robert TI Treatment of tardive dyskinesia with galantamine: A randomized controlled crossover trial SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID DOPA-INDUCED DYSKINESIAS; MOVEMENT-DISORDERS; CHOLINERGIC NEURONS; ALZHEIMERS-DISEASE; RATING-SCALE; DOUBLE-BLIND; SCHIZOPHRENIA; DONEPEZIL; HALOPERIDOL; RATS AB Objective: Recent evidence suggests that tardive dyskinesia may result from antipsychotic-induced damage to striatal cholinergic neurons. To test whether cholinesterase inhibitors compensate for diminished cholinergic activity, we conducted a 30-week randomized, double-blind, placebo-controlled crossover trial of galantamine in patients with tardive dyskinesia. Method: Patients with tardive dyskinesia were recruited between June 2001 and June 2004. After a 2-week baseline period, 35 male schizophrenia patients, on stable doses of antipsychotics, were randomly assigned to receive galantamine (8-24 mg) or placebo for two 12-week phases separated by a 4-week washout period. Patients were evaluated every 2 weeks for changes in extrapyramidal symptoms and before and after each treatment for effects on psychiatric symptoms and cognition. Results: Galantamine reduced mean total Abnormal Involuntary Movement Scale (AIMS) scores more than placebo, but this difference was not statistically significant (p =.08). However, patients initially randomly assigned to galantamine showed a reversal of AIMS scores after switching to placebo. Simpson-Angus Scale ratings of parkinsonism were significantly higher with galantamine than placebo (p =.0005) and correlated with age. There were no significant differences between groups in akathisia, cognition, or psychiatric symptoms. More patients dropped out while receiving galantamine, but this outcome did not significantly influence the results. Conclusions: In contrast to previous reports, reductions in tardive dyskinesia associated with galantamine were not statistically significant compared with placebo in this trial. However, galantamine was associated with a modest rebound in dyskinesia scores after discontinuation and clinically minor but statistically higher ratings of parkinsonism. These findings support the need for further investigations of cholinergic mechanisms underlying tardive dyskinesia and extrapyramidal effects of cholinesterase inhibitors when used in combination with antipsychotics in susceptible patients. C1 Univ Penn, Sch Med, Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. W Chester Univ, Dept Appl Math & Stat, W Chester, PA 19380 USA. RP Caroff, SN (reprint author), Vet Affairs Med Ctr, 116A,Univ Ave, Philadelphia, PA 19104 USA. EM stanley.caroff@va.gov NR 55 TC 16 Z9 16 U1 1 U2 2 PU PHYSICIANS POSTGRADUATE PRESS PI MEMPHIS PA P O BOX 240008, MEMPHIS, TN 38124 USA SN 0160-6689 J9 J CLIN PSYCHIAT JI J. Clin. Psychiatry PD MAR PY 2007 VL 68 IS 3 BP 410 EP 415 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 152CK UT WOS:000245338200009 PM 17388711 ER PT J AU Owens, DK Sundaram, V Lazzeroni, LC Douglass, LR Tempio, P Holodniy, M Sanders, GD Shadle, VM McWhorter, VC Agoncillo, T Haren, N Chavis, D Borowsky, LH Yano, EM Jensen, P Simberkoff, MS Bozzette, SA AF Owens, Douglas K. Sundaram, Vandana Lazzeroni, Lauro C. Douglass, Lena R. Tempio, Patricia Holodniy, Mark Sanders, Gillian D. Shadle, Vera M. McWhorter, Valerie C. Agoncillo, Teodoro Haren, Noreen Chavis, Darlene Borowsky, Leila H. Yano, Elizabeth M. Jensen, Peter Simberkoff, Michael S. Bozzette, Samuel A. TI HIV testing of at risk patients in a large integrated health care system SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE HIV; screening; risk factors ID HUMAN-IMMUNODEFICIENCY-VIRUS; RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-CARE; ANTIRETROVIRAL THERAPY; COST-EFFECTIVENESS; UNITED-STATES; INFECTION; BEHAVIORS; WOMEN AB OBJECTIVE: Early identification of HIV infection is critical for patients to receive life-prolonging treatment and risk-reduction counseling. Understanding HIV screening practices and barriers to HIV testing is an important prelude to designing successful HIV screening programs. Our objective was to evaluate current practice patterns for identification of HIV. METHODS: We used a retrospective cohort analysis of 13,991 at-risk patients seen at 4 large Department of Veterans Affairs (VA) health-care systems. We also reviewed 1, 100 medical records of tested patients. We assessed HIV testing rates among at-risk patients, the rationale for HIV testing, and predictors of HIV testing and of HIV infection. RESULTS: Of the 13,991 patients at risk for HM only 36% had been HIV-tested. The prevalence of HTV ranged from 1% to 20% among tested patients at the 4 sites. Approximately 90% of patients who were tested had a documented reason for testing. CONCLUSION. One-half to two-thirds of patients at risk for HIV had not been tested within our selected VA sites. Among tested patients, the rationale for HIV testing was well documented. Further testing of at-risk patients could clearly benefit patients who have unidentified HIV infection by providing earlier access to life-prolonging therapy. C1 VA Palo Alto Healthcare Syst, Palo Alto, CA USA. Stanford Univ, Ctr Primary Care & Outcomes Res, Dept Med, Stanford, CA 94305 USA. Stanford Univ, Sch Med, Dept Hlth Res & Policy, Stanford, CA 94305 USA. Stanford Univ, Sch Med, Div Infect Dis & Geog Med, Stanford, CA 94305 USA. Duke Univ, Duke Clin Res Inst, Durham, NC 27706 USA. VA San Francisco Healthcare Syst, San Francisco, CA USA. VA San Diego Healthcare Syst, San Diego, CA USA. VA New York Harbor Healthcare Syst, New York, NY USA. VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Owens, DK (reprint author), VA Palo Alto Healthcare Syst, Palo Alto, CA USA. EM owens@stanford.edu RI Lazzeroni, Laura/F-2903-2010 OI Lazzeroni, Laura/0000-0002-1846-6920 FU NIDA NIH HHS [R01 DA015612, R01 DA15612-01] NR 26 TC 16 Z9 16 U1 2 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAR PY 2007 VL 22 IS 3 BP 315 EP 320 DI 10.1007/s11606-006-0028-9 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 143JX UT WOS:000244718600005 PM 17356961 ER PT J AU Simpson, SA Long, JA AF Simpson, Scott A. Long, Judith A. TI Medical student-run health clinics: Important contributors to patient care and medical education SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE medical student-run clinics-underserved population; medical education; community health ID HOMELESS; SERVICES; CENTERS; ACCESS AB BACKGROUND: Despite the popularity of medical student-run health clinics among U.S. medical schools, there is no information about how many clinics exist, how many students volunteer there, or how many patients they see and what services they offer. OBJECTIVE: We describe, for the first time, the prevalence and operation of medical student-run health clinics nationwide. DESIGN AND PARTICIPANTS: A web-based survey was sent to all 124 Association of American Medical Colleges allopathic schools in the 50 states. RESULTS: Ninety-four schools responded (76%); 49 schools had at least 1 student-run clinic (52%). Fiftynine student-run clinics provided detailed data on their operation. The average clinic had 16 student volunteers a week, and most incorporated preclinical students (56/59, 93%). Nationally, clinics reported more than 36,000. annual patient-physician visits, in addition to more nonvisit encounters. Patients were predominantly minority: 31% Hispanic; 3 1 % Black/African American; 25% White; 11% Asian; and 3% Native American or other. Most student-run health clinics had resources both to treat acute illness and also to manage chronic conditions. Clinics were most often funded by private grants (42/59, 71%); among 27 clinics disclosing finances, a median annual operating budget of $12,000 was reported. CONCLUSIONS: Medical student-run health clinics offer myriad services to disadvantaged patients and are also a notable phenomenon in medical education. Wider considerations of community health and medical education should not neglect the local role of a studentrun health clinic. C1 Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Ctr Hlth Equ Res & Promo, Philadelphia, PA USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Simpson, SA (reprint author), Univ Penn, Sch Med, 1201 Blockley Hall 423 Guardian Dr, Philadelphia, PA 19104 USA. EM ss@mail.med.upenn.edu NR 21 TC 87 Z9 87 U1 1 U2 14 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAR PY 2007 VL 22 IS 3 BP 352 EP 356 DI 10.1007/s11606-006-0073-4 PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 143JX UT WOS:000244718600011 PM 17356967 ER PT J AU Dhaliwal, G Chou, CL AF Dhaliwal, Gurpreet Chou, Calvin L. TI A brief educational intervention in personal finance for medical residents SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE curriculum program/evaluation; financial management; medical student and residency education ID STRESS AB INTRODUCTION. Although medical educational debt continues to escalate, residents receive little guidance in financial planning. AIM. To educate interns about long-term investment strategies. SETTING: University-based medicine internship program. PROGRAM DESCRIPTION. An unselected cohort of interns (n=52; 84% of all interns) underwent a 90minute interactive seminar on personal finance, focusing on retirement savings. Participants completed a preseminar investor literacy test to assess baseline financial knowledge. Afterward, interns rated the seminar and expressed their intention to make changes to their long-term retirement accounts. After 37 interns had attended the seminar, a survey was administered to all interns to compare actual changes to these accounts between seminar attendees and nonattendees. MEASUREMENTS AND MAIN RESULTS: Interns' average score on the investor literacy test was 40% ' equal to the general population. Interns strongly agreed that the seminar was valuable (average 5.0 on 5-point Likert scale). Of the 46 respondents to the account allocation survey, interns who had already attended the seminar (n=25) were more likely than interns who had not yet attended (n=21) to have switched their investments from low to high-yield accounts at the university hospital (64 vs 19%, P= 0.003) and to enroll in the county hospital retirement plan (64 vs 33%, P=0.07). CONCLUSIONS: One 90-minute seminar on personal finances leads to significant changes in allocation of tax-deferred retirement savings. We calculate that these changes can lead to substantial long-term financial benefits and suggest that programs consider automatically enrolling trainees into higher yield retirement plans. C1 San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94131 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94131 USA. RP Dhaliwal, G (reprint author), San Francisco VA Med Ctr, Dept Med, 4150 Clement St,111, San Francisco, CA 94131 USA. EM gurpreet.dhaliwal@va.gov NR 12 TC 5 Z9 5 U1 0 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAR PY 2007 VL 22 IS 3 BP 374 EP 377 DI 10.1007/s11606-006-0078-z PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 143JX UT WOS:000244718600015 PM 17356971 ER PT J AU Takahashi, TA Baernstein, A Binswanger, I Bradley, K Merrill, JO AF Takahashi, Traci A. Baernstein, Amy Binswanger, Ingrid Bradley, Katharine Merrill, Joseph O. TI Predictors of hospitalization for injection drug users seeking care for soft tissue infections SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE injection drug use; soft tissue infection; cellulitis; abscess; substance abuse ID RESISTANT STAPHYLOCOCCUS-AUREUS; SAN-FRANCISCO; HIGH PREVALENCE; AUDIT-C; POPULATION; ABSCESSES; DRINKING; SKIN AB BACKGROUND: Soft tissue infections (STIs) from injection drug use are a common cause of Emergency Department visits, hospitalizations, and operating room procedures, yet little is known about factors that may predict the need for these costly medical services. OBJECTIVE: To describe a cohort of injection drug users seeking Emergency Department care for STIs and to identify risk factors associated with hospitalization. We hypothesized that participants who delayed seeking care would be hospitalized more often than those who did not. DESIGN: Cohort study using in-person structured interviews and medical record review. Logistic regression assessed the association between hospital admission and delay in seeking care as well as other demographic, clinical, and psychosocial factors. PARTICIPANTS: Injection drug users who sought Emergency Department care for STIs from May 2001 to March 2002. RESULTS: Of the 136 participants, 55 (40%) were admitted to the hospital. Delay in seeking care was not associated with hospital admission. Participants admitted for their infection were significantly more likely to be living in a shelter (P=.01) and to report being hospitalized 2 or more times in the past year (P <.01). CONCLUSIONS: We identified a subpopulation of injection drug users, mostly living in shelters, who were hospitalized frequently in the past year and who were more likely to be hospitalized for their current infections compared to others. As members of this subpopulation can be easily identified and located, they may benefit from interventions to reduce the health care utilization resulting from these infections. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. Univ Washington, Sch Med, Seattle, WA 98104 USA. Univ Colorado, Denver, CO 80202 USA. Hlth & Sci Ctr, Denver, CO USA. RP Takahashi, TA (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM traci@u.washington.edu OI Binswanger, Ingrid/0000-0001-8862-8078 FU NIAAA NIH HHS [K23 AA000313, K23AA00313]; NIDA NIH HHS [R03DA14518] NR 20 TC 21 Z9 21 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD MAR PY 2007 VL 22 IS 3 BP 382 EP 388 DI 10.1007/s11606-006-0079-y PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 143JX UT WOS:000244718600017 PM 17356973 ER PT J AU Sailer, CA Pott, GB Dinarello, CA Whinney, SM Forster, JE Larson-Duran, JK Landay, A Al-Harthi, L Schooley, RT Benson, CA Judson, FN Thompson, M Palella, FJ Shapiro, L AF Sailer, Carrie A. Pott, Gregory B. Dinarello, Charles A. Whinney, Samantha Ma Forster, Jeri E. Larson-Duran, Jacqueline K. Landay, Alan Al-Harthi, Lena Schooley, Robert T. Benson, Constance A. Judson, Franklyn N. Thompson, Melanie Palella, Frank J. Shapiro, Leland TI Whole-blood interleukin-18 level during early HIV-1 infection is associated with reduced CXCR4 coreceptor expression and interferon-gamma levels SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 12th Conference on Retroviruses and Opportunistic Infections CY FEB 22-25, 2005 CL Boston, MA ID HIV-1-INFECTED PATIENTS; DISEASE PROGRESSION; MONONUCLEAR-CELLS; PATHOGENESIS AB Interleukin ( IL)-18 generates T helper 1-type immunity and inhibits human immunodeficiency virus type 1 ( HIV-1) in primary cells in vitro. Because IL-18 may participate in HIV-1 containment, whole-blood IL-18 levels were measured in 20 healthy control subjects and longitudinally in 28 subjects with early HIV-1 infection. Compared with those in control subjects, IL-18 levels were higher during early HIV-1 infection, and IL-18 levels predicted reduced CXCR4 HIV-1 coreceptor expression and diminished interferon ( IFN)-gamma levels. By contrast, a direct association between IL-18 and IFN-gamma levels was observed in blood stimulated with lipopolysaccharide. During early HIV-1 infection, IL-18 may regulate HIV-1 coreceptor expression and have antiretroviral activity. C1 Hlth Sci Ctr, Denver, CO USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Denver Publ Hlth Dept, Denver, CO USA. Rush Univ, Med Ctr, Chicago, IL 60612 USA. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. AIDS Res Consortium Atlanta, Atlanta, GA USA. RP Shapiro, L (reprint author), Univ Colorado, Div Infect Dis, Dept Med, 4200 E 9th Ave,B168, Denver, CO 80262 USA. EM Leland.Shapiro@uchsc.edu FU NIAID NIH HHS [AI 15614, 5 P01 AI055356-02] NR 15 TC 9 Z9 10 U1 0 U2 2 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 MAR 1 PY 2007 VL 195 IS 5 BP 734 EP 738 DI 10.1086/511435 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 136RV UT WOS:000244242700020 PM 17262717 ER PT J AU Dallalio, G Brunson, CY Means, RT AF Dallalio, Gail Brunson, Chris Y. Means, Robert T., Jr. TI Cytokine concentrations in bone marrow of stable sickle cell anemia patients SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Article; Proceedings Paper CT Meeting of the Southern-Society-for-Clinical-Research CY FEB 24, 2005 CL New Orleans, LA SP So Soc Clin Res DE sickle cell anemia; inflammation; erythropoiesis; cytokines; placental growth factor; apoptosis ID SERUM TRANSFERRIN RECEPTOR; PLACENTA GROWTH-FACTOR; CFU-E; STEADY-STATE; DISEASE; ERYTHROPOIETIN; INFLAMMATION; ACTIVATION; CHILDREN; CULTURE AB Inflammation plays a significant role in the clinical manifestations of sickle cell anemia, In studies of anemic patients with other clinical syndromes, measurement of the concentrations of cytokine mediators of inflammation in bone marrow aspirates has provided unique correlations with clinical and laboratory parameters. We determined concentrations of interleukin (IL)-1, IL-6, tumor necrosis factor (TNF), and placental growth factor (PIGF) in bone marrow aspirates from six homozygous sickle cell (SS) patients who were not acutely ill and who were not receiving hydroxyurea, erythropoietin, or chronic transfusion and compared them with specimens from seven healthy controls. We also measured concentrations of soluble transferrin receptor (sTfR) and of marrow erythroid colony-forming units (CFU-E) as markers of erythropoietic activity. sTfR concentration was significantly higher in SS patients (p = .024). CFU-E concentration was not significantly different between the two groups. Bone marrow concentrations of IL-6 and IL-1 did not differ between the study groups. TNF was undetectable in all specimens, plasma or marrow. Bone marrow PIGF concentrations were significantly higher in SS patients (p = .004). Since PIGF is a product of erythroid cells, the ratio of marrow PIGF to marrow sTfR was determined and found to be significantly greater in SS patients. This suggests that the observed difference in marrow PIGF concentrations does not reflect increased erythropoiesis but rather represents increased PIGF production per erythroid unit. C1 Univ Kentucky, Lucille P Markey Canc Ctr, Lexington, KY USA. Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Vet Affairs Med Ctr, Div Hematol, Lexington, KY USA. Vet Affairs Med Ctr, Div Oncol, Lexington, KY USA. RP Means, RT (reprint author), VA Med Ctr, Med Serv 111, Room A429,1101 Vet Dr, Lexington, KY 40502 USA. EM robert.means@uky.edu RI Means, Robert/A-4454-2008 FU NHLBI NIH HHS [HL69418] NR 28 TC 3 Z9 3 U1 1 U2 2 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, PO BOX 620, L C D 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1081-5589 J9 J INVEST MED JI J. Invest. Med. PD MAR PY 2007 VL 55 IS 2 SU S BP 69 EP 74 DI 10.2310/6650.2007.06029 PG 6 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 191JX UT WOS:000248128600016 PM 17362693 ER PT J AU Shirernan, PK Contreras-Shannon, V Ochoa, O Karia, BP Michalek, JE McManus, LM AF Shirernan, Paula K. Contreras-Shannon, Veronica Ochoa, Oscar Karia, Bijal P. Michalek, Joel E. McManus, Linda M. TI MCP-1 deficiency causes altered inflammation with impaired skeletal muscle regeneration SO JOURNAL OF LEUKOCYTE BIOLOGY LA English DT Article DE CCL2; macrophage; neutrophils; chemokines; ischemia ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; CC-CHEMOKINE RECEPTOR-2; SATELLITE CELLS; MYOGENIC CELLS; MICE DEFICIENT; SNAKE-VENOM; P-SELECTIN; INJURY; MACROPHAGES; DIFFERENTIATION AB We examined the role of MCP-1, a potent chemotactic and activating factor for macrophages, in perfusion, inflammation, and skeletal muscle regeneration post-ischemic injury. MCP-1-/- or C57Bl/6J control mice [wild-type (WT)] underwent femoral artery excision (FAE). Muscles were collected for histology, assessment of tissue chemokines, and activity measurements of lactate dehydrogenase (LDH) and myeloperoxidase. In MCP-1-/- mice, restoration of perfusion was delayed, and LDH and fiber size, indicators of muscle regeneration, were decreased. Altered inflammation was observed with increased neutrophil accumulation in MCP-1-/- versus WT mice at Days I and 3 (P <= 0.003), whereas fewer macrophages were present in MCP-1-/- mice at Day 3. As necrotic tissue was removed in ViT mice, macrophages decreased (Day 7). In contrast, macrophage accumulation in MCP-1-/- was increased in association with residual necrotic tissue and impaired muscle regeneration. Consistent with altered inflammation, neutrophil chemotactic factors (keratinocyte-derived chemokine mid macrophage inflammatory protein-2) were increased at Day I post-FAE. The macrophage cheniotactic factor MCP-5 was increased significantly in WT juice at Day 3 compared with MCP-1-/- mice. However, at post-FAE Day 7, MCP-5 was significantly elevated in MCP-1-/- mice versus WT mice. Addition of exogenous MCP-1 did not induce proliferation in murine myoblasts (C2C12 cells) in vitro. MCP-1 is essential for reperfusion and the successful completion of normal skeletal muscle regeneration after ischemic tissue injury. Impaired muscle regeneration in MCP-1-/- mice suggests an important role for macrophages and MCP-1 in tissue reparative processes. C1 Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Epidemiol & Biostat, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Periodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Shirernan, PK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Surg, 7703 Floyd Curl Dr,MC 7741, San Antonio, TX 78229 USA. EM shireman@uthscsa.edu FU NHLBI NIH HHS [HL074236, HL070158, HL04776]; NIAMS NIH HHS [AR052610] NR 61 TC 99 Z9 102 U1 0 U2 4 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0741-5400 J9 J LEUKOCYTE BIOL JI J. Leukoc. Biol. PD MAR PY 2007 VL 81 IS 3 BP 775 EP 785 DI 10.1189/jlb.0506356 PG 11 WC Cell Biology; Hematology; Immunology SC Cell Biology; Hematology; Immunology GA 140LE UT WOS:000244505800024 PM 17135576 ER PT J AU Kilbourne, AM Bauer, MS Nossek, A Drill, LJ Cooley, S Post, EP AF Kilbourne, Amy M. Bauer, Mark S. Nossek, Agnes Drill, Larry J. Cooley, Susan Post, Edward P. TI Improving general medical care for patients with bipolar disorder: A randomized, controlled effectiveness trial SO JOURNAL OF MENTAL HEALTH POLICY AND ECONOMICS LA English DT Meeting Abstract C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh, Pittsburgh, PA 15240 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU INT CENTER MENTAL HEALTH POLICY & ECONOMICS-ICMPE PI MILANO PA VIA DANIELE CRESPI 7, MILANO, 20123, ITALY SN 1091-4358 J9 J MENT HEALTH POLICY JI J. Ment. Health Policy Econ. PD MAR PY 2007 VL 10 SU 1 BP S21 EP S22 PG 2 WC Health Policy & Services; Psychiatry SC Health Care Sciences & Services; Psychiatry GA 166OQ UT WOS:000246388800048 ER PT J AU Kilbourne, AM Biswas, K Sajatovic, M Pirraglia, PA Williford, WO Bauer, MS AF Kilbourne, Amy M. Biswas, Kousick Sajatovic, Martha Pirraglia, Paul A. Williford, William O. Bauer, Mark S. TI Is the chronic care model effective for complex patients?: Analyzing moderators of treatment effect in bipolar disorder SO JOURNAL OF MENTAL HEALTH POLICY AND ECONOMICS LA English DT Meeting Abstract C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh, Pittsburgh, PA 15240 USA. RI Sajatovic, Martha/I-8001-2014 NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT CENTER MENTAL HEALTH POLICY & ECONOMICS-ICMPE PI MILANO PA VIA DANIELE CRESPI 7, MILANO, 20123, ITALY SN 1091-4358 J9 J MENT HEALTH POLICY JI J. Ment. Health Policy Econ. PD MAR PY 2007 VL 10 SU 1 BP S22 EP S22 PG 1 WC Health Policy & Services; Psychiatry SC Health Care Sciences & Services; Psychiatry GA 166OQ UT WOS:000246388800049 ER PT J AU Aqel, R Zoghbi, GJ Bender, LW Scott, JW Baldwin, JA Heo, J Iskandrian, AE AF Aqel, Raed Zoghbi, Gilbert J. Bender, Luvenia W. Scott, Johnny W. Baldwin, Jon A. Heo, Jaekyeong Iskandrian, Ami E. TI Myocardial perfusion imaging after transient balloon occlusion during percutaneous coronary interventions SO JOURNAL OF NUCLEAR CARDIOLOGY LA English DT Article DE myocardial perfusion imaging; single photon emission computed tomography; ischemia; percutaneous coronary intervention ID HEXAKIS 2-METHOXYISOBUTYL ISONITRILE; VENTRICULAR-FUNCTION; TC-99M SESTAMIBI; BLOOD-FLOW; ISCHEMIA; ANGIOPLASTY; REPERFUSION; AREA; MITOCHONDRIAL; RESERVE AB Background. Myocardial perfusion imaging (MPI) is highly sensitive in detecting rest ischemia when the radiotracer is injected during the episode of ischemia. The frequency of abnormal MPI results after resolution of ischemia is not well defined. The aim of this study was to determine how long MPI results remain abnormal after transient coronary artery occlusion. Methods and Results. Patients undergoing single-vessel percutaneous coronary intervention were injected with technetium 99m sestamibi at 30 to 60 minutes (group 1) (n = 20) or 90 to 120 minutes (group 2) (n = 10) after the last balloon inflation and 24 hours later. There were 30 men aged 59 8 years. The culprit vessel was the left anterior descending artery in 14 patients and the right coronary artery in 13. The diameter stenosis was reduced from 76.1% 8.7% to 3.0% +/- 6.4% (P < .001). The duration of balloon inflation was 40.3 +/- 12.5 seconds. Chest pain or ST shifts occurred in 66% of patients. A perfusion defect in the territory of the culprit artery was detected in 3 of 20 patients (15%) in group 1 and in 0 of 10 patients (0%) in group 2 (P = .3). One of those three patients had a perfusion defect on MPI done 24 hours later, along with a regional wall motion abnormality on the 2 sets of images. Conclusions. Abnormal perfusion is seen in a small percentage of patients at 30 to 60 minutes and in none at 90 to 120 minutes after a brief transient balloon occlusion. These results might have important implications in patient care. C1 Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. Univ Alabama, Div Cardiovasc Dis, Birmingham, AL 35294 USA. Univ Alabama, Dept Radiol, Birmingham, AL 35294 USA. RP Zoghbi, GJ (reprint author), Univ Alabama, Birmingham VA Med Ctr, LHRB 306,1530 3rd Ave S, Birmingham, AL 35294 USA. EM gzoghbi@uab.edu NR 24 TC 2 Z9 2 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 1071-3581 J9 J NUCL CARDIOL JI J. Nucl. Cardiol. PD MAR-APR PY 2007 VL 14 IS 2 BP 221 EP 228 DI 10.1016/j.nuclcard.2006.11.012 PG 8 WC Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging SC Cardiovascular System & Cardiology; Radiology, Nuclear Medicine & Medical Imaging GA 152WF UT WOS:000245392100013 PM 17386385 ER PT J AU Salleh, NM Fueki, K Garrett, NR Ohyama, T AF Salleh, N. M. Fueki, K. Garrett, N. R. Ohyama, T. TI Objective and subjective hardness of a test item used for evaluating food mixing ability SO JOURNAL OF ORAL REHABILITATION LA English DT Article DE food texture; hardness; food mixing ability; masticatory function ID REMOVABLE PARTIAL DENTURES; MASTICATORY FUNCTION; NATURAL FOODS; CHEWING GUM; MUSCLE-ACTIVITY; IMPLANT; TEXTURE; WEARERS; ELECTROMYOGRAPHY; OVERDENTURES AB The aim of this study was to compare objective and subjective hardness of selected common foods with a wax cube used as a test item in a mixing ability test. Objective hardness was determined for 11 foods (cream cheese, boiled fish paste, boiled beef, apple, raw carrot, peanut, soft/hard rice cracker, jelly, plain chocolate and chewing gum) and the wax cube. Peak force (N) to compress each item was obtained from force-time curves generated with the Tensipresser. Perceived hardness ratings of each item were made by 30 dentate subjects (mean age 26.9 years) using a visual analogue scale (100 mm). These subjective assessments were given twice with a 1 week interval. High intraclass correlation coefficients (ICCs) for test-retest reliability were seen for all foods (ICC > 0.68; P < 0.001). One-way ANOVA found a significant effect of food type on both the objective hardness score and the subjective hardness rating (P < 0.001). The wax cube showed significant lower objective hardness score (32.6 N) and subjective hardness rating (47.7) than peanut (45.3 N, 63.5) and raw carrot (82.5 N, 78.4) [P < 0.05; Ryan-Einot-Gabriel-Welsch (REGW)-F]. A significant semilogarithmic relationship was found between the logarithm of objective hardness scores and subjective hardness ratings across twelve test items (r = 0.90; P < 0.001). These results suggest the wax cube has a softer texture compared with test foods traditionally used for masticatory performance test, such as peanut and raw carrot. The hardness of the wax cube could be modified to simulate a range of test foods by changing mixture ratio of soft and hard paraffin wax. C1 Tokyo Med & Dent Univ, Grad Sch, Bunkyo Ku, Tokyo 1138549, Japan. Univ Calif Los Angeles, Sch Dent, Jane & Jerry Weintraub Ctr Reconstruct Biotechnol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Div Adv Prosthodont Biomat & Hosp Dent, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Fueki, K (reprint author), Tokyo Med & Dent Univ, Grad Sch, Bunkyo Ku, 1-5-45 Yushima, Tokyo 1138549, Japan. EM kunfu.rpro@tmd.ac.jp RI Fueki, Kenji/A-9909-2008 OI Fueki, Kenji/0000-0002-5885-2447 FU NCRR NIH HHS [C06 RR-14529-01] NR 46 TC 24 Z9 24 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0305-182X J9 J ORAL REHABIL JI J. Oral Rehabil. PD MAR PY 2007 VL 34 IS 3 BP 174 EP 183 DI 10.1111/j.1365-2842.2006.01645.x PG 10 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 134WP UT WOS:000244115400003 PM 17302945 ER PT J AU Otomo-Corgel, J AF Otomo-Corgel, Joan TI Implants and oral bisphosphonates: Risky business? SO JOURNAL OF PERIODONTOLOGY LA English DT Editorial Material ID EXPERIMENTAL PERIODONTITIS; BEAGLE DOGS; OSTEONECROSIS; THERAPY; BONE; JAWS; OSTEOPOROSIS; ALENDRONATE; PREVENTION; RECOGNITION C1 Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Sch Dent, Dept Periodont, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Adm Hlth Care Syst, Los Angeles, CA USA. RP Otomo-Corgel, J (reprint author), 1127 Wilshire Blvd,Suite 1110, Los Angeles, CA 90017 USA. EM Joan@corgels.com NR 25 TC 7 Z9 7 U1 0 U2 1 PU AMER ACAD PERIODONTOLOGY PI CHICAGO PA 737 NORTH MICHIGAN AVENUE, SUITE 800, CHICAGO, IL 60611-2690 USA SN 0022-3492 J9 J PERIODONTOL JI J. Periodont. PD MAR PY 2007 VL 78 IS 3 BP 373 EP 376 DI 10.1902/jop.2007.073001 PG 4 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 146GW UT WOS:000244923500001 PM 17335360 ER PT J AU Giles, JT Mease, P Boers, M Bresnihan, B Conaghan, PG Heald, A Maksymowych, WP Maillefert, JF Simon, L Tsuji, W Wakefield, R Woodworth, T Schumacher, HR Bingham, CO AF Giles, Jon T. Mease, Philip Boers, Maarten Bresnihan, Barry Conaghan, Philip G. Heald, Alison Maksymowych, Walter P. Maillefert, Jean-Francis Simon, Lee Tsuji, Wayne Wakefield, Richard Woodworth, Thasia Schumacher, H. Ralph Bingham, Clifton O., III TI Assessing single joints in arthritis clinical trials SO JOURNAL OF RHEUMATOLOGY LA English DT Article; Proceedings Paper CT 8th International Consensus Conference on Outcome Measures in Rheumatology Clinical Trails CY MAY 10-14, 2006 CL Valletta, MALTA DE outcome assessment; arthritis; validity; reliability; responsiveness; joint examination ID OSTEOARTHRITIS INDEX WOMAC; WESTERN ONTARIO; KNEE OSTEOARTHRITIS; RHEUMATOID-ARTHRITIS; PHYSICAL-EXAMINATION; OUTCOME MEASURES; VALIDATION; ULTRASONOGRAPHY; RELIABILITY; HIP AB Endpoints and outcome measurements to detect changes in joint structure for the assessment of single joints are needed to enable rheumatology clinical trials of therapies targeting preservation of joint structure, especially via locally applied therapies. While the assessment of certain aspects of single joint inflammation and function is accepted in the evaluation of osteoarthritis (OA) using the WOMAC, it tends to be limited to the knee and hip. The advent of therapies that are directed toward a single joint in inflammatory arthritis, including intraarticular cytokine antagonists and gene therapeutics, requires reliable measures to assess change over time in single joints and the clinical meaningfulness of such change. Traditionally, clinical trials for inflammatory arthritis have used composite response indices such as American College of Rheumatology response or improvement in Disease Activity Score as outcomes based on multiple joint clinical measures, acute phase reactants, and functional status. However, it is not known whether these will appropriately detect changes referable to single joint intervention. This Special Interest Group was developed to bring together interested individuals to identify and evaluate outcome measurements for single joints. The knee was the initial focus, as clinical, radiographic, and functional assessments have been well developed for knee OA. A PubMed English language review was conducted before OMERACT 8, evaluating existing clinical instruments in the context of the OMERACT filter. At OMERACT 8, the group developed a research agenda to perform additional validation studies of clinical and functional indices, imaging, synovial histopathology, and soluble biomarkers. C1 Johns Hopkins Univ, Div Rheumatol, Baltimore, MD 21224 USA. Univ Washington, Div Rheumatol Res, Seattle, WA 98195 USA. Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands. Univ Coll Dublin, Dept Rheumatol, St Vincents Hosp, Dublin 4, Ireland. Univ Coll Dublin, Conway Inst Biomol & Biomed Res, Dublin 4, Ireland. Univ Leeds, Leeds, W Yorkshire, England. Targeted Genet Corp, Seattle, WA USA. Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA USA. Univ Alberta, Dept Med, Edmonton, AB, Canada. Univ Burgundy, INSERM, ERM 0207, Dijon Univ Hosp, Dijon, France. Amgen Inc, Seattle, WA USA. Univ Leeds, Acad Unit Musculoskeletal Dis, Leeds, W Yorkshire, England. Roche Pharmaceut, Welwyn Garden City, Herts, England. Vet Affairs Med Ctr, Philadelphia, PA USA. Johns Hopkins Univ, Div Rheumatol, Baltimore, MD USA. Johns Hopkins Univ, Div Clin Immunol & Allergy, Baltimore, MD USA. RP Giles, JT (reprint author), Johns Hopkins Univ, Div Rheumatol, 5501 Hopkins Bayview Circle,Suite 1B-1, Baltimore, MD 21224 USA. EM gilesjont@jhmi.edu NR 37 TC 13 Z9 13 U1 0 U2 3 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD MAR PY 2007 VL 34 IS 3 BP 641 EP 647 PG 7 WC Rheumatology SC Rheumatology GA 141YA UT WOS:000244613800031 PM 17343312 ER PT J AU Bikle, D Teichert, A Hawker, N Xie, Z Oda, Y AF Bikle, D. Teichert, A. Hawker, N. Xie, Z. Oda, Y. TI Sequential regulation of keratinocyte differentiation by 1,25(OH)(2)D-3, VDR, and its coregulators SO JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY LA English DT Article; Proceedings Paper CT 13th Workshop on Vitamin D CY APR 07-12, 2006 CL Victoria, CANADA SP Novacea Inc, Solvay Pharmaceut BV, Teijin Ltd DE keratinocytes; differentiation; vitamin D; gene transcription; heat shock proteins; coactivators; hairless ID VITAMIN-D-RECEPTOR; 1,25-DIHYDROXYVITAMIN-D3; HAIRLESS; COACTIVATORS; COMPLEXES; CALCIUM; CELLS; SKIN; 1-ALPHA,25-DIHYDROXYVITAMIN-D3; TRANSACTIVATION AB Keratinocyte differentiation requires the sequential regulation of gene expression. We have explored the role of 1,25(OH)(2)D-3 and its receptor (VDR) in this process. VDR sequentially binds to coactivator complexes such as Vitamin D receptor interacting protein (DRIP) and steroid receptor coactivator (SRC) during differentiation. Different genes respond differently to the VDR/coactivator complexes as determined by knockdown studies. The binding of DRIP205 and SRC to VDR is ligand (i.e. 1,25(OH)(2)D-3) dependent. LXXLL motifs in these coactivators are critical for this binding; however, the affinity for VDR of the different LXXLL motifs in these coactivators varies. Hairless is an inhibitor of 1,25(OH)(2)D-3 dependent gene transcription. A phi XX phi phi motif in hairless is crucial for hairless binding to VDR, and its binding is ligand independent. 1,25(OH)(2)D-3 displaces hairless and recruits the coactivators to VDREs. Hsp90 and p23 are chaperone proteins recruited to the DRIP/VDR complex, where they block the binding of the complex to VDREs and block 1,25(OH)(2)D-3 stimulated transcription. Thus four mechanisms explain the ability of 1,25(OH)(2)D-3 to sequentially regulate gene transcription during differentiation: changes in coregulator levels, their differential binding to VDR, differential gene responsiveness to the VDR/coregulator complexes, and chaperone proteins facilitating the cycling of VDR/coregulator complexes on and off the VDREs. Published by Elsevier Ltd. C1 San Francisco VA Med Ctr, Endocrine Res Unit, San Francisco, CA 94121 USA. Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94121 USA. RP Bikle, D (reprint author), San Francisco VA Med Ctr, Endocrine Res Unit, 111N,4150 Clement St, San Francisco, CA 94121 USA. EM Daniel.Bikle@ucsf.edu FU NIAMS NIH HHS [R01 AR038386] NR 28 TC 15 Z9 16 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0960-0760 J9 J STEROID BIOCHEM JI J. Steroid Biochem. Mol. Biol. PD MAR PY 2007 VL 103 IS 3-5 SI SI BP 396 EP 404 DI 10.1016/j.jsbmb.2006.12.063 PG 9 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 158WU UT WOS:000245826800034 PM 17229570 ER PT J AU Bray, JW Zarkin, GA Miller, WR Mitra, D Kivlahan, DR Martin, DJ Couper, DJ Cisler, RA AF Bray, Jeremy W. Zarkin, Gary A. Miller, William R. Mitra, Debanjali Kivlahan, Daniel R. Martin, Daniel J. Couper, David J. Cisler, Ron A. TI Measuring economic outcomes of alcohol treatment using the economic form 90 SO JOURNAL OF STUDIES ON ALCOHOL AND DRUGS LA English DT Article ID HEALTH-CARE UTILIZATION; PROJECT-MATCH; COSTS; VALIDATION; DEPENDENCE; ACCURACY; PHARMACOTHERAPIES; RELIABILITY; INSTRUMENT; VALIDITY AB Objective: This article assesses the ability of the economic outcome measures in the Economic Form 90 to detect differences across levels of alcohol dependence as measured by the Alcohol Dependence Scale. Method: We used baseline data from the Combining Medications and Behavioral Interventions (COMBINE) Study, a large, multisite clinical trial, to assess the extent to which the economic items on the Economic Form 90 instrument can detect differences across levels of alcohol dependence. Results: After adjusting for differences in demographic characteristics, the Economic Form 90 can detect significant differences across a range of dependence severity levels for the economic outcomes of inpatient medical care, emergency-department medical care, behavioral health care, being on parole or probation, and missed workdays, conditional on being employed. We did not detect significant differences across dependence severity for employment status, outpatient medical care, other criminal justice involvement, or motor vehicle accidents. Conclusions: The Economic Form 90 can identify differences in many economic outcomes associated with differing levels of alcohol dependence. This suggests that the Economic Form 90 may be useful in assessing changes in economic outcomes that result from changes in alcohol dependence. C1 RTI Int, Res Triangle Pk, NC 27709 USA. Univ New Mexico, Dept Psychol, Albuquerque, NM 87131 USA. Vet Affairs Puget Sound, Ctr Excellence Subst Abuse Treatment & Educ, Seattle, WA USA. Univ N Carolina, Dept Biostat, Chapel Hill, NC USA. Univ Wisconsin, Sch Med & Publ Hlth, Ctr Urban Populat Hlth, Aurora Sinai Med Ctr, Milwaukee, WI 53201 USA. RP Bray, JW (reprint author), RTI Int, 3040 Cornwallis Rd, Res Triangle Pk, NC 27709 USA. EM bray@rti.org FU NIAAA NIH HHS [1-R01-AA12788] NR 35 TC 10 Z9 10 U1 5 U2 10 PU ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV PI PISCATAWAY PA C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA SN 1937-1888 EI 1938-4114 J9 J STUD ALCOHOL DRUGS JI J. Stud. Alcohol Drugs PD MAR PY 2007 VL 68 IS 2 BP 248 EP 255 PG 8 WC Substance Abuse; Psychology SC Substance Abuse; Psychology GA 199RK UT WOS:000248712700010 PM 17286343 ER PT J AU Pickens, S Naik, AD Burnett, J Kelly, PA Gleason, M Dyer, CB AF Pickens, Sabrina Naik, Aanand D. Burnett, Jason Kelly, P. A. Gleason, Mary Dyer, Carmel B. TI The utility of the Kohlman evaluation of living skills test is associated with substantiated cases of elder self-neglect SO JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS LA English DT Article DE activities of daily living; instrumental activities of daily living; KELS test; elder self-neglect; Adult Protective Services ID DWELLING OLDER PERSONS; FUNCTIONAL STATUS; PHYSICAL FUNCTION; ABUSE; MISTREATMENT; DISABILITY; MORTALITY; COMPARE; ADULTS AB Purpose: Self-neglect is the most prevalent finding among cases reported to Adult Protective Services (APS) and is characterized by an inability to meet one's own basic needs. The Kohlman evaluation of living skills (KELS) has been validated in geriatric populations to assess performance with both instrumental and basic activities of daily living and as an assessment tool for the capacity to live independently; therefore, the purpose of this analysis was to compare the scores of the KELS between substantiated cases of self-neglect and matched community-dwelling elders. Data sources: This is a cross-sectional pilot study of 50 adults aged 65 years and older who were recruited from APS as documented cases of self-neglect and 50 control participants recruited from Harris County Hospital District outpatient clinics. Control participants were matched for age, race, gender, and ZIP code. A geriatric nurse practitioner (NP)-led team administered a comprehensive geriatric assessment in homes of all study participants. The assessment included the KELS and mini-mental state examination (MMSE) tests. Chi-square analyses were used to determine if cases of self-neglect were significantly more likely to fail the KELS test than matched controls. Conclusions: The analyses revealed that self-neglectors were significantly more likely to fail the KELS than non-self-neglectors (50% vs. 30%, p = .025). When stratified by MMSE scores, self-neglectors with intact cognitive function remained significantly more likely to fail the KELS compared to matched, cognitively intact controls (45% vs. 17%, p = .013). Abnormal results using an in-home KELS test were significantly associated with substantiated cases of self-neglect. Implications for practice: There is currently no gold-standard measure for identifying capacity with self-care behaviors among cases of self-neglect. As a result, self-neglect may remain unidentified in many clinical settings. The KELS provides clinicians with an objective measure of an individual's capacity and performance with everyday life-supporting tasks and thus, provides information that can help NPs identify elders at risk for self-neglect. These findings suggest that the KELS test has significant utility as part of a comprehensive geriatric assessment to aid clinicians in suspected cases of self-neglect. C1 Baylor Coll Med, Quentin Mease Hosp, Dept Internal Med, Div Geriatr, Houston, TX 77004 USA. Baylor Coll Med, Vet Affairs Med Ctr 152, Dept Internal Med, Div Geriatr,Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Vet Affairs Med Ctr 152, Dept Internal Med, Div Geriatr,Sect Geriatr, Houston, TX 77030 USA. Baylor Coll Med, Vet Affairs Med Ctr 152, Dept Internal Med, Div Geriatr,Sect Endocrinol, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Internal Med, Div Geriatr,Sect Endocrinol, Houston, TX 77030 USA. RP Pickens, S (reprint author), Baylor Coll Med, Quentin Mease Hosp, Dept Internal Med, Div Geriatr, 3601 N MacGregor Way, Houston, TX 77004 USA. EM sabrina_pickens@hchd.tmc.edu FU NCRR NIH HHS [P-20-RR020626-02, P20 RR020626-02]; NIA NIH HHS [K23 AG027144-01A1, K23 AG027144] NR 37 TC 22 Z9 22 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1041-2972 J9 J AM ACAD NURSE PRAC JI J. Am. Acad. Nurse Pract. PD MAR PY 2007 VL 19 IS 3 BP 137 EP 142 DI 10.1111/j.1745-7599.2007.00205.x PG 6 WC Health Care Sciences & Services; Nursing SC Health Care Sciences & Services; Nursing GA 141JE UT WOS:000244573800005 PM 17341281 ER PT J AU Vig, EK AF Vig, Elizabeth K. TI What is the true association between nursing home location and hospitalization of its residents? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Letter C1 Univ Washington, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Vig, EK (reprint author), Univ Washington, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 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 2007 VL 55 IS 3 BP 471 EP 472 DI 10.1111/j.1532-5415.2007.01076.x PG 3 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 140QA UT WOS:000244519400026 PM 17341257 ER PT J AU Dorr, D Bonner, LM Cohen, AN Shoai, RS Perrin, R Chaney, E Young, AS AF Dorr, David Bonner, Laura M. Cohen, Amy N. Shoai, Rebecca S. Perrin, Ruth Chaney, Edmund Young, Alexander S. TI Informatics systems to promote improved care for chronic illness: A literature review SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Review ID RANDOMIZED CONTROLLED-TRIALS; DISEASE MANAGEMENT PROGRAMS; DECISION-SUPPORT-SYSTEMS; HEALTH-CARE; COMPUTERIZED REMINDERS; CLINICAL-TRIALS; METAANALYSIS; QUALITY; TECHNOLOGY; STANDARDS AB Objective: To understand information systems components important in supporting team-based care of chronic illness through a literature search. Design: Systematic search of literature from 1996-2005 for evaluations of information systems used in the care of chronic illness. Measurements: The relationship of design, quality, information systems components, setting, and other factors with process, quality outcomes, and health care costs was evaluated. Results: In all, 109 articles were reviewed involving 112 information system descriptions. Chronic diseases targeted included diabetes (42.9% of reviewed articles), heart disease (36.6%), and mental illness (23.2%), among others. System users were primarily physicians, nurses, and patients. Sixty-seven percent of reviewed experiments had positive outcomes; 94% of uncontrolled, observational studies claimed positive results. Components closely correlated with positive experimental results were connection to an electronic medical record, computerized prompts, population management (including reports and feedback), specialized decision support, electronic scheduling, and personal health records. Barriers identified included costs, data privacy and security concerns, and failure to consider workflow. Conclusion: The majority of published studies revealed a positive impact of specific health information technology components on chronic illness care. Implications for future research and system designs are discussed. C1 Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR USA. VA Puget Sound Healthcare Syst, NW HSR&D Ctr Excellence, Seattle, WA USA. VA Desert Pacific Mental Illness Res Educ & Clin, Los Angeles, CA USA. VA Informat Resource Ctr, Hines, IL USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA USA. RP Dorr, D (reprint author), 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM dorrd@ohsu.edu RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NLM NIH HHS [K22 LM 8427-01, K22 LM008427] NR 40 TC 121 Z9 123 U1 0 U2 30 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 2007 VL 14 IS 2 BP 156 EP 163 DI 10.1197/jamia.M2255 PG 8 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Information Science & Library Science; Medical Informatics SC Computer Science; Information Science & Library Science; Medical Informatics GA 155FF UT WOS:000245562600003 PM 17213491 ER PT J AU Varghese, SA Powell, TB Budisavljevic, MN Oates, JC Raymond, JR Almeida, JS Arthur, JM AF Varghese, Sanju A. Powell, T. Brian Budisavljevic, Milos N. Oates, Jim C. Raymond, John R. Almeida, Jonas S. Arthur, John M. TI Urine biomarkers predict the cause of glomerular disease SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; ENDOTHELIAL GROWTH-FACTOR; IDIOPATHIC MEMBRANOUS GLOMERULONEPHRITIS; CAPILLARY-ELECTROPHORESIS; DIABETIC-NEPHROPATHY; MASS-SPECTROMETRY; IGA NEPHROPATHY; DIAGNOSTIC MARKERS; EXCRETION; PROTEIN AB Diagnosis of the type of glomerular disease that causes the nephrotic syndrome is necessary for appropriate treatment and typically requires a renal biopsy. The goal of this study was to identify candidate protein biomarkers to diagnose glomerular diseases. Proteomic methods and informatic analysis were used to identify patterns of urine proteins that are characteristic of the diseases. Urine proteins were separated by two-dimensional electrophoresis in 32 patients with FSGS, lupus nephritis, membranous nephropathy, or diabetic nephropathy. Protein abundances from 16 patients were used to train an artificial neural network to create a prediction algorithm. The remaining 16 patients were used as an external validation set to test the accuracy of the prediction algorithm. In the validation set, the model predicted the presence of the diseases with sensitivities between 75 and 86% and specificities from 92 to 67%. The probability of obtaining these results in the novel set by chance is 5 X 10(-8). Twenty-one gel spots were most important for the differentiation of the diseases. The spots were cut from the gel, and 20 were identified by mass spectrometry as charge forms of 11 plasma proteins: Orosomucoid, transferrin, alpha-1 microglobulin, zinc alpha-2 glycoprotein, alpha-1 antitrypsin, complement factor B, haptoglobin, transthyretin, plasma retinol binding protein, albumin, and hemopexin. These data show that diseases that cause nephrotic syndrome change glomerular protein permeability in characteristic patterns. The fingerprint of urine protein charge forms identifies the glomerular disease. The identified proteins are candidate biomarkers that can be tested in assays that are more amenable to clinical testing. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Jonshon VA Med Ctr, Dept Med, Charleston, SC USA. Univ Texas, MD Anderson Canc Ctr, Dept Biostat & Appl Math, Houston, TX 77030 USA. RP Arthur, JM (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, 96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. EM arthur@musc.edu FU NCRR NIH HHS [M01 RR001070]; NHLBI NIH HHS [N01 HV 28181, N01HV28181]; NIAMS NIH HHS [R21 AR051719, R21 AR051719-02] NR 44 TC 133 Z9 145 U1 0 U2 9 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 MAR PY 2007 VL 18 IS 3 BP 913 EP 922 DI 10.1681/ASN.2006070767 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 159NS UT WOS:000245873400030 PM 17301191 ER PT J AU Chang, J Cornell, JE Van Remmen, H Hakala, K Ward, WF Richardson, A AF Chang, Jinsook Cornell, John E. Van Remmen, Holly Hakala, Kevin Ward, Walter F. Richardson, Arlan TI Effect of aging and caloric restriction on the mitochondrial proteome SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID RESPIRATORY-CHAIN ACTIVITY; AGE-DEPENDENT IMPAIRMENT; HUMAN SKELETAL-MUSCLE; FREE FATTY-ACIDS; OXIDATIVE STRESS; RAT-HEART; OXYGEN-CONSUMPTION; PERMEABILITY TRANSITION; DIETARY RESTRICTION; RADICAL GENERATION AB The rat mitochondrial proteome was analyzed using two-dimensional polyacrylamide gel electrophoresis (2-D PAGE), and proteins altered by age or caloric restriction (CR) were identified using mass spectrometry. Of 2061 mitochondrial proteins analyzed in the three tissues, a significant change with age occurred in 25 liver proteins (19 increased, 6 decreased), 3 heart proteins (1 increased, 2 decreased), and 5 skeletal muscle proteins (all increased). CR prevented the age-related change in the level of one liver mitochondrial protein, altered the levels of four proteins (one increased, three decreased) from heart, and one protein (decreased) from skeletal muscle. Identification of the proteins that changed with age or CR revealed that they were varied among the three tissues, that is, not one mitochondrial protein was changed, in common, by age or CR in any tissue studied. Thus, the effect of age on the mitochondrial proteome appears to be tissue-specific, and CR has a minor effect on age-related protein changes. C1 Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Biochem, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Ward, WF (reprint author), Univ Texas, Hlth Sci Ctr, Dept Physiol, 7703 Floyd Curl Dr,MSC 7756, San Antonio, TX 78229 USA. EM wardw@uthscsa.edu FU NCI NIH HHS [CA54174]; NIA NIH HHS [R01 AG23843, R01 AG025362-01] NR 67 TC 25 Z9 25 U1 0 U2 7 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAR PY 2007 VL 62 IS 3 BP 223 EP 234 PG 12 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 228WM UT WOS:000250763300001 PM 17389719 ER PT J AU Yancik, R Ershler, W Satariano, W Hazzard, W Cohen, HJ Ferruci, L AF Yancik, Rosemary Ershler, William Satariano, William Hazzard, William Cohen, Harvey J. Ferruci, Luigi TI Report of the National Institute on Aging Task Force on Comorbidity SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Editorial Material C1 NIA, NIH, Geriat & Clin Gerontol Program, Geriatr Branch, Bethesda, MD 20892 USA. NIA, Clin Res Branch, Baltimore, MD 21224 USA. Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Duke Univ, Med Ctr, Ctr Study Aging, Durham, NC USA. RP Yancik, R (reprint author), NIA, NIH, Geriat & Clin Gerontol Program, Geriatr Branch, 7201 Wisconsin Ave,Suite 3C307, Bethesda, MD 20892 USA. EM yancikr@nia.nih.gov FU Intramural NIH HHS [Z99 AG999999] NR 4 TC 80 Z9 81 U1 1 U2 4 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD MAR PY 2007 VL 62 IS 3 BP 275 EP 280 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 228WM UT WOS:000250763300006 PM 17389724 ER PT J AU Sherbenou, DW Wong, MJ Humayun, A McGreevey, LS Harrell, P Yang, R Mauro, M Heinrich, MC Press, RD Druker, BJ Deininger, MW AF Sherbenou, D. W. Wong, M. J. Humayun, A. McGreevey, L. S. Harrell, P. Yang, R. Mauro, M. Heinrich, M. C. Press, R. D. Druker, B. J. Deininger, M. W. TI Mutations of the BCR-ABL-kinase domain occur in a minority of patients with stable complete cytogenetic response to imatinib SO LEUKEMIA LA English DT Article DE chronic myeloid leukemia; CCR; D-HPLC; imatinib; kinase domain ID CHRONIC MYELOID-LEUKEMIA; CHRONIC MYELOGENOUS LEUKEMIA; CLINICAL RESISTANCE; MESYLATE TREATMENT; CHRONIC-PHASE; CML; REMISSION; THERAPY; STI571 AB Residual leukemia is demonstrable by reverse transcriptase-polymerase chain reaction in most patients with chronic myeloid leukemia who obtain a complete cytogenetic response (CCR) to imatinib. In patients who relapse during imatinib therapy, a high rate of mutations in the kinase domain of BCR-ABL have been identified, but the mechanisms underlying disease persistence in patients with a CCR are poorly characterized. To test whether kinase domain mutations are a common mechanism of disease persistence, we studied patients in stable CCR. Mutations were demonstrated in eight of 42 (19%) patients with successful amplification and sequencing of BCR-ABL. Mutation types were those commonly associated with acquired drug resistance. Four patients with mutations had a concomitant rise of BCR-ABL transcript levels, two of whom subsequently relapsed; the remaining four did not have an increase in transcript levels and follow-up samples, when amplifiable, were wild type. BCR-ABL-kinase domain mutations in patients with a stable CCR are infrequent, and their detection does not consistently predict relapse. Alternative mechanisms must be responsible for disease persistence in the majority of patients. C1 Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Inst Canc, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Cell & Dev Biol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Pathol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Howard Hughes Med Inst, Portland, OR 97201 USA. RP Deininger, MW (reprint author), Oregon Hlth Sci Univ, Div Hematol & Med Oncol, Inst Canc, L592,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM deininge@ohsu.edu FU NHLBI NIH HHS [HL082978-01] NR 18 TC 60 Z9 62 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0887-6924 J9 LEUKEMIA JI Leukemia PD MAR PY 2007 VL 21 IS 3 BP 489 EP 493 DI 10.1038/sj.leu.2404554 PG 5 WC Oncology; Hematology SC Oncology; Hematology GA 139BN UT WOS:000244407100015 PM 17252009 ER PT J AU Meenan, RT Saha, S Chou, R Swarztrauber, K Krages, KP O'Keeffe-Rosetti, MC McDonagh, M Chan, BKS Hornbrook, MC Helfand, M AF Meenan, Richard T. Saha, Somnath Chou, Roger Swarztrauber, Karleen Krages, Kathryn Pyle O'Keeffe-Rosetti, Maureen C. McDonagh, Marian Chan, Benjamin K. S. Hornbrook, Mark C. Helfand, Mark TI Cost-effectiveness of echocardiography to identify intracardiac thrombus among patients with first stroke or transient ischemic attack SO MEDICAL DECISION MAKING LA English DT Review DE cost-effectiveness; decision analysis; stroke; transesophageal echocardiography; transthoracic echocardiography; diagnostic imaging ID TWO-DIMENSIONAL ECHOCARDIOGRAPHY; LEFT ATRIAL THROMBI; LEFT-VENTRICULAR THROMBUS; PATENT FORAMEN OVALE; POSITIVE BLOOD CULTURES; RHEUMATIC HEART-DISEASE; PERTH COMMUNITY STROKE; LONG-TERM RISK; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; CEREBRAL-ISCHEMIA AB Background and Purpose. Echocardiography to select stroke patients for targeted treatments, such as anticoagulation (AC), to reduce recurrent stroke risk is controversial. The authors objective was to evaluate the cost-effectiveness of imaging strategies that use transthoracic (TTE) and transesophageal (TEE) echocardiography for identifying intracardiac thrombus in new stroke patients. Methods. Model-based cost-effectiveness analysis of 7 echocardiographic imaging strategies and 2 nontesting strategies with model parameters based on systematic evidence review related to effectiveness of echocardiography in newly diagnosed ischemic stroke patients (white males aged 65 years in base case). Primary, outcome was cost per quality-adjusted life year (QALY). Results. All strategies containing TTE were dominated by others and were eliminated from the analysis. Assuming that AC reduces recurrent stroke risk from intracardiac thrombus by 43% over 1 year, TEE generated a cost per QALY of $137,000 (relative to standard treatment) among patients with 5% thrombus prevalence. Cost per QALY dropped to $50,000 in patients with at least 15% intracardiac thrombus prevalence, or, if an 86% relative risk reduction with AC is assumed, in patients with thrombus prevalence of at least 6%. Probabilistic analyses indicate considerable uncertainty around the cost-effectiveness of echocardiography across a wide range of intracardiac thrombus prevalence (pretest probability). Conclusions. Current evidence on cost-effectiveness is insufficient to justify widespread use of echocardiography in stroke patients. Additional research on recurrent stroke risk in patients with intracardiac thrombus and on the efficacy of AC in reducing that risk may contribute to a better understanding of the circumstances under which echocardiography will be cost-effective. C1 Kaiser Permanente NW, Ctr Hlth Res, Portland, OR 97227 USA. Oregon Hlth & Sci Univ, Evidence Based Practice Ctr, Portland, OR 97201 USA. Portland VA Med Ctr, Gen Internal Med Sect, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. RP Meenan, RT (reprint author), Kaiser Permanente NW, Ctr Hlth Res, 3800 N Interstate Ave, Portland, OR 97227 USA. EM Richard.meenan@kpchr.org FU PHS HHS [290-97-0018] NR 118 TC 20 Z9 20 U1 0 U2 2 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-989X J9 MED DECIS MAKING JI Med. Decis. Mak. PD MAR-APR PY 2007 VL 27 IS 2 BP 161 EP 177 DI 10.1177/0272989X06297388 PG 17 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 154ZL UT WOS:000245547200009 PM 17409366 ER PT J AU Thompson, BM Schneider, VF Haidet, P Levine, RE McMahon, KK Perkowski, LC Richards, BF AF Thompson, Britta M. Schneider, Virginia F. Haidet, Paul Levine, Ruth E. McMahon, Kathryn K. Perkowski, Linda C. Richards, Boyd F. TI Team-based learning at ten medical schools: two years later SO MEDICAL EDUCATION LA English DT Article DE education, medical, undergraduate, methods; teaching, methods; group processes; United States; faculty ID EDUCATION AB Purpose: In 2003, we described initial use of team-based learning (TBL) at 10 medical schools. The purpose of the present study was to review progress and understand factors affecting the use of TBL at these schools during the subsequent 2 years. Methods: Representatives from 10 schools evaluated in 2003 were again evaluated in 2005. They were interviewed by members of the Team Based Learning Collaborative using a semistructured interview process. Data were analysed by 2 researchers using the constant comparative method and were triangulated through sharing results with other interviewers at regular intervals to verify conclusions and form consensus. Results: TBL continued to be used in all but 1 school. At the 9 remaining schools, TBL was added to 18 courses, continued to be used in 19 and was discontinued in 13 courses. At some schools, it was discontinued in single courses in lieu of new, longitudinal integration courses in which TBL was a main instructional strategy. Faculty, student, course and institutional factors were associated with changes in TBL use. Conclusions: Faculty, administration/curriculum, students and characteristics of specific courses influence ongoing utilisation of TBL. Those who desire to implement TBL would do well to take these factors into account as they plan implementation efforts at their schools. C1 Baylor Coll Med, Off Curriculum, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Univ Texas, Med Branch, Galveston, TX 77555 USA. Texas Tech Univ, Hlth Sci Ctr, Lubbock, TX 79409 USA. Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. RP Thompson, BM (reprint author), Baylor Coll Med, Off Curriculum, M301, Houston, TX 77030 USA. EM brittat@bcm.tmc.edu RI Herring, Anna/L-7859-2014 NR 16 TC 80 Z9 83 U1 3 U2 13 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0308-0110 J9 MED EDUC JI Med. Educ. PD MAR PY 2007 VL 41 IS 3 BP 250 EP 257 DI 10.1111/j.1365-2929.2006.02684.x PG 8 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 138DD UT WOS:000244342400005 PM 17316209 ER PT J AU Kim, M Murphy, K Liu, F Parker, SE Dowling, ML Baff, W Kao, GD AF Kim, Mijin Murphy, Katie Liu, Fang Parker, Sharon E. Dowling, Melissa L. Baff, Wesley Kao, Gary D. TI Caspase-mediated specific cleavage of BubR1 is a determinant of mitotic progression (vol 25, pg 9232, 2007) SO MOLECULAR AND CELLULAR BIOLOGY LA English DT Correction C1 Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Kim, M (reprint author), Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA 19104 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0270-7306 J9 MOL CELL BIOL JI Mol. Cell. Biol. PD MAR PY 2007 VL 27 IS 5 BP 1991 EP 1991 DI 10.1128/MCB.02381-06 PG 1 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 137PW UT WOS:000244305500037 ER PT J AU Wright, JL Porter, MP AF Wright, Jonathan L. Porter, Michael P. TI Quality-of-life assessment in patients with bladder cancer SO NATURE CLINICAL PRACTICE UROLOGY LA English DT Review DE bladder cancer; cystectomy; quality of life; urinary bladder neoplasm; urinary diversion ID CONTINENT CUTANEOUS DIVERSION; CALMETTE-GUERIN THERAPY; RADICAL CYSTECTOMY; URINARY-DIVERSION; ILEAL CONDUIT; ORTHOTOPIC NEOBLADDER; SF-36 SURVEY; CARCINOMA; RECONSTRUCTION; QUESTIONNAIRE AB Health-related quality of life (HRQOL) in patients with bladder cancer is important, because radical cystectomy and urinary diversion significantly affect urinary and sexual function, and lead to associated sex-specific morbidity. This article reviews the current methods for defining HRQOL, describes the specific challenges in measuring HRQOL in patients with bladder cancer, and critically analyzes the existing literature on bladder cancer HRQOL. Previous studies have been limited by study design, generalizability, and by the different instruments used, namely nonvalidated questionnaires that are not specific for bladder cancer. To date, only two prospective studies with baseline HRQOL data have been published and few conclusions can be drawn from these cross-sectional, retrospective studies. On the basis of the published literature, there is no convincing evidence that superior HRQOL is achieved with a particular type of urinary diversion after cystectomy for bladder cancer. Patients should be counseled on all reconstructive alternatives and a diversion chosen on the basis of patient preference, patient anatomy and tumor status, rather than on a potential difference in HRQOL. Prospective studies with appropriate adjustment for confounding factors, which use validated and disease-specific questionnaires, are needed for HRQOL research on bladder cancer. C1 Univ Washington, Dept Urol, Seattle, WA 98108 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Porter, MP (reprint author), Univ Washington, Dept Urol, 1660 S Columbian Way S-112-GU, Seattle, WA 98108 USA. EM mporter@u.washington.edu NR 42 TC 31 Z9 33 U1 2 U2 5 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1743-4270 J9 NAT CLIN PRACT UROL JI Nat. Clin. Pract. Urol. PD MAR PY 2007 VL 4 IS 3 BP 147 EP 154 DI 10.1038/ncpuro0750 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 143UT UT WOS:000244752600012 PM 17347659 ER PT J AU Bartzokis, G Tishler, TA Lu, PH Villablanca, P Altshuler, LL Carter, M Huang, D Edwards, N Mintz, J AF Bartzokis, George Tishler, Todd A. Lu, Po H. Villablanca, Pablo Altshuler, Lori L. Carter, Michele Huang, Danny Edwards, Nancy Mintz, Jim TI Brain ferritin iron may influence age- and gender-related risks of neurodegeneration SO NEUROBIOLOGY OF AGING LA English DT Article; Proceedings Paper CT International Conference on Prevention of Dementia of the Alzheimers-Association CY JUN 18-21, 2005 CL Washington, DC SP Alzheimers Assoc DE brain; iron; ferritin; MRI; FDRI; gender; sex; dementia; risk; age; onset; neurodegeneration; hemochromatosis; free radicals; treatment; prevention; myelin; white matter; oligodendrocytes; hippocampus; frontal lobe; protemopathy ID MATTER STRUCTURAL INTEGRITY; HALLERVORDEN-SPATZ-SYNDROME; HEMOCHROMATOSIS GENE HFE; ONSET PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; ALPHA-SYNUCLEIN; RAT-BRAIN; IN-VIVO; LEWY BODIES; HEREDITARY HEMOCHROMATOSIS AB Background: Brain iron promotes oxidative damage and protein oligornerization that result in highly prevalent age-related proteinopathies such as Alzheimer's disease (AD), Parkinson's disease (PD), and Dementia with Lewy Bodies (DLB). Men are more likely to develop such diseases at earlier ages than women but brain iron levels increase with age in both genders. We hypothesized that brain iron may influence both the age- and gender-related risks of developing these diseases. Methods: The amount of iron in ferritin molecules (ferritin iron) was measured in vivo with MRI by utilizing the field dependent relaxation rate increase (FDRI) method. Ferritin iron was measured in four subcortical nuclei [caudate (C), putamen (P), globus pallidus (G), thalamus (T)], three white matter regions [frontal lobe (Fwm), genu and splenium of the corpus callosum (Gwm, Swm)] and hippocampus (Hipp) in 165 healthy adults aged 19-82. Results: There was a high correlation (r > 0.99) between published post-mortem brain iron levels and FDRI. There were significant age-related changes in ferritin iron (increases in Hipp, C, P, G, and decreases in Fwm). Women had significantly lower ferritin iron than men in five regions (C, T, Fwm, Gwm, Swm). Conclusions: This is the first demonstration of gender differences in brain ferritin iron levels. It is possible that brain iron accumulation is a risk factor that can be modified. MRI provides the opportunity to assess brain iron levels in vivo and may be useful in targeting individuals or groups for preventive therapeutic interventions. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Alzheimers Dis Res Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Lab Neuroimaging, Dept Neurol,Div Brain Mapping, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Neurosci Interdept Grad Program, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol, Los Angeles, CA 90095 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Alzheimers Dis Res Ctr, 710 Westwood Pl,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG 16570, R01 AG027342]; NIMH NIH HHS [MH066029-01A2, MH51928, MH6357-01A1] NR 123 TC 177 Z9 183 U1 2 U2 18 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 2007 VL 28 IS 3 BP 414 EP 423 DI 10.1016/j.neurobiolaging.2006.02.005 PG 10 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 137CG UT WOS:000244269800011 PM 16563566 ER PT J AU Gourcerol, G Tache, Y AF Gourcerol, G. Tache, Y. TI Obestatin - a ghrelin-associated peptide that does not hold its promise to suppress food intake and motility SO NEUROGASTROENTEROLOGY AND MOTILITY LA English DT Editorial Material DE food intake; gastric emptying; ghrelin; GPR39; obestatin ID COUPLED RECEPTOR GPR39; GROWTH-HORMONE; ENERGY-BALANCE; BODY-WEIGHT; RODENTS; RATS; SECRETION; MODIFY; LEPTIN; PLAYER AB Ghrelin is a gut peptide well established to induce prokinetic and appetite stimulatory actions. Obestatin is a novel 23-amino acid peptide derived from the processing of the ghrelin gene. The peptide name was in keeping with its initially reported actions to suppress food intake and digestive motility and to antagonize ghrelin's stimulatory effect through interaction with the orphan GPR-39 receptor. However, subsequently, these findings have been questioned because obestatin actions to reduce food intake and to inhibit gastrointestinal (GI) motility in vivo and in vitro have not been reproduced by several groups. Furthermore, while GPR-39 appears to be involved in gut motor functions, convergent reports showed that obestatin is not the cognate ligand for this receptor. In light of recent controversy over the effects of obestatin, the present findings from De Smet et al. provides additional evidence that obestatin does not influence food intake and GI motility in vivo and in vitro. Taken together, existing reports curtail the initial promise that obestatin is a new regulator of appetite and digestive motility. Therefore, it is proposed to rename obestatin as ghrelin-associated peptide. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, CURE Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA USA. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, CURE Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu NR 34 TC 52 Z9 55 U1 0 U2 3 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1350-1925 J9 NEUROGASTROENT MOTIL JI Neurogastroenterol. Motil. PD MAR PY 2007 VL 19 IS 3 BP 161 EP 165 DI 10.1111/j.1365-2982.2007.00916.x PG 5 WC Gastroenterology & Hepatology; Clinical Neurology; Neurosciences SC Gastroenterology & Hepatology; Neurosciences & Neurology GA 134QJ UT WOS:000244098400001 PM 17300284 ER PT J AU Zhu, ZT Munhall, AC Johnson, SW AF Zhu, Zi-Tao Munhall, Adam C. Johnson, Steven W. TI Tyramine excites rat subthalamic neurons in vitro by a dopamine-dependent mechanism SO NEUROPHARMACOLOGY LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the Society-for-Neuroscience CY OCT 23-27, 2004 CL San Diego, CA SP Soc Neurosci DE tyramine; dopamine; subthalamic neurons; inward current; synaptic current; subthalamic nucleus; brain slices; trace amine; electrophysiology ID CENTRAL-NERVOUS-SYSTEM; TRACE AMINES; SUBSTANTIA-NIGRA; NUCLEUS NEURONS; PARKINSONS-DISEASE; BASAL GANGLIA; AMPHETAMINE; RECEPTORS; RELEASE; BRAIN AB Tyramine. an endogenous ligand for mammalian trace amin e-associated receptors, may act as a neuromodulator that regulates neuronal activity in basal ganglia. Using whole-cell patch recordings of subthalamic nucleus (STN) neurons in rat brain slices, we found that bath application of tyramine evoked an inward current in voltage-clamp in over 60% of all STN neurons. The inward current induced by tyramine was mimicked by the D-2-like dopamine receptor agonist quinpirole, but was only partially blocked by the D-2-like receptor antagonist sulpiride. In contrast, the D-1-like receptor agonist SKF38393 evoked no current in STN neurons. Inward current evoked by tyramine was significantly reduced by the catecholamine uptake inhibitor nomifensine, and by exhausting catecholamines in the brain via pretreatment with reserpine. Tyramine also reduced the amplitude of GABA(A) receptor-mediated IPSCs that were evoked by focal electrical stimulation of the slice. Inhibition of IPSCs by tyramine was mimicked by quinpirole and was blocked by sulpiride but not by SCH23390, a D-1 receptor antagonist. Moreover, tyramine-induced inhibition of IPSCs was reduced in slices pretreated with reserpine, and this inhibition could be restored by briefly superfusing the slice with dopamine. These results suggest that tyramine acts as an indirect dopamine agonist in the STN. Although inhibition of IPSCs is mediated by D-2-like receptors, the dopamine-dependent inward currents evoked by tyramine do not fit a typical dopamine receptor pharmacological profile. (c) 2007 Elsevier Ltd. All rights reserved. C1 Portland VA Med Ctr, R&D 61, Dept Neurol Res, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R&D 61, Dept Neurol Res, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM johnsost@ohsu.edu FU NINDS NIH HHS [R01 NS038715, NS38715] NR 40 TC 8 Z9 8 U1 2 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3908 J9 NEUROPHARMACOLOGY JI Neuropharmacology PD MAR PY 2007 VL 52 IS 4 BP 1169 EP 1178 DI 10.1016/j.neuropharm.2006.12.005 PG 10 WC Neurosciences; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 153ZQ UT WOS:000245477000012 PM 17291545 ER PT J AU Houldin, AD AF Houldin, Arlene D. TI A qualitative study of caregivers' experiences with newly diagnosed advanced colorectal cancer SO ONCOLOGY NURSING FORUM LA English DT Article ID COLON-CANCER; ADJUSTMENT; DEPRESSION; COUPLES; BURDEN AB Purpose/Objectives: To report on a descriptive, qualitative study of 14 caregivers of patients newly diagnosed with advanced colorectal cancer. Research Approach: Qualitative. Setting: One urban ambulatory cancer center in the northeastern United States. Participants: 14 identified caregivers of patients newly diagnosed with stage III or IV colorectal cancer. Methodologic Approach: Sernistructured interviews were taped recorded. Interviewers asked participants to describe their experiences caring for a loved one with colorectal cancer. Thematic content analysis with inductive coding was used to code the transcribed interview data. Throughout the data-coding process, emics in each category were compared within and between categories to maximize the fit of participants' data. Categories were reviewed in a final stage of analysis and further organized into domains from which the core category was derived. Main Research Variables: Caregiver experiences of living with a person with colorectal cancer, effect on daily living, coping strategies used, and effect on children. Findings: The coded interview data yielded three domains: Experiencing Total Disruption of My Life, Staying Positive, and Attempting to Keep Family and Children's Routines as Normal as Possible. The core category that explained study participants' caregiving experiences was "balancing caregiving activities and disruptions while dealing positively with daily demands and personal impact." Conclusions: The dominant experiences of the participants focused on coming to terms with the disease's disruption in their lives, attempting to deal positively with the effect of the disease, and maintaining normalcy in family life. Interpretation: Targeted assessment of caregivers' needs is important in the three dimensions of the study domains. Clinicians who work with caregivers of patients with cancer should offer direct support because caregivers cope with the care of their loved one and struggle with their own distress and with maintaining normal family life. Findings suggest the importance of offering psychosocial support to caregivers and providing guidance to caregivers for support of their children and families. C1 Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Palliat Care Serv, Philadelphia, PA USA. RP Houldin, AD (reprint author), Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. EM houldin@nursing.upenn.edu NR 23 TC 32 Z9 34 U1 6 U2 10 PU ONCOLOGY NURSING SOCIETY PI PITTSBURGH PA 125 ENTERPRISE DR, PITTSBURGH, PA 15275 USA SN 0190-535X J9 ONCOL NURS FORUM JI Oncol. Nurs. Forum PD MAR PY 2007 VL 34 IS 2 BP 323 EP 330 DI 10.1188/07.ONF.323-330 PG 8 WC Oncology; Nursing SC Oncology; Nursing GA 146QP UT WOS:000244949700022 PM 17573296 ER PT J AU Kealey, C Chen, Z Christie, J Thorn, CF Whitehead, AS Price, M Samaha, FF Kimmel, SE AF Kealey, Canel Chen, Zhen Christie, Jason Thorn, Caroline F. Whitehead, Alexander S. Price, Maureen Samaha, Frederick F. Kimmel, Stephen E. TI Warfarin and cytochrome P4502C9 genotype: possible ethnic variation in warfarin sensitivity SO PHARMACOGENOMICS LA English DT Article DE anticoagulation; cytochrome P4502C9; polymorphisms; race; warfarin ID POLYMORPHISMS; ANTICOAGULATION; CYP2C9; ASSOCIATION; METABOLISM; VARIANTS; THERAPY; RISK; 2C9 AB Introduction: Warfarin is a widely prescribed, efficacious oral anticoagulant. S-warfarin, the more active form, is metabolized by the cytochrome P450 (CYP)2C9 enzyme. The aim was to evaluate the influence of two CYP2C9 functional polymorphisms (*2 and *3) on warfarin dose in African-Americans, an unstudied population and Caucasians, and also to assess the effect of these polymorphisms on anticoagulation response after accounting for nongenetic factors and genetic factors that might also impact the dose-response relationship of warfarin. Patients and methods: A prospective cohort of 362 patients with a target international normalized ratio of between 2.0 and 3.0 were genotyped. Warfarin sensitivity stratified by genotype was investigated using univariate and multivariate analyses. Results: The maintenance dose of warfarin was significantly related to genotype (p < 0.01) (variant carriers: 31.25 mg/week; wild-type: 37.5 mg/week), even after adjustment for possible confounding factors (p = 0.046). However, the effect of genotype was restricted to Caucasians, in whom variant carriers had a significantly lower maintenance dose compared with wild-type homozygotes (unadjusted: p < 0.01; adjusted: p = 0.02). There was a greater risk of over-anticoagulation among Caucasian variant carriers, although this was only observed prior to reaching maintenance dose. For African-American variant carriers, there was no difference in warfarin response based on CYP2C9 genotype. Discussion: CYP2C9 *2 and *3 variants provide predictive information in anticoagulation response. However, these variants may not be useful in African-Americans or as a marker of long-term over-anticoagulation once a stable dose is reached. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Div Cardiovasc Med, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Pharmacol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Pharmacogenet, Philadelphia, PA 19104 USA. RP Kimmel, SE (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. FU NCRR NIH HHS [P20RR020741]; NHLBI NIH HHS [R01HL066176-04] NR 23 TC 43 Z9 44 U1 0 U2 2 PU FUTURE MEDICINE LTD PI LONDON PA UNITEC HOUSE, 3RD FLOOR, 2 ALBERT PLACE, FINCHLEY CENTRAL, LONDON, N3 1QB, ENGLAND SN 1462-2416 J9 PHARMACOGENOMICS JI Pharmacogenomics PD MAR PY 2007 VL 8 IS 3 BP 217 EP 225 DI 10.2217/14622416.8.3.217 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 145OS UT WOS:000244875000006 PM 17324110 ER PT J AU Ross, JS Bernheim, SM Bradley, EH Teng, HM Gallo, WT AF Ross, Joseph S. Bernheim, Susannah M. Bradley, Elizabeth H. Teng, Hsun-Mei Gallo, William T. TI Use of preventive care by the working poor in the United States SO PREVENTIVE MEDICINE LA English DT Article DE poverty; socioeconomic factors; prevention and control; health promotion; mass screening/utilization; health services/utilization; United States ID HEALTH-CARE; UNINSURED ADULTS; SERVICES; INSURANCE; COVERAGE; CANCER; ACCESS; DISPARITIES; BEHAVIORS; OUTCOMES AB Objective. Examine the association between poverty and preventive care use among older working adults. Method. Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200% of the federal poverty level were defined as poor. Results. Among 10,088 older working adults, overall preventive care use ranged from 38% (influenza vaccination) to 76% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95% CI, 0.86-0.96), prostate cancer (RR 0.89, 95% CI, 0.81-0.97), and cholesterol screening (RR 0.91, 95% CI, 0.86-0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95% CI, 0.90-1.01) or influenza vaccination (RR 0.92, 95% CI, 0.84-1.01). Conclusion. The older working poor are at modestly increased risk for not receiving preventive care. (c) 2006 Elsevier Inc. All rights reserved. C1 CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. James J Peters Vet Adm Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Div Hlth Policy & Adm, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Internal Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. RP Ross, JS (reprint author), CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, 1 Gustave L Levy Pl,Box 1070, New York, NY 10029 USA. EM joseph.ross@mssm.edu FU NIA NIH HHS [K01 AG021983, P30 AG021342, P30 AG21342, T32 AG1934] NR 43 TC 18 Z9 18 U1 2 U2 7 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0091-7435 J9 PREV MED JI Prev. Med. PD MAR PY 2007 VL 44 IS 3 BP 254 EP 259 DI 10.1016/j.ypmed.2006.11.006 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 154AU UT WOS:000245480000013 PM 17196642 ER PT J AU Velicer, CM Dublin, S White, E AF Velicer, C. M. Dublin, S. White, E. TI Diabetes and the risk of prostate cancer: the role of diabetes treatment and complications SO PROSTATE CANCER AND PROSTATIC DISEASES LA English DT Article DE diabetes; insulin; VITAL; cohort; leptin; insulin-like growth factor ID BINDING PROTEIN-1 IGFBP-1; IGF-I; CARDIOVASCULAR RISK; GROWTH-FACTORS; UNITED-STATES; MELLITUS; INSULIN; LEPTIN; MEN; DISEASE AB Epidemiologic evidence suggests diabetic men have a slightly lower prostate cancer risk than nondiabetic men. We examined this association in a prospective cohort study of 35 239 men, 50-76 years old, in Washington State who completed a baseline questionnaire between 2000 and 2002. Incident prostate cancers as of 31 December 2004 were identified through the SEER registry. Diabetic men had a slightly lower risk of prostate cancer than non-diabetic men ( hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.64-1.07). Insulin users overall and insulin users with diabetic complications had decreased risks, compared to non-diabetic men ( HR 0.49, 95% CI 0.26-0.92) and ( HR 0.36, 95% CI 0.15-0.87), respectively. Oral medication use for diabetes was not associated with prostate cancer. Insulin is likely a marker of severity of diabetes. Future studies of this association should consider diabetes type, treatment, severity, complications and biomarkers. C1 Fred Hutchinson Canc Res Ctr, Canc Prevent Res Program, Seattle, WA 98109 USA. VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Velicer, CM (reprint author), Fred Hutchinson Canc Res Ctr, Canc Prevent Res Program, Mail Stop M4-B402, Seattle, WA 98109 USA. EM cvelicer@fhcrc.org NR 26 TC 23 Z9 23 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1365-7852 J9 PROSTATE CANCER P D JI Prostate Cancer Prostatic Dis. PD MAR PY 2007 VL 10 IS 1 BP 46 EP 51 DI 10.1038/sj.pcan.4500914 PG 6 WC Oncology; Urology & Nephrology SC Oncology; Urology & Nephrology GA 141UR UT WOS:000244604800006 PM 17033617 ER PT J AU Simpson, SM Krishnan, LL Kunik, ME Ruiz, P AF Simpson, Sherri M. Krishnan, Laura L. Kunik, Mark E. Ruiz, Pedro TI Racial disparities in diagnosis and treatment of depression: A literature review SO PSYCHIATRIC QUARTERLY LA English DT Review DE depression; racial disparities; diagnosis of depression; treatment of depression ID PRIMARY-CARE PATIENTS; ANTIDEPRESSANT TREATMENT; MAJOR DEPRESSION; UNITED-STATES; POPULATION; PREDICTORS; QUALITY; ILLNESS; ADULTS; TRENDS AB The purpose of this study was to systematically review the literature to determine whether racial disparities exist in the diagnosis and treatment of depression in the United States. A literature search using PubMed of potentially relevant articles in English that include data from population-based studies examining the diagnosis and/or treatment of depression; or data from prospective studies stratifying the rates of diagnosis and/or treatment of depression by race/ethnicity and ethnic comparisons between Caucasians, African Americans and/or Hispanics. Initial searches identified 2,396 articles. On the basis of our criteria, 14 articles were eligible for inclusion in this review. Four included data on the diagnosis of depression in different ethnic groups; their results were not consistent. Twelve included data on treatment variability in the treatment of depression; overall these suggested lower rates of treatment for African Americans and Hispanics than for Caucasians. More research is needed focusing on ethnic variation in the diagnosis of depression. Racial disparities exist in the treatment of depression. C1 Univ Texas, Sch Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Vet Affairs S Cent Mental Illness Res Educ & Clin, Little Rock, AR USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Hlth Serv Res & Dev Serv, Houston, TX USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP Ruiz, P (reprint author), Univ Texas, Sch Med, Dept Psychiat & Behav Sci, 1300 Moursund,MSI 102, Houston, TX 77030 USA. EM Pedro.Ruiz@uth.tmc.edu NR 20 TC 67 Z9 68 U1 1 U2 9 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0033-2720 J9 PSYCHIAT QUART JI Psychiatr. Q. PD MAR PY 2007 VL 78 IS 1 BP 3 EP 14 DI 10.1007/s11126-006-9022-y PG 12 WC Psychiatry SC Psychiatry GA 136EU UT WOS:000244206200002 PM 17102936 ER PT J AU Pollard, R Yanasak, EV Rogers, SA Tapp, A AF Pollard, Richard Yanasak, Elisia V. Rogers, Steven A. Tapp, Andre TI Organizational and unit factors contributing to reduction in the use of seclusion and restraint procedures on an acute psychiatric inpatient unit SO PSYCHIATRIC QUARTERLY LA English DT Article; Proceedings Paper CT 38th Annual Meeting of the Association-for-the-Advancement-of-Behavior-Therapy CY NOV, 2004 CL New Orleans, LA SP Assoc Advancement Behav Therapy DE seclusion; restraint; inpatient psychiatry ID MILIEU AB Objective: The use of seclusion or restraint (S/R) as an emergency medical intervention to assist patients in regaining behavioral control continues to be an area of interest and concern for the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), consistent with the ongoing concerns in the medical, patient advocate, legislative and legal communities. This study examined unit characteristics and the use of S/R in a VA facility with a secured, acute mental health unit before and after the promulgation of the JCAHO 2000 standards for utilization of S/R for behavioral health reasons. Methods: Variables examined include patient acuity, patient census, number of admits, number of discharges, length of stay, number of nursing staff on duty, critical incidents and S/R hours per month. Results: Results indicated S/R use began showing a notable decrease corresponding to the time that senior unit management began discussions of the new JCAHO standards. These reductions maintained statistical significance even after controlling for changes in unit environmental variables. C1 VA Puget Sound Hlth Care Syst, Amer Lake Div, Mental Hlth Serv, Tacoma, WA 98493 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Yanasak, EV (reprint author), VA Puget Sound Hlth Care Syst, Amer Lake Div, Mental Hlth Serv, A-116-R,9600 Vet Dr SW, Tacoma, WA 98493 USA. EM Elisia.Yanasak@med.va.gov NR 25 TC 26 Z9 26 U1 2 U2 4 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0033-2720 J9 PSYCHIAT QUART JI Psychiatr. Q. PD MAR PY 2007 VL 78 IS 1 BP 73 EP 81 DI 10.1007/s11126-006-9028-5 PG 9 WC Psychiatry SC Psychiatry GA 136EU UT WOS:000244206200008 PM 17102932 ER PT J AU Fineberg, I Asch, S Golden, J AF Fineberg, I Asch, S. Golden, J. TI A research-based model for family conferences in palliative care SO PSYCHO-ONCOLOGY LA English DT Meeting Abstract C1 Univ Lancaster, Inst Hlth Res, Int Observ End Life Care, Lancaster, England. VA Greater Los Angeles Hlthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1057-9249 J9 PSYCHO-ONCOL JI Psycho-Oncol. PD MAR PY 2007 VL 16 IS 3 SU S BP S67 EP S67 PG 1 WC Oncology; Psychology; Psychology, Multidisciplinary; Social Sciences, Biomedical SC Oncology; Psychology; Biomedical Social Sciences GA 147ZS UT WOS:000245044900128 ER PT J AU Green, GL Carter, DN Latini, DM Devadoss, R Kaniu-Mwaniki, P Barker, JC Sands, LP Chren, MM Knight, SJ AF Green, G. L. DN, Carter Latini, D. M. Devadoss, R. Kaniu-Mwaniki, P. Barker, J. C. Sands, L. P. Chren, M-M Knight, S. J. TI Symptoms following prostate cancer diagnosis and care: Expanding the range and identifying needs for symptom management SO PSYCHO-ONCOLOGY LA English DT Meeting Abstract C1 San Francisco VA Med Ctr, San Francisco, CA USA. Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Purdue Univ, W Lafayette, IN 47907 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1057-9249 J9 PSYCHO-ONCOL JI Psycho-Oncol. PD MAR PY 2007 VL 16 IS 3 SU S BP S69 EP S70 PG 2 WC Oncology; Psychology; Psychology, Multidisciplinary; Social Sciences, Biomedical SC Oncology; Psychology; Biomedical Social Sciences GA 147ZS UT WOS:000245044900133 ER PT J AU Guo, S Chen, DF Zhou, DF Sun, HQ Wu, GY Haile, CN Kosten, TA Kosten, TR Zhang, XY AF Guo, Song Chen, Da Fang Zhou, Dong Feng Sun, Hong Qiang Wu, Gui Ying Haile, Colin N. Kosten, Therese A. Kosten, Thomas R. Zhang, Xiang Yang TI Association of functional catechol O-methyl transferase (COMT) Val108Met polymorphism with smoking severity and age of smoking initiation in Chinese male smokers SO PSYCHOPHARMACOLOGY LA English DT Article DE COMT; polymorphism; nicotine; smoker; dependence ID METHYLTRANSFERASE COMT; NICOTINE DEPENDENCE; GENETIC-VARIATION; TRANSPORTER GENE; POPULATION; BEHAVIOR; WOMEN; CONSUMPTION; CESSATION; JAPANESE AB Rationale Catechol-O-methyltransferase (COMT) is an enzyme involved in the degradation and inactivation of the neurotransmitter dopamine, which is important in mediating drug reward such as nicotine in tobacco smoke. Different COMT alleles encode enzyme whose activity varies from three- to fourfold that may affect dopamine levels and alter subjective effects of nicotine. Recent evidence also suggests that a COMT polymorphism may be especially important in determining an individual's predisposition to developing nicotine dependence. Subjects and Methods We studied the COMT Val108Met polymorphism in a male population of 203 current smokers, 66 former smokers, and 102 non-smokers. The age-adjusted odds ratios were estimated by multiple logistic regression models. Results The results showed no significant association of the COMT Val108Met with initiation, persistent smoking, or smoking cessation. However, current smokers with the Met allele had significantly higher Fagerstrom Test for Nicotine Dependence scores (7.5 +/- 2.1 vs 6.8 +/- 1.8, p = 0.018) and started smoking significantly earlier (18.4 +/- 4.9 vs 20.1 +/- 5.9 years, p = 0.036). Conclusions These results suggest that the COMT Val108Met polymorphism may not influence smoking status in a Chinese male population but may influence the age at which smoking started and smoking severity among smokers. However, the findings must be regarded as preliminary because of the relatively small sample size and marginal associations and should be replicated in a larger cohort. C1 Peking Univ, Int Mental Hlth, Beijing 100083, Peoples R China. Peking Univ, Sch Publ Hlth, Dept Epidemiol & Stat, Beijing 100083, Peoples R China. Beijing Anding Hosp Capital Univ Med Sci, Natl Drug Dependence Treatment Ctr, Beijing, Peoples R China. Beijing Huilongguan Hosp, Ctr Biol Psychait, Beijing, Peoples R China. Baylor Coll Med, VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. RP Zhang, XY (reprint author), Peking Univ, Int Mental Hlth, Beijing 100083, Peoples R China. EM dafangchen@bjmu.edu.cn; zhoudf@bjmu.edu.cn; xyzhang@bcm.edu OI Haile, Colin/0000-0001-8293-7291 FU NIDA NIH HHS [K05-DA0454, P50-DA18827] NR 32 TC 31 Z9 33 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0033-3158 J9 PSYCHOPHARMACOLOGY JI Psychopharmacology PD MAR PY 2007 VL 190 IS 4 BP 449 EP 456 DI 10.1007/s00213-006-0628-4 PG 8 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 132FC UT WOS:000243926900005 PM 17206495 ER PT J AU Miravitlles, M Anzueto, A Legnani, D Forstmeier, L Fargel, M AF Miravitlles, Marc Anzueto, Antonio Legnani, Delfino Forstmeier, Leonhard Fargel, Matthias TI Patient's perception of exacerbations of COPD - the PERCEIVE study SO RESPIRATORY MEDICINE LA English DT Article DE COPD; chronic bronchitis; patient-reported outcomes; respiratory symptoms ID OBSTRUCTIVE PULMONARY-DISEASE; QUALITY-OF-LIFE; CHRONIC-BRONCHITIS; INTERNATIONAL SURVEY; UNITED-STATES; HEALTH; POPULATION; RECOVERY; COSTS; PERSPECTIVE AB The evaluation of therapies requires the development of patient-reported outcomes (PROs) that help clinicians to understanding the symptoms, perceptions and feelings of patients with exacerbations of chronic obstructive pulmonary disease (COPD). With the aim of obtaining information on the perceptions of patients with COPD, their exacerbations and expectations of treatment, a random telephone contact survey in six countries was performed. From 83,592 households screened, 1100 subjects with symptoms compatible with COPD were identified. The most frequent symptom was shortness of breath (78%). The most frequent complaint was that due to their COPD: "they could not complete the activities they like to do" (54%); 17% (187) of individuals were afraid that their COPD would cripple, or eventually kill them. Exacerbations generated a mean of 5.1 medical visits/year (SD=4.6) with the mean duration of exacerbation symptoms being 10.5 days. Increased coughing was the exacerbation symptom having the strongest impact on well-being (42%). Fifty-five percent of patients declared that quicker symptom relief was the most desired requirement for treatment. New data are provided on the impact of COPD and its exacerbations on the daily life of patients. These data will help to develop PROs designed to evaluate the effectiveness of different therapies for exacerbated COPD. (c) 2006 Elsevier Ltd. All rights reserved. C1 Hosp Clin Barcelona, Inst Clin Torax IDIBAPS, Serv Pneumol, Barcelona, Spain. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Milan, Inst Resp Dis, Milan, Italy. Bayer HealthCare, Wuppertal, Germany. Psyma Int Med Mkt Res GmbH, Rueckersdorf Nuernberg, Germany. RP Miravitlles, M (reprint author), Hosp Clin Barcelona, Inst Clin Torax IDIBAPS, Serv Pneumol, Barcelona, Spain. EM marcm@clinic.ub.es OI Miravitlles, Marc/0000-0002-9850-9520 NR 40 TC 54 Z9 55 U1 0 U2 3 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 0954-6111 J9 RESP MED JI Respir. Med. PD MAR PY 2007 VL 101 IS 3 BP 453 EP 460 DI 10.1016/j.rmed.2006.07.010 PG 8 WC Cardiac & Cardiovascular Systems; Respiratory System SC Cardiovascular System & Cardiology; Respiratory System GA 144XJ UT WOS:000244829500010 PM 16938447 ER PT J AU Leung, WW Blanchard, JJ AF Leung, W. W. Blanchard, J. J. TI Experience and expression of emotion in social anhedonia: An examination of social affiliative state in schizotypy SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 Bronx Vet Adm Med Ctr, Educ & Clin Ctr, Mental Illness Res, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 220 EP 220 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506600053 ER PT J AU Copeland, LA Lawrence, VA Zeber, JE Mortensen, EM AF Copeland, L. A. Lawrence, V. A. Zeber, J. E. Mortensen, E. M. TI Surgery rates among veterans with schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 S Texas Vet Hlth Care Syst, Verdict HSRD, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 230 EP 231 PG 2 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506600083 ER PT J AU Dougherty, GG van Kammen, DP Yao, JK AF Dougherty, G. G. van Kammen, D. P. Yao, J. K. TI Covariance analysis of CSF amino acids in healthy normal and schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 VA Pittsburgh Healthcare System, Med Res Serv, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 309 EP 309 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506600309 ER PT J AU Martin, LF Hall, MH Ross, RG Zerbe, G Freedman, R Olincy, A AF Martin, L. F. Hall, M. H. Ross, R. G. Zerbe, G. Freedman, R. Olincy, A. TI Discrimination of bipolar disorder and schizophrenia by physiological measures SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 408 EP 408 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506600589 ER PT J AU Kennedy, A Harvey, M Wood, AE Kilzieh, N Tapp, A AF Kennedy, A. Harvey, M. Wood, A. E. Kilzieh, N. Tapp, A. TI Adjunctive galantamine's effect on schizophrenic symptomatology: A case report SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 MIRECC, VA Puget Sound Hlth Care Syst, Tacoma, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 436 EP 436 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506601067 ER PT J AU Tapp, A Wood, AE Kennedy, A AF Tapp, A. Wood, A. E. Kennedy, A. TI Incidence of tardive dyskinesia in first and second generation antipsychotic medications SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 VA Puget Sound Hlth Care Syst, Tacoma, WA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 507 EP 507 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506601262 ER PT J AU Holland, C Vinogradov, S Merzenich, M AF Holland, C. Vinogradov, S. Merzenich, M. TI Neuroplasticity-based cognitive training in schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 524 EP 524 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506601311 ER PT J AU Vinogradov, S Holland, C Merzenich, M Mellon, S Wolkowitz, O AF Vinogradov, S. Holland, C. Merzenich, M. Mellon, S. Wolkowitz, O. TI Increased serum BDNF levels in schizophrenic subjects after intensive neuroplasticity-based cognitive training SO SCHIZOPHRENIA BULLETIN LA English DT Meeting Abstract CT 10th International Congress on Schizophrenia Research CY APR 02-06, 2005 CL Savannah, GA C1 Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Psychiat, San Francisco, CA 94143 USA. RI Wolkowitz, Owen/J-6649-2013 OI Wolkowitz, Owen/0000-0003-0655-5042 NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD MAR PY 2007 VL 33 IS 2 BP 547 EP 547 PG 1 WC Psychiatry SC Psychiatry GA 140LL UT WOS:000244506601380 ER PT J AU Hu, WP Li, JD Zhang, CK Boehmer, L Siegel, JM Zhou, QY AF Hu, Wang-Ping Li, Jia-Da Zhang, Chengkang Boehmer, Lisa Siegel, Jerome M. Zhou, Qun-Yong TI Altered circadian and homeostatic sleep regulation in prokineticin 2-deficient mice SO SLEEP LA English DT Article DE sleep; prokineticin 2; sleep homeostasis; circadian genes; EEG; behavioral challenge ID DORSAL RAPHE NUCLEUS; KNOCK-OUT MICE; SUPRACHIASMATIC NUCLEUS; BEHAVIORAL STATE; AROUSAL; CLOCK; EXPRESSION; DEPRIVATION; WAKEFULNESS; AMYGDALA AB Study Objectives: Sleep is regulated by circadian and homeostatic processes. Recent studies with mutant mice have indicated that circadian-related genes regulate sleep amount, as well as the timing of sleep. Thus a direct link between circadian and homeostatic regulation of sleep may exist, at least at the molecular level. Prokineticin 2 (PK2), which oscillates daily with high amplitude in the suprachiasmatic nuclei (SCN), has been postulated to be an SCN output molecule. In particular, mice lacking the PK2 gene (PK2-/-) have been shown to display significantly reduced rhythmicity for a variety of circadian physiological and behavioral parameters. We investigated the role of PK2 in sleep regulation. Design: EEG/EMG sleep-wake patterns were recorded in PK2-/- mice and their wild-type littermate controls under baseline and challenged conditions. Measurements and Results: PK24- mice exhibited reduced total sleep time under entrained light-dark and constant darkness conditions. The reduced sleep time in PK24- mice occurred predominantly during the light period and was entirely due to a decrease in non-rapid eye movement (NREM) sleep time. However, PK24- mice showed increased rapid eye movement (REM) sleep time in both light and dark periods. After sleep deprivation, compensatory rebound in NREM sleep, REM sleep, and EEG delta power was attenuated in PK24- mice. In addition, PK24- mice had an impaired response to sleep disturbance caused by cage change in the light phase. Conclusions: These results indicate that PK2 plays roles in both circathan and homeostatic regulation of sleep. PK2 may also be involved in maintaining the awake state in the presence of behavioral challenges. C1 Univ Calif Irvine, Dept Pharmacol, Irvine, CA 92697 USA. Univ Calif Los Angeles, Sch Med, VA GLAHS Sepulveda, Dept Psychiat, North Hills, CA USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, North Hills, CA USA. RP Zhou, QY (reprint author), Univ Calif Irvine, Dept Pharmacol, Irvine, CA 92697 USA. EM qzhou@uci.edu FU NIMH NIH HHS [R01 MH067753-05] NR 34 TC 47 Z9 50 U1 1 U2 2 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAR 1 PY 2007 VL 30 IS 3 BP 247 EP 256 PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 151QP UT WOS:000245305900002 PM 17425220 ER PT J AU Powell, NB Schechtman, KB Riley, RW Guilleminault, C Chiang, RPY Weaver, EM AF Powell, Nelson B. Schechtman, Kenneth B. Riley, Robert W. Guilleminault, Christian Chiang, Rayleigh Ping-Ying Weaver, Edward M. TI Sleepy driver near-misses may predict accident risks SO SLEEP LA English DT Article DE sleepy driving; sleep disorders; sleepy near-miss accidents; driving accidents; driving risks; Epworth Sleepiness Scale ID EPWORTH SLEEPINESS SCALE; MOTOR-VEHICLE CRASHES; DAYTIME SLEEPINESS; TRAFFIC ACCIDENTS; SERIOUS INJURY; APNEA; MANAGEMENT; PATIENT AB Study Objectives: To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents. Design: A prospective cross-sectional internet-linked survey on driving behaviors. Setting: Dateline NBC News website. Results: Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were >= 4 near-miss sleepy accidents (P < 0.0001). After covariate adjustments, subjects who reported at least one near-miss sleepy accident were 1.13 (95% Cl, 1.10 to 1.16) times as likely to have reported at least one actual accident as subjects reporting no near-miss sleepy accidents (P < 0.0001). The odds of reporting at least one actual accident in those reporting 4 near-miss sleepy accidents as compared to those reporting no near-miss sleepy accidents was 1.87 ( 95% Cl, 1.64 to 2.14). Furthermore, after adjustments, the summary Epworth Sleepiness Scale (ESS) score had an independent association with having a near-miss or actual accident. An increase of 1 unit of ESS was associated with a covariate adjusted 4.4% increase of having at least one accident (P < 0.0001). Conclusion: A statistically significant dose-response was seen between the numbers of self-reported sleepy near-miss accidents and an actual accident. These findings suggest that sleepy near-misses may be dangerous precursors to an actual accident. C1 Stanford Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Stanford, CA 94305 USA. Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA. Washington Univ, Sch Med, Div Biostat, St Louis, MO 63130 USA. Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA. Fu Jen Catholic Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Taipei, Taiwan. Shin Kong Wu Ho Su Mem Hosp, Dept Otolaryngol Head & Neck Surg, Taipei, Taiwan. Univ Washington, Sch Med, Sleep Disorders Ctr, Harborview Med Ctr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Powell, NB (reprint author), 750 Welch Rd Suite 317, Palo Alto, CA 94304 USA. EM npowell@ix.netcom.com FU NHLBI NIH HHS [K23 HL068849, K23 HL068849-04] NR 26 TC 58 Z9 59 U1 1 U2 4 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PD MAR 1 PY 2007 VL 30 IS 3 BP 331 EP 342 PG 12 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 151QP UT WOS:000245305900012 PM 17425230 ER PT J AU Cheng, EM Asch, SM Brook, RH Vassar, SD Jacob, EL Lee, ML Chang, DS Sacco, RL Hsiao, AF Vickrey, BG AF Cheng, Eric M. Asch, Steve M. Brook, Robert H. Vassar, Stefanie D. Jacob, Erin L. Lee, Martin L. Chang, Donald S. Sacco, Ralph L. Hsiao, An-Fu Vickrey, Barbara G. TI Suboptimal control of atherosclerotic disease risk factors after cardiac and cerebrovascular procedures SO STROKE LA English DT Article DE cardiac procedurest; carotid prevention; secondary prevention ID CAROTID-ENDARTERECTOMY; MYOCARDIAL-INFARCTION; ADMINISTRATIVE DATA; STROKE; MANAGEMENT; CARE; PREVENTION; HYPERLIPIDEMIA; HYPERTENSION AB Background and Purpose - Undergoing a carotid endarterectomy, a coronary artery bypass graft, or a percutaneous coronary intervention provides an opportunity to optimize control of blood pressure and low-density lipoprotein. Methods - Using Veterans Administration databases, we determined whether patients who underwent a carotid endarterectomy (n = 252), coronary artery bypass graft ( n = 486), or percutaneous coronary intervention ( n = 720) in 2002 to 2003 at 5 Veterans Administration Healthcare Systems had guideline-recommended control of blood pressure and low-density lipoprotein in 12-month periods before and after a vascular procedure. Postprocedure control of risk factors across procedure groups was compared using chi(2) tests and multivariate logistic regression. Results - The proportion of patients undergoing carotid endarterectomy who had optimal control of both blood pressure and low-density lipoprotein increased from 23% before the procedure to 33% after the procedure ( P = 0.05) compared with increases from 32% to 43% for coronary artery bypass graft ( P = 0.001) and from 29% to 45% for percutaneous coronary intervention ( P = 0.002). Compared with the carotid endarterectomy group, the percutaneous coronary intervention group was more likely to achieve optimal control of blood pressure ( OR: 1.92, 95% CI: 1.42 to 2.59) or low-density lipoprotein ( OR: 1.51, 95% CI: 1.01 to 2.26) and the coronary artery bypass graft group was more likely to achieve optimal control of blood pressure ( OR: 1.53, 95% CI: 1.42 to 2.59). Postprocedure cardiology visits, increase in medication intensity, and greater frequency of outpatient visits were also associated with optimal postprocedure risk factor control. Conclusions - Although modest improvements in risk factor control were detected, a majority of patients in each vascular procedure group did not achieve optimal risk factor control. More effective risk factor control programs are needed among most vascular procedure patients. C1 VA Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Div Cardiol, Los Angeles, CA 90073 USA. VA Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. Univ Calif Los Angeles, Div Cardiol, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Div Cardiol, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RAND Corp, Hlth Program, Santa Monica, CA USA. Univ Calif Irvine, Ctr Hlth Policy Res, Irvine, CA 92717 USA. VA Long Beach Healthcare Syst, Med Healthcare Grp, Long Beach, CA USA. Columbia Univ, Dept Epidemiol, New York, NY 10027 USA. Columbia Univ, Dept Neurol, New York, NY 10027 USA. RP Cheng, EM (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Neurol, 11301 Wilshire Blvd,B500,ML 127, Los Angeles, CA 90073 USA. EM eric.cheng@va.gov NR 24 TC 8 Z9 8 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD MAR PY 2007 VL 38 IS 3 BP 929 EP 934 DI 10.1161/01.STR.0000257310.08310.0f PG 6 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 140DB UT WOS:000244482500026 PM 17255549 ER PT J AU Yin, W Signore, AP Iwai, M Cao, GD Gao, YQ Johnnides, MJ Hickey, RW Chen, J AF Yin, Wei Signore, Armando P. Iwai, Masanori Cao, Guodong Gao, Yanqin Johnnides, Michael J. Hickey, Robert W. Chen, Jun TI Preconditioning suppresses inflammation in neonatal hypoxic ischemia via Akt activation SO STROKE LA English DT Article DE hypoxia-ischemia; inflammation; neonatal; p-Akt; preconditioning ID GLYCOGEN-SYNTHASE KINASE-3-BETA; BRAIN-INJURY; RAT-BRAIN; NEUROPROTECTION; DAMAGE; TOLERANCE; INHIBITION; EXPRESSION; MEDIATORS; RECEPTOR AB Background and Purpose - Hypoxic preconditioning ( PC) confers robust neuroprotection against neonatal hypoxic-ischemic brain injury (H-I), yet the underlying mechanism is poorly understood. In the adult brain, neuronal survival after ischemia is associated with the activation of the phosphatidylinositol 3-kinase (PI3-K)/Akt signaling pathway. Suppression of inflammation is a newly identified direct consequence of PI3-K/Akt signaling. We therefore investigated whether PI3-K/Akt suppresses inflammation and contributes to PC-induced neuroprotection. Methods - Postnatal day 7 rats were exposed for 3 hours to either ambient air or 8% oxygen, which induces hypoxic PC. H-I was produced 24 hours later by unilateral carotid artery ligation followed by 2.5 hours of hypoxia. Animals were euthanized 0 to 24 hours later for detecting Akt and glycogen synthetase kinase-3 beta phosphorylation (p-Akt, p-GSK-3 beta), 24 hours later for assessing cytokine expression and inflammatory markers, and 7 days later for measuring brain tissue loss. In addition, LY294002 was injected intracerebroventricularly to inhibit PI3-K/Akt. Results - Brains with H-I without PC showed delayed but sustained reduction in p-Akt. PC restored the levels of p-Akt and the Akt substrate GSK-3 beta, reduced proinflammatory markers (NF-kappa B, COX-2, CD68, myeloperoxidase, and microglial activation), and markedly ameliorated H-I-induced brain tissue loss. Inhibition of PI3-K/Akt using LY294002 attenuated PC neuroprotection and promoted the expression of NF-kappa B, COX-2, and CD68. Proteomic microarray analysis revealed that PC inhibited expression of proinflammatory cytokines induced by H-I or a dose of lipopolysaccharide that resulted in minimal tissue damage. Conclusions - Suppression of inflammatory responses may contribute to PC neuroprotection against neonatal H-I brain injury. This effect is mediated in part via upregulating PI3-K/Akt activity. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Inst Neurodegenerat Dis, Pittsburgh, PA 15213 USA. Fudan Univ, Sch Med, State Key Lab Med Neurobiol, Shanghai 200433, Peoples R China. Childrens Hosp Pittsburgh, Div Pediat Emergency Med, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Care Syst, Educ & Clin Ctr, Pittsburgh, PA USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S-507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu RI Gao, Yanqin/I-6790-2016 OI Gao, Yanqin/0000-0002-4915-9819 FU NINDS NIH HHS [NS36736, NS43802, NS45048] NR 28 TC 65 Z9 71 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD MAR PY 2007 VL 38 IS 3 BP 1017 EP 1024 DI 10.1161/01.STR.0000258102.18836.ca PG 8 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 140DB UT WOS:000244482500040 PM 17272774 ER PT J AU Cummings, DE Overduin, J Foster-Schubert, KE Carlson, MJ AF Cummings, David E. Overduin, Joost Foster-Schubert, Karen E. Carlson, Molly J. TI Role of the bypassed proximal intestine in the anti-diabetic effects of bariatric surgery SO SURGERY FOR OBESITY AND RELATED DISEASES LA English DT Editorial Material ID GLUCAGON-LIKE PEPTIDE-1; MORBIDLY OBESE SUBJECTS; ROUX-EN-Y; INDUCED WEIGHT-LOSS; GASTRIC-BYPASS; ILEAL TRANSPOSITION; JEJUNOILEAL BYPASS; GUT HORMONE; FOOD-INTAKE; ILEOJEJUNAL TRANSPOSITION C1 [Cummings, David E.; Overduin, Joost; Foster-Schubert, Karen E.; Carlson, Molly J.] Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111-Endo, Seattle, WA 98108 USA. EM davidec@u.washington.edu FU NIDDK NIH HHS [R01 DK061516-06, DK68384, P01 DK068384, P01 DK068384-040002, R01 DK061516, R01 DK61516] NR 56 TC 77 Z9 87 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1550-7289 J9 SURG OBES RELAT DIS JI Surg. Obes. Relat. Dis. PD MAR-APR PY 2007 VL 3 IS 2 BP 109 EP 115 DI 10.1016/j.soard.2007.02.003 PG 7 WC Surgery SC Surgery GA 375EO UT WOS:000261097100001 PM 17386391 ER PT J AU Collins, J Mattar, S Qureshi, F Warman, J Ramanathan, R Schauer, P Eid, G AF Collins, Joy Mattar, Samer Qureshi, Faisal Warman, Juanita Ramanathan, Ramesh Schauer, Philip Eid, George TI Initial outcomes of laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents SO SURGERY FOR OBESITY AND RELATED DISEASES LA English DT Article DE Morbid obesity; Adolescent obesity; Bariatric surgery; Gastric bypass; Quality of life ID POLYCYSTIC-OVARY-SYNDROME; TYPE-2 DIABETES-MELLITUS; INSULIN-RESISTANCE; CHILDHOOD OBESITY; US CHILDREN; BODY-MASS; SURGERY; OVERWEIGHT; ASSOCIATION; PREVALENCE AB Background: Adolescent obesity is an epidemic in the United States, leading to significant morbidity. Because the impact of laparoscopic bariatric surgery in this Population is not as well delineated as in adults, we examined the short-term outcome of adolescents undergoing laparoscopic Roux-en-Y gastric bypass at our institution. Methods: The medical records of patients <= 18 years of age who had undergone laparoscopic Roux-en-Y gastric bypass for morbid obesity from 1999 to June 2005 were reviewed. The outcome variables examined included preoperative body mass index, percent of excess weight lost for those with at least 3 months Of follow-up, length of hospital stay, postoperative morbidity and mortality, changes in cornorbid conditions, and effects Of Surgical weight loss on quality of life. Data are presented as the mean +/- standard error of the mean. Results: Eleven patients (seven girls and four boys) had undergone laparoscopic Roux-en-Y gastric bypass. The mean follow-up was 11.5 +/- 2.8 months (range 3-32). The average patient age was 16.5 +/- 0.2 years, and the average body mass index was 50.5 +/- 2.0 kg/m(2). The average number of comorbidities was 5.3, 70% of which improved or resolved postoperatively. No mortalities resulted. of the 11 patients, 1 had early postoperative bleeding and 2 developed a marginal ulcer. The quality-of-life, Surveys obtained from 9 patients, reflected an overall improvement in self-esteem, social functioning, and productivity in school or the workplace. Conclusions: The initial data suggest that laparoscopic gastric bypass is an effective weight loss treatment for morbidly obese adolescents. (Surg Obes Relat Dis 2007;3:147-152.) (C) 2007 American Society for Bariatric Surgery. All rights reserved. C1 [Collins, Joy; Mattar, Samer; Qureshi, Faisal; Warman, Juanita; Ramanathan, Ramesh; Eid, George] Univ Pittsburgh, Med Ctr, Div Minimally Invas Surg, Pittsburgh, PA USA. [Schauer, Philip] Cleveland Clin Fdn, Div Minimally Invas Surg, Cleveland, OH 44195 USA. [Eid, George] Vet Affairs Pittsburg Healthcare Syst, Pittsburgh, PA USA. RP Eid, G (reprint author), Minimally Invas Surg Ctr, 3380 Blvd Allies,Suite 390, Pittsburgh, PA 15213 USA. EM eidgm@upmc.edu OI Qureshi, Faisal/0000-0002-7986-720X FU Ethicon Endosurgery, Inc. (Johnson Johnson, Inc.); Stryker, Inc.; W.L. Gore, Inc. FX Dr. Schauer is on the speakers' bureau and a consultant and the recipient of an educational grant from Ethicon Endosurgery, Inc. (Johnson & Johnson, Inc.), a consultant for and recipient of an educational grant from Stryker, Inc., a recipient at the time of this study of an educational grant from U.S. Surgical, Inc. (Tyco Health, Inc.), and a consultant for and recipient of a research grant from W.L. Gore, Inc. NR 28 TC 40 Z9 40 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1550-7289 J9 SURG OBES RELAT DIS JI Surg. Obes. Relat. Dis. PD MAR-APR PY 2007 VL 3 IS 2 BP 147 EP 152 DI 10.1016/j.soard.2006.12.002 PG 6 WC Surgery SC Surgery GA 375EO UT WOS:000261097100008 PM 17324636 ER PT J AU O'Rourke, RW Kim, CY Chang, EY Hunter, JG Jobe, BA AF O'Rourke, Robert W. Kim, Charles Y. Chang, Eugene Y. Hunter, John G. Jobe, Blair A. TI Incorporation of Nissen fundoplication in a rat model of duodenoesophageal reflux SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES LA English DT Article DE Barrett's esophagus; esophageal adenocarcinoma; gastroesophageal reflux disease; rat ID BARRETTS-ESOPHAGUS; ANTIREFLUX SURGERY; ENDOSCOPIC SURVEILLANCE; GASTROESOPHAGEAL-REFLUX; ADENOCARCINOMA; EFFICACY; ANTERIOR AB Background: Few in vivo models of esophageal reflux and fundoplication suitable for the study of the pathogenesis of Barrett's esophagus and esophageal cancer exist. We describe a modification of a rat model of duodenoesophageal reflux that incorporates Nissen fundoplication and uses it to study the role of fundoplication in ameliorating esophageal reflux. Methods: A previously described rat model of duodenoesophageal reflux was modified to include Nissen fundoplication. Reflux threshold (RT), defined as the gastric pressure required to cause gastroesophageal reflux during transgastric instillation of saline, was measured in 12 Sprague-Dawley rats at baseline, after cardiomyotomy with esophagogastroduodenal anastomosis (EGDA), after subsequent Nissen fundoplication, and, finally, after takedown of Nissen fundoplication (NF). Results: Cardiomyotomy with EGDA induced no significant change in RT compared with baseline (mean RT SD: 4.0 +/- 1.9 mmHg and 6.0 +/- 2.5 mmHg, respectively, p = 0.741). Nissen fundoplication led to a 14-fold increase in RT (56.4 +/- 18.2 mmHg) compared with cardiomyotomy. RT pressure reverted to baseline levels after NF takedown (4.7 +/- 2.9 mmHg,p < 0.001). Antegrade esophageal flow was demonstrated without an increase in distal esophageal pressure after NF. Conclusions: Nissen fundoplication creates a one-way antireflux mechanism that eliminates gastroesophageal reflux in this rat model. This modification of an in vivo model of duodenoesophageal reflux represents a unique opportunity to investigate the effect of NF on cardiomyotomy-induced reflux and distal esophageal exposure to duodenogastric refluxate, and could be useful in the study of the role of NF in preventing progression to BE and ECA. C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR 97239 USA. RP Jobe, BA (reprint author), Oregon Hlth Sci Univ, Dept Surg, 3181 SW Sam Jackson Pk Rd,L-233A, Portland, OR 97239 USA. NR 21 TC 0 Z9 0 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0930-2794 J9 SURG ENDOSC JI Surg. Endosc. PD MAR PY 2007 VL 21 IS 3 BP 467 EP 470 DI 10.1007/s00464-006-9044-4 PG 4 WC Surgery SC Surgery GA 145DK UT WOS:000244845300022 PM 17103272 ER PT J AU Freedland, SJ Kane, CJ Amling, CL Aronson, WJ Terris, MK Presti, JC AF Freedland, Stephen J. Kane, Christopher J. Amling, Christopher L. Aronson, William J. Terris, Martha K. Presti, Joseph C., Jr. CA SEARCH Database Study Grp TI Upgrading and downgrading of prostate needle biopsy specimens: Risk factors and clinical implications SO UROLOGY LA English DT Article ID RADICAL PROSTATECTOMY; GLEASON SCORES; CANCER; GRADE; OBESITY; MORTALITY; ACCURACY; IMPROVES; DATABASE; SCHEME AB OBJECTIVES The prostate biopsy Gleason grade frequently differs from the radical prostatectomy (RP) grade. Given the critical role that needle biopsy plays in treatment decisions, we sought to determine the risk factors for upgrading and downgrading the prostate biopsy specimen. METHODS We determined the significant predictors of upgrading (worse RP grade than biopsy grade) and downgrading (better RP grade than biopsy grade) among 1113 men treated with RP from 1996 to 2005 within the Shared Equal Access Regional Cancer Hospital (SEARCH) database who had undergone at least sextant biopsy. The Gleason sum was examined as a categorical variable of 2 to 6, 3+4, and 4+3 or greater. RESULTS Overall, the disease of 299 men (27%) was upgraded and 123 (11%) was downgraded, and 691 men (62%) had identical biopsy and pathologic Gleason sum groups. Upgrading was associated with adverse pathologic features (P <= 0.001) and the risk of biochemical progression (P = 0.001). Downgrading was associated with more favorable pathologic features (P <= 0.01) and a decreased risk of progression (P = 0.04). On multivariate analysis, greater prostate-specific antigen levels (P < 0.001), more biopsy cores with cancer (P = 0.001), and obesity (P = 0.003) were all significantly and positively associated with upgrading. In contrast, biopsy Gleason sum 3+4 (P = 0.001) and obtaining eight or more biopsy cores (P = 0.01) were associated with a lower likelihood of upgrading. CONCLUSIONS Men whose disease was upgraded were at a greater risk of adverse pathologic features and biochemical progression. Men with "high-risk" cancer (greater prostate-specific antigen levels, more positive cores, and obese) were more likely to have their disease category upgraded, and obtaining more biopsy cores reduced the likelihood of upgrading. C1 Durham Vet Affairs Med Ctr, Dept Surg, Durham, NC USA. Duke Univ, Sch Med, Div Urol Surg, Dept Surg, Durham, NC USA. Duke Univ, Sch Med, Div Urol Surg, Dept Pathol, Durham, NC USA. Duke Univ, Sch Med, Duke Prostate Ctr, Durham, NC USA. San Francisco VA Med Ctr, Dept Surg, Urol Sect, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Univ Alabama, Dept Urol, Birmingham, AL USA. San Diego Naval Hosp, Dept Urol, San Diego, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Urol Sect, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. Med Coll Georgia, Augusta Vet Affairs Med Ctr, Dept Surg, Augusta, GA 30912 USA. Stanford Univ, Sch Med, Dept Urol, Stanford, CA 94305 USA. Vet Affairs Palo Alto Healthcare Syst, Dept Surg, Urol Sect, Palo Alto, CA USA. RP Freedland, SJ (reprint author), Duke Univ, Sch Med, Div Urol, DUMC, Box 3850, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Terris, Martha/0000-0002-3843-7270 FU NCI NIH HHS [P50 CA092131-01A10005, P50 CA92131-01A1, R01 CA100938, R01CA100938, P50 CA092131]; NCRR NIH HHS [M01 RR000865, M01 RR000865-310710] NR 19 TC 87 Z9 90 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 2007 VL 69 IS 3 BP 495 EP 499 DI 10.1016/j.urology.2006.10.036 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 155GS UT WOS:000245566500020 PM 17382152 ER PT J AU Ross, JS Ho, VV Wang, YF Cha, SS Epstein, AJ Masoudi, FA Nallamothu, BK Krumholz, HM AF Ross, Joseph S. Ho, Vivian Wang, Yongfei Cha, Stephen S. Epstein, Andrew J. Masoudi, Frederick A. Nallamothu, Brahmajee K. Krumholz, Harlan M. TI Certificate of need regulation and cardiac catheterization appropriateness after acute myocardial infarction SO CIRCULATION LA English DT Article; Proceedings Paper CT 29th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 27-29, 2006 CL Los Angeles, CA SP Soc Gen Internal Med DE angioplasty; myocardial infarction; certificate of need; quality of health care; government regulation ID PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; QUALITY-OF-CARE; HEALTH-CARE; AMERICAN-COLLEGE; UNITED-STATES; MEDICARE BENEFICIARIES; CORONARY-ANGIOGRAPHY; ACC/AHA GUIDELINES; MORTALITY AB Background - Certificate of need (CON) regulation was introduced to control healthcare costs and improve quality of care in part by limiting the number of facilities providing complex medical care. Our objective was to examine whether rates of appropriate cardiac catheterization after admission for acute myocardial infarction varied between states with and without CON regulation of cardiac catheterization. Methods and Results - We performed a retrospective analysis of chart-abstracted data for 137 279 Medicare patients admitted for acute myocardial infarction between 1994 and 1996 at 4179 US acute-care hospitals. Using 3-level hierarchical generalized linear modeling adjusted for patient sociodemographic and clinical characteristics and physician and hospital characteristics, we compared catheterization rates within 60 days of admission for states ( and the District of Columbia) with (n = 32) and without (n = 19) CON regulation in the full cohort and stratified by catheterization appropriateness. Appropriateness was categorized as strongly, equivocally, or weakly indicated. We found CON regulation was associated with a borderline-significant lower rate of catheterization overall (45.8% versus 46.5%; adjusted risk ratio [RR] 0.91, 95% confidence interval 0.82 to 1.00, P = 0.06). After stratification by appropriateness, CON regulation was not associated with a significantly lower rate of catheterization among 63 823 patients with strong indications (49.9% versus 50.3%; adjusted RR 0.94, 95% confidence interval 0.86 to 1.02, P = 0.17). However, CON regulation was associated with significantly lower rates of catheterization among 65 077 patients with equivocal indication (45.0% versus 46.0%; adjusted RR 0.88, 95% confidence interval 0.78 to 1.00, P = 0.05) and among 8379 patients with weak indications (19.8% versus 21.8%; adjusted RR 0.84, 95% confidence interval 0.71 to 0.98, P = 0.04). Associations were weakened substantially after adjustment for hospital coronary artery bypass graft surgery or cardiac catheterization capability. Conclusions - CON regulation was associated with modestly lower rates of equivocally and weakly indicated cardiac catheterization after admission for acute myocardial infarction, but no significant differences existed in rates of strongly indicated catheterization. C1 CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY 10029 USA. James J Peters VA Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY USA. Rice Univ, Baker Inst Publ Policy, Houston, TX 77251 USA. Yale Univ, Sch Med, Sect Cardiovasc Med, Dept Med, New Haven, CT USA. Yale Univ, Sch Med, Sect Hlth Policy & Adm, Dept Epidemiol & Publ Hlth, New Haven, CT USA. Univ Colorado, Denver Hlth Sci Ctr, Sect Cardiovasc Med, Dept Med,Denver Hlth Med Ctr, Denver, CO USA. Univ Colorado, Denver Hlth Sci Ctr, Colorado Hlth Outcomes Program, Dept Med, Denver, CO USA. Univ Michigan, Dept Med, Div Cardiovasc Med, Ann Arbor, MI 48109 USA. Ann Arbor VA Med Ctr, Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA. Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. RP Ross, JS (reprint author), CUNY Mt Sinai Sch Med, Dept Geriatr & Adult Dev, 1 Gustave L Levy Pl,Box 1070, New York, NY 10029 USA. EM joseph.ross@mssm.edu FU NCI NIH HHS [OK0412SC]; NHLBI NIH HHS [R01 HL073825] NR 41 TC 19 Z9 19 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 27 PY 2007 VL 115 IS 8 BP 1012 EP 1019 DI 10.1161/CIRCULATIONAHA.106.658377 PG 8 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 140CY UT WOS:000244482200013 PM 17283258 ER PT J AU Brouwer, IA Raitt, MH Dullemeijer, C Kraemer, DF Zock, PL Morris, C Katan, MB Connor, WE Schouten, EG McAnulty, J AF Brouwer, Ingeborg A. Raitt, Merritt H. Dullemeijer, Carla Kraemer, Dale F. Zock, Peter L. Morris, Cynthia Katan, Martijn B. Connor, William E. Schouten, Evert G. McAnulty, John TI Effect of fish oil on ventricular tachyarrhythmia in patients with implantable defibrillators: A pooled analysis SO CIRCULATION LA English DT Meeting Abstract CT 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY FEB 28-MAR 03, 2007 CL Orlando, FL SP Amer Heart Assoc, Council Epidemiol & Prevent, Council Nutr, Phys Activ & Metabolism, Natl Heart, Lung & Blood Inst C1 Wageningen Ctr Food Sci, Wageningen, Netherlands. Portland VA Med Ctr, Portland, OR USA. Oregon State Univ, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Vrije Univ Amsterdam, Inst Hlth Sci, Amsterdam, Netherlands. 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 27 PY 2007 VL 115 IS 8 BP E274 EP E274 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 140CY UT WOS:000244482200302 ER PT J AU Dublin, S Glazer, NL Smith, NL Psaty, BM Lumley, T Wiggins, KL Page, RL Heckbert, SR AF Dublin, Sascha Glazer, Nicole L. Smith, Nicholas L. Psaty, Bruce M. Lumley, Thomas Wiggins, Kerri L. Page, Richard L. Heckbert, Susan R. TI Diabetes mellitus is a risk factor for new-onset atrial fibrillation SO CIRCULATION LA English DT Meeting Abstract CT 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY FEB 28-MAR 03, 2007 CL Orlando, FL SP Amer Heart Assoc, Council Epidemiol & Prevent, Council Nutr, Phys Activ & Metabolism, Natl Heart, Lung & Blood Inst C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. RI Page, Richard/L-5501-2014 OI Page, Richard/0000-0001-5603-1330 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 27 PY 2007 VL 115 IS 8 BP E227 EP E227 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 140CY UT WOS:000244482200078 ER PT J AU Parashar, S Rumsfeld, JS Reid, KJ Spertus, JA Buchanan, D Wenger, NK Dawood, N Khizer, S Khan, BV Decker, C Garavalia, L Krumholz, HM Lichtman, JH Champney, K Bazari, RN Vaccarino, V AF Parashar, Susmita Rumsfeld, John S. Reid, Kimberly J. Spertus, John A. Buchanan, Donna Wenger, Nanette K. Dawood, Nazeera Khizer, Saadia Khan, Bobby V. Decker, Carole Garavalia, Linda Krumholz, Harlan M. Lichtman, Judith H. Champney, Kimberly Bazari, Rasha N. Vaccarino, Viola TI Women, depression, and outcome of myocardial infarction SO CIRCULATION LA English DT Meeting Abstract CT 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY FEB 28-MAR 03, 2007 CL Orlando, FL SP Amer Heart Assoc, Council Epidemiol & Prevent, Council Nutr, Phys Activ & Metab, Natl Heart, Lung & Blood Inst C1 Emory Univ, Atlanta, GA USA. Denver VA Med Ctr, Denver, CO USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. Emory Univ, Atlanta, GA 30322 USA. Yale Univ, Sch Med, New Haven, CT USA. Henry Ford Hlth Syst, Detroit, MI 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 27 PY 2007 VL 115 IS 8 BP E216 EP E217 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 140CY UT WOS:000244482200031 ER PT J AU Safford, MM Halanych, J Beall, J Durant, R Prineas, R Cushman, M Howard, G AF Safford, Monika M. Halanych, Jewell Beall, Jennifer Durant, Raegan Prineas, Ron Cushman, Mary Howard, George TI Medication adherence does not explain disparities in blood pressure control: The reasons for geographic and racial differences in stroke (REGARDS) study SO CIRCULATION LA English DT Meeting Abstract CT 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention CY FEB 28-MAR 03, 2007 CL Orlando, FL SP Amer Heart Assoc, Council Epidemiol & Prevent, Council Nutr, Phys Activ & Metabolism, Natl Heart, Lung & Blood Inst C1 Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL USA. Univ Alabama, Birmingham, AL USA. Samford Coll Pharm, Birmingham, AL USA. Wake Forest Univ, Winston Salem, NC 27109 USA. Univ Vermont, Burlington, VT USA. NR 0 TC 0 Z9 0 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD FEB 27 PY 2007 VL 115 IS 8 BP E288 EP E288 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 140CY UT WOS:000244482200368 ER PT J AU Griffin, WC Middaugh, LD Tyor, WR AF Griffin, W. C., III Middaugh, L. D. Tyor, W. R. TI Chronic cocaine exposure in the SCID mouse model of HIV encephalitis SO BRAIN RESEARCH LA English DT Article DE AIDS; dementia; HIV-associated dementia; animal model; drug abuse ID IMMUNODEFICIENCY-VIRUS ENCEPHALITIS; MONONUCLEAR CELL COCULTURES; C57BL/6J MICE; ANTIRETROVIRAL THERAPY; LOCOMOTOR STIMULATION; DRUG USE; REPLICATION; DEPENDENCE; INFECTION; SENSITIZATION AB Clinical and preclinical evidence suggests that cocaine exposure hastens progression of the HIV disease process. An established active, euphoric dose of cocaine (20 mg/kg) was administered to SCID mice according to a regimen consistent with exposure to the drug by cocaine-abusing HIV-infected patients to determine the effects of cocaine on four previously established pathological characteristics of HIV encephalitis: cognitive deficits, fatigue, astrogliosis, and microgliosis. Mice were intracranially inoculated with either HIV-infected, or uninfected macrophages and then injected with either cocaine or saline in a 2 (Infection)x2 (Cocaine) factorial design. Cognition was assessed by acquisition and retention of a spatially cued learning task. Fatigue was assessed by monitoring motor activity following a 2 min forced swim. Mice were then sacrificed to determine the extent of astrogliosis and microgliosis in the four groups. Results indicated that in comparison to uninfected controls, HIV positive mice had increased astrogliosis and microgliosis, cognitive deficits, and recovered more slowly from fatigue. However, despite evidence that the cocaine exposure regimen activated the central nervous system and had long-term CNS effects, the drug did not alter the behavioral or the neuropathological deficits noted in HIV-infected SCID mice. (c) 2006 Elsevier B.V. All rights reserved. C1 Med Univ S Carolina, Ctr Drug & Alcohol Programs, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. RP Tyor, WR (reprint author), Ralph H Johnson VAMC, Neurol Serv, 109 Bee St, Charleston, SC 29401 USA. EM tyorwr@musc.edu FU BLRD VA [I01 BX001506]; NIDA NIH HHS [T32 DA007288, T32 DA07288, R01 DA11870] NR 35 TC 7 Z9 7 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD FEB 23 PY 2007 VL 1134 IS 1 BP 214 EP 219 DI 10.1016/j.brainres.2006.11.059 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 142GZ UT WOS:000244638700025 PM 17189621 ER PT J AU Najt, P Nicoletti, M Chen, HH Hatch, JP Caetano, SC Sassie, RB Axelson, D Brambilla, P Keshavan, MS Ryan, ND Birmaher, B Soares, JC AF Najt, Pablo Nicoletti, Mark Chen, Hua Hsuan Hatch, John P. Caetano, Sheila C. Sassie, Roberto B. Axelson, David Brambilla, Paolo Keshavan, Macheri S. Ryan, Neal D. Birmaher, Boris Soares, Jair C. TI Anatomical measurements of the orbitofrontal cortex in child and adolescent patients with bipolar disorder SO NEUROSCIENCE LETTERS LA English DT Article DE orbitofrontal cortex; adolescents; bipolar disorder; MRI; mood disorders ID MOOD DISORDERS; MAJOR DEPRESSION; ESTROGEN; GENDER; SCHIZOPHRENIA; RELIABILITY; VALIDITY; VOLUME AB Imaging studies indicate smaller orbitofrontal cortex (OFC) volume in mood disorder patients compared with healthy subjects. We sought to determine whether child and adolescent patients with bipolar disorder have smaller OFC volumes than healthy controls. Fourteen children and adolescents meeting DSM-IV criteria for bipolar disorder (six males and eight females with a mean age +/- S.D. = 15.5 +/- 3.2 years) and 20 healthy controls (11 males and nine females with mean age +/- S.D. = 16.9 +/- 3.8 years) were studied. Orbitofrontal cortex volume was measured using magnetic resonance imaging. Male bipolar patients had smaller gray matter volumes in medial (p = 0.044), right medial (0.037) and right (p = 0.032) lateral OFC subdivisions compared to male controls. In contrast, female patients had larger gray matter volumes in left (p = 0.03), lateral (p = 0.012), left lateral (p = 0.007), and trends for larger volumes in right lateral and left medial OFC subdivisions compared with female controls. Male patients exhibit smaller gray matter volumes, while female patients exhibit larger volumes in some OFC sub-regions. Gender differences in OFC abnormalities may be involved in illness pathophysiology among young bipolar patients. (c) 2007 Published by Elsevier Ireland Ltd. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat MC 7792, Div Mood & Anxiety Disorders,MOOD CNS Program, San Antonio, TX 78229 USA. 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. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78284 USA. Univ Sao Paulo, Dept Psychiat, BR-05508 Sao Paulo, Brazil. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Udine, Dept Pathol & Expt & Clin Med, Sect Psychiat, I-33100 Udine, Italy. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat MC 7792, Div Mood & Anxiety Disorders,MOOD CNS Program, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI brambilla, paolo/B-4184-2010; Caetano, Sheila/H-5010-2012 OI brambilla, paolo/0000-0002-4021-8456; Caetano, Sheila/0000-0001-8403-7078 FU NCRR NIH HHS [RR02057]; NIMH NIH HHS [K23 MH001736, MH 01736, MH 069774, MH 30915, MH 59929, P30 MH030915, P30 MH055123, R01 MH059929, R01 MH069774] NR 21 TC 40 Z9 40 U1 1 U2 4 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 FEB 21 PY 2007 VL 413 IS 3 BP 183 EP 186 DI 10.1016/j.neulet.2006.10.016 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 143ZB UT WOS:000244763800001 PM 17276600 ER PT J AU Steinman, MA Chren, MM Landefeld, CS Bero, LA AF Steinman, Michael A. Chren, Mary-Margaret Landefeld, C. Seth Bero, Lisa A. TI The promotion of gahapentin - Reply SO ANNALS OF INTERNAL MEDICINE LA English DT Letter ID PHARMACEUTICAL-INDUSTRY; SELF-REGULATION; PHYSICIANS C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, San Francisco, CA 94121 USA. NR 6 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 20 PY 2007 VL 146 IS 4 BP 313 EP 314 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 137CS UT WOS:000244271000016 ER PT J AU Ryan, TD Rothstein, EC Aban, I Tallaj, JA Husain, A Lucchesi, PA Dell'Italia, LJ AF Ryan, Thomas D. Rothstein, Emily C. Aban, Inmaculada Tallaj, Jose A. Husain, Ahsan Lucchesi, Pamela A. Dell'Italia, Louis J. TI Left ventricular eccentric remodeling and matrix loss are mediated by bradykinin and precede cardiomyocyte elongation in rats with volume overload SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID MITRAL-REGURGITATION; METALLOPROTEINASE ACTIVITY; HEART-FAILURE; DOG; HYPERTROPHY; ACTIVATION; CHYMASE; CELLS; ALPHA AB Objectives We hypothesized that left ventricular (LV) remodeling and matrix loss in volume overload (VO) are mediated by bradykinin (BK) and exacerbated by chronic angiotensin-converting enzyme (ACE) inhibition. Background Chronic ACE inhibition increases anti-fibrotic BK and does not attenuate LV remodeling in pure VO. The relative contribution of changes in extracellular matrix versus cardiomyocyte elongation in acute and chronic LV chamber remodeling during VO is unknown. Methods Echocardiography, LV collagen content, and isolated cardiomyocytes were studied in rats after aortocaval fistula (ACF) of 12 h, 2 and 5 days, and 4, 8, and 15 weeks. We also studied ACF rats after BK2 receptor (BK2R) blockade (2 days) or ACE inhibition (4 weeks). Results At 2 days after ACF, LV end-diastolic dimension (LVEDD)/wall thickness was increased, and LV interstitial collagen was decreased by 50% without cardiornyocyte elongation. The BK2R blockade prevented collagen loss and normalized LVEDD/wall thickness. From 4 to 15 weeks after ACF, interstitial collagen decreased by 30% and left ventricular end-systolic (LVES) dimension increased despite normal LVES pressure and isolated cardiomyocyte function. The ACE inhibition did not decrease LVEDD/wall thickness, further decreased LV interstitial collagen, and did not improve LV fractional shortening despite decreased LVES pressure. Conclusions Immediately after ACF induction, eccentric LV remodeling is mediated by interstitial collagen loss without cardiomyocyte elongation. Acute BK2R blockade prevents eccentric LV remodeling and improves function. Chronic ACE inhibition does not prevent eccentric LV remodeling or improve function. These findings suggest that ACE inhibitor-mediated increase in LV BK exacerbates matrix loss and explains why ACE inhibition is ineffective in VO. C1 Univ Alabama, Ctr Heart Failure Res, Dept Physiol, Birmingham, AL 35294 USA. Univ Alabama, Dept Biophys, Birmingham, AL 35294 USA. Univ Alabama, Dept Biostat, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Dell'Italia, LJ (reprint author), Univ Alabama, Ctr Heart Failure Res, Dept Physiol, 432 BMR2,901 19th St S, Birmingham, AL 35294 USA. EM loudell@uab.edu RI Lucchesi, Pamela/E-3558-2011; Husain, Ahsan/J-6861-2012 OI Husain, Ahsan/0000-0003-3426-3469 FU NHLBI NIH HHS [5T32HL07918-05, P50HL077100, R01HL063318, R01HL54816, R01HL60707] NR 23 TC 60 Z9 63 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 20 PY 2007 VL 49 IS 7 BP 811 EP 821 DI 10.1016/j.jacc.2006.06.083 PG 11 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 137VE UT WOS:000244319900011 PM 17306712 ER PT J AU Stone, KE Chiquette, E Chilton, RJ AF Stone, Kenneth E. Chiquette, Elaine Chilton, Robert J. TI Diabetic endovascular disease: Role of coronary artery revascularization SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID DRUG-ELUTING STENTS; MYOCARDIAL-INFARCTION; CONTROLLED-TRIALS; GLYCEMIC CONTROL; BLOOD-INSTITUTE; RISK-FACTORS; MELLITUS; IMPLANTATION; RESTENOSIS; ATHEROSCLEROSIS AB This century brings a pandemic of diabetes mellitus, with marked increases in early-accelerated atherosclerosis. When asymptomatic patients with diabetes present for evaluation, they have more extensive coronary atherosclerosis, lower ejection fractions, higher rates of previous cardiac events, and more silent ischemia than the normal population. The challenge faced by clinicians is to accurately identify asymptomatic patients with diabetes who have significant coronary ischemia that would benefit from revascularization. Diabetic endovascular disease has all the high-risk features to promote atherosclerosis and coronary occlusion: hyperglycemia-induced endothelial dysfunction, impaired fibrinolysis, increased platelet aggregation, plaque instability, dysfunctional arterial remodeling, and fibrotic and calcified coronary arteries. The optimal revascularization strategy for patients with diabetes is an ongoing debate. The advent of drug-eluting stents has changed the landscape, and some have suggested that the current role of coronary artery bypass grafting may be reduced by as much as 46%. Unfortunately, there is limited evidence from randomized, controlled trials that reflects current practice and could guide clinicians in making the best choices for patients with diabetes and coronary disease. It is hoped that ongoing trials-including Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D), Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM), and Coronary Artery Revascularisation in Diabetes (CARDia)-will answer many of the remaining questions. Still, the best treatment includes lifestyle modification and early prevention strategies with global risk reduction. (c) 2007 Elsevier Inc. All rights reserved. C1 Brooke Army Med Ctr, Ft Sam Houston, TX 78234 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. RP Chilton, RJ (reprint author), S Texas Vet Hlth Care Syst, 7400 Merton Minter Dr, San Antonio, TX 78229 USA. EM Chilton@uthscsa.edu NR 55 TC 11 Z9 15 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD FEB 19 PY 2007 VL 99 IS 4A SU S BP 105B EP 112B DI 10.1016/j.amjcard.2006.11.024 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 143FR UT WOS:000244705900012 PM 17307063 ER PT J AU Ghosh-Choudhury, N Mandal, CC Choudhury, GG AF Ghosh-Choudhury, Nandini Mandal, Chandi Charan Choudhury, Goutam Ghosh TI Statin-induced Ras activation integrates the phosphatidylinositol 3-kinase signal to Akt and MAPK for bone morphogenetic protein-2 expression in osteoblast differentiation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID COA REDUCTASE INHIBITORS; NF-KAPPA-B; BMP-2 GENE-TRANSCRIPTION; GROWTH-FACTOR RECEPTOR; TUMOR-SUPPRESSOR PTEN; MESANGIAL CELLS; RETINOBLASTOMA PROTEIN; TRANSDUCTION PATHWAY; MC3T3-E1 CELLS; DNA-SYNTHESIS AB Lovastatin promotes osteoblast differentiation by increasing bone morphogenetic protein-2 (BMP-2) expression. We demonstrate that lovastatin stimulates tyrosine phosphorylation of the p85 regulatory subunit of phosphatidylinositol 3-kinase (PI3K), leading to an increase in its kinase activity in osteoblast cells. Inhibition of PI3K ameliorated expression of the osteogenic markers alkaline phosphatase, type I collagen, osteopontin, and BMP-2. Expression of dominant-negative PI3K and PTEN, an inhibitor of PI3K signaling, significantly attenuated lovastatin-induced transcription of BMP-2. Akt kinase was also activated in a PI3K-dependent manner. However, our data suggest involvement of an additional signaling pathway. Lovastatin-induced Erk1/2 activity contributed to BMP-2 transcription. Inhibition of PI3K abrogated Erk1/2 activity in response to lovastatin, indicating the presence of a signal relay between them. We provide, as a mechanism of this cross-talk, the first evidence that lovastatin stimulates rapid activation of Ras, which associates with and activates PI3K in the plasma membrane, which in turn regulates Akt and Erk1/2 to induce BMP-2 expression for osteoblast differentiation. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Geriatr Res Educ & Clin Ctr, San Antonio, TX 78229 USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM choudhury@uthscsa.edu FU NIAMS NIH HHS [R01 AR52425] NR 51 TC 83 Z9 87 U1 1 U2 5 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 16 PY 2007 VL 282 IS 7 BP 4983 EP 4993 DI 10.1074/jbc.M606706200 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 140CX UT WOS:000244482000081 PM 17179158 ER PT J AU Sharafkhaneh, A Babb, TG Officer, TM Hanania, NA Sharafkhaneh, H Boriek, AM AF Sharafkhaneh, Arnir Babb, Tony G. Officer, Todd M. Hanania, Nicholas A. Sharafkhaneh, Hossein Boriek, Aladin M. TI The confounding effects of thoracic gas compression on measurement of acute bronchodilator response SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article DE FEV1; chronic obstructive pulmonary disease; asthma; lung mechanics; albuterol ID EXPIRATORY FLOW; AIRWAY-OBSTRUCTION; VOLUME; PRESSURE; HYPERINFLATION; LIMITATION; RESISTANCE; DYNAMICS; LUNGS; PEAK AB Rationale: Improvement in FEV1 is a main endpoint in clinical trials assessing the efficacy of bronchodilators. However, the effect of bronchodilators on maximal expiratory flow may be confounded by thoracic gas compression (TGC). Objective: To determine whether TGC confounds effect of albuterol on FEV1. Methods: We evaluated the response to albuterol inhalation in 10 healthy subjects, 9 subjects with asthma, and 15 subjects with chronic obstructive pulmonary disease (COPD) with mean (SD) age in years of 38 (SD, 11), 45 (SD, 11), and 64 (SD, 8), respectively. Lung mechanics were measured at baseline and 20 minutes after inhalation of 180 mu g of albuterol. We then applied a novel method to calculate FEV1 corrected for the effect of TGC (NFEV1). Results: Prior to albuterol administration, NFEV1 was significantly higher than FEV1. However, post-albuterol inhalation, FEV1 increased more than NFEV1 because of reduced TGC. In multiple regression analysis, the changes in TGC, inspiratory lung resistance, and ratio of residual volume to total lung capacity postalbuterol predicted more than 75% of FEV1 improvement in patients with COPD. Conclusion: Improvements in FEV1 after albuterol in patients with COPD are due to reduction of lung resistance, hyperinflation, and TGC. The latter is negligible during tidal breathing. Thus, although reduction of lung resistance and hyperinflation may result in improved dyspnea with a bronchodilator, the contribution of TGC reduction to improvement of FEV1 may not exert any meaningful clinical effect during tidal breathing. This fact has to be taken into consideration when assessing the efficacy of new bronchodilators. C1 Baylor Coll Med, VAMC, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Univ Texas, SW Med Ctr, Dallas, TX USA. RP Sharafkhaneh, A (reprint author), Baylor Coll Med, VAMC, Bldg 100 111i,2002 Holcombe Blvd, Houston, TX 77030 USA. EM amirs@bcm.tmc.edu FU NHLBI NIH HHS [HL-072839] NR 24 TC 17 Z9 17 U1 0 U2 0 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 15 PY 2007 VL 175 IS 4 BP 330 EP 335 DI 10.1164/rccm.200602-255OC PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 136ZW UT WOS:000244263600008 PM 17110648 ER PT J AU Guzman-Clark, JRS Fang, MA Sehl, ME Traylor, L Hahn, TJ AF Guzman-Clark, Jenice Ria S. Fang, Meika A. Sehl, Mary E. Traylor, Laural Hahn, Theodore J. TI Barriers in the management of glucocorticoid-induced osteoporosis SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE glucocorticoids; osteoporosis; veterans ID PRIMARY-CARE; CONTROLLED-TRIAL; OLDER PATIENTS; PREVENTION; FRACTURE; RECOMMENDATIONS; GUIDELINES; RISK AB Objective. To determine present practice for the management of glucocorticoid-induced osteoporosis (GIOP) in veterans; to characterize provider knowledge, beliefs, and practice behaviors regarding management of GIOP; and to identify potential barriers and interventions in the management of GIOP. Methods. To characterize current management of GIOP in an academic veterans administration medical center, we conducted a retrospective chart review of 100 patients who were prescribed a 90-day supply of prednisone. To assess clinicians' knowledge of GIOP clinical guidelines and perceptions of GIOP management, primary care clinicians and subspecialists completed a questionnaire and participated in focus groups. Results. Chart review revealed that only 32 of 100 patients receiving long-term glucocorticoid treatment underwent bone mineral density testing, and only 32 patients were prescribed the recommended calcium supplements. Of the 23 providers who completed the questionnaire and participated in the focus groups, 4 correctly identified both the dose and duration of glucocorticoid use at which GIOP prevention measures should be instituted. Common GIOP management barriers cited by participants were lack of knowledge, having limited time during the clinic visit to address all problems, patient nonadherence, and system problems. The most commonly mentioned potential interventions were the use of computerized clinical reminders and patient education. Conclusion. Clinicians frequently do not follow recommended guidelines for the management of GIOP. Improving the management of GIOP will likely require a fundamental redesigning of care processes for this disorder in order to overcome provider, patient-related, and system barriers. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Guzman-Clark, JRS (reprint author), VA Greater Los Angeles Healthcare Syst, GRECC 11G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jenice.guzman@med.va.gov NR 35 TC 23 Z9 24 U1 0 U2 5 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 FEB 15 PY 2007 VL 57 IS 1 BP 140 EP 146 DI 10.1002/art.22462 PG 7 WC Rheumatology SC Rheumatology GA 135EY UT WOS:000244138100020 PM 17266078 ER PT J AU Hansen, JE Fischer, LK Chan, G Chang, SS Baldwin, SW Aragon, RJ Carter, JJ Lilly, M Nishimura, RN Weisbart, RH Reeves, ME AF Hansen, James E. Fischer, Laurice K. Chan, Grace Chang, Sophia S. Baldwin, Scott W. Aragon, Robert J. Carter, Jacqueline J. Lilly, Michael Nishimura, Robert N. Weisbart, Richard H. Reeves, Mark E. TI Antibody-mediated p53 protein therapy prevents liver metastasis in vivo SO CANCER RESEARCH LA English DT Article ID CANCER-CELLS; HIV-1 TAT; TRANSDUCTION; DELIVERY; IMMUNOGLOBULIN; INDUCTION; TOLERANCE; PEPTIDE; NEURONS; BRAIN AB To evaluate the clinical efficacy of monoclonal antibody (mAb) 3E10 Fv antibody-mediated p53 protein therapy, an Fv-p53 fusion protein produced in Pichia pastoris was tested on CT26.CL25 colon cancer cells in vitro and in vivo in a mouse model of colon cancer metastasis to the liver. In vitro experiments showed killing of CT26.CL25 cells by Fv-p53 but not Fv or p53 alone, and immunohistochemical staining confirmed that Fv was required for transport of p53 into cells. Prevention of liver metastasis in vivo was tested by splenic injection of 100 nmol/L Fv-p53 10 min and I week after injection of CT26.CL25 cancer cells into the portal vein of BALB/c mice. Mice were sacrificed I week after the second injection of Fv-p53 and assigned a quantitative metastasis score. Control mice had an average metastasis score of 3.3 +/- 1.3, whereas mice treated with Fv-p53 had an average metastasis score of 0.8 +/- 0.4 (P = 0.004). These results indicate that Fv-p53 treatment had a profound effect on liver metastasis and represent the first demonstration of effective full-length p53 protein therapy in vivo. mAb 3E10 Fv has significant clinical potential as a mediator of intraceflular and intranuclear delivery of p53 for prevention and treatment of cancer metastasis. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. Loma Linda Vet Affairs Med Ctr, Loma Linda, CA USA. Loma Linda Univ, Loma Linda, CA 92350 USA. Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Weisbart, RH (reprint author), Vet Affairs Med Ctr, 111S,16111 Plummer St, Sepulveda, CA 91343 USA. EM rweisbar@ucla.edu NR 20 TC 25 Z9 27 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 15 PY 2007 VL 67 IS 4 BP 1769 EP 1774 DI 10.1158/0008-5472.CAN-06-3783 PG 6 WC Oncology SC Oncology GA 137JP UT WOS:000244289200045 PM 17308119 ER PT J AU Lavery, LA Armstrong, DG Murdoch, DP Peters, EJG Lipsky, BA AF Lavery, Lawrence A. Armstrong, David G. Murdoch, Douglas P. Peters, Edgar J. G. Lipsky, Benjamin A. TI Validation of the Infectious Diseases Society of America's diabetic foot infection classification system SO CLINICAL INFECTIOUS DISEASES LA English DT Editorial Material ID ULCER CLASSIFICATION; RISK; AMPUTATION; DIAGNOSIS; SCORE AB longitudinal study of 1666 persons with diabetes, there was an observed trend toward an increased risk for amputation (chi(2) test for trend, 108.0; P <.001), higher-level amputation (chi(2) test for trend, 113.3;), and lower P < .001 extremity-related hospitalization (chi(2) test for trend, 118.6;) with increasing infection severity. The Infectious P < .001 Diseases Society of America's foot infection classification system may be a useful tool for grading foot infections. C1 Texas A&M Univ, Hlth Sci Ctr, Scott & White Hosp, Dept Surg,Coll Med, Temple, TX 76508 USA. Rosalind Franklin Univ Med & Sci, Scholls Ctr Lower Extrem Ambulatory Res, CLEAR, N Chicago, IL USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Leiden Univ, Med Ctr, Dept Internal Med, NL-2300 RA Leiden, Netherlands. Leiden Univ, Med Ctr, Dept Infect Dis, NL-2300 RA Leiden, Netherlands. RP Lavery, LA (reprint author), 703 Highland Spring Ln, Georgetown, TX 78628 USA. EM llavery@swmail.sw.org RI Lipsky, Benjamin/B-4645-2013; Peters, Edgar /B-7790-2014 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 24 TC 110 Z9 121 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 FEB 15 PY 2007 VL 44 IS 4 BP 562 EP 565 DI 10.1086/511036 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 127PB UT WOS:000243597700017 PM 17243061 ER PT J AU Moeller, PDR Beauchesne, KR Huncik, KM Davis, WC Christopher, SJ Riggs-Gelasco, P Gelasco, AK AF Moeller, Peter D. R. Beauchesne, Kevin R. Huncik, Kevin M. Davis, W. Clay Christopher, Steven J. Riggs-Gelasco, Pamela Gelasco, Andrew K. TI Metal complexes and free radical toxins produced by Pfiesteria piscicida SO ENVIRONMENTAL SCIENCE & TECHNOLOGY LA English DT Article ID PRYMNESIUM PARVUM CARTER; ALGAL TOXINS; MASS-SPECTROMETRY; DOMOIC ACID; SPIN-TRAP; TOXICITY; ASSAY; ICHTHYOTOXIN; SHUMWAYAE; GROWTH AB Metal-containing organic toxins produced by Pfiesteria piscicida were characterized, for the first time, by corroborating data obtained from five distinct instrumental methods: nuclear magnetic resonance spectroscopy (NMR), inductively coupled plasma mass spectrometry (ICP-MS), liquid chromatography particle beam glow discharge mass spectrometry (LC/PB-GDMS), electron paramagnetic resonance spectroscopy (EPR), and X-ray absorption spectroscopy (XAS). The high toxicity of the metal-containing toxins is due to metal-mediated free radical production. This mode of activity explains the toxicity of Pfiesteria, as well as previously reported difficulty in observing the molecular target, due to the ephemeral nature of radical species. The toxins are highly labile in purified form, maintaining activity for only 2-5 days before all activity is lost. The multiple toxin congeners in active extracts are also susceptible to decomposition in the presence of white light, pH variations, and prolonged heat. These findings represent the first formal isolation and characterization of a radical forming toxic organic-ligated metal complex isolated from estuarine/marine dinoflagellates. These findings add to an increased understanding regarding the active role of metals interacting with biological systems in the estuarine environment, as well as their links and implications to human health. C1 Natl Ocean & Atmospher Adm, Natl Ocean Serv, Hollings Marine Lab, Toxin Nat Prod Chem Program,Ctr Coastal Environm, Charleston, SC 29412 USA. Natl Inst Stand & Technol, Hollings Marine Lab, Charleston, SC 29412 USA. Coll Charleston, Dept Chem, Charleston, SC 29424 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Columbia, SC 29425 USA. Ralph H Johnson VA Med Ctr, Res Serv, Charleston, SC 29425 USA. RP Moeller, PDR (reprint author), Natl Ocean & Atmospher Adm, Natl Ocean Serv, Hollings Marine Lab, Toxin Nat Prod Chem Program,Ctr Coastal Environm, Charleston, SC 29412 USA. EM Peter.Moeller@noaa.gov FU NCRR NIH HHS [P20 RR-016461, RR13656]; NIDDK NIH HHS [DK059950] NR 57 TC 29 Z9 30 U1 2 U2 23 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0013-936X J9 ENVIRON SCI TECHNOL JI Environ. Sci. Technol. PD FEB 15 PY 2007 VL 41 IS 4 BP 1166 EP 1172 DI 10.1021/es0617993 PG 7 WC Engineering, Environmental; Environmental Sciences SC Engineering; Environmental Sciences & Ecology GA 135NZ UT WOS:000244161600020 PM 17598275 ER PT J AU Suntsova, N Guzman-Marin, R Kumar, S Alam, MN Szymusiak, R McGinty, D AF Suntsova, Natalia Guzman-Marin, Ruben Kumar, Sunil Alam, Md. Noor Szymusiak, Ronald McGinty, Dennis TI The median preoptic nucleus reciprocally modulates activity of arousal-related and sleep-related neurons in the perifornical lateral hypothalamus SO JOURNAL OF NEUROSCIENCE LA English DT Article DE perifornical lateral hypothalamus; median preoptic nucleus; electrical stimulation; microdialysis; neuronal activity; sleep-waking cycle ID MELANIN-CONCENTRATING HORMONE; WAKING DISCHARGE PATTERNS; C-FOS EXPRESSION; OREXIN NEURONS; POSTERIOR HYPOTHALAMUS; OREXIN/HYPOCRETIN NEURONS; PARAVENTRICULAR NUCLEUS; PREFRONTAL CORTEX; GABAERGIC CONTROL; CORTICAL-NEURONS AB The perifornical-lateral hypothalamic area (PF/LH) contains neuronal groups playing an important role in control of waking and sleep. Among the brain regions that regulate behavioral states, one of the strongest sources of projections to the PF/LH is the median preoptic nucleus (MnPN) containing a sleep-active neuronal population. To evaluate the role of MnPN afferents in the control of PF/LH neuronal activity, we studied the responses of PF/LH cells to electrical stimulation or local chemical manipulation of the MnPN in freely moving rats. Single-pulse electrical stimulation evoked responses in 79% of recorded PF/LH neurons. No cells were activated antidromically. Direct and indirect transynaptic effects depended on sleep-wake discharge pattern of PF/LH cells. The majority of arousal-related neurons, that is, cells discharging at maximal rates during active waking (AW) or during AW and rapid eye movement (REM) sleep, exhibited exclusively or initially inhibitory responses to stimulation. Sleep-related neurons, the cells with elevated discharge during non-REM and REM sleep or selectively active in REM sleep, exhibited exclusively or initially excitatory responses. Activation of the MnPN via microdialytic application of L-glutamate or bicuculline resulted in reduced discharge of arousal-related and in excitation of sleep-related PF/LH neurons. Deactivation of the MnPN with muscimol caused opposite effects. The results indicate that the MnPN contains subset(s) of neurons, which exert inhibitory control over arousal-related and excitatory control over sleep-related PF/LH neurons. We hypothesize that MnPN sleep-active neuronal group has both inhibitory and excitatory outputs that participate in the inhibitory control of arousal-promoting PF/LH mechanisms. C1 Vet Affairs Greater Los Angeles, Healthcare Syst, Res Serv 151A3, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Rostov State Univ, AB Kogan Res Inst Neurocybernet, Rostov Na Donu 344091, Russia. RP McGinty, D (reprint author), Vet Affairs Greater Los Angeles, Healthcare Syst, Res Serv 151A3, 16111 Plummer St, North Hills, CA 91343 USA. EM dmcginty@ucla.edu FU NHLBI NIH HHS [HL60296, P50 HL060296]; NIMH NIH HHS [MH47480, MH63323, R01 MH047480, R01 MH063323, R01 MH075076, R01 MH075076-03]; NINDS NIH HHS [NS-50939, R01 NS050939] NR 63 TC 50 Z9 53 U1 0 U2 3 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD FEB 14 PY 2007 VL 27 IS 7 BP 1616 EP 1630 DI 10.1523/JNEUROSCI.3498-06.2007 PG 15 WC Neurosciences SC Neurosciences & Neurology GA 136QQ UT WOS:000244239600014 PM 17301170 ER PT J AU Costanzo, MR Guglin, ME Saltzberg, MT Jessup, ML Bart, BA Teerlink, JR Jaski, BE Fang, JC Feller, ED Haas, GJ Anderson, AS Schollmeyer, MP Sobotka, PA AF Costanzo, Maria Rosa Guglin, Maya E. Saltzberg, Mitchell T. Jessup, Mariell L. Bart, Bradley A. Teerlink, John R. Jaski, Brian E. Fang, James C. Feller, Erika D. Haas, Garrie J. Anderson, Allen S. Schollmeyer, Michael P. Sobotka, Paul A. CA UNLOAD Trial Investigations TI Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID LEFT-VENTRICULAR DYSFUNCTION; RENAL-FUNCTION; OVERLOADED PATIENTS; BODY-FLUID; FUROSEMIDE; MORTALITY; DIAGNOSIS; REMOVAL; THERAPY; UPDATE AB Objectives This study was designed to compare the safety and efficacy of veno-venous ultrafiltration and standard intravenous diuretic therapy for hypervolemic heart failure (HF) patients. Background Early ultrafiltration may be an alternative to intravenous diuretics in patients with decompensated HF and volume overload. Methods Patients hospitalized for HF with >= 2 signs of hypervolemia were randomized to ultrafiltration or intravenous diuretics. Primary end points were weight loss and dyspnea assessment at 48 h after randomization. Secondary end points included net fluid loss at 48 h, functional capacity, HF rehospitalizations, and unscheduled visits in 90 days. Safety end points included changes in renal function, electrolytes, and blood pressure. Results Two hundred patients (63 +/- 15 years, 69% men, 71% ejection fraction <= 40%) were randomized to ultrafiltration or intravenous diuretics. At 48 h, weight (5.0 +/- 3.1 kg vs. 3.1 +/- 3.5 kg; p = 0.001) and net fluid loss (4.6 vs. 3.3 l; p = 0.001) were greater in the ultrafiltration group. Dyspnea scores were similar. At 90 days, the ultrafiltration group had fewer patients rehospitalized for HF (16 of 89 [18%] vs. 28 of 87 [32%]; p = 0.037), HF rehospitalizations (0.22 +/- 0.54 vs. 0.46 +/- 0.76; p = 0.022), rehospitalization days (1.4 +/- 4.2 vs. 3.8 +/- 8.5; p = 0.022) per patient, and unscheduled visits (14 of 65 [21%] vs. 29 of 66 [44%]; p = 0.009). No serum creatinine differences occurred between groups. Nine deaths occurred in the ultrafiltration group and 11 in the diuretics group. Conclusions In decompensated HF, ultrafiltration safely produces greater weight and fluid loss than intravenous diuretics, reduces 90-day resource utilization for HIP, and is an effective alternative therapy. C1 Midw Heart Fdn, Lombard, IL USA. Wayne State Univ, John D Dingell VA Med Ctr, Dept Med, Div Cardiol, Detroit, MI 48202 USA. Univ Penn, Dept Med, Div Cardiol, Philadelphia, PA 19104 USA. Hennepin Cty Med Ctr, Dept Med, Div Cardiol, Minneapolis, MN 55415 USA. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Sharp Mem Hosp & Rehabil Ctr, San Diego Cardiac Ctr, San Diego, CA 90034 USA. Harvard Univ, Brigham & Womens Hosp, Dept Med, Div Cardiol, Boston, MA 02115 USA. Univ Maryland, Dept Med, Div Cardiol, College Pk, MD 20742 USA. Ohio State Univ, Div Cardiovasc Med, Columbus, OH 43210 USA. Univ Chicago, Dept Med, Div Cardiol, Chicago, IL 60637 USA. CHF Solut, Brooklyn Pk, MN USA. RP Costanzo, MR (reprint author), Edward Heart Hosp, Midw Heart Fdn, 4th Floor,801 S Washington St,POB 3226, Naperville, IL 60566 USA. EM mcostanzo@midwestheart.com RI Teerlink, John/D-2986-2012 OI Guglin, Maya/0000-0001-5746-3135 NR 26 TC 407 Z9 449 U1 5 U2 17 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 13 PY 2007 VL 49 IS 6 BP 675 EP 683 DI 10.1016/j.jacc.2006.07.073 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 137TO UT WOS:000244315300005 PM 17291932 ER PT J AU Persson, H Lonn, E Edner, M Baruch, L Lang, CC Morton, JJ Ostergren, J McKelvie, RS AF Persson, Hans Lonn, Eva Edner, Magnus Baruch, Lawrence Lang, Chim C. Morton, John J. Ostergren, Jan McKelvie, Robert S. CA Investigators CHARM Echocardiograp TI Diastolic dysfunction in heart failure with preserved systolic function: Need for objective evidence - Results from the CHARM echocardiographic Substudy CHARMES SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID LEFT-VENTRICULAR HYPERTROPHY; NATRIURETIC PEPTIDES; DOPPLER-ECHOCARDIOGRAPHY; ATRIAL-FIBRILLATION; NONINVASIVE ASSESSMENT; POPULATION; ABNORMALITIES; HYPERTENSION; CANDESARTAN; PRESSURES AB Objectives We tested the hypothesis that diastolic dysfunction (DD) was an important predictor of cardiovascular (CV) death or heart failure (HF) hospitalization in a subset of patients (ejection fraction [EF] > 40%) in the CHARM-Preserved study. Background More than 40% of hospitalized patients with HF have preserved systolic function (HF-PSF), suggesting that DD may be responsible for the clinical manifestations of HF. Methods Patients underwent Doppler echocardiographic examination that included assessment of pulmonary venous flow or determination of plasma NT-pro-brain natriuretic peptide >= 14 months after randomization to candesartan or placebo. The patients were classified into 1 of 4 diastolic function groups: normal, relaxation abnormality (mild dysfunction), pseudonormal (moderate dysfunction), and restrictive (severe dysfunction). Results There were 312 patients in the study, mean age was 66 +/- 11 years, EF was 50 +/- 10%, and 34% were women. The median follow-up was 18.7 months. Diastolic dysfunction was found in 67% of classified patients (n = 293), and moderate and severe DD were identified in 44%. Moderate and severe DD had a poor outcome compared with normal and mild DD (18% vs. 5%, p < 0.01). Diastolic dysfunction, age, diabetes, previous HF, and atrial fibrillation were univariate predictors of outcome. In multivariate analysis, moderate (hazard ratio [HR] 3.7, 95% confidence interval [CI] 1.2 to 11.1) and severe DD (HR 5.7, 95% CI 1.4 to 24.0) remained the only independent predictors (p = 0.003). Conclusions Objective evidence of DD was found in two-thirds of HF-PSF patients. Moderate and severe DD, which were found in less than one-half of the patients, were important predictors of adverse outcome. The results demonstrate the prognostic significance and need for objective evidence of DD in HF-PSF patients. C1 Danderyd Hosp, Dept Cardiol, Dept Clin Sci, Karolinska Inst, Stockholm, Sweden. Populat Hlth Res Inst, Hamilton, ON, Canada. McMaster Univ, Hamilton, ON L8S 4L8, Canada. Mt Sinai Sch Med, Bronx Vet Affairs Med Ctr, Bronx, NY USA. Univ Dundee, Ninewells Hosp & Med Sch, Dundee DD1 9SY, Scotland. Univ Glasgow, Western Infirm, Glasgow G11 6NT, Lanark, Scotland. Karolinska Univ Hosp, Dept Med, Stockholm, Sweden. RP Persson, H (reprint author), Danderyd Hosp, Dept Cardiol, Dept Clin Sci, Karolinska Inst, Stockholm, Sweden. EM hans.persson@ds.se NR 30 TC 145 Z9 152 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD FEB 13 PY 2007 VL 49 IS 6 BP 687 EP 694 DI 10.1016/j.jacc.2006.08.062 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 137TO UT WOS:000244315300007 PM 17291934 ER PT J AU Kimmel, SE Chen, Z Price, M Parker, CS Metlay, JP Christie, JD Brensinger, CM Newcomb, CW Samaha, FF Gross, R AF Kimmel, Stephen E. Chen, Zhen Price, Maureen Parker, Catherine S. Metlay, Joshua P. Christie, Jason D. Brensinger, Colleen M. Newcomb, Craig W. Samaha, Frederick F. Gross, Robert TI The influence of patient adherence on anticoagulation control with warfarin - Results from the International Normalized Ratio Adherence and Genetics (IN-RANGE) Study SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID ATRIAL-FIBRILLATION; ORAL ANTICOAGULANTS; STROKE PREVENTION; ELDERLY PATIENTS; THERAPY; COMPLICATIONS; OUTCOMES; ASPIRIN; RISK AB Background: Warfarin sodium is a highly efficacious drug, but proper levels of anticoagulation are difficult to maintain. Conflicting data exist on the influence of patient adherence on anticoagulation control. Methods: We performed a prospective cohort study at 3 anticoagulation clinics to determine the effect of adherence on anticoagulation control. Patients treated with warfarin with a target international normalized ratio of 2.0 to 3.0 were monitored with electronic Medication Event Monitoring System (MEMS) medication bottle caps. Detailed information was collected on other factors that might alter warfarin response. Results: Among 136 participants observed for a mean of 32 weeks, 92% had at least 1 missed or extra bottle opening; 36% missedmorethan 20% of their bottle openings; and 4% had more than 10% extra bottle openings. In multivariable analyses, there was a significant association between under adherence and underanticoagulation. For each 10% increase in missed pill bottle openings, there was a 14% increase in the odds of underanticoagulation (P <. 001); participants with more than 20% missed bottle openings(1-2 missed days each week) had more than a 2-fold increase in the odds of underanticoagulation (adjusted odds ratio, 2.10; 95% confidence interval, 1.48-2.96). Participants who had extra pill bottle openings on more than 10% of days had a statistically significant increase in over anticoagulation (adjusted odds ratio, 1.73; 95% confidence interval, 1.09-2.74). Conclusion: Patients have substantial difficulties maintaining adequate adherence with warfarin regimens, and this poor adherence has a significant effect on anticoagulation control. C1 Univ Penn, Sch Med, Dept Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Kimmel, SE (reprint author), Univ Penn, Sch Med, Dept Med, Ctr Clin Epidemiol & Biostat, 717 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM skimmel@cceb.med.upenn.edu FU AHRQ HHS [P01 HS 011530]; NHLBI NIH HHS [R01 HL 066176-04] NR 26 TC 133 Z9 141 U1 0 U2 7 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 12 PY 2007 VL 167 IS 3 BP 229 EP 235 DI 10.1001/archinte.167.3.229 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 135OP UT WOS:000244163200002 PM 17296877 ER PT J AU Glazer, NL Dublin, S Smith, NL French, B Jackson, LA Hrachovec, JB Siscovick, DS Psaty, BM Heckbert, SR AF Glazer, Nicole L. Dublin, Sascha Smith, Nicholas L. French, Benjamin Jackson, Lisa A. Hrachovec, Jennifer B. Siscovick, David S. Psaty, Bruce M. Heckbert, Susan R. TI Newly detected atrial fibrillation and compliance with antithrombotic guidelines SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper 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 ID ADJUSTED-DOSE WARFARIN; STROKE PREVENTION; ASPIRIN THERAPY; CLINICAL-TRIALS; RISK-FACTORS; ANTICOAGULATION; PREDICTORS; PATTERNS; EFFICACY; THROMBOEMBOLISM AB Background: Guidelines recommend the use of antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF), but compliance with such guidelines has not been widely studied among patients with newly detected AF. Our objective was to assess compliance with antithrombotic guidelines and to identify patient characteristics associated with warfarin use. Methods: A population-based study of newly detected AF (patient age, 30-84 years) was conducted within a large health plan. Cardiovascular disease risk factors, comorbid conditions, medication use, and international normalized ratios were abstracted from the medical record. Patients were stratified by embolic risk according to American College of Chest Physicians (ACCP) criteria. We analyzed the proportion of patients with AF receiving warfarin or aspirin (>= 325 mg/d) during the 6 months following AF. Relative risk regression estimated the association of risk factors and patient characteristics with warfarin use. Results: Overall, 73% of patients (418/572) with newly detected AF had evidence of antithrombotic use after AF onset. Among the 76% (437/572) of patients with AF at high risk for stroke, 59% (257/437) used warfarin, 28% (123/437) used aspirin, and 24% (104/437) used neither. The major predictor of warfarin use was AF classification; intermittent or sustained AF had relative risks for warfarin use of 2.8 (95% confidence interval, 2.23.6) and 2.9 ( 95% confidence interval, 2.2-3.7), respectively, compared with transitory AF. Conclusions: Three quarters of the patients with newly detected AF received antithrombotic therapy, yet many at high risk of stroke did not receive warfarin. Atrial fibrillation classification, rather than stroke risk factors, was strongly associated with warfarin use. C1 Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98101 USA. Univ Washington, Dept Biostat, Seattle, WA 98101 USA. Univ Washington, Dept Med, Seattle, WA 98101 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98101 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Glazer, NL (reprint author), Univ Washington, Cardiovasc Hlth Res Unit, 1730 Minor Ave,Suite 1360, Seattle, WA 98101 USA. EM nlg@u.washington.edu FU NHLBI NIH HHS [T32 HL 07902, HL 68639, HL 68986, HL 73410, HL 43201] NR 33 TC 92 Z9 95 U1 0 U2 1 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 12 PY 2007 VL 167 IS 3 BP 246 EP 252 DI 10.1001/archinte.167.3.246 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 135OP UT WOS:000244163200004 PM 17296879 ER PT J AU Singh, H Thomas, EJ Khan, MM Petersen, LA AF Singh, Hardeep Thomas, Eric J. Khan, Myrna M. Petersen, Laura A. TI Identifying diagnostic errors in primary care using an electronic screening algorithm SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 29th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 27-29, 2006 CL Los Angeles, CA SP Soc Gen Internal Med ID ADVERSE DRUG EVENTS; HOSPITALIZED-PATIENTS; MALPRACTICE CLAIMS; MEDICAL ERROR; RETURN VISITS; HEALTH-CARE; SURVEILLANCE; EMERGENCY; ACCIDENT AB Background: Diagnostic errors are the leading basis for malpractice claims in primary care, yet these errors are underidentified and understudied. Computerized methods used to screen for other types of errors (eg, medication related) have not been applied to diagnostic errors. Our objectives were to assess the feasibility of computerized screening to identify diagnostic errors in primary care and to categorize diagnostic breakdowns using a recently published taxonomy. Methods: We used an algorithm to screen the electronic medical records of patients at a single hospital that is part of a closed health care system. A Structured Query Language-based program detected the presence of 1 of 2 mutually exclusive electronic screening criteria: screen 1, a primary care visit ( index visit) followed by a hospitalization in the next 10 days; or screen 2, an index visit followed by 1 or more primary care, urgent care, or emergency department visits within 10 days. Two independent, blinded reviewers determined the presence or absence of diagnostic error through medical record review of visits with positive and negative screening results. Results: Among screen 1 and 2 positive visits, 16.1% and 9.4%, respectively, were associated with a diagnostic error. The error rate was 4% in control cases that met neither screening criterion. The most common primary errors in the diagnostic process were failure or delay in eliciting information and misinterpretation or suboptimal weighing of critical pieces of data from the history and physical examination. The most common secondary errors were suboptimal weighing or prioritizing of diagnostic probabilities and failure to recognize urgency of illness or its complications. Conclusions: Electronic screening has potential to identify records that may contain diagnostic errors in primary care, and its performance is comparable to screening tools for other types of errors. Future studies that validate these findings in other settings could provide improvement initiatives in this area. C1 Michael E DeBakey VA Med Ctr 152, Div Hlth Policy & Qual, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv, Houston, TX 77030 USA. Univ Texas, Sch Med, Dept Med, Div Gen Med, Houston, TX 77030 USA. Univ Texas, Ctr Excellence Patient Safety Res & Practice, Houston, TX 77030 USA. RP Singh, H (reprint author), Michael E DeBakey VA Med Ctr 152, Div Hlth Policy & Qual, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.tmc.edu FU AHRQ HHS [1P01 HS 11544-01]; NCRR NIH HHS [K12 RR 17665] NR 33 TC 52 Z9 52 U1 5 U2 7 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 12 PY 2007 VL 167 IS 3 BP 302 EP 308 DI 10.1001/archinte.167.3.302 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 135OP UT WOS:000244163200014 PM 17296888 ER PT J AU Shuster, E AF Shuster, Evelyne TI Microarray genetic screening: a prenatal roadblock for life? SO LANCET LA English DT Article ID DIAGNOSIS; DNA C1 Philadelphia Vet Affairs Med Ctr, Off Med Eth, Philadelphia, PA USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. RP Shuster, E (reprint author), Philadelphia Dept Vet Affairs, Univ & Woodland Ave, Philadelphia, PA 19104 USA. EM Evelyn.shuster@med.va.gov NR 31 TC 38 Z9 38 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0140-6736 J9 LANCET JI Lancet PD FEB 10 PY 2007 VL 369 IS 9560 BP 526 EP 529 DI 10.1016/S0140-6736(07)60239-6 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 135XX UT WOS:000244188300035 PM 17292772 ER PT J AU Page, ST Matsumoto, AM Bremner, WJ AF Page, Stephanie T. Matsumoto, Alvin M. Bremner, William J. TI DHEA and testosterone in the elderly SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter ID EXOGENOUS TESTOSTERONE; OLDER MEN; STRENGTH C1 Univ Washington, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Page, ST (reprint author), Univ Washington, Seattle, WA 98195 USA. EM page@u.washington.edu FU NIA NIH HHS [K23 AG027238-02, K23 AG027238] NR 6 TC 5 Z9 5 U1 0 U2 1 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 8 PY 2007 VL 356 IS 6 BP 635 EP 635 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 133KV UT WOS:000244012700020 PM 17287487 ER PT J AU Darouiche, RO AF Darouiche, Rabih O. TI Spinal epidural abscess - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Darouiche, RO (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. EM rdarouiche@aol.com NR 4 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 8 PY 2007 VL 356 IS 6 BP 638 EP 639 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 133KV UT WOS:000244012700028 ER PT J AU Kurella, M Covinsky, KE Collins, AJ Chertow, GM AF Kurella, Manjula Covinsky, Kenneth E. Collins, Alan J. Chertow, Glenn M. TI Octogenarians and nonagenarians starting dialysis in the United States SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID STAGE RENAL-DISEASE; REPLACEMENT THERAPY; CLINICAL-OUTCOMES; DECISION-MAKING; SURVIVAL; HEMODIALYSIS; INITIATION; COHORT; PREVALENCE; VALIDATION AB Background: The elderly constitute the fastest-growing segment of the end-stage renal disease (ESRD) population, but the epidemiology and outcomes of dialysis among the very elderly, that is, those 80 years of age and older, have not been previously examined at a national level. Objective: To describe recent trends in the incidence and outcomes of octogenarians and nonagenarians starting dialysis. Design: Observational study. Setting: U.S. Renal Data System, a comprehensive, national registry of patients with ESRD. Participants: Octogenarians and nonagenarians initiating dialysis between 1996 and 2003. Measurements: Rates of dialysis initiation and survival. Results: The number of octogenarians and nonagenarians starting dialysis increased from 7054 persons in 1996 to 13 577 persons in 2003, corresponding to an average annual increase in dialysis initiation of 9.8%. After we accounted for population growth, the rate of dialysis initiation increased by 57% (rate ratio, 1.57 [95% CI, 1.53 to 1.62]) between 1996 and 2003. One-year mortality for octogenarians and nonagenarians after dialysis initiation was 46%. Compared with octogenarians and nonagenarians initiating dialysis in 1996, those starting dialysis in 2003 had a higher glomerular filtration rate and less morbidity related to chronic kidney disease but no difference in 1-year survival. Clinical characteristics strongly associated with death were older age, nonambulatory status, and more comorbid conditions. Limitations: Survival of patients with incident ESRD who did not begin dialysis could not be assessed. Conclusions: The number of octogenarians and nonagenarians initiating dialysis has increased considerably over the past decade, while overall survival for patients on dialysis remains modest. Estimates of prognosis based on patient characteristics, when considered in conjunction with individual values and preferences, may aid in dialysis decision making for the very elderly. C1 Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. US Renal Data Syst, Minneapolis, MN USA. RP Kurella, M (reprint author), Univ Calif San Francisco, Div Nephrol, UCSF Laurel Heights,Suite 430,3333 Calif St, San Francisco, CA 94143 USA. EM manjula.kurella@ucsf.edu RI Kurella Tamura, Manjula/C-8284-2014 OI Kurella Tamura, Manjula/0000-0001-5227-2479 FU NIA NIH HHS [K24 AG029812]; NIDDK NIH HHS [R01 DK01005, R01 DK58411] NR 25 TC 279 Z9 293 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 6 PY 2007 VL 146 IS 3 BP 177 EP 183 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 132QN UT WOS:000243957400003 PM 17283348 ER PT J AU Garza, R Hudson, RA McMahan, CA Walter, CA Vogel, KS AF Garza, Rene Hudson, Robert A., III McMahan, C. Alex Walter, Christi A. Vogel, Kristine S. TI A mild mutator phenotype arises in a mouse model for malignancies associated with neurofibromatosis type 1 SO MUTATION RESEARCH-FUNDAMENTAL AND MOLECULAR MECHANISMS OF MUTAGENESIS LA English DT Article DE neurofibrornatosis type 1; mutant frequency; peripheral nerve sheath tumor; Big Blue mouse; p53 ID NERVE SHEATH TUMORS; LACI TRANSGENIC MICE; MULTIPLE MUTATIONS; HETEROZYGOUS MICE; FRAUMENI-SYNDROME; MUTANT MICE; DNA-DAMAGE; WILD-TYPE; P53; CANCER AB Defects in genes that control DNA repair, proliferation, and apoptosis can increase genomic instability, and thus promote malignant progression. Although most tumors that arise in humans with neurofibromatosis type 1 (NF1) are benign, these individuals are at increased risk for malignant peripheral nerve sheath tumors (MPNST). To characterize additional mutations required for the development of MPNST from benign plexiform neurofibromas, we generated a mouse model for these tumors by combining targeted null mutations in Nf1 and p53, in cis. CisNf1+/-; p53+/- mice spontaneously develop PNST, and these tumors exhibit loss-of-heterozygosity at both the Nf1 and p53 loci. Because p53 has well-characterized roles in the DNA damage response, DNA repair, and apoptosis, and because DNA repair genes have been proposed to act as modifiers in NF1, we used the cisNf1+/-; p53+/- mice to determine whether a mutator phenotype arises in NF1-associated malignancies. To quantitate spontaneous mutant frequencies (MF), we crossed the Big Blue mouse, which harbors a lacI transgene, to the cisNf1+/-; p53+/- mice, and isolated genomic DNA from both tumor and normal tissues in compound heterozygotes and wild-type siblings. Many of the PNST exhibited increased mutant frequencies (MF = 4.70) when compared to normal peripheral nerve and brain (MF = 2.09); mutations occurred throughout the entire lacI gene, and included base substitutions, insertions, and deletions. Moreover, the brains, spleens, and livers of these cisNf1+/-; p53+/- animals exhibited increased mutant frequencies when compared to tissues from wild-type littermates. We conclude that a mild mutator phenotype arises in the tumors and tissues of cisNf1+/-; p53+/- mice, and propose that genomic instability influences NF1 tumor progression and disease severity. (c) 2006 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, San Antonio, TX 78229 USA. RP Vogel, KS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM vogelk@uthscsa.edu NR 54 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0027-5107 J9 MUTAT RES-FUND MOL M JI Mutat. Res.-Fundam. Mol. Mech. Mutagen. PD FEB 3 PY 2007 VL 615 IS 1-2 BP 98 EP 110 DI 10.1016/j.mrfmmm.2006.11.031 PG 13 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology SC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology GA 133WP UT WOS:000244044900009 PM 17208258 ER PT J AU Mulky, A Vu, BC Conway, JA Hughes, SH Kappes, JC AF Mulky, Alok Vu, B. Christie Conway, Joan A. Hughes, Stephen H. Kappes, John C. TI Analysis of amino acids in the beta 7-beta 8 loop of human immunodeficiency virus type 1 reverse transcriptase for their role in virus replication SO JOURNAL OF MOLECULAR BIOLOGY LA English DT Article DE HIV-1; reverse transcriptase; reverse transcription ID TRYPTOPHAN-REPEAT MOTIF; CRYSTAL-STRUCTURE; PRIMER GRIP; NONNUCLEOSIDE INHIBITORS; ANGSTROM RESOLUTION; INFECTIOUS VIRIONS; TSAO DERIVATIVES; DNA-SYNTHESIS; P51 SUBUNIT; RNASE-H AB The HIV-1 p51/p66 reverse transcriptase (RT) heterodimer interface comprises, in part, intermolecular interaction of the loop region between beta-strands 7 and 8 (beta 7-beta 8 loop) in the p51 fingers subdomain with the p66 palm subdomain. In this study, for the first time in the context of infectious HIV-1 particles, we analyzed the contribution of amino acid residues (S134, I135, N136, N137, T139 and P140) in the beta 7-beta 8 loop for RT heterodimerization, enzymatic activity, and virus infectivity. Mutating asparagine 136 to alanine (N136A) reduced viral infectivity and enzyme activity dramatically. The N136A mutation appeared to destabilize the RT heterodimer and render both the p66 and p51 subunits susceptible to aberrant cleavage by the viral protease. Subunit-specific mutagenesis demonstrated that the presence of the N136A mutation in the p51 subunit alone was sufficient to cause degradation of RT within the virus particle. Alanine mutation at other residues of the beta 7-beta 8 loop did not affect either RT stability or virus infectivity significantly. None of the beta 7-beta 8 loop alanine mutations affected the sensitivity of virus to inhibition by NNRTIs. In the context of infectious virions, our results indicate a critical role of the p51 N136 residue within the beta 7-beta 8 loop for RT heterodimer stability and function. These findings suggest the interface comprising N136 in p51 and interacting residues in p66 as a possible target for rational drug design. (c) 2006 Published by Elsevier Ltd. C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. NCI, HIV Drug Resistance Program, Ft Detrick, MD 21702 USA. Birmingham Vet Affairs Med Ctr, Res Serv, Birmingham, AL 35233 USA. RP Kappes, JC (reprint author), Univ Alabama, Dept Med, Birmingham, AL 35294 USA. EM kappesjc@uab.edu FU Intramural NIH HHS; NIAID NIH HHS [P30 AI 27767, R01 AI 47714]; NIDDK NIH HHS [R24 DK 64400] NR 47 TC 11 Z9 12 U1 0 U2 2 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2836 J9 J MOL BIOL JI J. Mol. Biol. PD FEB 2 PY 2007 VL 365 IS 5 BP 1368 EP 1378 DI 10.1016/j.jmb.2006.10.089 PG 11 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 129SE UT WOS:000243749600011 PM 17141805 ER PT J AU Sherman, SE Fotiades, J Rubenstein, LV Gilman, SC Vivell, S Chaney, E Yano, EM Felker, B AF Sherman, Scott E. Fotiades, John Rubenstein, Lisa V. Gilman, Stuart C. Vivell, Susan Chaney, Edmund Yano, Elizabeth M. Felker, Bradford TI Teaching systems-based practice to primary care physicians to foster routine implementation of evidence-based depression care SO ACADEMIC MEDICINE LA English DT Article ID COLLABORATIVE CARE; OUTCOMES; VETERANS AB Although health care organizations seeking to improve quality often must change the system for delivering care, there is little available evidence on how to educate staff and providers about this change. As part of a 2002-2003 Veterans Health Administration multisite project using collaborative care to improve the management of depression, the authors implemented the Translating Initiatives for Depression into Effective Solutions (TIDES) program. Five steps were followed for teaching systems-based practice: (1) determine providers' educational needs (through administrative data, expert opinion, and provider discussion), (2) develop educational materials (based on needs assessed), (3) help each of seven sites develop an educational intervention, (4) implement the intervention, and (5) monitor the intervention's effectiveness. Sites relied primarily on passive educational strategies. There was variable implementation of the different components (e.g., lecture, educational outreach). No site chose to write up its education plan, as was suggested. The authors thus suggest that the educational model was successful at identifying providers' needs and creating appropriate materials, because the program was not advertised in other ways and because almost all providers referred patients to the program. However, the educational model was only partially successful at getting sites to develop and implement an educational plan, although provider behavior did change. Overall, the program was somewhat effective at teaching systems-based practice. The authors believe the best way to enhance effectiveness is to build education into the system rather than rely on a separate system for education. C1 VA New York Harbor Healthcare Syst, New York, NY 10010 USA. NYU, Sch Med, New York, NY USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Ctr Excellence Study Healthcare Provider Behav, Sepulveda, CA USA. James J Peters VA Med Ctr, Bronx, NY USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Corp, Hlth Program, Santa Monica, CA USA. Vet Hlth Adm, Off Acad Affilitat, Special Fellowships Program, Washington, DC USA. Univ Calif Irvine, Irvine, CA USA. Tulane Univ, New Orleans, LA 70118 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RP Sherman, SE (reprint author), VA New York Harbor Healthcare Syst, 111,423 E 23rd St, New York, NY 10010 USA. EM scott.sherman@va.gov OI Sherman, Scott/0000-0003-1752-7303 NR 28 TC 9 Z9 9 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-2446 J9 ACAD MED JI Acad. Med. PD FEB PY 2007 VL 82 IS 2 BP 168 EP 175 DI 10.1097/ACM.0b013e31802d9165 PG 8 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA 135HQ UT WOS:000244145100010 PM 17264696 ER PT J AU Prochaska, JJ Fromont, SC Banys, P Eisendrath, SJ Horowitz, MJ Jacobs, MH Hall, SM AF Prochaska, Judith J. Fromont, Sebastien C. Banys, Peter Eisendrath, Stuart J. Horowitz, Mardi J. Jacobs, Marc H. Hall, Sharon M. TI Addressing nicotine dependence in psychodynamic psychotherapy: Perspectives from residency training SO ACADEMIC PSYCHIATRY LA English DT Article ID COGNITIVE-BEHAVIORAL THERAPY; PRACTICE GUIDELINE; SMOKING; PSYCHIATRY; DEPRESSION; PREVALENCE; DISORDER; CANCER; RISK AB Objective: According to APA treatment recommendations, psychiatrists should assess and intervene in tobacco use with all of their patients who smoke. The ease with which this occurs may vary by treatment model. This study examined perspectives in residency training to identify a framework for addressing nicotine dependence within psychodynamic psychotherapy. Method: The authors collected data from a focus group of psychiatry residents and interviews with psychiatry residency faculty with expertise in psychodynamic psychotherapy. The transcribed interviews were analyzed for key themes and synthesized. Results: Though the residents reported hesitancy to address patients' tobacco use, specifically in psychodynamic psychotherapy, the consensus from the expert faculty consultants was that tobacco interventions can and should be incorporated. The faculty provided suggestions, consistent with a psychodynamic formulation, for assessing patients' tobacco use and their interest in quitting, providing cessation treatment and/or referrals, and following up with patients to address relapse. Conclusions: The findings provide a useful framework, consistent with a psychodynamic model, for assessing and treating tobacco use with patients. Additional training and supervision likely are needed to increase residents' confidence and comfort with implementing these strategies. C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Alta Bates Summit Med Ctr, Berkeley, CA USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. RP Prochaska, JJ (reprint author), 401 Parnassus Ave,TRC 0984, San Francisco, CA 94143 USA. EM JProchaska@lppi.ucsf.edu FU NIDA NIH HHS [K05 DA016752, K23 DA018691, P50 DA009253, P50 DA09253]; NIMH NIH HHS [R25 MH060482] NR 24 TC 2 Z9 2 U1 2 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1042-9670 J9 ACAD PSYCHIATR JI Acad. Psych. PD FEB PY 2007 VL 31 IS 1 BP 8 EP 14 DI 10.1176/appi.ap.31.1.8 PG 7 WC Education & Educational Research; Psychiatry SC Education & Educational Research; Psychiatry GA 127PY UT WOS:000243600000003 PM 17242046 ER PT J AU Levine, RE Kelly, PA Karakoc, T Haidet, P AF Levine, Ruth E. Kelly, P. Adam Karakoc, Tayfun Haidet, Paul TI Peer evaluation in a clinical clerkship: Students' attitudes, experiences, and correlations with traditional assessments SO ACADEMIC PSYCHIATRY LA English DT Article ID TUTORIALS; RESIDENCY; RATINGS; SELF AB Objective: The authors performed this study to determine whether clerkship peer evaluations, initiated as part of our "team-based learning" curriculum in 2002, correlated with other student performance measures, and to determine what qualities students rate in their peer evaluations. Method: The authors correlated peer evaluation scores with other student performance measures and performed a qualitative examination of student comments to assess reasons students gave for giving high and low scores. Results: Peer evaluation scores correlated modestly with the National Board of Medical Examiners' (NBME) subject test, in-class quiz, and clinical scores. Qualitative comments demonstrated that students made assessments based on three thematic areas: personal attributes, team contributions, and cognitive abilities. Conclusions: Peers' evaluation scores modestly predict which students will perform well on other measures. However, there may be other qualities that are also important factors in peer evaluation. For example, most students value qualities of preparation and participation. Though students sometimes dislike peer evaluations, their assessments may enhance traditional course assessments and complement a comprehensive evaluation strategy. C1 Univ Texas, Med Branch, Dept Psychiat, Galveston, TX 77550 USA. Houseton Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. RP Levine, RE (reprint author), 301 Univ Blvd,Route 0193, Galveston, TX 77555 USA. EM rlevine@utmb.edu RI Herring, Anna/L-7859-2014; Karakoc, Tahir Hikmet/D-7087-2015 OI Karakoc, Tahir Hikmet/0000-0001-8182-8667 NR 21 TC 20 Z9 20 U1 0 U2 7 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1042-9670 J9 ACAD PSYCHIATR JI Acad. Psych. PD FEB PY 2007 VL 31 IS 1 BP 19 EP 24 DI 10.1176/appi.ap.31.1.19 PG 6 WC Education & Educational Research; Psychiatry SC Education & Educational Research; Psychiatry GA 127PY UT WOS:000243600000005 PM 17242048 ER PT J AU McChargue, DE Cook, JW AF McChargue, Dennis E. Cook, Jessica Werth TI Depression vulnerability within smoking research: How accurate are one-item screening items? SO ADDICTIVE BEHAVIORS LA English DT Article DE cigarette smoking; assessment; depression ID ANHEDONIA; HISTORY AB Epidemiological and large scale treatment studies within smoking research have utilized many one-item screening items to examine the influence of current depressive symptoms on smoking behavior and quitting. Little is known about that concurrent validity of screening items that may reflect depression vulnerability independent of current symptoms. The present paper evaluated the concurrent validity of two one-item screening items that were essential for diagnosing past episodes of major depression. Screening questions were administered to seventy-seven nicotine dependent participants via a telephone screening interview. Smokers then returned to the laboratory for a comprehensive structured assessment of depressive vulnerability. Vulnerability measures were clinician-diagnosed history of major depressive disorder and other self-reported depressive vulnerability factors. Telephone screening items accurately classified a clinician-diagnosed history of major depression, and predicted the number of recurrent depressive episodes, self-reported rumination, and self-reported depression-proneness (all p < 0.05). Results support the utility of one-item screening questions as a "proxy" of a depressive vulnerability for smoking treatment studies that are not designed for comprehensive assessment procedures. (c) 2006 Elsevier Ltd. All rights reserved. C1 Univ Nebraska, Lincoln, NE 68588 USA. Univ Illinois, Chicago, IL USA. VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA USA. RP McChargue, DE (reprint author), Univ Nebraska, 238 Burnett Hall,POB 880308, Lincoln, NE 68588 USA. EM dmcchargue2@unl.edu FU NIDA NIH HHS [DA00467, DA14144] NR 12 TC 19 Z9 19 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4603 J9 ADDICT BEHAV JI Addict. Behav. PD FEB PY 2007 VL 32 IS 2 BP 404 EP 409 DI 10.1016/j.addbeh.2006.05.006 PG 6 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 128OM UT WOS:000243667200020 PM 16854531 ER PT J AU Morfin, JP Kulig, C Everson, G Beresford, T AF Morfin, John-Paul Kulig, Clark Everson, Gregory Beresford, Thomas TI Controlling for serum albumin level improves the correlation between serum fatty acid ethyl esters and blood ethanol level SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE fatty acid ethyl esters (FAEEs); ethanol; albumin ID HEPG2 CELLS; MARKERS; LIPOPROTEINS; CONSUMPTION; PLASMA AB Background: Fatty acid ethyl esters (FAEEs) are generated by the nonoxidative metabolism of alcohol and correlate positively with blood alcohol levels (BAL). As FAEEs are produced predominantly in the liver and bind to albumin in plasma, blood FAEE concentrations may be affected by serum albumin levels. The aim of this exploratory study was to define the relationship of FAEE levels with BAL after adjustment for serum albumin concentration. Methods: Fatty acid ethyl ester, BAL, and albumin concentrations were measured from de-identified, ethanol-containing serum samples (N=18). The assay focused on 3 FAEE species ethyl palmitate, ethyl stearate, and ethyl oleate. The relationships of individual and total FAEE concentrations with BAL using albumin as a covariate were analyzed. Values for Pearson's r between the BAL and the natural log-transformed FAEE (ln FAEE) levels were calculated, and then compared with partial correlation coefficients when controlling for albumin. The impact of serum albumin levels on the relationship between ln FAEE and BAL was evaluated by simple linear regression analysis. Results: Concentrations of total FAEE ranged from 632 to 20,166 nM, and BAL ranged from 9 to 375 mg/dL. In the 18 samples, the Pearson correlation coefficient between BAL and total FAEE levels was 0.868, and increased to 0.909 when controlling for albumin (p < 0.0001). Similar statistically significant increases in the partial correlation coefficient occurred for each of the individual species of FAEE when controlling for albumin. In simple linear regression, albumin significantly reduced the variability in the model correlating BAL and FAEE for each of the individual species, as well as for total FAEE. Conclusions: The association between FAEE levels and BAL is enhanced by consideration of serum albumin concentrations. Our findings suggest that serum albumin should be included in any model attempting to define the relationship between BAL and FAEE. C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver, CO 80262 USA. Univ Colorado, Dept Psychiat, Denver, CO 80262 USA. Denver VA Med Ctr, Div Gastroenterol & Hepatol, Denver, CO USA. Univ Colorado, Div Gastroenterol & Hepatol, Hlth Sci Ctr, Denver, CO 80202 USA. RP Morfin, JP (reprint author), Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, 4200 E 9th Ave, Denver, CO 80262 USA. EM john-paul.morfin@uchsc.edu NR 19 TC 2 Z9 2 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD FEB PY 2007 VL 31 IS 2 BP 265 EP 268 DI 10.1111/j.1530-0277.2006.00302.x PG 4 WC Substance Abuse SC Substance Abuse GA 128QW UT WOS:000243674200011 PM 17250618 ER PT J AU Groeneveld, PW Kruse, GB Chen, Z Asch, DA AF Groeneveld, Peter W. Kruse, Gregory B. Chen, Zhen Asch, David A. TI Variation in cardiac procedure use and racial disparity among Veterans Affairs Hospitals SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; HEALTH-CARE-SYSTEM; DIFFUSION; MORTALITY; CATHETERIZATION; TECHNOLOGY; OUTCOMES; TRENDS; IMPACT; RACE AB Background Lower or less racially equitable cardiac procedure rates at Veterans Affairs medical centers (VAMCs) with larger minority populations may be sources of racial disparities. This study's objectives were to determine if VAMCs with higher proportions of black inpatients performed fewer cardiac procedures or had larger racial differences in procedure rates than predominantly white VAMCs. Methods We identified 87536 potential candidates for bioprosthetic aortic valve replacement, 50517 for implanted card ioverter/defi brillator (ICD), 92 292 for dual-chambered pacemaker (DCP), and 70 269 for percutaneous coronary intervention (PCI) hospitalized between 1998 and 2003. Multivariate regression models were fitted that controlled for patients' demographic and clinical characteristics as well as hospital factors such as academic affiliation and inpatient racial composition. Racial differences in procedure rates both across and within hospital-level classifications were examined. Results Across VA hospital types, there were few significant differences in adjusted procedure rates at VAMCs with larger compared with smaller black inpatient populations. Conversely, within-hospital estimates of black versus white procedure use indicated VAMCs with > 30% black inpatients had greater racial differences compared to predominantly white VAMCs (adjusted black-white odds ratios of 0.45 vs 0.81 for aortic valve replacement [P =.07], 0.54 vs.0.85 for DCPs [ P < .001], 0.54 vs 0.65 for ICDs [ P =.301, and 0.69 vs 0.86 for PCI [P =.01].) Conclusions Although VAMCs with larger black inpatient populations performed cardiac procedures at similar rates as predominantly white VAMCs, racial differences in procedures were greater within VAMCs with larger black populations. Improving equity at VAMCs with larger minority populations is critical to achieving systemwide health care equality. C1 Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. RP Groeneveld, PW (reprint author), 1229 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM peter.groeneveld@va.gov OI Asch, David/0000-0002-7970-286X NR 23 TC 17 Z9 17 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD FEB PY 2007 VL 153 IS 2 BP 320 EP 327 DI 10.1016/j.ahj.2006.10.032 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 133XQ UT WOS:000244047600027 PM 17239696 ER PT J AU Schillerstrom, JE Rickenbacker, D Joshi, KG Royall, DR AF Schillerstrom, Jason E. Rickenbacker, Denae Joshi, Kaustubh G. Royall, Donald R. TI Executive function and capacity to consent to a noninvasive research protocol SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE decision-making capacity; competency; executive function; cognition ID MACCAT-T; COMPETENCE AB Objective: This study measured the association between executive function and decision-making capacity in subjects consenting to a noninvasive research protocol. Method: Subjects consenting to a noninvasive research protocol (N = 21; mean age: 65.5 [standard deviation: 9.2] years) were administered a modified version of The MacArthur Competency Assessment Tool-Treatment (MacCAT-T), Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX), and Mini-Mental State Examination (MMSE). Results: The EXIT25 was the only instrument to correlate with each decision-making capacity domain: understanding, appreciation, and reasoning. Conclusions: Executive function as measured by the EXIT25 is associated with multiple decision-making capacity domains. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Wilford Hall USAF Med Ctr, Dept Psychiat, Lackland AFB, TX 78236 USA. S Texas Vet Hlth Syst, Audie L Murphy Div GRECC, San Antonio, TX USA. RP Schillerstrom, JE (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM schillerstr@uthscsa.edu NR 10 TC 11 Z9 11 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD FEB PY 2007 VL 15 IS 2 BP 159 EP 162 DI 10.1097/01.JGP.0000249392.10426.c6 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 136HF UT WOS:000244212500009 PM 17272736 ER PT J AU Hayden, KM Welsh-Bohmer, KA Wengreen, HJ Zandi, PP Lyketsos, CG Breitner, JCS AF Hayden, Kathleen M. Welsh-Bohmer, Kathleen A. Wengreen, Heidi J. Zandi, Peter P. Lyketsos, Constantine G. Breitner, John C. S. CA Cache County Investigators TI Risk of mortality with vitamin E supplements: The Cache County Study SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE vitamin E; mortality; cardiovascular disease; cohort study; proportional hazards; survival analysis ID RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; CARDIOVASCULAR-DISEASE; NITRATE TOLERANCE; ALL-CAUSE; ANTIOXIDANT; EVENTS; TOCOPHEROL; HEALTH; CANCER AB PURPOSE: A recent meta-analysis reported increased mortality in clinical trial participants randomized to high-dose vitamin E. We sought to determine whether these mortality risks with vitamin E reflect adverse consequences of its use in the presence of cardiovascular disease. METHODS: In a defined population aged 65 years or older, baseline interviews captured self- or proxy-reported history of cardiovascular illness. A medicine cabinet inventory verified nutritional supplement and medication use. Three sources identified subsequent deaths. Cox proportional hazards methods examined the association between vitamin E use and mortality. RESULTS: After adjustment for age and sex, there was no association in this population between vitamin E use and mortality (adjusted hazard ratio [aHR] 0.93; 95% confidence interval [CI], 0.74-1.15). Predictably, deaths were more frequent with a history of diabetes, stroke, coronary artery bypass graft surgery, or myocardial infarction, and with the use of warfarin, nitrates, or diuretics. None of these conditions or treatments altered the null main effect with vitamin E, but mortality was increased in vitamin E users who had a history of stroke (aHR 3.64; CI, 1.73-7.68), coronary bypass graft surgery (aHR 4.40; CI, 2.83-6.83), or myocardial infarction (aHR 1.95; CI, 1.29-2.95) and, independently, in those taking nitrates (aHR 3.95; CI, 2.04-7.65), warfarin (aHR 3.71; CI, 2.22-6.21), or diuretics (aHR 1.83;CI, 1.35-2.49). Although not definitive, a consistent trend toward reduced mortality was seen in vitamin E users without these conditions or treatments. CONCLUSIONS: In this population-based study, vitamin E use was unrelated to mortality, but this apparently null finding seems to represent a combination of increased mortality in those with severe cardiovascular disease and a possible protective effect in those without. (c) 2007 Elsevier Inc. All rights reserved. C1 Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. Utah State Univ, Dept Nutr & Food Sci, Logan, UT 84322 USA. Utah State Univ, Ctr Epidemiol Studies, Logan, UT 84322 USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA. Johns Hopkins Univ, Sch Med, Dept Psychiat, Div Geriatr Psychiat & Neuropsychiat, Baltimore, MD 21205 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Hayden, KM (reprint author), 2200 W Main St,Suite A-200, Durham, NC 27705 USA. EM khayden@duke.edu RI Hayden, Kathleen/B-6442-2012 OI Hayden, Kathleen/0000-0002-7745-3513 FU NIA NIH HHS [AG-11380, R01 AG011380, T32-AG00029] NR 22 TC 32 Z9 35 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD FEB PY 2007 VL 120 IS 2 BP 180 EP 184 DI 10.1016/j.amjmed.2006.03.039 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 131ZL UT WOS:000243911400016 PM 17275460 ER PT J AU Contreras-Shannon, V Ochoa, O Reyes-Reyna, SM Sun, DX Michalek, JE Kuziel, WA McManus, LM Shireman, PK AF Contreras-Shannon, Veronica Ochoa, Oscar Reyes-Reyna, Sara M. Sun, Dongxu Michalek, Joel E. Kuziel, William A. McManus, Linda M. Shireman, Paula K. TI Fat accumulation with altered inflammation and regeneration in skeletal muscle of CCR2-/- mice following ischemic injury SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE adipocyte; macrophage; MyoD; myogenic progenitor cell; neutrophil; signal transducers of and activators of transcription-3 ID PERITONEAL-MACROPHAGES; CHEMOKINE RECEPTOR-2; MOLECULAR REGULATION; POSTISCHEMIC TISSUE; CELL-PROLIFERATION; STEM-CELLS; ACTIVATION; STAT3; AGE; MONOCYTE AB Chemokines recruit inflammatory cells to sites of injury, but the role of the CC chemokine receptor 2 ( CCR2) during regenerative processes following ischemia is poorly understood. We studied injury, inflammation, perfusion, capillary formation, monocyte chemotactic protein- 1 ( MCP- 1) levels, muscle regeneration, fat accumulation, and transcription factor activation in hindlimb muscles of CCR2(-/-) and wild- type ( WT) mice following femoral artery excision ( FAE). In both groups, muscle injury and restoration of vascular perfusion were similar. Nevertheless, edema and neutrophil accumulation were significantly elevated in CCR2(-/-) compared with WT mice at day 1 post-FAE and fewer macrophages were present at day 3. MCP- 1 levels in post-ischemic calf muscle of CCR2(-/-) animals were significantly elevated over baseline through 14 days post- FAE and were higher than WT mice at days 1, 7, and 14. In addition, CCR2(-/-) mice exhibited impaired muscle regeneration, decreased muscle fiber size, and increased intermuscular adipocytes with similar capillaries/ mm(2) postinjury. Finally, the transcription factors, MyoD and signal transducers of and activators of transcription3 ( STAT3), were significantly increased above baseline but did not differ significantly between groups at any time point post- FAE. These findings suggest that increases in MCP- 1, and possibly, MyoD and STAT3, may modulate molecular signaling in CCR2(-/-) mice during inflammatory and regenerative events. Furthermore, alterations in neutrophil and macrophage recruitment in CCR2(-/-) mice may critically alter the normal progression of downstream regenerative events in injured skeletal muscle and may direct myogenic precursor cells in the regenerating milieu toward an adipogenic phenotype. C1 Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Epidemiol & Biostat, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Periodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. Prot Design Labs, Fremont, CA USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Shireman, PK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Surg, 7703 Floyd Curl Dr,MC 7741, San Antonio, TX 78229 USA. EM shireman@uthscsa.edu NR 66 TC 73 Z9 76 U1 1 U2 5 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6143 J9 AM J PHYSIOL-CELL PH JI Am. J. Physiol.-Cell Physiol. PD FEB PY 2007 VL 292 IS 2 BP C953 EP C967 DI 10.1152/ajpcell.00154.2006 PG 15 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 135RQ UT WOS:000244171100034 PM 17020936 ER PT J AU Deem, S Min, JH Moulding, JD Eveland, R Swenson, ER AF Deem, Steven Min, Jin-Hye Moulding, Jennifer D. Eveland, Randy Swenson, Erik R. TI Red blood cells prevent inhibition of hypoxic pulmonary vasoconstriction by nitrite in isolated, perfused rat lungs SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE erythrocytes; hemoglobin; pulmonary circulation ID S-NITROSOHEMOGLOBIN; CIRCULATING NITRITE; BIOLOGICAL-SYSTEMS; FLOW REGULATION; OXIDE FORMATION; IN-VIVO; HEMOGLOBIN; DEOXYHEMOGLOBIN; ERYTHROCYTES; REDUCTASE AB Nitrite reduction to nitric oxide (NO) may be potentiated by a nitrite reductase activity of deoxyHb and contribute to systemic hypoxic vasodilation. The effect of nitrite on the pulmonary circulation has not been well characterized. We explored the effect of nitrite on hypoxic pulmonary vasoconstriction (HPV) and the role of the red blood cell (RBC) in nitrite reduction and nitrite-mediated vasodilation. As to method, isolated rat lungs were perfused with buffer, or buffer with RBCs, and subjected to repeated hypoxic challenges, with or without nitrite. As a result, in buffer-perfused lungs, HPV was reduced at nitrite concentrations of 7 mu M and above. Nitrite inhibition of HPV was prevented by excess free Hb and RBCs, suggesting that vasodilation was mediated by free NO. Nitrite-inhibition of HPV was not potentiated by mild acidosis (pH = 7.2) or xanthine oxidase activity. RBCs at 15% but not 1% hematocrit prevented inhibition of HPV by nitrite ( maximum nitrite concentration of similar to 35 mu M) independent of perfusate PO2. Degradation of nitrite was accelerated by hypoxia in the presence of RBCs but not during buffer perfusion. In conclusion, low micromolar concentrations of nitrite inhibit HPV in buffer-perfused lungs and when RBC concentration is subphysiological. This effect is lost when RBC concentration approaches physiological levels, despite enhanced nitrite degradation in the presence of RBCs. These data suggest that, although deoxyHb may generate NO from nitrite, insufficient NO escapes the RBC to cause vasodilation in the pulmonary circulation under the dynamic conditions of blood flow through the lungs and that RBCs are net scavengers of NO. C1 Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Kwandong, Coll Med, Dept Anesthesiol, Kangnung, South Korea. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. RP Deem, S (reprint author), Harborview Med Ctr, Dept Anesthesiol, Seattle, WA 98104 USA. EM sdeem@u.washington.edu FU NHLBI NIH HHS [1-K02-HL-077614-01A1, HL-66542] NR 42 TC 23 Z9 23 U1 1 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD FEB PY 2007 VL 292 IS 2 BP H963 EP H970 DI 10.1152/ajpheart.00812.2006 PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 134FK UT WOS:000244068700029 PM 17012349 ER PT J AU Jonker, SS Faber, JJ Anderson, DF Thornburg, KL Louey, S Giraud, GD AF Jonker, Sonnet S. Faber, J. Job Anderson, Debra F. Thornburg, Kent L. Louey, Samantha Giraud, George D. TI Sequential growth of fetal sheep cardiac myocytes in response to simultaneous arterial and venous hypertension SO AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY LA English DT Article DE hypertrophy; hyperplasia; terminal differentiation; cardiomyocyte ID INTRAVASCULAR INFUSIONS; BLOOD-FLOW; STEM-CELLS; HYPERTROPHY; PLASMA; REGENERATION; HYPERPLASIA; MATURATION; CORTISOL; LAMB AB Sequential growth of fetal sheep cardiac myocytes in response to simultaneous arterial and venous hypertension. Am J Physiol Regul Integr Comp Physiol 292: R913-R919, 2007. First published October 5, 2006; doi: 10.1152/ajpregu. 00484.2006.-While the fetal heart grows by myocyte enlargement and proliferation, myocytes lose their capacity for proliferation in the perinatal period after terminal differentiation. The relationship between myocyte enlargement, proliferation, and terminal differentiation has not been studied under conditions of combined arterial and venous hypertension, as occurs in some clinical conditions. We hypothesize that fetal arterial and venous hypertension initially leads to cardiomyocyte proliferation, followed by myocyte enlargement. Two groups of fetal sheep received intravascular plasma infusions for 4 or 8 days (from 130 days gestation) to increase vascular pressures. Fetal hearts were arrested in diastole and dissociated. Myocyte size, terminal differentiation (%binucleation), and cell cycle activity (Ki-67[+] cells as a % of mononucleated myocytes) were measured. We found that chronic plasma infusion greatly increased venous and arterial pressures. Heart (but not body) weights were similar to 30% greater in hypertensive fetuses than controls. The incidence of cell cycle activity doubled in hypertensive fetuses compared with controls. After 4 days of hypertension, myocytes were (similar to 11%) longer, but only after 8 days were they wider (similar to 12%). After 8 days, %binucleation was similar to 50% greater in hypertensive fetuses. We observed two phases of cardiomyocyte growth and maturation in response to fetal arterial and venous hypertension. In the early phase, the incidence of cell cycle activity increased and myocytes elongated. In the later phase, the incidence of cell cycle activity remained elevated, % binucleation increased, and cross sections were greater. This study highlights unique fetal adaptations of the myocardium and the importance of experimental duration when interpreting fetal cardiac growth data. C1 Oregon Hlth Sci Univ, Sch Med Cardiovasc Med, Heart Res Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Sch Med Cardiovasc Med, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Jonker, SS (reprint author), Univ Iowa, 285 Newton Rd,1270 CBRB, Iowa City, IA 52242 USA. EM sonnet-jonker@uiowa.edu OI Jonker, Sonnet/0000-0002-1097-2562 FU NICHD NIH HHS [HD-034430] NR 24 TC 30 Z9 30 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6119 J9 AM J PHYSIOL-REG I JI Am. J. Physiol.-Regul. Integr. Comp. Physiol. PD FEB PY 2007 VL 292 IS 2 BP R913 EP R919 DI 10.1152/ajpregu.00484.2006 PG 7 WC Physiology SC Physiology GA 132KU UT WOS:000243942500034 PM 17023664 ER PT J AU Janech, MG Raymond, JR Arthur, JM AF Janech, Michael G. Raymond, John R. Arthur, John M. TI Proteomics in renal research SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Review DE two-dimensional gel electrophoresis; DIGE; mass spectrometry; nephron; glomerulus; renal tubule ID 2-DIMENSIONAL GEL-ELECTROPHORESIS; LASER CAPTURE MICRODISSECTION; MEDULLARY COLLECTING DUCT; TANDEM MASS-SPECTROMETRY; KIDNEY PROTEIN EXPRESSION; THICK ASCENDING LIMB; CELL CARCINOMA; CAPILLARY-ELECTROPHORESIS; RAT-KIDNEY; TARGETED PROTEOMICS AB Proteomic technologies are used with increasing frequency in the renal community. In this review, we highlight the use in renal research of a number of available techniques including two-dimensional gel electrophoresis, liquid chromatography/mass spectrometry, surface-enhanced laser desorption/ionization, capillary electrophoresis/mass spectrometry, and antibody and tissue arrays. These techniques have been used to identify proteins or changes in proteins specific to regions of the kidney or associated with renal diseases or toxicity. They have also been used to examine protein expression changes and posttranslational modifications of proteins during signaling. A number of studies have used proteomic methodologies to look for diagnostic biomarkers in body fluids. The rapid rate of development of the technologies along with the combination of classic physiological and biochemical techniques with proteomics will enable new discoveries. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Arthur, JM (reprint author), Med Univ S Carolina, Charleston, SC 29425 USA. EM arthurj@musc.edu OI Janech, Michael/0000-0002-3202-4811 FU NHLBI NIH HHS [N01-HV-28181] NR 140 TC 32 Z9 37 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 FEB PY 2007 VL 292 IS 2 BP F501 EP F512 DI 10.1152/ajprenal.00298.2006 PG 12 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 133FC UT WOS:000243997200001 PM 17107941 ER PT J AU Lee, MJ Feliers, D Mariappan, MM Sataranatarajan, K Mahimainathan, L Musi, N Foretz, M Viollet, B Weinberg, JM Choudhury, GG Kasinath, BS AF Lee, Myung-Ja Feliers, Denis Mariappan, Meenalakshmi M. Sataranatarajan, Kavithalakshmi Mahimainathan, Lenin Musi, Nicolas Foretz, Marc Viollet, Benoit Weinberg, Joel M. Choudhury, Goutam Ghosh Kasinath, Balakuntalam S. TI A role for AMP-activated protein kinase in diabetes-induced renal hypertrophy SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE protein synthesis; mRNA translation ID GLOMERULAR EPITHELIAL-CELLS; GROWTH-FACTOR-BETA; ANGIOTENSIN-II; GENE-EXPRESSION; ELONGATION-FACTOR-2 KINASE; SIGNALING PATHWAYS; PROXIMAL TUBULES; SKELETAL-MUSCLE; GAMMA-SUBUNITS; POTENTIAL ROLE AB We tested the hypothesis that AMP-activated protein kinase ( AMPK), an energy sensor, regulates diabetes-induced renal hypertrophy. In kidney glomerular epithelial cells, high glucose ( 30 mM), but not equimolar mannitol, stimulated de novo protein synthesis and induced hypertrophy in association with increased phosphorylation of eukaryotic initiation factor 4E binding protein 1 and decreased phosphorylation of eukaryotic elongation factor 2, regulatory events in mRNA translation. These high-glucose-induced changes in protein synthesis were phosphatidylinositol 3-kinase, Akt, and mammalian target of rapamycin ( mTOR) dependent and transforming growth factor-beta independent. High glucose reduced AMPK alpha-subunit theronine (Thr) 172 phosphorylation, which required Akt activation. Changes in AMP and ATP content could not fully account for high-glucose-induced reductions in AMPK phosphorylation. Metformin and 5-aminoimidazole-4-carboxamide-1 beta-riboside ( AICAR) increased AMPK phosphorylation, inhibited high-glucose stimulation of protein synthesis, and prevented high-glucose-induced changes in phosphorylation of 4E binding protein 1 and eukaryotic elongation factor 2. Expression of kinase-inactive AMPK further increased high-glucose-induced protein synthesis. Renal hypertrophy in rats with Type 1 diabetes was associated with reduction in AMPK phosphorylation and increased mTOR activity. In diabetic rats, metformin and AICAR increased renal AMPK phosphorylation, reversed mTOR activation, and inhibited renal hypertrophy, without affecting hyperglycemia. AMPK is a newly identified regulator of renal hypertrophy in diabetes. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Obrien Kidney Res Ctr,Div Nephrol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Obrien Kidney Res Ctr,Div Diabet, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, Geriatr Res Educ & Clin Ctr, San Antonio, TX USA. Univ Paris 05, INSERM, Inst Cochin, Dept Endocrinol Metab & Canc,U567, Paris, France. Univ Michigan, Sch Med, Ann Arbor, MI 48109 USA. RP Kasinath, BS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Obrien Kidney Res Ctr,Div Nephrol, 7703 Floyd Curl Dr,Mail Code 7882, San Antonio, TX 78229 USA. EM kasinath@uthscsa.edu OI /0000-0001-5077-3552 FU NIDDK NIH HHS [DK-55815, R01 DK-50190] NR 63 TC 131 Z9 145 U1 0 U2 5 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 FEB PY 2007 VL 292 IS 2 BP F617 EP F627 DI 10.1152/ajprenal.00278.2006 PG 11 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 133FC UT WOS:000243997200014 PM 17018841 ER PT J AU Maclayton, DO Hall, RG AF Maclayton, Darego O. Hall, Ronald G., II TI Pharmacologic treatment options for nosocomial pneumonia involving methicillin-resistant Staphylococcus aureus SO ANNALS OF PHARMACOTHERAPY LA English DT Article DE linezolid; methicillin-resistant Staphylococcus aureus; nosocomial pneumonia; vancomycin ID VENTILATOR-ASSOCIATED PNEUMONIA; GRAM-POSITIVE INFECTIONS; RESPIRATORY-TRACT INFECTIONS; CRITICALLY-ILL PATIENTS; SOFT-TISSUE INFECTIONS; INTENSIVE-CARE-UNIT; DOUBLE-BLIND; OBESE-PATIENTS; INTRAPULMONARY PHARMACOKINETICS; ANTIMICROBIAL ACTIVITY AB OBJECTIVE: To discuss current and potential treatment options for nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). DATA SOURCES: A MEDLINE search (1966-January 2007) was conducted to identify English-language literature on pharmacotherapy of nosocomial pneumonia and the bibliographies of pertinent articles. Programs and abstracts from infectious disease meetings were also searched. Search terms included MRSA, nosocomial pneumonia, pulmonary infections, vancomycin, quinupristin/dalfopristin, linezolid, daptomycin, tigecycline, dalbavancin, oritavancin, and ceftobiprole. DATA SELECTION AND DATA EXTRACTION: All articles were critically evaluated and all pertinent information was included in this review. DATA SYNTHESIS: Vancomycin has been the drug of choice for MRSA infections for many years. Recent data suggest that linezolid may be superior to vancomycin in the treatment of MRSA nosocomial pneumonia. However, there are limitations to the available data. Therefore, prospective, randomized studies are needed before linezolid is recommended as the preferred first-line therapy. Other approved agents for nosocomial MRSA infections, such as quinupristin/dalfopristin and daptomycin, should not be used in the treatment of MRSA pneumonia, as they were inferior in clinical trials. Tigecycline has excellent activity against MRSA in vitro, but should not be routinely used for the treatment of MRSA pneumonia, as clinical data are lacking. In a Phase III clinical trial, an anti-MRSA cephalosporin, ceftobiprole, is being evaluated for effectiveness against nosocomial pneumonia. Investigational glycopeptides may eventually have a role in the treatment of nosocomial pneumonia, but data are currently lacking. CONCLUSIONS: Vancomycin is still the drug of choice for treatment of MRSA pneumonia, and linezolid should be used as an alternative agent. Linezolid should carry strong consideration for patients with vancomycin-incluced nephrotoxicity or a documented lack of response to vancomycin. Tigecycline and investigational agents with activity against MRSA may be future options for nosocomial pneumonia due to MRSA. C1 Texas So Univ, Coll Pharm & Hlth Sci, Dept Pharm Practice, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77004 USA. Texas Tech Univ, Hlth Sci Ctr, Sch Pharm, Dallas, TX USA. Univ Texas, SW Med Ctr, Vet Affairs N Texas Hlth Care Syst, Dallas, TX 75230 USA. RP Maclayton, DO (reprint author), Texas So Univ, Coll Pharm & Hlth Sci, Dept Pharm Practice, Michael E DeBakey Vet Affairs Med Ctr, 3100 Cleburne Ave, Houston, TX 77004 USA. EM maclaytondo@tsu.edu NR 85 TC 33 Z9 35 U1 0 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1060-0280 EI 1542-6270 J9 ANN PHARMACOTHER JI Ann. Pharmacother. PD FEB PY 2007 VL 41 IS 2 BP 235 EP 244 DI 10.1345/aph.1H414 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 141ZK UT WOS:000244617600008 PM 17299012 ER PT J AU Leonardi, MJ McGory, ML Ko, CY AF Leonardi, Michael J. McGory, Marcia L. Ko, Clifford Y. TI A systematic review of deep venous thrombosis prophylaxis in cancer patients: Implications for improving quality SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article; Proceedings Paper CT 59th Annual Cancer Symposium of the Society-of-Surgical-Oncology CY MAR 23-26, 2006 CL San Diego, CA SP Soc Surg Oncol DE DVT; prophylaxis; cancer; surgery; heparin; review ID MOLECULAR-WEIGHT HEPARIN; LOW-DOSE HEPARIN; GRADUATED COMPRESSION STOCKINGS; GENERAL ABDOMINAL-SURGERY; VEIN THROMBOSIS; UNFRACTIONATED HEPARIN; MULTICENTER TRIAL; STANDARD HEPARIN; PREVENTION; THROMBOEMBOLISM AB Introduction: Deep venous thrombosis (DVT) prophylaxis is particularly important for surgical oncologists given the high rate of DVT in patients with malignancy. Additionally, DVT prophylaxis may soon be implemented by some payers as a "pay for performance" quality measure. This is a systematic review of randomized controlled trial (RCT) evidence for DVT prophylaxis in cancer patients undergoing surgery. We examine overall rates of DVT, the efficacy of high versus low-dose heparin prophylaxis, and the rate of bleeding complications. Methods: The Medline database was searched for English language RCTs using key words DVT, venous thromboembolism, prophylaxis, and general surgery. Inclusion criteria were RCTs evaluating surgical oncology patients. Results: Fifty-five RCTs studied DVT prophylaxis in surgery (nonorthopedic) patients. Twenty-six RCTs evaluated 7,639 cancer patients. The overall DVT rate was 12.7% for pharmacologic prophylaxis and 35.2% for controls. High-dose low-molecular weight heparin (LMWH) was more effective than low dose, lowering the DVT rate from 14.5% to 7.9% (P < 0.01). Heparin decreased the rate of proximal DVTs. Bleeding complications requiring discontinuation of prophylaxis occurred in 3% of the patients. There was no difference between LMWH and unfractionated heparin in efficacy, DVT location, or bleeding complications. Conclusion: Using RCT data, this study demonstrates a greatly reduced DVT rate with pharmacologic prophylaxis in cancer patients, and higher doses appear more effective. Complication rates are low and should not prevent the use of prophylaxis in most patients. Finally, we found no difference between LMWH and unfractionated heparin in these RCTs. These results highlight the importance of routine pharmacologic prophylaxis in surgical patients with malignancy. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Surg Outcomes & Qual, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Leonardi, MJ (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 Le Conte Ave,72-215 CHS,Box 956904, Los Angeles, CA 90095 USA. EM mjleonardi@mednet.ucla.edu NR 33 TC 46 Z9 48 U1 0 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1068-9265 EI 1534-4681 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD FEB PY 2007 VL 14 IS 2 BP 929 EP 936 DI 10.1245/s10434-006-9183-9 PG 8 WC Oncology; Surgery SC Oncology; Surgery GA 129YH UT WOS:000243765500088 PM 17103259 ER PT J AU Mooney, S Hasssanein, TI Hilsabeck, RC Ziegler, EA Carlson, M Maron, LM Perry, W AF Mooney, Scott Hasssanein, Tarek I. Hilsabeck, Robin C. Ziegler, Elizabeth A. Carlson, Meghan Maron, Leeza M. Perry, William CA UCSD Hepatology Neurobehavioral R TI Utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in patients with end-stage liver disease awaiting liver transplant SO ARCHIVES OF CLINICAL NEUROPSYCHOLOGY LA English DT Article DE Repeatable Battery for the Assessment of Neuropsychological Status; end stage liver disease ID SUBCLINICAL HEPATIC-ENCEPHALOPATHY; QUALITY-OF-LIFE; COGNITIVE IMPAIRMENT; MULTIPLE-SCLEROSIS; CIRRHOTIC-PATIENTS; TEST-PERFORMANCE; SCREENING-TEST; VALIDITY; SCHIZOPHRENIA; SPECTROSCOPY AB Cognitive impairment is common among patients with end-stage liver disease (ESLD). This study examined cognitive dysfunction in patients with ESLD using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). METHOD: 66 patients with ESLD awaiting liver transplant were recruited. Patients were evaluated with the RBANS, Peabody Picture Vocabulary Test-Revised, and Beck Depression Inventory-II. RESULTS: Patients with ESLD uniformly performed below expectations on all RBANS index scores compared to the healthy normative sample (all p's < .0001) and they also displayed a "subcortical" pattern of cognitive performance (p < .0001). Performances on RBANS attention, language, immediate memory, and total index scores were correlated with education and ethnicity (r's range = vertical bar.32-.57 vertical bar; p's < .01). There was no association between performance on any of the RBANS index scores or subtests and ESLD patient characteristics. In summary, the RBANS appears to adequately characterize known patterns of cognitive dysfunction in ESLD patients. (c) 2007 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. C1 Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. RP Perry, W (reprint author), Univ Calif San Diego, Dept Psychiat, 200 W Arbor Dr 8218, San Diego, CA 92103 USA. EM wperry@UCSD.edu NR 58 TC 33 Z9 35 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0887-6177 J9 ARCH CLIN NEUROPSYCH JI Arch. Clin. Neuropsychol. PD FEB PY 2007 VL 22 IS 2 BP 175 EP 186 DI 10.1016/j.acn.2006.12.005 PG 12 WC Psychology, Clinical; Psychology SC Psychology GA 154WT UT WOS:000245539300005 PM 17280813 ER PT J AU Robbins, J Kays, SA Gangnon, RE Hind, JA Hewitt, AL Gentry, LR Taylor, AJ AF Robbins, JoAnne Kays, Stephanie A. Gangnon, Ronald E. Hind, Jacqueline A. Hewitt, Angela L. Gentry, Lindell R. Taylor, Andrew J. TI The effects of lingual exercise in stroke patients with dysphagia SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT 15th Annual Meeting of the Dysphagia-Research-Society CY MAR 24, 2006 CL Scottsdale, AZ SP Dysphagia Res Soc DE deglutition; cerebrovascular disease; exercise; rehabilitation; therapeutics; tongue ID PENETRATION-ASPIRATION SCALE; QOL OUTCOMES TOOL; OROPHARYNGEAL DYSPHAGIA; SWAL-QOL; SWALLOWING PRESSURE; NATURAL-HISTORY; MOTOR FUNCTION; STRENGTH; ADULTS; MUSCLE AB Objective: To examine the effects of lingual exercise on swallowing recovery poststroke. Design: Prospective cohort intervention study, with 4- and 8-week follow-ups. Setting: Dysphagia clinic, tertiary care center. Participants: Ten stroke patients (n=6, acute: <= 3mo poststroke: n=4, chronic: > 3mo poststroke), age 51 to 90 years (mean, 69.7y). Intervention: Subjects performed an 8-week isometric lingual exercise program by compressing an air-filled bulb between the tongue and the hard palate. Main Outcome Measures: Isometric and swallowing lingual pressures, bolus flow parameters, diet, and a dysphagia-specific quality of life questionnaire were collected at baseline, week 4, and week 8. Three of the 10 subjects underwent magnetic resonance imaging at each time interval to measure lingual volume. Results: All subjects significantly increased isometric and swallowing pressures. Airway invasion was reduced for liquids. Two subjects increased lingual volume. Conclusions: The findings indicate that lingual exercise enables acute and chronic dysphagic stroke patients to increase lingual strength with associated improvements in swallowing pressures, airway protection, and lingual volume. C1 William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI USA. Univ Wisconsin, Dept Biomed Engn, Madison, WI USA. Univ Wisconsin, Dept Radiol, Madison, WI 53706 USA. RP Robbins, J (reprint author), William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, 2500 Overlook Ter GRECC 11G, Madison, WI 53705 USA. EM jrobbin2@wisc.edu NR 36 TC 133 Z9 139 U1 3 U2 30 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD FEB PY 2007 VL 88 IS 2 BP 150 EP 158 DI 10.1016/j.apmr.2006.11.002 PG 9 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 135IX UT WOS:000244148400003 PM 17270511 ER PT J AU Lopes-Virella, MF McHenry, MB Lipsitz, S Yim, E Wilson, PF Lackland, DT Lyons, T Jenkins, AJ Virella, G AF Lopes-Virella, Maria F. McHenry, Michael Brent Lipsitz, Stuart Yim, Eunsil Wilson, Peter F. Lackland, Daniel T. Lyons, Timothy Jenkins, Alicia J. Virella, Gabriel CA DCCT EDIC Res Grp TI Immune complexes containing modified lipoproteins are related to the progression of internal carotid intima-media thickness in patients with type 1 diabetes SO ATHEROSCLEROSIS LA English DT Article DE atherosclerosis; type 1 diabetes; autoimmunity; oxidized LDL antibodies; modified lipoprotein IC; intima-media thickness; diabetic complications ID LOW-DENSITY-LIPOPROTEIN; CORONARY-ARTERY-DISEASE; MODIFIED LDL ANTIBODIES; OXIDIZED LDL; HEART-DISEASE; ATHEROSCLEROTIC LESIONS; COMPLICATIONS TRIAL; METABOLIC-CONTROL; VASCULAR-DISEASE; DEFICIENT MICE AB Modified lipoproteins induce autoimmune responses including the synthesis of autoantibodies with pro-inflammatory characteristics. Circulating modified lipoprotein autoantibodies combine with circulating antigens and form immune complexes (IC). We now report the results of a study investigating the role of circulating IC containing modified lipoproteins in the progression of carotid intima-media thickness (IMT) in patients enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) Trial, a follow-up study of the Diabetes Control and Complications Trial (DCCT). This cohort includes 1229 patients with type 1 diabetes in whom B-mode Ultrasonography of internal and common carotid arteries was performed in 1994-1996 and in 1998-2000. Conventional CHD risk factors, antibodies against modified forms of LDL and modified lipoprotein IC were determined in 1050 of these patients from blood collected in 1996-1998. Cholesterol and apolipoprotein B content of IC (surrogate markers of modified ApoB-rich lipoproteins) were significantly higher in patients who showed progression of the internal carotid IMT than in those showing no progression, regression or mild progression. Multivariate linear and logistic regression modeling using conventional and non-conventional risk factors showed that the cholesterol content of IC was a significant positive predictor of internal carotid IMT progression. In conclusion these data demonstrate that increased levels of modified ApoB-rich IC are associated with increased progression of internal carotid IMT in the DCCT/EDIC cohort of type 1 diabetes. (c) 2006 Elsevier Ireland Ltd. All rights reserved. C1 Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Met Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Univ Oklahoma, Dept Med, Oklahoma City, OK USA. Univ Melbourne, Dept Med, Melbourne, Vic, Australia. RP Lopes-Virella, MF (reprint author), Ralph H Johnson VA Med Ctr, Charleston, SC USA. EM virellam@musc.edu RI Jenkins, Alicia/N-2482-2015 FU NCRR NIH HHS [M01-RR-1070]; NHLBI NIH HHS [P01 HL55782] NR 54 TC 44 Z9 45 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0021-9150 EI 1879-1484 J9 ATHEROSCLEROSIS JI Atherosclerosis PD FEB PY 2007 VL 190 IS 2 BP 359 EP 369 DI 10.1016/j.atherosclerosis.2006.02.007 PG 11 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 135SJ UT WOS:000244173000016 PM 16530770 ER PT J AU Bernardi, RE Lattal, KM Berger, SP AF Bernardi, Rick E. Lattal, K. Matthew Berger, S. Paul TI Anisomycin disrupts a contextual memory following reactivation in a cocaine-induced locomotor activity paradigm SO BEHAVIORAL NEUROSCIENCE LA English DT Article DE reconsolidation; cocaine; sensitization; memory ID CONDITIONED PLACE PREFERENCE; LONG-TERM-MEMORY; PROTEIN-SYNTHESIS; RETROGRADE-AMNESIA; BEHAVIORAL SENSITIZATION; RECONSOLIDATION HYPOTHESIS; INCENTIVE-SENSITIZATION; RETRIEVAL; EXTINCTION; FEAR AB In experiments examining the potential reconsolidation of drug-associated contextual memories, rats were given a single pairing of cocaine with a specific context, and the ability of the protein synthesis inhibitor anisomycin administered following a context-only memory retrieval trial to impair conditioned locomotor sensitization was tested. Rats receiving 150 mg/kg anisomycin immediately following a 5-min reexposure to the cocaine-conditioned context showed decreased activity compared with the vehicle control group in response to a low-dose cocaine challenge during a subsequent test for conditioned sensitization. This effect was not seen when anisomycin was administered following a 30-min reexposure to the context or when anisomycin was administered 25 min after a 5-min reexposure. These results are consistent with a growing literature suggesting that following retrieval, associative contextual memories may undergo a transient protein synthesis-dependent reconsolidation phase that normally serves to maintain memory. C1 Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Portland VA Med Ctr, Dept Psychiat, Portland, OR USA. RP Bernardi, RE (reprint author), Oregon Hlth Sci Univ, Dept Behav Neurosci, Mail Code L470,3181 SW Sam Jackson Rd, Portland, OR 97239 USA. EM bernardi@ohsu.edu FU NIAAA NIH HHS [AA01760]; NIMH NIH HHS [MH074547] NR 59 TC 21 Z9 22 U1 0 U2 3 PU AMER PSYCHOLOGICAL ASSOC/EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0735-7044 J9 BEHAV NEUROSCI JI Behav. Neurosci. PD FEB PY 2007 VL 121 IS 1 BP 156 EP 163 DI 10.1037/0735-7044.121.1.156 PG 8 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 137IW UT WOS:000244287300015 PM 17324060 ER PT J AU Patel, RC Burzynski, JA Ochoa-Bayona, JL Toro, J Greene, RE Freytes, CO AF Patel, R. C. Burzynski, J. A. Ochoa-Bayona, J. L. Toro, J. Greene, R. E. Freytes, C. O. TI Efficacy and toxicity of a second autologous peripheral blood stem cell transplant for patients with relapsed or recurrent multiple myeloma SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Meeting Abstract CT Tandem BMT Meeting 2007 CY FEB 08-12, 2007 CL Keystone, CO SP Amer Soc Blood & Marrow Transplantat, Ctr Int Blood & Marrow Transplantat Res, Pfizer Inc 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 ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD FEB PY 2007 VL 13 IS 2 SU 2 MA 152 BP 57 EP 57 DI 10.1016/j.bbmt.2006.12.156 PG 1 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 133QU UT WOS:000244028300153 ER PT J AU Schiller, GJ Sohn, JP Malone, P Bartoni, K Habtemariam, B Paquette, P deVos, S Territo, M AF Schiller, G. J. Sohn, J. P. Malone, P. Bartoni, K. Habtemariam, B. Paquette, P. deVos, S. Territo, M. TI Phase I/II trial of bortezomib maintenance following autologous peripheral blood progenitor cell transplantation as treatment for intermediate- and advanced-stage multiple myeloma SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Meeting Abstract CT Tandem BMT Meeting 2007 CY FEB 08-12, 2007 CL Keystone, CO SP Amer Soc Blood & Marrow Transplantat, Ctr Int Blood & Marrow Transplantat Res, Pfizer Inc C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Ctr, 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 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD FEB PY 2007 VL 13 IS 2 SU 2 MA 153 BP 57 EP 57 DI 10.1016/j.bbmt.2006.12.157 PG 1 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 133QU UT WOS:000244028300154 ER PT J AU Garcia-Palacios, V Chung, HY Choi, SJ Sarmasik, A Kurihara, N Lee, JW Galson, DL Collins, R Roodman, GD AF Garcia-Palacios, Veronica Chung, Ho Yeon Choi, Sun Jin Sarmasik, Allye Kurihara, Norlyoshi Lee, Jun Won Galson, Deborah L. Collins, Robert Roodman, G. David TI Eosinophil chemotactic factor-L (ECF-L) enhances osteoclast formation by increasing in osteoclast precursors expression of LFA-1 and ICAM-1 SO BONE LA English DT Article DE ECF-L; osteoclast; RANKL; ICAM-1; LFA-1 ID INTERCELLULAR-ADHESION MOLECULE-1; FUNCTION-ASSOCIATED ANTIGEN-1; FACTOR RECEPTOR FAMILY; DIFFERENTIATION; IDENTIFICATION; PROTEIN; LECTIN; LIGAND; CELLS; INFLAMMATION AB ECF-L is a novel autocrine stimulator of osteoclast (OCL) formation that enhances the effects of 1,25-(OH)(2)D-3 and RANK ligand (RANKL) and is increased in inflammatory conditions such as rheumatoid arthritis. ECF-L acts at the later stages of OCL formation and does not increase RANKL expression. Thus, its mechanism of action is unclear. Therefore, RAW 264.7 cells and M-CSF-dependent murine bone marrow macrophage (MDBM) cells were treated with RANKL and/or with recombinant ECF-L expressed as a Fc fusion protein (ECF-L-Fc) to determine their effects on NF-kappa B, AP-1 and JNK activity, and on the expression of the adhesion molecules that have been implicated in OCL formation. These parameters were measured by semiquantitative and PCR and Western blot analysis. In addition, the role of ICAM-I was further assessed by treating normal mouse marrow cultures with ECF-L-Fc and 10(-10) M 1,25-(OH)(2)D-3 in the presence or absence of a blocking ICAM-1 antibody or treating marrow cultures from ICAM-1 knockout mice with ECF-L and 1,25-(OH)2D3. ECF-L-Fc by itself only modestly increased NF-kappa B binding and JNK activity in RAW 264.7 cells, which was further enhanced by RANKL. In contrast, ECF-L-Fc 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. Furthermore, ECF-L did not increase OCL formation in marrow cultures from ICAM-1 knockout mice. Taken together, these results demonstrate that ECF-L enhances RANKL and 1,25-(OH)(2)D-3-induced OCL formation by increasing adhesive interactions between OCL precursors through increased expression of ICAM-1 and LFA-1. (c) 2006 Elsevier Inc. All rights reserved. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Med, Div Hematol Oncol, Pittsburgh, PA 15260 USA. Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA. RP Roodman, GD (reprint author), VA Pittsburgh Healthcare Syst, 111-H Univ Dr C, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu RI Galson, Deborah/E-9370-2010 OI Galson, Deborah/0000-0002-2045-8807 FU NIAID NIH HHS [AI-32177, R37 AI032177, R37 AI032177-15]; NIAMS NIH HHS [R01 AR041336, R01 AR041336-15, R01-AR41336] NR 19 TC 9 Z9 11 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 8756-3282 J9 BONE JI Bone PD FEB PY 2007 VL 40 IS 2 BP 316 EP 322 DI 10.1016/j.bone.2006.08.004 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 129ZD UT WOS:000243767700007 PM 16996813 ER PT J AU Alvi, F Idkowiak-Baldys, J Baldys, A Raymond, JR Hannun, YA AF Alvi, F. Idkowiak-Baldys, J. Baldys, A. Raymond, J. R. Hannun, Y. A. TI Regulation of membrane trafficking and endocytosis by protein kinase C: emerging role of the pericentrion, a novel protein kinase C-dependent subset of recycling endosomes SO CELLULAR AND MOLECULAR LIFE SCIENCES LA English DT Review DE PKC; endocytosis; trafficking; pericentrion ID BETA-ADRENERGIC-RECEPTOR; GROWTH-FACTOR RECEPTOR; NEUROTRANSMITTER TRANSPORTERS; PHOSPHOLIPASE-D; PHORBOL ESTERS; LIPID RAFTS; PHOSPHORYLATION; INTERNALIZATION; DESENSITIZATION; MECHANISMS AB The protein kinase C (PKC) family of isoenzymes has been shown to regulate a variety of cellular processes, including receptor desensitization and internalization, and this has sparked interest in further delineation of the roles of specific isoforms of PKC in membrane trafficking and endocytosis. Recent studies have identified a novel translocation of PKC to a juxtanuclear compartment, the pericentrion, which is distinct from the Golgi complex but epicentered on the centrosome. Sustained activation of PKC (longer than 30 min) also results in sequestration of plasma membrane lipids and proteins to the same compartment, demonstrating a global effect on endocytic trafficking. This review summarizes these studies, particularly focusing on the characterization of the pericentrion as a distinct PKC-dependent subset of recycling endosomes. We also discuss emerging insights into a role for PKC as a central hub in regulating vesicular transport pathways throughout the cell, with implications for a wide range of pathobiologic processes, e.g. diabetes and abnormal neurotransmission or receptor desensitization. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Hannun, YA (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, 173 Ashley Ave,POB 250209, Charleston, SC 29425 USA. EM hannun@musc.edu NR 74 TC 41 Z9 43 U1 1 U2 7 PU BIRKHAUSER VERLAG AG PI BASEL PA VIADUKSTRASSE 40-44, PO BOX 133, CH-4010 BASEL, SWITZERLAND SN 1420-682X J9 CELL MOL LIFE SCI JI Cell. Mol. Life Sci. PD FEB PY 2007 VL 64 IS 3 BP 263 EP 270 DI 10.1007/s00018-006-6363-5 PG 8 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 138UZ UT WOS:000244390100002 PM 17180302 ER PT J AU Labarere, J Stone, RA Obrosky, DS Yealy, DM Meehan, TP Fine, JM Graff, LG Fine, MJ AF Labarere, Jose Stone, Roslyn A. Obrosky, D. Scott Yealy, Donald M. Meehan, Thomas P. Fine, Jonathan M. Graff, Louis G. Fine, Michael J. TI Comparison of outcomes for low-risk outpatients and inpatients with pneumonia - A propensity-adjusted analysis SO CHEST LA English DT Article DE ambulatory care; community-acquired infections; pneumonia; treatment outcomes ID COMMUNITY-ACQUIRED PNEUMONIA; RANDOMIZED-TRIAL; PREDICTION RULE; SEVERITY INDEX; HOSPITALIZATION; GUIDELINES; CARE; MANAGEMENT; DECISIONS; ADULTS AB Background: Low-risk patients with community-acquired pneumonia are often hospitalized despite guideline recommendations for outpatient treatment. Methods: Using data from a randomized trial conducted in 32 emergency departments, we performed a propensity-adjusted analysis to compare 30-day mortality rates, time to the return to work and to usual activities, and patient satisfaction with care between 944 outpatients and 549 inpatients in pneumonia severity index risk classes I to III who did not have evidence of arterial oxygen desaturation, or medical or psychosocial contraindications to outpatient treatment. Results: After adjusting for quintile of propensity score for outpatient treatment, which eliminated all significant differences for baseline characteristics, outpatients were more likely to return to work (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.5 to 2.6) or, for nonworkers, to usual activities (OR, 1.4; 95% Cl, 1.1 to 1.8) than were inpatients. Satisfaction with the site-of-treatment decision (OR, 1.1; 95% CI, 0.7 to 1.8), with emergency department care (OR, 1.4; 95% CI, 0.9 to 1.9), and with overall medical care (OR, 1.1; 95% Cl, 0.8 to 1.6) was not different between outpatients and inpatients. The overall mortality rate was higher for inpatients than outpatients (2.6% vs 0.1%, respectively; p < 0.01); the mortality rate was not different among the 242 outpatients and 242 inpatients matched by their propensity score (0.4% vs 0.8%, respectively; p = 0.99). Conclusions: After adjusting for the propensity of site of treatment, outpatient treatment was associated with a more rapid return to usual activities and to work, and with no increased risk of mortality. The higher observed mortality rate among all low-risk inpatients suggests that physician judgment is an important complement to objective risk stratification in the site-of-treatment decision for patients with pneumonia. C1 VA Pittsburgh Healthcare Syst, Vet Affairs Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA 15260 USA. Yale Univ, Sch Med, Dept Med, New Haven, CT 06520 USA. Qualidigm, Middletown, CT USA. RP Fine, MJ (reprint author), VA Pittsburgh Healthcare Syst, Vet Affairs Ctr Hlth Equ Res & Promot, Univ Dr C,Bldg 28,1A102, Pittsburgh, PA 15240 USA. EM Michael.Fine@med.va.gov RI Labarere, Jose/N-1688-2014 OI Labarere, Jose/0000-0001-7621-6586 FU AHRQ HHS [R01 HS10049]; NIAID NIH HHS [5K24 AI01769] NR 28 TC 31 Z9 32 U1 1 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD FEB PY 2007 VL 131 IS 2 BP 480 EP 488 DI 10.1378/chest.06-1393 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 138AS UT WOS:000244335500026 PM 17296651 ER PT J AU Lieberman, D AF Lieberman, David TI Eighty-year-old patient with history of a twelve millimeter adenomatous polyp resected at age of seventy-five years SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID COLORECTAL-CANCER; SCREENING COLONOSCOPY; ELDERLY-PATIENTS; LIFE EXPECTANCY; SURVEILLANCE; POLYPECTOMY; RECURRENCE; IMPACT C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol, Portland, OR USA. RP Lieberman, D (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Div Gastroenterol, Portland, OR USA. EM lieberma@ohsu.edu NR 10 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 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD FEB PY 2007 VL 5 IS 2 BP 166 EP 169 DI 10.1016/j.cgh.2006.11.018 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 140NH UT WOS:000244511700007 PM 17296526 ER PT J AU Pumbwe, L Wareham, DW Aduse-Opoku, J Brazier, JS Wexler, HM AF Pumbwe, L. Wareham, D. W. Aduse-Opoku, J. Brazier, J. S. Wexler, H. M. TI Genetic analysis of mechanisms of multidrug resistance in a clinical isolate of Bacteroides fragilis SO CLINICAL MICROBIOLOGY AND INFECTION LA English DT Article DE Bacteroides fragilis; cross-resistance; efflux pumps; multidrug resistance; plasmid; susceptibility ID ANAEROBIC-BACTERIA; METRONIDAZOLE RESISTANCE; CONJUGATIVE TRANSPOSON; NIM GENES; ANTIMICROBIAL RESISTANCE; ANTIBIOTIC-RESISTANCE; EFFLUX; SUSCEPTIBILITY; CLINDAMYCIN; PREVALENCE AB This study investigated the mechanisms of multidrug resistance (MDR) in an isolate of Bacteroides fragilis (WI1) from a patient with anaerobic sepsis. The MDR of WI1 affected susceptibility to beta-lactams, clindamycin, fluoroquinolones, metronidazole and tetracycline. In addition to its 5.31-Mb chromosome, WI1 possessed two low-copy-number plasmids, pHagl (5.6 kb) and pHag2 (9.9 kb), that were absent from B. fragilis NCTC 9343. Restriction digestion with EcoRV, HindIII and SstI, combined with DNA sequencing, revealed that pHAG2 contained a tet(Q) gene at base position 3689 that resided on the conjugative transposon CTn341. Genes cfiA (encoding a metallo-beta-lactamase) and erm(F) (encoding a macrolide-lincosamide-streptogramin B resistance determinant) were also found in WI1, but were absent from B. fragilis NCTC 9343. Nitrocefin hydrolysis revealed that WI1 had high beta-lactamase activity. Sequencing of the gyrA quinolone resistance-determining region revealed a mutation causing a Ser82 -> Phe substitution, and comparative quantitative real-time RT-PCR revealed that the cfiA, erm(F) and tet(Q) genes were all expressed in WI1. In addition, the resistance-nodulation-division efflux pump genes bmeB9 and bmeB15 were significantly over-expressed (12.30 +/- 0.42-fold and 3541.1 +/- 95.4-fold, respectively), and the efflux pump inhibitors carbonyl cyanide m-chlorophenylhydrazone and reserpine significantly increased the susceptibility of the isolate to several unrelated antibiotics (p < 0.005). These data suggested that WI1 was highly multidrug-resistant because of the additive effects of chromosome- and plasmid-encoded resistance determinants. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ London, Dept Microbiol, Queen Marys Sch Med & Dent, Barts London NHS Trust, London, England. Univ London, Ctr Infect Dis, Queen Marys Sch Med & Dent, Inst Cell & Mol Sci, London, England. Univ Wales Hosp, Anaerobe Reference Lab, Natl Publ Hlth Serv Microbiol Cardiff, Cardiff, Wales. RP Wexler, HM (reprint author), Wadsworth Anaerobe Lab, Bldg 304,Room E3-224,GLAVAHCS 691-151J, Los Angeles, CA 90073 USA. EM hwexler@ucla.edu RI Wareham, David/A-3583-2008 OI Wareham, David/0000-0003-4331-5224 NR 36 TC 25 Z9 25 U1 1 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1198-743X J9 CLIN MICROBIOL INFEC JI Clin. Microbiol. Infect. PD FEB PY 2007 VL 13 IS 2 BP 183 EP 189 DI 10.1111/j.1469-0691.2006.01620.x PG 7 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 128UE UT WOS:000243683500010 PM 17328731 ER PT J AU Ahmed, A AF Ahmed, Ali TI Clinical manifestations, diagnostic assessment, and etiology of heart failure in older adults SO CLINICS IN GERIATRIC MEDICINE LA English DT Article ID VENTRICULAR SYSTOLIC FUNCTION; CONVERTING ENZYME-INHIBITORS; EJECTION FRACTION; DIASTOLIC DYSFUNCTION; CARDIOVASCULAR HEALTH; HEPATOJUGULAR REFLUX; NATRIURETIC PEPTIDE; GUIDELINE UPDATE; AMERICAN-COLLEGE; VENOUS-PRESSURE AB Aging is characterized by heterogeneity, both in health and in disease. Older adults who have heart failure (HF) often have atypical and delayed clinical manifestations and many have diastolic HE The assessment and management of HF in older adults may be simplified by a 5-step process called DEFEAT HF: (1) Establish a clinical Diagnosis of HF; (2) Establish an Etiology for HF, preferably in collaboration with a cardiologist; (3) Determine Fluid status and achieve euvolemia; (4) Determine left ventricular Ejection frAction; and (5) Provide evidence-based Therapy C1 Univ Alabama, Sch Med, Dept Med, Div Gerontol & Geriatr Med, Birmingham, AL 35294 USA. Univ Alabama, Sch Publ Hlth, Dept Epidemiol, Geriatr Heart Failure Clin,Ctr Aging, Birmingham, AL 35294 USA. Univ Alabama, Ctr Heart Failure Res, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Sect Geriatr, Birmingham, AL 35233 USA. Birmingham Vet Affairs Med Ctr, Geriatr Heart Failure Clin, Birmingham, AL 35233 USA. RP Ahmed, A (reprint author), Univ Alabama, Sch Med, Dept Med, Div Gerontol & Geriatr Med, 1530 3rd Ave S,CH19-219, Birmingham, AL 35294 USA. EM aahmed@uab.edu RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 NR 85 TC 8 Z9 9 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0749-0690 J9 CLIN GERIATR MED JI Clin. Geriatr. Med. PD FEB PY 2007 VL 23 IS 1 BP 11 EP + DI 10.1016/j.cger.2006.08.002 PG 21 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 119YG UT WOS:000243049800003 PM 17126753 ER PT J AU Dobscha, SK Winterbottom, LM Snodgrass, LS AF Dobscha, Steven K. Winterbottom, Lisa M. Snodgrass, LeAnn S. TI Reducing drug costs at a veterans affairs hospital by increasing market-share of generic fluoxetine SO COMMUNITY MENTAL HEALTH JOURNAL LA English DT Article DE economics; pharmaceutical; antidepressive agents; decision support systems; clinical; drug utilization ID CONTINUING MEDICAL-EDUCATION; STRATEGIES; TRENDS; CARE AB We previously showed that a multifaceted intervention designed to contain costs of prescribing selective serotonin reuptake inhibitors (SSRIs) at a Veterans Affairs hospital resulted in substantial projected savings. Intervention components included clinician education and pharmacy and computer information process changes. We now report on effects of altering the intervention to promote prescribing of generic fluoxetine. Over 30 months, fluoxetine's market-share increased from 12 to 32% of all SSRIs prescribed. A total of $2,500,000 in cost avoidance resulted from substituting generic for brand fluoxetine, and $600,000 resulted from increases in market-share of fluoxetine. The results highlight the robustness and flexibility of the intervention approach. C1 Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Portland Ctr Evaluat Clin Serv, Portland, OR USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Behav Hlth & Clin Neurosci Div, POB 1034,P3MHDC, Portland, OR 97207 USA. EM steven.dobscha@med.va.gov NR 18 TC 2 Z9 2 U1 0 U2 0 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0010-3853 J9 COMMUNITY MENT HLT J JI Community Ment. Health J. PD FEB PY 2007 VL 43 IS 1 BP 75 EP 84 DI 10.1007/s10597-006-9062-7 PG 10 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 142GG UT WOS:000244636800006 PM 17029000 ER PT J AU Mendez, MF Shapira, JS Clark, DG AF Mendez, Mario F. Shapira, Jill S. Clark, David G. TI "apperceptive" alexia in posterior cortical atrophy SO CORTEX LA English DT Article DE posterior cortical atrophy; dementia; Alzheimer's disease; alexia; dyslexia ID ALZHEIMERS-DISEASE; PURE ALEXIA; ATTENTIONAL DYSLEXIA; DEVELOPMENTAL DYSLEXIA; BALINTS-SYNDROME; DEMENTIA; SIMULTANAGNOSIA; PERCEPTION; MECHANISMS; NONWORDS AB The most common presenting complaint in posterior cortical atrophy (PCA) is reading difficulty. Although often described as an alexia without agraphia, alexia in PCA may have multiple causes, including a primary visuoperceptual etiology, attentional alexia, and central reading difficulty. This study evaluated 14 patients with early PCA and disturbances in reading ability in comparison to 14 normal controls. All 14 patients had a progressive disorder of complex visual functions and neuroimaging evidence of occipitoparietal dysfunction. They underwent a task requiring identification of single letters with and without flanking distractors. They also read single words consisting of regular English spelling or irregular grapheme-phoneme correspondence (irregular words) and pronounceable nonsense words (pseudowords). The PCA patients made errors in letter identification when letters were flanked by visually similar letters or numbers. They could read most single regular and irregular words but made visual errors and had particular trouble with pseudowords. They could not use a letter-by-letter reading strategy effectively. The PCA patients had similar difficulties on other visuoperceptual tests. These findings are consistent with an alexia manifested by perceptual and attentional difficulty on attempting serial visual processing of letters in the context of other letters. This "apperceptive alexia" results when the configuration of letters into words is impaired during letter-by-letter reading. Disproportionate difficulty reading pseudowords suggests an additional impairment in phonological processing. PCA patients have variable neuropathology and individual patients may have other contributions to their reading impairment. C1 VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@ucla.edu NR 64 TC 16 Z9 16 U1 0 U2 5 PU MASSON DIVISIONE PERIODICI PI MILANO PA VIA MUZIO ATTENDOLO DETTO SFORZA 7-9, 20141 MILANO, ITALY SN 0010-9452 J9 CORTEX JI Cortex PD FEB PY 2007 VL 43 IS 2 BP 264 EP 270 DI 10.1016/S0010-9452(08)70481-7 PG 7 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 155JZ UT WOS:000245575000010 PM 17405672 ER PT J AU Maudsley, S Martin, B Luttrell, LM AF Maudsley, Stuart Martin, Bronwen Luttrell, Louis M. TI G protein-coupled receptor signaling complexity in neuronal tissue: Implications for novel therapeutics SO CURRENT ALZHEIMER RESEARCH LA English DT Review ID METABOTROPIC GLUTAMATE RECEPTORS; IMMUNODEFICIENCY-VIRUS TYPE-1; BETA(2) ADRENERGIC-RECEPTOR; MU-OPIOID RECEPTOR; MUSCARINIC ACETYLCHOLINE-RECEPTORS; AMYLOID-PRECURSOR PROTEIN; ADENOSINE A(1) RECEPTOR; 3RD INTRACELLULAR LOOP; GENE-RELATED PEPTIDE; ALZHEIMERS-DISEASE AB The manipulation of transmembrane signaling by G protein-coupled receptors (GPCRs) constitutes perhaps the single most important therapeutic target in medicine. Therapeutics acting on GPCRs have traditionally been classified as agonists, partial agonists, or antagonists based on a two state model of receptor function embodied in the ternary complex model. Over the past decade, however, many lines of investigation have shown that GPCR signaling exhibits greater diversity and 'texture' than previously appreciated. Signal diversity arises from numerous factors, among them the ability of receptors to adopt multiple 'active' states with different effector coupling profiles, the formation of receptor dimers that exhibit unique pharmacology, signaling, and trafficking, the dissociation of receptor 'activation' from desensitization and internalization, and the discovery that non-G protein effectors mediate some aspects of GPCR signaling. At the same time, clustering of GPCRs with their downstream effectors in membrane microdomains, and interactions between receptors and a plethora of multidomain scaffolding proteins and accessory/chaperone molecules confers signal preorganization, efficiency, and specificity. More importantly it is likely that alteration in the interactions of these proteins with GPCRs may occur in aging or neurodegenerative disorders, thus defining a distinct 'pharmacology' from that seen in young organisms or normal physiology. In this context, the concept of agonist selective trafficking of receptor signaling, which recognizes that a bound ligand may select between a menu of 'active' receptor conformations and induce only a subset of the possible response profile, presents the opportunity to develop drugs that change the quality as well as the quantity of efficacy and enhance these qualities for specific disorders or other paradigms. As a more comprehensive understanding of the complexity of GPCR signaling is developed, the rational design of ligands possessing increased specific efficacy and attenuated side effects may become the standard mode of drug development. C1 NIA, Lab Neurosci, Intramural Res Program, Gerontol Res Ctr,Johns Hopkins Med Ctr, Baltimore, MD 21224 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. RP Maudsley, S (reprint author), NIA, Lab Neurosci, Intramural Res Program, Gerontol Res Ctr,Johns Hopkins Med Ctr, 5600 Nathan Shock Dr, Baltimore, MD 21224 USA. EM maudsleyst@grc.nia.nih.gov RI X, Simon/F-4678-2011 NR 186 TC 29 Z9 29 U1 0 U2 5 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1567-2050 J9 CURR ALZHEIMER RES JI Curr. Alzheimer Res. PD FEB PY 2007 VL 4 IS 1 BP 3 EP 19 DI 10.2174/156720507779939850 PG 17 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 149AU UT WOS:000245119800002 PM 17316162 ER PT J AU Starks, H Back, AL Pearlman, RA Koenig, BA Hsu, C Gordon, JR Bharucha, AJ AF Starks, Helene Back, Anthony L. Pearlman, Robert A. Koenig, Barbara A. Hsu, Clarissa Gordon, Judith R. Bharucha, Ashok J. TI Family member involvement in hastened death SO DEATH STUDIES LA English DT Article ID PHYSICIAN-ASSISTED SUICIDE; TERMINALLY-ILL; EUTHANASIA; CARE; PATIENT; AWARENESS; REQUESTS; ILLNESS; LIFE; END AB Four cases reveal the main themes: "taking care" included mutual protection between patients and family members; "midwifing the death" without professional support left families unprepared for adverse events; "tying up loose ends" included dealing with family members' fear of legal consequences; and "moving ahead" involved a greater risk of complicated grief when families encountered complications during the dying process. These results highlight the positive and negative consequences of family members' participation in a hastened C1 Univ Washington, Dept Med Hist & Eth, Seattle, WA 98195 USA. Seattle Canc Care Alliance, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Mayo Clin Fdn, Rochester, MN USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. RP Starks, H (reprint author), Univ Washington, Dept Med Hist & Eth, Box 357120, Seattle, WA 98195 USA. EM tigiba@u.washington.edu FU AHRQ HHS [T32 HS-013853] NR 31 TC 8 Z9 8 U1 1 U2 5 PU BRUNNER/MAZEL INC PI BRISTOL PA 1900 FROST RD, STE 101, BRISTOL, PA 19007-1598 USA SN 0748-1187 J9 DEATH STUD JI Death Stud. PD FEB PY 2007 VL 31 IS 2 BP 105 EP 130 DI 10.1080/07481180601100483 PG 26 WC Psychology, Multidisciplinary; Social Issues; Social Sciences, Biomedical SC Psychology; Social Issues; Biomedical Social Sciences GA 130ZT UT WOS:000243838200001 PM 17410692 ER PT J AU Zraika, S Hull, RL Udayasankar, J Clark, A Utzschneider, KM Tong, J Gerchman, F Kahn, SE AF Zraika, Sakeneh Hull, Rebecca L. Udayasankar, Jayalakshmi Clark, Anne Utzschneider, Kristina M. Tong, Jenny Gerchman, Fernando Kahn, Steven E. TI Identification of the amyloid-degrading enzyme neprilysin in mouse islets and potential role in islet amyloidogenesis SO DIABETES LA English DT Article ID BETA-CELL MASS; ALZHEIMERS-DISEASE; DIABETES-MELLITUS; TRANSGENIC MOUSE; A-BETA; POLYPEPTIDE IAPP; INSULIN; PEPTIDE; MODEL; BRAIN AB Islet amyloid contributes to loss of P-cell mass and function in type 2 diabetes. It is poorly understood how the building block of amyloid, islet amyloid polypeptide (IAPP), misfolds and accumulates within the islet to contribute to cellular dysfunction. We sought to determine whether neprilysin, an amyloid-degrading enzyme, is present in islets and plays a role in the accumulation of amyloid fibrils. Human hIAPP (hIAPP) transgenic mice, a model of islet amyloid in which primarily male mice develop amyloid by 12 months of age, were studied at 10 weeks and 6 months of age, enabling investigation of islet changes before and during early amyloidogenesis. Neprilysin was present in islets, including P-cells, and islet neprilysin mRNA and activity were found to decline with age in nontransgenic mice as well as in hIAPP transgenic female mice. In contrast, neprilysin mRNA and activity did not decrease in amyloid-prone IAPP transgenic male mice at 6 months compared with nontransgenic mice and female hIAPP transgenic mice. Islet amyloid was detected in 43% of the 6-month-old hIAPP transgenic male mice only, suggesting the sustained elevation of islet neprilysin in these mice was a compensatory mechanism aimed at preventing amyloid accumulation. In keeping with amyloid formation, the proportion of insulin-positive area to islet area was significantly reduced in 6-month-old hIAPP transgenic male mice, which also displayed mild fasting hyperglycemia compared with age-matched transgenic female and nontransgenic mice. Together, these findings demonstrate that neprilysin is a factor associated with islet amyloid accumulation and subsequent deterioration of beta-cell function in hIAPP transgenic male mice. C1 VA Puget Sound Hlth Care Syst 151, US Dept Vet Affairs, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. Churchill Hosp, Oxford Ctr Diabet, Diabet Res Labs, Oxford OX3 7LJ, England. RP Zraika, S (reprint author), VA Puget Sound Hlth Care Syst 151, US Dept Vet Affairs, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM zraikas@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087 NR 52 TC 22 Z9 22 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD FEB PY 2007 VL 56 IS 2 BP 304 EP 310 DI 10.2337/db06-0430 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 133CQ UT WOS:000243989600003 PM 17259373 ER PT J AU Mariappan, MM Feliers, D Mummidi, S Choudhury, GG Kasinath, BS AF Mariappan, Meenalakshmi M. Feliers, Denis Mummidi, Srinivas Choudhury, Goutam Ghosh Kasinath, Balakuntalam S. TI High glucose, high insulin, and their combination rapidly induce laminin-beta 1 synthesis by regulation of mRNA translation in renal epithelial cells SO DIABETES LA English DT Article ID DEPENDENT DIABETES-MELLITUS; INITIATION-FACTOR 4E; PROTEIN-SYNTHESIS; GENE-EXPRESSION; MOLECULAR-MECHANISMS; SIGNALING PATHWAYS; DB/DB MICE; PHOSPHORYLATION; NEPHROPATHY; KINASE AB Laminin is a glycoprotein that contributes to renal extracellular matrix expansion in diabetes. We investigated regulation of laminin-beta 1 synthesis in murine renal proximal tubular epithelial cells by 30 mmol/l glucose (high glucose), 1 nmol/l insulin (high insulin), and their combination (high glucose+high insulin), simulating conditions observed during progression of type 2 diabetes. Compared with 5 mmol/l glucose and no insulin (control), high glucose alone, high. insulin alone, or high glucose+high insulin together increased laminin-beta 1 chain protein synthesis within 5 min, lasting for up to 60 min with no change in laminin-beta 1 mRNA levels. Cycloheximide, but not actmiomycin-D, abrogated increased laminin-beta 1 synthesis. High glucose, high insulin, and high glucose+high insulin stimulated phosphorylation of 4E-BP1, a repressor binding protein for eukaryotic initiation factor 4E (eIF4E), that was dependent on activation of phosphatidylinositol 3-kinase, Akt, and mammalian target of rapamycin. High glucose, high insulin, and high glucose+high insulin also promoted release of eIF4E from 4E-BP1, phosphorylation of eIF4E, and increase in eIF4E association with eIF4G, critical events in the initiation phase of mRNA translation. High glucose, high insulin, and high glucose+high insulin increased Erk phosphorylation, which is an upstream regulator of eIF4E phosphorylation, and PD098059, which is a MEK inhibitor that blocks Erk activation, abolished laminin-beta 1 synthesis. This is the first demonstration of rapid increment in laminin-beta 1 synthesis by regulation of its mRNA translation by cells exposed to high glucose, high insulin, or high glucose+high insulin. C1 Univ Texas, Hlth Sci Ctr, Dept Med,GRECC San Antonio, O Brien Kidney Res Ctr,S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, GRECC San Antonio,Div Infect Dis,Dept Med, San Antonio, TX 78229 USA. RP Kasinath, BS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med,GRECC San Antonio, O Brien Kidney Res Ctr,S Texas Vet Hlth Care Syst, 7703 Floyd Curl Dr,MC7882, San Antonio, TX 78229 USA. EM kasinath@uthscsa.edu RI Mummidi, Srinivas/C-1004-2008 OI Mummidi, Srinivas/0000-0002-4068-6380 FU NIDDK NIH HHS [DK 50190, DK 55815] NR 53 TC 50 Z9 53 U1 1 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD FEB PY 2007 VL 56 IS 2 BP 476 EP 485 DI 10.2337/db05-1334 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 133CQ UT WOS:000243989600024 PM 17259394 ER PT J AU Maney, M Miller, DR Tseng, CL Pogagh, LM Safford, MM AF Maney, Miriam Miller, Donald R. Tseng, Chin-Lin Pogagh, Leonard M. Safford, Monika M. TI Impact of self-reported patient characteristics upon assessment of glycemic control in the Veterans Health Administration SO DIABETES CARE LA English DT Article ID QUALITY-OF-CARE; DIABETES-MELLITUS; SOCIOECONOMIC POSITION; MANAGED CARE; ADULTS; COMPLICATIONS; SYSTEM AB OBJECTIVE-The purpose of this article was to evaluate the impact of self-reported patient factors on quality assessment of Veterans Health Administration medical centers in achieving glycemic control. RESEARCH DESIGN AND METHODS-We linked survey data and administrative records for veterans who self-reported diabetes on a 1999 national weighted survey. Linear regression models were used to adjust A1C levels in fiscal year 2000 for socioeconomic status (education level, employment, and concerns of having enough food), social support (marital status and living alone), health behaviors (smoking, alcohol use, and exercise level), physical and mental health status, BMI, and diabetes duration. Medical centers were ranked by deciles, with and without adjustment for patient characteristics, on proportions of patients achieving A1C < 7 or < 8%. RESULTS-There was substantial medical center level variation in patient characteristics of the 56,740 individuals from 105 centers, e.g., grade school education (mean 15.3% [range 2.3-32.7%]), being retired (38.3% [19.9-59.7%]) or married (65.2% [43.7-77.8%]), food insufficiency (13.9% [7.2-24.6%]), and no reported exercise (43.2% [31.1-53.6%]). The final model had an R-2 of 7.8%. The Spearman rank coefficient comparing the thresholds adjusted only for age and sex to the full model was 0.71 for < 7% and 0.64 for < 8% (P < 0.0001). After risk adjustment, 4 of the 11 best-performing centers changed at least two deciles for the < 7% threshold, and 2 of 11 changed two deciles for the < 8% threshold. CONCLUSIONS-Adjustment for patient self-reported socioeconomic status and health impacts medical center rankings for glycerine control, suggesting the need for risk adjustment to assure valid inferences about quality. C1 VA New Jersey Healthcare Syst, Ctr Healthcare Knowledge Management Res, Dept Vet Affairs, VA HSR&D, E Orange, NJ USA. Univ Med & Dent New Jersey, New Jersey Med Sch, Newark, NJ 07103 USA. Univ Alabama, Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA. Bedford VA Med Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. RP Pogagh, LM (reprint author), VA New Jersey Healthcare Syst, Ctr Healthcare Knowledge Management Res, Dept Vet Affairs, VA HSR&D, 385 Tremont Ave, E Orange, NJ USA. EM len.pogach@verison.net NR 31 TC 14 Z9 14 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 FEB PY 2007 VL 30 IS 2 BP 245 EP 251 DI 10.2337/dc06-0771 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 133PF UT WOS:000244024100008 PM 17259489 ER PT J AU Lavery, LA Peters, EJG Armstrong, DG Lipsky, BA AF Lavery, Lawrence A. Peters, Edgar J. G. Armstrong, David G. Lipsky, Benjamin A. TI Probe-to-bone test for diagnosing diabetic foot osteomyelitis - Reliable or relic? SO DIABETES CARE LA English DT Article ID LEUKOCYTE SCINTIGRAPHY; UNSUSPECTED OSTEOMYELITIS; ANTIBIOTIC-THERAPY; INFECTIONS; ULCERS; RISK; CLASSIFICATION; PREVALENCE; VALIDATION; MANAGEMENT AB OBJECTIVE-We sought to assess the accuracy of the probe-to-bone (PTB) test in diagnosing foot osteomyelitis in a cohort of diabetic patients with bone culture proven disease. RESEARCH DESIGN AND METHODS-in this 2-year longitudinal cohort study, we enrolled 1,666 consecutive diabetic individuals who under-went an initial standardized detailed foot assessment, followed by examinations at regular intervals. Patients were instructed to immediately come to the foot clinic if they developed a lower-extremity complication. For all patients with a lower-extremity wound, we compared the results of the PTB test with those of a culture of the affected bone. We called PTB positive if the bone or joint was palpable and defined osteomyelitis as a positive bone culture. RESULTS-Over a mean of 27.2 months of follow-up, 247 patients developed a foot wound and 151 developed 199 foot infections. Osteomyelitis was found in 30 patients: 12% of those with a foot wound and 20% in those with a foot infection. When all wounds were considered, the PT13 test was highly sensitive (0.87) and specific (0.91); the positive predictive value was only 0.57, but the negative predictive value was 0.98. CONCLUSIONS-The PTB test, when used in a population of diabetic patients with a foot wound among whom the prevalence of osteomyelitis was 12%, had a relatively low positive predictive value, but a negative test may exclude the diagnosis. C1 Texas A&M Univ, Scott & White Hosp, Hlth Sci Ctr, Coll Med,Dept Surg, Temple, TX 76508 USA. Rosalind Franklin Univ Med & Sci, Scholls Ctr Lower Extrem Ambulatory Res, CLEAR, N Chicago, IL USA. Leiden Univ, Med Ctr, Dept Infect Dis, NL-2300 RA Leiden, Netherlands. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Lavery, LA (reprint author), Scott & White Mem Hosp & Clin, Dept Surg, 703 Highland Spring Lane, Georgetown, TX 78628 USA. EM llavery@swmail.sw.org RI Lipsky, Benjamin/B-4645-2013; Peters, Edgar /B-7790-2014 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 57 TC 107 Z9 108 U1 0 U2 5 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 FEB PY 2007 VL 30 IS 2 BP 270 EP 274 DI 10.2337/dc06-1572 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 133PF UT WOS:000244024100012 PM 17259493 ER PT J AU Tong, J Utzschneider, KM Carr, DB Zraika, S Udayasankar, J Gerchman, F Knopp, RH Kahn, SE AF Tong, J. Utzschneider, K. M. Carr, D. B. Zraika, S. Udayasankar, J. Gerchman, F. Knopp, R. H. Kahn, S. E. TI Plasma pancreatic polypeptide levels are associated with differences in body fat distribution in human subjects SO DIABETOLOGIA LA English DT Article DE insulin resistance; pancreatic polypeptide; parasympathetic nervous system; visceral fat ID PIMA-INDIANS; FOOD-INTAKE; SECRETION; OBESITY AB Pancreatic polypeptide (PP) is produced by the F-cells of the pancreas, and its plasma concentration has been used as a marker of parasympathetic activity. Recent work in rodents suggests that there is both sympathetic and parasympathetic innervation of white adipose tissue and that parasympathetic activity is anabolic resulting in lipid accumulation. We have examined whether in humans increased PP levels are associated with increased intra-abdominal fat (IAF), and thereby insulin resistance. We measured PP levels in 177 non-diabetic subjects (75 male/102 female; age 32-75 years) 3 min after an i.v. glucose bolus during a frequently sampled intravenous glucose tolerance test. IAF and s.c. fat (SCF) areas were measured by CT scan. The insulin sensitivity index (S (I)) was quantified using Bergman's minimal model. PP levels were higher in men than in women (96.2 +/- 72.2 vs 76.1 +/- 55.0 pg/ml, mean +/- SD, p=0.037), as was IAF area (124.7 +/- 67.4 vs 83.0 +/- 57.7 cm(2), p < 0.001). While PP levels were significantly associated with IAF (r=0.16, p=0.031), WHR (r=0.30, p < 0.001) and age (r=0.37, p < 0.01), they were not associated with SCF (r=0.02, p=0.829). The association between PP and IAF was not independent of age and/or sex. S-I was negatively associated with PP levels (r=-0.17, p=0.026) and IAF area (r=-0.65, p < 0.001). The association between S-I and PP disappeared after adjusting for IAF area, indicating that S-I was not a major determinant of PP levels. In humans, age and sex may modulate the association between plasma PP level and IAF area, suggesting that they may be determinants of parasympathetic activity and thus IAF accumulation. C1 Univ Washington, Harborview Med Ctr, VA Puget Sound Hlth Care Syst, Dept Med,Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. RP Tong, J (reprint author), Univ Washington, Harborview Med Ctr, VA Puget Sound Hlth Care Syst, Dept Med,Div Metab Endocrinol & Nutr, 151,1660 S Columbia Way, Seattle, WA 98108 USA. EM tongj@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002 FU NHLBI NIH HHS [HL-30086, HL-07028]; NIDDK NIH HHS [DK-02456, DK-02654, DK-17047, DK-35747, DK-35816, DK-59417] NR 10 TC 7 Z9 7 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD FEB PY 2007 VL 50 IS 2 BP 439 EP 442 DI 10.1007/s00125-006-0553-4 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 123VC UT WOS:000243323200024 PM 17171555 ER PT J AU Leung, FW AF Leung, Felix W. TI Etiologic factors of chronic constipation - Review of the scientific evidence SO DIGESTIVE DISEASES AND SCIENCES LA English DT Review DE chronic constipation; etiology ID FLUID INTAKE; EXERCISE; DIETARY AB Geriatric patient educational material and a general practice review suggest insufficient dietary fiber intake, inadequate fluid intake, decrease physical activity, side effects of drugs, hypothyroidism, sex harmones and colorectal cancer obstructin may play a role in the pathogenesis of constipation. A search of recent literature, however, reveals that there is a paucity of evidence-based publications that address the etiologic factors of chronic constipation. Much of current writings on the subject may be based primarily on myths handed down from one generation to the next. In the absence of well-designed studies, there do not appear to be sufficient evidence-based information to implicate the above as major etilogic factors in the development of chronic constipation. The etiological role of each of these factors in the development of chronic constipation deserves to be assessed by modern techniques and methodologies. Funding agencies including the government and industry sponsors should support the development of evidence-based data sets. The understanding of the etiology of chronic constipation is the foundation on which cost-effective management strategies are to be built. C1 VA Sepulveda Ambulatory Care Ctr, Div Gastroenterol Res & Med Serv, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 91343 USA. RP Leung, FW (reprint author), VA Sepulveda Ambulatory Care Ctr, Div Gastroenterol Res & Med Serv, 111G,16111 Plummer St, Sepulveda, CA 91343 USA. EM felix.leung@va.gov NR 16 TC 27 Z9 27 U1 2 U2 6 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD FEB PY 2007 VL 52 IS 2 BP 313 EP 316 DI 10.1007/s10620-006-9298-7 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 131XD UT WOS:000243904600002 PM 17219073 ER PT J AU Cao, ZP Liu, LJ Lickey, M Graves, A Pham, T Gordon, B AF Cao, Zhiping Liu, Lijuan Lickey, Marvin Graves, Aundrea Pham, Tony Gordon, Barbara TI Virally mediated knock-down of NR2 subunits ipsilateral to the deprived eye blocks ocular dominance plasticity SO EXPERIMENTAL BRAIN RESEARCH LA English DT Article DE knock-down; NMDA; NR2A; NR2B; adenovirus; visual cortex; plasticity; monocular deprivation ID D-ASPARTATE RECEPTOR; RAT VISUAL-CORTEX; AMYOTROPHIC-LATERAL-SCLEROSIS; CU/ZN-SUPEROXIDE-DISMUTASE; FOCAL CEREBRAL-ISCHEMIA; LONG-TERM POTENTIATION; NMDA RECEPTOR; GENE-TRANSFER; CRITICAL PERIOD; IN-VIVO AB NMDA receptors (NMDARs) are important in developmental plasticity in the visual cortex. The NR2A and NR2B subunits of this receptor develop with different time courses, suggesting that they play different roles in plasticity. To understand the role of the NR2B subunit, we knocked-down NR2B gene expression in visual cortex by injecting a recombinant adenovirus containing an antisense NR2B oligonucleotide. To assess knock-down, we injected the recombinant adenovirus into the right visual cortex of rats (p22) or mice (p30). Eight days later we perfused the animals and processed the visual cortex for NMDAR subunit immunoreactivity (IR). NR2B-IR was depleted dramatically in the neuropil near the injection. Depletion was more modest in the neuronal somata. Surprisingly, NR2A-IR was also reduced, but NR1-IR was not reduced. To assess the functional effects of depletion, we measured ocular dominance plasticity with monocular deprivation (MD). We compared mice receiving the NR2B antisense virus with mice receiving virus containing only the GFP sequence and mice receiving no injection. All injections were between p26 and p29 in the right cortex and bilateral recordings were performed 6-8 days later. Animals receiving the antisense virus lost plasticity if the right eye was deprived. If the left eye was deprived, the cortex was normally plastic bilaterally. Injection of control virus had no effect on plasticity. The data indicate that ocular dominance plasticity requires normal NMDARs in the hemisphere ipsilateral to the deprived eye but not in the hemisphere contralateral to the deprived eye. C1 Univ Oregon, Inst Neurosci, Eugene, OR 97403 USA. Portland VA Med Ctr, Portland, OR 97239 USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. RP Gordon, B (reprint author), Univ Oregon, Inst Neurosci, Eugene, OR 97403 USA. EM bgl@uoneuro.uoregon.edu FU NEI NIH HHS [R01 EY014238, EY04050] NR 70 TC 3 Z9 5 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0014-4819 J9 EXP BRAIN RES JI Exp. Brain Res. PD FEB PY 2007 VL 177 IS 1 BP 64 EP 77 DI 10.1007/s00221-006-0647-8 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 131XJ UT WOS:000243905300006 PM 16944113 ER PT J AU Thakkar, K El-Serag, HB Mattek, N Gilger, MA AF Thakkar, Kalpesh El-Serag, Hashem B. Mattek, Nora Gilger, Mark A. TI Complications of pediatric EGD: a 4-year experience in PEDS-CORI SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID UPPER GASTROINTESTINAL ENDOSCOPY; UPPER GI ENDOSCOPY; FIBEROPTIC ENDOSCOPY; CONSCIOUS SEDATION; AMERICAN-SOCIETY; FOLLOW-UP; CHILDREN; INFANTS; ESOPHAGOGASTRODUODENOSCOPY; PERFORATIONS AB Background: Available estimates of the incidence and type of complications during pediatric EGD are inconsistent. Objective: To determine the frequency and the determinants of immediate complications during EGD in children. Design: We conducted a cross-sectional database study. Setting: The study involved 13 pediatric facilities that use the PEDS-CORI (Pediatric Endoscopy Database System Clinical Outcomes Research Initiative). Patients: Children (0-18 years) who underwent EGD at 13 facilities between November 1999 and December 2003. Main Outcome Measurements: We identified complications (recorded shortly after the procedure) and analyzed their occurrence with respect to procedure indication, American Society of Anesthesiologists (ASA) class, sex, age, anesthesia type, and unplanned interventions. Results: We analyzed 10,236 procedures performed in 9234 patients. Immediate complications were reported in 239 procedures (2.3%, 95% confidence interval 2.0%-2.6%). The most common complications were hypoxia (157 [1.5%]) and bleeding (28 [0.3%]). Complication rates were significantly higher in the youngest age group, highest ASA class, female gender, intravenous (IV) sedation group, and in the presence of a fellow. Limitations: The study is limited by a lack of specific details and explicit criteria for reported complications. Conclusions: The overall immediate complication rate of pediatric EGD is 2.3%. All complications were non-fatal, and most were hypoxia related (157/239 [66%]) and reversible. Young age, higher ASA class, female sex, and IV sedation are risk factors for developing complications. C1 Texas Childrens Hosp, Sect Pediat Gastroenterol Hepatol, Houston, TX 77030 USA. Texas Gulf Coast Digest Dis Ctr, Houston, TX USA. Baylor Coll Med, Sect Gastroenterol, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Oregon Hlth Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA. RP Thakkar, K (reprint author), Baylor Coll Med, Dept GI Hepatol & Nutr, 6621 Fannin St CCC 1010, Houston, TX 77030 USA. NR 35 TC 48 Z9 50 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD FEB PY 2007 VL 65 IS 2 BP 213 EP 221 DI 10.1016/j.gie.2006.03.015 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 133VL UT WOS:000244041900007 PM 17258979 ER PT J AU Fujita, T Timme, TL Tabata, K Naruishi, K Kusaka, N Watanabe, M Abdelfattah, E Zhu, JX Ren, C Ren, C Yang, G Goltsov, A Wang, H Vlachaki, MT Teh, BS Butler, EB Thompson, TC AF Fujita, T. Timme, T. L. Tabata, K. Naruishi, K. Kusaka, N. Watanabe, M. Abdelfattah, E. Zhu, J. X. Ren, C. Ren, C. Yang, G. Goltsov, A. Wang, H. Vlachaki, M. T. Teh, B. S. Butler, E. B. Thompson, T. C. TI Cooperative effects of adenoviral vector-mediated interleukin 12 gene therapy with radiotherapy in a preclinical model of metastatic prostate cancer SO GENE THERAPY LA English DT Article DE prostate cancer; radiotherapy; interleukin-12; radio-gene therapy ID VIRUS THYMIDINE KINASE; TK PLUS GCV; INTENSITY-MODULATED RADIOTHERAPY; ORTHOTOPIC MOUSE MODEL; IN-SITU; PHASE-I; GANCICLOVIR THERAPY; IONIZING-RADIATION; INTRATUMORAL INJECTION; HORMONAL-THERAPY AB We investigated the potential benefits of combining adenoviral vector mediated in situ interleukin-12 (AdmIL-12) gene therapy with radiation therapy (XRT) to enhance therapeutic efficacy. In a metastatic mouse prostate cancer cell line, 1782 BMA, AdmIL-12+XRT demonstrated enhanced therapeutic activities in vitro as determined by clonogenic survival, apoptosis, and mIL-12 levels. At the molecular level, increased expression of tumor necrosis factor-alpha mRNA was specific for the combined therapy. In a subcutaneous 178-2 BMA in vivo model, the combination of AdmIL-12+XRT produced statistically significant tumor growth suppression compared to control vector Ad beta gal, Ad beta gal XRT, or AdmIL-12 as monotherapy. In addition, significant prolongation of survival was demonstrated for the combination of AdmIL-12+XRT. The combination of AdmIL-12+XRT significantly suppressed both spontaneous and pre-established lung metastases, and led to a prolonged elevation of serum IL-12 and significantly increased natural killer (NK) activities. Importantly, in vivo depletion of NK cells resulted in significant attenuation of the antimetastatic activities of AdmIL-12 alone or AdmIL-12+XRT. These combined effects suggest that AdIL-12 gene therapy together with radiotherapy may achieve maximal tumor control (both local and systemic) in selected prostate cancer patients via radio-gene therapy induced local cytotoxicity and local and systemic antitumor immunity. C1 Baylor Coll Med, Scott Dept Urol, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. RP Thompson, TC (reprint author), Baylor Coll Med, Scott Dept Urol, 6560 Fannin,Suite 2100, Houston, TX 77030 USA. EM timothyt@bcm.tmc.edu FU NCI NIH HHS [P50-CA58204] NR 55 TC 10 Z9 11 U1 1 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0969-7128 J9 GENE THER JI Gene Ther. PD FEB PY 2007 VL 14 IS 3 BP 227 EP 236 DI 10.1038/sj.gt.3302788 PG 10 WC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Genetics & Heredity; Research & Experimental Medicine GA 127OZ UT WOS:000243597500005 PM 17024109 ER PT J AU Arar, N Nath, S Thameem, F Bauer, R Voruganti, S Comuzzie, A Cole, S Blangero, J MacCluer, J Abboud, H AF Arar, Nedal Nath, Subrata Thameem, Farook Bauer, Richard Voruganti, Saroja Comuzzie, Anthony Cole, Shelley Blangero, John MacCluer, Jean Abboud, Hanna TI Genome-wide scans for microalbuminuria in Mexican Americans: The San Antonio Family Heart Study SO GENETICS IN MEDICINE LA English DT Article DE microalbuminuria; albumin to creatinine ratio; cardiovascular diseases; Mexican Americans; family genetic study ID CARDIOVASCULAR RISK-FACTORS; QUANTITATIVE TRAIT LOCUS; URINARY ALBUMIN EXCRETION; DIABETIC-NEPHROPATHY; LINKAGE ANALYSIS; BLOOD-PRESSURE; INSULIN-RESISTANCE; GENES; DISEASE; CHROMOSOME-20 AB Purpose: Microalbuminuria, defined as urine albumin-to-creatinine ratio of 0.03 to 0.299 mg/mg, is a major risk factor for cardiovascular disease. Several genetic epidemiological studies have established that microalbuminuria clusters in families, suggesting a genetic predisposition. Method: We estimated heritability of microalbuminuria and performed a genome-wide linkage analysis to identify chromosomal regions influencing urine albumin-to-creatinine ratio in 486 Mexican Americans from 26 multiplex families. Results: Significant heritability was demonstrated for urine albumin-to-creatinine ratio (h(2) = 24%, P < 0.003) after accounting for age, sex, body mass index, triglycerides, and hypertension. Genome scan revealed significant evidence of linkage of urine albumin-to-creatinine ratio to a region on chromosome 20q12 (LOD score of 3.5, P < 0.001) near marker D20S481. This region also exhibited a LOD score of 2.8 with diabetes status as a covariate and 3.0 with hypertension status as a covariate suggesting that the effect of this locus on urine albumin-to-creatinine ratio is largely independent of diabetes and hypertension. Conclusion: Findings indicate that there is a gene or genes located on human chromosome 20q12 that may have functional relevance to albumin excretion in Mexican Americans. Identifying and understanding the role of the genes that determine albumin excretion would lead to the development of novel therapeutic strategies targeted at high-risk individuals in whom intensive preventive measures may be most beneficial. C1 Univ Texas, Hlth Sci Ctr, Dept Med Nephrol, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Arar, N (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Nephrol, S Texas Vet Hlth Care Syst, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM ararn@uthscsa.edu FU NCRR NIH HHS [M01-RR01346]; NHLBI NIH HHS [HL45522]; NIDDK NIH HHS [P50-DK-061597] NR 52 TC 10 Z9 12 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1098-3600 J9 GENET MED JI Genet. Med. PD FEB PY 2007 VL 9 IS 2 BP 80 EP 87 DI 10.1097/GIM.0b013e31803068ec PG 8 WC Genetics & Heredity SC Genetics & Heredity GA 140FX UT WOS:000244491100005 PM 17304049 ER PT J AU Ross, JS Siu, AL AF Ross, Joseph S. Siu, Albert L. TI The importance of population-based performance measures SO HEALTH SERVICES RESEARCH LA English DT Editorial Material ID QUALITY-OF-CARE; CLINICAL-TRIALS; HEART-FAILURE; DISEASE; GUIDELINES; MEDICARE; PITFALLS; SYSTEM; PAY C1 Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. James J Peters Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Ross, JS (reprint author), Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. NR 25 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2007 VL 42 IS 1 BP 1 EP 6 DI 10.1111/j.1475-6773.2006.00693.x PN 1 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 128CN UT WOS:000243634800002 PM 17355578 ER PT J AU Hysong, SJ Best, RG Pugh, JA AF Hysong, Sylvia J. Best, Richard G. Pugh, Jacqueline A. TI Clinical practice guideline implementation strategy patterns in veterans affairs primary care clinics SO HEALTH SERVICES RESEARCH LA English DT Article DE guidelines; qualitative research; implementation research; evidence based medicine; health services research ID QUALITY-OF-CARE; GENERAL-PRACTICE; CONTROLLED-TRIAL; DISEASES; TIME AB Background. The Department of Veterans Affairs (VA) mandated the system-wide implementation of clinical practice guidelines (CPGs) in the mid-1990s, arming all facilities with basic resources to facilitate implementation; despite this resource allocation, significant variability still exists across VA facilities in implementation success. Objective. This study compares CPG implementation strategy patterns used by high and low performing primary care clinics in the VA. Research Design. Descriptive, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low performance on six CPGs. Subjects. One hundred and two employees ( management, quality improvement, clinic personnel) involved with guideline implementation at each VAMC primary care clinic. Measures. Participants reported specific strategies used by their facility to implement guidelines in 1-hour semi-structured interviews. Facilities were classified as high or low performers based on their guideline adherence scores calculated through independently conducted chart reviews. Findings. High performing facilities (HPFs) ( a) invested significantly in the implementation of the electronic medical record and locally adapting it to provider needs, (b) invested dedicated resources to guideline-related initiatives, and ( c) exhibited a clear direction in their strategy choices. Low performing facilities exhibited ( a) earlier stages of development for their electronic medical record, ( b) reliance on preexisting resources for guideline implementation, with little local adaptation, and ( c) no clear direction in their strategy choices. Conclusion. A multifaceted, yet targeted, strategic approach to guideline implementation emphasizing dedicated resources and local adaptation may result in more successful implementation and higher guideline adherence than relying on standardized resources and taxing preexisting channels. C1 Baylor Coll Med, Michael E DeBakey VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Lcokheed Martin Informat Technol, Healthcare Solut, Alexandria, VA USA. S Texas Vet Helth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Hysong, SJ (reprint author), Baylor Coll Med, Michael E DeBakey VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Hysong, Sylvia/B-8420-2008 OI Hysong, Sylvia/0000-0002-9063-5207; Pugh, Jacqueline/0000-0003-4933-141X NR 29 TC 21 Z9 21 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2007 VL 42 IS 1 BP 84 EP 103 DI 10.1111/j.1475-6773.2006.00610.x PN 1 PG 20 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 128CN UT WOS:000243634800007 PM 17355583 ER PT J AU Richardson, SS Sullivan, G Hill, A Yu, W AF Richardson, Samuel S. Sullivan, Greer Hill, Ariel Yu, Wei TI Use of aggressive medical treatments near the end of life: Differences between patients with and without dementia SO HEALTH SERVICES RESEARCH LA English DT Article DE acute inpatient care; end-of-life decisions; VA health care system; administrative data uses ID INTENSIVE-CARE-UNIT; ADVANCE DIRECTIVES; ALZHEIMERS-DISEASE; MYOCARDIAL-INFARCTION; HOSPITALIZED-PATIENTS; REVERSIBLE DEMENTIAS; QUALITY INDICATORS; CRITICALLY-ILL; SERIOUSLY ILL; NURSING-HOME AB Objectives. To analyze whether acute care patients with dementia are more or less likely to receive each of five aggressive medical services near the end of life, compared with patients without dementia. Data Source. Two years of Veterans Affairs (VA) and Medicare utilization data for all 169,036 VA users nationwide age 67 and older who died between October 1, 1999 and September 30, 2001. Study Design. We performed a retrospective analysis of acute care stays discharged in the final 30 days of life. The main outcome measure was the patient's likelihood of receiving each of five aggressive services (intensive care unit [ICU] admission, ventilator, cardiac catheterization, pulmonary artery monitor, and dialysis), controlling for demographic and clinical factors in probit regressions. Principal Findings. There were 122,740 acute-stay discharges during the final 30 days of life, representing 94,100 unique patients (31,654 with dementia). In probit models comparing acute care patients with and without dementia, patients with dementia were 7.5 percentage points less likely to be admitted to the ICU (95 percent confidence interval [CI], 6.9-8.1; percent of stays with ICU admission=36.8 percent), 5.4 percentage points less likely to be placed on a ventilator (95 percent CI, 5.0-5.9; percent of stays with ventilator use=17.1 percent), 0.7 percentage points less likely to receive cardiac catheterization (95 percent CI, 0.6-0.8; percent of stays with cardiac catheterization=2.7 percent), 1.4 percentage points less likely to receive pulmonary artery monitoring (95 percent CI, 1.2-1.5; percent of stays with pulmonary artery monitoring=2.6 percent), and 0.6 percentage points less likely to receive dialysis (95 percent CI, 0.4-0.8; percent of stays with dialysis=4.6 percent). Conclusions. During the final 30 days of life, acute care patients with dementia are treated substantially less aggressively than patients without dementia. Further research is warranted to determine the causes and appropriateness of these patterns of care. C1 VA Palo Alto Hlth Care Syst, Menlo Pk, CA 94025 USA. US Dept Vet Affairs, Hlth Econ Resource Ctr, Hlth Serv Res & Dev Serv, Menlo Pk, CA USA. US Dept Vet Affairs, S Cent Mental Illness Res Educ & Clin Ctr, Little Rock, AR USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. RP Richardson, SS (reprint author), VA Palo Alto Hlth Care Syst, 795 Willow Rd,152 MPD, Menlo Pk, CA 94025 USA. NR 50 TC 12 Z9 12 U1 3 U2 9 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD FEB PY 2007 VL 42 IS 1 BP 183 EP 200 DI 10.1111/j.1475-6773.2006.00608.x PN 1 PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 128CN UT WOS:000243634800012 PM 17355588 ER PT J AU Sundar, PD Yu, CE Sieh, W Steinbart, E Garruto, RM Oyanagi, K Craig, UK Bird, TD Wijsman, EM Galasko, DR Schellenberg, GD AF Sundar, Purnima Desai Yu, Chang-En Sieh, Weiva Steinbart, Ellen Garruto, Ralph M. Oyanagi, Kiyomitsu Craig, Ulla-Katrina Bird, Thomas D. Wijsman, Ellen M. Galasko, Douglas R. Schellenberg, Gerard D. TI Two sites in the MAPT region confer genetic risk for Guam ALS/PDC and dementia SO HUMAN MOLECULAR GENETICS LA English DT Article ID AMYOTROPHIC-LATERAL-SCLEROSIS; PROGRESSIVE SUPRANUCLEAR PALSY; SPORADIC ALZHEIMERS-DISEASE; SAITOHIN Q7R POLYMORPHISM; PARKINSONISM-DEMENTIA; TAU-GENE; NEUROFIBRILLARY TANGLES; NEURODEGENERATIVE DISEASES; CORTICOBASAL DEGENERATION; LINKAGE DISEQUILIBRIUM AB Unusual forms of amyotrophic lateral sclerosis (ALS-G), Parkinsonism dementia complex (PDC-G) and Guam dementia (GD) are found in Chamorros, the indigenous people of Guam. Neurofibrillary tangles composed of hyperphosphorylated tau are a neuropathologic feature of these closely related disorders. To determine if variation in the gene that encodes microtubule-associated protein tau gene (MAPT) contributes to risk for these disorders, we genotyped nine single nucleotide polymorphism (SNP) sites and one insertion/deletion in the 5' end of MAPT in 54 ALS-G, 135 PDC-G, 153 GD and 258 control subjects, all of whom are Chamorros. Variation at three SNPs (sites 2, 6 and 9) influenced risk for ALS-G, PDC-G and GD. SNP2 acts through a dominant mechanism and is independent of the risk conferred by SNPs 6 and 9, the latter two acting by a recessive mechanism. Persons with the high-risk SNP6 and SNP9 AC/AC diplotype had an increased risk of 3-fold [95% confidence interval (CI)=1.10-8.25] for GD, 4-fold (95% CI=1.40-11.64) for PDC-G and 6-fold (95% CI=1.44-32.14) for ALS-G, compared to persons with other diplotypes after adjusting for SNP2. Carriers of the SNP2 G allele had an increased risk of 1.6-fold (95% CI=1.00-2.62) for GD, 2-fold (95% CI=1.28-3.66) for PDC-G, and 1.5-fold (95% CI=0.74-3.00) for ALS-G, compared to non-carriers after adjusting for SNPs 6 and 9. Others have shown that SNP6 is also associated with risk for progressive supranuclear palsy. These two independent cis-acting sites presumably influence risk for Guam neuro-degenerative disorders by regulating MAPT expression. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC S 182B, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Med Genet, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Neurol & Pharmacol, Seattle, WA 98195 USA. SUNY Binghamton, Dept Anthropol, Lab Biomed Anthropol & Neurosci, Binghamton, NY 13902 USA. Tokyo Metropolitan Inst Neurosci, Dept Neuropathol, Tokyo, Japan. Univ Guam, Mangilao, GU 96923 USA. Univ Calif San Diego, Dept Neurosci, La Jolla, CA 92093 USA. RP Schellenberg, GD (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC S 182B, 1660 S Columbia Way, Seattle, WA 98108 USA. EM zachdad@u.washington.edu OI Wijsman, Ellen/0000-0002-2725-6669 FU NIA NIH HHS [P01 AG14382, P50 AG 05136] NR 73 TC 39 Z9 40 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0964-6906 J9 HUM MOL GENET JI Hum. Mol. Genet. PD FEB 1 PY 2007 VL 16 IS 3 BP 295 EP 306 DI 10.1093/hmg/ddl463 PG 12 WC Biochemistry & Molecular Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Genetics & Heredity GA 135AK UT WOS:000244126000006 PM 17185385 ER PT J AU Shea, JA Guerra, CE Ravenell, KL Mcdonald, VJ Henry, CAN Asch, DA AF Shea, Judy A. Guerra, Carmen E. Ravenell, Karima L. Mcdonald, Vanessa J. Henry, Camille A. N. Asch, David A. TI Health literacy weakly but consistently predicts primary care patient dissatisfaction SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE health literacy; patient satisfaction; Veterans Health Administration ID AFRICAN-AMERICAN; MEDICAL-CARE; SATISFACTION; SERVICES; QUALITY; QUESTIONNAIRE; COMORBIDITY; PERCEPTIONS; INSTRUMENT; VETERANS AB Objectives. To study relationships between health literacy and multiple satisfaction domains. Health literacy is related to some domains of patient satisfaction such as communication and understanding, but little is known about relationships of health literacy with other satisfaction domains. Moreover, the importance of health literacy in predicting satisfaction compared with other patient sociodemographics is underexplored. Design. Cross-sectional survey. Setting. Primary care waiting areas with a Veterans Administration Medical Center and a university health system. Participants. One thousand five hundred and twenty-eight primary care patients. Main outcome measures. A brief demographics questionnaire, the Rapid Estimate of Adult Literacy in Medicine, the Veterans Affairs ambulatory care patient satisfaction survey, and an adaptation of the Charlson Comorbidity Index. Results. In unadjusted regression analyses, lower health literacy level was a significant predictor of worse satisfaction in 7 of 10 domains (P < 0.01). When adjusting for patient sociodemographics, predicted relationships remained significant in six of the seven domains (P < 0.05), with each unit change in the 4-stage literacy classification associated with a 3-6 point decrease in dissatisfaction scores (0-100 scale). Health literacy did not predict overall dissatisfaction (P = 0.55). Conclusions. These results suggest that health literacy, as assessed through a pronunciation exercise that is closely related to more comprehensive measures of literacy, has a consistent, albeit weak relationship with patient satisfaction. Future work is needed to clarify if patients with lower literacy are really receiving different care than those with higher literacy and to pinpoint the sources of their more negative responses. C1 Univ Penn, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Shea, JA (reprint author), Univ Penn, 1223 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM sheaja@mail.med.upenn.edu OI Asch, David/0000-0002-7970-286X NR 27 TC 14 Z9 15 U1 1 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1353-4505 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD FEB PY 2007 VL 19 IS 1 BP 45 EP 49 DI 10.1093/intqhc/mzl068 PG 5 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 133DU UT WOS:000243993000008 PM 17178765 ER PT J AU Kang, H O'Connell, JB Leonardi, MJ Maggard, MA McGory, ML Ko, CY AF Kang, Hakjung O'Connell, Jessica B. Leonardi, Michael J. Maggard, Melinda A. McGory, Marcia L. Ko, Clifford Y. TI Rare tumors of the colon and rectum: a national review SO INTERNATIONAL JOURNAL OF COLORECTAL DISEASE LA English DT Review DE colorectal; SEER; carcinoid; lymphoma; rare tumor ID NON-HODGKINS-LYMPHOMA; SQUAMOUS-CELL CARCINOMA; GASTROINTESTINAL-TRACT; TIME TRENDS; EXPERIENCE; PROGNOSIS; SURVIVAL; JAPAN AB Background Most literature available on rare colorectal cancer (CRC) is from case series reports. This population-based evaluation is the first comprehensive look at four rare histologic types of CRC, allowing comparisons with the more common adenocarcinoma for clinical and pathological features and survival rates. Materials and ethods All patients diagnosed with carcinoid (n=2,565), malignant lymphoma (n=955), non-carcinoid neuroendocrine (n=455), squamous cell (n=437), and adenocarcinoma (n=164,638) in SEER cancer database (1991-2000) were analyzed. Evaluation of age-adjusted incidence rate, stage at presentation, and 5-year relative survival were determined for each histologic subtype. Results All rare histologic subtypes had younger mean age than adenocarcinomas (70 years; p < 0.05). Lymphoma was more common in males (65.1%; P < 0.01). Incidence rates in 2000 per million were: carcinoid 10.6, lymphoma 3.5, neuroendocrine 2.0, squamous 1.9, and adenocarcinoma 496.3. The annual percent change in incidence for each rare tumor increased significantly during the 10 years (range: 3.1-9.4%, p < 0.05), except squamous cell carcinoma (5.9%, p > 0.05). Squamous (93.4%) and carcinoid (73.7%) tumors occurred more often in the rectum; lymphoma (79.0%), neuroendocrine (70.8%), and adenocarcinoma (70.1%) occurred more often in the colon (P < 0.01). Carcinoids presented at earlier stage (localized/regional, 90.5%) more often than adenocarcinoma (80.6%; p < 0.01), but squamous cell (82.1%; p=0.50), lymphoma (70.6%; p < 0.01), and neuroendocrine (37.8%; p < 0.01) presented at earlier stage similarly or less often than adenocarcinoma. Relative 5-year survival rate was highest for carcinoid (91.3%), and lowest for neuroendocrine tumors (21.4%). Conclusion This study provides the first population-based analysis of the epidemiology, tumor characteristics, and survival rates for rare CRC. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Daehang Hosp, Dept Surg, Seoul, South Korea. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Surg Outcomes & Qual, Los Angeles, CA 90095 USA. RP Ko, CY (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, 10833 Le Conte Ave,72-215 CHS,POB 956904, Los Angeles, CA 90095 USA. NR 24 TC 50 Z9 53 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0179-1958 J9 INT J COLORECTAL DIS JI Int. J. Colorectal Dis. PD FEB PY 2007 VL 22 IS 2 BP 183 EP 189 DI 10.1007/s00384-006-0145-2 PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 117PE UT WOS:000242884400011 PM 16845516 ER PT J AU Purnell, JQ Cummings, D Weigle, DS AF Purnell, J. Q. Cummings, D. Weigle, D. S. TI Changes in 24-h area-under-the-curve ghrelin values following diet-induced weight loss are associated with loss of fat-free mass, but not with changes in fat mass, insulin levels or insulin sensitivity SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article DE ghrelin; insulin; insulin sensitivity; fat mass; fat-free mass; weight loss ID PRADER-WILLI-SYNDROME; PLASMA GHRELIN; CIRCULATING GHRELIN; HUMAN OBESITY; HUMANS; RESISTANCE; SECRETION; GLUCOSE; INDEX; MEN AB Objective: To determine which parameters of body composition or metabolism best correlate with changes in 24 h ghrelin levels following weight loss. Design: A 3-month low-calorie diet followed by 3 months of weight stabilization. Subjects: Twelve overweight and obese adult men and women. Measurements: Body composition by underwater weighing, abdominal fat depots, leptin, ghrelin and parameters of insulin and lipid metabolism. Results: Increased 24 h ghrelin levels after weight loss correlated with decreases in body mass index, subcutaneous fat and fat-free mass (FFM), but not with changes in fat mass, fat cell size, leptin, insulin, insulin sensitivity, lipids or free fatty acid levels. The change in FFM correlated with the rise in ghrelin levels independently of body adiposity. Discussion: Alterations in FFM with diet-induced weight loss may play a role in ghrelin regulation. Changes in ghrelin levels could, then, serve as an integrative signal reflecting changes in FFM to hypothalamic centers controlling energy homeostasis. C1 Oregon Hlth Sci Univ, Ctr Study Weight Regulat & Associated Disorders, Dept Med, Div Endocrinol Diabet & Clin Nutr, Portland, OR 97201 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Harborview Med Ctr, Seattle, WA USA. RP Purnell, JQ (reprint author), Oregon Hlth Sci Univ, Ctr Study Weight Regulat & Associated Disorders, Dept Med, Div Endocrinol Diabet & Clin Nutr, Mail Stop L607,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM purnellj@ohsu.edu RI Biguzzi, Felipe/E-4724-2015 FU NCRR NIH HHS [M01RR00037, M01RR00334]; NIDDK NIH HHS [K23 DK02689, K24 DK02860, P30DK17047, R01 DK 61516, R01 DK55460] NR 28 TC 21 Z9 22 U1 1 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD FEB PY 2007 VL 31 IS 2 BP 385 EP 389 DI 10.1038/sj.ijo.0803401 PG 5 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 134KI UT WOS:000244081500029 PM 16819531 ER PT J AU Clark, RSB Nathaniel, PD Zhang, XP Dixon, CE Alber, SM Watkins, SC Melick, JA Kochanek, PM Graham, SH AF Clark, Robert S. B. Nathaniel, Paula D. Zhang, Xiaopeng Dixon, C. Edward Alber, Sean M. Watkins, Simon C. Melick, John A. Kochanek, Patrick M. Graham, Steven H. TI boc-Aspartyl(OMe)-fluoromethylketone attenuates mitochondrial release of cytochrome c and delays brain tissue loss after traumatic brain injury in rats SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE apoptosis; caspase; cysteine protease; head injury; nerve growth factor; programmed cell death ID CONTROLLED CORTICAL IMPACT; NEURONAL APOPTOSIS; CELL-DEATH; COGNITIVE DEFICITS; CASPASE ACTIVATION; DNA FRAGMENTATION; SPATIAL PROFILE; IN-VITRO; INHIBITION; RECEPTOR AB The pathobiology of traumatic brain injury (TBI) includes activation of multiple caspases followed by cell death with a spectrum of apoptotic phenotypes. There are initiator (e. g. caspase-2, -8, and -9) and effector (e. g. caspase-3 and -7) caspases. Recently, caspase-2 and -8 have been shown to regulate cell death via provoking cytochrome c release from the mitochondria upstream of caspase-9. Here, we show that an intracerebral injection of the pan-caspase inhibitor boc-Aspartyl(OMe)fluoromethylketone (BAF; 1 mu mol) 1 min after TBI in rats reduces caspase-3-like activity, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and tissue damage, and cytochrome c release in ipsilateral cortex at 24 h versus vehicle. To investigate whether either caspase-2 and/or caspase-8 activation may contribute to cytochrome release, the effect of BAF treatment on caspase-2 and caspase-8 proteolysis was also examined. boc-aspartyl(OMe) fluoromethylketone treatment inhibited proteolysis of caspase-2 but not caspase-8 24 h after TBI in rats versus vehicle. However, BAF with or without nerve growth factor (12.5 ng/h x 14 days intracerebrally via osmotic pump) did not result in differences in motor function, Morris water maze performance, hippocampal neuron survival, nor contusion volume at 14 days. These data suggest that BAF treatment reduces acute cell death after TBI by inhibiting mitochondrial release of cytochrome c, possibly via a mechanism involving initiator caspases; however, BAF appears to delay cell death, rather than result in permanent protection. C1 Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Brain Trauma Res Ctr, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Pediat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. Childrens Hosp Pittsburgh, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Clark, RSB (reprint author), Univ Pittsburgh, Safar Ctr Resuscitat Res, Dept Crit Care Med, 3434 5th Ave, Pittsburgh, PA 15260 USA. EM clarkrs@ccm.upmc.edu RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X FU NINDS NIH HHS [P50 NS30318, R01 NS38620] NR 46 TC 20 Z9 20 U1 0 U2 2 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 2007 VL 27 IS 2 BP 316 EP 326 DI 10.1038/sj.jcbfm.9600338 PG 11 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 128UY UT WOS:000243685700008 PM 16736044 ER PT J AU Lafosse, JM Corboy, JR Leehey, MA Seeberger, LC Filley, CM AF Lafosse, Jose M. Corboy, John R. Leehey, Maureen A. Seeberger, Lauren C. Filley, Christopher M. TI MS vs. HD: Can white matter and subcortical gray matter pathology be distinguished neuropsychologically? SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article ID PROGRESSIVE SUPRANUCLEAR PALSY; MULTIPLE-SCLEROSIS; HUNTINGTONS-DISEASE; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; RECOGNITION MEMORY; VERBAL RECOGNITION; CORTICAL DEMENTIA; IMPLICIT MEMORY AB This study was conducted to examine the neuropsychological effects of white matter and subcortical gray matter pathology. Nineteen patients with multiple sclerosis (MS), 16 with Huntington's disease (HD), and 17 normal controls (NC) participated. Participants completed the California Verbal Learning Test (CVLT), Rotary Pursuit (RP) and Mirror Tracing (MT) tasks, and the Symbol Digit Modalities Test (SDMT). The principal findings pertain to a dissociation in procedural memory: on RP, the HD group demonstrated impaired sequence learning compared to the MS group, which performed similarly to the NC group, yet on MT, the MS and HD groups demonstrated normal perceptual-motor integration learning. On the CVLT, both patient groups performed better on recognition than on recall. On the SDMT, both patient groups performed worse than the NC group, with the HD group performing more poorly than the MS and NC groups. These results suggest that involvement of white and subcortical gray matter may produce different neuropsychological effects. C1 Regis Univ, Dept Psychol, Denver, CO 80221 USA. Regis Univ, Neurosci Program D12, Denver, CO 80221 USA. Univ Colorado, Sch Med, Boulder, CO 80309 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Colorado Neurol Inst, Denver, CO USA. RP Lafosse, JM (reprint author), Regis Univ, Dept Psychol, 3333 Regis Blvd, Denver, CO 80221 USA. EM jlafosse@regis.edu NR 79 TC 15 Z9 16 U1 1 U2 2 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 FEB PY 2007 VL 29 IS 2 BP 142 EP 154 DI 10.1080/13803390600582438 PG 13 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 146HX UT WOS:000244926200003 PM 17365249 ER PT J AU Seal, KH Currie, SL Shen, H Anand, BS Bini, EJ Brau, N Jeffers, L Wright, TL AF Seal, Karen H. Currie, Sue L. Shen, Hui Anand, Bhupinderjit S. Bini, Edmund J. Brau, Norbert Jeffers, Lennox Wright, Teresa L. CA VA HCV-001 Study Grp TI Hepatitis C treatment candidacy and outcomes among 4318 US veterans with chronic hepatitis C virus infection - Does a history of injection drug use matter? SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE injection drug use; hepatitis C; hepatitis C treatment; alcohol ID INTERFERON-ALPHA-2B PLUS RIBAVIRIN; ANTIVIRAL THERAPY; INITIAL TREATMENT; RANDOMIZED-TRIAL; UNITED-STATES; RISK; CARE; ELIGIBILITY; DRINKERS; BARRIERS AB Background/Goals: Many patients with a history of injection drug use (IDU) are excluded from hepatitis C virus (HCV) treatment. This prospective multicenter study aimed to determine the impact of IDU history on HCV treatment candidacy and outcomes. Study: Between 1999 and 2001, 4318 HCV-infected patients seen at 24 VA Medical Centers were evaluated for HCV treatment candidacy and followed prospectively. Univariate and multivariate logistic regression analyses were used to determine whether an IDU history was associated with HCV treatment candidacy, HCV treatment acceptance, early treatment discontinuation, and virologic response. Results: Of 4318 participants, 2611 (61%) reported an IDU history. IDU history was not significantly associated with HCV treatment candidacy, acceptance, early discontinuation of therapy, or virologic response (all P values nonsignificant). Instead, reduced HCV treatment candidacy was independently associated with low-income [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.22-1.74), education <= 12 years (OR = 1.23, 95% CI = 1.03-1.46), and alcohol consumption >= 3 drinks/d (OR = 2.08, 95% CI = 1.68-2.57), whereas early discontinuation of HCV therapy was independently associated with low-income and consuming >= 3 alcoholic drinks/d. Conclusions: A history of IDU was not associated with HCV treatment candidacy or outcomes, supporting national guidelines to evaluate former IDUs on a case-by-case basis for HCV treatment. C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. VA Med Ctr, Houston, TX USA. VA New York Harbor Healthcare Syst, New York, NY USA. NYU, Sch Med, New York, NY USA. VA Med Ctr, Bronx, NY USA. VA Med Ctr, Miami, FL USA. RP Seal, KH (reprint author), San Francisco VA Med Ctr, Box 111A-1,4150 Clement St, San Francisco, CA 94121 USA. EM Karen.Seal@va.gov NR 34 TC 22 Z9 22 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD FEB PY 2007 VL 41 IS 2 BP 199 EP 205 DI 10.1097/01.mcg.0000212644.82853.51 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 135DD UT WOS:000244133400014 PM 17245220 ER PT J AU Chattergoon, NN Giraud, GD Thornburg, KL AF Chattergoon, N. N. Giraud, G. D. Thornburg, K. L. TI Thyroid hormone inhibits proliferation of fetal cardiac myocytes in vitro SO JOURNAL OF ENDOCRINOLOGY LA English DT Article ID CARDIOMYOCYTE DNA-SYNTHESIS; CYCLIN D1; POSTNATAL-DEVELOPMENT; RAT CARDIOMYOCYTES; ANDROGEN RECEPTOR; ESTROGEN-RECEPTOR; LATE-GESTATION; NEONATAL-RAT; SHEEP FETUS; GROWTH AB Thyroid hormone (T-3) is a key regulator of fetal organ maturation. Premature elevations of thyroid hormone may lead to a 'mature' cardio-phenotype. Thyroid hormone will stimulate maturation of ovine fetal cardiomyocytes in culture by decreasing their proliferative capacity. Group 1 fetal cardiomyocytes (similar to 135 days gestation) were incubated with T-3 (1.5, 3, 10, and 100 nM) and bromodeoxyuridine (BrdU; 10 mu M) for 24 and 48 h. Group 2 cardiomyocytes were cultured with T-3 alone for later protein analysis of cell cycle regulators. At all concentrations, T-3 decreased BrdU uptake fourfold in serum media (P < 0.001 versus serum, n=5). Following serum-free (SF) T3 treatment, BrdU uptake was inhibited when compared with serum (P < 0-001 versus serum, n=5). p21 expression increased threefold (P < 0.05 versus serum free, n=4) and cyclin D1 expression decreased twofold (P < 0.05 versus serum, n=4) in T-3-treated cardiomyocytes. (1) T-3 inhibits fetal cardiomyocyte proliferation, while (2) p21 protein levels increase, and (3) cyclin D1 levels decrease. Thus, T-3 may be a potent regulator of cardiomyocyte proliferation and maturation in the late gestation fetus. C1 Oregon Hlth Sci Univ, Heart Res Ctr, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Med Cardiovasc Med, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR 97201 USA. RP Chattergoon, NN (reprint author), Oregon Hlth Sci Univ, Heart Res Ctr, L464,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM chatterg@ohsu.edu FU NICHD NIH HHS [P01HD34430, 3 P01 HD034430-09S1] NR 44 TC 18 Z9 18 U1 0 U2 2 PU SOC ENDOCRINOLOGY PI BRISTOL PA 22 APEX COURT, WOODLANDS, BRADLEY STOKE, BRISTOL BS32 4JT, ENGLAND SN 0022-0795 J9 J ENDOCRINOL JI J. Endocrinol. PD FEB PY 2007 VL 192 IS 2 BP R1 EP R8 DI 10.1677/JOE-06-0114 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 146TS UT WOS:000244958200021 PM 17283226 ER PT J AU Vargas, RB Mangione, CM Asch, S Keesey, J Rosen, M Schonlau, M Keeler, EB AF Vargas, Roberto B. Mangione, Carol M. Asch, Steven Keesey, Joan Rosen, Mayde Schonlau, Matthias Keeler, Emmett B. TI Can a chronic care model collaborative reduce heart disease risk in patients with diabetes? SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 27th Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 12-15, 2004 CL Chicago, IL SP Soc Gen Internal Med DE chronic care; diabetes; cardiovascular disease; collaborative; intervention ID QUALITY IMPROVEMENT; BLOOD-PRESSURE; CARDIOVASCULAR-DISEASE; CLINICAL-RESEARCH; CONTROLLED-TRIAL; CHRONIC ILLNESS; MELLITUS; COMPLICATIONS; COMMUNITY; HYPERTENSION AB BACKGROUND: There is a need to identify effective practical interventions to decrease cardiovascular disease risk in patients with diabetes. OBJECTIVE: We examine the impact of participation in a collaborative implementing the chronic care model (CCM) on the reduction of cardiovascular disease risk in patients with diabetes. DESIGN: Controlled pre- and postintervention study. PATIENTS/PARTICIPANTS: Persons with diabetes receiving care at 13 health care organizations exposed to the CCM collaborative and controls receiving care in nonexposed sites. MEASUREMENTS AND MAIN RESULTS: Ten-year risk of cardiovascular disease; determined using a modified United Kingdom Prospective Diabetes Study risk engine score. A total number of 613 patients from CCM intervention sites and 557 patients from usual care control sites met the inclusion criteria. The baseline mean 10-year risk of cardiovascular disease was 31% for both the intervention group and the control group. Participants in both groups had improved blood pressure, lipid levels, and HbA1c levels during the observation period. Random intercept hierarchical regression models showed that the intervention group had a 2.1% (95% CI -3.7%, -0.5%) greater reduction in predicted risk for future cardiovascular events when compared to the control group. This would result in a reduced risk of one cardiovascular disease event for every 48 patients exposed to the intervention. CONCLUSIONS: Over a 1-year interval, this collaborative intervention using the CCM lowered the cardiovascular disease risk factors of patients with diabetes who were cared for in the participating organization's settings. Further work could enhance the impact of this promising multifactorial intervention on cardiovascular disease risk reduction. C1 Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, David Geffen Sch Med, Los Angeles, CA 90024 USA. RAND Hlth, Santa Monica, CA USA. Univ Calif Los Angeles, Div Gen Internal Med, David Geffen Sch Med, W Los Angeles Vet Adm Hosp, Los Angeles, CA 90024 USA. RP Vargas, RB (reprint author), Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, David Geffen Sch Med, 911 Broxton Ave, Los Angeles, CA 90024 USA. EM RBVargas@mednet.ucla.edu FU NIMHD NIH HHS [P20 MD000148] NR 47 TC 47 Z9 47 U1 1 U2 7 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD FEB PY 2007 VL 22 IS 2 BP 215 EP 222 DI 10.1007/s11606-006-0072-5 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 140QX UT WOS:000244521900009 PM 17356989 ER PT J AU Goodroe, R Bonnema, DD Lunsford, S Anderson, P Ryan-Baille, B Uber, W Ikonomidis, J Crumbley, AJ VanBakel, A Zile, MR Pereira, N AF Goodroe, Randy Bonnema, D. Dirk Lunsford, Shayna Anderson, Phillip Ryan-Baille, Barbara Uber, Walt Ikonomidis, John Crumbley, Arthur J. VanBakel, Adrian Zile, Michael R. Pereira, Naveen TI Severe left ventricular hypertrophy 1 year after transplant predicts mortality in cardiac transplant recipients SO JOURNAL OF HEART AND LUNG TRANSPLANTATION LA English DT Article ID CYCLOSPORINE-INDUCED HYPERTENSION; SYSTEMIC HYPERTENSION; ECHOCARDIOGRAPHIC MEASUREMENTS; BLOOD-PRESSURE; HEART; MASS; TACROLIMUS; THERAPY; INDEXATION; MECHANISMS AB Background: Left ventricular hypertrophy (LVH) is a known predictor of morbidity and mortality in patients with essential hypertension. The prevalence and significance of LVH in heart transplant recipients is unknown. Methods: Transthoracic echocardiograms were performed as part of a routine protocol I year after heart transplantation in 141 consecutive patients. Demographic and echocardiographic data were collected using patients' records and center-specific data from the Cardiac Transplant Research Database and analyzed to determine the prevalence and predictors of LVH at 1 year posttransplantation. Patients were divided into three groups based on left ventricular mass (LVM): normal (LVM < 150 g); mild-moderate LVH (LVM 150 to 250 g); and severe LVH (LVM > 250 g). Results: LVH was common at 1 year after heart transplantation, present in 83% of heart transplant recipients. Univariate predictors of severe LVH were increased body mass index (p < 0.01), pre-transplant diabetes mellitus (p = 0.02) and pre-transplant hypertension (p = 0.01). By multivariate analysis, pre-transplant hypertension was the only independent predictor of severe LVH (hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.1 to 5.4,p = 0.05). Heart transplant recipients with severe LVH had significantly decreased survival, as compared to patients with normal LVM and mild-moderate LVH (P = 0.03). After multivaniate analysis adjusting for age, race, gender, pre-transplant hypertension and diabetes, severe LVH remained a strong, independent predictor of mortality (HR 3.6, 95% CI 1.0 to 12.1, P = 0.04). Conclusions: LVH is common at 1 year after heart transplantation and is a strong, independent predictor of increased mortality. Hypertension before transplantation is an independent predictor of the presence of severe LVH at 1 year after heart transplantation. C1 Med Univ S Carolina, Div Cardiol, Dept Med, Charleston, SC 29425 USA. Vet Affairs Med Ctr, Ralph H Johnson Dept, Charleston, SC 29403 USA. Med Univ S Carolina, Div Transplant Surg, Dept Surg, Charleston, SC 29425 USA. Med Univ S Carolina, Transplant Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pharm Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Div Cardiothorac Surg, Dept Surg, Charleston, SC 29425 USA. RP Pereira, N (reprint author), Med Univ S Carolina, Div Cardiol, Dept Med, 135 Rutledge Ave,Suite 1201,POB 250592, Charleston, SC 29425 USA. EM pereiran@musc.edu FU NCRR NIH HHS [M01-RR-01070-251]; NHLBI NIH HHS [P01-HL-48788] NR 32 TC 18 Z9 18 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1053-2498 J9 J HEART LUNG TRANSPL JI J. Heart Lung Transplant. PD FEB PY 2007 VL 26 IS 2 BP 145 EP 151 DI 10.1016/j.healun.2006.11.003 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery; Transplantation SC Cardiovascular System & Cardiology; Respiratory System; Surgery; Transplantation GA 137KG UT WOS:000244290900008 PM 17258148 ER PT J AU Bastani, S Schnickel, GT Hsieh, GR Garcia, C Fishbein, MC Ardebali, A AF Bastani, S. Schnickel, G. T. Hsieh, G. R. Garcia, C. Fishbein, M. C. Ardebali, A. TI CXCR3 and CCR5 blockade prevents acute rejection via induction of regulatory CD4 lymphocytes SO JOURNAL OF HEART AND LUNG TRANSPLANTATION LA English DT Meeting Abstract C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Cardiac Surg, Dept Surg, Los Angeles, CA USA. W Los Angeles VA Med Ctr, Div Cardiac Surg, Dept Surg, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, 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 1053-2498 J9 J HEART LUNG TRANSPL JI J. Heart Lung Transplant. PD FEB PY 2007 VL 26 IS 2 SU S MA 422 BP S212 EP S212 DI 10.1016/j.healun.2006.11.444 PG 1 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery; Transplantation SC Cardiovascular System & Cardiology; Respiratory System; Surgery; Transplantation GA 138DB UT WOS:000244342200421 ER PT J AU Franco, V Tallaj, JA Rayburn, BK Pamboukian, SV Benza, RL Kirklin, JK McGiffin, DC Smallfield, M Bourge, RC AF Franco, V. Tallaj, J. A. Rayburn, B. K. Pamboukian, S. V. Benza, R. L. Kirklin, J. K. McGiffin, D. C. Smallfield, M. Bourge, R. C. TI Ibutilide is safe and efficatious in heart transplant recipients SO JOURNAL OF HEART AND LUNG TRANSPLANTATION LA English DT Meeting Abstract C1 Univ Alabama, Div Cardiovasc Med, Birmingham, AL USA. Birmingham VA Med Ctr, Dept Med, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1053-2498 J9 J HEART LUNG TRANSPL JI J. Heart Lung Transplant. PD FEB PY 2007 VL 26 IS 2 SU S MA 259 BP S153 EP S153 DI 10.1016/j.healun.2006.11.278 PG 1 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery; Transplantation SC Cardiovascular System & Cardiology; Respiratory System; Surgery; Transplantation GA 138DB UT WOS:000244342200260 ER PT J AU Mehendiratta, V McCarty, BC Gomez, L Graviss, EA Musher, DM AF Mehendiratta, Vaibhav McCarty, Brandon Chase Gomez, Luis Graviss, Edward A. Musher, Daniel M. TI Computerized tomography (CT)-guided aspiration of abscesses: Outcome of therapy at a tertiary care hospital SO JOURNAL OF INFECTION LA English DT Article DE CT-guided; aspiration; abscesses; outcome of therapy ID PERCUTANEOUS CATHETER DRAINAGE; INTRAABDOMINAL ABSCESSES; ABDOMINAL ABSCESSES; OPERATIVE DRAINAGE; SCORE AB Objective: To review the experience with percutaneous aspiration of abscesses at a general, tertiary care hospital from 2000 to 2005. Methods: Computerized medical records of 90 patients who underwent radiologically guided drainage of 92 fluid collections were reviewed for demographic data, co-morbid conditions, location, radiographic imaging characteristics and culture results and to determine the tong-term outcome of the procedure. Results: Sixty-seven of 92 (73%) abscesses were cured without the need for open surgical drainage; 44 were cured within 14 days, and 23 had delayed resolution requiring prolonged antibiotics and/or a second drainage. Of the abscesses 85% were drained using a catheter in situ, the remaining aspirated using a needle. Twenty-five (27%) of the 92 abscesses failed percutaneous drainage, requiring open surgical drainage or lead to sepsis and death. Neither co-morbid conditions nor the location of abscesses affected the outcome of drainage. Patients who had sterile cultures of aspirated material after receiving antibiotics prior to the procedure had a significantly higher cure rate than otherwise (P < 0.05). Catheter drainage was associated with a significantly higher cure rate than was needle aspiration (P < 0.05). Conclusion: Percutaneous drainage, along with appropriate antibiotics, is an effective approach to treat deep abscesses. Drainage, itself, is the major determinant of outcome, rather than the Location, characteristics of the abscess or condition of the patient prior to the procedure. Published by Elsevier Ltd on behalf of The British Infection Society. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. Baylor Coll Med, Phys Assistant Program, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Radiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. RP Musher, DM (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. EM daniel.musher@med.va.gov NR 24 TC 7 Z9 9 U1 0 U2 0 PU W B SAUNDERS CO LTD PI LONDON PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND SN 0163-4453 J9 J INFECTION JI J. Infect. PD FEB PY 2007 VL 54 IS 2 BP 122 EP 128 DI 10.1016/j.jinf.2006.03.004 PG 7 WC Infectious Diseases SC Infectious Diseases GA 129SB UT WOS:000243749300003 PM 16678902 ER PT J AU Manguno-Mire, G Sautter, F Lyons, J Myers, L Perry, D Sherman, M Glynn, S Sullivan, G AF Manguno-Mire, Gina Sautter, Frederic Lyons, Judith Myers, Leann Perry, Dana Sherman, Michelle Glynn, Shirley Sullivan, Greer TI Psychological distress and burden among female partners of combat veterans with PTSD SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Article DE PTSD; psychological distress; marital relationships; partner burden; spouses; family factors ID POSTTRAUMATIC-STRESS-DISORDER; MALE VIETNAM VETERANS; EXPRESSED EMOTION; CAREGIVER BURDEN; SOCIAL SUPPORT; PSYCHOMETRIC PROPERTIES; MENTAL-ILLNESS; FAMILY BURDEN; FOLLOW-UP; PREDICTORS AB Psychological distress among cohabitating female partners of combat veterans with posttraumatic stress disorder (PTSD) was examined in a cross-sectional study using a modified version of the Health Belief Model. A convenience sample of 89 cohabitating female partners of male veterans in outpatient PTSD treatment was interviewed by telephone using a structured interview. Partners endorsed high levels of psychological distress with elevations on clinical scales at or exceeding the 90th percentile. Severe levels of overall psychological distress, depression, and suicidal ideation were prevalent among partners. Multivariate analyses revealed that perceived threat, recent mental health treatment, and level of involvement with veterans predicted global partner psychological distress. Partner burden was predicted by partner self-efficacy, perceived threat, barriers to mental health treatment, and partner treatment engagement. These findings are compelling since they demonstrate that partners of veterans with combat-related PTSD experience significant levels of emotional distress that warrant clinical attention. Psychological distress and partner burden were each associated with a unique combination of predictors, suggesting that although these constructs are related, they have distinct correlates and potentially different implications within the family environment. Future research should examine these constructs separately using causal modeling analyses to identify modifiable targets for interventions to reduce psychological distress among partners of individuals with PTSD. C1 Tulane Hlth Sci Ctr, Sch Med, Dept Psychiat & Neurol, New Orleans, LA 70112 USA. VA S Cent VISN 16, Mental Illness Res Educ & Clin Ctr, Little Rock, AR USA. GV Sonny Montgomery Vet Affairs Med Ctr, Jackson, MS USA. Tulane Univ, Sch Publ Hlth & Trop Med, New Orleans, LA 70118 USA. Oklahoma City Vet Affairs Med Ctr, Oklahoma City, OK USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Hlth Care Syst W, Los Angeles, CA USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. RP Manguno-Mire, G (reprint author), Tulane Hlth Sci Ctr, Sch Med, Dept Psychiat & Neurol, 1440 Canal St TB-53, New Orleans, LA 70112 USA. NR 63 TC 53 Z9 53 U1 1 U2 12 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3018 J9 J NERV MENT DIS JI J. Nerv. Ment. Dis. PD FEB PY 2007 VL 195 IS 2 BP 144 EP 151 DI 10.1097/01.nmd.0000254755.53549.69 PG 8 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 138YD UT WOS:000244398300008 PM 17299302 ER PT J AU Rodriguez, KL Barnato, AE Arnold, RM AF Rodriguez, Keri L. Barnato, Amber E. Arnold, Robert M. TI Perceptions and utilization of palliative care services in acute care hospitals SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID OF-LIFE; MECHANICAL VENTILATION; DECISION-MAKING; TEAMS IMPROVE; END; DISEASE; DEATH; DOCTORS; CANCER; NEEDS AB Objective: To understand perceptions of palliative care in acute care hospitals and identify barriers to earlier use of palliative care in the illness trajectory. Methods: In Pennsylvania hospitals, we completed semistructured interviews with 131 providers involved in decision making or discharge planning. We used qualitative methods to analyze transcripts. Results: Most interviewees characterized palliative care as end-of-life or hospice care that is initiated after the decision to limit curative treatment is made. Few recognized the role of palliative care in managing symptoms and addressing psychosocial needs of patients with chronic illnesses other than cancer. Interviewees viewed earlier and broader palliative care consultations less in terms of clinical benefits than in terms of cost savings accrued from shorter terminal hospitalizations. In general, they thought nurses were most likely to facilitate these consultations, surgeons were most likely to resist them, and intensive care specialists were most likely to view palliative care as within their own scope of practice. Suggestions for broadening palliative care utilization included providing education and training, improving financial reimbursement and sustainability for palliative care, and fostering a hospital culture that turns to high-intensity care only if it meets individual needs and goals of chronically ill patients. Conclusions: In acute care hospitals, palliative care is primarily perceived as a means to limit life-sustaining treatment or allow death. Moving consultation earlier in the hospitalization of "dying" patients is a greater preoccupation than increasing palliative service use earlier in the illness trajectory. Any move short of far upstream will require palliative care specialists to market benefits to patients and referring providers in ways that emphasize compatibility with parallel treatment plans and do not threaten provider autonomy. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Family Equity Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA USA. Univ Pittsburgh, Sect Palliat Care & Med Eth, Pittsburgh, PA USA. Univ Pittsburgh, Inst Entrance Palliat Care, Pittsburgh, PA USA. RP Rodriguez, KL (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Family Equity Res & Promot, Univ Dr C 151C-U,Bldg 28,Room 1A129, Pittsburgh, PA 15240 USA. EM keri.rodriguez@med.va.gov FU NCATS NIH HHS [UL1 TR000005]; NIA NIH HHS [P01 AG019783, AG 19783, AG 21921, K08 AG021921, P01 AG019783-07] NR 53 TC 52 Z9 52 U1 3 U2 10 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD FEB PY 2007 VL 10 IS 1 BP 99 EP 110 DI 10.1089/jpm.2006.0155 PG 12 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 135DU UT WOS:000244135100018 PM 17298258 ER PT J AU Nareika, A Maldonado, A He, L Game, BA Slate, EH Sanders, JJ London, SD Lopes-Virella, MF Huang, Y AF Nareika, A. Maldonado, A. He, L. Game, B. A. Slate, E. H. Sanders, J. J. London, S. D. Lopes-Virella, M. F. Huang, Y. TI High glucose-boosted inflammatory responses to lipopolysaccharide are suppressed by statin SO JOURNAL OF PERIODONTAL RESEARCH LA English DT Article DE diabetes mellitus; glucose; lipopolysaccharide; periodontal diseases ID TUMOR-NECROSIS-FACTOR; MONOCYTE CHEMOATTRACTANT PROTEIN-1; C-REACTIVE PROTEIN; DIABETIC-PATIENTS; GENE-EXPRESSION; FACTOR-ALPHA; ATORVASTATIN; DISEASE; INTERLEUKIN-1; MACROPHAGES AB Background and Objective: It has been established that periodontal diseases are more prevalent and of greater severity in diabetic patients than in nondiabetic patients. Recent studies have underscored the role of monocytes and macrophages in periodontal tissue inflammation and destruction in diabetic patients. Although it has been shown that monocytes isolated from diabetic patients produce more inflammatory cytokines and that gingival crevicular fluid collected from diabetic patients contains higher levels of inflammatory cytokines than that obtained from nondiabetic patients, the underlying mechanisms are not well understood. Material and Methods: U937 histiocytes cultured in medium containing either normal (5 mM) or high (25 mM) glucose were treated with 100 ng/ml of lipopolysaccharide for 24h. After the treatment, cytokines in the medium and cytokine mRNA in the cells were quantified using enzyme-linked immunosorbet assay and real-time polymerase chain reaction, respectively. Results: In this study, we demonstrated that the pre-exposure of U937 histiocytes to high glucose concentrations markedly increased the lipopolysaccharide-induced secretion of pro-inflammatory cytokines and chemokines and the cellular inducible nitric oxide level compared with pre-exposure to normal glucose. Our data also showed that the increased secretion of cytokines was a result of increased mRNA expression. Furthermore, the effects of statin and peroxisome proliferators-activated receptor agonists on high glucose-enhanced secretion of cytokines were determined. The results showed that simvastatin, but not fenofibrate or pioglitazone, inhibited high glucose-enhanced cytokine release. Conclusion: This study has shown that high glucose concentrations and lipopolysaccharide act synergistically to stimulate the secretion of inflammatory mediators, and that statin is capable of suppressing the high glucose-boosted proinflammatory response. This study therefore delineates a novel mechanism by which hyperglycemia enhances the inflammatory responses of macrophages and suggests that statin may be useful in the treatment of periodontal disease in diabetic patients. C1 Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29403 USA. Med Univ S Carolina, Coll Dent Med, Charleston, SC 29403 USA. Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Dept Med, Charleston, SC 29403 USA. RP Huang, Y (reprint author), Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, 114 Doughty St, Charleston, SC 29403 USA. EM huangyan@musc.edu FU NIDCR NIH HHS [DE16353] NR 32 TC 17 Z9 19 U1 0 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3484 J9 J PERIODONTAL RES JI J. Periodont. Res. PD FEB PY 2007 VL 42 IS 1 BP 31 EP 38 DI 10.1111/j.1600-0765.2006.00911.x PG 8 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 122PY UT WOS:000243240100005 PM 17214637 ER PT J AU Starkebaum, G AF Starkebaum, Gordon TI Rheumatoid arthritis and lymphoma: Risky business for B cells SO JOURNAL OF RHEUMATOLOGY LA English DT Editorial Material ID EPSTEIN-BARR-VIRUS; NON-HODGKIN-LYMPHOMA; LYMPHOPROLIFERATIVE DISORDERS; T-CELLS; METHOTREXATE; THERAPY; EPIDEMIOLOGY; AUTOIMMUNITY; INDUCTION; ANTIGEN C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Starkebaum, G (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, S-01 COS,1660 S Columbian Way, Seattle, WA 98108 USA. EM Gordon.Starkebaum@va.gov NR 33 TC 10 Z9 10 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD FEB PY 2007 VL 34 IS 2 BP 243 EP 246 PG 4 WC Rheumatology SC Rheumatology GA 134VQ UT WOS:000244112900001 PM 17304645 ER PT J AU Friedlander, AH Weinreb, J Friedlander, I Yagiela, JA AF Friedlander, Arthur H. Weinreb, Jane Friedlander, Ida Yagiela, John A. TI Metabolic syndrome - Pathogenesis, medical care and dental implications SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Article DE hypertension; obesity; atherosclerosis; metabolic syndrome ID CARDIOVASCULAR RISK-FACTORS; LOW-DOSE ASPIRIN; NUTRITION EXAMINATION SURVEY; CORONARY-HEART-DISEASE; 3RD NATIONAL-HEALTH; TREATMENT PANEL-III; NUTRIENT INTAKE; DIABETES-MELLITUS; ORAL-HEALTH; US ADULTS AB Background. The dental literature contains little information about metabolic syndrome (MetS) and its dental implications. Types of Studies Reviewed. The authors conducted a MEDLINE search for the period 2000 through 2005, using the term "metabolic syndrome" to define its pathophysiology, medical treatment and dental implications. Results. MetS is the co-occurrence of abdominal obesity, hypertriglyceridemia, reduced high-density lipoprotein cholesterol levels, hypertension and impaired fasting glucose, which results from consumption of a high-calorie diet and decreased levels of physical activity superimposed on the appropriate genetic setting. Components of MetS synergistically promote the development of atherosclerosis, resulting in myocardial infarction and stroke. Clinical Implications. Deteriorating oral health status is associated with worsening of the atherogenic profile. Tooth loss often results in chewing difficulties because of inadequate occlusive surfaces and may lead to alterations in food selection and dietary quality. This, in turn, adversely affects body composition and nutritional status, both of which are related to vascular health. Dentists should develop treatment plans that preserve and restore the dentition, thus ensuring maximum masticatory efficiency and affording patients the optimum opportunity to consume food that will not foster atherogenesis. C1 VA Greater Los Angeles Healthcare Syst, Diabet Program, Los Angeles, CA 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. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. N Hollywood Hlth Ctr, N Hollywood, CA USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, Diabet Program, 11301 Wilshire Blvd, Los Angeles, CA USA. EM arthur.friedlander@med.va.gov RI Biguzzi, Felipe/E-4724-2015 NR 80 TC 14 Z9 16 U1 0 U2 6 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 FEB PY 2007 VL 138 IS 2 BP 179 EP 187 PG 9 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 136QG UT WOS:000244238600017 PM 17272372 ER PT J AU Rubenstein, LZ Alessi, CA Josephson, KR Hoyl, MT Harker, JO Pietruszka, FM AF Rubenstein, Laurence Z. Alessi, Cathy A. Josephson, Karen R. Hoyl, M. Trinidad Harker, Judith O. Pietruszka, Fern M. TI A randomized trial of a screening, case finding, and referral system for older veterans in primary care SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE geriatric assessment; elderly; health screening ID OUTPATIENT GERIATRIC EVALUATION; ELDERLY-PEOPLE; GENERAL-PRACTICE; CLINICAL-TRIAL; QUESTIONNAIRE; RELIABILITY; VALIDITY; HOME; MANAGEMENT; SF-36 AB OBJECTIVES: To test whether a system of screening, assessment, referral, and follow-up provided within primary care for high-risk older outpatients improves recognition of geriatric conditions and healthcare outcomes. DESIGN: Controlled clinical trial with 3-year follow-up; intervention versus control group allocation based on practice group assignment. SETTING: Department of Veterans Affairs (VA) ambulatory care center. PARTICIPANTS: Seven hundred ninety-two community-dwelling patients aged 65 and older identified by postal screening survey. INTERVENTION: The intervention combined a structured telephone geriatric assessment by a physician assistant, individualized referrals and recommendations, selected referral to outpatient geriatric assessment, and ongoing telephone case management. MEASUREMENTS: Main outcomes were VA medical record evidence of recognition and evaluation of target geriatric conditions (depression, cognitive impairment, urinary incontinence, falls, functional impairment), functional status (Functional Status Questionnaire, FSQ), and hospitalization (VA databases and self-reported non-VA usage). RESULTS: Intervention participants were more likely to have target conditions recognized, evaluated, and referred to specialized services within 12 months of enrollment, although there were no significant differences in FSQ scores or acute hospitalization between intervention and control groups at 1, 2, or 3 years follow-up. Subgroup analyses suggested improvements in depression symptoms and functional impairment at 1-year follow-up in intervention participants with these problems at baseline, but these findings were not evident at later follow-up. CONCLUSION: The intervention increased recognition and evaluation of target geriatric conditions but did not improve functional status or decrease hospitalization. Innovative screening methods can identify older people in need of geriatric services, but achieving measurable improvement in functional status or hospitalization rates will likely require a more-intensive intervention than a program involving primarily unsolicited referrals and short-term consultations. C1 VA Greater Los Angeles Healthcare Syst, GRECC, North Hills, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA 90024 USA. Catholic Univ Chile, Sch Med, Dept Internal Med, Geriatr Program, Santiago, Chile. RP Alessi, CA (reprint author), VA Greater Los Angeles Healthcare Syst, GRECC, 11E,16111 Plummer St, North Hills, CA 91343 USA. EM cathy.alessi@va.gov NR 24 TC 38 Z9 40 U1 2 U2 7 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 2007 VL 55 IS 2 BP 166 EP 174 DI 10.1111/j.1532-5415.2007.01044.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 131LH UT WOS:000243869900003 PM 17302651 ER PT J AU Mavandadi, S Ten Have, TR Katz, IR Durai, UNB Krahn, DD Llorente, MD Kirchner, JE Olsen, EJ Van Stone, WW Cooley, SL Oslin, DW AF Mavandadi, Shahrzad Ten Have, Thomas R. Katz, Ira R. Durai, U. Nalla B. Krahn, Dean D. Llorente, Maria D. Kirchner, Joann E. Olsen, Edwin J. Van Stone, William W. Cooley, Susan L. Oslin, David W. TI Effect of depression treatment on depressive symptoms in older adulthood: The moderating role of pain SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE depressive symptoms; pain; primary care; depression treatment ID RANDOMIZED CONTROLLED-TRIAL; PRIMARY-CARE PATIENTS; LATE-LIFE DEPRESSION; LOW-BACK-PAIN; PHYSICAL-DISABILITY; TREATMENT RESPONSE; ELDERLY COMMUNITY; PRISM-E; OUTCOMES; POPULATIONS AB OBJECTIVES: To investigate whether pain severity and interference with normal work activities moderate the effects of depression treatment on changes in depressive symptoms over time in older adults in primary care. DESIGN: Patient-randomized, clinical trial. SETTING: Multisite: three clinics located in Veterans Affairs Medical Centers. PARTICIPANTS: Adults aged 60 and older (n=524) who screened positive for depression and participated in the Primary Care Research in Substance Abuse and Mental Health for the Elderly Study. INTERVENTION: Integrated care versus enhanced specialty referral care. MEASUREMENTS: Pain severity, the degree to which pain interferes with work inside and outside of the home, and depressive symptoms were examined at baseline and 3, 6, and 12 months. RESULTS: Intention-to-treat analyses revealed that both treatment groups showed reduced depressive symptoms over time, although self-reported pain moderated reductions in depressive symptoms. At higher levels of pain severity and interference with work activities, improvements in depressive symptoms were blunted. Furthermore, pain interference appeared to have a greater effect on depressive symptoms than did pain severity; in individuals with major depression, pain interference fully accounted for the moderating effects of pain severity on changes in depressive symptoms over time. CONCLUSION: Pain and its interference with functioning interfere with recovery from depression. Findings highlight the importance of addressing multiple domains of functioning (e.g., physical and social disability) and the degree to which pain and other forms of physical comorbidity may hinder or minimize treatment-related improvements in depressive symptoms. C1 Univ Penn, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epiodemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Study Addict, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Mental Illness Res, Educ & Clin Ctr, Philadelphia, PA USA. Univ Illinois, VA W Side Med Ctr, Dept Psychiat, Chicago, IL 60607 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Univ Miami, Miami Va Med Ctr, Dept Psychiat, Miami, FL 33152 USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. US Dept Vet Affairs, Off Mental Hlth Serv, Washington, DC USA. US Dept Vet Affairs, Off Geriatr & Extended Care, Washington, DC USA. RP Mavandadi, S (reprint author), 3535 Market St,3005, Philadelphia, PA 19104 USA. EM smavanda@mail.med.upenn.edu NR 35 TC 30 Z9 30 U1 0 U2 4 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 2007 VL 55 IS 2 BP 202 EP 211 DI 10.1111/j.1532-5415.2007.01042.x PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 131LH UT WOS:000243869900008 PM 17302656 ER PT J AU Holroyd-Leduc, JM Sen, S Bertenthal, D Sands, LP Palmer, RM Kresevic, DM Covinsky, KE Landefeld, CS AF Holroyd-Leduc, Jayna M. Sen, Saunak Bertenthal, Dan Sands, Laura P. Palmer, Robert M. Kresevic, Denise M. Covinsky, Kenneth E. Landefeld, C. Seth TI The relationship of indwelling urinary catheters to death, length of hospital stay, functional decline, and nursing home admission in hospitalized older medical patients SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE urinary catheters; hospitalized older patients; mortality; morbidity ID REGIONAL-VARIATIONS; ELDERLY-PATIENTS; OUTCOMES; CARE; MORTALITY; DISEASE AB OBJECTIVES: To determine the association between indwelling urinary catheterization without a specific medical indication and adverse outcomes. DESIGN: Prospective cohort. SETTING: General medical inpatient services at a teaching hospital. PARTICIPANTS: Five hundred thirty-five patients aged 70 and older admitted without a specific medical indication for urinary catheterization. INTERVENTION: Indwelling urinary catheterization within 48 hours of admission. MEASUREMENTS: Death, length of hospital stay, decline in ability to perform activities of daily living (ADLs), and new admission to a nursing home. RESULTS: Indwelling urinary catheters were placed in 76 of the 535 (14%) patients without a specific medical indication. Catheterized patients were more likely to die in the hospital (6.6% vs 1.5% of those not catheterized, P=.006) and within 90 days of hospital discharge (25% vs 10.5%, P <.001); the greater risk of death with catheterization persisted in a propensity-matched analysis (hazard ratio (HR)=2.42, 95% confidence interval (CI)=1.04-5.65). Catheterized patients also had longer lengths of hospital stay (median, 6 days vs 4 days; P=.001); this association persisted in a propensity-matched analysis (HR=1.46, 95% CI=1.03-2.08). Catheterization was not associated (P >.05) with decline in ADL function or with admission to a nursing home. CONCLUSION: In this cohort of older patients, urinary catheterization without a specific medical indication was associated with greater risk of death and longer hospital stay. C1 Univ Calgary, Dept Med, Calgary, AB T2N 1N4, Canada. San Francisco Vet Affairs Med Ctr, Div Geriatr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Purdue Univ, Sch Nursing, W Lafayette, IN 47907 USA. Purdue Univ, Ctr Aging & Life Course, W Lafayette, IN 47907 USA. Cleveland Clin, Geriatr Med Sect, Cleveland, OH 44106 USA. Louis Stokes Cleveland Vet Affairs Med Ctr, Cleveland, OH USA. Univ Hosp Cleveland, Dept Med Surg Nursing, Cleveland, OH 44106 USA. RP Holroyd-Leduc, JM (reprint author), Foothills Med Ctr, Room 707,7th Floor N Tower,1403-29th St NW, Calgary, AB T2N 2T9, Canada. EM jayna.holroyd-leduc@calgaryhealthregion.ca RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU NIA NIH HHS [AG 00912, AG 10418] NR 33 TC 39 Z9 40 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 2007 VL 55 IS 2 BP 227 EP 233 DI 10.1111/j.1532-5415.2007.01064.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 131LH UT WOS:000243869900011 PM 17302659 ER PT J AU Radcliff, TA Dobalian, A Levy, C AF Radcliff, Tiffany A. Dobalian, Aram Levy, Cari TI Do orders limiting aggressive treatment impact care for acute myocardial infarction? SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article ID COOPERATIVE CARDIOVASCULAR PROJECT; NOT-RESUSCITATE ORDERS; QUALITY-OF-CARE; PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; ADVANCE DIRECTIVES; MEDICARE BENEFICIARIES; NURSING-HOME; RACIAL-DIFFERENCES; AMERICAN-COLLEGE AB Objectives: Little is known about whether advance directives impact inpatient care for a condition with clear treatment guidelines. The goal of this research was to determine the association between limitation of aggressive treatment (LAT) orders and guideline adherence for acute myocardial infarction (AMI). Design: Secondary examination of data from the national Cooperative Cardiovascular Project (CCP) baseline data. We used seemingly unrelated regression to correct for potential selection bias between patients with and without LAT orders and to determine whether such orders predict guideline adherence for several treatments related to acute myocardial infarction. Setting: The setting included 4111 short-term non-federal acute care hospitals in the United States. Participants: Participants were 147,475 AMI cases with complete data abstracted from inpatient hospital charts, representing most fee-for-service Medicare patients who were hospitalized with AMI between February 1994 and July 1995. Measurements: Adherence to guidelines for treating acute myocardial infarction, including aspirin, Beta blockers, and reperfusion via thrombolytics or PTCA. Results: Patients with LAT orders are less likely to receive care in accordance with guidelines when controlling for other factors that may explain a lower likelihood of guideline adherence. After adjustment for selection effects, we found a lower predicted probability that patients received more invasive treatments. Conclusion: Patients with LAT orders appear to receive care that is less aggressive and less congruent with acute myocardial infarction care guidelines compared with patients without such orders. Quality improvement measures will need to take this difference into account and ensure that physicians are not penalized for complying with patient care preferences. C1 VA Eastern Colorado Healthcare Syst, HSR&D TREP Long Term Care Res, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Div Hlth Care Policy & Res, Aurora, CO USA. VA Greater Los Angeles Healthcare Syst HSR&D, Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. Univ Calif Los Angeles, Dept Hlth Sci, Los Angeles, CA USA. RP Radcliff, TA (reprint author), 1055 Clemont St,MS 151, Denver, CO 80220 USA. EM Tiffany.Radcliff@uchsc.edu NR 49 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 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD FEB PY 2007 VL 8 IS 2 BP 91 EP 97 DI 10.1016/j.jamda.2006.06.004 PG 7 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 138RX UT WOS:000244381100006 PM 17289538 ER PT J AU French, DD Werner, DC Campbell, RR Powell-Cope, GM Nelson, AL Rubenstein, LZ Bulat, T Spehar, AM AF French, Dustin D. Werner, Dennis C. Campbell, Robert R. Powell-Cope, Gail M. Nelson, Audrey L. Rubenstein, Laurence Z. Bulat, Tatjana Spehar, Andrea M. TI A multivariate fall risk assessment model for VHA nursing homes using the Minimum Data Set SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE accidental falls; falls; patient safety; nursing homes; long-term care; minimum data set; risk factors; risk assessment; multivariate analysis; veterans ID LONG-TERM-CARE; OLDER-ADULTS; RESIDENTIAL CARE; ELDERLY FALLERS; PREVENTION; COMMUNITY; PEOPLE; GAIT; INJURIES; BALANCE AB Objectives: The purpose of this study was to develop a multivariate fall risk assessment model beyond the current fall Resident Assessment Protocol (RAP) triggers for nursing home residents using the Minimum Data Set (MDS). Design: Retrospective, clustered secondary data analysis. Setting: National Veterans Health Administration (VHA) long-term care nursing homes (N = 136). Participants: The study population consisted of 6577 national VHA nursing home residents who had an annual assessment during FY 2005, identified from the MDS, as well as an earlier annual or admission assessment within a 1-year look-back period. Measurement. A dichotomous multivariate model of nursing home residents coded with a fall on selected fall risk characteristics from the MDS, estimated with general estimation equations (GEE). Results: There were 17 170 assessments corresponding to 6577 long-term care nursing home residents. The increased odds ratio (OR) of being classified as a faller relative to the omitted "dependent" category of activities of daily living (ADL) ranged from OR = 1.35 for "limited" ADL category up to OR = 1.57 for "extensive-2" ADL (P < .0001). Unsteady gait more than doubles the odds of being a faller (OR = 2.63, P < .0001). The use of assistive devices such as canes, walkers, or crutches, or the use of wheelchairs increases the odds of being a faller (OR = 1.17, P < .0005) or (OR = 1.19, P < .0002), respectively. Foot problems may also increase the odds of being a faller (OR = 1.26, P < .0016). Alzheimer's or other dementias also increase the odds of being classified as a faller (OR = 1.18, P < .0219) or (OR = 1.22, P < .0001), respectively. In addition, anger (OR = 1.19, P < .0065); wandering (OR = 1.53, P < .0001); or use of antipsychotic medications (OR = 1.15, P < .0039), antianxiety medications (OR = 1.13, P < .0323), or antidepressant medications (OR = 1.39, P < .0001) was also associated with the odds of being a faller. Conclusions: This national study in one of the largest managed healthcare systems in the United States has empirically confirmed the relative importance of certain risk factors for falls in long-term care settings. The model incorporated an ADL index and adjusted for case mix by including only long-term care nursing home residents. The study offers clinicians practical estimates by combining multiple univariate MDS elements in an empirically based, multivariate fall risk assessment model. C1 James A Haley VAMC, Patient Safety Ctr Inquiry VISN8, Tampa, FL 33612 USA. Univ Calif Los Angeles, David Geffen Sch Med, North Hills, CA USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda Div, North Hills, CA USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, W Los Angeles Div, North Hills, CA USA. Univ S Florida, Coll Publ Hlth, Tampa, FL USA. RP French, DD (reprint author), James A Haley VAMC, Patient Safety Ctr Inquiry VISN8, 13000 Bruce B Downs Blvd 118M, Tampa, FL 33612 USA. EM Dustin.French@va.gov OI French, Dustin/0000-0003-4064-3206; Powell-Cope, Gail/0000-0002-4608-0128 NR 67 TC 35 Z9 35 U1 6 U2 15 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 2007 VL 8 IS 2 BP 115 EP 122 DI 10.1016/j.jamda.2006.08.005 PG 8 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 138RX UT WOS:000244381100010 PM 17289542 ER PT J AU Nace, DA Hoffman, EL Resnick, NM Handler, SM AF Nace, David A. Hoffman, Erika L. Resnick, Neil M. Handler, Steven M. TI Achieving and sustaining high rates of influenza immunization among long-term care staff SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE nursing homes; immunization programs; influenza; health care workers ID NURSING-HOME; WORKERS; VACCINATION; MORTALITY; OUTBREAK AB Background: Influenza causes significant morbidity and mortality in long-term care facilities. Immunization of health care workers has been shown to reduce the impact of influenza in this setting, yet few studies address improvement efforts aimed at long-term care staff immunization. Objective: To determine the feasibility of achieving and sustaining high rates of staff influenza immunization for a community-based long-term care facility. Methods: A needs analysis was conducted to determine the organizational and individual level barriers to influenza vaccination of staff. Systems changes, educational interventions, and reminders were implemented based on the barriers assessment. Staff immunization rates were calculated over a 10-year period from 1996 to 2006. Results: Organizational and individual barriers were identified and targeted. Using data from 1996 and 1997 as a baseline, staff immunization rates improved from 54% to 55% to between 74% and 95% over the past 4 years. Conclusions: Achieving and sustaining high staff influenza immunization rates is possible in a community-based long-term care facility with an involved quality improvement team and medical director. C1 Univ Pittsburgh, Div Geriatr Med, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Biomed Informat, Pittsburgh, PA USA. Univ Pittsburgh, Inst Aging, Pittsburgh, PA USA. RP Nace, DA (reprint author), Univ Pittsburgh, Div Geriatr Med, 3471 5th Ave,Suite 500, Pittsburgh, PA 15213 USA. EM naceda@upmc.edu RI Nace, David/D-2638-2014 OI Handler, Steven/0000-0002-3940-3224 FU NCRR NIH HHS [8K12RR023267] NR 38 TC 21 Z9 21 U1 1 U2 4 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 2007 VL 8 IS 2 BP 128 EP 133 DI 10.1016/j.jamda.2006.09.014 PG 6 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 138RX UT WOS:000244381100012 PM 17289544 ER PT J AU Farjah, F Symons, RG Krishnadasan, B Wood, DE Flum, DR AF Farjah, Farhood Symons, Rebecca Gaston Krishnadasan, Bahirathan Wood, Douglas E. Flum, David R. TI Management of pleural space infections: A population-based analysis SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the Western-Thoracic-Surgical-Association CY JUN 21-24, 2006 CL Sun Valley, ID SP Western Thorac Surg Assoc ID PARAPNEUMONIC EFFUSIONS; THORACIC EMPYEMA; EXPERIENCE; TRIAL AB Objective: Management options for pleural space infections have changed over the last 2 decades. This study evaluated trends over time in the incidence of disease and use of different management strategies and their associated outcomes. Methods: A retrospective study was performed by using a statewide administrative database of all hospitalizations for pleural space infections between 1987 and 2004. Results: Four thousand four hundred twenty-four patients (age, 57.1 +/- 18.6 years; 67% male; comorbidity index, 1.1 +/- 1.9) were hospitalized with pleural space infections. The incidence rate increased 2.8% per year (95% confidence interval, 2.2%-3.4%; P < .001). Overall, 51.6% of patients underwent an operation, and the proportion increased from 42.4% in 1987 to 58.4% in 2004 (P < .001). The risk of death within 30 days was less for patients undergoing operations compared with that for patients not undergoing operations (5.4% vs 16.6%, P < .001); however, patients undergoing operations were younger (52.9 +/- 17.6 years vs 61.5 +/- 18.6 years, P < .001) and had a lower comorbidity index (0.8 +/- 1.6 vs 1.4 +/- 2.1, P < .001). After adjusting for age, sex, comorbidity index, and insurance status, patients undergoing operative therapy had a 58% lower risk of death (odds ratio, 0.42; 95% confidence interval, 0.32-0.56; P < .001) than those undergoing nonoperative management. Conclusions: The incidence of pleural space infections and the proportion of patients undergoing operative management have increased over time. Patients undergoing operations were younger and had less comorbid illness than those not undergoing operations but had a much lower risk of early death, even after adjusting for these factors. C1 Univ Washington, Div Gen Surg, Dept Surg, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Surg, Div Cardiothorac Surg, Seattle, WA USA. Univ Washington, Div Cardiovasc Surg, Dept Surg, Seattle, WA 98195 USA. Univ Washington, Div Gen Surg, Dept Surg, Seattle, WA 98195 USA. Univ Washington, Div Gen Surg, Dept Hlth Serv, Seattle, WA 98195 USA. RP Flum, DR (reprint author), Univ Washington, Div Gen Surg, Dept Surg, 1959 NE Pacific,Box 356410, Seattle, WA 98195 USA. EM daveflum@u.washington.edu NR 15 TC 55 Z9 56 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD FEB PY 2007 VL 133 IS 2 BP 346 EP U10 DI 10.1016/j.jctvs.2006.09.038 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 130FB UT WOS:000243783900013 PM 17258562 ER PT J AU Bush, RL Johnson, ML Hedayati, N Henderson, WG Lin, PH Lumsden, AB AF Bush, Ruth L. Johnson, Michael L. Hedayati, Nasim Henderson, William G. Lin, Peter H. Lumsden, Alan B. TI Performance of endovascular aortic aneurysm repair in high-risk patients: Results from the Veterans Affairs National Surgical Quality Improvement Program SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 60th Annual Meeting of the Society-for-Vascular-Surgery CY JUN 01-04, 2006 CL Philadelphia, PA SP Soc Vasc Surg ID RANDOMIZED CONTROLLED-TRIAL; LOGISTIC-REGRESSION MODELS; OPERATIVE MORTALITY; SERUM-ALBUMIN; AAA REPAIR; OF-LIFE; OUTCOMES; OCTOGENARIANS; COST; CARE AB Objective: Recent results after endovascular abdominal aortic aneurysm repair (EVAR) have brought into question its value in patients deemed at high-risk for surgical intervention. The Department of Veteran Affairs (VA) National Surgical Quality Improvement Program (NSQIP) is the largest prospectively collected and validated United States surgical database representing current clinical practice. The purpose of our study was to evaluate outcomes after elective EVAR performed in high-risk veterans. Methods: Using NSQIP data from 123 participating VA hospitals, we retrospectively evaluated patients who underwent elective aneurysm repair from May 2001 to December 2004. High-risk criteria were used to identify a cohort for analysis (EVAR, n = 788; open, n = 1580). High-risk criteria analyzed included age >= 60 years, American Society of Anesthesiology (ASA) classification 3 or 4, and the comorbidity variables of history of cardiac, respiratory, or hepatic disease, cardiac revascularization, renal insufficiency, and low serum albumin level. Our primary end points were 30-day and 1-year all-cause mortality, and we evaluated a secondary end point of perioperative complications. Statistical analysis included univariate analysis and multivariate modeling. Results: Veterans who were classified as high-risk underwent elective EVAR with significantly lower 30-day (3.4% vs 5.2%, P = .047) and 1-year all-cause mortality (9.5% vs 12.4%, P = .038) than patients having open repair. EVAR was associated with a decrease in 30-day postoperative mortality (adjusted odds ratio [OR], 0.65; 95% confidence interval [CI], 0.42 to 1.03; P = .067) as well as 1-year mortality (adjusted OR, 0.68; 95% CI, 0.51 to 0.91; P = .0094) despite the presence of severe comorbid conditions. The risk of perioperative complications was significantly lower after EVAR (16.2% vs 31.0%; P < .0001; adjusted OR, 0.41; 95% CI, 0.33 to 0.52; P < .0001). A subset analysis of higher-risk patients (ASA 4 and the above comorbidity variables) still demonstrated an acceptable 30-day mortality rate. Conclusion: In veterans deemed high-risk for surgical therapy, outcomes after elective EVAR are excellent, and the procedure is relatively safe in this special patient population. Our retrospective data demonstrate that patients with considerable medical comorbidities and infrarenal abdominal aortic aneurysms benefit from and should be considered for primary EVAR. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Univ Houston, Michael E DeBakey Dept Surg, Coll Pharm, Baylor Coll Med, Houston, TX 77030 USA. Univ Colorado, Hlth Outcomes Program, Boulder, CO 80309 USA. RP Bush, RL (reprint author), Univ Houston, Michael E DeBakey Dept Surg, Coll Pharm, Baylor Coll Med, 1709 Dryden,Suite 1568, Houston, TX 77030 USA. EM rbush@bcm.tmc.cdu NR 42 TC 60 Z9 63 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD FEB PY 2007 VL 45 IS 2 BP 227 EP 233 DI 10.1016/j.jvs.2006.10.005 PG 7 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 133BS UT WOS:000243987200001 PM 17263992 ER PT J AU Appelt, CJ Burant, CJ Siminoff, LA Kwoh, CK Ibrahim, SA AF Appelt, Cathleen J. Burant, Christopher J. Siminoff, Laura A. Kwoh, C. Kent Ibrahim, Said A. TI Arthritis-specific health beliefs related to aging among older male patients with knee and/or hip osteoarthritis SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article; Proceedings Paper CT National Annual Meeting of the US Department of Veterans Affairs Health Services Research and Development Service CY FEB, 2005 CL Baltimore, MD ID AFRICAN-AMERICAN; RHEUMATOID-ARTHRITIS; ETHNIC-DIFFERENCES; JOINT REPLACEMENT; UNITED-STATES; ARTHROPLASTY; PERCEPTIONS; CARE; EXPECTATIONS; PREFERENCES AB Background. Disease-specific beliefs may impact patients' perceptions of the efficacy of various treatment options, thus, it is important to understand these beliefs. We examined the relationship between patients' demographic characteristics and arthritis-specific beliefs related to aging. Methods. We performed a cross-sectional survey of 591 elderly primary care patients, who had symptomatic osteoarthritis (OA) of the knee and/or hip, at the Louis Stokes VA Medical Center in Cleveland, Ohio. Data were collected on age, race, educational level, income, and whether patients agreed or disagreed with four statements regarding aging and arthritis. We also assessed OA symptom severity using the Western Ontario McMaster Universities Index (WOMAC) and depressive symptoms using the Geriatric Depression Scale. We used logistic regression analyses to examine relationships between patients' age, race, and educational level and arthritis-specific health beliefs, while adjusting for OA symptom severity, radiographic confirmation of OA, OA joint burden, depressive symptoms, and income. Results. Patients 70 years old or older, as compared to patients 50-59 years old, were more likely to believe that: arthritis is a natural part of growing old; people should expect that when they get older, they won't be able to walk as well, and people should expect to live with pain as they grow older. Conclusion. Among older, male veterans, health beliefs regarding the relationship between aging and arthritis vary by age. Clinicians should consider these differences when discussing treatment strategies with their patients with knee and/or hip OA. C1 VA Pittsburgh Healthcare Syst, Mental Illness Res Educ & Clin Ctr, Pittsburgh, PA 15206 USA. Case Western Reserve Univ, Sch Med, Dept Bioeth, Cleveland, OH 44106 USA. Virginia Commonwealth Univ, Sch Med, Dept Social & Behav Hlth, Richmond, VA 23284 USA. Vet Adm Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA 15260 USA. RP Appelt, CJ (reprint author), VA Pittsburgh Healthcare Syst, Mental Illness Res Educ & Clin Ctr, 7180 Highland Dr Div,151R-HD, Pittsburgh, PA 15206 USA. EM cathleen.appelt@va.gov RI Siminoff, Laura /H-6277-2012 NR 38 TC 16 Z9 16 U1 2 U2 6 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD FEB PY 2007 VL 62 IS 2 BP 184 EP 190 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 178KU UT WOS:000247220400009 PM 17339644 ER PT J AU Keller, CR Odden, MC Fried, LF Newman, AB Angleman, S Green, CA Cummings, SR Harris, TB Shlipak, MG AF Keller, C. R. Odden, M. C. Fried, L. F. Newman, A. B. Angleman, S. Green, C. A. Cummings, S. R. Harris, T. B. Shlipak, M. G. TI Kidney function and markers of inflammation in elderly persons without chronic kidney disease: The health, aging, and body composition study SO KIDNEY INTERNATIONAL LA English DT Article DE inflammation; biomarkers; cystatin; kidney; epidemiology ID SERUM CYSTATIN-C; GLOMERULAR-FILTRATION-RATE; CORONARY-HEART-DISEASE; CHRONIC-RENAL-FAILURE; REACTIVE PROTEIN; HEMODIALYSIS-PATIENTS; CARDIOVASCULAR EVENTS; PLASMA; RISK; INTERLEUKIN-6 AB Inflammatory markers are elevated in persons with estimated glomerular filtration rates less than 60ml/min/1.73m(2). As cystatin C may detect small changes in kidney function not detected by estimated glomerular filtration rate, we evaluated the association between cystatin C and serum markers of inflammation in older adults with estimated glomerular filtration rate >= 60. This is an analysis using measures from the Health, Aging, and Body Composition Study, a cohort of well-functioning adults aged 70-79 years. Cystatin C correlated with all five inflammatory biomarkers: C-reactive protein ( r = 0.08), interleukin-6 ( r = 0.19), tumor necrosis factor alpha ( TNF-alpha) ( r = 0.41), soluble TNF receptor 1 ( STNF-R1) ( r = 0.61), and soluble TNF receptor 2 ( STNF-R2) ( r = 0.54); P < 0.0005 for all. In adjusted analyses, cystatin C concentrations appeared to have stronger associations with each biomarker compared with estimated glomerular filtration rate or serum creatinine. Participants with a cystatin C >= 1.0mg/l had significantly higher levels of all five biomarkers compared to those with a cystatin C < 1.0 ( mean differences ranging 16-29%, all P < 0.05). Cystatin C has a linear association with inflammatory biomarkers in an ambulatory elderly cohort with estimated glomerular filtration rates >= 60; associations are particularly strong with TNF-alpha and the STNF-R. C1 Vet Adm Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Pittsburgh, Sch Med, Renal Sect, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Renal Sect, Renal Electrolyte Div, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15260 USA. NIA, Lab Epidemiol Demog & Biometry, Intramural Res Program, Bethesda, MD 20892 USA. Univ Tennessee, Dept Med, Div Nephrol, Knoxville, TN 37996 USA. Calif Pacific Med Ctr, Res Inst, San Francisco, CA 94115 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Shlipak, MG (reprint author), Vet Adm Med Ctr, Gen Internal Med Sect, 111A1,4150 Clement St, San Francisco, CA 94121 USA. EM shlip@itsa.ucsf.edu RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150; Angleman, Sara/0000-0002-9520-5716 FU Intramural NIH HHS; NHLBI NIH HHS [R01 HL073208-01]; NIA NIH HHS [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106]; NIDDK NIH HHS [R01 DK066488-01] NR 42 TC 79 Z9 81 U1 2 U2 6 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 FEB PY 2007 VL 71 IS 3 BP 239 EP 244 DI 10.1038/sj.ki.5002042 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 129LK UT WOS:000243730800011 PM 17183246 ER PT J AU Roman, GC Navarro-Roman, LI AF Roman, Gustavo C. Navarro-Roman, Lydia I. TI The discovery of HTLV-1 myelitis: 21 years later SO LANCET NEUROLOGY LA English DT Editorial Material ID TROPICAL SPASTIC PARAPARESIS; MYELOPATHY C1 Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78229 USA. Vet Adm Hosp, San Antonio, TX USA. Alliance Wellness Grp, San Antonio, TX USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78229 USA. NR 7 TC 1 Z9 1 U1 1 U2 1 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1474-4422 J9 LANCET NEUROL JI Lancet Neurol. PD FEB PY 2007 VL 6 IS 2 BP 104 EP 105 DI 10.1016/S1474-4422(07)70012-1 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 130JG UT WOS:000243795300007 PM 17239794 ER PT J AU Ardekani, S Kumar, A Bartzokis, G Sinha, U AF Ardekani, Siamak Kumar, Anand Bartzokis, George Sinha, Usha TI Exploratory voxel-based analysis of diffusion indices and hemispheric asymmetry in normal aging SO MAGNETIC RESONANCE IMAGING LA English DT Article DE diffusion tensor imaging; voxel-based analysis; aging; hemispheric asymmetry ID WHITE-MATTER; HUMAN BRAIN; RHESUS-MONKEY; NERVE-FIBERS; AGE; MRI; SCHIZOPHRENIA; ANISOTROPY; INTEGRITY; BREAKDOWN AB Age-related microstructural changes in brain white matter can be studied by utilizing indices derived from diffusion tensor imaging (DTI): apparent difftision coefficient (ADC) and fractional anisotropy (FA). The objective of this study is to examine alterations in FA and ADC by employing exploratory voxel-based analysis (VBA) and region(s) of interest (ROI)-based analysis. A highly nonlinear registration algorithm was used to align the ADC and FA image volumes of different subjects to perform accurate voxel-level statistics for two age groups, as well as for hemispheric asymmetry for both age groups. VBA shows significant age-related decline in FA with frontal predominance (frontal white matter, and genu and anterior body of the corpus callosum), superior portions of a splenium and highly oriented fibers of the posterior limb of the internal capsule and the anterior and posterior limbs of the external capsule. Hemispheric asymmetry of FA, as assessed by VBA, showed that for the young-age group, significant right-greater-than-left asymmetry exists in the genu, splenium and body of the corpus callosum and that left-greater-than-right asymmetry exists in the anterior limb of the external capsule and in the posterior limb of the internal capsule, thalamus, cerebral peduncle and temporal-parietal regions. VBA of the hemispheric asymmetry of the middle-age group revealed much less asymmetry. Regions showing age-related changes and hemispheric asymmetry from VBA were, for a majority of the findings, in conformance with ROI analysis and with the known pattern of development and age-related degradation of fiber tracks. The study shows the feasibility of the VBA of DTI indices for exploratory investigations of subtle differences in population cohorts, especially when findings are not localized and/or known a priori. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, Biomed Engn IDP, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Radiol, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Psychiat, David Geffen Sch Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurol, David Geffen Sch Med, Div Brain Mapping,Lab Neuroimaging, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Dept Psychiat, West Los Angeles, CA 90073 USA. RP Sinha, U (reprint author), Univ Calif Los Angeles, Biomed Engn IDP, Los Angeles, CA 90095 USA. EM usinha@mii.ucla.edu RI Ardekani, Siamak/A-3487-2010; Bartzokis, George/K-2409-2013 FU NIBIB NIH HHS [P01-EB00216] NR 42 TC 76 Z9 77 U1 1 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0730-725X J9 MAGN RESON IMAGING JI Magn. Reson. Imaging PD FEB PY 2007 VL 25 IS 2 BP 154 EP 167 DI 10.1016/j.mri.2006.09.045 PG 14 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 136YZ UT WOS:000244261300002 PM 17275609 ER PT J AU Federman, AD Halm, EA Siu, AL AF Federman, Alex D. Halm, Ethan A. Siu, Albert L. TI Use of generic cardiovascular medications by elderly medicare beneficiaries receiving generalist or cardiologist care SO MEDICAL CARE LA English DT Article DE medicare; generic drugs; elderly; cardiovascular disease; generalist; cardiologist ID PHARMACEUTICAL SALES REPRESENTATIVES; DRUG BENEFIT PLANS; PRESCRIPTION DRUGS; POTENTIAL SAVINGS; PHYSICIANS; COST; SUBSTITUTION; UNDERUSE; COMMUNICATION; FORMULARY AB Background: Elderly Medicare beneficiaries can reduce out-of-pocket spending and increase their options for low-cost Medicare Part D plans by using generic drugs. Physicians play a key role in determining use of generics and specialty may be a particularly influential factor. Objectives: We sought to compare generic cardiovascular drug use by older adults receiving cardiologist and generalist care. Research Design: We undertook a cross-sectional analysis of data from the nationally representative Medicare Current Beneficiary Survey. Included were community-dwelling adults 66 years of age or older with hypertension, coronary disease, or congestive heart failure, one or more Medicare Part B claims for outpatient visits with generalists (internist or family practitioner) or cardiologists, using one or more cardiovascular drug available in both brand-name and generic formulations (n = 1828). Measures: The primary outcome was use of one or more generic medication aggregated across 5 drug classes: beta-blockers, thiazides, calcium channel blockers (CCB), angiotensin-converting enzyme (ACE) inhibitors, and alpha(1)-adrenergic receptor antagonists. Within-class generic use also was examined. The main independent variable was cardiologist (20.7%) versus generalist-only care (79.3%). Results: In the aggregate, fewer individuals under cardiologist care used generics compared with generalist-only care (75% vs. 81%, P = 0.03; adjusted relative risk 0.89, 95% confidence interval = 0.79-0.99). Overall use of generic beta-blockers was 86.6%; thiazides, 92.0%; ACE inhibitors, 59.0%; CCB, 55.5%; alpha-blockers 47.7%. In adjusted analysis, generic CCB use occurred 34% less often among cardiologist versus generalist-only patients. Conclusions: Older patients of generalists and, to a greater extent, cardiologists, often use brand-name drugs when generic equivalents are available. Promoting generic prescribing among specialists and generalists may increase opportunities for patients and third-party payers to reduce spending on prescription drugs. C1 CUNY Mt Sinai Sch Med, Div Gen Internal Med, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Brookdale Dept Geriatr & Adult Dev, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Federman, AD (reprint author), CUNY Mt Sinai Sch Med, Div Gen Internal Med, 1470 Madison Ave,Box 1087, New York, NY 10029 USA. EM alex.federman@mssm.edu NR 32 TC 15 Z9 17 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD FEB PY 2007 VL 45 IS 2 BP 109 EP 115 DI 10.1097/01.mlr.0000250293.24939.2e PG 7 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 138GR UT WOS:000244351600002 PM 17224772 ER PT J AU Holmes, WC Gariti, KO Sadeghi, L Joisa, SD AF Holmes, William C. Gariti, Katherine O. Sadeghi, Leila Joisa, Sowmya D. TI Abuse of war zone detainees: Veterans' perceptions of acceptability SO MILITARY MEDICINE LA English DT Article; Proceedings Paper CT 21st Annual Meeting of the International-Society-for-Traumatic-Stress-Studies (ISTSS) CY NOV 02-05, 2005 CL Toronto, CANADA SP Int Soc Traumat Stress Studies, Natl Inst Ment Hlth ID POSTTRAUMATIC-STRESS-DISORDER AB We assessed detainee abuse acceptance and variables associated with it. Outpatients from a veterans' hospital were administered questionnaires with three increasingly severe scenarios of a U.S. soldier abusing a detainee. Three questionnaire versions differed in the final line of each version's scenarios, describing abuse either as: soldier initiated, superior ordered, or wrong by a "whistleblower" soldier. Three hundred fifty-one veterans participated, 80% with service during the Vietnam War. Zero tolerance for abuse-"completely unacceptable" regardless of who the detainee was-increased with abuse severity (16% for exposure, 31% for humiliation, and 48% for rape of detainee) and with soldier initiation. The strongest, most consistently significant odds were of depressed veterans, veterans with comorbid depression/post-traumatic stress disorder, and men being approximately 2, 3, and 4 to 20 times more tolerant of abuse than those without depression/post-traumatic stress disorder and women, respectively. There may be potential value to using similar scenario-based questionnaires to study active duty military perceptions of detainee abuse. Results may inform prevention policies. C1 Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Mental Hlth Clin, Philadelphia, PA 19104 USA. Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. RP Holmes, WC (reprint author), Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, 733 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 16 TC 1 Z9 1 U1 2 U2 4 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 FEB PY 2007 VL 172 IS 2 BP 175 EP 181 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 136NY UT WOS:000244232600015 PM 17357773 ER PT J AU Matsuo, K Glahn, DC Peluso, MAM Hatch, JP Monkul, ES Najt, P Sanches, M Zamarripa, F Li, J Lancaster, JL Fox, PT Gao, JH Soares, JC AF Matsuo, K. Glahn, D. C. Peluso, M. A. M. Hatch, J. P. Monkul, E. S. Najt, P. Sanches, M. Zamarripa, F. Li, J. Lancaster, J. L. Fox, P. T. Gao, J-H Soares, J. C. TI Prefrontal hyperactivation during working memory task in untreated individuals with major depressive disorder SO MOLECULAR PSYCHIATRY LA English DT Article; Proceedings Paper CT 60th Annual Convention of the Society-of-Biological-Psychiatry CY MAY 19-21, 2005 CL Atlanta, GA SP Soc Biol Psychiat DE gyrus cinguli; attention; cognition; prefrontal cortex; mood disorders; functional magnetic resonance imaging; memory ID FUNCTIONAL MAGNETIC-RESONANCE; POSITRON-EMISSION-TOMOGRAPHY; ANTERIOR CINGULATE CORTEX; POSTTRAUMATIC-STRESS-DISORDER; OBSESSIVE-COMPULSIVE DISORDER; UNIPOLAR DEPRESSION; BIPOLAR DISORDER; MOOD DISORDERS; PANIC DISORDER; FRONTAL LOBES AB The prefrontal cortex, a part of the limbic-thalamic-cortical network, participates in regulation of mood, cognition and behavior and has been implicated in the pathophysiology of major depressive disorder (MDD). Many neuropsychological studies demonstrate impairment of working memory in patients with MDD. However, there are few functional neuroimaging studies of MDD patients during working memory processing, and most of the available ones included medicated patients or patients with both MDD and bipolar disorder. We used functional magnetic resonance imaging (fMRI) to measure prefrontal cortex function during working memory processing in untreated depressed patients with MDD. Fifteen untreated individuals with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition recurrent MDD (mean age +/- s.d. = 34.3 +/- 11.5 years) and 15 healthy comparison subjects (37.7 +/- 12.1 years) matched for age, sex and race were studied using a GE/Elscint 2T MR system. An echo-planar MRI sequence was used to acquire 24 axial slices. The n-back task (0-back, 1-back and 2-back) was used to elicit frontal cortex activation. Data were analyzed with a multiple regression analysis using the FSL-FEAT software. MDD patients showed significantly greater left dorsolateral cortex activation during the n-back task compared to the healthy controls (P < 0.01), although task performance was similar in the two groups. Furthermore, the patients showed significant anterior cingulate cortex activation during the task, but the comparison subjects did not (P < 0.01). This study provides in vivo imaging evidence of abnormal frontolimbic circuit function during working memory processing in individuals with MDD. C1 Univ Texas, Hlth Sci Ctr, MOOD CNS Program, Dept Psychiat,Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Res Imaging Ctr, San Antonio, TX USA. Univ Sao Paulo, Dept Psychiat, Sao Paulo, Brazil. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX 78229 USA. Univ Chicago, Dept Radiol, Chicago, IL 60637 USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, MOOD CNS Program, Dept Psychiat,Div Mood & Anxiety Disorders, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM soares@uthscsa.edu RI Lancaster, Jack/F-2994-2010; Li, Jinqi/F-7778-2010; Fox, Peter/B-4725-2010 OI Fox, Peter/0000-0002-0465-2028 FU NCRR NIH HHS [M01-RR-01346, RR020571]; NIMH NIH HHS [MH 01736, MH 068662] NR 75 TC 103 Z9 106 U1 5 U2 17 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 2007 VL 12 IS 2 BP 158 EP 166 DI 10.1038/sj.mp.4001894 PG 9 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 130EZ UT WOS:000243783700005 PM 16983390 ER PT J AU Yaffe, K Barnes, D Lindquist, K Cauley, J Simonsick, EM Penninx, B Satterfield, S Harris, T Cummings, SR AF Yaffe, K. Barnes, D. Lindquist, K. Cauley, J. Simonsick, E. M. Penninx, B. Satterfield, S. Harris, T. Cummings, S. R. CA Hlth ABC Investigators TI Endogenous sex hormone levels and risk of cognitive decline in an older biracial cohort SO NEUROBIOLOGY OF AGING LA English DT Article DE cognition; dementia; sex hormones; estrogen ID CENTRAL-NERVOUS-SYSTEM; HEALTH INITIATIVE MEMORY; ESTROGEN-RECEPTOR-ALPHA; BETA-AMYLOID PEPTIDES; POSTMENOPAUSAL WOMEN; ALZHEIMERS-DISEASE; MESSENGER-RNA; ELDERLY-WOMEN; FREE TESTOSTERONE; MEN AB Background: Older women treated with conjugated estrogens may have an increased risk of dementia. but the effect of naturally occurring sex hormones on cognition is not certain. Methods: Bioavailable estradio and free testosterone level were obtained from 792 (55% men, 51% black) participants. We assessed cognition with the Modified Mini-Mental State Examination (3MS). Selective Reminding Test (SRT) and CLOX 1 at baseline and 2 years later. Results: Women in the lowest estradiol tertile were more likely than those in the highest fertile to decline (>= 1.0 S.D. of change) on 3MS (25% versus 9%, adjusted odds ratio [OR] = 3.9; 95% confidence interval [CI] = 1.6-9.6) and on SRT (28% versus 12%, adjusted OR [95% CI] = 3.3 [1.4-7.9]) but not CLOX 1. There was a borderline association between low estradiol tertile and decline on SRT in men (22% versus 14%, adjusted OR [95% CI] = 1.9 [0.0-3.9]). Testosterone level was not associated with decline in cognition in either men or women. Findings did not differ by race. Conclusions: Older women with low estradiol levels were more likely to experience decline in global cognitive function and verbal memory and a similar trend was observec for verbal memory in men. This supports, the hypothesis that endogenous sex hormones may play an important role in the maintenance of cognitive function in older adults. (c) 2006 Elsevier Inc. All rights reserved. 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 Geriatr, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Pittsburgh, Sch Med, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA. NIA, Clin Res Branch, Baltimore, MD 21224 USA. NIA, Lab Epidemiol Demog & Biometry, Baltimore, MD 21224 USA. Vrije Univ Amsterdam, Med Ctr, Dept Psychiat, EMGO Inst, NL-1007 MB Amsterdam, Netherlands. Univ Tennessee, Dept Prevent Med, Memphis, TN 38163 USA. Calif Pacific Med Ctr, San Francisco, CA 94107 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 RI Cauley, Jane/N-4836-2015 OI Cauley, Jane/0000-0003-0752-4408 FU Intramural NIH HHS; NIA NIH HHS [N01-AG-2103, N01-AG-2106, N01-AG-6-2101, R01 AG021918-03] NR 47 TC 66 Z9 71 U1 3 U2 4 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 2007 VL 28 IS 2 BP 171 EP 178 DI 10.1016/j.neurobiolaging.2006.10.004 PG 8 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 128ZK UT WOS:000243698000001 PM 17097195 ER PT J AU Quinn, JF Bussiere, JR Hammond, RS Montine, TJ Henson, E Jones, RE Stackman, RW AF Quinn, Joseph F. Bussiere, Joseph R. Hammond, Rebecca S. Montine, Thomas J. Henson, Edward Jones, Richard E. Stackman, Robert W., Jr. TI Chronic dietary alpha-lipoic acid reduces deficits in hippocampal memory of aged Tg2576 mice SO NEUROBIOLOGY OF AGING LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the Society-for-Neuroscience CY NOV 08-12, 2003 CL NEW ORLEANS, LA SP Soc Neurosci DE spatial memory; cortex memory; hippocampus; antioxidant; Alzheimer's disease; amyloid; nitrotyrosine ID TRANSGENIC MOUSE MODEL; AMYLOID-BETA PROTEIN; LONG-TERM POTENTIATION; RADICAL-CATALYZED MECHANISM; ACETYL-L-CARNITINE; ALZHEIMERS-DISEASE; A-BETA; IN-VIVO; OXIDATIVE STRESS; COGNITIVE IMPAIRMENT AB Oxidative stress may play a key role in Alzheimer's disease (AD) neuropathology. Here, the effects of the antioxidant, a-lipoic acid (ALA) were tested on the Tg2576 mouse, a transgenic model of cerebral amyloidosis associated with AD. Ten-month old T-2576 and wild type mice were fed an ALA-contain ng diet (0.1%) or control diet for 6 months and then assessed for the influence of diet on memory and neuropathology. ALA-treated Tg2576 mice exhibited significantly improved learning, and memory retention in the Morris water maze task compared to untreated T-2576 mice. Twenty-four hours after contextual fear conditioning, untreated Tg2576 mice exhibited significantly impaired context-dependent freezing. ALA-treated T,,2576 mice exhibited significantly more context freezing than the untreated Tg2576 mice. Assessment of brain soluble and insoluble beta-amyloid levels revealed no differences between ALA-treated and untreated Tg2576 mice. Brain levels of nitrotyrosine, a marker of nitrative stress, were elevated in T-2576 mice, while F2 isoprostanes and neuroprostanes, oxidative stress markers, were not elevated in the Tg2576 mice relative to wild type. These data indicate that chronic dietary ALA can reduce hippocampal-dependent memory deficits of Tg2576 mice without affecting beta-amyloid levels or plaque deposition. (c) 2006 Elsevier Inc. All rights reserved. C1 Portland Vet Affairs Med Ctr, R&D P3, Portland, OR USA. Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Dept Pediat, Portland, OR 97201 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. RP Stackman, RW (reprint author), Florida Atlantic Univ, Dept Psychol, BS 101,777 Glades Rd, Boca Raton, FL 33431 USA. EM rstackma@fau.edu FU NCCIH NIH HHS [AT00066] NR 91 TC 88 Z9 92 U1 1 U2 4 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 2007 VL 28 IS 2 BP 213 EP 225 DI 10.1016/j.neurobiolaging.2005.12.014 PG 13 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 128ZK UT WOS:000243698000006 PM 16448723 ER PT J AU Raskind, MA Burke, BL Crites, NJ Tapp, AM Rasmussen, DD AF Raskind, Murray A. Burke, Brianna L. Crites, Norman J. Tapp, Andre M. Rasmussen, Dennis D. TI Olanzapine-induced weight gain and increased visceral adiposity is blocked by melatonin replacement therapy in rats SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE olanzapine; obesity; melatonin; schizophrenia; antipsychotic drug ID DOUBLE-BLIND; BODY-WEIGHT; FOOD-INTAKE; PLASMA LEPTIN; MIDDLE-AGE; SCHIZOPHRENIA; PLACEBO; FAT; OBESITY; ANTIPSYCHOTICS AB The atypical antipsychotic drug olanzapine increases body weight and visceral adiposity in schizophrenia. In rats, aging-associated increased body weight and visceral adiposity are reversed by administration of the pineal hormone melatonin. We asked if melatonin similarly would reverse olanzapine-induced increased weight and visceral adiposity in rats. Four groups (n = 11/group) of female rats (240-250 g) were treated for 8 weeks with olanzapine, melatonin, olanzapine + melatonin, or vehicle alone in drinking water. Body weight and food and water consumption were determined weekly, locomotor activity at weeks 3 and 6, and nocturnal plasma melatonin concentration at week 7. At week 8, the rats were killed and visceral ( perirenal, retroperitoneal, omental, and mesenteric) fat pads dissected and weighed. Olanzapine treatment reduced nocturnal plasma melatonin by 55% (p < 0.001), which was restored to control levels by olanzapine + melatonin. Body weight increased 18% in rats treated with olanzapine alone, but only 10% with olanzapine + melatonin, 5% with melatonin alone, and 7% with vehicle control. Body weight and visceral fat pad weight increases in rats treated with olanzapine alone were greater than in each of the other three groups (all p < 0.01), which were not significantly different. These results suggest that olanzapine-induced increases in body weight and visceral adiposity may be at least in part secondary to olanzapine-induced reduction of plasma melatonin levels, and that melatonin may be useful for the management of olanzapine-induced weight gain in humans. C1 VA Puget Sound Hlth Care Syst, Mental Hlth Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Rasmussen, DD (reprint author), VA Puget Sound Hlth Care Syst, Mental Hlth Res Educ & Clin Ctr, 116MIRECC,1660 S Columbian Way, Seattle, WA 98108 USA. EM drasmuss@u.washington.edu FU NIAAA NIH HHS [AA013881] NR 30 TC 50 Z9 53 U1 3 U2 6 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD FEB PY 2007 VL 32 IS 2 BP 284 EP 288 DI 10.1038/sj.npp.1301093 PG 5 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 128EH UT WOS:000243640500004 PM 16710316 ER PT J AU Friedlander, AH Chaudhuri, G Altman, L AF Friedlander, Arthur H. Chaudhuri, Gautam Altman, Lisa TI A past medical history of gestational diabetes: its medical significance and its dental implications SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTOLOGY LA English DT Article ID IMPAIRED GLUCOSE-TOLERANCE; GLYCEMIC CONTROL; PERIODONTAL-DISEASE; GLYCATED HEMOGLOBIN; RISK-FACTORS; ORAL-HEALTH; MELLITUS; WOMEN; POPULATION; PREVENTION AB Approximately 7% of pregnant women develop gestational diabetes mellitus (GDM), a usually transient form of diabetes mellitus, because of the production of some placental and maternal adipose tissue elaborated hormones that alter glucose metabolism. In most women the disorder resolves at delivery, but within 10 years 50% to 70% of these women go on to develop type 2 diabetes. The identification of women with past medical histories of GDM is a clinically useful marker for alerting the dentist to patients at heightened risk of occult type 2 diabetes, with a possible greater risk of developing periodontal disease and dental caries. Screening these patients for diabetes and establishing a preventative dental regimen may result in reducing the number of women with undiagnosed diabetes and diabetes-associated dental and cardiovascular diseases. C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Sch Dent, Los Angeles, CA 90024 USA. RP Friedlander, AH (reprint author), Univ Calif Los Angeles, VA Med Ctr, ACOS Educ, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 71 TC 5 Z9 6 U1 1 U2 6 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD FEB PY 2007 VL 103 IS 2 BP 157 EP 163 DI 10.1016/j.tripleo.2006.08.001 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 133AW UT WOS:000243985000003 PM 17234528 ER PT J AU Profit, J McCormick, MC Escobar, GJ Richardson, DK Zheng, Z Coleman-Phox, K Roberts, R Zupancic, JAF AF Profit, Jochen McCormick, Marie C. Escobar, Gabriel J. Richardson, Douglas K. Zheng, Zheng Coleman-Phox, Kim Roberts, Rebecca Zupancic, John A. F. TI Neonatal intensive care unit census influences discharge of moderately preterm infants SO PEDIATRICS LA English DT Article DE infant; newborn; census; discharge; health services research; workforce ID PREMATURE-INFANTS; HOSPITAL MORTALITY; EARLIER DISCHARGE; ILLNESS SEVERITY; STAFFING LEVELS; OUTCOMES; RISK; PROGRAM; STAY; COMPLICATIONS AB OBJECTIVE. The timely discharge of moderately premature infants has important economic implications. The decision to discharge should occur independent of unit census. We evaluated the impact of unit census on the decision to discharge moderately preterm infants. DESIGN/METHODS. In a prospective multicenter cohort study, we enrolled 850 infants born between 30 and 34 weeks' gestation at 10 NICUs in Massachusetts and California. We divided the daily census from each hospital into quintiles and tested whether discharges were evenly distributed among them. Using logistic regression, we analyzed predictors of discharge within census quintiles associated with a greater- or less-than-expected likelihood of discharge. We then explored parental satisfaction and postdischarge resource consumption in relation to discharge during census periods that were associated with high proportions of discharge. RESULTS. There was a significant correlation between unit census and likelihood of discharge. When unit census was in the lowest quintile, patients were 20% less likely to be discharged when compared with all of the other quintiles of unit census. In the lowest quintile of unit census, patient/nurse ratio was the only variable associated with discharge. When census was in the highest quintile, patients were 32% more likely to be discharged when compared with all of the other quintiles of unit census. For patients in this quintile, a higher patient/nurse ratio increased the likelihood of discharge. Conversely, infants with prolonged lengths of stay, an increasing Score for Neonatal Acute Physiology II, and minor congenital anomalies were less likely to be discharged. Infants discharged at high unit census did not differ from their peers in terms of parental satisfaction, emergency department visits, home nurse visits, or rehospitalization rates. CONCLUSIONS. Discharges are closely correlated with unit census. Providers incorporate demand and case mix into their discharge decisions. C1 Houston Ctr Qual Care & Utilizat Studies, Div Hlth Policy & Qual, Michael E DeBakey Vet Adm Med Ctr, Houston, TX 77030 USA. Childrens Hosp Boston, Harvard Newborn Med Program, Boston, MA USA. Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. Texas Childrens Hosp, Baylor Coll Med, Dept Pediat, Sect Neonatol, Houston, TX 77030 USA. Harvard Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA USA. Kaiser Permanente, Med Care Program, Perinatal Res Unit, Oakland, CA USA. Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA. RP Profit, J (reprint author), Houston Ctr Qual Care & Utilizat Studies, Div Hlth Policy & Qual, Michael E DeBakey Vet Adm Med Ctr, VA HSR&D 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM profit@bcm.edu OI Zupancic, John/0000-0003-1734-7193; McCormmick, Marie/0000-0002-3938-1707; Andridge, Rebecca/0000-0001-9991-9647 FU AHRQ HHS [R01 HS010131, T32 HS000063]; NICHD NIH HHS [K23 HD056298, K23 HD056298-02] NR 45 TC 23 Z9 23 U1 5 U2 6 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD FEB PY 2007 VL 119 IS 2 BP 314 EP 319 DI 10.1542/peds.2005-2909 PG 6 WC Pediatrics SC Pediatrics GA 132KP UT WOS:000243942000011 PM 17272621 ER PT J AU Pan, S Zhu, D Quinn, JF Peskind, ER Montjne, TJ Lin, BY Goodlett, DR Taylor, G Eng, J Zhang, J AF Pan, Sheng Zhu, David Quinn, Joseph F. Peskind, Elaine R. Montjne, Thomas J. Lin, Biaoyang Goodlett, David R. Taylor, Greg Eng, Jimmy Zhang, Jing TI A combined dataset of human cerebrospinal fluid proteins identified by multi-dimensional chromatography and tandem mass spectrometry SO PROTEOMICS LA English DT Article DE Alzheimer's disease; human cerebrospinal fluid; mass spectrometry; Parkinson's disease ID BIOMARKER DISCOVERY; MULTIPLE-SCLEROSIS; PROTEOMIC ANALYSIS; STATISTICAL-MODEL; ELDERLY SUBJECTS; DATABASE SEARCH; PEPTIDE; DISEASE; MS/MS; IDENTIFICATIONS AB Human cerebrospinal fluid (CSF) is an important source for studying protein biomarkers of agerelated neurodegenerative diseases. Before characterizing biomarkers unique to each disease, it is necessary to categorize CSF proteins systematically and extensively. However, the enormous complexity, great dynamic range of protein concentrations, and tremendous protein heterogeneity due to post-translational modification of CSF create significant challenges to the existing proteomics technologies for an in-depth, nonbiased profiling of the human CSF proteome. To circumvent these difficulties, in the last few years, we have utilized several different separation methodologies and mass spectrometric platforms that greatly enhanced the identification coverage and the depth of protein profiling of CSF to characterize CSF proteome. In total, 2594 proteins were identified in well-characterized pooled human CSF samples using stringent proteomics criteria. This report summarizes our efforts to comprehensively characterize the human CSF proteome to date. C1 Univ Washington, Sch Med, Div Neuropathol, Harborview Med Ctr,Dept Pathol, Seattle, WA 98104 USA. Oregon Hlth & Sci Univ, Portland, OR USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA. VA Puget Sound Hlth Care Syst, VA NW Network Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Inst Syst Biol, Seattle, WA USA. Univ Washington, Dept Med Chem, Seattle, WA 98104 USA. RP Zhang, J (reprint author), Univ Washington, Sch Med, Div Neuropathol, Harborview Med Ctr,Dept Pathol, Box 359635, Seattle, WA 98104 USA. EM zhangj@u.washington.edu RI Eng, Jimmy/I-4202-2012; Eng, Jimmy/C-6556-2017 OI Eng, Jimmy/0000-0001-6352-6737; Eng, Jimmy/0000-0001-6352-6737 FU NIA NIH HHS [AG025327, AG05136, AG08017, AG08419]; PHS HHS [WS012703] NR 33 TC 82 Z9 85 U1 0 U2 3 PU WILEY-V C H VERLAG GMBH PI WEINHEIM PA PO BOX 10 11 61, D-69451 WEINHEIM, GERMANY SN 1615-9853 J9 PROTEOMICS JI Proteomics PD FEB PY 2007 VL 7 IS 3 BP 469 EP 473 DI 10.1002/pmic.200600756 PG 5 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 137CW UT WOS:000244271500015 PM 17211832 ER PT J AU Goodman, M Triebwasser, J Shah, S New, AS AF Goodman, Marianne Triebwasser, Joseph Shah, Sweta New, Antonia S. TI Neuroimaging in personality disorders: Current concepts, findings, and implications SO PSYCHIATRIC ANNALS LA English DT Article ID POSITRON-EMISSION-TOMOGRAPHY; TAKING DECISION-MAKING; SCHIZOTYPAL PERSONALITY; ANTISOCIAL PERSONALITY; INDIVIDUAL-DIFFERENCES; AMYGDALA ACTIVATION; CAUDATE-NUCLEUS; FEARFUL FACES; GRAY-MATTER; CRIMINAL PSYCHOPATHS C1 Mt Sinai Sch Med, Dept Psychiat, Bronx, NY USA. RP Goodman, M (reprint author), Bronx Vet Adm Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Mari-anne.Goodmon@med.va.gov NR 68 TC 3 Z9 3 U1 3 U2 6 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0048-5713 J9 PSYCHIAT ANN JI Psychiatr. Ann. PD FEB PY 2007 VL 37 IS 2 BP 100 EP + PG 7 WC Psychiatry SC Psychiatry GA 135AN UT WOS:000244126300005 ER PT J AU Weissman, EM Dellenbaugh, C AF Weissman, Ellen M. Dellenbaugh, Cornelia TI Impact of splitting risperidone tablets on medication adherence and on clinical outcomes for patients with schizophrenia SO PSYCHIATRIC SERVICES LA English DT Article ID COST SAVINGS AB Objective: Tablet splitting is a strategy aimed at reducing the cost of prescriptions. Some clinicians question whether patients with psychosis can understand and follow tablet-splitting instructions. The clinical impact of tablet splitting for individuals with severe mental illness is unknown. The research objectives were to determine whether risperidone tablet splitting is associated with changes in medication adherence, service utilization, or clinical outcomes. Methods: The study was a retrospective analysis of administrative data from the New York-New Jersey region of the Veterans Health Administration for 2,436 individuals with schizophrenia or schizoaffective disorder who were prescribed risperidone from January 2001 through March 2003. Antipsychotic medication adherence was measured by medication possession ratio (MPR). Clinical outcomes included attendance at scheduled and unscheduled outpatient appointments and psychiatric and medical admission rates. Results: The MPR increased from .83 to.90 (p <.001) after initiating tablet splitting. The rate of unscheduled mental health appointments increased significantly, particularly in the first 60 days after initiating splitting; attendance at scheduled outpatient mental health appointments was unchanged. Psychiatric admission and general medical admission rates were unchanged. Conclusions: The results provide some assurance that prescribing tablet splitting for patients with schizophrenia does not result in poor outcomes as measured by psychiatric and medical inpatient admissions. Increased MPRs and unscheduled appointments suggest that some patients may have experienced minor difficulty, especially early on ( crumbled tablets or misunderstood splitting instructions). Patients should be instructed carefully when tablet splitting is prescribed. Future studies should address longer-term clinical outcomes and systemwide costs. C1 Bronx Vet Affairs Med Ctr, Targeted Res Enhancement Program, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Mental Illness Res Educ & Clin Ctr, Vet Integrated Serv Network 3, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Geriatr Res Educ & Clin Ctr, Bronx, NY 10468 USA. RP Weissman, EM (reprint author), Bronx Vet Affairs Med Ctr, Targeted Res Enhancement Program, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM ellenweissman@optonline.net NR 17 TC 8 Z9 9 U1 1 U2 1 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 FEB PY 2007 VL 58 IS 2 BP 201 EP 206 DI 10.1176/appi.ps.58.2.201 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 134GF UT WOS:000244070800008 PM 17287376 ER PT J AU Jackson, CT Covell, NH Drake, RE Essock, SM AF Jackson, Carlos T. Covell, Nancy H. Drake, Robert E. Essock, Susan M. TI Relationship between diabetes and mortality among persons with co-occurring psychotic and substance use disorders SO PSYCHIATRIC SERVICES LA English DT Article ID SCHIZOPHRENIA-PATIENTS; PREVALENCE; MELLITUS AB Objective: Individuals with diabetes and individuals with serious mental illness are more likely than the general population to die prematurely. The study examined the impact of diabetes on mortality among 197 individuals with co-occurring psychotic and substance use disorders who participated in a randomized controlled study of integrated mental health and substance abuse treatment. Methods: The authors examined Medicaid claims for evidence of diabetes and applied survival analyses to examine whether time from study entry until death was different for individuals with and without evidence of diabetes. Results: Of individuals with co-occurring psychotic and substance use disorders, 21% had evidence of diabetes. In a 12-year period, 41% of those with evidence of diabetes died compared with 10% of those without evidence of diabetes. Conclusions: Interventions targeted for diabetes prevention and diabetes management are critical for persons with serious mental illness, particularly among those who also abuse substances. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. James J Peters Vet Affairs Med Ctr, Mental Illness Res Educ & Clin Ctr, Bronx, NY USA. DMHAS, Div Res, Hartford, CT USA. Dartmouth Coll, Hitchcock Med Ctr, Dartmouth Med Sch, Dept Psychiat, Hanover, NH 03756 USA. Dartmouth Psychiat Res Ctr, Lebanon, NH USA. RP Jackson, CT (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, 1 Gustave Levy Pl,Box 1230, New York, NY 10029 USA. EM carlos.jackson@mssm.edu FU CMHS SAMHSA HHS [UD3-SM51560, UD3-SM51802]; NIAAA NIH HHS [R01-AA-10265]; NIMH NIH HHS [R01-MH-52872, R01-MH-63463, UD9-MH51958] NR 13 TC 15 Z9 15 U1 0 U2 2 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 FEB PY 2007 VL 58 IS 2 BP 270 EP 272 DI 10.1176/appi.ps.58.2.270 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 134GF UT WOS:000244070800019 PM 17287387 ER PT J AU Barry, LC Lichtman, JH Spertus, JA Rumsfeld, JS Vaccarino, V Jones, PG Ploniondon, ME Parashar, S Krumholz, HM AF Barry, Lisa C. Lichtman, Judith H. Spertus, Joifn A. Rumsfeld, John S. Vaccarino, Viola Jones, Philip G. Ploniondon, Mary E. Parashar, Susmita Krumholz, Harlan M. TI Patient satisfaction with treatment after acute myocardial infarction: Role of psychosocial Factors SO PSYCHOSOMATIC MEDICINE LA English DT Article DE treatment satisfaction; psychosocial; outcomes; myocardial infarction; registry ID ARTERY-BYPASS-SURGERY; HEALTH-STATUS; MEDICAL-CARE; SOCIAL SUPPORT; DEPRESSIVE SYMPTOMS; HEART-FAILURE; EMOTIONAL SUPPORT; SEX-DIFFERENCES; OLDER PATIENTS; MORTALITY AB Objective: To determine if psychosocial status influences treatment satisfaction, a quality-of-care indicator, of patients who were hospitalized for acute myocardial infarction (AMI). Methods: Psychosocial variables (social support, dispositional optimism, and depression) were assessed in 1847 AMI patients who completed a 1-month assessment in Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER), a multicenter, prospective cohort study. Patients' treatment satisfaction was determined using the Treatment Satisfaction scale of the Seattle Angina Questionnaire. The association between psychosocial variables and treatment satisfaction-adjusted for site, sociodemographics, medical history, clinical presentation, and treatment procedures-was evaluated using a censored normal model. Results: Study participants were primarily white (77.6%) and male (68.8%), with a mean age of 60.6 +/- 12.7 (SD) years. Satisfaction with posthospitalization treatment following AMI increased as social support (Wald chi(2) = 35.02,p <.001) and dispositional optimism (beta = 1.42; 95% CI 0.24, 2.60) increased. Participants with mild (-3.10, 95% CI -5.77, -0.44), moderate (-4.77, 95% Cl -8.16, -1.38), moderately severe (-8.49, 95% Cl -13.47, -3.52), and severe (- 11.65, 95% Cl - 18.77, -4.53) depression had significantly worse treatment satisfaction compared with the nondepressed participants. Conclusion: Assessing psychosocial variables, such as social support, dispositional optimism, and depression severity before hospital discharge, may indicate who is likely to be more satisfied with posthospitalization cardiac care I month following AMI. Without controlling for psychosocial status, treatment satisfaction may be a biased indicator of quality. Future studies should evaluate whether psychosocial intervention after AMI can improve satisfaction. C1 Yale Univ, Sch Med, Program Aging, Dept Internal Med Geriatr, New Haven, CT 06511 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06511 USA. Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06511 USA. Mid Amer Heart Inst, Kansas City, MO USA. Univ Missouri, Kansas City, MO 64110 USA. Denver Vet Affairs Med Ctr, Cardiol Sect, Denver, CO USA. Emory Univ, Sch Med, Atlanta, GA USA. RP Barry, LC (reprint author), Yale Univ, Sch Med, Program Aging, Dept Internal Med Geriatr, 300 George St,Suite 775, New Haven, CT 06511 USA. EM lisa.barry@yale.edu FU AHRQ HHS [R-01 HS11282-01]; NIA NIH HHS [T32AG019134] NR 75 TC 14 Z9 14 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0033-3174 J9 PSYCHOSOM MED JI Psychosom. Med. PD FEB-MAR PY 2007 VL 69 IS 2 BP 115 EP 123 DI 10.1097/PSY.0b013e31802f2785 PG 9 WC Psychiatry; Psychology; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 144OD UT WOS:000244804800001 PM 17289828 ER PT J AU Li, YF Lake, ET Sales, AE Sharp, ND Greiner, GT Lowy, E Liu, CF Mitchell, PH Sochalski, JA AF Li, Yu-Fang Lake, Eileen T. Sales, Anne E. Sharp, Nancy D. Greiner, Gwendolyn T. Lowy, Elliott Liu, Chuan-Fen Mitchell, Pamela H. Sochalski, Julie A. TI Measuring nurses' practice environments with the revised nursing work index: Evidence from registered nurses in the veterans health administration SO RESEARCH IN NURSING & HEALTH LA English DT Article DE hospital/institutional; LISREL/SEM/Path analysis; instrument development and validation; Revised Nursing Work Index; Practice Environment Scale of the Nursing Work Index; PES-NWI; Practice Environment Index ID CONFIRMATORY FACTOR-ANALYSIS; FIT INDEXES; HOSPITALS; OUTCOMES; SCALE AB The Revised Nursing Work Index (NWI-R) is a widely used instrument for evaluating registered nurses' (RNs) Practice environments. The existenceof multiple subscale sets from the NWI-R raises questions about its generalizability. We tested the validity of the one-, three-, and five-subscale sets from the NWI-R and derived a short-form subscale set using a sample of RNs from the Veterans Health Administration (VHA). The prior sets do not have an excellent fit to these data. Results of exploratory factor analyses suggested a four-factor model with Opportunity for Advancement, Collegial Nurse-Physician Relations, Staffing Adequacy, and Nurse Manager Leadership as the most salient and parsimonious solution. Additional research is needed to corroborate these findings in other nurse samples and settings. (c) 2007 Wiley Periodicals, Inc. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. Univ Washington, Dept Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA. Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Alberta, Fac Nursing, Edmonton, AB, Canada. RP Li, YF (reprint author), VA Puget Sound Hlth Care Syst, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. RI Sales, Anne/D-9678-2012 OI Sales, Anne/0000-0001-9360-3334 NR 43 TC 36 Z9 37 U1 1 U2 10 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0160-6891 J9 RES NURS HEALTH JI Res. Nurs. Health PD FEB PY 2007 VL 30 IS 1 BP 31 EP 44 DI 10.1002/nur.20172 PG 14 WC Nursing SC Nursing GA 129ZZ UT WOS:000243770000003 PM 17243106 ER PT J AU Ranganath, VK Furst, DE AF Ranganath, Veena K. Furst, Daniel E. TI Disease-modifying antirheumatic drug use in the elderly rheumatoid arthritis patient SO RHEUMATIC DISEASE CLINICS OF NORTH AMERICA LA English DT Article ID ETANERCEPT ENBREL(R); METHOTREXATE; LEFLUNOMIDE; HYDROXYCHLOROQUINE; EFFICACY; PLACEBO; SAFETY; TRIAL; PHARMACOKINETICS; CHLOROQUINE AB During the 10-year period since the last review was done by Gardner and Furst, studies have furthered the knowledge of the use of disease-modifying antirheumatic drugs (DMARDs) in the elderly rheumatoid arthritis (RA) patient. This article briefly reviews the clinical pharmacology of humans as they age, and details the effects of aging on the specific pharmacokinetics and responses to commonly used DMARDs. There has been some progress in understanding the elderly RA patient; however, data are insufficient to provide much confidence in DMARDs effects in the elderly. C1 Univ Calif Los Angeles, Div Rheumatol, Dept Med, David Geffen Sch Med, Los Angeles, CA 90025 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Furst, DE (reprint author), Univ Calif Los Angeles, Div Rheumatol, Dept Med, David Geffen Sch Med, 1000 Vet Ave,Room 32-59, Los Angeles, CA 90025 USA. EM defurst@mednet.ucla.edu NR 19 TC 22 Z9 24 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0889-857X J9 RHEUM DIS CLIN N AM JI Rheum. Dis. Clin. North Am. PD FEB PY 2007 VL 33 IS 1 BP 197 EP + DI 10.1016/j.rdc.2006.12.011 PG 22 WC Rheumatology SC Rheumatology GA 158NC UT WOS:000245797200012 PM 17367700 ER PT J AU Byne, W Fernandes, J Haroutunian, V Huacon, D Kidkardnee, S Kim, J Tatusov, A Thakur, U Yiannoulos, G AF Byne, William Fernandes, Jason Haroutunian, Vhram Huacon, Dennis Kidkardnee, Smith Kim, John Tatusov, Alex Thakur, Uma Yiannoulos, Georgia TI Reduction of right medial pulvinar volume and neuron number in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; thalamus; pulvinar; postmortem ID MEDIODORSAL THALAMIC NUCLEUS; ANTERIOR CINGULATE CORTEX; PREFRONTAL CORTEX; RHESUS-MONKEY; POSTMORTEM; DENSITY; DEFICITS AB Several studies have described a reduction of pulvinar volume and/or neuronal number in schizophrenia (SZ). In order to better localize these changes, we assessed volume and neuronal number of the pulvinar and several of its subdivisions in postmortem material from subjects with chronic SZ and subjects with no psychiatric history. Total pulvinar volume and neuronal number were significantly lower in SZ and these differences were significant in only in its medial division. The medial pulvinar interconnects various heteromodal cortical regions suggesting that these deficits may contribute to the abnormalities of higher order integrative functions characteristic of schizophrenia. (c) 2006 Elsevier B.V. All rights reserved. C1 Bronx Vet Affairs Med Ctr, Div Basic & Lab Res, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. RP Byne, W (reprint author), Bronx Vet Affairs Med Ctr, Div Basic & Lab Res, 130 W Kingsbridge Rd,Res Bldg,Rm 2F37, Bronx, NY 10468 USA. EM william.byne@mssm.edu FU NIMH NIH HHS [MH066392, MH66998] NR 30 TC 20 Z9 20 U1 1 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD FEB PY 2007 VL 90 IS 1-3 BP 71 EP 75 DI 10.1016/j.schres.2006.10.006 PG 5 WC Psychiatry SC Psychiatry GA 149NF UT WOS:000245152900007 PM 17141474 ER PT J AU Reddy, R Keshavan, M Yao, JK AF Reddy, Ravinder Keshavan, Matcheri Yao, Jeffrey K. TI Blunted serotonergic responsivity in neuroleptic-naive patients at first-episode of schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE first-episode; schizophrenia; mood disorder; human platelets; platelet aggregation; serotonin ID POLYUNSATURATED FATTY-ACIDS; PLATELET-AGGREGATION; BRAIN; METABOLITES; RECEPTORS; DOPAMINE; FLUIDITY; BINDING AB Objective: To determine whether serotonergic responsivity, as assessed in platelets, is blunted in treatment-naive patients with first episode psychosis, similar to observations in chronic schizophrenia. Methods: Serotonin (5-HT)-amplified platelet aggregation was determined in 26 first-episode treatment-naive patients with psychosis (14 with schizophrenia, 12 with mood disorders with psychosis) and 16 matched healthy comparison subjects. Platelet aggregation was measured in fresh whole blood after stimulation with 5.0 mu M adenosine diphosphate (ADP) alone and with the addition of 0.2 mu g and 1.0 mu g 5-HT. Results: Healthy subjects showed expected robust increases in platelet aggregation (+106% and +146% at 0.2 mu g and 1.0 mu g 5-HT, respectively). Ely contrast, patients with schizophrenia showed almost no changes in aggregation (+6% and +3%), while patients with mood disorders showed intermediate increases (+59% and +66%). Conclusions: Blunted platelet serotonergic responsivity appears to be independent of treatment effects. To determine whether this is trait-related factor will require prospective studies. (c) 2006 Published by Elsevier B.V. C1 Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Wayne State Univ, Detroit, MI 48202 USA. Univ Pittsburgh, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. RP Reddy, R (reprint author), Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, 3811 OHara St, Pittsburgh, PA 15213 USA. EM reddyr@upmc.edu FU NCATS NIH HHS [UL1 TR000005]; NCRR NIH HHS [M01 RR00056]; NIMH NIH HHS [MH-46118, MH-45203, MH-58141, MH45156] NR 20 TC 3 Z9 4 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD FEB PY 2007 VL 90 IS 1-3 BP 81 EP 85 DI 10.1016/j.schres.2006.11.013 PG 5 WC Psychiatry SC Psychiatry GA 149NF UT WOS:000245152900009 PM 17204398 ER PT J AU Niv, N Cohen, AN Mintz, J Ventura, J Young, AS AF Niv, Noosha Cohen, Amy N. Mintz, Jim Ventura, Joseph Young, Alexander S. TI The validity of using patient self-report to assess psychotic symptoms in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE assessment; psychometrics; validity; psychosis; schizophrenia ID QUALITY-ASSURANCE; MENTAL-ILLNESS; IMPROVE CARE; SCALE AB Brief, reliable and valid measures of psychosis can be very useful in both clinical practice and research, and for identifying unmet treatment needs in persons with schizophrenia. This study examines the concurrent validity and receiver operating characteristics of the psychosis scale of the Revised Behavior and Symptom Identification Scale (BASIS-R). The study was conducted with 71 adults with schizophrenia who were randomly sampled from a large mental health clinic. Study participants at the West Los Angeles Veterans Healthcare Center were assessed using the BASIS-R, a subjective, self-report measure, and the UCLA Brief Psychiatric Rating Scale (BPRS), a clinician-rated measure administered by highly trained research staff. The psychosis scale of the BASIS-R shows good concurrent validity with the psychosis items on the BPRS. Using the BPRS as the gold standard for measuring psychosis, receiver operating characteristics suggest that both the weighted and unweighted versions of the BASIS-R psychosis scale adequately identify psychosis that is moderate or greater or severe. The performance of the two versions was similar. Unweighted scores are easier to calculate, and we therefore recommend cutoff scores based on the unweighted BASIS-R. We identified a cutoff score of 0.5 to best detect moderate or greater psychosis, and a cutoff score of 1.0 to best detect severe or extremely severe psychosis. The BASIS-R has potential as an assessment tool and screening instrument in schizophrenia. (c) 2006 Elsevier B.V. All rights reserved. C1 W Los Angeles VA, MIRECC, VA Desert Pacific Mental Illness Res, Educ & Clin Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90025 USA. RP Niv, N (reprint author), W Los Angeles VA, MIRECC, VA Desert Pacific Mental Illness Res, Educ & Clin Ctr, 11301 Wilshire Blvd,210A, Los Angeles, CA 90073 USA. EM noosha23@yahoo.com RI Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NIH HHS [NH 068639] NR 15 TC 19 Z9 19 U1 0 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD FEB PY 2007 VL 90 IS 1-3 BP 245 EP 250 DI 10.1016/j.schres.2006.11.011 PG 6 WC Psychiatry SC Psychiatry GA 149NF UT WOS:000245152900028 PM 17204397 ER PT J AU Sergi, MJ Rassovsky, Y Widmark, C Reist, C Erhart, S Braff, DL Marder, SR Green, MF AF Sergi, Mark J. Rassovsky, Yuri Widmark, Clifford Reist, Christopher Erhart, Stephen Braff, David L. Marder, Stephen R. Green, Michael F. TI Social cognition in schizophrenia: Relationships with neurocognition and negative symptoms SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; social cognition; neurocognition; negative symptoms; social perception; emotion perception ID AFFECT RECOGNITION; PERCEPTION; PERFORMANCE; COMMUNICATION; DEFICITS; EMOTION; MEMORY; MIND AB Despite the growing importance of social cognition in schizophrenia, fundamental issues concerning the nature of social cognition in schizophrenia remain unanswered. One issue concerns the strength of the relationships between social cognition and key features of the disorder such as neurocognitive deficits and negative symptoms. The current study employed structural equation modeling to examine three key questions regarding the nature of social cognition in schizophrenia: 1) Are social cognition and neurocognition in schizophrenia better modeled as one or two separate constructs? 2) Are social cognition and negative symptoms in schizophrenia better modeled as one or two separate constructs?, and 3) When social cognition, neurocognition, and negative symptoms are included in a single model, is social cognition more closely related to neurocognition or to negative symptoms? In this cross sectional study, one hundred outpatients with schizophrenia or schizoaffective disorder were administered measures of social cognition, neurocognition, and negative symptoms. A two-factor model that represented social cognition and neurocognition as separate constructs fit the data significantly better than a one-factor model, suggesting that social cognition and neurocognition are distinct, yet highly related, constructs. Likewise, a two-factor model that represented social cognition and negative symptoms as separate constructs fit the data significantly better than a one-factor model, suggesting that social cognition and negative symptoms are distinct constructs. A three-factor model revealed that the relationship between social cognition and neurocognition was stronger than the relationship between social cognition and negative symptoms. The current findings start to provide insights into the structure of social cognition, neurocognition, and negative symptoms in schizophrenia. (c) 2006 Elsevier B.V. All rights reserved. C1 Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Irvine, Sch Med, Dept Psychiat & Human Behav, Irvine, CA 92717 USA. VA Long Beach Healthcare Syst, Long Beach, CA USA. Olive View UCLA Med Ctr, Dept Psychiat, Sylmar, CA 91342 USA. Univ Calif San Diego, Sch Med, Dept Psychiat, San Diego, CA 92103 USA. RP Sergi, MJ (reprint author), Calif State Univ Northridge, Dept Psychol, 18111 Nordhoff St, Northridge, CA 91330 USA. EM mark.sergi@csun.edu NR 45 TC 188 Z9 193 U1 6 U2 22 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD FEB PY 2007 VL 90 IS 1-3 BP 316 EP 324 DI 10.1016/j.schres.2006.09.028 PG 9 WC Psychiatry SC Psychiatry GA 149NF UT WOS:000245152900038 PM 17141477 ER PT J AU Fan, Y Won, SJ Hong, S Lac, D Weinstein, PR Liu, JL AF Fan, Yang Won, Seok Joon Hong, Shwuhuey Lac, Diana Weinstein, Philip R. Liu, Jialing TI Reduced frequency of embryonic neural stem cells does not impair ischemia or growth factor-induced neurogenesis in adult Emx1 null mice SO STROKE LA English DT Meeting Abstract CT 32nd International Stroke Conference CY FEB 07-08, 2007 CL San Francisco, CA C1 Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD FEB PY 2007 VL 38 IS 2 BP 552 EP 552 PG 1 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 134ZE UT WOS:000244122600507 ER PT J AU Rodriguez, KL Gambino, FJ Butow, P Hagerty, R Arnold, RM AF Rodriguez, Keri L. Gambino, Frank J. Butow, Phyllis Hagerty, Rebecca Arnold, Robert M. TI Pushing up daisies: implicit and explicit language in oncologist-patient communication about death SO SUPPORTIVE CARE IN CANCER LA English DT Article DE communication; prognosis; cancer; terminally ill; qualitative research ID BREAKING BAD-NEWS; EARLY BREAST-CANCER; MEDICAL-STUDENTS; PREFERENCES; PROGNOSIS; CARE; PARTICIPATION; INFORMATION; SATISFACTION; COMPASSION AB Goals of work: Although there are guidelines regarding how conversations with patients about prognosis in life-limiting illness should occur, there are little data about what doctors actually say. This study was designed to qualitatively analyze the language that oncologists and cancer patients use when talking about death. Subjects and methods: We recruited 29 adults who had incurable forms of cancer, were scheduled for a first-time visit with one of six oncologists affiliated with a teaching hospital in Australia, and consented to having their visit audiotaped and transcribed. Using content analytic techniques, we coded various features of language usage. Main results: Of the 29 visits, 23 (79.3%) included prognostic utterances about treatment-related and disease-related outcomes. In 12 (52.2%) of these 23 visits, explicit language about death ("terminal," variations of "death") was used. It was most commonly used by the oncologist after the physical examination, but it was sometimes used by patients or their kin, usually before the examination and involving emotional questioning about the patient's future. In all 23 (100%) visits, implicit language ( euphemistic or indirect talk) was used in discussing death and focused on an anticipated life span ( mentioned in 87.0% of visits), estimated time frame (69.6%), or projected survival (47.8%). Conclusions: Instead of using the word " death," most participants used some alternative phrase, including implicit language. Although oncologists are more likely than patients and their kin to use explicit language in discussing death, the oncologists tend to couple it with implicit language, possibly to mitigate the message effects. C1 Univ Pittsburgh, Ctr Bioeth & Hlth Law, Pittsburgh, PA USA. Univ Pittsburgh, Montefiore Univ Hosp, Dept Med, Sch Med, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. RP Rodriguez, KL (reprint author), Univ Pittsburgh, Ctr Bioeth & Hlth Law, Pittsburgh, PA USA. EM Keri.Rodriguez@med.va.gov; Rabob@pitt.edu FU NCATS NIH HHS [UL1 TR000005] NR 43 TC 22 Z9 22 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0941-4355 J9 SUPPORT CARE CANCER JI Support. Care Cancer PD FEB PY 2007 VL 15 IS 2 BP 153 EP 161 DI 10.1007/s00520-006-0108-8 PG 9 WC Oncology; Health Care Sciences & Services; Rehabilitation SC Oncology; Health Care Sciences & Services; Rehabilitation GA 140EF UT WOS:000244486300005 PM 16969631 ER PT J AU Walker, RH Danek, A Uttner, I Offner, R Reid, M Lee, S AF Walker, Ruth H. Danek, Adrian Uttner, Ingo Offner, Robert Reid, Marion Lee, Soohee TI McLeod phenotype without the McLeod syndrome SO TRANSFUSION LA English DT Article ID CHRONIC GRANULOMATOUS-DISEASE; BLOOD-GROUP SYSTEM; X-LINKED MYOPATHY; SYNDROME GENE; CHOREA-ACANTHOCYTOSIS; CEREBRAL INVOLVEMENT; MUSCULAR-DYSTROPHY; JAPANESE FAMILY; KELL; MUTATION AB Background: McLeod neuroacanthocytosis syndrome is a late-onset X-linked multisystem disorder affecting the peripheral and central nervous systems, red blood cells (RBCs), and internal organs. A variety of mutations have been found in the responsible gene (XK) including single nonsense and missense mutations, nucleotide mutations at or near the splice junctions of introns of XK, and different deletion mutations. To date no clear phenotype-genotype correlation is apparent. The clinical details of one case of McLeod phenotype without apparent neuromuscular abnormalities have been reported. Here the clinical details of two additional cases are presented, of which the genetic details have previously been published. Study Design amd Methods: Two asymptomatic or minimally symptomatic cases at ages expected to manifest the McLeod syndrome (MLS) were evaluated. The first case had been authenticated as a genuine McLeod both by serology and by genotyping (R222G missense mutation) and the second case had a mutation in XK (IVS2+5G > A) and by serology exhibited very weak Kx antigen and no detectable Kell antigens, except extremely low k antigen by adsorption-elution technique. The patients were examined for hematologic, neurologic, and other clinical abnormalities. Results: Despite documented McLeod phenotype on RBCs, and identified mutations of XK, neurologic and other clinical findings were minimal at ages expected to manifest MLS. Conclusions: The different XK mutations may have different effects upon the XK gene product and thus may account for the variable phenotype. C1 James J Peters Vet Affairs Med Ctr, Dept Neurol, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. New York Blood Ctr, Lindsley F Kimball Res Inst, New York, NY 10021 USA. Univ Munich, Neurol Hosp, Munich, Germany. Univ Munich, Ctr Hlth, Munich, Germany. Univ Ulm, Neurol Hosp, Ulm, Germany. Bavarian Red Cross, Blood Bank Serv, Inst Transfus Med Bayreuth, Bayreuth, Germany. RP Walker, RH (reprint author), James J Peters Vet Affairs Med Ctr, Dept Neurol, 127,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM ruth.walker@mssm.edu RI Danek, Adrian/G-7339-2011 OI Danek, Adrian/0000-0001-8857-5383 FU NHLBI NIH HHS [HL075716, HL54459] NR 57 TC 18 Z9 18 U1 0 U2 2 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0041-1132 J9 TRANSFUSION JI Transfusion PD FEB PY 2007 VL 47 IS 2 BP 299 EP 305 DI 10.1111/j.1537-2995.2007.01106.x PG 7 WC Hematology SC Hematology GA 128DQ UT WOS:000243638400020 PM 17302777 ER PT J AU Junghans, C Feder, G Timmis, AD Eldridge, S Sekhri, N Black, N Shekelle, P Hemingway, H AF Junghans, Cornelia Feder, Gene Timmis, Adam D. Eldridge, Sandra Sekhri, Neha Black, Nick Shekelle, Paul Hemingway, Harry TI Effect of patient-specific ratings vs conventional guidelines on investigation decisions in angina - Appropriateness of referral and investigation in angina (ARIA) trial SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID CORONARY-ARTERY DISEASE; STABLE ANGINA; PRIMARY-CARE; TASK-FORCE; MANAGEMENT; QUALITY; CARDIOLOGY; PECTORIS; COLLEGE; WOMEN AB Background: Conventional guidelines have limited effect on changing physicians' test ordering. We sought to determine the effect of patient-specific ratings vs conventional guidelines on appropriate investigation of angina. Methods: Randomized controlled trial of 145 physicians receiving patient-specific ratings (online prompt stating whether the specific vignette was considered appropriate or inappropriate for investigation, with access to detailed information on how the ratings were derived) and 147 physicians receiving conventional guidelines from the American Heart Association and the European Society of Cardiology. Physicians made recommendations on 12 Web-based patient vignettes before and on 12 vignettes after these interventions. The outcome was the proportion of appropriate investigative decisions as defined by 2 independent expert panels. Results: Decisions for exercise electrocardiography were more appropriate with patient-specific ratings (819/1491 [55%]) compared with conventional guidelines (648/1488 [44%]) (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.36-1.82). The effect was stronger for angiography (1274/1595 [80%] with patient-specific ratings compared with 1009/1576 [64%] with conventional guidelines [OR, 2.24; 95% CI, 1.90-2.62]). Within-arm comparisons confirmed that conventional guidelines had no effect but that patient-specific ratings significantly changed physicians' decisions toward appropriate recommendations for exercise electrocardiography (55% vs 42%; OR, 2.62; 95% CI, 2.14-3.22) and for angiography (80% vs 65%; OR, 2.10; 95% CI, 1.79-2.47). These effects were robust to physician specialty (cardiologists and general practitioners) and to vignette characteristics, including older age, female sex, and nonwhite race/ethnicity. Conclusion: Patient-specific ratings, unlike conventional guidelines, changed physician testing behavior and have the potential to reduce practice variations and to increase the appropriate use of investigation. C1 UCL, Sch Med, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England. UCL, Dept Primary Care, Queen Marys Sch Med & Dent, London WC1E 6BT, England. London Sch Hyg & Trop Med, Cardiac Directorate, Barts & London NHS Trust, London WC1, England. London Sch Hyg & Trop Med, Dept Publ Hlth & Policy, London WC1, England. Greater Los Angeles Vet Affairs Hlth Care Syst, Los Angeles, CA USA. RP Hemingway, H (reprint author), UCL, Sch Med, Dept Epidemiol & Publ Hlth, 1-19 Torrington Pl, London WC1E 6BT, England. EM h.hemingway@ucl.ac.uk RI Hemingway, Harry/C-1219-2009 OI Hemingway, Harry/0000-0003-2279-0624 NR 29 TC 13 Z9 13 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 22 PY 2007 VL 167 IS 2 BP 195 EP 202 DI 10.1001/archinte.167.2.195 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 128US UT WOS:000243685100014 PM 17242322 ER PT J AU Castle, JS Xing, JH Warner, MR Korsten, MA AF Castle, James S. Xing, Jin-Hong Warner, Mark R. Korsten, Mark A. TI Environmental noise alters gastric myoelectrical activity: Effect of age SO WORLD JOURNAL OF GASTROENTEROLOGY LA English DT Article DE activity; electrogastrogram; autonomic nervous system; noise; acoustic stress; gastric myoelectrical ID AIRCRAFT NOISE; HYPERTENSION; STIMULATION; EXPOSURE; ELECTROGASTROGRAPHY; RECORDINGS; HUMANS; GENDER AB AIM: To evaluate the effect of age and acoustic stress on gastric myoelectrical activity (GMA) and autonomic nervous system function. METHODS: Twenty-one male subjects (age range 22-71 years, mean 44 years) were recruited and exposed, in random order, to three auditory stimuli (Hospital noise, conversation babble and traffic noise) after a 20-min baseline. All periods lasted 20 min and were interspersed with a 10 min of recovery. GMA was obtained using a Synectics Microdigitrapper. Autonomic nerve function was assessed by monitoring blood pressure and heart rate using an automatic recording device. RESULTS: Dominant power tended to decrease with increase of age (P < 0.05). The overall percentage of three cycle per minute (CPM) activity decreased during exposure to hospital noise (12.0%, P < 0.05), traffic noise (13.9%, P < 0.05), and conversation babble (7.1%). The subjects in the younger group (< 50 years) showed a consistent reduction in the percentage of 3 CPM activity during hospital noise (22.9%, P < 0.05), traffic noise (19.0%, P < 0.05), and conversation babble (15.5%). These observations were accompanied by a significant increase in bradygastria: hospital noise (P < 0.05) and traffic noise (P < 0.05). In contrast, the subjects over 50 years of age did not exhibit a significant decrease in 3 CPM activity. Regardless of age, noise did not alter blood pressure or heart rate. CONCLUSION: GMA changes with age. Loud noise can alter GMA, especially in younger individuals. Our data indicate that even short-term exposure to noise may alter the contractility of the stomach. (c) 2007 The WJG Press. All rights reserved. C1 James J Peters VA Med Ctr, Program Med, Bronx, NY 10468 USA. James J Peters VA Med Ctr, Audiol Serv, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Korsten, MA (reprint author), James J Peters VA Med Ctr, Program Med, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM mark.korsten@med.va.gov NR 32 TC 6 Z9 6 U1 2 U2 2 PU W J G PRESS PI BEIJING PA PO BOX 2345, BEIJING 100023, PEOPLES R CHINA SN 1007-9327 J9 WORLD J GASTROENTERO JI World J. Gastroenterol. PD JAN 21 PY 2007 VL 13 IS 3 BP 403 EP 407 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 127VH UT WOS:000243613900011 PM 17230609 ER PT J AU Tran, T Lowry, AM El-Serag, HB AF Tran, T. Lowry, A. M. El-Serag, H. B. TI Meta-analysis: the efficacy of over-the-counter gastro-oesophageal reflux disease therapies SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID RANITIDINE 75 MG; DOUBLE-BLIND; INDUCED HEARTBURN; PLACEBO; SAFETY; ESOPHAGITIS; PREVENTION; NIZATIDINE; REDUCTION; RELIEF AB Background Over-the-counter histamine-2 receptor antagonists, antacids and alginate/antacids are commonly used for gastro-oesophageal reflux disease. Aim To conduct a systematic review and meta-analysis of related treatment trials. Methods We performed a systematic search and abstraction of randomized, placebo-controlled trials conducted during 1972-2005. Study quality was measured by the Jadad score (0-5). Results were pooled using random effects model. Results Ten trials (n = 3442, placebo = 2940; Jadad score 3.5) showed a higher response with histamine-2 receptor antagonists in regard to complete relief of heartburn, symptomatic improvement, and episodes requiring rescue antacids. The absolute benefit increase was 10-12% and relative benefit increase was 19-41%. Four trials (n = 578, placebo = 577; Jadad score 3.5) showed a trend in favour of antacids in symptomatic improvement (absolute benefit increase 8%, 95% CI: 0-16%; relative benefit increase 0.11) and requirement of rescue antacids (OR 0.70, 95% CI: 0.59-0.84). Four trials (n = 146, placebo = 138; Jadad score 3.8) found alginate/antacid combination superior to placebo in symptomatic improvement (absolute benefit increase 26%, 95% CI: 12%-41%, relative benefit increase 0.60). Conclusions Over-the-counter medications are effective in treating symptomatic gastro-oesophageal reflux disease. Compared with the placebo response, which ranged between 37% and 64%, the relative benefit increase was up to 41% with histamine-2 receptor antagonists, 60% with alginate/antacid combinations, and 11% with antacids. C1 Houston Vet Affairs Med Ctr, Sect Hlth Serv Res & Gastroenterol, Houston, TX 77030 USA. Baylor Coll Med, Dept Anesthesiol, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr, Sect Hlth Serv Res & Gastroenterol, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 20 TC 16 Z9 18 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD JAN 15 PY 2007 VL 25 IS 2 BP 143 EP 153 DI 10.1111/j.1365-2063.2006.03135.x PG 11 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 122ME UT WOS:000243230300004 PM 17229239 ER PT J AU Boden, WE O'Rourke, RA Teo, KK Hartigan, PM Maron, DJ Kostuk, W Knudtson, M Dada, M Casperson, P Harris, CL Spertus, JA Shaw, L Chaitman, BR Mancini, J Berman, DS Gau, G Weintraub, WS AF Boden, William E. O'Rourke, Robert A. Teo, Koon K. Hartigan, Pamela M. Maron, David J. Kostuk, William Knudtson, Merril Dada, Marcin Casperson, Paul Harris, Crystal L. Spertus, John A. Shaw, Leslee Chaitman, Bernard R. Mancini, John Berman, Daniel S. Gau, Gerald Weintraub, William S. CA COURAGE Trial Co-Principal Invest TI The evolving pattern of symptomatic coronary artery disease in the United States and Canada: Baseline characteristics of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID MEDICAL THERAPY; MYOCARDIAL-INFARCTION; RANDOMIZED TRIAL; CARDIOVASCULAR EVENTS; RITA-2 TRIAL; ANGIOPLASTY; INTERVENTION; CLOPIDOGREL; MORTALITY; SURVIVAL AB Major improvements in medical therapy and percutaneous coronary intervention for coronary artery disease (CAD) have emerged during the previous 2 decades, but no randomized trial in patients with stable CAD has been powered to compare these 2 strategies for the hard clinical end points of death or myocardial infarction (MI), and previous studies have not evaluated the effect of coronary stents and intensive medical therapy on cardiac events during long-term follow-up. Between 1999 and 2004, 2,287 patients with documented myocardial ischemia and angiographically confirmed CAD were randomized to the Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial, with a principal hypothesis that a strategy of percutaneous coronary intervention plus intensive, guideline-driven medical therapy would be superior to a strategy of intensive medical therapy alone. The primary end point was a composite of all-cause mortality or acute MI (time to first event) during a 2.5- to 7-year (median 5) follow-up. Baseline characteristics were a mean age of 62 +/- 5 years, 85% men, and 86% Caucasian. Mean duration of angina before randomization was 26 months (average 10 episodes/week), and 29% of patients were smokers, 67% had hypertension, 38% had previous MI, 71% had dyslipidemia, 34% had diabetes, 27% had previous revascularization, and 69% had multivessel CAD. Approximately 55% of patients met established criteria for the metabolic syndrome. In conclusion, baseline characteristics of the COURAGE trial study population indicate a highly symptomatic group of patients with CAD who have a significant duration and frequency of antecedent angina pectoris and a high prevalence of cardiac risk factors. (c) 2007 Elsevier Inc. All rights reserved. C1 VA Connecticut Healthcare Syst, Coordinating Ctr, Vet Affairs Cooperat Studies Program, West Haven, CT USA. Hartford Hosp, Hartford, CT 06115 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. McMaster Univ, Med Sci Ctr, Hamilton, ON L8S 4L8, Canada. London Hlth Sci Ctr, London, ON, Canada. Foothills Prov Gen Hosp, Calgary, AB T2N 2T9, Canada. Vancouver Hosp & Hlth Sci Ctr, Vancouver, BC V5Z 1M9, Canada. Vanderbilt Univ, Med Ctr, Nashville, TN USA. Clin Res Pharm Coordinating Ctr, Vet Affairs Cooperat Studies Program, Albuquerque, NM USA. Mid Amer Heart Inst, Kansas City, MO USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Mayo Clin, Rochester, MN USA. Christiana Healthcare Syst, Newark, DE USA. Ctr Outcomes Res, Newark, DE USA. RP Boden, WE (reprint author), VA Connecticut Healthcare Syst, Coordinating Ctr, Vet Affairs Cooperat Studies Program, West Haven, CT USA. EM wboden@kaleidahealth.org NR 20 TC 40 Z9 40 U1 0 U2 3 PU EXCERPTA MEDICA INC PI BRIDGEWATER PA 685 ROUTE 202-206, BRIDGEWATER, NJ 08807 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JAN 15 PY 2007 VL 99 IS 2 BP 208 EP 212 DI 10.1016/j.amjcard.2006.07.082 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 126WJ UT WOS:000243545900012 PM 17223420 ER PT J AU Siegle, GJ Thompson, W Carter, CS Steinhauer, SR Thase, ME AF Siegle, Greg J. Thompson, Wesley Carter, Cameron S. Steinhauer, Stuart R. Thase, Michael E. TI Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: Related and independent features SO BIOLOGICAL PSYCHIATRY LA English DT Article DE amygdala; DLPFC; emotion; executive control; fMRI; regulation ID CEREBRAL-BLOOD-FLOW; EVENT-RELATED FMRI; MAJOR DEPRESSION; AFFECTIVE NEUROSCIENCE; EMOTIONAL INFORMATION; PUPIL-DILATION; CORTEX; MOOD; TASK; SCHIZOPHRENIA AB Background: Major depressive disorder is characterized by increased and sustained emotional reactivity, which has been linked to sustained amygdala activity. It is also characterized by disruptions in executive control, linked to abnormal dorsolateral prefrontat cortex (DLPFC) function. These mechanisms have been hypothesized to interact in depression. This study explored relationships between amygdala and DLPFC activity during emotional and cognitive information processing in unipolar depression. Method: Twenty-seven unmedicated patients with DSM-IV unipolar major depressive disorder and 25 never-depressed healthy control subjects completed tasks requiring executive control (digit sorting) and emotional information processing (personal relevance rating of words) during event-related functional magnetic resonance imaging (IMRJ) assessment. Results: Relative to control subjects, depressed subjects displayed sustained amygdala reactivity on the emotional tasks and decreased DLPFC activity on the digit-sorting task. Decreased relationships between the time-series of amygdala and DLPFC activity were observed within tasks in depression, but different depressed individuals showed each type of bias. Conclusions: Depression is associated with increased limbic activity in response to emotional information processing and decreased DLPFC activity in response to cognitive tasks though these may reflect separate mechanism. Depressed individuals also display decreased relationships between amygdala and DLPFC activity, potentially signifying decreasedfunctional relationships among these structures. C1 Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Stat, Pittsburgh, PA 15260 USA. Univ Calif Davis, Dept Psychiat & Psychol, Davis, CA 95616 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Siegle, GJ (reprint author), Western Psychiat Inst & Clin, 3811 OHara St, Pittsburgh, PA 15213 USA. EM gsiegle@pitt.edu RI Frank, David/E-8213-2012 FU NIMH NIH HHS [MH55762, K02 MH082998, K25 MH076981, MH064159, MH58356, MH58397, MH60473] NR 53 TC 413 Z9 425 U1 9 U2 72 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JAN 15 PY 2007 VL 61 IS 2 BP 198 EP 209 DI 10.1016/j.biopsych.2006.05.048 PG 12 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 125PS UT WOS:000243454900011 PM 17027931 ER PT J AU Gould, GG Javors, MA Frazer, A AF Gould, Georgianna G. Javors, Martin A. Frazer, Alan TI Effect of chronic administration of duloxetine on serotonin and norepinephrine transporter binding sites in rat brain SO BIOLOGICAL PSYCHIATRY LA English DT Article DE autoradiography; binding; dual uptake inhibitor; duloxetine; norepinephrine transporter; serotonin transporter ID SPECIES-SCANNING MUTAGENESIS; POSITRON-EMISSION-TOMOGRAPHY; ADULT-MOUSE BRAIN; REUPTAKE INHIBITORS; QUANTITATIVE AUTORADIOGRAPHY; ANTIDEPRESSANT TREATMENTS; EXTRACELLULAR DOPAMINE; HEALTHY-SUBJECTS; DUAL-SEROTONIN; IN-VIVO AB Background: Chronic treatment of rats with certain selective serotonin or norepinepbrine reuptake inhibitors produces significant decreases, respectively, in serotonin and norepinephrine transporter binding sites in brain. Duloxetine may be a dual serotonin/ norepinepbrine reuptake inhibitor, as it is only a slightly more potent inhibitor of serotonin than norepinepbrine uptake in vitro. Consequently, we hypothesized that chronic duloxetine treatment, at doses producing serum levels within its therapeutic range, would affect both morroamine transporters dose-dependently, with a higher dose causing greater reductions of binding sites for both transporters. Methods: Rats were treated with either 4 or 8 mg/kg/d of duloxetine, paroxetine, desipramine, or vehicle via subcutaneous osmotic minipumps for 21 days. Binding sites for serotonin and norepinephrine transporters were measured in amygdala and hippocampus using quantitative autoradiography. Results: Both doses of duloxetine and paroxetine produced equivalent and significant decreases in [H-3] cyanoimipramine binding to serotonin transporters, but only desipramine treatment significantly reduced [HI rusoxetine binding to norepinepbrine transporters. Conclusions. At doses producing rat serum concentrations in the range achieved in patients at recommended daily doses of the drug, duloxetine behaves in vivo more as a selective serotonin reuptake inhibitor than a dual reuptake inhibitor in its capacity to selectively reduce serotonin transporter density. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Gould, GG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, MC 7764,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM gouldg@uthscsa.edu OI Gould, Georgianna/0000-0002-5470-8763 FU NIMH NIH HHS [MH57001] NR 48 TC 6 Z9 6 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JAN 15 PY 2007 VL 61 IS 2 BP 210 EP 215 DI 10.1016/j.biopsych.2006.02.029 PG 6 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 125PS UT WOS:000243454900012 PM 16650830 ER PT J AU Cassaday, RD Sondel, PM King, DM Macklin, MD Gan, J Warner, TF Zuleger, CL Bridges, AJ Schalch, HG Kim, KM Hank, JA Mahvi, DM Albertini, MR AF Cassaday, Ryan D. Sondel, Paul M. King, David M. Macklin, Michael D. Gan, Jacek Warner, Tom F. Zuleger, Cindy L. Bridges, Alan J. Schalch, Heidi G. Kim, Kyung Mann Hank, Jacquelyn A. Mahvi, David M. Albertini, Mark R. TI A phase I study of immunization using particle-mediated epidermal delivery of genes for gp100 and GM-CSF into uninvolved skin of melanoma patients SO CLINICAL CANCER RESEARCH LA English DT Article ID COLONY-STIMULATING FACTOR; CYTOTOXIC T-LYMPHOCYTE; PLASMID DNA VACCINE; ANTIBODY-RESPONSES; TUMOR-CELLS; ANTIGEN; THERAPY; BOMBARDMENT; EXPRESSION; INFLUENZA AB Purpose: We examined in vivo particle-mediated epidermal delivery (PMED) of cDNAs for gp100 and granulocyte macrophage colony-stimulating factor (GM-CSF) into uninvolved skin of melanoma patients. The aims of this phase I study were to assess the safety and immunologic effects of PMED of these genes in melanoma patients. Experimental Design: Two treatment groups of six patients each were evaluated. Group I received PMED with cDNA for gp100, and group 11 received PMED with cDNA for GM-CSF followed by PMED for gp100 at the same site. One vaccine site per treatment cycle was biopsied and divided for protein extraction and sectioning to assess transgene expression, gold-bead penetration, and dendritic cell infiltration. Exploratory immunologic monitoring of HLA-A2(+) patients included flow cytometric analyses of peripheral blood lymphocytes and evaluation of delayed-type hypersensitivity to gp100 peptide. Results: Local toxicity in both groups was mild and resolved within 2 weeks. No systemic toxicity could be attributed to the vaccines. Monitoring for autoimmunity showed no induction of pathologic autoantibodies. GM-CSF transgene expression in vaccinated skin sites was detected. GM-CSF and gp100 PMED yielded a greater infiltration of dendritic cells into vaccine sites than did gp100 PMED only. Exploratory immunologic monitoring suggested modest activation of an antimelanoma response. Conclusions: PMED with cDNAs for gp100 alone or in combination with GM-CSF is well tolerated by patients with melanoma. Moreover, pathologic autoimmunity was not shown. This technique yields biologically active transgene expression in normal human skin, Although modest immune responses were observed, additional investigation is needed to determine how to best utilize PMED to induce antimelanoma immune responses. C1 Univ Wisconsin, Paul P Carbone Comprehens Canc Ctr, Madison, WI USA. Univ Wisconsin, Dept Pediat, Madison, WI USA. Univ Wisconsin, Dept Human Oncol, Madison, WI USA. Univ Wisconsin, Dept Genet, Madison, WI 53706 USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. Univ Wisconsin, Dept Pathol, Madison, WI 53706 USA. Univ Wisconsin, Dept Biostat, Madison, WI 53706 USA. Univ Wisconsin, Dept Surg, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Med Serv, Madison, WI USA. Hubert H Humphrey Canc Ctr, Fridley, MN USA. RP Albertini, MR (reprint author), Univ Wisconsin, Ctr Clin Sci, Room K4-414,600 Highland Ave, Madison, WI 53792 USA. EM mralbert@facstaff.wisc.edu FU NCI NIH HHS [R29 CA 6846, P30 CA 14520, U01 CA 61498]; NCRR NIH HHS [M01 RR 003186] NR 29 TC 51 Z9 55 U1 1 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 JAN 15 PY 2007 VL 13 IS 2 BP 540 EP 549 DI 10.1158/1078-0432.CCR-06-2039 PN 1 PG 10 WC Oncology SC Oncology GA 132RO UT WOS:000243960100023 PM 17255276 ER PT J AU Katiyar, SK Meeran, SM AF Katiyar, Santosh K. Meeran, Syed M. TI Obesity increases the risk of UV radiation-induced oxidative stress and activation of MAPK and NF-kappa B signaling SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE skin; oxidative stress; hydrogen peroxide; glutathione peroxidase; mitogen-activated protein kinasc; NF-kappa B; cytokines; ultraviolet radiation; free radicals ID POLYPHENOL (-)-EPIGALLOCATECHIN-3-GALLATE TREATMENT; HUMAN EPIDERMAL-KERATINOCYTES; GREEN TEA POLYPHENOLS; HUMAN SKIN; ANTIOXIDANT ENZYMES; LIPID-PEROXIDATION; DIETARY-FAT; MOUSE SKIN; MAMMARY CARCINOGENESIS; HYDROGEN-PEROXIDE AB Obesity has been implicated in several diseases, including cancer; however, the relationship of obesity and susceptibility to ultraviolet (UV) radiation-caused skin diseases has not been investigated. As UV-induced oxidative stress has been implicated in several skin diseases, we assessed the role of obesity on UVB-induced oxidative stress in genetically obese Lep(ob)/Lep(ob) (leptin-deficient) mice. Here, we report that chronic exposure to UVB (120 mJ/cm(2)) resulted in greater oxidative stress in the skin of obese mice in terms of higher levels of H2O2 and NO production, photo-oxidative damage of lipids and proteins, and greater depletion of antioxidant defense enzymes, like glutathione, glutathione peroxidase, and catalase. As UV-induced oxidative stress mediates activation of MAPK and NF-kappa B signaling pathways, we determined the effects of UVB on these pathways in obese mice. Exposure of obese mice to UVB resulted in phosphorylation of ERK1/2, JNK, and p38 proteins of the MAPK family. Compared to wild-type mice, the obese mice exhibited higher levels of phosphorylation of these proteins, greater activation of NF-kappa B/p65, and higher levels of circulating proinflammatory cytokines, including TNF-alpha, IL-1 beta and IL-6, on UVB irradiation. Taking these results together, our study suggests for the first time that obesity in mice is associated with greater susceptibility to UVB-induced oxidative stress and therefore may be a risk factor for skin diseases associated with UVB-induced oxidative stress. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL 35294 USA. RP Katiyar, SK (reprint author), Univ Alabama, Dept Dermatol, POB 202,Voker Hall 557,1670 Univ Blvd, Birmingham, AL 35294 USA. EM skatiyar@uab.edu FU NCCIH NIH HHS [R01 AT002536, AT002536]; NCI NIH HHS [R21 CA104428, CA104428]; NIDDK NIH HHS [P30 DK056336, P30DK56336] NR 63 TC 52 Z9 58 U1 0 U2 2 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. PD JAN 15 PY 2007 VL 42 IS 2 BP 299 EP 310 DI 10.1016/j.freeradbiomed.2006.10.049 PG 12 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 125AH UT WOS:000243413400015 PM 17189835 ER PT J AU Seo, YK Chung, YT Kim, S Echchgadda, I Song, CS Chatterjee, B AF Seo, Young-Kyo Chung, Yoon-Tae Kim, Soyoung Echchgadda, Ibtissam Song, Chung S. Chatterjee, Bandana TI Xenobiotic- and vitamin D-responsive induction of the steroid/bile acid-sulfotransferase Sult2A1 in young and old mice: The role of a gene enhancer in the liver chromatin SO GENE LA English DT Article DE aging; sulfotransferase; gene enhancer; nuclear receptor; tissue ChIP ID X-RECEPTOR PXR; DEHYDROEPIANDROSTERONE SULFOTRANSFERASE; CALORIC RESTRICTION; EXPRESSION PROFILE; METABOLISM; TRANSCRIPTION; ALPHA; IMMUNOPRECIPITATION; DETOXIFICATION; SYSTEM AB The xenobiotic-activated nuclear receptors PXR (pregnane X receptor) and CAR (constitutive androstane receptor) and the vitamin D-3-activated nuclear receptor VDR regulate steroid and xenobiotic metabolism by inducing the phase I cytochrome P450 monooxygenases, phase II conjugating transferases, and the phase III transporters, which mediate the efflux of water-soluble lipid metabolites from cells. Metabolic stress due to the deviant expression of steroid- and xenobiotic-metabolizing enzymes is known to have severe health consequences including accelerated aging, and increased expression of these enzymes is associated with extended longevity [Gachon, F, Olela, FF, Schaad, O, Descombes, P and Schibler, U, 2006. The circadian PAR-domain basic leucine zipper transcription factors DBP, TEE, and HLF modulate basal and inducible xenobiotic detoxification. 4, 25-36.; McElwee, JJ, Schuster, E, Blanc, E, Thomas, JH and Gems, D, 2004. Shared Transcriptional Signature in Caenorhabditis elegans Dauer Larvae and Long-lived daf-2 Mutants Implicates Detoxification System in Longevity Assurance. J. Biol. Chem., 279, 44533-43.]. Information on the similarities and dissimilarities in drug metabolism between the young and old, as may be uncovered by studying aging regulation of the genes relevant to steroid and xenobiotic metabolism, is likely to have clinical significance. In this report, we examined the VDR- and PXR-mediated gene induction of the phase II sulfotransferase Sult2Al in the livers of 4-month- and 20-month-old mice. Sult2Al converts bile acids, steroids and a number of drugs to the corresponding sulfated metabolites, which are readily eliminated from the body due to increased water solubility. In RT-PCR assay, aging did not change the induction of Sult2Al mRNAs by the hormonally active vitamin D-3 and the catatoxic synthetic steroid PCN (pregnenolone-16 alpha-carbonitrile). Chromatin immunoprecipitation (ChlP) from liver nuclei showed that aging had no effect on the activity of an IR0 enhancer in the Sult2Al chromatin to recruit VDR, RXR-alpha (retinoid X receptor) and PXR in mice injected with D-3 or PCN. Thus, mice in late life are as competent as those in early life in responding to the hormonal and xenobiotic signaling for Sult2Al induction. This is the first report describing the role of aging in the functional response of an enhancer in the liver chromatin to the nuclear receptor-dependent signaling. (c) 2006 Elsevier B.V. All rights reserved. C1 S Texas Vet Hlth Care Syst, Inst Biotechnol, Dept Mol Med, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78245 USA. RP Chatterjee, B (reprint author), S Texas Vet Hlth Care Syst, Inst Biotechnol, Dept Mol Med, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM Chatterjee@uthscsa.edu FU NIA NIH HHS [AG 10486, AG-19660, R01 AG010486, R01 AG019660, R37 AG010486] NR 28 TC 15 Z9 15 U1 3 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1119 J9 GENE JI Gene PD JAN 15 PY 2007 VL 386 IS 1-2 BP 218 EP 223 DI 10.1016/j.gene.2006.10.006 PG 6 WC Genetics & Heredity SC Genetics & Heredity GA 129NU UT WOS:000243737000025 PM 17123747 ER PT J AU Gunzler, SA Stoessl, AJ Egan, RA Weleber, RG Wang, P Nutt, JG AF Gunzler, Steven A. Stoessl, A. Jon Egan, Robert A. Weleber, Richard G. Wang, Paul Nutt, John G. TI Joubert syndrome surviving to adulthood associated with a progressive movement disorder SO MOVEMENT DISORDERS LA English DT Article DE Joubert syndrome; ataxia; Parkinsonism; extrapyramidal; fluorodopa PET; oculomotor apraxia ID BRAIN-STEM DEVELOPMENT; EYE-MOVEMENTS; FOLLOW-UP; CEREBELLAR; CHILDREN AB A 48-year-old man presented with a progressive gait disorder. He had longstanding ataxia, oculomotor apraxia, motor delay, and cognitive impairment, diagnosed as cerebral palsy. Physical examination revealed ataxia, oculomotor apraxia, extrapyramidal signs, and a wide-based, shuffling gait. Magnetic resonance imaging showed vermian aplasia, consistent with Joubert syndrome. Positron emission tomography scan revealed normal fluorodopa uptake, but elevated raclopride binding, compatible with dopamine deficiency. This case demonstrates that a patient with Joubert syndrome may survive into adulthood and present as a chronic neurologic disorder with subacute extrapyramidal signs. (C) 2006 Movement Disorder Society. C1 Oregon Hlth & Sci Univ, Parkinson Ctr Oregon, Portland, OR 97239 USA. Portland VA Med Ctr, PADRECC, Portland, OR USA. Univ British Columbia, Pacific Parkinsons Res Ctr, Vancouver, BC V5Z 1M9, Canada. Oregon Hlth & Sci Univ, Casey Eye Inst, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Diagnost Radiol, Portland, OR USA. RP Gunzler, SA (reprint author), Oregon Hlth & Sci Univ, Parkinson Ctr Oregon, Mail Code OP32,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM gunzlers@ohsu.edu NR 15 TC 1 Z9 1 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JAN 15 PY 2007 VL 22 IS 2 BP 262 EP 265 DI 10.1002/mds.21263 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 132LR UT WOS:000243944800022 PM 17149728 ER PT J AU Walker, M Kim, H Samii, A AF Walker, Melanie Kim, Hojoong Samii, Ali TI Holmes-like tremor of the lower extremity following brainstem hemorrhage SO MOVEMENT DISORDERS LA English DT Article DE hypertrophic olivary degeneration; leg tremor; Holmes tremor; hemorrhage; brainstem ID HYPERTROPHIC OLIVARY DEGENERATION; PONTINE HEMORRHAGE; LESIONS AB Holmes tremor is an arrhythmic, 2- to 5-Hz resting, postural, and kinetic upper extremity movement disorder that occurs weeks to months after acute mesencephalic pathology. We present a patient who developed tremor in three body parts postbrainstem hemorrhage with subsequent hypertrophic olivary degeneration and discuss the relevant clinical evolution. Our case is unique because in addition to expected upper extremity and cervical dystonic head tremors, the patient also developed a severe lower extremity movement disorder, which we believe to be a form of Holmes tremor. Tremor involving the lower extremity in, this setting has not been previously reported. (C) 2006 Movement Disorder Society. C1 Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. RP Samii, A (reprint author), VA Puget Sound Hlth Care Syst, Dept Neurol, 1660 S Columbian Way,MS-127, Seattle, WA 98108 USA. EM asamii@u.washington.edu NR 15 TC 8 Z9 8 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JAN 15 PY 2007 VL 22 IS 2 BP 272 EP 274 DI 10.1002/mds.21271 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 132LR UT WOS:000243944800025 PM 17149732 ER PT J AU Brousseau, K AF Brousseau, Kristin TI Psychosocial aspects of HIV treatment SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID INFECTION C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Brousseau, K (reprint author), Denver Vet Affairs Med Ctr, VISN 19 MIRECC, Denver, CO 80220 USA. EM kristin.brousseau@va.gov NR 6 TC 1 Z9 1 U1 1 U2 1 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 10 PY 2007 VL 297 IS 2 BP 157 EP 158 DI 10.1001/jama.297.2.157-b PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 124GI UT WOS:000243355900023 PM 17213399 ER PT J AU Bibbins-Domingo, K Gupta, R Na, B Wu, AHB Schiller, NB Whooley, MA AF Bibbins-Domingo, Kirsten Gupta, Reena Na, Beeya Wu, Alan H. B. Schiller, Nelson B. Whooley, Mary A. TI N-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP), cardiovascular events, and mortality in patients with stable coronary heart disease SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID LEFT-VENTRICULAR DYSFUNCTION; C-REACTIVE PROTEIN; ARTERY-DISEASE; MYOCARDIAL-INFARCTION; PROGNOSTIC VALUE; RISK; FAILURE; POPULATION; PREDICTORS; PREVENTION AB Context Identification of individuals at high risk for cardiovascular events is important for the optimal use of primary and secondary prevention measures. Objective To determine whether plasma levels of amino terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular events or death independent of other available prognostic tests. Design, Setting, and Participants Prospective cohort study (2000-2002) of 987 individuals in California with stable coronary heart disease in the Heart and Soul Study, who were followed up for a mean of 3.7 (range, 0.1-5.3) years. Main Outcome Measures The association of baseline NT-proBNP levels with death or cardiovascular events (myocardial infarction, stroke, or heart failure). Traditional clinical risk factors, echocardiographic measures, ischemia, other biomarkers, and New York Heart Association classification were adjusted for to determine whether NT-proBNP levels were independent of other prognostic factors. Receiver operating characteristic (ROC) curves were used to assess the incremental prognostic value of adding NT-proBNP level to these other measures. Results A total of 256 participants (26.2%) had a cardiovascular event or died. Each increasing quartile of NT-proBNP level (range of quartile 1, 8.06-73.95 pg/mL; quartile 2, 74-174.5 pg/mL; quartile 3, 175.1-459 pg/mL; quartile 4, >= 460 pg/mL) was associated with a greater risk of cardiovascular events or death, ranging from 23 of 247 (annual event rate, 2.6%) in the lowest quartile to 134 of 246 (annual event rate, 19.6%) in the highest quartile (unadjusted hazard ratio [HR] for quartile 4 vs quartile 1, 7.8; 95% confidence interval [CI], 5.0-12.1; P < .001). Each SD increase in log NT-proBNP level (1.3 pg/mL) was associated with a 2.3-fold increased rate of adverse cardiovascular outcomes (unadjusted HR, 2.3; 95% CI, 2.0-2.6; P < .001), and this association persisted after adjustment for all of the other prognostic measures (adjusted HR, 1.7; 95% CI, 1.3-2.2; P < .001). The addition of NT-proBNP level to standard clinical assessment and complete echocardiographic parameters significantly improved the area under the ROC curves for predicting subsequent adverse cardiovascular outcomes (0.80 for clinical risk factors and echocardiographic parameters plus log NT-proBNP vs 0.76 for clinical risk factors and echocardiographic parameters only; P = .006). Conclusions Elevated levels of NT-proBNP predict cardiovascular morbidity and mortality, independent of other prognostic markers, and identify at-risk individuals even in the absence of systolic or diastolic dysfunction by echocardiography. Level of NT-proBNP may help guide risk stratification of high-risk individuals, such as those with coronary heart disease. C1 Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA. San Francisco Gen Hosp, Div Gen Internal Med, San Francisco, CA USA. San Francisco Vet Adm Med Ctr, San Francisco, CA USA. RP Bibbins-Domingo, K (reprint author), Univ Calif San Francisco, Dept Med, Box 1364, San Francisco, CA 94143 USA. EM bibbinsk@medicine.ucsf.edu FU NHLBI NIH HHS [N01-HC-95095, N01HC95095, R01 HL079235, R01 HL079235-01A1] NR 28 TC 151 Z9 161 U1 0 U2 9 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 10 PY 2007 VL 297 IS 2 BP 169 EP 176 DI 10.1001/jama.297.2.169 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 124GI UT WOS:000243355900026 PM 17213400 ER PT J AU Walker, RH Jung, HH Dobson-Stone, C Rampoldi, L Sano, A Tison, F Danek, A AF Walker, R. H. Jung, H. H. Dobson-Stone, C. Rampoldi, L. Sano, A. Tison, F. Danek, A. TI Neurologic phenotypes associated with acanthocytosis SO NEUROLOGY LA English DT Review ID KINASE-ASSOCIATED NEURODEGENERATION; HALLERVORDEN-SPATZ-SYNDROME; DEEP BRAIN-STIMULATION; DOMINANT CHOREA-ACANTHOCYTOSIS; DISEASE-LIKE 2; MCLEOD-SYNDROME; HUNTINGTONS-DISEASE; BASAL GANGLIA; PALLIDAL DEGENERATION; RETINITIS-PIGMENTOSA AB The term "neuroacanthocytosis" is normally used to refer to autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome, but there are other movement disorders in which erythrocyte acanthocytosis may also be seen, such as Huntington disease-like 2 and pantothenate kinase-associated neurodegeneration. Disorders of serum lipoproteins such as Bassen-Kornzweig disease form a distinct group of neuroacanthocytosis syndromes in which ataxia is observed, but movement disorders are not seen. Genetic testing has enabled us to distinguish between these disorders, even when there are considerable similarities between phenotypes. Improved detection is important for accurate genetic counseling, for monitoring for complications, and, it is hoped, for implementing causal treatments, once these become available. As in other neurodegenerative conditions, animal models are a promising strategy for the development of such therapies. C1 James J Peters Vet Affairs Med Ctr, Dept Neurol, Bronx, NY USA. Mt Sinai Sch Med, New York, NY USA. Univ Zurich Hosp, Dept Neurol, CH-8091 Zurich, Switzerland. Garvan Inst Med Res, Sydney, NSW, Australia. Dibit San Raffaele Sci Inst, Dulbecco Telethon Inst, Milan, Italy. Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Psychiat, Kagoshima 890, Japan. Univ Bordeaux, Dept Neurol, Bordeaux, France. Univ Hosp Bordeaux, Neurol Unit, Bordeaux, France. Univ Munich, Neurol Klin & Poliklin, Munich, Germany. RP Walker, RH (reprint author), Vet Affairs Med Ctr, Dept Neurol 12, Bronx, NY 10468 USA. EM ruth.walker@mssm.edu RI Danek, Adrian/G-7339-2011 OI Danek, Adrian/0000-0001-8857-5383; Rampoldi, Luca/0000-0002-0544-7042 FU Telethon [TCP03018] NR 106 TC 61 Z9 65 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JAN 9 PY 2007 VL 68 IS 2 BP 92 EP 98 DI 10.1212/01.wnl.0000250356.78092.cc PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 124FP UT WOS:000243353300004 PM 17210889 ER PT J AU Wang, J Caruano-Yzermans, A Rodriguez, A Scheurmann, JP Slunt, HH Cao, XH Gitlin, J Hart, PJ Borchelt, DR AF Wang, Jiou Caruano-Yzermans, Amy Rodriguez, Angela Scheurmann, Jonathan P. Slunt, Hilda H. Cao, Xiaohang Gitlin, Jonathan Hart, P. John Borchelt, David R. TI Disease-associated mutations at copper ligand histidine residues of superoxide dismutase 1 diminish the binding of copper and compromise dimer stability SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID AMYOTROPHIC-LATERAL-SCLEROSIS; CU,ZN SUPEROXIDE-DISMUTASE; MOTOR-NEURON DEGENERATION; TRANSGENIC MICE; FAMILIAL ALS; CHAPERONE CCS; WILD-TYPE; SOD1; AGGREGATION; GENE AB A subset of superoxide dismutase 1 (Cu/Zn-SOD1) mutants that cause familial amyotrophic lateral sclerosis (FALS) have heightened reactivity with -ONOO and H2O2 in vitro. This reactivity requires a copper ion bound in the active site and is a suggested mechanism of motor neuron injury. However, we have found that transgenic mice that express SOD1-H46R/ H48Q, which combines natural FALS mutations at ligands for copper and which is inactive, develop motor neuron disease. Using a direct radioactive copper incorporation assay in transfected cells and the established tools of single crystal x-ray diffraction, we now demonstrate that this variant does not stably bind copper. We find that single mutations at copper ligands, including H46R, H48Q, and a quadruple mutant H46R/H48Q/H63G/H120G, also diminish the binding of radioactive copper. Further, using native polyacrylamide gel electrophoresis and a yeast two-hybrid assay, the binding of copper was found to be related to the formation of the stable dimeric enzyme. Collectively, our data demonstrate a relationship between copper and assembly of SOD1 into stable dimers and also define disease-causing SOD1 mutants that are unlikely to robustly produce toxic radicals via copper-mediated chemistry. C1 Univ Florida, Dept Neurosci, Santa Fe Hlth Alzheimers Dis Res Ctr, McKnight Brain Inst, Gainesville, FL 32610 USA. Johns Hopkins Univ, Dept Pathol, Baltimore, MD 21205 USA. Johns Hopkins Univ, Dept Neurosci, Baltimore, MD 21205 USA. Washington Univ, Sch Med, Edward Mallinckrodt Dept Pediat, St Louis, MO 63110 USA. Univ Texas, San Antonio Hlth Sci Ctr, Dept Biochem, Xray Crystallog Core Lab, San Antonio, TX 78229 USA. Univ Texas, San Antonio Hlth Sci Ctr, Geriatr Res Educ & Clin Ctr, Dept Vet Affairs,S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Borchelt, DR (reprint author), Univ Florida, Dept Neurosci, Santa Fe Hlth Alzheimers Dis Res Ctr, McKnight Brain Inst, 100 Newell Dr,Room L1-100H,POB 100244, Gainesville, FL 32610 USA. EM Borchelt@mbi.ufl.edu FU NCI NIH HHS [R24 CA86307, R24 CA086307]; NINDS NIH HHS [P01 NS049134, R01 NS039112, R01 NS039112-07, R01 NS039912, R01 NS39912]; PHS HHS [44464] NR 48 TC 30 Z9 31 U1 0 U2 4 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JAN 5 PY 2007 VL 282 IS 1 BP 345 EP 352 DI 10.1074/jbc.M604503200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 121OI UT WOS:000243166500039 PM 17092942 ER PT J AU Ganz, DA Bao, Y Shekelle, PG Rubenstein, LZ AF Ganz, David A. Bao, Yeran Shekelle, Paul G. Rubenstein, Laurence Z. TI Will my patient fall? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID RISK-FACTORS; OLDER-PEOPLE; ELDERLY-PATIENTS; RECURRENT FALLS; COMMUNITY; PREDICTORS; HOME; METAANALYSIS; OSTEOARTHRITIS; PREVENTION AB Context Effective multifactorial interventions reduce the frequent falling rate of older patients by 30% to 40%. However, clinical consensus suggests reserving these interventions for high-risk patients. Limiting fall prevention programs to high-risk patients implies that clinicians must recognize features that predict future falls. Objective To identify the prognostic value of risk factors for future falls among older patients. Data Sources and Study Selection Search of MEDLINE ( 1966-September 2004), CINAHL (1982-September 2004), and authors' own files to identify prospective cohort studies of risk factors for falls that performed a multivariate analysis of such factors. Data Extraction Two reviewers independently determined inclusion of articles and assessed study quality. Disagreements were resolved by consensus. Included studies were those identifying the prognostic value of risk factors for future falls among community-dwelling persons 65 years and older. Clinically identifiable risk factors were identified across 6 domains: orthostatic hypotension, visual impairment, impairment of gait or balance, medication use, limitations in basic or instrumental activities of daily living, and cognitive impairment. Data Synthesis Eighteen studies met inclusion criteria and provided a multivariate analysis including at least 1 of the risk factor domains. The estimated pretest probability of falling at least once in any given year for individuals 65 years and older was 27% (95% confidence interval, 19%-36%). Patients who have fallen in the past year are more likely to fall again [ likelihood ratio range, 2.3-2.8]. The most consistent predictors of future falls are clinically detected abnormalities of gait or balance ( likelihood ratio range, 1.7-2.4). Visual impairment, medication variables, decreased activities of daily living, and impaired cognition did not consistently predict falls across studies. Orthostatic hypotension did not predict falls after controlling for other factors. Conclusions Screening for risk of falling during the clinical examination begins with determining if the patient has fallen in the past year. For patients who have not previously fallen, screening consists of an assessment of gait and balance. Patients who have fallen or who have a gait or balance problem are at higher risk of future falls. C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Vet Affairs Geriatr Res Educ & Clin Ctr 11G, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA USA. Robert Wood Johnson Clin Scholars Program, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. RP Ganz, DA (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, Vet Affairs Geriatr Res Educ & Clin Ctr 11G, 11301 Wilshire Blvd,Bldg 220,Room 308, Los Angeles, CA 90073 USA. EM dganz@mednet.ucla.edu NR 51 TC 308 Z9 321 U1 9 U2 30 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 3 PY 2007 VL 297 IS 1 BP 77 EP 86 DI 10.1001/jama.297.1.77 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 123BS UT WOS:000243271900024 PM 17200478 ER PT S AU Wang, HW Grindle, GG Connor, S Cooper, RA AF Wang, Hongwu Grindle, Garrett G. Connor, Samuel Cooper, Rory A. GP IEEE TI An experimental method for measuring the moment of inertia of an electric power wheelchair SO 2007 ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, VOLS 1-16 SE PROCEEDINGS OF ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY LA English DT Proceedings Paper CT 29th Annual International Conference of the IEEE-Engineering-in-Medicine-and-Biology-Society CY AUG 22-26, 2007 CL Lyon, FRANCE SP IEEE Engn Med & Biol Soc AB This study describe an experiment measuring the moment of inertia of an electric powered wheelchair (EPW) using a torsional pendulum method. Inertia of the wheelchair is an important factor for control, which is a key issue in wheelchair driving. The experimental test platform consisted of a bottom circular wood plate, an upper metal plate, and four ropes. Materials with known moments of inertia such as the metal disk and cylinder were used to test the accuracy of the system. The EPW used in the experiment was Invacare G3 Torque SP Storm Series. The measured result of the moment inertia of the wheelchair was 5.2280 kg.m(2) and the errors of the system are less than 10% even when the object is only 25lbs. The results are consistent when compared with other approximate methods. In addition, the experimental method could be used to measure the moment of inertia of manual wheelchairs and other irregular objects. C1 [Wang, Hongwu; Connor, Samuel; Cooper, Rory A.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. RP Wang, HW (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA 15206 USA. EM wangh@herlpitt.org; grindleg@herlpitt.org; connors@herlpitt.org; rcooper@pitt.edu RI Wang, Hongwu/J-6133-2013 OI Wang, Hongwu/0000-0002-6567-9144 NR 8 TC 5 Z9 5 U1 0 U2 2 PU IEEE PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017 USA SN 1094-687X BN 978-1-4244-0787-3 J9 P ANN INT IEEE EMBS PY 2007 BP 4798 EP 4801 DI 10.1109/IEMBS.2007.4353413 PG 4 WC Engineering, Biomedical; Imaging Science & Photographic Technology; Radiology, Nuclear Medicine & Medical Imaging SC Engineering; Imaging Science & Photographic Technology; Radiology, Nuclear Medicine & Medical Imaging GA BHI92 UT WOS:000253467003255 ER PT J AU Chen, JWY Naylor, DE Wasterlain, CG AF Chen, J. W. Y. Naylor, D. E. Wasterlain, C. G. TI Advances in the pathophysiology of status epilepticus SO ACTA NEUROLOGICA SCANDINAVICA LA English DT Article; Proceedings Paper CT International Symposium on Status Epilepticus in Infants and Young Children CY APR 29-30, 2006 CL Osaka, JAPAN SP Infantile Seizure Soc Japan ID SUSTAINING STATUS EPILEPTICUS; CONVULSIVE STATUS EPILEPTICUS; LIMBIC STATUS EPILEPTICUS; NEURON-SPECIFIC ENOLASE; SEIZURE MODULATION; GABA(A) RECEPTORS; PROTEIN-SYNTHESIS; PERFORANT-PATH; NEUROPEPTIDE-Y; BRAIN-DAMAGE AB Status epilepticus (SE) describes an enduring epileptic state during which seizures are unremitting and tend to be self-perpetuating. We describe the clinical phases of generalized convulsive SE, impending SE, established SE, and subtle SE. We discuss the physiological and biochemical cascades which characterize self-sustaining SE (SSSE) in animal models. At the transition from single seizures to SSSE, GABA(A) (gamma-aminobutyric acid) receptors move from the synaptic membrane to the cytoplasm, where they are functionally inactive. This reduces the number of GABA(A) receptors available for binding GABA or GABAergic drugs, and may in part explain the development of time-dependent pharmacoresistance to benzodiazepines and the tendency of seizures to become self-sustaining. At the same time, 'spare' subunits of AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) and NMDA (N-methyl-D-aspartic acid) receptors move from subsynaptic sites to the synaptic membrane, causing further hyperexcitability and possibly explaining the preserved sensitivity to NMDA blockers late in the course of SE. Maladaptive changes in neuropeptide expression occur on a slower time course, with depletion of the inhibitory peptides dynorphin, galanin, somatostatin and neuropeptide Y, and with an increased expression of the proconvulsant tachykinins, substance P and neurokinin B. Finally, SE-induced neuronal injury and epileptogenesis are briefly discussed. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Wasterlain, CG (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM wasterla@ucla.edu NR 78 TC 39 Z9 44 U1 0 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0001-6314 J9 ACTA NEUROL SCAND JI Acta Neurol. Scand. PY 2007 VL 115 SU 186 BP 7 EP 15 DI 10.1111/j.1600-0404.2007.00803.x PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 157VI UT WOS:000245749100002 PM 17362270 ER PT J AU Rosman, AS Korsten, MA AF Rosman, A. S. Korsten, M. A. TI Application of summary receiver operating characteristics (sROC) analysis to diagnostic clinical testing SO ADVANCES IN MEDICAL SCIENCES LA English DT Article DE summary receiver operating characteristic (sROC) curve; meta-analysis; diagnostic tests ID ROC CURVE; MAGNETIC-RESONANCE; PULMONARY-EMBOLISM; TEST ACCURACY; METAANALYSIS; CT; ULTRASONOGRAPHY; COLONOGRAPHY; PERFORMANCE; AREA AB Receiver operating characteristics (sROC) analysis is a recently developed statistical technique that can be applied to meta-analysis, of diagnostic tests. This technique call overcome some of, the limitations associated with pooling the,sensitivities and specificities Of published studies. The sROC Curve is initially constructed by plotting the sensitivity (true positivity) and false positivity (1-specificity) of each study. After mathematical manipulation of the true and false positivities, linear regression is performed to calculate the slope and y-intercept. These coefficients are then entered into the sROC equation to generate the sROC Curve. There are three commonly used methods 10 assess the accuracy of the test: the exact area under the Curve (AUC) for the sROC function, the homogeneous AUC, and the index Q*. Statistical formulas call compare these values front different diagnostic tests. With the introduction of sROC software software and better understanding of this method, the application of sROC analysis should continue to increase. C1 [Rosman, A. S.] James J Peters VA Med Ctr, Gastroenterol Sect, Bronx, NY 10468 USA. James J Peters VA Med Ctr, Program Med, Bronx, NY 10468 USA. Mt Sinai Sch Med NYU, New York, NY USA. RP Rosman, AS (reprint author), James J Peters VA Med Ctr, Gastroenterol Sect, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Alan.Rosman@VA.Gov NR 21 TC 37 Z9 38 U1 0 U2 1 PU MEDICAL UNIV BIALYSTOK PI BIALYSTOK PA UL KILINSKIEGO 1, BIALYSTOK, 15-089, POLAND SN 1896-1126 J9 ADV MED SCI JI Adv. Med. Sci. PY 2007 VL 52 BP 76 EP 82 PG 7 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 342NR UT WOS:000258791300010 PM 18217394 ER PT J AU LoboPrabhu, S Molinari, V Pate, J Lomax, J AF LoboPrabhu, S. Molinari, V. Pate, J. Lomax, J. TI The after-death call to family members: A clinical perspective SO AGING & MENTAL HEALTH LA English DT Article ID TELEPHONE CALL; GRIEF AB In this paper, we discuss the value of an after-death telephone call made by the treating mental health clinician to family members, after the death of a geriatric patient with a psychiatric disorder. We outline the process of the after-death call including the optimal method, nature, and content. We note the psychotherapeutic value of an after-death telephone call in addressing complex emotions, and helping the family to cope with bereavement. We also discuss institutional, legal, and ethical ramifications. We conclude that an after-death call may be of sufficient benefit to be considered as a 'best practice' approach in the care of every patient. C1 Michael E DeBakey Dept Vet Affairs Med Ctr, Mental Hlth Care Line, Houston, TX 77030 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Univ S Florida, Dept Aging & Mental Hlth, Louis De La Parte Florida Mental Hlth Inst, Tampa, FL 33612 USA. RP LoboPrabhu, S (reprint author), Michael E DeBakey Dept Vet Affairs Med Ctr, Mental Hlth Care Line, 2002 Holcombe Blvd,116GERO, Houston, TX 77030 USA. EM sloboprabhu@yahoo.com NR 8 TC 2 Z9 2 U1 0 U2 1 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1360-7863 J9 AGING MENT HEALTH JI Aging Ment. Health PY 2007 VL 11 IS 2 BP 192 EP 196 DI 10.1080/13607860600844291 PG 5 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 156JV UT WOS:000245644900009 PM 17453552 ER PT J AU Einhorn, PT Davis, BR Massie, BM Cushman, WC Piller, LB Simpson, LM Levy, D Nwachuku, CE Black, HR AF Einhorn, Paula T. Davis, Barry R. Massie, Barry M. Cushman, William C. Piller, Linda B. Simpson, Lara M. Levy, Daniel Nwachuku, Chuke E. Black, Henry R. CA ALLHAT Collaborative Res Grp TI The antihypertensive and lipid lowering treatment to prevent heart attack trial (ALLHAT) Heart Failure Validation Study: Diagnosis and prognosis SO AMERICAN HEART JOURNAL LA English DT Article ID MAJOR CARDIOVASCULAR EVENTS; CONVERTING-ENZYME-INHIBITOR; OUTCOMES; SURVIVAL; HYPERTENSION; TRENDS; CHLORTHALIDONE; POPULATION; PREDICTORS; AMLODIPINE C1 NHLBI, Div Epidemiol & Clin Applicat, Bethesda, MD 20892 USA. Univ Texas, Hlth Sci Ctr, Sch Publ Hlth, Houston, TX USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Memphis Vet Affairs Med Ctr, Memphis, TN USA. NHLBI, Framingham Heart Study, Framingham, MA USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL USA. RP Einhorn, PT (reprint author), NHLBI, Div Epidemiol & Clin Applicat, 2 Rockledge Ctr Room 8122,6701 Rockledge Dr MSC 7, Bethesda, MD 20892 USA. EM einhornp@mail.nih.gov FU NHLBI NIH HHS [N01-HC-35130] NR 30 TC 33 Z9 34 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD JAN PY 2007 VL 153 IS 1 BP 42 EP + DI 10.1016/j.ahj.2006.10.012 PG 12 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 129CM UT WOS:000243706000011 PM 17174636 ER PT J AU McGinnis, JM Birt, DF Brannon, PM Carroll, RJ Gibbons, RD Hazzard, WR Kamerow, DB Levin, B Ntambi, JM Paneth, N Rogers, D Saftlas, AF Vaughan, W AF McGinnis, J. Michael Birt, Diane F. Brannon, Patsy M. Carroll, Raymond J. Gibbons, Robert D. Hazzard, William R. Kamerow, Douglas B. Levin, Bernard Ntambi, James M. Paneth, Nigel Rogers, Douglas Saftlas, Audrey F. Vaughan, William CA NIH State Sci Panel TI National institutes of health state-of-the-science conference statement: Multivitamin/mineral supplements and chronic disease prevention SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Reprint ID RANDOMIZED CONTROLLED-TRIAL; NUTRITION INTERVENTION TRIALS; AGE-RELATED CATARACT; BETA-CAROTENE; VITAMIN-E; CARDIOVASCULAR-DISEASE; ALPHA-TOCOPHEROL; LUNG-CANCER; COLORECTAL-CANCER; PROSTATE-CANCER C1 Natl Acad, Inst Med, Washington, DC USA. Iowa State Univ, Dept Food Sci & Human Nutr, Ctr Res Bot Dietary Supplements, Ames, IA USA. Iowa State Univ, Coll Agr, Ames, IA USA. Iowa State Univ, Coll Human Sci, Ames, IA USA. Cornell Univ, Div Nutr Sci, Ithaca, NY 14853 USA. Texas A&M Univ, Dept Stat, College Stn, TX 77843 USA. Univ Illinois, Ctr Hlth Stat, Chicago, IL USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Georgetown Univ, Washington, DC USA. RTI Int, Washington, DC USA. Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA. Univ Wisconsin, Dept Biochem, Madison, WI 53705 USA. Univ Wisconsin, Dept Nutr Sci, Madison, WI 53705 USA. Michigan State Univ, Coll Human Med, E Lansing, MI 48824 USA. Cleveland Clin, Sect Pediat & Adolescent Endocrinol, Cleveland, OH 44106 USA. Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA. Consumers Union, Washington, DC USA. RP McGinnis, JM (reprint author), Natl Acad, Inst Med, Washington, DC USA. NR 27 TC 19 Z9 19 U1 0 U2 8 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JAN PY 2007 VL 85 IS 1 BP 257S EP 264S PG 8 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 125CP UT WOS:000243419400041 ER PT J AU Mendez, MF Shapira, JS McMurtray, A Licht, E AF Mendez, Mario F. Shapira, Jill S. McMurtray, Aaron Licht, Eliot TI Preliminary findings: Behavioral worsening on donepezil in patients with frontotemporal dementia SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE frontotemporal dementia; donepezil; acetylcholinesterase inhibitors ID NEUROPSYCHIATRIC SYMPTOMS; ALZHEIMER-DISEASE; EFFICACY; INHIBITORS; FEATURES AB Objective: The objective of this study was to evaluate donepezil, an acetylcholinesterase inhibitor, in the treatment of frontotemporal dementia (FTD). Methods: Twelve patients with FTD who received donepezil for six months were compared with 12 FTD controls on behavioral measures. Results: The groups did not differ on most variables at baseline or at six months; however, the donepezil group had greater worsening on the FTD Inventory. Four treated patients had increased disinhibited or compulsive acts, which abated with discontinuation of the medication. Conclusion: There were no changes in global cognitive performance or dementia severity; however, a subgroup of patients with FTD can experience worsening of symptoms with donepezil. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare, Neurobehav Unit, 116AF,Bldg 500,3S,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@ucla.edu FU NIA NIH HHS [AG19724-01] NR 10 TC 100 Z9 106 U1 0 U2 5 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 JAN PY 2007 VL 15 IS 1 BP 84 EP 87 DI 10.1097/01.JGP.0000231744.69631.33 PG 4 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 125FY UT WOS:000243429000010 PM 17194818 ER PT J AU Marcus, GM Cohen, J Varosy, PD Vessey, J Rose, E Massie, BM Chatterjee, K Waters, D AF Marcus, Gregory M. Cohen, Joshua Varosy, Paul D. Vessey, Joshua Rose, Emily Massie, Barry M. Chatterjee, Kanu Waters, David TI The utility of gestures in patients with chest discomfort SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE chest discomfort; Levine sign; myocardial infarction; cardiac ischemia; patient gestures ID MYOCARDIAL-INFARCTION; PAIN; DIAGNOSIS AB PURPOSE: Patient gestures are thought to be useful in determining the etiology of chest discomfort. We sought to determine the utility of certain patient gestures in the diagnosis of ischemic chest discomfort or myocardial infarction. METHODS: We performed a prospective observational study of 202 patients admitted with chest discomfort. Patients were observed for the Levine Sign ( clenched fist to the chest), the Palm Sign ( palm of the hand to the chest), the Arm Sign ( touching the left arm), and, as an indicator of nonischemic chest discomfort, the Pointing Sign ( pointing with 1 finger). RESULTS: Prevalences of the Levine, Palm, Arm, and Pointing Signs were 11%, 35%, 16%, and 4%, respectively. Using troponin levels and results of functional studies and coronary angiograms as reference standards, none of the sensitivities of the signs exceeded 38%. Specificities of the Levine and Arm Signs ranged between 78% and 86%, but the positive predictive values did not exceed 55%. The Pointing Sign had a specificity of 98% for evidence of nonischemic chest discomfort, and the positive predictive value of a negative troponin was 88%. The diameter of discomfort significantly correlated with certain gestures. Larger chest pain diameters were associated with evidence of myocardial ischemia. CONCLUSIONS: Although certain gestures are exhibited by patients presenting with chest discomfort, they generally have poor test characteristics. The Pointing Sign has a high specificity for nonischemic chest discomfort, but a low prevalence. The gestures may communicate the size of the chest discomfort, with larger areas suggestive of ischemia. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA. Mt Sinai Med Ctr, Div Cardiol, New York, NY 10029 USA. Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA. San Francisco Vet Affairs Med Ctr, Div Cardiol, San Francisco, CA USA. San Francisco Gen Hosp, Div Cardiol, San Francisco, CA 94110 USA. RP Marcus, GM (reprint author), Univ Calif San Francisco, Div Cardiol, 500 Parnassus,Box 1354, San Francisco, CA 94143 USA. EM marcusg@medicine.ucsf.edu NR 11 TC 11 Z9 11 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JAN PY 2007 VL 120 IS 1 BP 83 EP 89 DI 10.1016/j.amjmed.2006.05.045 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 123PY UT WOS:000243309000015 PM 17208083 ER PT J AU Olson, AL Zwillich, C AF Olson, Amy L. Zwillich, Clifford TI Treatment of erythrocytosis associated with obesity hypoventilation syndrome - Reply SO AMERICAN JOURNAL OF MEDICINE LA English DT Letter ID OBSTRUCTIVE SLEEP-APNEA; RENIN-ANGIOTENSIN SYSTEM; BLOOD-PRESSURE; POLYCYTHEMIA; ACTIVATION C1 Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Denver, CO USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Olson, AL (reprint author), Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Denver, CO 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 0002-9343 J9 AM J MED JI Am. J. Med. PD JAN PY 2007 VL 120 IS 1 DI 10.1016/j.amjmed.2006.02.023 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 123PY UT WOS:000243309000023 ER PT J AU Weaver, FM Collins, EG Kurichi, J Miskevics, R Smith, B Rajan, S Gater, D AF Weaver, Frances M. Collins, Eileen G. Kurichi, Jibby Miskevics, Rott Smith, Bridget Rajan, Suparna Gater, David TI Prevalence of obesity and high blood pressure in veterans with spinal cord injuries and disorders - A retrospective review SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Review DE spinal cord injury; veterans; obesity; blood pressure; cardiovascular risk ID BODY-MASS INDEX; HYPERTENSION; DISEASE; FAT AB Objective: A frequent cause of mortality in spinal cord injuries and disorders (SCI&D) is cardiovascular disease (CVD). Obesity and high blood pressure (BP) are modifiable risk factors for CVD. Design: Retrospective review of clinical and administrative data for 7959 veterans with SCI&D. Data elements included height, weight, blood pressure, demographics, and level of injury. Analyses included descriptive statistics and generalized logistic regressions. Results: Twenty percent of veterans were obese according to their body mass index (BMI), and 33% were overweight; 22% had high BP (>= 140/90 mm Hg). Because BMI underestimates obesity in SCI&D, adjusted BMIs for overweight (23-27 kg/m(2)) and obesity (28+ kg/m(2)) indicate that those overweight increased to 37%, and 31% were obese. Veterans ages 50-64 or who had paraplegia were more likely to be overweight and obese than others; being white or age 65+ was associated with a higher likelihood of being overweight. Veterans who were overweight or obese, black, older (age 50+), and paraplegic were more likely to have higher blood pressure. Conclusions: Obesity and high BP rates were lower for veterans with SCI&D than the general population. However, because BMI underestimates body adiposity in SCI&D, obesity is likely a much more prevalent problem in this population and warrants attention. C1 Edward Hines Jr Vet Adm Hosp, HSR&D, Mid W Ctr Hlth Serv & Policy Res & Res, Hines, IL 60141 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Healthcare Studies, Chicago, IL 60611 USA. Univ Illinois, Coll Nursing, Chicago, IL USA. Univ Penn Hlth Syst, Dept Surg, Philadelphia, PA USA. SCI QUERI, Philadelphia, PA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Michigan, Dept Phys Med & Rehabil, Ann Arbor, MI 48109 USA. Univ Michigan, Dept Spinal Cord Injury Med, Ann Arbor, MI 48109 USA. RP Weaver, FM (reprint author), Edward Hines Jr Vet Adm Hosp, HSR&D, Mid W Ctr Hlth Serv & Policy Res & Res, 151H, Hines, IL 60141 USA. NR 30 TC 61 Z9 62 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD JAN PY 2007 VL 86 IS 1 BP 22 EP 29 DI 10.1097/PHM.0b013e31802b8937 PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 123FR UT WOS:000243282300005 PM 17304685 ER PT J AU Wang, L Martinez, V Kimura, H Tache, Y AF Wang, L. Martinez, V. Kimura, H. Tache, Y. TI 5-Hydroxytryptophan activates colonic myenteric neurons and propulsive motor function through 5-HT4 receptors in conscious mice SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE cholinergic neurons; NADPH-diaphorase; peripheral choline acetyltransferase; serotonin; serotonin receptors ID IRRITABLE-BOWEL-SYNDROME; RAT DISTAL COLON; ENTEROCHROMAFFIN CELL HYPERPLASIA; ENTERIC NERVOUS-SYSTEM; GUINEA-PIG COLON; PERISTALTIC REFLEX; INCREASED DEFECATION; FOS EXPRESSION; GASTROINTESTINAL MOTILITY; CHOLINE-ACETYLTRANSFERASE AB Serotonin [5-hydroxytryptamine (5-HT)] acts as a modulator of colonic motility and secretion. We characterized the action of the 5-HT precursor 5-hydroxytryptophan (5-HTP) on colonic myenteric neurons and propulsive motor activity in conscious mice. Fos immunoreactivity (IR), used as a marker of neuronal activation, was monitored in longitudinal muscle/myenteric plexus whole mount preparations of the distal colon 90 min after an intraperitoneal injection of 5-HTP. Double staining of Fos IR with peripheral choline acetyltransferase (pChAT) IR or NADPH-diaphorase activity was performed. The injection of 5-HTP (0.5, 1, 5, or 10 mg/kg ip) increased fecal pellet output and fluid content in a dose-related manner, with a peak response observed within the first 15 min postinjection. 5-HTP (0.5-10 mg/kg) dose dependently increased Fos expression in myenteric neurons, with a maximal response of 9.9 +/- 1.0 cells/ganglion [P < 0.05 vs. vehicle-treated mice (2.3 +/- 0.6 cells/ganglion)]. There was a positive correlation between Fos expression and fecal output. Of Fos-positive ganglionic cells, 40 +/- 4% were also pChAT positive and 21 +/- 5% were NADPH-diaphorase positive in response to 5-HTP, respectively. 