FN Thomson Reuters Web of Science™ VR 1.0 PT B AU Naeim, F Rao, PN Grody, WW AF Naeim, Faramarz Rao, P. Nagesh Grody, Wayne W. BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Lymphoid Malignancies of Non-precursor Cells: General Considerations SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID NON-HODGKIN-LYMPHOMA; MOLECULAR PATHOGENESIS; HELICOBACTER-PYLORI; EPIDEMIOLOGY; P53; CLASSIFICATION; CYTOGENETICS; INFECTION; PATHWAYS; BIOLOGY C1 [Naeim, Faramarz; Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. [Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Clin & Mol Cytogenet Labs, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 42 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 287 EP 296 DI 10.1016/B978-0-12-370607-2.00014-4 PG 10 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800015 ER PT J AU Naeim, F Rao, PN Grody, WW AF Naeim, Faramarz Rao, P. Nagesh Grody, Wayne W. BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Mature B-Cell Neoplasms SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID CHRONIC LYMPHOCYTIC-LEUKEMIA; MARGINAL-ZONE LYMPHOMA; MINIMAL RESIDUAL DISEASE; PRIMARY EFFUSION LYMPHOMA; POLYMERASE-CHAIN-REACTION; IN-SITU HYBRIDIZATION; C VIRUS-INFECTION; LYMPHOPLASMACYTIC LYMPHOMA/WALDENSTROM MACROGLOBULINEMIA; CHRONIC LYMPHOPROLIFERATIVE DISORDERS; IMMUNOGLOBULIN GENE REARRANGEMENTS C1 [Naeim, Faramarz; Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. [Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Clin & Mol Cytogenet Labs, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 331 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 297 EP 372 DI 10.1016/B978-0-12-370607-2.00015-6 PG 76 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800016 ER PT J AU Naeim, F Rao, PN Grody, WW AF Naeim, Faramarz Rao, P. Nagesh Grody, Wayne W. BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Plasma Cell Myeloma and Related Disorders SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID FAMILIAL MEDITERRANEAN FEVER; HEAVY-CHAIN DISEASE; OF-THE-LITERATURE; NONSECRETORY MULTIPLE-MYELOMA; SMALL-INTESTINAL DISEASE; IN-SITU HYBRIDIZATION; MONOCLONAL GAMMOPATHY; UNDETERMINED SIGNIFICANCE; EXTRAMEDULLARY PLASMACYTOMA; GENETIC EVENTS C1 [Naeim, Faramarz; Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. [Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Clin & Mol Cytogenet Labs, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 100 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 373 EP 396 DI 10.1016/B978-0-12-370607-2.00016-8 PG 24 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800017 ER PT J AU Naeim, F Rao, PN Song, S Grody, WW AF Naeim, Faramarz Rao, P. Nagesh Song, Sophie Grody, Wayne W. BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Mature T-Cell and NK-Cell Neoplasms SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID GRANULAR LYMPHOCYTE LEUKEMIA; NON-HODGKINS-LYMPHOMA; EPSTEIN-BARR-VIRUS; OF-THE-LITERATURE; POLYMERASE-CHAIN-REACTION; IN-SITU HYBRIDIZATION; NATURAL-KILLER NK; MYCOSIS FUNGOIDES/SEZARY-SYNDROME; HTLV ENVELOPE SEROREACTIVITY; PRIMARY CUTANEOUS LYMPHOMAS C1 [Naeim, Faramarz; Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. [Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Clin & Mol Cytogenet Labs, Los Angeles, CA 90095 USA. [Song, Sophie] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, UCLA Med Ctr, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 222 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 397 EP 440 DI 10.1016/B978-0-12-370607-2.00017-X PG 44 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800018 ER PT J AU Song, S Grody, WW Naeim, F AF Song, Sophie Grody, Wayne W. Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Hodgkin Lymphoma SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID REED-STERNBERG CELLS; EPSTEIN-BARR-VIRUS; CENTER B-CELLS; IMMUNOGLOBULIN GENE REARRANGEMENTS; CHILDHOOD SOCIAL-ENVIRONMENT; POLYMERASE-CHAIN-REACTION; EUROPEAN TASK-FORCE; NF-KAPPA-B; INFECTIOUS-MONONUCLEOSIS; DIFFERENTIAL-DIAGNOSIS C1 [Song, Sophie] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, UCLA Med Ctr, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Song, S (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, UCLA Med Ctr, Los Angeles, CA 90095 USA. NR 106 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 441 EP 454 DI 10.1016/B978-0-12-370607-2.00018-1 PG 14 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800019 ER PT J AU Naeim, F Rao, PN Grody, WW AF Naeim, Faramarz Rao, P. Nagesh Grody, Wayne W. BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Non-neoplastic and Borderline Lymphocytic Disorders SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID EPSTEIN-BARR-VIRUS; WISKOTT-ALDRICH-SYNDROME; LINKED LYMPHOPROLIFERATIVE-DISEASE; B-CELL LYMPHOCYTOSIS; SEVERE COMBINED IMMUNODEFICIENCY; BONE-MARROW-TRANSPLANTATION; UNEXPLAINED OPPORTUNISTIC INFECTIONS; CD4+ T-LYMPHOCYTOPENIA; NON-HODGKIN-LYMPHOMA; MALIGNANT-LYMPHOMA C1 [Naeim, Faramarz; Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. [Rao, P. Nagesh] Univ Calif Los Angeles, David Geffen Sch Med, Clin & Mol Cytogenet Labs, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. [Grody, Wayne W.] Univ Calif Los Angeles, David Geffen Sch Med, Mol Pathol Labs, Los Angeles, CA 90095 USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 183 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 455 EP 476 DI 10.1016/B978-0-12-370607-2.00019-3 PG 22 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800020 ER PT B AU Naeim, F AF Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Mastocytosis SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID CELL PROLIFERATIVE DISORDERS; KIT MUTATION D816V; OF-THE-ART; MAST-CELL; SYSTEMIC MASTOCYTOSIS; C-KIT; PEDIATRIC MASTOCYTOSIS; CUTANEOUS MASTOCYTOSIS; SOLITARY MASTOCYTOMA; PERIPHERAL-BLOOD C1 [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 47 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 477 EP 488 DI 10.1016/B978-0-12-370607-2.00020-X PG 12 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800021 ER PT B AU Naeim, F AF Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Histiocytic and Dendritic Cell Disorders SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID NIEMANN-PICK-DISEASE; CHEDIAK-HIGASHI-SYNDROME; FAMILIAL HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS; EPSTEIN-BARR-VIRUS; OF-THE-LITERATURE; CD4(+)/CD56(+) HEMATODERMIC NEOPLASM; LYSOSOMAL STORAGE DISORDERS; GAUCHER-DISEASE; LANGERHANS CELLS; EOSINOPHILIC GRANULOMA C1 [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 153 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 489 EP 512 DI 10.1016/B978-0-12-370607-2.00021-1 PG 24 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800022 ER PT J AU Naeim, F AF Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Granulocytic Disorders SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID TRANSIENT MYELOPROLIFERATIVE DISORDER; HEREDITARY MYELOPEROXIDASE DEFICIENCY; CHRONIC IDIOPATHIC NEUTROPENIA; CHRONIC GRANULOMATOUS-DISEASE; SEVERE CONGENITAL NEUTROPENIA; CHEDIAK-HIGASHI-SYNDROME; ACUTE MYELOID-LEUKEMIA; PELGER-HUET; BONE-MARROW; DOWN-SYNDROME C1 [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 105 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5 PY 2008 BP 513 EP 527 DI 10.1016/B978-0-12-370607-2.00022-3 PG 15 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800023 ER PT B AU Naeim, F AF Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Disorder of Red Blood Cells: Anemias SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID CONGENITAL DYSERYTHROPOIETIC ANEMIA; DIAMOND-BLACKFAN ANEMIA; AUTOIMMUNE HEMOLYTIC-ANEMIA; PYRUVATE-KINASE DEFICIENCY; PREIMPLANTATION GENETIC DIAGNOSIS; TOTAL HOMOCYSTEINE CONCENTRATIONS; INTRINSIC-FACTOR DEFICIENCY; PARVOVIRUS B19 INFECTION; LONG-TERM OBSERVATION; CHRONIC-RENAL-FAILURE C1 [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Naeim, F (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. NR 310 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5; 978-0-12-370607-2 PY 2008 BP 529 EP 565 DI 10.1016/B978-0-12-370607-2.00023-5 PG 37 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800024 ER PT B AU Howard, TE Naeim, F AF Howard, Tom E. Naeim, Faramarz BA Naeim, F Rao, PN Grody, WW BF Naeim, F Rao, PN Grody, WW TI Disorders of Megakaryocytes and Platelets SO HEMATOPATHOLOGY: MORPHOLOGY, IMMUNOPHENOTYPE, CYTOGENETICS AND MOLECULAR APPROACHES LA English DT Article; Book Chapter ID THROMBOTIC THROMBOCYTOPENIC PURPURA; HEMOLYTIC-UREMIC SYNDROME; WISKOTT-ALDRICH-SYNDROME; BERNARD-SOULIER-SYNDROME; CONGENITAL AMEGAKARYOCYTIC THROMBOCYTOPENIA; INDUCED IMMUNE THROMBOCYTOPENIA; MEMBRANE GLYCOPROTEIN-IIIA; STORAGE POOL DEFICIENCY; IX-V COMPLEX; BONE-MARROW C1 [Howard, Tom E.] VA Greater Los Angeles Healthcare Syst, Hemostasis & Pharmacogenet Labs, Los Angeles, CA USA. [Howard, Tom E.] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA. [Naeim, Faramarz] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Naeim, Faramarz] VA Greater Los Angeles Healthcare Syst, Dept Pathol & Lab Med, Los Angeles, CA USA. RP Howard, TE (reprint author), VA Greater Los Angeles Healthcare Syst, Hemostasis & Pharmacogenet Labs, Los Angeles, CA USA. NR 165 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-091948-5; 978-0-12-370607-2 PY 2008 BP 567 EP 582 DI 10.1016/B978-0-12-370607-2.00024-7 PG 16 WC Hematology; Pathology SC Hematology; Pathology GA BER05 UT WOS:000317820800025 ER PT J AU Weisbord, SD Kimmel, PL AF Weisbord, Steven D. Kimmel, Paul L. TI Health-related quality of life in the era of erythropoietin SO HEMODIALYSIS INTERNATIONAL LA English DT Review DE depression; renal transplantation; dialysis; hematocrit; hemoglobin; mortality ID STAGE RENAL-DISEASE; RECOMBINANT-HUMAN-ERYTHROPOIETIN; SICKNESS IMPACT PROFILE; CHRONIC KIDNEY-DISEASE; PATIENTS RECEIVING HEMODIALYSIS; RANDOMIZED CONTROLLED-TRIAL; EXERCISE CAPACITY; DIALYSIS PATIENTS; PSYCHOSOCIAL FACTORS; COGNITIVE FUNCTION AB Patients with end-stage renal disease treated with maintenance hemodialysis suffer substantial impairments in health-related quality of life (HRQOL). Despite widespread efforts, there are few interventions that improve the overall well-being and quality of life of this patient population. The current review provides a description of HRQOL as an essential, yet arguably overlooked health-related domain in hemodialysis patients, and discusses interventions that have been evaluated to improve the functional status and well-being of this population, with a particular focus on therapy with recombinant human erythropoietin. We review the controversy surrounding recombinant human erythropoietin as it relates to HRQOL, and describe the delicate balance faced by renal providers who seek to reduce hemodialysis patients' morbidity and mortality while simultaneously striving to improve patients' HRQOL. C1 [Kimmel, Paul L.] George Washington Univ, Med Ctr, Sch Med, Div Renal Dis & Hypertens, Washington, DC 20037 USA. [Weisbord, Steven D.] Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA USA. [Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Weisbord, Steven D.] VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. RP Kimmel, PL (reprint author), George Washington Univ, Med Ctr, Sch Med, Div Renal Dis & Hypertens, 2150 Pennsylvania Ave NW, Washington, DC 20037 USA. EM pkimmel@mfa.gwu.edu NR 62 TC 20 Z9 21 U1 1 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1492-7535 J9 HEMODIAL INT JI Hemodial. Int. PD JAN PY 2008 VL 12 IS 1 BP 6 EP 15 DI 10.1111/j.1542-4758.2008.00233.x PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 306TU UT WOS:000256271500002 PM 18271834 ER PT J AU Carr, D Newton, K Utzschneider, K Faulenbach, M Kahn, S Easterling, T Heckbert, S AF Carr, Darcy Newton, Katherine Utzschneider, Kristina Faulenbach, Mirjam Kahn, Steven Easterling, Thomas Heckbert, Susan TI Gestational Diabetes or Lesser Degrees of Glucose Intolerance and Risk of Preeclampsia. SO HYPERTENSION IN PREGNANCY LA English DT Meeting Abstract C1 [Heckbert, Susan] Univ Washington, Grp Hlth Ctr Hlth Studies, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA. [Utzschneider, Kristina; Faulenbach, Mirjam; Kahn, Steven] Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1064-1955 J9 HYPERTENS PREGNANCY JI Hypertens. Pregnancy PY 2008 VL 27 IS 4 BP 639 EP 639 PG 1 WC Obstetrics & Gynecology; Physiology; Peripheral Vascular Disease SC Obstetrics & Gynecology; Physiology; Cardiovascular System & Cardiology GA 371MC UT WOS:000260834400292 ER PT J AU Zinn, KR Chaudhuri, TR Szafran, AA O'Quinn, D Weaver, C Dugger, K Lamar, D Kesterson, RA Wang, XD Frank, SJ AF Zinn, Kurt R. Chaudhuri, Tandra R. Szafran, April Adams O'Quinn, Darrell Weaver, Casey Dugger, Kari Lamar, Dale Kesterson, Robert A. Wang, Xiangdong Frank, Stuart J. TI Noninvasive bioluminescence imaging in small animals SO ILAR JOURNAL LA English DT Article DE bioluminescence; imaging; luciferase; transgenic mice ID TRANSGENIC MOUSE MODEL; SIMPLEX-VIRUS TYPE-1; PATHOGEN CITROBACTER-RODENTIUM; PROTEIN-PROTEIN INTERACTIONS; REPORTER GENE-EXPRESSION; IN-VIVO; LIVING ANIMALS; THYMIDINE KINASE; MICE; ADENOVIRUS AB There has been a rapid growth of bioluminescence imaging applications in small animal models in recent years, propelled by the availability of instruments, analysis software, reagents, and creative approaches to apply the technology in molecular imaging. Advantages include the sensitivity of the technique as well as its efficiency, relatively low cost, and versatility. Bioluminescence imaging is accomplished by sensitive detection of light emitted following chemical reaction of the luciferase enzyme with its substrate. Most imaging systems provide 2-dimensional (2D) information in rodents, showing the locations and intensity of light emitted from the animal in pseudo-color scaling. A 3-dimensional (3D) capability for bioluminescence imaging is now available, but is more expensive and less efficient; other disadvantages include the requirement for genetically encoded luciferase, the injection of the substrate to enable light emission, and the dependence of light signal on tissue depth. All of these problems make it unlikely that the method will be extended to human studies. However, in small animal models, bioluminescence imaging is now routinely applied to serially detect the location and burden of xenografted tumors, or identify and measure the number of immune or stem cells after an adoptive transfer. Bioluminescence imaging also makes it possible to track the relative amounts and locations of bacteria, viruses, and other pathogens over time. Specialized applications of bioluminescence also follow tissue-specific luciferase expression in transgenic mice, and monitor biological processes such as signaling or protein interactions in real time. In summary, bioluminescence imaging has become an important component of biomedical research that will continue in the future. C1 [Zinn, Kurt R.] Univ Alabama Birmingham, Lab Multimodal Imaging, Birmingham, AL 35294 USA. [Chaudhuri, Tandra R.] UAB, Dept Radiol, Birmingham, AL USA. [Szafran, April Adams; Weaver, Casey; Dugger, Kari] UAB, Dept Pathol, Birmingham, AL USA. [Lamar, Dale; Kesterson, Robert A.] UAB, Dept Genet, Birmingham, AL USA. [Wang, Xiangdong] UAB, Dept Med, Birmingham, AL USA. [Frank, Stuart J.] Birmingham VA Med Ctr, Med Serv, Endocrinol Sect, Birmingham, AL USA. RP Zinn, KR (reprint author), Univ Alabama Birmingham, Lab Multimodal Imaging, 1530 3rd Ave S,BDB 802, Birmingham, AL 35294 USA. EM kurtzinn@uab.edu OI Weaver, Casey/0000-0002-2180-1793; Zinn, Kurt/0000-0001-7463-4741 FU NCI NIH HHS [P30 CA013148-37, 5P30CA013148-36, P30 CA013148, P30 CA013148-35, P30 CA013148-35S1, P30 CA013148-35S2, P30 CA013148-36, P30 CA013148-36S1, P30 CA013148-37S1, P30 CA013148-37S2, P30 CA13148]; NIAMS NIH HHS [P30 AR048311, P30 AR48311]; NIDDK NIH HHS [DK58259, R01 DK058259, R01 DK058259-01A1, R01 DK058259-02, R01 DK058259-03, R01 DK058259-04, R01 DK058259-04S1, R01 DK058259-05A1, R01 DK058259-06, R01 DK058259-07, R56 DK058259] NR 49 TC 67 Z9 68 U1 1 U2 11 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1084-2020 EI 1930-6180 J9 ILAR J JI ILAR J. PY 2008 VL 49 IS 1 BP 103 EP 115 PG 13 WC Veterinary Sciences SC Veterinary Sciences GA 311UI UT WOS:000256625500010 PM 18172337 ER PT J AU Houston, TK Ford, DE AF Houston, Tom K. Ford, Daniel E. TI A tailored Internet-delivered intervention for smoking cessation designed to encourage social support and treatment seeking: usability testing and user tracing SO INFORMATICS FOR HEALTH & SOCIAL CARE LA English DT Article DE Internet; smoking cessation; physician-patient relations; social support ID PROGRAM; WEB; EDUCATION; QUIT; INFORMATION; SMOKERS; SYSTEM; TRIAL; TOOL AB While Internet technologies show promise for changing behavior, new methods for engaging individuals are needed to maximize effectiveness. The aim of this study is to design and evaluate an Internet-delivered intervention for smoking cessation that encouraged seeking support from family and treatment from doctors. To evaluate different introductions to the Internet site. We conducted usability testing and analyzed server logs to trace user participation in the website. Two groups of users (current smokers) were recruited using Google advertisements. In Phase 1, 58% (75/ 126) of users accessed the selfmanagement strategies, but few users accessed the social support (28%) and treatment-seeking modules (33%). Then, a brief motivational introduction was added, stating the proven effectiveness of content in the unused modules, low use of these modules, and recommendations by two doctors to use all modules. Compared with Phase 1, in Phase 2 the mean time spent on the website per session increased (8 to 18 min, p 0.01) and use of the social support (50%) and treatment seeking modules (56%) increased (both p<0.01). At 1-month follow-up, reports of talking to family about smoking cessation also increased from 84% to 100% (p = 0.038). Changing the rationale and context of Web-based health information using a motivational introduction can change user behavior. C1 [Houston, Tom K.] Univ Alabama, Div Gen Internal Med, Birmingham, AL 35294 USA. [Houston, Tom K.] Birmingham VA Med Ctr, A HSR&D REAP, Deep S Ctr Effectiveness Res, Birmingham, AL USA. [Houston, Tom K.] Univ Alabama, Ctr Outcomes & Effectiveness Res, Birmingham, AL 35294 USA. [Ford, Daniel E.] Johns Hopkins Sch Med, Div Gen Internal Med, Baltimore, MD USA. [Ford, Daniel E.] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA. RP Houston, TK (reprint author), Univ Alabama, Div Gen Internal Med, 1530 3rd Ave S,FOT 720, Birmingham, AL 35294 USA. EM thouston@uab.edu RI Houston, Thomas/F-2469-2013 FU National Cancer Institute [1R21CA089011-01A1] FX The authors would like to acknowledge the efforts of Heather Coley, MPH in the editing of this manuscript. This work was supported by funding from the National Cancer Institute (1R21CA089011-01A1). NR 40 TC 25 Z9 25 U1 0 U2 11 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1753-8157 J9 INFORM HEALTH SOC CA JI Inform. Health Soc. Care PY 2008 VL 33 IS 1 BP 5 EP 19 DI 10.1080/14639230701842240 PG 15 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 352LN UT WOS:000259498800002 PM 18604759 ER PT B AU Draznin, B AF Draznin, Boris BE Zeitler, PS Nadeau, KJ TI Molecular Mechanisms of Insulin Resistance SO INSULIN RESISTANCE: CHILDHOOD PRECURSORS AND ADULT DISEASE SE Contemporary Endocrinology Series LA English DT Article; Book Chapter DE insulin resistance; insulin action; IRS-1; PI3-kinase ID P85 REGULATORY SUBUNIT; NECROSIS-FACTOR-ALPHA; PROTEIN-KINASE B; P70 S6 KINASE; PHOSPHOINOSITIDE 3-KINASE; SKELETAL-MUSCLE; PHOSPHATIDYLINOSITOL 3-KINASE; RECEPTOR SUBSTRATE-1; MAMMALIAN TARGET; SIGNALING PATHWAYS C1 [Draznin, Boris] Denver VA Med Ctr, Res Serv, Denver, CO USA. [Draznin, Boris] Univ Colorado Denver, Dept Med, Aurora, CO USA. RP Draznin, B (reprint author), Denver VA Med Ctr, Res Serv, Denver, CO USA. NR 120 TC 0 Z9 0 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DR, STE 208, TOTOWA, NJ 07512-1165 USA BN 978-1-58829-875-1 J9 CONTEMP ENDOCRINOL S PY 2008 BP 95 EP 108 PG 14 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BJR35 UT WOS:000267023100006 ER PT J AU Yamaoka, Y Kato, M Asaka, M AF Yamaoka, Yoshio Kato, Mototsugu Asaka, Masahiro TI Geographic Differences in Gastric Cancer Incidence Can be Explained by Differences between Helicobacter pylori Strains SO INTERNAL MEDICINE LA English DT Review DE Helicobacter pylori; genotypes; gastric cancer; cagA; vacA ID CAG PATHOGENICITY ISLAND; ANTIGEN-BINDING ADHESIN; OUTER-MEMBRANE PROTEINS; VACUOLATING CYTOTOXIN; EPITHELIAL-CELLS; VIRULENCE FACTORS; TYROSINE PHOSPHORYLATION; MOLECULAR EPIDEMIOLOGY; GASTRODUODENAL DISEASE; PROMOTER ACTIVATION AB Certain populations with high incidences of Helicobacter pylori infection, such as those in East Asian countries, have high incidences of gastric cancer, while other highly infected populations, such as those in Africa and South Asia, do not. The various rates of gastric cancer associated with different geographic areas can be explained, at least in part, by the differences in the genotypes of H. pylori cagA and vacA. Populations expressing a high incidence of gastric cancer are mostly identical with regions where East Asian type CagA is predominant. In contrast, incidence of gastric cancer is low in Africa, South Asia, and Europe, where strains typically possess Western type CagA. Within East Asia, strains from northern parts, where the incidence of gastric cancer is high, predominantly possess the vacA m1 genotype, whereas the m2 genotype is predominant in southern parts where the gastric cancer incidence is low. C1 [Yamaoka, Yoshio] Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX USA. [Yamaoka, Yoshio] Baylor Coll Med, Houston, TX 77030 USA. [Kato, Mototsugu] Hokkaido Univ Hosp, Div Endoscopy, Sapporo, Hokkaido 060, Japan. [Asaka, Masahiro] Hokkaido Univ, Grad Sch Med, Dept Gastroenterol, Sapporo, Hokkaido, Japan. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX USA. EM yyamaoka@bcm.tme.edu RI Asaka, Masahiro/A-5948-2012; Kato, Mototsugu/A-6736-2012 FU National Institutes of Health [DK62813] FX This work was supported in part by grants from the National Institutes of Health DK62813. NR 77 TC 112 Z9 128 U1 1 U2 4 PU JAPAN SOC INTERNAL MEDICINE PI TOKYO PA 34-3 3-CHOME HONGO BUNKYO-KU, TOKYO, 113, JAPAN SN 0918-2918 J9 INTERNAL MED JI Intern. Med. PY 2008 VL 47 IS 12 BP 1077 EP 1083 DI 10.2169/internalmedicine.47.0975 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 349RA UT WOS:000259297800001 PM 18552463 ER PT J AU Willey, CD Palanisamy, AP Johnston, RK Mani, SK Shiraishi, H Tuxworth, WJ Zile, MR Balasubramanian, S Kuppuswamy, D AF Willey, Christopher D. Palanisamy, Arun P. Johnston, Rebecca K. Mani, Santhosh K. Shiraishi, Hirokazu Tuxworth, William J. Zile, Michael R. Balasubramanian, Sundaravadivel Kuppuswamy, Dhandapani TI STAT3 activation in pressure-overloaded feline myocardium: Role for integrins and the tyrosine kinase BMX SO INTERNATIONAL JOURNAL OF BIOLOGICAL SCIENCES LA English DT Article DE STAT3; BMX; integrin; pressure-overload; cardiac hypertrophy ID FOCAL COMPLEX-FORMATION; CARDIAC-HYPERTROPHY; SIGNAL TRANSDUCER; C-SRC; CONSTITUTIVE ACTIVATION; BIOMECHANICAL STRESS; GENE-EXPRESSION; CARCINOMA-CELLS; HEART-FAILURE; TEC FAMILY AB Growth, survival and cytoskeletal rearrangement of cardiomyocytes are critical for cardiac hypertrophy. Signal transducer and activator of transcription-3 (STAT3) activation is an important cardioprotective factor associated with cardiac hypertrophy. Although STAT3 activation has been reported via signaling through Janus Kinase 2 (JAK2) in several cardiac models of hypertrophy, the importance of other nonreceptor tyrosine kinases (NTKs) has not been explored. Utilizing an in vivo feline right ventricular pressure-overload (RVPO) model of hypertrophy, we demonstrate that in 48 h pressure-overload (PO) myocardium, STAT3 becomes phosphorylated and redistributed to detergent-insoluble fractions with no accompanying JAK2 activation. PO also caused increased levels of phosphorylated STAT3 in both cytoplasmic and nuclear fractions. To investigate the role of other NTKs, we used our established in vitro cell culture model of hypertrophy where adult feline cardiomyocytes are embedded three-dimensionally (3D) in type-I collagen and stimulated with an integrin binding peptide containing an Arg-Gly-Asp (RGD) motif that we have previously shown to recapitulate the focal adhesion complex (FAC) formation of 48 h RVPO. RGD stimulation of adult cardiomyocytes in vitro caused both STAT3 redistribution and activation that were accompanied by the activation and redistribution of c-Src and the TEC family kinase, BMX, but not JAK2. However, infection with dominant negative c-Src adenovirus was unable to block RGD-stimulated changes on either STAT3 or BMX. Further analysis in vivo in 48 h PO myocardium showed the presence of both STAT3 and BMX in the detergent-insoluble fraction with their complex formation and phosphorylation. Therefore, these studies indicate a novel mechanism of BMX-mediated STAT3 activation within a PO model of cardiac hypertrophy that might contribute to cardiomyocyte growth and survival. C1 [Willey, Christopher D.; Palanisamy, Arun P.; Johnston, Rebecca K.; Mani, Santhosh K.; Shiraishi, Hirokazu; Tuxworth, William J.; Zile, Michael R.; Balasubramanian, Sundaravadivel; Kuppuswamy, Dhandapani] Med Univ S Carolina, Gazes Cardiac Res Inst, Div Cardiol, Dept Med, Charleston, SC 29425 USA. [Zile, Michael R.; Kuppuswamy, Dhandapani] Vet Affairs Med Ctr, Ralph H Johnson Dept, Charleston, SC 29425 USA. RP Kuppuswamy, D (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, Div Cardiol, Dept Med, 114 Doughty St, Charleston, SC 29425 USA. EM kuppusd@musc.edu RI Palanisamy, Arun/L-2019-2014 OI Palanisamy, Arun/0000-0002-7793-0682; Willey, Christopher/0000-0001-9953-0279 FU NHLBI NIH HHS [P01 HL048788, PPG HL-48788]; NIGMS NIH HHS [GM08716, T32 GM008716] NR 43 TC 17 Z9 18 U1 0 U2 2 PU IVYSPRING INT PUBL PI LAKE HAVEN PA PO BOX 4546, LAKE HAVEN, NSW 2263, AUSTRALIA SN 1449-2288 J9 INT J BIOL SCI JI Int. J. Biol. Sci. PY 2008 VL 4 IS 3 BP 184 EP 199 PG 16 WC Biochemistry & Molecular Biology; Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics GA 331TF UT WOS:000258034800008 PM 18612371 ER PT J AU Kilzieh, N Rastam, S Maziak, W Ward, KD AF Kilzieh, Nael Rastam, Samar Maziak, Wasim Ward, Kenneth D. TI Comorbidity of depression with chronic diseases: A population-based study in Aleppo, Syria SO INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE LA English DT Article DE depression; chronic disease; comorbidity; epidemiologic studies; Arab world ID QUALITY-OF-LIFE; MAJOR DEPRESSION; GENERAL-POPULATION; PSYCHIATRIC MORBIDITY; RHEUMATOID-ARTHRITIS; MENTAL-DISORDERS; RISK-FACTOR; SYMPTOMS; HEALTH; PREVALENCE AB Objective: To assess the comorbidity and correlates of depression in chronic diseases in the community in Aleppo, Syria. This has never been previously investigated in an Arab country. Method: We conducted a cross-sectional, population-based study in Aleppo on adults aged 18-65 (N = 2038). We collected data utilizing a structured inter-view questionnaire. Socio-demographics, general health information, and self-report of physician-diagnosed depression and chronic diseases active in the past year were obtained. We used logistic regression to estimate the odds of depression in chronic diseases and socio-demographic correlates of depression comorbid with chronic diseases. Results: Mean age (SD) was 35.3 (12.1) years, 55% were female. In women, predictors of depression were heart disease (OR = 3.95, 95% CI: 1.50-10.40), hypertension (OR = 2.92, 95% CI: 1.53-5.55), and kidney disease (OR = 2.96, 95% Cl: 1.64-5.32). Depression comorbidity with any chronic disease decreased in higher socio-economic status (middle vs. low: OR = 0.28, 95% CI: 0.12-0.65; high vs. low: OR = 0.20, 95% CI: 0.05-0.81). In men, predictors of depression were rheumatism (OR = 7.10, 95% CI: 2.58-19.60) and respiratory disease (OR = 3.77, 95% CI: 1.23-11.60). Depression comorbidity decreased in residence in formal zones (OR = 0.22, 95% CI: 0.06-0.80). Conclusion: Depression is associated with many chronic diseases in the community in Aleppo, a finding consistent with reports from other cultures., Potential gender-related risk factors were identified. Findings inform public mental health planning and support the delivery of depression treatment in primary care settings. C1 [Kilzieh, Nael] VA Puget Sound Hlth Care Syst, Amer Lake Div, Tacoma, WA 98493 USA. [Kilzieh, Nael] Univ Washington, Seattle, WA 98195 USA. [Rastam, Samar; Maziak, Wasim] Syrian Ctr Tobacco Studies, Aleppo, Syria. [Maziak, Wasim; Ward, Kenneth D.] Univ Memphis, Memphis, TN 38152 USA. RP Kilzieh, N (reprint author), VA Puget Sound Hlth Care Syst, Amer Lake Div, A-116, Tacoma, WA 98493 USA. EM nael.kilzieh@va.gov OI Rastam, Samer/0000-0002-4004-7773 FU FIC NIH HHS [R01 TW005962, R01 TW05962, R21 TW006545]; NIDA NIH HHS [R01 DA024876, R01 DA024876-01] NR 51 TC 14 Z9 15 U1 5 U2 9 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 2008 VL 38 IS 2 BP 169 EP 184 DI 10.2190/PM.38.2.d PG 16 WC Psychiatry SC Psychiatry GA 336EZ UT WOS:000258348400004 PM 18724568 ER PT J AU Pfefferbaum, RL Reissman, DB Pfefferbaum, B Wyche, KF Norris, FH Klomp, RW AF Pfefferbaum, Rose L. Reissman, Dori B. Pfefferbaum, Betty Wyche, Karen Fraser Norris, Fran H. Klomp, Richard W. BE Blumenfield, M Ursano, RJ TI Factors in the development of community resilience to disasters SO INTERVENTION AND RESILIENCE AFTER MASS TRAUMA LA English DT Article; Book Chapter ID CAPACITY C1 [Pfefferbaum, Rose L.] Phoenix Coll, Liberal Arts Dept, Phoenix, AZ USA. [Reissman, Dori B.] Ctr Dis Control & Prevent, CAPT, US Publ Hlth Serv, US Dept Hlth & Human Serv, Atlanta, GA USA. [Pfefferbaum, Betty; Wyche, Karen Fraser] Univ Oklahoma, Hlth Sci Ctr, Coll Med, Dept Psychiat & Behav Sci, Oklahoma City, OK 73190 USA. [Norris, Fran H.] US Dept Vet Affairs, Dept Psychiat, Dartmouth Med Sch, White River Jct, VT USA. [Norris, Fran H.] US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, White River Jct, VT USA. [Klomp, Richard W.] Ctr Dis Control & Prevent, Off Hlth & Safety, Off Chief Operating Officer, US Dept Hlth & Human Serv, Atlanta, GA USA. RP Pfefferbaum, RL (reprint author), Phoenix Coll, Liberal Arts Dept, Phoenix, AZ USA. NR 31 TC 6 Z9 6 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI CAMBRIDGE PA THE PITT BUILDING, TRUMPINGTON ST, CAMBRIDGE CB2 1RP, CAMBS, ENGLAND BN 978-0-521-88374-0 PY 2008 BP 49 EP 68 DI 10.1017/CBO9780511585975.004 D2 10.1017/CBO9780511585975 PG 20 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA BDP17 UT WOS:000314290100004 ER PT B AU Watson, PJ AF Watson, Patricia J. BE Blumenfield, M Ursano, RJ TI Psychological first aid SO INTERVENTION AND RESILIENCE AFTER MASS TRAUMA LA English DT Article; Book Chapter ID POSTTRAUMATIC-STRESS-DISORDER; COGNITIVE-BEHAVIOR THERAPY; COPING SELF-EFFICACY; SEPTEMBER-11 TERRORIST ATTACKS; RANDOMIZED CONTROLLED-TRIAL; NEW-YORK-CITY; REPRESENTATIVE SAMPLE; EARLY INTERVENTION; FUTURE-DIRECTIONS; TRAUMATIC EVENTS C1 US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, White River Jct, VT USA. RP Watson, PJ (reprint author), US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, White River Jct, VT USA. NR 70 TC 0 Z9 0 U1 2 U2 2 PU CAMBRIDGE UNIV PRESS PI CAMBRIDGE PA THE PITT BUILDING, TRUMPINGTON ST, CAMBRIDGE CB2 1RP, CAMBS, ENGLAND BN 978-0-521-88374-0 PY 2008 BP 69 EP 84 DI 10.1017/CBO9780511585975.005 D2 10.1017/CBO9780511585975 PG 16 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA BDP17 UT WOS:000314290100005 ER PT J AU Friedman, MJ AF Friedman, Matthew J. BE Blumenfield, M Ursano, RJ TI The role of pharmacotherapy in early interventions SO INTERVENTION AND RESILIENCE AFTER MASS TRAUMA LA English DT Article; Book Chapter ID POSTTRAUMATIC-STRESS-DISORDER; WORKING-MEMORY PERFORMANCE; FEAR-POTENTIATED STARTLE; MEDIAL PREFRONTAL CORTEX; COMBAT-RELATED PTSD; HIPPOCAMPAL VOLUME; ADULT SURVIVORS; NMDA RECEPTORS; NEUROPEPTIDE-Y; DENTATE GYRUS C1 US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, White River Jct, VT USA. RP Friedman, MJ (reprint author), US Dept Vet Affairs, Natl Ctr Posttraumat Stress Disorder, White River Jct, VT USA. NR 84 TC 5 Z9 5 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI CAMBRIDGE PA THE PITT BUILDING, TRUMPINGTON ST, CAMBRIDGE CB2 1RP, CAMBS, ENGLAND BN 978-0-521-88374-0 PY 2008 BP 107 EP 125 DI 10.1017/CBO9780511585975.007 D2 10.1017/CBO9780511585975 PG 19 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA BDP17 UT WOS:000314290100007 ER PT J AU Vuletic, S Li, G Peskind, ER Kennedy, H Marcovina, SM Leverenz, JB Petrie, EC Lee, VMY Galasko, D Schellenberg, GD Albers, JJ AF Vuletic, Simona Li, Ge Peskind, Elaine R. Kennedy, Hal Marcovina, Santica M. Leverenz, James B. Petrie, Eric C. Lee, Virginia M-Y. Galasko, Douglas Schellenberg, Gerard D. Albers, John J. TI Apolipoprotein E Highly Correlates with A beta PP- and Tau-Related Markers in Human Cerebrospinal Fluid SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article DE Amyloid-beta; amyloid-beta protein precursor protein; apolipoprotein E; cerebrospinal fluid; phospholipid transfer protein; tau ID PHOSPHOLIPID TRANSFER PROTEIN; CHOLESTEROL TRANSPORT PROTEIN; AMYLOID PRECURSOR PROTEIN; TRANSGENIC MOUSE MODEL; ALZHEIMERS-DISEASE; IN-VITRO; SYNAPTIC PROTEINS; EPSILON-4 ALLELE; FIBRIL FORMATION; LIPOPROTEINS AB We assessed cerebrospinal fluid (CSF) levels of apolipoprotein E (apoE), phospholipid transfer protein (PLTP) activity, cholesterol, secreted amyloid-beta protein precursor alpha and beta (sA beta PP alpha, sA beta PP beta), amyloid-beta peptides 1-40 (A beta(40)) and 1-42 (A beta(42)), total tau and tau phosphorylated at threonine 181 (pTau) in neurologically healthy, cognitively intact adults. ApoE significantly correlated with sA beta PP alpha (r = 0.679), sA beta PP beta (r = 0.634), A beta(40) (r = 0.609), total and pTau (r = 0.589 and r = 0.673, respectively, all p < 0.001), PLTP activity (r = 0.242, p = 0.002) and cholesterol (r = 0.194, p < 0.01). PLTP activity significantly correlated with sA beta PP alpha (r = 0.292), sA beta PP beta (r = 0.281), total and pTau (r = 0.265 and 0.258, respectively; all p <= 0.001). Using partial correlations of CSF biomarkers with apoE, PLTP activity, age and gender, apoE remained significantly correlated with sA beta PP alpha, sA beta PP beta, A beta(40), total and pTau (p < 0.001). The presence of apoE epsilon 2 was associated with lower levels of apoE, PLTP activity and A beta(42), while APOE epsilon 4 had no significant impact on any of the measured variables. Our data suggest that there is a significant physiological link between apoE and A beta PP, as well as between apoE and tau in neurologically healthy, cognitively intact individuals. C1 [Vuletic, Simona; Kennedy, Hal; Marcovina, Santica M.; Albers, John J.] Univ Washington, Sch Med, NW Lipid Metab & Diabet Res Labs, Seattle, WA 98109 USA. [Li, Ge; Peskind, Elaine R.; Leverenz, James B.; Petrie, Eric C.] Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98109 USA. [Leverenz, James B.] Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. [Lee, Virginia M-Y.] Univ Penn, Dept Pathol & Lab Med, Ctr Neurodegenerat Dis Res, Philadelphia, PA 19104 USA. [Galasko, Douglas] Univ Calif San Diego, Dept Neurosci, ADRC, La Jolla, CA 92093 USA. [Schellenberg, Gerard D.] GRECC, Seattle, WA USA. [Schellenberg, Gerard D.] VA Puget Sound Hlth Care Syst, Seattle Div, Seattle, WA USA. RP Albers, JJ (reprint author), Univ Washington, Sch Med, NW Lipid Metab & Diabet Res Labs, 401 Queen Anne Ave N, Seattle, WA 98109 USA. EM jja@u.washington.edu FU NIH [P01 HL030086]; NIA [P50 AG05136, K08 AG023670, K23 AG20020]; Department of Veterans Affairs FX Funding sources: NIH P01 HL030086; The Friends of Alzheimer's Research; NIA P50 AG05136; NIA K08 AG023670; NIA K23 AG20020; and the Department of Veterans Affairs. The funding sponsors were not involved in the study design and conduct, data collection, management, analyses or interpretation, nor in the preparation, review or approval of the manuscript. NR 50 TC 9 Z9 9 U1 1 U2 1 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PY 2008 VL 15 IS 3 BP 409 EP 417 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 371US UT WOS:000260857500007 PM 18997294 ER PT J AU Begum, AN Yang, FS Teng, E Hu, SX Jones, MR Rosario, ER Beech, W Hudspeth, B Ubeda, OJ Cole, GM Frautschy, SA AF Begum, Aynun N. Yang, Fusheng Teng, Edmond Hu, Shuxin Jones, Mychica R. Rosario, Emily R. Beech, Walter Hudspeth, Beverly Ubeda, Oliver J. Cole, Greg M. Frautschy, Sally A. TI Use of Copper and Insulin-Resistance to Accelerate Cognitive Deficits and Synaptic Protein Loss in a Rat A beta-Infusion Alzheimer's Disease Model SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article DE Alzheimer's disease; amyloid-beta; copper; cognitive deficit; high density lipoprotein; insulin resistance ID AMYLOID PRECURSOR PROTEIN; HIGH-DENSITY-LIPOPROTEIN; APOLIPOPROTEIN-E GENOTYPE; TRANSGENIC MICE; MEMORY DEFICITS; IN-VIVO; MOUSE MODEL; INTRACEREBROVENTRICULAR INFUSION; LEARNING-DEFICITS; OXIDATIVE STRESS AB The rat amyloid-beta (A beta) intracerebroventricular infusion can model aspects of Alzheimer's disease (AD) and has predicted efficacy of therapies such as ibuprofen and curcumin in transgenic mouse models. High density lipoprotein (HDL), a normal plasma carrier of A beta, is used to attenuate A beta aggregation within the pump, causing A beta-dependent toxicity and cognitive deficits within 3 months. Our goal was to identify factors that might accelerate onset of A beta-dependent deficits to improve efficiency and cost-effectiveness of model. We focused on: 1) optimizing HDL-A beta preparation for maximal toxicity; 2) evaluating the role of copper, a factor typically in water that can impact oligomer stability; and 3) determining impact of insulin resistance (type II diabetes), a risk factor for AD. In vitro studies were performed to determine doses of copper and methods of A beta-HDL preparation that maximized toxicity. These preparations when infused resulted in earlier onset of cognitive deficits within 6 weeks post-infusion. Induction of insulin resistance did not exacerbate A beta-dependent cognitive deficits, but did exacerbate synaptic protein loss. In summary, the newly described in vivo infusion model may be useful cost-effective method for screening for new therapeutic drugs for AD. C1 [Begum, Aynun N.; Yang, Fusheng; Hu, Shuxin; Jones, Mychica R.; Rosario, Emily R.; Beech, Walter; Hudspeth, Beverly; Ubeda, Oliver J.; Cole, Greg M.; Frautschy, Sally A.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Teng, Edmond; Cole, Greg M.; Frautschy, Sally A.] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. [Begum, Aynun N.; Yang, Fusheng; Hu, Shuxin; Jones, Mychica R.; Rosario, Emily R.; Beech, Walter; Hudspeth, Beverly; Ubeda, Oliver J.; Cole, Greg M.; Frautschy, Sally A.] GRECC, North Hills, CA USA. [Teng, Edmond] Greater Angeles Vet Affairs Healthcare Syst, Neurobehav Unit, Los Angeles, CA USA. RP Frautschy, SA (reprint author), Sepulveda Ambulatory Care Ctr, Greater Los Angeles VA Healthcare Syst, Res 151,16111 Plummer St, North Hills, CA 91343 USA. EM frautsch@ucla.edu FU NIH [RO1AG685, AG21795] FX This work was supported by NIH grants RO1AG685 and AG21795. The authors state that there are no financial conflicts of interests. NR 79 TC 11 Z9 11 U1 0 U2 4 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PY 2008 VL 15 IS 4 BP 625 EP 640 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 391CE UT WOS:000262209800009 PM 19096161 ER PT J AU Wang, W Shinto, L Connor, WE Quinn, JF AF Wang, Wei Shinto, Lynne Connor, William E. Quinn, Joseph F. TI Nutritional biomarkers in Alzheimer's disease: The association between carotenoids, n-3 fatty acids, and dementia severity SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article DE Alzheimer's disease; beta-carotene; carotenoids; dementia; docosahexaenoic acid; lutein ID MILD COGNITIVE IMPAIRMENT; NATIONAL-HEALTH; PLASMA ANTIOXIDANTS; SINGLET OXYGEN; RHESUS-MONKEYS; UNITED-STATES; CONSUMPTION; ZEAXANTHIN; LUTEIN; BRAIN AB Carotenoids are fat-soluble antioxidants that may protect polyunsaturated fatty acids, such as n-3 fatty acids from oxidation, and are potentially important for Alzheimer's disease (AD) prevention and treatment. Fasting plasma carotenoids were measured in 36 AD subjects and 10 control subjects by HPLC. Correlations between plasma carotenoid levels, red blood cell (RBC) n-3 fatty acids, and dementia severity were examined in AD patients. Moderately severe AD patients (MMSE = 16-19) had much lower plasma levels of two major carotenoids: lutein and beta-carotene, compared to mild AD patients (MMSE = 24-27) or controls. Among AD patients, variables (lutein, beta-carotene, RBC docosahexaenoic acid (DHA) and LDL-cholesterol) were significantly correlated with MMSE. A lower MMSE score was associated with lower lutein, beta-carotene and RBC DHA levels, and a higher LDL-cholesterol level. These variables explained the majority of variation in dementia severity (55% of variance in MMSE). Lutein, beta-carotene and beta-cryptoxanthin were positively correlated with RBC DHA in AD patients. The association between higher carotenoids levels and DHA and higher MMSE scores, supports a protective role of both types of nutrients in AD. These findings suggest targeting multiple specific nutrients, lutein, beta-carotene, and DHA in strategies to slow the rate of cognitive decline. C1 [Wang, Wei; Connor, William E.] Oregon Hlth & Sci Univ, Dept Med, Portland, OR 97239 USA. [Shinto, Lynne; Quinn, Joseph F.] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. [Quinn, Joseph F.] Portland VA Med Ctr, Dept Neurol, Portland, OR 97239 USA. RP Wang, W (reprint author), Oregon Hlth & Sci Univ, Dept Med, L465, Portland, OR 97239 USA. EM wangwe@ohsu.edu FU NCRR NIH HHS [5M01 RR 000334]; NIA NIH HHS [AG 08017, R21 AG 023805-01] NR 36 TC 49 Z9 51 U1 0 U2 16 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PY 2008 VL 13 IS 1 BP 31 EP 38 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 278RG UT WOS:000254303400003 PM 18334754 ER PT J AU Carlsson, CM Gleason, CE Hess, TM Moreland, KA Blazel, HM Koscik, RL Schreiber, NTN Johnson, SC Atwood, CS Puglielli, L Hermann, BP McBride, PE Stein, JH Sager, MA Asthana, S AF Carlsson, Cynthia M. Gleason, Carey E. Hess, Timothy M. Moreland, Kimberly A. Blazel, Hanna M. Koscik, Rebecca L. Schreiber, Nathan T. N. Johnson, Sterling C. Atwood, Craig S. Puglielli, Luigi Hermann, Bruce P. McBride, Patrick E. Stein, James H. Sager, Mark A. Asthana, Sanjay TI Effects of simvastatin on cerebrospinal fluid biomarkers and cognition in middle-aged adults at risk for Alzheimer's disease SO JOURNAL OF ALZHEIMERS DISEASE LA English DT Article DE Alzheimer's disease; amyloid beta-protein; biological markers; cerebrospinal fluid; genetic predisposition to disease; hydroxymethylglutaryl-CoA reductase inhibitors; neuropsychological tests; simvastatin; tau proteins ID AMYLOID PRECURSOR PROTEIN; LIPID-LOWERING AGENTS; CLINICAL-DIAGNOSIS; INCIDENT DEMENTIA; EPSILON-4 ALLELE; TAU; BETA-AMYLOID(1-42); STATINS; HEALTH; TRIAL AB Background: Statins reduce amyloid-beta (A beta) levels in the brain and cerebrospinal fluid (CSF) in animals and may thereby favorably alter the pathobiology of AD. It is unclear if statins modify A beta metabolism or improve cognition in asymptomatic middle-aged adults at increased risk for AD. Methods: In a 4-month randomized, double-blind, controlled study, we evaluated the effects of simvastatin 40 mg daily vs. placebo on CSF A beta 42 levels and cognition in 57 asymptomatic middle-aged adult children of persons with AD. Results: Compared to placebo, individuals randomized to simvastatin for 4 months had similar changes in CSF A beta 42 (p = 0.344) and total tau levels (p = 0.226), yet greater improvements in some measures of verbal fluency (p = 0.024) and working memory (p = 0.015). APOE4 genotype, gender, and vascular risk factors were associated with CSF biomarker levels, but did not modify treatment effects. Conclusion: In asymptomatic middle-aged adults at increased risk for AD, simvastatin use improved selected measures of cognitive function without significantly changing CSF A beta 42 or total tau levels. Further studies are needed to clarify the impact of higher dose and/or longer duration statin therapy on not only A beta metabolism, but also other preclinical processes related to the development of AD. C1 [Carlsson, Cynthia M.; Gleason, Carey E.; Moreland, Kimberly A.; Blazel, Hanna M.; Schreiber, Nathan T. N.; Johnson, Sterling C.; Atwood, Craig S.; Puglielli, Luigi; Sager, Mark A.; Asthana, Sanjay] Univ Wisconsin, Sch Med & Publ Hlth,Dept Med, Sect Geriatr & Gerontol,GRECC, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. [Hess, Timothy M.; Koscik, Rebecca L.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Biostat & Med Informat, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. [Hermann, Bruce P.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Neurol, Madison, WI 53705 USA. [McBride, Patrick E.; Stein, James H.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Div Cardiovasc Med, Madison, WI 53705 USA. [Carlsson, Cynthia M.; Gleason, Carey E.; Johnson, Sterling C.; Atwood, Craig S.; Puglielli, Luigi; Asthana, Sanjay] GRECC, Dept Vet Affairs, Madison, WI USA. RP Carlsson, CM (reprint author), Univ Wisconsin, Sch Med & Publ Hlth,Dept Med, Sect Geriatr & Gerontol,GRECC, William S Middleton Mem Vet Hosp, 11G,2500 Overlook Terrace, Madison, WI 53705 USA. EM cmc@medicine.wisc.edu NR 42 TC 58 Z9 64 U1 3 U2 7 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1387-2877 J9 J ALZHEIMERS DIS JI J. Alzheimers Dis. PY 2008 VL 13 IS 2 BP 187 EP 197 PG 11 WC Neurosciences SC Neurosciences & Neurology GA 278RH UT WOS:000254303500009 PM 18376061 ER PT J AU Radcliff, TA Henderson, WG Stoner, TJ Khuri, SF Dohm, M Hutt, E AF Radcliff, Tiffany A. Henderson, William G. Stoner, Tamara J. Khuri, Shukri F. Dohm, Michael Hutt, Evelyn TI Patient risk factors, operative care, and outcomes among older community-dwelling male veterans with hip fracture SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME LA English DT Article ID SURGICAL CARE; MORTALITY; MORBIDITY; FIXATION; QUALITY; ARTHROPLASTY; VALIDATION; REDUCTION; AFFAIRS; MEN AB Background: Although more than 1200 hip fracture repairs are performed in United States Department of Veterans Affairs hospitals annually, little is known about the relationship between perioperative care and short-term outcomes for veterans with hip fracture. The purpose of the present study was to test whether perioperative care impacts thirty-day outcomes, with patient characteristics being taken into account. Methods: A national sample of 5683 community-dwelling male veterans with an age of sixty-five years or older who had been hospitalized for the operative treatment of a hip fracture at one of 108 Veterans Administration hospitals between 1998 and 2003 was identified from the National Surgical Quality Improvement Program data set. Operative care characteristics were assessed in relation to thirty-day outcomes (mortality, complications, and readmission to a Veterans Administration facility for inpatient care). Results: A surgical delay of four days or more after admission was associated with a higher adjusted mortality risk (odds ratio, 1.29; 95% confidence interval, 1.02 to 1.61) but a reduced risk of readmission (odds ratio, 0.70; 95% confidence interval, 0.54 to 0.91). Compared with spinal or epidural anesthesia, general anesthesia was related to a significantly higher risk of both mortality (odds ratio, 1.27; 95% confidence interval, 1.01 to 1.55) and complications (odds ratio, 1.33; 95% confidence interval, 1.15 to 1.53). The type of procedure was not significantly associated with outcome after controlling for other variables in the model. However, a higher American Society of Anesthesiologists Physical Status Classification (ASA class) was associated with worse thirty-day outcomes. Conclusions: In addition to recognizing the importance of patient-related factors, we identified operative factors that were related to thirty-day surgical outcomes. It will be important to investigate whether modifying operative factors, such as reducing surgical delays to less than four days, can directly improve the outcomes of hip fracture repair. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence. C1 [Radcliff, Tiffany A.; Henderson, William G.; Stoner, Tamara J.; Khuri, Shukri F.; Dohm, Michael; Hutt, Evelyn] Denver VA Med Ctr, Denver, CO USA. RP Radcliff, TA (reprint author), VA Eastern Colorado Hlth Care Syst, Colorado REAP Improve Care Coordinat, 1055 Clermont St MS 151, Denver, CO 80220 USA. EM Tiffany.Radcliff@uchsc.edu NR 32 TC 82 Z9 88 U1 0 U2 3 PU JOURNAL BONE JOINT SURGERY INC PI NEEDHAM PA 20 PICKERING ST, NEEDHAM, MA 02192 USA SN 0021-9355 J9 J BONE JOINT SURG AM JI J. Bone Joint Surg.-Am. Vol. PD JAN PY 2008 VL 90A IS 1 BP 34 EP 42 DI 10.2106/JBJS.G.00065 PG 9 WC Orthopedics; Surgery SC Orthopedics; Surgery GA 250PV UT WOS:000252313400005 PM 18171955 ER PT J AU Levine, AJ Hardy, DJ Barclay, TR Reinhard, MJ Cole, MM Hinkin, CH AF Levine, Andrew J. Hardy, David J. Barclay, Terry R. Reinhard, Matthew J. Cole, Michael M. Hinkin, Charles H. TI Elements of attention in HIV-infected adults: Evaluation of an existing model SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article ID NEUROPSYCHOLOGICAL IMPAIRMENT; MEDICATION ADHERENCE; WORKING-MEMORY; PERFORMANCE; DEPRESSION; DISORDERS; NETWORKS; THERAPY AB Because of the multifactorial nature of neuropsychological tests, attention remains poorly defined from a neuropsychological perspective, and conclusions made regarding attention across studies may be limited due to the different nature of the measures used. Thus, a more definitive schema for this neurocognitive domain is needed. We assessed the applicability of Mirsky and Duncan's (2001) neuropsychological model of attention to a cohort of 104 HIV+ adults. Our analysis resulted in a five-factor structure similar to that of previous studies, which explained 74.5% of the variance. However, based on the psychometric characteristics of the measures comprising each factor, we offer an alternative interpretation of the factors. Findings also indicate that one factor, which is generally not assessed in clinical neuropsychology settings, may be more predictive of real-world behaviors (such as medication adherence) than those composed of traditional measures. Suggestions for further research in this important area are discussed. C1 [Levine, Andrew J.] Univ Calif Los Angeles, Natl Neurol AIDS Bank, Los Angeles, CA 90025 USA. [Hardy, David J.] Loyola Marymount Univ, Los Angeles, CA 90045 USA. [Hardy, David J.; Barclay, Terry R.; Reinhard, Matthew J.; Cole, Michael M.; Hinkin, Charles H.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90025 USA. [Hinkin, Charles H.] Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Levine, AJ (reprint author), Univ Calif Los Angeles, Natl Neurol AIDS Bank, 11645 Wilshire Blvd,Suite 770, Los Angeles, CA 90025 USA. EM ajlevine@mednet.ucla.edu FU NIDA NIH HHS [R01 DA013799, R01 DA013799-04, R01 DA13799]; NIMH NIH HHS [T32 MH019535]; NINDS NIH HHS [NS-38841, R24 NS038841] NR 56 TC 14 Z9 14 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. PY 2008 VL 30 IS 1 BP 53 EP 62 DI 10.1080/13803390601186684 PG 10 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 251AP UT WOS:000252343000006 PM 17852595 ER PT J AU Levine, AJ Hinkin, CH Ando, K Santangelo, G Martinez, M Valdes-Sueiras, M Saxton, EH Mathisen, G Commins, DL Moe, A Farthing, C Singer, EJ AF Levine, Andrew J. Hinkin, Charles H. Ando, Kazuhiro Santangelo, Gianni Martinez, Mariana Valdes-Sueiras, Miguel Saxton, Ernestina H. Mathisen, Glen Commins, Deborah L. Moe, Ardis Farthing, Charles Singer, Elyse J. TI An exploratory study of long-term neurocognitive outcomes following recovery from opportunistic brain infections in HIV+ adults SO JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY LA English DT Article DE opportunistic infection; AIDS; neuropsychological functioning; toxoplasmosis encephalitis; progressive multifocal leukoencephalopathy; cryptococcal meningitis ID PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY; HUMAN-IMMUNODEFICIENCY-VIRUS; PSYCHIATRIC RESEARCH INTERVIEW; CRYPTOCOCCAL MENINGITIS; CEREBRAL TOXOPLASMOSIS; ANTIRETROVIRAL THERAPY; AIDS PATIENTS; MENTAL-DISORDERS; DEMENTIA; ENCEPHALITIS AB Central nervous system opportunistic infections (CNS-OI) are a significant cause of morbidity and mortality in AIDS. While current interventions are increasingly successful in treating CNS-OI, little information exists regarding long-term behavioral outcomes among survivors. In this exploratory study we examined neurocognitive data among three groups of adults with different AIDS-related CNS-OI: 15 with past cryptococcal meningitis (CM), 8 with toxoplasmosis encephalitis (TE), and 8 with progressive multifocal leukoencephalopathy (PML). A group of 61 individuals with AIDS, but without CNS-OI, was used as a comparison group. A battery of standardized neuropsychological tests assessing a variety of cognitive domains was administered upon entry. Results indicate that individuals with a history of CNS-OI were most impaired on measures of cognitive and psychomotor speed relative to the HIV+ comparison group. Among the CNS-OI groups, individuals with history of TE had the most severe and varied deficits. The results are discussed in relation to what is known about the neuropathological consequences of the various CNS-OIs. While this is the first systematic group study of residual CNS-OI effects on neurocognitive function, future studies employing more participants, perhaps focusing on specific CNS-OIs, will further characterize the long-term outcomes in AIDS-related CNS-OI. C1 [Levine, Andrew J.; Hinkin, Charles H.; Ando, Kazuhiro; Santangelo, Gianni; Martinez, Mariana; Valdes-Sueiras, Miguel; Saxton, Ernestina H.; Mathisen, Glen; Commins, Deborah L.; Moe, Ardis; Farthing, Charles; Singer, Elyse J.] Univ Calif Los Angeles, Natl Neurol AIDS Bank, Los Angeles, CA 90025 USA. [Hinkin, Charles H.] Vet Adm Greater Angeles Healthcare Syst, Los Angeles, CA USA. [Valdes-Sueiras, Miguel; Mathisen, Glen] Olive View UCLA Med Ctr, Dept Med, Sylmar, CA 91342 USA. [Valdes-Sueiras, Miguel; Farthing, Charles] AIDS Healthcare Fdn, Los Angeles, CA USA. [Mathisen, Glen; Moe, Ardis] Univ Calif Los Angeles, David Geffen Sch Med, Dept Internal Med, Los Angeles, CA 90025 USA. [Commins, Deborah L.] Univ So Calif, Dept Pathol, Univ Hosp, Los Angeles, CA 90089 USA. RP Levine, AJ (reprint author), Univ Calif Los Angeles, Natl Neurol AIDS Bank, 11645 Wilshire Blvd,Suite 770, Los Angeles, CA 90025 USA. EM ajlevine@mednet.ucla.edu FU National Neurological AIDS Bank [NS38841] FX This study was supported by Grant NS38841, National Neurological AIDS Bank. NR 34 TC 10 Z9 10 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1380-3395 J9 J CLIN EXP NEUROPSYC JI J. Clin. Exp. Neuropsychol. PY 2008 VL 30 IS 7 BP 836 EP 843 DI 10.1080/13803390701819036 PG 8 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 345EH UT WOS:000258978400011 PM 18608693 ER PT J AU Hartman, ML Weltman, A Zagar, A Qualy, RL Hoffman, AR Merriam, GR AF Hartman, Mark L. Weltman, Arthur Zagar, Anthony Qualy, Rebecca L. Hoffman, Andrew R. Merriam, George R. TI Growth hormone replacement therapy in adults with growth hormone deficiency improves maximal oxygen consumption independently of dosing regimen or physical activity SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID GH TREATMENT; LACTATE THRESHOLD; HYPOPITUITARY ADULTS; CHILDHOOD-ONSET; DOSE TITRATION; BLOOD LACTATE; EXERCISE; PERFORMANCE; MUSCLE; CAPACITY AB Context: Several studies have demonstrated an improvement in aerobic exercise capacity with 6 months of GH replacement in adults with GH deficiency (GHD). Objective: The objective of the study was to determine whether improvements in aerobic exercise capacity with GH treatment in adults with GHD are related to changes in physical activity or affected by the GH dosing regimen. Design: This was a randomized, two-arm, parallel, open-label study. Setting: The study was conducted at five academic medical centers with exercise physiology laboratories. Subjects: Study subjects were adults (n = 29) with GHD due to hypothalamic-pituitary disease. Interventions: The intervention was GH replacement therapy, administered either as a fixed body weight-based dosing regimen as an individualized dose titration regimen for 32 wk. Main Outcome Measures: Maximal oxygen consumption (VO2 max) and oxygen consumption (VO2) at the lactate threshold, ventilatory threshold using a cycle ergometry protocol, and weekly energy expenditure (physical activity questionnaire), assessed at baseline and end point, were measured. Results: In the group as a whole, VO2 max increased significantly (by 9%) from baseline (19.1 +/- 0.89 ml/ kg.min) to end point (21.6 +/- 1.23 ml/kg.min, P = 0.010). Compared with baseline, VO2 max also changed significantly within the individualized dose titration regimen group (+ 2.5 +/- 0.98 ml/kg.min, P =0.034) but not within the fixed body weight-based dosing regimen group (+ 1.2 +/- 0.78 ml/kg.min, P = 0.15), although these changes from baseline were not significantly different between the two groups. VO2 at lactate threshold, VO2 at ventilatory threshold, and weekly energy expenditure also did not change. Conclusions: GH replacement therapy in G H-deficient adults improved VO2 max similarly with both dosing regimens, without any influence of physical activity. There was no effect on submaximal exercise performance. C1 [Hartman, Mark L.; Zagar, Anthony; Qualy, Rebecca L.] Eli Lilly & Co, Lilly Res Labs, Indianapolis, IN 46285 USA. [Weltman, Arthur] Univ Virginia, Dept Human Serv & Med, Charlottesville, VA 22908 USA. [Hoffman, Andrew R.] Vet Affairs Palo Alto Hlth Care Syst, Med Serv, Palo Alto, CA 94304 USA. [Hoffman, Andrew R.] Stanford Univ, Stanford, CA 94305 USA. [Merriam, George R.] Vet Affairs Puget Sound Hlth Care Syst, Med Res Serv, Tacoma, WA 98493 USA. [Merriam, George R.] Univ Washington, Sch Med, Seattle, WA 98195 USA. RP Merriam, GR (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, 9600 Vet Dr SW, Tacoma, WA 98493 USA. EM merriam@u.washington.edu OI Weltman, Arthur/0000-0002-0125-3769 NR 37 TC 10 Z9 10 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD JAN PY 2008 VL 93 IS 1 BP 125 EP 130 DI 10.1210/jc.2007-1430 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 251GC UT WOS:000252359400023 PM 17956953 ER PT J AU Basile, J AF Basile, Jan TI Shifting Paradigms in Defining and Treating Hypertension: Addressing Global Risk With Combination Therapy Introduction SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Editorial Material C1 [Basile, Jan] Ralph H Johnson VA Med Ctr, Primary Care Serv Line, Charleston, SC 29401 USA. [Basile, Jan] Med Univ S Carolina, Div Gen Internal Med Geriatr, Charleston, SC 29425 USA. RP Basile, J (reprint author), Ralph H Johnson VA Med Ctr, Primary Care Serv Line, 109 Bee St, Charleston, SC 29401 USA. EM jan.basile@med.va.gov NR 0 TC 1 Z9 1 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD JAN PY 2008 VL 10 IS 1 BP 2 EP 3 DI 10.1111/j.1524-6175.2007.08026.x PG 2 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 378FO UT WOS:000261306800001 PM 18174777 ER PT J AU Basile, J AF Basile, Jan TI The Importance of Prompt Blood Pressure Control SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Review ID FIXED-DOSE COMBINATION; PROSPECTIVELY-DESIGNED OVERVIEWS; RANDOMIZED CONTROLLED-TRIAL; HYPERTENSION TREATMENT; CARDIOVASCULAR EVENTS; ANTIHYPERTENSIVE THERAPY; SYSTOLIC HYPERTENSION; ACCOMPLISH TRIAL; LOWERING DRUGS; ELDERLY SCOPE AB Hypertension affects almost one-third of adults in the United States, but blood pressure is adequately controlled in only about 50% to 60% of persons with treated hypertension. Abundant clinical trial evidence has shown that antihypertensive therapy significantly reduces the risk of vascular events, and meta-analyses of observational and clinical trials have shown that greater reductions in blood pressure are associated with greater reductions in risk. Recent trials have also suggested that prompt control of blood pressure is beneficial in high-risk patients with hypertension. A post hoc analysis of a trial comparing an angiotensin If receptor blocker-based program with a calcium channel blocker-based treatment regimen found that the blood pressure response after 1 month (regardless of the drug used) predicted the risk of vascular events and survival. Therapy with >= 2 medications given separately or as a fixed combination is more likely than monotherapy to lower blood pressure to goal in part because drugs from different classes target different mechanisms that regulate blood pressure. Moreover, the likelihood of achieving blood pressure goals is greater if the time to achieve control is shortened, and prompt control of blood pressure is more likely with multiple-drug therapy than with monotherapy. (J Clin Hypertens (Greenwich). 2008;10(1 suppl 1):13-19) (C) 2008 Le Jacq C1 [Basile, Jan] Ralph H Johnson VA Med Ctr, Primary Care Serv Line, Charleston, SC 29403 USA. [Basile, Jan] Med Univ S Carolina, Div Gen Internal Med Geriatr, Charleston, SC 29425 USA. RP Basile, J (reprint author), Ralph H Johnson VA Med Ctr, Primary Care Serv Line, 109 Bee St, Charleston, SC 29403 USA. EM jan.basile@va.gov FU National Heart, Lung, and Blood Institute; Boehringer Ingelheim (ONTARGET); Novartis; Novartis Pharmaceuticals Corporation FX Dr Basile receives grant/research support from the National Heart, Lung, and Blood Institute, Boehringer Ingelheim (ONTARGET), and Novartis. He has served as a consultant for AstraZeneca, Merck, Novartis, and Daiichi Sankyo and has served on the Speakers' Bureau of Abbott, AstraZeneca, Boehringer Ingelheim, Forest, Merck, Novartis, Pfizer, and Daiichi Sankyo. The author acknowledges the assistance of Landmark Programs, Inc. in preparing this review article and styling the paper for journal submission. Editorial support was funded by Novartis Pharmaceuticals Corporation and the author received an honorarium for time and effort spent preparing this article. NR 42 TC 6 Z9 6 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD JAN PY 2008 VL 10 IS 1 BP 13 EP 19 DI 10.1111/j.1524-6175.2007.08027.x PG 7 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 378FO UT WOS:000261306800003 PM 18174779 ER PT J AU Jamerson, KA Basile, J AF Jamerson, Kenneth A. Basile, Jan TI Prompt, Aggressive BP Lowering in High-Risk Patients SO JOURNAL OF CLINICAL HYPERTENSION LA English DT Review ID TYPE-2 DIABETES-MELLITUS; RANDOMIZED CONTROLLED-TRIAL; HIGH CARDIOVASCULAR RISK; BLOOD-PRESSURE CONTROL; ANGIOTENSIN RECEPTOR BLOCKER; END-POINT REDUCTION; HYPERTENSIVE PATIENTS; COMBINATION THERAPY; STAGE-2 HYPERTENSION; ACCOMPLISH TRIAL AB Various populations with hypertension have been singled out by current treatment guidelines as requiring more specific treatment. These include patients with stage 2 hypertension, black patients, and patients with coexistent diabetes mellitus and coronary heart disease. Hypertension in these groups is often associated with higher risk of cardiovascular morbidity and mortality. This article reviews current knowledge regarding hypertension in high-risk patient populations, with a particular focus on the importance of prompt, aggressive treatment to lower blood pressure and prevent cardiovascular disease progression. Such treatment includes the earl), use of multiple-drug therapy with agents that have complementary blood pressure-lowering mechanisms and provide protection from target, organ damage. While 2- or 3-drug antihypertensive therapy in these high-risk groups has typically included a diuretic, other combinations of agents may be indicated. Evidence suggests that therapy with a calcium channel blocker and an inhibitor of the renin-angiotensin system is one effective strategy for lowering blood pressure and improving outcomes in these populations. (J Clin Hypertens (Greenwich). 2008;10(1 suppl 1):40-48) (c) 2008 Le Jacq C1 [Jamerson, Kenneth A.] Univ Michigan Hlth Care Syst, Ann Arbor, MI USA. [Basile, Jan] Ralph H Johnson VA Med Ctr, Primary Care Serv Line, Charleston, SC USA. [Basile, Jan] Med Univ S Carolina, Div Gen Internal Med Geriatr, Charleston, SC USA. RP Jamerson, KA (reprint author), Univ Michigan Hlth Syst, Dept Internal Med, Div Cardiovasc Med, Ann Arbor, MI 48109 USA. EM jamerson@umich.edu FU National Heart, Lung, and Blood Institute; Boehringer Ingelheim (ONTARGET); Novartis; King Pharmaceuticals; National Institute of Diabetes and Digestive and Kidney Diseases; Speedel; Novartis Pharmaceuticals Corporation FX Dr Basile receives grant/research support from the National Heart, Lung, and Blood Institute, Boehringer Ingelheim (ONTARGET); and Novartis. He has served as a consultant for AstraZeneca, Merck, Novartis, and Daiichi Sankyo and has served on the Speakers' Bureau of Abbott, AstraZeneca, Boehringer Ingelheim, Forest, Merck, Novartis, Pfizer, and Daiichi Sankyo. Dr Jamerson has received grants/research support from King Pharmaceuticals; the National Heart, Lung, and Blood Institute; the National Institute of Diabetes and Digestive and Kidney Diseases; Novartis, and Speedel. He has served as a consultant for Merck, Novartis, Pfizer, Sanofi-Aventis, Sankyo, and Speedel and on the Speakers' Bureau for Abbott, GlaxoSmithKline, Merck, Nitromed, and Novartis. The authors acknowledge the assistance of Landmark Programs, Inc. in preparing this review article and styling the paper for journal submission. Editorial support was funded by Novartis Pharmaceuticals Corporation and the authors received an honorarium for time and effort spent preparing this article. NR 69 TC 11 Z9 11 U1 0 U2 0 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1524-6175 J9 J CLIN HYPERTENS JI J. Clin. Hypertens. PD JAN PY 2008 VL 10 IS 1 BP 40 EP 48 DI 10.1111/j.1524-6175.2007.08145.x PG 9 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 378FO UT WOS:000261306800007 PM 18174783 ER PT J AU McSwain, CS Benza, R Shapiro, S Hill, N Schilz, R Elliott, CG Zwicke, DL Oudiz, RJ Staszewski, JR Arneson, CR Wade, M Zaccardelli, D McLaughlin, V AF McSwain, C. Shane Benza, Ray Shapiro, Shelley Hill, Nicholas Schilz, Robert Elliott, C. Gregory Zwicke, Dianne L. Oudiz, Ronald J. Staszewski, James R. Arneson, Carl R. Wade, Michael Zaccardelli, David McLaughlin, Vallerie TI Dose proportionality of treprostinil sodium administered by continuous subcutaneous and intravenous infusion SO JOURNAL OF CLINICAL PHARMACOLOGY LA English DT Article DE treprostinil; prostacyclin; pharmacokinetic; pulmonary arterial hypertension (PAH) ID PULMONARY-ARTERIAL-HYPERTENSION; CONTROLLED-TRIAL; PROSTACYCLIN; EPOPROSTENOL; PHARMACOKINETICS; EFFICACY; SAFETY; ANALOG AB This study assessed the relationship between dose and plasma concentration following administration of treprostinil sodium infusion therapy in pulmonary arterial hypertension patients. This was a multicenter, open-label, multiple-cohort, steady-state, pharmacokinetic study in subjects with pulmonary arterial hypertension receiving treprostinil by continuous intravenous or subcutaneous infusion at doses between 10 and 125 ng/kg/min. A blood sample was obtained from each patient at steady state and analyzed via a liquid chromatogrophy/tandem mass spectrometry method. Forty-nine subjects receiving treprostinil were enrolled. Treprostinil doses ranged from 12.1 to 125 ng/kg/min; treprostinil plasma concentrations ranged from 14.9 to 18 248 pg/mL. Linear regression analysis revealed a correlation between treprostinil dose and treprostinil plasma concentration with an R 2 value of 0.561. Using a power model to assess dose proportionality, the estimated nonproportionality parameter was 0.641 (95% confidence interval: 0.083-1.199), reflecting consistency with dose proportionality. Subset linear regression analysis, which excluded 2 subjects with anomalous treprostinil plasma concentrations, increased the R 2 value to 0.796. Using a power model to assess dose proportionality of this subset, the estimated nonproportionality parameter was 0.941 (95% confidence interval: 0.809-1.073). This study supports previous findings of linearity at lower doses up to 15 ng/kg/min and demonstrates linearity at treprostinil doses up to 125 ng/kg/min. C1 [McSwain, C. Shane; Staszewski, James R.; Arneson, Carl R.; Wade, Michael; Zaccardelli, David] United Therapeut Corp, Clin Affairs, Res Triangle Pk, NC 27709 USA. [Benza, Ray] Univ Alabama, Birmingham, AL USA. [Shapiro, Shelley] W Los Angeles VA Healthcare Ctr, Los Angeles, CA USA. [Hill, Nicholas] Tufts Univ New England Med Ctr, Boston, MA USA. [Schilz, Robert] Univ Hosp Cleveland, Cleveland, OH 44106 USA. [Elliott, C. Gregory] LDS Hosp, Salt Lake City, UT USA. [Elliott, C. Gregory] Univ Utah, Salt Lake City, UT USA. [Zwicke, Dianne L.] St Lukes Hosp, Milwaukee, WI USA. [Oudiz, Ronald J.] Univ Calif Los Angeles, Harbor Med Ctr, LA Biomed Res Inst, Torrance, CA 90509 USA. [McLaughlin, Vallerie] Univ Michigan, Med Ctr, Ann Arbor, MI 48109 USA. RP McSwain, CS (reprint author), United Therapeut Corp, Clin Affairs, 1 Pk Dr,4th Floor, Res Triangle Pk, NC 27709 USA. EM csmcswain@unither.com NR 13 TC 30 Z9 31 U1 0 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0091-2700 J9 J CLIN PHARMACOL JI J. Clin. Pharmacol. PD JAN PY 2008 VL 48 IS 1 BP 19 EP 25 DI 10.1177/0091270007309708 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 248JS UT WOS:000252150200004 PM 18094217 ER PT J AU Thase, ME AF Thase, Michael E. TI Selecting Appropriate Treatments for Maintenance Therapy for Bipolar Disorder SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID TREATMENT ENHANCEMENT PROGRAM; WEEKLY SYMPTOMATIC STATUS; I-DISORDER; LITHIUM MAINTENANCE; NATURAL-HISTORY; CLINICAL-TRIAL; DOUBLE-BLIND; STEP-BD; DIVALPROEX; PLACEBO AB Long-term management of bipolar disorder is a crucial component of treatment because the recurrence of the illness negatively affects patients' daily lives and increases their risks for poor health and suicide. An ideal maintenance treatment for bipolar disorder is relatively simple to take, prevents recurrence of both manic and depressive episodes, and is well-tolerated over the long term. Although many different types of medications are used for maintenance therapy of bipolar disorder, none can be considered ideal for a majority of people with bipolar disorder, and each specific form of therapy has different strengths and limitations. Clinicians need to be aware of unique efficacy and side effect factors when choosing long-term therapy and consider treatment components, goals, and individual patient characteristics, which are essential to the successful long-term management of bipolar disorder. Additionally, several forms of psychotherapy specifically tailored to the needs of people with bipolar disorder should be considered as an adjunct to medication. C1 [Thase, Michael E.] Univ Penn, Dept Psychiat, Sch Med, Philadelphia, PA 19104 USA. [Thase, Michael E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Thase, Michael E.] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. RP Thase, ME (reprint author), Univ Penn, Dept Psychiat, Sch Med, 3535 Market St,Suite 670, Philadelphia, PA 19104 USA. EM thase@mail.med.upenn.edu NR 47 TC 5 Z9 5 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 PY 2008 VL 69 SU 5 BP 28 EP 35 PG 8 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 373PH UT WOS:000260983700005 PM 19265638 ER PT J AU Osman, A Barrios, FX Gutierrez, PM Williams, JE Bailey, J AF Osman, Augustine Barrios, Francisco X. Gutierrez, Peter M. Williams, John E. Bailey, Jennifer TI Psychometric properties of the beek depression inventory-II in nonclinical adolescent samples SO JOURNAL OF CLINICAL PSYCHOLOGY LA English DT Article DE depression severity; factor analyses; nonclinical adolescents; psychometrics ID IDEATION PANSI INVENTORY; PSYCHIATRIC-INPATIENTS; LIVING INVENTORY; PRELIMINARY VALIDATION; NEGATIVE AFFECTIVITY; RISK-FACTORS; SELF-HARM; BECK; DISORDER; VALIDITY AB This study examined the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; A. T. Beck, Steer, & Brown, 1996) in samples of high-school adolescents (N=414; 210 boys and 204 girls, ages 14-18 years). Confirmatory factor analyses provided satisfactory fit estimates for the two- and three-factor oblique solutions reported frequently in the extant literature. The solution to a general factor with domain-specific somatic and cognitive-affective factors was examined as an alternative model to previously established models for the current high-school sample data. Results provided stronger support for the general factor model. Estimates of internal consistency for scores on this instrument were high (coefficient alpha =.92, average interitern correlation =.35). The mean BDI-II total score for the nonclinical samples (M= 12.50, SD = 10.50) was compared with the mean scores reported for various adolescent normative samples in the extant literature. The BDI-11 total score correlated moderately and significantly with scores on self-report measures of hopelessness (r=.63), anxiety (r=.53), and suicide-related behaviors (r=.57), providing support of adequate correlates for the BDI-11. Estimates of known-groups validity were evaluated using data from a small sample of 167 clinical adolescent inpatients. Specific study findings, limitations, and recommendations are discussed. (c) 2007 Wiley Periodicals, Inc. C1 [Osman, Augustine] Univ Texas San Antonio, Dept Psychol, San Antonio, TX 78249 USA. [Barrios, Francisco X.] Texas State Univ, San Marcos, TX USA. [Gutierrez, Peter M.] Denver VA Med Ctr, Denver, CO USA. [Williams, John E.; Bailey, Jennifer] Univ No Iowa, Cedar Falls, IA 50614 USA. RP Osman, A (reprint author), Univ Texas San Antonio, Dept Psychol, UTSA Circle 1, San Antonio, TX 78249 USA. EM augustine.osman@gmail.com OI Gutierrez, Peter/0000-0001-8981-8404 NR 68 TC 67 Z9 70 U1 6 U2 21 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9762 J9 J CLIN PSYCHOL JI J. Clin. Psychol. PD JAN PY 2008 VL 64 IS 1 BP 83 EP 102 DI 10.1002/jclp.20433 PG 20 WC Psychology, Clinical SC Psychology GA 249AE UT WOS:000252197900007 PM 18161034 ER PT J AU Nareika, A Im, YB Game, BA Slate, EH Sanders, JJ London, SD Lopes-Virella, MF Huang, Y AF Nareika, Alena Im, Yeong-Bin Game, Bryan A. Slate, Elizabeth H. Sanders, John J. London, Steven D. Lopes-Virella, Maria F. Huang, Yan TI High glucose enhances lipopolysaccharide-stimulated CD14 expression in U937 mononuclear cells by increasing nuclear factor kappa B and AP-1 activities SO JOURNAL OF ENDOCRINOLOGY LA English DT Article; Proceedings Paper CT 66th Annual Meeting of the American-Diabetes-Association CY JUN 09-13, 2006 CL Washington, DC SP Amer Diabet Assoc ID SOLUBLE CD14; DIABETES-MELLITUS; GENE-EXPRESSION; MESSENGER-RNA; MEMBRANE CD14; RECEPTOR; DISEASE; ACTIVATION; PROTEIN; LPS AB We have demonstrated recently that high glucose augments lipopolysaccharide (LPS)-stimulated matrix metalloproteinase (MMP) and cytokine expression by U937 mononuclear cells and human mono cyte-derived macrophages. Since CD14 is a receptor for LPS, one potential underlying mechanism is that high glucose enhances CD14 expression. In the present study, we determined the effect of high glucose on CD14 expression by U937 mononuclear cells. After being chronically exposed to normal or high glucose for 2 weeks or longer, cells were treated with LPS for 24 h. Real-time PCR showed that although high glucose by itself did not increase CD14 expression significantly, it augmented LPS-stimulated CD14 expression by 15-fold. Immunoassay showed a marked enhancement of both membrane-associated and soluble CD14 protein levels by high glucose. Further investigations using transcription factor activity assays and gel shift assays revealed that high glucose augmented LPS-stimulated CD14 expression by enhancing transcription factor nuclear factor kappa B (NF kappa B) and activator protein-1 (AP-1) activities. Finally, studies using anti-CD14 neutralizing antibody showed that CD14 expression is essential for the enhancement of LPS-stimulated MMP-1 expression by high glucose. Taken together, this study has demonstrated a robust augmentation by high glucose of LPS-stimulated CD 14 expression through AP-1 and NF kappa B transcriptional activity enhancement, elucidating a new mechanism by which hyperglycemia boosts LPS-elicited gene expression involved in inflammation and tissue destruction. C1 [Game, Bryan A.; Lopes-Virella, Maria F.; Huang, Yan] Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. [Nareika, Alena; Im, Yeong-Bin; Lopes-Virella, Maria F.; Huang, Yan] Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29401 USA. [Slate, Elizabeth H.] Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29401 USA. [Sanders, John J.; London, Steven D.] Med Univ S Carolina, Coll Dent Med, Charleston, SC 29401 USA. RP Huang, Y (reprint author), Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, 114 Doughty St, Charleston, SC 29401 USA. EM huangyan@musc.edu FU NCRR NIH HHS [P20 RR017696]; NIDCR NIH HHS [DE16353] NR 39 TC 28 Z9 30 U1 0 U2 3 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 JAN PY 2008 VL 196 IS 1 BP 45 EP 55 DI 10.1677/JOE-07-0145 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 257MK UT WOS:000252803000005 PM 18180316 ER PT J AU Peden-Adams, MM Eudaly, JG Lee, AM Miller, J Keil, DE Gilkeson, GS AF Peden-Adams, Margie M. Eudaly, Jackie G. Lee, A. Michelle Miller, Julie Keil, Deborah E. Gilkeson, Gary S. TI Lifetime exposure to trichloroethylene (TCE) does not accelerate autoimmune disease in MRL+/+ mice SO JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH PART A-TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING LA English DT Article DE TCE; trichloroethylene; immune; developmental; autoimmune; MRL plus / ID SYSTEMIC LUPUS-ERYTHEMATOSUS; ANTI-DNA ANTIBODIES; TRICHLOROACETIC-ACID; BACTERIAL-DNA; NZB/NZW MICE; AUTOANTIBODIES; WATER; IMMUNOTOXICITY; IMMUNIZATION; ASSOCIATION AB A genetically-prone murine lupus model was used to assess the developmental effects of trichloroethylene (TCE) exposure on disease symptom onset (e.g., autoantibody production and proteinuria), lymphocyte proliferation, splenic B-cell populations, and thymic and splenic T-cell populations. MRL +/+ mice were exposed to TCE (0, 1,400 or 14,000 ppb) via drinking water beginning on gestation day (GD) 0 and continuing until 12 months of age. With the exception of splenic CD4-/CD8-cells in female mice only, no alterations were observed in splenic T-cell populations, numbers of splenic B220+ cells, or in lymphocyte proliferation at 12 months of age. Furthermore, populations of all thymic T-cell subpopulations were decreased in male but not female mice following exposure to 14,000 ppb TCE. Autoantibody levels (anti-dsDNA and anti-GA) were assessed periodically from 4 to 12 months of age. Over this period, no increase in autoantibody levels as compared to control was detected, suggesting that TCE did not contribute to or accelerate the development of autoimmune disease markers following lifetime exposure. Not only does this study offer encouraging results, but it is the first study to approach the development of autoimmunity in a novel lifetime exposure paradigm, using an autoimmune prone model, at environmentally relevant exposure levels. C1 [Peden-Adams, Margie M.] Med Univ S Carolina, MBES, Dept Pediat, Charleston, SC 29412 USA. [Peden-Adams, Margie M.; Eudaly, Jackie G.; Miller, Julie; Gilkeson, Gary S.] Med Univ S Carolina, Div Rheumatol & Immunol, Charleston, SC 29412 USA. [Peden-Adams, Margie M.; Eudaly, Jackie G.; Lee, A. Michelle; Gilkeson, Gary S.] Med Univ S Carolina, Marine Biomed & Environm Sci Ctr, Charleston, SC 29412 USA. [Keil, Deborah E.] Univ Nevada, Clin Sci Lab, Las Vegas, NV 89154 USA. [Gilkeson, Gary S.] Ralph Johnson VAMC, Med Res Serv, Charleston, SC USA. RP Peden-Adams, MM (reprint author), Med Univ S Carolina, MBES, Dept Pediat, 221 Ft Johnson Rd, Charleston, SC 29412 USA. EM pedenada@musc.edu FU Medical Research Service, Ralph H. Johnson VAMC; Department of Energy to the MUSC Environmental Biosciences Program [DE-FC09-02CH11109] FX The authors would like to thank Raymond Kivi and Jennifer Berger-Ritchie for assistance with manuscript preparation. This research was supported by the Medical Research Service, Ralph H. Johnson VAMC and by Contract DE-FC09-02CH11109 from the Department of Energy to the MUSC Environmental Biosciences Program. NR 32 TC 4 Z9 4 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1093-4529 J9 J ENVIRON SCI HEAL A JI J. Environ. Sci. Health Part A-Toxic/Hazard. Subst. Environ. Eng. PY 2008 VL 43 IS 12 BP 1402 EP 1409 DI 10.1080/10934520802232063 PG 8 WC Engineering, Environmental; Environmental Sciences SC Engineering; Environmental Sciences & Ecology GA 348QZ UT WOS:000259226300008 PM 18780217 ER PT J AU Chang, EY Li, X Jerosch-Herold, M Priest, RA Enestvedt, CK Xu, J Springer, CS Jobe, BA AF Chang, Eugene Y. Li, Xin Jerosch-Herold, Michael Priest, Ryan A. Enestvedt, C. Kristian Xu, Jingang Springer, Charles S., Jr. Jobe, Blair A. TI The evaluation of esophageal adenocarcinoma using dynamic contrast-enhanced magnetic resonance imaging SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 20th World Congress of International-Society-for-Digestive-Surgery CY NOV 29-DEC 02, 2006 CL Rome, ITALY SP Int Soc Digest Surg DE esophageal adenocarcinoma; dynamic contrast-enhanced magnetic resonance imaging; neoadjuvant chemoradiation ID POSITRON-EMISSION-TOMOGRAPHY; SQUAMOUS-CELL CARCINOMA; TRANSCYTOLEMMAL WATER EXCHANGE; CR BOLUS-TRACKING; NEOADJUVANT CHEMORADIOTHERAPY; BARRETTS-ESOPHAGUS; SHUTTER-SPEED; PREOPERATIVE CHEMORADIATION; ENDOSCOPIC ULTRASONOGRAPHY; INDUCTION CHEMORADIATION AB Although neoadjuvant chemoradiation eradicates esophageal adenocarcinoma in a substantial proportion of patients, conventional imaging techniques cannot accurately detect this response. Dynamic contrast-enhanced magnetic resonance imaging is an emerging approach that may be well suited to fill this role. This pilot study evaluates the ability of this method to discriminate adenocarcinoma from normal esophageal tissue. Patients with esophageal adenocarcinoma and control subjects underwent scanning. Patients treated with neoadjuvant therapy underwent pre- and postchemoradiation scans. Parameters were extracted for each pixel were K-trans (equilibrium rate for transfer of contrast reagent across the vascular wall), v(e) (volume fraction of interstitial space), and tau(i) (mean intracellular water lifetime). Five esophageal adenocarcinoma patients and two tumor-free control subjects underwent scanning. The mean K-trans value was 5.7 times greater in esophageal adenocarcinoma, and tau(i) is 2.0 times smaller, than in the control subjects. K-trans decreased by 11.4-fold after chemoradiation. Parametric maps qualitatively demonstrate a difference in K-trans. DCE MRI of the esophagus is feasible. K-trans, a parameter that has demonstrated discriminative ability in other malignancies, also shows promise in differentiating esophageal adenocarcinoma from benign tissue. The determination of K-trans represents an in vivo assay for endothelial permeability and thus may serve as a quantitative measure of response to induction chemoradiation. C1 [Chang, Eugene Y.; Priest, Ryan A.; Enestvedt, C. Kristian; Jobe, Blair A.] Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97239 USA. [Li, Xin; Jerosch-Herold, Michael; Xu, Jingang; Springer, Charles S., Jr.] Oregon Hlth & Sci Univ, Adv Imaging Res Ctr, Portland, OR 97201 USA. [Jobe, Blair A.] Portland VA Med Ctr, Dept Surg, Portland, OR USA. RP Jobe, BA (reprint author), Oregon Hlth & Sci Univ, Dept Surg, Mail Code L223,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM jobeb@ohsu.edu RI Jerosch-Herold, Michael/F-2496-2010 OI Springer, Charles/0000-0002-5966-2135 FU NIBIB NIH HHS [R01 EB00422]; NINDS NIH HHS [R01 NS40801] NR 58 TC 15 Z9 17 U1 1 U2 7 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD JAN PY 2008 VL 12 IS 1 BP 166 EP 175 DI 10.1007/s11605-007-0253-5 PG 10 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 250JW UT WOS:000252297100027 PM 17768665 ER PT J AU Plomondon, MLE Magid, DJ Mosoudi, FA Jones, PG Barry, LC Havronek, E Peterson, ED Krumholz, HM Spertus, JA Rumsfeld, JS AF Plomondon, Mary E. Magid, David J. Mosoudi, Frederick A. Jones, Philip G. Barry, Liso C. Havronek, Edward Peterson, Eric D. Krumholz, Harlon M. Spertus, John A. Rumsfeld, John S. CA PREMIER Investigators TI Association between angina and treatment satisfaction after myocardial infarction SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE angina; treatment satisfaction; myocardial infarction ID QUALITY-OF-LIFE; ACUTE CORONARY SYNDROMES; STABLE ANGINA; FUNCTIONAL STATUS; ARTERY DISEASE; MANAGED CARE; IMPACT; QUESTIONNAIRE; PERFORMANCE; DEPRESSION AB BACKGROUND: Patient satisfaction is increasingly recognized as a quality indicator and important outcome of care. Little is known about the clinical factors associated with satisfaction after myocardial infarction (MI). OBJECTIVE: To assess the hypothesis that angina after MI is independently associated with lower treatment satisfaction. METHODS: We evaluated 1,815 MI patients from 19 U.S. centers. Angina was measured at I and 6 months after MI using the Seattle Angina Questionnaire (SAQ). Treatment satisfaction was measured using the SAQ at 6 months. Multivariable regression was used to evaluate the association between 1- and 6-month angina and 6-month treatment satisfaction. RESULTS: Sixty-two percent of patients had no angina at 1 and 6 months after MI, 14% had transient angina (angina at 1 month, no angina at 6 months), 11% had new angina (angina at 6 months only), and 13% had persistent angina (angina at both 1 and 6 months). In unadjusted analysis, the presence of angina at 6 months, whether new or persistent, was associated with lower treatment satisfaction (p < 0.001). In multivariable analysis, angina was associated with lower treatment satisfaction [relative risk (RR) 2.9, 95%confidence interval (Cl) 2.4-3.5 patients with new angina; RR 3.1, 95%CI 2.5-3.9 patients with persistent angina, vs patients with no angina]. CONCLUSION: In conclusion, angina in the 6 months following MI is present in almost 1 in 4 patients and is strongly associated with lower treatment satisfaction. This suggests the importance of angina surveillance and management after MI as a possible target to improve treatment satisfaction and, thereby, quality of care. C1 [Plomondon, Mary E.; Rumsfeld, John S.] Denver VA Med Ctr, Eastern Colorado Hlth Care Syst, Denver, CO 80220 USA. [Magid, David J.] Colorado Kaiser Permanente, Aurora, CO USA. [Mosoudi, Frederick A.; Havronek, Edward] Denver Hlth Med Ctr, Denver, CO USA. [Jones, Philip G.; Spertus, John A.] St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. [Barry, Liso C.; Krumholz, Harlon M.] Yale Univ, Med Ctr, New Haven, CT USA. [Peterson, Eric D.] Duke Univ, Med Ctr, Durham, NC USA. RP Plomondon, MLE (reprint author), Denver VA Med Ctr, Eastern Colorado Hlth Care Syst, 1055 Clermont St 111B, Denver, CO 80220 USA. EM Meg.Plomondon@va.gov FU AHRQ HHS [R01 HS011282, R-01 HS11282-01]; NIA NIH HHS [T32AG019134, T32 AG019134] NR 32 TC 11 Z9 11 U1 0 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 2008 VL 23 IS 1 BP 1 EP 6 DI 10.1007/s11606-007-0430-y PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 256GM UT WOS:000252715700001 PM 17955303 ER PT J AU Goldstein, NE Mehta, D Teitelbaum, E Bradley, EH Morrison, RS AF Goldstein, Nathon E. Mehta, Dovendra Teitelbaum, Ezra Bradley, Elizabeth H. Morrison, R. Sean TI "It's Like Crossing a Bridge" complexities preventing physicians from discussing deactivation of implantable defibrillators at the end of life SO JOURNAL OF GENERAL 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 DE palliative care; advanced technology; communicatiom; patient-physician relationship; implantable cardioverter defibrillator ID INTENSIVE-CARE-UNIT; CARDIOVERTER-DEFIBRILLATOR; SUSTAINING TREATMENTS; OF-LIFE; HOSPITALIZED ADULTS; ADVANCE DIRECTIVES; PALLIATIVE CARE; SERIOUSLY ILL; HEART-FAILURE; DECISIONS AB OBJECTIVE: To understand potential barriers to physician-initiated discussions about Implantable Cardioverter Defibrillator (ICD) deactivation in patients with advanced illness. DESIGN. Qualitative one-on-one interviews. PARTICIPANTS: Four electrophysiologists, 4 cardiologists, and 4 generalists (internists and geriatricians) from 3 states. APPROACH: Clinicians were interviewed using open-ended questions to elicit their past experiences with discussing deactivating ICDs and to determine what barriers might impede these discussions. Transcripts of these interviews were analyzed using the qualitative method of constant comparison. RESULTS: Although many physicians believed that conversations about deactivating ICDs should be included in advance care planning discussions, they acknowledged that they rarely did this. Physicians indicated that there was something intrinsic to the nature of these devices that makes it inherently difficult to think of them in the same context as other management decisions at the end of a patient's life. Other explanations physicians gave as to why they did not engage in conversations included: the small internal nature of these devices and hence absence of a physical reminder to discuss the ICD, the absence of an established relationship with the patient, and their own general concerns relating to withdrawing care. CONCLUSION: Whereas some of the barriers to discussing ICD deactivation are common to all forms of advance care planning, ICDs have unique characteristics that make these conversations more difficult. Future educational interventions will need to be designed to teach physicians how to improve communication with patients about the management of ICDs at the end of life. C1 [Goldstein, Nathon E.; Teitelbaum, Ezra; Morrison, R. Sean] Mt Sinai Sch Med, Dept Geriatr, New York, NY 10029 USA. [Goldstein, Nathon E.; Morrison, R. Sean] James J Vet Affairs Hlth Syst, Geriatr Res Educ & Clin Care Ctr, Bronx, NY USA. [Mehta, Dovendra] Mt Sinai Sch Med, Dept Med, New York, NY USA. [Bradley, Elizabeth H.] Yale Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT USA. [Bradley, Elizabeth H.] Yale Sch Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT USA. RP Goldstein, NE (reprint author), Mt Sinai Sch Med, Dept Geriatr, 1 Gustave Levy Pl,Box 1070, New York, NY 10029 USA. EM Nathan.Goldstein@mssm.edu FU NIA NIH HHS [K24 AG022345, 1 K23 AG025933-01A1, K23 AG025933, 1K24AG22345-01] NR 40 TC 46 Z9 46 U1 2 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 JAN PY 2008 VL 23 SU 1 BP 2 EP 6 DI 10.1007/s11606-007-0237-x PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 249FG UT WOS:000252212300002 PM 18095036 ER PT J AU Zickmund, SL Hess, R Bryce, CL McTigue, K Olshansky, E Fitzgerald, K Fischer, GS AF Zickmund, Susan L. Hess, Rachel Bryce, Cindy L. McTigue, Kathleen Olshansky, Ellen Fitzgerald, Katharine Fischer, Gary S. TI Interest in the use of computerized patient portals: We of the provider-patient relationship SO JOURNAL OF GENERAL 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 DE patient portal; bioinformatics; provider-patient communication; diabetes; e-mail communication ID CONGESTIVE-HEART-FAILURE; PRIMARY-CARE; E-MAIL; CONTROLLED-TRIAL; DIGITAL DIVIDE; COMMUNICATION; PHYSICIANS; DISEASE; ACCESS; RECORD AB BACKGROUND: Bioinformatics experts are developing interactive patient portals to help those living with diabetes and other chronic diseases to better manage their conditions. However, little is known about what influences patients' desires to use this technology. OBJECTIVE: To discern the impact of the provider-patient relationship on interest in using a web-based patient portal. DESIGN: Qualitative analysis of focus groups. PARTICIPANTS: Ten focus groups involving 39 patients (range 2-7) recruited from four primary care practices. APPROACH: A qualitative approach was used, which involved reading transcribed texts until a consensus was reached on data interpretation. An intercoder reliability kappa score (0.89) was determined by comparing the provider-patient relationship talk selected by the two coders. A conceptual framework was developed, which involved the development and refinement of a codebook and the application of it to the transcripts. RESULTS: Interest in the portal was linked to dissatisfaction with the provider-patient relationship, including dissatisfaction with provider communication/ responsiveness, the inability to obtain medical information, and logistical problems with the office. Disinterest in the portal was linked to satisfaction with the provider-patient relationship, including provider communication/responsiveness, difficulty in using the portal, and fear of losing relationships and e-mail contact with the provider. No patient identified encrypted e-mail communication through the portal as an advantage. CONCLUSIONS: Promoting the use of computerized portals requires patient-based adaptations. These should include ease of use, direct provider e-mail, and reassurances that access and interpersonal relationships will not be lost. Education is needed about privacy concerns regarding traditional e-mail communication. C1 [Zickmund, Susan L.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. [Zickmund, Susan L.; Hess, Rachel; Bryce, Cindy L.; McTigue, Kathleen; Fischer, Gary S.] Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. [Zickmund, Susan L.; Hess, Rachel; Bryce, Cindy L.; McTigue, Kathleen; Fitzgerald, Katharine] Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. [Bryce, Cindy L.] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA USA. [McTigue, Kathleen] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. [Olshansky, Ellen] Univ Calif Irvine, Program Nursing Sci, Irvine, CA USA. [Fitzgerald, Katharine] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Behav & Community Hlth Sci, Pittsburgh, PA USA. [Zickmund, Susan L.] Univ Pittsburgh, Dept Commun, Pittsburgh, PA USA. RP Zickmund, SL (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 151C-U,Univ Dr C, Pittsburgh, PA 15240 USA. EM Susan.Zickmund@rned.va.gov FU NCATS NIH HHS [UL1 TR000005] NR 49 TC 38 Z9 38 U1 3 U2 15 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 2008 VL 23 SU 1 BP 20 EP 26 DI 10.1007/s11606-007-0273-6 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 249FG UT WOS:000252212300005 PM 18095039 ER PT J AU Nuckols, TK Lim, YW Wynn, BO Mattke, S Maclean, CH Harber, P Brook, RH Wallace, P Garland, RH Asch, S AF Nuckols, Teryl K. Lim, Yee-Wei Wynn, Barbara O. Mattke, Soeren Maclean, Catherine H. Harber, Philip Brook, Robert H. Wallace, Peggy Garland, Reno H. Asch, Steven TI Rigorous development does not ensure that guidelines are acceptable to a panel of knowledgeable providers SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE practice guidelines; quality assurance; health care; evidence-based medicine; attitude of health personnel; evaluation ID CLINICAL-PRACTICE GUIDELINES; HEALTH-CARE; METHODOLOGICAL QUALITY; APPROPRIATENESS METHOD; PHYSICIAN AWARENESS; GENERAL-PRACTICE; VALIDITY; ADHERENCE; ATTITUDES; BARRIERS AB BACKGROUND: Rigorous guideline development methods are designed to produce recommendations that are relevant to common clinical situations and consistent with evidence and expert understanding, thereby promoting guidelines' acceptability to providers. No studies have examined whether this technical quality consistently leads to acceptability. OBJECTIVE: To examine the clinical acceptability of guidelines having excellent technical quality. DESIGN AND MEASUREMENTS: We selected guidelines covering several musculoskeletal disorders and meeting 5 basic technical quality criteria, then used the widely accepted AGREE Instrument to evaluate technical quality. Adapting an established modified Delphi method, we assembled a multidisciplinary panel of providers recommended by their specialty societies as leaders in the field. Panelists rated acceptability, including "perceived comprehensiveness" (perceived relevance to common clinical situations) and "perceived validity" (consistency with their understanding of existing evidence and opinions), for ten common condition/therapy pairs pertaining to Surgery, physical therapy, and chiropractic manipulation for lumbar spine, shoulder, and carpal tunnel disorders. RESULTS: Five guidelines met selection criteria. Their AGREE scores were generally high indicating excellent technical quality. However, panelists found 4 guidelines to be only moderately comprehensive and valid, and a fifth guideline to be invalid overall. Of the topics covered by each guideline, panelists rated 50% to 69% as "comprehensive" and 6% to 50% as "valid". CONCLUSION. Despite very rigorous development methods compared with guidelines assessed in prior studies, experts felt that these guidelines omitted common clinical situations and contained much content of uncertain validity. Guideline acceptability should be independently and formally evaluated before dissemination. C1 [Nuckols, Teryl K.; Lim, Yee-Wei; Wynn, Barbara O.; Mattke, Soeren; Brook, Robert H.; Garland, Reno H.; Asch, Steven] RAND Corp, Santa Monica, CA 90407 USA. [Nuckols, Teryl K.; Brook, Robert H.; Asch, Steven] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. [Maclean, Catherine H.] WellPoint Inc, Thousand Oaks, CA USA. [Harber, Philip] Univ Calif Los Angeles, David Geffen Sch Med, Dept Family Med, Div Occupat & Environm Med, Los Angeles, CA USA. [Wallace, Peggy] ACS Healthcare Solut Inc, Playa Del Rey, CA USA. [Asch, Steven] VA Greater Los Angeles Hlth Syst, Los Angeles, CA USA. RP Nuckols, TK (reprint author), RAND Corp, 1776 Main St,PO Box 2138, Santa Monica, CA 90407 USA. EM teryl@rand.org NR 44 TC 22 Z9 22 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 2008 VL 23 IS 1 BP 37 EP 44 DI 10.1007/s11606-007-0440-9 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 256GM UT WOS:000252715700006 PM 18030541 ER PT J AU Butt, AA Kahloon, A Skanderson, M McGinnis, KA AF Butt, A. A. Kahloon, A. Skanderson, M. McGinnis, K. A. TI Medical, psychiatric and substance use comorbidities in HCV and HCV-HIV coinfected persons SO JOURNAL OF HEPATOLOGY LA English DT Meeting Abstract CT 43rd Annual Meeting of the European-Association-for-the-Study-of-the-Liver CY APR 23-27, 2008 CL Milan, ITALY SP European Assoc Study Liver C1 [Butt, A. A.; Kahloon, A.] Univ Pittsburgh, Pittsburgh, PA USA. [Butt, A. A.; Skanderson, M.; McGinnis, K. A.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. EM bufta@dom.pitt.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PY 2008 VL 48 SU 2 MA 642 BP S239 EP S239 DI 10.1016/S0168-8278(08)60644-3 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 312PL UT WOS:000256683201133 ER PT J AU Kwan, DM Dhaliwal, G Baudendistel, TE AF Kwan, Damon M. Dhaliwal, Gurpreet Baudendistel, Thomas E. TI Thinking inside the box SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material ID CONSTRICTIVE PERICARDITIS; PORTAL-HYPERTENSION; MODERN-ERA C1 [Kwan, Damon M.; Baudendistel, Thomas E.] Calif Pacific Med Ctr, Kanbar Cardiac Ctr, Dept Med, San Francisco, CA 94115 USA. [Dhaliwal, Gurpreet] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, San Francisco, CA USA. RP Kwan, DM (reprint author), Calif Pacific Med Ctr, Kanbar Cardiac Ctr, Dept Med, 2333 Buchanan St,Room 1-109, San Francisco, CA 94115 USA. EM amgine18@yahoo.com NR 18 TC 2 Z9 2 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD JAN-FEB PY 2008 VL 3 IS 1 BP 71 EP 76 DI 10.1002/jhm.267 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 292IB UT WOS:000255258600012 PM 18257049 ER PT J AU Smyk-Pearson, S Golden-Mason, L Klarquist, J Burton, JR Tester, IA Wang, CC Culbertson, N Vandenbark, AA Rosen, HR AF Smyk-Pearson, Susan Golden-Mason, Lucy Klarquist, Jared Burton, James R., Jr. Tester, Ian A. Wang, Chia C. Culbertson, Nicole Vandenbark, Arthur A. Rosen, Hugo R. TI Functional suppression by FoxP3(+)CD4(+)CD25(high) regulatory T cells during acute hepatitis C virus infection SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 56th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 11-15, 2005 CL San Francisco, CA SP Amer Assoc Study Liver Dis ID IN-VITRO PROLIFERATION; MULTIPLE-SCLEROSIS; DENDRITIC CELLS; IMMUNE-RESPONSE; VIRAL CLEARANCE; CORE PROTEIN; FOXP3; LYMPHOCYTES; DYSFUNCTION; ACTIVATION AB Background. Infection with hepatitis C virus (HCV) is characterized by impairment of viral effector T cell responses and a high propensity for viral persistence. Previous studies have demonstrated that chronic HCV infection is associated with an increased frequency of regulatory T (T-reg) cells, compared with that in persons whose infection resolved and in healthy persons. However, all patients in prior analyses had exposures in the distant past, precluding the ability to determine whether Treg cells play a causal role in establishing persistence during the earliest stages of infection or whether they are expanded because of viral persistence. Methods. For the first time, we longitudinally analyzed T-reg cells in patients with acute HCV infection (n = 27). We used a multiparameter approach, including fluorescence-activated cell sorting analysis of cell-surface and intracellular antigens, coculture experiments with highly purified CD4(+) CD25(high) regulatory and CD4(+)CD25(-) responder cell populations, and multiplex analysis of secreted cytokines. Results. Forkhead transcription factor 3 (FoxP3) expression and Treg cell suppression were greater in patients with acute HCV infection than in healthy control subjects but were not different at the first time point among patients who subsequently developed persistence or resolved HCV infection spontaneously; however, 6 months later, the resolution of disease was associated with a relative loss of functional suppression. Conclusions. Collectively, these data indicate that patients with acute HCV infection who develop chronicity versus spontaneous resolution exhibit temporal changes in T-reg cell function. It is possible that repetitive viral antigenic stimulation alters the function of T-reg cells over time. C1 [Smyk-Pearson, Susan; Golden-Mason, Lucy; Klarquist, Jared; Burton, James R., Jr.; Tester, Ian A.; Rosen, Hugo R.] Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, GI Div,Hepatitis C Ctr, Denver, CO 80262 USA. [Smyk-Pearson, Susan; Golden-Mason, Lucy; Klarquist, Jared; Burton, James R., Jr.; Tester, Ian A.; Rosen, Hugo R.] Univ Colorado, Hlth Sci Ctr, Integrated Program Immunol, Denver, CO 80262 USA. [Smyk-Pearson, Susan; Golden-Mason, Lucy; Klarquist, Jared; Burton, James R., Jr.; Tester, Ian A.; Rosen, Hugo R.] Natl Jewish Med & Res Ctr, Denver, CO USA. [Wang, Chia C.] Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. [Culbertson, Nicole; Vandenbark, Arthur A.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Culbertson, Nicole; Vandenbark, Arthur A.] Portland VA Med Ctr, Portland, ME USA. RP Rosen, HR (reprint author), Univ Colorado, Hlth Sci Ctr, Div Gastroenterol & Hepatol, GI Div,Hepatitis C Ctr, 4200 E 9th Ave,B-158, Denver, CO 80262 USA. EM Hugo.Rosen@UCHSC.edu FU NIDDK NIH HHS [R01 DK060590]; PHS HHS [U19 A 1066328-01] NR 31 TC 61 Z9 65 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JAN 1 PY 2008 VL 197 IS 1 BP 46 EP 57 DI 10.1086/523651 PG 12 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 251TV UT WOS:000252399000009 PM 18171284 ER PT J AU Nguyen, MK Chan, AM Shimazaki, K Moniz, R Kelly, K Gordon, LK Braun, J AF Nguyen, M. K. Chan, A. M. Shimazaki, K. Moniz, R. Kelly, K. Gordon, L. K. Braun, J. TI Role of epithelial membrane protein (EMP2) in Chlamydia infectivity in vivo SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 30-FEB 02, 2008 CL Carmel, CA SP Amer Federat Med Res C1 [Nguyen, M. K.; Chan, A. M.; Shimazaki, K.; Moniz, R.; Kelly, K.; Braun, J.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. [Chan, A. M.; Shimazaki, K.; Gordon, L. K.] Jules Stein Eye Inst, Los Angeles, CA USA. [Gordon, L. K.] Greater Los Angeles VA 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 2008 VL 56 IS 1 MA 17 BP 108 EP 108 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793300027 ER PT J AU Nguyen, MK Chan, AM Shimazaki, K Moniz, R Kelly, K Gordon, LK Braun, J AF Nguyen, M. K. Chan, A. M. Shimazaki, K. Moniz, R. Kelly, K. Gordon, L. K. Braun, J. TI Role of epithelial membrane protein (EMP2) in Chlamydia infectivity in vivo SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 30-FEB 02, 2008 CL Carmel, CA SP Amer Federat Med Res C1 [Nguyen, M. K.; Chan, A. M.; Shimazaki, K.; Moniz, R.; Kelly, K.; Braun, J.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. [Chan, A. M.; Shimazaki, K.; Gordon, L. K.] Jules Stein Eye Inst, Los Angeles, CA USA. [Gordon, L. K.] Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. OI Braun, Jonathan/0000-0003-1646-2974 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 2008 VL 56 IS 1 MA 253 BP 187 EP 187 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793300264 ER PT J AU Pereira, RI Leitner, J Draznin, B AF Pereira, R. I. Leitner, J. Draznin, B. TI Pioglitazone stimulates adiponectin secretion from 3T3-L1 adipocytes via activation of the phosphatidylinositol 3 '-kinase SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 30-FEB 02, 2008 CL Carmel, CA SP Amer Federat Med Res C1 [Pereira, R. I.; Leitner, J.; Draznin, B.] Denver Vet Affairs Med Ctr, Denver, CO USA. [Pereira, R. I.; Draznin, B.] UCHSC, Aurora, CO USA. [Pereira, R. I.] Denver Hlth, 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 2008 VL 56 IS 1 MA 268 BP 192 EP 193 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793300279 ER PT J AU Duclekula, A Kulig, C Trotter, J Everson, G AF Duclekula, A. Kulig, C. Trotter, J. Everson, G. TI Five year experience with Tenofovir for lamivudine resistant hepatitis B virus SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Western Regional Meeting of the American-Federation-for-Medical-Research CY JAN 30-FEB 02, 2008 CL Carmel, CA SP Amer Federat Med Res C1 [Duclekula, A.; Kulig, C.; Trotter, J.; Everson, G.] Univ Colorado, Hlth Sci Ctr, Denver, CO USA. [Kulig, C.] Denver VAMC, 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 2008 VL 56 IS 1 MA 353 BP 221 EP 221 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301013 ER PT J AU Baker, D Obeid, L Gilkeson, G AF Baker, D. Obeid, L. Gilkeson, G. TI Role of sphingosine kinase I in a mouse model of chronic inflammation SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Baker, D.; Obeid, L.; Gilkeson, G.] Med Univ S Carolina, Charleston, SC USA. [Baker, D.; Obeid, L.; Gilkeson, G.] Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 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 2008 VL 56 IS 1 MA 39 BP 356 EP 356 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301189 ER PT J AU Campbell, R Cooper, GS Gilkeson, GS AF Campbell, R. Cooper, G. S. Gilkeson, G. S. TI The economic burden of systemic lupus erythematosus among patients of the carolina lupus study early in the course of disease SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Campbell, R.; Gilkeson, G. S.] Med Univ S Carolina, Charleston, SC USA. [Cooper, G. S.] US EPA, Washington, DC USA. [Gilkeson, G. S.] Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 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 2008 VL 56 IS 1 MA 142 BP 390 EP 390 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301292 ER PT J AU Bryan, AC Parker, TM Bruner, GR Harley, JB Gilkeson, GS Kamen, DL AF Bryan, A. C. Parker, T. M. Bruner, G. R. Harley, J. B. Gilkeson, G. S. Kamen, D. L. TI Relationship between smoking and autoantibody positivity among female African American lupus patients SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Bryan, A. C.; Parker, T. M.; Gilkeson, G. S.; Kamen, D. L.] Med Univ S Carolina, Charleston, SC USA. [Gilkeson, G. S.] Ralph H Johnson VAMC, Charleston, SC USA. [Bruner, G. R.; Harley, J. B.] OMRF, Oklahoma City, OK USA. [Harley, J. B.] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA. [Harley, J. B.] Oklahoma City VAMC, Oklahoma City, OK 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 2008 VL 56 IS 1 MA 262 BP 429 EP 430 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301410 ER PT J AU Markland, AD Richter, HE Burgio, KL Wheeler, TL Malone, MP Goode, PS AF Markland, A. D. Richter, H. E. Burgio, K. L. Wheeler, T. L., III Malone, M. P. Goode, P. S. TI Outcomes of combination treatment of fecal incontinence in women SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Markland, A. D.; Richter, H. E.; Wheeler, T. L., III; Malone, M. P.; Goode, P. S.] Univ Alabama, Birmingham, AL USA. [Markland, A. D.; Burgio, K. L.; Goode, P. S.] Birmingham VAMC, 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 2008 VL 56 IS 1 MA 283 BP 436 EP 437 PG 2 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301430 ER PT J AU Snyder, E Farless, L Cherrington, A Estrada, C Bryan, T Boobaker, E AF Snyder, E. Farless, L. Cherrington, A. Estrada, C. Bryan, T. Boobaker, E. TI An objective evaluation of Women's Health Track curriculum utilizing the American College of Physicians In-Training Examination SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Snyder, E.; Farless, L.; Cherrington, A.; Estrada, C.; Bryan, T.; Boobaker, E.] Univ Alabama, Birmingham, AL USA. [Snyder, E.; Estrada, C.; Bryan, T.] 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 2008 VL 56 IS 1 MA 421 BP 484 EP 484 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301568 ER PT J AU Willett, LL Paranjape, A Estrada, C AF Willett, L. L. Paranjape, A. Estrada, C. TI Identifying key components for an effective poster presentation: An observational study SO JOURNAL OF INVESTIGATIVE MEDICINE LA English DT Meeting Abstract CT Southern Regional Meeting of the American-Federation-for-Medical-Research CY FEB 12-14, 2008 CL New Orleans, LA SP Amer Federat Med Res, So Reg C1 [Willett, L. L.] Univ Alabama, Birmingham, AL USA. [Paranjape, A.] Temple Univ, Sch Med, Philadelphia, PA 19122 USA. [Estrada, C.] Birmingham Vet Affairs Med Ctr, Birmingham, AL 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 2008 VL 56 IS 1 MA 442 BP 491 EP 491 PG 1 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 257IV UT WOS:000252793301589 ER PT J AU Ford, ME Kallen, M Richardson, P Matthiesen, E Cox, V Teng, EJ Cook, KF Petersen, NJ AF Ford, M. E. Kallen, M. Richardson, P. Matthiesen, E. Cox, V. Teng, E. J. Cook, K. F. Petersen, N. J. TI Effect of social support on informed consent in older adults with Parkinson disease and their caregivers SO JOURNAL OF MEDICAL ETHICS LA English DT Article ID MULTIPLE-SCLEROSIS AB PURPOSE: To evaluate the effects of social support on comprehension and recall of consent form information in a study of Parkinson disease patients and their caregivers. DESIGN and METHODS: Comparison of comprehension and recall outcomes among participants who read and signed the consent form accompanied by a family member/friend versus those of participants who read and signed the consent form unaccompanied. Comprehension and recall of consent form information were measured at one week and one month respectively, using Part A of the Quality of Informed Consent Questionnaire (QuIC). RESULTS: The mean age of the sample of 143 participants was 71 years (SD = 8.6 years). Analysis of covariance was used to compare QuIC scores between the intervention group (n = 70) and control group (n = 73). In the 1-week model, no statistically significant intervention effect was found (p = 0.860). However, the intervention status by patient status interaction was statistically significant (p = 0.012). In the 1-month model, no statistically significant intervention effect was found (p = 0.480). Again, however, the intervention status by patient status interaction was statistically significant (p = 0.040). At both time periods, intervention group patients scored higher (better) on the QuIC than did intervention group caregivers, and control group patients scored lower (worse) on the QuIC than did control group caregivers. IMPLICATIONS: Social support played a significant role in enhancing comprehension and recall of consent form information among patients. C1 [Ford, M. E.] Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. [Kallen, M.; Richardson, P.; Matthiesen, E.; Cox, V.; Petersen, N. J.] Baylor Coll Med, Dept Med, Michael E DeBakey Vet Affairs Med Ctr 152, Houston, TX 77030 USA. [Kallen, M.; Richardson, P.; Matthiesen, E.; Cox, V.; Petersen, N. J.] Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. [Teng, E. J.] Michael E DeBakey Vet Affairs Med Ctr 152, Houston, TX USA. [Cook, K. F.] Baylor Coll Med, Dept Neurol, PADRECC, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Ford, ME (reprint author), Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, 135 Cannon St,Suite 303,POB 250835, Charleston, SC 29425 USA. EM fordmar@musc.edu FU NCI NIH HHS [N01-CN-25512]; NIA NIH HHS [I P30 AG 21677]; NIMHD NIH HHS [RFA-MD-04-0] NR 15 TC 8 Z9 8 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0306-6800 J9 J MED ETHICS JI J. Med. Ethics PD JAN 1 PY 2008 VL 34 IS 1 BP 41 EP 47 DI 10.1136/jme.2006.018192 PG 7 WC Ethics; Medical Ethics; Social Issues; Social Sciences, Biomedical SC Social Sciences - Other Topics; Medical Ethics; Social Issues; Biomedical Social Sciences GA 243ZO UT WOS:000251836000013 PM 18156521 ER PT J AU Houston, TK Richman, JS Ray, MN Allison, JJ Gilbert, GH Shewchuk, RM Kohler, CL Kiefe, CI AF Houston, Thomas K. Richman, Joshua S. Ray, Midge N. Allison, Jeroan J. Gilbert, Gregg H. Shewchuk, Richard M. Kohler, Connie L. Kiefe, Catarina I. CA DPBRN Collaborative Grp TI Internet Delivered Support for Tobacco Control in Dental Practice: Randomized Controlled Trial SO JOURNAL OF MEDICAL INTERNET RESEARCH LA English DT Article DE Smoking cessation; Internet; general practice; dental; randomized controlled trial; health services research ID ECOLOGICAL MOMENTARY ASSESSMENT; CONTINUING MEDICAL-EDUCATION; SMOKING-CESSATION; HEALTH-CARE; INTERVENTION; PHYSICIANS; DENTISTS; PROGRAM; USERS; BIOTERRORISM AB Background: The dental visit is a unique opportunity for tobacco control. Despite evidence of effectiveness in dental settings, brief provider-delivered cessation advice is underutilized. Objective: To evaluate an Internet-delivered intervention designed to increase implementation of brief provider advice for tobacco cessation in dental practice settings. Methods: Dental practices (N = 190) were randomized to the intervention website or wait-list control. Pre-intervention and after 8 months of follow-up, each practice distributed exit cards (brief patient surveys assessing provider performance, completed immediately after the dental visit) to 100 patients. Based on these exit cards, we assessed: whether patients were asked about tobacco use (ASK) and, among tobacco users, whether they were advised to quit tobacco (ADVISE). All intervention practices with follow-tip exit card data were analyzed as randomized regardless of whether they participated in the Internet-delivered intervention. Results: Of the 190 practices randomized, 143 (75%) dental practices provided follow-up data. Intervention practices' mean performance improved post-intenention by 4% on ASK (29% baseline, adjusted odds ratio = 1.29 [95% CI 1.17-1.42]), and by 11% on ADVISE (44% baseline, OR = 1.55 [95% CI 1.28-1.87]). Control practices improved by 3% on ASK (Adj. OR I. 18 [95% CI 1.07-1.29]) and did not significantly improve in ADVISE. A significant group-by-time interaction effect indicated that intervention practices improved more over the study period than control practices for ADVISE (P = 0.042) but not for ASK. Conclusion: This low-intensity, easily disseminated intervention was successful in improving provider performance on advice to quit. C1 [Houston, Thomas K.; Allison, Jeroan J.] Univ Alabama, Div Gen Internal Med, Birmingham, AL 35294 USA. [Houston, Thomas K.] Birmingham VA Med Ctr, Surg & Med Acute Care & Adv Illness Res & Transit, VA HSR&D REAP, Birmingham, AL USA. [Houston, Thomas K.; Richman, Joshua S.; Ray, Midge N.; Allison, Jeroan J.; Gilbert, Gregg H.; Shewchuk, Richard M.; Kiefe, Catarina I.] Univ Alabama, Ctr Outcomes & Effectiveness Res, Birmingham, AL 35294 USA. [Richman, Joshua S.; Allison, Jeroan J.; Kiefe, Catarina I.] Univ Alabama, Div Prevent Med, Birmingham, AL 35294 USA. [Ray, Midge N.; Shewchuk, Richard M.] Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL 35294 USA. [Gilbert, Gregg H.] Univ Alabama, Sch Dent, Dept Diagnost Sci, Birmingham, AL 35294 USA. [Kohler, Connie L.] Univ Alabama, Sch Publ Hlth, Dept Hlth Behav, Birmingham, AL 35294 USA. [DPBRN Collaborative Grp] Dent PBRN Org, Birmingham, AL USA. RP Houston, TK (reprint author), Univ Alabama, Div Gen Internal Med, 1530 3rd Ave S,FOT 720, Birmingham, AL 35294 USA. EM thouston@uab.edu RI Houston, Thomas/F-2469-2013 OI Allison, Jeroan/0000-0003-4472-2112 FU National Institute on Drug Abuse (NIDA) [R01-DA-17971]; Translational Research In Dental Practice-Based Tobacco Control Interventions [RFA DE-03-007]; National Institute of Dental and Craniofacial Research (NIDCR) [U01-DE-16747, U01-DE-16746]; National Institute of Dental and Craniofacial Research (NIDCR); National Institutes of Health FX We would like to thank Dr. Sharina Person, Biostatistician, Jackie Causey, Data Base Analyst, and Jessica Williams and Heather Coley, Research Assistants, for their contributions. We are grateful for their invaluable assistance with the study. This project was supported by grants R01-DA-17971 from the National Institute on Drug Abuse (NIDA) funded through RFA DE-03-007 "Translational Research In Dental Practice-Based Tobacco Control Interventions", and grants U01-DE-16747, and U01-DE-16746 from the National Institute of Dental and Craniofacial Research (NIDCR) at the National Institutes of Health. The investigators were independent of the funding agency in terms of study design, intervention development, data collection and analyses, and interpretation. NR 57 TC 19 Z9 19 U1 1 U2 4 PU JOURNAL MEDICAL INTERNET RESEARCH PI TORONTO PA TORONTO GENERAL HOSPITAL, R FRASER ELLIOTT BLDG, 4TH FL, R 4S435, 190 ELIZABETH ST, TORONTO, ON M5G 2C4, CANADA SN 1438-8871 J9 J MED INTERNET RES JI J. Med. Internet Res. PY 2008 VL 10 IS 5 AR e38 DI 10.2196/jmir.1095 PG 12 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 405HW UT WOS:000263214800006 PM 18984559 ER PT J AU Greyson, CR Schwartz, GG Lu, L Ye, SY Helmke, S Xu, Y Ahmad, H AF Greyson, Clifford R. Schwartz, Gregory G. Lu, Li Ye, Shuyu Helmke, Steve Xu, Ya Ahmad, Hasan TI Calpain inhibition attenuates right ventricular contractile dysfunction after acute pressure overload SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE hypertension; pulmonary; ventricular dysfunction; right; myocardial contraction; calpain; protease inhibitors; calpastatin ID RECRUITABLE STROKE WORK; RAT-HEART; PULMONARY-HYPERTENSION; TROPONIN-I; STUNNED MYOCARDIUM; SKELETAL-MUSCLE; CONSCIOUS DOGS; BRIEF ISCHEMIA; INTACT HEART; CALPASTATIN AB Right ventricular contractile failure from acute RV pressure overload is an important cause of morbidity and mortality, but the mechanism of RV failure in this setting is incompletely defined. We hypothesized that RV dysfunction from acute RV pressure overload is, in part, due to activation of calpain, and that calpain inhibition would therefore attenuate RV dysfunction. Anesthetized, open chest pigs were treated with the calpain inhibitor MDL-28170 or with inactive vehicle, and then subjected to acute RV pressure overload for 90 min. RV contractile function was assessed by the regional Frank-Starling relation. RV myocardial tissue was analyzed for evidence of calpain activation and calpain-mediated proteolysis. RV pressure overload caused severe contractile dysfunction, along with significant alterations in the endogenous calpain inhibitor calpastatin typical of calpain activation. MDL-28170 attenuated RV free wall dysfunction by more than 50%. However, there were no differences in degradation of spectrin, desmin, troponin-I or SERCA2 between SHAM operated pigs and pigs subjected to acute RV pressure overload, or between vehicle and MDL-28170 treated pigs. Acute RV pressure overload causes calpain activation, and RV contractile dysfunction from acute RV pressure overload is attenuated by the calpain inhibitor MDL-28170; however, the effect is not explained by inhibition of calpain-mediated degradation of spectrin, desmin, troponin-I or SERCA2. Because this is the first report of any agent that can directly attenuate RV contractile dysfunction in acute RV pressure overload, further investigation of the mechanism of action of MDL-28170 in this setting is warranted. (C) 2007 Elsevier Inc. All rights reserved. C1 [Greyson, Clifford R.; Schwartz, Gregory G.; Lu, Li; Ye, Shuyu; Xu, Ya; Ahmad, Hasan] Denver VA Med Ctr, Cardiol Sect, Denver, CO 80220 USA. [Greyson, Clifford R.; Schwartz, Gregory G.; Lu, Li; Ye, Shuyu; Xu, Ya; Ahmad, Hasan] Univ Colorado, Hlth Sci Ctr, Denver, CO 80202 USA. [Helmke, Steve] Univ Colorado, Hlth Sci Ctr, Sch Med, Div Gastroenterol & Hepatol, Denver, CO 80202 USA. RP Greyson, CR (reprint author), Denver VA Med Ctr, Cardiol Sect, Cardiol 111B,1055 Clermont St, Denver, CO 80220 USA. EM Clifford.Greyson@UCHSC.edu FU NHLBI NIH HHS [K08 HL003475-06, F32HL076072, F32 HL076072, R01 HL068606-02, R01 HL068606, R01 HL049944, R01 HL068606-01A2, HL49944, HL68606, K08 HL003475-05, R01 HL068606-03, R01 HL068606-04, R56 HL049944] NR 46 TC 17 Z9 17 U1 0 U2 2 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD JAN PY 2008 VL 44 IS 1 BP 59 EP 68 DI 10.1016/j.yjmcc.2007.10.010 PG 10 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 257MR UT WOS:000252803700007 PM 18068185 ER PT J AU Spruill, LS Baicu, CF Zile, MR McDermott, PJ AF Spruill, Laura S. Baicu, Catalin F. Zile, Michael R. McDermott, Paul J. TI Selective translation of mRNAs in the left ventricular myocardium of the mouse in response to acute pressure overload SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE cardiac hypertrophy; gene expression; protein biosynthesis; translation; polyribosomes; messenger RNA; 5 ' untranslated regions ID CARDIAC-HYPERTROPHY; PROTEIN-SYNTHESIS; ADULT MYOCARDIUM; GENE-EXPRESSION; HEART-FAILURE; C-JUN; INITIATION; GROWTH; MECHANISMS; MDM2 AB During pressure overload hypertrophy, selective changes in cardiac gene expression occur that regulate growth and modify the structural and functional properties of the myocardium. To determine the role of translational mechanisms, a murine model of transverse aortic constriction was used to screen a set of specified mRNAs for changes in translational activity by measuring incorporation into polysomes in response to acute pressure overload. Candidate mRNAs were selected on the basis of two main criteria: (1) the 5'-untranslated region of the mRNA contains an excessive amount of secondary structure (Delta G < -50 kCal/mol), which is postulated to regulate efficiency of translation, and (2) the protein product has been implicated in the regulation of cardiac hypeytrophy. After 24 h of transverse aortic constriction, homogenates derived from the left ventricle were layered onto 15-50% linear sucrose gradients and resolved into monosome fractions (messenger ribonucleoprotein particles) and polysome fractions by density gradient ultracentrifugation. The levels of mRNA in each fraction were quantified by real-time RT-PCR. The screen revealed that pressure overload increased translational activity of 6 candidate mRNAs as determined by a significant increase in the percentage of total mRNA incorporated into the polysome fractions. The mRNAs code for several functional classes of proteins linked to cardiac hypertrophy: the transcription factors c-myc, c-jun and MEF2D, growth factors VEGF and FGF-2 and the E3 ubiquitin ligase MDM2. These studies demonstrate that acute pressure overload alters cardiac gene expression by mechanisms that selectively regulate translational activity of specific mRNAs. (C) 2007 Elsevier Inc. All rights reserved. C1 [McDermott, Paul J.] Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Charleston, SC 29403 USA. Vet Affairs Med Ctr, Ralph H Johnson Dept, Charleston, SC 29403 USA. RP McDermott, PJ (reprint author), Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Room303,Strom Thurmond Biomed Res Bldg,114 Dought, Charleston, SC 29403 USA. EM mcdermp@musc.edu FU NHLBI NIH HHS [P01 HL048788-159006, P01 HL048788-150001, P01 HL048788, P01 HL-48788] NR 37 TC 11 Z9 11 U1 0 U2 2 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD JAN PY 2008 VL 44 IS 1 BP 69 EP 75 DI 10.1016/j.yjmcc.2007.10.011 PG 7 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 257MR UT WOS:000252803700008 PM 18036610 ER PT J AU Copeland, LA Zeber, JE Salloum, IM Pincus, HA Fine, MJ Kilbourne, AM AF Copeland, Laurel A. Zeber, John E. Salloum, Ihsan M. Pincus, Harold A. Fine, Michael J. Kilbourne, Amy M. TI Treatment adherence and illness insight in veterans with bipolar disorder SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Article DE bipolar disorder; illness insight; patient acceptance of health care; patient nonadherence; veterans ID RANDOMIZED CONTROLLED-TRIAL; MEDICATION ADHERENCE; COGNITIVE THERAPY; ANTIPSYCHOTIC MEDICATIONS; RELAPSE PREVENTION; SCHIZOPHRENIA; MAINTENANCE; LITHIUM; MANIA; NONADHERENCE AB Insight into the perceived value of psychotherapy and pharmacological treatment may improve adherence to medication regimens among patients with bipolar disorder, because patients are more likely to take medication they believe will make them better. We conducted a cross-sectional survey of patients recruited into the Continuous Improvement for Veterans in Care-Mood Disorders (CIVIC-MD; July 2004-July 2006), assessing therapeutic insight and 2 measures of medication adherence: the Morisky scale of intrapersonal barriers and missing any doses the previous 4 days. Among 435 patients with bipolar disorder, 27% had poor adherence based on missed dose and 46% had poor adherence based on the Morisky. In multivariable models, greater insight into medication was negatively associated with both measures of poor adherence. Odds of poor adherence increased for women, African Americans, mania, and hazardous drinking. The association of mutable factors-hazardous drinking, manic symptoms, and insight-could represent an opportunity to improve adherence. C1 [Copeland, Laurel A.; Zeber, John E.] VERDICT, S Texas Vet Hlth Care Syst, HSR&D, San Antonio, TX 78229 USA. [Copeland, Laurel A.; Zeber, John E.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA. [Salloum, Ihsan M.] Univ Miami, Dept Psychiat & Behav Sci, Leonard M Miller Sch Med, Miami, FL 33152 USA. [Pincus, Harold A.] Columbia Univ, Dept Psychiat, New York, NY USA. [Pincus, Harold A.] New York Presbyterian Hosp, New York, NY USA. [Fine, Michael J.] Ctr Hlth Equ Res & Promot, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Fine, Michael J.] Univ Pittsburgh, Div Gen Internal Med, Dept Med, Pittsburgh, PA USA. [Kilbourne, Amy M.] Serious Mental Illness Treatment Res & Educ Ctr, VA Ann Arbor Healthcare Syst, Ann Arbor, MI USA. [Kilbourne, Amy M.] Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. RP Copeland, LA (reprint author), VERDICT, S Texas Vet Hlth Care Syst, HSR&D, 7400 Merton Minter 11c6, San Antonio, TX 78229 USA. EM laurel.copeland@va.gov OI Copeland, Laurel/0000-0002-9478-0209 FU NIAID NIH HHS [5K24AI01769] NR 43 TC 37 Z9 40 U1 4 U2 6 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 JAN PY 2008 VL 196 IS 1 BP 16 EP 21 DI 10.1097/NMD.0b013e31815fa4d4 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 253IN UT WOS:000252512000003 PM 18195637 ER PT J AU Elkassabany, NM Bhatia, J Deogaonkar, A Barnett, GH Lotto, M Maurtua, M Ebrahim, Z Schubert, A Ference, S Farag, E AF Elkassabany, Nabil M. Bhatia, Jasmine Deogaonkar, Anupa Barnett, Gene H. Lotto, Michelle Maurtua, Marco Ebrahim, Zeyd Schubert, Armin Ference, Sandra Farag, Ehab TI Perioperative complications of blood brain barrier disruption under general anesthesia: A retrospective review SO JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY LA English DT Review DE blood brain barrier disruption; primary central nervous system lymphoma ID ENHANCED CHEMOTHERAPY DELIVERY; INTRAARTERIAL CHEMOTHERAPY; TUMORS AB Blood brain barrier disruption enhances drug delivery in pritmary central nervous system lymphoma. In this study, we report adverse events that were encountered intraoperatively and in the postoperative period in these patients. A retrospective analysis of 17 patients documenting demographic data, pre-procedure medical history, intraoperative, and postoperative anesthetic complications was conducted between January 2002 and December 2004. Seventeen patients underwent 210 treatments under general anesthesia with a mean of 12.4 +/- 7.2 treatments per patient. Focal seizures occurred in 13% of patients. Generalized motor seizures occurred in 4 treatment sessions in 2 different patients. The incidence of seizures was significantly higher when the internal carotid artery was used for injection, as opposed to the vertebral artery (20.8% and 6.02%, respectively, P = 0.0034). Tachycardia associated with ST segment depression occurred 9 times (4.3%) in 3 patients. One patient had significant ST segment elevation (more than 1.5mm). Transient cerebral vasospasm after methotrexate injection occurred in 9% of patients. Postoperative nausea and vomiting were observed in 11.9% of patients. After emergence, lethargy and obtundation occurred in 7.6% of the cases. The incidence of postoperative headache and reversible motor deficits was 6% and 3.8%, respectively. Our review highlights the problems that were encountered during blood brain barrier disruption under anesthesia and in the postoperative period. Further prospective studies are required for comprehensive evaluation of intraprocedure and postprocedure complications that will allow development of an optimal anesthetic plan and will improve patient outcome by preventing potential complications. C1 [Lotto, Michelle; Maurtua, Marco; Ebrahim, Zeyd; Schubert, Armin; Farag, Ehab] Cleveland Clin, Dept Gen Anesthesiol, Cleveland, OH 44195 USA. [Barnett, Gene H.; Ference, Sandra] Cleveland Clin, Dept Brain Tumor, Cleveland, OH 44195 USA. [Barnett, Gene H.; Ference, Sandra] Cleveland Clin, Neurooncol Ctr, Cleveland, OH 44195 USA. [Farag, Ehab] Cleveland Clin, Dept Outcomes Res, Cleveland, OH 44195 USA. [Bhatia, Jasmine; Deogaonkar, Anupa] Cleveland Clin, Div Anesthesiol & Crit Care Med, Cleveland, OH 44195 USA. [Lotto, Michelle; Maurtua, Marco; Schubert, Armin; Farag, Ehab] Case Western Reserve Univ, Cleveland Clin, Lerner Coll Med, Cleveland, OH 44106 USA. [Elkassabany, Nabil M.] Univ Penn, Dept Anesthesia & Crit Care, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Farag, E (reprint author), Cleveland Clin, Dept Gen Anesthesiol, E31,9500 Euclid Ave, Cleveland, OH 44195 USA. EM farage@ccf.org RI Schubert, Armin/D-3589-2011 NR 15 TC 13 Z9 13 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0898-4921 J9 J NEUROSURG ANESTH JI J. Neurosurg. Anesthesiol. PD JAN PY 2008 VL 20 IS 1 BP 45 EP 48 PG 4 WC Anesthesiology; Clinical Neurology; Surgery SC Anesthesiology; Neurosciences & Neurology; Surgery GA 247VB UT WOS:000252109600008 PM 18157025 ER PT J AU Friedlander, AH Tajima, T Kawakami, KT Wang, MB Tomlinson, J AF Friedlander, Arthur H. Tajima, Tracey Kawakami, Kyle T. Wang, Marilene B. Tomlinson, James TI The relationship between measures of nutritional status and masticatory function in untreated patients with head and neck cancer SO JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY LA English DT Article; Proceedings Paper CT 89th Annual Meeting of the American-Association-of-Oral-and-Maxillofacial-Surgeons CY OCT 12, 2007 CL Honolulu, HI SP Amer Assoc Oral & Maxillofacial Surg ID QUALITY-OF-LIFE; ORAL-CANCER; ADVANCED-CARCINOMA; WEIGHT-LOSS; DENTITION; DISEASE; CACHEXIA; ALCOHOL; RISK; DIET AB Purpose: Nearly 40% of newly diagnosed patients with head and neck cancer are malnourished before treatment begins with many researchers ascribing the malnutrition to a paucity of teeth. We attempted to determine if inadequate numbers of occluding pairs of teeth, rather than mere numbers of teeth, in newly hospitalized, untreated head and neck cancer patients correlates with nutritional status parameters used to identify those at heightened risk for malnutrition-related complications. Patients and Methods: Patients and cancer-free, matched controls were evaluated for malnutrition (body mass index <= 20 [weight (kg)/height (m(2))]), serum albumin <= 2.7 g/dL, hemoglobin <= 11.9 g/dL, and total lymphocyte count <= 1,449/mu L), and inadequate numbers of occluding pairs of teeth variably defined as less than 5 "posterior pairs" of occluding teeth or less than 6 or 7 "total pairs" of occluding teeth. Results: Head and neck cancer patients had significantly lower body mass index (P =.005) and total lymphocyte count (P =.019) than controls, but there were no significant correlations between the nutritional and dental variables in either group. Conclusions: Untreated head and neck cancer patients frequently have nutritional status parameters indicating heightened risk for malnutrition-related complications but inadequate masticatory function is not a causative factor. C1 [Friedlander, Arthur H.; Tajima, Tracey; Kawakami, Kyle T.; Wang, Marilene B.; Tomlinson, James] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. [Friedlander, Arthur H.] Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. [Friedlander, Arthur H.] Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. [Tomlinson, James] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Friedlander, AH (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM arthur.friedlander@med.va.gov NR 55 TC 6 Z9 7 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 0278-2391 J9 J ORAL MAXIL SURG JI J. Oral Maxillofac. Surg. PD JAN PY 2008 VL 66 IS 1 BP 85 EP 92 DI 10.1016/j.joms.2007.08.023 PG 8 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 245VG UT WOS:000251966300014 PM 18083420 ER PT J AU Dworkin, RH Gnann, JW Oaklander, AL Raja, SN Schmader, KE Whitley, RJ AF Dworkin, Robert H. Gnann, John W., Jr. Oaklander, Anne Louise Raja, Srinivasa N. Schmader, Kenneth E. Whitley, Richard J. TI Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia SO JOURNAL OF PAIN LA English DT Article DE herpes zoster; postherpetic neuralgia; diagnosis; assessment; acute pain; chronic pain ID QUALITY-OF-LIFE; PLACEBO-CONTROLLED TRIAL; NEUROPATHIC PAIN; CLINICAL-TRIALS; IMMPACT RECOMMENDATIONS; OUTCOME MEASURES; DOUBLE-BLIND; ACYCLOVIR; THERAPY; IMPACT AB Accurate evaluation of pain plays a critical role in identifying new interventions for the treatment and prevention of herpes zoster and postherpetic neuralgia (PHN). Different types of pain and other sensory symptoms are found in patients with herpes zoster, and these vary greatly with respect to their presence, location, duration, intensity, and quality. The results of recent studies of herpes zoster and PHN and the development of new methods for assessing neuropathic pain provide a foundation for diagnosing and assessing the pain associated with herpes zoster. We review the results of recent research to identify the essential components that must be considered in developing an evidence-based description of pain associated with herpes zoster and PHN. Perspective: Comprehensive assessments of pain are necessary for clinical research on the epidemiology, natural history, pathophysiologic mechanisms, treatment and prevention of pain in herpes zoster and PHN. (c) 2008 by the American Pain Society. C1 [Dworkin, Robert H.] Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA. [Dworkin, Robert H.] Univ Rochester, Sch Med & Dent, Dept Neurol, Rochester, NY 14642 USA. [Gnann, John W., Jr.] Univ Alabama, Dept Med, Birmingham, AL 35294 USA. [Gnann, John W., Jr.] Birmingham VA Med Ctr, Birmingham, AL 35294 USA. [Oaklander, Anne Louise] Harvard Univ, Dept Neurol, Boston, MA 02115 USA. [Raja, Srinivasa N.] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21205 USA. [Schmader, Kenneth E.] Duke Univ, Durham VA Med Ctr, Dept Med, Durham, NC USA. [Whitley, Richard J.] Univ Alabama, Dept Pediat, Birmingham, AL USA. 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 OI Yang, Shuman/0000-0002-9638-0890 NR 55 TC 62 Z9 68 U1 1 U2 7 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD JAN PY 2008 VL 9 IS 1 SU 1 BP S37 EP S44 DI 10.1016/j.jpain.2007.10.008 PG 8 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 256AK UT WOS:000252699900006 PM 18166464 ER PT J AU Gnann, JW AF Gnann, John W., Jr. TI Vaccination to prevent herpes zoster in older adults SO JOURNAL OF PAIN LA English DT Article DE herpes zoster; zoster vaccine; postherpetic neuralgia ID ATTENUATED VARICELLA VACCINE; CELL-MEDIATED-IMMUNITY; POSTHERPETIC NEURALGIA; VIRUS; RESPONSES; INFECTIONS; DECLINE; AGE AB Herpes zoster causes substantial morbidity, especially among older adults. Although the acute cutaneous manifestations can be painful and troublesome, the most important consequence of herpes zoster (shingles) is the chronic pain syndrome known as postherpetic neuralgia (PHN). Previous studies have suggested that declining varicella-zoster virus (VZV)-specific cell-mediated immune (CMI) responses account for the increased frequency of herpes zoster seen in older adults. This led to the idea that immunization designed to boost VZV-specific CMI responses might reduce the risk of herpes zoster. This hypothesis was tested in a large, randomized, placebo-controlled clinical trial called the Shingles Prevention Study (SPS). Compared with the placebo group, herpes zoster vaccine recipients had a 61.1% reduction in zoster "burden of illness" (an index incorporating incidence and severity of herpes zoster); a 66.5% reduction in the incidence of postherpetic neuralgia; and a 51.3% reduction in the incidence of herpes zoster. The incidence of serious adverse events was not different between the overall vaccine and placebo populations. The most frequently encountered adverse event among vaccine recipients was local reactogenicity, with self-limited and generally mild tenderness, warmth, or erythema occurring at the injection site in about one-half of vaccine recipients. The zoster vaccine was approved by the US Food and Drug Administration in 2006 and is indicated for prevention of herpes zoster in immunocompetent persons aged 60 years and older. Perspective: The herpes zoster vaccine provides physicians with an effective means for reducing a patient's risk for developing shingles and its attendant complications. No significant safety concerns regarding the vaccine have been identified Indications for use of the attenuated-virus vaccine in special subpopulations continue to evolve. (c) 2008 by the American Pain Society. C1 [Gnann, John W., Jr.] Univ Alabama, Dept Med, Birmingham, AL 35294 USA. [Gnann, John W., Jr.] Univ Alabama, Dept Pediat, Birmingham, AL 35294 USA. [Gnann, John W., Jr.] Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. [Gnann, John W., Jr.] Birmingham VA Med Ctr, Birmingham, AL USA. RP Gnann, JW (reprint author), Univ Alabama, Dept Med, 330 Community care Bldg,908 20th St S, Birmingham, AL 35294 USA. EM jgnann@uab.edu NR 33 TC 23 Z9 26 U1 0 U2 2 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 1526-5900 J9 J PAIN JI J. Pain PD JAN PY 2008 VL 9 IS 1 SU 1 BP S31 EP S36 DI 10.1016/j.jpain.2007.10.007 PG 6 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 256AK UT WOS:000252699900005 PM 18166463 ER PT J AU Casarett, D Pickard, A Bailey, FA Ritchie, CS Furman, CD Rosenfeld, K Shreve, S Shea, J AF Casarett, David Pickard, Amy Bailey, F. Amos Ritchie, Christine Seel Furman, Christian Davis Rosenfeld, Ken Shreve, Scott Shea, Judy TI A nationwide VA palliative care quality measure: The Family Assessment of Treatment at the End of Life SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID ITEM RESPONSE THEORY; HOSPICE CARE; DATA SET; PERSPECTIVES; VALIDATION; MEMBERS; HEALTH; DEATH; OLDER AB Objectives: To evaluate the FATE ( Family Assessment of Treatment at End of Life) Survey for use as a nationwide quality measure in the VA health care system. Design: Nationwide telephone survey. Setting: Five VA medical centers. Participants: Eligible patients received inpatient or outpatient care from a participating VA facility in the last month of life. One respondent/patient was selected using predefined eligibility criteria and invited to participate. Measurements: The FATE survey consists of 32 items in 9 domains: Well-being and dignity (4 items), Information and communication (5 items), Respect for treatment preferences (2 items), Emotional and spiritual support (3 items), Management of symptoms (4 items), Choice of inpatient facility (1 item), Care around the time of death (6 items), Access to VA services (4 items), and Access to VA benefits after the patient's death (3 items). Results: Interviews were completed with 309 respondents. The FATE showed excellent psychometric characteristics, with good homogeneity (e.g., Cronbach (alpha = 0.91) and no evidence of significant ceiling effects. The FATE also demonstrated good discriminant validity. For instance, FATE scores varied across facilities ( range 44-72; Kruskal Wallis test p < 0.001). Patients who were seen by a palliative care service had better scores ( mean 66 versus 52; rank sum test p < 0.001), as did patients who were referred to hospice (67 versus 49; rank sum test p < 0.001). Conclusions: The FATE survey offers an important source of quality data that can be used to improve the end-of-life care of all veterans, regardless of the type of care they receive or their site of death. C1 [Casarett, David] Univ Penn, Philadelphia, PA 19104 USA. [Shreve, Scott] Lebanon VA, Lebanon, PA USA. [Rosenfeld, Ken] Greater Los Angeles VA, Los Angeles, CA USA. [Furman, Christian Davis] Univ Louisville, Dept Family & Geriatr Med, Louisville, KY 40292 USA. [Ritchie, Christine Seel] Univ Alabama, Ctr Palliat Care, Birmingham, AL USA. [Bailey, F. Amos; Ritchie, Christine Seel] Birmingham VAMC, Birmingham, AL USA. [Casarett, David; Pickard, Amy; Shea, Judy] Philadelphia VAMC, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Casarett, D (reprint author), Univ Penn, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM Casarett@mail.med.upenn.edu NR 21 TC 39 Z9 40 U1 0 U2 5 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 JAN PY 2008 VL 11 IS 1 BP 68 EP 75 DI 10.1089/jpm.2007.0104 PG 8 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 254AY UT WOS:000252559900014 PM 18370895 ER PT J AU Hermsen, JL Gomez, FE Maeshima, Y Sano, Y Woodae, K Kudsk, KA AF Hermsen, Joshua L. Gomez, F. Enrique Maeshima, Yoshinori Sano, Yoshifumi Kang, Woodae Kudsk, Kenneth A. TI Decreased enteral stimulation alters mucosal immune chemokines SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID TOTAL PARENTERAL-NUTRITION; HIGH ENDOTHELIAL VENULES; ADHESION MOLECULE-1 MADCAM-1; UPPER RESPIRATORY-TRACT; MAJOR ABDOMINAL-TRAUMA; RNA-BINDING PROTEIN; LYMPHOID-TISSUE; MESSENGER-RNA; DENDRITIC CELLS; INTRAEPITHELIAL LYMPHOCYTES AB Background: Migration of lymphocytes into and through the mucosal immune system depends upon adhesion molecules to attract circulating cells and chemokines to stimulate diapedesis into tissues. Decreased enteral stimulation significantly reduces mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) levels, an adhesion molecule critical for homing of T and B cells to Peyer's patches (PP), which reduces PP and intestinal T and B cells. We studied the effect of type and route of nutrition on tissue specific chemokines in PP (CXCL-12, -13 and CCL-19, -20 and -21), small intestine (SI; CCL-20, -25 and -28) and lung (CXCL-12, CCL-28). Methods: Intravenously cannulated male Institute of Cancer Research (ICR) mice were randomized to chow or parenteral nutrition (PN) for 5 days. PP, SI, and lung chemokine mRNA levels were measured using real-time qRT-polymerase chain reaction, and analyzed serniquantitatively by the Delta Delta Ct method. Protein levels were quantified using enzyme-linked immunosorbent assay (ELISA) techniques, and groups compared using Student's t-test. Results: PP CXCL13 protein significantly decreased, whereas CCL21 protein increased significantly in the parenterally fed group. Parenteral feeding significantly decreased SI CCL20 and CCL 25 protein levels. CCL28 decreased significantly in the SI and lung of intravenously fed animals. mRNA levels changed in the opposite direction (compared with protein) for all chemokines except CCL28. Conclusions: Decreased enteral stimulation significantly alters key mucosal immune chemokine protein levels at multiple sites. In general, PN (and concomitant lack of enteral stimulation) results in decreased levels of chemokines that control lymphocyte migration within the mucosal immune system. C1 [Hermsen, Joshua L.; Gomez, F. Enrique; Maeshima, Yoshinori; Sano, Yoshifumi; Kang, Woodae; Kudsk, Kenneth A.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Surg, Madison, WI 53792 USA. [Kudsk, Kenneth A.] Univ Wisconsin Hosp & Clin, William S Middleton Mem Vet Adm Hosp, Madison, WI 53792 USA. RP Kudsk, KA (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, Dept Surg, H4-736 Clin Sci Ctr, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu FU PHS HHS [R01 6M53439] NR 60 TC 10 Z9 12 U1 0 U2 2 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD JAN-FEB PY 2008 VL 32 IS 1 BP 36 EP 44 DI 10.1177/014860710803200136 PG 9 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 247IO UT WOS:000252072000006 PM 18165445 ER PT J AU Gesty-Palmer, D Luttrell, LM AF Gesty-Palmer, Diane Luttrell, Louis M. TI Heptahelical terpsichory. Who calls the tune? SO JOURNAL OF RECEPTORS AND SIGNAL TRANSDUCTION LA English DT Article; Proceedings Paper CT Annual Meeting of the Great Lakes GPCR Retreat CY SEP 27-29, 2007 CL London, CANADA ID PROTEIN-COUPLED RECEPTOR; BETA(2) ADRENERGIC-RECEPTOR; PARATHYROID-HORMONE PTH; NUCLEAR EXPORT SIGNAL; TERNARY COMPLEX MODEL; BETA(2)-ADRENERGIC RECEPTOR; ERK1/2 ACTIVATION; EFFECTOR PATHWAY; TYROSINE PHOSPHORYLATION; CONSTITUTIVE ACTIVATION AB The discovery that arrestins can function as ligand-regulated signaling scaffolds has revealed a previously unappreciated level of complexity in G protein-coupled receptor (GPCR) signal transduction. Because arrestin-bound GPCRs are uncoupled from G proteins, arrestin binding can be viewed as switching receptors between two temporally and spatially distinct signaling modes. Recent work has established two factors that underscore this duality of GPCR signaling and suggest it may ultimately have therapeutic significance. The first is that signaling by receptor-arrestin "signalsomes" does not require heterotrimeric G protein activation. The second is that arrestin-dependent signals can be initiated by pathway-specific "biased agonists," creating the potential for drugs that selectively modulate different aspects of GPCR function. Currently, however, little is known about the physiological relevance of G protein-independent signals at the cellular or whole animal levels, and additional work is needed to determine whether arrestin pathway-selective drugs will find clinical application. C1 [Luttrell, Louis M.] Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. [Luttrell, Louis M.] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Luttrell, Louis M.] Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC USA. [Gesty-Palmer, Diane] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. [Gesty-Palmer, Diane] Vet Affairs Med Ctr, Durham, NC USA. RP Luttrell, LM (reprint author), Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, 96 Jonathan Lucas St,816 CSB,POB 250624, Charleston, SC 29425 USA. EM luttrell@musc.edu NR 112 TC 18 Z9 19 U1 0 U2 2 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 2008 VL 28 IS 1-2 BP 39 EP 58 DI 10.1080/10799890801941921 PG 20 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 299JR UT WOS:000255752400005 PM 18437629 ER PT J AU Cooper, RA AF Cooper, Rory A. TI In Memoriam: Men Beyond Measure SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Biographical-Item C1 [Cooper, Rory A.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Serv, Pittsburgh, PA USA. [Cooper, Rory A.] Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. [Cooper, Rory A.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Serv, Pittsburgh, PA USA. EM rcooper@pitt.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PY 2008 VL 45 IS 9 BP XVII EP XVIII PG 2 WC Rehabilitation SC Rehabilitation GA 426RN UT WOS:000264725500004 ER PT J AU Kwarciak, AM Cooper, RA Fitzgerald, SG AF Kwarciak, Andrew M. Cooper, Rory A. Fitzgerald, Shirley G. TI Curb descent testing of suspension manual wheelchairs SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE acceleration; curb descent; folding frame; manual wheelchair; rehabilitation; rigid frame; suspension; vibration suppression; wheelchair use; whole-body vibrations ID WHOLE-BODY VIBRATION; LOW-BACK-PAIN; SEAT; RESPONSES; SHOCK AB Manual wheelchair users are subjected to whole-body vibrations (WBV) on a regular basis as they traverse obstacles and uneven surfaces. One way users could protect themselves from secondary injuries related to WBV is by using a suspension manual wheelchair. This study investigated the ability of suspension manual wheelchairs to reduce seat accelerations during curb descents of various heights (5, 10, and 15 cm). Sixteen manual wheelchairs (four suspension, four folding, four rigid, and four rigid titanium) were tested. Suspension wheelchairs transmitted significantly lower peak seat accelerations than folding wheelchairs during the 5 cm curb descents (p = 0.048) and significantly lower frequency-weighted peak seat accelerations during the 5 and 10 cm curb descents (p = 0.03 for both heights). However, when the suspension wheelchair Quickie XTR (Sunrise Medical; Carlsbad, California) was removed from the analysis, the suspension wheelchairs were not significantly different from the nonsuspension wheelchairs. When weight was considered, the suspension wheelchairs had significantly lower peak seat accelerations than the lighter rigid wheelchairs during 5 cm curb descents (p = 0.047). While suspension manual wheelchairs offer some reduction in WBV during curb descents, their limitations should be considered when a wheelchair is selected for everyday use. C1 [Kwarciak, Andrew M.; Cooper, Rory A.; Fitzgerald, Shirley G.] VA Pittsburgh Healthcare Syst, VA Ctr Excellence Wheelchairs & Associated Rehabi, Human Engn Res Labs, Dept Vet Affairs, Pittsburgh, PA 15206 USA. [Kwarciak, Andrew M.; Cooper, Rory A.; Fitzgerald, Shirley G.] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. [Kwarciak, Andrew M.; Cooper, Rory A.] Univ Pittsburgh, Sch Engn, Dept Bioengn, Pittsburgh, PA 15261 USA. [Cooper, Rory A.] Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, Pittsburgh, PA 15261 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, VA Ctr Excellence Wheelchairs & Associated Rehabi, Human Engn Res Labs, Dept Vet Affairs, 151R1-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu NR 29 TC 4 Z9 4 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 2008 VL 45 IS 1 BP 73 EP 84 DI 10.1682/JRRD.2006.11.0142 PG 12 WC Rehabilitation SC Rehabilitation GA 290PB UT WOS:000255133600007 PM 18566927 ER PT J AU Magruder, KM Yeager, DE AF Magruder, Kathryn M. Yeager, Derik E. TI Patient factors relating to detection of posttraumatic stress disorder in Department of Veterans Affairs primary care settings SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE detection; diagnosis; posttraumatic stress disorder; primary care; provider recognition; PTSD; rehabilitation; screening; VA; veterans ID MENTAL-HEALTH-SERVICES; TREATMENT-SEEKING; CHRONIC PAIN; PSYCHOMETRIC PROPERTIES; MUTUAL MAINTENANCE; VIETNAM VETERANS; SOMATIC SYMPTOMS; PHYSICAL HEALTH; COMBAT VETERANS; TRAUMA VICTIMS AB We examined the impact of patient-level factors on provider recognition of posttraumatic stress disorder (PTSD). Analyses were based on a random sample of 1,079 consenting patients who had an outpatient visit at any of four southeastern Department of Veterans Affairs hospitals in 1999. We collected data on PTSD symptoms, sociodemographics, functional status, medical record diagnoses, and independent PTSD diagnostic assessments for 888 patients. Complete and usable data were available for 819 patients. A total of 98 patients (12%) met criteria for PTSD, and of these, 42 (43%) were correctly classified as such by their provider. Results indicate that age (50-64), war-zone service, worse functioning on the 36-Item Short Form Health Survey role emotional subscale, a diagnosis of musculoskeletal pain, a greater percentage of persistent reexperiencing or avoidance/numbing symptoms, and a previously diagnosed substance use disorder were all independently related to provider recognition of PTSD. Knowledge of these factors may help inform. providers and direct improved screening and case finding. C1 Ralph H Johnson Dept 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 VAMC, Mental Hlth Serv, 109 Bee St, Charleston, SC 29401 USA. EM kathryn.magruder@va.gov NR 53 TC 10 Z9 10 U1 0 U2 1 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PY 2008 VL 45 IS 3 BP 371 EP 381 DI 10.1682/JRRD.2007.06.0091 PG 11 WC Rehabilitation SC Rehabilitation GA 320JU UT WOS:000257230300005 PM 18629746 ER PT J AU Dicianno, BE Aguila, ED Cooper, RA Pasquina, PF Clark, MJ Collins, DM Fitzgerald, SG Wichman, TA AF Dicianno, Brad E. Aguila, Eric D. Cooper, Rory A. Pasquina, Paul F. Clark, Mary J. Collins, Diane M. Fitzgerald, Shirley G. Wichman, Todd A. TI Acute mountain sickness in disability and adaptive sports: Preliminary data SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE altitude sickness; brain injuries; headache; military; multiple sclerosis; rehabilitation; spinal cord injuries; sports; veterans; visual impairment ID ALTITUDE ILLNESS AB Acute mountain sickness (AMS) is a frequent complication for military personnel, veterans, athletes, and travelers at high altitudes. Symptoms may occur in individuals with less cerebrospinal fluid volume and less ability to accommodate increased brain volume. No studies on AMS exist in individuals with neurological impairments. We studied 64 subjects, including active and sedentary controls and those with tetraplegia, paraplegia, multiple sclerosis, and traumatic brain injury at the 2007 National Veterans Winter Sports Clinic in Snowmass, Colorado. Subjects completed three Lake Louise Score surveys to quantify symptoms. We found a higher than expected occurrence of AMS overall (51.6%) but no differences among groups, and few participants sought treatment. Fatigue and weakness were common symptoms. High subject activity levels may explain these findings. More research is warranted on larger sample sizes and on preventative medications and treatments for AMS, especially since many military personnel with neurological impairments are returning to full active service. C1 [Dicianno, Brad E.; Cooper, Rory A.; Collins, Diane M.] Univ Pittsburgh, Human Engn Res Labs, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.; Cooper, Rory A.] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.; Cooper, Rory A.; Collins, Diane M.] Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.; Cooper, Rory A.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15206 USA. [Dicianno, Brad E.; Cooper, Rory A.; Collins, Diane M.] Ctr Excellence Wheelchairs & Related Technol, Dept Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Aguila, Eric D.; Pasquina, Paul F.; Wichman, Todd A.] Walter Reed Army Med Ctr, Dept Phys Med & Rehabil, Washington, DC 20307 USA. [Clark, Mary J.] Grand Junct VA Med Ctr, Grand Junction, CO USA. [Fitzgerald, Shirley G.] James A Haley Tampa VA Med Ctr, Patient Safety Ctr Inquiry, Tampa, FL USA. RP Dicianno, BE (reprint author), Univ Pittsburgh, Human Engn Res Labs, VA Pittsburgh Healthcare Syst, 7180 Highland Dr,Bldg 4,2nd Floor E,151R1-H, Pittsburgh, PA 15206 USA. EM diciannob@herlpitt.org OI Dicianno, Brad/0000-0003-0738-0192 NR 12 TC 3 Z9 3 U1 0 U2 4 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 2008 VL 45 IS 4 BP 479 EP 487 DI 10.1682/JRRD.2007.08.0136 PG 9 WC Rehabilitation SC Rehabilitation GA 331KX UT WOS:000258012200002 PM 18712635 ER PT J AU Rintala, DH Matamoros, R Seitz, LL AF Rintala, Diana H. Matamoros, Rebeca Seitz, Laura L. TI Effects of assistance dogs on persons with mobility or hearing impairments: A pilot study SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE assistance; assistance dogs; deaf; disability; hearing; hearing dogs; independence; longitudinal; mobility impairment; rehabilitation; service dogs ID SOCIAL ACKNOWLEDGMENTS; SERVICE DOGS; RECIPIENTS; PEOPLE AB Service dogs help persons with mobility impairments by retrieving items and performing other tasks. Hearing dogs alert persons with hearing impairments to environmental sounds. We conducted a pre-post, wait list-controlled pilot study to assess the impact of the dogs on the lives of recipients. Participants were recruited through two assistance dog training organizations and completed an initial questionnaire packet. The Experimental group completed another packet 6 months after receiving a dog. The Control group completed a second packet 6 months after the initial data collection. On average, dog recipients were very satisfied with their assistance dogs. Both service and hearing dog recipients reduced their dependence on other persons. Service dog recipients reduced hours of paid assistance. No other significant change occurred in various standardized outcome measures. Assistance dogs had a major positive impact on the lives of recipients. More appropriate measurement instruments are needed to capture the impact of these dogs. C1 [Rintala, Diana H.; Matamoros, Rebeca; Seitz, Laura L.] Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX USA. [Rintala, Diana H.; Matamoros, Rebeca] Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. [Seitz, Laura L.] Baylor Coll Med, Dept Otorhinolaryngol, Houston, TX 77030 USA. RP Rintala, DH (reprint author), 5451 Indigo St, Houston, TX 77096 USA. EM drintala@bcm.tmc.edu NR 21 TC 13 Z9 14 U1 6 U2 25 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 2008 VL 45 IS 4 BP 489 EP 503 DI 10.1682/JRRD.2007.06.0094 PG 15 WC Rehabilitation SC Rehabilitation GA 331KX UT WOS:000258012200003 PM 18712636 ER PT J AU Bresler, L Walter, JS Jahoda, A Wheeler, JS Turk, T Wurster, RD AF Bresler, Larissa Walter, James S. Jahoda, Andrew Wheeler, John S. Turk, Thomas Wurster, Robert D. TI Effective methods of pelvic plexus nerve and bladder stimulation in anesthetized animal model SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE dog; electrical stimulation; pelvic plexus nerves; spinal cord injuries; urinary bladder; urinary incontinence; urinary retention; urinary tract physiology; urination disorders; urodynamic ID ELECTRICAL-STIMULATION; CLINICAL EXPERIENCE; ELECTRODES AB Urinary retention is a serious urological problem associated with spinal cord injuries (SCIs) and other pelvic disorders. Effective methods of pelvic nerve stimulation were investigated for this problem. Following anesthesia in five dogs, the bladder was surgically exposed. Bladder and anal sphincter pressures were recorded. Testing was first conducted with probe electrodes. Barb electrodes were then implanted with a needle near the pelvic plexus nerves and the bladder wall. We tested different electrode arrangements and stimulating parameters to induce bladder contractions without skeletal muscle stimulation. The pelvic plexus nerves near the bladder were identified, and the barb electrodes were effectively implanted. Stimulation with bipolar and bilateral electrodes induced pressures over 30 cmH(2)O without skeletal muscle activation. Common stimulation parameters were 40 pps, 400 microseconds pulse duration, and 15 to 25 mA stimulating current applied for 3 s. Effective electrode implantation methods were shown. Also identified were electrode arrangements and stimulating parameters that induced strong bladder contractions without skeletal muscle activation. However, voiding studies were not conducted. Further studies with barb electrodes are warranted, and these methods may have applications for bladder stimulation following SCI. C1 [Bresler, Larissa; Jahoda, Andrew; Wheeler, John S.; Turk, Thomas] Edward Hines Jr Dept Vet Affairs Hosp, Urol Sect, Hines, IL USA. [Bresler, Larissa; Walter, James S.; Jahoda, Andrew; Wheeler, John S.; Turk, Thomas; Wurster, Robert D.] Loyola Univ Chicago, Dept Urol, Stritch Sch Med, Maywood, IL USA. [Walter, James S.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Res Serv, Hines, IL 60141 USA. [Wurster, Robert D.] Loyola Univ Chicago, Dept Neurol Surg, Stritch Sch Med, Maywood, IL USA. [Wurster, Robert D.] Loyola Univ Chicago, Dept Physiol, Stritch Sch Med, Maywood, IL USA. RP Walter, JS (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Res Serv, Bldg 1,Rm C-318,151,5000 S 5th Ave, Hines, IL 60141 USA. EM james.walter@va.gov NR 30 TC 2 Z9 2 U1 0 U2 0 PU JOURNAL REHAB RES & DEV PI BALTIMORE PA DEPT OF VETERANS AFFAIRS REHABIL RES & DEVELOP CTR 103 SOUTH GAY STREET, BALTIMORE, MD 21202-4051 USA SN 0748-7711 J9 J REHABIL RES DEV JI J. Rehabil. Res. Dev. PY 2008 VL 45 IS 4 BP 627 EP 637 DI 10.1682/JRRD.2007.04.0058 PG 11 WC Rehabilitation SC Rehabilitation GA 331KX UT WOS:000258012200015 PM 18712648 ER PT J AU Orris, BG Jahoda, AE Walter, JS Nemchausky, BN Wurzel, R Homan, HD Melloy, S Wheeler, JS AF Orris, Bradley G. Jahoda, Andrew E. Walter, James S. Nemchausky, Bernard N. Wurzel, Rafael Homan, Harvey D. Melloy, Sally Wheeler, John S. TI A 24-hour feasibility study of intraurethral valved catheter for bladder management in males with spinal cord injury SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE catheterization; cystometry; cystoscopy; intraurethral valved catheter; neurogenic bladder; rehabilitation; spinal cord injury; urinary incontinence; urinary retention; UTI ID BENIGN PROSTATIC HYPERPLASIA; TEMPORARY; COMPLICATIONS; DYSFUNCTION; OBSTRUCTION; RISK AB This feasibility study was conducted to evaluate design features of the novel intraurethral valved catheter, Surinate (Urovalve, Inc; Newark, New Jersey). The device extends from the bladder neck to just beyond the external sphincter and contains a valve that can be activated by an external magnet for bladder emptying. Five patients were recruited from the Edward Hines Jr Department of Veterans Affairs Hospital spinal cord injury population. We conducted cystometry and cystoscopy to evaluate the lower urinary tract. Then, the device was inserted for 24 hours with careful monitoring. The catheter was removed from the first patient because he developed autonomic dysreflexia during implantation. The next four patients used the catheter overnight and tolerated it well: one with independent use and two with increased abdominal pressure. Emptying time was 208 +/- 99 s, residual was 42 +/- 33 mL, and the first-stream flow rate was 1.8 +/- 0.7 mL/s. The safety tether was used in three patients because the extraction device did not work. Results showed effective implantation and stability of the device in the urethra. However, objectives for use and extraction were not met. This feasibility study provided important information that will help guide design improvements for the intraurethral valved catheter. C1 [Orris, Bradley G.; Jahoda, Andrew E.; Wheeler, John S.] Edward Hines Jr Dept Vet Affairs Hosp, Dept Surg, Hines, IL USA. [Orris, Bradley G.; Jahoda, Andrew E.; Walter, James S.; Wheeler, John S.] Loyola Univ, Med Ctr, Dept Urol, Maywood, IL 60153 USA. [Walter, James S.; Melloy, Sally] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Res, Hines, IL 60141 USA. [Nemchausky, Bernard N.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Spinal Cord Injury, Hines, IL 60141 USA. [Wurzel, Rafael; Homan, Harvey D.] Urovalve Inc, Newark, NJ USA. RP Walter, JS (reprint author), Edward Hines Jr VA Hosp 151, Res Serv, Hines, IL 60141 USA. EM james.walter@med.va.gov FU NICHD NIH HHS [5R44HD039566-03] NR 17 TC 2 Z9 2 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 2008 VL 45 IS 4 BP 639 EP 646 DI 10.1682/JRRD.2007.07.0112 PG 8 WC Rehabilitation SC Rehabilitation GA 331KX UT WOS:000258012200016 PM 18712649 ER PT J AU Ullrich, PM Jensen, MP Loeser, JD Cardenas, DD Weaver, FM AF Ullrich, Philip M. Jensen, Mark P. Loeser, John D. Cardenas, Diana D. Weaver, Frances M. TI Pain among veterans with spinal cord injury SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE age; catastrophizing; chronic pain; functioning; pain; pain intensity; pain interference; rehabilitation; spinal cord injury; veterans ID COPING STRATEGIES QUESTIONNAIRE; LOW-BACK-PAIN; PSYCHOLOGICAL DISTRESS; PERCEIVED STRESS; LIFE EVENTS; INTERFERENCE; VALIDITY; AGE; INDIVIDUALS; NONVETERANS AB The Department of Veterans Affairs Veterans Health Administration cares for approximately 15% of persons with spinal cord injury (SCI) in the United States. However, the nature and characteristics of pain among veterans with SCI are not well understood. This study used a postal Survey to compare veterans with SCI and nonveterans with SCI on pain intensity; pain interference; functioning; and other pain, demographic, and medical characteristics. Veterans tended to be older than nonveterans but these groups were otherwise comparable on demographic and medical variables. Veterans were not significantly different from nonveterans on pain intensity or pain interference. Veterans reported lower levels of functioning than nonveterans and higher levels of pain-related catastrophizing. However, differences in functioning between veterans and nonveterans were attributable to age differences between the groups. In summary, differences between veterans with SCI and nonveterans with SCI were few and small in magnitude, suggesting that veterans with SCI are not at greater risk for pain and pain-related problems. However, pain-related catastrophizing may be a particular concern among veterans with SCI.prevalence of chronic pain after SCI is more than 75 percent [1-3]. Persons with SCI consistently report average pain levels between 4 and 6 in studies using the 0-10 numerical rating scale (NRS) [4-5], pain levels that are high enough to warrant comprehensive treatment and prompt follow-up in primary-care settings [6]. Pain is severe, with a strong negative impact on daily functioning, in about one-third of persons with SCI [1-2]. Of significant concern is the finding that once pain conditions following SCI emerge, they tend to persist [3-4] or worsen [2,7] over time, despite the many efforts to treat this pain. In summary, while pain is a ubiquitous, recalcitrant problem among persons with SCI, the degree to which pain has a pronounced effect on functioning is much more variable. Developing a better understanding of subgroups of persons with SCI that may be especially vulnerable to pain-related functional disruptions is critical. C1 [Ullrich, Philip M.] VA Puget Sound Healthcare Syst, SCI QUERI, Dept Vet Affairs VA, Seattle, WA USA. [Ullrich, Philip M.; Jensen, Mark P.] Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. [Loeser, John D.] Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. [Cardenas, Diana D.] Univ Miami, Miller Sch Med, Dept Rehabil Med, Miami, FL 33136 USA. [Weaver, Frances M.] US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, VA SCI QUERI, Hines, IL 60141 USA. RP Ullrich, PM (reprint author), 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM philip.ullrich@va.gov FU NICHD NIH HHS [P01 HD033988-10, P01 HD033988, P01 HD33988] NR 40 TC 12 Z9 12 U1 1 U2 5 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 2008 VL 45 IS 6 BP 793 EP 800 DI 10.1682/JRRD.2008.01.0005 PG 8 WC Rehabilitation SC Rehabilitation GA 372UG UT WOS:000260926900003 PM 19009466 ER PT J AU Ding, D Leister, E Cooper, RA Cooper, R Kelleher, A Fitzgerald, SG Boninger, ML AF Ding, Dan Leister, Elizabeth Cooper, Rory A. Cooper, Rosemarie Kelleher, Annmarie Fitzgerald, Shirley G. Boninger, Michael L. TI Usage of tilt-in-space, recline, and elevation seating functions in natural environment of wheelchair users SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE backrest recline; data logging; posture; pressure ulcer; rehabilitation; seat elevator; seating posture; tilt-in-space; usage pattern; wheelchair; wheelchair prescription ID SPINAL-CORD-INJURY; INTERFACE PRESSURE; RELIABILITY; DISCOMFORT; SYSTEMS; POSTURE AB This study examined the usage of powered seating functions, including tilt-in-space, backrest recline, and seat elevation, among a group of wheelchair users during their typical daily activities. Twelve individuals who used a power wheelchair with seating functions participated in the study. They drove their own wheelchair and used the seating functions as needed in their community environment for about 2 weeks while the seating function usage was recorded with a portable device. We found that Subjects occupied their wheelchair for 11.8 +/- 3.4 hours a day (all data shown as mean +/- standard deviation). While occupying their wheelchairs, they accessed tilt-in-space, backrest recline, and seat elevation 19 +/- 14 times a day for 64.1% +/- 36.8%, 12 +/- 8 times for 76.0% +/- 29.8%, and 4 +/- 4 times for 22.5% +/- 34.9%, respectively. Subjects chose to stay in tilted and reclined positions in their wheelchair for 39.3% +/- 36.5% of their time each day. They spent little time in a fully upright position. Subjects changed their seating positions every 53.6 +/- 47.0 minutes. Time spent in positions of different seating pressures varied among subjects. The information collected could enhance clinical practice of wheelchair provision, resulting in better compliance with clinical instructions and appropriate use of seating functions among wheelchair users. C1 [Ding, Dan; Leister, Elizabeth; Cooper, Rory A.; Cooper, Rosemarie; Kelleher, Annmarie; Fitzgerald, Shirley G.; Boninger, Michael L.] Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. [Ding, Dan; Leister, Elizabeth; Cooper, Rory A.; Cooper, Rosemarie; Kelleher, Annmarie; Fitzgerald, Shirley G.; Boninger, Michael L.] Dept Vet Affairs Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA USA. [Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Sch Med, Dept Phys Med & Rehabil, Pittsburgh, PA USA. [Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Swanson Sch Engn, Dept Bioengn, Pittsburgh, PA USA. RP Ding, D (reprint author), VA Pittsburgh Healthcare Syst, HERL, 7180 Highland Dr,Bldg 4,2d Fl E,151R1-H, Pittsburgh, PA 15206 USA. EM dad5@pitt.edu OI Boninger, Michael/0000-0001-6966-919X FU Paralyzed Veterans of America Research Foundation [2264-01]; National Institute on Disability and Rehabilitation Research [H13317040006]; VA Rehabilitation Research and Development Center [B3142C] FX This material was based on work supported by the Paralyzed Veterans of America Research Foundation, grant 2264-01; National Institute on Disability and Rehabilitation Research, grant H13317040006; and VA Rehabilitation Research and Development Center, grant B3142C. NR 35 TC 28 Z9 28 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 2008 VL 45 IS 7 BP 973 EP 983 DI 10.1682/JRRD.2007.11.0178 PG 11 WC Rehabilitation SC Rehabilitation GA 387WI UT WOS:000261981900004 PM 19165687 ER PT J AU Liu, HY Cooper, RA Pearlman, J Cooper, R Connor, S AF Liu, Hsin-Yi Cooper, Rory A. Pearlman, Jonathan Cooper, Rosemarie Connor, Samuel TI Evaluation of titanium ultralight manual wheelchairs using ANSI/RESNA standards SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE ANSI/RESNA; durability; failure; fatigue tests; lightweight; reference standards; rehabilitation; titanium wheelchair; ultralight wheelchair; wheelchair ID ELECTRIC-POWERED WHEELCHAIRS; SPINAL-CORD-INJURY; PERFORMANCE; DURABILITY; LIFE AB Comfortable propulsion and support, light weight, and small dimensions are important features that help preserve tipper-limb integrity of manual wheelchair users and improve accessibility. The titanium wheelchair is a product developed in response to these goals, but none of the test results of titanium wheelchairs had been disclosed before this study was performed. We hypothesized that these titanium wheelchairs would be in compliance with American National Standards Institute (ANSI)/Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) standards. We tested 12 ultralight titanium rigid-frame wheelchairs (4 models) using ANSI/RESNA testing procedures and compared the test results with previously tested ultralight and lightweight aluminum wheelchairs. All wheelchairs passed the forward braking effectiveness test, but eight wheelchairs tipped backward before inclining to 7 degrees in the rearward braking effectiveness test. All wheelchairs passed the impact strength tests, but six wheelchairs failed in the static strength tests. Three wheelchairs Successfully completed the fatigue tests, but the remaining wheelchairs failed prematurely. This group of titanium wheelchairs had less equivalent cycles and value than the Ultralight aluminum wheelchairs that were tested in a previous study. The failure modes revealed important design issues of each model. Our results suggest that manufacturers may need to perform more careful analyses before commercializing new products. C1 [Liu, Hsin-Yi; Cooper, Rory A.; Pearlman, Jonathan; Cooper, Rosemarie; Connor, Samuel] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Dept Vet Affairs, VA Rehabil Res & Dev Serv, Pittsburgh, PA 15206 USA. [Liu, Hsin-Yi; Cooper, Rory A.; Pearlman, Jonathan; Cooper, Rosemarie] Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. [Cooper, Rory A.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. [Cooper, Rory A.] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Dept Vet Affairs, VA Rehabil Res & Dev Serv, 151R-1HD,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM rcooper@pitt.edu OI Pearlman, Jon/0000-0003-0830-9136 FU Department of Veterans Affairs Rehabilitation Research and Development Service [B3142C]; National Science Foundation-Integrative Graduate Education and Research Traineeship program [DGE 0333420] FX This material was based on work supported by the Department of Veterans Affairs Rehabilitation Research and Development Service (grant B3142C) and the National Science Foundation-Integrative Graduate Education and Research Traineeship program (grant DGE 0333420). NR 23 TC 9 Z9 10 U1 2 U2 4 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 2008 VL 45 IS 9 BP 1251 EP 1267 DI 10.1682/JRRD.2007.12.0204 PG 17 WC Rehabilitation SC Rehabilitation GA 426RN UT WOS:000264725500005 PM 19319751 ER PT J AU Rentschler, AJ Simpson, R Cooper, RA Boninger, ML AF Rentschler, Andrew J. Simpson, Richard Cooper, Rory A. Boninger, Michael L. TI Clinical evaluation of Guido robotic walker SO JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT LA English DT Article DE clinical testing; mobility aid; navigation assistance; obstacle avoidance; older adults; rehabilitation; robotic walker; safety; visual impairment; walker ID MOBILITY AB The Guido is a robotic walker that provides navigation and obstacle-avoidance assistance. Engineering tests have found that the device performs adequately and presents no hazard to the user. The performance of the Guido was compared with a low-tech mobility aid, the Assistive Mobility Device (AMD) developed at the Atlanta Department of Veterans Affairs Medical Center, in trials involving older adults with Visual impairments. The purpose of this study was to determine whether the Guido Could increase the safety and mobility of elderly Visually impaired individuals in supervised care facilities. Subjects traversed all obstacle course with the Guido and the AMD. Completion time, obstacle/wall contacts, and reorientations were compared for both devices. No significant differences were found between the devices for any of the tests. The Guido did not perform better than the AMD during the trials. Revisions to the device as well as a change in Subject requirements and testing protocol may produce different results. C1 [Rentschler, Andrew J.; Simpson, Richard; Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. [Simpson, Richard; Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15260 USA. [Cooper, Rory A.; Boninger, Michael L.] Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. [Rentschler, Andrew J.; Simpson, Richard; Cooper, Rory A.; Boninger, Michael L.] VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Dept Vet Affairs, VA Rehabil Res & Dev Ctr Excellence Wheelchairs &, Pittsburgh, PA USA. RP Simpson, R (reprint author), Univ Pittsburgh, Dept Rehabil Sci & Technol, Forbes Tower,Suite 5044, Pittsburgh, PA 15260 USA. EM ris20@pitt.edu RI Simpson, Richard/G-5683-2015 OI Simpson, Richard/0000-0002-6306-9393; Boninger, Michael/0000-0001-6966-919X FU VA Research and Development Merit Review [C2272R] FX This material was based on work supported by VA Research and Development Merit Review grant C2272R. NR 29 TC 20 Z9 22 U1 2 U2 4 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 2008 VL 45 IS 9 BP 1281 EP 1293 DI 10.1682/JRRD.2007.10.0160 PG 13 WC Rehabilitation SC Rehabilitation GA 426RN UT WOS:000264725500007 PM 19319753 ER PT J AU Svircev, JN Wallbom, AS AF Svircev, Jelena N. Wallbom, Agnes S. TI False-negative triple-phase bone scans in spinal cord injury to detect clinically suspect heterotopic ossification: A case series SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Article DE spinal cord injuries; heterotopic ossification; radionuclide imaging; bone scan ID RISK-FACTORS AB Background/Objective: Heterotopic ossification (HO) is a complication seen in patients after spinal cord injury (SCI). Triple-phase nuclear bone scanning is the most sensitive test for the detection of HO. This retrospective study assesses whether patients with clinically suspected HO but negative triple-phase nuclear bone scans develop delayed positive nuclear bone scans. Methods: Case series: A cohort of patients with SCI and clinically suspected HO who underwent triple phase nuclear bone scans over a period of 2 years was identified from retrospective chart review of an acute inpatient SCI rehabilitation service. A subgroup of 7 patients with initially negative but subsequently positive triple-phase nuclear bone scans was identified, and the following data were collected: date, mechanism, admission level, and admission completeness of injury as well as date, number, and results of bone scans. Laboratory studies were also collected during the time of imaging. Results: Over a 2-year period, 343 patients were admitted to the SCI rehabilitation service; 60 patients were suspected of having HO and underwent a total of 85 triple-phase nuclear bone scans. Seven patients were identified with initially negative but subsequently positive bone scans. Conclusions: In patients with clinically suspicious HO but negative bone scans, follow-up scans are indicated to identify initial false-negative studies. C1 [Wallbom, Agnes S.] David Geffen UCLA Sch Med, Dept Phys Med & Rehabil, Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. [Svircev, Jelena N.] Puget Sound VA Hlth Care Syst, Seattle, WA USA. RP Wallbom, AS (reprint author), David Geffen UCLA Sch Med, Dept Phys Med & Rehabil, Greater Los Angeles VA Healthcare Syst, 11301 Wilshire Blvd 117, Los Angeles, CA 90073 USA. EM awallbom@ucla.edu NR 10 TC 1 Z9 1 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 2008 VL 31 IS 2 BP 194 EP 196 PG 3 WC Clinical Neurology SC Neurosciences & Neurology GA 315KA UT WOS:000256876200009 PM 18581667 ER PT J AU Rajan, S McNeely, MJ Warms, C Goldstein, B AF Rajan, Suparna McNeely, Marguerite J. Warms, Catherine Goldstein, Barry TI Clinical assessment and management of obesity in individuals with spinal cord injury: A review SO JOURNAL OF SPINAL CORD MEDICINE LA English DT Review DE spinal cord injuries; obesity; weight control; body composition; paraplegia; tetraplegia; actigraphy; bariatric surgery; Orlistat; sibutramine ID BODY-MASS INDEX; CORONARY-HEART-DISEASE; QUALITY-OF-LIFE; RESIDUAL NEUROLOGICAL DEFICIT; DAILY ENERGY-EXPENDITURE; STYLE PHYSICAL-ACTIVITY; RESTING METABOLIC-RATE; SLEEP-APNEA SYNDROME; TERM WEIGHT-LOSS; NUTRITIONAL-STATUS AB Background: Diagnosing and managing obesity in individuals with spinal cord injury (SCI) remain challenging. Methods: Literature on the epidemiology, impact, and management of obesity in individuals with SCI was reviewed. Findings: Although nearly 66% of individuals with SCI are either overweight or obese, little guidance is available to measure and monitor obesity in the clinical setting. The use of anthropometric indices and specific cut points available for able-bodied persons is limited by the body composition changes that follow SCI. Indices of upper body obesity warrant examination in SCI because they provide an index of central obesity, which is more closely linked to some obesity-related conditions than is overall obesity. Investigations into the sequelae of excess body fat and its distribution are also needed in SCI because past research in this area has been inconclusive. Although limited, evidence regarding obesity interventions in SCI may be promising. Conclusions: The best anthropometric tool to define obesity in the clinical setting remains unknown. SCI-specific assessment tools and a better understanding of the sequelae of excess body weight will lead to better targeting of prevention and treatment efforts. More research is needed on the individual components of a weight management program unique to SCI. Until then, providers are urged to use a team approach and draw on existing resources and applicable research in able-bodied individuals to facilitate weight management in individuals with SCI. C1 [Rajan, Suparna; Goldstein, Barry] VA Puget Sound Hlth Care Syst, Dept Vet Affairs Med Ctr, SCI QUERI, Seattle, WA 98101 USA. [McNeely, Marguerite J.; Warms, Catherine; Goldstein, Barry] Univ Washington, Seattle, WA 98195 USA. RP Rajan, S (reprint author), VA Puget Sound Hlth Care Syst, Dept Vet Affairs Med Ctr, SCI QUERI, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM suparna.rajan@va.gov FU VA Puget Sound Health Care System; Seattle Washington FX This material is the result of work supported by resources from the VA Puget Sound Health Care System, Seattle Washington. NR 122 TC 29 Z9 30 U1 1 U2 8 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 2008 VL 31 IS 4 BP 361 EP 372 PG 12 WC Clinical Neurology SC Neurosciences & Neurology GA 356MY UT WOS:000259783500003 PM 18959353 ER PT J AU Frances, A Sreenivasan, S Weinberger, LE AF Frances, Allen Sreenivasan, Shoba Weinberger, Linda E. TI Defining mental disorder when it really counts: DSM-IV-TR and SVP/SDP statutes SO JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW LA English DT Editorial Material AB Civil commitment under the sexually violent predator (SVP) statutes requires the presence of a statutorily defined diagnosed mental disorder linked to sexual offending. As a consequence of broad statutory definitions and ambiguously written court decisions, a bright line separating an SVP mental disorder from ordinary criminal behavior is difficult to draw. Some forensic evaluators reject whole categories of DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders: Text Revision) diagnoses as qualifying disorders (e.g., personality and substance abuse disorders), while others debate whether recurrent rape constitutes a paraphilic disorder. We argue that the ramifications of the SVP process, in representing both the balancing of public safety and the protection of an individual's right to liberty, demand that decisions about what is a legally defined mental disorder not be made in an arbitrary and idiosyncratic manner. Greater clarity and standardization must come from both sides: the legalists who interpret the law and the clinicians who apply and work under it. C1 [Frances, Allen] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. [Sreenivasan, Shoba; Weinberger, Linda E.] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA. [Sreenivasan, Shoba] Greater Los Angeles VA Med Ctr, Forens Outreach Serv, Los Angeles, CA USA. [Weinberger, Linda E.] Univ So Calif, Inst Psychiat Law & Behav Sci, Los Angeles, CA USA. RP Sreenivasan, S (reprint author), 11301 Wilshire Blvd,Bldg 258,Room 136, Los Angeles, CA 90073 USA. EM shoba.sreenivasan@med.va.gov NR 12 TC 17 Z9 17 U1 0 U2 2 PU AMER ACAD PSYCHIATRY & LAW PI BLOOMFIELD PA ONE REGENCY DR, PO BOX 30, BLOOMFIELD, CT 06002 USA SN 1093-6793 J9 J AM ACAD PSYCHIATRY JI J. Am. Acad. Psychiatry Law PY 2008 VL 36 IS 3 BP 375 EP 384 PG 10 WC Law; Psychiatry SC Government & Law; Psychiatry GA 356EZ UT WOS:000259762800016 PM 18802187 ER PT J AU Covinsky, KE Lindquist, K Dunlop, DD Gill, TM Yelin, E AF Covinsky, Kenneth E. Lindquist, Karla Dunlop, Dorothy D. Gill, Thomas M. Yelin, Edward TI Effect of arthritis in middle age on older-age functioning SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE arthritis; ADL; mobility ID MUSCULOSKELETAL CONDITIONS; UNITED-STATES; DISABILITY; ADULTS; IMPACT; COMMUNITY; TRANSITIONS; MORBIDITY; LIFE; POPULATION AB OBJECTIVES: To examine whether symptomatic arthritis in middle age predicts the earlier onset of functional difficulties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons. DESIGN: Prospective longitudinal study. SETTING: The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years. PARTICIPANTS: Seven thousand five hundred forty-three subjects with no difficulty in mobility or ADL function at baseline. MEASUREMENTS: Arthritis was measured at baseline according to self-report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walking several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject interview every 2 years. Analyses were adjusted for other comorbid conditions, body mass index, exercise, and demographic characteristics. RESULTS: Twenty-nine percent of subjects reported arthritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow-up (34% vs 18%, adjusted hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.43-1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with persistent difficulty in mobility (30% vs 16%, adjusted HR=1.55, 95% CI=1.41-1.71) and persistent difficulty in ADL function (13% vs 5%, adjusted HR=1.85, 95% CI=1.58-2.16). CONCLUSION: Middle-aged persons who report a history of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life-course approach to preventing the disabling effect of arthritis. C1 [Covinsky, Kenneth E.; Lindquist, Karla; Yelin, Edward] Univ Calif San Francisco, Vet Adm Med Ctr 181G, Dept Med, San Francisco, CA 94121 USA. [Covinsky, Kenneth E.; Lindquist, Karla] Univ Calif San Francisco, Vet Adm Med Ctr 181G, Div Geriatr, San Francisco, CA 94121 USA. [Yelin, Edward] Univ Calif San Francisco, VA Med Ctr 181G, Div Rheumatol, Sch Med, San Francisco, CA 94121 USA. [Yelin, Edward] Univ Calif San Francisco, Inst Hlth Policy Studies, San Francisco, CA 94143 USA. [Covinsky, Kenneth E.; Lindquist, Karla] San Francisco VA Med Ctr, San Francisco, CA USA. [Dunlop, Dorothy D.] Northwestern Univ, Feinberg Sch Med, Dept Med, Inst Healthcare Studies, Chicago, IL 60611 USA. [Gill, Thomas M.] Yale Univ, Sch Med, Dept Med, New Haven, CT USA. RP Covinsky, KE (reprint author), Univ Calif San Francisco, Vet Adm Med Ctr 181G, Dept Med, 4150 Clement, San Francisco, CA 94121 USA. EM ken.covinsky@ucsf.edu FU NIA NIH HHS [K24 AG021507, K24 AG029812, K24AG021507, K24AG029812, R01 AG023626, R01AG023626, U01 AG009740, U01AG009740]; NIAMS NIH HHS [P60 AR053308, 5P60AR053308-020, P60 AR053308-01] NR 36 TC 19 Z9 19 U1 3 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2008 VL 56 IS 1 BP 23 EP 28 DI 10.1111/j.1532-5415.2007.01511.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000004 PM 18184204 ER PT J AU Spira, AP Blackwell, T Stone, KL Redline, S Cauley, JA Ancoli-Israel, S Yaffe, K AF Spira, Adam P. Blackwell, Terri Stone, Katie L. Redline, Susan Cauley, Jane A. Ancoli-Israel, Sonia Yaffe, Kristine TI Sleep-disordered breathing and cognition in older women SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE sleep apnea; cognition; older adults; women; APOE ID JAPANESE-AMERICAN MEN; APOLIPOPROTEIN-E; ALZHEIMERS-DISEASE; APNEA SYNDROME; NEUROPSYCHOLOGICAL DEFICITS; DAYTIME SLEEPINESS; APOE EPSILON-4; IMPAIRMENT; POPULATION; PERFORMANCE AB OBJECTIVES: To investigate the association between objectively measured sleep-disordered breathing (SDB) and cognitive impairment in community-dwelling older women and to determine whether the apolipoprotein E (APOE) epsilon 4 allele modifies this association. DESIGN: Cross-sectional. SETTINGS: Participants' homes and two sites of the Study of Osteoporotic Fractures (SOF). PARTICIPANTS: Four hundred forty-eight women with a mean age +/- standard deviation (SD) of 82.8 +/- 3.4. MEASUREMENTS: Participants completed the Mini-Mental State Examination (MMSE), Trail Making Test Part B (Trails B), and polysomnography (PSG). SDB indices were the apnea-hypopnea index (AHI), the central apnea index (CAI), and oxygen saturation (SaO(2)) nadir less than 80%. APOE epsilon 4 was determined for a subset of 242 women. Cognitive impairment was defined as 1.5 SDs or more from the sample mean on either cognitive test (MMSE or Trails B). RESULTS:All SDB indices were associated with cognitive impairment according to the MMSE (AHI (per SD, odds ratio (OR)=1.4, 95% confidence interval (CI)=1.03-1.9), AHI of >= 30 (OR=3.4, 95% CI=1.4-8.1), SaO(2) nadir < 80% (OR=2.7, 95% CI=1.1-6.6), and CAI (per SD, OR=1.4, 95% CI=1.1-1.7)). Weaker, nonsignificant associations emerged between SDB and Trails B. In women who completed genotyping, each SD increase in AHI was associated with 70% greater odds of cognitive impairment according to the MMSE (OR=1.7, 95% CI=1.2-2.6). Women with the epsilon 4 allele had a nearly five times greater odds of impairment (per SD, OR=4.6, 95% CI-1.0-20.7); the association was smaller and nonsignificant in women without the epsilon 4 allele (per SD, OR=1.5, 95% CI-0.9-2.4; P for interaction=.08). CONCLUSION: SDB is an important risk factor for cognitive impairment in older women, especially those with the APOE epsilon 4 allele. Mechanisms linking these disorders need to be identified. C1 [Spira, Adam P.] Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA USA. [Spira, Adam P.; Yaffe, Kristine] San Francisco VA Med Ctr, San Francisco, CA USA. [Blackwell, Terri; Stone, Katie L.] Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. [Redline, Susan] Case Western Reserve Univ, Dept Pediat, Cleveland, OH 44106 USA. [Cauley, Jane A.] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA. [Ancoli-Israel, Sonia] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. [Ancoli-Israel, Sonia] Vet Affairs San Diego Healthcare Syst, San Diego, CA USA. RP Spira, AP (reprint author), 4150 Clement St 181-G, San Francisco, CA 94121 USA. EM adam.spira@ucsf.edu RI Cauley, Jane/N-4836-2015 OI Cauley, Jane/0000-0003-0752-4408 FU NHLBI NIH HHS [HL40489]; NIA NIH HHS [AG08415, 2 R01 AG005394-22A1, 2 R01 AG027574-22A1, AG021918, AG026720, AG05394, AG05407, R01 AG005407, R01 AG026720, R01 AG027576-22, T32 AG000212-14]; NIAMS NIH HHS [AR35582, AR35583, AR35584] NR 38 TC 68 Z9 73 U1 0 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2008 VL 56 IS 1 BP 45 EP 50 DI 10.1111/j.1532-5415.2007.01506.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000007 PM 18047498 ER PT J AU Carey, EC Covinsky, KE Lui, LY Eng, C Sands, LP Walter, LC AF Carey, Elise C. Covinsky, Kenneth E. Lui, Li-Yung Eng, Catherine Sands, Laura P. Walter, Louise C. TI Prediction of mortality in community-living frail elderly people with long-term care needs SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE mortality; aging; frailty; functional impairment; long-term care; palliative care ID OLDER HOSPITALIZED-PATIENTS; PROGNOSTIC INDEX; RISK-ADJUSTMENT; MODEL; VALIDATION; ADULTS; LIFE; SURVIVAL; PACE; END AB OBJECTIVES: To develop and validate a prognostic index for mortality in community-living, frail elderly people. DESIGN: Cohort study of Program of All-Inclusive Care for the Elderly (PACE) participants enrolled between 1988 and 1996. SETTING: Eleven PACE sites, a community-based long-term care program that cares for frail, chronically ill elderly people who meet criteria for nursing home placement. PARTICIPANTS: Three thousand eight hundred ninety-nine PACE enrollees. The index was developed in 2,232 participants and validated in 1,667. MEASUREMENTS: Time to death was predicted using risk factors obtained from a geriatric assessment performed by the PACE interdisciplinary team at the time of enrollment. Risk factors included demographic characteristics, comorbid conditions, and functional status. RESULTS: The development cohort had a mean age of 79 (68% female, 40% white). The validation cohort had a mean age of 79 (76% female, 65% white). In the development cohort, eight independent risk factors of mortality were identified and weighted, using Cox regression, to create a risk score: male sex, 2 points; age (75-79, 2 points; 80-84, 2 points; >= 85, 3 points); dependence in toileting, 1 point; dependence in dressing (partial dependence, 1 point; full dependence, 3 points); malignant neoplasm, 2 points; congestive heart failure, 3 points; chronic obstructive pulmonary disease, 1 point; and renal insufficiency, 3 points. In the development cohort, respective 1- and 3-year mortality rates were 6% and 21% in the lowest-risk group (0-3 points), 12% and 36% in the middle-risk group (4-5 points), and 21% and 54% in the highest-risk group (> 5 points). In the validation cohort, respective 1- and 3-year mortality rates were 7% and 18% in the lowest-risk group, 11% and 36% in the middle-risk group, and 22% and 55% in the highest-risk group. The area under the receiver operating characteristic curve for the point score was 0.66 and 0.69 in the development and validation cohorts, respectively. CONCLUSION: A multidimensional prognostic index was developed and validated using age, sex, functional status, and comorbidities that effectively stratifies frail, community-living elderly people into groups at varying risk of mortality. C1 [Covinsky, Kenneth E.; Eng, Catherine; Walter, Louise C.] Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. [Carey, Elise C.] Mayo Clin, Coll Med, Div Gen Internal Med, Rochester, MN USA. [Covinsky, Kenneth E.; Walter, Louise C.] San Francisco VA Med Ctr, San Francisco, CA USA. [Lui, Li-Yung] Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. [Eng, Catherine] On Lok Senior Hlth Serv, San Francisco, CA USA. [Sands, Laura P.] Purdue Univ, Sch Nursing, Ctr Healthcare Engn, Ctr Aging & Life Course, W Lafayette, IN 47907 USA. RP Walter, LC (reprint author), VA Med Ctr 181G, 4150 Clement St, San Francisco, CA 94121 USA. EM Louise.Walter@ucsf.edu RI Sands, Laura/E-8919-2015 OI Sands, Laura/0000-0003-2446-4486 FU AHRQ HHS [K02HS00006-01]; NIA NIH HHS [AG022090, K24 AG029812, R01 AG023626]; PHS HHS [1K01HP00125-01] NR 31 TC 73 Z9 75 U1 1 U2 17 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2008 VL 56 IS 1 BP 68 EP 75 DI 10.1111/j.1532-5415.2007.01496.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000010 PM 18031487 ER PT J AU Leff, B Burton, L Mader, SL Naughton, B Burl, J Koehn, D Clark, R Greenough, WB Guido, S Steinwachs, D Burton, JR AF Leff, Bruce Burton, Lynda Mader, Scott L. Naughton, Bruce Burl, Jeffrey Koehn, Debbie Clark, Rebecca Greenough, William B., III Guido, Susan Steinwachs, Donald Burton, John R. TI Comparison of stress experienced by family members of patients treated in hospital at home with that of those receiving traditional acute hospital care SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE "Hospital at Home"; caregiver; stress; aged; hospital care; acute care for the elderly ID RANDOMIZED CONTROLLED-TRIAL; BURDEN; CAREGIVERS; OUTCOMES; ILLNESS; PROGRAM; INDEX; ILL AB OBJECTIVES: To compare differences in the stress experienced by family members of patients cared for in a physician-led substitutive Hospital at Home (HaH) and those receiving traditional acute hospital care. DESIGN: Survey questionnaire completed as a component of a prospective, nonrandomized clinical trial of a substitutive HaH care model. SETTING: Three Medicare managed care health systems and a Veterans Affairs Medical Center. PARTICIPANTS: Two hundred fourteen community-dwelling elderly patients who required acute hospital admission for community-acquired pneumonia, exacerbation of chronic heart failure, exacerbation of chronic obstructive pulmonary disease, or cellulitis. INTERVENTION: Treatment in a substitutive HaH model. MEASUREMENTS: Fifteen-question survey questionnaire asking family members whether they experienced a potentially stressful situation and, if so, whether stress was associated with the situation while the patient received care. RESULTS: The mean and median number of experiences, of a possible 15, that caused stress for family members of HaH patients was significantly lower than for family members of acute care hospital patients (mean +/- standard deviation 1.7 +/- 1.8 vs 4.3 +/- 3.1, P <.001; median 1 vs 4, P <.001). HaH care was associated with lower odds of developing mean levels of family member stress (adjusted odds ratio=0.12, 95% confidence interval=0.05-0.30). CONCLUSION: HaH is associated with lower levels of family member stress than traditional acute hospital care and does not appear to shift the burden of care from hospital staff to family members. C1 [Leff, Bruce; Greenough, William B., III; Guido, Susan; Burton, John R.] Johns Hopkins Univ, Sch Med, John Hopkins Care Ctr, Div Geriatr Med,Dept Med, Baltimore, MD 21224 USA. [Leff, Bruce; Burton, Lynda; Koehn, Debbie; Clark, Rebecca; Steinwachs, Donald; Burton, John R.] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21224 USA. [Mader, Scott L.] Portland VA Med Ctr, Portland, OR USA. [Mader, Scott L.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Naughton, Bruce] SUNY Buffalo, Buffalo, NY USA. [Naughton, Bruce] Univera Hlth, Buffalo, NY USA. [Burl, Jeffrey] Fallon Community Hlth Plan & Fallon Clin, Worcester, MA USA. Independent Hlth, Buffalo, NY USA. RP Leff, B (reprint author), Johns Hopkins Univ, Sch Med, John Hopkins Care Ctr, Div Geriatr Med,Dept Med, 5505 Hopkins Bayview Circle, Baltimore, MD 21224 USA. EM bleff@jhmi.edu NR 29 TC 17 Z9 17 U1 1 U2 8 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 JAN PY 2008 VL 56 IS 1 BP 117 EP 123 DI 10.1111/j.1532-5415.2007.01459.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000017 PM 17979955 ER PT J AU Morss, S Shugarman, LR Lorenz, KA Mularski, RA Lynn, J AF Morss, Sydney Shugarman, Lisa R. Lorenz, Karl A. Mularski, Richard A. Lynn, Joanne CA RAND So California Evidence Based TI A systematic review of satisfaction with care at the end of life SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE systematic review; satisfaction; end-of-life care; palliative care ID RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; PALLIATIVE CARE; PATIENTS PERSPECTIVES; NURSING-HOMES; CANCER; EXPERIENCES; FAMILIES; DEATH; CAREGIVERS AB The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients' decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A meta-analysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven of 32 studies addressed this as an outcome; two of the three that compared satisfaction between groups showed a significant difference. Evaluations used many different measures, only one of which was designed for the end of life. In conclusion, researchers have conceptualized satisfaction in palliative care, and different types of palliative care interventions can improve satisfaction, but it is often not included as an outcome. More focus on these satisfaction elements might improve the effectiveness of end-of-life interventions and their evaluation. C1 [Morss, Sydney] Johns Hopkins Univ, Dept Hlth Policy & Management, Baltimore, MD 21218 USA. [Morss, Sydney] Johns Hopkins Univ, Dept Oncol, Baltimore, MD USA. [Morss, Sydney] Johns Hopkins Univ, Dept Med, Baltimore, MD USA. [Shugarman, Lisa R.; Lorenz, Karl A.; Lynn, Joanne] RAND Hlth, Santa Monica, CA USA. [Shugarman, Lisa R.; Lorenz, Karl A.; Lynn, Joanne] So California Evidence Based Practice Ctr, Santa Monica, CA USA. [Lorenz, Karl A.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Mularski, Richard A.] Kaiser Permanente NW, Ctr Hlth Res, Portland, OR USA. RP Morss, S (reprint author), Room 609,624 N Broadway, Baltimore, MD 21205 USA. EM sdy@jhsph.edu NR 40 TC 0 Z9 0 U1 2 U2 13 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2008 VL 56 IS 1 BP 124 EP 129 DI 10.1111/j.1532-5415.2007.01507.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000018 ER PT J AU Norris, SL High, K Gill, TM Hennessy, S Kutner, JS Reuben, DB Unutzer, J Landefeld, CS AF Norris, Susan L. High, Kevin Gill, Thomas M. Hennessy, Sean Kutner, Jean S. Reuben, David B. Unuetzer, Juergen Landefeld, C. Seth TI Health care for older americans with multiple chronic conditions: A research agenda SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE aging; research agenda; older adults ID RANDOMIZED CLINICAL-TRIAL; OUTPATIENT GERIATRIC EVALUATION; LEUKEMIA-GROUP-B; DEPRESSIVE SYMPTOMS; ELDERLY PERSONS; FUNCTIONAL DECLINE; FOLLOW-UP; LATE-LIFE; PROGRAM; CANCER AB In response to the substantial and increasing healthcare requirements of older adults with multiple chronic conditions and acknowledgment of major gaps in knowledge and funding, two expert meetings were convened to identify a research agenda addressing the needs of this population. Research priorities are to develop and evaluate more-effective models of health care, develop and evaluate management practices and organizational structures that lead to improved long-term care, develop and implement relevant and effective preventive health strategies, determine the most effective interventions in patients who have concurrent cognitive or emotional impairments, and determine how interventions during and after hospitalization affect the outcomes of hospitalized patients. C1 [Norris, Susan L.] Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97239 USA. [High, Kevin] Wake Forest Univ, Dept Internal Med, Winston Salem, NC 27109 USA. [Gill, Thomas M.] Yale Univ, Sch Med, Dept Epidemiol & Investigat Med, New Haven, CT USA. [Hennessy, Sean] Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Kutner, Jean S.] Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO 80262 USA. [Reuben, David B.] Univ Calif Los Angeles, David Gaffen Sch Med, Div Geriatr, Los Angeles, CA USA. [Unuetzer, Juergen] Univ Washington, Med Ctr, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Landefeld, C. Seth] Univ Calif San Francisco, Div Geriatr, San Francisco, CA 94143 USA. [Landefeld, C. Seth] San Francisco VA Med Ctr, San Francisco, CA USA. RP Norris, SL (reprint author), Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, 3181 SW Sam Jackson Pk Rd,Mail Stop B1CC, Portland, OR 97239 USA. EM norriss@ohsu.edu NR 76 TC 47 Z9 47 U1 6 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JAN PY 2008 VL 56 IS 1 BP 149 EP 159 DI 10.1111/j.1532-5415.2007.01530.x PG 11 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 246CL UT WOS:000251985000023 PM 18047493 ER PT J AU Rosenbloom, ST Miller, RA Johnson, KB Elkin, PL Brown, SH AF Rosenbloom, S. Trent Miller, Randolph A. Johnson, Kevin B. Elkin, Peter L. Brown, Steven H. TI A model for evaluating interface terminologies SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article ID MEDICAL INFORMATICS; CLINICAL-DATA; VOCABULARIES; REPRESENTATION; SYSTEMS; CLASSIFICATIONS; AGREEMENT; FRAMEWORK; SELECTION; COVERAGE AB Objective: Evaluations of individual terminology systems should be driven in part by the intended usages of such systems. Clinical interface terminologies support interactions between healthcare providers and computer-based applications. They aid practitioners in converting clinical "free text" thoughts into the structured, formal data representations used internally by application programs. Interface terminologies also serve the important role of presenting existing stored, encoded data to end users in human-understandable and actionable formats. The authors present a model for evaluating functional utility of interface terminologies based on these intended uses. Design: Specific parameters defined in the manuscript comprise the metrics for the evaluation model. Measurements: Parameters include concept accuracy, term expressivity, degree of semantic consistency for term construction and selection, adequacy of assertional knowledge supporting concepts, degree of complexity of pre-coordinated concepts, and the "human readability" of the terminology. The fundamental metric is how well the interface terminology performs in supporting correct, complete, and efficient data encoding or review by humans. Results: Authors provide examples demonstrating performance of the proposed evaluation model in selected instances. Conclusion: A formal evaluation model will permit investigators to evaluate interface terminologies using a consistent and principled approach. Terminology developers and evaluators can apply the proposed model to identify areas for improving interface terminologies. C1 [Rosenbloom, S. Trent; Miller, Randolph A.; Johnson, Kevin B.; Brown, Steven H.] Vanderbilt Univ, Dept Biomed Informat, Nashville, TN USA. [Rosenbloom, S. Trent; Miller, Randolph A.] Vanderbilt Univ, Sch Nursing, Nashville, TN 37240 USA. [Rosenbloom, S. Trent; Johnson, Kevin B.] Vanderbilt Univ, Dept Pediat, Nashville, TN 37240 USA. [Elkin, Peter L.] Mayo Fdn Med Educ & Res, Rochester, MN USA. [Brown, Steven H.] US Dept Vet Affairs, Nashville, TN USA. RP Rosenbloom, ST (reprint author), Eskind Biomed Lib, Room 440,2209 Garland Ave, Nashville, TN 37232 USA. EM trent.rosenbloom@vanderbilt.edu FU NLM NIH HHS [K22 LM008576, R01 LM007995, 5R01 LM007995, 5K22 LM008576-02]; PHITPO CDC HHS [HK00014-01, U38 HK000014]; PHPPO CDC HHS [PH000022-02, R01 PH000022] NR 64 TC 19 Z9 19 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD JAN-FEB PY 2008 VL 15 IS 1 BP 65 EP 76 DI 10.1197/jamia.M2506 PG 12 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 250PM UT WOS:000252312500011 PM 17947616 ER PT J AU Smith, GL Masoudi, FA Shlipak, MG Krumholz, HM Parikh, CR AF Smith, Grace L. Masoudi, Frederick A. Shlipak, Michael G. Krumholz, Harlan M. Parikh, Chirag R. TI Renal impairment predicts long-term mortality risk after acute myocardial infarction SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROMES; HEART-FAILURE; CARDIOVASCULAR OUTCOMES; PROGNOSTIC IMPLICATIONS; SYSTOLIC DYSFUNCTION; SERUM CREATININE; TEMPORAL TRENDS; UREA NITROGEN AB Renal function predicts mortality after acute myocardial infarction (AMI), but it is unknown whether the prognostic importance of renal function persists over time. This study examined how the association between renal function and mortality changed in the 10 yr after AMI in a cohort of patients. In 118,753 patients (age >= 65 yr) from the Cooperative Cardiovascular Project, mean Cockcroft-Gault creatinine clearance was 55 +/- 24 ml/min and estimated GFR was 57 +/- 21 ml/min per 1.73 m(2) at baseline. By 10 yr, 68% of patients had died. Compared with normal renal function, even mild renal impairment increased the 10-yr risk for mortality risk by 10%. Severe renal impairment more than doubled the risk for mortality at 1 yr, and this increased risk persisted at both 5 and 10 yr. At 1 yr, the contribution of creatinine clearance to mortality risk rivaled traditional factors such as BP and systolic function; by 10yr, creatinine clearance surpassed these other risk factors, rivaled only by patient age. Associations with estimated GFR demonstrated similar trends. In conclusion, renal function in hospitalized patients with AMI is an important and consistent predictor of mortality for up to 10 yr. C1 [Parikh, Chirag R.] Yale Univ, Sch Med, Dept Internal Med, Nephrol Sect, West Haven, CT 06516 USA. [Parikh, Chirag R.] Vet Adm Med Ctr, Clin Epidemiol Res Ctr, West Haven, CT 06516 USA. [Smith, Grace L.; Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06510 USA. [Masoudi, Frederick A.] Univ Colorado, Hlth Sci Ctr, Denver Hlth Med Ctr, Div Cardiol, Denver, CO 80202 USA. [Masoudi, Frederick A.] Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80262 USA. [Masoudi, Frederick A.] Colorado Fdn Med Care, Aurora, CO USA. [Shlipak, Michael G.] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Med Serv, Gen Internal Med Sect, San Francisco, CA 94143 USA. [Shlipak, Michael G.] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Krumholz, Harlan M.] Yale New Haven Med Ctr, Robert Wood Johnson Clin Scholars Program, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. [Krumholz, Harlan M.] Yale Univ, Sch Med, Dept Internal Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. RP Parikh, CR (reprint author), Yale Univ, Sch Med, Dept Internal Med, Nephrol Sect, 950 Campbell Ave,Mail Code 151B,Bldg 35 A,Room 21, West Haven, CT 06516 USA. EM chirag.parikh@yale.edu FU NIDDK NIH HHS [R01 DK066488-01, R01 DK066488]; NIGMS NIH HHS [GM07205, T32 GM007205] NR 33 TC 28 Z9 30 U1 0 U2 0 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD JAN PY 2008 VL 19 IS 1 BP 141 EP 150 DI 10.1681/ASN.2007050554 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 250IL UT WOS:000252293100020 PM 18003773 ER PT J AU Buschemeyer, WC Hamilton, RJ Aronson, WJ Presti, JC Terris, MK Kane, CJ Amling, CL Freedland, SJ AF Buschemeyer, W. Cooper, III Hamilton, Robert J. Aronson, William J. Presti, Joseph C., Jr. Terris, Martha K. Kane, Christopher J. Amling, Christopher L. Freedland, Stephen J. TI Is a positive bladder neck margin truly a T4 lesion in the prostate specific antigen era? Results from the SEARCH database SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; prostatectomy; bladder; neoplasm staging ID RADICAL PROSTATECTOMY; PATHOLOGICAL ANALYSIS; SURGICAL MARGINS; CANCER; RECURRENCE; PREDICTOR; PROGNOSIS; IMPACT; RISK AB Purpose: Positive bladder neck margins after radical prostatectomy are currently designated as pT4 lesions. However, to our knowledge the prognostic significance of a positive bladder neck margin in the prostate specific antigen era is unknown. We examined the association between positive bladder neck margins and prostate specific antigen recurrence relative to other pathological findings. Materials and Methods: We examined 1,722 men from the Shared Equal Access Research Cancer Hospital Database who were treated with radical prostatectomy without lymph node metastases. Time to prostate specific antigen recurrence was compared in men with positive vs negative bladder neck margins using Cox proportional hazards models adjusted for multiple clinical and pathological features. Results: A positive bladder neck margin in 79 patients (5%) was significantly associated with other poor prognostic features, including higher prostate specific antigen, higher pathological Gleason sum, extracapsular extension, seminal vesicle invasion and other positive margins. After adjusting for clinical and pathological characteristics positive bladder neck margins were associated with an increased risk of prostate specific antigen recurrence (HR 1.52, 95% CI 1.06-2.19, p = 0.02). Relative to organ confined margin negative disease a positive bladder neck margin associated with other positive margins showed a recurrence risk that was similar to that of seminal vesicle invasion (HR 4.14, 95% CI 2.55-6.73 and HR 4.22, 95% CI 3.08-5.78, respectively, each p <0.001). An isolated positive bladder neck margin was a rare event, noted in 15 patients (0.7%). In these men the recurrence risk was difficult to estimate due to the small number. However, the HR was similar to that in men with nonbladder neck positive margins or extracapsular extension (HR 2.65, 95% CI 0.97-7.25, p = 0.06 and HR 2.19, 95% CI 1.71-2.82, p <0.001, respectively). Conclusions: In the current study a positive bladder neck margin was frequently associated with other adverse features. When it was concomitant with other positive margins, a positive bladder neck margin was associated with a progression risk similar to that of seminal vesicle invasion (T3b disease). Although men with an isolated positive bladder neck margin had a more favorable pathological profile, there were too few of them to assess outcome reliably. However, the limited data suggest that they may best be categorized as having pT3a disease. C1 [Freedland, Stephen J.] Duke Univ, Sch Med, Div Urol, Dept Pathol, Durham, NC 27710 USA. [Buschemeyer, W. Cooper, III; Hamilton, Robert J.; Freedland, Stephen J.] Duke Univ, Sch Med, Div Urol Surg, Dept Surg, Durham, NC 27710 USA. [Buschemeyer, W. Cooper, III; Freedland, Stephen J.] VA Med Ctr, Surg Serv, Urol Sect, Durham, NC USA. [Hamilton, Robert J.] Univ Toronto, Dept Urol Surg, Toronto, ON, Canada. [Aronson, William J.] VA Greater Los Angeles Hlth Care Syst, Surg Serv, Urol Sect, Los Angeles, CA USA. [Aronson, William J.] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. [Presti, Joseph C., Jr.] Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. [Presti, Joseph C., Jr.] Vet Affairs Med Ctr, Surg Serv, Urol Sect, Palo Alto, CA 94304 USA. [Kane, Christopher J.] Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. [Kane, Christopher J.] Vet Affairs Med Ctr, Surg Serv, Urol Sect, San Francisco, CA 94121 USA. [Terris, Martha K.] Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. [Terris, Martha K.] Vet Affairs Med Ctr, Urol Sect, Augusta, GA USA. [Freedland, Stephen J.] Univ Alabama, Div Urol, Birmingham, AL USA. RP Freedland, SJ (reprint author), Duke Univ, Sch Med, Div Urol, Dept Pathol, Box 2626 Duke Univ Med Ctr, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Hamilton, Robert/0000-0002-6715-5934; Terris, Martha/0000-0002-3843-7270 FU NCI NIH HHS [R01CA100938, P50 CA92131-01A1] NR 12 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 JAN PY 2008 VL 179 IS 1 BP 124 EP 129 DI 10.1016/j.juro.2007.08.130 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 241IN UT WOS:000251650200035 PM 17997433 ER PT J AU Hoppe, H Barnwell, SL Nesbit, GM Petersen, BD AF Hoppe, Hanno Barnwell, Stanley L. Nesbit, Gary M. Petersen, Bryan D. TI Stent-grafts in the treatment of emergent or urgent carotid artery disease: Review of 25 cases SO JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY LA English DT Article ID TECHNICAL CASE-REPORT; COVERED STENT; ENDOVASCULAR TREATMENT; BLOWOUT SYNDROME; FOLLOW-UP; PSEUDOANEURYSM; ANEURYSMS; REPAIR; EXPERIENCE; MANAGEMENT AB PURPOSE: To report the authors' initial experience with carotid artery stent-grafts in a comparatively large patient series for the treatment of acute bleeding and impending rupture or the prevention of distal embolization. MATERIALS AND METHODS: This retrospective study was approved by the institutional review boards and performed according to HIPPA standards. Twenty-five patients were treated with 27 carotid artery stent-grafts (Gore Viabahn, n = 10; Bard Fluency, n = 9; polytetrafluoroethylene- covered Palmaz, n = 5; and Wallgraft, n = 3). Thirteen stent-grafts were placed in patients with carotid blow-out syndrome (including three patients with carotid-airway fistula), 12 in patients with either pseudoaneurysm (n = 9) or true aneurysm (n = 3), and two in patients with intractable high-grade bare stent restenosis. RESULTS: The technical success rate was 100% (27 of 27 cases). No acute procedural transient ischemic attacks or strokes occurred. Procedural dissections occurred in two of the 27 cases (7.4%). Short-term complications occurred in three of the 27 cases (11%) (repeat hemorrhage, n = 2; common carotid artery occlusion, n = 1). The overall patient mortality rate was 36% (nine of 25 patients, all with carotid blow-out syndrome). Six-month follow-up in 15 of the 16 living patients demonstrated widely patent stent-grafts. Two patients with pseudoaneurysm also demonstrated patent stents at 18- and 33-month follow-up. CONCLUSIONS: Stent-grafts may be useful in the treatment of carotid artery bleeding syndrome, aneurysm, and stenosis, with a high procedural success rate in selected cases. The results of mid-term follow-up are encouraging, but results of long-term follow-up must be evaluated in future studies. C1 [Hoppe, Hanno; Barnwell, Stanley L.; Nesbit, Gary M.; Petersen, Bryan D.] Oregon Hlth & Sci Univ, Dotter Intervent Inst, Portland, OR 97201 USA. [Petersen, Bryan D.] Portland VA Med Ctr, Dept Angiog, Portland, OR USA. RP Petersen, BD (reprint author), Oregon Hlth & Sci Univ, Dotter Intervent Inst, L-342,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM Bryan.Petersen@med.va.gov NR 23 TC 28 Z9 28 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1051-0443 J9 J VASC INTERV RADIOL JI J. Vasc. Interv. Radiol. PD JAN PY 2008 VL 19 IS 1 BP 31 EP 41 DI 10.1016/j.jvir.2007.08.024 PG 11 WC Radiology, Nuclear Medicine & Medical Imaging; Peripheral Vascular Disease SC Radiology, Nuclear Medicine & Medical Imaging; Cardiovascular System & Cardiology GA 258FG UT WOS:000252853200007 PM 18192465 ER PT J AU Jones, JA Barbour, JR Stroud, RE Bouges, S Stephens, SL Spinale, FG Ikonomidis, JS AF Jones, Jeffrey A. Barbour, John R. Stroud, Robert E. Bouges, Shenikqua Stephens, Shelly L. Spinale, Francis G. Ikonomidis, John S. TI Altered Transforming Growth Factor-Beta Signaling in a Murine Model of Thoracic Aortic Aneurysm SO JOURNAL OF VASCULAR RESEARCH LA English DT Article DE TGF-beta; Aneurysm; Signal transduction; Extracellular matrix; Remodeling ID BONE MORPHOGENETIC PROTEIN-2; MATRIX METALLOPROTEINASES; VASCULAR DISORDERS; TISSUE INHIBITOR; GENE-EXPRESSION; ANGIOGENESIS; RECEPTOR; INTERLEUKIN-6; CELLS; ACTIVATION AB Objective: Thoracic aortic aneurysms (TAAs) develop by a multifactorial process involving maladaptive signaling pathways that alter the aortic vascular environment. Transforming growth factor-beta (TGF-beta) has been implicated in regulating the structure and composition of the extracellular matrix by differential activation of various intracellular signaling pathways. However, whether and to what degree TGF-beta signaling contributes to TAA development remains unclear. Accordingly, the hypothesis that alterations in TGF-beta signaling occur during aneurysm formation was tested in a murine model of TAA. Methods: TAAs were surgically induced in mice (C57BL/6J) and aortas were analyzed at predetermined time points (1, 2, and 4 weeks post-TAA induction). Quantitative real-time PCR (QPCR) was performed to evaluate the expression of 84 relevant TGF-beta superfamily genes, and the protein levels of key signaling intermediates were measured by immunoblotting. Results were compared to unoperated reference control mice. Results: QPCR revealed increased expression of TGF-beta superfamily ligands (Gdf-2, -6, -7, Inhba), ligand inhibitors (Bmper, Chrd, Gsc), and transcriptional regulators (Dlx2, Evi1), among other genes (Cdkn2b, Igf1, IL-6). Protein levels of TGF-beta receptor(II), Smad2, Smad1/5/8, phospho-Smad1/5/8, and Smurf1 were increased from control values post-TAA induction. Both TGF-beta receptor(1) and Smad4 were decreased from control values, while ALK-1 levels remained unchanged. Conclusions: These alterations in the TGF-beta pathway suggest a mechanism by which primary signaling is switched from a TGF-beta R-1/Smad2-dependent response, to an ALK-1/Smad1/5/8 response, representing a significant change in signaling outcome, which may enhance matrix degradation. Copyright (C) 2008 S. Karger AG, Basel. C1 [Jones, Jeffrey A.] Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg Res, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Jones, JA (reprint author), Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg Res, Strom Thurmond Res Bldg,114 Doughty St,Suite 625, Charleston, SC 29425 USA. EM jonesja@musc.edu FU NHLBI NIH HHS [R01 HL059165-07, R01 HL075488, R01 HL059165, R01 HL075488-04, R01 HL075488-05, R01 HL102121]; NIA NIH HHS [R01 AG036954] NR 56 TC 19 Z9 20 U1 0 U2 1 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-1172 J9 J VASC RES JI J. Vasc. Res. PY 2008 VL 45 IS 6 BP 457 EP 468 DI 10.1159/000127437 PG 12 WC Physiology; Peripheral Vascular Disease SC Physiology; Cardiovascular System & Cardiology GA 363AQ UT WOS:000260238700001 PM 18434745 ER PT J AU Ritchie, CS Locher, JL Roth, DL Mcvie, T Sawyer, P Allman, R AF Ritchie, Christine S. Locher, Julie L. Roth, David L. McVie, Theresa Sawyer, Patricia Allman, Richard TI Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community-dwelling older adults SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article DE weight loss; body composition; function; mobility ID BODY-MASS INDEX; PHYSICAL FUNCTION; RISK-FACTORS; WOMEN; INTENTION; QUALITY; OBESITY; PEOPLE; HEALTH; NHANES AB Background. The relationship between body mass index (BMI), weight loss, and changes in activities of daily living (ADL) function and mobility in older adults is not clear. We sought to study the relationship between BMI and weight loss on the rate of decline in ADL function and life-space mobility over a 4-year period among older African Americans and whites. Methods. The participants were 983 enrollees in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal study of mobility among community-dwelling older adults stratified to achieve a balanced sample in terms of sex, race, and residence. Primary outcome measures were changes in ADL function and mobility assessed by the UAB Study of Aging Life-Space Assessment (LSA) which were measured every 6 months. Results. Relative to normal weight participants, those with BMI levels in the obese range did not show more rapid ADL functional decline, but a history of unintentional weight loss predicted more rapid decline. Relative to normal-weight participants, other BMI categories were not associated with more rapid decline in LSA scores. However, unintentional weight loss predicted more rapid declines in LSA. Intentional weight loss had no relation to ADL function or LSA decline. Conclusions. In this population of community-dwelling older African Americans and whites, neither BMI nor intentional weight loss had an association with rate of functional decline. Unintentional weight loss had a negative relation with rate of functional decline, regardless of baseline BMI. Whether this is causal remains to be determined. C1 [Ritchie, Christine S.; Locher, Julie L.; Sawyer, Patricia; Allman, Richard] UAB, Sch Med, Dept Med, Div Gerontol, Birmingham, AL 35924 USA. [Ritchie, Christine S.; Locher, Julie L.; Sawyer, Patricia; Allman, Richard] UAB, Dept Geriatr, Birmingham, AL 35924 USA. [Ritchie, Christine S.; Locher, Julie L.; Sawyer, Patricia; Allman, Richard] UAB, Dept Palliat Care, Birmingham, AL 35924 USA. [Locher, Julie L.] UAB, Dept Hlth Care Org & Policy, Birmingham, AL 35924 USA. [Locher, Julie L.] UAB, Dept Sociol, Birmingham, AL 35924 USA. [Locher, Julie L.; Sawyer, Patricia; Allman, Richard] UAB, Ctr Aging, Birmingham, AL USA. [Roth, David L.; McVie, Theresa] UAB, Sch Publ Hlth, Dept Biostat, Birmingham, AL USA. [Ritchie, Christine S.; Allman, Richard] Birmingham Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL USA. RP Ritchie, CS (reprint author), UAB, Sch Med, Dept Med, Div Gerontol, 1530 3rd Ave S,Ch-19,Rm 219, Birmingham, AL 35924 USA. EM critchie@uab.edu RI Allman, Richard/D-5964-2011 FU NIA NIH HHS [R01-AG-15062] NR 28 TC 38 Z9 40 U1 1 U2 6 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 JAN PY 2008 VL 63 IS 1 BP 67 EP 75 PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 301FU UT WOS:000255882600009 PM 18245763 ER PT J AU Zanjani, F Mavandadi, S TenHave, T Katz, I Durai, NB Krahn, D Llorente, M Kirchner, J Olsen, E Van Stone, W Cooley, S Oslin, DW AF Zanjani, Faika Mavandadi, Shahrzad TenHave, Tom Katz, Ira Durai, Nalla B. Krahn, Dean Llorente, Maria Kirchner, JoAnn Olsen, Edwin Van Stone, William Cooley, Susan Oslin, David W. TI Longitudinal course of substance treatment benefits in older male veteran at-risk drinkers SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article DE alcohol; at-risk drinking; problem drinkers ID MODERATE ALCOHOL-CONSUMPTION; RANDOMIZED CONTROLLED-TRIAL; BRIEF PHYSICIAN ADVICE; PRIMARY MEDICAL-CARE; BRIEF INTERVENTIONS; PRISM-E; DEPENDENCE; ADULTS; NALTREXONE; DRINKING AB Background. This investigation aims to determine the 12-month drinking trajectory of older at-risk drinkers in treatment. Furthermore, the drinking trajectory between at-risk drinkers who had met the threshold suggestive of alcohol dependence (problem at-risk drinkers) and those who did not meet this threshold (nonproblematic at-risk drinkers) were compared. Methods. This investigation is a component of the PRISM-E (Primary Care Research in Substance Abuse and Mental Health for the Elderly) Study, a multisite randomized trial comparing service use, outcomes, and cost between Integrated (IC) versus Enhanced Specialty Referral (ESR) care models for older (65-1 years) adults with depression, anxiety, and/or at-risk alcohol consumption. This investigation focuses only on at-risk drinkers, generally defined as exceeding recommended drinking limits, which in the case of older adults has been classified as consuming more than one drink per day. Two hundred fifty-eight randomized older at-risk drinkers were examined, of whom 56% were problem drinkers identified through the Short Michigan Alcohol Screening Test-Geriatric version. Results. Over time, all at-risk drinkers showed a significant reduction in drinking. Problem drinkers showed reductions in average weekly consumption and number of occurrences of binge drinking at 3, 6, and 12 months, whereas nonproblematic drinkers showed significant reductions in average weekly consumption at 3, 6, and 12 months and number of occurrences of binge drinking at only 6 months. IC treatment assignment led to higher engagement in treatment, which led to better binge drinking outcomes for problem drinkers. Despite significant reductions in drinking, approximately 29% of participants displayed at-risk drinking at the end of the study. Conclusions. Results suggest that older at-risk drinkers, both problem and nonproblematic, show a considerable decrease in drinking, with slightly greater improvement evidenced in problem drinkers and higher engagement in treatment seen in those assigned to IC. C1 Univ Kentucky, Grad Ctr Gerontol, Lexington, KY 40506 USA. [Mavandadi, Shahrzad; Katz, Ira] Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. [TenHave, Tom] Univ Penn, Dept Biostat, Philadelphia, PA 19104 USA. [Katz, Ira] Philadelphia Vet Affairs Med Ctr, VISN Mental Illness 4, Res Educ & Clin Ctr, Philadelphia, PA USA. [Durai, Nalla B.] Univ Illinois, Coll Med Psychiat, Chicago, IL 60680 USA. [Durai, Nalla B.] Chicago VA Med Ctr, Chicago, IL USA. [Krahn, Dean] William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. [Krahn, Dean] Univ Wisconsin, Sch Med, Dept Psychiat, Madison, WI 53792 USA. [Llorente, Maria] Univ Miami, Dept Psychiat, Coral Gables, FL 33124 USA. [Kirchner, JoAnn] Univ Arkansas Med Sci, Little Rock, AR 72205 USA. [Olsen, Edwin] Miami VAMC, Miami, FL USA. [Van Stone, William] US Dept Vet Affairs, Off Mental Hlth Serv, Washington, DC USA. [Cooley, Susan] US Dept Vet Affairs, Off Geriatr & Extended Care, W Palm Beach, FL USA. [Oslin, David W.] Philadelphia Ctr Excellence Subst Abuse Treatment, Philadelphia, PA USA. [Oslin, David W.] Univ Penn, Dept Psychiat, Ctr Studies Addict, Philadelphia, PA 19104 USA. RP Zanjani, F (reprint author), Univ Kentucky Gerontol, 306 B Wethington Hlth Sci Bldg,900 S Limestone, Lexington, KY 41094 USA. EM f.zanjani@uky.edu FU NIMH NIH HHS [5 T32 MH19931-08A1] NR 46 TC 8 Z9 8 U1 3 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 JAN PY 2008 VL 63 IS 1 BP 98 EP 106 PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 301FU UT WOS:000255882600013 PM 18245767 ER PT J AU Truong, LD Zhai, QJ Shen, SS Hamilton, C Krishnan, H AF Truong, L. D. Zhai, Q. J. Shen, S. S. Hamilton, C. Krishnan, H. TI Renal injury associated with urinary obstruction. Participation of an immune mechanism? SO LABORATORY INVESTIGATION LA English DT Meeting Abstract CT 97th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY MAR 01-07, 2008 CL Denver, CO SP US & Canadian Acad Pathol C1 Methodist Hosp, Houston, TX 77030 USA. Cornell Univ, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. DeBakey VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0023-6837 J9 LAB INVEST JI Lab. Invest. PD JAN PY 2008 VL 88 SU 1 MA 1350 BP 296A EP 296A PG 1 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 248UG UT WOS:000252181101478 ER PT J AU Truong, LD Zhai, QJ Shen, SS Krishnan, B Ro, J AF Truong, L. D. Zhai, Q. J. Shen, S. S. Krishnan, B. Ro, J. TI Lymphangiogenesis in chronic obstructive uropathy SO LABORATORY INVESTIGATION LA English DT Meeting Abstract CT 97th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY MAR 01-07, 2008 CL Denver, CO SP US & Canadian Acad Pathol C1 Methodist Hosp, Houston, TX 77030 USA. Cornell Univ, New York, NY USA. Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 0023-6837 J9 LAB INVEST JI Lab. Invest. PD JAN PY 2008 VL 88 SU 1 MA 1349 BP 296A EP 296A PG 1 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 248UG UT WOS:000252181101477 ER PT J AU Kulich, SM Cagle, PT Cozza, EM Land, SR Lenzner, D Brcic, L Dacic, S AF Kulich, S. M. Cagle, P. T. Cozza, E. M. Land, S. R. Lenzner, D. Brcic, L. Dacic, S. TI Immunohistochemical expression of signaling molecules Erb-b3, MKP-3, and Stat1 in non-small cell lung carcinoma SO LABORATORY INVESTIGATION LA English DT Meeting Abstract CT 97th Annual Meeting of the United-States-and-Canadian-Academy-of-Pathology CY MAR 01-07, 2008 CL Denver, CO SP US & Canadian Acad Pathol C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. Methodist Hosp, Houston, TX 77030 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. Univ Zagreb, Sch Med, Zagreb 41000, Croatia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0023-6837 J9 LAB INVEST JI Lab. Invest. PD JAN PY 2008 VL 88 SU 1 MA 1571 BP 345A EP 345A PG 1 WC Medicine, Research & Experimental; Pathology SC Research & Experimental Medicine; Pathology GA 248UG UT WOS:000252181101699 ER PT J AU Mirza, N Machtay, M Devine, PA Troxel, A Abboud, SK Doty, RL AF Mirza, Natasha Machtay, Mitchell Devine, Pamela A. Troxel, Andrea Abboud, Soo K. Doty, Richard L. TI Gustatory Impairment in Patients Undergoing Head and Neck Irradiation SO LARYNGOSCOPE LA English DT Article DE Radiation; taste; dysgeusia; videomicroscopy; taste pores ID TASTE-BUDS; FUNGIFORM PAPILLAE; SALIVARY FUNCTION; NERVE-FIBERS; HUMAN TONGUE; RADIOTHERAPY; PERFORMANCE; CANCER; RADIATION; RECOVERY AB Objectives: To determine whether radiation alters taste function and structure. Research Design: Prospective, longitudinal study. Methodology: Testing prior to starting radiation, and 2 weeks, 2 months, and 6 months after completing radiation. Results: Relative to controls, patients had lower taste identification test scores for bitter, salty, and sour tastes. Sour taste also showed a significant group-by-time interaction (P = .03). Taste pores were decreased in the irradiated group, with a significant group-by-time interaction (P = .03). Conclusion: Head and neck cancer patients have decreased taste function, and radiation adversely affected sour taste and taste pores. C1 [Mirza, Natasha; Abboud, Soo K.] Univ Penn, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. [Devine, Pamela A.] Philadelphia Vet Affairs Med Ctr, Dept Radiat Oncol, Philadelphia, PA USA. [Machtay, Mitchell] Thomas Jefferson Univ, Dept Radiat Oncol, Philadelphia, PA 19107 USA. [Troxel, Andrea] Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. [Doty, Richard L.] Univ Penn, Ctr Smell & Taste, Philadelphia, PA 19104 USA. RP Mirza, N (reprint author), Univ Penn, Dept Otolaryngol Head & Neck Surg, 5 Silverstein,3400 Spruce St, Philadelphia, PA 19104 USA. EM Natasha.mirza@uphs.upenn.edu RI Doty, Richard/B-7623-2012; Doty, Richard/G-1602-2013 OI Troxel, Andrea/0000-0002-1393-3075 FU Department of Veterans Affairs; Philadelphia VA Medical Center; Competitive Pilot Project Fund FX This research was supported by a grant from the Department of Veterans Affairs, Philadelphia VA Medical Center, Competitive Pilot Project Fund. NR 43 TC 15 Z9 15 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD JAN PY 2008 VL 118 IS 1 BP 24 EP 31 DI 10.1097/MLG.0b013e318155a276 PG 8 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 386CR UT WOS:000261860400006 PM 17975512 ER PT J AU Bredy, TW Barad, M AF Bredy, Timothy W. Barad, Mark TI The histone deacetylase inhibitor valproic acid enhances acquisition, extinction, and reconsolidation of conditioned fear SO LEARNING & MEMORY LA English DT Article ID MEMORY RECONSOLIDATION; PROTEIN-SYNTHESIS; FACILITATES EXTINCTION; MOUSE MODEL; LONG-TERM; REACTIVATION; HIPPOCAMPUS; MECHANISMS; RETRIEVAL; RAT AB Histone modifications contribute to the epigenetic regulation of gene expression, a process now recognized to be important for the consolidation of long-term memory. Valproic acid (VPA), used for many years as an anticonvulsant and a mood stabilizer, has effects on learning and memory and enhances the extinction of conditioned fear through its function as a histone deacetylase inhibitor (HDAC). Here we report that VPA enhances long-term memory for both acquisition and extinction of cued-fear. Interestingly, VPA enhances extinction, but also enhances renewal of the original conditioned fear when tested in a within-subjects design. This effect appears to be related to a reconsolidation-like process since a single CS reminder in the presence of VPA can enhance long-term memory for the original fear in the context in which fear conditioning takes place. We also show that by modifying the intertrial interval during extinction training, VPA can strengthen reconsolidation of the original fear memory or enhance long-term memory for extinction such that it becomes independent of context. These findings have important implications for the use of HDAC inhibitors as adjuncts to behavior therapy in the treatment of phobia and related anxiety disorders. C1 [Bredy, Timothy W.; Barad, Mark] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA. [Bredy, Timothy W.; Barad, Mark] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. [Barad, Mark] W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Barad, M (reprint author), Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90095 USA. EM mbarad@mednet.ucla.edu NR 38 TC 148 Z9 157 U1 1 U2 22 PU COLD SPRING HARBOR LAB PRESS, PUBLICATIONS DEPT PI COLD SPRING HARBOR PA 1 BUNGTOWN RD, COLD SPRING HARBOR, NY 11724 USA SN 1072-0502 J9 LEARN MEMORY JI Learn. Mem. PD JAN PY 2008 VL 15 IS 1 BP 39 EP 45 DI 10.1101/lm.801108 PG 7 WC Neurosciences; Psychology, Experimental SC Neurosciences & Neurology; Psychology GA 248WU UT WOS:000252188700006 PM 18174372 ER PT J AU Jeffries, M Bruner, G Glenn, S Sadanandan, P Carson, CW Harley, JB Sawalha, AH AF Jeffries, M. Bruner, G. Glenn, S. Sadanandan, P. Carson, C. W. Harley, J. B. Sawalha, A. H. TI Sulpha allergy in lupus patients: a clinical perspective SO LUPUS LA English DT Article DE lupus; sulpha allergy; lymphopenia; pericarditis; serology ID SULFASALAZINE-INDUCED LUPUS; INDUCED AUTOIMMUNE ABNORMALITIES; RHEUMATIC DISEASE; REVISED CRITERIA; ERYTHEMATOSUS; ARTHRITIS; CLASSIFICATION AB Systemic lupus erythematosus is a chronic, relapsing autoimmune disease that can affect multiple organ systems. An increased prevalence of drug allergy has been reported in lupus patients compared with the general population. Using a cohort of 417 lupus patients, we found a history of sulpha allergy in 27.3% of patients. European-American lupus patients with sulpha allergy are about two times more likely to suffer from lymphopenia, two times more likely to have anti-Ro autoantibody, and four times less likely to have anti-nRNP antibodies compared with lupus patients without a reported sulpha allergy (P = 0.0075, 0.025, and 0.032, respectively). In African-American lupus patients, a history of sulpha allergy was associated with over three times increased odds of developing pericarditis (P = 0.005). C1 [Jeffries, M.] Univ Oklahoma, Hlth Sci Ctr, Coll Med, Oklahoma City, OK 73190 USA. [Jeffries, M.; Bruner, G.; Glenn, S.; Harley, J. B.; Sawalha, A. H.] Oklahoma Med Res Fdn, Arthritis & Immunol Program, Oklahoma City, OK 73104 USA. [Sadanandan, P.] Marion Gen Hosp, Marion, IN USA. [Carson, C. W.] Oklahoma Arthritis Ctr, Edmond, OK USA. [Harley, J. B.; Sawalha, A. H.] Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. [Harley, J. B.; Sawalha, A. H.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Sawalha, AH (reprint author), 825 NE 13th St,MS 24, Oklahoma City, OK 73104 USA. EM amr-sawalha@omrf.ouhse.edu FU NCRR NIH HHS [P20-RR023477, RR020143, P20-RR015577]; NIAID NIH HHS [AI31584, AI024717]; NIAMS NIH HHS [AR62277, AR048940, AR42460, AR0490084, P30 AR053483] NR 27 TC 6 Z9 6 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2008 VL 17 IS 3 BP 202 EP 205 DI 10.1177/0961203307086640 PG 4 WC Rheumatology SC Rheumatology GA 295KH UT WOS:000255472900007 PM 18372360 ER PT J AU Jeffries, M Hamadeh, F Aberle, T Glenn, S Kamen, DL Kelly, JA Reichlin, M Harley, JB Sawalha, AH AF Jeffries, M. Hamadeh, F. Aberle, T. Glenn, S. Kamen, D. L. Kelly, J. A. Reichlin, M. Harley, J. B. Sawalha, A. H. TI Haemolytic anaemia in a multi-ethnic cohort of lupus patients: a clinical and serological perspective SO LUPUS LA English DT Article DE anaemia; haemolysis; haemolytic; lupus ID REVISED CRITERIA; DISEASE-ACTIVITY; ERYTHEMATOSUS; CLASSIFICATION AB Systemic lupus erythematosus is a chronic autoimmune disease that can be associated with a variety of haematological manifestations. We identified 76 patients with haemolytic anaemia in a cohort of 1251 unrelated female lupus patients enrolled in our studies. The presence of the various American College of Rheumatology clinical criteria for lupus and serological specificities were determined in lupus patients with haemolytic anaemia and compared with a group of race-matched control lupus patients without haemolytic anaemia. Clinical data were obtained from medical records, and serological specificities were determined in our clinical immunology laboratory at OMRF. The presence of haemolytic anaemia in lupus patients was associated with a higher frequency of proteinuria (OR = 2.70, P = 0.000031), urinary cellular casts (OR=2.83, P = 0.000062), seizures (OR = 2.96, P = 0.00024), pericarditis (OR = 2.21, P = 0.0019), pleuritis (OR = 1.72, P = 0.028) and lymphopenia (OR = 1.79, P = 0.015). These findings were independent of the presence of thrombocytopenia, which was approximately five times more common in lupus patients with haemolytic anaemia. Lupus patients with haemolytic anaemia were about 8 years younger than lupus patients without haemolytic anaemia at the time of disease onset (P = 0.000001). In the absence of thrombocytopenia, lupus patients with haemolytic anaemia were approximately two times more likely to have anti-dsDNA antibodies (P = 0.024). The presence of haemolytic anaemia is associated with a subset of lupus characterized by a younger age of disease onset, and a more severe disease with a higher likelihood of renal involvement, seizures, serositis and other cytopenias. C1 [Jeffries, M.] Univ Oklahoma, Hlth Sci Ctr, Coll Med, Oklahoma City, OK 73190 USA. [Jeffries, M.; Aberle, T.; Glenn, S.; Kelly, J. A.; Reichlin, M.; Harley, J. B.; Sawalha, A. H.] Oklahoma Med Res Fdn, Arthrit & Immunol Program, Oklahoma City, OK 73104 USA. [Hamadeh, F.; Reichlin, M.; Harley, J. B.; Sawalha, A. H.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. [Kamen, D. L.] Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. [Reichlin, M.; Harley, J. B.; Sawalha, A. H.] Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. RP Sawalha, AH (reprint author), 825 NE 13th St,MS 24, Oklahoma City, OK 73104 USA. EM amr-sawalha@omrf.ouhsc.edu FU National Center for Research Resources [P20-RR015577]; University of Oklahoma College of Medicine; Arthritis National Research Foundation (AHS); NIH [AR42460, AI024717, AI31584, AR62277, AR048940, AR0490084, RR020143]; Kirkland Scholar award; Alliance for Lupus Research; US Department of Veterans Affairs (JBH) FX This publication was made possible by NIH Grant Number P20-RR015577 from the National Center for Research Resources and by funding from the University of Oklahoma College of Medicine and the Arthritis National Research Foundation (AHS) and NIH Grants Number AR42460, AI024717, AI31584, AR62277, AR048940, AR0490084, RR020143, Kirkland Scholar award, Alliance for Lupus Research, and US Department of Veterans Affairs (JBH). NR 14 TC 18 Z9 22 U1 0 U2 1 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2008 VL 17 IS 8 BP 739 EP 743 DI 10.1177/0961203308090990 PG 5 WC Rheumatology SC Rheumatology GA 337MT UT WOS:000258440900007 PM 18625652 ER PT J AU Sestak, AL Nath, SK Kelly, JA Bruner, GR James, JA Harley, JB AF Sestak, A. L. Nath, S. K. Kelly, J. A. Bruner, G. R. James, J. A. Harley, J. B. TI Patients with familial and sporadic onset SLE have similar clinical profiles but vary profoundly by race SO LUPUS LA English DT Article DE SLE; familial; sporadic; genders; race; clinical profile ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; 3 ETHNIC-GROUPS; IMMUNOLOGICAL FEATURES; GENOME SCAN; LINKAGE; COHORT; MANIFESTATIONS; SEX; AGE AB Few large, multi-ethnic studies have examined the clinical and serologic differences between familial and sporadic SLE patients. Understanding these similarities and differences is critical for interpreting genetic studies and developing therapeutic strategies. We compiled information on 1915 patients with SLE in a large multi-racial cohort, including general demographics, pedigree structure and the specific American College of Rheumatology (ACR) criteria met. One patient was randomly selected from each multiplex family for analysis, yielding 554 European-Americans (EA), 373 African-Americans (AA), 193 Hispanics (HI) and 237 patients of other of mixed races. When comparing familial and sporadic patients stratified by race, lupus erythematosus (LE) cells and arthritis were increased in white familial cases (P = 5.5 x 10(-6) and P = 0.028, respectively), but no other significant differences between familial and sporadic patients were found. We found that there were profound differences in clinical profiles between races. For example, photosensitivity and malar rash were decreased in AA (P = 1.3 x 10(-13) and 1.4 x 10(-7), respectively), whereas discoid rash was increased in AA (P = 5.5x10(-6)). EA had significantly less renal disease (P = 5.4x10(-13)), proteinuria (P = 4 x 10(-12)) and anti-Sm (P = 1.7 x 10(-12)) than AA or HI. We therefore, conclude that familial and sporadic onset patients may be treated similarly with respect to clinical and genetic studies. Lupus (2008) 17, 1004-1009. C1 [Sestak, A. L.; Nath, S. K.; Kelly, J. A.; Bruner, G. R.; James, J. A.; Harley, J. B.] Oklahoma Med Res Fdn, Dept Arthritis & Immunol, Oklahoma City, OK 73104 USA. [James, J. A.; Harley, J. B.] Univ Oklahoma, Hlth Sci Ctr, Dept Med, Oklahoma City, OK USA. [Nath, S. K.] Univ Oklahoma, Hlth Sci Ctr, Dept Pediat, Oklahoma City, OK 73190 USA. [Harley, J. B.] US Dept Vet Affairs, Med Ctr, Oklahoma City, OK USA. RP Sestak, AL (reprint author), Oklahoma Med Res Fdn, Dept Arthritis & Immunol, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM Andrea-Sestak@omrf.ouhsc.edu FU National Institute of Health [AR012253, AR012753, RR020143, AI024717, AR042460, AR048940, AR049084, AR049272, AI063622, AR053483]; The Alliance for Lupus Research; The Kirkland Foundation; US Department of Veterans Affairs FX We would like to thank the staff of the LFRR, as well as contributing physicians Dr Maria Ballesteros, Dr Craig Carson, Dr Luis R Espinoza, Dr Gary S Gilkeson, Dr Diane L Kamen, Dr David Karp, Dr Joan Merrill, Dr Michelle Petri, Dr Marilyn Punaro, Dr Ana Quintero, Dr Roberto Rivera and Dr Daniel Wallace. This study is supported by National Institute of Health (grants AR012253, AR012753, RR020143, AI024717, AR042460, AR048940, AR049084, AR049272, AI063622, AR053483), The Alliance for Lupus Research, The Kirkland Foundation and the US Department of Veterans Affairs. NR 25 TC 11 Z9 11 U1 0 U2 1 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 0961-2033 J9 LUPUS JI Lupus PY 2008 VL 17 IS 11 BP 1004 EP 1009 DI 10.1177/0961203308091969 PG 6 WC Rheumatology SC Rheumatology GA 369UW UT WOS:000260720400007 PM 18852224 ER PT J AU Finegold, SM AF Finegold, Sydney M. TI Therapy and epidemiology of autism-clostridial spores as key elements SO MEDICAL HYPOTHESES LA English DT Article ID SPECTRUM DISORDERS; ONSET AUTISM; CHILDREN; MICROFLORA; DIFFICILE; HANDS AB This manuscript reviews evidence indicating that intestinal, bacteria, specifically clostridia, may play a role in certain cases of autism and hypothesizes that the clostridial spores (which are notably resistant to antimicrobial agents and commonly used germicides) are involved in: (1) relapse in the autistic subject after a response to an agent such as oral vancomycin, after the drug is discontinued, (2) the unexplained increased incidence of autism in recent years, and (3) the unexplained increase in numbers of multiple cases in the same family. Hypothesis (1), if established as valid, would spur research to find well-tolerated and safe agents that could be given together with vancomycin (or other appropriate antimicrobial agent) to eliminate spores; this would revolutionize the therapeutic approach. Hypotheses (2) and (3) relate to widespread use of antimicrobial agents, poor hygiene in young autistic children, and difficulty in removing spores from the home environment. These tatter two hypotheses have major implications with regard to the epidemiology of this important and distressing disease and would encourage research into methods to eliminate clostridial spores from the home and other environments. (c) 2007 Elsevier Ltd. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111F, Los Angeles, CA 90073 USA. [Finegold, Sydney M.] Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. [Finegold, Sydney M.] Univ Calif Los Angeles, Sch Med, Dept Microbiol Immunol & Mol Genet, Los Angeles, CA 90073 USA. RP Finegold, SM (reprint author), W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect 111F, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sidfinegol@aol.com NR 13 TC 39 Z9 44 U1 0 U2 15 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0306-9877 J9 MED HYPOTHESES JI Med. Hypotheses PY 2008 VL 70 IS 3 BP 508 EP 511 DI 10.1016/j.mehy.2007.07.019 PG 4 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 268WI UT WOS:000253610300009 PM 17904761 ER PT J AU Schwid, HA AF Schwid, Howard A. BE Westwood, JD Haluck, RS Hoffman, HM Mogel, GT Phillips, R Robb, RA Vosburgh, KG TI Open-Source Shared Case Library SO MEDICINE MEETS VIRTUAL REALITY 16 SE Studies in Health Technology and Informatics LA English DT Proceedings Paper CT 16th Conference on Medicine Meets Virtual Reality CY JAN 30-FEB 01, 2008 CL Long Beach, CA DE Simulation; case library AB Sharing simulator case scenarios among educators will greatly reduce the cost and effort involved in bringing simulation to our students. A library of 72 cases was posted to the internet to freely share. The cases in the library consist of text files utilizing a simple open-source format. In the first four months after posting, cases were downloaded over 18,000 times. In addition, the library encouraged the development of 23 new cases by 16 new contributors. This experience indicates a strong interest in obtaining free cases, but only modest willingness to share new scenarios among authors and institutions. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Schwid, HA (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM hschwid@u.washington.edu NR 0 TC 0 Z9 0 U1 0 U2 1 PU I O S PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 0926-9630 J9 ST HEAL T PY 2008 VL 132 BP 442 EP 445 PG 4 WC Computer Science, Interdisciplinary Applications; Health Care Sciences & Services; Medical Informatics SC Computer Science; Health Care Sciences & Services; Medical Informatics GA BMK36 UT WOS:000272668400095 PM 18391339 ER PT J AU Stone, AM AF Stone, Andrew M. TI Dual agency for VA clinicians: Defining an evolving ethical question SO MILITARY PSYCHOLOGY LA English DT Article ID MENTAL-HEALTH PROBLEMS; AFGHANISTAN; IRAQ AB Changing patterns of military service have altered the circumstances of patients being treated in the facilities of the Department of Veterans Affairs (VA). Formerly, all patients seen by the VA were veterans who had completed their service; now, many are eligible to return to duty. Potential redeployment of patients raises new questions for VA mental health practitioners. This article describes the current situation, presenting representative cases and discussing questions of assessment and diagnosis. The topic of dual agency, the obligations of the provider both to the individual and to the system, inherent in the military context, is explored as a model. Ethical mandates and issues of the various mental health disciplines involved are reviewed. Differences in the roles of military and VA mental health providers are discussed, and approaches to decision-making with application of relevant principles are presented. C1 [Stone, Andrew M.] Vet Affairs Med Ctr, Philadelphia, PA USA. [Stone, Andrew M.] Univ Penn, Philadelphia, PA 19104 USA. RP Stone, AM (reprint author), VA Med Ctr Philadelphia 116MHC, 3900 Woodland Ave, Philadelphia, PA 19104 USA. EM Andrew.Stone2@med.va.gov NR 16 TC 2 Z9 2 U1 0 U2 0 PU LAWRENCE ERLBAUM ASSOC INC-TAYLOR & FRANCIS PI PHILADELPHIA PA 325 CHESTNUT STREET, STE 800, PHILADELPHIA, PA 19106 USA SN 0899-5605 J9 MIL PSYCHOL JI Milit. Psychol. PY 2008 VL 20 IS 1 BP 37 EP 48 DI 10.1080/08995600701753177 PG 12 WC Psychology, Multidisciplinary SC Psychology GA 256GG UT WOS:000252715100004 ER PT S AU Qin, WP Zhao, W Ho, L Wang, J Walsh, K Gandy, S Pasinetti, GM AF Qin, Weiping Zhao, Wei Ho, Lap Wang, Jun Walsh, Kenneth Gandy, Sam Pasinetti, Giulio Maria BE Gibson, GE Ratan, RR Beal, MF TI Regulation of Forkhead Transcription Factor FoxO3a Contributes to Calorie Restriction-induced Prevention of Alzheimer's Disease-type Amyloid Neuropathology and Spatial Memory Deterioration SO MITOCHONDRIA AND OXIDATIVE STRESS IN NEURODEGENERATIVE DISORDERS SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT Conference on Mitochondria and Oxisative Stress in Neurodegenerative Disorders CY SEP 26-29, 2007 CL New York Acad Sci, New York, NY SP Weill Med Coll, Cornell Univ, Grad Sch Med Sci, Ellison Med Fdn, Burke Med Res Inst HO New York Acad Sci DE Alzheimer's disease; amyloid-beta peptide; calorie restriction; Forkhead transcription factor FoxO3a ID TRANSGENIC MOUSE MODEL; INSULIN-RESISTANCE; SIGNALING PATHWAY; CELL-SURVIVAL; SIRT1; LONGEVITY; MICE; BIM; DEACETYLASE; MODULATION AB Forkhead transcription factor FoxO3a, also known as DAF-16 in Caenorhabditis elegans, is a key regulator of the insulin receptor (IR)/insulin-like growth factor-I signaling pathway mediated extension of life span in worms and yeast. In this study, we report that calorie restriction (CR)-mediated activation of the IR signaling pathway leads to hyperphosphorylation of FoxO3a transcription factor and, consequently, its exclusion front the nucleus. This inactivation of FoxO3a activity is correlated with attenuation of Alzheimer's disease (AD)-type amyloid neuropathology and with preservation of spatial reference memory in the Tg2576 mouse model of AD. Further, in vitro studies reveal that exogenous expression of viral, triple-mutant, constitutively active FoxO3a resulting in increased nuclear FoxO3a activity in primary neuron cultures derived from Tg2576 mouse embryos, causally promotes AD amyloid-beta peptide (AP) levels by inhibiting non-amyloidogenic a-secretase activity, indicating the existence of an inverse correlation between FoxO3a activity and cerebral As amyloidosis. Moreover, we report for the first time that the exclusion of the FoxO3a transcription factor from the nucleus in combination with inhibition of nuclear FoxO3a activity by SIRT1-mediated deacetylation in response to CR is a mechanism resulting in the repression of Rho-associated protein kinase-1 gene expression, thereby activating nonamyloidogenic alpha-secretase processing of the amyloid precursor protein and lowering AS generation. This study provides a novel metabolic pathway for prevention and/or treatment of AD. C1 [Qin, Weiping; Zhao, Wei; Ho, Lap; Wang, Jun; Pasinetti, Giulio Maria] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Ho, Lap; Pasinetti, Giulio Maria] Mt Sinai Sch Med, Dept Neurosci, New York, NY 10029 USA. [Gandy, Sam] Mt Sinai Sch Med, Dept Neurol, New York, NY 10029 USA. [Ho, Lap; Pasinetti, Giulio Maria] James J Peters VA Med Ctr, Geriatr Res Clin Ctr, Bronx, NY USA. [Walsh, Kenneth] Boston Univ, Sch Med, Whitaker Cardiovasc Inst, Boston, MA 02118 USA. RP Pasinetti, GM (reprint author), Mt Sinai Sch Med, Dept Psychiat, 1 Gustave L Levy Pl,Box 1668, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu RI Zhao, Wei/B-3220-2010; Zhao, Wei/A-2206-2010 FU Atkins Foundation; National Institute of Health (NIH) [AG14766, AG10491]; Danal Foundation FX These studies were supported by the Dr. Robert C. Atkins Foundation, National Institute of Health (NIH) AG14766, the Danal Foundation for Brain Research Initiative, and Merit Review to G.P.; S.M. was supported by NIH Program Project AG10491. We thank Drs. W. Todd Penberthy and Soumya Chari for their editorial comments. NR 28 TC 55 Z9 56 U1 1 U2 9 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 978-1-57331-713-9 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2008 VL 1147 BP 335 EP 347 DI 10.1196/annals.1427.024 PG 13 WC Cell Biology; Multidisciplinary Sciences; Neurosciences; Physiology SC Cell Biology; Science & Technology - Other Topics; Neurosciences & Neurology; Physiology GA BIR99 UT WOS:000262397800031 PM 19076455 ER PT S AU Szymusiak, R McGinty, D AF Szymusiak, Ronald McGinty, Dennis BE Pfaff, DW Kieffer, BL TI Hypothalamic regulation of sleep and arousal SO MOLECULAR AND BIOPHYSICAL MECHANISMS OF AROUSAL, ALERTNESS, AND ATTENTION SE Annals of the New York Academy of Sciences LA English DT Article DE median preoptic nucleus; ventrolateral preoptic area; sleep homeostasis; hypocretin; monoamines; GABA; adenosine ID EYE-MOVEMENT SLEEP; VENTROLATERAL PREOPTIC NUCLEUS; PERIFORNICAL LATERAL HYPOTHALAMUS; WAKING DISCHARGE PATTERNS; POSTTRAUMATIC-STRESS-DISORDER; BASAL FOREBRAIN NEURONS; FOS PROTEIN EXPRESSION; CENTRAL-NERVOUS-SYSTEM; DORSAL RAPHE NEURONS; LOCUS-COERULEUS AB Normal waking is associated with neuronal activity in several chemically defined ascending arousal systems. These include monoaminergic neurons in the brainstem and posterior hypothalamus, cholinergic neurons in the brainstem and basal forebrain, and hypocretin (orexin) neurons in the lateral hypothalamus. Collectively, these systems impart tonic activation to their neuronal targets in the diencephalon and neocortex that is reflected in the low-voltage fast-frequency electroencephalogram patterns of wakefulness. Neuronal discharge in these arousal systems declines rapidly at sleep onset. Transitions from waking to sleep, therefore, involve coordinated inhibition of multiple arousal systems. An important source of sleep-related inhibition of arousal arises from neurons located in the preoptic hypothalamus. These preoptic neurons are strongly activated during sleep, exhibiting sleep/waking state-dependent discharge patterns that are the reciprocal of that observed in the arousal systems. The majority of preoptic sleep regulatory neurons synthesize the inhibitory neurotransmitter GABA. Anatomical and functional evidence supports the hypothesis that GABAergic neurons in the median preoptic nucleus (MnPN) and ventrolateral preoptic area (VLPO) exert inhibitory control over the monoaminergic systems and the hypocretin system during sleep. Recent findings indicate that MnPN and VLPO neurons integrate homeostatic aspects of sleep regulation and are important targets for endogenous sleep factors, such as adenosine and growth hormone releasing hormone. C1 [Szymusiak, Ronald; McGinty, Dennis] Greater Los Angeles Healthcare Syst, Vet Adm, Res Serv, Los Angeles, CA USA. [Szymusiak, Ronald] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. [Szymusiak, Ronald] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. [McGinty, Dennis] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. RP Szymusiak, R (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv 151A3, 16111 Plummer St, North Hills, CA 91434 USA. EM rszym@ucla.edu NR 110 TC 116 Z9 119 U1 3 U2 17 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN STREET, MALDEN 02148, MA USA SN 0077-8923 BN 978-1-57331-703-0 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2008 VL 1129 BP 275 EP 286 DI 10.1196/annals.1417.027 PG 12 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA BHU95 UT WOS:000256620900025 PM 18591488 ER PT J AU Quinones, MP Kalkonde, Y Estrada, CA Jimenez, F Ramirez, R Mahimainathan, L Mummidi, S Choudhury, GG Martinez, H Adams, L Mack, M Reddick, RL Maffi, S Haralambous, S Probert, L Ahuja, SK Ahuja, SS AF Quinones, Marlon P. Kalkonde, Yogeshwar Estrada, Carlos A. Jimenez, Fabio Ramirez, Robert Mahimainathan, Lenin Mummidi, Srinivas Choudhury, Goutam G. Martinez, Hernan Adams, Lisa Mack, Matthias Reddick, Robert L. Maffi, Shivani Haralambous, Sylva Probert, Lesley Ahuja, Sunil K. Ahuja, Seema S. TI Role of astrocytes and chemokine systems in acute TNF alpha induced demyelinating syndrome: CCR2-dependent signals promote astrocyte activation and survival via NF-kappa B and Akt SO MOLECULAR AND CELLULAR NEUROSCIENCE LA English DT Article DE multiple sclerosis; chemokines; TNF alpha; biomarker; inflammation; transgenic mice ID TUMOR-NECROSIS-FACTOR; EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; CENTRAL-NERVOUS-SYSTEM; MULTIPLE-SCLEROSIS; TRANSGENIC MICE; NEURONAL SURVIVAL; MCP-1 CCL2; RECEPTOR 2; EXPRESSION; DISEASE AB Chemotactic factors known as chemokines play an important role in the pathogenesis of multiple sclerosis (MS). Transgenic expression of TNF alpha in the central nervous system (CNS) leads to the development of a demyelinating phenotype (TNF alpha-induced demyelination; TID) that is highly reminiscent of MS. Little is known about the role of chemokines in TID but insights derived from studying this model might extend our current understanding of MS pathogenesis and complement data derived from the classic autoimmune encephalomyelitis (EAE) model system. Here we show that in TID, chemokines and their receptors were significantly increased during the acute phases of disease. Notably, the CCL2 (MCP-1)-CCR2 axis and the closely related ligand-receptor pair CCR1-CCL3 (MIP-1 alpha) were among the most up-regulated during disease. On the other hand, receptors like CCR3 and CCR4 were not elevated. This significant increase in the levels of chemokines/receptors correlated with robust immune infiltration of the CNS by inflammatory cells, i.e., macrophages, and immune cells particularly T and B cells. Immurrostaining and confocal microscopy, along with in vitro studies revealed that astrocytes were a major source of locally produced chemokines and expressed functional chemokine receptors such as CCR2. Using an in vitro system we demonstrate that expression of CCR2 was functional in astrocytes and that signaling via this receptor lead to activation of NF-kappa B and Akt and was associated with increased astrocyte survival. Collectively, our data suggests that transgenic murine models of NIS are useful to dissect mechanisms of disease and that in these models, up-regulation of chemokines and their receptors may be key determinants in TID. (C) 2007 Elsevier Inc. All rights reserved. C1 [Quinones, Marlon P.; Kalkonde, Yogeshwar; Estrada, Carlos A.; Jimenez, Fabio; Ramirez, Robert; Mahimainathan, Lenin; Mummidi, Srinivas; Choudhury, Goutam G.; Martinez, Hernan; Adams, Lisa; Maffi, Shivani; Ahuja, Sunil K.; Ahuja, Seema S.] S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. [Estrada, Carlos A.; Jimenez, Fabio; Ramirez, Robert; Mahimainathan, Lenin; Mummidi, Srinivas; Choudhury, Goutam G.; Martinez, Hernan; Adams, Lisa; Maffi, Shivani; Ahuja, Sunil K.; Ahuja, Seema S.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Reddick, Robert L.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Ahuja, Sunil K.; Ahuja, Seema S.] Vet Adm Ctr Res AIDS & HIV 1 Infect, San Antonio, TX USA. [Mack, Matthias] Univ Munich, Munich, Germany. [Probert, Lesley] Hellenic Pasteur Inst, Mol Genet Lab, Athens, Greece. [Haralambous, Sylva] Mol Genet Lab, Transgen Technol Unit, Athens, Greece. RP Ahuja, SS (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med MC 7870, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM ahuja@uthscsa.edu RI Mummidi, Srinivas/C-1004-2008 OI Mummidi, Srinivas/0000-0002-4068-6380 FU NCI NIH HHS [P30 CA054174, P30 CA54174]; NIA NIH HHS [P30 AG013319, P01 AG019316, P01AG19316]; NIAID NIH HHS [AI48644, R01 AI048644, R01 AI048644-05]; NIAMS NIH HHS [AR 052755, R01 AR052755, R01 AR052755-02] NR 49 TC 36 Z9 38 U1 1 U2 5 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1044-7431 J9 MOL CELL NEUROSCI JI Mol. Cell. Neurosci. PD JAN PY 2008 VL 37 IS 1 BP 96 EP 109 DI 10.1016/j.mcn.2007.08.017 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 255UM UT WOS:000252683100009 PM 17949991 ER PT J AU Qiao, LY Hamamichi, S Caldwell, KA Caldwell, GA Yacoubian, TA Wilson, S Xie, ZL Speake, LD Parks, R Crabtree, D Liang, QL Crimmins, S Schneider, L Uchiyama, Y Iwatsubo, T Zhou, Y Peng, LS Lu, YM Standaert, DG Walls, KC Shacka, JJ Roth, KA Zhang, JH AF Qiao, Liyan Hamamichi, Shusei Caldwell, Kim A. Caldwell, Guy A. Yacoubian, Talene A. Wilson, Scott Xie, Zuo-Lei Speake, Lisa D. Parks, Rachael Crabtree, Donna Liang, Qiuli Crimmins, Stephen Schneider, Lonnie Uchiyama, Yasuo Iwatsubo, Takeshi Zhou, Yi Peng, Lisheng Lu, YouMing Standaert, David G. Walls, Ken C. Shacka, John J. Roth, Kevin A. Zhang, Jianhua TI Lysosomal enzyme cathepsin D protects against alpha-synuclein aggregation and toxicity SO MOLECULAR BRAIN LA English DT Article AB alpha-synuclein (alpha-syn) is a main component of Lewy bodies (LB) that occur in many neurodegenerative diseases, including Parkinson's disease (PD), dementia with LB (DLB) and multi-system atrophy. alpha-syn mutations or amplifications are responsible for a subset of autosomal dominant familial PD cases, and overexpression causes neurodegeneration and motor disturbances in animals. To investigate mechanisms for alpha-syn accumulation and toxicity, we studied a mouse model of lysosomal enzyme cathepsin D (CD) deficiency, and found extensive accumulation of endogenous alpha-syn in neurons without overabundance of alpha-syn mRNA. In addition to impaired macroautophagy, CD deficiency reduced proteasome activity, suggesting an essential role for lysosomal CD function in regulating multiple proteolytic pathways that are important for alpha-syn metabolism. Conversely, CD overexpression reduces alpha-syn aggregation and is neuroprotective against alpha-syn overexpression-induced cell death in vitro. In a C. elegans model, CD deficiency exacerbates alpha-syn accumulation while its overexpression is protective against alpha-syn-induced dopaminergic neurodegeneration. Mutated CD with diminished enzymatic activity or overexpression of cathepsins B (CB) or L (CL) is not protective in the worm model, indicating a unique requirement for enzymatically active CD. Our data identify a conserved CD function in alpha-syn degradation and identify CD as a novel target for LB disease therapeutics. C1 [Qiao, Liyan; Xie, Zuo-Lei; Speake, Lisa D.; Parks, Rachael; Crabtree, Donna; Liang, Qiuli; Crimmins, Stephen; Schneider, Lonnie; Walls, Ken C.; Shacka, John J.; Roth, Kevin A.; Zhang, Jianhua] Univ Alabama Birmingham, Dept Pathol, Birmingham, AL 35294 USA. [Hamamichi, Shusei; Caldwell, Kim A.; Caldwell, Guy A.] Univ Alabama, Dept Biol Sci, Tuscaloosa, AL USA. [Caldwell, Kim A.; Caldwell, Guy A.; Yacoubian, Talene A.; Wilson, Scott; Zhou, Yi; Standaert, David G.; Roth, Kevin A.; Zhang, Jianhua] Univ Alabama Birmingham, Dept Neurobiol, Birmingham, AL 35294 USA. [Caldwell, Kim A.; Caldwell, Guy A.; Yacoubian, Talene A.; Standaert, David G.] Univ Alabama Birmingham, Dept Neurol, Birmingham, AL 35294 USA. [Caldwell, Kim A.; Caldwell, Guy A.; Yacoubian, Talene A.; Shacka, John J.; Roth, Kevin A.; Zhang, Jianhua] Univ Alabama Birmingham, Ctr Neurodegenerat & Expt Therapeut, Birmingham, AL 35294 USA. [Uchiyama, Yasuo] Osaka Univ, Dept Cell Biol & Neurosci, Osaka, Japan. [Iwatsubo, Takeshi] Univ Tokyo, Dept Neuropathol, Dept Neuropathol & Neurosci, Grad Sch Med,Grad Sch Pharmaceut Sci, Tokyo, Japan. [Peng, Lisheng; Lu, YouMing] Burnett Coll Biomed Sci, Biomol Sci Ctr, Orlando, FL USA. [Shacka, John J.] Birmingham VA Med Ctr, Dept Vet Affairs, Birmingham, AL 35294 USA. RP Zhang, JH (reprint author), Univ Alabama Birmingham, Dept Pathol, Birmingham, AL 35294 USA. EM lqiao@uab.edu; hamam@bama.ua.edu; kcaldwell@ua.edu; gcaldwell@ua.edu; tyacoub@uab.edu; wilson@nrc.uab.edu; xie_zl1969@yahoo.com.cn; ldspeake@bsu.edu; rparks1@mvnu.edu; donna.crabtree@gmail.com; lianglql02@gmail.com; scrimmins@nrc.uab.edu; lonnie11@uab.edu; y-uchi@anat1.med.osaka-u.ac.jp; iwatsubo@mol.f.u-tokyo.ac.jp; yzhou@nrc.uab.edu; youming@mail.ucf.edu; youming@mail.ucf.edu; dstandaert@uab.edu; kcwalls@uab.edu; shacka@uab.edu; karoth@uab.edu; zhanja@uab.edu RI zhang, jianhua/D-3404-2009 FU American Parkinson's Disease Association; Michael J. Fox Foundation; Batten Disease Support and Research Association; VA career development award; UAB Alzheimer Disease Research Center; NIH [NS35107, NS41962]; UAB faculty development and start-up fund; UAB Neuroscience Core Facilities [NS47466, NS57098]; American Heart Association [05553413]; NIH/NINDS [R01NS5051383]; NIH/NIA [R01AG033282] FX We thank Songsong Cao for generating the alpha-syn::GFP transgenic worms, Dr. Pam McLean for plasmids used for alpha-syn aggregation assay in H4 cells, Drs. M Brenner and Y-F Chen for critically reading the manuscript, Drs. J Wu and J Tucholski, and members of our laboratories for technical assistance and discussions. Ctsd mutant mice were generously provided by Dr. P Saftig (University of Kiel). We thank Genta Ito for handling the shipping of the phospho-alpha-syn antibody. This work is funded by the American Parkinson's Disease Association and Michael J. Fox Foundation (GAC, KAC, DGS), Batten Disease Support and Research Association, VA career development award, and UAB Alzheimer Disease Research Center (JJS), NIH grants NS35107 and NS41962 (KAR), a UAB faculty development and start-up fund, UAB Alzheimer Disease Research Center, the American Parkinson's Disease Association, and Michael J. Fox Foundation (JZ). This work is also supported by UAB Neuroscience Core Facilities (NS47466 and NS57098). This work was also supported by the American Heart Association (05553413, YL), NIH/NINDS (R01NS5051383, YL) and NIH/NIA (R01AG033282, YL). NR 72 TC 101 Z9 101 U1 1 U2 12 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1756-6606 J9 MOL BRAIN JI Mol. Brain PY 2008 VL 1 DI 10.1186/1756-6606-1-17 PG 18 WC Neurosciences SC Neurosciences & Neurology GA V25CV UT WOS:000208457000017 PM 19021916 ER PT J AU Nowling, TK Fulton, JD Chike-Harris, K Gilkeson, GS AF Nowling, Tamara K. Fulton, Jennifer Dziadyk Chike-Harris, Katherine Gilkeson, Gary S. TI Ets factors and a newly identified polymorphism regulate Fli1 promoter activity in lymphocytes SO MOLECULAR IMMUNOLOGY LA English DT Article DE transcription; gene regulation; transcription factors; Ets; B cells; T cells; systemic lupus erythematosus ID SYSTEMIC-LUPUS-ERYTHEMATOSUS; DNA-BINDING SPECIFICITIES; MURINE LEUKEMIA-VIRUS; TRANSCRIPTION FACTOR; RENAL-DISEASE; GENE; FAMILY; EXPRESSION; PROTEIN; CELLS AB Fli1 is an Ets family member that is essential for embryonic development. Increasing evidence suggests modulating FIR gene expression impacts lymphocyte development/function and is an important mediator in the autoimmune disease lupus. Fli1 is over-expressed in splenic lymphocytes in lupus prone mouse strains and in PBMCs of lupus patients. Presently, it is unknown how Fli1 gene expression is controlled in lymphocytes or how it becomes over-expressed in lupus. Therefore, we examined Fli1 regulation in a murine B cell line and T cell line and identified several cis-regulatory elements within a 230 bp region that contribute to Fli1 promoter activity. Ets factors Elf 1, Tel and Fli1 bind in vitro to this region and increase endogenous Fli1 expression when over-expressed in a T cell line. In addition, we determined that a microsatellite located adjacent to the region containing these cis-regulatory elements is polymorphic in three lupus prone mouse strains and that the length of the microsatellite is inversely correlated with promoter activity in a T cell line. These results suggest that several Ets factors, including Fli1 itself, are involved in the transcriptional regulation of Fli1 in lymphocytes. Furthermore, the presence of a polymorphic microsatellite in the Fli1 promoter may contribute to increased Fli1 expression in T cells during lupus disease progression. (C) 2007 Elsevier Ltd. All rights reserved. C1 Med Univ S Carolina, Div Rheumatol, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Med Res Serv, Charleston, SC 29425 USA. RP Nowling, TK (reprint author), Med Univ S Carolina, Div Rheumatol, Dept Med, 96 Jonathan Lucas St,Ste 912 CSB, Charleston, SC 29425 USA. EM nowling@muse.edu FU NIAMS NIH HHS [AR47451, R01 AR047451]; NIDDK NIH HHS [K01 DK072306, K01 DK072306-01, DK072306, K01 DK072306-02] NR 37 TC 14 Z9 14 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0161-5890 J9 MOL IMMUNOL JI Mol. Immunol. PD JAN PY 2008 VL 45 IS 1 BP 1 EP 12 DI 10.1016/j.molimm.2007.05.018 PG 12 WC Biochemistry & Molecular Biology; Immunology SC Biochemistry & Molecular Biology; Immunology GA 218KE UT WOS:000250013600001 PM 17606295 ER PT S AU Ehsan, A Herrick, JL AF Ehsan, Aamir Herrick, Jennifer L. BE Zander, DS Popper, HH Jagirdar, J Haque, AK Cagle, PT Barrios, R TI Posttransplantation Lymphoproliferative Disorder SO MOLECULAR PATHOLOGY OF LUNG DISEASES SE Molecular Pathology Library LA English DT Article; Book Chapter ID EPSTEIN-BARR-VIRUS; ORGAN TRANSPLANT RECIPIENTS; LATENT MEMBRANE PROTEIN-1; CYTOTOXIC T-CELLS; MONOCLONAL-ANTIBODY RITUXIMAB; BURKITTS-LYMPHOMA CELLS; INFECTED B-CELLS; SOLID-ORGAN; PERIPHERAL-BLOOD; LIVER-TRANSPLANT C1 [Ehsan, Aamir] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Ehsan, Aamir] Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Ehsan, A (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. NR 90 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013, UNITED STATES SN 1935-987X BN 978-0-387-72429-4 J9 MOL PATHOL LIB PY 2008 VL 1 BP 315 EP 333 DI 10.1007/978-0-387-72430-0_31 D2 10.1007/978-0-387-72430-0 PG 19 WC Biochemistry & Molecular Biology; Pathology SC Biochemistry & Molecular Biology; Pathology GA BKG48 UT WOS:000268026600031 ER PT J AU Zhao, JB Zhang, YF Zhao, WD Wu, Y Pan, JP Bauman, WA Cardozo, C AF Zhao, Jingbo Zhang, Yuangfei Zhao, Weidong Wu, Yong Pan, Jiiangping Bauman, William A. Cardozo, Christopher TI Effects of nandrolone on denervation atrophy depend upon time after nerve transection SO MUSCLE & NERVE LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Paraplegia-Society CY SEP 05-07, 2006 CL Las Vegas, NV SP Amer Paraplegia Soc ID SKELETAL-MUSCLE ATROPHY; GENE-EXPRESSION; UBIQUITIN LIGASES; MESSENGER-RNA; IGF-I; RAT; TESTOSTERONE; DECANOATE; MEN; OXANDROLONE AB Anabolic steroids prevent disuse atrophy and reverse atrophy caused by glucocorticoids. To determine whether these beneficial effects extend to denervation atrophy, we tested whether nandrolone blocked denervation atrophy acutely or reversed subacute denervation atrophy. We also tested the association of such anabolic effects with expression of MAFbx, MuRF1 (both of which accelerate denervation atrophy), and IGF-1 (which prevents such atrophy). When begun at the time of denervation, nandrolone did not alter atrophy or expression of MAFbx, MuRF1, or IGF-1 measured 3, 7, or 14 days thereafter. When nandrolone administration was begun 28 days after denervation, atrophy was significantly reduced 7 and 28 days later (16% and 30%, respectively), and this was associated with significant reductions in expression of MAFbx and MuRF1, without alterations in the expression of IGF-1. The findings indicate that the actions of nandrolone depend on time after nerve transection and that the timing of anabolic steroid administration is an important determinant of responses of atrophying muscle to these agents. C1 [Zhao, Jingbo; Zhang, Yuangfei; Zhao, Weidong; Wu, Yong; Pan, Jiiangping; Bauman, William A.; Cardozo, Christopher] James J Peters VA Med Ctr, Dept Vet Affairs, Bronx, NY 10468 USA. [Zhao, Jingbo; Bauman, William A.; Cardozo, Christopher] Mt Sinai Hosp, Mt Sinai Sch Med, Dept Med, New York, NY 10029 USA. RP Cardozo, C (reprint author), James J Peters VA Med Ctr, Dept Vet Affairs, Room 1E-02, Bronx, NY 10468 USA. EM chris.cardozo@mssm.edu NR 38 TC 26 Z9 26 U1 0 U2 0 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0148-639X EI 1097-4598 J9 MUSCLE NERVE JI Muscle Nerve PD JAN PY 2008 VL 37 IS 1 BP 42 EP 49 DI 10.1002/mus.20888 PG 8 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 247WV UT WOS:000252114200007 PM 17763458 ER PT S AU Tillisch, K Wang, Z Kilpatrick, L Hoischneider, DP Mayer, EA AF Tillisch, Kirsten Wang, Zhuo Kilpatrick, Lisa Hoischneider, Daniel P. Mayer, Emeran A. BE Goetzl, EJ TI Studying the Brain-Gut Axis with Pharmacological Imaging SO Neural Signaling: Opportunities for Novel Diagnostic Approaches and Therapies SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT International Conference on Neural Signaling - Opportunities for Novel Diagnostic Approaches and Therapies CY FEB 16-20, 2008 CL Pacific Grove, CA DE irritable bowel syndrome; brain-gut axis; neuroimaging; functional gastrointestinal disorder ID IRRITABLE-BOWEL-SYNDROME; C-FOS EXPRESSION; NOXIOUS COLORECTAL DISTENSION; RECEPTOR ANTAGONIST ALOSETRON; LUMBOSACRAL SPINAL-CORD; COLONIC DISTENSION; VISCERAL STIMULATION; ANTERIOR CINGULATE; MAJOR DEPRESSION; PAIN AB Pharmacological imaging provides great potential both for evaluating the efficacy of new candidate compounds in the treatment of gastrointestinal symptom-based disorders, and for furthering our understanding of the underlying pathophysiology of such disorders. By combining evaluation of symptoms, behavior, and brain responses to relevant stimuli, use of neuroimaging is able to move the study of brain-gut disorders away from more subjective outcomes and emphasize the underlying neural networks involved in symptom generation and treatment. This chapter reviews the state of the art in pharmacological imaging studies, both in human subjects and in animal models of brain-gut interactions. C1 [Mayer, Emeran A.] Univ Calif Los Angeles, Ctr Neurobiol Stress, Div Digest Dis, Dept Med,David Geffen Sch Med, Los Angeles, CA 90095 USA. [Hoischneider, Daniel P.] Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. [Hoischneider, Daniel P.] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. [Hoischneider, Daniel P.] Univ Calif Los Angeles, Dept Cell & Neurobiol, Los Angeles, CA 90095 USA. [Hoischneider, Daniel P.] Univ Calif Los Angeles, Dept Biomed Engn, Los Angeles, CA 90095 USA. [Mayer, Emeran A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Physiol, Los Angeles, CA 90095 USA. [Mayer, Emeran A.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. [Wang, Zhuo; Hoischneider, Daniel P.; Mayer, Emeran A.] Greater Los Angeles Vet Adm Healthcare Syst, Res Serv, Los Angeles, CA USA. RP Mayer, EA (reprint author), Univ Calif Los Angeles, Ctr Neurobiol Stress, Div Digest Dis, Dept Med,David Geffen Sch Med, 10945 Le Conte Ave,Ste 2338,Room F, Los Angeles, CA 90095 USA. EM emayer@ucla.edu RI Kilpatrick, Lisa/E-6995-2015 FU NIDDK NIH HHS [R01 DK048351] NR 49 TC 6 Z9 6 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 978-1-57331-704-7 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2008 VL 1144 BP 256 EP 264 DI 10.1196/annals.1418.025 PG 9 WC Multidisciplinary Sciences; Neurosciences SC Science & Technology - Other Topics; Neurosciences & Neurology GA BIT17 UT WOS:000262481000028 PM 19076383 ER PT B AU Walker, RH Saiki, S Danek, A AF Walker, R. H. Saiki, S. Danek, A. BE Walker, RH Saiki, S Danek, A TI Neuroacanthocytosis syndromesA current overview SO NEUROACANTHOCYTOSIS SYNDROMES II LA English DT Proceedings Paper CT International Conference on Neuroacanthocytosis Syndromes CY 2006 CL Bethesda, MD ID HEREDITARY NEUROLOGICAL DISEASE; ERYTHROCYTE-MEMBRANE ABNORMALITIES; DOMINANT CHOREA-ACANTHOCYTOSIS; MCLEOD SYNDROME GENE; HUNTINGTONS-DISEASE; AMYOTROPHIC CHOREA; INVOLUNTARY MOVEMENTS; CHAC GENE; FAMILY; MUTATION AB Neuroacanthocytosis syndromes are characterized by the presence of "thorny" red blood cells and neurodegeneration of the basal ganglia, along with peripheral neuromuscular findings, seizures, and a variety of neuropsychiatric features. In recent years significant progress has been made in understanding the molecular pathophysiology of these disorders; cases are now identified as autosomal recessive chorea-acanthocytosis, X-linked McLeod syndrome, or more rarely, pantothenase kinase-associated neurodegeneration or Huntington's disease-like 2. Molecular analysis of classic reports of neuroacanthocytosis will clarify nomenclature and improve understanding of genotype-phenotype correlations. In addition, there are issues of atypical inheritance patterns which remain to be elucidated. A relatively high incidence of chorea-acanthocytosis in Japan may indicate a genetic founder effect, and has led to significant developments from Japanese researchers. C1 [Walker, R. H.] James J Peters Vet Affairs Med Ctr, Bronx, NY USA. [Saiki, S.] Cambridge Inst Med Res, Dept Med Genet, Wellcome Trust, Cambridge CB2 2XY, England. [Danek, A.] Univ Munich, Neurol Klin, D-81366 Munich, Germany. RP Walker, RH (reprint author), James J Peters Vet Affairs Med Ctr, Bronx, NY USA. EM ruth.walker@mssm.edu; ss644@cam.ac.uk; danek@lmu.de RI Danek, Adrian/G-7339-2011 OI Danek, Adrian/0000-0001-8857-5383 NR 153 TC 1 Z9 1 U1 0 U2 1 PU SPRINGER-VERLAG BERLIN PI BERLIN PA HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY BN 978-3-540-71692-1 PY 2008 BP 3 EP + DI 10.1007/978-3-540-71693-8_1 PG 8 WC Neurosciences SC Neurosciences & Neurology GA BHG19 UT WOS:000252885800001 ER PT J AU Yaffe, K Kanaya, AM Lindquist, K Hsueh, WC Cummings, SR Beamer, B Newman, A Rosano, C Li, R Harrisi, T AF Yaffe, K. Kanaya, A. M. Lindquist, K. Hsueh, W. C. Cummings, S. R. Beamer, B. Newman, A. Rosano, C. Li, R. Harrisi, T. TI PPAR-gamma Pro12Ala genotype and risk of cognitive decline in elders SO NEUROBIOLOGY OF AGING LA English DT Article DE cognitive function; PPAR-gamma; cognitive impairment; dementia; metabolism ID BODY-MASS INDEX; ACTIVATED RECEPTOR-GAMMA-2 GENE; AFRICAN-AMERICANS; ALZHEIMER-DISEASE; OLDER WOMEN; PEROXISOME; PPAR-GAMMA-2; POLYMORPHISM; DEMENTIA; INSULIN AB Background: The Pro12Ala polymorphism of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) has been associated with decreased risk of diabetes and obesity, both disorders linked to cognitive impairment. We tested whether this polymorphism is associated with cognition. Methods: Two thousand nine hundred sixty-one participants (mean age, 74.1; 41% Black; 52% women) were administered the Modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST) at baseline and 4 year follow-up. Test scores were adjusted for age, sex, education, cerebrovascular disease, depression and APOE genotype and additionally for race. We determined the association between Ala allele and development of cognitive decline (3MS decline of >= 5 points). Results: At baseline, unadjusted scores on both cognitive tests were higher for Ala carriers compared to non-carriers (3MS, 94.2 versus 92.5, p<0.001; DSST, 40.2 versus 34.5, p<0.001). Similarly, follow-up scores were higher for Ala carriers. Multivariable adjustment led to similar results; additional adjustment for race attenuated the baseline 3MS results. After 4 years, 17.5% of Ala carriers developed cognitive decline compared to 25% among non-carriers (unadjusted OR = 0.61; 95%CI, 0.46-0.82; adjusted OR = 0.75; 95%CI, 0.55-1.02). Further adjustment for metabolic variables including fasting blood glucose and lipid level did not change the results. Conclusions: The PPAR-gamma Ala12 allele carriers may have less risk of developing cognitive decline. (C) 2006 Elsevier Inc. All rights reserved. C1 Univ Calif San Francisco, Dept Psychiat & Neurol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Geriatr, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. San Francisco VA Med Ctr, San Francisco, CA USA. Calif Pacific Med Ctr, San Francisco, CA USA. Johns Hopkins Univ, Dept Med, Baltimore, MD USA. Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA. Univ Tennessee, Ctr Hlth Sci, Ctr Genom & Bioinformat, Dept Prevent Med, Memphis, TN 38163 USA. NIA, Lab Epidemiol Demog & Biometry, Bethesda, MD 20892 USA. RP Yaffe, K (reprint author), Univ Calif San Francisco, Dept Psychiat & Neurol, POB 181,4150 Clement St, San Francisco, CA 94121 USA. EM Kristine.yaffe@ucsf.edu OI Rosano, Caterina/0000-0002-0909-1506; Rosano, Caterina/0000-0002-4271-6010 FU Intramural NIH HHS; NIA NIH HHS [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106, R01 AG021918, R01 AG021918-03]; NIDDK NIH HHS [DK070713, R21 DK070713, R21 DK070713-01] NR 29 TC 20 Z9 21 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD JAN PY 2008 VL 29 IS 1 BP 78 EP 83 DI 10.1016/j.neurobiolaging.2006.09.010 PG 6 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 239SD UT WOS:000251537100008 PM 17052804 ER PT J AU Sattin, A Pekary, AE Blood, J AF Sattin, Albert Pekary, Albert E. Blood, James TI Escitalopram regulates expression of TRH and TRH-like peptides in rat brain and peripheral tissues SO NEUROENDOCRINOLOGY LA English DT Article DE thyrotropin-releasing hormone; escitalopram; limbic system; epididymis ID THYROTROPIN-RELEASING-HORMONE; SEROTONIN REUPTAKE INHIBITORS; OBSESSIVE-COMPULSIVE DISORDER; HIPPOCAMPAL-LESIONS; RAPID MODULATION; PANIC DISORDER; CITALOPRAM; RECEPTORS; ANXIETY; NEURONS AB Background: Escitalopram (eCIT) is a highly selective serotonin reuptake inhibitor (SSRI) that can be an effective treatment for a number of neuropsychiatric disorders including major depression. We, and others, have previously reported that thyrotropin-releasing hormone (TRH, pGlu-His-ProNH 2) and TRH-like peptides with the general structure pGlu-X-Pro-NH2, where 'X' can be any amino acid residue, have neuroprotective, antidepressant, analeptic, arousal, and anti-epileptic effects that could mediate the neuropsychiatric and therapeutic effects of a variety of neurotropic agents. The present work explores the possible mediation of the therapeutic effects of eCIT by TRH and TRH-like peptides. Methods: In order to extend our understanding of the range of neurotransmitter systems that are modulated by and, in turn, influence the expression of TRH and TRH-like peptides, 16 male Sprague-Dawley rats were injected i.p. with eCIT (24 mg/kg BW) and the brain levels of TRH and TRH-like peptides in various brain regions involved in mood regulation and peripheral tissues with serotonergic innervation were measured 0, 2, 4, and 6 h later by combined HPLC and RIA. Results and Conclusion: Remarkable 3- to 25-fold increases in TRH and TRH-like peptide levels were observed 2 h after i.p. eCIT in the epididymis. This reproductive tissue has the highest level of serotonin found in most mammals. The acute ( 2 h) effect of eCIT in brain regions involved in mood regulation, particularly the nucleus accumbens and medulla oblongata, cerebellum, and striatum was to increase the levels of TRH-like peptides, most consistently Phe-TRH. An important exception was a decrease in the level of TRH in the nucleus accumbens. These responses, in general, were the opposite of those we have previously observed after acute restraint stress in this same rat strain. We conclude that some of the therapeutic effects of inhibition of serotonin reuptake are mediated by altered release of TRH and TRH-like peptides. Copyright (C) 2008 S. Karger AG, Basel. C1 [Pekary, Albert E.] Univ Calif Los Angeles, VA Greater Angeles Healthcare Syst, Ctr Ulcer Res & Educ, Los Angeles, CA 90073 USA. [Sattin, Albert] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. [Sattin, Albert] Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90024 USA. [Pekary, Albert E.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Sattin, Albert; Pekary, Albert E.; Blood, James] Univ Calif Los Angeles, VA Greater Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. RP Pekary, AE (reprint author), Univ Calif Los Angeles, VA Greater Angeles Healthcare Syst, Res Serv, Bldg 114,Rm 229,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Eugene.Pekary@va.gov NR 62 TC 13 Z9 13 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0028-3835 EI 1423-0194 J9 NEUROENDOCRINOLOGY JI Neuroendocrinology PY 2008 VL 88 IS 2 BP 135 EP 146 DI 10.1159/000121595 PG 12 WC Endocrinology & Metabolism; Neurosciences SC Endocrinology & Metabolism; Neurosciences & Neurology GA 343TV UT WOS:000258879000008 PM 18354249 ER PT J AU Llinas-Regla, J Lopez-Pousa, S Vilalta-Franch, J Garre-Olmo, J Roman, GC AF Llinas-Regla, Jordi Lopez-Pousa, Secundino Vilalta-Franch, Joan Garre-Olmo, Josep Roman, Gustavo C. TI Mortality after a diagnosis of dementia in a population aged 75 and over in Spain SO NEUROEPIDEMIOLOGY LA English DT Article DE dementia; mortality rates; dementia; comorbidity; elderly population; Spain ID ALZHEIMERS-DISEASE; APOLIPOPROTEIN-E; COGNITIVE IMPAIRMENT; FUNCTIONAL STATUS; CACHE COUNTY; SURVIVAL; COMMUNITY; DEATH; PREVALENCE; PREDICTORS AB Objectives: To examine the impact of incident dementia on the risk of death, taking into account other chronic illnesses potentially related to death. Design: Six-year, prospective, two-phase, observational cohort study. Setting: 8 municipalities from a rural area in Girona (Spain). Participants: A representative community-based cohort of 1,153 adults aged over 70 living at home at study enrolment. Measurements: Surviving participants underwent detailed clinical evaluation and were assessed by means of the Cambridge Examination for Mental Disorders of the Elderly. Relatives of deceased participants were interviewed using the Retrospective Collateral Dementia Interview. Mortality rates and relative risk of death for subjects with a diagnosis of dementia were calculated. The Cox proportional hazards regression model was used to assess the relationship between mortality and the diagnosis of dementia. Results: In this cohort, 40.0% (n = 49) of the subjects with a diagnosis of dementia died. The mortality rate specific to dementia was 1.0 per 100 person-years. Mortality risk ratios for dementia were 1.79 in men [95% confidence interval (CI) = 1.06-3.02], and 3.14 in women (95% CI = 2.04-4.85). The population death risk attributable to the diagnosis of dementia in our cohort was 11.8%. The most important mortality risks were severe dementia (hazard ratio = 5.7, 95% CI = 3.7-8.6), cancer (hazard ratio = 3.2, 95% CI = 2.2-4.5), heart disease, and an age over 85 (hazard ratio = 1.4, 95% CI = 1.1-1.9). Conclusion: Dementia is a major risk factor for death in advanced age, with the highest mortality rates in women. Moderate and severe dementia was associated with an increased mortality risk even after appropriate control of comorbid conditions. Copyright (C) 2008 S. Karger AG, Basel. C1 [Llinas-Regla, Jordi; Lopez-Pousa, Secundino; Vilalta-Franch, Joan; Garre-Olmo, Josep] Parc Hosp Marti & Julia, Memory & Dementia Unit, Salt, Spain. [Roman, Gustavo C.] Univ Texas Hlth Sci Ctr San Antonio, Div Neurol, San Antonio, TX 78229 USA. [Roman, Gustavo C.] Vet Adm Hosp, San Antonio, TX USA. RP Lopez-Pousa, S (reprint author), C Dr Castany S-N, ES-17190 Salt, Spain. EM uvamid@ias.scs.es OI Garre-Olmo, Josep /0000-0002-7817-0814 FU Spanish National Healthcare System [90-0797, 94-1799] FX We are thankful to the residents from the 8 municipalities participating in the Girona dementia study. This research was supported by Health Research Fund Grants 90-0797 and 94-1799 of the Spanish National Healthcare System. NR 59 TC 18 Z9 19 U1 0 U2 4 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PY 2008 VL 31 IS 2 BP 80 EP 88 DI 10.1159/000144088 PG 9 WC Public, Environmental & Occupational Health; Clinical Neurology SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA 348SU UT WOS:000259231200002 PM 18622143 ER PT J AU Chang, L Kahler, KH Sarawate, C Quimbo, R Kralstein, J AF Chang, L. Kahler, K. H. Sarawate, C. Quimbo, R. Kralstein, J. TI Assessment of potential risk factors associated with ischaemic colitis SO NEUROGASTROENTEROLOGY AND MOTILITY LA English DT Article DE constipation; irritable bowel syndrome; ischaemic colitis; risk factors ID IRRITABLE-BOWEL-SYNDROME; SYSTEMIC-LUPUS-ERYTHEMATOSUS; GASTROESOPHAGEAL-REFLUX; AORTOILIAC SURGERY; COLONIC ISCHEMIA; CONSTIPATION; PREVALENCE; COMPLICATIONS; POPULATION; OPERATIONS AB Ischaemic colitis (IC) has been associated with a number of diverse disorders and risk factors, including irritable bowel syndrome (IBS) and constipation. We sought to assess, through a large-scale population study, the potential risk factors associated with IC. Patients with IC and matched controls without IC were identified using the medical and pharmacy claims data from the HealthCore Managed Care Database from 1st January 2000 to 31st May 2005. A multivariate conditional logistic regression model was developed to identify significant risk factors of IC. Interactions of age, sex, prior IBS diagnosis, and prior constipation diagnosis were further evaluated. We identified 1754 patients with IC and 6970 non-IC controls; 64% were women, and mean ages were 63 and 62 years respectively. The final parsimonious model comprised 19 independent variables associated with increased risk for IC including shock, dysentery, bloating, IBS, colon carcinoma, constipation, cardiovascular disease, dyspepsia, abdominal, aortic, or cardiovascular surgery, 12-month laxative, H(2) receptor blocker and oral contraceptive use. A significant interaction was observed between age and prior IBS on risk for IC. In conclusion, multiple risk factors for IC were identified and we confirmed that patients with IBS or constipation are at greater risk for IC. C1 [Chang, L.] Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Div Digest Dis,Ctr Neurovisceral Sci & Womens Hlt, Los Angeles, CA 90073 USA. [Kahler, K. H.; Kralstein, J.] Novartis Pharmaceut, E Hanover, NJ USA. [Sarawate, C.; Quimbo, R.] HealthCore Inc, Wilmington, DE USA. RP Chang, L (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, Div Digest Dis,Ctr Neurovisceral Sci & Womens Hlt, 11301 Wilshire Blvd,Bldg 115,Room 223, Los Angeles, CA 90073 USA. EM linchang@ucla.edu NR 32 TC 23 Z9 27 U1 0 U2 0 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 JAN PY 2008 VL 20 IS 1 BP 36 EP 42 DI 10.1111/j.1365-2982.2007.01015.x PG 7 WC Gastroenterology & Hepatology; Clinical Neurology; Neurosciences SC Gastroenterology & Hepatology; Neurosciences & Neurology GA 242QO UT WOS:000251740700007 PM 17919313 ER PT J AU Szekely, CA Breitner, JCS Fitzpatrick, AL Rea, TD Psaty, BM Kuller, LH Zandi, PP AF Szekely, C. A. Breitner, J. C. S. Fitzpatrick, A. L. Rea, T. D. Psaty, B. M. Kuller, L. H. Zandi, P. P. TI NSAID use and dementia risk in the cardiovascular health study - Role of APOE and NSAID type SO NEUROLOGY LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; ALZHEIMERS-DISEASE; CONTROLLED-TRIAL; DOUBLE-BLIND; INDOMETHACIN; INFLAMMATION; POPULATION; ROFECOXIB; DIAGNOSIS; ASPIRIN AB Background: Epidemiologic and laboratory studies suggest that nonsteroidal antiinflammatory drugs (NSAIDs) reduce risk of Alzheimer disease ( AD). We therefore investigated the association between use of NSAIDs, aspirin, and the non-NSAID analgesic acetaminophen with incidence of dementia and AD. Methods: Participants in the Cardiovascular Health Cognition Study included 3,229 individuals aged 65 or older, free of dementia at baseline, with information on medication use. We used Cox proportional hazards regression to estimate the association of medication use with incident all-cause dementia, AD, and vascular dementia (VaD). Additional analyses considered the NSAID-AD relationship as a function of age, presence of at least one epsilon 4 allele at APOE, race, and individual NSAIDs' reported ability to reduce production of the amyloid-beta peptide variant A beta(42). Results: Use of NSAIDs was associated with a lower risk of dementia ( adjusted hazard ratio or aHR 0.76, 95% CI or CI 0.60 - 0.96) and, in particular, AD (aHR 0.63, CI 0.45-0.88), but not VaD (aHR 0.92, CI 0.65-1.28). No similar trends were observed with acetaminophen (aHR 0.99, CI 0.79-1.24). Closer examination suggested AD risk reduction with NSAIDs only in participants having an APOE epsilon 4 allele (aHR 0.34, CI 0.18-0.65; aHR for others 0.88, CI 0.59-1.32). There was no advantage in AD risk reduction with NSAIDs reported to selectively reduce A beta(42). Conclusions: Results were consistent with previous cohort studies showing reduced risk of AD in NSAID users, but this association was found only in those with an APOE epsilon 4 allele, and there was no advantage for A beta(42)-lowering NSAIDs. C1 [Rea, T. D.; Psaty, B. M.] Univ Washington, Dept Med, Seattle, WA 98195 USA. [Fitzpatrick, A. L.; Psaty, B. M.] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. [Breitner, J. C. S.] Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. [Breitner, J. C. S.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Kuller, L. H.] Univ Pittsburgh, Sch Med, Dept Epidemiol, Pittsburgh, PA USA. [Szekely, C. A.; Zandi, P. P.] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA. RP Zandi, PP (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, 624 N Broadway, Baltimore, MD 21205 USA. EM pzandi@jhsph.edu RI Szekely, Christine/C-1342-2009 FU NHLBI NIH HHS [N01HC85079, N01 HC015103, N01 HC035129, N01 HC045133, N01-HC-55222, N01-HC-75150, N01-HC-85079, N01-HC-85086, N01HC55222, N01HC75150, N01HC85086, U01 HL080295, U01 HL080295-01, U01-HL080295]; NIA NIH HHS [R01 AG009556, R01 AG015928, R01-AG-09556, R01-AG-88930, R01-AG15928] NR 39 TC 98 Z9 104 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA SN 0028-3878 EI 1526-632X J9 NEUROLOGY JI Neurology PD JAN 1 PY 2008 VL 70 IS 1 BP 17 EP 24 DI 10.1212/01.wnl.0000284596.95156.48 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 246ZL UT WOS:000252046800005 PM 18003940 ER PT J AU Trivedi, MA Schmitz, TW Ries, ML Hess, TM Fitzgerald, ME Atwood, CS Rowley, HA Asthana, S Sager, MA Johnson, SC AF Trivedi, Mehul A. Schmitz, Taylor W. Ries, Michele L. Hess, Timothy M. Fitzgerald, Michele E. Atwood, Craig S. Rowley, Howard A. Asthana, Sanjay Sager, Mark A. Johnson, Sterling C. TI FMRI activation during episodic encoding and metacognitive appraisal across the lifespan: Risk factors for Alzheimer's disease SO NEUROPSYCHOLOGIA LA English DT Article DE aging; Alzheimer disease; hippocampus; functional imaging; self; APOE genotype ID MILD COGNITIVE IMPAIRMENT; AGE-RELATED-CHANGES; SELF-APPRAISAL; BRAIN ACTIVITY; GENETIC RISK; OLDER-ADULTS; MEMORY; ANOSOGNOSIA; MECHANISMS; NETWORKS AB In the present study, we used fMRI to examine the influence of age on two other known risk factors for Alzheimer's disease (AD), APOE genotype and parental history of AD (FH status), during episodic encoding (ENC) and metacognitive self-appraisal (SA) paradigms. These paradigms have previously been shown to evoke activity from brain regions that are implicated in AD. First we examined the effect of age across the adult lifespan (age 18-84 years) on cerebral activity in a large sample (n = 23 1) of cognitively healthy individuals. Next we examined a subset (n = 155) on whom APOE status and FH status were known. For ENC, we found that increasing age was associated with reduced activity in the ventral temporal lobes and hippocampus. Our analysis of risk factors suggested that FH and age exerted independent effects, but APOE interacted with age such that APOE e4 carriers exhibit age-related increases in activity in the hippocampus. For the metacognifive SA task, increasing age was found to be associated with reduced activity in the medial prefrontal cortex, and increased activity in the mesial temporal lobe, posterior orbital cortex and striatum. Neither AD risk factor significantly modified age-related changes in brain activity during SA. These results suggest that FH and aging are exerting independent effects in both tasks while APOE affected the relationship with age in the hippocampus in one of the two tasks given. (c) 2007 Elsevier Ltd. All rights reserved. C1 [Trivedi, Mehul A.; Schmitz, Taylor W.; Ries, Michele L.; Hess, Timothy M.; Fitzgerald, Michele E.; Atwood, Craig S.; Asthana, Sanjay; Johnson, Sterling C.] William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. [Trivedi, Mehul A.; Schmitz, Taylor W.; Ries, Michele L.; Fitzgerald, Michele E.; Atwood, Craig S.; Asthana, Sanjay; Sager, Mark A.; Johnson, Sterling C.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Med, Madison, WI 53705 USA. [Hess, Timothy M.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Biostat, Madison, WI 53705 USA. [Rowley, Howard A.] Univ Wisconsin, Sch Med & Publ Hlth, Dept Radiol, Madison, WI 53705 USA. RP Johnson, SC (reprint author), William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. EM scj@medicine.wisc.edu OI Johnson, Sterling/0000-0002-8501-545X FU NIA NIH HHS [R01 AG021155, R01 AG021155-01A2, R01 AG021155-02, R01 AG021155-03, R01 AG021155-04]; NIMH NIH HHS [R01 MH065723, R01 MH065723-02, R01 MH065723-03, R01 MH065723-04, R01 MH065723-05, R01 MH065723-06, R01 MH65723] NR 38 TC 30 Z9 30 U1 4 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3932 J9 NEUROPSYCHOLOGIA JI Neuropsychologia PY 2008 VL 46 IS 6 BP 1667 EP 1678 DI 10.1016/j.neuropsychologia.2007.11.035 PG 12 WC Behavioral Sciences; Neurosciences; Psychology, Experimental SC Behavioral Sciences; Neurosciences & Neurology; Psychology GA 318YH UT WOS:000257128200009 PM 18241895 ER PT J AU Foerde, K Poldrack, RA Knowlton, BJ Sabb, FW Bookheirner, SY Bilder, RM Guthrie, D Granholm, E Nuechterlein, KH Marder, SR Asarnow, RF AF Foerde, Karin Poldrack, Russell A. Knowlton, Barbara J. Sabb, Fred W. Bookheirner, Susan Y. Bilder, Robert M. Guthrie, Don Granholm, Eric Nuechterlein, Keith H. Marder, Stephen R. Asarnow, Robert F. TI Selective corticostriatal dysfunction in schizophrenia: Examination of motor and cognitive skill learning SO NEUROPSYCHOLOGY LA English DT Article DE schizophrenia; corticostriatal circuits; skill learning; automaticity ID BASAL GANGLIA; MEMORY-SYSTEMS; NONDECLARATIVE MEMORY; HALOPERIDOL; NEUROLEPTICS; PERFORMANCE; OLANZAPINE; CIRCUITS; IMPLICIT; DEFICITS AB It has been suggested that patients with schizophrenia have corticostriatal circuit dysfunction (Carlsson & Carlsson. 1990). Skill learning is thought to rely on corticostriatal circuitry and different types of skill learning may be related to separable corticostriatal loops (Grafton, Hazeltine, & Ivry, 1995; Poldrack, Prabhakaran. Seger, & Gabrieli, 1999). The authors examined motor (Serial Reaction Time task, SRT) and cognitive (Probabilistic Classification task, PCT) skill learning in patients with schizophrenia and normal controls. Development of automaticity was examined, using a dual task paradigm, across three training sessions. Patients with schizophrenia were impaired at learning on the PCT compared to controls. Performance gains of controls occurred within the first session, whereas patients only improved gradually and never reached the performance level of controls. In contrast, patients were not impaired at learning on the SRT relative to controls, suggesting that patients with schizophrenia may have dysfunction in a specific corticostriatal subcircuit. C1 [Foerde, Karin; Poldrack, Russell A.; Knowlton, Barbara J.; Nuechterlein, Keith H.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. [Sabb, Fred W.; Bookheirner, Susan Y.; Bilder, Robert M.; Guthrie, Don; Nuechterlein, Keith H.; Asarnow, Robert F.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90024 USA. [Granholm, Eric] Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. [Granholm, Eric] VA San Diego Healthcare Syst, San Diego, CA USA. [Marder, Stephen R.] Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. [Marder, Stephen R.] W Los Angeles VA, Los Angeles, CA USA. RP Foerde, K (reprint author), Columbia Univ, Dept Psychol, 1190 Amsterdam Ave,MC 5501, New York, NY 10027 USA. EM kf2265@columbia.edu RI Bilder, Robert/A-8894-2008; Granholm, Eric/P-7680-2014 OI Bilder, Robert/0000-0001-5085-7852; Foerde, Karin/0000-0002-5804-9312 FU NCRR NIH HHS [RR020750]; NIMH NIH HHS [MH 66286, MH 37705, MH 72697] NR 63 TC 47 Z9 48 U1 1 U2 3 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0894-4105 J9 NEUROPSYCHOLOGY JI Neuropsychology PD JAN PY 2008 VL 22 IS 1 BP 100 EP 109 DI 10.1037/0894-4105.22.1.100 PG 10 WC Psychology, Clinical; Neurosciences; Psychology SC Psychology; Neurosciences & Neurology GA 253ZG UT WOS:000252555500011 PM 18211159 ER PT J AU Kalivas, PW O'Brien, C AF Kalivas, Peter W. O'Brien, Charles TI Drug addiction as a pathology of staged neuroplasticity SO NEUROPSYCHOPHARMACOLOGY LA English DT Review DE addiction; neuroplasticity; motivational circuitry; glutamate; dopamine ID COCAINE-INDUCED REINSTATEMENT; ELEMENT-BINDING PROTEIN; VENTRAL TEGMENTAL AREA; MESOLIMBIC DOPAMINE SYSTEM; NUCLEUS-ACCUMBENS NEURONS; MEDIAL PREFRONTAL CORTEX; D-3 RECEPTOR EXPRESSION; SEEKING BEHAVIOR; SYNAPTIC PLASTICITY; DENDRITIC SPINES AB Using addictive drugs can evolve from controlled social use into the compulsive relapsing disorder that characterizes addiction. This transition to addiction results from genetic, developmental, and sociological vulnerabilities, combined with pharmacologically induced plasticity in brain circuitry that strengthens learned drug-associated behaviors at the expense of adaptive responding for natural rewards. Advances over the last decade have identified the brain circuits most vulnerable to drug-induced changes, as well as many associated molecular and morphological underpinnings. This growing knowledge has contributed to an expanded understanding of how drugs usurp normal learning circuitry to create the pathology of addiction, as evidenced by involuntary activation of reward circuits in response to drug-associated cues and simultaneous reports of drug craving. This new understanding provides unprecedented potential opportunities for novel pharmacotherapeutic targets in treating addiction. There appears to be plasticity associated with the addiction phenomenon in general as well as changes produced by addiction to a specific class of addicting drugs. These findings also provide the basis for the current understanding of addiction as a chronic, relapsing disease of the brain with changes that persist long after the last use of the drug. Here, we describe the neuroplasticity in brain circuits and cell function induced by addictive drugs that is thought to underlie the compulsions to resume drug-taking, and discuss how this knowledge is impelling exploration and testing of novel addiction therapies. C1 Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Univ Penn, Philadelphia VA Med Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. RP Kalivas, PW (reprint author), Med Univ S Carolina, Dept Neurosci, 173 Ashley Ave,BSB 10, Charleston, SC 29425 USA. EM kalivasp@musc.edu FU NIDA NIH HHS [P50 DA015369, P60 DA01586] NR 147 TC 352 Z9 372 U1 3 U2 40 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD JAN PY 2008 VL 33 IS 1 BP 166 EP 180 DI 10.1038/sj.npp.1301564 PG 15 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 235XH UT WOS:000251267100013 PM 17805308 ER PT J AU Moberg, PJ Rick, JH AF Moberg, Paul J. Rick, Jacqueline H. TI Decision-making capacity and competency in the elderly: A clinical and neuropsychological perspective SO NEUROREHABILITATION LA English DT Article DE Decision-making capacity; competency; geriatric; neuropsychology ID DIFFERENT LEGAL STANDARDS; ALZHEIMERS-DISEASE; COGNITIVE IMPAIRMENT; PROTOTYPE-INSTRUMENT; MEDICAL-TREATMENT; FINANCIAL SKILLS; INFORMED CONSENT; OLDER-ADULTS; DEMENTIA; MODEL AB With our ageing population, the number of older adults with cognitive impairment has also increased. There is both an acute and growing need for evidence-based assessments to identify their decision making capacity and competence. In the present article we (1) present definitions of decision-making capacity and competence, (2) review cognitive functions that are central to decision-making capacity as well as the methods and procedures commonly used to assess these domains, and (3) address the communication of assessment findings to patients and their loved ones. The importance of assessing decision-making capacity in the context of specific functions and of respecting the values and interests of older adults are emphasized. C1 [Moberg, Paul J.] Univ Penn, Sch Med, Dept Psychiat, Brain Behav Lab, Philadelphia, PA 19104 USA. [Moberg, Paul J.; Rick, Jacqueline H.] Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA. [Moberg, Paul J.] Univ Penn, Sch Med, ADC, Philadelphia, PA 19104 USA. RP Moberg, PJ (reprint author), Univ Penn, Sch Med, Dept Psychiat, Brain Behav Lab, 10th Floor,Gates Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. EM moberg@upenn.edu NR 47 TC 15 Z9 15 U1 2 U2 7 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2008 VL 23 IS 5 BP 403 EP 413 PG 11 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 372PW UT WOS:000260914500004 PM 18957727 ER PT J AU Uomoto, JM AF Uomoto, Jay M. TI Older adults and neuropsychological rehabilitation following acquired brain injury SO NEUROREHABILITATION LA English DT Article DE Geriatric; brain injury; excess disability; rehabilitation ID TRANSCRANIAL MAGNETIC STIMULATION; INDUCED MOVEMENT THERAPY; STROKE REHABILITATION; ALZHEIMERS-DISEASE; DEPRESSION; OUTCOMES; TRIAL; PAIN; COMMUNITY; IMPACT AB The literature related to neurorehabilitation methods specific to older adults is now emerging, the timing of which is important given the epidemiology of acquired brain injury in this population. Examined are epidemiological characteristics of acquired brain injury, with a focus on traumatic brain injury and stroke. Principles of geriatric neurorehabilitation are proposed by using a Neo-Lurian framework, and employing the PASS model of brain-behavior relationship forwarded by J. P. Das. Discussed are specific issues and strategies of geriatric neurorehabilitation by removing excess disability that complicates acquired brain injury. These include addressing depression, sleep disturbance, chronic pain, and social support. Restorative interventions may now also appear as a part of geriatric neurorehabilitation practices. A focus on team functioning as a critical contributor to functional outcomes in those older adults with acquired brain injury is presented along with future directions that capitalize upon the ideals of primary, secondary, and tertiary prevention. C1 VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Ctr Polytrauma Care, Seattle, WA 98108 USA. RP Uomoto, JM (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Ctr Polytrauma Care, S-117-RCS,1660 S Columbian Way, Seattle, WA 98108 USA. EM jay.uomoto@va.gov NR 60 TC 2 Z9 2 U1 0 U2 3 PU IOS PRESS PI AMSTERDAM PA NIEUWE HEMWEG 6B, 1013 BG AMSTERDAM, NETHERLANDS SN 1053-8135 J9 NEUROREHABILITATION JI Neurorehabilitation PY 2008 VL 23 IS 5 BP 415 EP 424 PG 10 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 372PW UT WOS:000260914500005 PM 18957728 ER PT J AU Pawlyk, AC Morrison, AR Ross, RJ Brennan, FX AF Pawlyk, Aaron C. Morrison, Adrian R. Ross, Richard J. Brennan, Francis X. TI Stress-induced changes in sleep in rodents: Models and mechanisms SO NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS LA English DT Review DE amygdala; corticotropin-releasing factor; stress; sleep; REM; PTSD ID CORTICOTROPIN-RELEASING HORMONE; EYE-MOVEMENT SLEEP; COMBAT-RELATED PTSD; REM-SLEEP; IMMOBILIZATION STRESS; SEROTONERGIC NEURONS; PARADOXICAL SLEEP; ALLOSTATIC LOAD; CONTEXTUAL FEAR; C57BL/6J MICE AB Psychological stressors have a prominent effect on sleep in general, and rapid eye movement (REM) sleep in particular. Disruptions in sleep are a prominent feature, and potentially even the hallmark, of posttraumatic stress disorder (PTSD) (Ross, R.J., Ball, W.A., Sullivan, K., Caroff, S., 1989. Sleep disturbance as the hallmark of posttraumatic stress disorder. American Journal of Psychiatry 146, 697-707). Animal models are critical in understanding both the causes and potential treatments of psychiatric disorders. The current review describes a number of studies that have focused on the impact of stress on sleep in rodent models. The studies are also in Table 1, summarizing the effects of stress in 4-h blocks in both the light and dark phases. Although mild stress procedures have sometimes produced increases in REM sleep, more intense stressors appear to model the human condition by leading to disruptions in sleep, particularly REM sleep. We also discuss work conducted by our group and others looking at conditioning as a factor in the temporal extension of stress-related sleep disruptions. Finally, we attempt to describe the probable neural mechanisms of the sleep disruptions. A complete understanding of the neural correlates of stress-induced sleep alterations may lead to novel treatments for a variety of debilitating sleep disorders. Published by Elsevier Ltd. C1 [Pawlyk, Aaron C.] Wyeth Res, Collegeville, PA 19426 USA. [Morrison, Adrian R.; Ross, Richard J.] Univ Penn, Sch Med, Ctr Sleep & Resp Neurobiol, Philadelphia, PA 19104 USA. [Morrison, Adrian R.; Ross, Richard J.; Brennan, Francis X.] Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. RP Brennan, FX (reprint author), Philadelphia VA Med Ctr, 3900 Woodland Ave, Philadelphia, PA 19104 USA. EM brennan_f@mail.trc.upenn.edu FU NIMH NIH HHS [R01 MH072897-02, R01-MH072897] NR 74 TC 61 Z9 64 U1 1 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0149-7634 J9 NEUROSCI BIOBEHAV R JI Neurosci. Biobehav. Rev. PY 2008 VL 32 IS 1 BP 99 EP 117 DI 10.1016/j.neubiorev.2007.06.001 PG 19 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 250KH UT WOS:000252298300007 PM 17764741 ER PT J AU Tyler, KL Gilden, DH AF Tyler, Kenneth L. Gilden, Donald H. BE Reiss, CS TI Clinical management of viral encephalitis SO NEUROTROPIC VIRAL INFECTIONS LA English DT Article; Book Chapter ID HERPES-SIMPLEX ENCEPHALITIS; STEM-CELL TRANSPLANT; GANCICLOVIR-RESISTANT CYTOMEGALOVIRUS; HUMAN HERPESVIRUS-6 ENCEPHALITIS; BONE-MARROW-TRANSPLANTATION; POLYMERASE-CHAIN-REACTION; CENTRAL-NERVOUS-SYSTEM; VIRUS-INFECTION; CEREBROSPINAL-FLUID; VIDARABINE THERAPY C1 [Tyler, Kenneth L.] Univ Colorado, Dept Neurol Microbiol & Med, Denver, CO 80202 USA. [Tyler, Kenneth L.] Denver Vet Affairs Med Ctr, Neurol Serv, Denver, CO USA. [Gilden, Donald H.] Univ Colorado, Sch Med, Dept Neurol, Denver, CO USA. [Gilden, Donald H.] Univ Colorado, Sch Med, Dept Microbiol, Denver, CO USA. RP Tyler, KL (reprint author), Univ Colorado, Dept Neurol Microbiol & Med, Denver, CO 80202 USA. NR 85 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 978-0-521-86964-5 PY 2008 BP 347 EP 361 DI 10.1017/CBO9780511541728.024 D2 10.1017/CBO9780511541728 PG 15 WC Infectious Diseases; Virology SC Infectious Diseases; Virology GA BDI54 UT WOS:000313454600024 ER PT J AU Shimazaki, K Jirawuthiworavong, GV Nguyen, EV Awazu, M Levinson, RD Gordon, LK AF Shimazaki, Kaori Jirawuthiworavong, Guy V. Nguyen, Eddy V. Awazu, Midori Levinson, Ralph D. Gordon, Lynn K. TI Tubulointerstitial nephritis and uveitis syndrome: A case with an autoimmune reactivity against retinal and renal antigens SO OCULAR IMMUNOLOGY AND INFLAMMATION LA English DT Article DE antiretinal reactivity; autoantibody; autoantigen; autoimmune reactivity; tubulointerstitial nephritis and uveitis (TINU) ID CELLS AB Tubulointerstitial nephritis and uveitis (TINU) generally occurs at young age and has a female preponderance. Renal biopsy reveals interstitial infiltration of inflammatory cells and edema, and the associated intraocular inflammation typically consists of an anterior, bilateral uveitis. The pathogenesis of TINU likely involves both humoral and cellular immunity and is mediated by medications, infectious agents, or other unknown causes. A previous report detected a renal antigen recognized by the serum of a TINU patient. In this report the authors extend these observations to document seroreactivity against a retinal antigen of similar size. C1 [Jirawuthiworavong, Guy V.; Nguyen, Eddy V.; Levinson, Ralph D.; Gordon, Lynn K.] Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, Dept Ophthalmol, Los Angeles, CA 90095 USA. [Gordon, Lynn K.] Greater Los Angeles Vet Affairs Heathcare Syst, Dept Surg, Los Angeles, CA USA. [Shimazaki, Kaori] Univ Calif Los Angeles, David Geffen Sch Med, Inst Mol Biol, Los Angeles, CA 90095 USA. [Awazu, Midori] Keio Univ, Sch Med, Dept Pediat, Tokyo, Japan. RP Gordon, LK (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, Dept Ophthalmol, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM lgordon@ucla.edu NR 5 TC 6 Z9 7 U1 0 U2 1 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0927-3948 J9 OCUL IMMUNOL INFLAMM JI Ocul. Immunol. Inflamm. PD JAN-APR PY 2008 VL 16 IS 1-2 BP 51 EP 53 DI 10.1080/09273940801899772 PG 3 WC Ophthalmology SC Ophthalmology GA 289OW UT WOS:000255064800012 PM 18379944 ER PT B AU Myaskovsky, L Switzer, GE Mor, MK Ramkumar, M Shapiro, R Dew, MA AF Myaskovsky, Larissa Switzer, Galen E. Mor, Maria K. Ramkumar, Mohan Shapiro, Ron Dew, Mary Amanda BE Weimar, W Bos, MA Busschbach, JJ TI Cultural factors related to race differences in preference for living donor kidney transplantation SO ORGAN TRANSPLANTATION: ETHICAL, LEGAL AND PSYCHOSOCIAL ASPECTS - TOWARDS A COMMON EUROPEAN POLICY LA English DT Proceedings Paper CT International Congress on Organ Transplantation - Ethical, Legal and Psychosocial Aspects CY APR 01-04, 2007 CL Rotterdam, NETHERLANDS SP European Commiss, Dutch Transplant Fdn, Hlth Council Netherlands, Erasmus Med Ctr ID RENAL-TRANSPLANTATION; AFRICAN-AMERICANS; CONSPIRACY BELIEFS; RACIAL-DIFFERENCES; ORGAN DONATION; HEALTH; DISPARITIES; ATTITUDES; ACCESS; CARE AB Living donor kidney transplantation (LDKT) is the optimum treatment for patients with end-stage renal disease (ESRD). In the United States, African Americans (AAs) are less than half as likely to be referred for or undergo LDKT as white patients. This study examined how cultural factors (perceptions of discrimination and racism, medical mistrust) and transplant knowledge are related to race differences in transplant preference. Questionnaires were completed by 36 patients awaiting kidney transplantation. Results indicated that AA patients in this sample had less transplant knowledge than white patients. AAs reported more experiences of discrimination and perceived more racism in health-care settings than whites. AA and white patients did not differ on medical mistrust. Patients who experienced more discrimination in health-care settings were less willing to ask someone to be a living donor for them. Results indicate that previous experience of discrimination may contribute to race disparities in kidney transplantation. C1 [Myaskovsky, Larissa; Switzer, Galen E.; Mor, Maria K.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. NR 38 TC 1 Z9 1 U1 0 U2 0 PU PABST SCIENCE PUBLISHERS PI D-49525 LENGERICH PA EICHENGRUND 28, D-49525 LENGERICH, GERMANY BN 978-3-89967-415-6 PY 2008 BP 366 EP 376 PG 11 WC Health Policy & Services; Law; Medicine, Research & Experimental; Social Sciences, Biomedical SC Health Care Sciences & Services; Government & Law; Research & Experimental Medicine; Biomedical Social Sciences GA BHT50 UT WOS:000256225000047 ER PT J AU Nissenson, RA AF Nissenson, Robert A. BE Marcus, R Feldman, D Nelson, DA Rosen, CJ TI Parathyroid Hormone and Parathyroid Hormone-Related Protein SO OSTEOPOROSIS, VOLS I AND II, 3RD EDITION LA English DT Article; Book Chapter ID (PTH)/PTH-RELATED PEPTIDE RECEPTOR; OSTEOBLAST-LIKE CELLS; OPOSSUM KIDNEY-CELLS; PTH-RELATED-PROTEIN; VASCULAR SMOOTH-MUSCLE; KAPPA-B LIGAND; OSTEOCLASTOGENESIS-INHIBITORY FACTOR; MESSENGER-RIBONUCLEIC-ACID; CARBOXYL-TERMINAL REGION; 25-HYDROXYVITAMIN D-3 1-ALPHA-HYDROXYLASE C1 [Nissenson, Robert A.] Univ Calif San Francisco, Endocrine Unit, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. [Nissenson, Robert A.] Univ Calif San Francisco, Dept Med, San Francisco, CA USA. [Nissenson, Robert A.] Univ Calif San Francisco, Dept Physiol, San Francisco, CA USA. RP Nissenson, RA (reprint author), Univ Calif San Francisco, Endocrine Unit, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. NR 488 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055347-4 PY 2008 BP 283 EP 316 PG 34 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BDH03 UT WOS:000313195400013 ER PT J AU Wiren, KM AF Wiren, Kristine M. BE Marcus, R Feldman, D Nelson, DA Rosen, CJ TI Androgens and Skeletal Biology: Basic Mechanisms SO OSTEOPOROSIS, VOLS I AND II, 3RD EDITION LA English DT Article; Book Chapter ID BONE-MINERAL DENSITY; OSTEOBLAST-LIKE CELLS; GROWTH-FACTOR-BETA; ESTROGEN-RECEPTOR-ALPHA; MESSENGER-RIBONUCLEIC-ACID; THYROID-HORMONE RECEPTOR; GENITAL SKIN FIBROBLASTS; AGED MALE-RATS; OVARIECTOMIZED RATS; CORTICAL BONE C1 [Wiren, Kristine M.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Wiren, Kristine M.] Portland VA Med Ctr, Portland, OR USA. RP Wiren, KM (reprint author), Oregon Hlth & Sci Univ, Portland, OR 97201 USA. OI Wiren, Kristine/0000-0002-6159-4450 NR 197 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055347-4 PY 2008 BP 425 EP 449 PG 25 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BDH03 UT WOS:000313195400016 ER PT J AU Orwoll, ES Klein, RF AF Orwoll, Eric S. Klein, Robert F. BE Marcus, R Feldman, D Nelson, DA Rosen, CJ TI Osteoporosis in Men: Epidemiology, Pathophysiology, and Clinical Characterization SO OSTEOPOROSIS, VOLS I AND II, 3RD EDITION LA English DT Article; Book Chapter ID BONE-MINERAL DENSITY; AGE-RELATED-CHANGES; HIP FRACTURE INCIDENCE; GROWTH-FACTOR-I; EUROPEAN VERTEBRAL OSTEOPOROSIS; ANDROGEN-INSENSITIVITY SYNDROME; MEDULLARY SPONGE KIDNEY; X-RAY ABSORPTIOMETRY; LEAN BODY-MASS; IDIOPATHIC HYPOGONADOTROPIC HYPOGONADISM C1 [Orwoll, Eric S.; Klein, Robert F.] Oregon Hlth & Sci Univ, Bone & Mineral Res Unit, Portland, OR 97201 USA. [Orwoll, Eric S.; Klein, Robert F.] Portland VA Med Ctr, Portland, OR USA. RP Orwoll, ES (reprint author), Oregon Hlth & Sci Univ, Bone & Mineral Res Unit, Portland, OR 97201 USA. NR 484 TC 2 Z9 2 U1 1 U2 1 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055347-4 PY 2008 BP 1055 EP 1094 PG 40 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BDH03 UT WOS:000313195400043 ER PT J AU Halloran, B Bikle, DD AF Halloran, Bernard Bikle, Daniel D. BE Marcus, R Feldman, D Nelson, DA Rosen, CJ TI Mechanisms of Immobilization-Induced Bone Loss SO OSTEOPOROSIS, VOLS I AND II, 3RD EDITION LA English DT Article; Book Chapter ID GROWTH-FACTOR-I; SIGNAL-TRANSDUCTION PATHWAYS; FLUID-FLOW; INTEGRIN EXPRESSION; PARATHYROID-HORMONE; GENE-EXPRESSION; SIMULATED WEIGHTLESSNESS; OSTEOPROGENITOR CELLS; STRAIN MAGNITUDE; GROWING RATS C1 [Halloran, Bernard] Vet Affairs Med Ctr, San Francisco, CA 94121 USA. [Bikle, Daniel D.] San Francisco VA Med Ctr, Dept Vet Affairs, San Francisco, CA USA. RP Halloran, B (reprint author), Vet Affairs Med Ctr, San Francisco, CA 94121 USA. NR 69 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055347-4 PY 2008 BP 1177 EP 1185 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BDH03 UT WOS:000313195400047 ER PT J AU Bikle, DD AF Bikle, Daniel D. BE Marcus, R Feldman, D Nelson, DA Rosen, CJ TI Osteoporosis in Gastrointestinal, Pancreatic, and Hepatic Diseases SO OSTEOPOROSIS, VOLS I AND II, 3RD EDITION LA English DT Article; Book Chapter ID PRIMARY BILIARY-CIRRHOSIS; METABOLIC BONE-DISEASE; TOTAL PARENTERAL-NUTRITION; VITAMIN-D METABOLITES; INFLAMMATORY-BOWEL-DISEASE; INTESTINAL CALCIUM-ABSORPTION; CHOLESTATIC LIVER-DISEASE; GLUTEN-FREE DIET; LACTASE-DEFICIENT SUBJECTS; ADULT CELIAC-DISEASE C1 San Francisco VA Med Ctr, Dept Vet Affairs, San Francisco, CA USA. RP Bikle, DD (reprint author), San Francisco VA Med Ctr, Dept Vet Affairs, San Francisco, CA USA. NR 255 TC 1 Z9 1 U1 0 U2 1 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055347-4 PY 2008 BP 1203 EP 1226 PG 24 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BDH03 UT WOS:000313195400050 ER PT J AU Goldstein, NA Stewart, MG Witsell, DL Hannley, MT Weaver, EM Yueh, B Smith, TL Orvidas, LJ AF Goldstein, Nira A. Stewart, Michael G. Witsell, David L. Hannley, Maureen T. Weaver, Edward M. Yueh, Bevan Smith, Timothy L. Orvidas, Laura J. CA Treat Study Investigators TI Quality of life after tonsillectomy in children with recurrent tonsillitis SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article; Proceedings Paper CT 110th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery-Foundation CY SEP 17-20, 2006 CL Toronto, CANADA SP Amer Acad Otolaryngol Head & Neck Surg Fdn ID OBSTRUCTIVE SLEEP-APNEA; ADENOID DISEASE; ADENOTONSILLECTOMY; DISORDERS; BEHAVIOR; HEALTH AB OBJECTIVE: To describe changes in disease-specific and global quality of life (QOL) for children with recurrent or chronic tonsillitis at 6 months and 1 year after tonsillectomy using two validated instruments, the Tonsil and Adenoid Health Status Instrument (TAHSI) and the Child Health Questionaire-PF28 (CHQ-PF28). STUDY DESIGN AND SETTING: A multicenter, prospective observational outcomes study. RESULTS: Ninety-two children, mean age (SD) 10.6 (3.4) years, enrolled with follow-up available for 58 children at 6 months and 38 children at 1 year. The children showed significant improvements in all subscales of the TAHSI including airway and breathing, infection, health care utilization, cost of care, eating and swallowing (all P < 0.001), and behavior (P = 0.01). Significant improvements were also found on several subscales of the CHQ-PF28, such as general health perceptions, physical functioning, parental impact, and family activities (all P < 0.001). CONCLUSION/SIGNIFICANCE: This uncontrolled study provides prospective evidence of improved disease-specific and global QOL in children after tonsillectomy. (c) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved. C1 [Goldstein, Nira A.] Suny Downstate Med Ctr, Dept Otolaryngol, Div Pediatr Otolaryngol, Brooklyn, NY 11203 USA. [Stewart, Michael G.] Weill Cornell Med Coll, Dept Otorhinolaryngol, New York, NY USA. [Witsell, David L.] Duke Univ, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Durham, NC 27706 USA. [Weaver, Edward M.; Yueh, Bevan] Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. [Witsell, David L.; Hannley, Maureen T.] VA Puget Sound Healthcare Syst, Seattle, WA USA. [Smith, Timothy L.] Oregon Hlth & Sci Univ, Dept Otolaryngol, Portland, OR 97201 USA. [Orvidas, Laura J.] Mayo Clin, Dept Otorhinolaryngol, Rochester, MN USA. RP Goldstein, NA (reprint author), Suny Downstate Med Ctr, Dept Otolaryngol, Div Pediatr Otolaryngol, 450 Clarkson Ave,Box 126, Brooklyn, NY 11203 USA. EM ngoldstein@downstate.edu OI Yueh, Bevan/0000-0003-1380-1053 FU NHLBI NIH HHS [K23 HL068849, R01 HL084139] NR 20 TC 25 Z9 27 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD JAN PY 2008 VL 138 IS 1 SU S BP S9 EP S16 DI 10.1016/j.otohns.2006.12.029 PG 8 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 251RW UT WOS:000252392600002 PM 18164376 ER PT J AU Witsell, DL Orvidas, LJ Stewart, MG Hannley, MT Weaver, EM Yueh, B Smith, TL Goldstein, NA AF Witsell, David L. Orvidas, Laura J. Stewart, Michael G. Hannley, Maureen T. Weaver, Edward M. Yueh, Bevan Smith, Timothy L. Goldstein, Nira A. CA Treat Study Investigators TI Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis SO OTOLARYNGOLOGY-HEAD AND NECK SURGERY LA English DT Article; Proceedings Paper CT 110th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery-Foundation CY SEP 17-20, 2006 CL Toronto, CANADA SP Amer Acad Otolaryngol Head & Neck Surg Fdn ID VALIDATION; EFFICACY; BENEFIT; THROAT; NOSE AB OBJECTIVE: To describe changes in disease-specific and global quality of life (QOL) for adults with recurrent or chronic tonsillitis at 6 months and I year after tonsillectomy using two instruments: the Tonsil and Adenoid Health Status Instrument (TAHSI) and the SF-12 Health Survey (12-item short form of SF-36 Health Survey). STUDY DESIGN AND SETTING: Multicenter, prospective observational outcomes study. RESULTS: Seventy-two adults, mean age 28.0 years (SD 7.2 years), were enrolled with follow-up available for 42 adults at 6 months and for 40 adults at 1 year. Patients showed significant improvements in all six subscales of the TAHSI: airway and breathing, infection, health care utilization, cost of care, eating and swallowing, and behavior (all P < 0.0001). Significant improvements were also found in the physical functioning subscale of the SF-12 at 1 year. CONCLUSION: After tonsillectomy for recurrent and chronic tonsillitis, we found large improvements in disease-specific and global QOL. SIGNIFICANCE: Most prior studies on tonsillectomy for recurrent tonsillitis have assessed only the frequency of infections as an outcome measure. This study describes the changes in QOL measured in our cohort of reporting adults after tonsillectomy for chronic or recurrent tonsillitis. This study provides prospective evidence of the effectiveness of tonsillectomy on adult QOL. (c) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved. C1 [Witsell, David L.] Duke Univ, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Durham, NC 27706 USA. [Witsell, David L.; Hannley, Maureen T.] Amer Acad Otolaryngol Head & Neck Surg Fdn, Alexandria, VA USA. [Orvidas, Laura J.] Mayo Clin, Dept Otorhinolaryngol, Rochester, MN USA. [Stewart, Michael G.] Weill Cornell Med Coll, Dept Otorhinolaryngol, New York, NY USA. [Weaver, Edward M.; Yueh, Bevan] Univ Washington, Sch Med, Dept Otolaryngol Head & Neck Surg, Seattle, WA USA. [Smith, Timothy L.] Oregon Hlth & Sci Univ, Dept Otolaryngol, Portland, OR 97201 USA. [Goldstein, Nira A.] Suny Downstate Med Ctr, Div Pediat Otolaryngol, New York, NY USA. [Weaver, Edward M.; Yueh, Bevan] VA Puget Sound Healthcare Syst, Seattle, WA USA. RP Witsell, DL (reprint author), Duke Univ, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Durham, NC 27706 USA. EM david.witsell@duke.edu OI Yueh, Bevan/0000-0003-1380-1053 FU NHLBI NIH HHS [K23 HL068849, R01 HL084139] NR 11 TC 18 Z9 18 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0194-5998 J9 OTOLARYNG HEAD NECK JI Otolaryngol. Head Neck Surg. PD JAN PY 2008 VL 138 IS 1 SU S BP S1 EP S8 DI 10.1016/j.otohns.2007.08.015 PG 8 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 251RW UT WOS:000252392600001 PM 18164373 ER PT J AU Cheng, EM Siderowf, AD Swarztrauber, K Lee, M Vassar, S Jacob, E Eisa, MS Vickrey, BG AF Cheng, E. M. Siderowf, A. D. Swarztrauber, K. Lee, M. Vassar, S. Jacob, E. Eisa, M. S. Vickrey, B. G. TI Disparities of care in veterans with Parkinson's disease SO PARKINSONISM & RELATED DISORDERS LA English DT Article DE Parkinson's disease; disparities; quality indicators; quality of care ID QUALITY-OF-LIFE; STANDARDS SUBCOMMITTEE; PRACTICE PARAMETER; OLDER PATIENTS; HEALTH; DEPRESSION; AMERICAN; VARIABLES; NEUROLOGY; ACCESS AB Background: Disparities of Parkinson's disease (PD) care have not been assessed. Methods: We examined the medical records of 309 (83%) non-Hispanic White and 65 (17%) non-White Los Angeles veterans with PD from 1998 to 2004 to determine if care quality as measured by 10 PD indicators different by race/ethnicity. Results: In multivariate modeling, adherence to indicators was higher among non-Hispanic Whites (71% vs. 65%, risk ratio 1.15, 95% CI [1.07-1.32]) compared to non-Whites. Differences in adherence by race/ethnicity were greatest for depression treatment (P<0.05). Conclusions: We detected disparities in quality of PD care, particularly in depression treatment. Future research should determine causes for these so that interventions can be designed to reduce such disparities. Published by Elsevier Ltd. C1 [Cheng, E. M.; Vassar, S.; Jacob, E.; Vickrey, B. G.] VA Greater Los Angeles Healthcare Syst, PADRECC, Los Angeles, CA 90073 USA. [Cheng, E. M.; Vassar, S.; Vickrey, B. G.] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. [Siderowf, A. D.] Philadelphia VA Med Ctr, PADRECC, Philadelphia, PA USA. [Siderowf, A. D.] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. [Swarztrauber, K.] Providence Hlth Syst, Providence Med Grp, Newberg, OR USA. [Lee, M.] VA Greater Los Angeles Healthcare Syst, VA Ctr Study Healthcare Provider Behav, Los Angeles, CA USA. [Lee, M.] Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90024 USA. [Eisa, M. S.] Neurol Neurosurg & Spine Clin S Georgia, Valdosta, GA USA. RP Cheng, EM (reprint author), VA Greater Los Angeles Healthcare Syst, PADRECC, 11301 Wilshire Blvd,B500,ML 127, Los Angeles, CA 90073 USA. EM Eric.Cheng@va.gov FU NIMHD NIH HHS [P20MD000148, P20MD000182, P20 MD000148] NR 33 TC 12 Z9 12 U1 1 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1353-8020 J9 PARKINSONISM RELAT D JI Parkinsonism Relat. Disord. PY 2008 VL 14 IS 1 BP 8 EP 14 DI 10.1016/j.parkreldis.2007.05.001 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 270VG UT WOS:000253747700002 PM 17702625 ER PT J AU Guggenheim, MA Frost, JD Hrachovy, RA AF Guggenheim, Mary Anne Frost, James D., Jr. Hrachovy, Richard A. TI Time interval from a brain insult to the onset of infantile spasms SO PEDIATRIC NEUROLOGY LA English DT Article ID POSTTRAUMATIC EPILEPSY; WEST-SYNDROME; IMMUNIZATION; ENCEPHALITIS; PROGNOSIS; INJURY; MODEL AB The temporal latency between an encephalopathic event and the onset of infantile spasms cannot be determined in the majority of symptomatic cases (e.g. genetic conditions, cerebral malformations). However, we can measure this interval when a previously normal infant sustains brain injury followed by infantile spasms. This information has implications for understanding the underlying pathophysiologic basis for infantile spasms and, also, is germane to allegations that a close temporal relationship between vaccination and the onset of this seizure disorder establishes causation. We identified 19 published cases with sufficient information. The interval between brain injury and the onset of infantile spasms ranged from 6 weeks to 11 months (mean = 5.1 months). A similar temporal latency occurs in children with perinatal cerebral infarction and infantile spasms. We conclude that infantile spasms do not occur acutely following an encephalopathic event. This interval of weeks to months is consistent with prior studies indicating temporal latency between brain injury and the onset of other types of epilepsy, as well as with the previously proposed developmental desynchronization hypothesis. The findings refute claims that a close temporal association between an immunization and the onset of infantile spasms establishes causation. (C) 2008 by Elsevier Inc. All rights reserved. C1 [Guggenheim, Mary Anne] Univ Colorado, Sch Med, Dept Pediat, Denver, CO USA. [Frost, James D., Jr.; Hrachovy, Richard A.] Baylor Coll Med, Peter Kellaway Sect Neurophysiol, Dept Neurol, Houston, TX 77030 USA. [Frost, James D., Jr.; Hrachovy, Richard A.] Baylor Coll Med, Peter Kellaway Sect Neurophysiol, Dept Neurosci, Houston, TX 77030 USA. [Hrachovy, Richard A.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Guggenheim, MA (reprint author), 7575 Priest Pass Rd, Helena, MT 59601 USA. EM sweenycrik@wildblue.net NR 25 TC 13 Z9 14 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0887-8994 J9 PEDIATR NEUROL JI Pediatr. Neurol. PD JAN PY 2008 VL 38 IS 1 BP 34 EP 37 DI 10.1016/j.pediatrneurol.2007.08.005 PG 4 WC Clinical Neurology; Pediatrics SC Neurosciences & Neurology; Pediatrics GA 242VB UT WOS:000251753200006 PM 18054690 ER PT J AU Shah, SS Downes, KJ Elliott, MR Bell, LM McGowan, KL Metlay, JP AF Shah, Samir S. Downes, Kevin J. Elliott, Michael R. Bell, Louis M. McGowan, Karin L. Metlay, Joshua P. TI How long does it take to "Rule Out" bacteremia in children with central venous catheters? SO PEDIATRICS LA English DT Article DE child; bacteremia; sepsis; central venous catheterization; blood culture ID PEDIATRIC OBSERVATION UNIT; BLOOD-STREAM INFECTIONS; ANTIBIOTIC-TREATMENT; HOSPITAL CHARGES; TIME; CULTURES; POSITIVITY; TECHNOLOGY; EMERGENCY; FUNGEMIA AB BACKGROUND. Children with central venous catheters and suspected bloodstream infection are often hospitalized for 48 hours to receive empiric antibiotic therapy pending blood-culture results. Continuous monitoring blood-culture systems allow for more rapid detection of bloodstream infection than previous blood-culture systems, a feature that may facilitate earlier determination of the true presence or absence of bloodstream infection and shorten empiric antibiotic therapy and duration of hospitalization. METHODS. This retrospective cohort study included children with central venous catheters who were diagnosed with laboratory-confirmed bloodstream infection after evaluation in the ambulatory care setting. RESULTS. Two-hundred episodes of bloodstream infection were included. The median patient age was 5.5 years. Central venous catheters were in place for a median of 80.5 days. Gram-negative bacteria accounted for 51% of infections as part of either a monomicrobial (25%) or polymicrobial (26%) infection. The overall median time to blood-culture positivity was 14 hours. The predicted probability for a culture being positive at 36 hours was 99.2% for infections caused by Gram-negative bacteria and 96.6% for any infection after adjusting for age, catheter type, and recent antibiotic use. In a multivariate Cox proportional-hazards regression model, polymicrobial infections with >= 1 Gram-negative bacteria and monomicrobial infections caused by Gram-negative bacteria were independently associated with an earlier time to blood-culture positivity after adjusting for age, catheter type, and recent antibiotic use. CONCLUSIONS. The time to blood-culture positivity depends on bacterial category. Bloodstream infections caused by Gram-negative bacteria are detected most quickly. Our data suggest that discontinuation of empiric antibiotic coverage may be warranted in clinically stable children with central venous catheters if the blood-culture results remain negative 24 to 36 hours after collection. C1 [Shah, Samir S.; Downes, Kevin J.] Childrens Hosp Philadelphia, Div Infect Dis, Philadelphia, PA 19104 USA. [Bell, Louis M.] Childrens Hosp Philadelphia, Div Gen Pediat, Philadelphia, PA 19104 USA. [McGowan, Karin L.] Childrens Hosp Philadelphia, Dept Clin Microbiol Lab, Philadelphia, PA 19104 USA. [Shah, Samir S.; Metlay, Joshua P.] Univ Penn, Sch Med, Dept Epidemiol, Philadelphia, PA 19104 USA. [Shah, Samir S.] Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. [Metlay, Joshua P.] Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. [McGowan, Karin L.] Univ Penn, Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. [Shah, Samir S.; Metlay, Joshua P.] Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Shah, Samir S.; Metlay, Joshua P.] Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. [Metlay, Joshua P.] Vet Affairs Med Ctr, Philadelphia, PA USA. [Elliott, Michael R.] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI 48109 USA. [Elliott, Michael R.] Univ Michigan, Inst Social Res, Survey Methodol Program, Ann Arbor, MI 48109 USA. RP Shah, SS (reprint author), Childrens Hosp Philadelphia, Div Infect Dis, Room 1526,North Campus,34th St & Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM shahs@email.chop.edu OI Shah, Samir/0000-0001-7902-7000 NR 27 TC 13 Z9 14 U1 0 U2 0 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 JAN PY 2008 VL 121 IS 1 BP 135 EP 141 DI 10.1542/peds.2007-1387 PG 7 WC Pediatrics SC Pediatrics GA 247RC UT WOS:000252096300018 PM 18166567 ER PT J AU Keyhani, S Kleinman, LC Rothschild, M Bernstein, JM Anderson, R Simon, M Chassin, M AF Keyhani, Salomeh Kleinman, Lawrence C. Rothschild, Michael Bernstein, Joseph M. Anderson, Rebecca Simon, Melissa Chassin, Mark TI Clinical characteristics of New York City children who received tympanostomy tubes in 2002 SO PEDIATRICS LA English DT Article; Proceedings Paper CT AcademyHealth Annual Research Meeting CY JUN 03-05, 2007 CL Orlando, FL SP AcademyHealth DE tympanostomy tubes; epidemiology; physician's practice pattern; use ID ASSESSING FEBRILE CHILDREN; ACUTE PEDIATRIC ILLNESSES; PERSISTENT OTITIS-MEDIA; QUALITY-OF-LIFE; DEVELOPMENTAL OUTCOMES; OBSERVATION VARIABLES; DELAYED INSERTION; EFFUSION; HISTORY; PERFORMANCE AB OBJECTIVE. Tympanostomy tube insertion is the most common procedure that requires general anesthesia for children in the United States. We report on the clinical characteristics of a cohort of New York City children who received tympanostomy tubes in 2002. METHODS. This retrospective cohort study included all 1046 children who received tubes in 2002 in any of 5 New York City area hospitals. We analyzed clinical data for all 682 (65%) children for whom we were able to abstract data for the preceding year from all of 3 sources: hospital, pediatrician, and otolaryngologist medical charts. RESULTS. Mean age was 3.8 years, 57% were male, and 74% had private insurance. More than 25% of children had received tubes previously. The stated reason for surgery was otitis media with effusion for 60.4% of children, recurrent acute otitis media for 20.7%, and eustachian tube dysfunction for 10.6%. Children with recurrent acute otitis media averaged 3.1 +/- 0.2 episodes ( median: 3.0) in the previous year; those with otitis media with effusion averaged effusions that were 29 +/- 1.7 days long ( median: 16 days) at surgery. Twenty-five percent of children had bilateral effusions of > 42 days' duration at surgery. Despite a clinical practice guideline for otitis media with effusion that recommends withholding tympanostomy tubes for otherwise healthy children until a bilateral effusion is at least 3 to 4 months old, 50% of children had surgery without having had 3 months of effusion cumulatively during the year before surgery. CONCLUSIONS. The clinical characteristics of children who received tympanostomy tubes varied widely. Many children with otitis media with effusion had shorter durations of effusions than are generally recommended before surgery. The extent of variation in treating this familiar condition with limited treatment options suggests both the importance and the difficulty of managing common practice in accordance with clinical practice guidelines. C1 [Keyhani, Salomeh; Kleinman, Lawrence C.; Anderson, Rebecca; Chassin, Mark] Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10029 USA. [Keyhani, Salomeh] James J Peters VA Med Ctr, Bronx, NY USA. [Rothschild, Michael] Mt Sinai Sch Med, Dept Pediat & Otolaryngol, New York, NY USA. [Bernstein, Joseph M.] NYU, Sch Med, Dept Pediat & Otolaryngol, New York, NY USA. [Simon, Melissa] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Keyhani, S (reprint author), Mt Sinai Sch Med, Dept Hlth Policy, New York, NY 10029 USA. FU AHRQ HHS [R01 HS 10302] NR 36 TC 14 Z9 15 U1 1 U2 1 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 JAN PY 2008 VL 121 IS 1 BP E24 EP E33 DI 10.1542/peds.2007-0623 PG 10 WC Pediatrics SC Pediatrics GA 247RC UT WOS:000252096300042 PM 18166541 ER PT J AU Blevins, JE Chelikani, PK Haver, AC Reidelberger, RD AF Blevins, J. E. Chelikani, P. K. Haver, A. C. Reidelberger, R. D. TI PYY(3-36) induces Fos in the arcuate nucleus and in both catecholaminergic and non-catecholaminergic neurons in the nucleus tractus solitarius of rats SO PEPTIDES LA English DT Article DE PYY(3-36); satiety; forebrain; hindbrain; Fos; tyrosine hydroxylase ID INHIBITS FOOD-INTAKE; BRAIN-STEM NUCLEI; PEPTIDE YY3-36; INTRAVENOUS-INFUSION; RECEPTOR SUBTYPES; BETA-ENDORPHIN; OBESE SUBJECTS; ALPHA-MSH; PYY3-36; EXPRESSION AB Peptide YY (3-36) [PYY(3-36)] inhibits feeding in rodents, nonhuman primates and humans, yet the neural circuits underlying this action remain to be determined. Here we assessed whether PYY(3-36) inhibits feeding by activating neurons in forebrain and hindbrain sites containing Y2 receptors and linked to control of food intake, or in hindbrain sites immediately downstream of vagal afferent neurons. Rats received an anorexigenic dose of PYY(3-36), and the number of neurons expressing Fos, an indicator of neuronal activation, was determined in anterior hypothalamus (AH), arcuate nucleus (ARC), dorsomedial hypothalamus (DMH), lateral hypothalamus (LH), ventromedial hypothalamus (VMH), central nucleus of the amygdala (CeA), area postrema (AP), and caudal medial nucleus tractus solitarius (cmNTS), commissural NTS (cNTS), and gelatinosus NTS (gNTS). Expression of tyrosine hydroxylase (TH), an indicator of catecholamine synthesis, was also measured in the cmNTS. PYY(3-36) increased Fos in ARC, cmNTS, gNTS and AP. Approximately 10% of Fos(+) neurons in the cmNTS were TH(+). These results suggest that PYY(3-36) inhibits feeding through direct activation of ARC neurons, and direct and/or indirect activation via vagal afferent nerves of cmNTS, gNTS and AP, including some catecholaminergic neurons in the cmNTS. (C) 2007 Elsevier Inc. All rights reserved. C1 [Blevins, J. E.] Univ Washington, Sch Med, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA USA. [Blevins, J. E.] VA Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. [Chelikani, P. K.; Reidelberger, R. D.] Creighton Univ, Dept Biomed Sci, Omaha, NE 68178 USA. [Haver, A. C.; Reidelberger, R. D.] VA Nebraska Western Iowa Hlth Care Syst, Res Serv, Omaha, NE 68105 USA. RP Blevins, JE (reprint author), Vet Adm Med Ctr, Res-151,1660 S Columbian Way, Seattle, WA 98108 USA. EM jeblevin@u.washington.edu; prasanth.chelikani@ucalgary.ca; ahaver@juno.com; roger.reidelberger@va.gov FU NCRR NIH HHS [RR-16469, P20 RR016469]; NIDDK NIH HHS [DK-41301, DK-56805, DK-73152, P30 DK017047, P30 DK017047-31, P30 DK017047-316819, P30 DK041301, R01 DK055830, R01 DK055830-05, R01 DK056805, R01 DK073152, R01 DK073152-02] NR 39 TC 35 Z9 36 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD JAN PY 2008 VL 29 IS 1 BP 112 EP 119 DI 10.1016/j.peptides.2007.11.003 PG 8 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 254LR UT WOS:000252588600015 PM 18082288 ER PT J AU Rothman, MS Wierman, ME AF Rothman, Micol S. Wierman, Margaret E. TI Female hypogonadism: evaluation of the hypothalamic-pituitary-ovarian axis SO PITUITARY LA English DT Article DE female hypogonadism; amenorrhea; hypopituitarism; ovarian reserve testing ID IDIOPATHIC HYPOGONADOTROPIC HYPOGONADISM; KALLMANN-SYNDROME; MUTATIONS; HORMONE; WOMEN; DEFICIENCY; PHENOTYPES; FAILURE; GPR54; GENE AB Female hypogonadism refers to deficient or abnormal function of the hypothalamic-pituitary-ovarian axis that clinically presents with menstrual cycle disturbances. Female hypogonadism can be due to a congenital or acquired cause, and the defect can be at the level of the hypothalamus, pituitary or ovary. A careful history, physical exam and selected laboratory testing can often determine the locus of the defect and whether it results from a structural or hormonal problem. Laboratory testing generally relies on basal hormone levels; however, timing of blood sampling in relation to menses is important to interpretation of the data. C1 [Rothman, Micol S.; Wierman, Margaret E.] Univ Colorado Denver, Dept Med, Div Endocrinol, Aurora, CO 80045 USA. [Rothman, Micol S.; Wierman, Margaret E.] Hlth Sci Ctr, Aurora, CO 80045 USA. [Wierman, Margaret E.] Denver Vet Affairs Med Ctr, Res Serv, Denver, CO 80220 USA. RP Rothman, MS (reprint author), Univ Colorado Denver, Dept Med, Div Endocrinol, 1635 N Ursula St,MS F732, Aurora, CO 80045 USA. EM Micol.Rothman@uchsc.edu NR 31 TC 9 Z9 10 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 1386-341X J9 PITUITARY JI Pituitary PY 2008 VL 11 IS 2 BP 163 EP 169 DI 10.1007/s11102-008-0109-3 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 307HR UT WOS:000256310500008 PM 18404388 ER PT J AU Rubins, JB Boulware, DR Janoff, EN AF Rubins, Jeffrey B. Boulware, David R. Janoff, Edward N. BE Siber, GR Klugman, KP Makela, PH TI Pneumococcal Pneumonia in Adults: Epidemiology, Clinical Features, Diagnosis, and Therapy SO PNEUMOCOCCAL VACCINES: THE IMPACT OF CONJUGATE VACCINE LA English DT Article; Book Chapter ID COMMUNITY-ACQUIRED PNEUMONIA; IMMUNODEFICIENCY-VIRUS-INFECTION; POLYMERASE-CHAIN-REACTION; SURFACE ADHESIN-A; SPUTUM GRAM STAIN; RAPID IMMUNOCHROMATOGRAPHIC ASSAY; VIRIDANS GROUP STREPTOCOCCI; LINKED-IMMUNOSORBENT-ASSAY; URINARY ANTIGEN TEST; INTENSIVE-CARE-UNIT C1 [Rubins, Jeffrey B.] Vet Adm Med Ctr, Div Pulm Med, Minneapolis, MN 55417 USA. [Rubins, Jeffrey B.] Univ Minnesota, Minneapolis, MN 55417 USA. [Boulware, David R.] Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA. [Janoff, Edward N.] Univ Colorado, Colorado Ctr AIDS Res, Div Infect Dis, Denver, CO 80220 USA. [Janoff, Edward N.] Denver Vet Affairs Med Ctr, Hlth Sci Ctr, Denver, CO 80220 USA. RP Rubins, JB (reprint author), Vet Adm Med Ctr, Div Pulm Med, Minneapolis, MN 55417 USA. RI Boulware, David/B-5516-2011; Boulware, David/I-4533-2013 NR 162 TC 2 Z9 2 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N STREET NW, WASHINGTON, DC 20036-2904 USA BN 978-1-55581-582-0 PY 2008 BP 117 EP 138 PG 22 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA BOY53 UT WOS:000278065300010 ER PT J AU Hoey, P Eisenberg, M AF Hoey, Patty Eisenberg, Matt BE Payne, TH TI WORKING WITH THE USER COMMUNITY SO PRACTICAL GUIDE TO CLINICAL COMPUTING SYSTEMS: DESIGN, OPERATIONS, AND INFRASTRUCTURE LA English DT Article; Book Chapter C1 [Hoey, Patty] VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. [Eisenberg, Matt] Childrens Hosp & Reg Med Ctr, Seattle, WA USA. RP Hoey, P (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER ACADEMIC PRESS INC PI SAN DIEGO PA 525 B STREET, SUITE 1900, SAN DIEGO, CA 92101-4495 USA BN 978-0-08-055792-2 PY 2008 BP 129 EP 155 DI 10.1016/B978-0-12-374002-1.00008-1 PG 27 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Health Care Sciences & Services SC Computer Science; Health Care Sciences & Services GA BFF43 UT WOS:000319660300009 ER PT B AU Wiren, KM AF Wiren, Kristine M. BE Bilezikian, JP Raisz, LG Martin, TJ TI Androgens Receptor Expression and Steroid Action in Bone SO PRINCIPLES OF BONE BIOLOGY, VOL 2, 3RD EDITION LA English DT Article; Book Chapter ID OSTEOBLAST-LIKE CELLS; GROWTH-FACTOR-BETA; CAG-REPEAT POLYMORPHISM; MESSENGER-RIBONUCLEIC-ACID; THYROID-HORMONE RECEPTOR; GENITAL SKIN FIBROBLASTS; ADULT MALE-MICE; AGED MALE-RATS; MINERAL DENSITY; OVARIECTOMIZED RATS C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. RP Wiren, KM (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97201 USA. OI Wiren, Kristine/0000-0002-6159-4450 NR 231 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS BN 978-0-08-056875-1; 978-0-12-373884-4 PY 2008 BP 1001 EP 1023 DI 10.1016/B978-0-12-373884-4.00062-8 PG 23 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BCS75 UT WOS:000311296900005 ER PT B AU Singer, FR Roodman, GD AF Singer, Frederick R. Roodman, G. David BE Bilezikian, JP Raisz, LG Martin, TJ TI Paget's Disease of Bone SO PRINCIPLES OF BONE BIOLOGY, VOL 2, 3RD EDITION LA English DT Article; Book Chapter ID CANINE-DISTEMPER VIRUS; RESPIRATORY SYNCYTIAL VIRUS; FAMILIAL EXPANSILE OSTEOLYSIS; POLYMERASE CHAIN-REACTION; MEASLES-VIRUS; CHROMOSOME 18Q; GENETIC-HETEROGENEITY; OSTEOCLAST PRECURSORS; OSTEITIS DEFORMANS; RIBONUCLEIC-ACID C1 [Singer, Frederick R.] St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA 90404 USA. [Roodman, G. David] Univ Pittsburgh, Dept Med, Div Hematol, Pittsburgh, PA USA. [Roodman, G. David] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Singer, FR (reprint author), St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA 90404 USA. EM singerf@yahoo.com NR 70 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS BN 978-0-08-056875-1; 978-0-12-373884-4 PY 2008 BP 1599 EP 1609 DI 10.1016/B978-0-12-373884-4.00081-1 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA BCS75 UT WOS:000311296900033 ER PT J AU Freedland, SJ Mavropoulos, J Wang, A Darshan, M Demark-Wahnefried, W Aronson, WJ Cohen, P Hwang, D Peterson, B Fields, T Pizzo, SV Isaacs, WB AF Freedland, Stephen J. Mavropoulos, John Wang, Amy Darshan, Medha Demark-Wahnefried, Wendy Aronson, William J. Cohen, Pinchas Hwang, David Peterson, Bercedis Fields, Timothy Pizzo, Salvatore V. Isaacs, William B. TI Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis SO PROSTATE LA English DT Article DE prostatic neoplasms; diet; carbohydrate; fat; ketogenesis; insulin; IGF-1 ID LOW-FAT DIET; KETOGENIC DIET; WEIGHT-LOSS; RANDOMIZED-TRIAL; HEART-DISEASE; RISK-FACTORS; FACTOR-I; PATTERNS; WOMEN; MICE AB BACKGROUND. Recent evidence suggests carbohydrate intake may influence prostate cancer biology. We tested whether a no-carbohydrate ketogenic diet (NCKD) would delay prostate cancer growth relative to Western and low-fat diets in a xenograft model. METHODS. Seventy-five male SCID mice were fed a NCKD (84% fat-0% carbohydrate-16% protein kcal), low-fat (12% fat-72% carbohydrate-16% protein kcal), or Western diet (40% fat-44% carbohydrate-16% protein kcal). Low-fat mice were fed ad libitum and the other arms fed via a modified-paired feeding protocol. After 24 days, all mice were injected with LAPC-4 cells and sacrificed when tumors approached 1,000 mm(3). RESULTS. Despite consuming equal calories, NCKD-fed mice lost weight (up to 15% body weight) relative to low-fat and Western diet-fed mice and required additional kcal to equalize body weight. Fifty-one days after injection, NCKD mice tumor volumes were 33% smaller than Western mice (rank-sum, P = 0.009). There were no differences in tumor volume between low-fat and NCKD mice. Dietary treatment was significantly associated with survival (log-rank, P = 0.006), with the longest survival among the NCKD mice, followed by the low-fat mice. Serum IGFBP-3 was highest and IGF-1:IGFBP-3 ratio was lowest among NCKD mice while serum insulin and IGF-1 levels were highest in Western mice. NCKD mice had significantly decreased hepatic fatty infiltration relative to the other arms. CONCLUSIONS. In this xenograft model, despite consuming more calories, NCKD-fed mice had significantly reduced tumor growth and prolonged survival relative to Western mice and was associated with favorable changes in serum insulin and IGF axis hormones relative to low-fat or Western diet. C1 [Freedland, Stephen J.; Demark-Wahnefried, Wendy] Duke Univ, Med Ctr, Sch Nursing, Durham, NC 27710 USA. [Freedland, Stephen J.] Durham VA Med Ctr, Dept Surg, Durham, NC USA. [Freedland, Stephen J.; Demark-Wahnefried, Wendy] Duke Univ, Sch Med, Dept Surg, Div Urol,Duke Prostate Ctr, Durham, NC USA. [Wang, Amy; Darshan, Medha; Isaacs, William B.] Johns Hopkins Sch Med, James Buchanan Brady Urol Inst, Dept Urol, Baltimore, MD USA. [Freedland, Stephen J.; Mavropoulos, John; Fields, Timothy; Pizzo, Salvatore V.] Duke Univ, Sch Med, Dept Pathol, Durham, NC 27706 USA. [Aronson, William J.] Greater Los Angeles VA Med Ctr, Dept Surg, Los Angeles, CA USA. [Aronson, William J.] Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. [Cohen, Pinchas; Hwang, David] Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90024 USA. [Peterson, Bercedis] Duke Univ, Sch Med, Dept Biostat, Durham, NC USA. RP Freedland, SJ (reprint author), Duke Univ, Med Ctr, Sch Nursing, Box 2626, Durham, NC 27710 USA. EM steve.freedland@duke.edu FU NCI NIH HHS [P50 CA092131-01A1, P50 CA092131, P50CA92131, R01 CA085740] NR 35 TC 70 Z9 72 U1 1 U2 8 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-4137 J9 PROSTATE JI Prostate PD JAN 1 PY 2008 VL 68 IS 1 BP 11 EP 19 DI 10.1002/pros.20683 PG 9 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 245TD UT WOS:000251957800002 PM 17999389 ER PT J AU Arthur, JM Janech, MG Varghese, SA Almeida, JS Powell, TB AF Arthur, John M. Janech, Michael G. Varghese, Sanju A. Almeida, Jonas S. Powell, T. Brian TI Diagnostic and prognostic biomarkers in acute renal failure SO PROTEOMICS IN NEPHROLOGY - TOWARDS CLINICAL APPLICATIONS SE CONTRIBUTIONS TO NEPHROLOGY LA English DT Article ID ACUTE KIDNEY INJURY; PROTEOMIC ANALYSIS; LEAD-EXPOSURE; GEL-ELECTROPHORESIS; PROTEIN ALTERATIONS; HOSPITAL MORTALITY; URINARY BIOMARKER; RIFLE CRITERIA; IDENTIFICATION; DISCOVERY AB Acute kidney injury (AKI) is a process that can lead to renal failure. No biological markers are available for predicting the cause or prognosis of AKI. Tests that can predict which patients will need renal replacement therapy (RRT) are needed. In this chapter, we review the recent literature for proteomic analysis in AKI and identify new candidate markers to predict the need for RRT. We also used artificial neural network (ANN) analysis of urine protein data obtained by two-dimensional gel electrophoresis from 19 patients with acute tubular necrosis to identify a set of proteins that can predict whether a patient will require RRT. Ten patients were randomly selected to train an ANN algorithm. The remaining 9 patients were withheld to serve as an independent validation set. The ANN algorithm correctly predicted the renal prognosis of all 10 patients in the training set. In the validation set, the test correctly predicted the future course of renal failure in 7 of the 9 patients (78% accuracy) including 3 of 4 patients who would require RRT (75% sensitivity) and 4 of 5 who L would not (80% specificity). Combinations of urine proteins can be used to predict which patients will require RRT. (c) Copyright (c) 2008 S. Karger AG, Basel. C1 Med Univ S Carolina, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA. RP Arthur, JM (reprint author), Med Univ S Carolina, Div Nephrol, 96 Jonathan Lucas St POB 250623, Charleston, SC 29425 USA. EM arthurj@musc.edu OI Janech, Michael/0000-0002-3202-4811 FU NHLBI NIH HHS [N01-HV-28181] NR 24 TC 4 Z9 4 U1 0 U2 0 PU KARGER PI BASEL PA POSTFACH, CH-4009 BASEL, SWITZERLAND SN 0302-5144 J9 CONTRIB NEPHROL JI Contrib.Nephrol. PY 2008 VL 160 BP 53 EP 64 DI 10.1159/000125929 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA BHX13 UT WOS:000257140500005 PM 18401161 ER PT J AU Cohen, AN Glynn, SM Murray-Swank, AB Barrio, C Fischer, EP McCutcheon, SJ Perlick, DA Rotondi, AJ Sayers, SL Sherman, MD Dixon, LB AF Cohen, Amy N. Glynn, Shirley M. Murray-Swank, Aaron B. Barrio, Concepcion Fischer, Ellen P. McCutcheon, Susan J. Perlick, Deborah A. Rotondi, Armando J. Sayers, Steven L. Sherman, Michelle D. Dixon, Lisa B. TI The family forum: Directions for the implementation of family psychoeducation for severe mental illness SO PSYCHIATRIC SERVICES LA English DT Article ID CONTROLLED-TRIAL; RATING-SCALE; TREATMENT RECOMMENDATIONS; SCHIZOPHRENIC-PATIENTS; MEASURING EMPOWERMENT; PATIENT OUTCOMES; PRIMARY-CARE; INTERVENTION; RELAPSE; MANAGEMENT AB It is well documented that family psychoeducation decreases relapse rates of individuals with schizophrenia. Despite the evidence, surveys indicate that families have minimal contact with their relative's treatment team, let alone participate in the evidence-based practice of family psychoeducation. The Department of Veterans Affairs (VA) sponsored a conference, the Family Forum, to assess the state of the art regarding family psychoeducation and to form a consensus regarding the next steps to increase family involvement. The forum reached consensus on these issues: family psychoeducation treatment models should be optimized by efforts to identify the factors mediating their success in order to maximize dissemination; leadership support, training in family psychoeducation models for managers and clinicians, and adequate resources are necessary to successfully implement family psychoeducation; because family psychoeducation may not be appropriate, indicated, or acceptable for all families, additional complementary strategies are needed that involve families in the mental health care of the patient; and work is required to develop and validate instruments that appropriately assess the intervention process and consumer and family outcomes. A treatment heuristic for working with families of persons with severe mental illness is also offered and provides a match of interventions at varying levels of intensity, tailored to family and consumer needs and circumstances. The article describes opportunities for the research and clinical communities to expand the proportion of families served. C1 [Cohen, Amy N.] Greater Los Angeles Vet Affairs Hlth Ctr, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. [Glynn, Shirley M.] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. [Glynn, Shirley M.] Univ Calif Los Angeles, Greater Los Angeles VA Healthcare Syst W Los Ange, Los Angeles, CA 90024 USA. [Murray-Swank, Aaron B.; Dixon, Lisa B.] Univ Maryland, Sch Med, Dept Psychiat, Baltimore, MD 21201 USA. [Murray-Swank, Aaron B.; Dixon, Lisa B.] Univ Maryland, VA Capitol Network MIRECC, Baltimore, MD 21201 USA. [Barrio, Concepcion] Univ So Calif, Sch Social Work, Los Angeles, CA 90089 USA. [Fischer, Ellen P.] Cent Arkansas Vet Healthcare Syst, Ctr Mental Healthcare & Outcomes Res, N Little Rock, AR USA. [Fischer, Ellen P.; Sherman, Michelle D.] VA S Cent MIRECC, N Little Rock, AR USA. [McCutcheon, Susan J.] VA Off Mental Hlth Serv, Dept Vet Affairs, Washington, DC USA. [Perlick, Deborah A.] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. [Perlick, Deborah A.] Mt Sinai Sch Med, Vet Integrated Serv Network 3 MIRECC, New York, NY USA. [Rotondi, Armando J.] Univ Pittsburgh, Dept Crit Care Med, Pittsburgh, PA 15260 USA. [Rotondi, Armando J.] Univ Pittsburgh, VA Stars & Stripes MIRECC, Pittsburgh, PA 15260 USA. [Sayers, Steven L.] Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. [Sayers, Steven L.] Univ Penn, VA Stars & Stripes MIRECC, Philadelphia, PA 19104 USA. [Sherman, Michelle D.] VA Med Ctr, Oklahoma City, OK USA. RP Cohen, AN (reprint author), Greater Los Angeles Vet Affairs Hlth Ctr, Mental Illness Res Educ & Clin Ctr, 11301 Blvd,MIRECC 210A, Los Angeles, CA 90073 USA. EM ancohen@ucla.edu NR 70 TC 34 Z9 34 U1 6 U2 17 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 JAN PY 2008 VL 59 IS 1 BP 40 EP 48 DI 10.1176/appi.ps.59.1.40 PG 9 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 266OA UT WOS:000253444400010 PM 18182538 ER PT J AU Henderson, C Swanson, JW Szmukler, G Thornicroft, G Zinkler, M AF Henderson, Claire Swanson, Jeffrey W. Szmukler, George Thornicroft, Graham Zinkler, Martin TI A typology of advance statements in mental health care SO PSYCHIATRIC SERVICES LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; JOINT CRISIS PLANS; PSYCHIATRIC-TREATMENT; TREATMENT ORDERS; DECISION-MAKING; DIRECTIVES; COMMUNITY; SERVICE; USERS; HOSPITALIZATION AB Advance statements documenting mental health service consumers' preferences for treatment during a future mental health crisis or period of incapacity have gained currency in recent years in the United States and some European countries. Several kinds of advance statements have emerged-some as legal instruments, others as treatment planning methods-but no formal comparison has been made among them. This article reviews the literature in English and German to develop a comparative typology of advance statements: joint crisis plans, crisis cards, treatment plans, wellness recovery action plans, and psychiatric advance directives (with and without formal facilitation). The features that distinguish them are the extent to which they are legally binding, whether health care providers are involved in their production, and whether an independent facilitator assists in their production. The differing nature of advance statements is related to the diverse models of care upon which they are based and the legislative and service contexts in which they have been developed. However, there is recent convergence between the United Kingdom and the United States with respect to research interventions that facilitate the production of advance statements, as evidence emerges for the effectiveness of facilitated psychiatric advance directives and joint crisis plans. Different types of advance statements can coexist and in some cases may interact in complementary ways. However, the relationship of advance statements to involuntary treatment is more problematic, as is their effective implementation in many mental health service settings. C1 [Henderson, Claire] Vet Adm Med Ctr, James J Peters Dept, Mental Illness Res Educ & Clin Ctrs, Bronx, NY 10468 USA. [Swanson, Jeffrey W.] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. [Szmukler, George; Thornicroft, Graham] Kings Coll London, Inst Psychiat, Hlth Serv & Populat Res Dept, London WC2R 2LS, England. RP Henderson, C (reprint author), Vet Adm Med Ctr, James J Peters Dept, Mental Illness Res Educ & Clin Ctrs, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rosalind.henderson@va.gov RI Henderson, Claire/E-4664-2010; Thornicroft, Graham/B-4027-2010 OI Henderson, Claire/0000-0002-6998-5659; Thornicroft, Graham/0000-0003-0662-0879 NR 48 TC 43 Z9 44 U1 0 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 JAN PY 2008 VL 59 IS 1 BP 63 EP 71 DI 10.1176/appi.ps.59.1.63 PG 9 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 266OA UT WOS:000253444400013 PM 18182541 ER PT J AU Trivedi, MH Kocsis, JH Thase, ME Morris, DW Wisniewski, SR Leon, AC Gelenberg, AJ Klein, DN Niederehe, G Schatzberg, AF Ninan, PT Keller, MB AF Trivedi, Madhukar H. Kocsis, James H. Thase, Michael E. Morris, David W. Wisniewski, Stephen R. Leon, Andrew C. Gelenberg, Alan J. Klein, Daniel N. Niederehe, George Schatzberg, Alan F. Ninan, Philip T. Keller, Martin B. TI REVAMP - Research Evaluating the Value of Augmenting Medication with Psychotherapy: Rationale and Design SO PSYCHOPHARMACOLOGY BULLETIN LA English DT Article DE antidepressant; algorithm; pharmacotherapy; psychotherapy; augmentation; remission; response; measurement-based care; personalized care AB This report presents the rationale, design, and baseline sample characteristics for the REVAMP study. This project is a multisite clinical trial designed to evaluate the efficacy of augmenting state-of-the-art pharmacotherapy with psychotherapy in chronically depressed patients who fail to respond or respond incompletely to an initial trial of antidepressant medication. Background: Chronic forms of major depression disorder (cMDD) are longitudinally continuous forms of major depressive disorder (MDD), and may account for a significant portion of the societal burden of disease associated with MDD. Antidepressant medications and depression-focused psychotherapies have been shown to be effective for cMDD, though the majority fail to achieve remission following an acute course of treatment. There is a pressing need to evaluate whether the outcomes obtained from a well implemented medication algorithm combined with depression-focused psychotherapy can significantly enhance outcomes for cMDD. Rationale: Although there is evidence for the effectiveness of depression-focused psychotherapy for the treatment of cMDD, this is the first prospective, randomized, controlled trial investigating psychotherapy as an augmentation strategy for patients with cMDD incompletely responsive to a trial of antidepressant medication. Specific Aims: The REVAMP study has three specific aims: first, to compare the efficacy of adding psychotherapy to a medication change versus changing medication alone in chronic depressives with partial response or nonresponse to an initial trial of antidepressant medication; second, to test efficacy of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) as an augmentation strategy by comparing it to Supportive Psychotherapy (SP); and third, to test a hypothesized mechanism of therapeutic action of CBASP by examining whether patients receiving CBASP exhibit significantly greater improvements in social problem solving than patients receiving adjunctive SP or continued medication alone. As a subsidiary aim, the study also compares the effects of the three randomized treatments on psychosocial outcomes. Design: The study involves two 12-week phases. During Phase 1, patients with cMDD receive antidepressant monotherapy selected according to an algorithm that takes into account their prior treatment history. Their pattern of response is evaluated, those with no response at 8 weeks or less than a full response at 12 weeks advance to Phase 2. At the beginning of Phase 2, patients who did not respond to the initial antidepressant monotherapy during Phase 1 are switched to the next medication in the pharmacotherapy algorithm and randomly assigned in a 2:2: ratio to one of three treatment cells: 16 sessions of either CBASP (40% of randomizations) or SP (40%) added to pharmacotherapy, or medication alone (20%) with no added psychotherapy. Similarly, patients achieving a partial response during Phase 1 have their initial medication augmented with a second antidepressant agent during Phase 2 and are randomly assigned to either CBASP, SP, or medication alone. Patients who achieve remission during Phase 1 are not randomized to Phase 2, but rather are monitored monthly for an additional 12 weeks. Comment: Recent sequential treatment studies have provided state-of-the-art knowledge about the need for multiple steps in order to achieve remission. The current study, therefore, provides an important next step in understanding the role of depression-focused psychotherapy in a treatment algorithm so essential in the management of difficul-to-treat depression such as chronic forms of major depression. Psychopharmacology Bulletin. 2008; 41(4): 5-33. C1 [Trivedi, Madhukar H.; Morris, David W.] Univ Texas SW Med Ctr Dallas, Dept Psychiat, Dallas, TX 75390 USA. [Kocsis, James H.; Leon, Andrew C.] Cornell Univ, Weill Med Coll, Dept Psychiat, New York, NY USA. [Thase, Michael E.] Univ Penn Sch Med, Philadelphia, PA USA. [Thase, Michael E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Wisniewski, Stephen R.] Univ Pittsburgh, Grad Sch Publ Hlth, Epidemiol Data Ctr, Dept Psychiat, Pittsburgh, PA USA. [Gelenberg, Alan J.] Univ Arizona, Dept Psychiat, Tucson, AZ USA. [Klein, Daniel N.] SUNY Stony Brook, Dept Psychol, Stony Brook, NY 11794 USA. [Niederehe, George] NIMH, Geriatr Res Branch, Bethesda, MD 20892 USA. [Schatzberg, Alan F.] Stanford Univ Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA. [Ninan, Philip T.] Emory Univ Sch Med, Dept Psychiat, Mood & Anxiety Disorders Program, Collegeville, PA USA. [Keller, Martin B.] Brown Univ, Dept Psychiat & Human Behav, Providence, RI 02912 USA. RP Trivedi, MH (reprint author), Univ Texas SW Med Ctr Dallas, Dept Psychiat, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. EM madhukar.trivedi@utsouthwestern.edu OI Wisniewski, Stephen/0000-0002-3877-9860 FU Cornell University [UO1 MH62475]; University of Pittsburgh [UO1 MH61587]; University of Stony Brook [UO1 MH62546]; University of Texas Southwestern Medical Center [UO1 MH61562]; Emory University School of Medicine [UO1 MH63481]; University of Arizona [UO1 MH62465]; Brown Medical School [UO1 MH61590]; Stanford University [UO1 MH61504]; Agency for Healthcare Research and Quality; Corcept Therapeutics, Inc.; Cyberonics, Inc.; Merck; National Alliance for Research MedAvante, Inc.; Neuronetics, Inc.; Novartis; Organon Inc.; Sepracor, Inc.; Shire US, Inc.; Transcept; Wyeth Pharmaceuticals; AstraZeneca; Bristol-Myers Squibb; Eli Lilly Co.; GlaxoSmithKline; Sepracor; American Psychiatric Publishing, Inc; Guilford Publications and Herald House FX Cornell University (UO1 MH62475): James H. Kocsis, M.D.; John C. Markowitz, M.D.; Andrew C. Leon, Ph.D.; Richard A. Friedman, M.D.; University of Pittsburgh (UO1 MH61587): Michael E. Thase, M.D.; Edward S. Friedman, M.D.; Robert H. Howland, M.D.; Stephen R. Wisniewski, Ph.D.; Jennifer Barkin, M.S.; University of Stony Brook (UO1 MH62546): Daniel N. Klein, Ph.D.; Dina Vivian, Ph.D.; Frank Dowling, M. D.; Thomas D'Zurilla, Ph.D.; University of Texas Southwestern Medical Center (UO1 MH61562): Madhukar H. Trivedi, M. D.; Prabha Sunderajan, M.D.; David W. Morris, Ph.D.; Beverly Kleiber, Ph.D.; Emory University School of Medicine (UO1 MH63481): Barbara O. Rothbaum, Ph.D.; Broadie Dunlop, M.D.; Philip T. Ninan, M.D.; Steven J. Garlow, M.D., Ph.D.; University of Arizona (UO1 MH62465): Alan J. Gelenberg, M.D.; John Misiazek, M.D.; Brown Medical School (UO1 MH61590): Martin B. Keller, M. D.; Ivan Miller, M.D.; Gabor Keitner, M. D.; Susan Raffa, Ph.D.; Stanford University (UO1 MH61504): Alan Schatzberg, M.D.; Bruce Arnow, Ph.D.; Rachel Manber, Ph.D.; Brent Solvason, M.D., Ph.D.; NIMH collaborators: George Niederehe, Ph.D; Louise Ritz, M.B.A.; Elizabeth Zachariah, M.S.; Madhukar H. Trivedi, M. D. has been a consultant or served on speakers bureaus for Abbott Laboratories, Inc.; Abdi Brahim; Akzo (Organon Pharmaceuticals Inc.); AstraZeneca; Bristol-Myers Squibb Company; Cephalon, Inc.; Fabre-Kramer Pharmaceuticals, Inc. Forest Pharmaceuticals; GlaxoSmithKline; Janssen Pharmaceutica Products, LP; Johnson & Johnson PRD; Eli Lilly & Company; Meade Johnson; Neuronetics; Parke-Davis Pharmaceuticals, Inc.; Pfizer, Inc.; Sepracor; VantagePoint; and Wyeth-Ayerst Laboratories. He has received research support from the Agency for Healthcare Research and Quality; Corcept Therapeutics, Inc.; Cyberonics, Inc.; Merck; National Alliance for Research MedAvante, Inc., Neuronetics, Inc., Novartis, Organon Inc., Sepracor, Inc., Shire US, Inc., Transcept, and Wyeth Pharmaceuticals. Dr Thase has received honoraria for talks sponsored by: AstraZeneca, Bristol-Myers Squibb, Eli Lilly & Co., and Wyeth Pharmaceuticals. Dr Thase has received grants from Eli Lilly & Co., GlaxoSmithKline, and Sepracor. He has equity holdings in MedAvante, Inc and receives income from royalties from American Psychiatric Publishing, Inc., Guilford Publications and Herald House. NR 105 TC 4 Z9 4 U1 1 U2 5 PU MEDWORKS MEDIA GLOBAL, LLC PI HERMOS BEACH PA 670 FIFTH STREET, STE A, HERMOS BEACH, CA 90254 USA SN 0048-5764 J9 PSYCHOPHARMACOL BULL JI Psychopharmacol. Bull. PY 2008 VL 41 IS 4 BP 5 EP 33 PG 29 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA V15HJ UT WOS:000207792800001 PM 19015627 ER PT J AU Thase, ME AF Thase, Michael E. TI Are SNRIs More Effective than SSRIs? A Review of the Current State of the Controversy SO PSYCHOPHARMACOLOGY BULLETIN LA English DT Article DE depression; meta-analysis; antidepressants; SSRIs; SNRIs ID MAJOR DEPRESSIVE DISORDER; SEROTONIN REUPTAKE INHIBITORS; VENLAFAXINE EXTENDED-RELEASE; ANTIDEPRESSANT CLINICAL-TRIALS; DRUG-ADMINISTRATION DATABASE; DOSE-RESPONSE RELATIONSHIP; META-REGRESSION ANALYSIS; DOUBLE-BLIND; BIPOLAR DEPRESSION; REMISSION RATES AB The selective serotonin reuptake inhibitors (SSRI) are widely considered to be the first choice for antidepressant therapy. There is evidence from inpatient studies dating to 1986, however, suggesting that the tricyclic antidepressant clomipramine, which inhibits reuptake of both serotonin and norepinephrine, may have greater efficacy than some SSRIs for severe depression. There is controversy whether the newer, better tolerated, and safer serotonin norepinephrine reuptake inhibitors (SNRIs; venlafaxine, duloxetine, and-in some countries-milnacipran and desvenlafaxine) are more efficacious than SSRIs. In addressing this controversy, this article first focuses on the limitations of randomized controlled trials (RCTs), including the factors that limit their sensitivity to detect differences between active antidepressants, and meta-analysis to examine results of large sets of RCTs. Next, the results of RCTs and meta-analyses are reviewed. Although few individual studies report significant differences, meta-analyses consistently suggest that venlafaxine may have greater efficacy than the SSRIs as a class. The magnitude of this advantage is modest (i.e., differences in remission rates of 5-10%) and no advantage has been demonstrated versus escitalopram. The advantage for duloxetine versus selected SSRIs is limited to patients with more severe depression and the RCTs are flawed by use of minimum therapeutic doses of SSRIs. No evidence of an advantage is found in RCTs of milnacipran versus SSRIs. Even a modest difference in antidepressant efficacy-if sustained-may have important public health implications for the common, disabling condition of depression. Nevertheless, differences in tolerability and cost also must be considered when choosing therapies. Psychopharmacology Bulletin. 2008; 41(2): 58-85. C1 [Thase, Michael E.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Thase, Michael E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Thase, ME (reprint author), Univ Penn, Sch Med, 3535 Market St,Suite 670, Philadelphia, PA 19104 USA. EM thase@mail.med.upenn.edu NR 113 TC 30 Z9 32 U1 2 U2 11 PU MEDWORKS MEDIA GLOBAL, LLC PI HERMOS BEACH PA 670 FIFTH STREET, STE A, HERMOS BEACH, CA 90254 USA SN 0048-5764 J9 PSYCHOPHARMACOL BULL JI Psychopharmacol. Bull. PY 2008 VL 41 IS 2 BP 58 EP 85 PG 28 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA V15HG UT WOS:000207792500007 PM 18668017 ER PT J AU Jones, NP Siegle, GJ Muelly, ER Haggerty, A Ghinassi, F Thase, ME AF Jones, Neil P. Siegle, Greg J. Muelly, Emilie R. Haggerty, Agnes Ghinassi, Frank Thase, Michael E. TI Pupillary correlates of rumination during a frustrating serial working memory task in unipolar depression SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract CT 48th Annual Meeting of the Society-for-Psychophysiological-Research CY OCT 01-05, 2008 CL Austin, TX SP Soc Psychophysiol Res C1 [Jones, Neil P.; Siegle, Greg J.; Haggerty, Agnes; Ghinassi, Frank] Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA. [Jones, Neil P.; Siegle, Greg J.; Haggerty, Agnes; Ghinassi, Frank] Univ Pittsburgh, Pittsburgh, PA 15260 USA. [Muelly, Emilie R.] Penn State Univ, University Pk, PA 16802 USA. [Thase, Michael E.] Univ Penn, Philadelphia, PA 19104 USA. [Thase, Michael E.] Philadelphia Vet Affairs Med Ctr, Philadelphia, 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 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PY 2008 VL 45 SU 1 BP S80 EP S80 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 347LX UT WOS:000259144200332 ER PT J AU Kinder, LS Bradley, KA Katon, WJ Ludman, E McDonell, MB Bryson, CL AF Kinder, Leslie S. Bradley, Katharine A. Katon, Wayne J. Ludman, Evette McDonell, Mary B. Bryson, Chris L. TI Depression, posttraumatic stress disorder, and mortality SO PSYCHOSOMATIC MEDICINE LA English DT Article DE depression; posttraumatic stress disorder; mortality; veterans ID NATIONAL-COMORBIDITY-SURVEY; ALCOHOL-CONSUMPTION QUESTIONS; PRIMARY-CARE PATIENTS; MYOCARDIAL-INFARCTION; MAJOR DEPRESSION; COMMUNITY SAMPLE; VETERANS HEALTH; SCREENING-TEST; US VETERANS; EPIDEMIOLOGY AB Objective: To determine whether a history of depression and/or posttraumatic stress disorder (PTSD) is associated with all-cause mortality in primary care patients over an average of 2 years. Methods: Patients from seven Department of Veterans Affairs medical centers completed mailed questionnaires. Depression and PTSD status were determined from patient self-report of a prior diagnosis and/or electronic administrative data. Date of death was ascertained from Veterans Health Information Systems and Technology Architecture and the Department of Veterans Affairs' Beneficiary Identification and Records Locator System. Results: Among 35,715 primary care patients, those with a history of depression without a history of PTSD (n = 6876) were at increased risk of death over an average of 2 years compared with patients with neither depression nor PTSD after adjustment for demographic variables, health behaviors, and medical comorbidity (hazard ratio (HR) = 1.17; 95% Confidence Interval (CI) = 1.06-1.28). However, patients with a history of PTSD without a history of depression (n = 748) were not at increased risk of death compared with patients with neither depression nor PTSD (HR = 0.841; 95% CI = 0.63-1.13). Patients with a history of both (n = 3762) were at increased risk of death after adjustment for demographic factors, although not after additional adjustment for health behaviors and medical comorbidity (HR = 0.90; 95% CI = 0.78-1.04). Conclusions: In a large sample of veterans, a prior diagnosis of depression, but not PTSD, was associated with an increased risk of death over an average of 2 years after adjusting for age, demographic variables, health behaviors, and medical comorbidity. C1 [Kinder, Leslie S.; Bradley, Katharine A.; McDonell, Mary B.; Bryson, Chris L.] Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. [Kinder, Leslie S.; Bradley, Katharine A.] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. [Bradley, Katharine A.; Bryson, Chris L.] Univ Washington, Dept Med, Seattle, WA USA. [Katon, Wayne J.; Ludman, Evette] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Ludman, Evette] Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. [Bradley, Katharine A.] VA Ctr Excellence Substance Abuse Treatment & Edu, Seattle, WA USA. [Bradley, Katharine A.] VA Med Ctr, Primary & Specialty Med Care, Seattle, WA USA. RP Kinder, LS (reprint author), 8506 SE 72nd St, Mercer Isl, WA 98040 USA. EM lskinder@stanfordalumni.org NR 33 TC 25 Z9 25 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0033-3174 J9 PSYCHOSOM MED JI Psychosom. Med. PD JAN PY 2008 VL 70 IS 1 BP 20 EP 26 DI 10.1097/PSY.0b013e31815aac93 PG 7 WC Psychiatry; Psychology; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 253GM UT WOS:000252506700004 PM 17991816 ER PT J AU Weisbord, SD AF Weisbord, Steven D. TI Iodinated contrast media and the kidney SO REVIEWS IN CARDIOVASCULAR MEDICINE LA English DT Article DE contrast-induced acute kidney injury; lodinated contrast; Osmolality ID HIGH-RISK PATIENTS; INDUCED NEPHROPATHY; RAT-KIDNEY; RENAL-INSUFFICIENCY; DOUBLE-BLIND; RADIOCONTRAST AGENTS; CORONARY-ANGIOGRAPHY; BLOOD-FLOW; IODIXANOL; TRIAL AB One of the principal complications of radiographic procedures utilizing intravascular iodinated contrast media is acute kidney injury. Although several clinical and procedural factors impact a patient's risk for contrast-induced acute kidney injury (CIAKI), substantial attention has been focused on the relationship between the type of contrast agent used and renal injury. Multiple contrast agents are available for clinical use, each defined by a series of physicochemical properties. The evolution from high osmolal to low osmolal and, more recently, iso-osmolal contrast media has led to several clinical trials and meta-analyses comparing the nephrotoxicity of different contrast agents. This article summarizes the physicochemical properties that define and differentiate iodinated contrast media, discusses the purported relationship between these properties and kidney injury, and describes the salient findings of clinical trials and meta-analyses that have compared the nephrotoxic effects of contrast agents. Although ongoing and future studies will further elucidate our understanding of the relationship between iodinated contrast and risk for CIAKI, a sound understanding of the currently available data will help inform evidence-based decisions on the use of these agents in clinical practice. C1 [Weisbord, Steven D.] VA Pittsburgh Healthcare, Renal Sect, Pittsburgh, PA USA. [Weisbord, Steven D.] VA Pittsburgh Healthcare, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. [Weisbord, Steven D.] Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare, Renal Sect, Pittsburgh, PA USA. NR 28 TC 6 Z9 7 U1 0 U2 0 PU MEDREVIEWS PI NEW YORK PA 1333 BROADWAY, STE 400, NEW YORK, NY 10018 USA SN 1530-6550 J9 REV CARDIOVASC MED JI Rev. Cardiovasc. Med. PY 2008 VL 9 SU 1 BP S14 EP S23 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 283CS UT WOS:000254614800003 PM 18418313 ER PT J AU Bradberry, CW AF Bradberry, Charles W. TI Comparison of acute and chronic neurochemical effects of cocaine and cocaine cues in rhesus monkeys and rodents: Focus on striatal and cortical dopamine systems SO REVIEWS IN THE NEUROSCIENCES LA English DT Article; Proceedings Paper CT Satellite Meeting on Primate Models for Psychiatric Disorder held at the 16th International Behavioral Neuroscience Meeting CY JUN, 2007 CL Joao Pressoa, BRAZIL DE cocaine; rhesus monkey; rodent; extracellular dopamine; nucleus accumbens; cortex ID CORTICOTROPIN-RELEASING-FACTOR; SELF-ADMINISTERED COCAINE; NUCLEUS-ACCUMBENS DOPAMINE; MEDIAL PREFRONTAL CORTEX; HUMAN CEREBRAL-CORTEX; EXTRACELLULAR DOPAMINE; SEEKING BEHAVIOR; INTRAVENOUS COCAINE; NONHUMAN PRIMATE; DORSAL STRIATUM AB Preclinical work into the effects of cocaine on mesostriatal and mesocorticolimbic dopamine systems has rightly been dominated by studies in rodent models. From the wealth of data that has resulted from those studies, models of chronic neurobiological adaptations have been developed that might illuminate the cellular and systems bases for the compulsive and self-injurious aspects of addiction. Chronic adaptations of dopaminergic mechanisms often dominate these models. Our studies into the acute and chronic dopaminergic effects of cocaine in non-human primates are compared to important aspects of the larger rodent literature. In some ways there is good concordance, but in others the non-human primate results differ in ways that are more similar to the human literature. This is especially true in regard to sensitization of dopamine systems in response to chronic self-administration. To best evaluate potential models of addiction, it will be important to also consider data from non-human primates as a more proximal animal model to the human condition, particularly in the greater complexity of cortical development. C1 [Bradberry, Charles W.] Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15203 USA. [Bradberry, Charles W.] Univ Pittsburgh, Dept Neurosci, Pittsburgh, PA 15203 USA. [Bradberry, Charles W.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Bradberry, CW (reprint author), Univ Pittsburgh, Dept Psychiat, 3025 E Carson St, Pittsburgh, PA 15203 USA. EM bradberrycw@upmc.edu RI bradberry, charles/M-2082-2015 OI bradberry, charles/0000-0003-2630-4144 FU PHS HHS [10331] NR 100 TC 14 Z9 14 U1 1 U2 3 PU FREUND & PETTMAN PUBLISHERS PI EAST YORKSHIRE PA ENHOLMES HALL, PATRINGTON, EAST YORKSHIRE HU12 OPR, ENGLAND SN 0334-1763 J9 REV NEUROSCIENCE JI Rev. Neurosci. PY 2008 VL 19 IS 2-3 BP 113 EP 128 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 334RX UT WOS:000258240000005 PM 18751519 ER PT J AU Offner, H Sinha, S Wang, CH Burrows, GG Vandenbark, AA AF Offner, Halina Sinha, Sushmita Wang, Chunhe Burrows, Gregory G. Vandenbark, Arthur A. TI Recombinant T Cell Receptor Ligands: Immunomodulatory, Neuroprotective and Neuroregenerative Effects Suggest Application as Therapy for Multiple Sclerosis SO REVIEWS IN THE NEUROSCIENCES LA English DT Article DE RTL; experimental autoimmune encephalomyelitis; multiple sclerosis; neuroprotection; immunomodulation ID EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS; MHC CLASS-II; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; STRUCTURAL BASIS; TRANSGENIC MICE; PEPTIDE LIGANDS; BINDING-SITE; MYELIN; TCR; ANTIGEN AB Recombinant T cell receptor (TCR) ligands (RTL) represent the minimal interactive surface with antigen-specific T cell receptors. These novel constructs fold similarly to native four-domain NIHC/peptide complexes but deliver suboptimal and qualitatively different signals that cause a 'cytokine switch' to anti-inflammatory factors in targeted encephalitogenic T cells. RTL treatment can reverse clinical and histological signs of experimental autoimmune encephalomyelitis (EAE) and most dramatically can promote myelin and axonal recovery in the CNS of mice with chronic disease. These properties of RTL suggest that this novel antigen-specific approach may hold unusual promise as a therapy for multiple sclerosis. C1 [Offner, Halina; Sinha, Sushmita; Wang, Chunhe; Vandenbark, Arthur A.] VA Med Ctr, Portland, OR USA. [Offner, Halina; Sinha, Sushmita; Wang, Chunhe; Burrows, Gregory G.; Vandenbark, Arthur A.] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. [Offner, Halina] Oregon Hlth & Sci Univ, Dept Anesthesiol & Perioperat Med, Portland, OR 97239 USA. [Vandenbark, Arthur A.] Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97239 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D31, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU National Multiple Sclerosis Society [RG3794A, RG3468]; NIH [NS47661, A143960, NS41965, NS46877]; The Nancy Davis MS Center; Biomedical Laboratory RD Service; Department of Veterans Affairs FX This work was supported by the National Multiple Sclerosis Society Grants RG3794A and RG3468, NIH Grants NS47661, A143960, NS41965, and NS46877, The Nancy Davis MS Center Without Walls, and the Biomedical Laboratory R&D Service, Department of Veterans Affairs. NR 52 TC 12 Z9 13 U1 0 U2 1 PU FREUND & PETTMAN PUBLISHERS PI EAST YORKSHIRE PA ENHOLMES HALL, PATRINGTON, EAST YORKSHIRE HU12 OPR, ENGLAND SN 0334-1763 J9 REV NEUROSCIENCE JI Rev. Neurosci. PY 2008 VL 19 IS 4-5 BP 327 EP 339 PG 13 WC Neurosciences SC Neurosciences & Neurology GA 380OV UT WOS:000261475900006 PM 19145988 ER PT J AU Matsuda, K Yamauchi, K Matsumoto, T Sano, K Yamaoka, Y Ota, H AF Matsuda, Kazuyuki Yamauchi, Kazuyoshi Matsumoto, Takehisa Sano, Kenji Yamaoka, Yoshio Ota, Hiroyoshi TI Quantitative analysis of the effect of Helicobacter pylori on the expressions of SOX2, CDX2, MUC2, MUC5AC, MUC6, TFF1, TFF2, and TFF3 mRNAs in human gastric carcinoma cells SO SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY LA English DT Article DE CDX2; Helicobacter pylori; MUC; PDX1; real-time PCR; TFF ID HOMEODOMAIN PROTEIN CDX2; EPITHELIAL-CELLS; GENE-EXPRESSION; INTESTINAL METAPLASIA; TREFOIL FACTOR; ABERRANT EXPRESSION; ECTOPIC EXPRESSION; MUCOUS LAYER; CAGA PROTEIN; IV SECRETION AB Objective. To investigate the phenotypic characters of carcinoma cells and the response of gastric epithelial cells to Helicobacter pylori (H. pylori) infection using the gastric carcinoma cell lines. Material and methods. Real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to assess the effect of H. pylori infection on mRNA levels of transcription factors (SOX2 and CDX2), mucin core proteins (MUC2, MUC5AC, and MUC6), and trefoil factor family peptides (TFF) (TFF1, TFF2, and TFF3) in gastric carcinoma cells (AGS, MKN45, and KATO III cells). H. pylori ATCC 43504 and its isogenic cag pathogenicity island (PAI) deleted mutant were used. Results. These cell lines expressed mixed gastric and intestinal phenotypes. The intestinal phenotype predominated in AGS cells and gastric phenotypes in MKN45 and KATO III cells. In all three cell lines, H. pylori infection inhibited SOX2 mRNA expression, but induced the three TFFs mRNAs. In AGS cells, H. pylori induced cag PAI-dependent mRNA expression of CDX2, MUC2, MUC5AC, and MUC6. mRNA expressions of CDX2, MUC5AC, and MUC6 were inhibited in KATO III cells, whereas MUC2 mRNA expression was unchanged. In MKN45 cells, H. pylori induced the three MUCs mRNAs but inhibited CDX2 mRNA expression. Conclusions. This study provides a useful platform for selecting appropriate cell lines to model H. pylori-related changes in the gastric epithelium that mirror the changes seen in vivo. The outcome of H. pylori infection may reflect changes in the mucus gel layer caused by altered expression of mucins and TFF peptides. C1 [Ota, Hiroyoshi] Shinshu Univ, Sch Med, Dept Biomed Lab Sci, Sch Hlth Sci, Matsumoto, Nagano 3908621, Japan. [Matsuda, Kazuyuki; Yamauchi, Kazuyoshi; Matsumoto, Takehisa; Sano, Kenji] Shinshu Univ Hosp, Dept Lab Med, Matsumoto, Nagano, Japan. [Yamaoka, Yoshio] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX 77030 USA. RP Ota, H (reprint author), Shinshu Univ, Sch Med, Dept Biomed Lab Sci, Sch Hlth Sci, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan. EM hohta@shinshu-u.ac.jp FU NIDDK NIH HHS [DK62813, R01 DK062813, R01 DK062813-03] NR 47 TC 19 Z9 21 U1 0 U2 4 PU TAYLOR & FRANCIS AS PI OSLO PA PO BOX 12 POSTHUSET, NO-0051 OSLO, NORWAY SN 0036-5521 J9 SCAND J GASTROENTERO JI Scand. J. Gastroenterol. PY 2008 VL 43 IS 1 BP 25 EP 33 DI 10.1080/00365520701579795 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 244CF UT WOS:000251842900004 PM 18938748 ER PT J AU Becher, A El-Serag, HB AF Becher, Anja El-Serag, Hashem B. TI Mortality associated with gastroesophageal reflux disease and its non-malignant complications: a systematic review SO SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY LA English DT Review DE GERD; epidemiology; esophagus ID AORTOESOPHAGEAL FISTULA SECONDARY; NATURAL-HISTORY; TEMPORAL TRENDS; TIME TRENDS; FOLLOW-UP; EPIDEMIOLOGY; ESOPHAGITIS; POPULATION; GERD; PREVALENCE AB Objective. The mortality associated with malignant complications of gastroesophageal reflux disease (GERD) is well recognized. The aim of this systematic review was to assess the less well-examined mortality associated with GERD and its non-malignant complications, including esophageal erosions, ulcers, bleeding, perforation and strictures. Material and methods. Studies reporting mortality in GERD and its non-malignant complications were identified via systematic PubMed searches, and previously unpublished population mortality statistics from public access databases. Results. Three countries were examined (USA, UK, Finland). Cohort studies (n=3) in the UK showed a 1.16- to 1.6-fold increase in risk of death in individuals with GERD compared with the general population, the majority of deaths being due to cardiac disease. Population data indicate that GERD and its likely esophageal complications were the cause of death in 685 and 521 cases, respectively, in the USA (year: 2003) (age-adjusted mortality: 2.3/million and 1.8/million, respectively), and in 36 and 349 cases, respectively, in England and Wales (2004) (0.6/million and 5.4/million, respectively). In Finland (2000), GERD-related mortality was 4.6/million. Mortality from GERD and its likely esophageal complications increased with age, and was between 1.2-fold and 1.8-fold higher in men than in women. Cohort studies in the USA are inconsistent on mortality risk associated with surgical therapy. Time-trend data suggest that mortality from GERD and its non-malignant complications has been increasing. Conclusions. Data from Europe and the USA show that GERD and its non-malignant complications can on rare occasions cause death. C1 [Becher, Anja] Oxford PharmaGenesis Ltd, Res Evaluat Unit, Oxford, England. [El-Serag, Hashem B.] Baylor Coll Med, Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. [El-Serag, Hashem B.] Baylor Coll Med, Houston Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. [El-Serag, Hashem B.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Sect Gastroenterol & Hlth Serv Res, 2002 Holcombe Blvd,152, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 29 TC 6 Z9 6 U1 0 U2 1 PU TAYLOR & FRANCIS AS PI OSLO PA PO BOX 12 POSTHUSET, NO-0051 OSLO, NORWAY SN 0036-5521 J9 SCAND J GASTROENTERO JI Scand. J. Gastroenterol. PY 2008 VL 43 IS 6 BP 645 EP 653 DI 10.1080/00365520701785475 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 317NY UT WOS:000257028100002 PM 18569980 ER PT J AU Toracchio, S El-Zimaity, HMT Urmacher, C Katz, S Graham, DY AF Toracchio, Sonia El-Zimaity, Hala M. T. Urmacher, Carlos Katz, Seymour Graham, David Y. TI Mycobacterium avium subspecies paratuberculosis and Crohn's disease granulomas SO SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY LA English DT Article DE Crohn's disease; granuloma; IS900; Mycobacterium paratuberculosis; paraffin embedded ID INFLAMMATORY-BOWEL-DISEASE; POLYMERASE-CHAIN-REACTION; TISSUES; ABSENCE; DNA; INDIVIDUALS AB Objective. Chronic infection with Mycobacterium avium subspecies paratuberculosis (M. paratuberculosis) has been proposed as a cause of Crohn's disease. Although numerous investigators have examined the link between M. paratuberculosis and Crohn's disease, the evidence remains controversial. The aim of this study was to examine intestinal granuloma from Crohn's patients for M. paratuberculosis using a semi-nested M. paratuberculosis-specific IS900 polymerase chain reaction (PCR). Material and methods. Paraffin-embedded ileal or colonic tissues of patients with Crohn's disease were analyzed. Microdissection of this tissue into granulomas and not granulomas was performed. On the basis of sequences reported in GenBank alignments, we designed primer sets specific for M. paratuberculosis. The presence of the M. paratuberculosis was examined by semi-nested IS900-specific PCR with human -actin gene as a control for DNA quality. Results. Biopsies from 20 Crohn's patients were examined. Human -actin gene was amplified in all samples. M. paratuberculosis DNA was detected in the microdissected granuloma in 1 (5%) patient with Crohn's disease and in none of the not granuloma tissues. Conclusions. M. paratuberculosis DNA can rarely be detected within Crohn's granuloma. These results do not support M. paratuberculosis as the primary etiology of Crohn's disease. C1 [Toracchio, Sonia; El-Zimaity, Hala M. T.; Graham, David Y.] Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX USA. [Toracchio, Sonia; El-Zimaity, Hala M. T.; Graham, David Y.] Baylor Coll Med, Houston, TX 77030 USA. [Toracchio, Sonia] Univ G dAnnunzio, Sect Mol Pathol, Dept Oncol & Neurosci, Chieti, Italy. [Toracchio, Sonia] G dAnnunzio Fdn, Ctr Excellence Aging, Chieti, Italy. [Urmacher, Carlos] CBLPath Inc, New York, NY USA. [Katz, Seymour] NYU, Sch Med, N Shore Univ Hosp Long Isl Jewish Syst, New York, NY USA. RP Graham, DY (reprint author), VA Med Ctr, 111-D,2002 Holcombe Blvd,RM 3A320, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu OI katz, seymour/0000-0002-3492-9200 FU Fondazione Italiana per la Ricerca sul Cancro (FIRC), Milan, Italy; Associazione Italiana per la Ricerca sul Cancro FX Sonia Toracchio was supported by a fellowship from Fondazione Italiana per la Ricerca sul Cancro (FIRC), Milan, Italy. NR 27 TC 10 Z9 10 U1 0 U2 1 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 0036-5521 J9 SCAND J GASTROENTERO JI Scand. J. Gastroenterol. PY 2008 VL 43 IS 9 BP 1108 EP 1111 DI 10.1080/00365520802116455 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 339PM UT WOS:000258589500013 PM 18609156 ER PT J AU Essa, AS Nouh, MAE Ghaniam, NM Graham, DY Sabry, HS AF Essa, Abdallah Said Nouh, Mohammed Alaa Eldeen Ghaniam, Naglaa Mohammed Graham, David Y. Sabry, Hany Said TI Prevalence of cagA in relation to clinical presentation of Helicobacter pylori infection in Egypt SO SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PEPTIC-ULCER DISEASE; CYTOTOXIN PRODUCTION; DYSPEPTIC PATIENTS; VACA GENOTYPES; ANTIBODIES; GASTRITIS; GENES; RISK AB Helicobacter pylori infection, peptic ulcer and gastric cancer are common problems in Egypt. We investigated the prevalence of cagA-positive Helicobacter pylori infections among Egyptian adults in relation to presentation (e.g. dyspepsia vs asymptomatic controls) in Minofyia, Egypt. Patients included men or women seeking care for at least 3 months of upper gastrointestinal symptoms. Helicobacter pylori status was determined by rapid urease test and gastric histopathology in patients and by anti-Helicobacter pylori IgG antibodies in controls. CagA status was determined using an anti-cag A ELISA. 99 Helicobacter pylori infected patients were entered including 90 dyspeptic patients (30 each with gastric cancer, peptic ulcer, and non-ulcer dyspepsia) and 9 non-dyspeptic healthy controls. Age ranged from 27 to 78 y (mean 49.5 y); 50% were men. Anti-cagA antibodies were present in 62.2% of dyspeptic patients compared with 11% of asymptomatic controls (p=0.004). Anti-cagA antibodies were more prevalent among dyspeptic patients with gastric cancer or peptic ulcer (73.3%) compared to those with non-ulcer dyspepsia (40%) (p=0.004). The prevalence of cagA in Egypt was related to the clinical presentation of Helicobacter pylori infection being lowest in asymptomatic controls (11.1%) and increasingly prevalent in non-ulcer dyspepsia (40%), peptic ulcer (66.7%), and gastric cancer (89%). C1 Minofyia Univ, Dept Trop Med, Minofyia, Egypt. Minofyia Univ, Dept Biochem, Minofyia, Egypt. Michael E DeBakey VA Med Ctr, Dept Med, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), Vet Affairs Med Ctr 111D, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu NR 24 TC 6 Z9 7 U1 0 U2 0 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 0036-5548 J9 SCAND J INFECT DIS JI Scand. J. Infect. Dis. PY 2008 VL 40 IS 9 BP 730 EP 733 DI 10.1080/00365540802023725 PG 4 WC Infectious Diseases SC Infectious Diseases GA 340CN UT WOS:000258623800007 ER PT J AU Byne, W Dracheva, S Chin, B Schmeidler, JM Davis, KL Haroutunian, V AF Byne, William Dracheva, Stella Chin, Benjamin Schmeidler, James M. Davis, Kenneth L. Haroutunian, Vahram TI Schizophrenia and sex associated differences in the expression of neuronal and oligodendrocyte-specific genes in individual thalamic nuclei SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; thalamus; neurons; oligodendrocytes; gene expression ID MESSENGER-RNA EXPRESSION; NEVER-MEDICATED PATIENTS; PREFRONTAL CORTEX; MEDIODORSAL NUCLEUS; BIPOLAR DISORDER; ELDERLY-PATIENTS; PROTEIN EXPRESSION; MAJOR DEPRESSION; BINDING PROTEINS; POSTMORTEM AB Considerable evidence based on the study of postmortem brain tissue suggests deficits in both neuronal and myelin systems in schizophrenia (SZ), To date, the majority of the biochemical and molecular biological studies have focused on the cerebral cortex. Most information traveling to or from the cortex is relayed or synaptically gated through the thalamus, and numerous studies suggest structural and functional abnormalities in interconnected regions of the thalamus and cortex in SZ. The present study extends our gene expression studies of neuronal and myelin systems to the thalamus. Quantitative PCR was employed to assess the expression of 10 genes in 5 divisions of the thalamus which were precisely harvested using Laser Capture Microdissection. The divisions studied were present on coronal sections at the level of the centromedian nucleus (CMN) taken from 14 schizophrenic and 16 normal control postmortem brains. The genes examined were specific for oligodendrocytes (MAG, CNP MBP), neurons (ENO2), glutamatergic, neurons (VGlut1, VGlut2, PV, CB) or GABAergic neurons (GAD65, GAD67). Expression levels for each of these markers were quantitated and compared between diagnoses, between sexes, and across nuclei. CB was much more highly expressed in the CMN in SZs compared to NCs. No other diagnosis related differences in gene expression were observed. The expression levels of CNP and MAG, but not MBP, were highly correlated with one another and both, but not MBP, were much more highly expressed in females than in males in all thalamic divisions examined. All markers were differentially expressed across nuclei. Published by Elsevier B.V. C1 [Byne, William; Dracheva, Stella; Chin, Benjamin; Haroutunian, Vahram] Bronx Vet Affairs Med Ctr, Bronx, NY 10468 USA. [Byne, William; Dracheva, Stella; Schmeidler, James M.; Davis, Kenneth L.; Haroutunian, Vahram] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP Haroutunian, V (reprint author), Bronx Vet Affairs Med Ctr, Psychiat Res 3F-02,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Vahram.Haroutunian@mssm.edu FU NIMH NIH HHS [MH066392, MH064673, P50 MH066392, P50 MH066392-05A19004, R01 MH064673, R01 MH064673-06] NR 65 TC 27 Z9 25 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 JAN PY 2008 VL 98 IS 1-3 BP 118 EP 128 DI 10.1016/j.schres.2007.09.034 PG 11 WC Psychiatry SC Psychiatry GA 253BQ UT WOS:000252494100015 PM 18029146 ER PT J AU Li, YH Liu, YJ Zhang, J Xiao, GZ Vodovotz, Y Billiar, T Wilson, M Fan, J AF Li, Yuehua Liu, Yujian Zhang, Jian Xiao, Guozhi Vodovotz, Yoram Billiar, Timothy Wilson, Mark Fan, Jie TI Role of TLR2 signaling in hemorrhagic shock-primed IL-1 beta processing SO SHOCK LA English DT Meeting Abstract CT 6th Congress of the International-Federation-of-Shock-Societies/31st Annual Conference of the Shock-Society CY JUN 28-JUL 02, 2008 CL Cologne, GERMANY SP Int Federat Shock Soc, Shock Soc C1 [Wilson, Mark; Fan, Jie] Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15213 USA. [Vodovotz, Yoram; Billiar, Timothy; Wilson, Mark; Fan, Jie] Univ Pittsburgh, Dept Surg, Pittsburgh, PA 15213 USA. [Zhang, Jian; Xiao, Guozhi] Univ Pittsburgh, Dept Med, Pittsburgh, PA 15213 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1073-2322 J9 SHOCK JI Shock PY 2008 VL 29 SU 1 MA P195 BP 66 EP 67 PG 2 WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System & Cardiology GA 308SE UT WOS:000256409500214 ER PT J AU Morgenthaler, TI Aurora, N Brown, T Zak, R Alessi, C Boehlecke, B Chesson, AL Friedman, L Kapur, V Maganti, R Owens, J Pancer, J Swick, TJ AF Morgenthaler, Timothy I. Aurora, Nisha Brown, Terry Zak, Rochelle Alessi, Cathy Boehlecke, Brian Chesson, Andrew L., Jr. Friedman, Leah Kapur, Vishesh Maganti, Rama Owens, Judith Pancer, Jeffrey Swick, Todd J. CA Standards Practice Comm AASM TI Practice parameters for the use of autotitrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome: An update for 2007 SO SLEEP LA English DT Article DE obstructive sleep apnea; continuous positive airway pressure; CPAP; sleep disordered breathing; autotitrating; APAP ID AUTOMATIC CPAP TITRATION; NASAL CPAP; APNEA/HYPOPNEA SYNDROME; BREATHING DISORDERS; HYPOPNEA SYNDROME; AUTO-CPAP; HOME; THERAPY; TRIAL; POLYSOMNOGRAPHY AB These practice parameters are an update of the previously published recommendations regarding the use of autotitrating positive airway pressure (APAP) devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. Continuous positive airway pressure (CPAP) at an effective setting verified by attended polysomnography is a standard treatment for obstructive sleep apnea (OSA). APAP devices change the treatment pressure based on feedback from various patient measures such as airflow, pressure fluctuations, or measures of airway resistance. These devices may aid in the pressure titration process, address possible changes in pressure requirements throughout a given night and from night to night, aid in treatment of OSA when attended CPAP titration has not or cannot be accomplished, or improve patient comfort. A task force of the Standards of Practice Committee of the American Academy of Sleep Medicine has reviewed the literature published since the 2002 practice parameter on the use of APAP. Current recommendations follow: (1) APAP devices are not recommended to diagnose OSA; (2) patients with congestive heart failure, patients with significant lung disease such as chronic obstructive pulmonary disease; patients expected to have nocturnal arterial oxyhemoglobin desaturation due to conditions other than OSA (e.g., obesity hypoventilation syndrome); patients who do not snore (either naturally or as a result of palate surgery); and patients who have central sleep apnea syndromes are not currently candidates for APAP titration or treatment; (3) APAP devices are not currently recommended for splitnight titration; (4) certain APAP devices may be used during attended titration with polysomnography to identify a single pressure for use with standard CPAP for treatment of moderate to severe OSA; (5) certain APAP devices may be initiated and used in the self-adjusting mode for unattended treatment of patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (6) certain APAP devices may be used in an unattended way to determine a fixed CPAP treatment pressure for patients with moderate to severe OSA without significant comorbidities (CHF, COPD, central sleep apnea syndromes, or hypoventilation syndromes); (7) patients being treated with fixed CPAP on the basis of APAP titration or being treated with APAP must have close clinical follow-up to determine treatment effectiveness and safety; and (8) a reevaluation and, if necessary, a standard attended CPAP titration should be performed if symptoms do not resolve or the APAP treatment otherwise appears to lack efficacy. C1 [Aurora, Nisha; Zak, Rochelle] Mt Sinai Med Ctr, New York, NY 10029 USA. [Brown, Terry] St Joseph Mem Hosp, Murphysboro, IL USA. [Alessi, Cathy] VA Greater Los Angeles Healthcare Syst Sepulveda, Los Angeles, CA USA. [Boehlecke, Brian] Univ N Carolina, Chapel Hill, NC USA. [Chesson, Andrew L., Jr.] Louisiana State Univ, Shreveport, LA 71105 USA. [Friedman, Leah] Stanford Univ, Stanford, CA 94305 USA. [Kapur, Vishesh] Univ Washington, Seattle, WA 98195 USA. [Maganti, Rama] Barrow Neurol Inst, Phoenix, AZ 85013 USA. [Owens, Judith] Rhode Isl Hosp, Providence, RI 02903 USA. [Swick, Todd J.] Houston Sleep Ctr, Houston, TX USA. [Morgenthaler, Timothy I.] Mayo Clin, Rochester, MN 55905 USA. RP Morgenthaler, TI (reprint author), Mayo Clin, Rochester, MN 55905 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 40 TC 95 Z9 99 U1 1 U2 1 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 JAN 1 PY 2008 VL 31 IS 1 BP 141 EP 147 PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 249XN UT WOS:000252264000018 PM 18220088 ER PT J AU Atwood, CW Shalaby, A Selzer, F Strollo, PJ Goresan, J Hickey, K AF Atwood, C. W. Shalaby, A. Selzer, F. Strollo, P. J. Goresan, J. Hickey, K. TI Periodic breathing in wakefulness is associated with severe sleep APNEA in heart failure patients who are candidates for cardiac resynchronization therapy SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Atwood, C. W.] VA Pittsburgh Healthcare Syst, Pulm Unit, Pittsburgh, PA USA. [Atwood, C. W.; Strollo, P. J.] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. [Shalaby, A.; Hickey, K.] VA Pittsburgh Healthcare Syst, Cardiol Sect, Pittsburgh, PA USA. [Shalaby, A.; Goresan, J.] Univ Pittsburgh, Med Ctr, Cardiovasc Inst, Pittsburgh, PA USA. [Selzer, F.] Univ Pittsburgh, Sch Publ Hlth, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2008 VL 31 SU S MA 0922 BP A303 EP A303 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001351 ER PT J AU Barilla, HE Cook, J Gehrman, P Ross, R AF Barilla, H. E. Cook, J. Gehrman, P. Ross, R. TI Changes in content of combat-related nightmares in Vietnam veterans with PTSD receiving Imagery Rehearsal therapy SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD SP Amer Acad Sleep Med, Sleep Res Soc C1 [Barilla, H. E.; Gehrman, P.] Univ Sci Philadelphia, Dept Psychol, Philadelphia, PA USA. [Cook, J.; Ross, R.] Philadelphia VA Med Ctr, Mental Hlth Clin, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 1 U2 3 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 PY 2008 VL 31 SU S MA 1156 BP A381 EP A381 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001585 ER PT J AU Berka, C Johnson, R Morgan, T Levendowski, D Westbrook, P Olmstead, R Davis, G Leathers, R Whitmoyer, M AF Berka, C. Johnson, R. Morgan, T. Levendowski, D. Westbrook, P. Olmstead, R. Davis, G. Leathers, R. Whitmoyer, M. TI Influence of sleep-disordered breathing on neurocognitive functions pre- and post-treatment with oral appliance therapy SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD SP Amer Acad Sleep Med, Sleep Res Soc C1 [Berka, C.; Johnson, R.; Levendowski, D.; Westbrook, P.; Davis, G.; Leathers, R.; Whitmoyer, M.] Adv Brain Monitoring, Carlsbad, CA USA. [Morgan, T.] Scripps Mem Hosp, Encinitas, CA USA. [Olmstead, R.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 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 PY 2008 VL 31 SU S MA 457 BP A152 EP A153 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000457 ER PT J AU Dzierzewski, JM McCrae, CS Rowe, M Marsiske, M McCoy, K McNamara, J Dautovich, N AF Dzierzewski, J. M. McCrae, C. S. Rowe, M. Marsiske, M. McCoy, K. McNamara, J. Dautovich, N. TI Nightly sleep patterns in older adults: Night-to-night fluctuations in the sleep of older good-noncomplaining, good-complaining, poor-noncomplaining, poor-complaining/insomnia, and caregivers SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Dzierzewski, J. M.; McCrae, C. S.; Rowe, M.; Marsiske, M.; McNamara, J.; Dautovich, N.] Univ Florida, Gainesville, FL USA. [McCoy, K.] Vet Adm, San Antonio, TX USA. NR 0 TC 2 Z9 2 U1 0 U2 1 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 PY 2008 VL 31 SU S MA 315 BP A104 EP A104 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000315 ER PT J AU King, C Popovic, D Levendowski, DJ Guerrero, M Olmstead, R Andrada, T Velimirovic, V Yan, N Zavora, T Westbrook, P AF King, C. Popovic, D. Levendowski, D. J. Guerrero, M. Olmstead, R. Andrada, T. Velimirovic, V. Yan, N. Zavora, T. Westbrook, P. TI Validation of changes in forehead venous pressure as a measure of respiratory effort SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [King, C.; Guerrero, M.; Andrada, T.] Walter Reed Army Med Ctr, Washington, DC 20307 USA. [Popovic, D.; Levendowski, D. J.; Velimirovic, V.; Yan, N.; Zavora, T.; Westbrook, P.] Adv Brain Monitoring Inc, Carlsbad, CA USA. [Olmstead, R.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2008 VL 31 SU S MA 1006 BP A332 EP A332 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001435 ER PT J AU Kumar, S Alam, M Rai, S McGinty, D Szymusiak, R AF Kumar, S. Alam, M. Rai, S. McGinty, D. Szymusiak, R. TI Microdialysis perfusion of eszopiclone into the rat perifornical-lateral hypothalamus suppresses waking c-Fos expression in hypocretin neurons SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Kumar, S.; Alam, M.; Rai, S.; McGinty, D.; Szymusiak, R.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Alam, M.; McGinty, D.; Szymusiak, R.] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2008 VL 31 SU S MA 66 BP A21 EP A21 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000067 ER PT J AU Lyamin, O Kosenko, P Lapierre, J Pryaslova, J Vyssotski, A Lipp, H Siegel, J Mukhametov, L AF Lyamin, O. Kosenko, P. Lapierre, J. Pryaslova, J. Vyssotski, A. Lipp, H. Siegel, J. Mukhametov, L. TI Study of sleep in a walrus SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Lyamin, O.; Lapierre, J.; Siegel, J.] Univ Calif Los Angeles, Dept Psychiat, North Hills, CA USA. [Lyamin, O.; Lapierre, J.; Siegel, J.] Univ Calif Los Angeles, VA GLAHS Sepulveda, North Hills, CA USA. [Lyamin, O.; Kosenko, P.; Pryaslova, J.; Mukhametov, L.] Utrish Dolphinarium Ltd, Moscow, Russia. [Vyssotski, A.; Lipp, H.] Univ Zurich, Inst Anat, Zurich, Switzerland. NR 0 TC 2 Z9 2 U1 2 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 PY 2008 VL 31 SU S MA 73 BP A24 EP A25 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000074 ER PT J AU Martin, J Josephson, KR Khan-Hudson, A Harker, JO Alessi, CA AF Martin, J. Josephson, K. R. Khan-Hudson, A. Harker, J. O. Alessi, C. A. TI Self-reported sleep quality predicts mortality within one year of post-acute rehabilitation among older people SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Martin, J.; Alessi, C. A.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. [Josephson, K. R.; Khan-Hudson, A.; Harker, J. O.; Alessi, C. A.] VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, North Hills, CA USA. NR 0 TC 0 Z9 0 U1 0 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 PY 2008 VL 31 SU S MA 292 BP A96 EP A96 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000292 ER PT J AU Peterfi, Z McGinty, D Szymusiak, R AF Peterfi, Z. McGinty, D. Szymusiak, R. TI Growth hormone releasing hormone (GHRH) activates GABAergic neurons in the rat preoptic hypothalamus SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Peterfi, Z.; McGinty, D.; Szymusiak, R.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Peterfi, Z.; McGinty, D.; Szymusiak, R.] Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 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 PY 2008 VL 31 SU S MA 67 BP A21 EP A22 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000068 ER PT J AU Platt, A Field, SH Gupta, R Chen, Z Roche, D Patel, NP Gurubhagavatula, I Christie, JD Asch, DA Kuna, ST AF Platt, A. Field, S. H. Gupta, R. Chen, Z. Roche, D. Patel, N. P. Gurubhagavatula, I Christie, J. D. Asch, D. A. Kuna, S. T. TI Neighborhood socioeconomic factors predict initial CPAP adherence better than disease or patient-level characteristics SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Platt, A.; Field, S. H.; Patel, N. P.; Gurubhagavatula, I; Christie, J. D.; Asch, D. A.; Kuna, S. T.] Univ Penn, Dept Med, Philadelphia, PA 19104 USA. [Platt, A.; Chen, Z.; Patel, N. P.; Christie, J. D.; Asch, D. A.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Platt, A.; Field, S. H.; Gupta, R.; Roche, D.; Asch, D. A.; Kuna, S. T.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 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 PY 2008 VL 31 SU S MA 452 BP A151 EP A151 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000452 ER PT J AU Platt, A Field, SH Zhen, C Christie, JD Roche, D Gupta, R Asch, DA Kuna, ST AF Platt, A. Field, S. H. Zhen, C. Christie, J. D. Roche, D. Gupta, R. Asch, D. A. Kuna, S. T. TI Does adherence to lipid-lowering medications predict CPAP adherence? SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Platt, A.; Field, S. H.; Christie, J. D.; Asch, D. A.; Kuna, S. T.] Univ Penn, Dept Med, Philadelphia, PA 19104 USA. [Platt, A.; Zhen, C.; Christie, J. D.; Asch, D. A.] Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. [Platt, A.; Field, S. H.; Roche, D.; Gupta, R.; Asch, D. A.; Kuna, S. T.] Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. NR 0 TC 3 Z9 3 U1 0 U2 0 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 PY 2008 VL 31 SU S MA 451 BP A150 EP A151 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419000451 ER PT J AU Ross, RJ Gellis, LA Stepanski, EJ Green, DB Woodward, SH AF Ross, R. J. Gellis, L. A. Stepanski, E. J. Green, D. B. Woodward, S. H. TI REM phasic activity in PTSD-discordant monozygotic twins SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Ross, R. J.; Green, D. B.] Univ Penn, Philadelphia, PA 19104 USA. [Ross, R. J.; Gellis, L. A.] Philadelphia VA Med Ctr, Philadelphia, PA USA. [Stepanski, E. J.] Rush Univ, Med Ctr, Chicago, IL 60612 USA. [Woodward, S. H.] Natl Ctr PTSD, Palo Alto, CA USA. [Woodward, S. H.] VA Palo Alto Hlth Care Syst, Palo Alto, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2008 VL 31 SU S MA 953 BP A314 EP A315 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001382 ER PT J AU Sawyer, AM Deatrick, JA Kuna, ST Weaver, TE AF Sawyer, A. M. Deatrick, J. A. Kuna, S. T. Weaver, T. E. TI Adult perceptions of the diagnosis and treatment of obstructive sleep apnea: A mixed methods study examining the influence of patient experiences and beliefs on continuous positive airway pressure adherence outcomes SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Sawyer, A. M.; Kuna, S. T.; Weaver, T. E.] Univ Penn, Ctr Sleep Resp Neurobiol, Philadelphia, PA 19104 USA. [Deatrick, J. A.; Weaver, T. E.] Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. [Sawyer, A. M.; Kuna, S. T.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Sawyer, A. M.; Kuna, S. T.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. [Deatrick, J. A.] Univ Penn, Ctr Hlth Disparities Res, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 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 PY 2008 VL 31 SU S MA 639 BP A210 EP A210 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001068 ER PT J AU Woodward, S Stepanski, EJ Ross, RJ AF Woodward, S. Stepanski, E. J. Ross, R. J. TI Twins sleep more alike on night 2 than on night 1 SO SLEEP LA English DT Meeting Abstract CT 22nd Annual Meeting of the Associated-Professional-Sleep-Societies CY JUN 07-12, 2008 CL Baltimore, MD C1 [Woodward, S.] VA Palo Alto HCS, Palo Alto, CA USA. [Stepanski, E. J.] Accelerated Community Oncol Res Network Inc, Memphis, TN USA. [Ross, R. J.] Univ Penn, Philadelphia, PA 19104 USA. [Ross, R. J.] Vet Affairs Med Ctr, Behav Hlth Serv, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD SLEEP MEDICINE PI WESTCHESTER PA ONE WESTBROOK CORPORATE CTR, STE 920, WESTCHESTER, IL 60154 USA SN 0161-8105 J9 SLEEP JI Sleep PY 2008 VL 31 SU S MA 989 BP A326 EP A326 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 294PW UT WOS:000255419001418 ER PT J AU Blue-Howells, J McGuire, J Nakashima, J AF Blue-Howells, Jessica McGuire, Jim Nakashima, John TI Co-location of health care services for homeless veterans: A case study of innovation in program implementation SO SOCIAL WORK IN HEALTH CARE LA English DT Article DE program innovation; program implementation; homeless; veterans ID MEDICAL-CARE; LOS-ANGELES; ILLNESS; ADULTS AB This case study examines how the Veterans Affairs Greater Los Angeles Healthcare System (GLA) improved homeless veteran service utilization through program innovation that addressed service fragmentation. The new program offered same-day co-located mental health, medical, and homeless services with a coordinated intake system. The program is analyzed using a framework proposed by Rosenheck (2001) that has four phases: the decision to implement, initial implementation, sustained maintenance, and termination or transformation. GLA was able to successfully implement a new program that remains in the sustained maintenance phase five years after the initial decision to implement. Key factors from the Rosenheck innovation model in the program's success included coalition building, linking the project to legitimate goals, program monitoring, and developing communities of practicing clinicians. The key lesson from the case study is the need for a coalition to persistently problem solve and act as advocates for the program, even after successful initial implementation. Social work leadership was critical in all phases of program implementation. C1 [Blue-Howells, Jessica; Nakashima, John] W Los Angeles Healthcare Ctr, VA Greater Angeles Healthcare Syst, Los Angeles, CA USA. [McGuire, Jim] Univ Calif Los Angeles, Sch Publ Policy & Social Res, Los Angeles, CA USA. [McGuire, Jim] NEPEC, Dept Vet Affairs, CHALENG Evaluat, Los Angeles, CA USA. [McGuire, Jim] Homelessness Prevent & Incarcerated Vet Programs, Los Angeles, CA USA. RP Blue-Howells, J (reprint author), W Los Angeles Healthcare Ctr, VA Greater Angeles Healthcare Syst, 11301 Wilshire Blvd,Mail Code 10H-5,Bldg 206,Room, Los Angeles, CA USA. EM Jessica.Blue-Howells@va.gov NR 21 TC 11 Z9 11 U1 2 U2 8 PU HAWORTH PRESS INC PI BINGHAMTON PA 10 ALICE ST, BINGHAMTON, NY 13904-1580 USA SN 0098-1389 J9 SOC WORK HEALTH CARE JI Soc. Work Health Care PY 2008 VL 47 IS 3 BP 219 EP 231 DI 10.1080/00981380801985341 PG 13 WC Social Work SC Social Work GA 355BK UT WOS:000259683500001 PM 19042482 ER PT J AU Strachan, LR Scalapino, KJ Lawrence, HJ Ghadially, R AF Strachan, Lauren R. Scalapino, Kenneth J. Lawrence, H. Jeffery Ghadially, Ruby TI Rapid adhesion to collagen isolates murine keratinocytes with limited long-term repopulating ability in vivo despite high clonogenicity in vitro SO STEM CELLS LA English DT Article DE keratinocyte; stem cell; collagen; epidermis; colony forming ID EPIDERMAL STEM-CELLS; TRANSIT-AMPLIFYING CELLS; HAIR FOLLICLE BULGE; MOUSE BONE-MARROW; HEMATOPOIETIC STEM; SIDE POPULATION; REGULATORY LOCI; IDENTIFICATION; EXPRESSION; ASSAY AB A prevalent belief in epidermal biology is that stem cells are highly clonogenic; that is, they have the ability to produce many large colonies in vitro. However, it has been well-established in hematology, and recently suggested in epithelial biology, that short-term in vitro clonogenic assays may not be reliable predictors of long-term in vivo repopulating ability. Numerous groups have shown that rapid adhesion to collagen selects for highly clonogenic keratinocytes, but it has not been demonstrated whether this subpopulation is enriched in stem cells as defined by long- term repopulating ability in vivo. We found that although rapid adhesion to collagen (within 5 minutes) selected for cells with increased short-term colony forming ability in vitro, these cells were not enriched in long-term proliferative ability in vitro or in repopulating ability in vivo after 9 weeks. Conversely, keratinocytes that did not adhere to collagen (after 20 minutes) were less clonogenic in short-term assays but possessed equivalent long-term proliferative ability in vitro and superior long-term repopulating ability in vivo. Both the rapidly adherent cell and not rapidly adherent cell populations contained small, noncomplex basaloid cells, expressed integrin alpha 2 (a collagen IV receptor), and expressed the putative epidermal stem cell phenotype integrin alpha 6(hi)CD71(lo). Our results indicate that the superior short-term colony forming ability of collagen-adherent murine keratinocytes does not correlate with long-term repopulating ability in vitro or in vivo and that proliferation in vitro is not a reliable surrogate for stem cell behavior in vivo. C1 [Strachan, Lauren R.; Ghadially, Ruby] Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA. [Scalapino, Kenneth J.] Univ Calif San Francisco, Div Rheumatol, Dept Med, San Francisco, CA 94143 USA. [Lawrence, H. Jeffery] San Francisco VA Med Ctr, San Francisco, CA USA. RP Ghadially, R (reprint author), Vet Adm Med Ctr, Dept Dermatol 190, 4150 Clement St, San Francisco, CA 94121 USA. EM ghadiallyr@derm.ucsf.edu FU BLRD VA [I01 BX000794]; NIAMS NIH HHS [R01-AR020786, R01 AR053765] NR 48 TC 15 Z9 16 U1 0 U2 4 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 1066-5099 J9 STEM CELLS JI Stem Cells PY 2008 VL 26 IS 1 BP 235 EP 243 DI 10.1634/stemcells.2007-0534 PG 9 WC Cell & Tissue Engineering; Biotechnology & Applied Microbiology; Oncology; Cell Biology; Hematology SC Cell Biology; Biotechnology & Applied Microbiology; Oncology; Hematology GA 250LV UT WOS:000252302500026 PM 17932419 ER PT S AU Tache, Y Brunnhuber, S AF Tache, Yvette Brunnhuber, Stefan BE Kvetnansky, R Aguilera, G Goldstein, D Jezova, D Krizanova, O Sabban, EL Pacak, K TI From Hans Selye's Discovery of Biological Stress to the Identification of Corticotropin-Releasing Factor Signaling Pathways SO Stress, Neurotransmitters, and Hormones: Neuroendocrine and Genetic Mechanisms SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article; Proceedings Paper CT 9th Symposium on Catecholamines and Other Neurotransmitters in Stress CY JUN 16-21, 2007 CL Bethesda, MD SP Inst Exptl Endocrinol, Ctr Excellence European Commiss, Slovak Acad Sci, Natl Inst Hlth DE CRF; CRF receptors; CRF antagonists; colonic motor function; irritable bowel syndrome; stress ID IRRITABLE-BOWEL-SYNDROME; COLONIC MOTOR FUNCTION; HORMONE-RECEPTOR ANTAGONIST; WATER-AVOIDANCE STRESS; GASTRIC-ACID SECRETION; CENTRAL-NERVOUS-SYSTEM; FACTOR CRF ANTAGONIST; PARAVENTRICULAR NUCLEUS; GASTROINTESTINAL-TRACT; LOCUS-COERULEUS AB Selye pioneered the concept of biological stress in 1936, culminating in the identification of the corticotropin-releasing factor (CRF) signaling pathways by Vale's group in the last two decades. The characterization of the 41 amino-acid CRF and other peptide members of the mammalian CRF family, urocortin 1, urocortin 2, and urocortin 3, and the cloning of CRF(1) and CRF(2) receptors, which display distinct affinity for CRF ligands, combined with the development of selective CRF receptor antagonists enable us to unravel the importance of CRF(1) receptor in the stress-related endocrine (activation of pituitary-adrenal axis), behavioral (anxiety/depression, altered feeding), autonomic (activation of sympathetic nervous system), and immune responses. The activation of CRF(1) receptors is also one of the key mechanisms through which various stressors impact the gut to stimulate colonic propulsive motor function and to induce hypersensitivity to colorectal distension as shown by the efficacy of the CRF(1) receptor antagonists in blunting these stress-related components. The importance of CRF(1) signaling pathway in the visceral response to stress in experimental animals provided new therapeutic approaches for treatment of functional bowel disorder such as irritable bowel syndrome, a multifactor functional disorder characterized by altered bowel habits and visceral pain, for which stress has been implicated in the pathophysiology and is associated with anxiety-depression in a subset of patients. C1 [Tache, Yvette] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Brunnhuber, Stefan] Univ Wurzburg, Wurzburg, Germany. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, CURE Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU National Institute of Arthritis, Metabolism and Digestive Diseases [R01 DK-33061, R01 DK-57236, DK-41301, P50 AR-049550]; VA Merit and Senior Scientist Awards; University of Wuerzburg/Germany; European Academy of Science and Arts FX The authors' work was supported by the National Institute of Arthritis, Metabolism and Digestive Diseases, Grants R01 DK-33061, R01 DK-57236, DK-41301 (Animal Core), P50 AR-049550, and VA Merit and Senior Scientist Awards. The authors thank Drs. J. Rivier (Salk Institute, La Jolla, CA), D. Grigoriadis (Neurocrine Biosciences Inc., La Jolla, CA), and E.D. Pagani (Center Research Division, Pfizer Inc., Groton, CT) for the generous supply of different CRF agonises and antagonists used in the studies. Dr. S. Brunnhuber is supported by the University of Wuerzburg/Germany and the European Academy of Science and Arts (F. Unger), which is gratefully acknowledged. NR 131 TC 39 Z9 43 U1 1 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 BN 978-1-57331-692-7 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2008 VL 1148 BP 29 EP 41 DI 10.1196/annals.1410.007 PG 13 WC Endocrinology & Metabolism; Multidisciplinary Sciences; Neurosciences; Physiology SC Endocrinology & Metabolism; Science & Technology - Other Topics; Neurosciences & Neurology; Physiology GA BIS00 UT WOS:000262398300002 PM 19120089 ER PT J AU Mays, KL Clark, DL Gordon, AJ AF Mays, Kara L. Clark, David L. Gordon, Adam J. TI Treating Addiction with Tunes: A Systematic Review of Music Therapy for the Treatment of Patients with Addictions SO SUBSTANCE ABUSE LA English DT Review DE Addictions; music therapy; treatment AB Music therapy is the use of musical interventions in a therapeutic setting to accomplish health-related goals. Descriptions of music therapy exist in the peer-reviewed literature and indicate potential use of music therapy in treatment of patients with addiction disorders. This systematic review describes and compares the types of music therapy demonstrated in the literature and evaluates the evidence that music therapy improves outcomes of patients with addictions. A search and critical review of all the existing published literature on music therapy for the treatment of addictions was conducted using online databases and secondary search strategies. Few studies quantitatively assess the use of music therapy in the treatment of patients with addictions. Music listening provided by music therapists is commonly studied. Music therapy sessions reported were additive, not independent, treatment modalities. In the literature, no consensus exists regarding of the efficacy of music therapy as treatment for patients with addictions. C1 [Mays, Kara L.; Gordon, Adam J.] VA Pittsburgh Healthcare Syst, VISN Mental Illness Res Educ & Clin Ctr MIRECC 4, Pittsburgh, PA 15206 USA. [Clark, David L.] First Aid Treatment Humanity, Monaca, PA USA. [Gordon, Adam J.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15206 USA. [Gordon, Adam J.] Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. RP Gordon, AJ (reprint author), VA Pittsburgh Healthcare Syst, Mental Illness Res Educ & Clin Ctr, VISN 4, Mailcode 151C-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. EM adam.gordon@va.gov FU VISN 4 Mental Illness Research, Education, and Clinical Center (MIRECC), VA Pittsburgh Healthcare System FX This project was funded by infrastructure support funding from the VISN 4 Mental Illness Research, Education, and Clinical Center (MIRECC, Director: D. Oslin; Co-Director: G. Haas), VA Pittsburgh Healthcare System. NR 27 TC 11 Z9 11 U1 1 U2 19 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0889-7077 J9 SUBST ABUS JI Subst. Abus. PY 2008 VL 29 IS 4 BP 51 EP 59 DI 10.1080/08897070802418485 PG 9 WC Substance Abuse SC Substance Abuse GA V14AZ UT WOS:000207708600005 PM 19042198 ER PT J AU Walley, AY Phillips, KA Gordon, AJ AF Walley, Alexander Y. Phillips, Karran A. Gordon, Adam J. TI The Patients in Recovery (PIR) Perspective: Teaching Physicians About Methamphetamine SO SUBSTANCE ABUSE LA English DT Article DE Methamphetamine abuse; physician education; substance abuse training AB Methamphetamine dependence is an emerging epidemic confronting physicians. In an effort to improve understanding of its impact, the authors presented an educational workshop at a national meeting for general internists featuring small group discussions with patients in recovery (PIR) from methamphetamine dependence. Participants rated the workshop highly, stating it would lead to concrete change in their teaching, research, or patient care practices and they would invite the workshop to their institution for presentation. Direct interaction with PIR was the most valued aspect of the workshop. Lessons learned included patient's fear of being "turned in" limits disclosure of methamphetamine use to physicians; active users have little insight into methamphetamine-related changes in physical appearance; and a sense of productivity reinforces ongoing methamphetamine use. Workshops that include small group discussions between physicians and PIR are an innovative, practical, and acceptable method to teach physicians about their role in helping patients with substance dependence. C1 [Walley, Alexander Y.] Boston Med Ctr, Gen Internal Med Sect, Clin Addict Res & Educ Unit, Boston, MA 02218 USA. [Phillips, Karran A.] Johns Hopkins Sch Med, Div Gen Internal Med, Baltimore, MD USA. [Gordon, Adam J.] VA Pittsburgh Healthcare Syst, Mental Illness Res Educ & Clin Ctr, VISN 4, Pittsburgh, PA USA. [Gordon, Adam J.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. [Gordon, Adam J.] Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. RP Walley, AY (reprint author), Boston Med Ctr, Gen Internal Med Sect, Clin Addict Res & Educ Unit, 801 Massachusetts Ave,2nd Floor, Boston, MA 02218 USA. EM awalley@bu.edu OI Walley, Alexander/0000-0002-8158-4882 FU National Institute on Drug Abuse [R25-DA13582]; National Institute of Allergy and Infectious Diseases [T32-AI52074]; VA HSR&D Research Career Development Award [RCD-00038-2] FX The authors would like to acknowledge the assistance of Deborah Service of the Matrix Institute and the 10 volunteer small group leaders at the workshop. The authors would also like to acknowledge Maryann Amodeo, MSW, PhD, for guidance in developing the workshop. Dr. Walley was supported by the National Institute on Drug Abuse (R25-DA13582) and National Institute of Allergy and Infectious Diseases (T32-AI52074). Dr. Gordon was supported by a VA HSR&D Research Career Development Award (RCD-00038-2). The results of this paper were presented at the 2006 Association for Medical Education and Research in Substance Abuse (AMERSA) national conference, Washington, DC, November 2007. NR 12 TC 0 Z9 0 U1 1 U2 3 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0889-7077 J9 SUBST ABUS JI Subst. Abus. PY 2008 VL 29 IS 4 BP 61 EP 64 DI 10.1080/08897070802418493 PG 4 WC Substance Abuse SC Substance Abuse GA V14AZ UT WOS:000207708600006 PM 19042199 ER PT J AU Katzburg, JR Farmer, MM Poza, IV Sherman, SE AF Katzburg, Judith R. Farmer, Melissa M. Poza, Ines V. Sherman, Scott E. TI Listen to the consumer: Designing a tailored smoking-cessation program for women SO SUBSTANCE USE & MISUSE LA English DT Article DE women veterans; smoking cessation; tailored; consumer-focus ID VA HEALTH-CARE; FEMALE VETERANS; GENDER-DIFFERENCES; NICOTINE DEPENDENCE; CONTROLLED-TRIAL; SOCIAL SUPPORT; MEDICAL-CARE; TOBACCO; PREDICTORS; THERAPY AB We used a consumer-driven approach to develop a model smoking-cessation program for women. Four focus groups (N = 23 [5-7/group]), each lasting 2 hours, were led by a professional moderator and audiotaped in 2004. Researchers reviewed transcripts; key themes were identified using scrutiny techniques (Ryan and Bernard, 2003). Necessary elements of a smoking-cessation program for women included support and choice (i.e., control over the program components), suggesting the need for an individualized program. Identifying appropriate components is a critical step in the development of efficacious programs that target substance-abusing populations; focus group methodology is useful in this endeavor. The study's implications and limitations are noted. C1 [Katzburg, Judith R.] Univ Calif Los Angeles, Anderson Sch Management, Johnson & Johnson Healthcare Inst, Los Angeles, CA 90095 USA. [Farmer, Melissa M.] Vet Affairs Greater Los Angeles Healthcare Syst, Ctr Study Healthcare Provider Behav, North Hills, CA USA. [Poza, Ines V.] Poza Consulting Serv, Santa Monica, CA USA. [Sherman, Scott E.] VA New York Harbor Healthcare Syst, Dept Vet Affairs, New York, NY USA. [Sherman, Scott E.] NYU, Sch Med, New York, NY 10003 USA. RP Katzburg, JR (reprint author), Univ Calif Los Angeles, Anderson Sch Management, Johnson & Johnson Healthcare Inst, 110 Westwood Plaza,Gold Hall,Suite B307,Box 95148, Los Angeles, CA 90095 USA. EM Judith.Katzburg@anderson.ucla.edu OI Sherman, Scott/0000-0003-1752-7303 NR 58 TC 9 Z9 9 U1 1 U2 3 PU INFORMA HEALTHCARE PI LONDON PA TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND SN 1082-6084 J9 SUBST USE MISUSE JI Subst. Use Misuse PY 2008 VL 43 IS 8-9 BP 1240 EP 1259 DI 10.1080/10826080801914204 PG 20 WC Substance Abuse; Psychiatry; Psychology SC Substance Abuse; Psychiatry; Psychology GA 329DE UT WOS:000257846300018 PM 18649241 ER PT J AU Stewart, L Grifiss, JM Jarvis, GA Way, LW AF Stewart, Lygia Grifiss, J. McLeod Jarvis, Gary A. Way, Lawrence W. TI Elderly patients have more severe biliary infections: Influence of complement-killing and induction of TNF alpha production SO SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Hepato-Pancreato-Biliary-Association CY APR 14-17, 2005 CL Ft Lauderdale, FL SP Amer Hepato Pancreato Biliary Assoc ID NECROSIS-FACTOR-ALPHA; ACTIVE ANTIRETROVIRAL THERAPY; GALLSTONE DISEASE; INFLAMMATORY CYTOKINES; PIGMENT GALLSTONES; MORTALITY; BACTERIA; INTERLEUKIN-6; SEPSIS; PATHOGENESIS AB Background. Biliary bacteria are more common in elderly patients and cause more serious illnesses. The reasons for this are unclear. We noted previously that bacterial serum-sensitivily and induction of TNF alpha production in sera (iTNFsera) were associated with severe biliary infections. We examined the influence of age and these factors on illness severity. Methods. Three-hundred and forty Patients were studied. Gallstones and bile were cultured. Illness was staged as none (no clinical infection or inflammation), SIRS (fever, leukocytosis), severe (cholangitis, abscess, empyema), or MODS (bacteremia, hypotension, organ dysfunction/failure). Bacterial serum-sensitivity and TNF alpha induction were measured. Younger (< 70 years) and elderly (>= 70 years) patients were compared. Results. Biliaiy bacteria were more common in elderly (64% vs 41%, P < .0001). Among patients with biliary bacteria, the elderly had more serious illnesses: none: 44% younger, 19% elderly; SIRS: 16% younger, 22% elderly; severe: 22% younger, 21 % elderly; MODS 18% younger, 38% elderly (P = .003). Bacteria from elderly patients induced more TNF alpha (580 vs 310 pg/ml, P = .023). In both groups, serum-sensitive bacteria caused infectious manifestations and induced abundant TNF alpha; however, serum-resistant bacteria from elderly usually (69%) caused infectious manifestations and abundant TNF alpha, while serum-resistant bacteria from younger patients rarely (8%) caused infectious manifestations and minimal TNF alpha. Elderly patients with high iTNFsera bacteria had more severe illnesses. Conclusions. Biliary bacteria were more common in elderly patients and produced more serious illnesses. Many younger patients with biliary bacteria displayed no infectious manifestations. Elderly patients harbored more virulent bacteria, and had a heightened response to high iTNFsera bacteria, as well as bacteria largely tolerated by younger patients. C1 [Stewart, Lygia; Way, Lawrence W.] Univ Calif San Francisco, Dept Surg, San Francisco, CA 94143 USA. [Stewart, Lygia] San Francisco VA Med Ctr, Surg Serv, San Francisco, CA USA. [Grifiss, J. McLeod; Jarvis, Gary A.] Univ Calif San Francisco, San Francisco VA Med Ctr, Ctr Immunochem, San Francisco, CA 94143 USA. [Grifiss, J. McLeod; Jarvis, Gary A.] Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA. RP Stewart, L (reprint author), Dept Surg 112, 4150 Clement St, San Francisco, CA 94121 USA. EM lygia.stewart@med.va.gov 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 0039-6060 J9 SURGERY JI Surgery PD JAN PY 2008 VL 143 IS 1 BP 103 EP 112 DI 10.1016/j.surg.2007.06.035 PG 10 WC Surgery SC Surgery GA 245YB UT WOS:000251973600012 PM 18154938 ER PT J AU Lee, SWH Liong, ML Yuen, KH Leong, WS Cheah, PY Khan, NAK Krieger, JN AF Lee, Shaun Wen Huey Liong, Men Long Yuen, Kah Hay Leong, Wing Seng Cheah, Phaik Yeong Khan, Nurzalina Abdul Karim Krieger, John N. TI Adverse impact of sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome SO UROLOGY LA English DT Article ID INSTITUTES-OF-HEALTH; ERECTILE FUNCTION IIEF; CLINICAL CHARACTERISTICS; INTERNATIONAL INDEX; SYMPTOM INDEX; MEN; TRIAL; DISTURBANCES; EPIDEMIOLOGY; POPULATION AB OBJECTIVES To examine the prevalence, characteristics, and impact of sexual dysfunction in our primary care referral population. METHODS Participants seeking treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were recruited from general urology clinics. The subjects completed the National Institutes of Health-Chronic Prostatitis Symptom Index, International Index of Erectile Function-5, and selected questions from the University of Washington Symptom Score. Additional information on demographics and medical and treatment history were also obtained. Sexual dysfunction was defined as self-reported erectile dysfunction (ED) or ejaculatory difficulty, or both. RESULTS Of 296 participants with CP/CPPS, 214 (72.3%) reported sexual dysfunction. The National Institutes of Health-Chronic Prostatitis Symptom Index total score averaged 22.5 +/- 6.9 for participants with sexual dysfunction compared with 20.4 +/- 7.8 for participants who did not report sexual dysfunction (P = 0.03). Of the 214 participants with sexual dysfunction, 54 (25.0%) complained of ED only, 71 (33.4%) complained of ejaculatory difficulties only, and 89 (41.6%) complained of both ED and ejaculatory difficulties. Men reporting both ED and ejaculatory difficulty reported worse CP/CPPS symptoms (analysis of variance, P = 0.042) and worse quality of life (analysis of variance, P = 0.006) than men without sexual dysfunction. CONCLUSIONS Sexual dysfunction was reported by almost three quarters of patients with CP/CPPS. Patients with CP/CPPS and sexual dysfunction experienced substantially worse symptoms, particularly worse quality of life, than other patients with CP/CPPS. Sexual dysfunction merits consideration as an important aspect of CP/CPPS and a potential outcome measure. C1 [Krieger, John N.] Univ Washington, Sch Med, Dept Urol Surg, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Sci Malaysia, Sch Pharmaceut Sci, George Town, Malaysia. Lam Wah Ee Hosp, Dept Urol, George Town, Malaysia. RP Krieger, JN (reprint author), Univ Washington, Sch Med, Dept Urol Surg, Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM jkrieger@u.washington.edu RI Yuen, Kah Hay /F-9059-2010; Khan, Nurzalina/E-3875-2012 OI Lee, Shaun/0000-0001-7361-6576 FU NIDDK NIH HHS [DK065266, DK38955] NR 24 TC 36 Z9 47 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0090-4295 J9 UROLOGY JI Urology PD JAN PY 2008 VL 71 IS 1 BP 79 EP 84 DI 10.1016/j.urology.2007.08.043 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 263CH UT WOS:000253194700019 PM 18242370 ER PT J AU Burkitt, KH Larkin, GL AF Burkitt, Kelly H. Larkin, Gregory L. TI The Transtheoretical Model in Intimate Partner Violence Victimization: Stage Changes Over Time SO VIOLENCE AND VICTIMS LA English DT Article DE intimate partner violence; stages of change; transtheoretical model; medical advocacy; longitudinal studies AB The transtheoretical model of behavior change (TTM) has been extended to describe the process of change in victims of intimate partner violence (IPV); however, it has not been validated over time or in a population of women experiencing IPV who are not currently in shelter. This article examines the process of change in IPV victims longitudinally and identifies factors that may relate to staging and stage progression. Fifty-three women were enrolled on presentation to an emergency department for health care treatment and completed follow-up at 3 to 4 months. Measures of TTM staging, use of community resources, ongoing abuse, mental health, and social support were collected. Cluster analyses were conducted, and descriptive summaries of clusters and significant demographic, abuse, and outcome variables related to cluster membership are presented. A five-cluster solution was selected on the basis of parsimony, theory, and overall coherence with the data. Forward progression through the stages over time was related to both the use of community resources and ending the IPV relationship. C1 [Burkitt, Kelly H.] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15206 USA. [Larkin, Gregory L.] Yale Univ, Sch Med, Dept Surg, Sect Emergency Med, New Haven, CT 06510 USA. RP Burkitt, KH (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 7180 Highland Dr,151C-H, Pittsburgh, PA 15206 USA. EM Kelly.burkitt@va.gov NR 39 TC 13 Z9 14 U1 0 U2 2 PU SPRINGER PUBLISHING CO PI NEW YORK PA 11 WEST 42ND STREET, NEW YORK, NY 10036 USA SN 0886-6708 J9 VIOLENCE VICTIMS JI Violence Vict. PY 2008 VL 23 IS 4 BP 411 EP 431 DI 10.1891/0886-6708.23.4.411 PG 21 WC Criminology & Penology SC Criminology & Penology GA V18EP UT WOS:000207988400001 PM 18788336 ER PT J AU Ruff, RL McKerracher, L Selzer, ME AF Ruff, Robert L. McKerracher, Lisa Selzer, Michael E. TI Repair and Neurorehabilitation Strategies for Spinal Cord Injury SO YEAR IN NEUROLOGY 2008 SE ANNALS OF THE NEW YORK ACADEMY OF SCIENCES LA English DT Article DE spinal cord injury; neural repair; neural regeneration; neurorehabilitation; brain computer interface; functional electrical stimulation ID RETINAL GANGLION-CELLS; ENHANCES AXONAL REGENERATION; CENTRAL-NERVOUS-SYSTEM; CHONDROITIN SULFATE PROTEOGLYCAN; MYELIN-ASSOCIATED GLYCOPROTEIN; GROWTH-ASSOCIATED PROTEIN-43; INHIBITS NEURITE OUTGROWTH; FACTOR-KAPPA-B; FUNCTIONAL RECOVERY; NOGO RECEPTOR AB The failure of axons in the central nervous system (CNS) to regenerate has been considered the main factor limiting recovery from spinal cord injury (SCI). Impressive gains in identification of growth-inhibitory molecules in the CNS led to expectations that their neutralization would lead to functional regeneration. However, results of therapeutic approaches based on this assumption have been mixed. Recent data suggest that neurons differ in their ability to regenerate through similar extracellular environments, and moreover, they undergo a developmental loss of intrinsic regenerative ability. Factors mediating these intrinsic regenerative abilities include expression of (1) receptors for inhibitory molecules such as the myelin-associated growth inhibitors and developmental guidance molecules, (2) surface molecules that permit axon adhesion to cells in the path of growth, (3) cytoskeletal proteins that mediate the mechanics of axon growth, and (4) molecules in the intracellular signaling cascades that mediate responses to chemoattractive and chemorepulsive cues. In contrast to axon development, regeneration might involve internal protrusive forces generated by microtubules, either through their own elongation or by transporting other cytoskeletal elements such as neurofilaments into the axon tip. Because of the complexity of the regenerative program, one approach will probably be insufficient to achieve functional restoration of neuronal circuits. Combination treatments will be increasingly prominent. SCI is a debilitating and costly condition that compromises pursuit of activities usually associated with an independent and productive lifestyle. This article discusses recent advances in neurorehabilitation that can improve the life quality of individuals with SCI. C1 [Ruff, Robert L.] Vet Affairs Med Ctr, Louis Stokes Dept, Cleveland, OH USA. [Ruff, Robert L.] Case Western Reserve Univ, Dept Neurol, Cleveland, OH 44106 USA. [Ruff, Robert L.] Case Western Reserve Univ, Dept Neurosci, Cleveland, OH 44106 USA. [Selzer, Michael E.] Univ Penn, Med Ctr, Dept Neurol, Philadelphia, PA 19104 USA. [Selzer, Michael E.] US Dept Vet Affairs, Off Res & Dev, Washington, DC USA. RP Ruff, RL (reprint author), Cleveland VA Med Ctr, Neurol Serv 127W, 10701 East Blvd, Cleveland, OH 44106 USA. EM robert.ruffl@va.gov NR 133 TC 32 Z9 33 U1 1 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXEN, ENGLAND SN 0077-8923 J9 ANN NY ACAD SCI JI Ann.NY Acad.Sci. PY 2008 VL 1142 BP 1 EP 20 DI 10.1196/annals.1444.004 PG 20 WC Multidisciplinary Sciences; Neurosciences SC Science & Technology - Other Topics; Neurosciences & Neurology GA BIM55 UT WOS:000260858700001 PM 18990118 ER PT J AU Volpp, KG Rosen, A Rosenbaum, P Romano, P Bellini, L Silber, JH AF Volpp, Kevin G. Rosen, Amy Rosenbaum, Paul Romano, Patrick Bellini, Lisa Silber, Jeffrey H. TI Resident duty hour reform and mortality in hospitalized patients - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Philadelphia Vet Affairs Med Ctr, CHERP, Philadelphia, PA 19104 USA. Bedford VA Med Ctr, Bedford, MA USA. Univ Penn, Philadelphia, PA 19104 USA. Univ Calif Davis, Primary Care Ctr, Sacramento, CA 95817 USA. Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA. RP Volpp, KG (reprint author), Philadelphia Vet Affairs Med Ctr, CHERP, Philadelphia, PA 19104 USA. EM volpp70@wharton.upenn.edu RI Romano, Patrick/N-4225-2014 OI Romano, Patrick/0000-0001-6749-3979 NR 1 TC 0 Z9 0 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 DEC 26 PY 2007 VL 298 IS 24 BP 2866 EP 2866 DI 10.1001/jama.298.24.2866-a PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 243RW UT WOS:000251816000016 ER PT J AU Pollak, KI Arnold, RM Jeffreys, AS Alexander, SC Olsen, MK Abernethy, AP Skinner, CS Rodriguez, KL Tulsky, JA AF Pollak, Kathryn I. Arnold, Robert M. Jeffreys, Amy S. Alexander, Stewart C. Olsen, Maren K. Abernethy, Amy P. Skinner, Celette Sugg Rodriguez, Keri L. Tulsky, James A. TI Oncologist communication about emotion during visits with patients with advanced cancer SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Article ID PRIMARY-CARE; TRAINING MODEL; BAD-NEWS; PHYSICIAN; CONSULTATION; ENCOUNTERS; EFFICACY; SKILLS; TRIAL; SCALE AB Introduction Cancer care involves addressing patient emotion. When patients express negative emotions, empathic opportunities emerge. When oncologists respond with a continuer statement, which is one that offers empathy and allows patients to continue expressing emotions, rather than with a terminator statement, which is one that discourages disclosure, patients have less anxiety and depression and report greater satisfaction and adherence to therapy. We studied whether oncologist traits were associated with empathic opportunities and empathic responses. Patients and Methods We audio-recorded 398 clinic conversations between 51 oncologists and 270 patients with advanced cancer; oncologists also completed surveys. Conversations were coded for the presence of empathic opportunities and oncologist responses. Analyses examined the relationship with oncologists' demographics, self-reported confidence, outcome expectancies, and comfort to address social versus technical aspects of care. Results In 398 conversations, 37% contained at least one empathic opportunity; the range was 0 to 10, and the total empathic opportunities was 292. When they occurred, oncologists responded with continuers 22% of the time. Oncologist sex was related to the number of empathic opportunities; female patients seen by female oncologists had the most empathic opportunities (P = .03). Younger oncologists (P = .02) and those who rated their orientation as more socioemotional than technical (P = .03) were more likely to respond with empathic statements. Conclusion Oncologists encountered few empathic opportunities and responded with empathic statements infrequently. Empathic responses were more prevalent among younger oncologists and among those who were self-rated as socioemotional. To reduce patient anxiety and increase patient satisfaction and adherence, oncologists may need training to encourage patients to express emotions and to respond empathically to patients' emotions. C1 [Pollak, Kathryn I.] Duke Univ, Med Ctr, Dept Community & Family Med, Durham, NC 27705 USA. Duke Univ, Med Ctr, Duke Comprehens Canc Ctr, Canc Prevent Detect & Control Res Program, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Duke Univ, Med Ctr, Ctr Palliat Care, Durham, NC 27710 USA. Durham Vet Affairs Med Ctr, Ctr Hlth Serv Res, Durham, NC 27710 USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Inst Doctor Patient Commun, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Inst Enhance Palliat Care, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Pollak, KI (reprint author), Duke Univ, Med Ctr, Dept Community & Family Med, 2424 Erwin Rd,Suite 602, Durham, NC 27705 USA. EM polla007@mc.duke.edu FU NCI NIH HHS [R01 CA100387, R01CA100387] NR 30 TC 151 Z9 152 U1 2 U2 8 PU AMER SOC CLINICAL ONCOLOGY PI ALEXANDRIA PA 330 JOHN CARLYLE ST, STE 300, ALEXANDRIA, VA 22314 USA SN 0732-183X J9 J CLIN ONCOL JI J. Clin. Oncol. PD DEC 20 PY 2007 VL 25 IS 36 BP 5748 EP 5752 DI 10.1200/JCO.2007.12.4180 PG 5 WC Oncology SC Oncology GA 272UT UT WOS:000253886600012 PM 18089870 ER PT J AU Wells, DA Ross, JS Detsky, AS AF Wells, David A. Ross, Joseph S. Detsky, Allan S. TI What is different about the market for health care? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID CONTROLLED TRIAL; MEDICAL-CARE; INSURANCE; COMMONS; ADULTS; PLANS C1 Mt Sinai Hosp, Dept Med, Toronto, ON M5G 1X5, Canada. Mt Sinai Sch Med, Dept Geriatr, New York, NY USA. Mt Sinai Sch Med, Dept Adult Dev, New York, NY USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. James J Peters Vet Adm Med Ctr, Hlth Serv Res & Dev Serv Targeted Res Enhancement, Bronx, NY USA. James J Peters Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. Univ Toronto, Dept Hlth Policy, Toronto, ON, Canada. Univ Toronto, Dept Management, Toronto, ON, Canada. Univ Toronto, Dept Evaluat & Med, Toronto, ON, Canada. Univ Hlth Network, Toronto, ON, Canada. RP Detsky, AS (reprint author), Mt Sinai Hosp, Dept Med, 600 Univ Ave,Room 427, Toronto, ON M5G 1X5, Canada. EM allan.detsky@uhn.on.ca NR 19 TC 13 Z9 13 U1 1 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD DEC 19 PY 2007 VL 298 IS 23 BP 2785 EP 2787 DI 10.1001/jama.298.23.2785 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 242HK UT WOS:000251716000025 PM 18165673 ER PT J AU Goldberg, H Avins, A Bent, S AF Goldberg, Harley Avins, Andrew Bent, Stephen TI Chondroitin for osteoarthritis of the knee or hip SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Kaiser Permanente Northern Calif, Oakland, CA 94612 USA. [Avins, Andrew] Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Kaiser Permanente Northern Calif, Oakland, CA 94612 USA. [Bent, Stephen] Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94121 USA. RP Goldberg, H (reprint author), Kaiser Permanente Northern Calif, Oakland, CA 94612 USA. NR 3 TC 1 Z9 1 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 DEC 18 PY 2007 VL 147 IS 12 BP 883 EP 883 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 243HO UT WOS:000251787600013 PM 18087064 ER PT J AU Cavusoglu, E Chhabra, S Jiang, XC Hojjati, MR Chopra, V Eng, C Gupta, A Yanamadala, S Pinsky, DJ Marmur, JD AF Cavusoglu, Erdal Chhabra, Sandeep Jiang, Xian-Cheng Hojjati, Mohammad R. Chopra, Vineet Eng, Calvin Gupta, Amit Yanamadala, Sunitha Pinsky, David J. Marmur, Jonathan D. TI Relation of baseline plasma phospholipid levels to cardiovascular outcomes at two years in men with acute coronary syndrome referred for coronary angiography SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; INDEPENDENT PREDICTOR; I-MILANO; ATHEROSCLEROSIS; CHOLESTEROL; PHOSPHATIDYLCHOLINE; MICE; SPHINGOMYELIN; INFUSION; METABOLISM AB In addition to cholesterol and triglycerides, plasma also contains phospholipids. The choline-containing phospholipids constitute > 90% of total plasma phospholipids. To date, no studies have looked specifically at the prognostic significance of total phospholipids in patients with known or suspected coronary artery disease. The present study investigated the long-term prognostic significance of total choline-containing phospholipid levels in a well-characterized cohort of 193 men with acute coronary syndromes who were referred for coronary angiography at a Department of Veterans Affairs Medical Center. All patients were followed prospectively for the development of vascular outcomes. After controlling for a variety of baseline variables (including established biomarkers such high-sensitivity C-reactive protein and fibrinogen), plasma phospholipid values (analyzed as a continuous variable) were a strong and independent predictor of each of the individual end points of all-cause mortality (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.41 to 0.90, p = 0.0126), cardiac mortality (HR 0.49, 95% CI 0.29 to 0.81, p = 0.0057), and myocardial infarction (HR 0.71, 95% CI 0.52 to 0.98, p = 0.0342) when using a Cox proportional-hazards model. In addition, baseline phospholipid values were also an independent predictor of the composite outcome of all-cause mortality, fatal or nonfatal myocardial infarction, or stroke (HR 0.66, 95% CI 0.49 to 0.90, p = 0.0075). In conclusion, these data demonstrate that low baseline levels of total choline-containing phospholipid are a strong and independent predictor of cardiovascular outcomes (including mortality) in patients with acute coronary syndromes. (C) 2007 Elsevier Inc. All rights reserved. C1 [Cavusoglu, Erdal; Hojjati, Mohammad R.; Gupta, Amit; Marmur, Jonathan D.] Suny Downstate Med Ctr, Dept Med, Div Cardiol, Brooklyn, NY 11203 USA. [Cavusoglu, Erdal; Chhabra, Sandeep; Chopra, Vineet; Eng, Calvin] Bronx Vet Affairs Med Ctr, Dept Med, Div Cardiol, Bronx, NY USA. [Jiang, Xian-Cheng] Suny Downstate Med Ctr, Dept Anat & Cell Biol, Brooklyn, NY 11203 USA. [Yanamadala, Sunitha; Pinsky, David J.] Univ Michigan, Dept Med, Div Cardiovasc Med, Ann Arbor, MI 48109 USA. RP Cavusoglu, E (reprint author), Suny Downstate Med Ctr, Dept Med, Div Cardiol, Brooklyn, NY 11203 USA. EM ecavusoglu@aol.com NR 22 TC 5 Z9 5 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD DEC 15 PY 2007 VL 100 IS 12 BP 1739 EP 1743 DI 10.1016/j.amjcard.2007.07.037 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 248BQ UT WOS:000252126700006 PM 18082518 ER PT J AU Bartzokis, G Lu, PH Geschwind, DH Tingus, K Huang, D Mendez, MF Edwards, N Mintz, J AF Bartzokis, George Lu, Po H. Geschwind, Daniel H. Tingus, Kathleen Huang, Danny Mendez, Mario F. Edwards, Nancy Mintz, Jim TI Apolipoprotein e affects both myelin breakdown and cognition: Implications for age-related trajectories of decline into dementia SO BIOLOGICAL PSYCHIATRY LA English DT Article DE age; Alzheimer; ApoE; apolipoprotein; brain; breakdown; cognition; dementia; MRI; myelin; onset; prevention; processing; R-2; risk; speed; T-2; treatment; white matter ID INDUCED INTRAMYELINIC EDEMA; MATTER STRUCTURAL INTEGRITY; PRIMATE CEREBRAL-CORTEX; CENTRAL-NERVOUS-SYSTEM; PRIMARY VISUAL-CORTEX; ALZHEIMERS-DISEASE; RHESUS-MONKEY; APOE GENOTYPE; CORTICAL DISCONNECTION; CHOLESTEROL-METABOLISM AB Background: Age-related myelin breakdown is most evident in later-myelinating white matter (LMwm) brain regions. This process might degrade cognitive processing speed (CPS) underlying age-related cognitive decline and the predominance of age as a risk factor for Alzheimer's disease (AD). Apolipoprotein E (ApoE)4 allele is the second most important AD risk factor. We tested the hypothesis that ApoE4 accelerates age-related slowing in CPS through the process of myelin breakdown. Methods: Calculated transverse relaxation rates (R,), an indirect magnetic resonance imaging measure of myelin breakdown in LMwm, and measures of CPS were obtained in 22 ApoE4+ and 80 ApoE4-, healthy "younger-old" individuals. To assess specificity, contrasting early-myelinating white matter region and memory task were also examined. Results: The CPS versus LMwm R-2 remained significant in the ApoE4+ group even after age was statistically adjusted (r =.65, p =.001) and differed from the correlation observed in the ApoE4 - group (Fisher's z test = 3.22, p <.002). No significant associations were observed with the contrast region and memory task in either ApoE subgroup. Conclusions: A specific association between CPS and myelin breakdown in LMwm exists in asymptomatic "younger-old" individuals at increased genetic risk for AD. Although inferences of change over time and causality are limited by the cross-sectional study design, this finding lends support to the hypotheses that myelin breakdown underlies age-related slowing in CPS and that by altering the trajectory of myelin breakdown, ApoE alleles shift the age at onset of cognitive decline. Combined use of biomarkers and CPS measures might be useful in developing and targeting primary prevention treatments for AD. C1 Univ Calif Los Angeles, Alzheimers Dis Ctr, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Lab Neuroimaging, David Geffen Sch Med, Div Brain Mapping, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Alzheimers Dis Ctr, David Geffen Sch Med, Dept Neurol, 10911 Weyburn Ave,Room 200G, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [P50 AG 16570, R01 AG027342]; NIMH NIH HHS [MH51928, MH6357-01A1, MH066029-01A2] NR 97 TC 57 Z9 57 U1 2 U2 9 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 DEC 15 PY 2007 VL 62 IS 12 BP 1380 EP 1387 DI 10.1016/j.biopsych.2007.03.024 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 239CQ UT WOS:000251496400008 PM 17659264 ER PT J AU Masri, J Bernath, A Martin, J Jo, OD Vartanian, R Funk, A Gera, J AF Masri, Janine Bernath, Andrew Martin, Jheralyn Jo, Oak D. Vartanian, Raffi Funk, Alexander Gera, Joseph TI mTORC2 activity is elevated in gliomas and promotes growth and cell motility via overexpression of rictor SO CANCER RESEARCH LA English DT Article ID PROTEIN-KINASE-C; SUPPRESSES TUMOR-GROWTH; BREAST-CANCER; AKT ACTIVITY; PKC-ALPHA; CYCLIN D1; RAPAMYCIN; GLIOMAGENESIS; IDENTIFICATION; TARGET AB mTORC2 is a multimeric kinase composed of the mammalian target of rapamycin kinase (mTOR), mLST8, mSin1, and rictor. The complex is insensitive to acute rapamycin exposure and has shown functions in controlling cell growth and actin cytoskeletal assembly. mTORC2 has recently been shown to phosphorylate and activate Akt. Because similar to 70% of gliomas harbor high levels of activated Akt, we investigated whether mTORC2 activity was elevated in gliomas. In this study, we found that mTORC2 activity was elevated in glioma cell lines as well as in primary tumor cells as compared with normal brain tissue (P < 0.05). Moreover, we found that rictor protein and mRNA levels were also elevated and correlated with increased mTORC2 activity. Overexpression of rictor in cell lines led to increased mTORC2 assembly and activity. These lines exhibited increased anchorage-independent growth in soft agar, increased S-phase cell cycle distribution, increased motility, and elevated integrin I and 3 expression. In contrast, small interfering RNA-mediated knockdown of rictor inhibited these oncogenic activities. Protein kinase C alpha (PKC alpha) activity was shown to be elevated in rictor-overexpressing lines but reduced in rictor-knockdown clones, consistent with the known regulation of actin organization by mTORC2 via PKC alpha. Xenograft studies using these cell lines also supported a role for increased mTORC2 activity in tumorigenesis and enhanced tumor growth. In summary, these data suggest that mTORC2 is hyperactivated in gliomas and functions in promoting tumor cell proliferation and invasive potential due to increased complex formation as a result of the overexpression of rictor. C1 [Masri, Janine; Bernath, Andrew; Martin, Jheralyn; Jo, Oak D.; Vartanian, Raffi; Funk, Alexander; Gera, Joseph] Greater Los Angeles VA Hlthcare Syst, Dept Res & Dev, Sepulveda, CA 91343 USA. [Gera, Joseph] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Gera, J (reprint author), Greater Los Angeles VA Hlthcare Syst, Dept Res & Dev, 16111 Plummer St,Bldg 1,Room C111A, Sepulveda, CA 91343 USA. EM gera@ucla.edu FU NCI NIH HHS [CA109312, CA16042]; NIAID NIH HHS [AI28697] NR 50 TC 130 Z9 137 U1 1 U2 9 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD DEC 15 PY 2007 VL 67 IS 24 BP 11712 EP 11720 DI 10.1158/0008-5472.CAN-07-2223 PG 9 WC Oncology SC Oncology GA 244HV UT WOS:000251857900031 PM 18089801 ER PT J AU Goulet, JL Fultz, SL Rimland, D Butt, A Gibert, C Rodriguez-Barradas, M Bryant, K Justice, AC AF Goulet, Joseph L. Fultz, Shawn L. Rimland, David Butt, Adeel Gibert, Cynthia Rodriguez-Barradas, Maria Bryant, Kendall Justice, Amy C. TI Do patterns of comorbidity vary by HIV status, age, and HIV severity? SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID ACTIVE ANTIRETROVIRAL THERAPY; VETERANS AGING COHORT; INFECTED VETERANS; PSYCHIATRIC COMORBIDITY; ADMINISTRATIVE DATA; POST-HAART; DISEASE; PERSPECTIVE; PROGNOSIS; ALCOHOL AB Patterns of comorbidity among persons with human immunodeficiency virus (HIV) are not well described. We compared comorbidity among veterans with and without HIV infection. The sample consisted of 33,420 HIV-infected veterans and 66,840 HIV-uninfected veterans. We identified and clustered 11 comorbid conditions using validated International Classification of Diseases, 9th Revision, Clinical Modification codes. We defined multimorbidity as the presence of conditions in all clusters. Models restricted to HIV-infected veterans were adjusted for CD4 cell count and viral load. Comorbidity was common (prevalence, 60%-63%), and prevalence varied by HIV status. Differences remained when the veterans were stratified by age. In multivariable analyses, older HIV-infected veterans were more likely to have substance use disorder and multimorbidity. Renal, vascular, and pulmonary diseases were associated with CD4 cell count < 200 cells/mm(3); hypertension was associated with CD4 cell count > 200 cells/mm(3). Comorbidity is the rule, and multimorbidity is common among veterans with HIV infection. Patterns of comorbidity differ substantially by HIV status, age, and HIV severity. Primary care guidelines require adaptation for persons with HIV infection. C1 [Goulet, Joseph L.; Justice, Amy C.] VA CT Hlthcare Syst, West Haven, CT 06516 USA. [Goulet, Joseph L.; Justice, Amy C.] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA. [Fultz, Shawn L.] George Washington Univ, Med Ctr, Vet Hlth Adm, Washington, DC 20037 USA. [Gibert, Cynthia] George Washington Univ, Med Ctr, Vet Affairs Med Ctr, Washington, DC 20037 USA. [Rimland, David] Vet Affairs Med Ctr, Atlanta, GA 30033 USA. [Rimland, David] Emory Univ, Sch Med, Atlanta, GA USA. [Butt, Adeel] Vet Affairs Pittsburgh Hlth Syst, Pittsburgh, PA USA. [Butt, Adeel] Univ Pittsburgh, Pittsburgh, PA USA. [Rodriguez-Barradas, Maria] Michael E De Bakey Vet Affairs Med Ctr, Houston, TX USA. [Rodriguez-Barradas, Maria] Baylor Coll Med, Houston, TX 77030 USA. [Bryant, Kendall] NIH, NIAAA, Bethesda, MD 20892 USA. RP Goulet, JL (reprint author), VA CT Hlthcare Syst, 11ACSLG,Bldg 35A,Rm 2-207 950 Campbell Ave, West Haven, CT 06516 USA. EM joseph.goulet@med.va.gov OI Goulet, Joseph/0000-0002-0842-804X FU NIA NIH HHS [K23 AG00826]; NIAAA NIH HHS [U10 AA 13566, U01 AA 13566, U01 AA013566, U10 AA013566, U24 AA020794] NR 34 TC 135 Z9 137 U1 3 U2 6 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 15 PY 2007 VL 45 IS 12 BP 1593 EP 1601 DI 10.1086/523577 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 233HI UT WOS:000251081000011 PM 18190322 ER PT J AU Choi, AI Rodriguez, RA Bacchetti, P Volberding, PA Havlir, D Bertenthal, D Bostrom, A O'Hare, AM AF Choi, Andy I. Rodriguez, Rudolph A. Bacchetti, Peter Volberding, Paul A. Havlir, Diane Bertenthal, Daniel Bostrom, Alan O'Hare, Ann M. TI Low rates of antiretroviral therapy among HIV-infected patients with chronic kidney disease SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; PATIENTS RECEIVING DIALYSIS; VETERAN POPULATION; MORTALITY; ADHERENCE; RECOMMENDATIONS; ASCERTAINMENT; DETERMINANTS; GUIDELINES; SURVIVAL AB Background. It is unknown whether chronic kidney disease (CKD) influences receipt of highly active antiretroviral therapy ( HAART) among patients with the human immunodeficiency virus (HIV) and whether prescription practices contribute to excess mortality. Methods. We conducted a retrospective observational study involving HIV-infected patients with established indications for HAART and an outpatient serum creatinine level measured in the Veterans Affairs health care system. Patients were followed up for the outcomes of HAART exposure (percentage of follow-up time treated with HAART), inadequate dose adjustment of renally eliminated antiretroviral medications, and time to death. Results. A total of 1041 patients (8.5%) had CKD, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2). Compared with patients with an eGFR >= 60 mL/min/1.73 m(2), HAART exposure was 14% less (95% confidence interval [CI], 2%-24% less), 24% less (95% CI, 4% more to 45% less), 64% less (95% CI, 38%-79% less), and 49% less (95% CI, 32%-61% less) in patients who had an eGFR of 30-59 mL/min/1.73 m(2), 15-29 mL/min/1.73 m(2), and < 15 mL/min/1.73 m(2) (and were not receiving dialysis) and in patients receiving long-term dialysis, respectively. At study entry, 15.4% of patients with CKD received HAART unadjusted for the level of renal function. The adjusted hazard ratio for death was 1.36 (95% CI, 1.08-1.72) for patients with an eGFR of 30-59 mL/min/1.73 m(2), 2.17 (95% CI, 1.43-3.27) for patients with an eGFR of 15-29 mL/min/1.73 m(2), 5.97 (95% CI, 3.18-11.19) for patients with an eGFR < 15 mL/min/1.73 m(2), and 1.92 (95% CI, 1.30-2.82) for dialysis-dependent patients. Underexposure and inadequate dose adjustment of HAART were associated with 22.5%-35.5% of the excess mortality found among patients with different levels of CKD. Conclusions. Underexposure and inadequate dose adjustment of HAART may contribute to excess mortality among HIV-infected patients with CKD. C1 [Choi, Andy I.; Havlir, Diane] San Francisco Gen Hosp, Dept Med, San Francisco, CA 94110 USA. [Choi, Andy I.; Volberding, Paul A.; Havlir, Diane] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. [Bacchetti, Peter; Bostrom, Alan] Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. [Choi, Andy I.; Volberding, Paul A.] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Bertenthal, Daniel] San Francisco VA Med Ctr, Vet Affairs Res Enhancement Award Program, San Francisco, CA USA. [Rodriguez, Rudolph A.; O'Hare, Ann M.] Vet Affairs Puget Sound Hlthcare Syst, Dept Med, Seattle, WA USA. [Rodriguez, Rudolph A.; O'Hare, Ann M.] Univ Washington, Seattle, WA 98195 USA. RP Choi, AI (reprint author), San Francisco Gen Hosp, Dept Med, Box 1341 Renal Ctr,Bldg 100 Rm 350 1001 Potrero A, San Francisco, CA 94110 USA. EM andy.choi@ucsf.edu FU NIA NIH HHS [K23-AG028980-01]; NIAID NIH HHS [K24-AI51982, P30-AI27763]; NIDDK NIH HHS [T32-DK07219] NR 39 TC 32 Z9 33 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD DEC 15 PY 2007 VL 45 IS 12 BP 1633 EP 1639 DI 10.1086/523729 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 233HI UT WOS:000251081000016 PM 18190326 ER PT J AU Pierce, AP de Waal, E McManus, LM Shireman, PK Chaudhuri, AR AF Pierce, Anson P. de Waal, Eric McManus, Linda M. Shireman, Paula K. Chaudhuri, Asish R. TI Oxidation and structural perturbation of redox-sensitive enzymes in injured skeletal muscle SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE creatine kinase; glyceraldehyde-3-phosphate dehydrogenase; cardiotoxin; BisANS; skeletal muscle injury; free radicals ID GLYCERALDEHYDE-3-PHOSPHATE DEHYDROGENASE; CREATINE-KINASE; INFLAMMATORY RESPONSE; SNAKE-VENOM; IN-VITRO; PROTEIN; MICE; PROTEASOME; REGENERATION; DEGRADATION AB Molecular events that control skeletal muscle injury and regeneration are poorly understood. However, inflammation associated with oxidative stress is considered a key player in modulating this process. To understand the consequences of oxidative stress associated with muscle injury, inflammation, and regeneration, hind-limb muscles of C57BI/6J mice were studied after injection of cardiotoxin (CT). Within 1 day post-CT injection, polymorphonuclear neutrophilic leukocyte accumulation was extensive. Compared to baseline, tissue myeloperoxidase (MPO) activity was elevated eight- and fivefold at 1 and 7 days post-CT, respectively. Ubiquitinylated protein was elevated 1 day postinjury and returned to baseline by 21 days. Cysteine residues of creatine kinase (CK) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were irreversibly oxidized within 1 day post-CT injection and were associated with protein conformational changes that fully recovered after 21 days. Importantly, protein structural alterations occurred in conjunction with significant decreases in CK activity at 1, 3, and 7 days post-CT injury. Interestingly, elevations in tissue MPO activity paralleled the time course of conformational changes in CK and GAPDH. In combination, these results demonstrate that muscle proteins in vivo are structurally and functionally altered via the generation of reactive oxygen species produced during inflammatory events after muscle injury and preceding muscle regeneration. Published by Elsevier Inc. C1 [Pierce, Anson P.; McManus, Linda M.; Shireman, Paula K.; Chaudhuri, Asish R.] Univ Texas Hlth Sci Ctr San Antonio, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [Pierce, Anson P.] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. [de Waal, Eric; Chaudhuri, Asish R.] Univ Texas Hlth Sci Ctr San Antonio, Dept Biochem, San Antonio, TX 78229 USA. [McManus, Linda M.] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [McManus, Linda M.] Univ Texas Hlth Sci Ctr San Antonio, Dept Periodont, San Antonio, TX 78229 USA. [Shireman, Paula K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Surg, San Antonio, TX 78229 USA. [Shireman, Paula K.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Shireman, Paula K.; Chaudhuri, Asish R.] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78229 USA. RP Chaudhuri, AR (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. EM Chaudhurja@uthsesa.edu RI Pierce, Anson/D-1079-2012 OI Pierce, Anson/0000-0002-1383-0180 FU NHLBI NIH HHS [HL070158, HL074236]; NIA NIH HHS [AG013319] NR 36 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 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD DEC 15 PY 2007 VL 43 IS 12 BP 1584 EP 1593 DI 10.1016/j.freeradbiomed.2007.08.019 PG 10 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 241QI UT WOS:000251670500003 PM 18037124 ER PT J AU Tsao, JCI Stein, JA Dobalian, A AF Tsao, Jennie C. I. Stein, Judith A. Dobalian, Aram TI Pain, problem drug use history, and aberrant analgesic use behaviors in persons living with HIV SO PAIN LA English DT Article DE pain; opioids; substance abuse; problem drug use; HIV; AIDS ID AMBULATORY AIDS PATIENTS; NATIONAL PROBABILITY SAMPLES; SUBSTANCE-ABUSE TREATMENT; LOW-PREVALENCE DISEASES; QUALITY-OF-LIFE; SERVICES UTILIZATION; UNITED-STATES; HEALTH; ADULTS; PSEUDOADDICTION AB Little is known about the relationship between pain and aberrant use of prescription analgesics in persons living with HIV. We examined the predictive and concurrent associations among pain, aberrant use of opioids, and problem drug use history in a nationally representative longitudinal sample of 2267 HIV+ persons. Covariance structure analyses tested a conceptual model wherein HIV+ patients with a history of problematic drug use (n = 870), compared to those without such history (n = 1397), were hypothesized to report more pain and aberrant opioid use, as well as use of opioids specifically for pain at baseline and 6- and 12-month follow-ups, after controlling for key sociodemographic characteristics. In support of the hypothesized model, patients with a history of problematic drug use reported more pain, and were more likely to report aberrant use of prescription analgesics, as well as use of such medications specifically for pain, compared to patients without such history. We also found a trend toward greater stability of aberrant opioid use over time in problem drug users compared with non-problem users suggesting a persistent pattern of inappropriate medication use in the former group. Our findings suggest that even though HIV+ persons with a history of problematic drug use report on-going patterns of using prescription analgesics specifically for pain, these patients continued to experience persistently higher levels of pain, relative to non-problem users. Among non-problem users, pain was not linked to aberrant use of opioids, but was linked to the use of such medications specifically for pain. (c) 2007 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. C1 [Tsao, Jennie C. I.] Univ Calif Los Angeles, Dept Pediat, David Geffen Sch Med, Pediat Pain Program, Los Angeles, CA 90024 USA. [Stein, Judith A.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. [Dobalian, Aram] Univ Calif Los Angeles, Sch Publ Hlth, VA Greater Los Angeles Healthcare Syst HSR&D, Ctr Excellence Study Healthcare Provider Behav, Los Angeles, CA 90024 USA. [Dobalian, Aram] Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Tsao, JCI (reprint author), Univ Calif Los Angeles, Dept Pediat, David Geffen Sch Med, Pediat Pain Program, Los Angeles, CA 90024 USA. EM jtsao@mednet.ucla.edu FU AHRQ HHS [U01 HS008578, U01HS08578]; NIDA NIH HHS [DA01070, DA017026, P01 DA001070, R03 DA017026, R03 DA017026-02] NR 44 TC 19 Z9 21 U1 5 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0304-3959 J9 PAIN JI Pain PD DEC 15 PY 2007 VL 133 IS 1-3 BP 128 EP 137 DI 10.1016/j.pain.2007.03.016 PG 10 WC Anesthesiology; Clinical Neurology; Neurosciences SC Anesthesiology; Neurosciences & Neurology GA 247KN UT WOS:000252077800016 PM 17449182 ER PT J AU Xing, J Rochester, J Messer, CK Reiter, BP Korsten, MA AF Xing, Jinhong Rochester, Jeremy Messer, Caroline K. Reiter, Bruce P. Korsten, Mark A. TI A phantom gallbladder an endoscopic retrograde cholangiopancreatography SO WORLD JOURNAL OF GASTROENTEROLOGY LA English DT Article DE laparoscopic cholecystectomy; complication; abscess; gallbladder; endoscopic retrograde cholangiopancreatography ID LAPAROSCOPIC CHOLECYSTECTOMY AB Various complications have been related to laparoscopic cholecystectomy but most occur shortly after the procedure. In this report, we present a case with very late complications in which an abscess developed within the gallbladder fossa 6 years after laparoscopic cholecystectomy. The abscess resolved after treatment with CT-guided extrahepatic aspiration. However, 4 years later, an endoscopic retrograde cholangiopancreatography (ERCP) performed for choledocholithiasis demonstrated a "gallbladder" which communicated with the common bile duct via a patent cystic duct. This unique case indicates that a cystic duct stump may communicate with the gallbladder fossa many years following cholecystectomy. (c) 2007 WJG. All rights reserved. C1 James J Peters VA Med Ctr, Bronx, NY 10468 USA. [Xing, Jinhong; Rochester, Jeremy; Messer, Caroline K.; Reiter, Bruce P.; Korsten, Mark A.] James J Peters VA Med Ctr, Gastroenterol & Radiol Programs, Bronx, NY 10468 USA. [Xing, Jinhong; Rochester, Jeremy; Messer, Caroline K.; Reiter, Bruce P.; Korsten, Mark A.] Montefiore Med Ctr, Bronx, NY 10467 USA. [Xing, Jinhong; Rochester, Jeremy; Messer, Caroline K.; Reiter, Bruce P.; Korsten, Mark A.] Mt Sinai Sch Med, New York, NY USA. [Xing, Jinhong; Rochester, Jeremy; Messer, Caroline K.; Reiter, Bruce P.; Korsten, Mark A.] Albert Einstein Coll Med, Bronx, NY 10468 USA. RP Korsten, MA (reprint author), James J Peters VA Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM korsten.mark@med.va.gov NR 6 TC 2 Z9 2 U1 0 U2 0 PU W J G PRESS PI BEIJING PA APT 1066, YISHOU GARDEN, NO 58, NORTH LANGXINZHUANG RD, PO BOX 2345, BEIJING 100023, PEOPLES R CHINA SN 1007-9327 J9 WORLD J GASTROENTERO JI World J. Gastroenterol. PD DEC 14 PY 2007 VL 13 IS 46 BP 6274 EP 6276 DI 10.3748/wjg.13.6274 PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 244BE UT WOS:000251840200024 PM 18069773 ER PT J AU Hoschneider, DP Yang, J Guo, Y Maarek, JMI AF Hoschneider, D. P. Yang, J. Guo, Y. Maarek, J. -M. I. TI Reorganization of functional brain maps after exercise training: Importance of cerebellar-thalamic-cortical pathway SO BRAIN RESEARCH LA English DT Review DE brain mapping; cerebral blood flow; plasticity; exercise; motor training; rehabilitation ID RAT SUPERIOR COLLICULUS; RED NUCLEUS NEURONS; CEREBRAL BLOOD-FLOW; BASAL GANGLIA; MOTOR CORTEX; PARKINSONS-DISEASE; INDICATOR FRACTIONATION; SYNAPTIC REORGANIZATION; HORSERADISH-PEROXIDASE; MEDIODORSAL NUCLEUS AB Exercise training (ET) causes functional and morphologic changes in normal and injured brain. While studies have examined effects of short-term (same day) training on functional brain activation, less work has evaluated effects of long-term training, in particular treadmill running. An improved understanding is relevant as changes in neural reorganization typically require days to weeks, and treadmill training is a component of many neurorehabilitation programs. Adult, male rats (n=10) trained to run for 40 min/day, 5 days/week on a Rotarod treadmill at 11.5 cm/s, while control animals (n=10) walked for 1 min/day at 1.2 cm/s. Six weeks later, [C-14]-iodoantipyrine was injected intravenously during treadmill walking. Regional cerebral blood flow-related tissue radioactivity was quantified by autoradiography and analyzed in the three-dimensionally reconstructed brain by statistical parametric mapping. Exercised compared to nonexercised rats demonstrated increased influence of the cerebellar-thalamic-cortical (CbTC) circuit, with relative increases in perfusion in deep cerebellar nuclei (medial, interposed, lateral), thalamus (ventrolateral, midline, intralaminar), and paravermis, but with decreases in the vermis. In the basal ganglia-thalamic-cortical circuit, significant decreases were noted in sensorimotor cortex and striatum, with associated increases in the globus pallidus. Additional significant changes were noted in the ventral pallidum, superior colliculus, dentate gyrus (increases), and red nucleus (decreases). Following ET, the new dynamic equilibrium of the brain is characterized by increases in the efficiency of neural processing (sensorimotor cortex, striatum, vermis) and an increased influence of the CbTC circuit. Cerebral regions demonstrating changes in neural activation may point to alternate circuits, which may be mobilized during neurorehabilitation. (C) 2007 Elsevier B.V. All rights reserved. C1 [Hoschneider, D. P.] Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, Los Angeles, CA 90089 USA. [Hoschneider, D. P.] Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. [Hoschneider, D. P.] Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA USA. [Hoschneider, D. P.; Maarek, J. -M. I.] Univ So Calif, Viterbi Sch Engn, Dept Biomed Engn, Los Angeles, CA USA. [Hoschneider, D. P.] Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Hoschneider, DP (reprint author), Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, 1333 San Pablo St,BMT 403,MC 9112, Los Angeles, CA 90089 USA. EM holschne@usc.edu NR 105 TC 0 Z9 0 U1 1 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD DEC 12 PY 2007 VL 1184 BP 96 EP 107 DI 10.1016/j.brainres.2007.09.081 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 247RF UT WOS:000252096600012 ER PT J AU Thase, ME AF Thase, Michael E. TI Molecules that mediate mood SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material C1 Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. RP Thase, ME (reprint author), Univ Penn, Sch Med, Philadelphia, PA 19104 USA. NR 3 TC 7 Z9 7 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 DEC 6 PY 2007 VL 357 IS 23 BP 2400 EP 2402 DI 10.1056/NEJMcibr0706377 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 237QA UT WOS:000251389200014 PM 18057345 ER PT J AU Singh, BN Hohnloser, SH AF Singh, Bramah N. Hohnloser, Stefan H. TI Dronedarone in atrial fibrillation - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter ID QUALITY-OF-LIFE; SINUS RHYTHM C1 Vet Affairs Greater Los Angeles, Los Angeles, CA 90073 USA. Univ Frankfurt, D-60325 Frankfurt, Germany. RP Singh, BN (reprint author), Vet Affairs Greater Los Angeles, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu NR 4 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD DEC 6 PY 2007 VL 357 IS 23 BP 2404 EP 2404 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 237QA UT WOS:000251389200017 ER PT J AU Yoshiuchi, K Cook, DB Ohashi, K Kumano, H Kuboki, T Yamamoto, Y Natelson, BH AF Yoshiuchi, Kazuhiro Cook, Dane B. Ohashi, Kyoko Kumano, Hiroaki Kuboki, Tomifusa Yamamoto, Yoshiharu Natelson, Beniamin H. TI A real-time assessment of the effect of exercise in chronic fatigue syndrome SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE chronic fatigue syndrome; ecological momentary assessment; multilevel modeling ID CONTINUOUS PERFORMANCE-TEST; WORKING-MEMORY DEFICITS; DEPRESSION; MOMENTARY; PAIN; PERSPECTIVE; DEFINITION; MOOD AB Patients with chronic fatigue syndrome (CFS) report substantial symptom worsening after exercise. However, the time course over which this develops has not been explored. Therefore, the objective of this study was to investigate the influence of exercise on subjective symptoms and on cognitive function in CFS patients in natural settings using a computerized ecological momentary assessment method, which allowed us to track the effects of exercise within and across days. Subjects were 9 female patients with CFS and 9 healthy women. A watch-type computer was used to collect real-time data on physical and psychological symptoms and cognitive function for 1 week before and 2weeks after a maximal exercise test. For each variable, we investigated temporal changes after exercise using multilevel modeling. Following exercise, physical symptoms did get worse but not until a five-day delay in CFS patients. Despite this, there was no difference in the temporal pattern of changes in psychological symptoms or in cognitive function after exercise between CFS patients and controls. In conclusion, physical symptoms worsened after several days delay in patients with CFS following exercise while psychological symptoms or cognitive function did not change after exercise. (C) 2007 Elsevier Inc. All rights reserved. C1 [Cook, Dane B.; Kumano, Hiroaki; Kuboki, Tomifusa] Univ Tokyo, Fac Med, Dept Psychosomat Med, Bunkyo Ku, Tokyo 1138655, Japan. [Yoshiuchi, Kazuhiro; Natelson, Beniamin H.] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Neurosci, Newark, NJ 07103 USA. [Cook, Dane B.] Univ Wisconsin, William S Middleton Mem Vet Hosp, Res Serv, Madison, WI 53706 USA. [Cook, Dane B.] Univ Wisconsin, Dept Kinesiol, Madison, WI 53706 USA. [Ohashi, Kyoko; Yamamoto, Yoshiharu] Univ Tokyo, Grad Sch Educ, Educ Physiol Lab, Tokyo, Japan. RP Yoshiuchi, K (reprint author), Univ Tokyo, Fac Med, Dept Psychosomat Med, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan. EM kyoshiuc-tky@umin.ac.jp FU NIAID NIH HHS [U01 AI032247, U01 AI032247-11, AI-32247] NR 26 TC 21 Z9 21 U1 6 U2 12 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD DEC 5 PY 2007 VL 92 IS 5 BP 963 EP 968 DI 10.1016/j.physbeh.2007.07.001 PG 6 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 242BB UT WOS:000251698400024 PM 17655887 ER PT J AU Casarett, DJ Quill, TE AF Casarett, David J. Quill, Timothy E. TI Strategies for timely and effective hospice discussions: End-stage renal disease - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Univ Penn, Philadelpia Vet Affairs Med Ctr, Ctr Hlth Equiry Res & Promot, Philadelphia, PA 19104 USA. Univ Rochester, Sch Med, Ctr Eth Human & Palliat Care, Rochester, NY 14642 USA. RP Casarett, DJ (reprint author), Univ Penn, Philadelpia Vet Affairs Med Ctr, Ctr Hlth Equiry Res & Promot, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD DEC 4 PY 2007 VL 147 IS 11 BP 817 EP 817 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 239SX UT WOS:000251539100020 ER PT J AU Glickman, SW Boulding, W Staelin, R Mulgund, J Roe, MT Lytle, BL Rumsfeld, JS Gibler, WB Ohman, EM Schulman, KA Peterson, ED AF Glickman, Seth W. Boulding, William Staelin, Richard Mulgund, Jyotsna Roe, Matthew T. Lytle, Barbara L. Rumsfeld, John S. Gibler, W. Brian Ohman, E. Magnus Schulman, Kevin A. Peterson, Eric D. TI A framework for quality improvement: An analysis of factors responsible for improvement at hospitals participating in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) quality improvement initiative SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; HEALTH-CARE; OPINION LEADERS; PERFORMANCE; MANAGEMENT; MORTALITY; MEDICARE; CULTURE; TRIAL AB Background Hospitals are under increasing pressure to improve their quality of care. However, a key question remains: how can hospitals best design and implement successful quality improvement (Ql) programs? Hospitals currently employ a variety of Ql initiatives but have little empirical evidence on which to base their quality efforts. Methods We designed and applied a hospital cross-sectional survey to 212 hospitals participating in CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines), a voluntary Ql initiative of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). We factor analysis and an ordinary least squares regression model to determine the key hospital factors most associated with unexpected improvements in institutional Ql in the treatment of NSTE ACS. Results From 2002 to 2004, the following factors had a significant association with unexpected increases in the 2004 Ql in NSTE ACS treatment: the use of CRUSADE Q tools, clinical commitment to quality by a cardiology coadvocate, institutional financial commitment to quality, and barriers to Ql related to resource availability and cultural resistance to change (all P <.10). Of these factors, optimal use of CRUSADE Ql tools was associated with the highest absolute improvement in process adherence score relative to other factors. Conclusions We identified several institutional factors associated with improved quality of care in the treatment of high-risk NSTE ACS. We hope that this evidence-based framework will help guide the development and implementation of future Ql programs in order to improve the institutional quality of care for NSTE ACS. C1 Duke Univ, Duke Clin Res Inst, Durham, NC 27715 USA. Duke Univ, Med Ctr, Ctr Clin & Genet Econ, Durham, NC USA. Duke Univ, Fuqua Sch Business, Durham, NC 27706 USA. Denver VA Med Ctr, Cardiol Sect, Denver, CO USA. Univ Cincinnati, Coll Med, Dept Emergency Med, Cincinnati, OH USA. RP Peterson, ED (reprint author), Duke Univ, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA. EM peter016@mc.duke.edu NR 26 TC 21 Z9 21 U1 3 U2 5 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 DEC PY 2007 VL 154 IS 6 BP 1206 EP 1212 DI 10.1016/j.ahj.2007.08.001 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 237SH UT WOS:000251396200030 PM 18035096 ER PT J AU Metz, DC Sostek, MB Ruszniewski, P Forsmark, CE Monyak, J Pisegna, JR AF Metz, David C. Sostek, Mark B. Ruszniewski, Philippe Forsmark, Christopher E. Monyak, John Pisegna, Joseph R. TI Effects of esomeprazole on acid output in patients with Zollinger-Ellison syndrome or idiopathic gastric acid hypersecretion SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID PROTON PUMP INHIBITORS; ORAL PANTOPRAZOLE; INTRAGASTRIC PH; OMEPRAZOLE; LANSOPRAZOLE; THERAPY; EFFICACY; SAFETY AB OBJECTIVES: To evaluate the efficacy and safety of oral esomeprazole in the control of gastric acid hypersecretion in patients with hypersecretory states. METHODS: In this 12-month, open-label, multicenter study, acid output (AO) was evaluated at baseline, day 10, and months 3, 6, and 12. The starting dose of esomeprazole was 40 mg or 80 mg twice daily. On day 10, patients with controlled AO were maintained on the same dose, while those with uncontrolled AO had their doses increased (maximum dose 240 mg/day) until control was attained. Esophagogastroduodenoscopy (EGD) was performed at baseline and at 6 and 12 months. Safety and tolerability were assessed throughout the study by EGD, gastric analysis, and adverse events. RESULTS: Twenty-one patients (19 with Zollinger-Ellison syndrome [ZES], 2 with idiopathic gastric acid hypersecretion [IGH]) completed the study. Of the 20 patients with controlled AO at day 10, 18 (90%) had sustained AO control for the rest of the study. At 12 months, AO was controlled in 14 of 16 patients receiving esomeprazole 40 mg twice daily, in all 4 patients receiving esomeprazole 80 mg twice daily, and in the 1 patient receiving esomeprazole 80 mg 3 times daily. At 6 and 12 months, no patient had endoscopic evidence of mucosal disease. Esomeprazole was well tolerated; 1 patient had a serious adverse event (hypomagnesemia) attributed to treatment that resolved with magnesium supplementation during continued treatment. CONCLUSION: Esomeprazole in appropriately titrated doses controls AO over 12 months in patients with hypersecretory states and is well tolerated. C1 Univ Penn, Philadelphia, PA 19104 USA. AstraZeneca LP, Wilmington, DE USA. Beaujon Hosp, Clichy, France. Univ Florida, Gainesville, FL USA. Univ Calif Los Angeles, David Geffen Sch Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Metz, DC (reprint author), Univ Penn Hlth Syst, Div Gastroenterol, 3rd Floor Ravdin Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. FU NCRR NIH HHS [M01-RR00865] NR 22 TC 26 Z9 27 U1 0 U2 3 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 DEC PY 2007 VL 102 IS 12 BP 2648 EP 2654 DI 10.1111/j.1572-0241.2007.01509.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 235QL UT WOS:000251249300007 PM 17764495 ER PT J AU Naliboff, BD AF Naliboff, Bruce D. TI Towards a nondualistic approach to multisystem illness SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Editorial Material ID IRRITABLE-BOWEL-SYNDROME; DISORDERS; SYMPTOMS; ANXIETY; PAIN AB There is an increasing interest in understanding the etiology and treatment of patients who present with multiple chronic symptoms. The thesis of this comment is that the understanding of these problems and progress on effective treatment will be greatly enhanced by emerging new models that go beyond dualistic distinctions like those between organic versus functional disorders and psychological versus physiological causation. The outline of this new model includes a focus on common neurobiological and behavioral mechanisms that operate across disorders including altered pain modulation, affect regulation, and illness coping. Exciting new areas of research include functional and structural brain imaging studies and more recent studies linking imaging with genetic markers, behavior, and autonomic responses. These new studies, carried out across illness populations, hold great promise to tie together the data on psychosocial, genetic, and biological mechanisms of these complicated clinical problems. C1 Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Naliboff, BD (reprint author), VA WLA Healthcare Ctr, Bldg 115-Rm 223,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK64539]; NINR NIH HHS [NR007768] NR 18 TC 16 Z9 16 U1 6 U2 7 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 DEC PY 2007 VL 102 IS 12 BP 2777 EP 2780 DI 10.1111/j.1572-0241.2007.01535.x PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 235QL UT WOS:000251249300026 PM 18042107 ER PT J AU Carr, D Newton, K Hitti, J Easterling, T Utzschneider, K Faulenbach, M Kahn, S Heckbert, S AF Carr, Darcy Newton, Katherine Hitti, Jane Easterling, Thomas Utzschneider, Kristina Faulenbach, Mirjam Kahn, Steven Heckbert, Susan TI Preterm delivery is associated with future diabetes independent of preeclampsia or gestational diabetes SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Meeting Abstract CT 28th Annual Meeting of the Society-for-Maternal-Fetal-Medicine CY JAN 28-FEB 02, 2008 CL Dallas, TX SP Soc Maternal Fetal Med C1 [Carr, Darcy; Hitti, Jane; Easterling, Thomas; Heckbert, Susan] Univ Washington, Seattle, WA 98195 USA. [Newton, Katherine] Grp Hlth Ctr Hlth Studies, Washington, DC USA. [Utzschneider, Kristina; Faulenbach, Mirjam; Kahn, Steven] VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD DEC PY 2007 VL 197 IS 6 SU S MA 678 BP S194 EP S194 DI 10.1016/j.ajog.2007.10.706 PG 1 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 242EY UT WOS:000251708500670 ER PT J AU Carr, D Newton, K Hitti, J Easterling, T Utzschneider, K Faulenbach, M Kahn, S Heckbert, S AF Carr, Darcy Newton, Katherine Hitti, Jane Easterling, Thomas Utzschneider, Kristina Faulenbach, Mirjam Kahn, Steven Heckbert, Susan TI Vitamin D deficiency is common in pregnancy SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Meeting Abstract CT 28th Annual Meeting of the Society-for-Maternal-Fetal-Medicine CY JAN 28-FEB 02, 2008 CL Dallas, TX SP Soc Maternal Fetal Med C1 [Carr, Darcy; Hitti, Jane; Easterling, Thomas; Heckbert, Susan] Univ Washington, Seattle, WA 98195 USA. [Newton, Katherine] Grp Hlth Ctr Hlth Studies, Washington, DC USA. [Utzschneider, Kristina; Faulenbach, Mirjam; Kahn, Steven] VA Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 1 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD DEC PY 2007 VL 197 IS 6 SU S MA 679 BP S194 EP S194 DI 10.1016/j.ajog.2007.10.707 PG 1 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 242EY UT WOS:000251708500671 ER PT J AU Bradley, CS Nygaard, IE Brown, MB Gutman, RE Kenton, KS Whitehead, WE Goode, PS Wren, PA Ghetti, C Weber, AM AF Bradley, Catherine S. Nygaard, Ingrid E. Brown, Morton B. Gutman, Robert E. Kenton, Kimberly S. Whitehead, William E. Goode, Patricia S. Wren, Patricia A. Ghetti, Chiara Weber, Anne M. CA Pelvic Floor Disorders Network TI Bowel symptoms in women 1 year after sacrocolpopexy SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the Society-of-Gynecological-Surgeons CY APR 13, 2007 CL Orlando, FL SP Soc Gynecol Surg DE abdominal sacrocolpopexy; bowel symptoms; constipation; pelvic organ prolapse; questionnaires ID PELVIC ORGAN PROLAPSE; RECTOVAGINAL FASCIA REATTACHMENT; RECTOCELE REPAIR; ABDOMINAL SACROCOLPOPEXY; POSTERIOR COMPARTMENT; FLOOR DISORDERS; DYSFUNCTION; CONSTIPATION; POPULATION; COLPOPEXY AB OBJECTIVE: The objective of the study was to evaluate changes in bowel symptoms after sacrocolpopexy. STUDY DESIGN: This was a prospectively planned, ancillary analysis of the Colpopexy and Urinary Reduction Efforts study, a randomized trial of sacrocolpopexy with or without Burch colposuspension in stress continent women with stages II - IV prolapse. In addition to sacrocolpopexy (+/- Burch), subjects underwent posterior vaginal or perineal procedures ( PR) at each surgeon's discretion. The preoperative and 1 year postoperative Colorectal-anal Distress Inventory (CRADI) scores were compared within and between groups using Wilcoxon signed-rank and rank-sum tests, respectively. RESULTS: The sacrocolpopexy + PR group (n = 87) had more baseline obstructive colorectal symptoms (higher CRADI and CRADI-obstructive scores: P = .04 and < .01, respectively) than the sacrocolpopexy alone group ( n = 211). CRADI total, obstructive, and pain/irritation scores significantly improved in both groups ( all P < .01). Most bothersome symptoms resolved after surgery in both groups. CONCLUSION: Most bowel symptoms improve in women with moderate to severe pelvic organ prolapse after sacrocolpopexy. C1 [Bradley, Catherine S.] Univ Iowa, Carver Coll Med, Dept Obstet & Gynecol, Iowa City, IA 52242 USA. [Nygaard, Ingrid E.] Univ Utah, Dept Obstet & Gynecol, Salt Lake City, UT USA. [Brown, Morton B.] Univ Michigan, Dept Biostat, Ann Arbor, MI USA. [Gutman, Robert E.] Johns Hopkins Sch Med, Dept Obstet & Gynecol, Baltimore, MD USA. [Kenton, Kimberly S.] Loyola Univ, Med Ctr, Dept Obstet & Gynecol, Maywood, IL USA. Univ N Carolina, Dept Med, Chapel Hill, NC USA. [Whitehead, William E.] Univ N Carolina, Dept Obstet & Gynecol, Chapel Hill, NC USA. [Goode, Patricia S.] Univ Alabama, Birmingham Vet Affairs Med Ctr, Birmingham Atlanta Geriat Res Educ & Clin Ctr, Dept Med, Birmingham, AL USA. [Wren, Patricia A.] Oakland Univ, Sch Hlth Sci, Dept Wellness Hlth Promot & Injury Prevent, Rochester, MI USA. [Ghetti, Chiara] Univ Pittsburgh, Magee Womens Hosp, Med Ctr, Dept Obstet & Gynecol, Pittsburgh, PA USA. [Weber, Anne M.] NIH, NICHHD, Bethesda, MD USA. RP Bradley, CS (reprint author), Univ Iowa, Carver Coll Med, Dept Obstet & Gynecol, Iowa City, IA 52242 USA. NR 28 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 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD DEC PY 2007 VL 197 IS 6 AR 642.e1 DI 10.1016/j.ajog.2007.08.023 PG 8 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 241SI UT WOS:000251675700033 ER PT J AU Burgio, KL Nygaard, IE Richter, HE Brubaker, L Gutman, RE Leng, W Wei, J Weber, AM AF Burgio, Kathryn L. Nygaard, Ingrid E. Richter, Holly E. Brubaker, Linda Gutman, Robert E. Leng, Wendy Wei, John Weber, Anne M. CA Pelvic Fl Disorders Network TI Bladder symptoms 1 year after abdominal sacrocolpopexy with and without Burch colposuspension in women without preoperative stress incontinence symptoms SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the Society-of-Gynecological-Surgeons CY APR 13, 2007 CL Orlando, FL SP Soc Gynecol Surg DE irritative urinary symptoms; obstructive urinary symptoms; pelvic organ prolapse; sacrocolpopexy; urinary incontinence ID QUALITY-OF-LIFE; URINARY-INCONTINENCE; GENITAL PROLAPSE AB OBJECTIVE: The objective of the study was to examine changes in bladder symptoms 1 year after abdominal sacrocolpopexy (ASC) with vs without Burch colposuspension. STUDY DESIGN: Women without stress urinary incontinence (SUI) symptoms undergoing ASC were randomized to receive or not receive Burch. One year later, irritative, obstructive, and SUI symptoms were assessed in 305 women using Urogenital Distress Inventory subscales. A composite "stress endpoint" combined SUI symptoms, positive stress test, and retreatment. RESULTS: In all women, the mean irritative score decreased from 19.6 +/- 16.3 ( mean +/- SD) to 9.1 +/- 10.6; for obstructive symptoms, from 34.8 +/- 21.0 to 6.3 +/- 10.4 ( both P < .001). Preoperative bothersome irritative symptoms resolved in 74.6% ( 126 of 169) and obstructive symptoms in 85.1% ( 212 of 249), independent of Burch. Fewer women with Burch had urge incontinence (14.5% vs 26.8%, P = .048) and fulfilled the stress endpoint (25.0% vs 40.1%, P = .012). CONCLUSION: ASC reduced bothersome irritative and obstructive symptoms. Prophylactic Burch reduced stress and urge incontinence. C1 [Burgio, Kathryn L.] Univ Alabama, Sch Med, Dept Med, Birmingham, AL 35233 USA. [Richter, Holly E.] Univ Alabama, Sch Med, Dept Obstet & Gynecol, Birmingham, AL 35233 USA. [Burgio, Kathryn L.] Geriat Res Educ & Clin Ctr, Dept Vet Affairs, Birmingham, AL USA. [Nygaard, Ingrid E.] Univ Utah, Ctr Hlth Sci, Dept Obstet & Gynecol, Salt Lake City, UT 84112 USA. [Brubaker, Linda] Loyola Univ, Med Ctr, Dept Obstet & Gynecol, Chicago, IL USA. [Gutman, Robert E.] Johns Hopkins Sch Med, Dept Gynecol & Obstet, Baltimore, MD USA. [Leng, Wendy] Univ Pittsburgh, Magee Womens Hosp, Pittsburgh, PA 15260 USA. [Wei, John] Univ Michigan, Sch Publ Hlth, Dept Biostat, Ann Arbor, MI USA. [Weber, Anne M.] NIH, NICHHD, Bethesda, MD USA. RP Burgio, KL (reprint author), Univ Alabama, Birmingham VA Med Ctr, 11G, 700 S 19th St, Birmingham, AL 35233 USA. EM kburgio@aging.uab.edu NR 15 TC 0 Z9 0 U1 1 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD DEC PY 2007 VL 197 IS 6 AR 647. e1 DI 10.1016/j.ajog.2007.08.048 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 241SI UT WOS:000251675700035 ER PT J AU Handa, VL Zyczynski, HM Burgio, KL Fitzgerald, MP Borello-France, D Janz, NK Fine, PM Whitehead, W Brown, MB Weber, AM AF Handa, Victoria L. Zyczynski, Halina M. Burgio, Kathryn L. Fitzgerald, Mary Pat Borello-France, Diane Janz, Nancy K. Fine, Paul M. Whitehead, William Brown, Morton B. Weber, Anne M. CA Pelvic Floor Disorders Network TI The impact of fecal and urinary incontinence on quality of life 6 months after childbirth SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the Society-of-Gynecological-Surgeons CY APR 13, 2007 CL Orlando, FL SP Soc Gynecol Surg DE childbirth; fecal incontinence; quality of life; urinary incontinence ID ANAL-SPHINCTER DISRUPTION; VAGINAL DELIVERY; PRIMIPAROUS WOMEN; OBSTETRICS UNIT; SEVERITY INDEX; SHORT-FORM; PREVALENCE; SYMPTOMS; STRESS; RISK AB OBJECTIVE: The objective of the study was to investigate the impact of postpartum fecal incontinence (FI) and urinary incontinence (UI) on quality of life (QOL). STUDY DESIGN: Seven hundred fifty-nine primiparous women in the Childbirth and Pelvic Symptoms study were interviewed 6 months postpartum. FI and UI were assessed with validated questionnaires. We measured QOL with SF-12 summary scores, health utility index score ( a measure of self-rated overall health), and the modified Manchester Health Questionnaire. RESULTS: Women with FI had worse self-rated health utility index scores (85.1 +/- 9.8 vs 88.0 +/- 11.6, P = .02) and Medical Outcomes Study Short Form Health Survey (SF-12) mental summary scores ( 46.8 +/- 9.2 vs 51.1 +/- 8.7, P <.0001) than women without FI or flatal incontinence. Women with UI had worse SF-12 mental summary scores (48.3 +/- 9.8 vs 51.6 +/- 7.8, P <.01) and self-rated health utility index scores (84.1 +/- 12.5 vs 88.7 +/- 10.1, P <.01) than women without UI. Women with both FI and UI had the lowest SF-12 mental summary scores (44.5 +/- 9.0). CONCLUSION: Six months after delivery, women experiencing FI or UI reported negative effects on health-related QOL. FI and UI together have a greater impact than either condition alone. C1 [Handa, Victoria L.] Johns Hopkins Univ, Baltimore, MD 21218 USA. [Zyczynski, Halina M.