5-HTP-induced defecation and Fos expression were completely prevented by pretreatment with the selective 5-HT4 antagonist RS-39604. These results show that 5-HTP injected peripherally increases Fos expression in different populations of cholinergic and nitrergic myenteric neurons in the distal colon and stimulates propulsive colonic motor function through 5-HT4 receptors in conscious mice. These findings suggest an important role of activation of colonic myenteric neurons in the 5-HT4 receptor-mediated colonic propulsive motor response. C1 Univ Calif Los Angeles, Ctr Ulcer Res & Educ, Digest Dis Res Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Ctr Neurovisceral Sci & Womans Hlth, Div Digest Dis,David Geffen Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Shiga Univ Med Sci, Mol Neurosci Res Ctr, Otsu, Shiga 52021, Japan. RP Wang, L (reprint author), Bldg 115,Rm 117B,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM lixinw@ucla.edu RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [P50-DK-64539, R01-DK-57238, DK-41301] NR 67 TC 18 Z9 18 U1 1 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD JAN PY 2007 VL 292 IS 1 BP G419 EP G428 DI 10.1152/ajpgi.00289.2006 PG 10 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 124VW UT WOS:000243399800049 PM 16990446 ER PT J AU Chiu, AG Antunes, MB Feldman, M Cohen, NA AF Chiu, Alexander G. Antunes, Marcelo B. Feldman, Michael Cohen, Noam A. TI An animal model for the study of topical medications in sinusitis SO AMERICAN JOURNAL OF RHINOLOGY LA English DT Article; Proceedings Paper CT Combined Otolaryngology Spring Meeting CY MAY 19-22, 2006 CL Chicago, IL DE animal model; antibiotic; endoscopic sinus surgery; resistance; rhinosinusitis; topical medications ID CHRONIC RHINOSINUSITIS; ANTIBIOTIC-THERAPY; CULTURES; RABBITS AB Background: Rhinosinusitis after functional endoscopic sinus surgery often is recalcitrant to conventional medical management. Topical therapies have been popularized as a method to deliver powerful medications to diseased mucosa while limiting systemic toxicity. The aim of this study was to develop an animal model that will provide objective data in studying the efficacy of topical medications and establish a platform for translation to human clinical trials. Methods: The maxillary sinus ostium of white rabbits was obstructed with a pledget through an antrostomy created in the anterior face of the maxilla. The sinus was inoculated with Pseudomonas aeruginosa (PAO1) and 7 days later the antrostomy was reopened, the ostial obstruction was removed, and a single lumen catheter was placed. Normal saline was irrigated through the catheter for 7 days in one group of rabbits while a control group received no irrigation. At the end of 7 days, the rabbits were euthanized, analyzed under light microscopy, and bacterial counts of the nasal lavage were determined. Results: Sinusitis was confirmed in all rabbits 7 days after inoculation. Purulence, mucosal, and underlying bony inflammation persisted in both the control and the saline irrigation groups at study end. Nasal lavage bacterial counts were persistently elevated throughout the study period, indicative of bacterial viability. Conclusion: An animal model has been created for the study of topical medications in sinusitis. A novel catheter delivery system within an unoccluded maxillary sinus is described that will aid in efficacy studies of topical medications in the management of recalcitrant rhinosinusitis. C1 Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Div Rhinol, Philadelphia, PA 19104 USA. Univ Penn, Dept Pathol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Chiu, AG (reprint author), 3400 Spruce St,5 Ravdin, Philadelphia, PA 19104 USA. EM alexander.chiu@uphs.upenn.edu RI Chiu, Alexander/J-1230-2014 OI Chiu, Alexander/0000-0002-7592-6575; Cohen, Noam/0000-0002-9462-3932 NR 13 TC 17 Z9 17 U1 1 U2 4 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1050-6586 J9 AM J RHINOL JI Am. J. Rhinol. PD JAN-FEB PY 2007 VL 21 IS 1 BP 5 EP 9 DI 10.2500/ajr.2007.21.2903 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 131GH UT WOS:000243856100002 PM 17283553 ER PT J AU Rampey, AM Lathers, DMR Woodworth, BA Schlosser, RJ AF Rampey, Andrew M. Lathers, Deanne M. R. Woodworth, Bradford A. Schlosser, Rodney J. TI Immunolocalization of dendritic cells and pattern recognition receptors in chronic rhinosinusitis SO AMERICAN JOURNAL OF RHINOLOGY LA English DT Article; Proceedings Paper CT Combined Otolaryngology Spring Meeting CY MAY 19-22, 2006 CL Chicago, IL DE chronic sinusitis; DC markers; dendritic cells; TLR; toll-like receptors ID TOLL-LIKE RECEPTORS; EPIDERMAL LANGERHANS CELLS; PULMONARY INNATE IMMUNITY; SURFACTANT PROTEIN-A; C-TYPE LECTIN; DC-SIGN; ALVEOLAR MACROPHAGES; ENDOTHELIAL-CELLS; WALL COMPONENTS; T-CELLS AB Background: Dendritic cell (DC) activation and antigen presentation to T cells are critical to innate and adaptive immunity. Toll-like receptors (TLRs) are known to bind pathogen-associated molecular patterns in addition to sinonasally secreted surfactant proteins (SP) such as SP-A and SP-D. TLR binding is known to activate DCs. Based on these observations, we sought to establish the presence, in sinonasal mucosa, of DC and the pattern recognition receptors (PRRs), CD14, TLR2, and TLR4. Methods: Sinonasal biopsy specimens were taken from patients with eosinophilic nonatopic nasal polyposis (n = 4), allergic fungal sinusitis (n = 1), and nondiseased patients undergoing cerebrospinal fluid leak repair or pituitary tumor resection (n = 2). Tissue samples were stained immunohistochemically for PRR (CD14, TLR2, and TLR4), mature DC marker (CD208), iDC marker (CD209), or isotype controls. Results: Immature and mature DC were immunolocalized to the subepithelial stroma and ciliated epithelial surface, respectively. Diffuse staining of CD14 was observed throughout the stroma with additional staining in the ciliated epithelium. The TLR markers showed no staining in the ciliated epithelium. TLR2 primarily localized in stroma immediately deep to the ciliated epithelial surface. TLR4 immunolocalized to submucosal seromucinous gland ductal epithelium. Data from nondiseased patients were mixed, with one patient showing minimal staining of any of the tested cellular markers. Conclusion: This study indicates progressive DC activation and emigration of mature antigen-presenting cells from the epithelial surfaces of sinonasal mucosa. The presence of TLR known to bind SP-A and SP-D suggests a link between SP expression and immune response in sinonasal mucosa. C1 Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Schlosser, RJ (reprint author), Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, 135 Rutledge Ave,Suite 1130,POB 250550, Charleston, SC 29425 USA. EM schlossr@musc.edu NR 45 TC 15 Z9 18 U1 0 U2 0 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1050-6586 J9 AM J RHINOL JI Am. J. Rhinol. PD JAN-FEB PY 2007 VL 21 IS 1 BP 117 EP 121 DI 10.2500/ajr.2007.21.2998 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 131GH UT WOS:000243856100022 PM 17283573 ER PT J AU Plotzker, RE Metzger, DS Holmes, WC AF Plotzker, Rosalyn E. Metzger, David S. Holmes, William C. TI Childhood sexual and physical abuse histories, PTSD, depression, and HIV risk outcomes in women injection drug users: A potential mediating pathway SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; NATIONAL COMORBIDITY SURVEY; CAUSAL PATHWAYS; AMERICAN WOMEN; HEAVY DRINKING; BEHAVIORS; NEIGHBORHOOD; PROSTITUTION; ASSOCIATION; POPULATION AB We explored links between childhood sexual abuse (CSA), childhood physical abuse (CPA), posttraumatic stress disorder (PTSD)/depression, and women injection drug users' (IDUs') risk in 113 women recruited from two syringe exchange sites. More than half (56%) reported CSA, 68% CPA, 23% likely were depressed-only, and 53% likely had PTSD/depression. CSA was associated with sexual (p = 0.003) and drug risk (p = 0.05); CPA was not. CSA was associated with PTSD=depression (p = 0.03); PTSD/depression was associated with sexual (p < 0.01) and drug (p < 0.03) risk. After PTSD/depression adjustment, CSA was no longer associated with sexual or drug risk. These results suggest that women IDUs' CSA-to-risk path is mediated by PTSD/depression. C1 Univ Penn, Sch Med, Dept Psychiat, HIV Prevent Div,Ctr Studies Addict, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr AIDS Res, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Gen Internal Med, Dept Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Holmes, WC (reprint author), 733 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM holmeswc@mail.med.upenn.edu RI Metzger, David/D-9499-2012 FU NIAID NIH HHS [6-P30-AI-45008] NR 43 TC 49 Z9 49 U1 0 U2 7 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 2007 VL 16 IS 6 BP 431 EP 438 DI 10.1080/10550490701643161 PG 8 WC Substance Abuse SC Substance Abuse GA 237TN UT WOS:000251399400001 PM 18058406 ER PT J AU Fletcher, J Corless, C Liegl, B Fletcher, C Raut, C Donsky, R Bertagnolli, M Hadow, A Demetri, G Heinrich, M AF Fletcher, J. Corless, C. Liegl, B. Fletcher, C. Raut, C. Donsky, R. Bertagnolli, M. Hadow, A. Demetri, G. Heinrich, M. TI Molecular correlates ofsunitinib resistance in gastrointestinal stromal tumors (GISTS) SO ANNALS OF ONCOLOGY LA English DT Meeting Abstract CT 9th World Congress on Gastrointestinal Cancer CY JUN 28-JUL 01, 2007 CL Barcelona, SPAIN C1 Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA. OHSU Canc Inst, Dept Pathol, Portland, OR USA. Brigham & Womens Hosp, Dept Surg, Boston, MA 02115 USA. OHSU Canc Inst, Div Hematol Med Oncol, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Harvard Canc Ctr, Ludwig Ctr Dana Farber, Boston, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0923-7534 J9 ANN ONCOL JI Ann. Oncol. PY 2007 VL 18 SU 7 BP VII15 EP VII16 PG 2 WC Oncology SC Oncology GA 207WC UT WOS:000249280800017 ER PT J AU Friscia, ME Zhu, JL Kolff, JW Chen, Z Kaiser, LR Deutschman, CS Shrager, JB AF Friscia, Michael E. Zhu, Jianliang Kolff, Jeffrey W. Chen, Zhen Kaiser, Larry R. Deutschman, Clifford S. Shrager, Joseph B. TI Cytokine response is lower after lung volume reduction through bilateral thoracoscopy versus sternotomy SO ANNALS OF THORACIC SURGERY LA English DT Article ID SYSTEMIC IMMUNE-RESPONSE; SERUM INTERLEUKIN-6; ABDOMINAL HYSTERECTOMY; LAPAROSCOPIC SURGERY; POSTOPERATIVE PAIN; THORACIC-SURGERY; RANDOMIZED-TRIAL; OPEN COLECTOMY; LOBECTOMY; EMPHYSEMA AB Background. Lung volume reduction surgery performed through bilateral video-assisted thoracoscopy (BVATS) was associated in the National Emphysema Treatment Trial with a statistically significant reduction in intensive care unit days, failure to wean, hospital stay, and cost, and earlier recovery compared with median sternotomy. Studies comparing other minimally invasive techniques with "open" procedures, including pulmonary lobectomy, have demonstrated reduced serum proinflammatory mediators postoperatively. We measured these levels after lung volume reduction surgery through BVATS and sternotomy. Methods. Serum cytokine levels were measured by radioimmunoassay in 9 consecutive, steroid-free patients undergoing sternotomy and lung volume reduction surgery and 6 undergoing BVATS and lung volume reduction surgery. The groups were not statistically different with respect to age, partial pressure of arterial carbon dioxide, percent forced expiratory volume in 1 second, percent residual volume, percent total lung capacity, diffusion capacity of the lung for carbon monoxide, 6-minute walk, or apical perfusion fraction. Proinflammatory interleukin 6 and interleukin 8 and antiinflammatory interleukin 10 were evaluated preoperatively and postoperatively on days 1, 4, and 5. Clinical data were prospectively collected. Results. There were no major postoperative complications or deaths. Interleukin 6 levels were lower in the BVATS than the sternotomy group (p = 0.016 by repeated measures analysis of variance). Interleukin 8 levels were lower in the BVATS group at most postoperative time points, but there were no significant differences in interleukin 8 or interleukin 10 levels between the sternotomy and BVATS groups at any individual time point or by analysis of variance. Conclusions. Use of a BVATS approach to lung volume reduction surgery is associated with reduced postoperative release of proinflammatory cytokines compared with a sternotomy approach. This may account for the reduction in recovery time and some measures of postoperative morbidity seen with the BVATS approach. C1 Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Anesthesiol & Crit Care Med, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Surg Serv, Philadelphia, PA USA. Philadelphia VA Med Ctr, Res Serv, Philadelphia, PA USA. RP Shrager, JB (reprint author), 4 Silverstein,HUP,3400 Spruce St, Philadelphia, PA 19104 USA. EM joseph.shrager@uphs.upenn.edu NR 30 TC 8 Z9 10 U1 2 U2 5 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 JAN PY 2007 VL 83 IS 1 BP 252 EP 256 DI 10.1016/j.athoracsur.2006.08.012 PG 5 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 118TA UT WOS:000242963400041 PM 17184673 ER PT S AU Green, MF AF Green, Michael F. TI Stimulating the development of drug treatments to improve cognition in schizophrenia SO ANNUAL REVIEW OF CLINICAL PSYCHOLOGY SE Annual Review of Clinical Psychology LA English DT Review; Book Chapter DE neurocognition; MATRICS; FDA; NIMH ID PLACEBO-CONTROLLED TRIAL; SEVERE MENTAL-ILLNESS; NEUROCOGNITIVE DEFICITS; NEGATIVE SYMPTOMS; DOUBLE-BLIND; FUNCTIONAL STATUS; SOCIAL COGNITION; FOLLOW-UP; NEUROPSYCHOLOGICAL DEFICITS; ADMINISTRATION PERSPECTIVE AB Cognitive impairment in schizophrenia is a core feature of the illness (i.e., not a result of clinical symptoms or drug treatments) that is related to the daily functioning of patients. Because schizophrenia is associated with poor community functioning, there is considerable interest in finding treatments to improve cognition in schizophrenia in the hopes that such improvement will yield functional benefits. Before the U.S. Food and Drug Administration could consider granting approval to any new drug for improving cognition in schizophrenia, it was first necessary to achieve consensus on the measurements and methods that would be used in clinical trials, as well as neuropharmacological targets. The U.S. National Institute of Mental Health launched an initiative to help address these obstacles to drug approval (MATRICS). This initiative has generated several additional follow-up initiatives including a clinical trial network and consensus projects for other clinical targets, such as negative symptoms. This review describes how an area that was primarily of academic interest (cognition in schizophrenia) became a focus of public health concerns and drug-development policy. C1 [Green, Michael F.] Univ Calif Los Angeles, David Geffen Sch Med, Semel Neuropsychiat Inst, Los Angeles, CA 90095 USA. [Green, Michael F.] VA Greater Los Angeles Healthcare Syst, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. RP Green, MF (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Semel Neuropsychiat Inst, Los Angeles, CA 90095 USA. EM mgreen@ucla.edu NR 104 TC 50 Z9 54 U1 5 U2 8 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 1548-5943 BN 978-0-8243-3903-6 J9 ANNU REV CLIN PSYCHO JI Annu. Rev. Clin. Psychol. PY 2007 VL 3 BP 159 EP 180 DI 10.1146/annurev.clinpsy.3.022806.091529 PG 22 WC Psychology, Clinical; Psychology SC Psychology GA 295QK UT WOS:000255488800008 PM 17716052 ER PT J AU Barchiesi, F Spreghini, E Santinelli, A Fothergill, AW Pisa, E Giannini, D Rinaldi, MG Scalise, G AF Barchiesi, Francesco Spreghini, Elisabetta Santinelli, Alfredo Fothergill, Annette W. Pisa, Eleonora Giannini, Daniele Rinaldi, Michael G. Scalise, Giorgio TI Posaconazole prophylaxis in experimental systemic zygomycosis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID MICE AB Three isolates of zygomycetes belonging to two different genera (Rhizopus oryzae and Absidia corymbifera) were used to produce a systemic infection in neutropenic mice. On days -2 and -1 and at 2 h prior to infection, the mice received either posaconazole (POS) at doses ranging from 20 to 80 mg/kg of body weight/day or amphotericin B (AMB) at 1 mg/kg/day. Antifungal drug efficacy was assessed by determination of the prolongation of survival, determination of the percentage of infected organs (brain, lung, spleen, and kidney), and histological examination for the number of infection foci and their sizes in brain and kidney tissues. AMB significantly prolonged the survival of mice infected with all isolates. POS significantly prolonged the survival of mice infected with zygomycetes. Cultured organs from mice infected with R. oryzae were all positive, while treated mice challenged with A. corymbifera generally showed lower percentages of infected organs compared with the percentages for the controls. Zygomycete isolates established an active infection (the presence of hyphae) in the brains and the kidneys of all controls. In mice challenged with R. oryzae, both antifungal drugs were effective at reducing the number and the size of infection foci in the kidneys. Only AMB reduced the numbers, but not the sizes, of infection foci in the brain. Finally, both drugs significantly reduced the numbers and the sizes of infection foci in both tissues of mice infected with A. corymbifera. Our data suggest that prophylaxis with POS has some potential to prevent zygomycosis. C1 Univ Politecn Marche, Ist Malattie Infett & Med Pubbl, I-60020 Ancona, Italy. Univ Politecn Marche, Ist Anat Patol, I-60020 Ancona, Italy. Univ Politecn Marche, Ctr Gest Presidenza Med & Chirurg, I-60020 Ancona, Italy. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Barchiesi, F (reprint author), Univ Politecn Marche, Ist Malattie Infett & Med Pubbl, Azienda Osped Univ, Osped Riuniti Umberto I Lancisi Salesi, Via Conca, I-60020 Ancona, Italy. EM l.infettive@ao-umbertoprimo.marche.it RI Spreghini, Elisabetta/G-9378-2012 NR 15 TC 26 Z9 28 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JAN PY 2007 VL 51 IS 1 BP 73 EP 77 DI 10.1128/AAC.00969-06 PG 5 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 122GR UT WOS:000243214200008 PM 17060525 ER PT J AU Moore, JD Acosta, EP Johnson, VA Bassett, R Eron, JJ Fischl, MA Long, MC Kuritzkes, DR Sommadossi, JP AF Moore, Jeff D. Acosta, Edwgrd P. Johnson, Victoria A. Bassett, Roland Eron, Joseph J. Fischl, Margaret A. Long, Mary C. Kuritzkes, Daniel R. Sommadossi, Jean-Pierre TI Intracellular nucleoside triphosphate concentrations in HIV-infected patients on dual nucleoside reverse transcriptase inhibitor therapy SO ANTIVIRAL THERAPY LA English DT Article ID BLOOD MONONUCLEAR-CELLS; HUMAN-IMMUNODEFICIENCY-VIRUS; PERFORMANCE LIQUID-CHROMATOGRAPHY; TANDEM MASS-SPECTROMETRY; PHOSPHORYLATION IN-VITRO; ZIDOVUDINE TRIPHOSPHATE; LAMIVUDINE TRIPHOSPHATE; SIMULTANEOUS QUANTITATION; DRUG-INTERACTIONS; STAVUDINE AB Background: Intracellular nucleoside reverse transcriptase inhibitor triphosphate (NRTI-TP) concentrations are crucial in suppressing HIV replication. Little is known about how commonly used dual-NRTI regimens affect the intracellular levels of NRTI-TPs, the active form of these drugs. This study investigates the effect of dual-NRTI therapy in intracellular NRTI-TP levels. Methods: NRTI and NRTI-TP concentrations were evaluated in HIV-infected patients receiving either lamivudine (3TC) and stavudine (d4T) or lamivudine with zidovudine (ZDV); NRTI and NRTI-TP concentrations were determined using a validated IHPLC/MS/MS method. Plasma HIV-1 RNA levels were determined at baseline and monthly to examine the relationship between NRTI-TP concentrations and plasma HIV-1 RNA. Results: Forty-one subjects completed the study. 3TC-TP significantly increased between day 1 and week 28 from 1.48 to 5.00 pmol/10(6) peripheral blood mononuclear cells (PBMC; P < 0.0001). NRTI-TP concentrations for d4T and ZDV did not significantly increase, with values at week 28 of 0.011 and 0.02 pmol/10(6) PBMC, respectively. Mean NRTI-TP/plasma ratios were 3%, 0.007% and 0.05% for 3TC, d4T and ZDV, respectively. Linear relationships were observed between ZDV- and 3TC-TP and changes in plasma HIV-1 RNA. Conclusion: Of the three drugs studied, only 3TC-TP levels increased significantly between day 1 and week 28. ZDV-TP and 3TC-TP levels were unaffected by dual-NRTI therapy relative to monotherapy, regardless of the combination (3TC-ZDV or 3TC-d4T). Intracellular levels of d4T-TP were similar to previous reports for dual-NRTI therapy; however, in the case of d4T, these values appear lower than those achieved with d4T monotherapy. C1 Aniv Alabama, Div Clin Pharmacol, Birmingham, AL 35233 USA. Aniv Alabama, Birmingham Sch Med, Div Infect Dis, Birmingham, AL 35233 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35233 USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Univ N Carolina, Chapel Hill, NC 27515 USA. Miami Univ, Miami, FL USA. Brigham & Womens Hosp, Boston, MA 02115 USA. RP Acosta, EP (reprint author), Aniv Alabama, Div Clin Pharmacol, Birmingham, AL 35233 USA. EM EAcosta@uab.edu FU NIAID NIH HHS [U01-AI38858] NR 44 TC 14 Z9 15 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 2007 VL 12 IS 6 BP 981 EP 986 PG 6 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 214YD UT WOS:000249773400016 PM 17926654 ER PT J AU Madden, E Lee, GA Scherzer, R Wanke, C Kotler, D Heymsfield, S Bacchetti, P Shlipak, M Grunfeld, C AF Madden, E. Lee, G. A. Scherzer, R. Wanke, C. Kotler, D. Heymsfield, S. Bacchetti, P. Shlipak, M. Grunfeld, C. TI Association of antiretroviral therapy with fibrinogen levels in HIV infection SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT 9th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV CY JUL 19-21, 2007 CL Sydney, AUSTRALIA C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Tufts Univ, Boston, MA 02111 USA. St Lukes Roosevelt Hosp, New York, NY 10025 USA. Merck Res Lab, Rahway, NJ 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 2007 VL 12 IS 6 BP L38 EP L38 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 214YD UT WOS:000249773400074 ER PT J AU Belew, RK Looney, DJ Wong, JK AF Belew, R. K. Looney, D. J. Wong, J. K. TI Markov models of viral evolution trained on clinical patient data SO ANTIVIRAL THERAPY LA English DT Meeting Abstract CT 16th International HIV Drug Resistance Workshop CY JUN 12-16, 2007 CL BARBADOS C1 Univ Calif San Diego, San Diego, CA 92103 USA. Univ Calif San Diego, VA San Diego Healthcare Syst, San Diego, CA 92103 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 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 2007 VL 12 IS 5 BP S166 EP S166 PG 1 WC Infectious Diseases; Pharmacology & Pharmacy; Virology SC Infectious Diseases; Pharmacology & Pharmacy; Virology GA 197IC UT WOS:000248546900170 ER PT J AU Clarke, P Tyler, KL AF Clarke, Penny Tyler, Kenneth L. TI Down-regulation of cFLIP following reovirus infection sensitizes human ovarian cancer cells to TRAIL-induced apoptosis SO APOPTOSIS LA English DT Article DE reovirus; TRAIL; cFLIP; OVCAR3; apoptosis ID NF-KAPPA-B; BCL-X-L; MEDIATED APOPTOSIS; CASPASE-8 ACTIVATION; SIGNALING COMPLEX; CARCINOMA-CELLS; TUMOR-CELLS; INTRACELLULAR REGULATION; OSTEOPROTEGERIN OPG; CYTOTOXIC DRUGS AB Tumor necrosis factor-related apoptosis inducing ligand (TRAIL) shows promise as a chemotherapeutic agent. However, many human cancer cells are resistant to killing by TRAIL. We have previously demonstrated that reovirus infection increases the susceptibility of human lung (H157) and breast (ZR75-1) cancer cell lines to TRAIL-induced apoptosis. We now show that reovirus also increases the susceptibility of human ovarian cancer cell lines (OVCAR3, PA-1 and SKOV-3) to TRAIL-induced apoptosis. Reovirus-induced increases in susceptibility of OVCAR3 cells to TRAIL require virus uncoating and involve increased activation of caspases 3 and 8. Reovirus infection results in the down-regulation of cFLIP (cellular FLICE inhibitory protein) in OVCAR3 cells. Down-regulation of cFLIP following treatment of OVCAR3 cells with antisense cFLIP oligonucleotides or PI3 kinase inhibition also increases the susceptibility of OVCAR3 cells to TRAIL-induced apoptosis. Finally, over-expression of cFLIP blocks reovirus-induced sensitization of OVCAR3 cells to TRAIL-induced apoptosis. The combination of reovirus and TRAIL thus represents a promising new therapeutic approach for the treatment of ovarian cancer. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Dept Med, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Dept Microbiol, Denver, CO 80220 USA. Denver Vet Affairs Med Ctr, Dept Immunol, Denver, CO 80220 USA. RP Clarke, P (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, 4200 E 9th Ave,Box B182, Denver, CO 80262 USA. EM penny.clarke@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NINDS NIH HHS [R01 NS051403, 5R01NS050138, R01 NS050138-04, R01 NS051403-03, 1R01NS051403, R01 NS050138] NR 68 TC 12 Z9 18 U1 0 U2 6 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 1360-8185 J9 APOPTOSIS JI Apoptosis PD JAN PY 2007 VL 12 IS 1 BP 211 EP 223 DI 10.1007/s10495-006-0528-4 PG 13 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 118UO UT WOS:000242968200016 PM 17136319 ER PT J AU O'Bryant, SE Humphreys, JD Bauer, L McCaffrey, RJ Hilsabeck, RC AF O'Bryant, Sid E. Humphreys, Joy D. Bauer, Lyndsey McCaffrey, Robert J. Hilsabeck, Robin C. TI The influence of ethnicity on symbol digit modalities test performance: An analysis of a multi-ethnic college and hepatitis C patient sample SO APPLIED NEUROPSYCHOLOGY LA English DT Article DE culture; ethnicity; hepatitis C neuropsychology; validity ID NEUROPSYCHOLOGICAL ASSESSMENT SCALES; AFRICAN-AMERICAN ACCULTURATION; NORMATIVE DATA; SPANISH AB Neuropsychologists routinely assess patients from racially, ethnically, and culturally diverse populations. Despite this fact, there remains a paucity of research investigating the influence of these variables on neuropsychological test performance. The Symbol Digit Modalities Test (SDMT) is a widely used measure of attention, visual scanning and tracking, and psychomotor speed. The purpose of the present study was to assess the relation between ethnicity and SDMT performance in ethnically diverse cognitively normal and cognitively impaired samples. Participants were 168 college students (81 Caucasian, 49 African American, 20 Asian American, and 18 Hispanic) and 24 patients (12 Caucasian and 12 Hispanic) chronically infected with hepatitis C. Results revealed no significant group differences in SDMT performance in either the student or patient sample. Furthermore ethnicity accounted for only 2 and 3 percent of the variance in SDMT scores for the patient and student samples, respectively. These findings provide preliminary support for the use of the SDMT across ethnically diverse populations in both clinical and normal samples though further analysis is warranted. C1 [O'Bryant, Sid E.; Humphreys, Joy D.] Texas Tech Univ, Hlth Sci Ctr, Dept Neuropsychiat & Behav Sci, Lubbock, TX 79430 USA. [Bauer, Lyndsey; McCaffrey, Robert J.] SUNY Albany, Albany, NY 12222 USA. [Hilsabeck, Robin C.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP O'Bryant, SE (reprint author), Texas Tech Univ, Hlth Sci Ctr, Dept Neuropsychiat & Behav Sci, 3601 4th St STOP 8321, Lubbock, TX 79430 USA. EM sid.obryant@ttuhsc.edu OI O'Bryant, Sid/0000-0003-0582-5266 NR 26 TC 4 Z9 4 U1 1 U2 2 PU LAWRENCE ERLBAUM ASSOC INC-TAYLOR & FRANCIS PI PHILADELPHIA PA 325 CHESTNUT STREET, STE 800, PHILADELPHIA, PA 19106 USA SN 0908-4282 J9 APPL NEUROPSYCHOL JI Appl. Neuropsychol. PY 2007 VL 14 IS 3 BP 183 EP 188 PG 6 WC Clinical Neurology; Psychology SC Neurosciences & Neurology; Psychology GA 250OV UT WOS:000252310800006 PM 17848129 ER PT J AU Razani, J Casas, R Wong, JT Lu, P Alessi, C Josephson, K AF Razani, Jill Casas, Rachel Wong, Jennifer T. Lu, Po Alessi, Cathy Josephson, Karen TI Relationship between executive functioning and activities of daily living in patients with relatively mild dementia SO APPLIED NEUROPSYCHOLOGY LA English DT Article DE activities of daily living; Alzheimer's disease; dementia; executive functioning; functional ability ID MINI-MENTAL-STATE; ALZHEIMERS-DISEASE; NEUROPSYCHOLOGICAL TESTS; FRONTOTEMPORAL DEMENTIA; PERFORMANCE; INDIVIDUALS; IMPAIRMENT; UTILITY AB There is very little research regarding the relationship between tests of executive functioning and actual functional ability in patients with dementia. Thirty-three patients diagnosed with dementia and 35 age- and education-matched healthy controls were administered tests of executing functioning and an observation- and informant-based activities of daily living (ADL). As expected, the results revealed that the controls outperformed the dementia patients on the executive and ADL tests. Additionally, executive functioning correlated significantly with aspects of functional ability in patients with dementia. This relationship was strongest for tests of verbal fluency and a complex test of cognitive flexibility and reasoning ability (i.e., Wisconsin Card Sorting Test). These findings suggest that some executive function tests are more sensitive than others for predicting specific functional abilities and that they may be most useful to healthcare professionals for treatment planning. C1 [Razani, Jill; Casas, Rachel; Wong, Jennifer T.] Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. [Lu, Po] Calif State Univ Los Angeles, Dept Neurol, Los Angeles, CA 90032 USA. [Alessi, Cathy; Josephson, Karen] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Alessi, Cathy; Josephson, Karen] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Razani, J (reprint author), Calif State Univ Northridge, Dept Psychol, 18111 Nordhoff St, Northridge, CA 91330 USA. EM jill.razani@csun.edu FU NIGMS NIH HHS [GM08395, R25 GM063787, S06 GM048680, S06 GM048680-12A10013, S06GM048680, T34 GM008395] NR 25 TC 44 Z9 45 U1 3 U2 9 PU LAWRENCE ERLBAUM ASSOC INC-TAYLOR & FRANCIS PI PHILADELPHIA PA 325 CHESTNUT STREET, STE 800, PHILADELPHIA, PA 19106 USA SN 0908-4282 J9 APPL NEUROPSYCHOL JI Appl. Neuropsychol. PY 2007 VL 14 IS 3 BP 208 EP 214 PG 7 WC Clinical Neurology; Psychology SC Neurosciences & Neurology; Psychology GA 250OV UT WOS:000252310800008 PM 17848131 ER PT J AU Carlozzi, NE Horner, MD AF Carlozzi, Noelle E. Horner, Michael David TI Convergent and divergent validity of the Gordon Diaignostic System in adults SO ARCHIVES OF CLINICAL NEUROPSYCHOLOGY LA English DT Article DE neuropsychology; neuropsychological assessment; attentiom sustained attention; vigilance; psychometrics ID DEFICIT HYPERACTIVITY DISORDER; DIAGNOSTIC SYSTEM; ATTENTION; TESTS; PERFORMANCE; CHILDREN; UTILITY; ADHD AB The present study examined the convergent and divergent validity of the Gordon Diagnostic System (GDS) as a measure of attention in adults by examining correlations between GDS scores and scores on other attentional and non-attentional measures in 77 veterans (4 women and 73 men) referred for neuropsychological evaluation. Scores on the GDS were neither significantly correlated with scores on other attentional nor non-attentional measures. Participants were then divided into two groups, those who scored lower (< 1 S.D. below the published normative mean) and higher on the GDS for the Vigilance and Distractibility tasks separately. Participants with lower GDS scores on the Vigilance task performed more poorly on the Trailmaking Test, Part B than those with higher GDS scores. There were no other group differences on tests of attentional or non-attentional functions. These results do not provide strong support for the convergent and divergent validity of the GDS as a measure of attention in adults. (c) 2006 National Academy of Neuropsychology. Published by Elsevier Ltd. All rights reserved. C1 Indiana Univ, Dept Psychol & Brain Sci, Bloomington, IN 47405 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29401 USA. Med Univ S Carolina, Charleston, SC 29425 USA. RP Carlozzi, NE (reprint author), Indiana Univ, Dept Psychol & Brain Sci, 1101 E 10th St, Bloomington, IN 47405 USA. EM ncarlozz@indiana.edu; hornermd@musc.edu NR 31 TC 0 Z9 0 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0887-6177 J9 ARCH CLIN NEUROPSYCH JI Arch. Clin. Neuropsychol. PD JAN PY 2007 VL 22 IS 1 BP 37 EP 44 DI 10.1016/j.acn.2006.08.012 PG 8 WC Psychology, Clinical; Psychology SC Psychology GA 144RV UT WOS:000244814700004 PM 17123776 ER PT J AU Simon, GE Katon, WJ Lin, EHB Rutter, C Manning, WG Von Korff, M Ciechanowski, P Ludman, EJ Young, BA AF Simon, Gregory E. Katon, Wayne J. Lin, Elizabeth H. B. Rutter, Carolyn Manning, Willard G. Von Korff, Michael Ciechanowski, Paul Ludman, Evette J. Young, Bessie A. TI Cost-effectiveness of systematic depression treatment among people with diabetes mellitus SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID PRIMARY-CARE PATIENTS; RANDOMIZED CONTROLLED-TRIAL; PROBLEM-SOLVING TREATMENT; HEALTH MAINTENANCE ORGANIZATION; LATE-LIFE DEPRESSION; COLLABORATIVE CARE; MAJOR DEPRESSION; HIGH UTILIZERS; MEDICAL-CARE; QUALITY IMPROVEMENT AB Context: Depression co-occurring with diabetes mellitus is associated with higher health services costs, suggesting that more effective depression treatment might reduce use of other medical services. Objective: To evaluate the incremental cost and cost-effectiveness of a systematic depression treatment program among outpatients with diabetes. Design: Randomized controlled trial comparing systematic depression treatment program with care as usual. Setting: Primary care clinics of group-model prepaid health plan. Patients: A 2-stage screening process identified 329 adults with diabetes and current depressive disorder. Intervention: Specialized nurses delivered a 12-month, stepped-care depression treatment program beginning with either problem-solving treatment psychotherapy or a structured antidepressant pharmacotherapy program. Subsequent treatment ( combining psychotherapy and medication, adjustments to medication, and specialty referral) was adjusted according to clinical response. Main Outcome Measures: Depressive symptoms were assessed by blinded telephone assessments at 3, 6, 12, and 24 months. Health service costs were assessed using health plan accounting records. Results: Over 24 months, patients assigned to the intervention accumulated a mean of 61 additional days free of depression ( 95% confidence interval [ CI], 11 to 82 days) and had outpatient health services costs that averaged $314 less ( 95% CI, $1007 less to $379 more) compared with patients continuing in usual care. When an additional day free of depression is valued at $10, the net economic benefit of the intervention is $952 per patient treated ( 95% CI, $244 to $1660). Conclusions: For adults with diabetes, systematic depression treatment significantly increases time free of depression and appears to have significant economic benefits from the health plan perspective. Depression screening and systematic depression treatment should become routine components of diabetes care. C1 Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Div Gen Internal Med, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA USA. Univ Chicago, Harris Sch Publ Policy Studies, Chicago, IL 60637 USA. RP Simon, GE (reprint author), Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, 1730 Minor Ave,1600, Seattle, WA 98101 USA. EM simon.g@ghc.org FU NIMH NIH HHS [R01 MH 41739] NR 54 TC 165 Z9 167 U1 2 U2 11 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 2007 VL 64 IS 1 BP 65 EP 72 DI 10.1001/archpsyc.64.1.65 PG 8 WC Psychiatry SC Psychiatry GA 123CF UT WOS:000243273200008 PM 17199056 ER PT J AU Levine, DA Kiefe, CI Houston, TK Allison, JJ McCarthy, EP Ayanian, JZ AF Levine, Deborah A. Kiefe, Catarina I. Houston, Thomas K. Allison, Jeroan J. McCarthy, Ellen P. Ayanian, John Z. TI Younger stroke survivors have reduced access to physician care and medications - National Health Interview Survey from years 1998 to 2002 SO ARCHIVES OF NEUROLOGY LA English DT Article ID SECONDARY PREVENTION; UNINSURED ADULTS; ISCHEMIC ATTACK; UNITED-STATES; RISK-FACTORS; COVERAGE; HYPERTENSION; POPULATION; VALIDATION; INSURANCE AB Background: More than 5 million US stroke survivors require comprehensive care for risk factor modification and secondary prevention. Younger stroke survivors may have reduced access to physician care and medications because they are more frequently uninsured. Objective: To assess age-related differences in access to physician care and medications among stroke survivors (aged 45-64 years vs >= 65 years). Design: National Health Interview Survey from years 1998 to 2002. Setting: A US population-based survey. Participants: Stroke survivors (n=3681) aged 45 years and older among 159 985 survey respondents. Main Outcome Measures: General doctor visit, medical specialist visit, and inability to afford medications within the last 12 months. Results: Compared with older stroke survivors, younger stroke survivors more frequently reported no general doctor visit (10% vs 14%, respectively; P=.002), no general doctor or medical specialist visit (5% vs 8%, respectively; P=.003), and the inability to afford medications (6% vs 15%, respectively; P <.001). Younger age was independently associated with no general doctor visit (odds ratio, 1.40; 95% confidence interval, 1.04-1.88), no general doctor or medical specialist visit ( odds ratio, 1.69; 95% confidence interval, 1.14-2.52), and the inability to afford medications (odds ratio, 2.94; 95% confidence interval, 2.19-3.94) after adjusting for sex, race, income, neurological disability, health status, and comorbidity. With further adjustment for health insurance, younger age remained independently associated with the inability to afford medications but not the lack of physician visits. Conclusions: Stroke survivors younger than 65 years reported worse access to physician care and medication affordability than older stroke survivors. Inadequate access among younger stroke survivors may lead to inadequate risk factor modification and recurrent cardiovascular events. C1 Univ Alabama, Birmingham Vet Affairs Med Ctr, Deep S Ctr Effeciveness Res, Div Gen Internal Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Harvard Univ, Brigham & Womens Hosp, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA. Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Gen Med, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA. RP Levine, DA (reprint author), Univ Alabama, Birmingham Vet Affairs Med Ctr, Deep S Ctr Effeciveness Res, Div Gen Internal Med, 1530 3rd Ave S,FOT 720, Birmingham, AL 35294 USA. EM dlevine@uab.edu RI Houston, Thomas/F-2469-2013 OI Allison, Jeroan/0000-0003-4472-2112 NR 35 TC 13 Z9 13 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD JAN PY 2007 VL 64 IS 1 BP 37 EP 42 DI 10.1001/archneur.64.1.noc60002 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 123ZN UT WOS:000243336500005 PM 17101819 ER PT J AU Gillespie, MB Moody, MW Lee, FS Poole, LJ Hornig, JD Lathers, D Young, MR Day, TA AF Gillespie, M. Boyd Moody, Marcus W. Lee, Fu-Shing Poole, Lynn J. Hornig, Joshua D. Lathers, Deanne Young, M. Rita Day, Terry A. TI Head and neck cancer recurrence and mortality in nonselective cyclooxygenase inhibitor users SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article ID SQUAMOUS-CELL CARCINOMA; COX-2 INHIBITORS; OVEREXPRESSION; PREVENTION; LINES; CELECOXIB; DRUGS AB Objective: To determine whether ongoing use of a cyclooxygenase ( COX) inhibitor is associated with a reduction in mortality and disease recurrence after head and neck cancer treatment. Design: Retrospective case-control study. Patients: A total of 325 potential subjects with head and neck squamous cell carcinoma were identified using an electronic patient database. Main Outcome Measure: The rate of COX inhibitor use among patients who had died or whose disease had recurred ( cases) was compared with the rate of use among survivors or those without recurrence ( controls). The comparison was controlled for tumor site, tumor stage, treatment received, age, sex, race, smoking, and alcohol use. Results: The 325 patients were compared by logistic regressions, with recurrence rate and survival status as the dependent variables. There was no difference in COX inhibitor exposure between patients with recurrence and those with no recurrence ( P =. 42) or between survivors and those who died of disease ( P =. 66). The median survival of COX inhibitor users, however, was 96 months, compared with 47 months in nonusers. The only independent variable with a significant impact on recurrence and survival was tumor stage at the time of diagnosis. Conclusions: Although preliminary in vitro studies suggest an antitumor effect of COX inhibitors in head and neck cancer, this study found no difference in head and neck cancer recurrence or survival in nonselective COX inhibitor users vs nonusers. A randomized, double-blinded controlled trial is needed to determine if COX inhibitors are an effective chemopreventive therapy in patients with head and neck cancer. C1 Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs, Dept Otolaryngol Head & Neck Surg, Charleston, SC USA. Ralph H Johnson Vet Affairs, Res Serv, Charleston, SC USA. RP Gillespie, MB (reprint author), Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, 135 Rutledge Ave,Suite 1130, Charleston, SC 29425 USA. EM gillesmb@musc.edu NR 17 TC 3 Z9 3 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0886-4470 J9 ARCH OTOLARYNGOL JI Arch. Otolaryngol. Head Neck Surg. PD JAN PY 2007 VL 133 IS 1 BP 28 EP 31 DI 10.1001/archotol.133.1.28 PG 4 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 126JT UT WOS:000243509900005 PM 17224518 ER PT J AU Billingsley, KG Morris, AM Dominitz, JA Matthews, B Dobie, S Barlow, W Wright, GE Baldwin, LM AF Billingsley, Kevin G. Morris, Arden M. Dominitz, Jason A. Matthews, Barbara Dobie, Sharon Barlow, William Wright, George E. Baldwin, Laura-Mae TI Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery - Understanding the volume-outcome relationship SO ARCHIVES OF SURGERY LA English DT Article ID ADMINISTRATIVE DATA; OPERATIVE MORTALITY; RECTAL-CANCER; RESECTION; REGIONALIZATION; COMPLICATIONS; MORBIDITY; RATES AB Hypothesis: Although numerous studies have demonstrated an association between surgical volume and improved outcome in cancer surgery, the specific structures and mechanisms of care that are associated with volume and lead to improved outcomes remain poorly defined. We hypothesize that there are modifiable surgeon and hospital characteristics that explain observed volume-outcome relationships. Design: Retrospective cohort study. Setting: Surveillance, Epidemiology, and End Results cancer registry areas. Patients: Patients aged 66 years and older, diagnosed and surgically treated for stage I, II, or III colon cancer between 1992 and 1996 (n=22672). Main Outcome Measures: Thirty-day postoperative mortality and 30-day postoperative procedural interventions, including reoperation and image-guided percutaneous procedures. Results: Surgeon volume, but not hospital volume, is a significant predictor of postoperative procedural intervention (adjusted odds ratio for very high-volume surgeons vs low-volume surgeons, 0.79; 95% confidence interval, 0.64-0.98). In the unadjusted analyses, high hospital volume (odds ratio, 0.67; 95% confidence interval, 0.56-0.81) and very high hospital volume (odds ratio, 0.65; 95% confidence interval, 0.54-0.79) is associated with lower postoperative mortality. Postoperative procedural intervention is not a significant mediator of the relationship between hospital volume and mortality. A single variable the presence of sophisticated clinical services-was the most important explanatory variable underlying the relationship between hospital volume and mortality. Conclusions: Very high surgeon volume is associated with a reduction in surgical complications. However, the association between increasing hospital volume and postoperative mortality appears to derive mainly from a full spectrum of clinical services that may facilitate the prompt recognition and treatment of complications. C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97239 USA. Univ Michigan, Sch Med, Dept Surg, Ann Arbor, MI USA. VA Puget Sound Hlth Care Syst, Div Gastroenterol, Seattle, WA USA. Univ Washington, Sch Med, Dept Family Med, Seattle, WA USA. Canc Res & Biostat, Seattle, WA USA. RP Billingsley, KG (reprint author), Oregon Hlth Sci Univ, Dept Surg L223A, 3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM billingk@ohsu.edu NR 26 TC 89 Z9 89 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD JAN PY 2007 VL 142 IS 1 BP 23 EP 31 DI 10.1001/archsurg.142.1.23 PG 9 WC Surgery SC Surgery GA 126JU UT WOS:000243510000003 PM 17224497 ER PT J AU Jung, SM Schumacher, HR Kim, H Kim, M Lee, SH Pessler, F AF Jung, Sung Mun Schumacher, H. Ralph Kim, Hocheol Kim, Miyeon Lee, Seoung Hoon Pessler, Frank TI Reduction of urate crystal-induced inflammation by root extracts from traditional oriental medicinal plants: elevation of prostaglandin D-2 levels SO ARTHRITIS RESEARCH & THERAPY LA English DT Article ID SUBCUTANEOUS AIR POUCH; NECROSIS-FACTOR-ALPHA; MESSENGER-RNA; GROWTH-FACTOR; IN-VIVO; INDUCIBLE CYCLOOXYGENASE; ANGELICA-SINENSIS; LIPID MEDIATORS; RESOLUTION; INHIBITION AB Dried roots of the plants Acanthopanax senticosus, Angelica sinensis and Scutellaria baicalensis are used in traditional oriental medicine and reportedly possess anti-inflammatory properties. Using the murine air pouch model of inflammation, we investigated the efficacy and mode of action of an extract from these three plants in crystal-induced inflammation. Air pouches were raised on the backs of 8-week-old BALB/c mice. Mice were fed 100 mg/kg body weight of root extracts ( A. senticosus: A. sinensis: S. baicalensis mixed in a ratio of 5: 4: 1 by weight) or vehicle only on days 3-6. Inflammation was elicited on day 6 by injecting 2 mg of monosodium urate ( MSU) crystals into the pouch. Neutrophil density and IL- 6 and TNF-alpha mRNA levels were determined in the pouch membrane, and the leukocyte count and IL- 6, prostaglandin E-2 ( PGE(2)) and prostaglandin D-2 ( PGD(2)) levels were determined in the pouch exudate. Treatment with the root extracts led to a reduction in all inflammatory parameters: the leukocyte count in the pouch exudate decreased by 82%; the neutrophil density in the pouch membrane decreased by 68%; IL- 6 and TNF-alpha mRNA levels in the pouch membrane decreased by 100%; the IL- 6 concentration in the pouch fluid decreased by 50%; and the PGE(2) concentration in the pouch fluid decreased by 69%. Remarkably, the concentration of the potentially anti-inflammatory PGD(2) rose 5.2-fold in the pouch exudate ( p < 0.005), which led to a normalization of the PGD(2): PGE(2) ratio. A 3.7-fold rise in hematopoietic PGD synthase (h-PGDS) mRNA paralleled this rise in PGD(2) (p=0.01). Thus, the root extracts diminished MSU crystal-induced inflammation by reducing neutrophil recruitment and expression of pro-inflammatory factors and increasing the level of the potentially anti-inflammatory PGD(2). These results support a need for further studies of the efficacy of these extracts in the treatment of inflammatory arthropathies and suggest elevation of PGD(2) levels as a novel mechanism for an anti-inflammatory agent. C1 Childrens Hosp Philadelphia, Div Rheumatol, Philadelphia, PA 19104 USA. Univ Penn, Div Rheumatol, Philadelphia, PA 19104 USA. Univ Penn, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Div Rheumatol, Philadelphia, PA 19104 USA. Kyung Hee Univ, Coll Oriental Med, Dept Hebal Pharmacol, Fac Oriental Med, Seoul 130701, South Korea. RP Pessler, F (reprint author), Childrens Hosp Philadelphia, Div Rheumatol, 3405 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM pessler@email.chop.edu FU NCI NIH HHS [T32 CA009140, T32-CA 09140]; NIAMS NIH HHS [T32 AR007442, T32-AR 007442] NR 39 TC 16 Z9 17 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1478-6354 J9 ARTHRITIS RES THER JI Arthritis Res. Ther. PY 2007 VL 9 IS 4 AR R64 DI 10.1186/ar2222 PG 9 WC Rheumatology SC Rheumatology GA 222ZV UT WOS:000250339700011 PM 17612394 ER PT J AU Shao, WH Eisenberg, RA Cohen, PL AF Shao, Wen-Hai Eisenberg, Robert A. Cohen, Philip L. TI Disrupting Mer receptor tyrosine kinase expression prevents autoimmune chronic graft-versus-host disease SO ARTHRITIS RESEARCH & THERAPY LA English DT Meeting Abstract CT 6th Global Arthritis Research Network Meeting (GARN) CY MAY 10-13, 2007 CL Zurich, SWITZERLAND C1 [Shao, Wen-Hai; Eisenberg, Robert A.; Cohen, Philip L.] Univ Penn, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. [Cohen, Philip L.] Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1478-6354 J9 ARTHRITIS RES THER JI Arthritis Res. Ther. PY 2007 VL 9 SU 3 AR P7 DI 10.1186/ar2233 PG 1 WC Rheumatology SC Rheumatology GA 285YA UT WOS:000254810900008 ER PT J AU Namjou, B Kilpatrick, J Harley, JB AF Namjou, Bahram Kilpatrick, Jeff Harley, John B. TI Genetics of clinical expression in SLE SO AUTOIMMUNITY LA English DT Review DE genetic; systemic lupus erythematosus; autoantibodies; cytokine; expression ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; MAJOR HISTOCOMPATIBILITY COMPLEX; NECROSIS-FACTOR-ALPHA; INTERFERON-INDUCIBLE GENE; DOUBLE-STRANDED DNA; AFRICAN-AMERICAN FAMILIES; SIB-PAIR FAMILIES; HUMAN IL-10 LOCUS; HLA-DR ANTIGENS; CLASS-II AB Systemic lupus erythematosus (SLE) is the prototype of complex autoimmune diseases and is characterized by extreme breakdown of self-tolerance which results in a wide range of immunologic abnormalities and immune complex formation. Genetic, hormonal and environmental factors are known to contribute to the expression of the disease. SLE is very heterogeneous in clinical manifestations and different autoantibodies may predict different set of clinical outcome, however, despite considerable accumulated knowledge, the detailed pathogenesis of SLE still remains unknown. In genetic studies, recent findings in gene expression analyses strongly support the direct role of cytokines and interferons in various immune dysregulations described in SLE. By recent advances in high-throughput SNP genotyping, the association studies of this complex disease have become more practical and for the first time new genetic association results can be confirmed in different population. C1 [Namjou, Bahram; Kilpatrick, Jeff; Harley, John B.] Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. [Harley, John B.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK 73104 USA. [Harley, John B.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Harley, JB (reprint author), Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM john-harley@omrf.ouhsc.edu FU NIAMS NIH HHS [P30 AR053483] NR 113 TC 22 Z9 24 U1 0 U2 4 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0891-6934 J9 AUTOIMMUNITY JI Autoimmunity PY 2007 VL 40 IS 8 BP 602 EP 612 DI 10.1080/08916930701510962 PG 11 WC Immunology SC Immunology GA 240RZ UT WOS:000251606200007 PM 18075794 ER PT J AU Frey, KL Rojas, DC Anderson, CA Arciniegas, DB AF Frey, Kimberly L. Rojas, Donald C. Anderson, C. Alan Arciniegas, David B. TI Comparison of the O-Log and GOAT as measures of posttraumatic amnesia SO BRAIN INJURY LA English DT Article DE traumatic brain injury; posttraumatic amnesia; memory; rating scales ID TRAUMATIC BRAIN-INJURY; CLOSED-HEAD INJURY; GALVESTON ORIENTATION; COGNITIVE ORIENTATION; PRACTICAL SCALE; REHABILITATION; RECOVERY; RESOLUTION; SEVERITY; DURATION AB Primary objective: To compare PTA severity and duration assessments made by Orientation Log ( O-Log) and the Galveston Orientation and Amnesia Test ( GOAT) and the relationship of data yielded by these assessments to rehabilitation outcomes. Research design: Retrospective study. Methods and procedures: O-Log, GOAT, demographic, length of stay, and Functional Independence Measure ( FIM) data among 83 inpatient subjects with recent TBI requiring inpatient care were reviewed. Main outcomes and results: PTA severity and duration as assessed by the O-Log and the GOAT are statistically similar and correlate similarly with rehabilitation LOS and discharge total FIM score. Simple linear regression models suggest that O-Log scores better predict rehabilitation outcomes than GOAT scores. Conclusions: Although the O-Log and GOAT perform similarly as measures of PTA severity and duration, PTA assessments using the O-Log offers better prediction of rehabilitation outcomes. Further study of the O-Log as an alternate assessment of PTA is warranted. C1 Spalding Rehabil Hosp, Brain Injury Rehabil Unit, HealthONE, Aurora, CO 80011 USA. Univ Colorado, Sch Med, Dept Psychiat, Neuropsychiat Serv, Denver, CO 80262 USA. Univ Colorado, Sch Med, Dept Neurol Behav Neurol Sect, Denver, CO USA. Denver Vet Affairs Med Ctr, Neurol Serv, Denver, CO USA. RP Frey, KL (reprint author), Spalding Rehabil Hosp, Brain Injury Rehabil Unit, HealthONE, 900 Potomac St, Aurora, CO 80011 USA. EM Kim.Frey@uchsc.edu RI Arciniegas, David/A-3792-2009; Rojas, Don/F-4296-2012 OI Rojas, Don/0000-0001-6560-9616 NR 29 TC 14 Z9 14 U1 1 U2 3 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0269-9052 J9 BRAIN INJURY JI Brain Inj. PY 2007 VL 21 IS 5 BP 513 EP 520 DI 10.1080/02699050701311026 PG 8 WC Neurosciences; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 175FI UT WOS:000246998000008 PM 17522991 ER PT J AU Dorsey, JF Kao, GD AF Dorsey, Jay F. Kao, Gary D. TI Aloe(-emodin) for cancer? More than just a comforting salve SO CANCER BIOLOGY & THERAPY LA English DT Editorial Material DE aloe; anthraquinone; emodin; alkaline phosphatase ID ALOE-EMODIN; CARCINOMA; CELLS C1 Univ Penn, Sch Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA USA. RP Kao, GD (reprint author), Univ Penn, Sch Med, Dept Radiat Oncol, John Morgan 180 H, Philadelphia, PA 19104 USA. EM kao@xrt.upenn.edu NR 13 TC 10 Z9 11 U1 1 U2 1 PU LANDES BIOSCIENCE PI GEORGETOWN PA 810 SOUTH CHURCH STREET, GEORGETOWN, TX 78626 USA SN 1538-4047 J9 CANCER BIOL THER JI Cancer Biol. Ther. PD JAN PY 2007 VL 6 IS 1 BP 89 EP 90 DI 10.4161/cbt.6.1.3845 PG 2 WC Oncology SC Oncology GA 158RJ UT WOS:000245811100026 PM 17297301 ER PT S AU Glass, EC AF Glass, Edwin C. BE Leong, SPL TI Sentinel node identification using radionuclides in melanoma and breast cancer SO Cancer Metastasis and the Lymphovascular System: Basis for Rational Therapy SE CANCER TREATMENT AND RESEARCH LA English DT Proceedings Paper CT 1st International Symposium on Cancer Metastasis and the Lymphovascular System CY APR 28-30, 2005 CL San Francisco, CA ID EARLY-STAGE MELANOMA; LYMPH-NODE; BLUE-DYE; CUTANEOUS MELANOMA; DRAINAGE PATTERNS; RADIATION SAFETY; LYMPHOSCINTIGRAPHY; BIOPSY; INJECTION; REPRODUCIBILITY C1 VA Greater Los Angels Healthcare Syst, Los Angeles, CA 90024 USA. RP Glass, EC (reprint author), VA Greater Los Angels Healthcare Syst, Los Angeles, CA 90024 USA. NR 59 TC 3 Z9 3 U1 0 U2 0 PU SPRINGER-VERLAG BERLIN PI BERLIN PA HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY SN 0927-3042 BN 978-0-387-69218-0 J9 CANC TREAT PY 2007 BP 85 EP 100 PG 16 WC Oncology SC Oncology GA BGO74 UT WOS:000249089000007 ER PT J AU Vagin, O Turdikulova, S Tokhtaeva, E AF Vagin, Olga Turdikulova, Shahlo Tokhtaeva, Elmira TI Polarized membrane distribution of potassium-dependent ion pumps in epithelial cells: Different roles of the N-glycans of their beta subunits SO CELL BIOCHEMISTRY AND BIOPHYSICS LA English DT Review DE H,K-ATPase; Na,K-ATPase; N-glycosylation; sorting; membrane retention ID DARBY CANINE KIDNEY; H-K-ATPASE; NA,K-ATPASE ALPHA-SUBUNIT; MANNOSE TYPE GLYCANS; TRANS-GOLGI NETWORK; PLASMA-MEMBRANE; MDCK CELLS; ENDOPLASMIC-RETICULUM; APICAL MEMBRANE; FUNCTIONAL EXPRESSION AB The Na,K-ATPases and the H,K-ATPases are two potassium-dependent homologous heterodimeric P-2-type pumps that catalyze active transport of Na+ in exchange for K+ (Na,K-ATPase) or H+ in exchange for K+ (H,K-ATPase). The ubiquitous Na,K-ATPase maintains intracellular ion balance and membrane potential. The gastric H,K-ATPase is responsible for acid secretion by the parietal cell of the stomach. Both pumps consist of a catalytic alpha-subunit and a glycosylated beta-subunit that is obligatory for normal pump maturation and trafficking. Individual N-glycans linked to the beta-subunits of the Na,K-ATPase and H,K-ATPase are important for stable membrane integration of their respective alpha subunits, folding, stability, subunit assembly, and enzymatic activity of the pumps. They are also essential for the quality control of unassembled beta-subunits that results in either the exit of the subunits from the ER or their ER retention and subsequent degradation. Overall, the importance of N-glycans for the maturation and quality control of the H,K-ATPase is greater than that of the Na,K-ATPase. The roles of individual N-glycans of the beta-subunits in the post-ER trafficking, membrane targeting and plasma membrane retention of the Na,K-ATPase and H,K-ATPase are different. The Na,K-ATPase beta(1)-subunit is the major beta-subunit isoform in cells with lateral location of the pump. All three N-glycans of the Na,K-ATPase beta(1)-subunit are important for the lateral membrane retention of the pump due to glycan-mediated interaction between the beta(1)-subunits of the two neighboring cells in the cell monolayer and cytosolic linkage of the a-subunit to the cytoskeleton. This intercellular beta(1)-beta(1) interaction is also important for formation of cell-cell contacts. In contrast, the N-glycans unique to the Na,K-ATPase beta(2)-subunit,which has up to eight N-glycosylation sites, contain apical sorting information. This is consistent with the apical location of the Na,K-ATPase in normal and malignant epithelial cells with high abundance of the beta(2)-subunit. Similarly, all seven N-glycans of the gastric H,K-ATPase beta-subunit deter-mine apical sorting of this subunit. C1 Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. Vet Adm Greater Los Angeles Hlth Care Syst, West LA, Los Angeles, CA 90073 USA. RP Vagin, O (reprint author), Univ Calif Los Angeles, Sch Med, Dept Physiol, Bldg 113,Room 324,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM olgav@ucla.edu FU NIDDK NIH HHS [R01 DK077149-02, R01 DK077149-01A1, R01 DK077149] NR 109 TC 14 Z9 14 U1 0 U2 1 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 2007 VL 47 IS 3 BP 376 EP 391 DI 10.1007/s12013-007-0033-6 PG 16 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 182JU UT WOS:000247501700005 PM 17652782 ER PT J AU McMurtray, AM Liao, A Haider, J Licht, E Mendez, MF AF McMurtray, Aaron M. Liao, Alex Haider, Janelle Licht, Eliot Mendez, Mario F. TI Cognitive performance after lacunar stroke correlates with leukoaraiosis severity SO CEREBROVASCULAR DISEASES LA English DT Article DE vascular dementia; stroke; leukoaraiosis ID WHITE-MATTER LESIONS; ISCHEMIC VASCULAR DEMENTIA; ELDERLY-PEOPLE; ROTTERDAM SCAN; CARDIOVASCULAR-HEALTH; ALZHEIMERS-DISEASE; INFARCTS; IMPAIRMENT; PREVALENCE; CRITERIA AB Background: This study investigates the effect of leukoaraiosis on patients presenting with cognitive impairment after lacunar stroke. Methods: Fourty-six patients with cognitive impairment and newly discovered lacunar stroke detected by brain magnetic resonance imaging underwent neuropsychological testing. Results: Patients with both lacunar infarct and leukoaraiosis performed less well on cognitive measures, compared to those with lacunar infarcts alone. Additionally, leukoaraiosis severity inversely correlated with cognitive performance. Conclusions: In patients with lacunar stroke, presence of leukoaraiosis is associated with worse performance in multiple cognitive domains. These findings suggest lacunar infarcts plus leukoaraiosis is a common etiology for vascular dementia. Copyright (c) 2007 S. Karger AG, Basel. C1 VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. RP Mendez, MF (reprint author), VA Greater Los Angeles Healthcare Syst, Neurobehav Unit 116AF, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM mmendez@ucla.edu NR 27 TC 14 Z9 16 U1 0 U2 2 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1015-9770 J9 CEREBROVASC DIS JI Cerebrovasc. Dis. PY 2007 VL 24 IS 2-3 BP 271 EP 276 DI 10.1159/000105679 PG 6 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 198VT UT WOS:000248656300018 PM 17646691 ER PT J AU Komers, R Lindsley, JN Oyama, TT Anderson, S AF Komers, Radko Lindsley, Jessie N. Oyama, Terry T. Anderson, Sharon TI Cyclo-oxygenase-2 inhibition attenuates the progression of nephropathy in uninephrectomized diabetic rats SO CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY LA English DT Article DE albuminuria; diabetic nephropathy; glomerular filtration rate; glomerulosclerosis; MF-tricyclic; thromboxane A2 ID SELECTIVE CYCLOOXYGENASE-2 INHIBITOR; THROMBOXANE SYNTHESIS; RENAL HEMODYNAMICS; INDUCED INCREASES; RENIN CONTENT; EXPRESSION; MODEL; COX-2; MICE; PROSTAGLANDIN AB 1. Cyclo-oxygenase (COX)-2 is involved in constitutive production of prostanoids in the kidney and plays a role in the control of renal function and morphology. Renal cortical COX-2 expression and function is increased in experimental models of diabetes (DM). However, pathophysiological roles of this phenomenon in the diabetic kidney have not been fully elucidated. To address this issue, we studied the nephroprotective potential of long-term (16 weeks) COX-2 inhibition in uninephrectomized streptozotocin-diabetic rats (D). 2. Diabetic rats received either a low or high dose of the selective COX-2 inhibitor MF-tricyclic (MF; 1 or 5 mg/kg per day in chow). Another group of D rats received high-dose MF as late intervention starting at 8 weeks of DM (D-MFlate). The effects of treatments were compared with age-matched uninephrectomized diabetic and non-diabetic rats receiving drug-free chow (D-VE and C-VE, respectively). 3. No differences in blood pressure and metabolic control were observed between groups of D rats throughout the study. The D-VE group developed progressive albuminuria and glomerulosclerosis, associated with increased excretion of the thromboxane (TX) A(2) metabolite TxB(2). Treatment with MF attenuated albuminuria in diabetic rats with late intervention, but not in D rats treated with MF from the onset of DM. Moreover, D-MFlate rats demonstrated a significant reduction in the development of glomerulosclerosis. These effects coincided with prevention of diabetes-induced rise in urinary TxB(2) excretion. 4. In conclusion, long-term COX-2 inhibition is associated with modest nephroprotection in uninephrectomized diabetic rats when administered as late intervention. These effects are independent of metabolic control and blood pressure. C1 Oregon Hlth Sci Univ, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland VA Med Ctr, Med Serv, Portland, OR USA. Inst Clin & Expt Med, Ctr Diabet, Prague, Czech Republic. RP Komers, R (reprint author), Oregon Hlth Sci Univ, Div Nephrol & Hypertens, PP 262,3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM komersr@ohsu.edu FU NIA NIH HHS [AG 14699] NR 32 TC 40 Z9 43 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0305-1870 J9 CLIN EXP PHARMACOL P JI Clin. Exp. Pharmacol. Physiol. PD JAN-FEB PY 2007 VL 34 IS 1-2 BP 36 EP 41 DI 10.1111/j.1440-1681.2007.04534.x PG 6 WC Pharmacology & Pharmacy; Physiology SC Pharmacology & Pharmacy; Physiology GA 117QR UT WOS:000242888500006 PM 17201733 ER PT J AU Fujimoto, S Ojo, OO Arnqvist, A Wu, JY Odenbreit, S Haas, R Graham, DY Yamaoka, Y AF Fujimoto, Saori Ojo, Olabisi Olaniyi Arnqvist, Anna Wu, Jeng Yih Odenbreit, Stefan Haas, Rainer Graham, David Y. Yamaoka, Yoshio TI Helicobacter pylori BabA expression, gastric mucosal injury, and clinical outcome SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID ANTIGEN-BINDING ADHESIN; OUTER-MEMBRANE PROTEINS; BLOOD-GROUP ANTIGENS; DUODENAL-ULCER; VIRULENCE FACTORS; CAGA; INFECTION; DISEASE; VACA; INFLAMMATION AB Background & Aims: The blood group antigen binding adhesin (BabA) has been proposed to play a role in disease pathogenesis. This hypothesis is based on the functional BabA status as determined by polymerase chain reaction (PCR) analysis to distinguish functional babA2 genes from nonfunctional babA1 genes. Methods: We compared the ability of published PCR-based methods to assess BabA status with BabA immunoblotting and Lewis b (Le(b)) binding activity assays. We also used immunoblotting to examine the relationship between clinical presentation and levels of BabA expression. Results: Immunoblotting and Le(b) binding assays for 80 strains revealed 3 levels of BabA expression: BabA high producers (BabA-H) with Le(b) binding activity, BabA low producers (BabA-L) without Le(b) binding activity, and BabA-negative. BabA-negative strains lacked the babA gene. PCR methods to determine BabA status yielded poor results. babA1 sequences were never detected. BabA expression was examined in 250 strains from Western countries and 270 strains from East Asia. The results failed to confirm any relationship between triple-positive status (cagA-positive/vacA s1/BabA-H) and clinical outcome. BabA-negative strains typically were cagA-negative/vacA s2 and were associated with gastritis. BabA-L strains showed a higher level of mucosal injury and were associated more frequently with duodenal ulcer and gastric cancer than the other groups. Conclusions: Information gained from currently used PCR-based methods must be interpreted with caution. Le(b) binding activity does not accurately reflect the severity of mucosal damage or the clinical outcome. Quantitation of BabA expression revealed that Le(b)-nonbinding BabA-L strains are associated with higher levels of mucosal injury and clinical outcome. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Umea Univ, Dept Med Biochem & Biophys, S-90187 Umea, Sweden. Umea Univ, Dept Mol Biol, Umea, Sweden. Univ Munich, Max Von Pettenkofer Inst Hyg & Med Microbiol, Munich, Germany. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu FU NIDDK NIH HHS [R01 DK062813, R01 DK62813, P30 DK056338, R01 DK062813-03, DK56338] NR 39 TC 31 Z9 34 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD JAN PY 2007 VL 5 IS 1 BP 49 EP 58 DI 10.1016/j.cgh.2006.09.015 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 130ED UT WOS:000243781300010 PM 17157077 ER PT J AU Brooks-Worrell, B Ismail, H Wotring, M Liemin, AU Kimmie, C Felton, J Palmer, J AF Brooks-Worrell, Barbara Ismail, Heba Wotring, Michael Liemin, A. U. Kimmie, Crystal Felton, Jamie Palmer, Jerry TI Autoimmune development in phenotypic type 2 diabetes patients SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 7th Annual Meeting of the Federation-of-Clinical-Immunology-Societies CY JUN 07-11, 2007 CL San Diego, CA SP Federat Clin Immunol Soc C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 1 Z9 1 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 2007 VL 123 SU S BP S66 EP S67 DI 10.1016/j.clim.2007.03.367 PG 2 WC Immunology SC Immunology GA 177EU UT WOS:000247137200173 ER PT J AU Davey, M Zhang, ZL Martin, T Rosenzweig, H Planck, S Rosenbaum, J AF Davey, Michael Zhang, Zili Martin, Tammy Rosenzweig, Holly Planck, Steven Rosenbaum, James TI Variants of CARD15/NOD2 associated with Crohn's disease and blau syndrome differ from wild type NOD2 in regulating cytokine secretion induced by TLR2 and TLR4 agonists in a transduced macrophage cell line SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 7th Annual Meeting of the Federation-of-Clinical-Immunology-Societies CY JUN 07-11, 2007 CL San Diego, CA SP Federat Clin Immunol Soc C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, CEI, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Casey Eye Inst, Portland, OR 97201 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 2007 VL 123 SU S BP S135 EP S136 DI 10.1016/j.clim.2007.03.024 PG 2 WC Immunology SC Immunology GA 177EU UT WOS:000247137200352 ER PT J AU Offner, H Burrows, G Vandenbark, A Link, J AF Offner, Halina Burrows, Gregory Vandenbark, Arthur Link, Jason TI From EAE to an MS clinical trial: DR2/MOG-35-55 recombinant T cell receptor ligand (RTL) treats relapse of experimental encephalomyelitis in DR2 transgenic mice SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 7th Annual Meeting of the Federation-of-Clinical-Immunology-Societies CY JUN 07-11, 2007 CL San Diego, CA SP Federat Clin Immunol Soc C1 Oregon Hlth & Sci Univ, Portland, OR 97201 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 2007 VL 123 SU S BP S7 EP S7 DI 10.1016/j.clim.2007.03.191 PG 1 WC Immunology SC Immunology GA 177EU UT WOS:000247137200014 ER PT J AU Scalapi, K Daikh, D AF Scalapi, Kenneth Daikh, David TI Increased regulatory T cell prevalence and retained capacity to suppress effector T cells during disease in NZB/W lupus mice SO CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 7th Annual Meeting of the Federation-of-Clinical-Immunology-Societies CY JUN 07-11, 2007 CL San Diego, CA SP Federat Clin Immunol Soc C1 Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 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 2007 VL 123 SU S BP S102 EP S102 DI 10.1016/j.clim.2007.03.470 PG 1 WC Immunology SC Immunology GA 177EU UT WOS:000247137200265 ER PT J AU Renaud, B Coma, E Labarere, J Hayon, J Roy, PM Boureaux, H Moritz, F Cibien, JF Guerin, T Carre, E Lafontaine, A Bertrand, MP Santin, A Brun-Buisson, C Fine, MJ Roupie, E AF Renaud, Bertrand Coma, Eva Labarere, Jose Hayon, Jan Roy, Pierre-Marie Boureaux, Helene Moritz, Fabienne Cibien, Jean Francois Guerin, Thomas Carre, Emmanuel Lafontaine, Armelle Bertrand, Marie Pierre Santin, Aline Brun-Buisson, Christian Fine, Michael J. Roupie, Eric CA Pneunocom Study Invest TI Routine use of the pneumonia severity index for guiding the site-of-treatment decision of patients with pneumonia in the emergency department: A multicenter, prospective, observational, controlled cohort study SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; LOW-RISK PATIENTS; PREDICTION RULE; PRACTICE GUIDELINES; CONTROLLED-TRIAL; CARE; HOSPITALIZATION; OUTCOMES; MANAGEMENT; ACCESS AB Background. Although the Pneumonia Severity Index (PSI) has been extensively validated, little is known of the impact of its routine use as an aid to site-of-treatment decisions for patients with pneumonia who present to emergency departments (EDs). Methods. A prospective, observational, controlled cohort study of patients with pneumonia was conducted in 8 EDs that used the PSI (PSI-user EDs) and 8 EDs that did not use the PSI (PSI-nonuser EDs) in France. The outcomes examined included the proportion of " low- risk" patients (PSI risk classes I-III) treated as outpatients, all- cause 28- day mortality, admission of inpatients to the intensive care unit, and subsequent hospitalization of outpatients. Results. Of the 925 patients enrolled in the study, 472 (51.0%) were treated at PSI- user EDs, and 453 (49.0%) were treated at PSI-nonuser EDs; 449 (48.5%) of all patients were considered to be at low risk. In PSI- user EDs, 92 (42.8%) of 215 patients at low risk were treated as outpatients, compared with 56 (23.9%) of 234 patients at low risk in PSI- nonuser EDs. The adjusted odds ratios for outpatient treatment were higher for patients in PSI risk classes I and II who were treated in PSI- user EDs, compared with PSI- nonuser EDs (adjusted odds ratio, 7.0 [95% confidence interval, 2.0 - 25.0] and 4.6 [95% confidence interval, 1.3-16.2], respectively), whereas the adjusted odds ratio did not differ by PSI- user status among patients in risk class III or among patients at high risk. After adjusting for pneumonia severity, mortality was lower in patients who were treated in PSI-user EDs; other safety outcomes did not differ between patients treated in PSI- user and PSI- nonuser EDs. Conclusions. The routine use of the PSI was associated with a larger proportion of patients in PSI risk classes I and II who had pneumonia and who were treated in the outpatient environment without compromising their safety. C1 Ctr Hosp Univ Henri Mondor, AP HP, Dept Emergency Med, Paris, France. Ctr Hosp Univ Henri Mondor, AP HP, Intens Care Unit, Paris, France. Ctr Hosp Intercommunal, Emergency Dept, Creteil, France. Ctr Hosp Univ Grenoble, Qual Care Unit, Grenoble, France. Ctr Hosp Intercommunal Poissy St Germain, Intens Care Unit, St Germain En Laye, France. Univ Angers, Ctr Hosp, Emergency Dept, Angers, France. Univ Poitiers, Ctr Hosp, Emergency Dept, Poitiers, France. Univ Rouen, Ctr Hosp, Emergency Dept, Rouen, France. Univ Caen, Ctr Hosp, Emergency Dept, F-14032 Caen, France. Ctr Hosp Intercommunal, Tarbes, France. Hosp Mataro, Consorci Sanitari Maresme, Dept Emergency Med, Mataro, Spain. Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Renaud, B (reprint author), Ctr Hosp Univ Henri Mondor, AP HP, Dept Emergency Med, Paris, France. RI Labarere, Jose/N-1688-2014 NR 24 TC 61 Z9 64 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN 1 PY 2007 VL 44 IS 1 BP 41 EP 49 DI 10.1086/509331 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 111UC UT WOS:000242479500006 PM 17143813 ER PT J AU Musher, DM Logan, N Hamill, RJ DuPont, HL Lentnek, A Gupta, A Rossignol, JF AF Musher, Daniel M. Logan, Nancy Hamill, Richard J. DuPont, Herbert L. Lentnek, Arnold Gupta, Arvind Rossignol, Jean-Francois TI Nitazoxanide versus metronidazole for Clostridium difficile-associated colitis - Reply to Young et al. SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID VANCOMYCIN; DIARRHEA C1 Baylor Coll Med, Infect Dis Sect, Med Serv, 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 & Microbiol, Houston, TX 77030 USA. St Lukes Episcopal Hosp, Houston, TX 77030 USA. Wellstar Kennestone Hosp, Marietta, GA USA. Penn State Coll Med, Hershey, PA USA. Lehigh Valley Hosp Ctr, Allentown, PA 18102 USA. Romark Inst Med Res, Tampa, FL USA. RP Musher, DM (reprint author), Baylor Coll Med, Infect Dis Sect, Med Serv, Michael E DeBakey Vet Affairs Med Ctr, Rm 4B-370,2002 Holcombe Blvd, Houston, TX 77030 USA. EM daniel.musher@med.va.gov NR 5 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 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN 1 PY 2007 VL 44 IS 1 BP 152 EP 154 DI 10.1086/510207 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 111UC UT WOS:000242479500033 ER PT J AU Dworkin, RH Johnson, RW Breuer, J Gnann, JW Levin, MJ Backonja, M Betts, RF Gershon, AA Haanpaa, ML McKendrick, MW Nurmikko, TJ Oaklander, AL Oxman, MN Pavan-Langston, D Petersen, KL Rowbotham, MC Schmader, KE Stacey, BR Tyring, SK van Wijck, AJM Wallace, MS Wassilew, SW Whitley, RJ AF Dworkin, Robert H. Johnson, Robert W. Breuer, Judith Gnann, John W. Levin, Myron J. Backonja, Miroslav Betts, Robert F. Gershon, Anne A. Haanpaa, Maija L. McKendrick, Michael W. Nurmikko, Turo J. Oaklander, Anne Louise Oxman, Michael N. Pavan-Langston, Deborah Petersen, Karin L. Rowbotham, Michael C. Schmader, Kenneth E. Stacey, Brett R. Tyring, Stephen K. van Wijck, Albert J. M. Wallace, Mark S. Wassilew, Sawko W. Whitley, Richard J. TI Recommendations for the management of herpes zoster SO CLINICAL INFECTIOUS DISEASES LA English DT Review ID OUTER RETINAL NECROSIS; PLACEBO-CONTROLLED TRIAL; HUMAN-IMMUNODEFICIENCY-VIRUS; POLYMERASE-CHAIN-REACTION; RANDOMIZED CONTROLLED-TRIAL; CONTROLLED-CLINICAL-TRIAL; HUMAN TRIGEMINAL GANGLIA; QUALITY-STANDARDS-SUBCOMMITTEE; PREVENT POSTHERPETIC NEURALGIA; PAINFUL DIABETIC-NEUROPATHY AB The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic literature reviews, published randomized clinical trials, existing guidelines, and the authors' clinical and research experience relevant to the management of patients with HZ were reviewed at a consensus meeting. The results of controlled trials and the clinical experience of the authors support the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir as first-line antiviral therapy for the treatment of patients with HZ. Specific recommendations for the use of these medications are provided. In addition, suggestions are made for treatments that, when used in combination with antiviral therapy, may further reduce pain and other complications of HZ. C1 Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA. Univ Rochester, Dept Neurol, Rochester, NY 14642 USA. Univ Rochester, Dept Med, Rochester, NY 14642 USA. Columbia Univ, Dept Pediat, New York, NY USA. Univ Alabama, Dept Med, Birmingham, AL USA. Univ Alabama, Dept Pediat, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Colorado, Dept Pediat, Denver, CO 80202 USA. Univ Wisconsin, Dept Neurol, Madison, WI 53706 USA. Harvard Univ, Dept Neurol, Cambridge, MA 02138 USA. Harvard Univ, Sch Med, Dept Ophthalmol, Boston, MA USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Anesthesiol, San Diego, CA 92103 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA. Duke Univ, Dept Med, Durham, NC USA. Univ Texas, Hlth Sci Ctr, Houston, TX USA. Univ Oregon, Dept Anesthesiol, Portland, OR USA. Univ Bristol, Dept Anesthesiol, Bristol, Avon, England. Queen Mary Coll, Skin Virus Lab, London, England. Royal Hallamshire Hosp, Dept Infect & Trop Med, Sheffield S10 2JF, S Yorkshire, England. Univ Liverpool, Dept Neurol Sci, Liverpool, Merseyside, England. Helsinki Univ Hosp, Dept Anesthesiol & Intens Care, Helsinki, Finland. Helsinki Univ Hosp, Dept Neurol, Helsinki, Finland. Univ Utrecht, Pain Clin, Utrecht, Netherlands. Klinikum Krefeld, Dermatol Klin, Krefeld, Germany. RP Dworkin, RH (reprint author), Univ Rochester, Sch Med & Dent, Dept Anesthesiol, 601 Elmwood Ave,Box 604, Rochester, NY 14642 USA. EM robert_dworkin@urmc.rochester.edu NR 240 TC 233 Z9 242 U1 0 U2 13 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 2007 VL 44 SU 1 BP S1 EP S26 DI 10.1086/510206 PG 26 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 111UB UT WOS:000242479300001 PM 17143845 ER PT J AU Fulop, T Larbi, A Hirokawa, K Mocchegiani, E Lesourd, B Castle, S Wikby, A Franceschi, C Pawelec, G AF Fueloep, Tamas Larbi, Anis Hirokawa, Katsuiku Mocchegiani, Eugenio Lesourd, Bruno Castle, Stephen Wikby, Anders Franceschi, Claudio Pawelec, Graham TI Immunosupportive therapies in aging SO CLINICAL INTERVENTIONS IN AGING LA English DT Review DE immunosenescence; T cells; phagocytic cells; nutrition; vaccination; exercise; CMV; inflammaging; IRP; immunorestorative therapies AB The primary role of the immune system is to protect the organism against pathogens, but age-associated alterations to immunity increase the susceptibility of the elderly to infectious disease. The exact nature of these changes is still controversial, but the use of screening procedures, such as the SENIEUR protocol to exclude underlying illness, helped to better characterize the changes actually related to physiological aging rather than pathology. It is generally agreed that the most marked changes occur in the cellular immune response reflecting profound alterations in T cells. Much of this is due to thymic involution as well as changes in the proportions of T cell subpopulations resulting from antigen exposure, and altered T cell activation pathways. However, a body of data indicates that innate immune responses, including the critical bridge between innate and adaptive immunity, and antigen presenting capacity are not completely resistant to senescence processes. The consequences of all these alterations are an increased incidence of infections, as well as possibly cancers, autoimmune disorders, and chronic inflammatory diseases. The leading question is what, if anything, can we do to prevent these deleterious changes without dangerously dysregulating the precarious balance of productive immunity versus immunopathology? There are many potential new therapeutic means now available to modulate immunosenescence and many others are expected to be available shortly. One main problem in applying these experimental therapies is ethical: there is a common feeling that as ageing is not a disease; the elderly are not sick and therefore do not require adventurous therapies with unpredictable side-effects in mostly frail individuals. Animal models are not helpful in this context. In this chapter we will first briefly review what we think we know about human immunosenescence and its consequences for the health status of elderly individuals. We will then discuss possible interventions that might one day become applicable in an appropriate ethical environment. C1 [Fueloep, Tamas] Univ Sherbrooke, Fac Med, Res Ctr Aging, Immunol Program,Geriatr Div, Sherbrooke, PQ J1H 4C4, Canada. [Larbi, Anis; Pawelec, Graham] Univ Tubingen, Sch Med, Med Res Ctr, Tubingen Ageing & Tumour Immunol Grp, Tubingen, Germany. [Hirokawa, Katsuiku] Tokyo Med & Dent Univ, Grad Sch, Dept Pathol & Immunol Ageing & Dev Sci, Tokyo, Japan. [Mocchegiani, Eugenio] INRCA, Res Dept, Sect Nutr Immun & Ageing, Immunol Ctr, Ancona, Italy. [Lesourd, Bruno] Hop Univ Clermont Ferrand, Serv Soins Suite, F-63118 Cebazat, France. [Castle, Stephen] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, GRECC, Los Angeles, CA 90073 USA. [Castle, Stephen] Univ Calif Los Angeles, Dept Med, Multicampus Div Geriatr & Gerontol, Los Angeles, CA 90073 USA. [Wikby, Anders] Jonkoping Univ, Dept Nat Sci & Biomed, Sch Hlth Sci, Jonkoping, Sweden. [Franceschi, Claudio] Univ Bologna, Dept Expt Pathol, Italian Natl Res Ctr Aging, I-40126 Bologna, Italy. RP Fulop, T (reprint author), Univ Sherbrooke, Fac Med, Res Ctr Aging, Immunol Program,Geriatr Div, 1036 Rue Belvedere Sud, Sherbrooke, PQ J1H 4C4, Canada. EM tamas.fulop@usherbrooke.ca FU Canadian Institute of Health Research [63149]; ImAginE (EU) [QLK6-CT-1999-02031]; EU [FOOD-CT-2003-506850]; T cells and Aging "T-CIA" [QLK6-CT-2002-02283]; Deutsche Forschungsgemeinschaft [SFB 685-B4] FX This work was partly supported by a grant-in aid from the Canadian Institute of Health Research (No 63149), ImAginE (EU contract QLK6-CT-1999-02031), ZINCAGE project (EU contract n. FOOD-CT-2003-506850), T cells and Aging "T-CIA" (QLK6-CT-2002-02283) and the Deutsche Forschungsgemeinschaft (SFB 685-B4). NR 211 TC 24 Z9 25 U1 0 U2 6 PU DOVE MEDICAL PRESS LTD PI ALBANY PA PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND SN 1176-9092 J9 CLIN INTERV AGING JI Clin. Interv. Aging PY 2007 VL 2 IS 1 BP 33 EP 54 DI 10.2147/ciia.2007.2.1.33 PG 22 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA V21WS UT WOS:000208238300004 PM 18044074 ER PT J AU Hersch, EC Falzgraf, S AF Hersch, Elizabeth C. Falzgraf, Sharon TI Management of the behavioral and psychological symptoms of dementia SO CLINICAL INTERVENTIONS IN AGING LA English DT Review DE dementia; management; behavioral symptoms; psychological symptoms AB More than 50% of people with dementia experience behavioral and psychological symptoms of dementia (BPSD). BPSD are distressing for patients and their caregivers, and are often the reason for placement into residential care. The development of BPSD is associated with a more rapid rate of cognitive decline, greater impairment in activities of daily living, and diminished quality of life (QOL). Evaluation of BPSD includes a thorough diagnostic investigation, consideration of the etiology of the dementia, and the exclusion of other causes, such as drug-induced delirium, pain, or infection. Care of patients with BPSD involves psychosocial treatments for both the patient and family. BPSD may respond to those environmental and psychosocial interventions, however, drug therapy is often required for more severe presentations. There are multiple classes of drugs used for BPSD, including antipsychotics, anticonvulsants, antidepressants, anxiolytics, cholinesterase inhibitors and NMDA modulators, but the evidence base for pharmacological management is poor, there is no clear standard of care, and treatment is often based on local pharmacotherapy customs. Clinicians should discuss the potential risks and benefits of treatment with patients and their surrogate decision makers, and must ensure a balance between side effects and tolerability compared with clinical benefit and QOL. C1 [Hersch, Elizabeth C.] VA Puget Sound Hlth Care Syst, Geriatr & Extended Care A 182GEC, Tacoma, WA 98493 USA. RP Hersch, EC (reprint author), VA Puget Sound Hlth Care Syst, Geriatr & Extended Care A 182GEC, Bldg 2,Room 344,9600 Vet Dr SW, Tacoma, WA 98493 USA. EM herschec@yahoo.com NR 66 TC 32 Z9 33 U1 1 U2 8 PU DOVE MEDICAL PRESS LTD PI ALBANY PA PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND SN 1176-9092 J9 CLIN INTERV AGING JI Clin. Interv. Aging PY 2007 VL 2 IS 4 BP 611 EP 621 PG 11 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA V21WV UT WOS:000208238600014 PM 18225462 ER PT J AU McFall, M Saxon, AJ Thaneemit-Chen, S Smith, MW Joseph, AM Carmody, TP Beckham, LC Malte, CA Vertrees, JE Boardman, KD Lavori, PW AF McFall, Miles Saxon, Andrew J. Thaneemit-Chen, Surai Smith, Mark W. Joseph, Anne M. Carmody, Timothy P. Beckham, Lean C. Malte, Carol A. Vertrees, Julia E. Boardman, Kathy D. Lavori, Philip W. TI Integrating smoking cessation into mental health care for post-traumatic stress disorder SO CLINICAL TRIALS LA English DT Article ID QUALITY-OF-LIFE; VIETNAM COMBAT VETERANS; MAJOR DEPRESSION; FUNCTIONAL IMPAIRMENT; OUTCOME EXPECTANCIES; CLINICAL-TRIALS; SMOKERS; INTERVENTIONS; QUESTIONNAIRE; COMORBIDITY AB Background Post-traumatic stress disorder (PTSD) is associated with a high prevalence of smoking, heavy cigarette consumption and low cessation rates. Purpose This manuscript describes the design of a randomized, multisite effectiveness trial to test whether integrating smoking cessation treatment into mental health care (integrated care) improves prolonged abstinence rates among veterans with PTSD, compared with referral to specialized smoking cessation clinics (usual standard of care). Secondary objectives are to assess the cost-effectiveness of integrated care relative to usual standard of care, identify treatment variables that mediate differences between conditions in outcome and determine whether smoking cessation is associated with worsening PTSD and/or depression. Methods Following randomization, subjects (projected n = 1400) from 10 Veterans Health Administration (VHA) medical centers complete follow-up assessments every three or six months for up to four years. Endpoints include 1-year prolonged abstinence at 18 months postrandomization, 7- and 30-day point-prevalence abstinence and measures of depression, PTSD and economic outcomes. Results This study is unique in providing the largest scale test of the feasibility and effectiveness of having mental health clinicians implement evidence-based smoking cessation treatment in psychiatric care settings for veterans with PTSD. It incorporates methodological features that are desirable for cessation treatment trials, including: a) assessment of clinically meaningful long-term smoking outcomes; b) a manual guiding delivery of the experimental intervention; c) independent ratings of clinician competence and treatment adherence and d) methods for training clinicians that would enhance implementation of tobacco cessation treatment in large health care systems. Limitations Use of an exclusively VHA sample with few females limits generalizability. Conclusions The process for meeting challenges in designing this study may provide planning of other large-scale clinical effectiveness trials in tobacco control. Findings have potential to initiate system-wide change in clinical practice patterns for tobacco cessation treatment involving patients with mental disorders. C1 Vet Affairs Puget Sound Hlth Care Syst, PTSD Programs S116 MHC, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Palo Alto Hlth Care Syst, Vet Affairs Cooperat Studies Program, Palo Alto, CA USA. Dept Vet Affairs, Hlth Econ Resource Ctr, Menlo Pk, CA USA. Stanford Univ, Ctr Primary care & Outsomes Res, Stanford, CA 94305 USA. Minneapolis Vet Affairs Ctr Chron Dis Outcomes Re, Minneapolis, MN USA. Univ Minnesota, Minneapolis, MN USA. Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Durham Vet Affairs Med Ctr, Durham, NC USA. Duke Univ, Med Ctr, VA Mid Atlantic Reg MIRECC, Durham, NC 27706 USA. Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27706 USA. Clin Res Pharm Coordinating Ctr, Vet Affairs Cooperat Studies Program, Albuquerque, NM USA. Stanford Univ, Sch Med, Dept Hlth Res & Policy, Palo Alto, CA 94304 USA. RP McFall, M (reprint author), Vet Affairs Puget Sound Hlth Care Syst, PTSD Programs S116 MHC, 1660 S Columbian Way, Seattle, WA 98108 USA. EM miles.mcfall@va.gov RI Smith, Mark/G-1522-2012 OI Smith, Mark/0000-0002-4582-9088 NR 64 TC 15 Z9 15 U1 3 U2 8 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 2007 VL 4 IS 2 BP 178 EP 189 DI 10.1177/1740774507076923 PG 12 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 175PX UT WOS:000247026600011 PM 17456521 ER PT J AU Stelmack, JA Tang, XC Reda, DJ Moran, D Rinne, S Mancil, RM Cummings, R Mancil, G Stroupe, K Ellis, N Massof, RW AF Stelmack, Joan A. Tang, X. Charlene Reda, Domenic J. Moran, D'Anna Rinne, Stephen Mancil, Rickilyn M. Cummings, Roger Mancil, Gary Stroupe, Kevin Ellis, Nancy Massof, Robert W. TI The Veterans affairs low vision intervention trial (LOVIT): Design and methodology SO CLINICAL TRIALS LA English DT Article ID VISUAL FUNCTIONING QUESTIONNAIRE; READING TEST; REHABILITATION; OUTCOMES; PERFORMANCE; DEVICES; ABILITY; SCALE; SF-36 AB Background Visual impairment is a major public health problem. Vision rehabilitation programs have the potential to restore independence and improve quality of life for persons with permanent vision loss, and few have been evaluated in randomized controlled trials. Purpose The Veterans Affairs (VA) Low Vision Intervention Trial is a multicenter randomized clinical trial to evaluate the effectiveness of a new outpatient low vision rehabilitation program. Methods 126 patients with moderate and severe vision loss due to macular diseases are randomized to low vision treatment in an outpatient setting or a usual care control group at two VA facilities in Hines, Illinois, and Salisbury, North Carolina. The primary outcome is the change in visual reading ability from baseline to four months measured with the Veterans Affairs Low Vision Visual Functioning Questionnaire-48 (VA LV VFQ-48). Secondary outcomes compare the mean change in visual ability measured with the VA LV VFQ-48 (overall ability, mobility, visual information processing, visual motor skills) for the treatment and control groups. Costs and cost effectiveness of outpatient treatment are evaluated. Results The low vision rehabilitation setting, use of a waiting list control group to address ethical issues, development of the treatment protocol, development of a vision function questionnaire for patients to self-report the difficulty they experience performing daily activities, and the use of Rasch analysis to develop and estimate this outcome measure are described. Limitations If the new low vision rehabilitation program is proven effective, studies will be needed to determine which of the multiple aspects of the intervention are necessary and sufficient. Conclusions The challenges of conducting clinical trials in a rehabilitation setting and use of a waiting list (deferred treatment) control group extend beyond LOVIT. The design and methods of LOVIT may be applicable to other trials of rehabilitation services and to outcomes for which reliable and valid measurement tools must be developed. C1 [Stelmack, Joan A.; Moran, D'Anna; Rinne, Stephen] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Blind Rehabil Ctr, Hines, IL 60141 USA. [Stelmack, Joan A.] Illinois Coll Optometry, Chicago, IL USA. [Stelmack, Joan A.] Univ Illinois, Sch Med, Dept Ophthalmol & Visual Sci, Chicago, IL USA. [Tang, X. Charlene; Reda, Domenic J.; Stroupe, Kevin; Ellis, Nancy] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Vet Affairs Cooperat Studies Program Coordinat Ct, Hines, IL 60141 USA. [Mancil, Rickilyn M.; Cummings, Roger; Mancil, Gary] WG Hefner VA Med Ctr, Vis Rehabil Res Lab, Salisbury, NC USA. [Massof, Robert W.] Johns Hopkins Univ, Wilmer Eye Inst, Baltimore, MD 21218 USA. RP Stelmack, JA (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Blind Rehabil Ctr, POB 5000 124, Hines, IL 60141 USA. EM Joan.Stelmack@med.va.gov NR 34 TC 18 Z9 18 U1 0 U2 5 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 2007 VL 4 IS 6 BP 650 EP 660 DI 10.1177/1740774507085274 PG 11 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 253MH UT WOS:000252521800007 PM 18042574 ER PT J AU Hirshkowitz, M Black, J AF Hirshkowitz, Max Black, Jed TI Effect of adjunctive modafinil on wakefulness and quality of life in patients with excessive sleepiness-associated obstructive sleep apnoea/hypopnoea syndrome - A 12-month, open-label extension study SO CNS DRUGS LA English DT Article ID POSITIVE AIRWAY PRESSURE; PROMOTING AGENT MODAFINIL; APNEA-HYPOPNEA SYNDROME; DAYTIME SLEEPINESS; APNEA/HYPOPNEA SYNDROME; HEALTH-STATUS; DOUBLE-BLIND; CPAP; THERAPY; HYPERTENSION AB Objective: To evaluate the long-term effect on wakefulness, functional status and quality of life and tolerability of adjunctive modafinil in continuous positive airway pressure (CPAP)-treated patients with residual excessive sleepiness (ES) associated with obstructive sleep apnoea/bypopnoea syndrome (OSA/HS). Study design: 12-month, open-label extension of a 12-week, randomised, double-blind, placebo-controlled study. Setting: Thirty-seven centres in the US and four in the UK. Patients: Two hundred and sixty-six patients experiencing ES associated with OSA/HS who completed at least 8 weeks of the 12-week double-blind study, and who received adequate education and intervention efforts to encourage use of nasal CPAP (nCPAP). Intervention: Patients receiving nCPAP therapy were administered modafinil 200 mg/day during week 1, 300 mg/day during week 2, and then 200, 300 or 400 mg/day, based on the investigator's assessment of efficacy and tolerability, for the remainder of the study. Main outcome measures: Assessments included the Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ) and Short Form-36 Health Survey (SF-36). Results: One hundred and seventy five patients (66%) completed the study. Modafinil maintained a significant effect on wakefulness, as shown by improvement in the ESS total score at months 3, 6, 9 and 12 compared with baseline (all p < 0.0001). Modafinil also improved functional status (FOSQ total score) and general health (SF-36 mental and physical component scores) at months 6 And 12 compared with baseline (all p < 0.05). Modafinil was well tolerated. The most common adverse events reported were infection (11.3%), headache (9.4%) and nervousness (9.0%). Serious adverse events were reported in 13 patients, with two of these events (mild bradycardia and severe syncope, both in the same patient) considered to be possibly related to modafinil. There were few clinically meaningful changes in clinical laboratory data, vital signs, physical examination findings or ECG results. Important changes included significant increase in blood pressure in six patients, five of whom had a history of hypertension. Conclusions: Adjunctive modafinil maintained effects on wakefulness and functional outcomes, and improved quality of life in patients with OSA/HS experiencing residual ES over a 12-month period. Modafinil was well tolerated during long-term therapy. C1 Michael E DeBakey Vet Affairs Med Ctr, Sleep Disorders Ctr 111, Sleep Diagnost Clin, Houston, TX 77030 USA. Sleep Disorders Clin, Stanford, CA USA. RP Hirshkowitz, M (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Sleep Disorders Ctr 111, Sleep Diagnost Clin, Room 6-C344,2002 Holcombe Blvd, Houston, TX 77030 USA. EM maxh@bcm.edu NR 41 TC 16 Z9 16 U1 2 U2 2 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1172-7047 J9 CNS DRUGS JI CNS Drugs PY 2007 VL 21 IS 5 BP 407 EP 416 DI 10.2165/00023210-200721050-00004 PG 10 WC Clinical Neurology; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 172AY UT WOS:000246777700005 PM 17447828 ER PT J AU Spiegel, BMR Esrailian, E Laine, L Chamberlain, MC AF Spiegel, Brennan M. R. Esrailian, Eric Laine, Loren Chamberlain, Marc C. TI Clinical impact of adjuvant chemotherapy in glioblastoma multiforme - A meta-analysis SO CNS DRUGS LA English DT Article ID HIGH-GRADE GLIOMAS; LONG-TERM SURVIVAL; RADIATION-THERAPY; MALIGNANT GLIOMAS; LOCAL CHEMOTHERAPY; ONCOLOGY-GROUP; PHASE-III; RADIOTHERAPY; CARMUSTINE; BRAIN AB Background: A meta-analysis of chemotherapy for glioblastoma multiforme (GBM) was performed. We sought to update prior analyses by focusing exclusively on GBM, including new trials of novel treatments, assessing effectiveness of individual treatment categories and presenting data in a clinically useful format. Methods: A search of MEDLINE and EMBASE was conducted for randomised controlled trials of chemotherapy in GBM. Results: Relative risks (RRs) for survival in 16 trials comparing chemotherapy with no chemotherapy were 1.18 (95% CI 1.08, 1.30) at 6 months, 1.53 (95% CI 1.26, 1.86) at 12 months and 2.12 (95% C1 1.60, 2.80) at 24 months. Nitrosourea compounds, local therapy (e.g. carmustine [1,3-bis [2-chloroethyl]-1-nitrosourea] wafers) and temozolomide were all more effective than no chemotherapy. Absolute increases in survival at 6, 12 and 24 months were 11%, 8% and 1%, respectively, for nitrosourea compounds; 8%, 24% and 5%, respectively, for local therapy; and 4%, 15% and 17%, respectively, for temozolomide. Efficacy of local therapy and temozolomide peaked at 12 and 18 months, respectively. After 2 years, nitrosourea compounds no longer provided clinically relevant benefit (number needed-to-treat [NNT] = 100; effect size [ES] = 0.17 SD), local therapy had diminishing returns (NNT = 20) that remained clinically relevant (ES = 0.71 SD) and temozolomide continued to show good efficacy (NNT = 5.9; ES = 0.74 SD). Survival was not significantly improved with multi-agent versus single-agent nitrosourea-based therapy in five trials: 6-month RR 0.91 (95% Cl 0.71, 1.16); 24-month RR 1.33 (95% CI 0.72, 2.46). Conclusion: Although nitrosourea compounds, local therapy and temozolomide are all effective in the treatment of GBM, local therapy and temozolomide may be associated with greater response, with clinically significant benefits extending to 24 months. The timing of peak benefits of local and temozolomide therapy suggests this combination may be more effective than single-agent chemotherapy and warrants further study. C1 Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, UCLA VA Ctr Outcomes Res & Educ, Los Angeles, CA 90073 USA. Univ So Calif, Keck Sch Med, Los Angeles, CA USA. Univ S Florida, H Lee Moffit Canc Ctr & Res Inst, Tampa, FL USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, UCLA VA Ctr Outcomes Res & Educ, 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu FU NIDDK NIH HHS [T32 DK07180-30, 2P30 DK041301-17] NR 40 TC 31 Z9 33 U1 0 U2 3 PU ADIS INT LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 1311, NEW ZEALAND SN 1172-7047 J9 CNS DRUGS JI CNS Drugs PY 2007 VL 21 IS 9 BP 775 EP 787 DI 10.2165/00023210-200721090-00006 PG 13 WC Clinical Neurology; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 208HZ UT WOS:000249311700006 PM 17696576 ER PT J AU Murray, EJB Murray, SS Simon, R Behnam, K AF Murray, Elsa J. Brochmann Murray, Samuel S. Simon, Robert Behnam, Keyvan TI Recombinant expression, isolation, and proteolysis of extracellular matrix-secreted phosphoprotein-24 kDa SO CONNECTIVE TISSUE RESEARCH LA English DT Article DE secreted phosphoprotein-24 kDa; SP2; recombinant protein; proteolysis ID OSTEOBLAST-LIKE CELLS; PROTEIN; IDENTIFICATION; SEQUENCE AB Secreted phosphoprotein-24 kDa (spp24) is an extracellular matrix protein first cloned from bone. Bovine spp24 is transcribed as a 203 amino acid residue protein that undergoes cleavage of a secretory peptide to form the mature protein (spp24, residues 24 to 203). While not osteogenic itself, spp24 is degraded to a pro-osteogenic protein, spp18.5, in bone. Both spp18.5 and spp24 contain a cyclic TRH1 (TGF-beta receptor II homology-1) domain similar to that found in the receptor itself and in fetuin. A synthetic peptide corresponding to the TRH1 domain of spp18.5 and spp24 specifically binds BMP-2 and enhances the rate and magnitude of BMP-2-induced ectopic bone formation in vivo. The parental protein, spp24, exhibits a high affinity for bone and mineral complexes, but its abundance there is low, suggesting that it is rapidly degraded. The availability of recombinant spp24 and its degradation products would facilitate the elucidation of their structure: function relationships. We describe here the expression of His(6)-tagged bovine spp24 (residues 24 to 203) in E. coli, its purification by high-resolution IMAC (immobilized metal affinity chromatography), and the characterization of the full-length recombinant 21.5 kDa protein and its two major 16 kDa and 14.5 kDa degradation products (spp24, residues 24 to 157, and spp24, residues 24 to 143) by mass spectroscopy. The recombinant spp24 protein was resistant to proteolysis by MC3T3-E1 osteoblastic cell extracts in the absence of calcium; however, in the presence of 4mM Ca, it can undergo essentially complete proteolysis to small peptides, bypassing the 16 kDa and 14.5 kDa intermediates. This confirms the proteolytic susceptibility of spp24. It also suggests that the levels of spp24 in bone may be regulated, in part, by calcium-dependent proteolysis mediated by osteoblastic cells. C1 [Murray, Elsa J. Brochmann; Murray, Samuel S.] VA Greater Los Angeles Hlth Care Syst, Geriat Res Educ & Clin Ctr, Sepulveda, CA 91343 USA. [Murray, Elsa J. Brochmann; Murray, Samuel S.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA. [Simon, Robert] VA Greater Los Angeles Hlth Care Syst, Res Serv, Sepulveda, CA USA. [Behnam, Keyvan] Univ Calif Los Angeles, Dept Physiol Sci, Los Angeles, CA 90024 USA. RP Murray, SS (reprint author), VA Med Ctr, 16111 Plummer St, Sepulveda, CA 91343 USA. EM Samuel.Murray@med.va.gov FU NIAMS NIH HHS [5R21AR53259] NR 16 TC 15 Z9 16 U1 0 U2 3 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 0300-8207 J9 CONNECT TISSUE RES JI Connect. Tissue Res. PY 2007 VL 48 IS 6 BP 292 EP 299 DI 10.1080/03008200701692404 PG 8 WC Cell Biology; Orthopedics SC Cell Biology; Orthopedics GA 241BS UT WOS:000251632500003 PM 18075815 ER PT J AU Longo, FM Yang, T Knowles, JK Xie, YM Moore, LA Massa, SM AF Longo, Frank M. Yang, Tao Knowles, Juliet K. Xie, Youmei Moore, Laura A. Massa, Stephen M. TI Small molecule neurotrophin receptor ligands: Novel strategies for targeting Alzheimer's disease mechanisms SO CURRENT ALZHEIMER RESEARCH LA English DT Article; Proceedings Paper CT 7th International Conference on Alzheimers Disease Drug Discovery CY OCT 12-13, 2006 CL New York, NY SP Alzheimers Drug Discovery Fdn, Accera Inc, Acumen Pharmaceut Inc, Eisai Inc, Elan Pharmaceut Inc, Forest Lab Inc, Marteck Biosci Corp, Neurochem Inc, Ortho-McNeil Neurol Inc, Pfizer Inc, Sanofi-Aventis US Inc, Wyeth Res, Targacept Inc ID NERVE GROWTH-FACTOR; BETA-AMYLOID PEPTIDE; N-TERMINAL KINASE; HUMAN BRAIN; P75; RAT; ACTIVATION; EXPRESSION; APOPTOSIS; P75(NTR) AB A number of factors limit the therapeutic application of neurotrophin proteins, such as nerve growth factor (NGF) and brain-derived growth factor (BDNF), for Alzheimer's and other neurodegenerative diseases. These factors include unfavorable pharmacological properties typical of proteins and the pleiotropic effects mediated by protein-ligand interactions with p75(NTR), Trk, and sortilin neurotrophin receptors. Targeted modulation of p75(NTR) provides a strategy for preventing degeneration without promoting TrkA-mediated deleterious effects, and targeted activation of TrkB might achieve more favorable neurotrophic effects than those achieved by concomitant activation of p75(NTR) and TrkB. The discovery of small molecules functioning as ligands at specific neurotrophin receptors has made possible for the first time approaches for modulating selected components of neurotrophin signaling processes for the purpose of modulating underlying Alzheimer's disease mechanisms. C1 [Longo, Frank M.; Yang, Tao; Knowles, Juliet K.] Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA. [Longo, Frank M.; Xie, Youmei; Moore, Laura A.] Univ N Carolina, Dept Neurol, Chapel Hill, NC 27599 USA. [Massa, Stephen M.] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. [Massa, Stephen M.] San Francisco VA Med Ctr, San Francisco, CA 94143 USA. RP Longo, FM (reprint author), Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA. EM longo@stanford.edu FU NIA NIH HHS [R01 AG09873] NR 48 TC 52 Z9 53 U1 0 U2 3 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1567-2050 J9 CURR ALZHEIMER RES JI Curr. Alzheimer Res. PY 2007 VL 4 IS 5 BP 503 EP 506 DI 10.2174/156720507783018316 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 268PP UT WOS:000253592000002 PM 18220511 ER PT J AU Blutt, SE Conner, ME AF Blutt, Sarah E. Conner, Margaret E. TI Rotavirus: to the gut and beyond! SO CURRENT OPINION IN GASTROENTEROLOGY LA English DT Article DE antigenemia; extraintestinal; rotavirus; systemic; viremia ID EXTRAINTESTINAL SPREAD; HISTOLOGIC DISTRIBUTION; NEONATAL MOUSE; VIREMIA; GASTROENTERITIS; ANTIGENEMIA; INFECTION; CHILDREN; EFFICACY; DIARRHEA AB Purpose of review Rotavirus causes severe gastroenteritis in children. A principle of rotavirus pathogenesis has been that the infection remains localized to epithelial cells in the small intestine. This dogma was challenged by recent findings of rotavirus in the serum of experimentally infected animals and children with diarrhea. Repeated associations of rotavirus infections with a wide range of nongastroenteric clinical manifestations in humans were considered spurious because of lack of proof that rotavirus escaped the intestine. New data outlined in this review, however, show that rotavirus routinely infects systemically and highlight controversies and future research questions. Recent findings Rotavirus antigens (antigenemia), RNA, or infectious virus (viremia) has been demonstrated in the serum and many extraintestinal tissues in all experimental animal models. Rotavirus antigens and RNA have been detected in the sera of children with rotavirus diarrhea. The tissues and cell types that support rotavirus replication outside the intestine and the consequences of extraintestinal reservoirs of infection are beginning to be examined. Summary Rotavirus infection is systemic, with an acute active viremia and extraintestinal replication. The impact of systemic rotavirus on disease burden remains to be determined. C1 Baylor Coll Med, Dept Mol Virol & Microbiol, Michael E Debakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Conner, ME (reprint author), Baylor Coll Med, Dept Mol Virol & Microbiol, Michael E Debakey Vet Affairs Med Ctr, 1 Baylor Plaza, Houston, TX 77030 USA. EM mconner@bcm.edu FU NIAID NIH HHS [AI10604, AI24998]; NIDDK NIH HHS [DK56338] NR 24 TC 63 Z9 67 U1 0 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 JAN PY 2007 VL 23 IS 1 BP 39 EP 43 DI 10.1097/MOG.0b013e328011829d PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 127KH UT WOS:000243584200008 PM 17133083 ER PT J AU Edwards, K Royall, D Hershey, L Lichter, D Hake, A Farlow, M Pasquier, F Johnson, S AF Edwards, Keith Royall, Donald Hershey, Linda Lichter, David Hake, Ann Farlow, Martin Pasquier, Florence Johnson, Stewart TI Efficacy and safety of galantamine in patients with dementia with Lewy bodies: A 24-week open-label study SO DEMENTIA AND GERIATRIC COGNITIVE DISORDERS LA English DT Article DE dementia with Lewy bodies; galantamine; cholinesterase inhibitors; visual hallucinations ID NICOTINIC ACETYLCHOLINE-RECEPTORS; ALZHEIMERS-DISEASE; SCALE; BODY; CONSORTIUM; INVENTORY; CLINICIAN; DIAGNOSIS; STRIATUM; THALAMUS AB Background: Dementia with Lewy bodies (DLB) is a common dementia of the elderly. A significant cholinergic deficit has been demonstrated that may be responsive to treatment by cholinesterase inhibitors (ChEIs). Methods: A 24-week, open-label study was designed to assess the efficacy and safety of a ChEI, galantamine, in 50 patients with DLB. Results: This study showed beneficial effects with galantamine in 2 of the 3 primary efficacy parameters. The scores on the Neuropsychiatric Inventory (NPI-12) improved by 8.24 points from baseline ( p = 0.01) especially in visual hallucinations and nighttime behaviors ( p = 0.004). The scores on the Clinician's Global Impression of Change improved by 0.5 points from baseline ( p = 0.01). The third primary efficacy parameter, the Cognitive Drug Research Computerized Cognitive Assessment System, was unchanged from baseline. Adverse events were generally mild and transient. Conclusion: Galantamine appears to be an effective and safe therapy for patients with DLB. Copyright (c) 2007 S. Karger AG, Basel. C1 Neurol Res Ctr Inc, Alzheimers Diagnost & Treatment Ctr, Bennington, VT 05201 USA. Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Dept Neurol, Boston, MA USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Affairs Hosp, San Antonio, TX USA. Buffalo Vet Affairs Hosp, Dept Neurol, Buffalo, NY USA. Indiana Univ, Sch Med, Dept Neurol, Indianapolis, IN 46202 USA. Williams Coll, Dept Math, Williamstown, MA 01267 USA. CHU Lille, Neurol Clin, EA 2691, F-59037 Lille, France. RP Edwards, K (reprint author), Neurol Res Ctr Inc, Alzheimers Diagnost & Treatment Ctr, 140 Hosp Dr,Suite 210, Bennington, VT 05201 USA. EM kedwards@vtneuro.com NR 28 TC 31 Z9 31 U1 0 U2 3 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1420-8008 J9 DEMENT GERIATR COGN JI Dement. Geriatr. Cogn. Disord. PY 2007 VL 23 IS 6 BP 401 EP 405 DI 10.1159/000101512 PG 5 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 166QN UT WOS:000246394200007 PM 17409748 ER PT J AU Houser, CR AF Houser, Carolyn R. TI Interneurons of the dentate gyrus: an overview of cell types, terminal fields and neurochemical identity SO DENTATE GYRUS: A COMPHREHENSIVE GUIDE TO STRUCTURE, FUNCTION, AND CLINICAL IMPLICATIONS SE PROGRESS IN BRAIN RESEARCH LA English DT Review DE GABA; glutamate decarboxylase (GAD); interneurons; hilus; parvalbumin; somatostatin; calretinin ID GLUTAMIC-ACID DECARBOXYLASE; RAT HIPPOCAMPAL-FORMATION; NERVE GROWTH-FACTOR; SOMATOSTATIN-LIKE IMMUNOREACTIVITY; GABAERGIC NONPRINCIPAL NEURONS; GAMMA-AMINOBUTYRIC-ACID; GABA(A) RECEPTOR; MESSENGER-RNAS; MEDIAL SEPTUM; POSTSYNAPTIC TARGETS AB Interneurons of the dentate gyrus are a diverse group of neurons that use GABA as their primary neurotransmitter. Morphological studies of these neurons have been challenging since no single neuro-anatomical method provides a complete view of these interneurons. However, through the integration of findings obtained from multiple methods, an interesting picture of this complex group of neurons is emerging, and this review focuses on studies in rats and mice. In situ hybridization of mRNAs for the two isoforms of the GABA synthesizing enzyme, glutamate decarboxylase (GAD65 and GAD67), demonstrates the abundance of GABA neurons in the dentate gyrus and their high concentration in the hilus and along the base of the granule cell layer. Likewise, immunohistochemical studies, particularly of GAD65, demonstrate the rich fields of GABA terminals not only around the somata of granule cells but also in the dendritic regions of the molecular layer. This broad group of GABA neurons and their terminals can be subdivided according to their morphological characteristics, including the distribution of their axonal plexus, and their neurochemical identity. Intracellular labeling of single interneurons has been instrumental in demonstrating the extensiveness of their axonal plexus and the relatively specific spatial distribution of their axonal fields. These findings have led to the broad classification of interneurons into those that terminate primarily at perisomatic regions and those that innervate the dendrites of granule cells. The interneurons also can be classified according to their neuropeptide and calcium-binding protein content. These and other molecules contribute to the rich diversity of dentate interneurons and may provide opportunities for selectively regulating specific groups of GABA neurons in the dentate gyrus in order to enhance their function or protect vulnerable neurons from damage. C1 [Houser, Carolyn R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [Houser, Carolyn R.] Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. [Houser, Carolyn R.] VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. RP Houser, CR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU NINDS NIH HHS [NS046524, NS051311] NR 81 TC 81 Z9 81 U1 0 U2 22 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0079-6123 J9 PROG BRAIN RES PY 2007 VL 163 BP 217 EP + DI 10.1016/S0079-6123(07)63013-1 PG 17 WC Neurosciences SC Neurosciences & Neurology GA BHB02 UT WOS:000251961200014 PM 17765721 ER PT J AU Grubaugh, AL Elhai, JD Cusack, KJ Wells, C Frueh, BC AF Grubaugh, Anouk L. Elhai, Jon D. Cusack, Karen J. Wells, Chris Frueh, B. Christopher TI Screening for PTSD in public-sector mental health settings: The diagnostic utility of the PTSD checklist SO DEPRESSION AND ANXIETY LA English DT Article DE severe mental illness; trauma; PTSD; PCL; ROC; public psychiatric settings ID POSTTRAUMATIC-STRESS-DISORDER; PSYCHOMETRIC PROPERTIES; TRAUMA; ILLNESS; WOMEN; VICTIMIZATION; HISTORY; RELIABILITY; PREVALENCE; VALIDITY AB There are few available data on bow to accurately screen for and assess posttraumatic stress disorder (PTSD) among severely mentally ill adults, a group with high rates of unrecognized trauma and PTSD symptoms. We examined the diagnostic utility of a widely used screening instrument, the PTSD Checklist (PCL), for diagnosing PTSD among 44 traumatized, adult, public-sector mental health patients recruited through a community mental health program. Participants completed the PCL and the Clinician-Administered PTSD Scale (CAPS), which is considered the "gold standard" for determining PTSD diagnoses. Data provide preliminary support for the use of the PCL as a screening instrument in public psychiatric settings, indicating that the optimal cut-point for adults with severe mental illness is about 54 (with slightly higher or lower recommended cut-points depending on the clinical context and purpose of the PCL). Such data are critical to ensuring that public-sector mental health patients with trauma-related difficulties are identified and referred for appropriate services. C1 Med Univ S Carolina, Div Publ Psychiat, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. Univ S Dakota, Disaster Mental Hlth Inst, Vermillion, SD 57069 USA. Univ N Carolina, Cecil G Sheps Ctr Hlth Serv Res, Chapel Hill, NC USA. S Carolina Dept Mental Hlth, Charleston, SC 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 FU NIMH NIH HHS [MH65248] NR 27 TC 36 Z9 39 U1 7 U2 12 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 2007 VL 24 IS 2 BP 124 EP 129 DI 10.1002/da.20226 PG 6 WC Psychology, Clinical; Psychiatry; Psychology SC Psychology; Psychiatry GA 149LE UT WOS:000245147600006 PM 16892418 ER PT J AU Collier, AP Heilig, LF Schilling, LM Dellavalle, RP AF Collier, A. P. Heilig, L. F. Schilling, L. M. Dellavalle, R. P. TI Clinical questions asked by medical students: A learning tool for dermatology rotations SO DERMATOLOGY LA English DT Article DE evidence-based medicine; clinical questions; dermatology; medical training ID CARE; EDUCATION AB Background/Aims: To determine whether having medical students answer self-generated patient-specific questions in a clinical setting promotes learning. Methods: Medical students rotating through dermatology clinics at the Denver Veterans' Affairs (VA) Medical Center were asked to formulate and answer one clinical question arising during patient encounters, and to complete a survey regarding their findings and experience. Results: 49% (44/89) of rotating medical students completed the exercise. Self-generated questions frequently addressed therapy (61%, 27/44), prognosis (13%, 6/44), etiology/ risk factors (7%, 3/44), and harm (5%, 2/44). The most frequently used sources of clinical information were journal abstracts/articles (55%, 24/44), UpToDate (50%, 22/44), websites (27%, 12/44) and printed textbooks (25%, 11/44). Medical students rated the impact of answers they obtained on a Likert scale of 1 (strongly disagree) to 5 (strongly agree) for the following: can be used to assist in patient's care (mean 4.1), improved care (mean 3.7), improved communication (mean 4.4), improved confidence in care (mean 4.2), improved knowledge (mean 4.6), and will improve future care (mean 4.5). Conclusions: Medical students report increased knowledge, confidence and patient care skills after completing a self-directed formal exercise consisting of formulating and answering a patient-specific clinical question. Copyright (c) 2007 S. Karger AG, Basel. C1 Univ Colorado, Denver VA Med Ctr, Hlth Sci Ctr, Denver, CO 80220 USA. Univ Colorado, Dept Dermatol, Hlth Sci Ctr, Denver, CO 80220 USA. Univ Colorado, Dept Prevent Med & Biometr, Hlth Sci Ctr, Denver, CO 80220 USA. Univ Colorado, Dept Med, Hlth Sci Ctr, Denver, CO 80220 USA. RP Dellavalle, RP (reprint author), Univ Colorado, Denver VA Med Ctr, Hlth Sci Ctr, 1055 Clermont St,Mail Stop 165, Denver, CO 80220 USA. EM robert.dellavalle@uchsc.edu RI Dellavalle, Robert/L-2020-2013 OI Dellavalle, Robert/0000-0001-8132-088X FU NCI NIH HHS [CA92550]; NIAMS NIH HHS [T32 AR07411]; PHS HHS [5 D14HP00153-03] NR 14 TC 1 Z9 1 U1 0 U2 1 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-8665 J9 DERMATOLOGY JI Dermatology PY 2007 VL 214 IS 2 BP 108 EP 111 DI 10.1159/000098567 PG 4 WC Dermatology SC Dermatology GA 143TI UT WOS:000244747600002 PM 17341857 ER PT J AU Veluthakal, R Kaur, H Goalstone, M Kowluru, A AF Veluthakal, Rajakrishnan Kaur, Hitchintan Goalstone, Marc Kowluru, Anjaneyulu TI Dominant-negative alpha-subunit of farnesyl- and geranyltransferase inhibits glucose-stimulated, but not KCI-stimulated, insulin secretion in INS 832/13 cells SO DIABETES LA English DT Article ID GTP-BINDING PROTEINS; HUMAN PANCREATIC-ISLETS; BETA-CELLS; RHO-SUBFAMILY; NORMAL RAT; POSTTRANSLATIONAL MODIFICATIONS; DISSOCIATION INHIBITOR; CARBOXYL METHYLATION; CDC42; MODULATION AB The majority of small G-proteins undergo posttranslational modifications (e.g., isoprenylation) at their C-terminal cysteine residues. Such modifications increase their hydrophobicity, culminating in translocation of the modified proteins to their relevant membranous sites for interaction with their respective effectors. Previously, we reported glucose-dependent activation and membrane association of Rac1 in INS 832/13 cells. We also demonstrated modulatory roles for Rac1/GDP dissociation inhibitor in glucose-stimulated insulin secretion (GSIS) in INS 832/13 cells, further affirming roles for Racl in GSIS. Herein, we demonstrate that geranylgeranyltransferase inhibitor-2147 (GGTI-2147), an inhibitor of protein prenylation, markedly increased cytosolic accumulation of Racl and elicited significant inhibition of GSIS from INS 832/13 cells. In the current study, we also examined the localization of protein prenyltransferases (PPTases) and regulation of GSIS by PPTases in INS 832/13 cells. Western blot analyses indicated that the regulatory alpha-subunit and the structural R-subunit of PPTase holoenzyme are predominantly cytosolic in their distribution. Overexpression of an inactive mutant of the regulatory alpha-subunit of PPTase markedly attenuated glucose- but not KCI-induced insulin secretion from INS 832/13 cells. Together, our findings provide the first evidence for the regulation of GSIS by PPTase in INS 832/13 cells. Furthermore, they support our original hypothesis that prenylation of specific G-proteins may be necessary for GSIS. Diabetes C1 Wayne State Univ, Eugene Applebaum Coll Pharm & Hlth Sci, Dept Pharmaceut Sci, Detroit, MI 48201 USA. John D Dingell Vet Affairs Med Ctr, Beta Cell Biochem Res Lab, Detroit, MI USA. Denver VA Med Ctr, Res Serv, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. RP Kowluru, A (reprint author), Wayne State Univ, Eugene Applebaum Coll Pharm & Hlth Sci, Dept Pharmaceut Sci, 3601,259 Mack Ave, Detroit, MI 48201 USA. EM akowluru@med.wayne.edu FU NIDDK NIH HHS [R01 DK068326] NR 43 TC 36 Z9 36 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JAN PY 2007 VL 56 IS 1 BP 204 EP 210 DI 10.2337/db06-0668 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 125TY UT WOS:000243466900027 PM 17192483 ER PT J AU Sanders, NM Taborsky, GJ Wilkinson, CW Daumen, W Figlewicz, DP AF Sanders, Nicole M. Taborsky, Gerald J., Jr. Wilkinson, Charles W. Daumen, Wendi Figlewicz, Dianne P. TI Antecedent hindbrain glucoprivation does not impair the counterregulatory response to hypoglycemia SO DIABETES LA English DT Article ID DEPENDENT DIABETES-MELLITUS; VENTROMEDIAL HYPOTHALAMUS; AUTONOMIC FAILURE; SUBSEQUENT HYPOGLYCEMIA; RECURRENT HYPOGLYCEMIA; EXTRACELLULAR GLUCOSE; ARCUATE NUCLEUS; BLOOD-GLUCOSE; RATS; 5-THIO-D-GLUCOSE AB Recurrent hypoglycemia impairs hormonal counter-regulatory responses (CRRs) to further bouts of hypoglycemia. The hypothalamus and hindbrain are both critical for sensing hypoglycemia and triggering CRRs. Hypothalamic glucose sensing sites are implicated in the pathogenesis of defective CRRs; however, the contribution of hindbrain glucose sensing has not been elucidated. Using a rat model, we compared the effect of antecedent glucoprivation targeting hindbrain or hypothalamic glucose sensing sites with the effect of antecedent recurrent hypoglycemia, on CRR to hypoglycemia induced 24 h later. Recurrent hypoglycemia decreased sympathoadrenal (1,470 +/- 325 vs. 3,811 +/- 540 pg/ml in controls [t = 60 min], P = 0.001) and glucagon secretion (222 +/- 43 vs. 494 +/- 56 pg/ml in controls [t = 60]), P = 0.003) in response to hypoglycemia. Antecedent 5-thio-glucose (5TG) injected into the hindbrain did not impair sympathoadrenal (3,806 344 pg/ml [t = 60]) or glucagon (513 56 pg/ml [t = 60]) responses to subsequent hypoglycemia. However, antecedent 5TG delivered into the third ventricle was sufficient to blunt CRRs to hypoglycemia. These results show that hindbrain glucose sensing is not involved in the development of defective CRRs. However, neural substrates surrounding the third ventricle are particularly sensitive to glueoprivic stimulation and may contribute importantly to the development of defective CRRs. C1 VA Puget Sound Hlth Care Syst, Div Endocrinol & Metab, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Educ & Clin Ctr, Div Geriatr Res, Seattle, WA 98108 USA. Seattle Inst Biomed & Clin Res, Seattle, WA USA. RP Sanders, NM (reprint author), VA Puget Sound Hlth Care Syst, Div Endocrinol & Metab, S-151,1660 So Columbian Way, Seattle, WA 98108 USA. EM sandersn@u.washington.edu FU NIDDK NIH HHS [DK 40963, R01 DK050154, R56 DK050154, R01 DK040963, DK 50154, R01 DK050154-10] NR 42 TC 8 Z9 8 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JAN PY 2007 VL 56 IS 1 BP 217 EP 223 DI 10.2337/db06-1025 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 125TY UT WOS:000243466900029 PM 17192485 ER PT B AU Wheeler, S Singh, N Boyko, EJ AF Wheeler, Stephanie Singh, Nalini Boyko, Edward J. BE Veves, A Malik, RA TI The Epidemiology of Diabetic Neuropathy SO DIABETIC NEUROPATHY: CLINICAL MANAGEMENT, SECOND EDITION SE Contemporary Diabetes LA English DT Article; Book Chapter DE Diabetic neuropathy; diabetes; epidemiology; incidence; prevalence; risk factors ID CARPAL-TUNNEL-SYNDROME; INFLAMMATORY DEMYELINATING POLYNEUROPATHY; RISK-FACTORS; SENSORY NEUROPATHY; PITTSBURGH EPIDEMIOLOGY; FOOT ULCERATION; GLYCEMIC CONTROL; MICROVASCULAR COMPLICATIONS; PERIPHERAL NEUROPATHY; AUTONOMIC NEUROPATHY AB Peripheral neuropathy is a devastating complication of diabetes mellitus because of the debilitating symptoms it causes or associated higher risk of other complications, in particular those involving the lower extremity. This chapter will review the prevalence, incidence, and risk factors for different types of diabetic neuropathy. There are seven major types of diabetic neuropathy: (1) distal symmetric polyneuropathy, (2) autonomic neuropathy, (3) nerve entrapment syndromes, (4) proximal asymmetric mononeuropathy (also known as diabetic amyotrophy), (5) truncal radiculopathy, (6) cranial mononeuropathy, and (7) chronic inflammatory demyelinating polyradiculopathy (CIDP). This chapter will focus mainly on the first two types of neuropathy, but will review the available data on the epidemiology of the other types of neuropathy. Cross-sectional or case-control Studies conducted in a population-based sample (such as a defined community or health plan enrollment) were considered for this chapter based on review of Medline citations using the keywords "epidemiology," "diabetes," and "neuropathy" from 1966 to February 2005 review of bibliographies of the articles obtained from the Medline search for relevant citations, and review of the authors' files. Clinic-based cross-sectional or case-control studies have not been considered except in the case of rare conditions, for which no other data exists. All prospective studies, and some randomized controlled trials, were considered. Of the five community-based cross-sectional studies reviewed of subjects with type 2 diabetes that presented data on risk factors for neuropathy, three reported a higher prevalence of this outcome with longer diabetes duration and higher glycosylated hemoglobin, and two found neuropathy prevalence correlated with age and height. Only three community-based cross-sectional studies addressed neuropathy prevalence in subjects with type 1 diabetes in association with risk factors. Two of these investigations reported a correlation between diabetes duration and neuropathy prevalence. No other significant risk factor was reported by more than one community-based study done with subjects with type 1 diabetes. Prospective research on the risk of distal symmetric polyneuropathy confirms its relationship to poorer glycemic control as reflected by fasting plasma glucose or hemoglobin A1c (HbA1c) at baseline. Four prospective studies reported duration of diabetes as a risk factor for neuropathy, three reported smoking Lis a risk factor, two reported age and two reported baseline coronary artery disease as risk factors for neuropathy. The literature on risk factors for diabetic autonomic neuropathy can be characterized as smaller in size and less consistent in comparison with that available for distal symmetric polyneuropathy. The only risk factor reported in more than one study was female gender, found to be associated with higher risk by two authors. There have been no prospective population-based studies of diabetic amyotrophy and mononeuropathies in subjects with diabetes. However, some prevalence figures for these types of neuropathy can be derived from a few cross-sectional studies, which are described in the chapter. CIDP is a relatively new diagnosis. In 1991, the American Academy of Neurology defined diagnostic clinical and electrophysiological criteria for CIDP. All studies on CIDP are cross-sectional and clinic-based. C1 [Wheeler, Stephanie; Singh, Nalini; Boyko, Edward J.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Wheeler, S (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 59 TC 2 Z9 3 U1 0 U2 0 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DR, STE 208, TOTOWA, NJ 07512-1165 USA BN 978-1-58829-626-9 J9 CONTEMP DIABETES PY 2007 BP 7 EP 30 DI 10.1007/978-1-59745-311-0_2 D2 10.1007/978-1-59745-311-0 PG 24 WC Endocrinology & Metabolism; Medicine, General & Internal; Clinical Neurology; Neurosciences; Pathology SC Endocrinology & Metabolism; General & Internal Medicine; Neurosciences & Neurology; Pathology GA BJT76 UT WOS:000267142500002 ER PT J AU Zipfel, E Cooper, RA Pearlman, J Cooper, R McCartney, M AF Zipfel, Emily Cooper, Rory A. Pearlman, Jon Cooper, Rosemarie McCartney, Mark TI New design and development of a manual wheelchair for India SO DISABILITY AND REHABILITATION LA English DT Article DE assistive technology; wheelchair design; India ID FATIGUE-LIFE; PERFORMANCE AB Purpose. The most common methods of delivering assistive technology in developing countries are charitable donation and workshops. This describes a new approach to solving the problem, a collaboration undertaken by a US-based lab and a manufacturer in India to produce quality wheelchairs. One goal is to publicize the design free of charge to manufacturers and interested parties world-wide. The process, a demonstration of a new technology transfer method, and the product, an adult manual wheelchair, are described. Method. An iterative process occurred over four years to design and produce the wheelchair. This consisted of prototypes, small production runs, ANSI/RESNA testing, hardness and tensile testing and informal user testing. Results. The design is a manual folding cross-brace design with several points of adjustability. Final pre-production prototypes experienced fastener failures during durability testing. Higher grade bolts were specified. Trial-run production has begun. An ANSI/RESNA wheelchair test lab was constructed in India. Subsequent projects include power and pediatric tilt-in-space wheelchairs. Conclusions. The approach seems promising as a method to improve the quality of assistive technology available in India and begin to meet the vast need in India. Pitfalls encountered throughout the collaboration are described in this paper along with solutions to remedy these problems for future projects. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, 151-R1,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Pearlman, Jon/0000-0003-0830-9136 NR 24 TC 6 Z9 6 U1 2 U2 6 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0963-8288 J9 DISABIL REHABIL JI Disabil. Rehabil. PY 2007 VL 29 IS 11-12 BP 949 EP 962 DI 10.1080/09638280701240672 PG 14 WC Rehabilitation SC Rehabilitation GA 188PZ UT WOS:000247933100013 PM 17577729 ER PT J AU Authier, EL Pearlman, J Allegretti, AL Rice, I Cooper, RA AF Authier, Erica L. Pearlman, Jon Allegretti, Ana L. Rice, Ian Cooper, Rory A. TI A sports wheelchair for low-income countries SO DISABILITY AND REHABILITATION LA English DT Article DE wheelchair design; basketball; low-income country; sports wheelchair AB Purpose. Appropriate wheelchairs for basic mobility needs are still not commonly available in low-income countries, although several organizations are working toward this goal. After basic mobility is secured it is important to provide more diverse assistive technology to allow people with disabilities to more completely participate in society and live healthy lives. Our goal was to design an affordable sports wheelchair that would allow individuals in low-income countries to participate in basketball. Methods. Design requirements established for the sports wheelchair included: removable anti-tippers, adjustable tension backrest, 24" wheels, adjustable seat dump, variable camber, 4" casters, fore-aft axle position, removable bumpers, height adjustable footrest, four wheels, single anti-tipper (pivot), cost less than $125 without wheels, 16" seat width and backrest height, and nylon upholstery. The wheelchair was designed using 3D modeling, standard materials, and standard tools. Discussion. An affordable wheelchair, versatile enough to be used for a variety of sports and even everyday use, was designed and prototyped successfully. Documentation for the design including step-by-step directions, engineering drawings, and photographs are available at the Human Engineering Research Laboratories website (http://www.herlpitt.org/intw.htm). Future work on the prototype should include design refinement including adaptations for other sports, and standards testing. C1 VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Occupat Therapy, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, 151-R1,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper+@pitt.edu OI Pearlman, Jon/0000-0003-0830-9136 NR 9 TC 5 Z9 5 U1 0 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 0963-8288 J9 DISABIL REHABIL JI Disabil. Rehabil. PY 2007 VL 29 IS 11-12 BP 963 EP 967 DI 10.1080/09638280701240714 PG 5 WC Rehabilitation SC Rehabilitation GA 188PZ UT WOS:000247933100014 PM 17577730 ER PT J AU O'Rourke, RW Deveney, CW McConnell, DB Wolfe, BM Jobe, BA AF O'Rourke, R. W. Deveney, C. W. McConnell, D. B. Wolfe, B. M. Jobe, B. A. TI Esophageal motility disorders after gastric banding SO DISEASES OF THE ESOPHAGUS LA English DT Article DE esophageal motility disorder; gastric band; obesity ID MORBIDLY OBESE-PATIENTS; GASTROESOPHAGEAL-REFLUX DISEASE; FOLLOW-UP; SYMPTOMS; SYSTEM; RISK AB The long-term effects of gastric banding on esophageal function are not well described. This report describes a 28-year-old woman who developed signs and symptoms of abnormal esophageal motility and lower esophageal sphincter hypotension after gastric banding for morbid obesity. The current literature addressing the effects of gastric banding on esophageal function in light of this case report is discussed. C1 Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. RP O'Rourke, RW (reprint author), Oregon Hlth & Sci Univ, Dept Surg L223A, 3181 SW Sam JAckson Pk Rd, Portland, OR 97239 USA. EM orourkro@ohsu.edu NR 25 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1120-8694 J9 DIS ESOPHAGUS JI Dis. Esophagus PY 2007 VL 20 IS 3 BP 269 EP 273 DI 10.1111/j.1442-2050.2007.00685.x PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 169FL UT WOS:000246578000013 PM 17509126 ER PT J AU Rao, N Lipsky, BA AF Rao, Nalini Lipsky, Benjamin A. TI Optimising antimicrobial therapy in diabetic foot infections SO DRUGS LA English DT Review ID COLONY-STIMULATING FACTOR; RESISTANT STAPHYLOCOCCUS-AUREUS; LOWER-EXTREMITY INFECTIONS; SKIN-STRUCTURE INFECTIONS; OPEN-LABEL TRIAL; HYPERBARIC-OXYGEN; ANTIBIOTIC-THERAPY; COMPLICATED SKIN; MAGGOT THERAPY; CLINICAL-TRIAL AB Foot infections are common and the most serious lower extremity complication contributing to amputations, particularly in patients with diabetes mellitus. Infection is most often a consequence of foot ulcerations, which typically follows trauma to a neuropathic foot. Foot infections may be classified as mild, moderate and severe; this largely determines the approach to therapy. Gram-positive bacteria are the sole causative pathogens for most mild and moderate infections. These infections can usually be treated with culture-based narrow-spectrum antibacterials along with appropriate surgical debridement in an outpatient setting. In contrast, severe infections are often polymicrobial, requiring hospitalisation and treatment with broad-spectrum antibacterials along with appropriate medical and surgical interventions. The initial empirical antibacterial regimen may be tailored based on the results of culture and sensitivity tests from properly obtained specimens. Several antibacterial regimens have demonstrated effectiveness in randomised controlled trials, but no single regimen has shown superiority. Managing diabetic foot osteomyelitis is particularly controversial and requires reliable cultures to select an appropriate antibacterial regimen. Surgical resection of the infected and necrotic bone favours a good outcome in chronic osteomyelitis. The recommended duration of antibacterial therapy ranges from 1 to 4 weeks for soft tissue infection, to > 6 weeks for unresected osteomyelitis. The incidence of meticillin-resistant Staphylococcus aureus infection is increasing in both the healthcare setting and the community. This should be considered when selecting an antibacterial, especially if the patient does not improve with initial antibacterial therapy. Certain other organisms, such as Pseudomonas aeruginosa and Enterococcus spp., while potentially pathogenic, are often colonisers that do not require targeted therapy. C1 Univ Pittsburgh, Med Ctr, Div Infect Dis, Dept Med, Pittsburgh, PA 15232 USA. VA Puget Sound Healthcare Syst, Dept Med, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. RP Rao, N (reprint author), Univ Pittsburgh, Med Ctr, Div Infect Dis, Dept Med, 5230 Ctr Ave, Pittsburgh, PA 15232 USA. EM raon@upmc.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 147 TC 37 Z9 39 U1 2 U2 9 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 2007 VL 67 IS 2 BP 195 EP 214 DI 10.2165/00003495-200767020-00003 PG 20 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA 146TL UT WOS:000244957500003 PM 17284084 ER PT J AU Steinman, MA Maaravi, Y Walter, LC Hammerman-Rozenberg, R Stessman, J AF Steinman, Michael A. Maaravi, Yoram Walter, Louise C. Hammerman-Rozenberg, Robert Stessman, Jochanan TI Evolution of medication use in Jerusalem elders - Results from the Jerusalem longitudinal study SO DRUGS & AGING LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY 03-07, 2006 CL Chicago, IL SP Amer Geriatr Soc ID 70 YEAR OLDS; NONPRESCRIPTION DRUG-USE; SOCIAL NETWORKS; POPULATION; HEALTH; PRESCRIPTION; ISRAEL; POLYPHARMACY; DETERMINANTS; MEDICINES AB Background: While overall rates of medication use have been increasing over time, less is known about how medication use changes within individuals as they age. Objective: The aim of this study was to evaluate changes in medication use and predictors of medication accrual among community-dwelling elders followed for a 7-year period, from age 70 +/- 1 years to age 77 +/- 1 years. Methods: The study was a community-based, longitudinal, cohort study. The study group consisted of 280 patients from the Jerusalem Longitudinal Study, a population-based sample of Jerusalem residents born in 1920-1 who underwent extensive evaluation in 1990-1 and again in 1997-8. The main outcome measure of the study was the change in the total number of medications taken between baseline and follow-up. Medication use was assessed by home interviews. Results: Half of the sample were men. Medication use more than doubled over the 7-year study period, from a mean of 2.0 to 5.3 medications per patient (p < 0.001), and 57 patients (20%) increased their total drug use by six or more medications. Vitamins, minerals and cardiovascular medications were the most commonly prescribed medications at follow-up, and accounted for approximately half of the total increase in medication use. On multivariable logistic regression analyses, decline in self-rated health was the strongest predictor of above-median increases in medication use (odds ratio [OR] 3.2; 95% CI 1.8, 6.2). The only nonclinical predictor of above-median increases in medication use was good social engagement at baseline (OR 1.8; 95% CI 1.1, 3.1). Conclusion: Medication use in Jerusalem elders grew rapidly over the 1990s, more than doubling in volume over a 7-year period. While health status was the factor most strongly predictive of the degree of change, the magnitude of increase for elders as a whole suggests major changes in prescribing practices over this interval. C1 San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Hadassah Univ Hosp, Dept Rehabil & Geriatr, IL-91120 Jerusalem, Israel. RP Stessman, J (reprint author), San Francisco VA Med Ctr, Div Geriatr, 4150 Clement St,Box 181-G, San Francisco, CA 94121 USA. EM mike.steinman@ucsf.edu NR 32 TC 3 Z9 3 U1 0 U2 0 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 2007 VL 24 IS 2 BP 133 EP 145 DI 10.2165/00002512-200724020-00005 PG 13 WC Geriatrics & Gerontology; Pharmacology & Pharmacy SC Geriatrics & Gerontology; Pharmacology & Pharmacy GA 152XB UT WOS:000245394500005 PM 17313201 ER PT J AU Ludlow, CL Humbert, I Saxon, K Poletto, C Sonies, B Crujido, L AF Ludlow, Christy L. Humbert, Ianessa Saxon, Keith Poletto, Christopher Sonies, Barbara Crujido, Lisa TI Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal dysphagia SO DYSPHAGIA LA English DT Article DE deglutition; deglutition disorders; hyolaryngeal movement; aspiration; penetration; sensory stimulation; resistance; transcutaneous neuromuscular stimulation ID BEHAVIOR AB We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation (1) lowered the hyoid bone and/or larynx when applied at rest, and (2) increased aspiration, penetration, or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior and anterior-posterior dimensions and the subglottic air column position while stimulation was on or off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists, blinded to condition, tallied the frequency of aspiration, penetration, pooling, and esophageal entry from videofluorographic recordings of swallows. Only significant (p = 0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p = 0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p = 0.006). Stimulation may have acted to resist patients' hyoid elevation during swallowing. C1 NINDS, Laryngeal & Speech Sect, Bethesda, MD 20892 USA. Univ Wisconsin, Dept Med, GRECC, Madison, WI USA. Univ Wisconsin, Dept Radiol, GRECC, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. NIH, Dept Rehabil, Ctr Clin, Bethesda, MD 20892 USA. Arizona State Univ, Dept Speech & Hearing Sci, Tempe, AZ USA. RP Ludlow, CL (reprint author), 10 Ctr Dr MSC 1416 Bldg,10 Rm,5D38, Bethesda, MD 20892 USA. EM ludlowc@ninds.nih.gov OI Ludlow, Christy/0000-0002-2015-6171 FU Intramural NIH HHS; NINDS NIH HHS [Z01 NS 02980, Z01 NS002980, Z01 NS002980-08] NR 15 TC 91 Z9 114 U1 0 U2 10 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD JAN PY 2007 VL 22 IS 1 BP 1 EP 10 DI 10.1007/s00455-006-9029-4 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 132SN UT WOS:000243962600001 PM 16718620 ER PT J AU Fan, Y Liu, ZY Weinstein, PR Fike, JR Liu, JL AF Fan, Yang Liu, Zhengyan Weinstein, Philip R. Fike, John R. Liu, Jialing TI Environmental enrichment enhances neurogenesis and improves functional outcome after cranial irradiation SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article DE cognitive impairment; dentate gyrus; gerbil; memory; neural precursor cells; radiation injury ID INDUCED COGNITIVE DYSFUNCTION; EARLY-ONSET STIMULATION; TRAUMATIC BRAIN-INJURY; LONG-TERM POTENTIATION; HIPPOCAMPAL NEUROGENESIS; DENTATE GYRUS; ADULT NEUROGENESIS; NEURONAL DIFFERENTIATION; NEUROTROPHIN LEVELS; CELL-PROLIFERATION AB Radiation therapy is a widely used treatment for brain tumors but it can cause delayed progressive cognitive decline and memory deficits. Previous studies suggested that this neurocognitive dysfunction might be linked to the impairment of hippocampal neurogenesis. However, little is known regarding how to reduce the cognitive impairment caused by radiation therapy. To investigate whether environmental enrichment (EE) promotes neurogenesis and cognitive function after irradiation, irradiated gerbils were housed in EE for 2 months and evaluated by neurobehavioral testing for learning and memory function, and immunohistochemical analysis for neurogenesis. Our results demonstrated that even relatively low doses (5-10 Gy) of irradiation could acutely abolish precursor cell proliferation in the dentate gyrus by more than 90%. This reduction in precursor proliferation was persistent and led to a significant decline in the granule cell population 9 months later. EE housing enhanced the number of newborn neurons and increased residual neurogenesis. EE also significantly increased the total number of immature neurons in the dentate gyrus. Furthermore, irradiated animals after EE housing showed a significant improvement in spatial learning and memory during the water-maze test and in rotorod motor learning over a 5-day training paradigm. In conclusion, EE has a positive impact on hippocampal neurogenesis and functional recovery in irradiated adult gerbils. Our data suggest that there is still a considerable amount of plasticity remaining in the hippocampal progenitor cells in adult animals after radiation injury, which can become a target of therapeutic intervention for radiation-induced cognitive dysfunction. C1 Univ Calif San Francisco, Dept Neurol Surg 112C, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Fudan Univ, HuaShan Hosp, Dept Neurosurg, Shanghai 200433, Peoples R China. RP Liu, JL (reprint author), Univ Calif San Francisco, Dept Neurol Surg 112C, 4150 Clement St, San Francisco, CA 94121 USA. EM jialing.liu@ucsf.edu RI Liu, Jialing/A-8627-2012 OI Liu, Jialing/0000-0003-4420-4382 FU NINDS NIH HHS [R01 NS40469, R01 NS46051, R21 NS051576] NR 64 TC 75 Z9 81 U1 1 U2 7 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD JAN PY 2007 VL 25 IS 1 BP 38 EP 46 DI 10.1111/j.1460-9568.2006.05269.x PG 9 WC Neurosciences SC Neurosciences & Neurology GA 128TQ UT WOS:000243682100004 PM 17241265 ER PT J AU Kumar, S Szymusiak, R Bashir, T Rai, S McGinty, D Alam, MN AF Kumar, Sunil Szymusiak, Ronald Bashir, Tariq Rai, Seema McGinty, Dennis Alam, Md. Noor TI Effects of serotonin on perifornical-lateral hypothalamic area neurons in rat SO EUROPEAN JOURNAL OF NEUROSCIENCE LA English DT Article DE hypocretin; melanin-concentrating hormone; orexin; serotonin; sleep ID DORSAL RAPHE NEURONS; EYE-MOVEMENT SLEEP; OREXIN/HYPOCRETIN NEURONS; HYPOCRETIN NEURONS; 5-HT1A RECEPTOR; OREXIN NEURONS; WAKING; NARCOLEPSY; WAKEFULNESS; MICRODIALYSIS AB The hypocretin (HCRT) system of the perifornical-lateral hypothalamic area (PF-LHA) has been implicated in the facilitation of behavioral arousal. HCRT neurons receive serotonergic afferents from the dorsal raphe nucleus. Although in-vitro pharmacological studies suggest that serotonin (5-HT) inhibits HCRT neurons, the in-vivo effects of 5-HT on HCRT neurons in the PF-LHA and associated behavioral changes have not been described. We examined the effects of 5-HT delivered locally into the PF-LHA using reverse microdialysis on its neuronal activity and the consequent sleep-wake changes in rats. First, we quantified Fos expression (Fos-IR) in HCRT and other PF-LHA neurons following unilateral 5-HT perfusion in awake rats. Second, we determined the transient effects of 5-HT perfusion on the extracellular activity of the PF-LHA neurons recorded via microwires placed adjacent to the microdialysis probe. Third, we examined the effects of 5-HT perfusion into the PF-LHA on the sleep-wake profiles of the rats during the lights-off period. Unilateral perfusion of 5-HT into the PF-LHA in awake rats dose-dependently decreased the number of HCRT neurons exhibiting Fos-IR. 5-HT also inhibited the discharge activity of four of five responsive wake-related, putative HCRT neurons. However, unilateral perfusion of 5-HT into the PF-LHA did not produce significant behavioral changes during the 2-h recording period. These results confirm the in-vitro findings that 5-HT exerts inhibitory influences on HCRT neurons but further suggest that the inactivation of a limited number of HCRT neurons by unilateral 5-HT microdialysis may not be sufficient to induce behavioral changes. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Patna, Patna 800005, Bihar, India. RP Alam, MN (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Res Serv, 16111 Plummer St,151A3, Sepulveda, CA 91343 USA. EM noor@ucla.edu FU NHLBI NIH HHS [HL60296]; NIMH NIH HHS [R01 MH075076, MH63323, MH47480]; NINDS NIH HHS [NS-050939] NR 45 TC 17 Z9 20 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0953-816X J9 EUR J NEUROSCI JI Eur. J. Neurosci. PD JAN PY 2007 VL 25 IS 1 BP 201 EP 212 DI 10.1111/j.1460-9568.2006.05268.x PG 12 WC Neurosciences SC Neurosciences & Neurology GA 128TQ UT WOS:000243682100020 PM 17241281 ER PT J AU Magruder, KM Yeager, DE AF Magruder, Kathryn M. Yeager, Derik E. TI Mental health problems in primary care: Progress in North America SO EUROPEAN JOURNAL OF PSYCHIATRY LA English DT Article DE mental health; primary health care; United States ID RANDOMIZED CONTROLLED-TRIAL; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; CLINICAL-PRACTICE GUIDELINE; POSTTRAUMATIC-STRESS; NATIONAL TRENDS; DEPRESSION; MANAGEMENT; PREVALENCE; COMPUTER; INTERNET AB Background and Objectives: Research in the last decade has acknowledged that primary care plays a pivotal role in the delivery of mental health services. The aim of this paper is to review major accomplishments, emerging trends, and continuing gaps concerning mental health problems in primary care in North America. Methods: Literature from North America was reviewed and synthesized. Results: Major accomplishments include: the development and adoption of a number of clinical guidelines specifically for mental health conditions in primary care, the acceptance of the chronic care model as a framework for treating depression in primary care, and the clear adoption of pharmacologic approaches as the predominant mode for treating depression and anxiety. Emerging trends include: the use of non-physician facilitators as care managers in the treatment of depression in primary care, increasing use of technology in the assessment and treatment of mental health conditions in primary care, and dissemination and implementation of integrated mental health treatment approaches. Lingering issues include: the difficulty in moving beyond problem identification and initiation of treatment to sustaining evidence-based treatments, agreement on a common metric to evaluate outcomes, and the stigma still associated with mental illness. Conclusion: Though there now exists a solid and growing evidence base for the delivery of mental health services in primary care, there are still significant challenges which must be overcome in order to make further advances. C1 Vet Affairs Med Ctr, Mental Hlth Serv, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. RP Magruder, KM (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29425 USA. EM magrudkm@musc.edu NR 43 TC 3 Z9 4 U1 2 U2 5 PU EUROPEAN JOURNAL OF PSYCHIATRY PI SARAGOOSE PA PO BOX 6029, 50080 SARAGOOSE, SPAIN SN 0213-6163 J9 EUR J PSYCHIAT JI Eur. J. Psychiat. PD JAN-MAR PY 2007 VL 21 IS 1 BP 55 EP 61 PG 7 WC Psychiatry SC Psychiatry GA 181IX UT WOS:000247431500007 ER PT J AU Barnes, DE Whitmer, RA Yaffe, K AF Barnes, Deborah E. Whitmer, Rachel A. Yaffe, Kristine TI Physical activity and dementia: The need for prevention trials SO EXERCISE AND SPORT SCIENCES REVIEWS LA English DT Review DE exercise; fitness; cognitive decline; aged; epidemiology; mechanisms ID COGNITIVE IMPAIRMENT; OLDER-ADULTS; CARDIOVASCULAR FITNESS; ALZHEIMERS-DISEASE; ELDERLY PERSONS; RISK; EXERCISE; HEALTH; INFLAMMATION; POPULATION AB Dementia is a common and debilitating disease that will increase dramatically for the next 50 years unless a prevention or treatment is identified. This review summarizes the evidence that physical activity is associated with a reduced risk of dementia in older adults and recommends that prevention trials be performed to determine whether this association is causal. C1 Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94121 USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. Kaiser Permanente, Div Res, Oakland, CA USA. RP Barnes, DE (reprint author), Univ Calif San Francisco, Dept Psychiat, 4150 Clement St 181G, San Francisco, CA 94121 USA. EM Deborah.Barnes@ucsf.edu FU NIA NIH HHS [K01 AG024069, K01 AG024069-01A1] NR 25 TC 27 Z9 29 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0091-6331 J9 EXERC SPORT SCI REV JI Exerc. Sport Sci. Rev. PD JAN PY 2007 VL 35 IS 1 BP 24 EP 29 DI 10.1097/JES.0b013e31802d6bc2 PG 6 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 127EE UT WOS:000243567300006 PM 17211190 ER PT J AU Cole, GM Frautschy, SA AF Cole, Greg M. Frautschy, Sally A. TI The role of insulin and neurotrophic factor signaling in brain aging and Alzheimer's Disease SO EXPERIMENTAL GERONTOLOGY LA English DT Article; Proceedings Paper CT 8th International Symposium on the Neurobiology and Neuroendocrinology of Aging CY JUL 23-28, 2006 CL Bregenz, AUSTRIA DE insulin resistance; TZDs (thiazolidinediones); brain aging ID GROWTH-FACTOR-I; AMYLOID PRECURSOR PROTEIN; POLYUNSATURATED FATTY-ACIDS; MILD COGNITIVE IMPAIRMENT; APOLIPOPROTEIN-E GENOTYPE; TRANSGENIC MOUSE MODEL; DOCOSAHEXAENOIC ACID; DEGRADING ENZYME; BETA-PROTEIN; CELL-SURVIVAL AB Although increased lifespan is associated with reduced insulin signaling, insulin signaling is essential for neuronal development and survival. Insulin resistance is central to Type II diabetes and is also implicated in the pathogenesis of Alzheimer's Disease (AD). This has prompted ongoing clinical trials in AD patients to test the efficacy of improving insulin - like signaling with dietary omega-3 fatty acids or insulin - sensitizing drugs as well as exercise regimens. Here we review the role of insulin signaling in brain aging and AD, concluding that the signaling pathways downstream to neurotrophic and insulin signaling are defective and coincident with aberrant phosphorylation and translocation of key components, notably AKT and GSK3 beta, but also rac > PAK signaling. These responses are likely to contribute to defects in synaptic plasticity, learning and memory. Both oligomers of beta-amyloid (which are elevated in the AD brain) and pro-inflammatory cytokines (which are elevated in the aged or AD brain) can be used to mimic the trophic factor/insulin resistance observed in AD, but details on other factors and mechanisms contributing to this resistance remain elusive. A better understanding of the precise mechanisms underlying alterations in the insulin/neurotrophic factor signal transduction pathways should aid the search for better AD therapeutic and prevention strategies. (c) 2006 Elsevier Inc. All rights reserved. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. RP Cole, GM (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, Ctr Geriatr Res Educ & Clin, 16111 Plummer St, Sepulveda, CA 91343 USA. EM gmcole@ucla.edu FU NCCIH NIH HHS [AT003008-01, R01 AT003008, R01 AT13741]; NIA NIH HHS [P50 AG016570, R01 AG013741]; RRD VA [I01 RX000669] NR 108 TC 112 Z9 118 U1 1 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0531-5565 J9 EXP GERONTOL JI Exp. Gerontol. PD JAN-FEB PY 2007 VL 42 IS 1-2 SI SI BP 10 EP 21 DI 10.1016/j.exger.2006.08.009 PG 12 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 128HJ UT WOS:000243648500004 PM 17049785 ER PT J AU Perez, VI Pierce, A Masamsetti, P de Waal, EM Valerino, O Ward, WF Richardson, A Chaudhuri, A AF Perez, Viviana I. Pierce, Anson Masamsetti, Pragathi de Waal, Eric M. Valerino, Orlando Ward, Walter F. Richardson, Arlan Chaudhuri, Asish TI Detection of protein disulfides and aggregates in aging liver tissue: A fluorescence-based proteomic approach SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract CT 14th Annual Meeting of the Society-for-Free-Radical-Biology-and-Medicine CY NOV 14-18, 2007 CL Washington, DC SP Soc Free Rad Biol & Med C1 [Perez, Viviana I.; Pierce, Anson; Valerino, Orlando] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. [Masamsetti, Pragathi; Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [de Waal, Eric M.] Univ Texas San Antonio, Dept Biol, San Antonio, TX USA. [Ward, Walter F.] Univ Texas Hlth Sci Ctr San Antonio, Dept Physiol, San Antonio, TX 78229 USA. [Chaudhuri, Asish] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RI Pierce, Anson/D-1079-2012 OI Pierce, Anson/0000-0002-1383-0180 NR 0 TC 0 Z9 0 U1 0 U2 0 PU 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 2007 VL 43 SU 1 BP S114 EP S114 PG 1 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 229WC UT WOS:000250835900306 ER PT J AU Perez, VI Masamsetti, P Pierce, A Mele, J Ward, WF Richardson, A Buffenstein, R Chaudhuria, A AF Perez, Viviana I. Masamsetti, Pragathi Pierce, Anson Mele, James Ward, Walter F. Richardson, Arlan Buffenstein, Rochelle Chaudhuria, Asish TI Resistance to protein unfolding and cysteine oxidation in long-lived naked mole rat during aging: Are these determinants for longevity? SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Meeting Abstract CT 14th Annual Meeting of the Society-for-Free-Radical-Biology-and-Medicine CY NOV 14-18, 2007 CL Washington, DC SP Soc Free Rad Biol & Med C1 [Perez, Viviana I.; Pierce, Anson; Mele, James; Ward, Walter F.; Richardson, Arlan; Buffenstein, Rochelle] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Chaudhuria, Asish] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RI Pierce, Anson/D-1079-2012 OI Pierce, Anson/0000-0002-1383-0180 NR 0 TC 0 Z9 0 U1 1 U2 3 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 2007 VL 43 SU 1 BP S113 EP S113 PG 1 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 229WC UT WOS:000250835900305 ER PT J AU Ji, XM Luo, YM Ling, F Stetler, RA Lan, J Cao, GD Chen, J AF Ji, Xunming Luo, Yumin Ling, Feng Stetler, R. Anne Lan, Jing Cao, Guodong Chen, Jun TI Mild hypothermia diminishes oxidative DNA damage and pro-death signaling events after cerebral ischemia: a mechanism for neuroprotection SO FRONTIERS IN BIOSCIENCE LA English DT Article DE hypothermia; neuroprotection; cerebral ischemia; reperfusion; oxidative stress; DNA damage; apoptosis; NAD depletion ID TRANSIENT FOCAL ISCHEMIA; EXPERIMENTAL STROKE; RAT-BRAIN; ENDONUCLEASE EXPRESSION; RADICAL PRODUCTION; STRAND BREAKS; CELL-DEATH; REPAIR; APOPTOSIS; REPERFUSION AB Mild hypothermia, applied either during or soon after cerebral ischemia, has been shown to confer robust neuroprotection against brain injury in experimental stroke and in patients recovering from cardiac arrest. However, the mechanism underlying hypothermic neuroprotection is not completely understood. In this study, the effect of mild hypothermia on the induction of oxidative DNA damage, an early harmful event during post-ischemic reperfusion that triggers both necrotic and apoptotic cell death in the brain, was studied using the rat model of middle cerebral artery occlusion (MCAO) and reperfusion. Rats were subjected to 2-hr MCAO and reperfusion of various durations up to 3 days. Selective brain hypothermia (33 degrees C) was induced at the onset of ischemia and terminated at the beginning of reperfusion, and this significantly decreased infarct volume 72 hr later. Correlated with this protective effect, intraischemic mild hypothermia markedly attenuated the nuclear accumulations of several oxidative DNA lesions, including 8-oxodG, AP sites, and DNA single-strand breaks, after 2-hr MCAO. Consequently, harmful DNA damage-dependent signaling events, including NAD depletion, p53 activation, and mitochondrial translocation of PUMA and NOXA, were reduced during post-ischemic reperfusion in hypothermia-treated brains. These results suggest that the attenuation of oxidative DNA damage and DNA damage-triggered pro-death signaling events may be an important mechanism underlying the neuroprotective effect of mild hypothermia against ischemic brain injury. reperfusion, and this significantly decreased infarct volume 72 hr later. Correlated with this protective effect, intraischemic mild hypothermia markedly attenuated the nuclear accumulations of several oxidative DNA lesions, including 8-oxodG, AP sites, and DNA single-strand breaks, after 2-hr MCAO. Consequently, harmful DNA damage-dependent signaling events, including NAD depletion, p53 activation, and mitochondrial translocation of PUMA and NOXA, were reduced during post-ischemic reperfusion in hypothermia-treated brains. These results suggest that the attenuation of oxidative DNA damage and DNA damage-triggered pro-death signaling events may be an important mechanism underlying the neuroprotective effect of mild hypothermia against ischemic brain injury. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Capital Med Univ, Xuan Wu Hosp, Dept Neurosurg, Beijing, Peoples R China. Capital Med Univ, Xuan Wu Hosp, Cerebrovasc Res Inst, Beijing, Peoples R China. Vet Affairs Pittsburgh Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15261 USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu FU NINDS NIH HHS [NS45048, NS36736, NS38560] NR 33 TC 44 Z9 48 U1 0 U2 7 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 2007 VL 12 BP 1737 EP 1747 DI 10.2741/2185 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 129QS UT WOS:000243745000142 PM 17127418 ER PT J AU Luo, YM Ji, XM Ling, F Li, WJ Zhang, F Cao, GD Chen, J AF Luo, Yumin Ji, Xunming Ling, Feng Li, Wenjin Zhang, Feng Cao, Guodong Chen, Jun TI Impaired DNA repair via the base-excision repair pathway after focal ischemic brain injury: a protein phosphorylation-dependent mechanism reversed by hypothermic neuroprotection SO FRONTIERS IN BIOSCIENCE LA English DT Article DE hypothermia; neuroprotection; cerebral ischemia; reperfusion; oxidative stress; DNA damage; DNA repair; base-excision repair; AP endonuclease; DNA polymerase-beta ID CEREBRAL-ISCHEMIA; POLYMERASE-BETA; RAT-BRAIN; RADICAL PRODUCTION; MILD HYPOTHERMIA; MAMMALIAN-CELLS; STRAND BREAKS; DAMAGE; REPERFUSION; LESIONS AB Cerebral ischemia and reperfusion induces rapid accumulation of oxidative DNA lesions in the brain, which, if not repaired promptly, may trigger cell death. The base-excision repair (BER) pathway is the main mechanism employed by neurons to repair various types of oxidative DNA damage. Recent studies have suggested that the cellular activity of BER is highly regulated (up- or down-regulated) after ischemic brain injury, and this regulation may contribute to the outcome of cell injury. The mechanism through which cellular BER is regulated in response to neuronal injury is currently poorly understood. In the present study, we have examined BER regulation in the rat model of focal ischemic brain injury induced by 2 hr of middle cerebral artery occlusion and 0-72 hr of reperfusion. As determined using cerebral nuclear extracts, focal ischemia resulted in a marked reduction in BER activities, including the overall BER activity, AP endonuclease activity and DNA polymerase-beta activity, indicating functional impairment of the BER pathway. BER reduction occurred as early as 0.5 hr after the onset of reperfusion. Thereafter, BER activity failed to recover, and there were persistent accumulations of apurinic/apyrimidinic abasic sites and DNA single-strand breaks in ischemic tissues. The reduction in BER during the early reperfusion phase (< 6 hr) was not accompanied by any alterations in the levels of essential BER enzymes in brain extracts. However, increased serine- and threonine- specific phosphorylation was detected for both AP endonuclease and DNA polymerase-beta after ischemia, with the time course of serine phosphorylation closely correlated to that of changes in BER activity. Furthermore, dephosphorylation of nuclear extracts with alkaline phosphatase largely restored AP endonuclease and DNA polymerase-beta activities. Taking advantage of the neuroprotective effect of mild hypothermia (33 degrees C), which was induced in the brain during the first 2 hr of reperfusion, we found that the post-ischemic suppression of BER activity is a reversible event. Hypothermic treatment diminished the serine- specific phosphorylation of AP endonuclease and DNA polymerase-beta, promoted BER activities, and attenuated the levels of oxidative DNA lesions after ischemia. These results suggest that the functional impairment of the BER pathway after severe focal cerebral ischemia is due to the loss-of-function post-translational modifications of repair enzymes. Further investigations elucidating the precise mechanism underlying the post-translational regulation of BER enzymes may lead to novel therapeutic strategies for cerebral ischemia. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Capital Med Univ, Xuan Wu Hosp, Dept Neurosurg & Cerebrovasc Res Inst, Beijing, Peoples R China. Vet Affairs Pittsburgh Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA 15261 USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu FU NINDS NIH HHS [NS45048, NS36736, NS38560] NR 28 TC 22 Z9 24 U1 1 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 2007 VL 12 BP 1852 EP 1862 DI 10.2741/2193 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 129QS UT WOS:000243745000150 PM 17127426 ER PT J AU Naliboff, BD Mayer, EA AF Naliboff, Bruce D. Mayer, Emeran A. TI Visceral hypersensitivity in irritable bowel syndrome: Does it really normalize over time? Reply SO GASTROENTEROLOGY LA English DT Letter ID DISORDERS C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Med,Div Digest Dis, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis,Dept Physiol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Div Digest Dis,Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Naliboff, BD (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Dept Med,Div Digest Dis, Los Angeles, CA USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 2007 VL 132 IS 1 BP 465 EP 465 DI 10.1053/j.gastro.2006.11.036 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 131BR UT WOS:000243843500051 ER PT J AU Davila, JA El-Serag, HB AF Davila, Jessica A. El-Serag, Hashem B. BE Talley, NJ Locke, GR Saito, YA TI Large Databases for Epidemiologic Studies SO GI EPIDEMIOLOGY LA English DT Article; Book Chapter ID CHRONIC DISEASE SCORE; OF-VETERANS-AFFAIRS; AUTOMATED PHARMACY DATA; UNITED-STATES; HEPATOCELLULAR-CARCINOMA; INTRAHEPATIC CHOLANGIOCARCINOMA; ADMINISTRATIVE DATA; REFLUX DISEASE; RISK-FACTORS; CARE-SYSTEM C1 [Davila, Jessica A.] Vet Affairs Med Ctr, Gastroenterol Sect, Houston Dept, Houston, TX 77030 USA. [Davila, Jessica A.] Vet Affairs Med Ctr, Sect Hlth Serv, Houston Dept, Houston, TX 77030 USA. [El-Serag, Hashem B.] Baylor Coll Med, Houston VA Med Ctr, Houston, TX 77030 USA. RP Davila, JA (reprint author), Vet Affairs Med Ctr, Gastroenterol Sect, Houston Dept, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 32 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE PUBL PI OXFORD PA OSNEY MEAD, OXFORD OX2 0EL, ENGLAND BN 978-0-470-69218-9 PY 2007 BP 78 EP 84 DI 10.1002/9780470692189.ch11 D2 10.1002/9780470692189 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA BCJ73 UT WOS:000310305700013 ER PT J AU Prasad, R Giri, S Nath, N Singh, I Singh, AK AF Prasad, Ratna Giri, Shailendra Nath, Narender Singh, Inderjit Singh, Avtar K. TI GSNO attenuates EAE disease by S-nitrosylation-mediated modulation of endothelial-monocyte interactions SO GLIA LA English DT Article DE blood-brain barrier; intercellular cell adhesion molecule-1; cell adhesion molecule; phosphoinositide 3 kinase ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; NF-KAPPA-B; CENTRAL-NERVOUS-SYSTEM; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; NITRIC-OXIDE; MULTIPLE-SCLEROSIS; DNA-BINDING; OLIGODENDROCYTE PROGENITORS; TRANSCRIPTIONAL REGULATION; CELLULAR-RESPONSES AB S-Nitrosoglutathione (GSNO) is an endogenous nitric oxide carrier and recently, has been documented for its anti-inflammatory effects in rat model of cerebral ischemia (Khan et al. (2005) J Cereb Blood Flow Metab 25:177-192). Here, we explored the neuroprotective effects mediated by GSNO in Lewis rat model of EAE and its mechanism of action using in vitro model of monocyte-endothelial cell interaction. Oral administration of GSNO attenuated the clinical disease course in EAE animals by inhibiting the infiltration of vascular immune cells in the CNS that subsequently led to the reduction in the expression of proinflammatory cytokines and consequently limited demyelination. Based on the inhibition in infiltration of immune cells, we hypothesized that GSNO modulated endothelial cell activation that led to reduce cellular infiltration in the CNS. Using an in vitro model, we established that GSNO inhibited monocyte adhesion to the activated endothelial cell, which was mediated by down regulation of endothelial cell adhesion molecules (CAMs). The mechanism by which GSNO modulated CAMs expression appeared to be via Snitrosylation of p65, which consequently inhibited nuclear factor kappa B (NF-kappa B) activation in endothelial cells. These observations suggest that GSNO exerts its protective effects in EAE by inhibition of cellular infiltration into the CNS by S-nitrosylation of p65, thereby modulating NF-kappa B-CAMs pathway in endothelial cells. (c) 2006 Wiley-Liss, Inc. C1 Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Ralph Johnson Vet Affairs Med Ctr, Dept Pathol & Lab Med, Charleston, SC USA. RP Singh, AK (reprint author), Med Univ S Carolina, Dept Pediat, 513 Darby Childrens Res Inst, Charleston, SC 29425 USA. EM singha@musc.edu FU NCRR NIH HHS [C06 RR018823, C06 RR015455]; NINDS NIH HHS [NS-40144, NS-34741, NS-40810, NS-22576, NS-37766] NR 58 TC 59 Z9 61 U1 1 U2 4 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-1491 J9 GLIA JI Glia PD JAN 1 PY 2007 VL 55 IS 1 BP 65 EP 77 DI 10.1002/glia.20436 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 104LT UT WOS:000241960600007 PM 17019693 ER PT S AU Casserly, IP Yadav, JS AF Casserly, Ivan P. Yadav, Jay S. BE Saw, J Exaire, JE Lee, DS Yadav, JS TI The Approach to Intracranial Carotid Artery Intervention SO HANDBOOK OF COMPLEX PERCUTANEOUS CAROTID INTERVENTION SE Contemporary Cardiology LA English DT Article; Book Chapter DE Intracranial atherosclerosis; intracranial stenting; stroke ID PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; MIDDLE CEREBRAL-ARTERY; ATHEROSCLEROTIC STENOSIS; BALLOON ANGIOPLASTY; ISCHEMIC-STROKE; CORONARY INTERVENTION; STENT IMPLANTATION; INITIAL-EXPERIENCE; RANDOMIZED-TRIAL; RISK-FACTORS AB Intracranial large vessel atherosclerosis is believed to account for approx 5-10% of all ischemic strokes in the United States. Compared with extracranial artery atherosclerosis, the natural history of intracranial atherosclerosis, and the effectiveness of medical therapy and revascularization in modifying the natural history of the disease, are poorly defined. This chapter summarizes our current understanding of intracranial atherosclerosis and describes the emerging practice of endovascular revascularization for the treatment of this disease. C1 [Casserly, Ivan P.] Denver Vet Affairs Med Ctr, Cardiol Sect, Denver, CO USA. [Yadav, Jay S.] Cleveland Clin Fdn, Dept Cardiovasc Med, Cleveland, OH 44195 USA. RP Casserly, IP (reprint author), Denver Vet Affairs Med Ctr, Cardiol Sect, Denver, CO USA. NR 35 TC 0 Z9 0 U1 0 U2 0 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DR, STE 208, TOTOWA, NJ 07512-1165 USA SN 1191-7601 BN 978-1-59745-002-7 J9 CONTEMP CARDIOL JI Contemp. Cardiol. PY 2007 BP 189 EP 209 DI 10.1007/978-1-59745-002-7_13 D2 10.1007/978-1-59745-002-7 PG 21 WC Cardiac & Cardiovascular Systems; Surgery; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Surgery GA BLZ52 UT WOS:000271567000014 ER PT J AU O'Connell, KA Hosein, VL Schwartz, JE Leibowitz, RQ AF O'Connell, Kathleen A. Hosein, Vanessa L. Schwartz, Joseph E. Leibowitz, Ruth Q. TI How does coping help people resist lapses during smoking cessation? SO HEALTH PSYCHOLOGY LA English DT Article DE coping; smoking cessation; cognitive strategies; behavioral strategies; urge levels ID QUITTING SMOKING; NEGATIVE AFFECT; RELAPSE; TEMPTATIONS; STRATEGIES; ABSTINENCE; BEHAVIOR AB Objectives: To determine whether types of coping strategies have differential effects on preventing lapses and lowering urge levels and to investigate mechanisms by which coping strategies prevent lapses during smoking cessation. Design: Sixty-one respondents performed ecological momentary assessment using palm-top computers and tape recorders to report their coping strategies and urge levels before and after temptations to smoke. Multilevel linear regression models were used to compare the effects of individual strategy types with the average strategy. Main Outcome Measures: Lapses versus resisted temptations and changes in urge levels. Results: Number of strategies significantly predicted resisting smoking and change in urge levels. Compared with the effect of the average strategy, movement/exercise was marginally worse at preventing lapses, and food/drink was marginally related to higher postcoping urge levels. Conclusion: Although using multiple coping strategies helps people resist the urge to smoke, no particular coping strategy works better than any other. Coping strategies prevent lapses by reducing high urge levels during temptations. C1 Columbia Univ, Teachers Coll, Dept Hlth & Behav Studies, New York, NY 10027 USA. SUNY Stony Brook, Dept Psychiat, Stony Brook, NY 11794 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP O'Connell, KA (reprint author), Columbia Univ, Teachers Coll, Dept Hlth & Behav Studies, Box 35,525 W 120th St, New York, NY 10027 USA. EM oconnell@tc.columbia.edu NR 28 TC 35 Z9 35 U1 1 U2 9 PU AMER PSYCHOLOGICAL ASSOC/EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0278-6133 J9 HEALTH PSYCHOL JI Health Psychol. PD JAN PY 2007 VL 26 IS 1 BP 77 EP 84 DI 10.1037/0278-6133.26.1.77 PG 8 WC Psychology, Clinical; Psychology SC Psychology GA 125AF UT WOS:000243413200010 PM 17209700 ER PT J AU Xing, C Sestak, AL Kelly, JA Nguyen, KL Bruner, GR Harley, JB Gray-McGuire, C AF Xing, Chao Sestak, Andrea L. Kelly, Jennifer A. Nguyen, Kim L. Bruner, Gail R. Harley, John B. Gray-McGuire, Courtney TI Localization and replication of the systemic lupus erythematosus linkage signal at 4p16: interaction with 2p11, 12q24 and 19q13 in European Americans SO HUMAN GENETICS LA English DT Article ID SIB-PAIR FAMILIES; LOD SCORES; GENOME SCAN; SUSCEPTIBILITY GENES; MULTIPLEX FAMILIES; REVISED CRITERIA; COMPLEX TRAIT; UNITED-STATES; MODEL; LOCI AB Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by both population and phenotypic heterogeneity. Our group previously identified linkage to SLE at 4p16 in European Americans (EA). In the present study we replicate this linkage effect in a new cohort of 76 EA families multiplex for SLE by model-free linkage analysis. Using densely spaced microsatellite markers in the linkage region, we have localized the potential SLE susceptibility gene(s) to be telomeric to the marker D4S2928 by haplotype construction. In addition, marker D4S394 showed marginal evidence of linkage disequilibrium with the putative disease locus by the transmission disequilibrium test and significant evidence of association using a family-based association approach as implemented in the program ASSOC. We also performed both two-point and multipoint model-based analyses to characterize the genetic model of the potential SLE susceptibility gene(s), and the lod scores both maximized under a recessive model with penetrances of 0.8. Finally, we performed a genome-wide scan of the total 153 EA pedigrees and evaluated the possibility of interaction between linkage signals at 4p16 and other regions in the genome. Fourteen regions on 11 chromosomes (1q24, 1q42, 2p11, 2q32, 3p14.2, 4p16, 5p15, 7p21, 8p22, 10q22, 12p11, 12q24, 14q12, 19q13) showed evidence of linkage, among which, signals at 2p11, 12q24 and 19q13 also showed evidence of interaction with that at 4p16. These results provide important additional information about the SLE linkage effect at 4p16 and offer a unique approach to uncovering susceptibility loci involved in complex human diseases. C1 Case Western Reserve Univ, Dept Biostat & Epidemiol, Div Genet & Mol Epidemiol, Cleveland, OH 44106 USA. Oklahoma Med Res Fdn, Arthrit & Immunol Program, Oklahoma City, OK 73104 USA. Univ Oklahoma, Dept Med, Norman, OK 73019 USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Gray-McGuire, C (reprint author), Case Western Reserve Univ, Dept Biostat & Epidemiol, Div Genet & Mol Epidemiol, Wolstein Res Bldg,Rm 1312,10900 Euclid Ave, Cleveland, OH 44106 USA. EM chao.xing@case.edu; courtney.gray-mcguire@case.edu FU NCRR NIH HHS [RR03655, RR020143, M01 RR-14467]; NIAID NIH HHS [AI062629, AI31584, AI24717, AI53747]; NIAMS NIH HHS [AR049084, AR42460, AR12253, P30 AR053483]; NIDCR NIH HHS [DE015223] NR 44 TC 18 Z9 18 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0340-6717 J9 HUM GENET JI Hum. Genet. PD JAN PY 2007 VL 120 IS 5 BP 623 EP 631 DI 10.1007/s00439-006-0248-4 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 119GM UT WOS:000243000800003 PM 16983533 ER PT J AU Sieh, W Yu, CE Bird, TD Schellenberg, GD Wijsman, EM AF Sieh, Weiva Yu, Chang-En Bird, Thomas D. Schellenberg, Gerard D. Wijsman, Ellen M. TI Accounting for linkage disequilibrium among markers in linkage analysis: Impact of haplotype frequency estimation and molecular haplotypes for a gene in a candidate region for Alzheimer's disease SO HUMAN HEREDITY LA English DT Article DE Alzheimer's disease; familial Alzheimer's disease; chromosome 19 ID SINGLE-NUCLEOTIDE POLYMORPHISMS; MAXIMUM-LIKELIHOOD-ESTIMATION; SNPS; INFORMATION; STRATEGIES; EFFICIENCY; GENOME; MICROSATELLITES; GENOTYPES; FAMILIES AB Objectives: Linkage disequilibrium (LD) between closely spaced SNPs can be accommodated in linkage analysis by specifying the multi-SNP haplotype frequencies, if known. Phased haplotypes in candidate regions can provide gold standard haplotype frequency estimates, and may be of inherent interest as markers. We evaluated the effects of different methods of haplotype frequency estimation, and the use of marker phase information, on linkage analysis of a multi-SNP cluster in a candidate region for Alzheimer's disease (AD). Methods: We performed parametric linkage analysis of a five-SNP cluster in extended pedigrees to compare the use of: (1) haplotype frequencies estimated by molecular phase determination, maximum likelihood estimation, or by assuming linkage equilibrium (LE); (2) AD families or controls as the frequency source; and (3) unphased or molecularly phased SNP data. Results: There was moderate to strong pairwise LD among the five SNPs. Falsely assuming LE substantially inflated the LOD score, but the method of haplotype frequency estimation and particular sample used made little difference provided that LD was accommodated. Use of phased haplotypes produced a modest increase in the LOD score over unphased SNPs. Conclusions: Ignoring LD between markers can lead to substantially inflated evidence for linkage in LOD score analysis of extended pedigrees with missing data. Use of marker phase information in linkage analysis may be important in disease studies where the costs of family recruitment and phenotyping greatly exceed the costs of phase determination. Copyright (c) 2007 S. Karger AG, Basel. C1 Univ Washington, Div Med Genet, Dept Med, Seattle, WA 98195 USA. Univ Washington, Div Gerontol & Geriatr Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Neurol, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. Dept Genome Sci, Seattle, WA USA. RP Wijsman, EM (reprint author), Univ Washington, Div Med Genet, Dept Med, Box 357720, Seattle, WA 98195 USA. EM wijsman@u.washington.edu OI Wijsman, Ellen/0000-0002-2725-6669 FU NIA NIH HHS [AG 11762, AG 05136, AG 21544, U24 AG021886] NR 45 TC 5 Z9 5 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0001-5652 J9 HUM HERED JI Hum. Hered. PY 2007 VL 63 IS 1 BP 26 EP 34 DI 10.1159/000098459 PG 9 WC Genetics & Heredity SC Genetics & Heredity GA 127DF UT WOS:000243564800003 PM 17215579 ER PT J AU Rashid, RM Lee, JM Fareed, J Young, MRI AF Rashid, M. Rashid Lee, John M. Fareed, Jawed Young, M. Rita I. TI In vitro heparan sulfate modulates the immune responses of normal and tumor-bearing mice SO IMMUNOLOGICAL INVESTIGATIONS LA English DT Article DE heparan sulfate; Lewis lung carcinoma; tumor; T-cells ID SQUAMOUS-CELL CARCINOMA; MURINE DENDRITIC CELLS; T-CELLS; LUNG-CANCER; PROLIFERATION; HEAD; NECK; COSTIMULATION; LYMPHOCYTES; MACROPHAGE AB Tumor-bearing (TB) patients and TB animal models show a wide array of immunologic deficits. Heparan sulfate (HS) has been shown to both improve immune cell proliferative responses and to induce Th1 cytokine responses in normal animals. These HS effects, if harnessed, would be of great benefit to TB patients. The present study focused on replicating previous HS-induced Th1 and proliferative response results as well as extrapolating the beneficial immunomodulatory effects to an experimental model derived from TB animals of Lewis lung cell carcinoma. Lewis Lung Carcinoma (LLC)-TB and control mouse splenocytes were assessed for proliferation and cytokine response to concanavalin A (Con A) with 1 and 3 days' exposure to HS. Our results found HS treatment stimulated splenocyte proliferation to Con A in control mice splenocytes after 1 and 3 days of treatment, although HS proliferative effects were not seen in unfractionated TB cultures. Furthermore, cytokine studies revealed normal splenocytes treated with HS had increased levels of both Th1 and Th2 cytokines. Surprisingly, HS treated TB-splenocytes showed suppressed cytokine levels. Of particular interest was the decreased levels of the Th2 cytokine IL-4 in TB-derived samples. In conclusion, we found that HS did show immune-modulator properties in both normal and TB environments. Our studies reinforced the possibility that HS could one day be used as an immune-modulating therapeutic agent. C1 Loyola Univ, Med Ctr, Dept Pathol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Pharmacol, Maywood, IL 60153 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Otolaryngol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Rashid, RM (reprint author), Loyola Univ, Med Ctr, Dept Pathol, 2160 S 1st Ave,Bldg 102,Room 2638, Maywood, IL 60153 USA. EM rrashid@lumc.edu FU NCI NIH HHS [CA85266, CA79768, CA97813, 1F31CA103768-01] NR 40 TC 2 Z9 3 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0882-0139 J9 IMMUNOL INVEST JI Immunol. Invest. PY 2007 VL 36 IS 2 BP 183 EP 201 DI 10.1080/08820130600992024 PG 19 WC Immunology SC Immunology GA 150UI UT WOS:000245244700006 PM 17365019 ER PT J AU Dobscha, SK Leibowitz, RQ Flores, JA Doak, M Gerrity, MS AF Dobscha, Steven K. Leibowitz, Ruth Q. Flores, Jennifer A. Doak, Melanie Gerrity, Martha S. TI Primary care provider preferences for working with a collaborative support team SO IMPLEMENTATION SCIENCE LA English DT Article AB Background: Clinical interventions based on collaborative models require effective communication between primary care providers (PCPs) and collaborative support teams. Despite growing interest in collaborative care, we have identified no published studies describing how PCPs prefer to communicate and interact with collaborative support teams. This manuscript examines the communication and interaction preferences of PCPs participating in an ongoing randomized clinical trial of a collaborative intervention for chronic pain and depression. Methods: The trial is being conducted in five primary care clinics of a Veterans Affairs Medical Center. Twenty-one PCPs randomized to the study intervention completed a survey regarding preferences for interacting with the collaborative support team. Results: A majority of PCPs identified email (95%) and telephone calls (68%) as preferred modes for communicating with members of the support team. In contrast, only 29% identified in-person communications as preferred. Most PCPs preferred that the care manager and physician pain specialist assess patients (76%) and make initial treatment changes (71%) without first conferring with the PCP. One-half wanted to be designated cosigners of all support team notes in the electronic medical record, one-half wanted to receive brief and focused information rather than in-depth information about their patients, and one-half wanted their practice nurses automatically included in communications. Panel size was strongly associated (p < 0.001) with preference for brief, to-the-point discussions about patients. Conclusion: The substantial variation in PCP communication preferences suggests the need for knowledge of these preferences when designing and implementing collaborative interventions. Additional research is needed to understand relationships between clinician and practice characteristics and interaction preferences. C1 [Dobscha, Steven K.; Leibowitz, Ruth Q.; Flores, Jennifer A.; Gerrity, Martha S.] Portland VA Med Ctr, Columbia Ctr Study Chron Comorbid Mental & Phys D, Portland, OR USA. [Dobscha, Steven K.] Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. [Doak, Melanie] Portland VA Med Ctr, Primary Care Div, Portland, OR USA. [Doak, Melanie; Gerrity, Martha S.] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. [Gerrity, Martha S.] Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Columbia Ctr Study Chron Comorbid Mental & Phys D, Portland, OR USA. EM steven.dobscha@va.gov; ruth.leibowitz@med.va.gov; jennifer.flores@va.gov; melanie.doak@va.gov; gerritym@ohsu.edu FU Department of Veterans Affairs, Veterans Health Administration [PMI 03-195, RCD04129] FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Projects PMI 03-195 and RCD04129. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. NR 21 TC 6 Z9 6 U1 0 U2 1 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 2007 VL 2 AR 16 DI 10.1186/1748-5908-2-16 PG 6 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V00IX UT WOS:000206783100016 PM 17537251 ER PT J AU Helfrich, CD Li, YF Mohr, DC Meterko, M Sales, AE AF Helfrich, Christian D. Li, Yu-Fang Mohr, David C. Meterko, Mark Sales, Anne E. TI Assessing an organizational culture instrument based on the Competing Values Framework: Exploratory and confirmatory factor analyses SO IMPLEMENTATION SCIENCE LA English DT Article ID TOTAL-QUALITY-MANAGEMENT; FIT INDEXES; HEALTH-CARE; HOSPITALS; CRITERIA; CLIMATE; IMPACT AB Background: The Competing Values Framework (CVF) has been widely used in health services research to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments generally are presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale. Methods: We used exploratory and confirmatory factor analyses to examine the underlying structure of data from a CVF instrument. We analyzed cross-sectional data from a work environment survey conducted in the Veterans Health Administration (VHA). The study population comprised all staff in non-supervisory positions. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, team, and rational. Results: Data from 71,776 non-supervisory employees (approximate response rate 51%) from 168 VHA facilities were used in this analysis. Internal consistency of the subscales was moderate to strong (alpha = 0.68 to 0.85). However, the entrepreneurial, team, and rational subscales had higher correlations across subscales than within, indicating poor divergent properties. Exploratory factor analysis revealed two factors, comprising the ten items from the entrepreneurial, team, and rational subscales loading on the first factor, and two items from the hierarchical subscale loading on the second factor, along with one item from the rational subscale that cross-loaded on both factors. Results from confirmatory factor analysis suggested that the two-subscale solution provides a more parsimonious fit to the data as compared to the original four-subscale model. Conclusion: This study suggests that there may be problems applying conventional CVF subscales to non-supervisors, and underscores the importance of assessing psychometric properties of instruments in each new context and population to which they are applied. It also further highlights the challenges management scholars face in assessing organizational culture in a reliable and comparable way. More research is needed to determine if the emergent two-subscale solution is a valid or meaningful alternative and whether these findings generalize beyond VHA. C1 [Helfrich, Christian D.; Li, Yu-Fang; Sales, Anne E.] VA Puget Sound Healthcare Syst, NW HSR&D Ctr Excellence, Washington, DC USA. [Helfrich, Christian D.; Sales, Anne E.] Univ Washington, Sch Publ Hlth, Dept Hlth Serv, Seattle, WA 98195 USA. [Li, Yu-Fang] Univ Washington, Sch Nursing, Dept Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA. [Mohr, David C.; Meterko, Mark] Dept Vet Affairs, Ctr Org Leadership & Management Res, Boston, MA USA. [Mohr, David C.; Meterko, Mark] Boston Univ, Sch Publ Hlth, Dept Hlth Serv, Boston, MA USA. RP Helfrich, CD (reprint author), VA Puget Sound Healthcare Syst, NW HSR&D Ctr Excellence, Washington, DC USA. EM christian.helfrich@va.gov; YuFang.Li@va.gov; david.mohr2@va.gov; mark.meterko@va.gov; ann.sales@va.gov RI Sales, Anne/D-9678-2012; Helfrich, Christian/D-2382-2016 OI Helfrich, Christian/0000-0002-9827-4768; Sales, Anne/0000-0001-9360-3334 FU Veterans Health Administration; VA Center for Organizational Leadership and Management Research; VA Northwest HSR&D Center of Excellence FX We wish to thank the US Department of Veterans Affairs, Veterans Health Administration and especially the VHA All Employee Survey Committee for access to its survey data. We also wish to thank Dr. Haili Sun of the Northwest HSR&D Center of Excellence who assisted with initial evaluation of dataset reliability. Dr. Helfrich conducted this research under a postdoctoral fellowship in Health Services Research and Development from the Veterans Health Administration. Drs. Mohr and Meterko were supported by the VA Center for Organizational Leadership and Management Research and Drs. Li and Sales were supported by the VA Northwest HSR&D Center of Excellence. The authors' conclusions are solely their own and do not necessarily represent the views of the VA. NR 43 TC 21 Z9 21 U1 9 U2 34 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 2007 VL 2 AR 13 DI 10.1186/1748-5908-2-13 PG 14 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V00IX UT WOS:000206783100013 PM 17459167 ER PT J AU Leykum, LK Pugh, J Lawrence, V Parchman, M Noel, PH Cornell, J McDaniel, RR AF Leykum, Luci K. Pugh, Jacqueline Lawrence, Valerie Parchman, Michael Noel, Polly H. Cornell, John McDaniel, Reuben R., Jr. TI Organizational interventions employing principles of complexity science have improved outcomes for patients with Type II diabetes SO IMPLEMENTATION SCIENCE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; CLINICAL DECISION-MAKING; NURSE FOLLOW-UP; PRIMARY-CARE; HEALTH-CARE; DISEASE MANAGEMENT; CHRONIC ILLNESS; GLYCEMIC CONTROL; GENERAL-PRACTICE; AFRICAN-AMERICANS AB Background: Despite the development of several models of care delivery for patients with chronic illness, consistent improvements in outcomes have not been achieved. These inconsistent results may be less related to the content of the models themselves, but to their underlying conceptualization of clinical settings as linear, predictable systems. The science of complex adaptive systems (CAS), suggests that clinical settings are non-linear, and increasingly has been used as a framework for describing and understanding clinical systems. The purpose of this study is to broaden the conceptualization by examining the relationship between interventions that leverage CAS characteristics in intervention design and implementation, and effectiveness of reported outcomes for patients with Type II diabetes. Methods: We conducted a systematic review of the literature on organizational interventions to improve care of Type II diabetes. For each study we recorded measured process and clinical outcomes of diabetic patients. Two independent reviewers gave each study a score that reflected whether organizational interventions reflected one or more characteristics of a complex adaptive system. The effectiveness of the intervention was assessed by standardizing the scoring of the results of each study as 0 (no effect), 0.5 (mixed effect), or 1.0 (effective). Results: Out of 157 potentially eligible studies, 32 met our eligibility criteria. Most studies were felt to utilize at least one CAS characteristic in their intervention designs, and ninety-one percent were scored as either "mixed effect" or "effective." The number of CAS characteristics present in each intervention was associated with effectiveness (p = 0.002). Two individual CAS characteristics were associated with effectiveness: interconnections between participants and co-evolution. Conclusion: The significant association between CAS characteristics and effectiveness of reported outcomes for patients with Type II diabetes suggests that complexity science may provide an effective framework for designing and implementing interventions that lead to improved patient outcomes. C1 [Leykum, Luci K.; Pugh, Jacqueline; Lawrence, Valerie; Noel, Polly H.; Cornell, John] Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Parchman, Michael] Univ Texas Hlth Sci Ctr San Antonio, Dept Family & Community Med, San Antonio, TX 78229 USA. [McDaniel, Reuben R., Jr.] Univ Texas Austin, McCombs Sch Business, Austin, TX 78712 USA. RP Leykum, LK (reprint author), Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. EM leykum@uthscsa.edu; pugh@uthscsa.edu; vlawrence@uthscsa.edu; parchman@uthscsa.edu; noel@uthscsa.edu; cornell@uthscsa.edu; reuben.mcdaniel@mccombs.utexas.edu OI Parchman, Michael/0000-0001-7129-2889 FU Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service [TRX 01-091, REA 05-129] FX The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (TRX # 01-091 & REA 05-129). Investigator salary support is provided through this funding, and through the South Texas Veterans Health Care System. NR 58 TC 29 Z9 29 U1 0 U2 6 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 2007 VL 2 AR 28 DI 10.1186/1748-5908-2-28 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA V00IX UT WOS:000206783100028 PM 17725834 ER PT B AU Werner, RM Asch, DA AF Werner, Rachel M. Asch, David A. BE Clarke, S Oakley, J TI Examining the link between publicly reporting healthcare quality and quality improvement SO INFORMED CONSENT AND CLINICIAN ACCOUNTABILITY: THE ETHICS OF REPORT CARDS ON SURGEON PERFORMANCE LA English DT Article; Book Chapter ID NEW-YORK-STATE; BYPASS GRAFT-SURGERY; CARDIAC-SURGERY; OF-CARE; MEDICARE BENEFICIARIES; PERFORMANCE REPORTS; CONTRACTING PRACTICES; HOSPITAL PERFORMANCE; MORTALITY HOSPITALS; CONSUMER REPORTS C1 [Werner, Rachel M.; Asch, David A.] Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. [Asch, David A.] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Werner, RM (reprint author), Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 62 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 978-0-521-86507-4 PY 2007 BP 212 EP 225 DI 10.1017/CBO9780511545467.018 D2 10.1017/CBO9780511545467 PG 14 WC Medical Ethics; Medicine, Legal SC Medical Ethics; Legal Medicine GA BXT24 UT WOS:000297011900018 ER PT J AU Katerndahl, DA Obregon, ML AF Katerndahl, David A. Obregon, Maria Luisa TI An exploration of the spiritual and psychosocial variables associated with husband-to-wife abuse and its effect on women in abusive relationships SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article DE religion; domestic violence; marital incompatibility; coping; quality of life ID DOMESTIC VIOLENCE; RELIGIOUS INVOLVEMENT AB Objectives: The purpose was to: 1) determine which aspects of religious belief incompatibility were associated with husband-to-wife abuse; 2) determine whether religious coping was independently associated with functional status among victims of spousal abuse; and 3) whether degree of abuse correlated with degrees of religious belief incompatibility or functional status among abused wives. Method: Couples Were asked to complete a structured interview concerning marital satisfaction, argument frequency, alcohol use, witnessing violence as a child, spirituality, functional status, and domestic violence. Results: In four areas of spiritual belief (sense of being judged, closeness to God, congregational benefits, forgiveness), religious belief incompatibility significantly predicted abuse. Perceived congregational help and religious coping were associated with improved social support. Finally, abuse severity and duration correlated with functional status but not with degree of religious belief incompatibility. Conclusions: The addition of religious belief incompatibility may account for more variance in husband-to-wife abuse than non-spiritual predictors alone. Although the presence of abuse was associated with poorer functional status in women, religious coping was only linked to improved social support. C1 Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Katerndahl, DA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, 7703 Floyd Curl Dr,MC 7795, San Antonio, TX 78229 USA. EM katemdahl@uthscsa.edu NR 27 TC 3 Z9 3 U1 2 U2 4 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 2007 VL 37 IS 2 BP 113 EP 128 DI 10.2190/G674-15N5-4626-W138 PG 16 WC Psychiatry SC Psychiatry GA 219DY UT WOS:000250066100001 PM 17953230 ER PT J AU Knight, A Lee, SP Juillard, G Sayre, J Abelson, J McGibbon, B Sadeghi, A AF Knight, A. Lee, S. P. Juillard, G. Sayre, J. Abelson, J. McGibbon, B. Sadeghi, A. TI Predictors of non-compliance with radiotherapy among patients with squamous cell carcinoma of the head and neck treated at a veterans affairs hospital SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 28-NOV 01, 2007 CL Los Angeles, CA SP Amer Soc Therapeut & Oncol C1 [Knight, A.; Lee, S. P.; Juillard, G.; Sayre, J.; Abelson, J.; McGibbon, B.] Univ Calif Los Angeles, Los Angeles, CA 90024 USA. [Sadeghi, A.] W Los Angeles Vet Adm Hosp, 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 0360-3016 J9 INT J RADIAT ONCOL JI Int. J. Radiat. Oncol. Biol. Phys. PY 2007 VL 69 IS 3 SU S MA 2630 BP S554 EP S554 DI 10.1016/j.ijrobp.2007.07.1810 PG 1 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 217LU UT WOS:000249950201316 ER PT J AU Wilson, VC Claghorn, K Guo, M Hampshire, M O'Dwyer, P Sun, W Drebin, J Rosato, E Whittington, R Metz, JM AF Wilson, V. C. Claghorn, K. Guo, M. Hampshire, M. O'Dwyer, P. Sun, W. Drebin, J. Rosato, E. Whittington, R. Metz, J. M. TI Aggressive supportive care improves outcomes in the combined modality treatment of pancreatic and duodenal cancer SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 28-NOV 01, 2007 CL Los Angeles, CA SP Amer Soc Therapeut & Oncol C1 [Wilson, V. C.; Claghorn, K.; Guo, M.; Hampshire, M.; O'Dwyer, P.; Sun, W.; Drebin, J.; Rosato, E.; Metz, J. M.] Hosp Univ Penn, Philadelphia, PA 19104 USA. [Whittington, R.] Vet Affairs Med Ctr, Philadelphia, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 1 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 2007 VL 69 IS 3 SU S BP S278 EP S279 DI 10.1016/j.ijrobp.2007.07.1309 PG 2 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 217LU UT WOS:000249950200499 ER PT J AU Holodniy, M Hornberger, J Rapoport, D Robertus, K MaCurdy, TE Lopez, J Volberding, P Deyton, L AF Holodniy, Mark Hornberger, John Rapoport, Dana Robertus, Katherine MaCurdy, Thomas E. Lopez, Jude Volberding, Paul Deyton, Lawrence TI Relationship between antiretroviral prescribing patterns and treatment guidelines in treatment-naive HIV-1-infected US veterans (1992-2004) SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE antiretroviral; epidemiology; guidelines; HIV; patient safety; regional variation; veterans ID HIV-INFECTED PATIENTS; UNITED-STATES; PROTEASE INHIBITORS; TREATMENT DECISIONS; CLINICAL-PRACTICE; THERAPY; RECOMMENDATIONS; ADHERENCE; PANEL; AIDS AB To analyze temporal patterns of antiretroviral (ARV) prescribing practices relative to nationally defined guidelines in treatment-naive patients with HIV-1 infection. Design: Retrospective cohort study. Methods: We evaluated ARV prescribing patterns among ARV treatment-naive veterans who were receiving care within the US Department of Veterans Affairs (VA) from 1992 through 2004 in comparison to evolving adult HIV-1 treatment guidelines. Results: A total of 15,934 patients initiated ARV treatment. Since 1999, > 94% of patients initiated at least a 3-ARV medication combination, although the percentage of patients who initiated a guideline "preferred" or "alternative" regimen never rose to greater than 72% and was significantly associated with being black and with region of care. After 1999, 20% of patients started 4 or more active ARV agents in combination, which was significantly associated with lower baseline CD4 cell count, higher viral load, and receiving care in the western United States. The proportion of patients receiving guideline "not recommended" regimens (virologically undesirable or overlapping toxicities) was < 1% after 1997. VA prescribing trends generally predated guideline recommendations by 6 to 12 months. Conclusions: VA prescribing patterns for ARV initiation adhere to treatment guidelines that maximize safety. Guidelines designed to maximize efficacy were not followed as stringently. Evaluating clinical practice patterns against contemporary treatment guidelines can inform guideline development. C1 Vet Affairs Palo Alto Hlth Care Syst, AIDS Res Ctr, Palo Alto, CA 94304 USA. Stanford Univ, Div Infect Dis & Geog Med, Stanford, CA 94305 USA. Publ Hlth Strateg Hlth Care Grp, Vet Hlth Adm, Washington, DC USA. Acumen LLC, SPHERE Inst, Burlingame, CA USA. Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA. Stanford Univ, Sch Med, Dept Med, Stanford, CA 94305 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. George Washington Univ, Sch Med & Hlth Sci, Washington, DC 20052 USA. RP Holodniy, M (reprint author), Vet Affairs Palo Alto Hlth Care Syst, AIDS Res Ctr, 3801 Miranda Ave 132, Palo Alto, CA 94304 USA. EM mark.holodniy@med.va.gov NR 48 TC 20 Z9 20 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD JAN 1 PY 2007 VL 44 IS 1 BP 20 EP 29 DI 10.1097/01.qai.0000248354.63748.54 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 121XD UT WOS:000243189400004 PM 17091020 ER PT J AU Tien, PC Schneider, MF Cole, SR Justman, JE French, AL Young, M DeHovitz, J Nathwani, N Brown, TT AF Tien, Phyllis C. Schneider, Michael F. Cole, Stephen R. Justman, Jessica E. French, Audrey L. Young, Mary DeHovitz, Jack Nathwani, Niyati Brown, Todd T. TI Relation of stavudine discontinuation to anthropometric changes among HIV-infected women SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE anthropometry; antiretroviral therapy; HIV; lipoatrophy; stavudine ID ACTIVE ANTIRETROVIRAL THERAPY; INTERAGENCY HIV; LIPOATROPHY; ABACAVIR; SUBSTITUTION; 48-WEEK; FAT AB Objective: To characterize changes associated with stavudine exposure and Design: Seven hundred thirty-four reported using stavudine (574 of whom later discontinued stavudine) and 698 HIV-infected participants HIV Study provided anthropometrics between July 1999 and March 2005. Methods: Changes in weight, waist, midthigh circumferences were evaluated generalized estimating equations. Results: HIV-uninfected women demonstrated decreases in weight and circumferences of the waist, chest, hip, and thigh. A smaller annual decrease in hip circumference was seen after discontinuing stavudine for > 2.25 years compared with the decrease observed while on stavudine (P = 0.01). Discontinuing stavudine for > 2.25 years was associated with smaller (P < 0.05) decreases in hip (-0.06 cm/y) and thigh (-0.005 cm/y) circumference compared with the decreases observed between 1 and 2.25 years (hip: -0.46 cm/y, thigh: -0.24 cm/y) or : l year (hip: -0.64 cm/y, thigh: -0.27 cm/y) after stavudine discontinuation. Conclusions: Regardless of continuing or discontinuing stavudine, HIV-infected women demonstrate decreases in weight and body circumference measurements over time. The lower limb seems to be most affected by stavudine exposure, with stabilization observed more than 2 years after discontinuation. C1 Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Infect Dis Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21218 USA. Columbia Univ, Dept Epidemiol, New York, NY 10027 USA. Columbia Univ, Dept Med, New York, NY 10027 USA. Stroger Hosp Cook Cty, CORE Ctr, Chicago, IL USA. Georgetown Univ, Med Ctr, Dept Med, Washington, DC 20007 USA. SUNY Hlth Sci Ctr, Dept Med, Brooklyn, NY 11203 USA. Univ So Calif, Dept Med, Los Angeles, CA 90033 USA. Johns Hopkins Univ, Dept Med, Baltimore, MD 21218 USA. RP Tien, PC (reprint author), Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Infect Dis Sect, 111W 4150 Clement St, San Francisco, CA 94121 USA. EM ptien@ucsf.edu FU NCRR NIH HHS [M01-RR00083, M01-RR00079]; NIAID NIH HHS [U01-AI-34989, U01-AI-35004, U01-AI-31834, U01-AI-42590, U01-AI-34994, U01-AI-34993]; NICHD NIH HHS [U01-HD-32632] NR 21 TC 15 Z9 15 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 JAIDS-J ACQ IMM DEF JI JAIDS PD JAN 1 PY 2007 VL 44 IS 1 BP 43 EP 48 DI 10.1097/01.qai.0000248353.56125.43 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 121XD UT WOS:000243189400007 PM 17091021 ER PT J AU Hsu, RT Crawford, WW Klaustermeyer, WB Schatz, M AF Hsu, R. T. Crawford, W. W. Klaustermeyer, W. B. Schatz, M. TI Risk factors for asthma-related emergency hospital utilization differ between high and low users of asthma medications SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY FEB 23-27, 2007 CL San Diego, CA SP Amer Acad Allergy, Asthma & Immunol C1 [Hsu, R. T.; Klaustermeyer, W. B.] VA Greater Los Angeles Hlthcare Syst, Los Angeles, CA USA. [Crawford, W. W.] Harbor City Med Ctr, Kaiser Permanente, Harbor, CA USA. [Schatz, M.] San Diego Med Ctr, Kaiser Permanente, San Diego, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0091-6749 EI 1097-6825 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD JAN PY 2007 VL 119 IS 1 SU 1 MA 38 BP S10 EP S10 DI 10.1016/j.jaci.2006.11.056 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 238PT UT WOS:000251460400039 ER PT J AU McEldowney, SJ Bush, RK AF McEldowney, S. J. Bush, R. K. TI Idiopathic CD4+lymphocytopenia in a patient with progressive multifocal leukoencephalopathy treated with cidofovir SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Meeting Abstract CT 63rd Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology CY FEB 23-27, 2007 CL San Diego, CA SP Amer Acad Allergy, Asthma & Immunol C1 [McEldowney, S. J.; Bush, R. K.] Univ Wisconsin Hosp, William S Middleton Mem Vet Adm Hosp, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0091-6749 EI 1097-6825 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD JAN PY 2007 VL 119 IS 1 SU 1 MA 990 BP S253 EP S253 DI 10.1016/j.jaci.2006.12.359 PG 1 WC Allergy; Immunology SC Allergy; Immunology GA 238PT UT WOS:000251460401374 ER PT J AU Quinn, LS AF Quinn, L. S. TI Interleukin-15: A cytokine which modulates fat : lean body composition SO JOURNAL OF ANIMAL SCIENCE LA English DT Meeting Abstract DE interleukin-15; muscle; adipose tissue C1 [Quinn, L. S.] Univ Washington, Seattle, WA 98195 USA. [Quinn, L. S.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER SOC ANIMAL SCIENCE PI SAVOY PA 1111 NORTH DUNLAP AVE, SAVOY, IL 61874 USA SN 0021-8812 J9 J ANIM SCI JI J. Anim. Sci. PY 2007 VL 85 SU 1 BP 1 EP 1 PG 1 WC Agriculture, Dairy & Animal Science SC Agriculture GA 213UN UT WOS:000249692700003 ER PT J AU Kozak, AT Spates, CR McChargue, DE Bailey, KC Schneider, KL Liepman, MR AF Kozak, Andrea T. Spates, C. Richard McChargue, Dennis E. Bailey, Katherine C. Schneider, Kristin L. Liepman, Michael R. TI Naltrexone renders one-session exposure therapy less effective: A controlled pilot study SO JOURNAL OF ANXIETY DISORDERS LA English DT Article DE phobias; naltrexone; endogenous opiates; behavioral assessment ID STRESS-INDUCED ANALGESIA; LEARNED HELPLESSNESS; CLAUSTROPHOBIA; MORPHINE; ANXIETY; SHOCK AB In vivo exposure has become the gold standard treatment for specific phobia. The endogenous opioid system is one mechanism proposed to explain why exposure provides such quick and effective treatment for specific phobia. The effect of naltrexone on fear and avoidance behavior was investigated among 15 specific phobia participants who received exposure treatment. Participants were randomly assigned to receive naltrexone, placebo, or no drug prior to attending one-session exposure treatment. Mixed effects regression results revealed that across time, the naltrexone group tolerated significantly less time in the room with the feared animal (Behavioral Avoidance Index) as compared to the placebo and no drug groups. Phobic individuals assigned to the naltrexone group had significantly higher fear ratings across time in comparison to the placebo group. Results provide support for the endogenous opioid system as a potential underlying biological mechanism associated with behavioral changes during in vivo exposure. (c) 2006 Elsevier Ltd All rights reserved. C1 Western Michigan Univ, Kalamazoo, MI 49008 USA. Univ Illinois, Chicago, IL 60680 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Michigan State Univ, Kalamazoo Ctr Med Studies, Kalamazoo, MI USA. RP Kozak, AT (reprint author), Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, 680 N Lake Shore Dr,Suite 1102, Chicago, IL 60611 USA. EM akozak@northwestern.edu NR 26 TC 14 Z9 14 U1 1 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0887-6185 J9 J ANXIETY DISORD JI J. Anxiety Disord. PY 2007 VL 21 IS 1 BP 142 EP 152 DI 10.1016/j.janxdis.2006.03.011 PG 11 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 138PF UT WOS:000244374000010 PM 16647240 ER PT J AU Ledoux, WR Blevins, JJ AF Ledoux, William R. Blevins, Joanna J. TI The compressive material properties of the plantar soft tissue SO JOURNAL OF BIOMECHANICS LA English DT Article DE heel pad; soft tissue properties; viscoelasticity; hallux; metatarsal ID HUMAN HEEL PAD; MECHANICAL-PROPERTIES; FAT PAD; PARADOX; ADULTS; TIME AB The plantar soft tissue is the primary means of physical interaction between a person and the ground during locomotion. Dynamic loads greater than body weight are borne across the entire plantar surface during each step. However, most testing of these tissues has concentrated on the structural properties of the heel pad. The purpose of this study was to determine the material properties of the plantar soft tissue from six locations beneath: the great toe (subhallucal), the 1st, 3rd and 5th metatarsal heads (submetatarsal), the lateral midfoot (lateral submidfoot) and the heel (subcalcaneal). We obtained specimens from these locations from I I young, nondiabetic donors; the tissue was cut into 2 cm x 2 cm blocks and the skin was removed. Stress relaxation experiments were conducted and the data were fit using the quasi-linear viscoelastic (QLV) theory. To determine tissue modulus, energy loss and the effect of test frequency, we also conducted displacement controlled triangle waves at five frequencies ranging from 0.005 to 10 Hz. The subcalcaneal tissue was found to have an increased relaxation time compared to the other areas. The subcalcaneal tissue was also found to have an increased modulus and decreased energy loss compared to the other areas. Across all areas, the modulus and energy loss increased for the I and 10 Hz tests compared to the other testing frequencies. This study is the first to generate material properties for all areas of the plantar soft tissue, demonstrating that the subcalcaneal tissue is different than the other plantar soft tissue areas. These data will have implications for foot computational modeling efforts and potentially for orthotic pressure reduction devices. Published by Elsevier Ltd. C1 VA Puget Sound Hlth Care Syst, RR&D Ctr Excellence Limb Loss Prevent & Prothet E, Seattle, WA 98108 USA. Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. Univ Washington, Dept Orthoped & Sports Med, Seattle, WA 98195 USA. RP Ledoux, WR (reprint author), VA Puget Sound Hlth Care Syst, RR&D Ctr Excellence Limb Loss Prevent & Prothet E, Ms 151,1660 S Columbian Way, Seattle, WA 98108 USA. EM wrledoux@u.washington.edu RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 19 TC 45 Z9 45 U1 1 U2 14 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0021-9290 J9 J BIOMECH JI J. Biomech. PY 2007 VL 40 IS 13 BP 2975 EP 2981 DI 10.1016/j.jbiomech.2007.02.009 PG 7 WC Biophysics; Engineering, Biomedical SC Biophysics; Engineering GA 222EB UT WOS:000250277800019 PM 17433335 ER PT J AU Brent, GA AF Brent, Gregory A. TI Diagnosing thyroid dysfunction in pregnant women: Is case finding enough? SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Editorial Material ID SUBCLINICAL HYPOTHYROIDISM; DISEASE; DISORDERS; OUTCOMES; ASSOCIATION; MANAGEMENT; HORMONE C1 Univ Calif Los Angeles, Endocrinol & Diabet Div, VA Greater Los Angeles Healthcare Syst, Dept Med,David Geffen Sch Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Endocrinol & Diabet Div, VA Greater Los Angeles Healthcare Syst, Dept Physiol,David Geffen Sch Med, Los Angeles, CA 90073 USA. RP Brent, GA (reprint author), Univ Calif Los Angeles, Endocrinol & Diabet Div, VA Greater Los Angeles Healthcare Syst, Dept Med,David Geffen Sch Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM gbrent@ucla.edu NR 23 TC 28 Z9 34 U1 0 U2 1 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD JAN PY 2007 VL 92 IS 1 BP 39 EP 41 DI 10.1210/jc.2006-2461 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 123TB UT WOS:000243317500006 PM 17209222 ER PT J AU Chou, R Fu, RW Carson, S Saha, S Helfand, M AF Chou, Roger Fu, Rongwei Carson, Susan Saha, Somnath Helfand, Mark TI Methodological shortcomings predicted lower harm estimates in one of two sets of studies of clinical interventions SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE postoperative complications; endarterectomy; carotid; cerebrovascular accident; meta-analysis; regression analysis; cyclooxygenase-2 inhibitors ID RANDOMIZED CONTROLLED-TRIALS; CAROTID-ENDARTERECTOMY; RHEUMATOID-ARTHRITIS; HEALTH-CARE; QUALITY; ROFECOXIB; RISKS; MODEL; OSTEOARTHRITIS; METAANALYSIS AB Objectives: High quality harms data are necessary to appropriately assess the balance between benefits and harms of interventions. Little is known, however, about whether perceived methodological shortcomings are associated with lower estimates of harms. Study Design and Setting: Studies reporting harms associated with carotid endarterectomy (CEA) and rofecoxib were identified using published systematic reviews. A standardized abstraction form, including eight predefined criteria for assessing the quality of harms reporting, was used to extract data. Univariate and multivariate analyses were performed to empirically evaluate the association between quality criteria and estimates of harms. Results: In I I I studies of CEA, meeting five of the eight-quality criteria was associated with significantly higher adverse event rates. A quality-rating instrument with four criteria predicted adverse events (5.7% in studies rated "adequate," compared to 3.9% in studies rated "inadequate" [P = 0.0003]). In multivariate analyses, the quality-rating assignment remained significant when controlling for other clinical and study-related variables. Different quality criteria, however, predicted estimates of risk for myocardial infarction in 16 trials of rofecoxib. Conclusion: The presence of methodological shortcomings can predict lower estimates of serious harms. Clinicians and researchers should consider methodological shortcomings when evaluating estimates of harms associated with clinical interventions. (c) 2006 Elsevier Inc. All rights reserved. C1 Oregon Evidence Based Practice Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Dept Med, Portland, OR 97201 USA. Dept Med Informat & Clin Epidemiol, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Dept Publ Hlth & Prevent Med, Portland, OR USA. Dept Emergency Med, Portland, OR USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Chou, R (reprint author), 3181 W Sam Jackson Pk Rd,Mailcode BICC, Portland, OR 97239 USA. EM chour@ohsu.edu FU PHS HHS [290-97-0018] NR 45 TC 14 Z9 14 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD JAN PY 2007 VL 60 IS 1 BP 18 EP 28 DI 10.1016/j.jclinepi.2006.02.021 PG 11 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 120AN UT WOS:000243055800003 PM 17161750 ER PT J AU Cummings, DE Overduin, J AF Cummings, David E. Overduin, Joost TI Gastrointestinal regulation of food intake SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Review ID GLUCAGON-LIKE PEPTIDE-1; CENTRAL-NERVOUS-SYSTEM; ENTEROENDOCRINE STC-1 CELLS; PLASMA GHRELIN LEVELS; BODY-WEIGHT; PANCREATIC-POLYPEPTIDE; RHESUS-MONKEYS; CHOLECYSTOKININ SECRETION; ENERGY-EXPENDITURE; REDUCES APPETITE AB Despite substantial fluctuations in daily food intake, animals maintain a remarkably stable body weight, because overall caloric ingestion and expenditure are exquisitely matched over long periods of time, through the process of energy homeostasis. The brain receives hormonal, neural, and metabolic signals pertaining to body-energy status and, in response to these inputs, coordinates adaptive alterations of energy intake and expenditure. To regulate food consumption, the brain must modulate appetite, and the core of appetite regulation lies in the gut-brain axis. This Review summarizes current knowledge regarding the neuroendocrine regulation of food intake by the gastrointestinal system, focusing on gastric distention, intestinal and pancreatic satiation peptides, and the orexigenic gastric hormone ghrelin. We highlight mechanisms governing nutrient sensing and peptide secretion by enteroendocrine cells, including novel taste-like pathways. The increasingly nuanced understanding of the mechanisms mediating gut-peptide regulation and action provides promising targets for new strategies to combat obesity and diabetes. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,S-111-Endo, Seattle, WA 98108 USA. EM davidec@u.washington.edu RI Marion-Poll, Frederic/D-8882-2011 OI Marion-Poll, Frederic/0000-0001-6824-0180 FU NIDDK NIH HHS [P01 DK068384, P01 DK68384, R01 DK061516, R01 DK61516] NR 125 TC 563 Z9 585 U1 14 U2 136 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD JAN PY 2007 VL 117 IS 1 BP 13 EP 23 DI 10.1172/JCI30227 PG 11 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 126TM UT WOS:000243538400003 PM 17200702 ER PT J AU Tache, Y Bonaz, B AF Tache, Yvette Bonaz, Bruno TI Corticotropin-releasing factor receptors and stress-related alterations of gut motor function SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Review ID IRRITABLE-BOWEL-SYNDROME; CENTRAL-NERVOUS-SYSTEM; FACTOR CRF RECEPTOR; CYCLIC VOMITING SYNDROME; WATER-AVOIDANCE STRESS; ANXIETY-LIKE BEHAVIOR; GASTROINTESTINAL MOTILITY; COMPETITIVE ANTAGONISTS; PARAVENTRICULAR NUCLEUS; COLONIC MOTILITY AB Over the past few decades, corticotropin-releasing factor (CRF) signaling pathways have been shown to be the main coordinators of the endocrine, behavioral, and immune responses to stress. Emerging evidence also links the activation of CRF receptors type 1 and type 2 with stress-related alterations of gut motor function. Here, we review the role of CRF receptors in both the brain and the gut as part of key mechanisms through which various stressors impact propulsive activity of the gastrointestinal system. We also examine how these mechanisms translate into the development of new approaches for irritable bowel syndrome, a multifactorial disorder for which stress has been implicated in the pathophysiology. C1 VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, Div Digest Dis, Los Angeles, CA USA. Grenoble Fac Med & Hosp, Dept Gastroenterol & Hepatol, Grp Etud Stress & Interact Neurodigest, EA3744, Grenoble, France. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci, Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU NIAMS NIH HHS [P50 AR049550]; NIDDK NIH HHS [R01 DK33061, DK41301, P30 DK041301, R01 DK033061, R01 DK057236, R01 DK57236] NR 123 TC 172 Z9 180 U1 1 U2 6 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD JAN PY 2007 VL 117 IS 1 BP 33 EP 40 DI 10.1172/JCI30085 PG 8 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 126TM UT WOS:000243538400005 PM 17200704 ER PT J AU Omary, MB Lugea, A Lowe, AW Pandol, SJ AF Omary, M. Bishr Lugea, Aurelia Lowe, Anson W. Pandol, Stephen J. TI The pancreatic stellate cell: a star on the rise in pancreatic diseases SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Review ID SUPPRESSES CHRONIC-PANCREATITIS; BINDING PROTEIN-1 EXPRESSION; CONVERTING ENZYME-INHIBITOR; ERK-DEPENDENT PATHWAYS; CHRONIC HEPATITIS-C; EXTRACELLULAR-MATRIX; DESMOPLASTIC REACTION; MOUSE MODEL; STIMULATING PROLIFERATION; ALCOHOLIC PANCREATITIS AB Pancreatic stellate cells (PaSCs) are myofibroblast-like cells found in the areas of the pancreas that have exocrine function. PaSCs are regulated by autocrine and paracrine stimuli and share many features with their hepatic counterparts, studies of which have helped further our understanding of PaSC biology. Activation of PaSCs induces them to proliferate, to migrate to sites of tissue damage, to contract and possibly phagocytose, and to synthesize ECM components to promote tissue repair. Sustained activation of PaSCs has an increasingly appreciated role in the fibrosis that is associated with chronic pancreatitis and with pancreatic cancer. Therefore, understanding the biology of PaSCs offers potential therapeutic targets for the treatment and prevention of these diseases. C1 VA Palo Alto Hlth Care Syst, Dept Med, Palo Alto, CA 94304 USA. Stanford Univ, Sch Med, Stanford, CA 94305 USA. Univ Calif Los Angeles, Res Ctr Alcohol Liver & Pancreat Dis, USC, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Omary, MB (reprint author), VA Palo Alto Hlth Care Syst, Dept Med, 3801 Miranda Ave,154J, Palo Alto, CA 94304 USA. EM stephen.pandol@med.va.gov FU NIAAA NIH HHS [AA11999, AA15781, P50 AA011999, R21 AA015781]; NIDDK NIH HHS [DK47918, DK52951, DK56339, DK73909, P30 DK056339, R01 DK047918, R01 DK052951, R21 DK073909, R56 DK052951] NR 125 TC 286 Z9 294 U1 2 U2 34 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD JAN PY 2007 VL 117 IS 1 BP 50 EP 59 DI 10.1172/JCI30082 PG 10 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 126TM UT WOS:000243538400007 PM 17200706 ER PT J AU Coffey, RJ Washington, MK Corless, CL Heinrich, MC AF Coffey, Robert J. Washington, Mary Kay Corless, Christopher L. Heinrich, Michael C. TI Menetrier disease and gastrointestinal stromal tumors: hyperproliferative disorders of the stomach SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Review ID GROWTH-FACTOR-ALPHA; RECEPTOR TYROSINE KINASE; OF-FUNCTION MUTATIONS; BONE-SARCOMA-GROUP; EORTC-SOFT-TISSUE; TERM-FOLLOW-UP; INTERSTITIAL-CELLS; EPITHELIAL-CELLS; IMATINIB MESYLATE; TRANSGENIC MICE AB Menetrier disease and gastrointestinal stromal tumors (GISTs) are hyperproliferative disorders of the stomach caused by dysregulated receptor tyrosine kinases (RTKs). In Menetrier disease, overexpression of TGF-alpha, a ligand for the RTK EGFR, results in selective expansion of surface mucous cells in the body and fundus of the stomach. In GISTs, somatic mutations of the genes encoding the RTK KIT (or PDGFRA in a minority of cases) result in constitutive kinase activity and neoplastic transformation of gut pacemaker cells (interstitial cells of Cajal). On the basis of the involvement of these RTKs in the pathogenesis of these disorders, Menetrier disease patients have been effectively treated with a blocking monoclonal antibody specific for EGFR and GIST patients with KIT and PDGFRA tyrosine kinase inhibitors. C1 Vanderbilt Univ, Dept Med, Med Ctr, Nashville, TN 37232 USA. Vanderbilt Univ, Dept Cell & Dev Biol, Med Ctr, Nashville, TN USA. Vanderbilt Univ, Med Ctr, Dept Pathol, Nashville, TN 37232 USA. Nashville Vet Affairs Med Ctr, Nashville, TN USA. Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Cell & Dev Biol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Coffey, RJ (reprint author), Vanderbilt Univ, Dept Med, Med Ctr, Suite 4140 MRB 3,465 21st Ave S, Nashville, TN 37232 USA. EM robert.coffey@vanderbilt.edu FU NCI NIH HHS [CA46413, P50 CA095103, P50 CA95103, R01 CA046413] NR 109 TC 56 Z9 61 U1 0 U2 5 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD JAN PY 2007 VL 117 IS 1 BP 70 EP 80 DI 10.1172/JCI30491 PG 11 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 126TM UT WOS:000243538400009 PM 17200708 ER PT J AU Kurihara, N Hiruma, Y Zhou, H Subler, MA Dempster, DW Singer, FR Reddy, SV Gruber, HE Windle, JJ Roodman, GD AF Kurihara, Noriyoshi Hiruma, Yuko Zhou, Hua Subler, Mark A. Dempster, David W. Singer, Frederick R. Reddy, Sakamuri V. Gruber, Helen E. Windle, Jolene J. Roodman, G. David TI Mutation of the sequestosome 1 (p62) gene increases osteoclastogenesis but does not induce Paget disease SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID INTERACTING PROTEIN P62; KAPPA-B ACTIVATION; MARROW CULTURES; 1,25-DIHYDROXYVITAMIN D-3; MONONUCLEAR PRECURSORS; BONE-RESORPTION; CELLS; NOMENCLATURE; PHENOTYPE; LESIONS AB Paget disease is the most exaggerated example of abnormal bone remodeling, with the primary cellular abnormality in the osteoclast. Mutations in the p62 (sequestosome 1) gene occur in one-third of patients with familial Paget disease and in a minority of patients with sporadic Paget disease, with the P392L amino acid substitution being the most commonly observed mutation. However, it is unknown how p62(P392L) mutation contributes to the development of this disease. To determine the effects of p62(P392L) expression on osteoclasts in vitro and in vivo, we introduced either the p62(P392L) or WT p62 gene into normal osteoclast precursors and targeted p62(P392L) expression to the osteoclast lineage in transgenic mice. p62(P392L)-transduced osteoclast precursors were hyper-responsive to receptor activator of NF-kappa B ligand (RANKL) and TNF-alpha. and showed increased NF-kappa B signaling but did not demonstrate increased 1,25-(OH)(2)D-3 responsivity, TAF(II)-17 expression, or nuclear number per osteoclast. Mice expressing p62(P392L) developed increased osteoclast numbers and progressive bone loss, but osteoblast numbers were not coordinately increased, as is seen in Paget disease. These results indicate that p62(P392L) expression on osteoclasts is not sufficient to induce the full pagetic phenotype but suggest that p62 mutations cause a predisposition to the development of Paget disease by increasing the sensitivity of osteoclast precursors to osteoclastogenic cytokines. C1 VA Pittsburgh Healthcare Syst, Res & Dev, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Dept Med, Div Hematol Oncol, Pittsburgh, PA 15260 USA. Helen Hayes Hosp, Reg Bone Ctr, W Haverstraw, NY USA. Virginia Commonwealth Univ, Dept Human Genet, Richmond, VA 23284 USA. Columbia Univ, Coll Phys & Surg, Dept Pathol, New York, NY 10027 USA. John Wayne Canc Inst, Endocrine Bone Dis Program, Santa Monica, CA USA. Med Univ S Carolina, Childrens Res Inst, Dept Pediat, Charleston, SC 29425 USA. Carolinas Med Ctr, Dept Orthopaed Surg, Charlotte, NC 28203 USA. RP Kurihara, N (reprint author), VA Pittsburgh Healthcare Syst, Res & Dev, 151C-U,Univ Dr C, Pittsburgh, PA 15240 USA. EM kuriharan@upmc.edu OI Windle, Jolene/0000-0001-6690-385X FU NCATS NIH HHS [UL1 TR000005]; NCI NIH HHS [P30-CA16059, P30 CA016059]; NIAMS NIH HHS [P01 AR049363, P01-AR049363] NR 25 TC 62 Z9 65 U1 0 U2 2 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD JAN PY 2007 VL 117 IS 1 BP 133 EP 142 DI 10.1172/JCI28267 PG 10 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 126TM UT WOS:000243538400018 PM 17187080 ER PT J AU Thase, ME AF Thase, Michael E. TI Recognition and diagnosis of atypical depression SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Roundtable Conference on MAOIs Revisited - Their Role in Depressive Disorders CY JAN 29, 2006 CL Miami, FL ID CORTICOTROPIN-RELEASING HORMONE; STAR-ASTERISK-D; AGE-OF-ONSET; MAJOR DEPRESSION; CUSHINGS-SYNDROME; PSYCHIATRIC MANIFESTATIONS; BIPOLAR DEPRESSION; FEATURES; SYMPTOMS; VALIDATION AB The term atypical depression dates to the first wave of reports describing differential response to monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). In contrast to more TCA-responsive depressions, patients with so-called atypical symptoms (e.g., hypersomnia, interpersonal sensitivity, leaden paralysis, increased appetite and/or weight, and phobic anxiety) were observed to be more responsive to MAOIs. After several decades of controversy and debate, the phrase "with atypical features" was added as an episode specifier in the DSM-IV in 1994. The 1-year prevalence of the defined atypical depression subtype is approximately 1% to 4%; around 15% to 29% of patients with major depressive disorder have atypical depression. Hardly "atypical" in contemporary contexts, atypical depression also is common in dysthymic bipolar II disorders and is notable for its early age at onset, more chronic course, and high rates of comorbidity with social phobia and panic disorder with agoraphobia. The requirement of preserved mood reactivity is arguably the most controversial of the DSM-IV criteria for atypical depression. When compared with melancholia, the neurobiological profiles of patients with atypical depression are relatively normal. The utility of the atypical depression subtype for differential therapeutics diminished substantially when the TCAs were supplanted as first-line antidepressants by the selective serotonin reuptake inhibitors. Although introduction of safer MAOIs has fostered renewed interest in atypical depression, the validity and importance of the DSM-IV definition of atypical depression for the nosology of affective illness remains an open question. C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19380 USA. Philadelphia Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA USA. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. RP Thase, ME (reprint author), Univ Penn, Sch Med, Dept Psychiat, 3535 Market St,Room 689, Philadelphia, PA 19380 USA. EM thase@mail.med.upenn.edu NR 57 TC 36 Z9 37 U1 2 U2 10 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 2007 VL 68 SU 8 BP 11 EP 16 PG 6 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 196MQ UT WOS:000248487100002 PM 17640153 ER PT J AU Castriotta, RJ Wilde, MC Lai, JM Atanasov, S Masel, BE Kuna, ST AF Castriotta, Richard J. Wilde, Mark C. Lai, Jenny M. Atanasov, Strahil Masel, Brent E. Kuna, Samuel T. TI Prevalence and Consequences of Sleep Disorders in Traumatic Brain Injury SO JOURNAL OF CLINICAL SLEEP MEDICINE LA English DT Article DE Trauma; brain injury; hypersomnia; sleep apnea; narcolepsy; sleep disorders AB Study Objectives: Determine prevalence and consequences of sleepiness and sleep disorders after traumatic brain injury (TBI). Methods: Prospective evaluation with polysomnography (PSG), multiple sleep latency test (MSLT), Epworth Sleepiness Scale (ESS) and neuropsychological testing including Psychomotor Vigilance Test (PVT), Profile of Mood States (POMS), and Functional Outcome of Sleep Questionnaire (FOSQ). Setting: Three academic medical centers with level I trauma centers, accredited sleep disorders centers, and rehabilitative medicine programs. Participants: Eighty-seven (87) adults at least 3 months post TBI. Measurements And Results: Abnormal sleep studies were found in 40 subjects (46%), including 20 (23%) with obstructive sleep apnea (OSA), 10 (11%) with posttraumatic hypersomnia (PTH), 5 (6%) with narcolepsy, and 6 (7%) with periodic limb movements in sleep (PLMS). Among all subjects, 22 (25%) were found to have objective excessive daytime sleepiness with MSLT score <10 minutes. There was no correlation between ESS score and MSLT (r = 0.10). There were no differences in age, race, sex, or education between the sleepy and non-sleepy subjects. injury between sleepy and non-sleepy subjects. Sleepy subjects had a greater body mass index (BMI) than those who were not sleepy (p = 0.01). OSA was more common in obese subjects (BMI = 30, p <0.001). Sleepy subjects demonstrated poorer PVT scores (p <0.05), better self-reported sleep related quality of life (FOSQ scores [p <0.05]), and no differences in POMS. Conclusions: There is a high prevalence of sleep disorders (46%) and of excessive daytime sleepiness (25%) in subjects with TBI. Sleepy subjects may be more impaired than comparable non-sleepy TBI subjects, yet be unaware of problems. Given the high prevalence of OSA (23%), PTH (11%), and narcolepsy (7%) in this population, there is a clinical indication for NPSG and MSLT. C1 [Castriotta, Richard J.; Wilde, Mark C.; Lai, Jenny M.] Univ Texas Hlth Sci Ctr Houston, Houston, TX 77030 USA. [Castriotta, Richard J.; Wilde, Mark C.; Lai, Jenny M.] Mem Hermann Hosp Sleep Disorders Ctr, Houston, TX USA. [Atanasov, Strahil] Univ Texas Med Branch, Galveston, TX 77555 USA. [Masel, Brent E.] Transit Learning Ctr, Galveston, TX USA. [Kuna, Samuel T.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Kuna, Samuel T.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Castriotta, RJ (reprint author), Univ Texas Hlth Sci Ctr Houston, Div Pulm Crit Care & Sleep Med, 6431 Fannin St,MSB 1-274, Houston, TX 77030 USA. EM Richard.J.Castriotta@uth.tmc.edu OI Castriotta, Richard/0000-0003-3502-4558 FU Moody Foundation; Cephalon, Inc. FX This research was supported by the Moody Foundation and Cephalon, Inc. We would like to express our appreciation to Amal Abuelheiga, RPSGT for her assistance with this project. NR 41 TC 128 Z9 130 U1 1 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 2007 VL 3 IS 4 BP 349 EP 356 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA V44VK UT WOS:000209776300003 PM 17694722 ER PT J AU Quinn, LS AF Quinn, L. S. TI Interleukin-15: A cytokine which modulates fat : lean body composition SO JOURNAL OF DAIRY SCIENCE LA English DT Meeting Abstract CT Joint Annual Meeting of the American-Dairy-Science-Association/Poultry-Science-Association-Asociacio n-Mexicana-de-Produccion-Animal/American-Society-of-Animal-Science CY JUL 08, 2007 CL San Antonio, TX SP Amer Diary Sci Assoc, Poultry Sci Assoc, Asociac Mexicana Prod Anim, Amer Soc Anim Sci DE interleukin-15; muscle; adipose tissue C1 [Quinn, L. S.] Univ Washington, Seattle, WA 98195 USA. [Quinn, L. S.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER DAIRY SCIENCE ASSOC PI SAVOY PA 1111 N DUNLAP AVE, SAVOY, IL 61874 USA SN 0022-0302 J9 J DAIRY SCI JI J. Dairy Sci. PY 2007 VL 90 SU 1 BP 1 EP 1 PG 1 WC Agriculture, Dairy & Animal Science; Food Science & Technology SC Agriculture; Food Science & Technology GA 213UP UT WOS:000249692900003 ER PT J AU Bushberg, JT Kroger, LA Hartman, MB Leidholdt, EM Miller, KL Derlet, R Wraa, C AF Bushberg, Jerrold T. Kroger, Linda A. Hartman, Marcia B. Leidholdt, Edwin M., Jr. Miller, Kenneth L. Derlet, Robert Wraa, Cheryl TI Nuclear/radiological terrorism: Emergency department management of radiation casualties SO JOURNAL OF EMERGENCY MEDICINE LA English DT Article DE radiological emergency; radiological casualties; terrorism; dirty bombs; emergency planning AB Recent world events have increased concern that hospitals must be prepared for radiological emergencies. Emergency departments (EDs) must be ready to treat patients suffering from injuries in combination with radiation exposure or contamination with radioactive material. Every hospital should have a Radiological Emergency Medical Response Plan, tested through periodic drills, which will allow effective handling of contaminated and injured patients. Treatment of life-threatening or severe traumatic injuries must take priority over radiation-related issues. The risk to ED staff from radioactive contamination is minimal if universal precautions are used. The likelihood of significant radiation exposure to staff under most circumstances is small. Educating medical staff on the magnitude of the radiological hazards allows them to promptly and confidently provide the necessary patient care. Measures must be taken to prevent the "worried well" and uninjured people with radioactive contamination from overwhelming the ED. (c) 2007 Elsevier Inc. C1 Univ Calif Davis, Hlth Syst, Dept Environm Hlth & Safety, Sacramento, CA 95817 USA. Univ Calif Davis, Hlth Syst, Dept Radiol, Sacramento, CA 95817 USA. Univ Calif Davis, Hlth Syst, Dept Emergency Med, Sacramento, CA 95817 USA. US Dept Vet Affairs, Natl Hlth Phys Program, Mare Isl, CA USA. Penn State Univ, Milton S Hershey Med Ctr, Dept Radiol, Hershey, PA 17033 USA. RP Bushberg, JT (reprint author), Univ Calif Davis, Hlth Syst, Dept Environm Hlth & Safety, 2315 Stockton Blvd,FSSB 2500, Sacramento, CA 95817 USA. NR 31 TC 22 Z9 23 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0736-4679 J9 J EMERG MED JI J. Emerg. Med. PD JAN PY 2007 VL 32 IS 1 BP 71 EP 85 DI 10.1016/j.jemermed.2006.05.034 PG 15 WC Emergency Medicine SC Emergency Medicine GA 130SO UT WOS:000243819500012 PM 17239736 ER PT J AU Kirchner, JE Zubritsky, C Cody, M Coakley, E Chen, HT Ware, JH Oslin, DW Sanchez, HA Durai, UNB Miles, KM Llorente, MD Costantino, G Levkoff, S AF Kirchner, JoAnn E. Zubritsky, Cynthia Cody, Marisue Coakley, Eugenie Chen, Hongtu Ware, James H. Oslin, David W. Sanchez, Herman A. Durai, U. Nalla B. Miles, Keith M. Llorente, Maria D. Costantino, Giuseppe Levkoff, Sue TI Alcohol consumption among older adults in primary care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE elderly; alcohol; drinking patterns; primary care ID COGNITIVE IMPAIRMENT; PROBLEM DRINKING; DISABILITY; TRENDS; ABUSE; LIFE AB BACKGROUND: Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. OBJECTIVES: To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients. DESIGN: Cross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers. PARTICIPANTS: Patients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients. MEASUREMENTS: Quantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety. RESULTS: Of the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1-7 drinks/week), 4.1% were at-risk drinkers (8-14 drinks/ week), and 4.5% were heavy (> 14 drinks/ week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR ( 95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/ anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR ( 95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables. CONCLUSIONS: The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/ anxiety symptoms and perceived poor health. C1 VA S Cent Mental Illness Res Educ & Clin Ctr, Little Rock, AR USA. Univ Arkansas Med Sci, Little Rock, AR 72205 USA. VA HSR&D Ctr Mental Hlth & Outcomes Res, Little Rock, AR 72114 USA. John Snow Inc, Boston, MA USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Chicago VA Hlth Care Syst, Chicago, IL USA. Dartmouth Coll Sch Med, Dept Psychiat, Lebanon, NH USA. Univ Miami, Sch Med, Miami VA Med Ctr, Miami Beach, FL USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Lutheran Med Ctr, Sunset Pk Family Hlth Ctr Network, Brooklyn, NY USA. Trinity Partners Inc, Waltham, MA USA. RP Kirchner, JE (reprint author), VA S Cent Mental Illness Res Educ & Clin Ctr, Little Rock, AR USA. EM kirchnerjoanne@uams.edu NR 28 TC 64 Z9 65 U1 3 U2 11 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2007 VL 22 IS 1 BP 92 EP 97 DI 10.1007/s11606-006-0017-z PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 140QW UT WOS:000244521800013 PM 17351846 ER PT J AU Nwasuruba, C Khan, M Egede, LE AF Nwasuruba, Chiagozie Khan, Mokbul Egede, Leonard E. TI Racial/ethnic differences in multiple self-care behaviors in adults with diabetes SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE diabetes; racial/ethnic differences; self-care behavior ID RISK-FACTOR SURVEY; BLOOD-GLUCOSE; MANAGED-CARE; PHYSICAL-ACTIVITY; UNITED-STATES; LEISURE-TIME; HEALTH; COMPLICATIONS; ASSOCIATION; RELIABILITY AB OBJECTIVE: To assess racial/ethnic differences in multiple diabetes self-care behaviors. DESIGN: Cross-sectional study. PARTICIPANTS: 21,459 participants with diabetes in the 2003 Behavioral Risk Factor Surveillance survey. MEASUREMENTS: The study assessed self-care behaviors including physical activity, fruits/vegetables consumption, glucose testing, and foot examination, as well as a composite of the 4 self-care behaviors across racial/ethnic groups. Multiple logistic regression was used to assess the independent association between race/ethnicity, the composite variable, and each self-care behavior controlling for covariates. STATA was used for statistical analysis. RESULTS: Overall, 6% engaged in all 4 self-care behaviors, with a range of 5% in non-insulin users to 8% in insulin users. Blacks were less likely to exercise (OR 0.63, 95% CI 0.51, 0.79), while Hispanics and "others" were not significantly different from whites. Hispanics (OR 0.64, 95% CI 0.49, 0.82) and others (OR 0.69, 95% CI 0.49, 0.96) were less likely to do home glucose testing, while blacks were not significantly different from whites. Blacks (OR 1.42, 95% CI 1.12, 1.80) were more likely to do home foot examinations, while Hispanics and others were not significantly different from whites. Blacks (OR 0.56, 95% CI 0.36, 0.87) were less likely to engage in all 4 behaviors, while Hispanics and others were not significantly different from whites. There were no significant racial/ ethnic differences in fruit and vegetable consumption. CONCLUSIONS: Few patients engage in multiple selfcare behaviors at recommended levels, and there are significant racial/ ethnic differences in physical activity, dietary, and foot care behaviors among adults with diabetes. C1 Med Univ S Carolina, Dept Med, Ctr Hlth Dispar Res, Charleston, SC 29425 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Tyler, TX 75710 USA. Ralph H Johnson VA Med Ctr, Charleston VA TREP, Charleston, SC USA. RP Egede, LE (reprint author), Med Univ S Carolina, Dept Med, Ctr Hlth Dispar Res, 135 Rutledge Ave,Room 280H, Charleston, SC 29425 USA. EM egedel@musc.edu FU AHRQ HHS [5K08HS11417]; NIMHD NIH HHS [R24 MD000536] NR 27 TC 50 Z9 50 U1 1 U2 8 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2007 VL 22 IS 1 BP 115 EP 120 DI 10.1007/s11606-007-0120-9 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 140QW UT WOS:000244521800017 PM 17351850 ER PT J AU Tierney, WM Gerrity, MS AF Tierney, William M. Gerrity, Martha S. TI A new look and continued growth for JGIM SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 Indiana Univ, Wishard Mem Hosp, Sch Med, Regenstrief Inst Inc, Indianapolis, IN 46202 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Indianapolis, IN 46202 USA. RP Tierney, WM (reprint author), Indiana Univ, Wishard Mem Hosp, Sch Med, Regenstrief Inst Inc, Room M200-OPW,1001 W 10th St, Indianapolis, IN 46202 USA. EM wtierney@iupui.edu NR 5 TC 0 Z9 0 U1 1 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JAN PY 2007 VL 22 IS 1 BP 157 EP 159 DI 10.1007/s11606-006-0070-7 PG 3 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 140QW UT WOS:000244521800027 ER PT J AU Cao, Q Mak, KM Lieber, CS AF Cao, Qi Mak, Ki M. Lieber, Charles S. TI Leptin represses matrix metalloproteinase-1 gene expression in LX2 human hepatic stellate cells SO JOURNAL OF HEPATOLOGY LA English DT Article DE LX-2 human hepatic stellate cells; leptin; matrix metalloproteinase-1 gene; janus kinase; signal transducer and activator of transcription; extracellular signal-regulated kinase; p38; H2O2 ID GROWTH-FACTOR-BETA; ACTIVATED PROTEIN-KINASE; H2O2-DEPENDENT MAPK PATHWAYS; FIBROTIC HUMAN LIVER; BREAST-CANCER CELLS; TISSUE INHIBITOR; SIGNALING PATHWAYS; MESSENGER-RNA; RESPONSIVE ELEMENT; HYDROGEN-PEROXIDE AB Background/Aims: Collagen accumulation in liver fibrosis is due in part to decreased expression of matrix metalloproteinase (MMP)-1 relative to TIMP-1. LX-2 hepatic stellate cells produce increased amounts of collagen and tissue inhibitor of metalloproteinase (TIMP)-1 in response to leptin. The effect of leptin on MMP-1 production has not been reported. Methods: LX-2 cells were treated with leptin with or without inhibitors. We determined: phosphorylation of Janus kinase (JAK) 1 and -2, signal transducer and activator of transcription (STAT)3 and -5, extracellular signal-regulated kinase (ERK)1/2 and p38 by Western blot; H2O2 concentration by a colorimetric method; MMP-1 mRNA levels and stability by Northern blot; MMP-1 promoter activity as well as pro-MMP-1 by ELISA; and active MMP-1 by fluorescence. Results: LX-2 cells constitutively expressed the MMP-1 gene and leptin repressed the basal level of MMP-1 mRNA and its promoter activity. The repression was mediated by JAK/STAT pathway in synergism with JAK-mediated H2O2-dependent ERK1/2 and p38 pathways. ERK1/2 inhibited MMP-1 promoter activity, whereas p38 decreased the message stability, contributing to mRNA down-regulation. Inhibition of MMP-1 gene diminished secreted pro-MMP-1 and active MMP-1. Conclusions: Leptin represses MMP-1 gene expression via the synergistic actions of the JAK/STAT pathway and JAK-mediated H2O2-dependent ERK1/2 and p38 pathways. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. C1 James J Peters VA Med Ctr, Alcohol Res & Treatment Ctr, Bronx, NY USA. Mt Sinai Sch Med, New York, NY 10029 USA. RP Lieber, CS (reprint author), James J Peters VA Med Ctr, Alcohol Res & Treatment Ctr, Bronx, NY USA. EM liebercs@aol.com FU NIAAA NIH HHS [AA11115, R01 AA011115] NR 41 TC 47 Z9 54 U1 0 U2 4 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 2007 VL 46 IS 1 BP 124 EP 133 DI 10.1016/j.jhep.2006.07.027 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 124ES UT WOS:000243350900017 PM 17030072 ER PT J AU Khan, UA McGinnis, K Skanderson, M Butt, AA AF Khan, U. A. McGinnis, K. Skanderson, M. Butt, A. A. TI Comorbid medical and psychiatric illness and substance abuse in HCV-infected and uninfected veterans SO JOURNAL OF HEPATOLOGY LA English DT Meeting Abstract CT 42th Annual Meeting of the European-Association-for-the-Study-of-the-Liver CY APR 11-15, 2007 CL Barcelona, SPAIN SP European Assoc Study Liver C1 Albany Med Ctr, Albany, NY USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. EM u_khan@yahoo.com 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 0168-8278 J9 J HEPATOL JI J. Hepatol. PY 2007 VL 46 SU 1 MA 548 BP S208 EP S208 DI 10.1016/S0168-8278(07)62146-1 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 168WQ UT WOS:000246555100547 ER PT J AU Ahmed, S Veena, MS Tang, CG Wang, MB Srivatsan, ES AF Ahmed, S. Veena, M. S. Tang, C. G. Wang, M. B. Srivatsan, E. S. TI Differential sensitivity of head and neck squamous cell cancer cell lines to cisplatin-mediated cell death. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S155 EP S155 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400490 ER PT J AU Castiglioni, A Caldwell, J Estrada, C Massie, S AF Castiglioni, A. Caldwell, J. Estrada, C. Massie, S. TI Performance of physical examination skills by second- and fourth-year medical students: Does clinical experience matter? SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Alabama, Birmingham, AL USA. Birmingham VA Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S311 EP S312 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692401379 ER PT J AU Daines, SB Rohr, ES Pace, AP Fassbind, MH Sangeorzan, BJ Ledoux, WR AF Daines, S. B. Rohr, E. S. Pace, A. P. Fassbind, M. H. Sangeorzan, B. J. Ledoux, W. R. TI Simulation of a high-arch foot. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 VA Puget Sound, RR&D Ctr Excell Limb Loss Prevent & Prosthet Engn, Seattle, WA USA. Univ Washington, Dept Mech Engn, Seattle, WA 98195 USA. Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA USA. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S153 EP S154 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400483 ER PT J AU Estrada, CA Shewchuk, RM Staton, LJ Bigby, J Houston, TK Allison, J AF Estrada, C. A. Shewchuk, R. M. Staton, L. J. Bigby, J. Houston, T. K. Allison, J. TI What should we include in a cultural competence curriculum? A formative evaluation? SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Alabama, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Tennessee, Chattanooga, TN USA. Harvard Univ, Sch Med, Boston, MA USA. RI Houston, Thomas/F-2469-2013 NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S309 EP S309 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692401363 ER PT J AU Farnad, SA Hakimi, M Huang, W Rudkin, GH Ishida, K Huang, C Yamaguch, DT Miller, TA AF Farnad, S. A. Hakimi, M. Huang, W. Rudkin, G. H. Ishida, K. Huang, C. Yamaguch, D. T. Miller, T. A. TI Differentiation of MC3T3-E1 preosteoblastic cells on two-dimensional poly(lactide-co-glycolide) (PLGA) films and three-dimensional PLGA scaffolds: A real-time reverse transcriptase-polymerase chain reaction study. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Greater LA Healthcare Syst, Plast Surg Res Lab, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Surg, Div Plast Surg, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S104 EP S104 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400177 ER PT J AU Hedlund, R Leitner, JW Draznin, B AF Hedlund, R. Leitner, J. W. Draznin, B. TI Reduced expression of p85 alpha rescues 3T3-L1 adipocytes from the insulin resistance induced via serine phosphorylation of insulin receptor substrate-1 (IRS-1) SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S124 EP S124 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400300 ER PT J AU Houston, TK Slovensky, D Moye, K Pryor, E Terndrup, T Weissman, N Kiefe, CI AF Houston, T. K. Slovensky, D. Moye, K. Pryor, E. Terndrup, T. Weissman, N. Kiefe, C. I. TI Impact of a veteran-centric, case-based, internet-delivered intervention on providers' bioterrorism knowledge: A randomized trial at 15 VAMCS. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. Univ Alabama, Birmingham, AL USA. RI Houston, Thomas/F-2469-2013 NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S309 EP S309 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692401366 ER PT J AU Njoku, CJ Gilkeson, GS Hofbauer, A Ruiz, P Oates, JC AF Njoku, C. J. Gilkeson, G. S. Hofbauer, A. Ruiz, P. Oates, J. C. TI The response of MRL/lpr-inducible nitric oxide synthase knockout mice to inducible nitric oxide synthase inhibitor. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Med Univ S Carolina, Ralph H Johnson VAMC, Charleston, SC 29425 USA. Univ Miami, Sch Med, Miami, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S278 EP S278 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692401191 ER PT J AU Pace, AP Fassbind, MJ Daines, SB Rohr, ES Sangeorzan, BJ Ledoux, WR AF Pace, A. P. Fassbind, M. J. Daines, S. B. Rohr, E. S. Sangeorzan, B. J. Ledoux, W. R. TI Simulation of a dorsal bunion. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 VA Puget Sound, Ctr Excellence Limb Loss Prevent & Prosthet Engn, Seattle, WA USA. Univ Washington, Dept Engn Mech, Seattle, WA 98195 USA. Univ Washington, Dept Orthopaed, Seattle, WA 98195 USA. RI Ledoux, William/K-6815-2015 OI Ledoux, William/0000-0003-4982-7714 NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S155 EP S155 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400493 ER PT J AU Page, ST Amory, JK Anawalt, BD Matsumoto, AM Bremner, WJ AF Page, S. T. Amory, J. K. Anawalt, B. D. Matsumoto, A. M. Bremner, W. J. TI Acceptibility of a combination of testosterone gel and depomedroxyprogesterone acetate male contraceptive regimen. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Washington, Dept Med, Seattle, WA USA. Vet Affairs 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 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S138 EP S138 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400390 ER PT J AU Tabibian, JH Pierre, JM Wirshing, WC Wirshing, DA Kisicki, MD Guzik, L Menu, SJ AF Tabibian, J. H. Pierre, J. M. Wirshing, W. C. Wirshing, D. A. Kisicki, M. D. Guzik, L. Menu, S. J. TI Hepatitis B and C among veterans on a psychiatric ward. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S146 EP S146 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400438 ER PT J AU Tang, CG Ho, B Wang, D Veena, MS Ahmed, S Srivatsan, ES Wang, MB AF Tang, C. G. Ho, B. Wang, D. Veena, M. S. Ahmed, S. Srivatsan, E. S. Wang, M. B. TI Liposomal curcumin reduces growth in head and neck squamous cell carcinoma cell lines. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Div Head & Neck Surg, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Dept Surg, Los Angeles, CA 90073 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S154 EP S154 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400487 ER PT J AU Tang, CG Hoz, B Wang, D Veena, MS Ahmed, S Srivatsan, ES Wang, MB AF Tang, C. G. Hoz, B. Wang, D. Veena, M. S. Ahmed, S. Srivatsan, E. S. Wang, M. B. TI Liposomal curcumin reduces growth in head and neck squamous cell carcinoma cell lines. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Div Head & Neck Surg, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Healthcare Ctr, Dept Surg, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S79 EP S79 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692400033 ER PT J AU Willett, LL Castiglioni, A Heudebert, G Kertesz, S Centor, RM Estrada, CA AF Willett, L. L. Castiglioni, A. Heudebert, G. Kertesz, S. Centor, R. M. Estrada, C. A. TI Measuring the impact of a clinical vignette workshop: Differing perceptions between faculty and trainees. SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT 8th Conference of the Western Student Medical Research Forum CY FEB 02, 2007 CL Monterey, CA C1 Univ Alabama, Birmingham, AL USA. Birmingham Vet Aff Med Ctr, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU B C DECKER INC PI HAMILTON PA 50 KING STREET EAST, 2ND FLOOR, 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 2007 VL 55 IS 1 SU S BP S313 EP S313 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 185DU UT WOS:000247692401385 ER PT J AU Hank, SW David, SO Gordon, VO Pisegna, JR AF Hank, S. Wang David, S. Oh Gordon, V. Ohning Pisegna, Joseph R. TI Elevated serum ghrelin exerts an orexigenic effect that may maintain body mass with metastatic neuroendocrine index in patients tumors SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article; Proceedings Paper CT Joint Meeting of the Summer Neuropeptide Conference/European Neuropeptide Club CY JUN 27-JUL 01, 2006 CL Miami Beach, FL DE ghrelin; metastatic neuroendocrine tumors endogenous; orexigenic; cancer eachexia; somatostatin; gastrin ID SOMATOSTATIN ANALOGS; OCTREOTIDE THERAPY; ENDOCRINE TUMORS; EXPRESSION; SECRETION; APPETITE; CACHEXIA; STOMACH; HUMANS; CELLS AB Ghrelin is a potent orexigenic peptide principally produced in the stomach by a distinct population of neuroendocrine cells in the oxyntic mucosa of the fundus. Exogenous ghrelin given as an intravenous infusion has been shown to increase caloric intake in patients with cancer cachexia. In this study, we hypothesized that elevated endogenous ghrelin, produced by increased neuroendocrine cell tumor burden, also exerts an orexigenic effect helping to maintain body mass index. To evaluate the effect of elevated endogenous ghrelin, 35 patients with neuroendocrine tumors were enrolled, assigning them to one of two groups depending on the presence of hepatic metastases. Following an overnight fast, serum was collected and sent for ghrelin measurement by an outside laboratory. The two groups were well matched for all other relevant clinical variables including subtype of tumor, primary location of tumor and tumor treatment history. Nearly all patients with hepatic metastases had elevated levels of ghrelin compared to the standard reference range given for matched controls. The presence of hepatic metastases was associated with significantly elevated ghrelin levels (p<0.05) and a greater mean body mass index. In addition, we report a positive correlation between serum ghrelin and total tumor surface area and between serum ghrelin and body mass index, suggesting that elevated endogenous ghrelin may be sufficient to overcome any partial ghrelin resistance typically seen in cancer cachexia. These results support the possibility that ghrelin is co-released from neuroendocrine tumors and exerts an orexigenic effect in these patients, helping to maintain their body mass index despite widely disseminated disease. C1 VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. RP Pisegna, JR (reprint author), VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Bldg 115,Room 316,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jpisegna@ucla.edu NR 34 TC 0 Z9 0 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2007 VL 33 IS 3 BP 225 EP 231 PG 7 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 224HA UT WOS:000250436900001 ER PT J AU Pekary, AE Stevens, SA Sattin, A AF Pekary, Albert Eugene Stevens, Schetema A. Sattin, Albert TI Lipopolysaccharide modulation of thyrotropin-releasing hormone (TRH) and TRH-Like peptide levels in rat brain and endocrine organs SO JOURNAL OF MOLECULAR NEUROSCIENCE LA English DT Article DE thyrotropin-releasing hormone; limbic system; reproductive system; pancreas; HPLC; radioimmunoassay ID NECROSIS-FACTOR-ALPHA; PITUITARY-THYROID AXIS; GLIAL TNF-ALPHA; MICROGLIAL ACTIVATION; DOPAMINERGIC-NEURONS; BACTERIAL LIPOPOLYSACCHARIDE; INTERLEUKIN-6 LEVELS; INDUCED SUPPRESSION; PERIPHERAL-TISSUES; MAJOR DEPRESSION AB Lipopolysaccharide (LPS) is a proinflammatory and depressogenic agent whereas thyrotropin-releasing hormone (TRH; pGlu-His-Pro-NH2) is an endogenous antidepressant and neuroprotective peptide. LPS and TRH also have opposing effects on K+ channel conductivity. We hypothesized that LPS can modulate the expression and release of not only TRH but also TRH-like peptides with the general structure pGlu-X-Pro-NH2, where "X" can be any amino acid residue. The response might be "homeostatic," that is, LPS might increase TRH and TRH-like peptide release, thereby moderating the cell damaging effects of this bacterial cell wall constituent. On the other hand, LPS might impair the synthesis and release of these neuropeptides, thus facilitating the induction of early response genes, cytokines, and other downstream biochemical changes that contribute to the "sickness syndrome." Sprague-Dawley rats (300 g) received a single intraperitoneal injection of 100 mu g/kg LPS. Animals were then decapitated 0, 2, 4, 8, and 24 h later. Serum cytokines and corticosterone peaked 2 h after intraperitoneal LPS along with a transient decrease in serum T3. TRH and TRH-like peptides were measured by a combination of high-performance liquid chromatography and radioimmunoassay. TRH declined in the nucleus accumbens and amygdala in a manner consistent with LPS-accelerated release and degradation. Various TRH-like peptide levels increased at 2 h in the anterior cingulate, hippocampus, striatum, entorhinal cortex, posterior cingulate, and cerebellum, indicating decreased release and clearance of these peptides. These brain regions are part of a neuro-immunomodulatory system that coordinates the behavioral, endocrine, and immune responses to the stresses of sickness, injury, and danger. A sustained rise in TRH levels in pancreatic beta-cells accompanied LPS-impaired insulin secretion. TRH and Leu-TRH in prostate and TRH in epididymis remained elevated 2-24 h after intraperitoneal LPS. We conclude that these endogenous neuroprotective and antidepressant-like peptides both mediate and moderate some of the behavioral and toxic effects of LPS. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Psychiat Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. RP Pekary, AE (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. EM Eugene.Pekary@va.gov NR 67 TC 13 Z9 15 U1 0 U2 0 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0895-8696 J9 J MOL NEUROSCI JI J. Mol. Neurosci. PY 2007 VL 31 IS 3 BP 245 EP 259 DI 10.1385/JMN/31:03:245 PG 15 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 169JP UT WOS:000246588800005 PM 17726229 ER PT J AU Bohnen, NI Gedela, S Kuwabara, H Constantine, GM Mathis, CA Studenski, SA Moore, RY AF Bohnen, Nicolaas I. Gedela, Satyanarayana Kuwabara, Hiroto Constantine, Gregory M. Mathis, Chester A. Studenski, Stephanie A. Moore, Robert Y. TI Selective hyposmia and nigrostriatal dopaminergic denervation in Parkinson's disease SO JOURNAL OF NEUROLOGY LA English DT Article DE basal ganglia; [C-11]-beta-CFT; dopamine; olfaction; Parkinson's disease; PET ID SMELL IDENTIFICATION TEST; POSITRON-EMISSION-TOMOGRAPHY; DIAGNOSTIC-TEST BATTERY; REFERENCE TISSUE MODEL; ADULT OLFACTORY-BULB; C-11 METHYL TRIFLATE; PET RADIOLIGANDS; HUMAN BRAIN; DYSFUNCTION; DISTURBANCES AB Olfactory dysfunction is a frequent and early feature of Parkinson's disease (PD), often preceding the motor symptoms by several years. Assessment of olfactory deficits may be used in the diagnostic assessment of PD. In this study we investigated the relationship between selective deficits in smell identification and nigrostriatal dopaminergic denervation in patients with PD. Twenty-seven PD patients (Hoehn and Yahr stages I-III) and 27 healthy controls matched for gender and age underwent olfactory testing using the 40-odor University of Pennsylvania Smell Identification Test (UPSIT). PD patients underwent C-11-beta-CFT dopamine transporter (DAT) positron emission tomography (PET) imaging and clinical motor examination. We found that total UPSIT scores were significantly lower in the PD than in the control subjects (z = 4.7, p < 0.0001). Analysis of the individual smell scores identified 3 odors with an accuracy of > 0.75 for the diagnosis of PD. These odors were banana, licorice, and dill pickle. A PD-specific smell identification score (UPSIT-3) was calculated for these 3 odors. Analysis of the patient PET data demonstrated significant correlations between dorsal striatal DAT activity and the UPSIT-3 (R-S = 0.53, p = 0.0027) and total UPSIT (R-S = 0.44, p = 0.023) scores. UPSIT-3 (R-S = 0.43, p = 0.027) but not total UPSIT (R-S = 0.20, ns) correlated with nigral DAT activity. We conclude that patients with PD have selective hyposmia. A simplified UPSIT smell identification test consisting of 3 PD-selective odors had more robust correlation with nigral and dorsal striatial dopaminergic activity compared with the full UPSIT scores in patients with PD. Assessment of selective olfactory deficits may be used as a simplified olfactory screening test in the evaluation of subjects with possible PD. C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Radiol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Math & Stat, Pittsburgh, PA 15260 USA. Johns Hopkins Univ, Sch Med, Dept Radiol, Baltimore, MD 21205 USA. Dept Vet Affairs Med Ctr, Neurol Serv, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Geriatr Res Educ Ctr, Pittsburgh, PA USA. RP Bohnen, NI (reprint author), Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. EM nbohnen@umich.edu RI Mathis, Chester/A-8607-2009 NR 48 TC 54 Z9 58 U1 0 U2 7 PU DR DIETRICH STEINKOPFF VERLAG PI DARMSTADT PA PO BOX 10 04 62, D-64204 DARMSTADT, GERMANY SN 0340-5354 J9 J NEUROL JI J. Neurol. PD JAN PY 2007 VL 254 IS 1 BP 84 EP 90 DI 10.1007/s00415-006-0284-y PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 137NV UT WOS:000244300200012 PM 17508142 ER PT J AU Tyor, WR Sas, AR Bimonte-Nelson, H AF Tyor, William R. Sas, Andrew R. Bimonte-Nelson, Heather TI Neutralizing antibody to interferon-alpha treatment in SCID mice with HIV encephalitis SO JOURNAL OF NEUROVIROLOGY LA English DT Meeting Abstract CT 8th International Symposium on Neurovirology CY OCT 30-NOV 02, 2007 CL San Diego, CA SP NIMH, NINDS, NIDA, Biogen Idec, Dept Microbiol & Immunol, Drexel Univ Coll Med, Inst Mol Med & Infect Dis, Temple Univ Sch Med, Dept Neurosci, Sbarro Inst Canc Res & Mol Med, Journal NeuroVirol C1 [Tyor, William R.; Sas, Andrew R.] Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. [Tyor, William R.] Ralph H Johnson VAMC, Charleston, SC USA. [Bimonte-Nelson, Heather] Arizona State Univ, Dept Psychol, Tempe, AZ 85287 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1355-0284 J9 J NEUROVIROL JI J. Neurovirol. PY 2007 VL 13 SU 1 BP 130 EP 131 PG 2 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 228SX UT WOS:000250754000263 ER PT J AU Fletcher, CE Baker, SJ Copeland, LA Reeves, PJ Lowery, JC AF Fletcher, Carol E. Baker, S. Jill Copeland, Laurel A. Reeves, Pamela J. Lowery, Julie C. TI Nurse practitioners' and physicians' views of NPs as providers of primary care to veterans SO JOURNAL OF NURSING SCHOLARSHIP LA English DT Article DE nurse practitioner; primary care; collaborative practice; veterans ID QUALITATIVE RESEARCH AB Purpose: To describe NPs' and MDs' perceptions of the role of NPs, the degree of collegiality between professions, and NPs' feeling of acceptance, three relationship components that may affect the acceptance of NPs as providers of primary care. Design and Methods: A descriptive study including both closed- and open-ended questions plus several Likert-type questions conducted June-August 2004. Our sample included all primary care NPs (87) and MDs (162) within a Midwestern Veterans Health Administration (VHA) region. Data were collected from 153 providers. Findings: NPs saw their role as one of autonomous practice with physician back-up as needed, while MD respondents envisioned a role akin to a physician extender. Most of the physician respondents did not think NPs could provide adequate primary care to veterans who tend to have many comorbid conditions. Yet both groups considered their relationships to be collegial and most NPs felt accepted by physicians. MDs particularly valued NPs' teaching and interpersonal skills leading to greater patient satisfaction. Conclusions: To facilitate the teamwork of NPs and MDs while improving utilization of NPs as primary care providers, VHA officials should routinely clarify roles, monitor quality of care of both MDs and NPs, and provide feedback to all concerned. C1 VA Ann Arbor Healthcare Syst, Ctr Practice Management & Outcomes Res, Ann Arbor, MI 48113 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. RP Fletcher, CE (reprint author), VA Ann Arbor Healthcare Syst, Ctr Practice Management & Outcomes Res, 11-H,Box 130170, Ann Arbor, MI 48113 USA. EM cefletch@umich.edu NR 31 TC 12 Z9 12 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1527-6546 J9 J NURS SCHOLARSHIP JI J. Nurs. Scholarsh. PY 2007 VL 39 IS 4 BP 358 EP 362 DI 10.1111/j.1547-5069.2007.00193.x PG 5 WC Nursing SC Nursing GA 231YL UT WOS:000250985000012 PM 18021137 ER PT J AU Gomez, FE Lan, JG Kang, WD Ueno, C Kudsk, KA AF Gomez, F. Enrique Lan, Jinggang Kang, Woodae Ueno, Chikara Kudsk, Kenneth A. TI Parenteral nutrition and fasting reduces mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) mRNA in Peyer's patches of mice SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID UPPER RESPIRATORY-TRACT; IMMUNOGLOBULIN-A LEVELS; MAJOR ABDOMINAL-TRAUMA; LYMPHOID-TISSUE; ENTERAL NUTRITION; SEPTIC MORBIDITY; GENE-EXPRESSION; L-SELECTIN; IMMUNITY; GLUTAMINE AB Background: Mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) in Peyer's patches (PP) is the gateway molecule for cellular migration into the mucosal immune system. Lack of enteral feeding during parenteral nutrition (PN) rapidly decreases PP MAdCAM-1, leading to drops in mucosal T and B cells and intestinal and respiratory IgA. We determined the molecular events associated with MAdCAM-1 mRNA and protein during PN (short and long term) and fasting (1 and 2 days). Methods: Experiment 1: Cannulated mice received PN for 8 hours (short-term PN, n = 6) or chow + saline (chow, n = 6). Experiment 2: Cannulated mice received PN (long-term PN, n = 4) or chow (n = 3) for 5 days. Experiment 3: Noncannulated chow mice were fasted for 1 and 2 days (n = 2/time). Total cellular RNA from the PP was quantified for MAdCAM-1 mRNA by real-time polymerase chain reaction (PCR). MAdCAM-1 protein was measured by Western blot. Results: PN rapidly down-regulated MAdCAM-1 gene expression. After 8 hours of PN with lack of enteral feeding, MAdCAM-1 mRNA levels dropped 20% (0.8-fold us chow, p >.05); 5 days of PN reduced MAdCAM-1 levels 64% (0.34-fold us chow, p <.05). PN reduced MAdCAM-1 protein levels by 30% (chow: 329 +/- 14 us PN: 230 +/- 35, p <.05) after 5 days. Fasting of uncannulated mice decreased MAdCAM-1 mRNA levels by 16% (0.84-fold, p <.05) at day 1 and 30% 47-fold, p <.05) by day 2 compared with chow. Conclusions: Both PN with lack of enteral feeding and fasting down-regulate MAdCAM-1 mRNA and protein levels in PP. The MAdCAM-1 changes are due to lack of enteral stimulation rather than toxic effects of PN. C1 William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI 53705 USA. Univ Wisconsin, Coll Med & Publ Hlth, Dept Surg, Madison, WI 53706 USA. RP Kudsk, KA (reprint author), 600 Highland Ave,H4-736 CSC, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu FU NIGMS NIH HHS [R01 GM53439] NR 28 TC 8 Z9 10 U1 0 U2 1 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD JAN-FEB PY 2007 VL 31 IS 1 BP 47 EP 52 DI 10.1177/014860710703100147 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 195XD UT WOS:000248444800009 PM 17202440 ER PT J AU Turner, JH Garnovskaya, MN Coaxum, SD Vlasova, TM Yakutovich, M Lefler, DM Raymond, JR AF Turner, Justin H. Garnovskaya, Maria N. Coaxum, Sonya D. Vlasova, Tamara M. Yakutovich, Margarita Lefler, David M. Raymond, John R. TI Ca2+-calmodulin and Janus kinase 2 are required for activation of sodium-proton exchange by the G(i)-coupled 5-hydroxytryptamine(1a) receptor SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID NA+-H+ EXCHANGER; PROTEIN-KINASE-C; EPIDERMAL-GROWTH-FACTOR; TYROSINE RESIDUES; 5-HT1A RECEPTOR; JANUS KINASE-2; PHOSPHORYLATION; CALMODULIN; NHE1; CELLS AB The type 1 sodium-proton exchanger (NHE-1) is expressed ubiquitously and regulates key cellular functions, including mitogenesis, cell volume, and intracellular pH. Despite its importance, the signaling pathways that regulate NHE- 1 remain incompletely defined. In this work, we present evidence that stimulation of the 5- hydroxytryptamine(1A) ( 5- HT1A) receptor results in the formation of a signaling complex that includes activated Janus kinase 2 ( Jak2), Ca2+/calmodulin ( CaM), and NHE- 1, and which involves tyrosine phosphorylation of CaM. The signaling pathway also involves rapid agonist- induced association of CaM and NHE- 1 as assessed by coimmunoprecipitation studies and by bioluminescence resonance energy transfer studies in living cells. We propose that NHE- 1 is activated through this pathway: 5- HT1A receptor -> G(i2)alpha and/ or G(i3)alpha -> Jak2 activation -> tyrosine phosphorylation of CaM -> increased binding of CaM to NHE -> induction of a conformational change in NHE- 1 that unmasks an obscured protonsensing and/ or proton- transporting region of NHE-1 -> activation of NHE-1. The G(i/o)-coupled 5-HT1A receptor now joins a handful of G(q)-coupled receptors and hypertonic shock as upstream activators of this emerging pathway. In the course of this work, we have presented clear evidence that CaM can be activated through tyrosine phosphorylation in the absence of a significant role for elevated intracellular Ca2+. We have also shown for the first time that the association of CaM with NHE-1 in living cells is a dynamic process. C1 Med Univ S Carolina, Med & Res Serv, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. RP Raymond, JR (reprint author), Off Provost, 179 Ashley Ave, Charleston, SC 29425 USA. EM raymondj@musc.edu FU NIDDK NIH HHS [DK52448]; NIGMS NIH HHS [GM63909, GM08716] NR 40 TC 15 Z9 15 U1 0 U2 0 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD JAN PY 2007 VL 320 IS 1 BP 314 EP 322 DI 10.1124/jpet.106.112581 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 119ER UT WOS:000242995600037 PM 17050776 ER PT J AU Liu, Y Buck, DC Macey, TA Lan, HX Neve, KA AF Liu, Yong Buck, David C. Macey, Tara A. Lan, Hongxiang Neve, Kim A. TI Evidence that calmodulin binding to the dopamine D-2 receptor enhances receptor signaling SO JOURNAL OF RECEPTORS AND SIGNAL TRANSDUCTION LA English DT Article DE D2 receptor; calmodulin; protein : protein interaction; receptor signaling; mitogen-activated protein kinase; adenylate cyclase ID ACTIVATED PROTEIN-KINASE; GROWTH-FACTOR RECEPTOR; D2 RECEPTORS; TRANSACTIVATION; STIMULATION; ERK; PHOSPHORYLATION; RECOGNITION; CALCIUM; NEURONS AB The Ca2+ sensor calmodulin (CaM) regulates numerous proteins involved in G protein-coupled receptor (GPCR) signaling. CaM binds directly to some GPCRs, including the dopamine D-2 receptor. We confirmed that the third intracellular loop of the D-2 receptor is a direct contact point for CaM binding using coimmunoprecipitation and a polyHis pulldown assay, and we determined that the D-2-like receptor agonist 7-OH-DPAT increased the colocalization of the D-2 receptor and endogenous CaM in both 293 cells and in primary neostriatal cultures. The N-terminal three or four residues of D-2-IC3 were required for the binding of CaM; mutation of three of these residues in the full-length receptor (I210C/K211C/I212C) decreased the coprecipitation of the D-2 receptor and CaM and also significantly decreased D-2 receptor signaling, without altering the coupling of the receptor to G proteins. Taken together, these findings suggest that binding of CaM to the dopamine D-2 receptor enhances D-2 receptor signaling. C1 Portland Vet Affairs Med Ctr, R&D 30, Portland, OR 97239 USA. Oregon Hlth Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. RP Neve, KA (reprint author), Portland Vet Affairs Med Ctr, R&D 30, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM nevek@ohsu.edu FU NIMH NIH HHS [MH045372] NR 33 TC 17 Z9 18 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1079-9893 J9 J RECEPT SIG TRANSD JI J. Recept. Signal Transduct. PY 2007 VL 27 IS 1 BP 47 EP 65 DI 10.1080/10799890601094152 PG 19 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 131PQ UT WOS:000243882600003 PM 17365509 ER PT J AU Henry, JA Loovis, C Montero, M Kaelin, C Anselmi, KA Coombs, R Hensley, J James, KE AF Henry, James A. Loovis, Carl Montero, Melissa Kaelin, Christine Anselmi, Kathryn-Anne Coombs, Rebecca Hensley, June James, Kenneth E. TI Randomized clinical trial: Group counseling based on tinnitus retraining therapy SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article; Proceedings Paper CT 57th Annual Meeting of the American-Academy-of-Neurology CY APR 09-16, 2005 CL Miami Beach, FL SP Amer Acad Neurol DE auditory; clinical trial; educational counseling; hearing disorders; intervention; outcomes; rehabilitation; tinnitus; tinnitus retraining therapy; Tinnitus Severity Index ID MECHANISMS; MANAGEMENT AB The main component of tinnitus retraining therapy (TRT) is structured counseling. We conducted a randomized clinical trial to test the hypothesis that group educational counseling based on TRT principles would effectively treat veterans who have clinically significant tinnitus. Veterans with clinically significant tinnitus were randomized into one of three groups: educational counseling, traditional support, and no treatment. Subjects in the first two groups attended four 1.5 h group sessions each week. All subjects completed outcome questionnaires at baseline and at 1, 6, and 12 mo. A total of 269 subjects participated: 94 in the educational counseling group, 84 in the traditional support group, and 91 in the no-treatment group. Statistical analyses showed that educational counseling provided significantly more benefit than either traditional support or no treatment, as measured by the Tinnitus Severity Index. Results suggest that group educational counseling can significantly benefit many tinnitus patients and could be integral to a "progressive intervention" approach to tinnitus clinical management. C1 VA Med Ctr, Natl Ctr Rehabil Auditory Res, Dept Vet Affairs, VA Rehabil Res & Dev Serv, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, Portland, OR 97201 USA. VA Puget Sound Hlth Care Syst, VA Audiol Clin, Seattle, WA USA. Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. RP Henry, JA (reprint author), VA Med Ctr, Natl Ctr Rehabil Auditory Res, Dept Vet Affairs, VA Rehabil Res & Dev Serv, Portland, OR USA. EM james.henry@med.va.gov NR 31 TC 17 Z9 17 U1 0 U2 12 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. PY 2007 VL 44 IS 1 BP 21 EP 31 DI 10.1682/JRRD.2006.02.0018 PG 11 WC Rehabilitation SC Rehabilitation GA 178PG UT WOS:000247232000004 PM 17551855 ER PT J AU Tan, G Craine, MH Bair, MJ Garcia, MK Giordano, J Jensen, MP McDonald, SM Patterson, D Sherman, RA Williams, W Tsao, JCI AF Tan, Gabriel Craine, Michael H. Bair, Matthew J. Garcia, M. Kay Giordano, James Jensen, Mark P. McDonald, Shelley M. Patterson, David Sherman, Richard A. Williams, Wright Tsao, Jennie C. I. TI Efficacy of selected complementary and alternative medicine interventions for chronic pain SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Review DE biologically based medicine; chronic pain; complementary and alternative medicine; efficacy; energy medicine; manipulative and body-based medicine; mind-body medicine; pain management; rehabilitation; whole or professionalized CAM practices ID LOW-BACK-PAIN; PULSED ELECTROMAGNETIC-FIELDS; RANDOMIZED CONTROLLED-TRIAL; CRANIAL ELECTROTHERAPY STIMULATION; COGNITIVE-BEHAVIORAL THERAPY; CHRONIC MUSCULOSKELETAL PAIN; MUSCULAR COACTIVATION DMC; IRRITABLE-BOWEL-SYNDROME; HERB-DRUG INTERACTIONS; SHAM-CONTROLLED TRIAL AB Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as "whole or professionalized CAM practices." Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners. C1 Michael E DeBakey VAMC, Dept Anesthesiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Denver VAMC, VA Eastern Colorado Hlth Care Syst, Patient Focused Care Serv, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Phys Med & Rehabil, Denver, CO 80202 USA. Richard L Roudebush VAMC, Hlth Serv Res & Dev Ctr Excellence Implementing, Indianapolis, IN USA. Univ Texas, MD Anderson Canc Ctr, Dept Anesthesiol & Pain Med, Houston, TX 77030 USA. Amer Coll Acupuncture & Oriental Med, Houston, TX USA. Georgetown Univ, Med Ctr, Ctr Clin Bioeth, Washington, DC 20007 USA. Georgetown Univ, Med Ctr, Div Palliat Med, Washington, DC 20007 USA. Samueli Inst, Alexandria, VA USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. Behav Med Res & Training Fdn, Port Angeles, WA USA. Baylor Coll Med, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Univ Calif Los Angeles, Pediat Pain Program, Dept Pediat, David Geffen Sch Med, Los Angeles, CA USA. RP Tan, G (reprint author), Michael E DeBakey VAMC, Dept Anesthesiol, Anesthesiol Care Line 145,2002 Holcombe Blvd, Houston, TX 77030 USA. EM tan.gabriel@med.va.gov FU NICHD NIH HHS [P01 HD33988]; NIDA NIH HHS [5R03 DA17026-2]; NIGMS NIH HHS [R01 GM42725-09A1]; NIMH NIH HHS [5R01 MH063779-03] NR 174 TC 21 Z9 22 U1 8 U2 21 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. PY 2007 VL 44 IS 2 BP 195 EP 222 DI 10.1682/JRRD.2006.06.0063 PG 28 WC Rehabilitation SC Rehabilitation GA 176NJ UT WOS:000247091700007 PM 17551873 ER PT J AU Chang, VT Sorger, B Rosenfeld, KE Lorenz, KA Bailey, AF Bui, T Weinberger, L Montagnini, M AF Chang, Victor T. Sorger, Brooke Rosenfeld, Kenneth E. Lorenz, Karl A. Bailey, Amos F. Bui, Trinh Weinberger, Lawrence Montagnini, Marcos TI Pain and palliative medicine SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Review DE cancer; health services; heart failure; HIV; information technology; pain; palliative; PTSD; quality of care; rehabilitation; veterans ID QUALITY-OF-LIFE; OBSTRUCTIVE PULMONARY-DISEASE; TRANSMUCOSAL FENTANYL CITRATE; CONGESTIVE-HEART-FAILURE; ADVANCED CANCER-PATIENTS; LAST 6 MONTHS; SYMPTOM-ASSESSMENT; HOSPITALIZED-PATIENTS; CHRONIC ILLNESS; METASTATIC CANCER AB Severe pain is highly prevalent, with rates of 40% to 70% in patients with advanced cancer, liver disease, heart failure, human immunodeficiency virus, and renal failure. Wide variations in pain assessment and reporting methods and the measurement of multiple symptoms should be addressed in future studies. Regarding psychological approaches, determining whether hypnotherapy or other individual psychotherapeutic interventions reduce pain and/or psychological distress in a palliative care population is difficult. Interest is increasing in the concept of demoralization syndromes and the role of posttraumatic stress disorder in modulating responses to pain at the end of life. We review evidence from multiple studies that the use of rehabilitative therapy improves functional status and pain control among patients with advanced cancer, and we raise the possibility that rehabilitation therapy will be helpful in patients with other advanced diseases. We summarize ongoing clinical trials of electronic order sets, clinical care pathways, and care management pathways to improve pain management in palliative care. Wagner's Chronic Illness Model provides a way of analyzing how healthcare systems can be changed to provide adequate and continuing pain management in palliative care. Much work remains to ensure that pain is recognized, treated, and monitored effectively. C1 Dept VA New Jersey Hlth Care Syst, Sect Hematol Oncol 111, E Orange, NJ 07018 USA. Univ Med & Dent New Jersey, Newark, NJ 07103 USA. James J Peters VA Med Ctr, Bronx, NY USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Birmingham VAMC, Birmingham, AL USA. Univ Alabama, Birmingham, AL USA. VA Ann Arbor Hlth Care Syst, Ann Arbor, MI USA. RP Chang, VT (reprint author), Dept VA New Jersey Hlth Care Syst, Sect Hematol Oncol 111, 385 Tremont Ave, E Orange, NJ 07018 USA. EM Victor.chang@med.va.gov RI Montagnini, Marcos /B-6873-2014 NR 123 TC 7 Z9 7 U1 2 U2 7 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. PY 2007 VL 44 IS 2 BP 279 EP 294 DI 10.1682/JRRD.2006.06.0067 PG 16 WC Rehabilitation SC Rehabilitation GA 176NJ UT WOS:000247091700013 PM 17551879 ER PT J AU Jones, KR Vojir, CP Hutt, E Fink, R AF Jones, Katherine R. Vojir, Carol P. Hutt, Evelyn Fink, Regina TI Determining mild, moderate, and severe pain equivalency across pain-intensity tools in nursing home residents SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE dementia; elderly; Faces Pain Scale; Numeric Rating Scale; nursing homes; pain assessment; pain intensity; pain-intensity tools; pain-level equivalency; rehabilitation ID IMPAIRED OLDER-ADULTS; CANCER PAIN; CUTPOINTS; DEMENTIA; SCALE AB Older adults in nursing homes experience pain that is often underassessed and undertreated. Visual analog pain-intensity scales, recommended for widespread use in adults, do not work well in the older adult population. A variety of other tools are in use, including the Verbal Descriptor Scale, the Faces Pain Scale (FPS), and the Numeric Rating Scale. These tools are more acceptable to older adults, but no agreement exists about how to compare the resulting pain-intensity scores across residents. This study examined the equivalency of pain-intensity scores for 135 nursing home residents who reported their pain on the three different instruments. The results were validated with a second sample of 135 nursing home residents. The pain levels across the three tools were highly correlated, but residents were found to underrate higher pain intensity on the FPS. A modification of scoring for the FPS led to greater agreement across the three tools. The findings have implications for use of these tools for quality improvement and public reporting of pain. C1 Univ Colorado, Sch Nursing, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Denver Dept Vet Affairs Med Ctr, Res Enhancement Award Program, Denver, CO USA. Univ Colorado, Sch Med, Denver, CO 80202 USA. Univ Colorado Hosp, Denver, CO USA. RP Hutt, E (reprint author), Denver VAMC, 151,1055 Clermont St, Denver, CO 80220 USA. EM evelyn.hutt@uchsc.edu FU AHRQ HHS [U18-HS11093] NR 34 TC 61 Z9 65 U1 0 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. PY 2007 VL 44 IS 2 BP 305 EP 314 DI 10.1682/JRRD.2006.05.0051 PG 10 WC Rehabilitation SC Rehabilitation GA 176NJ UT WOS:000247091700015 PM 17551881 ER PT J AU Buffum, MD Hutt, E Chang, VT Craine, MH Snow, AL AF Buffum, Martha D. Hutt, Evelyn Chang, Victor T. Craine, Michael H. Snow, A. Lynn TI Cognitive impairment and pain management: Review of issues and challenges SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE amnestic; analgesia; cognitive disorders; delirium; dementia; intensive care; nursing homes; pain; pain measurement; palliative care ID NURSING-HOME RESIDENTS; ALZHEIMERS-DISEASE; OLDER PERSONS; DEMENTIA; SCALES; INSTRUMENTS; VETERANS; SYSTEM; ADULTS AB The assessment and treatment of pain in persons with cognitive impairments pose unique challenges. Disorders affecting cognition include neurodegenerative, vascular, toxic, anoxic, and infectious processes. Persons with memory, language, and speech deficits and consciousness alterations are often unable to communicate clearly about their pain and discomfort. Past research has documented that persons with cognitive impairments, particularly dementia, are less likely to ask for and receive analgesics. This article provides an overview of the assessment, treatment, and management of pain in adults with cognitive impairments. We review types of cognitive impairment; recent work specific to best practices for pain management in patients with dementia, including assessment-tool development and pharmacological treatment; challenges in patients with delirium and in medical intensive care and palliative care settings; and directions for future research. C1 Dept VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Nursing, San Francisco, CA 94143 USA. Denver VAMC, VA Eastern Colorado Hlth Care Syst, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. VA New Jersey Hlth Care Syst E Orange, E Orange, NJ USA. Univ Med & Dent New Jersey, Newark, NJ 07103 USA. Univ Alabama, Tuscaloosa, AL USA. RP Buffum, MD (reprint author), Dept VA Med Ctr, 4150 Clement St 118, San Francisco, CA 94121 USA. EM Martha.Buffum@va.gov NR 32 TC 40 Z9 41 U1 1 U2 10 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. PY 2007 VL 44 IS 2 BP 315 EP 326 DI 10.1682/JRRD.2006.06.0064 PG 12 WC Rehabilitation SC Rehabilitation GA 176NJ UT WOS:000247091700016 PM 17551882 ER PT J AU Stevens, AB Strasser, DC Uomoto, J Bowen, SE Falconer, JA AF Stevens, Alan B. Strasser, Dale C. Uomoto, Jay Bowen, Susan E. Falconer, Judith A. TI Utility of treatment implementation methods in clinical trial with rehabilitation teams SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article; Proceedings Paper CT 82nd Annual Meeting of the American-Congress-of-Rehabilitation-Medicine CY SEP 28-OCT 02, 2005 CL Chicago, IL SP Amer Congress Rehabil Med DE behavioral science; clinical trials; effectiveness; interdisciplinary teams; patient care team; rehabilitation outcomes; research methods; stroke rehabilitation; team training; treatment implementation ID DEMENTIA CAREGIVERS; HOSPITALS; OUTCOMES AB Clinical trials of rehabilitation interventions pose unique challenges to researchers. Treatments can be technically complex, often requiring a multidisciplinary team of professions. This article demonstrates the application of Treatment Implementation (TI) methods in a rehabilitation team-training intervention conducted with 29 team leaders (12 medical doctors, 4 physical therapists, 3 speech-language pathologists, 2 occupational therapists, 3 kinesiotherapists, 2 registered nurses, I social worker, I program coordinator, and I administrator) from 15 Department of Veterans Affairs hospitals. We describe the intervention along with the influence of three TI categories (delivery, receipt, and enactment) on the design and implementation of the team-training intervention. Positive findings from the use of TI methods include (1) consistent and accurate presentation of intervention components and (2) evidence of study participants' receipt and enactment of intervention strategies. C1 Atlanta VA Med Ctr, Decatur, GA 30033 USA. Scott & White Mem Hosp & Clin, Temple, TX 76508 USA. Texas A&M Univ, Hlth Sci Ctr, College Stn, TX USA. Birmingham Atlanta Geriatr Res Educ & Clin Ctr, Birmingham, AL USA. Emory Univ, Atlanta, GA 30322 USA. VA Puget Sound Hlth Care Syst, Seattle Div, Ctr Polytrauma Care Neuropsychol & Rehabil Psycho, Seattle, WA USA. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. Atlanta Dept Vet Affairs VA Med Ctr, Decatur, GA USA. RP Strasser, DC (reprint author), Atlanta VA Med Ctr, 1670 Clairmont Rd 11B, Decatur, GA 30033 USA. EM Dale.Strasser@va.gov NR 12 TC 12 Z9 12 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. PY 2007 VL 44 IS 4 BP 537 EP 546 DI 10.1682/JRRD.2006.09.0120 PG 10 WC Rehabilitation SC Rehabilitation GA 223DV UT WOS:000250350700007 PM 18247250 ER PT J AU Tolerico, ML Ding, D Cooper, RA Spaeth, DM Fitzgerald, SG Cooper, R Kelleher, A Boninger, ML AF Tolerico, Michelle L. Ding, Dan Cooper, Rory A. Spaeth, Donald M. Fitzgerald, Shirley G. Cooper, Rosemarie Kelleher, Annmarie Boninger, Michael L. TI Assessing mobility characteristics and activity levels of manual wheelchair users SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE activity levels; activity monitor; data logger; manual wheelchair; mobility; mobility characteristics; national veterans wheelchair games; physical activity; rehabilitation; wheelchair users ID SPINAL-CORD-INJURY; PHYSICAL-ACTIVITY; HEALTH; PROPULSION; EMPLOYMENT; CAPACITY; VALIDITY; STRAIN; LIFE AB Although engaging in an active lifestyle is beneficial for maintaining quality of life, a majority of wheelchair users are inactive. This study investigated the mobility characteristics and activity levels of manual wheelchair users in the residential setting and at the National Veterans Wheelchair Games (NVWG). Demographic factors that may have influenced activity in the home environment were also identified. Fifty-two manual wheelchair users completed a brief survey, and their activity was monitored with a custom data logger over a period of 13 or 20 days. We found that they traveled a mean +/- standard deviation of 2,457.0 +/- 1,195.7 m/d at a speed of 0.79 +/- 0.19 m/s for 8.3 +/- 3.3 h/d while using their primary wheelchair in the home environment. No significant differences in mobility characteristics or activity levels were found for level of spinal cord injury or disability. We also found that subjects traveled significantly farther and faster and were active for more hours during an average day at the NVWG than in the home environment (p < 0.001). We found that manual wheelchair users who were employed covered more distance, accumulated more minutes, and traveled a greater average maximum distance between consecutive stops than those who were unemployed. Results from this study provide a better understanding of the activity levels achieved by manual wheelchair users and insight into factors that may influence this activity. C1 Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Dept Vet Affairs Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, Pittsburgh, PA USA. Univ Pittsburgh, Sch Engn, Dept Bioengn, Pittsburgh, PA 15261 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, 7180 Highland Dr,151R-1H, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Boninger, Michael/0000-0001-6966-919X NR 29 TC 72 Z9 72 U1 0 U2 9 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. PY 2007 VL 44 IS 4 BP 561 EP 571 DI 10.1682/JRRD.2006.02.0017 PG 11 WC Rehabilitation SC Rehabilitation GA 223DV UT WOS:000250350700010 PM 18247253 ER PT J AU Wolf, E Cooper, RA Pearlman, J Fitzgerald, SG Kelleher, A AF Wolf, Erik Cooper, Rory A. Pearlman, Jonathan Fitzgerald, Shirley G. Kelleher, Annmarie TI Longitudinal assessment of vibrations during manual and power wheelchair driving over select sidewalk surfaces SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE accessible surface; concrete; injury; manual wheelchair; power wheelchair; rehabilitation; sidewalks; vibration; wheelchairs; whole-body vibrations ID WHOLE-BODY VIBRATION; LOW-BACK-PAIN; SEAT SUSPENSION DESIGN; EXPOSURE; POSTURE AB Wheelchair users rely on their wheelchairs for mobility for extended periods of time every day. According to the International Standards Organization 2631-1 standard on human vibration, individuals in a seated position when exposed to whole-body vibrations (WBV) are at risk of injury. This study evaluated vibration exposure during manual and power wheelchair driving over nine sidewalk surfaces and differences in vibration exposure over 3 years. Ten nondisabled subjects were asked to drive a manual wheelchair at 1 m/s and a power wheelchair at I m/s and 2 m/s over nine sidewalk surfaces while WBV were measured at the seat and footrest of the wheelchair. At I rn/s, significant differences existed between surfaces and years at both the seat and the footrest for the manual and power wheelchair users. At 2 m/s, significant differences existed between surfaces and years at the seat and the footrest for power wheelchair users. Our results show that both manual and power wheelchair users may. be at risk for secondary injuries from WBV when traveling over certain surfaces. C1 Univ Pittsburgh, Sch Engn, Dept Bioengn, Pittsburgh, PA 15261 USA. Dept Vet Affairs Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, 7180 Highland Dr,151R-1H, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Wolf, Erik/0000-0002-6353-7978; Pearlman, Jon/0000-0003-0830-9136 NR 20 TC 8 Z9 8 U1 0 U2 2 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. PY 2007 VL 44 IS 4 BP 573 EP 580 DI 10.1682/JRRD.2006.05.0049 PG 8 WC Rehabilitation SC Rehabilitation GA 223DV UT WOS:000250350700011 PM 18247254 ER PT J AU Collins, MP Souza, PE O'Neill, S Yueh, B AF Collins, Margaret P. Souza, Pamela E. O'Neill, Sami Yueh, Bevan TI Effectiveness of group versus individual hearing aid visits SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE education; group visits (non-Medical Subject Heading); health resources; health services research; hearing aids; hearing impaired; hearing loss; outcome assessment; patient satisfaction; rehabilitation of hearing impaired; veterans ID HEALTH MAINTENANCE ORGANIZATION; BEHAVIORAL TREATMENT APPROACH; CHRONIC CARE CLINICS; 2-YEAR FOLLOW-UP; RANDOMIZED-TRIAL; AUDIOLOGICAL REHABILITATION; COMMUNICATION COURSE; HANDICAP INVENTORY; DIABETES EDUCATION; OLDER-ADULTS AB Demand for hearing aid services in the Veterans Health Administration increased over 300% from 1996 to 2005, challenging the delivery of timely, high-quality care. Using group visits may help meet these needs, but whether this approach would still provide high-quality rehabilitation is unclear. This study determined whether group visits worsen hearing aid outcomes. It included a retrospective observational cohort in veterans seeking hearing aids at the Department of Veterans Affairs Puget Sound Health Care System from September 2004 to March 2005, when the clinic was using both individual and group visits. Medical records were reviewed for all new hearing aid patients seen during this period. Hearing-related outcome questionnaires were compared between patients seen for individual versus group fitting and/or follow-up visits. Results revealed that hearing thresholds were similar between patients seen individually and in groups. Of 74 patients who returned self-administered questionnaires after the follow-up, those who received both fitting and follow-up in a group format reported similar hearing handicap and better hearing-related function, satisfaction, and adherence than patients who received individual visits. Group visits did not appear to yield worse outcomes in this nonrandomized retrospective chart review. Definitive statements must await randomized comparisons. C1 [Collins, Margaret P.; Yueh, Bevan] Dept Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98108 USA. [Collins, Margaret P.; Souza, Pamela E.; O'Neill, Sami] Univ Washington, Dept Speech & Hearing Sci, Seattle, WA 98195 USA. [Yueh, Bevan] VA Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, Seattle, WA USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. [Yueh, Bevan] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [O'Neill, Sami] Dept Vet Affairs Puget Sound Hlth Care Syst, Rehabil Care Serv, Audiol Clin, Seattle, WA 98108 USA. RP Collins, MP (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Audiol Clin, 1600 S Columbian Way, Seattle, WA 98108 USA. EM margaret.collins@va.gov OI Yueh, Bevan/0000-0003-1380-1053 NR 53 TC 7 Z9 8 U1 2 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. PY 2007 VL 44 IS 5 BP 739 EP 749 DI 10.1682/JRRD.2007.02.009 PG 11 WC Rehabilitation SC Rehabilitation GA 242SA UT WOS:000251744800013 PM 17943685 ER PT J AU Silverman, SL Shen, W Minshall, ME Xie, S Moses, KH AF Silverman, Stuart L. Shen, Wei Minshall, Michael E. Xie, Sunny Moses, Kathryn H. TI Prevalence of depressive symptoms in postmenopausal women with low bone mineral density and/or prevalent vertebral fracture: Results from the Multiple Outcomes of Raloxifene Evaluation (MORE) Study SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE vertebral fracture; osteoporosis; depression; geriatric depression scale; health-related quality of life ID QUALITY-OF-LIFE; OSTEOPOROSIS; ASSOCIATION; QUESTIONNAIRE; RISK AB Objective. To examine the prevalence of depressive symptoms in a cross-sectional study of postmenopausal women with osteoporosis with and without prevalent vertebral fracture. Methods. Participants were a subset of English-speaking women (n = 3798, mean age 66.7 yrs) from the Multiple Outcomes of Raloxifene Evaluation trial, who had low bone mineral density (BMD) and/or prevalent vertebral fractures. Vertebral fractures were measured at baseline by radiography using a semiquantitative technique. Depressive symptoms were assessed at baseline using the Geriatric Depression Scale (GDS), a valid and reliable scale for depression screening in elderly patients. Women were considered as probably depressed if >= 6 symptoms of depression were reported. Results. Postmenopausal women with prevalent vertebral fracture reported more depressive symptoms as assessed by the GDS than women without prevalent vertebral fracture (1.54 vs 1.26; p = 0.001). There was an absolute increase of 2.5% (p = 0.008) in the prevalence of probable depression (GDS score >= 6) in women with prevalent fracture compared to those without prevalent fracture. The prevalence of probable depression was 4.1 % among women without prevalent vertebral fracture and 6.6% in women with a prevalent vertebral fracture. The prevalence of probable depression was 3-fold higher in women with at least 3 prevalent vertebral fractures compared to women without prevalent fracture (12.8% vs 4.1%; p < 0.001). Conclusion. Postmenopausal women with prevalent vertebral fractures had greater prevalence of depressive symptoms and probable depression as assessed by the GDS than women without vertebral fracture with low BMD. The dual diagnosis of depression and osteoporosis may mean worse health outcomes. Patients with prevalent vertebral fractures may be considered not only for interventions that address fracture risk reduction, but also for psychosocial interventions that address depressive symptoms. C1 Univ Calif Los Angeles, Cedars Sinai Med Ctr, Greater Los Angeles Vet Adm Hlth Syst, Los Angeles, CA 90048 USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. Indiana Univ, Sch Med, Ctr Outcomes Res, Dept Publ Hlth, Indianapolis, IN 46204 USA. Forest Labs Inc, New York, NY USA. RP Silverman, SL (reprint author), OMC Clin Res Ctr, 8641 Wilshire Blvd,Suite 310, Beverly Hills, CA 90211 USA. EM stuarts@OMCresearch.org NR 26 TC 27 Z9 28 U1 1 U2 1 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD JAN PY 2007 VL 34 IS 1 BP 140 EP 144 PG 5 WC Rheumatology SC Rheumatology GA 125UC UT WOS:000243467300024 PM 17216681 ER PT J AU Wecht, JM Weir, JP Krothe, AH Spungen, AM Bauman, WA AF Wecht, Jill M. Weir, Joseph P. Krothe, AnnMarie H. Spungen, Ann M. Bauman, William A. TI Normalization of supine blood pressure after nitric oxide synthase inhibition in persons with tetraplegia SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; arterial pressure; orthostatic hypotension; nitro-L-arginine methyl ester; nitric oxide inhibitor; tetraplegia ID SPINAL-CORD-INJURY; ORTHOSTATIC HYPOTENSION; SIMULATED MICROGRAVITY; VASCULAR ADAPTATION; L-NAME; COUNTERMEASURE; SPACEFLIGHT; INTOLERANCE; MECHANISMS; EXPRESSION AB Background/Objective: Orthostatic hypotension is a well-defined clinical consequence of spinal cord injury (SCI), particularly in those with tetraplegia. The etiology of orthostatic hypotension is thought to be loss of sympathetic vasomotor control, although other factors may play a role. There is evidence of up-regulation of nitric oxide synthase (NOS) activity after hind-limb suspension in rats, a condition of antigravity that may have similar vascular effects as shown in persons with tetraplegia caused by paralysis. The study objective was to determine the effect of a NOS inhibitor (nitro-L-arginine methyl ester [L-NAME]) on supine mean arterial pressure in persons with chronic tetraplegia compared with non-SCI controls. Methods: Fourteen individuals participated (7 with tetraplegia and 7 controls). Subjects visited the laboratory twice for placebo on day 1 and L-NAME (1 mg/kg) on day 2; both were infused intravenously over 60 minutes. Blood pressure was monitored for 3 hours after infusion at the brachial artery using a standard manual cuff. Results: Mean arterial pressure (MAP) was lower at baseline (P < 0.05) and after placebo administration (P < 0.0001) in the tetraplegia group compared with the control group. L-NAME increased MAP in both groups; however, the relative increase was greater in the tetraplegia group compared with the control group, Such that group differences for MAP were eliminated. Supine MAP was normalized with L-NAME, and there was an increased sensitivity to NOS inhibition in the group with tetraplegia. Conclusions: These findings indicate that blood pressure dysregulation in persons with tetraplegia may reflect increased vascular NO and suggest a novel treatment of hypotension using NOS inhibition in this population. C1 James J Peters VA Med Ctr, VA Ctr Excellence, Bronx, NY 10468 USA. RP Wecht, JM (reprint author), James J Peters VA Med Ctr, VA Ctr Excellence, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM jwecht@hotmail.com NR 28 TC 13 Z9 14 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2007 VL 30 IS 1 BP 5 EP 9 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 145ZL UT WOS:000244904200003 PM 17385265 ER PT J AU Weaver, FM Smith, B LaVela, S Wallace, C Evans, CT Hammond, M Goldstein, B AF Weaver, Frances M. Smith, Bridget LaVela, Sherri Wallace, Carolyn Evans, Charlesnika T. Hammond, Margaret Goldstein, Barry TI Interventions to increase influenza vaccination rates in veterans with spinal cord injuries and disorders SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE vaccination; spinal cord injuries; influenza; prevention; veterans; respiratory infections ID CONTROLLED-TRIAL; IMMUNIZATION; REMINDERS; BEHAVIOR; OLDER; IMPLEMENTATION; METAANALYSIS; STRATEGIES; ATTITUDES; DELIVERY AB Objective: To increase the percentage of veterans with spinal cord injuries and disorders (SCI&D) who receive annual influenza vaccinations. Design: A repeated measures quality improvement project using several integrated evidence-based interventions. Setting: 23 Veterans Affairs (VA) SCI Centers. Patients: Veterans with SCI&D average age = 57.3 years (range 21-102 y). Interventions: Patient reminder letters and education; provider reminders and posters; computerized clinical reminders for vaccination targeted to SCI & D; standing orders. Main outcome measures: Patient self-reported vaccination status. Results: Baseline vaccination rate was 33% in fiscal year (FY) 2001. The percentage of veterans with SCI&D who reported receiving vaccinations increased from 62.5% in year 1 (FY2002) to 67.4% in FY2003 (P = 0.004); for individuals younger than 50 years of age, rates increased from 50% to 54%. Predictors of vaccination were age 65 years of age or older, VA health care visit in past year, nonsmoker, believing vaccination is important, having a health condition that may contribute to respiratory complications, and self-reported influenza in prior year. Conclusions: Vaccination rates were higher than baseline and higher than reported for other high-risk groups. Interventions that incorporate system-wide approaches plus patient and provider education and reminders were moderately effective in increasing vaccination rates. Targeting younger persons, smokers, and those who do not use VA care may further improve rates. C1 Northwestern Univ, Midwest Ctr Hlth Serv & Policy Res, Chicago, IL 60611 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Hlth Serv & Policy Res, Chicago, IL 60611 USA. Edward Hines Vet Adm Med Ctr, Spinal Cord Injury Qual Enhancement Res Initiat, Hines, IL USA. VA Puget Sound Hlth Care Syst, SCI QUERI Dept Vet Affairs, Seattle, WA USA. Seattle Spinal Cord Injury & Disorders Strateg He, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Weaver, FM (reprint author), Hines VA Hosp, Midwest Ctr Hlth Serv & Policy Res 151H, Hines, IL 60141 USA. EM frances.weaver@va.gov NR 42 TC 18 Z9 18 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2007 VL 30 IS 1 BP 10 EP 19 PG 10 WC Clinical Neurology SC Neurosciences & Neurology GA 145ZL UT WOS:000244904200004 PM 17387805 ER PT J AU Evans, CT LaVela, SL Smith, B Wallace, C Goldstein, B Weaver, FM AF Evans, Charlesnika T. LaVela, Sherri L. Smith, Bridget Wallace, Carolyn Goldstein, Barry Weaver, Frances M. TI Response to the 2004-2005 influenza vaccine shortage in veterans with spinal cord injuries and disorders and their providers SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE influenza; vaccination; health care workers; spinal cord injuries; prevention ID ATTITUDES AB Background/Objectives: To assess patient and provider behaviors regarding influenza vaccination, diagnosis, and testing strategies and the availability of influenza vaccine during the 2004-2005 nationwide influenza vaccine shortage. Design/Methods: Multisite, anonymous, cross-sectional surveys of patients and providers and qualitative interviews after the 2004-2005 influenza season. Setting: Department of Veterans Affairs (VA) health care facilities with spinal cord injury centers or clinics. Participants: Stratified random sample of 3,958 veterans with spinal cord injuries and disorders (SCI & D; 31% response rate), 177 providers who treat persons with SCI&D, and 17 key informants. Results: Most patient respondents (96.1%) reported awareness of a vaccine shortage (n = 938). When asked whether the shortage affected their ability to get the vaccine, 64.8% said they had no problem, whereas 12.1% reported an inability to get the vaccine. The vaccination rate was 71.8%; most veterans received the vaccine early (October-November) at the VA, and vaccination rates increased with age (P < 0.0001). Although vaccine shortages were reported by 47.5% of provider survey respondents (n = 177), most reported that the vaccine shortage did not affect availability of vaccine for patients with SCI&D. Few clinicians conducted diagnostic tests for influenza more often than in past years (4.9%). Although providers reported shortages at 12 centers (n = 23), patients with SCI&D had priority at 11 of 12 centers. Conclusions: Most patients were aware of the vaccine shortage, and the vaccination rate remained high and comparable with previous years. VA providers and facilities targeted SCI&D as a high-risk group and prioritized use of the limited vaccine supply for them. C1 Vet Affairs Edward Hines Jr Hosp, Dept Vet Affairs, Spinal Cord Injury Qual Enhancement Res Initiat, Midwest Ctr Hlth Serv & Policy Res, Hines, IL 60141 USA. Vet Affairs Puget Sound Healthcare Syst, Spinal Cord Injury Qual Enhancement Res Initiat, Dept Vet Affairs, Spinal Cord Injury & Disorders Strateg Healthcare, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Northwestern Univ, Inst Hlth Serv & Policy Res, Chicago, IL 60611 USA. RP Evans, CT (reprint author), Edward J Hines Jr VA Hosp 151H, 5th Ave & Roosevelt Rd,POB 5000,Room D302, Hines, IL 60141 USA. EM charlesnika.evansc@va.gov NR 19 TC 2 Z9 2 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2007 VL 30 IS 1 BP 20 EP 26 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 145ZL UT WOS:000244904200005 PM 17387806 ER PT J AU Korsten, MA Singal, AK Monga, A Chaparala, G Khan, AM Palmon, R Mendoza, JRD Lirio, JP Rosman, AS Spungen, A Bauman, WA AF Korsten, Mark A. Singal, Ashwani K. Monga, Amit Chaparala, Geeta Khan, Amir M. Palmon, Ron Mendoza, John Reagan D. Lirio, Juan P. Rosman, Alan S. Spungen, Ann Bauman, William A. TI Anorectal stimulation causes increased colonic motor activity in subjects with spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE digital rectal stimulation; spinal cord injury; neurogenic bowel; colonic motility; anorectal colonic reflex; paraplegia; tetraplegia ID NEUROGENIC BOWEL; DYSFUNCTION; MANAGEMENT; MOTILITY; CARE AB Background: Difficulty with evacuation (DWE) is a major problem after spinal cord injury (SCI). Stimulation of the anal canal and lower rectum, accomplished using a gloved finger (so-called digital rectal stimulation or DRS) is often used as an adjunct to laxatives and enemas to facilitate bowel evacuation. However, the basis for the efficacy of DRS is not known. This study assessed the effect of DRS on colonic motility. Methods: Six subjects with SCI were studied several hours after a bowel care session. Colonic motility was assessed using a manometric catheter (affixed endoscopically to the splenic flexure) at baseline, during DRS, and after DRS. In addition, evacuation of barium oatmeal paste (with the consistency of stool and introduced into the rectum and descending colon) was assessed simultaneously using fluoroscopic techniques. Results: The mean number (+/- SEM) of peristaltic waves per minute increased from 0 at baseline to 1.9 (+/-0.5/min) during DRS and 1.5 (+/-0.3/min) during the period immediately after cessation of DRS (P < 0.05). The mean amplitude (+/-SEM) of the peristaltic contractions was 43.4 (+/-2.2) mmHg. The frequency of contractions, as well as amplitude of contractions, during or immediately after DRS was not significantly different. These manometric changes in response to DRS were accompanied by expulsion of barium oatmeal paste in every subject by the fifth DRS. Conclusions: DRS causes left-sided colonic activity in subjects with SCI. At least in part, an anorectal colonic reflex that results in enhanced contractions of the descending colon and rectum may contribute to bowel evacuation in individuals with SCI. C1 James J Peters Vet Affairs Med Ctr, Ctr Excellence Med Consequences Spinal Cord Injur, Rehabil Res & Dev Serv, Dept Vet Affairs, Bronx, NY USA. Mt Sinai Sch Med, New York, NY USA. RP Korsten, MA (reprint author), VAMC, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM mark.korsten@med.va.gov NR 17 TC 9 Z9 13 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 2007 VL 30 IS 1 BP 31 EP 35 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 145ZL UT WOS:000244904200007 PM 17385267 ER PT J AU Cardozo, CP AF Cardozo, Christopher P. TI Respiratory complications of spinal cord injury SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Editorial Material C1 James J Peters VA Med Ctr, Spinal Cord Damage Res Ctr, Bronx, NY 10468 USA. RP Cardozo, CP (reprint author), James J Peters VA Med Ctr, Spinal Cord Damage Res Ctr, Room 1E-02,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM chris.cardozo@mssm.edu NR 5 TC 8 Z9 10 U1 2 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 2007 VL 30 IS 4 BP 307 EP 308 PG 2 WC Clinical Neurology SC Neurosciences & Neurology GA 201SQ UT WOS:000248853300002 PM 17853651 ER PT J AU Smith, BM Evans, CT Kurichi, JE Weaver, FM Patel, N Burns, SP AF Smith, Bridget M. Evans, Charlesnika T. Kurichi, Jibby E. Weaver, Frances M. Patel, Nayna Burns, Stephen P. TI Acute respiratory tract infection visits of veterans with spinal cord injuries and disorders: Rates, trends, and risk factors SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; veterans; acute respiratory tract infection; pneumonia; influenza; bronchitis; paraplegia; tetraplegia ID UNITED-STATES; HOSPITALIZATIONS; COMPLICATIONS; DEATH AB Background/Objectives: Respiratory complications are a major cause of illness and death in persons with spinal cord injuries and dysfunction (SCI&Ds). The objectives of this study were to examine rates of outpatient visits over 5 years for acute respiratory tract infections (ARIs), including pneumonia and influenza (P&I), lower respiratory tract infections (LRIs), and upper respiratory tract infections (URIs), in veterans with SCI&Ds and to determine whether individual characteristics were associated with the number of annual visits for each type of ARI. Methods: This was a longitudinal (fiscal years 1998-2002) study of ARI visits at the Veterans Health Administration (VA) in 18,693 veterans with SCI&Ds. To examine the associations between time, patient characteristics, and annual number of ARI visits, we used random effect negative binomial models. Results: Veterans with SCI&Ds had a total of 11,113 ARI visits over the 5-year period. There was a slightly decreasing trend for LRI visits over time (P < 0.01) but no significant change for other ARIs over time. There were 30 to 35 pneumonia visits and 21 to 30 acute bronchitis visits per 1,000 SCI&D veterans per year. Older veterans were more likely than younger to have P&I visits and less likely to have URI visits (P < 0.01). Veterans with paraplegia had fewer P&I visits than subjects with tetraplegia (IRR = 0.58; CI = 0.51-0.67). Conclusions: Visit rates for ARIs are stable for veterans with SCI&Ds. Identifying risk factors associated with ARI visits is an important first step to improve prevention and treatment of ARIs and to improve the health of veterans with SCI&Ds. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, SCI QUERI, Hines, IL 60141 USA. Northwestern Univ, Inst Healthcare Studies, Chicago, IL 60611 USA. Univ Penn, Philadelphia, PA 19104 USA. Northwestern Univ, Dept Neurol, Chicago, IL 60611 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. RP Smith, BM (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, SCI QUERI, 151-H,POB 5000, Hines, IL 60141 USA. EM Bridget.Smith@va.gov NR 18 TC 15 Z9 15 U1 0 U2 1 PU AMER PARAPLEGIA SOC PI JACKSON HWIGHTS PA 75-20 ASTORIA BLVD, JACKSON HWIGHTS, NY 11370-1177 USA SN 1079-0268 J9 J SPINAL CORD MED JI J. Spinal Cord. Med. PY 2007 VL 30 IS 4 BP 355 EP 361 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 201SQ UT WOS:000248853300008 PM 17853657 ER EF