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. [Burgio, Kathryn L.] Univ Alabama, Tuscaloosa, AL 35487 USA. [Burgio, Kathryn L.] Birmingham VA Med Ctr, Birmingham, AL USA. [Fitzgerald, Mary Pat] Loyola Univ, Chicago, IL USA. [Borello-France, Diane] Duquesne Univ, Pittsburgh, PA USA. [Janz, Nancy K.; Brown, Morton B.] Univ Michigan, Ann Arbor, MI 48109 USA. [Fine, Paul M.] Baylor Coll Med, Houston, TX USA. [Whitehead, William] Univ N Carolina, Chapel Hill, NC USA. [Weber, Anne M.] NIH, NICHHD, Chapel Hill, NC USA. RP Handa, VL (reprint author), Johns Hopkins Univ, Baltimore, MD 21218 USA. FU NCRR NIH HHS [M01 RR002719, M01 RR002719-225499]; NICHD NIH HHS [U10 HD41263, U10 HD41250, U10 HD041268, U10 HD041250, U10 HD41267, U10 HD041263, U01 HD041249, U01 HD41249, U10 HD41261, U10 HD41268, U10 HD041261, U10 HD041269, U10 HD041267, U10 HD041248, U10 HD41248, U10 HD41269, U10 HD041268-05] NR 28 TC 4 Z9 4 U1 0 U2 5 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9378 EI 1097-6868 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD DEC PY 2007 VL 197 IS 6 AR 636.e1 DI 10.1016/j.ajog.2007.08.020 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 241SI UT WOS:000251675700030 PM 18060960 ER PT J AU Sataranatarajan, K Mariappan, MM Lee, MJ Feliers, D Choudhury, GG Barnes, JL Kasinath, BS AF Sataranatarajan, Kavithalakshmi Mariappan, Meenalakshmi M. Lee, Myung Ja Feliers, Denis Choudhury, Goutarn Ghosh Barnes, Jeffrey L. Kasinath, Balakuntalam S. TI Regulation of elongation phase of mRNA translation in diabetic nephropathy - Amelioration by rapamycin SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID RENAL EPITHELIAL-CELLS; MAMMALIAN TARGET; KIDNEY-DISEASE; PROTEIN-KINASE; DB/DB MICE; RAT MODEL; FACTOR-II; MTOR; HYPERTROPHY; GROWTH AB High glucose and high insulin, pathogenic factors in type 2 diabetes, induce rapid synthesis of the matrix protein laminin-beta 1 in renal proximal tubular epithelial cells by stimulation of initiation phase of mRNA translation. We investigated if elongation phase of translation also contributes to high glucose and high insulin induction of laminin-beta 1 synthesis in proximal tubular epithelial cells. High glucose or high insulin rapidly increased activating Thr56 dephosphorylation of eEF2 and inactivating Ser366 phosphorylation of eEF2 kinase, events that facilitate elongation. Studies with inhibitors showed that PI3 kinase-Akt-mTOR-p70S6 kinase pathway controlled changes in phosphorylation of eEF2 and eEF2 kinase induced by high glucose or high insulin. Renal cortical homogenates from db/db mice in early stage of type 2 diabetes showed decrease in eEF2 phosphorylation and increment in eEF2 kinase phosphorylation in association with renal hypertrophy and glomerular and tubular increase in laminin-beta 1 content. Rapamycin, an inhibitor of mTOR, abolished diabetes-induced changes in phosphorylation of eEF2, eEF2 kinase, and p70S6 kinase and ameliorated renal hypertrophy and laminin-beta 1 protein content, without affecting hyperglycemia. These data show that mTOR is an attractive target for amelioration of diabetes-induced renal injury. C1 [Sataranatarajan, Kavithalakshmi; Mariappan, Meenalakshmi M.; Lee, Myung Ja; Feliers, Denis; Choudhury, Goutarn Ghosh; Barnes, Jeffrey L.; Kasinath, Balakuntalam S.] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, OBrien Kidney Res Ctr, San Antonio, TX 78229 USA. [Choudhury, Goutarn Ghosh; Barnes, Jeffrey L.; Kasinath, Balakuntalam S.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Kasinath, BS (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, OBrien Kidney Res Ctr, MC 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM kasinath@uthscsa.edu FU NIDDK NIH HHS [R29 DK050190, R01 DK050190, DK061597, R01 DK077295, DK050190, P50 DK061597, DK077295] NR 37 TC 66 Z9 70 U1 1 U2 4 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD DEC PY 2007 VL 171 IS 6 BP 1733 EP 1742 DI 10.2353/ajpath.2007.070412 PG 10 WC Pathology SC Pathology GA 241EE UT WOS:000251638900002 PM 17991718 ER PT J AU Quinn, LS Anderson, BG Plymate, SR AF Quinn, LeBris S. Anderson, Barbara G. Plymate, Stephen R. TI Muscle-specific overexpression of the type 1 IGF receptor results in myoblast-independent muscle hypertrophy via PI3K, and not calcineurin, signaling SO AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM LA English DT Article DE insulin-like growth factor; insulin-like growth factor receptor; protein synthesis; protein degradation; sarcopenia ID GROWTH-FACTOR-I; STIMULATES PROTEIN-SYNTHESIS; MAMMALIAN SKELETAL-MUSCLE; DIGITORUM LONGUS MUSCLE; SATELLITE CELL-ACTIVITY; TRANSGENIC MICE; MYOTUBE HYPERTROPHY; MYONUCLEAR NUMBER; GAMMA-IRRADIATION; UBIQUITIN LIGASES AB Quinn LS, Anderson BG, Plymate SR. Muscle-specific overexpression of the type 1 IGF receptor results in myoblast-independent muscle hypertrophy via PI3K, and not calcineurin, signaling. Am J Physiol Endocrinol Metab 293: E1538-E1551, 2007. First published October 16, 2007; doi: 10.1152/ajpendo.00160.2007. - The insulinlike growth factors (IGF-I and IGF-II), working through the type 1 IGF receptor (IGF-1R), are key mediators of skeletal muscle fiber growth and hypertrophy. These processes are largely dependent on stimulation of proliferation and differentiation of muscle precursor cells, termed myoblasts. It has not been rigorously determined whether the IGFs can also mediate skeletal muscle hypertrophy in a myoblast-independent fashion. Similarly, although the phosphatidylinositol 3-kinase (PI3K) and calcineurin signaling pathways have been implicated in skeletal muscle hypertrophy, these pathways are also involved in skeletal myoblast differentiation. To determine whether the IGFs can stimulate skeletal muscle hypertrophy in a myoblast-independent fashion, we developed and validated a retroviral expression vector that mediated overexpression of the human IGF-1R in rat L6 skeletal myotubes (immature muscle fibers), but not in myoblasts. L6 myotubes transduced with this vector accumulated significantly higher amounts of myofibrillar proteins, in a ligand-and receptor-dependent manner, than controls and demonstrated significantly increased rates of protein synthesis. Stimulation of myotube hypertrophy was independent of myoblast contributions, inasmuch as these cultures did not exhibit increased levels of myoblast proliferation or differentiation. Experiments with PI3K and calcineurin inhibitors indicated that myoblast-independent myotube hypertrophy was mediated by PI3K, but not calcineurin, signaling. This study demonstrates that IGF can mediate skeletal muscle hypertrophy in a myoblast-independent fashion and suggests that muscle-specific overexpression of the IGF-1R or stimulation of its signaling pathways could be used to develop strategies to ameliorate muscle wasting without stimulating proliferative pathways leading to carcinogenesis or other pathological sequelae. C1 Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Washington, DC USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. RP Quinn, LS (reprint author), VA Puget Sound Hlth Care Syst, 151 Amer Lake Div, Tacoma, WA 98493 USA. EM quinnL@u.washington.edu FU NIA NIH HHS [R01 AG-024136] NR 81 TC 19 Z9 21 U1 0 U2 3 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1849 J9 AM J PHYSIOL-ENDOC M JI Am. J. Physiol.-Endocrinol. Metab. PD DEC PY 2007 VL 293 IS 6 BP E1538 EP E1551 DI 10.1152/ajpendo.00160.2007 PG 14 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 239HU UT WOS:000251510200009 PM 17940216 ER PT J AU Akiba, Y Mizumori, M Guth, PH Engel, E Kaunitz, JD AF Akiba, Yasutada Mizumori, Misa Guth, Paul H. Engel, Eli Kaunitz, Jonathan D. TI Duodenal brush border intestinal alkaline phosphatase activity affects bicarbonate secretion in rats SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE duodenum; brush-border membrane; ELF-97 phosphate ID STIMULATED ATPASE ACTIVITY; HCO3-SECRETION; EPITHELIAL-CELLS; PANCREATIC-DUCT; ADENOSINE-TRIPHOSPHATASE; CARBONIC-ANHYDRASES; HYDROGEN-SULFIDE; LUMINAL CO2; GUINEA-PIG; RECEPTORS AB We hypothesized that duodenal HCO3- secretion alkalinizes the microclimate surrounding intestinal alkaline phosphatase (IAP), increasing its activity. We measured AP activity in rat duodenum in situ in frozen sections with the fluorogenic substrate ELF-97 phosphate and measured duodenal HCO3-secretion with a pH-stat in perfused duodenal loops. We examined the effects of the IAP inhibitors L-cysteine or L-phenylalanine ( 0.1 - 10 mM) or the tissue nonspecific AP inhibitor levamisole ( 0.1 - 10 mM) on AP activity in vitro and on acid-induced duodenal HCO3- secretion in vivo. AP activity was the highest in the duodenal brush border, decreasing longitudinally to the large intestine with no activity in stomach. Villous surface AP activity measured in vivo was enhanced by PGE(2) intravenously and inhibited by luminal L-cysteine. Furthermore, incubation with a pH 2.2 solution reduced AP activity in vivo, whereas pretreatment with the cystic fibrosis transmembrane regulator (CFTR) inhibitor CFTRinh-172 abolished AP activity at pH 2.2. L-Cysteine and L-phenylalanine enhanced acid-augmented duodenal HCO3- secretion. The nonselective P2 receptor antagonist suramin (1 mM) reduced acid-induced HCO3- secretion. Moreover, L-cysteine or the competitive AP inhibitor glycerol phosphate (10 mM) increased HCO3- secretion, inhibited by suramin. In conclusion, enhancement of the duodenal HCO3- secretory rate increased AP activity, whereas inhibition of AP activity increased the HCO3- secretory rate. These data support our hypothesis that HCO3- secretion increases AP activity by increasing local pH at its catalytic site and that AP hydrolyzes endogenous luminal phosphates, presumably ATP, which increases HCO3- secretion via activation of P2 receptors. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Biomath, Los Angeles, CA 90024 USA. Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jake@ucla.edu FU NIDDK NIH HHS [R01 DK54221, P30 DK0413] NR 69 TC 44 Z9 48 U1 1 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD DEC PY 2007 VL 293 IS 6 BP G1223 EP G1233 DI 10.1152/ajpgi.00313.2007 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 239HX UT WOS:000251510500014 PM 17916646 ER PT J AU Martin, LF Hall, MH Ross, RG Zerbe, G Freedman, R Olincy, A AF Martin, Laura F. Hall, Mei-Hua Ross, Randal G. Zerbe, Gary Freedman, Robert Olincy, Ann TI Physiology of schizophrenia, bipolar disorder, and Schizoaffective disorder SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article; Proceedings Paper CT 11th International Congress on Schizophrenia Research/8th Biennial Mt Sinai Conference on Cognition in Schizophrenia CY MAR 27-APR 01, 2007 CL Colorado Springs, CO ID PURSUIT EYE-MOVEMENTS; SMOOTH-PURSUIT; SACCADIC ABNORMALITIES; ANTICIPATORY SACCADES; PSYCHOTIC-PATIENTS; VOLUNTARY CONTROL; GRAY-MATTER; TASK; PERFORMANCE; MANIA AB Objective: Endophenotypes have been proposed to identify the genetic and biological substrates of complex disorders. Three physiological inhibitory endophenotypes of large effect size in schizophrenia include suppression of P50 auditory evoked responses, inhibition of leading (small anticipatory) saccades during smooth pursuit eye movements, and cancellation of reflexive saccades in the anti-saccade eye movement task. The aim of this study was to determine if the pattern of endophenotype abnormalities within individuals with schizophrenia differed from that within individuals with bipolar disorder. A second aim was to determine whether subjects with schizoaffective disorder, bipolar type, were neurophysiologically more similar to subjects with schizophrenia or subjects with bipolar disorder. Method: Endophenotypes were recorded for subjects diagnosed with schizophrenia (N=29), bipolar disorder (DSM-IV-TR) (N=40), and schizoaffective disorder, bipolar type (N=18). Data from normal comparison subjects were used to establish normal performance. Results: Logistic regression determined that P50 ratio and frequency of leading saccades identified subjects with schizophrenia and bipolar disorder with a sensitivity of 95% and a specificity of 83%. The schizoaffective disorder group was split, with six subjects physiologically classified as schizophrenia-like and 12 subjects as bipolar-like. Those classified as schizophrenia-like were significantly younger at illness onset and had higher symptom ratings. Conclusion: A composite endophenotype of P50 ratio and frequency of leading saccades is consistent with the current clinical nosology of schizophrenia and bipolar disorder and parses patients with schizoaffective disorder, bipolar type, into two subgroups. C1 Hlth Sci Ctr, Denver, CO 80262 USA. Denver VA Med Ctr, Dept Psychiat, Denver, CO USA. Univ Colorado, Dept Prevent Med & Biometr, Denver, CO USA. Kings Coll London, Inst Psychiat, Social Genet & Dev Psychiat Ctr, London, England. RP Martin, LF (reprint author), Univ Colorado, Dept Psychiat, 4200 E 9th Ave,C268-71, Denver, CO 80262 USA. EM laura.martin@uchsc.edu FU NIMH NIH HHS [MH 38321] NR 39 TC 38 Z9 39 U1 1 U2 6 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD DEC PY 2007 VL 164 IS 12 BP 1900 EP 1906 DI 10.1176/appi.ajp.2007.06010017 PG 7 WC Psychiatry SC Psychiatry GA 238VN UT WOS:000251476200022 PM 18056246 ER PT J AU Ibrahim, SA AF Ibrahim, S. A. TI The Veterans Health Administration: A domestic model for a national health care system? SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID QUALITY-OF-CARE C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Univ Dr C 151C-U, Pittsburgh, PA 15240 USA. EM said.ibrahim2@va.gov FU NIAMS NIH HHS [K24 AR055259, K24AR055259] NR 16 TC 5 Z9 5 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD DEC PY 2007 VL 97 IS 12 BP 2124 EP 2126 DI 10.2105/AJPH.2007125575 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 237SE UT WOS:000251395900012 PM 17971535 ER PT J AU Volpp, KG AF Volpp, Kevin G. TI Designing a model health care system SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID QUALITY-OF-CARE; REGIONALIZATION; PERFORMANCE; OUTCOMES; PAY C1 Vet Adm Hosp, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Dept Med, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Volpp, KG (reprint author), Philadelphia Vet Affairs Med Ctr, Univ & Woodland Aves, Philadelphia, PA 19104 USA. EM volpp70@wharton.upenn.edu NR 20 TC 3 Z9 3 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD DEC PY 2007 VL 97 IS 12 BP 2126 EP 2128 DI 10.2105/AJPH.2007.124461 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 237SE UT WOS:000251395900013 PM 17971536 ER PT J AU Good, CB Valentino, M AF Good, Chester B. Valentino, Michael TI Access to affordable medications: The department of veterans affairs pharmacy plan as a national model SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material C1 VA Pittsburgh Healthcare Syst, Ctr Healthcare Equ Res & Promot, Pittsburgh, PA 15206 USA. Dept Vet Affairs, Pharm Benefits Management Strateg Healthcare Grp, Washington, DC USA. RP Good, CB (reprint author), VA Pittsburgh Healthcare Syst, Ctr Healthcare Equ Res & Promot, 7180 High-Land Dr 151C-H, Pittsburgh, PA 15206 USA. EM chester.good@va.gov NR 5 TC 10 Z9 10 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD DEC PY 2007 VL 97 IS 12 BP 2129 EP 2131 DI 10.2105/AJPH.2007.124008 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 237SE UT WOS:000251395900014 PM 17971537 ER PT J AU Yano, EM Simon, BF Lanto, AB Rubenstein, LV AF Yano, Elizabeth M. Simon, Barbara F. Lanto, Andrew B. Rubenstein, Lisa V. TI The evolution of changes in primary care delivery underlying the Veterans Health Administration's quality transformation SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID ORGANIZATIONAL CHARACTERISTICS; MATRIX MANAGEMENT; AMBULATORY CARE; OF-CARE; SYSTEM; AFFAIRS; VA; NETWORKS; LESSONS AB Objectives. Suffering from waning demand, poor quality, and reform efforts enabling veterans to "vote with their feet" and leave, the Veterans Health Administration (VA) health care system transformed itself through a series of substantive changes. We examined the evolution of primary care changes underlying VA's transformation. Methods. We used 3 national organizational surveys from 1993, 1996, and 1999 that measured primary care organization, staffing, management, and resource sufficiency to evaluate changes in VA primary care delivery. Results. Only rudimentary primary care was in place in 1993. Primary care enrollment grew from 38% in 1993 to 45% in 1996, and to 95% in 1999 as VA adopted team structures and increased the assignment of patients to individual providers. Specialists initially staffed primary care until generalist physicians and nonphysican providers increased. Primary care-based quality improvement and authority expanded, and resource sufficiency (e.g., computers, space) grew. Provider notification of admissions and emergency department, urgent-care visit, and subspecialty-consult results increased nearly 5 times. Conclusions. Although VA's quality transformation had many underlying causes, investment in primary care development may have served as an essential substrate for many VA quality gains. C1 Vet Hlth Adm Greater Los Angeles HSR&D Ctr Excell, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RAND Hlth, Santa Monica, CA USA. RP Yano, EM (reprint author), VA Greater Los Angeles HSR&D Ctr Excellence, 16111 Plummer St,Mailcode 152, Sepulveda, CA 91343 USA. EM elizabeth.yano@va.gov NR 56 TC 26 Z9 26 U1 1 U2 3 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD DEC PY 2007 VL 97 IS 12 BP 2151 EP 2159 DI 10.2105/AJPH.2007.115709 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 237SE UT WOS:000251395900019 PM 17971540 ER PT J AU Au, DH Chien, JW Bryson, CL AF Au, David H. Chien, Jason W. Bryson, Christopher L. TI Lung cancer chemoprevention with inhaled corticosteroids? - Reply SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Letter C1 VA Puget Sound Health Care Syst, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. RP Au, DH (reprint author), VA Puget Sound Health Care Syst, Seattle, WA 98108 USA. NR 1 TC 0 Z9 0 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 DEC 1 PY 2007 VL 176 IS 11 BP 1169 EP 1169 PG 1 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 237OG UT WOS:000251384100017 ER PT J AU Knight, SJ Latini, DM Sands, LP Chang, CH AF Knight, Sara J. Latini, David M. Sands, Laura P. Chang, Chih-Hung TI PATIENT VALUES AND PREFERENCES FOR CARE: METHODS FOR IMPROVING MEASURES SO ANNALS OF BEHAVIORAL MEDICINE LA English DT Meeting Abstract C1 [Knight, Sara J.] San Francisco VA Med Ctr, Hlth Serv Res & Dev, San Francisco, CA 94121 USA. [Latini, David M.] Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Sands, Laura P.] Purdue Univ, Sch Nursing, W Lafayette, IN 47907 USA. [Chang, Chih-Hung] Northwestern Univ, Feinberg Sch Med, Buehler Ctr Aging Hlth & Soc, Chicago, IL 60611 USA. [Knight, Sara J.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Latini, David M.] Baylor Coll Med, Dept Urol, Houston, TX 77030 USA. [Latini, David M.] Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA. EM sara.knight@va.gov NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0883-6612 J9 ANN BEHAV MED JI Ann. Behav. Med. PD DEC PY 2007 VL 33 BP S1 EP S1 PG 1 WC Psychology, Multidisciplinary SC Psychology GA 376LO UT WOS:000261185300003 ER PT J AU Lyle, J Tomcho, TJ Juryea, B Sayers, SL AF Lyle, Jennifer Tomcho, Thomas J. Juryea, Bambi Sayers, Steven L. TI RCTS OF TELEPHONE INTERVENTIONS FOR CANCER: META-ANALYSIS OF PSYCHOLOGICAL OUTCOMES SO ANNALS OF BEHAVIORAL MEDICINE LA English DT Meeting Abstract C1 [Lyle, Jennifer; Tomcho, Thomas J.; Juryea, Bambi; Sayers, Steven L.] Philadelphia VA Med Ctr, Philadelphia, PA USA. EM jenniferlyle@hotmail.com NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0883-6612 J9 ANN BEHAV MED JI Ann. Behav. Med. PD DEC PY 2007 VL 33 BP S172 EP S172 PG 1 WC Psychology, Multidisciplinary SC Psychology GA 376LO UT WOS:000261185300669 ER PT J AU Purnell, J Andersen, B AF Purnell, Jason Andersen, Barbara TI TESTING A SOCIOCULTURAL MODEL OF COLORECTAL CANCER SCREENING AMONG AFRICAN AMERICANS SO ANNALS OF BEHAVIORAL MEDICINE LA English DT Meeting Abstract C1 [Purnell, Jason; Andersen, Barbara] S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. [Purnell, Jason] Ohio State Univ, Columbus, OH 43210 USA. EM Jason.Purnell@va.gov NR 0 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0883-6612 J9 ANN BEHAV MED JI Ann. Behav. Med. PD DEC PY 2007 VL 33 BP S84 EP S84 PG 1 WC Psychology, Multidisciplinary SC Psychology GA 376LO UT WOS:000261185300328 ER PT J AU Sun, BC Mangione, CM Hoffman, JR Mower, WR AF Sun, Benjamin C. Mangione, Carol M. Hoffman, Jerome R. Mower, William R. TI External validation of the San Francisco Syncope Rule - In reply SO ANNALS OF EMERGENCY MEDICINE LA English DT Letter ID SERIOUS OUTCOMES; PREDICT PATIENTS C1 Univ Calif Los Angeles, Dept Med, W Los Angles Vet Affairs Med Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Emergency Med, Los Angeles, CA 90024 USA. RP Sun, BC (reprint author), Univ Calif Los Angeles, Dept Med, W Los Angles Vet Affairs Med Ctr, Los Angeles, CA 90024 USA. NR 7 TC 0 Z9 0 U1 0 U2 1 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 DEC PY 2007 VL 50 IS 6 BP 743 EP 744 DI 10.1016/j.annemergmed.2007.10.002 PG 2 WC Emergency Medicine SC Emergency Medicine GA 238IJ UT WOS:000251440500023 ER PT J AU Bilimoria, KY Stewart, AK Tomlinson, JS Gay, EG Ko, CY Talamonti, MS Bentrem, DJ AF Bilimoria, Karl Y. Stewart, Andrew K. Tomlinson, James S. Gay, E. Greer Ko, Clifford Y. Talamonti, Mark S. Bentrem, David J. TI Impact of adjuvant radiation on survival: A note of caution when using cancer registry data to evaluate adjuvant treatments SO ANNALS OF SURGICAL ONCOLOGY LA English DT Article DE survival; radiation; chemotherapy; National Cancer Data Base; SEER; adjuvant therapy; chemoradiation ID COLORECTAL-CANCER; THERAPY; CHEMOTHERAPY; INFORMATION; CARCINOMA AB Background: With increasing frequency, studies using cancer registries have evaluated the treatment effect of adjuvant radiation; however, these analyses generally do not include chemotherapy treatment data. Our objective is to evaluate the potential impact the absence of adjuvant chemotherapy data has on the estimated survival benefit attributed to adjuvant radiation therapy. Methods: Using the National Cancer Data Base, patients were identified who underwent surgery for cancers that often require radiation therapy: breast, esophageal, gastric, pancreatic, and rectal cancer. Cox proportional hazards modeling with and without chemotherapy as a predictor variable was used to assess the impact of radiation therapy on 5-year survival. Results: From 1998 to 1999, 295,206 patients underwent surgical resection for one of five cancers. Chemotherapy administration ranged from 27.5% for gastric to 56.1% for rectal cancer. For cancers where chemotherapy affected survival, the impact of radiation therapy was overestimated in the multivariate model when chemotherapy was not included. For example, radiation treatment for rectal cancer was associated with a 31% decrease in the risk of death in the model that did not control for chemotherapy; however, the addition of chemotherapy to the model resulted in only a 14% decrease in the risk of death associated with receiving radiation therapy. Conclusions: For selected tumor sites, the administration of chemotherapy is not evenly distributed among patients receiving and not receiving radiation. Survival analyses that do not include chemotherapy administration overestimate the beneficial impact of radiation on survival. Evaluating the effect of radiation on survival retrospectively without adjusting for chemotherapy administration should be done cautiously. C1 Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. Amer Coll Surg, Canc Program, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, VA Greater Los Angeles Hlthcare Syst, Los Angeles, CA USA. RP Bentrem, DJ (reprint author), Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. EM dbentrem@nmff.org NR 27 TC 7 Z9 7 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1068-9265 J9 ANN SURG ONCOL JI Ann. Surg. Oncol. PD DEC PY 2007 VL 14 IS 12 BP 3321 EP 3327 DI 10.1245/s10434-007-9576-4 PG 7 WC Oncology; Surgery SC Oncology; Surgery GA 231VE UT WOS:000250976500011 PM 17899285 ER PT J AU Wang, L Zhou, XH AF Wang, Lan Zhou, Xiao-Hua TI Assessing the adequacy of variance function in heteroscedastic regression models SO BIOMETRICS LA English DT Article DE goodness-of-fit test; heteroscedastic errors; kernel smoothing; pseudolikelihood; variance function ID LINEAR-MODELS; COVARIANCE; CHECKING AB Heteroscedastic data arise in many applications. In heteroscedastic regression analysis, the variance is often modeled as a parametric function of the covariates or the regression mean. We propose a kernel-smoothing type nonparametric test for checking the adequacy of a given parametric variance structure. The test does not need to specify a parametric distribution for the random errors. It is shown that the test statistic has an asymptotical normal distribution under the null hypothesis and is powerful against a large class of alternatives. We suggest a simple bootstrap algorithm to approximate the distribution of the test statistic in finite sample size. Numerical simulations demonstrate the satisfactory performance of the proposed test. We also illustrate the application by the analysis of a radioimmunoassay data set. C1 Univ Minnesota, Sch Stat, Minneapolis, MN 55455 USA. VA Puget Sound Hlth Care Syst, HSR&D, Seattle, WA 98101 USA. Univ Washington, Dept Biostat, Seattle, WA 98198 USA. RP Wang, L (reprint author), Univ Minnesota, Sch Stat, 224 Church St SE, Minneapolis, MN 55455 USA. EM lan@stat.umn.edu; azhou@u.washington.edu FU AHRQ HHS [R01HS013105] NR 19 TC 5 Z9 5 U1 1 U2 7 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0006-341X J9 BIOMETRICS JI Biometrics PD DEC PY 2007 VL 63 IS 4 BP 1218 EP 1225 DI 10.1111/j.1541-0420.2007.00805.x PG 8 WC Biology; Mathematical & Computational Biology; Statistics & Probability SC Life Sciences & Biomedicine - Other Topics; Mathematical & Computational Biology; Mathematics GA 239HB UT WOS:000251508300027 PM 17484775 ER PT J AU Roodman, GD AF Roodman, G. D. TI Treatment strategies for bone disease SO BONE MARROW TRANSPLANTATION LA English DT Review DE osteoclast; osteoblast; myeloma; MIP; 1 alpha;; RANKL; DKK1; IL-6; IL-3; IL-7 ID KAPPA-B LIGAND; MACROPHAGE INFLAMMATORY PROTEIN-1-ALPHA; MARROW STROMAL CELLS; TUMOR-NECROSIS-FACTOR; FORMATION IN-VITRO; MULTIPLE-MYELOMA; RECEPTOR ACTIVATOR; OSTEOCLAST FORMATION; ZOLEDRONIC ACID; OSTEOPROTEGERIN LIGAND AB Multiple myeloma is characterized by extensive bone destruction with little or no new bone formation. A multiplicity of factors including receptor activator NF-kappa B (RANKL), macrophage inflammatory protein-1 alpha, interleukin-3 and interleukin-6 can induce osteoclast formation in myeloma and drive the bone destructive process. Furthermore, factors are also produced either in the microenvironment or by myeloma cells themselves, which inhibit osteoblast differentiation and new bone formation. The combination of increased osteoclast formation with little or no bone repair in response to the previous bone destruction explains the severity of the bone disease in myeloma. Studies of the pathophysiology of myeloma bone disease have identified several novel therapeutic targets. These include antibodies to RANKL, chemokine receptor antagonists, which block the effects of chemokines on osteoclast differentiation and proteasome antagonists, which can affect both RANKL production and osteoprotegerin levels as well as inhibit osteoclast and enhance osteoblast differentiation. In addition, many of the new biologic agents being used for the treatment of patients with myeloma also further inhibit the bone destructive process. New therapies that can target both the tumor as well as the severe bone disease should be on the horizon to treat this devastating complication of myeloma. C1 Univ Pittsburgh, Dept Med Hematol Oncol, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Roodman, GD (reprint author), Univ Pittsburgh, Dept Med Hematol Oncol, VA Pittsburgh Healthcare Syst Res & Dev 151 U, Univ Dr C, Pittsburgh, PA 15240 USA. EM roodmangd@upmc.edu NR 70 TC 21 Z9 25 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0268-3369 J9 BONE MARROW TRANSPL JI Bone Marrow Transplant. PD DEC PY 2007 VL 40 IS 12 BP 1139 EP 1146 DI 10.1038/sj.bmt.1705802 PG 8 WC Biophysics; Oncology; Hematology; Immunology; Transplantation SC Biophysics; Oncology; Hematology; Immunology; Transplantation GA 235WI UT WOS:000251264600006 PM 17680018 ER PT J AU Smith, LK Suhler, EB Lim, LL Choi, D Cioffi, GA Rosenbaum, JT AF Smith, Lynnelle K. Suhler, Eric B. Lim, Lyndell L. Choi, Dongseok Cioffi, George A. Rosenbaum, James T. TI Possible association between scleritis and lymphoma SO BRITISH JOURNAL OF OPHTHALMOLOGY LA English DT Letter ID AUTOIMMUNE-DISEASES; NECROSIS C1 Oregon Hlth & Sci Univ, Casey Eye Inst, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. Univ Melbourne, Melbourne, Vic, Australia. Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. Legacy Good Samaritan Hosp, Devers Eye Inst, Portland, OR USA. RP Rosenbaum, JT (reprint author), Oregon Hlth & Sci Univ, Casey Eye Inst, 3375 SW Terwilliger Blvd, Portland, OR 97239 USA. EM rosenbaj@ohsu.edu NR 10 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 0007-1161 J9 BRIT J OPHTHALMOL JI Br. J. Ophthalmol. PD DEC PY 2007 VL 91 IS 12 BP 1727 EP 1729 DI 10.1136/bjo.2007.116830 PG 6 WC Ophthalmology SC Ophthalmology GA 232PS UT WOS:000251032200054 ER PT J AU Zwillich, C Welsh, CH AF Zwillich, Clifford Welsh, Carolyn. H. TI Hypercapnic obstructive sleep apnea: An underappreciated marker of severity SO CHEST LA English DT Editorial Material ID OBESITY-HYPOVENTILATION-SYNDROME C1 [Zwillich, Clifford] Univ Colorado, Denver Vet Affairs Med Ctr, Denver, CO 80202 USA. [Welsh, Carolyn. H.] Univ Colorado, Denver Hlth Sci Ctr, Div Plum Sci & Crit Care Med, Denver, CO 80202 USA. RP Zwillich, C (reprint author), Univ Colorado, Denver Vet Affairs Med Ctr, 1055 Clermont St, Denver, CO 80202 USA. EM Clifford.zwillich@va.gov NR 8 TC 2 Z9 2 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD DEC PY 2007 VL 132 IS 6 BP 1729 EP 1730 DI 10.1378/chest.07-1792 PG 2 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 246HA UT WOS:000251996900006 PM 18079215 ER PT J AU McGhan, R Radcliff, T Fish, R Sutherland, ER Welsh, C Make, B AF McGhan, Ryan Radcliff, Tiffany Fish, Ron Sutherland, E. Rand Welsh, Carolyn Make, Barry TI Predictors of rehospitalization and death after a severe exacerbation of COPD SO CHEST LA English DT Article DE age; chronic obstructive; comorbidity; exacerbation; gender; hospitalization; mortality; population groups; pulmonary disease; race; risk factors; US Department of Veterans Affairs ID OBSTRUCTIVE PULMONARY-DISEASE; INHALED CORTICOSTEROIDS; GENDER-DIFFERENCES; LUNG-FUNCTION; RISK-FACTORS; MORTALITY; HOSPITALIZATION; CARE; MORBIDITY; AMERICANS AB Background: Patients who survive a severe exacerbation of COPD are at high risk of rehospitalization for COPD and death. The objective of this study was to determine predictors of these events in a large cohort of Veterans Affairs (VA) patients. Methods: We identified 51,353 patients who were discharged after an exacerbation of COPD in the VA health-care system from 1999 to 2003, and determined the rates of rehospitalization for COPD and death from all causes. Potential risk factors were assessed with univariate and multivariate survival analysis. Results: On average, the cohort was elderly (mean age, 69 years), predominately white (78% white, 13% black, 3% other, and 6% unknown), and male (97%), consistent with the underlying VA population. The risk of death was 21% at 1 year, and 55% at 5 years. Independent risk factors for death were age, male gender, prior hospitalizations, and comorbidities including weight loss and pulmonary hypertension; nonwhite race and other comorbidities (asthma, hypertension, and obesity) were associated with decreased mortality. The risk of rehospitalization for COPD was 25% at I year, and 44% at 5 years, and was increased by age, male gender, prior hospitalizations, and comorbidities including asthma and pulmonary hypertension. Hispanic ethnicity and other comorbidities (diabetes and hypertension) were associated with a decreased risk of rehospitalization. Conclusions: Age, male gender, prior hospitalizations, and certain comorbid conditions were risk factors for death and rehospitalization in patients discharged after a severe COPD exacerbation. Nonwhite race and other comorbidities were associated with decreased risk. C1 [Sutherland, E. Rand] Univ Colorado, Hlth Sci Ctr, Dept Med, Div Pulm Sci & Crit Care Med, Boulder, CO 80309 USA. [McGhan, Ryan] Denver Hlth & Hosp Author, Denver, CO USA. [Radcliff, Tiffany; Welsh, Carolyn] Denver Vet Affairs Med Ctr, Denver, CO USA. [Fish, Ron] Univ Colorado, Hlth Sci Ctr, Dept Med, Div Hlth Care Policy & Res, Boulder, CO 80309 USA. [Make, Barry] Natl Jewish Med & Res Ctr, Denver, CO USA. RP McGhan, R (reprint author), 2841 DeBarr Rd,St 771, Anchorage, AK 99508 USA. EM ryanmcghan11@hotmail.com RI Sutherland, Everett/B-7666-2008 FU NHLBI NIH HHS [2 T32 HL 007085] NR 41 TC 111 Z9 112 U1 0 U2 4 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD DEC PY 2007 VL 132 IS 6 BP 1748 EP 1755 DI 10.1378/chest.06-3018 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 246HA UT WOS:000251996900010 PM 17890477 ER PT J AU Shalaby, AA El-Saed, A Nemec, J Moossy, JJ Balzer, JR AF Shalaby, Alaa A. El-Saed, Aiman Nemec, Jan Moossy, John J. Balzer, Jeffrey R. TI Exacerbation of electrical storm subsequent to implantation of a right vagal stimulator SO CLINICAL AUTONOMIC RESEARCH LA English DT Article DE implantable defibrillator; vagal stimulation; ventricular tachycardia; cardiac arrhythmia; treatment; autonomic nervous system ID NERVE-STIMULATION; HEART-FAILURE; VENTRICULAR-ARRHYTHMIAS; CARDIAC TISSUE; PROPAGATION; CONDUCTION; SURVIVAL; PROTEIN; SUDDEN; DEATH AB A patient with advanced ischemic cardiomyopathy underwent implantation of a vagal stimulator in an attempt to control recurrent drug refractory ventricular arrhythmia. Electrical storm was exacerbated after the implant and continued after neurostimulation was discontinued. The report aims to provide a cautionary note to application of vagal stimulation for control of cardiac arrhythmia. C1 [Shalaby, Alaa A.; Nemec, Jan] Univ Pittsburgh, Div Cardiol, Pittsburgh, PA 15240 USA. [Shalaby, Alaa A.; Moossy, John J.; Balzer, Jeffrey R.] VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. [El-Saed, Aiman] Univ Pittsburgh, Sch Publ Hlth, Pittsburgh, PA 15260 USA. [Moossy, John J.] Univ Pittsburgh, Div Neurosurg, Pittsburgh, PA USA. [Balzer, Jeffrey R.] Univ Pittsburgh, Div Neurosci, Pittsburgh, PA USA. RP Shalaby, AA (reprint author), Univ Pittsburgh, Div Cardiol, 111C Univ Dr, Pittsburgh, PA 15240 USA. EM alaa.shalaby@med.va.gov OI El-Saed, Aiman/0000-0002-1781-2203 NR 18 TC 3 Z9 3 U1 0 U2 0 PU SPRINGER HEIDELBERG PI HEIDELBERG PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY SN 0959-9851 J9 CLIN AUTON RES JI Clin. Auton. Res. PD DEC PY 2007 VL 17 IS 6 BP 385 EP 390 DI 10.1007/s10286-007-0440-1 PG 6 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 241FC UT WOS:000251641300011 PM 17898926 ER PT J AU Brambilla, DJ O'Donnell, AB Matsumoto, AM McKinlay, JB AF Brambilla, Donald J. O'Donnell, Amy B. Matsumoto, Alvin M. McKinlay, John B. TI Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men SO CLINICAL ENDOCRINOLOGY LA English DT Article ID MIDDLE-AGED MEN; HEALTHY-MEN; LUTEINIZING-HORMONE; CIRCADIAN VARIATION; BOUND TESTOSTERONE; BINDING GLOBULIN; HYPOGONADAL MEN; ELDERLY-MEN; YOUNG MEN; FOLLITROPIN AB Background Estimates of intraindividual variation in hormone levels provide the basis for interpreting hormone measurements clinically and for developing eligibility criteria for trials of hormone replacement therapy. However, reliable systematic estimates of such variation are lacking. Objective To estimate intraindividual variation of serum total, free and bioavailable testosterone (T), dihydrotestosterone (DHT), SHBG, LH, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), oestrone, oestradiol and cortisol, and the contributions of biological and assay variation to the total. Design Paired blood samples were obtained 1-3 days apart at entry and again 3 months and 6 months later (maximum six samples per subject). Each sample consisted of a pool of equal aliquots of two blood draws 20 min apart. Study participants Men aged 30-79 years were randomly selected from the respondents to the Boston Area Community Health Survey, a study of the health of the general population of Boston, MA, USA. Analysis was based on 132 men, including 121 who completed all six visits, 8 who completed the first two visits and 3 who completed the first four visits. Measurements Day-to-day and 3-month (long-term) intraindividual standard deviations, after transforming measurements to logarithms to eliminate the contribution of hormone level to intraindividual variation. Results Biological variation generally accounted for more of total intraindividual variation than did assay variation. Day-to-day biological variation accounted for more of the total than did long-term biological variation. Short-term variability was greater in hormones with pulsatile secretion (e.g. LH) than those that exhibit less ultradian variation. Depending on the hormone, the intraindividual standard deviations imply that a clinician can expect to see a difference exceeding 18-28% about half the time when two measurements are made on a subject. The difference will exceed 27-54% about a quarter of the time. Conclusions Given the level of intraindividual variability in hormone levels found in this study, one sample is generally not sufficient to characterize an individual's hormone levels but collecting more than three is probably not warranted. This is true for clinical measurements and for hormone measurements used to determine eligibility for a clinical trial of hormone replacement therapy. C1 New England Res Inst, Watertown, MA 02472 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Seattle, WA USA. RP Brambilla, DJ (reprint author), New England Res Inst, 9 Galen St, Watertown, MA 02472 USA. EM dbrambilla@neriscience.com RI Perez , Claudio Alejandro/F-8310-2010 OI Perez , Claudio Alejandro/0000-0001-9688-184X FU NIA NIH HHS [AG23027] NR 36 TC 78 Z9 80 U1 2 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0300-0664 J9 CLIN ENDOCRINOL JI Clin. Endocrinol. PD DEC PY 2007 VL 67 IS 6 BP 853 EP 862 DI 10.1111/j.1365-2265.2007.02976.x PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 232NC UT WOS:000251025400008 PM 18052942 ER PT J AU Thase, ME AF Thase, Michael E. TI Augmentation strategies for depression: History and concepts SO CNS SPECTRUMS LA English DT Editorial Material ID RESISTANT RECURRENT DEPRESSION; OPEN CLINICAL-TRIAL; THYROID-HORMONE; REFRACTORY DEPRESSION; LITHIUM AUGMENTATION; UNIPOLAR DEPRESSION; IMIPRAMINE; CHLORDIAZEPOXIDE; TRANYLCYPROMINE; AMITRIPTYLINE C1 [Thase, Michael E.] Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. [Thase, Michael E.] Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA. RP Thase, ME (reprint author), Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. NR 24 TC 9 Z9 10 U1 0 U2 0 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD DEC PY 2007 VL 12 IS 12 SU 22 BP 3 EP 5 PG 3 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 250WN UT WOS:000252332100001 PM 18396507 ER PT J AU Lang, JD Chaiwat, O AF Lang, John D. Chaiwat, Onuma TI Clinical use of hydroxyethylstarch: Colloidal confusion or clarity? SO CRITICAL CARE MEDICINE LA English DT Editorial Material ID CRITICALLY-ILL PATIENTS; ACUTE-RENAL-FAILURE; VOLUME REPLACEMENT; FLUID RESUSCITATION; STARCH; ADHESION; INFUSION; SURGERY; GELATIN; ALBUMIN C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Dept Anesthesiol, Seattle, WA 98195 USA. RP Lang, JD (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Dept Anesthesiol, Seattle, WA 98195 USA. NR 19 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD DEC PY 2007 VL 35 IS 12 BP 2864 EP 2866 DI 10.1097/01.CCM.0000288095.96147.47 PG 3 WC Critical Care Medicine SC General & Internal Medicine GA 237BD UT WOS:000251346700032 PM 18043209 ER PT J AU Restrepo, MI Mortensen, EM Echevarria, K Frei, C Castellanos-Matteus, P Malave, A Sanchez, JF Swiggum, J Velez, JA Anzueto, A AF Restrepo, Marcos I. Mortensen, Eric M. Echevarria, Kelly Frei, Christopher Castellanos-Matteus, Patricia Malave, Adriel Sanchez, Juan F. Swiggum, Joseph Velez, Jose A. Anzueto, Antonio TI Impact of MRSA on outcomes in patients with HAP/VAP patients SO CRITICAL CARE MEDICINE LA English DT Meeting Abstract CT 37th Critical Care Congress of the Society-of-Critical-Care-Medicine CY FEB 02-08, 2008 CL Honolulu, HI SP Soc Crit Care Med C1 [Restrepo, Marcos I.; Mortensen, Eric M.; Echevarria, Kelly; Frei, Christopher] S Texas Vet Hlth Care Syst Audie L Murphy Div, San Antonio, TX USA. [Castellanos-Matteus, Patricia; Malave, Adriel; Sanchez, Juan F.; Swiggum, Joseph; Velez, Jose A.; Anzueto, Antonio] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD DEC PY 2007 VL 35 IS 12 SU S MA 635 BP A176 EP A176 PG 1 WC Critical Care Medicine SC General & Internal Medicine GA 237TI UT WOS:000251398901115 ER PT J AU Restrepo, MJ Mortensen, EM Echevarria, K Frei, CR Castellanos-Matteus, P Malave, A Sanchez, JF Swiggun, J Velez, JA Anzueto, A AF Restrepo, Marcos J. Mortensen, Eric M. Echevarria, Kelly Frei, Christopher R. Castellanos-Matteus, Patricia Malave, Adriel Sanchez, Juan F. Swiggun, Joseph Velez, Jose A. Anzueto, Antonio TI Outcomes in HCAP/HAP/VAP patients with multidrug resistant risk factors SO CRITICAL CARE MEDICINE LA English DT Meeting Abstract CT 37th Critical Care Congress of the Society-of-Critical-Care-Medicine CY FEB 02-08, 2008 CL Honolulu, HI SP Soc Crit Care Med C1 [Restrepo, Marcos J.; Mortensen, Eric M.; Echevarria, Kelly] S Texas Vet Hlth Care Syst, Audie L Murphys Div, San Antonio, TX USA. [Frei, Christopher R.; Castellanos-Matteus, Patricia; Malave, Adriel; Sanchez, Juan F.; Swiggun, Joseph; Velez, Jose A.; Anzueto, Antonio] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 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 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD DEC PY 2007 VL 35 IS 12 SU S MA 654 BP A181 EP A181 PG 1 WC Critical Care Medicine SC General & Internal Medicine GA 237TI UT WOS:000251398901136 ER PT J AU Schwartz, GG AF Schwartz, Gregory G. TI Lipid management after acute coronary syndrome SO CURRENT OPINION IN LIPIDOLOGY LA English DT Review DE acute coronary syndrome; HDL-cholesterol; HMG-CoA reductase inhibitor; statin ID MYOCARDIAL-ISCHEMIA REDUCTION; CHOLESTEROL-LOWERING MIRACL; INTENSIVE STATIN THERAPY; LOW-DENSITY-LIPOPROTEIN; RANDOMIZED CONTROLLED-TRIALS; HIGH-DOSE ATORVASTATIN; SHORT-TERM PROGNOSIS; CLINICAL-OUTCOMES; METABOLIC SYNDROME; PROVE IT-TIMI-22 AB Early, intensive statin therapy is safe and effective after acute coronary syndrome. Future research will determine whether drugs that raise or mimic HDL-cholesterol are effective adjuncts to statin therapy. C1 Denver VA Med Ctr, Cardiol Sect, Denver, CO 80220 USA. [Schwartz, Gregory G.] Univ Colorado, Hlth Sci Ctr, VA Med Ctr, Denver, CO USA. RP Schwartz, GG (reprint author), Denver VA Med Ctr, Cardiol Sect, 1055 Clermont St, Denver, CO 80220 USA. EM gregory.schwartz@va.gov NR 39 TC 1 Z9 2 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0957-9672 J9 CURR OPIN LIPIDOL JI Curr. Opin. Lipidology PD DEC PY 2007 VL 18 IS 6 BP 626 EP 632 PG 7 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Peripheral Vascular Disease SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Cardiovascular System & Cardiology GA 242YU UT WOS:000251762900003 PM 17993807 ER PT J AU Bradesi, S Mayer, EA AF Bradesi, Sylvie Mayer, Emeran A. TI Novel therapeutic approaches in IBS SO CURRENT OPINION IN PHARMACOLOGY LA English DT Review ID IRRITABLE-BOWEL-SYNDROME; FUNCTIONAL GASTROINTESTINAL DISORDERS; CORTICOTROPIN-RELEASING HORMONE; CHLORIDE CHANNEL ACTIVATOR; BRAIN-GUT AXIS; SYNDROME C-IBS; DOUBLE-BLIND; RECEPTOR ANTAGONISTS; VISCERAL HYPERALGESIA; SENSORY FUNCTION AB Irritable bowel syndrome (IBS) remains an incompletely understood, common syndrome with significant unmet medical needs. Significant progress has been made in the development of novel therapies aimed at normalizing bowel habit alterations and abdominal discomfort, even though some of the most effective treatments are currently only available for patients under a restricted access program from the FDA. Preclinical evidence supports the potential usefulness of several compounds in development for the treatment of chronic abdominal pain. Recent new evidence for a possible role of altered microflora and altered host microbial interactions may provide new treatment targets in the future. C1 [Bradesi, Sylvie; Mayer, Emeran A.] Univ Calif Los Angeles, UCLA Ctr Neurovisceral Sci & Womens Hlth, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. [Mayer, Emeran A.] Univ Calif Los Angeles, UCLA Ctr Neurovisceral Sci & Womens Hlth, David Geffen Sch Med, Dept Physiol, Los Angeles, CA 90024 USA. [Mayer, Emeran A.] Univ Calif Los Angeles, UCLA Ctr Neurovisceral Sci & Womens Hlth, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90024 USA. [Bradesi, Sylvie] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Mayer, EA (reprint author), Univ Calif Los Angeles, UCLA Ctr Neurovisceral Sci & Womens Hlth, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. EM emayer@ucla.edu FU NCCIH NIH HHS [R24 AT 002681, R24 AT002681]; NIDDK NIH HHS [R01 DK 48351, R01 DK048351, P50 DK 64539, P50 DK064539] NR 59 TC 11 Z9 11 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 1471-4892 J9 CURR OPIN PHARMACOL JI Curr. Opin. Pharmacol. PD DEC PY 2007 VL 7 IS 6 BP 598 EP 604 DI 10.1016/j.coph.2007.09.012 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 244HK UT WOS:000251856800008 PM 18006379 ER PT J AU Halanych, JH Safford, MM Keys, WC Person, SD Shikany, JM Kim, YI Centor, RM Allison, JJ AF Halanych, Jewell H. Safford, Monika M. Keys, Wendy C. Person, Sharina D. Shikany, James M. Kim, Young-Il Centor, Robert M. Allison, Jeroan J. TI Burden of comorbid medical conditions and quality of diabetes care SO DIABETES CARE LA English DT Article ID OF-CARE; GLUCOSE CONTROL; MORTALITY; DISEASE; HEALTH; MULTIMORBIDITY; PERFORMANCE; GUIDELINES; TRIALS; INDEX AB OBJECTIVE - With performance-based reimbursement pressures, it is concerning that most performance measurements treat each condition in isolation, ignoring the complexities of patients with multiple comorbidities. We sought to examine the relationship between comorbidity and commonly assessed services for diabetic patients in a managed care organization. RESEARCH DESIGN AND METHODS - In 6,032 diabetic patients, we determined the association between the independent variable medical comorbidity, measured by the Charlson Comorbidity Index (CCI), and the dependent variables AlC testing, lipid testing, dilated eye exam, and urinary microalbumin testing. We calculated predicted probabilities of receiving tests for patients with increasing comorbid illnesses, adjusting for patient demographics. RESULTS - AlC and lipid testing decreased slightly at higher CCI: predicted probabilities for CCI quartiles 1, 2, 3, and 4 were 0.83 (95% CI 0.70-0.91), 0.83 (0.69-0.92), 0.82 (0.68-0.91), and 0.78 (0.61-0.88) for AlC, respectively, and 0.82 (0.69-0.91), 0.81(0.67-0.90), 0.79 (0.64-0.89), and 0.77 (0.61-0.88) for lipids. Dilated eye exam and urinary microalbumin testing did not differ across CCI quartiles: for quartiles 1, 2, 3, and 4, predicted probabilities were 0.48 (0.33-0.63), 0.54 (0.38-0.69), 0.50 (0.34-0.65), and 0.50 (0.34-0.65) for eye exam, respectively, and 0.23 (0.12-0.40), 0.24 (0.12-0.42), 0.24 (0.12-0.41), and 23 (0.11-0.40) for urinary microalbumin. CONCLUSIONS - Services received did not differ based on comorbid illness burden. Because it is not clear whether equally aggressive care confers equal benefits to patients with varying comorbid illness burden, more evidence confirming such benefits may be warranted before widespread implementation of pay-for-performance programs using currently available "one size fits all" performance measures. C1 Univ Alabama, Dept Med, Div Prevent Med, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. Univ Alabama, Dept Med, Div Gen Internal Med, Birmingham, AL 35294 USA. RP Halanych, JH (reprint author), MT 639,1530 3rd Ave S, Birmingham, AL 35294 USA. EM jhalanych@uab.edu OI Allison, Jeroan/0000-0003-4472-2112 FU NHLBI NIH HHS [N01-HC-48047]; NIMHD NIH HHS [P60MD00502-01] NR 31 TC 25 Z9 25 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 DEC PY 2007 VL 30 IS 12 BP 2999 EP 3004 DI 10.2337/dc06-1836 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 237HQ UT WOS:000251365200003 PM 17717287 ER PT J AU Krouse, RS Grant, M Wendel, CS Mohler, MJ Rawl, SM Baldwin, CM Coons, SJ McCorkle, R Ko, CY Schmidt, CM AF Krouse, Robert S. Grant, Marcia Wendel, Christopher S. Mohler, M. Jane Rawl, Susan M. Baldwin, Carol M. Coons, Stephen Joel McCorkle, Ruth Ko, Clifford Y. Schmidt, C. Max TI A mixed-methods evaluation of health-related quality of life for male veterans with and without intestinal stomas SO DISEASES OF THE COLON & RECTUM LA English DT Article DE Ostomy; focus groups; quality of life; stomas ID PSYCHOSOCIAL MORBIDITY; RECTAL-CANCER; SURGERY; COLOSTOMY; DYSFUNCTION; ADJUSTMENT AB PURPOSE: Intestinal stomas have a major impact on Cases' lives. It is essential to better understand the areas in which interventions may help to minimize the negative consequences. METHODS: This was a case-control survey study using validated instruments (City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans). Cases were accrued from Veterans Affairs Medical Centers in Tucson, Indianapolis, and Los Angeles. Eligibility included a major intra-abdominal surgical procedure that led to an ostomy (cases), or a similar procedure that did not mandate a stoma (controls). Analysis included quantitative and qualitative responses. RESULTS: The response rate was 48 percent (511/1063). Cases and controls had relatively similar demographic characteristics. Because of low numbers of female respondents (13 cases and 11 controls), only results for males are reported. Based on both the City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans, cases reported significantly poorer scores on scales/domains reflecting psychologic and social functioning and well being. Additionally, cases reported poorer scores on Short Form 36 for Veterans scales reflecting physical functioning and significantly lower scores on multiple Life-Ostomy compared with controls. Two-thirds of cases replied to an open-ended question on their "greatest challenge" related to their ostomy, which led to further clarification of major issues. CONCLUSIONS: Multiple health-related quality of life problems were reported by male veterans with intestinal stomas. The greatest differences between cases and controls were observed in the social and psychologic domains/scales. Findings from this study provide a greater understanding of the challenges faced by ostomates and will inform the development and evaluation of urgently needed intervention strategies. C1 [Krouse, Robert S.; Wendel, Christopher S.; Mohler, M. Jane] Univ Arizona, Coll Med, So Arizona VA Hlth Care Syst, Tucson, AZ 85723 USA. [Grant, Marcia] City Hope Natl Med Ctr, Dept Nursing Res & Educ, Duarte, CA 91010 USA. [Mohler, M. Jane] Univ Arizona, Coll Publ Hlth, Tucson, AZ USA. [Rawl, Susan M.] Indiana Univ, Sch Nursing, Ctr Nursing Res, Indianapolis, IN 46204 USA. [Baldwin, Carol M.] Arizona State Univ, Coll Nursing, Phoenix, AZ USA. [Mohler, M. Jane; Coons, Stephen Joel] Univ Arizona, Coll Pharm, Div Social & Adm Sci, Tucson, AZ 85721 USA. [McCorkle, Ruth] Yale Univ, Sch Nursing, New Haven, CT 06536 USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Ctr Hlth Sci, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. [Schmidt, C. Max] Indiana Univ, Sch Med, Dept Surg, Richard L Roudebush VA Med Ctr, Indianapolis, IN 46204 USA. RP Krouse, RS (reprint author), Univ Arizona, Coll Med, So Arizona VA Hlth Care Syst, 2-112,3601 S 6th Ave, Tucson, AZ 85723 USA. EM robert.krouse@va.gov OI Baldwin, Carol/0000-0002-0732-2307; Rawl, Susan/0000-0003-2052-2853 NR 44 TC 26 Z9 26 U1 1 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-3706 J9 DIS COLON RECTUM JI Dis. Colon Rectum PD DEC PY 2007 VL 50 IS 12 BP 2054 EP 2066 DI 10.1007/s10350-007-9004-7 PG 13 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 241FG UT WOS:000251641700007 PM 17701071 ER PT J AU Gourcerol, G Wang, L Wang, YH Million, M Tache, Y AF Gourcerol, G. Wang, L. Wang, Y. H. Million, M. Tache, Y. TI Urocortins and cholecystokinin-8 act synergistically to increase satiation in lean but not obese mice: Involvement of corticotropin-releasing factor receptor-2 pathway SO ENDOCRINOLOGY LA English DT Article ID SUPPRESSES FOOD-INTAKE; CRF RECEPTORS; HORMONE RECEPTOR-2; BODY-WEIGHT; FEEDING MICROSTRUCTURE; FUNCTIONAL DYSPEPSIA; ENERGY-BALANCE; IN-VITRO; CCK; RATS AB Interactions between gastrointestinal signals are a part of integrated systems regulating food intake (FI). We investigated whether cholecystokinin (CCK)-8 and urocortin systems potentiate each other to inhibit FI and gastric emptying (GE) in fasted mice. Urocortin 1 and urocortin 2 (1 mu g/kg) were injected ip alone or with CCK ( 3 mu g/kg) in lean, diet-induced obese ( DIO) or corticotropin-releasing factor receptor-2 (CRF(2))-deficient mice. Gastric vagal afferent activity was recorded from a rat stomach-vagus in vitro preparation. When injected separately, urocortin 1, urocortin 2, or CCK did not modify the 4-h cumulative FI in lean mice. However, CCK plus urocortin 1 or CCK plus urocortin 2 decreased significantly the 4-h FI by 39 and 27%, respectively, compared with the vehicle + vehicle group in lean mice but not in DIO mice. Likewise, CCK-urocortin-1 delayed GE in lean but not DIO mice, whereas either peptide injected alone at the same dose had no effect. CCK-urocortin 2 suppression of FI was observed in wild-type but not CRF2-deficient mice. Gastric vagal afferent activity was increased by intragastric artery injection of urocortin 2 after CCK at a subthreshold dose, and the response was reversed by devazepide. These data establish a peripheral synergistic interaction between CCK and urocortin 1 or urocortin 2 to suppress FI and GE through CRF2 receptor in lean mice that may involve CCK modulation of gastric vagal afferent responsiveness to urocortin 2. Such synergy is lost in DIO mice, suggesting a resistance to the satiety signaling that may contribute to maintain obesity. C1 VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Digest Dis Res Ctr, Los Angeles, CA 90073 USA. RP Tache, Y (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Neurovisceral Sci & Womens Hlth, Dept Med, CURE Bldg 115,Room 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU NIDDK NIH HHS [DK 41301, R01 DK 33061] NR 69 TC 18 Z9 19 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0013-7227 J9 ENDOCRINOLOGY JI Endocrinology PD DEC PY 2007 VL 148 IS 12 BP 6115 EP 6123 DI 10.1210/en.2007-0678 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 231RP UT WOS:000250967000056 PM 17932219 ER PT J AU Chin, PS Berg, AT Spencer, SS Sperling, MR Haut, SR Langfitt, JT Bazil, CW Walczak, TS Pacia, SV Vickrey, BG AF Chin, Peter S. Berg, Anne T. Spencer, Susan S. Sperling, Michael R. Haut, Sheryl R. Langfitt, John T. Bazil, Carl W. Walczak, Thaddeus S. Pacia, Steven V. Vickrey, Barbara G. TI Employment outcomes following resective epilepsy surgery SO EPILEPSIA LA English DT Article DE epilepsy surgery; employment ID REFRACTORY EPILEPSY; SEIZURE SURGERY; ADJUSTMENT AB Purpose: Analyze determinates of employment changes from before to 2 years after surgery in refractory focal epilepsy patients. Methods: Preoperative employment was prospectively assessed in 375 adults with refractory epilepsy. Two-year postsurgical employment status was obtained for 299; factors potentially associated with employment status change among subgroups unemployed and employed at baseline were analyzed. Results: Presurgical employment status was full-time (n = 148, 39.5%), part-time (n = 26, 6.9%), disabled and unemployed (n = 100, 26.7%), unemployed n = 44, 11.7%), and other (n = 57, 15.2%). Those with and without 2-year follow-up did not differ on baseline characteristics (all p > 0.10). Two years after surgery, 42.8% were employed full-time and 12.4%, part-time. Among those unemployed before surgery, better seizure outcome was associated with gaining employment at 2 years (p = 0.03). Conclusions: Net employment gains were modest 2 years after surgery and higher with better seizure outcomes, reinforcing the need for optimizing surgical candidate selection, long-term follow-up studies, and postsurgical vocational rehabilitation. C1 [Vickrey, Barbara G.] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. [Pacia, Steven V.] NYU Med Ctr, Comprehens Epilepsy Ctr, New York, NY 10016 USA. [Walczak, Thaddeus S.] MINCEP Epilepsy Care, Minneapolis, MN USA. [Bazil, Carl W.] Columbia Univ, Neurol Inst, Comprehens Epilepsy Ctr, New York, NY USA. [Langfitt, John T.] Univ Rochester, Dept Neurol, Rochester, NY USA. [Langfitt, John T.] Univ Rochester, Dept Psychiat, Rochester, NY USA. [Haut, Sheryl R.] Montefiore Med Ctr, Albert Einstein Coll Med, Comprehens Epilepsy Management Ctr, Bronx, NY 10467 USA. [Haut, Sheryl R.] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Neurol, Bronx, NY 10467 USA. [Sperling, Michael R.] Thomas Jefferson Univ, Dept Neurol, Jefferson Comprehens Epilepsy Ctr, Philadelphia, PA 19107 USA. [Spencer, Susan S.] Yale Univ, Sch Med, Dept Neurol, New Haven, CT 06510 USA. [Spencer, Susan S.] Yale Univ, Sch Med, Dept Neurosurg, New Haven, CT USA. [Berg, Anne T.] No Illinois Univ, Dept Biol, De Kalb, IL 60115 USA. [Chin, Peter S.] Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. [Chin, Peter S.] Univ Calif Los Angeles, Dept Med, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. [Chin, Peter S.] Univ Calif Los Angeles, Dept Neurol, Robert Wood Johnson Clin Scholars Program, Los Angeles, CA 90024 USA. RP Vickrey, BG (reprint author), Univ Calif Los Angeles, Dept Neurol, C109 RNRC,Box 951769, Los Angeles, CA 90095 USA. EM bvickrey@ucla.edu RI shengkun, yu/B-8440-2012 FU PHS HHS [R01 32375-06] NR 14 TC 24 Z9 26 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD DEC PY 2007 VL 48 IS 12 BP 2253 EP 2257 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 239XU UT WOS:000251552400006 PM 17645537 ER PT J AU Pramuka, M Hendrickson, R Zinski, A Van Cott, AC AF Pramuka, Michael Hendrickson, Rick Zinski, Anne Van Cott, Anne C. TI A psychosocial self-management program for epilepsy: A randomized pilot study in adults SO EPILEPSY & BEHAVIOR LA English DT Article DE self-management; quality of life; QOLIE-89; randomized; clinical trial; intervention; psychosocial; treatment ID EFFICACY; PEOPLE; EMPOWERMENT; DEPRESSION; THERAPY; TRIALS; CHARGE; LIFE AB Objective. The goal of the work described here was to develop and pilot a theoretically based self-management intervention in adults with epilepsy. Methods. A randomized, controlled trial examined intervention effectiveness of a 6-week psychosocial intervention designed to improve self-efficacy and quality of life for 61 adults with diagnosed epilepsy. Measures included the Quality of Life in Epilepsy-89 inventory (QOLIE-89), the Washington Psychosocial Seizure Inventory (WPSI), a locus of control scale (LOC), and the Epilepsy Self-Efficacy Scale-2000 (ESES). Group differences were examined between groups using analysis of covariance. Results. There was a significant improvement in the QOLIE-89 Role Limitations-Emotional score in the treatment group at followup, but no significant differences in overall quality of life. Strong and significant correlations were observed between outcome measures. Conclusion. Although the intervention had little effect on improving overall quality of life, we observed promising trends in postintervention group comparisons linking self-efficacy and other psychosocial factors with quality of life. Intervention material can be modified for stage-based behavior change and retested in another study. (C) 2007 Elsevier Inc. All rights reserved. C1 [Pramuka, Michael; Hendrickson, Rick; Van Cott, Anne C.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. [Zinski, Anne] Univ Alabama, Birmingham, AL 35487 USA. [Van Cott, Anne C.] Vet Affairs Pittsburg Hlthcare Syst, Pittsburgh, PA USA. RP Pramuka, M (reprint author), Univ Pittsburgh, Sch Hlth & Rehabil Sci, Dept Rehabil Sci & Technol, 5044 Forbes Tower-Atwood, Pittsburgh, PA 15260 USA. EM mpramuka@pitt.edu FU PHS HHS [U48/CCU320171] NR 42 TC 26 Z9 28 U1 0 U2 10 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD DEC PY 2007 VL 11 IS 4 BP 533 EP 545 DI 10.1016/j.yebeh.2007.06.013 PG 13 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA 243GM UT WOS:000251783500008 PM 17904909 ER PT J AU Morales, SA Mareninov, S Prasad, P Wadehra, M Braun, J Gordon, LK AF Morales, Shawn A. Mareninov, Sergey Prasad, Pradeep Wadehra, Madhuri Braun, Jonathan Gordon, Lynn K. TI Collagen gel contraction by ARPE-19 cells is mediated by a FAK-Src dependent pathway SO EXPERIMENTAL EYE RESEARCH LA English DT Article DE proliferative vitreoretinopathy; retinal pigment epithelium; focal adhesion kinase; integrin; collagen gel contraction ID PIGMENT EPITHELIAL-CELLS; FOCAL ADHESION KINASE; GROWTH-FACTOR; PROLIFERATIVE VITREORETINOPATHY; INTEGRIN RECEPTOR; IN-VITRO; FIBROBLASTS; PROTEIN; INHIBITION; EXPRESSION AB Proliferative vitreoretinopathy (PVR) may result in part from de-differentiation of retinal pigment epithelium (RPE) in an aberrant wound-healing strategy. An in vitro model of PVR, collaggen gel contraction by RPE, likely requires integrin engagement and activation as an important initial step. The purpose of this study was to identify the important associated integrins and signal transduction pathway. The retinal pigment epithelial cell line ARPE-19 was used in these studies. Cell surface integrin expression was assessed using flow cytometry. An in vitro contraction assay was performed and the percent contraction quantified at specific time intervals using image capture (Gel Doc) and NIH Image software. Cells were pretreated with either small molecule inhibitors of signal transduction pathways or monoclonal antibodies with specificity for specific integrin isoforms. Transient transfections with a FAK siRNA were used to decrease FAK expression. ARPE-19 cells express alpha 1, alpha 2, and alpha 3 integrin, isoforms involved in collagen ligation. Cell surface integrin blockade using anti-integrin alpha 2 (P = 0.02), alpha 3 (P = 0.01), or a combination of alpha 1, alpha 2, and alpha 3 (P = 0.001) antibodies significantly reduced collagen gel contraction. Inhibition of the FAK-Src complex, but not MEK or PI3K, significantly decreased contraction (P = 0.0001). FAK siRNA transient transfection significantly reduced FAK protein expression by 71% (P = 0.02) and concordantly decreased gel contraction (P = 0.0001). RPE-mediated collagen gel contraction is a multi-step process. Integrin ligation and FAK-Src activation is necessary for collagen gel contraction produced by the ARPE-19 cell line. Validation of these observations in primary RPE cells may suggest new targets for therapeutic intervention in PVR. (C) 2007 Elsevier Ltd. All rights reserved. C1 [Morales, Shawn A.; Wadehra, Madhuri; Braun, Jonathan] Univ Calif Los Angeles, Dept Pathol & Lab Med, Los Angeles, CA 90095 USA. [Morales, Shawn A.; Mareninov, Sergey; Prasad, Pradeep; Gordon, Lynn K.] Univ Calif Los Angeles, Dept Ophthalmol, Los Angeles, CA 90095 USA. [Gordon, Lynn K.] Greater Los Angeles Vet Affairs Healthcare Syst, Dept Surg, Los Angeles, CA 90099 USA. RP Gordon, LK (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM lgordon@ucla.edu OI Braun, Jonathan/0000-0003-1646-2974 FU NIAID NIH HHS [AI 52031]; NICHD NIH HHS [HD 48540] NR 31 TC 23 Z9 25 U1 0 U2 2 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0014-4835 J9 EXP EYE RES JI Exp. Eye Res. PD DEC PY 2007 VL 85 IS 6 BP 790 EP 798 DI 10.1016/j.exer.2007.08.014 PG 9 WC Ophthalmology SC Ophthalmology GA 246VZ UT WOS:000252037100007 PM 17915217 ER PT J AU Kanwal, F Hoang, T Spiegel, BMR Eisen, S Dominitz, JA Gifford, A Goetz, M Asch, SM AF Kanwal, Fasiha Hoang, Tuyen Spiegel, Brennan M. R. Eisen, Seth Dominitz, Jason A. Gifford, Allen Goetz, Mathew Asch, Steven M. TI Predictors of treatment in patients with chronic hepatitis C infection - Role of patient versus nonpatient factors SO HEPATOLOGY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; UNITED-STATES; VIRUS-INFECTION; GEOGRAPHIC-VARIATION; ANTIVIRAL THERAPY; EXPLAINED VARIATION; US VETERANS; HEALTH-CARE; MANAGEMENT; ASSOCIATION AB Treatment with interferon and ribavirin is effective in patients with chronic infection with hepatitis C vim (HCV). Previous data indicate that treatment rates arc suboptimal. We sought to identify patient and providcr-lcvel predictors of treatment receipt in HCV by conducting a retrospective cohort study of 5701 HCV patients in a large regional Veteran's Administration (VA) healthcare network. We also determined the degree of variation in treatment rates attributable to patient, provider, and facility factors. Three thousand seven hundred forty-three patients (65%) were seen by a specialist and 894 (15.7%) received treatment. Treatment rates varied from 6% to 29% across the 5 facilities included in the analysis. Patients were less likely to receive treatment if they were older [RR, 0.55; 95% CI, 0.45, 0.67), single (RR, 0.77; 95%CI, 0.67, 0.88), had hepatic dysfimction MR, 0.73; 95%CI, 0.66,0.89), had normal alanine aminotransferase (ALT) (RR, 0.73; 95%CI, 0.59, 0.89), had HCV genotype 1 (RR, 0.78; 95%CI, 0.71, 0.86), were African American with genotype 1 (RR, 0.78; 95% CI, 0.71, 0.86), or were anemic (RR, 0.70; CI, 0.60, 0.89). In addition, patients evaluated by less experienced providers were 77% less likely to receive treatment than those evaluated by more experienced providers. The patient, provider, and facility factors explained 23%, 25%, and 7% of variation in treatment rates, respectively. Conclusion: These data suggest that although patient characteristics arc important predictors of treatment in HCV, a significant proportion of variation in treatment rates is explained by provider factors. These potentially modifiable provider-level factors may serve as high-yield targets for future quality improvement initiatives in HCV. C1 St Johns Mercy Med Ctr, St Louis, MO 63141 USA. St Louis Univ, Div Gastroenterol, St Louis, MO USA. Univ Calif Los Angeles, Ctr Outcomes Res & Educ, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Internal Med, Los Angeles, CA USA. Washington Univ, Sch Med, Dept Internal Med, St Louis, MO USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Div Gastroenterol, Seattle, WA 98195 USA. Boston Univ, Dept Internal Med, Boston, MA 02215 USA. RP Kanwal, F (reprint author), St Johns Mercy Med Ctr, 915 N Grand,111 JC-G1, St Louis, MO 63141 USA. EM fasiha.kanwal@va.gov NR 36 TC 75 Z9 76 U1 0 U2 2 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD DEC PY 2007 VL 46 IS 6 BP 1741 EP 1749 DI 10.1002/hep.21927 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 238TY UT WOS:000251471700012 PM 18046707 ER PT J AU Linkin, DR Fishman, NO Landis, JR Barton, TD Gluckman, S Kostman, J Metlay, JP AF Linkin, Darren R. Fishman, Neil O. Landis, J. Richard Barton, Todd D. Gluckman, Steven Kostman, Jay Metlay, Joshua P. TI Effect of communication errors during calls to an antimicrobial stewardship program SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID MANAGEMENT PROGRAM; OUTCOMES; RESISTANCE; HOSPITALS; INFECTION; PHYSICIAN; COSTS AB OBJECTIVE. To determine how inaccurate communication of patient data by clinicians in telephone calls to the prior-approval antimicrobial stewardship program (ASP) staff affects the incidence of inappropriate antimicrobial recommendations made by ASP practitioners. DESIGN. A retrospective cohort design was used. The accuracy of the patient data communicated was evaluated against patients' medical records to identify predetermined, clinically significant inaccuracies. Inappropriate antimicrobial recommendations were defined having been made if an expert panel unanimously rated the actual recommendations as inappropriate after reviewing vignettes derived from inpatients' medical records. SETTING. The setting was an academic medical center with a prior-approval ASP. PATIENTS. All inpatient subjects of ASP prior-approval calls were eligible for inclusion. RESULTS. Of 200 ASP telephone calls, the panel agreed about whether or not antimicrobial recommendations were inappropriate for 163 calls (82%); these 163 calls were then used as the basis for further analyses. After controlling for confounders, inaccurate communication was found to be associated with inappropriate antimicrobial recommendations (odds ratio [OR], of 2.2; P=.03). In secondary analyses of specific data types, only inaccuracies in microbiological data were associated with the study outcome ( OR, 7.5; P= .002). The most common reason panelists gave for rating a recommendation as inappropriate was that antimicrobial therapy was not indicated. CONCLUSIONS. Inaccurate communication of patient data, particularly microbiological data, during prior-approval calls is associated with an increased risk of inappropriate antimicrobial recommendations from the ASP. Clinicians and ASP practitioners should work to confirm that critical data has been communicated accurately prior to use of that data in prescribing decisions. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Infect Dis, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Linkin, DR (reprint author), 809 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM linkin@mail.med.upenn.edu RI Landis, J. Richard/A-9330-2010 OI Landis, J Richard/0000-0001-8099-0988 FU AHRQ HHS [F32-HS-023982, U18 HS010399, U18-HS10399]; NIAID NIH HHS [K23 AI060887, K23 AI060887-05, K23-AI-060887, L30 AI057268-01] NR 22 TC 14 Z9 15 U1 1 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD DEC PY 2007 VL 28 IS 12 BP 1374 EP 1381 DI 10.1086/523861 PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 226VG UT WOS:000250616000011 PM 17994518 ER PT J AU Norman, DC Wong, MB Yoshikawa, TT AF Norman, Dean C. Wong, Megan Bernadette Yoshikawa, Thomas T. TI Fever of unknown origin in older persons SO INFECTIOUS DISEASE CLINICS OF NORTH AMERICA LA English DT Article ID COMMUNITY-ACQUIRED PNEUMONIA; ELDERLY-PATIENTS; PROSPECTIVE MULTICENTER; INFECTIVE ENDOCARDITIS; BACTERIAL-MENINGITIS; CLINICAL-FEATURES; AGE; ADULTS; BACTEREMIA; TUBERCULOSIS AB Infectious diseases in general in the aged are associated with higher morbidity and mortality rates. Decremental biologic changes with age affect host defenses and responses to infection, and the frequent presence of comorbidities also may adversely impact host defenses, especially in frail older persons. Infections may present differently in older persons than in younger populations, making early diagnosis difficult. Within this context, the article explores the importance of how fever of unknown origin (FUO) in the old differs significantly from FUO in younger adults because the etiology is different. Moreover, it is important to aggressively determine the etiology of FUO in this older population because it is often treatable. C1 [Norman, Dean C.; Yoshikawa, Thomas T.] Univ Calif Los Angeles, Los Angeles David Geffen Sch Med, Los Angeles, CA USA. [Norman, Dean C.; Wong, Megan Bernadette; Yoshikawa, Thomas T.] VA Greater Los Angeles Healthcare Syst 11, Los Angeles, CA 90073 USA. RP Norman, DC (reprint author), W Los Angeles Hlth Care Ctr, US Dept Vet Affairs, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM dean.norman@va.gov NR 47 TC 9 Z9 11 U1 2 U2 7 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0891-5520 J9 INFECT DIS CLIN N AM JI Infect. Dis. Clin. North Am. PD DEC PY 2007 VL 21 IS 4 BP 937 EP + DI 10.1016/j.ide.2007.09.003 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 246QM UT WOS:000252022000005 PM 18061083 ER PT J AU Tseng, CL Helmer, D Rajan, M Tiwari, A Miller, D Crystal, S Safford, M Greenberg, J Pogach, L AF Tseng, Chin-Lin Helmer, Drew Rajan, Mangala Tiwari, Anjali Miller, Donald Crystal, Stephen Safford, Monika Greenberg, Jeffrey Pogach, Leonard TI Evaluation of regional variation in total, major, and minor amputation rates in a national health-care system SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE amputation; diabetes mellitus; Medicare; quality of health care; veterans ID FOOT ULCER; VETERANS; QUALITY; INDICATORS; PREVALENCE; VALIDATION; IMPACT; RISK; CITY AB Background. Health-care systems need actionable information on amputation rates in order to improve foot-care delivery. Objective. To evaluate regional variation in total, major, and minor amputation rates using individual-level data. Methods. This was a retrospective cohort study of Veterans Health Administration users with diabetes who were Medicare enrolled between fiscal years 1998 and 2000 (10/1/1997-9/30/2000). The outcome was outlier status, based upon observed-to-expected ratios, for total, major, and minor amputations of 22 regional networks in fiscal year 2000. Results. 331,806 patients incurred a total of 4,037 (12.2 per 1000; range 9.3-16.7 across networks) amputations in fiscal year 2000: 2,271 major amputations (6.8 per 1000; 4.7-9.1) and 1,766 minor amputations (5.3 per 1000; 3.9-7.6). All network outliers based upon the total amputation observed-to-expected ratio were also outliers based on major amputation observed-to-expected ratio. However, two of the five non-outliers based on total amputations were outliers based on major amputations. Simultaneous evaluation of major and minor amputation observed-to-expected ratios demonstrated four patterns of dual outlier status among networks: two networks had lower than expected minor and major amputation rates; two had higher than expected minor and major amputation rates; one network was lower than expected by major but higher by minor amputation rate; one was higher than expected by major but lower by minor amputation rate. Conclusions. Simultaneous evaluation of major and minor amputation rates identifies different patterns of regional outlier status compared to total or major amputation rates alone. This strategy may facilitate targeted evaluations of health-care processes and structures. C1 [Tseng, Chin-Lin; Helmer, Drew; Rajan, Mangala; Tiwari, Anjali; Pogach, Leonard] Ctr Healthcare Knowledge Management, New Jersey Healthcare Syst, Dept Vet Affairs, E Orange, NJ 07018 USA. [Tseng, Chin-Lin; Helmer, Drew; Tiwari, Anjali; Pogach, Leonard] Univ Med & Dent New Jersey, New Jersey Med Coll, Newark, NJ USA. [Miller, Donald] Bedford VA Med Ctr, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. [Miller, Donald] Boston Univ, Sch Publ Hlth, Boston, MA USA. [Crystal, Stephen] Rutgers State Univ, New Brunswick, NJ 08903 USA. [Safford, Monika] Deep S Ctr Effectiveness, Birmingham VA Med Ctr, Birmingham, AL USA. [Safford, Monika] Univ Alabama, Birmingham, AL USA. [Greenberg, Jeffrey] NYU, Sch Med, New York, NY USA. RP Tseng, CL (reprint author), Ctr Healthcare Knowledge Management, New Jersey Healthcare Syst, Dept Vet Affairs, 385 Tremont Ave,129, E Orange, NJ 07018 USA. EM chin-lin.tseng@va.gov NR 30 TC 13 Z9 13 U1 0 U2 0 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 DEC PY 2007 VL 19 IS 6 BP 368 EP 376 DI 10.1093/intqhc/mzm044 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 245UH UT WOS:000251963800006 PM 17947387 ER PT J AU Kasckow, J Montross, L Golshan, S Mohamed, S Patterson, T Sollanzano, E Zisook, S AF Kasckow, J. Montross, L. Golshan, S. Mohamed, S. Patterson, T. Sollanzano, E. Zisook, S. TI Suicidality in middle aged and older patients with schizophrenia and depressive symptoms: relationship to functioning and Quality of Life SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE suicidality; schizophrenia; geriatric middle aged; depression; functioning; Quality of Life ID RISK-FACTORS; SCHIZOAFFECTIVE PATIENTS; COMPLETED SUICIDE; RATING-SCALE; OUTPATIENTS/; RELIABILITY; ASSOCIATION; VALIDITY AB Background Suicidality is a health concern inpatients with schizophrenia. We examined the hypotheses: (1) Middle aged and older patients with schizophrenia, depressive symptoms and suicidality would exhibit worse quality of life and worse everyday functioning, social skills and medication management relative to those without suicidality; (2) higher levels of suicidality would be significantly associated with worse functioning, worse quality of life and older age. Methods We examined 146 outpatients with schizophrenia and depression. Patients were at least 40 years old and were diagnosed with schizophrenia or schizoaffective disorder and had two or more depressive symptoms based on DSM-IV criteria for major depression. We assessed suicidality with the Intersept Suicide Scale (ISS) and functioning with the UCSD Performance-based Skills Assessment (UPSA), Social Skills Performance Assessment (SSPA), and Medication Management Ability Assessment (MMAA). Quality of life was assessed with the Heinrichs Quality of Life Scale (QLS). Results The mean age of patients was 52.4 + 6.9 years. Subjects with suicidality (ISS scores > 0) had lower QLS scores compared to those without suicidality. However, there were no differences in UPSA, SSPA nor MMAA scores between the two groups. In addition, based on Spearman's rho correlational analysis, there were significant associations of QLS scores with ISS scores (r = -0.236) and with MMAA "total errors" scores (r = 0. 174). Logistic regression demonstrated that only QLS scores predicted suicidality. Conclusion Thirty-six percent of our sample had at least mild degrees of suicidality. Lower quality of life appears to bean important predictor of suicidality. Copyright (c) 2007 John Wiley & Sons, Ltd. C1 [Kasckow, J.] VA Pittsburgh Hlth Care Syst, Pittsburgh, PA 15206 USA. [Kasckow, J.] Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. [Montross, L.; Golshan, S.; Patterson, T.; Sollanzano, E.; Zisook, S.] Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. [Montross, L.; Golshan, S.; Patterson, T.; Sollanzano, E.; Zisook, S.] VA San Diego Healthcare Syst, San Diego, CA USA. [Mohamed, S.] Cent Texas Vet Hlth Care Syst, Temple, TX USA. RP Kasckow, J (reprint author), VA Pittsburgh Hlth Care Syst, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM kasckowjw@upmc.edu FU NIMH NIH HHS [1R01 MH6398-01, R01 MH063798, R01 MH063798-06, R01 MH063931, R01 MH063931-05] NR 22 TC 12 Z9 13 U1 3 U2 5 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD DEC PY 2007 VL 22 IS 12 BP 1223 EP 1228 DI 10.1002/gps.1817 PG 6 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 241JG UT WOS:000251652100006 PM 17506025 ER PT J AU Burman, W Weis, S Vernon, A Khan, A Benator, D Jones, B Silva, C King, B LaHart, C Mangura, B Weiner, M El-Sadr, W AF Burman, W. Weis, S. Vernon, A. Khan, A. Benator, D. Jones, B. Silva, C. King, B. LaHart, C. Mangura, B. Weiner, M. El-Sadr, W. TI Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE tuberculosis; HIV; antiretroviral therapy; immune reconstitution ID ACTIVE ANTIRETROVIRAL THERAPY; INFLAMMATORY SYNDROME; INFECTED PATIENTS; RISK-FACTORS; MYCOBACTERIAL INFECTIONS; HIV-1-INFECTED ADULTS; PARADOXICAL REACTIONS; INITIATION; HAART; ERA AB SETTING: Patients were enrolled in a prospective trial of rifabutin-based tuberculosis (TB) treatment for human immunodeficiency virus related TB. Antiretroviral therapy (ART) was encouraged, but not required. OBJECTIVE: To evaluate the frequency, risk factors and duration of immune reconstitution events. DESIGN: Patients were prospectively evaluated for immune reconstitution events, and all adverse event reports were reviewed to identify possible unrecognized events. RESULTS: Of 169 patients, 25 (15%) developed immune, reconstitution events related to TB. All 25 were among the 137 patients who received ART during TB treatment, so the frequency in this subgroup was 18% (25/137). Risk factors for an immune reconstitution event in multivariate analysis were Black race, the presence of extra-pulmonary TB and a shorter interval from initiation of TB treatment to initiation of ART. The most common clinical manifestations were fever (64%), new or worsening adenopathy (52%) and worsening pulmonary infiltrates (40%). Twelve patients (48%) were hospitalized for a median of 7 days, six underwent surgery and 11 had needle aspiration. The median duration of events was 60 days (range 11-442). CONCLUSION: Immune reconstitution events we're common among patients receiving ART during TB treatment, produced substantial morbidity and had a median duration of 2 months. C1 [Burman, W.; Mangura, B.] Univ Colorado, Hlth Sci Ctr, Denver, CO USA. [Weis, S.; King, B.; Weiner, M.] Univ N Texas Hlth Sci Ctr, Tarrant Cty Hlth Dept, Ft Worth, TX USA. [Vernon, A.; Khan, A.; El-Sadr, W.] Ctr Dis Control & Prevent, Atlanta, GA USA. [Benator, D.] George Washington Univ, Med Ctr, Vet Affairs Med Ctr, Washington, DC USA. [Jones, B.; Silva, C.] Univ So Calif, Med Ctr, Los Angeles, CA USA. [LaHart, C.] Baylor Coll Med, Houston, TX 77030 USA. [Mangura, B.] Univ Med & Dent New Jersey, Sch Med, Natl Tuberculosis Ctr, Newark, NJ 07103 USA. [Weiner, M.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [El-Sadr, W.] Columbia Univ, Coll Phys & Surg, Harlem Hosp Ctr, New York, NY USA. RP Burman, W (reprint author), 605 Bannock St, Denver, CO 80204 USA. EM bburman@dhha.org NR 32 TC 81 Z9 83 U1 0 U2 1 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD DEC PY 2007 VL 11 IS 12 BP 1282 EP 1289 PG 8 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 240YH UT WOS:000251623600004 PM 18229435 ER PT J AU Szekely, CA Breitner, JCS Zandi, PP AF Szekely, C. A. Breitner, J. C. S. Zandi, P. P. TI Prevention of Alzheimer's disease SO INTERNATIONAL REVIEW OF PSYCHIATRY LA English DT Review ID MILD COGNITIVE IMPAIRMENT; RANDOMIZED CONTROLLED-TRIAL; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; PLACEBO-CONTROLLED TRIAL; NATURAL CHOLINESTERASE INHIBITOR; ANTIHYPERTENSIVE-MEDICATION-USE; ESTROGEN REPLACEMENT THERAPY; DIETARY MODIFICATION TRIAL; TOTAL HOMOCYSTEINE LEVELS; BETA IMMUNIZATION AN1792 AB The already considerable public health burden of Alzheimer's disease will likely worsen as populations around the world age. As a result, there is considerable motivation to develop effective strategies for preventing the disease. A wide variety of such strategies are under investigation and include pharmaceuticals, nutriceuticals, diet, physical activity and cognitive activity. We review here the most promising candidates and the epidemiologic evidence for their efficacy. Although none of these have yet to be definitively shown to prevent Alzheimer's disease, further research should help to clarify what role they may play in reducing the burden of this disease. C1 [Breitner, J. C. S.] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA. [Breitner, J. C. S.] Univ Washington, Seattle, WA 98195 USA. [Breitner, J. C. S.] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Zandi, PP (reprint author), Johns Hopkins Bloomberg Sch Publ Hlth, Hampton House Suite 850,624 N Broadway, Baltimore, MD 21205 USA. EM pzandi@jhsph.edu RI Szekely, Christine/C-1342-2009 NR 175 TC 16 Z9 16 U1 4 U2 13 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0954-0261 J9 INT REV PSYCHIATR JI Int. Rev. Psych. PD DEC PY 2007 VL 19 IS 6 BP 693 EP 706 DI 10.1080/09540260701797944 PG 14 WC Psychiatry SC Psychiatry GA 253RL UT WOS:000252535200009 PM 18092245 ER PT J AU Woody, GE Kane, V Lewis, K Thompson, R AF Woody, George E. Kane, Vince Lewis, Kimberly Thompson, Richard TI Premature deaths after discharge from methadone maintenance: A replication SO JOURNAL OF ADDICTION MEDICINE LA English DT Article DE methadone maintenance; mortality; treatment discharge ID RANDOMIZED CONTROLLED-TRIAL; DRUG-USE; OPIOID DEPENDENCE; HEROIN-ADDICTION; MORTALITY; IMPACT; REINFORCEMENT; ABSTINENCE; ABUSE; USERS AB Objective: Examine rate and causes of death among patients discharged from methadone maintenance, relate them to reasons for discharge, and discuss treatment implications. Method: Naturalistic study of deaths and causes of death among 636 opioid-dependent veterans treated with methadone maintenance between January 1, 2000 and August 31, 2002. Results: Among 456 patients who remained on methadone, 31 (6.8%) died (overdose, 1 accident, 13 liver problems, 16 other medical). Among 180 discharged patients, 34 (18.8%) died. Reasons for discharge and causes of death were: continuing drug use IN 52), 11 deaths (4 overdoses, 4 liver problems, 3 other medical); other disciplinary problems (N = 31), 8 deaths (2 suicides, 2 overdoses, 3 other medical, 1 unknown); other reasons (N = 97), 15 deaths (2 suicides, 1 overdose, 1 accident, 7 liver problems, 3 other medical, 1 unknown). Deaths were significantly less (P < 0.05) among patients who remained on methadone than in each category of those discharged. Follow-up interviews of 99 of 146 discharged patients showed problems in drug use, medical, employment, and psychiatric areas, and that only 21% were in treatment. Conclusions: These findings are consistent with a previous study from the same program, and also from other studies, showing that participating in methadone maintenance reduces mortality. Considered in light of the increased mortality among patients discharged for continuing drug use or behavioral problems, these data suggest that premature mortality can be reduced by keeping patients in treatment and/or taking steps to ensure that discharged patients are promptly enrolled in another program. C1 [Woody, George E.; Kane, Vince; Lewis, Kimberly; Thompson, Richard] Dept Vet Affairs Med Ctr, Res Educ & Clin Ctr MIRECC, VISN Mental Illness 4, Philadelphia, PA 19104 USA. [Woody, George E.] Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. [Woody, George E.] Univ Illinois, Dept Psychiat, Chicago, IL 60612 USA. [Thompson, Richard] Univ Illinois, Dept Psychol, Chicago, IL 60612 USA. RP Woody, GE (reprint author), Treatment Res Inst, 600 Publ Ledger Bldg,150 S Independence Mall W, Philadelphia, PA USA. EM woody@tresearch.org RI Thompson, Richard/G-5408-2011 OI Thompson, Richard/0000-0003-0127-513X NR 41 TC 21 Z9 21 U1 0 U2 1 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 DEC PY 2007 VL 1 IS 4 BP 180 EP 185 DI 10.1097/ADM.0b013e318155980e PG 6 WC Substance Abuse SC Substance Abuse GA 305GM UT WOS:000256166000002 PM 21768955 ER PT J AU Pumbwe, L Skilbeck, CA Wexler, HM AF Pumbwe, Lilian Skilbeck, Christopher A. Wexler, Hannah M. TI Induction of multiple antibiotic resistance in Bacteroides fragilis by benzene and benzene-derived active compounds of commonly used analgesics, antiseptics and cleaning agents SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article DE cross-resistance; detergents; disinfectants; gene derepression ID ESCHERICHIA-COLI; EFFLUX PUMP; SALICYLATE INDUCTION; MAR OPERON; DISINFECTANTS; MUTANTS; STRAINS; CHLORIDE AB Objectives: To determine the potential of active compounds (ACs) present in commonly used analgesics/antiseptics and cleaning agents (detergents and disinfectants) to induce multiple antibiotic resistance (MAR) in Bacteroides fragilis. Methods: B. fragilis ATCC 25285 untreated or pretreated with sublethal concentrations of ACs (n = 25) was grown for 12 h. Susceptibility of cells pre-treated with various ACs to antibiotics and expression of resistance nodulation division family (bmeB) efflux pumps and putative marA-like global activators (PGAs) were measured. Results: Twelve aromatic ACs containing benzene or its activated derivatives (salicylate, acetaminophen, gingerol, benzoate, phenol, chlorhexidine gluconate, capsaicin, juglone, cinnamaldehyde, benzene, ibuprofen and Triton X-100) induced MAR, which was reduced by carbonyl cyanide m-chlorophenylhydrazone. There was a positive correlation between the predicted degree of benzene activation and the level of induction. Deactivated benzene or non-aromatic ACs were either poor inducers or non-inducers. Efflux pumps bmeB1, 3, 4, 7 and two PGAs bfrA1 and bfrA2 were overexpressed. Expression of bfrA1 or bfrA2 in Escherichia coli caused a > 2-fold increase in the MAR and overexpression of acrB, suggesting that they were putative marA orthologues. Conclusions: These data demonstrate (i) the presence of an MarA-like system(s) in B. fragilis and (ii) the propensity of benzene or its activated derivatives present in pharmaceutical products to induce MAR. C1 Univ Calif Los Angeles, Dept Med, Wadsworth Anaerobe Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. RP Pumbwe, L (reprint author), Univ Calif Los Angeles, Dept Med, Wadsworth Anaerobe Lab, Bldg 304,Room E3-226,GLAVAHCS 691-151J, Los Angeles, CA 90073 USA. EM lilskil@ucla.edu NR 32 TC 11 Z9 12 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD DEC PY 2007 VL 60 IS 6 BP 1288 EP 1297 DI 10.1093/jac/dkm363 PG 10 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 234XV UT WOS:000251198800014 PM 17884830 ER PT J AU Vagin, O Sachs, G Tokhtaeva, E AF Vagin, Olga Sachs, George Tokhtaeva, Elmira TI The roles of the Na,K-ATPase beta 1 subunit in pump sorting and epithelial integrity SO JOURNAL OF BIOENERGETICS AND BIOMEMBRANES LA English DT Article DE Na; K-ATPase beta subunit; N-glycosylation; Adherens junctions; tight junctions; cell adhesion; epithelial integrity ID CELL-ADHESION; E-CADHERIN; N-GLYCANS; JUNCTIONS; POLARITY; ANKYRIN; SIGNALS; COMPLEX; FODRIN AB In epithelial MDCK cells, the Na,K-ATPase is co-localized with adherens junctions in all stages of monolayer formation starting from initiation of cell-cell contact. The Na,K-ATPase and adherens junction proteins stay partially co-localized even after internalization due to disruption of intercellular contacts by Ca2+ deprivation. Similar to adherens junction proteins, the Na,K-ATPase is resistant to extraction with non-ionic detergent, suggesting pump association with the cytoskeleton. In contrast, the heterodimer formed by expressed unglycosylated Na,K-ATPase beta(1) subunit and the endogenous alpha(1) subunit is easily dissociated from the adherens junctions and cytoskeleton by detergent extraction. The MDCK cells in which half of the endogenous beta(1) subunits in the lateral membrane are substituted by unglycosylated beta(1) subunits display a slower rate of cell-to-cell contact formation and decreased ability to both spread over the surface and migrate. The lack of N-glycans in the Na,K-ATPase beta(1) subunit results in an impairment of mature cell-cell junctions as detected by an increase in the paracellular permeability of the MDCK cell monolayers and by a decrease in resistance of adherens junction proteins to extraction by a non-ionic detergent. Therefore the N-glycans of the Na,K-ATPase beta(1) subunit are important for retention of the pump at the sites of cell-cell contact. Moreover, they are important for the integrity and stability of cell-cell junctions in mature epithelia. In addition, N-glycans contribute to the formation of cell-cell contacts between surface-attached dispersed cells by mediating lamellipodia formation and stabilizing the newly formed adherens junctions. C1 [Vagin, Olga; Sachs, George; Tokhtaeva, Elmira] Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. [Vagin, Olga; Sachs, George; Tokhtaeva, Elmira] Vet Adm Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Vagin, O (reprint author), Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. EM olgav@ucla.edu FU NIDDK NIH HHS [R01 DK077149, DK58333, R01 DK077149-01A1, DK077149, R01 DK077149-02]; PHS HHS [D53642] NR 19 TC 15 Z9 16 U1 0 U2 2 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0145-479X J9 J BIOENERG BIOMEMBR JI J. Bioenerg. Biomembr. PD DEC PY 2007 VL 39 IS 5-6 BP 367 EP 372 DI 10.1007/s10863-007-9103-0 PG 6 WC Biophysics; Cell Biology SC Biophysics; Cell Biology GA 252TC UT WOS:000252468500003 PM 18000747 ER PT J AU Quinones, MP Ahmadi, S Ahuja, SS Torres, V Nery, FG Olvera, R Hatch, JP Pliszka, S Soares, JC AF Quinones, Marlon P. Ahmadi, Sara Ahuja, Seema S. Torres, Victor Nery, Fabiano G. Olvera, Rene Hatch, John P. Pliszka, Steve Soares, Jair C. TI Differential involvement of inflammatory markers in adult and pediatric bipolar disorder SO JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY LA English DT Meeting Abstract CT 47th Annual Meeting of the New-Clinical-Drug-Evaluation-Unit CY JUN 11-14, 2007 CL Boca Raton, FL SP New Clin Drug Evaluat Unit, NIMH C1 [Quinones, Marlon P.; Soares, Jair C.] Univ N Carolina, CERT BD, Chapel Hill, NC 27515 USA. [Quinones, Marlon P.; Soares, Jair C.] Univ N Carolina, Chapel Hill, NC USA. [Ahmadi, Sara; Ahuja, Seema S.; Torres, Victor; Olvera, Rene; Hatch, John P.; Pliszka, Steve] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX USA. [Ahuja, Seema S.] Vet Adm Ctr Res AIDS & HIV 1 Infect, San Antonio, TX USA. [Ahuja, Seema S.; Nery, Fabiano G.; Olvera, Rene; Pliszka, Steve] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Nery, Fabiano G.] Univ Sao Paulo, Sch Med, BR-05508 Sao Paulo, Brazil. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1044-5463 J9 J CHILD ADOL PSYCHOP JI J. Child Adolesc. Psychopharmacol. PD DEC PY 2007 VL 17 IS 6 BP 882 EP 883 PG 2 WC Pediatrics; Pharmacology & Pharmacy; Psychiatry SC Pediatrics; Pharmacology & Pharmacy; Psychiatry GA 256QU UT WOS:000252745500032 ER PT J AU Kawai, M Hrachovy, RA Franklin, PJ Foreman, PJ AF Kawai, Makoto Hrachovy, Richard A. Franklin, Peggy J. Foreman, Perry J. TI Video-EEG monitoring in a geriatric veteran population SO JOURNAL OF CLINICAL NEUROPHYSIOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Clinical-Neurophysiology-Society CY NOV 01-05, 2006 CL Chicago, IL DE video-EEG monitoring; veteran; epilepsy; elderly; nonepileptic ID NONEPILEPTIC SEIZURES; EPILEPSY AB Video-EEG monitoring is a standard too] to evaluate possible seizures. However, there are limited data available for the elderly population, and no data are available for the elderly veteran population. The records of 71 veterans ages 60 and older who underwent video-EEG monitoring at the Michael E. DeBakey Veterans Affairs Medical Center from 1999 to 2006 were reviewed. The average age was 68 years, and 94% were male. Typical events occurred in 34 of 71 patients (48%). Twelve patients (35%) had epileptic seizures; most were temporal lobe seizures (75%). The remaining 22 patients (65%) had a nonepileptic event. Of these, 10 (45%) had psychogenic nonepileptic seizures and 12 (55%) had other physiologic nonepileptic events. AEDs were previously prescribed in 14 of the 22 nonepileptic patients (64%). In our study, most events were nonepileptic, partly reflecting the unique nature of the VA population. There was a slightly higher number of physiologic nonepileptic events; however, psychogenic seizures are also frequently seen. Most of the patients with nonepileptic events were previously treated with AEDs. Most of the epileptic events captured were temporal lobe seizures. Video-EEG monitoring in the elderly is useful in the characterization of paroxysmal events. C1 [Kawai, Makoto; Hrachovy, Richard A.; Franklin, Peggy J.; Foreman, Perry J.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. [Kawai, Makoto; Hrachovy, Richard A.; Foreman, Perry J.] Baylor Coll Med, Dept Neurol, Peter Kellaway Sect Neurophysiol, Houston, TX 77030 USA. RP Kawai, M (reprint author), Toyota Mem Hosp, Heiwa Cho 1-1, Toyota, Aichi 4515813, Japan. EM makoto_kawai_ab@mail.toyota.co.jp NR 14 TC 5 Z9 5 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0736-0258 J9 J CLIN NEUROPHYSIOL JI J. Clin. Neurophysiol. PD DEC PY 2007 VL 24 IS 6 BP 429 EP 432 DI 10.1097/WNP.0b013e31815ba0c8 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 242SI UT WOS:000251745600002 PM 18090522 ER PT J AU Thase, ME Pritchett, YL Ossanna, MJ Swindle, RW Xu, J Detke, MJ AF Thase, Michael E. Pritchett, Yili Lu Ossanna, Melissa J. Swindle, Ralph W. Xu, Jimmy Detke, Michael J. TI Efficacy of duloxetine and selective serotonin reuptake inhibitors - Comparisons as assessed by remission rates in patients with major depressive disorder SO JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY LA English DT Article; Proceedings Paper CT 42nd Meeting of the American-College-of-Neuropsychopharmacology CY DEC 07-11, 2003 CL San Juan, PR SP Amer Coll Neuropsychopharmacol ID PAROXETINE-CONTROLLED TRIAL; CLINICAL-TRIALS; PLACEBO; VENLAFAXINE; ANTIDEPRESSANTS; FOOD AB It has been proposed that serotonin and norepinephrine reuptake inhibitors (SNRIs) may result in higher remission rates of major depressive disorder than therapy with selective serotonin reuptake inhibitors (SSRIs). To test this hypothesis, a meta-analysis of individual patient data (N = 1833) was performed for the complete set of 6 phase II/III studies that compared duloxetine (fixed doses; range, 40-120 mg/d) with 2 SSRIs (paroxetine or fluoxetine; 20 mg/d) in outpatients with major depressive disorder. Remission was defined as an end point score of less than or equal to 7 on the 17-item Hamilton Rating Scale for Depression (HAMD(17)); alternate outcome criteria were also examined, as were remission rates among the 1044 patients with moderate-to-severe depression (HAMD17 total score greater than or equal to 19). The HAMD(17) remission rates were 40.3% (351/871), 38.3% (162/423), and 28.4% (144/507) for duloxetine, the 2 SSRIs, and placebo, respectively. Both active treatments were superior to placebo; the difference between duloxetine and SSRIs was not statistically significant. Similar findings were observed for alternate outcomes. Duloxetine therapy was significantly more effective than therapy with the 2 SSRIs for patients with more severe depression, with remission rates of 35.9% (183/510) versus 28.6% (70/245) (P = 0.046). A secondary analysis of dose-response relationships indicated that this advantage was not attributable to the studies using higher doses of duloxetine. Thus, whereas duloxetine and the 2 SSRIs were comparably efficacious overall, therapy with the serotonin and norepinephrine reuptake inhibitor resulted in a significantly higher remission rate among patients with moderate-to-severe depression. C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA USA. Univ Pittsburgh, Ctr Med, Dept Psychiat, Pittsburgh, PA USA. Abbott Labs, Abbott Pk, IL 60064 USA. Indiana Univ, Sch Med, Dept Psychiat, Indianapolis, IN 46204 USA. McLean Hosp, Dept Psychiat, Belmont, MA 02178 USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA USA. Eli Lilly & Co, Indianapolis, IN 46285 USA. RP Thase, ME (reprint author), Univ Penn, Sch Med, Dept Psychiat, 3535 Market St,Room 689, Philadelphia, PA 19104 USA. EM thase@mail.med.upenn.edu NR 23 TC 72 Z9 81 U1 6 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-0749 J9 J CLIN PSYCHOPHARM JI J. Clin. Psychopharmacol. PD DEC PY 2007 VL 27 IS 6 BP 672 EP 676 DI 10.1097/jcp.0b013e31815a4412 PG 5 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 234RO UT WOS:000251181600016 PM 18004135 ER PT J AU Safford, MM Allison, JJ Kiefe, CI AF Safford, Monika M. Allison, Jeroan J. Kiefe, Catarina I. TI Patient complexity: More than comorbidity. The Vector Model of Complexity SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT AcademyHealth Annual Research Meeting CY JUN 03-05, 2007 CL Orlando, FL SP AcademyHealth DE patient complexity; evidence-based care; Vector Model of Complexity ID ACUTE MYOCARDIAL-INFARCTION; CHRONIC DISEASE; CHRONIC ILLNESS; HEART-FAILURE; MEDICAL-CARE; HEALTH; GUIDELINES; OLDER; HYPERTENSION; MORBIDITY AB BACKGROUND: The conceptualization of patient complexity is just beginning in clinical medicine. OBJECTIVES: This study aims (1) to propose a conceptual approach to complex patients; (2) to demonstrate how this approach promotes achieving congruence between patient and provider, a critical step in the development of maximally effective treatment plans; and (3) to examine availability of evidence to guide trade-off decisions and assess healthcare quality for complex patients. METHODS/RESULTS: The Vector Model of Complexity portrays interactions between biological, socioeconomic, cultural, environmental and behavioral forces as health determinants. These forces are not easily discerned but exert profound influences on processes and outcomes of care for chronic medical conditions. Achieving congruence between patient, physician, and healthcare system is essential for effective, patient-centered care; requires assessment of all axes of the Vector Model; and, frequently, requires trade-off decisions to develop a tailored treatment plan. Most evidence-based guidelines rarely provide guidance for trade-off decisions. Quality measures often exclude complex patients and are not designed explicitly to assess their overall healthcare. CONCLUSIONS/RECOMMENDATIONS: We urgently need to expand the evidence base to inform the care of complex patients of all kinds, especially for the clinical trade-off decisions that are central to tailoring care. We offer long- and short-term strategies to begin to incorporate complexity into quality measurement and performance profiling, guided by the Vector Model. Interdisciplinary research should lay the foundation for a deeper understanding of the multiple sources of patient complexity and their interactions, and how provision of healthcare should be harmonized with complexity to optimize health. C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Safford, MM (reprint author), Univ Alabama, 1717 11th Ave S,MT643, Birmingham, AL 35294 USA. EM msafford@uab.edu OI Allison, Jeroan/0000-0003-4472-2112 FU NHLBI NIH HHS [R01 HL080477]; NIDDK NIH HHS [R18 DK065001, R18DK65001-01AZ] NR 57 TC 79 Z9 80 U1 2 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 DEC PY 2007 VL 22 SU 3 BP 382 EP 390 DI 10.1007/s116O6-007-0307-0 PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 239UM UT WOS:000251543500004 PM 18026806 ER PT J AU Young, AS Chaney, E Shoai, R Bonner, L Cohen, AN Doebbeling, B Dorr, D Goldstein, MK Kerr, E Nichol, P Perrin, R AF Young, Alexander S. Chaney, Edmund Shoai, Rebecca Bonner, Laura Cohen, Amy N. Doebbeling, Brad Dorr, David Goldstein, Mary K. Kerr, Eve Nichol, Paul Perrin, Ruth TI Information technology to support improved care for chronic illness SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT State of the Art Conference on Managing Complexity in Chronic Care CY SEP 13-15, 2006 CL Arlington, VA SP Dept Vet Affairs Res & Dev DE chronic disease; informatics; clinical information systems; quality improvement; decision making ID CLINICAL DECISION-SUPPORT; QUALITY-OF-CARE; HEALTH-CARE; GUIDELINE IMPLEMENTATION; UNITED-STATES; SYSTEMS; SCHIZOPHRENIA; STRATEGIES; LESSONS; RECORDS AB BACKGROUND: In populations with chronic illness, outcomes improve with the use of care models that integrate clinical information, evidence-based treatments, and proactive management of care. Health information technology is believed to be critical for efficient implementation of these chronic care models. Health care organizations have implemented information technologies, such as electronic medical records, to varying degrees. However, considerable uncertainty remains regarding the relative impact of specific informatics technologies on chronic illness care. OBJECTIVE: To summarize knowledge and increase expert consensus regarding informatics components that support improvement in chronic illness care. Design: A systematic review of the literature was performed. "Use case" models were then developed, based on the literature review, and guidance from clinicians and national quality improvement projects. A national expert panel process was conducted to increase consensus regarding information system components that can be used to improve chronic illness care. RESULTS: The expert panel agreed that informatics should be patient-centered, focused on improving outcomes, and provide support for illness self-management. They concurred that outcomes should be routinely assessed, provided to clinicians during the clinical encounter, and used for population-based care management. It was recommended that interactive, sequential, disorder-specific treatment pathways be implemented to quickly provide clinicians with patient clinical status, treatment history, and decision support. CONCLUSIONS: Specific informatics strategies have the potential to improve care for chronic illness. Software to implement these strategies should be developed, and rigorously evaluated within the context of organizational efforts to improve care. C1 VA Desert Pacific Mental Illness Res Educ & Clin, W Los Angeles VA Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. VA VISN Hlth Serv Res & Dev Ctr, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Indianapolis VA, Indianapolis, IN USA. Indiana Univ, Sch Med, Indianapolis, IN USA. Portland VA, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med Informat & Clin Epidemiol, Portland, OR 97201 USA. GRECC, VA Palo Alto Hlth Care Syst, Palo Alto, CA USA. Stanford Univ, Stanford, CA 94305 USA. Ann Arbor VA, Ann Arbor, MI USA. Univ Michigan, Ann Arbor, MI 48109 USA. VA Informat Resource Ctr, Hines, IL USA. RP Young, AS (reprint author), VA Desert Pacific Mental Illness Res Educ & Clin, W Los Angeles VA Healthcare Ctr, Los Angeles, CA 90073 USA. EM ayoung@ucla.edu RI Doebbeling, Bradley/C-6620-2009; Young, Alexander/A-1523-2009 OI Young, Alexander/0000-0002-9367-9213 FU NIMH NIH HHS [P30 MH068639] NR 39 TC 21 Z9 22 U1 2 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 DEC PY 2007 VL 22 SU 3 BP 425 EP 430 DI 10.1007/s116O6-007-0303-4 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 239UM UT WOS:000251543500010 PM 18026812 ER PT J AU Safford, MM Shewchuk, R Qu, HY Williams, JH Estrada, CA Ovalle, F Allison, JJ AF Safford, Monika M. Shewchuk, Richard Qu, Haiyan Williams, Jessica H. Estrada, Carlos A. Ovalle, Fernando Allison, Jeroan J. TI Reasons for not intensifying medications: Differentiating "Clinical inertia" from appropriate care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE clinical inertia; primary care; conceptual model ID BLOOD-PRESSURE; HYPERTENSION; PERFORMANCE; MANAGEMENT; PAY AB BACKGROUND "Clinical inertia" has been defined as inaction by physicians caring for patients with uncontrolled risk factors such as blood pressure. Some have proposed that it accounts for up to 80% of cardiovascular events, potentially an important quality problem. However, reasons for so-called clinical inertia are poorly understood. OBJECTIVE To derive an empiric conceptual model of clinical inertia as a subset of all clinical inactions from the physician perspective. METHODS We used Nominal Group panels of practicing physicians to identify reasons why they do not intensify medications when seeing an established patient with uncontrolled blood pressure. MEASUREMENTS AND MAIN RESULTS We stopped at 2 groups (N=6 and 7, respectively) because of the high degree of agreement on reasons for not intensifying, indicating saturation. A third group of clinicians (N=9) independently sorted the reasons generated by the Nominal Groups. Using multidimensional scaling and hierarchical cluster analysis, we translated the sorting results into a cognitive map that represents an empirically derived model of clinical inaction from the physician's perspective. The model shows that much inaction may in fact be clinically appropriate care. CONCLUSIONS/RECOMMENDATIONS Many reasons offered by physicians for not intensifying medications suggest that low rates of intensification do not necessarily reflect poor quality of care. The empirically derived model of clinical inaction can be used as a guide to construct performance measures for monitoring clinical inertia that better focus on true quality problems. C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Safford, MM (reprint author), Univ Alabama, Birmingham, AL 35294 USA. EM msafford@uab.edu OI Allison, Jeroan/0000-0003-4472-2112 FU NIDDK NIH HHS [R18 DK065001, R18DK65001-01A2] NR 23 TC 61 Z9 62 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 DEC PY 2007 VL 22 IS 12 BP 1648 EP 1655 DI 10.1007/s11606-007-0433-8 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 232IC UT WOS:000251011100003 PM 17957346 ER PT J AU Washington, DL Shacter, HE Saha, S Cooper, LA Long, JA AF Washington, Donna L. Shacter, Hannah E. Saha, Somnath Cooper, Lisa A. Long, Judith A. TI Update in health disparities SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE ethnic groups; continental population groups ID BREAST-CANCER; RACIAL/ETHNIC GROUP; CARE; AMERICANS; TRIAL C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Philadelphia VA Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Vet Affairs Med Ctr, Gen Internal Med Sect, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med, Portland, OR USA. Johns Hopkins Univ, Sch Med, Dept Med, Div Gen Internal Med, Baltimore, MD USA. Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. EM donna.washington@va.gov NR 14 TC 0 Z9 0 U1 0 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 DEC PY 2007 VL 22 IS 12 BP 1756 EP 1761 DI 10.1007/s11606-007-0442-7 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 232IC UT WOS:000251011100019 ER PT J AU Pugh, JA AF Pugh, Jacqueline A. TI Priority setting for patients with multiple comorbidities: Diabetes may not end up number one SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78285 USA. RP Pugh, JA (reprint author), Univ Texas Hlth Sci Ctr San Antonio, S Texas Vet Hlth Care Syst, San Antonio, TX 78285 USA. EM pugh@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X NR 2 TC 0 Z9 0 U1 0 U2 0 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 DEC PY 2007 VL 22 IS 12 BP 1783 EP 1784 DI 10.1007/s11606-007-0434-7 PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 232IC UT WOS:000251011100025 PM 17985189 ER PT J AU Moschella, PC Rao, VU McDermott, PJ Kuppuswamy, D AF Moschella, Phillip C. Rao, Vijay U. McDermott, Paul J. Kuppuswamy, Dhandapani TI Regulation of mTOR and S6K1 activation by the nPKC isoforms, PKC epsilon and PKC epsilon in adult cardiac muscle cells SO JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY LA English DT Article DE cardiomyocytes; PKC; mTOR; S6K1; endothelin-1; phenylephrine; hypertrophy ID PROTEIN-KINASE-C; MAMMALIAN TARGET; SIGNALING PATHWAYS; RAPAMYCIN MTOR; GROWTH CONTROL; P70S6 KINASE; CYCLIC-AMP; IN-VIVO; PHOSPHORYLATION; HYPERTROPHY AB Activation of both mTOR and its downstream target, S6K1 (p70 S6 kinase) have been implicated to affect cardiac hypertrophy. Our earlier work, in a feline model of 1-48 It pressure overload, demonstrated that mTOR/S6K1 activation occurred primarily through a PKC/c-Raf pathway. To further delineate the role of specific PKC isoforms on rnTOR/S6K1 activation, we utilized primary cultures of adult feline cardiomyocytes in vitro and stimulated with endothelin-1 (ET-1), phenylephrine (PE), TPA, or insulin. All agonist treatments resulted in S2248 phosphorylation of mTOR and T389 and S421/T424 phosphorylation of S6K1, however only ET-1 and TPA-stimulated mTOR/S6K1 activation was abolished with infection of a dominant negative adenoviral c-Raf (DN-Raf) construct. Expression of DN-PKC epsilon blocked ET-1-stimulated mTOR S2448 and S6K1 S421/T424 and T389 phosphorylation but had no effect on insulin-stimulated S6KI phosphorylation. Expression of DN-PKC delta or pretreatment of cardiomyocytes with rottlerin, a PKC delta specific inhibitor, blocked both ET-I and insulin stimulated mTOR S2448 and S6KI T389 phosphorylation. However, treatment with Go6976, a specific classical PKC (cPKC) inhibitor did not affect mTOR/S6K1 activation. These data indicate that: (i) PKC, is required for ET-1-stimulated T421/S424 phosphorylation of S6K1, (ii) both PKC epsilon and PKC epsilon are required for ET-1-stimulated mTOR S2448 and S6K1 T389 phosphorylation, (iii) PKC epsilon, is also required for insulin-stimulated mTOR S2448 and S6K1 T389 phosphorylation. Together, these data delineate both distinct and combinatorial roles of specific PKC isoforms on mTOR and S6K1 activation in adult cardiac myocytes following hypertrophic stimulation, (c) 2007 Elsevier Inc. All rights reserved. C1 [Moschella, Phillip C.; Rao, Vijay U.; McDermott, Paul J.; Kuppuswamy, Dhandapani] Med Univ S Carolina, Gazes Cardiac Res Inst, Dept Med, Div Cardiol, Columbia, SC 29208 USA. [McDermott, Paul J.; Kuppuswamy, Dhandapani] Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Kuppuswamy, D (reprint author), Gazes Cardiac Res Inst, 114 Doughty St, Charleston, SC 29425 USA. EM kuppusd@musc.edu FU NHLBI NIH HHS [P01 HL048788-159006, P01 HL048788-150001, P01 HL048788-119006, P01 HL048788-140007, P01 HL048788-140001, P01 HL048788-110007, P01 HL048788, P01 HL048788-150007, P01 HL048788-129006, P01 HL048788-120001, T32 HL007260, T32 HL 07260, P01 HL048788-120007, P01 HL048788-130007, P01 HL048788-149006, P01 HL048788-130001, P01 HL048788-139006, P01 HL048788-110001, HL 48788] NR 50 TC 35 Z9 38 U1 0 U2 2 PU ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0022-2828 EI 1095-8584 J9 J MOL CELL CARDIOL JI J. Mol. Cell. Cardiol. PD DEC PY 2007 VL 43 IS 6 BP 754 EP 766 DI 10.1016/j.yjmcc.2007.09.015 PG 13 WC Cardiac & Cardiovascular Systems; Cell Biology SC Cardiovascular System & Cardiology; Cell Biology GA 245IR UT WOS:000251928800013 PM 17976640 ER PT J AU Takeuchi, T Ham, M Mizumori, M Guth, PH Engel, E Kaunitz, JD Akiba, Y AF Takeuchi, T. Ham, M. Mizumori, M. Guth, P. H. Engel, E. Kaunitz, J. D. Akiba, Y. TI Solute diffusion through stripped mouse duodenum SO JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY LA English DT Article DE upper villous cells; fluorescence; CO2; ion transport inhibitor; chemical diffusion; serosal perfusate; duodenum; diffusion barrier carboxyfluorescein; dimethylamiloride; carbon dioxide; zomporide ID MUCOSAL BICARBONATE SECRETION; RAT SMALL-INTESTINE; HYDROGEN EXCHANGER ISOFORM-1; NECTURUS ANTRAL MUCOSA; INTRACELLULAR PH; IN-VIVO; HCO3-SECRETION; USSING CHAMBER; ION-TRANSPORT; CARBONIC-ANHYDRASES AB We measured villous cell intracellular pH (pH(i)) and solute diffusion between the bathing media and the epithelial cells in stripped, chambered mouse duodenum. Apical perfusion of a high CO2 solution rapidly acidified the upper villous cells with recovery after its removal. Apical zoniporide (ZP) enhanced CO2-induced acidification. Serosal ZP, dimethylamiloride (DMA) or stilbene anion transport inhibitors failed to alter CO2-induced acidification, whereas serosal high CO2 buffer acidified the upper villous cells. Serosal 5-hydroxytryptamine rapidly acidified the upper villous cells. All serosally-perfused fluorescent compounds stained the crypt area, but not the villi or villous cells. In contrast, intravenous carboxyfluorescein quickly diffused into the interstitial space of the entire mucosa, and mucosally perfused fluorescent compound rapidly penetrated the epithelial cell layer. In muscle-stripped duodenum mounted in a small-aperture perfusion chamber, serosal solutes can readily diffuse only to the crypt cell region, whereas access to the villous epithelial cells is diffusion-limited. In contrast, rapid villous cell responses to serosally applied solutes are best explained by neural reflexes. Limited viability of the villous cells and impaired structural stability of the villi further limit long-term, villous cell functional studies of mucosal preparations mounted in small aperture diffusion chambers. C1 [Guth, P. H.; Kaunitz, J. D.] Univ Calif Los Angeles, Greater Los Angles Vet Affairs Healthcare Syst, Los Angeles, CA 90024 USA. [Takeuchi, T.; Mizumori, M.; Kaunitz, J. D.; Akiba, Y.] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. [Ham, M.] Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. [Engel, E.] Univ Calif Los Angeles, Dept Biomath, Los Angeles, CA 90024 USA. [Akiba, Y.] Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Suite 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jake@ucla.edu NR 53 TC 4 Z9 4 U1 0 U2 4 PU POLISH PHYSIOLOGICAL SOC PI GRZEGORZECKA PA JAGIELLONIAN UNIV SCHOOL MED, INST PHYSIOLOGY, 31-531 KRAKOW, 16 GRZEGORZECKA, POLAND SN 0867-5910 J9 J PHYSIOL PHARMACOL JI J. Physiol. Pharmacol. PD DEC PY 2007 VL 58 IS 4 BP 767 EP 791 PG 25 WC Physiology SC Physiology GA 245ZB UT WOS:000251976200013 PM 18195487 ER PT J AU Fueki, K Kimoto, K Ogawa, T Garrett, NR AF Fueki, Kenji Kimoto, Katsuhiko Ogawa, Takahiro Garrett, Neal R. TI Effect of implant-supported or retained dentures on masticatory performance: A systematic review SO JOURNAL OF PROSTHETIC DENTISTRY LA English DT Review ID REMOVABLE PARTIAL DENTURES; COOPERATIVE DENTAL IMPLANT; WEARING FIXED PROSTHESIS; 2 TREATMENT MODALITIES; BLADE-VENT IMPLANTS; OSSEOINTEGRATED IMPLANTS; PATIENT SATISFACTION; ORAL FUNCTION; MANDIBULAR OVERDENTURES; CONVENTIONAL DENTURES AB Statement of problem. While subjective patient-based measures have been recognized as critical outcomes for prosthodontic treatment, there continues to be a need to validate for patients what changes in masticatory function can be expected with the provision of new implant-supported or retained dentures. Purpose. The purpose of this review was to evaluate the critical factors impacting change in masticatory performance following the provision of new implant-supported or retained dentures. Material and methods. Information retrieval followed a systematic approach using PubMed and the Cochrane Library. English articles published from 1966 to June 2007, in which the masticatory performance of subjects with implant-supported or retained dentures was assessed by objective methods and compared to performance with conventional dentures, were included. Ratings of the evidence provided in each article followed United States Agency for Healthcare Research and Quality recommendations. Results. From 281 articles identified, 18 peer-reviewed articles met prespecified criteria for inclusion. Specific outcomes of significance identified by these articles rated as level II are: (1) fixed implant-supported partial dentures do not provide significant improvement in masticatory performance compared to conventional removable partial dentures for Kennedy Class I and II partially edentulous mandibles; (2) the combination of a mandibular implant-supported or retained overdenture (IOD) and maxillary conventional complete denture (CD) provides significant improvement in masticatory performance compared to CDs in both the mandible and maxilla for a limited population having persistent functional problems with an existing mandibular CD due to severely resorbed mandible; and (3) the type of implant and attachment system for mandibular IODs has a limited impact. Specific outcomes of significance identified by articles rated as having a moderate level of evidence (level III) are: (1) mandibular fixed implant-supported complete dentures provide significant improvement in masticatory performance compared to mandibular CDs in subjects dissatisfied with their CDs; and (2) implant-supported mandibular resection dentures have an advantage over conventional dentures in masticatory performance on the defect side of the mouth. C1 [Fueki, Kenji] Tokyo Med & Dent Univ, Bunkyo Ku, Tokyo 1138549, Japan. [Kimoto, Katsuhiko] Kanagawa Dent Coll, Dept Oral & Maxillofacial Rehabil, Yokosuka, Kanagawa 238, Japan. [Ogawa, Takahiro] Univ Calif Los Angeles, Jane & Jerry Weintraub Ctr Reconstruct Biotechnol, Sch Dent, Los Angeles, CA USA. [Garrett, Neal R.] Vet Adm Greater Los Angeles Healthhcare Syst, Dent Res Lab, Los Angeles, CA USA. [Ogawa, Takahiro; Garrett, Neal R.] Univ Calif Los Angeles, Jane & Jerry Weintraub Ctr Reconstruct Biotechnol, Div Adv Prosthodont Biomat, Los Angeles, CA 90024 USA. [Ogawa, Takahiro; Garrett, Neal R.] Univ Calif Los Angeles, Hosp Dent, Jane & Jerry Weintraub Ctr Reconstruct, Los Angeles, CA 90024 USA. RP Fueki, K (reprint author), Tokyo Med & Dent Univ, Bunkyo Ku, 1-5-45 Yuhima, 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 40 TC 61 Z9 69 U1 3 U2 26 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 DEC PY 2007 VL 98 IS 6 BP 470 EP 477 DI 10.1016/S0022-3913(07)60147-4 PG 8 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 248OS UT WOS:000252164100007 PM 18061741 ER PT J AU Zhang, XY Tan, YL Zhou, DF Cao, LY Wu, GY Xu, Q Shen, Y Halle, CN Kosten, TA Kosten, TR AF Zhang, Xiang Yang Tan, Yun Long Zhou, Dong Feng Cao, Lian Yuan Wu, Gui Ying Xu, Qi Shen, Yan Halle, Colin N. Kosten, Therese A. Kosten, Thomas R. TI Serum BDNF levels and weight gain in schizophrenic patients on long-term treatment with antipsychotics SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article DE schizophrenia; antipsychotic; weight gain; BDNF; serum; sex difference ID NEUROTROPHIC FACTOR; MESSENGER-RNA; ATYPICAL ANTIPSYCHOTICS; TARDIVE-DYSKINESIA; DECREASED LEVELS; RAT HIPPOCAMPUS; BRAIN; MICE; EXPRESSION; OBESITY AB Several lines of evidence suggest that central brain-derived neurotrophic factor (BDNF) modulates food intake, metabolism, and increases in body weight. Reports have also shown that serum BDNF is altered in schizophrenic patients treated with antipsychotics. This study aimed to determine if there was a relationship between BDNF and antipsychotic-induced weight gain in patients with chronic schizophrenia. Serum BDNF was measured in 124 schizophrenia patients chronically treated with clozapine (n = 57), risperidone (n = 23) or typical antipsychotics (n = 44) and 50 healthy control subjects. To further assess group differences in serum BDNF, additional analyses were performed in a subset of patients and controls individually matched for body mass index (BMI). BDNF levels were lower in patients with schizophrenia than normal controls. However, this difference was not present when controlling for current BMI. In the individually BMI-matched sample, no differences in serum BDNF levels were observed in schizophrenic patients compared to BMI-matched healthy controls. BDNF levels negatively correlated with BMI gain in female but not in male patients when gender was considered. Antipsychotic class exerted differential effects over BDNF levels and BMI gain. Our findings suggest that decreased BDNF levels may be associated with weight gain in female schizophrenic patients on long-term antipsychotic treatment. (c) 2006 Published by Elsevier Ltd. C1 Baylor Coll Med, VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Peking Univ, Inst Metal Hlth, Beijing 100083, Peoples R China. Beijing Hui Long Guan Hosp, Ctr Biol Psychiat, Beijing 100096, Peoples R China. Chinese Acad Med Sci, Inst Basic Med Sci, Natl Lab Med Mol Biol, Beijing 100005, Peoples R China. Peking Union Med, Beijing 100005, Peoples R China. RP Zhang, XY (reprint author), Baylor Coll Med, VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Bldg 109,Rm 130,2002 Holcombe Blvd, Houston, TX 77030 USA. EM xyzhang@bcm.edu OI Haile, Colin/0000-0001-8293-7291 FU NIDA NIH HHS [K05-DA0454, P50-DA18827] NR 52 TC 44 Z9 47 U1 2 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3956 J9 J PSYCHIATR RES JI J. Psychiatr. Res. PD DEC PY 2007 VL 41 IS 12 BP 997 EP 1004 DI 10.1016/j.jpsychires.2006.08.007 PG 8 WC Psychiatry SC Psychiatry GA 215TZ UT WOS:000249833200003 PM 17095017 ER PT J AU Bunton, K Kent, RD Duffy, JR Rosenbek, JC Kent, JF AF Bunton, Kate Kent, Raymond D. Duffy, Joseph R. Rosenbek, John C. Kent, Jane F. TI Listener agreement for auditory-perceptual ratings of dysarthria SO JOURNAL OF SPEECH LANGUAGE AND HEARING RESEARCH LA English DT Article DE auditory-perceptual ratings; dysarthria; listener agreement ID VOICE QUALITY; SPEAKING TASK; SPEECH; RELIABILITY; SAMPLES AB Purpose: Darley, Aronson, and Brown (1969a, 1969b) detailed methods and results of auditory-perceptual assessment for speakers with dysarthrias of varying etiology. They reported adequate listener reliability for use of the rating system as a tool for differential diagnosis, but several more recent studies have raised concerns about listener reliability using this approach. Method: In the present study, the authors examined intrarater and interrater agreement for perceptual ratings of 47 speakers with various dysarthria types by 2 listener groups (inexperienced and experienced). The entire set of perceptual features proposed by Darley et al. was rated based on a 40-s conversational speech sample. Results: No differences in levels of agreement were found between the listener groups. Agreement was within 1 scale value or better for 67% of the pairwise comparisons. Levels of agreement were lower when the average rating fell in the mid-range of the scale compared with samples that had an average rating near either of the scale endpoints; agreement was above chance level. No significant differences in agreement were found between the perceptual features. Discussion: The levels of listener agreement that were found indicate that auditory-perceptual ratings show promise during clinical assessment for identifying salient features of dysarthria for speakers with various etiologies. C1 [Bunton, Kate; Kent, Raymond D.] Waisman Ctr Mental Retardat & Human Dev, Madison, WI USA. [Duffy, Joseph R.] Mayo Clin, Rochester, NY USA. [Rosenbek, John C.] William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Bunton, K (reprint author), Univ Arizona, Dept Speech Language & Hearing Sci, POB 210071, Tucson, AZ 85721 USA. EM bunton@u.arizona.edu FU NIDCD NIH HHS [R03 DC005902, R01 DC00319] NR 31 TC 32 Z9 32 U1 0 U2 6 PU AMER SPEECH-LANGUAGE-HEARING ASSOC PI ROCKVILLE PA 10801 ROCKVILLE PIKE, ROCKVILLE, MD 20852-3279 USA SN 1092-4388 J9 J SPEECH LANG HEAR R JI J. Speech Lang. Hear. Res. PD DEC 1 PY 2007 VL 50 IS 6 BP 1481 EP 1495 DI 10.1044/1092-4388(2007/102) PG 15 WC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation SC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation GA 267HG UT WOS:000253499500006 PM 18055769 ER PT J AU Lauer, AM Dooling, RJ Leek, MR Poling, K AF Lauer, Amanda M. Dooling, Robert J. Leek, Marjorie R. Poling, Kirsten TI Detection and discrimination of simple and complex sounds by hearing-impaired Belgian Waterslager canaries SO JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA LA English DT Article ID PARAKEET MELOPSITTACUS-UNDULATUS; STARLING STURNUS-VULGARIS; AUDITORY INTENSITY DISCRIMINATION; TEMPORAL INTEGRATION; SERINUS-CANARIUS; FREQUENCY DISCRIMINATION; DURATION DISCRIMINATION; HARMONIC COMPLEXES; DIFFERENCE LIMENS; ADULT CHICKENS AB Belgian Waterslager canaries (BWC) are bred to produce a distinctive low-pitched song with energy restricted to a lower range of frequencies than in other types of canaries. Previous studies have shown a high frequency hearing loss primarily above 2000 Hz that is related to hair cell abnormalities in BWC, but little is known about auditory perception in these birds. Here, frequency, duration, and intensity discrimination, temporal integration, gap detection, and discrimination of temporally reversed harmonic cornplexes in BWC were measured and compared to normal-hearing non-BWC. BWC had excellent frequency discrimination ability at 1000 Hz, but showed poor frequency discrimination compared to non-BWC at frequencies in the region of hearing loss. Duration and intensity discrimination were not adversely affected in BWC. Temporal integration was reduced in BWC, except at 2000 Hz. Gap detection and discrimination of temporally reversed stimuli were somewhat better in BWC than in non-BWC. Those tests that relied primarily on temporal processing were less affected by the cochlear damage in BWC than tests that probably relied more on audibility and spectral analysis. Thus, despite significant high frequency hearing loss and extensive damage along the basilar papilla, BWC retain relatively good hearing abilities under many conditions. (c) 2007 Acoustical Society of America. C1 [Lauer, Amanda M.; Dooling, Robert J.; Poling, Kirsten] Univ Maryland, Dept Psychol, College Pk, MD 20742 USA. [Leek, Marjorie R.] Portland VA Med Ctr, Natl Ctr Rehabilitat Auditory Res, Portland, OR 97207 USA. RP Lauer, AM (reprint author), Johns Hopkins Univ, 521 Traylor Res Bldg,720 Rutland Ave, Baltimore, MD 21205 USA. EM alauer2@jhmi.edu OI Lauer, Amanda/0000-0003-4184-7374 FU NIDCD NIH HHS [DC-04664, P30 DC004664, DC-00626, DC-005450, F31 DC005450, DC-01372, R01 DC001372] NR 68 TC 6 Z9 7 U1 1 U2 9 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 EI 1520-8524 J9 J ACOUST SOC AM JI J. Acoust. Soc. Am. PD DEC PY 2007 VL 122 IS 6 BP 3615 EP 3627 DI 10.1121/1.2799482 PG 13 WC Acoustics; Audiology & Speech-Language Pathology SC Acoustics; Audiology & Speech-Language Pathology GA 241IS UT WOS:000251650700043 PM 18247769 ER PT J AU Jakupcak, M Conybeare, D Phelps, L Hunt, S Holmes, HA Felker, B Klevens, M McFall, ME AF Jakupcak, Matthew Conybeare, Daniel Phelps, Lori Hunt, Stephen Holmes, Hollie A. Felker, Bradford Klevens, Michele McFall, Miles E. TI Anger, hostility, and aggression among Iraq and Afghanistan war veterans reporting PTSD and subthreshold PTSD SO JOURNAL OF TRAUMATIC STRESS LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; VIETNAM COMBAT VETERANS; TRAUMA-RELATED SYMPTOMS; OPERATION DESERT-STORM; PRIMARY-CARE; COMPENSATION-SEEKING; FOLLOW-UP; VICTIMS; PREVALENCE; PREDICTORS AB Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies. C1 [Jakupcak, Matthew; Conybeare, Daniel; Phelps, Lori; Hunt, Stephen; Holmes, Hollie A.; Felker, Bradford; Klevens, Michele; McFall, Miles E.] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Conybeare, Daniel; Phelps, Lori; Holmes, Hollie A.; Klevens, Michele; McFall, Miles E.] Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. RP Jakupcak, M (reprint author), Seattle VA Med Ctr, Deployment Hlth Clin, 1660 S Columbian Way, Seattle, WA 98108 USA. EM matthew.jakupcak@va.gov NR 61 TC 183 Z9 185 U1 2 U2 16 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD DEC PY 2007 VL 20 IS 6 BP 945 EP 954 DI 10.1002/jts.20258 PG 10 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 245RG UT WOS:000251952900003 PM 18157891 ER PT J AU Garzotto, M AF Garzotto, Mark TI Untitled - Editorial comments SO JOURNAL OF UROLOGY LA English DT Editorial Material ID PROSTATE-CANCER; PREDICTORS C1 Oregon Hlth & Sci Univ, Dept Urol, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Radiat Med, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Garzotto, M (reprint author), Oregon Hlth & Sci Univ, Dept Urol, Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD DEC PY 2007 VL 178 IS 6 BP 2365 EP 2365 DI 10.1016/j.juro.2007.08.202 PG 1 WC Urology & Nephrology SC Urology & Nephrology GA 230AO UT WOS:000250847900033 ER PT J AU Rowan, PJ Dunn, NJ El-Serag, HB Kunik, ME AF Rowan, P. J. Dunn, N. J. El-Serag, H. B. Kunik, M. E. TI Views of hepatitis C virus patients delayed from treatment for psychiatric reasons SO JOURNAL OF VIRAL HEPATITIS LA English DT Article DE chronic hepatitis; communication; decision making; qualitative research ID ANTIVIRAL THERAPY; VETERANS; ALCOHOL; DEPRESSION; INFECTION AB For patients with chronic hepatitis C virus, certain psychiatric disorders are contraindications for antiviral therapy with interferon-alpha (IFN). Although these conditions delay a significant portion of patients from beginning therapy, no one has yet portrayed the views of these patients. A qualitative analysis, drawing upon semi-structured interviews, was developed to generate hypotheses regarding patient views of the treatment disposition process, and to generate strategies for increasing the portion of treatment-eligible patients. Two focus groups were conducted: one for patients delayed from treatment due to current or recent depression, and one for patients delayed due to current or recent alcohol use. A grounded theory analysis of the interview data were conducted. Patients were generally satisfied with the decision-making process, based largely on education from, and trust in, physicians. Upon learning their diagnosis, patients reported making healthy behaviour changes regarding alcohol, diet, exercise and herbal remedies. Some patients reported that requiring a period of alcohol abstinence was excessive, as they believed that they could discontinue alcohol use immediately, if so instructed by a physician. Patients seemed to over-interpret the likelihood of suicide during interferon-alpha (IFN) therapy. Current or recent psychiatric morbidity delays many patients from beginning interferon therapy. Nonetheless, this may be an optimal time for physicians to encourage healthy behaviours including abstinence from alcohol. Also, physicians may need to extensively assess the use of herbal remedies by patients. To help patients make judgments about beginning therapy, physicians should focus upon risk communication regarding the likelihood of suicide on therapy with interferon. C1 Univ Texas Houston, Sch Publ Hlth, Div Management Policy & Community Hlth, Houston, TX 77030 USA. Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Gastroenterol Sect, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Rowan, PJ (reprint author), Univ Texas Houston, Sch Publ Hlth, Div Management Policy & Community Hlth, 1200 Herman Pressler, Houston, TX 77030 USA. EM paul.j.rowan@uth.tmc.edu NR 23 TC 12 Z9 12 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1352-0504 J9 J VIRAL HEPATITIS JI J. Viral Hepatitis PD DEC PY 2007 VL 14 IS 12 BP 883 EP 889 DI 10.1111/j.1365-2893.2007.00884.x PG 7 WC Gastroenterology & Hepatology; Infectious Diseases; Virology SC Gastroenterology & Hepatology; Infectious Diseases; Virology GA 237LH UT WOS:000251374700009 PM 18070292 ER PT J AU Butt, AA Khan, UA McGinnis, KA Skanderson, M Kwoh, CK AF Butt, A. A. Khan, U. A. McGinnis, K. A. Skanderson, M. Kwoh, C. Kent TI Co-morbid medical and psychiatric illness and substance abuse in HCV-infected and uninfected veterans SO JOURNAL OF VIRAL HEPATITIS LA English DT Article DE comorbidities; drug abuse; HCV; psychiatric illness; substance abuse; veterans ID CHRONIC HEPATITIS-C; INTERFERON-ALPHA-2B PLUS RIBAVIRIN; UNITED-STATES VETERANS; VIRUS-INFECTION; HEPATOCELLULAR-CARCINOMA; DIABETES-MELLITUS; INITIAL TREATMENT; RANDOMIZED-TRIAL; HIV; PREVALENCE AB Comorbidities may affect the decision to treat chronic hepatitis C virus (HCV) infection. We undertook this study to determine the prevalence of these conditions in the HCV-infected persons compared with HCV-uninfected controls. Demographic and comorbidity data were retrieved for HCV-infected and -uninfected subjects from the VA National Patient Care Database using ICD-9 codes. Logistic regression was used to determine the odds of comorbid conditions in the HCV-infected subjects. HCV-uninfected controls were identified matched on age, race/ethnicity and sex. We identified 126 926 HCV-infected subjects and 126 926 controls. The HCV-infected subjects had a higher prevalence of diabetes, anaemia, hypertension, chronic obstructive pulmonary disease (COPD)/asthma, cirrhosis, hepatitis B and cancer, but had a lower prevalence of coronary artery disease and stroke. The prevalence of all psychiatric comorbidities and substance abuse was higher in the HCV-infected subjects. In the HCV-infected persons, the odds of being diagnosed with congestive heart failure, diabetes, anaemia, hypertension, COPD/asthma, cirrhosis, hepatitis B and cancer were higher, but lower for coronary artery disease and stroke. After adjusting for alcohol and drug abuse and dependence, the odds of psychiatric illness were not higher in the HCV-infected persons. The prevalence and patterns of comorbidities in HCV-infected veterans are different from those in HCV-uninfected controls. The association between HCV and psychiatric diagnoses is at least partly attributable to alcohol and drug abuse and dependence. These factors should be taken into account when evaluating patients for treatment and designing new intervention strategies. C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Albany Med Ctr, Albany, NY USA. RP Butt, AA (reprint author), Univ Pittsburgh, Med Ctr, 3601 5th Ave,Suite 3A,Falk Med Bldg, Pittsburgh, PA 15213 USA. EM butta@dom.pitt.edu FU NIDA NIH HHS [K23 DA016175-01A1] NR 38 TC 60 Z9 60 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1352-0504 J9 J VIRAL HEPATITIS JI J. Viral Hepatitis PD DEC PY 2007 VL 14 IS 12 BP 890 EP 896 DI 10.1111/j.1365-2893.2007.00885.x PG 7 WC Gastroenterology & Hepatology; Infectious Diseases; Virology SC Gastroenterology & Hepatology; Infectious Diseases; Virology GA 237LH UT WOS:000251374700010 PM 18070293 ER PT J AU Choi, AI Rodriguez, RA Bacchetti, P Bertenthal, D Volberding, PA O'Hare, AM AF Choi, A. I. Rodriguez, R. A. Bacchetti, P. Bertenthal, D. Volberding, P. A. O'Hare, A. M. TI The impact of HIV on chronic kidney disease outcomes SO KIDNEY INTERNATIONAL LA English DT Article DE AIDS; HIV nephropathy; epidemiology and outcomes ID HUMAN-IMMUNODEFICIENCY-VIRUS; GLOMERULAR-FILTRATION-RATE; STAGE RENAL-DISEASE; ANTIRETROVIRAL THERAPY; INFECTED PATIENTS; SERUM CREATININE; VETERAN POPULATION; DIETARY-PROTEIN; MORTALITY RISK; UNITED-STATES AB Chronic kidney disease (CKD) is a known complication of the human immunodeficiency virus (HIV) but outcomes among HIV-infected patients with kidney disease are unknown. We studied a national sample of 202 927 patients with CKD (stage 3 or higher) for death, end-stage renal disease (ESRD) and the mean annual rate of decline in estimated glomerular filtration rate (eGFR) over a median period of 3.8 years. Within this sample, 0.3% of the patients were diagnosed with HIV, 43.5% were diabetic, whereas the remainder had neither disease. In this national CKD cohort, HIV-infected black patients were at higher risk of death, a similar risk for ESRD and loss of eGFR than black patients with diabetes. HIV-infected white patients experienced higher rates of death but a lower risk of ESRD than their counterparts with diabetes. Our results highlight a need to study mortality and mechanisms of ESRD in the HIV infected population. C1 San Francisco Gen Hosp, Renal Ctr, San Francisco, CA 94110 USA. Univ Calif San Francisco, San Francisco Gen Hosp, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94143 USA. Univ Washington, Dept Med, VA Puget Sound Healthcare Syst, Seattle, WA 98195 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, VA Res Enhancement Award Program, San Francisco, CA USA. RP Choi, AI (reprint author), San Francisco Gen Hosp, Renal Ctr, 1001 Potrero Ave,Bldg 100,Rm 342,Box 1341, San Francisco, CA 94110 USA. EM andy.choi@ucsf.edu FU NIA NIH HHS [K23-AG28980-01]; NIAID NIH HHS [P30-AI27763]; NIDDK NIH HHS [T32-DK07219] NR 55 TC 43 Z9 43 U1 1 U2 1 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 DEC PY 2007 VL 72 IS 11 BP 1380 EP 1387 DI 10.1038/sj.ki.5002541 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 231NR UT WOS:000250955900018 PM 17805235 ER PT J AU Parchman, ML Zeber, JE Romero, RR Pugh, JA AF Parchman, Michael L. Zeber, John E. Romero, Raquel R. Pugh, Jacqueline A. TI Risk of coronary artery disease in type 2 diabetes and the delivery of care consistent with the chronic care model in primary care settings - A STARNet study SO MEDICAL CARE LA English DT Article; Proceedings Paper CT Conference of the Practice-Based-Research-Networks CY 2005 CL Washington, DC SP Practice Based Res Networks DE primary care; type 2 diabetes; chronic disease; myocardial infarction; organization of care ID CHRONIC ILLNESS CARE; QUALITY IMPROVEMENT; HEART-DISEASE; OF-CARE; IMPLEMENTATION; CHALLENGES; ADULTS AB Background: Modifiable risks for coronary heart disease (CHD) in type 2 diabetes include glucose, blood pressure, lipid control, and smoking. The chronic care model (CCM) provides an organizational framework for improving these outcomes. Objective: To examine the relationship between CHD risk attributable to modifiable risk factors among patients with type 2 diabetes and whether care delivered in primary care settings is consistent with the CCM. Subjects/Methods: Approximately 30 patients in each of 20 primary care clinics. CHD risk factors were assessed by patient survey and chart abstraction. Absolute 10-year CHD risk was calculated using the UK Prospective Diabetes Study risk engine. Attributable risk was calculated by setting all 4 modifiable risk factors to guideline indicated values, recalculating the risk, and subtracting it from the absolute risk. In each clinic, the consistency of care with the CCM was evaluated using the Assessment of Chronic Illness Care (ACIC) survey. Results: Only 15.4% had guideline-recommended control of Alc, blood pressure, and lipids. The absolute 10-year risk CHD was 16.2% (SD 16.6). One-third of this risk, 5.0% (SD 7.4), was attributable to poor risk factor control. After controlling for patient and clinic characteristics, the ACIC score was inversely associated with attributable risk: a I point increase in the ACIC score was associated with a 16% (95% CI, 5-26%) relative decrease in attributable risk. Discussion: The degree to which care delivered in a primary care clinic conforms to the CCM is an important predictor of the 10-year risk of CHD among patients with type 2 diabetes. C1 S Texas Vet Hlth Care Syst, VERDICT Ctr 11C6, Audie L Murphys Div, Vet Affairs HSR&D, San Antonio, TX 78229 USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Family & Community Med, San Antonio, TX 78229 USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. RP Parchman, ML (reprint author), S Texas Vet Hlth Care Syst, VERDICT Ctr 11C6, Audie L Murphys Div, Vet Affairs HSR&D, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM parchman@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU AHRQ HHS [K08 HS013008-02] NR 28 TC 34 Z9 34 U1 0 U2 6 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 DEC PY 2007 VL 45 IS 12 BP 1129 EP 1134 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 239ST UT WOS:000251538700003 PM 18007162 ER PT J AU Peterfy, M Ben-Zeev, O Mao, HZ Weissglas-Volkov, D Aouizerat, BE Pullinger, CR Frost, PH Kane, JP Malloy, MJ Reue, K Pajukanta, P Doolittle, MH AF Peterfy, Miklos Ben-Zeev, Osnat Mao, Hui Z. Weissglas-Volkov, Daphna Aouizerat, Bradley E. Pullinger, Clive R. Frost, Philip H. Kane, John P. Malloy, Mary J. Reue, Karen Pajukanta, Paeivi Doolittle, Mark H. TI Mutations in LMF1 cause combined lipase deficiency and severe hypertriglyceridemia SO NATURE GENETICS LA English DT Article ID LIPOPROTEIN-LIPASE; ENDOPLASMIC-RETICULUM; HEPATIC LIPASE; MATURATION; CLD/CLD; MOUSE; MICE; CLD; METABOLISM; SECRETION AB Hypertriglyceridemia is a hallmark of many disorders, including metabolic syndrome, diabetes, atherosclerosis and obesity(1-3). A well-known cause is the deficiency of lipoprotein lipase ( LPL), a key enzyme in plasma triglyceride hydrolysis(4-6). Mice carrying the combined lipase deficiency ( cld) mutation show severe hypertriglyceridemia owing to a decrease in the activity of LPL and a related enzyme, hepatic lipase ( HL)(7-9), caused by impaired maturation of nascent LPL and hepatic lipase polypeptides in the endoplasmic reticulum ( ER)(10). Here we identify the gene containing the cld mutation as Tmem112 and rename it Lmf1 ( Lipase maturation factor 1). Lmf1 encodes a transmembrane protein with an evolutionarily conserved domain of unknown function that localizes to the ER. A human subject homozygous for a deleterious mutation in LMF1 also shows combined lipase deficiency with concomitant hypertriglyceridemia and associated disorders. Thus, through its profound effect on lipase activity, LMF1 emerges as an important candidate gene in hypertriglyceridemia(4,11,12). C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Human Genet, Los Angeles, CA 90095 USA. Univ Calif San Francisco, Sch Nursing, Dept Physiol Nursing, San Francisco, CA 94143 USA. Univ Calif San Francisco, Inst Human Genet, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Biochem & Biophys, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Pediat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Cardiovasc Res Inst, San Francisco, CA 94143 USA. RP Peterfy, M (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA. EM mpeterfy@ucla.edu; markdool@ucla.edu FU NCRR NIH HHS [KL2-RR024130]; NHGRI NIH HHS [T32 HG002536, T32 HG02536]; NHLBI NIH HHS [HL082762, HL28481] NR 26 TC 95 Z9 101 U1 0 U2 5 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1061-4036 J9 NAT GENET JI Nature Genet. PD DEC PY 2007 VL 39 IS 12 BP 1483 EP 1487 DI 10.1038/ng.2007.24 PG 5 WC Genetics & Heredity SC Genetics & Heredity GA 235XK UT WOS:000251267400016 PM 17994020 ER PT J AU Yehuda, R Harvey, PD Buchsbaum, M Tischler, L Schmeidler, J AF Yehuda, Rachel Harvey, Philip D. Buchsbaum, Monte Tischler, Lisa Schmeidler, James TI Enhanced effects of cortisol administration on episodic and working memory in aging veterans with PTSD SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE posttraumatic stress disorder; combat veterans; cortisol/glucocorticoids; memory performance; cognitive function; aging ID POSTTRAUMATIC-STRESS-DISORDER; GLUCOCORTICOID-INDUCED IMPAIRMENT; POSITRON-EMISSION-TOMOGRAPHY; MAJOR DEPRESSIVE DISORDER; HIPPOCAMPAL VOLUME; DECLARATIVE MEMORY; HOLOCAUST SURVIVORS; PREFRONTAL CORTEX; NUCLEUS-ACCUMBENS; DOPAMINE RELEASE AB Though both glucocorticoid alterations and memory impairments have been noted in posttraumatic stress disorder (PTSD), it is not clear if these phenomena are causally linked. As there is emerging evidence that these domains become further altered in PTSD with increasing age, it is of interest to examine these relationships in an older cohort. Aging ( mean age, 62.7 +/- 8.9; range, 52-81) combat veterans with (n = 13) and without (n = 17) PTSD received an intravenous bolus of 17.5 mg hydrocortisone (cortisol), a naturally occurring glucocorticoid, or placebo in a randomized, double-blind manner, on two mornings approximately 1-2 weeks apart. Neuropsychological testing to evaluate episodic and working memory performance was performed 75 min later. Cortisol enhanced episodic memory performance in both groups of subjects, but enhanced elements of working memory performance only in the PTSD + group. The preferential effect of cortisol administration on working memory in PTSD may be related to the superimposition of PTSD and age, as cortisol had impairing effects on this task in a previously studied, younger cohort. The findings suggest that there may be opportunities for developing therapeutic strategies using glucocorticoids in the treatment of aging combat veterans. C1 Mt Sinai Sch Med, Traumat Stress Studies Program, Dept Psychiat, New York, NY USA. James J Peters Bronx Vet Affairs Med Ctr, PTSD Program, Bronx, NY USA. Mt Sinai Sch Med, Neurosci PET Lab, New York, NY USA. Mt Sinai Sch Med, Ctr Biomath Sci, New York, NY USA. RP Yehuda, R (reprint author), 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Rachel.Yehuda@med.va.gov FU NCRR NIH HHS [5 M01 RR00071] NR 80 TC 31 Z9 31 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD DEC PY 2007 VL 32 IS 12 BP 2581 EP 2591 DI 10.1038/sj.npp.1301380 PG 11 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 231NS UT WOS:000250956000014 PM 17392739 ER PT J AU Sudore, RL Landefeld, CS Barnes, DE Lindquist, K Williams, BA Brody, R Schillinger, D AF Sudore, Rebecca L. Landefeld, C. Seth Barnes, Deborah E. Lindquist, Karla Williams, Brie A. Brody, Robert Schillinger, Dean TI An advance directive redesigned to meet the literacy level of most adults: A randomized trial SO PATIENT EDUCATION AND COUNSELING LA English DT Article DE advance directive; health literacy; communication; decision-making; ethics; health disparities ID FUNCTIONAL HEALTH LITERACY; SURROGATE DECISION-MAKERS; OF-LIFE CARE; LIVING WILLS; MEDICAL-CARE; TREATMENT PREFERENCES; DIABETES PATIENTS; END; COMMUNICATION; COMPREHENSION AB Objective: To determine whether an advance directive redesigned to meet most adults' literacy needs (fifth grade reading level with graphics) was more useful for advance care planning than a standard form (> 12th grade level). Methods: We enrolled 205 English and Spanish-speaking patients, aged >= 50 years from an urban, general medicine clinic. We randomized participants to review either form. Main outcomes included acceptability and usefulness in advance care planning. Participants then reviewed the alternate form; we assessed form preference and six-month completion rates. Results: Forty percent of enrolled participants had limited literacy. Compared to the standard form, the redesigned form was rated higher for acceptability and usefulness in care planning, P <= 0.03, particularly for limited literacy participants (P for interaction <= 0.07). The redesigned form was preferred by 73% of participants. More participants randomized to the redesigned form completed an advance directive at six months (19% vs. 8%, P = 0.03); of these, 95% completed the redesigned form. Conclusions: The redesigned advance directive was rated more acceptable and useful for advance care planning and was preferred over a standard form. It also resulted in higher six-month completion rates. Practice implications: An advance directive redesigned to meet most adults' literacy needs may better enable patients to engage in advance care planning. (c) 2007 Elsevier Ireland Ltd. All rights reserved. C1 [Sudore, Rebecca L.; Landefeld, C. Seth; Barnes, Deborah E.; Lindquist, Karla; Williams, Brie A.] Univ Calif San Francisco, VAMC, Div Geriatr, San Francisco, CA 94121 USA. [Sudore, Rebecca L.; Landefeld, C. Seth; Barnes, Deborah E.; Lindquist, Karla; Williams, Brie A.] San Francisco VA Med Ctr, San Francisco, CA USA. [Brody, Robert; Schillinger, Dean] Univ Calif San Francisco, San Francisco Gen Hosp, Ctr Vulnerable Populat, Div Gen Internal Med, San Francisco, CA 94143 USA. RP Sudore, RL (reprint author), Univ Calif San Francisco, VAMC, Div Geriatr, Clement St 4150,Box 181G, San Francisco, CA 94121 USA. EM rsuesf@yahoo.com FU NCRR NIH HHS [K-23 RR16539, K23 RR016539]; NIA NIH HHS [T32 AG000212, 5R01AG023626-02, AG000212, K07 AG000912, K23 AG030344, K23 AG030344-01, R01 AG023626] NR 42 TC 51 Z9 51 U1 2 U2 12 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 DEC PY 2007 VL 69 IS 1-3 BP 165 EP 195 DI 10.1016/j.pec.2007.08.015 PG 31 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 244WP UT WOS:000251896300021 PM 17942272 ER PT J AU Kelly, PA AF Kelly, P. Adam TI Untitled SO PATIENT EDUCATION AND COUNSELING LA English DT Letter ID LITERACY C1 [Kelly, P. Adam] US Dept Vet Affairs, Houston, TX 77030 USA. [Kelly, P. Adam] Baylor Coll Med, Dept Med, Michael E DeBakey VA Med Ctr, Houston, TX 77030 USA. RP Kelly, PA (reprint author), US Dept Vet Affairs, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM pakelly@bcm.edu NR 2 TC 0 Z9 0 U1 1 U2 1 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 DEC PY 2007 VL 69 IS 1-3 BP 214 EP 214 DI 10.1016/j.pec.2007.09.012 PG 1 WC Public, Environmental & Occupational Health; Social Sciences, Interdisciplinary SC Public, Environmental & Occupational Health; Social Sciences - Other Topics GA 244WP UT WOS:000251896300026 ER PT J AU Mortensen, EM Restrepo, MI Copeland, LA Pugh, JA Anzueto, A Cornell, JE Pugh, MJV AF Mortensen, Eric M. Restrepo, Marcos I. Copeland, Laurel A. Pugh, Jacqueline A. Anzueto, Antonio Cornell, John E. Pugh, Mary Jo V. TI Impact of previous statin and angiotensin II receptor blocker use on mortality in patients hospitalized with sepsis SO PHARMACOTHERAPY LA English DT Article DE sepsis; 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor; statin; angiotensin II receptor blocker; mortality ID CHRONIC HEART-FAILURE; C-REACTIVE PROTEIN; CYTOKINE PRODUCTION; THERAPY; INHIBITORS; EPIDEMIOLOGY; PNEUMONIA; RISK; HYPERCHOLESTEROLEMIA; INFLAMMATION AB Study Objective. To examine the effect of previous outpatient use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and/or angiotensin II receptor blockers (ARBs) on 30-day mortality in patients hospitalized with sepsis. Design. Retrospective national cohort study. Data Source. Department of Veterans Affairs (VA) national patient care and pharmacy databases. Patients. A total of 3018 patients who were hospitalized with sepsis in fiscal year 2000, had at least I year of previous VA outpatient care, and had at least one active and filled VA prescription within 90 days of admission. Measurements and Main Results. The primary outcome was 30-day mortality. The primary analysis was a multilevel model with hospital as a random effect and control variables that included comorbid conditions, demographics, and other drugs. Among the 3018 patients hospitalized with sepsis, mean age was 74.4 years, 2975 (98.6%) were male, and 811 (26.9%) died within 30 days of admission. Regarding prescription drug use, 480 patients (15.9%) were taking statins and 107 (3.5%) were taking ARBs. After adjusting for potential confounders, statin use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.36-0.64) and ARB use (OR 0.42, 95% CI 0.24-0.76) were significantly associated with decreased 30-day mortality. Conclusions. Use of statins and/or ARBs before admission was associated with decreased mortality in patients hospitalized with sepsis. Further research is needed to determine if these drugs might be started on admission for those with sepsis. C1 Univ Texas San Antonio, Res Ctr, VERDICT, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Texas Hlth Sci Ctr San Antonio, Div Gen Internal Med, San Antonio, TX USA. Univ Texas Hlth Sci Ctr San Antonio, Div Pulm & Crit Care Med, San Antonio, TX USA. Univ Texas Hlth Sci Ctr San Antonio, Div Psychiat, San Antonio, TX USA. RP Mortensen, EM (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Audie L Murphy Mem Vet Hosp, VERDICT, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. EM mortensene@uthscs.edu RI Restrepo, Marcos/H-4442-2014 OI Pugh, Jacqueline/0000-0003-4933-141X; Mortensen, Eric/0000-0002-3880-5563; Copeland, Laurel/0000-0002-9478-0209 NR 42 TC 33 Z9 35 U1 0 U2 2 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER, 806, 750 WASHINGTON ST, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD DEC PY 2007 VL 27 IS 12 BP 1619 EP 1626 DI 10.1592/phco.27.12.1619 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 240DL UT WOS:000251567300003 PM 18041882 ER PT J AU Schuna, AA AF Schuna, Arthur A. TI Rituximab for the treatment of rheumatoid arthritis SO PHARMACOTHERAPY LA English DT Review DE rituximab; rheumatoid arthritis; tumor necrosis factor-alpha; inhibitors; TNF-alpha ID ANTITUMOR NECROSIS FACTOR; B-LYMPHOCYTE DEPLETION; DOUBLE-BLIND; MONOCLONAL-ANTIBODY; INADEQUATE RESPONSE; CLINICAL-RESPONSE; CELL DEPLETION; TRIAL; EFFICACY; METHOTREXATE AB Rituximab has been approved by the United States Food and Drug Administration in combination with methotrexate for the treatment of rheumatoid arthritis in patients who failed to achieve adequate benefit from tumor necrosis factor-alpha inhibitors. Rituximab is a biologic agent that depletes peripheral B cells-an action thought to reduce rheumatoid arthritis activity-and induces prolonged clinical improvement. Two 1000-mg infusions administered 2 weeks apart can result in a response that lasts for months. Most patients will require retreatment, but the effect of repeated dosing on patient outcomes has not yet been determined. Combination therapy with methotrexate is recommended as this appears to achieve the best outcomes. Rituximab also has been shown to be safe, although the lack of long-term efficacy and safety data limit its use. More studies are needed, but this agent has been demonstrated to be safe and effective in patients who fail to achieve adequate clinical response to methotrexate and tumor necrosis factor-alpha inhibitors. C1 Univ Wisconsin, William S Middleton Mem Vet Adm Med Ctr, Sch Pharm, Serv Pharm, Madison, WI USA. RP Schuna, AA (reprint author), William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM aaschuna@wisc.edu NR 34 TC 12 Z9 12 U1 0 U2 1 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER, 806, 750 WASHINGTON ST, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD DEC PY 2007 VL 27 IS 12 BP 1702 EP 1710 DI 10.1592/phco.27.12.1702 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 240DL UT WOS:000251567300011 PM 18041890 ER PT J AU Taylor, WJ Schumacher, HR Singh, JA Grainger, R Dalbeth, N AF Taylor, W. J. Schumacher, H. R., Jr. Singh, J. A. Grainger, R. Dalbeth, N. TI Assessment of outcome in clinical trials of gouta review of current measures SO RHEUMATOLOGY LA English DT Review ID HEALTH-ASSESSMENT QUESTIONNAIRE; DOUBLE-BLIND TRIAL; RHEUMATOID-ARTHRITIS; INDOMETHACIN; HYPERURICEMIA; EFFICACY; FIBROMYALGIA; ETORICOXIB; REDUCTION; THERAPY AB There has been renewed interest in the treatment of gout with recent reported intervention studies of new agents such as etoricoxib, febuxostat and pegylated-uricase. However, these studies have highlighted the relative paucity of validated outcome measures with which to judge efficacy. This review outlines the published information regarding which endpoints have been measured in randomized clinical trials, what should be measured, what tools or instruments are available for this and the technical properties of such instruments. It highlights recent work that validates measures of tophi, radiographic damage and patient-reported outcomes. The absence of a valid definition of gout-flare or how flare reduction defines response is problematic; this forms the basis for a current ACR-EULAR sponsored project. C1 Univ Otago, Wellington Sch Med & Hlth Sci, Dept Med, Rehabil Teaching & Res Unit, Wellington 6242, New Zealand. Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. Univ Penn, Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. VA Med Ctr, Rheumatol Sect, Med Serv, Minneapolis, MN USA. VA Med Ctr, Ctr Epidemiol & Clin Res, Ctr Chron Dis Outcomes Res, Minneapolis, MN USA. Univ Minnesota, Dept Med, Div Rheumatol, Minneapolis, MN 55455 USA. Univ Auckland, Dept Med, Fac Med & Hlth Sci, Auckland, New Zealand. Malaghan Inst Med Res, Wellington, New Zealand. RP Taylor, WJ (reprint author), Univ Otago, Wellington Sch Med & Hlth Sci, Dept Med, Rehabil Teaching & Res Unit, POB 7343, Wellington 6242, New Zealand. EM will.taylor@otago.ac.nz RI Grainger, Rebecca/I-1866-2012 OI singh, jasvinder/0000-0003-3485-0006 NR 44 TC 20 Z9 21 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1462-0324 J9 RHEUMATOLOGY JI RHEUMATOLOGY PD DEC PY 2007 VL 46 IS 12 BP 1751 EP 1756 DI 10.1093/rheumatology/kem178 PG 6 WC Rheumatology SC Rheumatology GA 234XN UT WOS:000251197900004 PM 17650521 ER PT J AU Tregellas, JR Shatti, S Tanabe, JL Martin, LF Gibson, L Wylie, K Rojas, DC AF Tregellas, Jason R. Shatti, Shireen Tanabe, Jody L. Martin, Laura F. Gibson, Linzi Wylie, Korey Rojas, Donald C. TI Gray matter volume differences and the effects of smoking on gray matter in schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; voxel-based morphometry; VBM; smoking; superior temporal gyrus; orbitofrontal cortex ID VOXEL-BASED MORPHOMETRY; NICOTINIC RECEPTORS; WHITE-MATTER; HUMAN BRAIN; ABNORMALITIES; MRI; CORTEX; METAANALYSIS; REDUCTION; SYMPTOMS AB Objective: Many studies have evaluated differences in gray matter volume in schizophrenia, but have not considered the possible effects of smoking, which is extraordinarily common in people with the illness. The present study used voxel-based morphometry (VBM) to examine differences in gray matter in subjects with schizophrenia and evaluate the effects of smoking on this measure. Methods: Thirty-two subjects with schizophrenia (14 smokers, 18 non-smokers) and 32 healthy comparison subjects participated in the study. Whole brain, voxel-wise analyses of regional gray matter volume were conducted using voxel-based morphometry (VBM). Results: Reduced gray matter was observed in the schizophrenia group in the orbitofrontal cortex, bilateral insula and superior temporal gyri (STG), bilateral dorsolateral prefrontal cortices (DLPFC), medial frontal gyrus, and cingulate gyrus. Within this group, smoking subjects had greater lateral prefrontal and STG gray matter volumes relative to non-smoking subjects. Conclusions: The finding of reduced gray matter volume in prefrontal and temporal regions in schizophrenia is consistent with prior anatomical tracing and whole-brain voxel-based studies. Greater gray matter volumes in smoking relative to non-smoking subjects with schizophrenia highlight a potential experimental confound in volumetric studies and suggests that smoking may be associated with a relative preservation of lateral prefrontal and temporal gray matter in schizophrenia. Published by Elsevier B.V. C1 [Tregellas, Jason R.; Shatti, Shireen; Tanabe, Jody L.; Martin, Laura F.; Gibson, Linzi; Wylie, Korey; Rojas, Donald C.] Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. [Tregellas, Jason R.; Martin, Laura F.] Denver VA Med Ctr, Res Serv, Denver, CO USA. RP Tregellas, JR (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Campus Box C268-71,4200 E 9th Ave, Denver, CO 80262 USA. EM Jason.Tregellas@UCHSC.edu RI Rojas, Don/F-4296-2012; Tregellas, Jason/J-3637-2015 OI Rojas, Don/0000-0001-6560-9616 FU NIMH NIH HHS [5 P50 MH068582] NR 52 TC 38 Z9 40 U1 2 U2 6 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC PY 2007 VL 97 IS 1-3 BP 242 EP 249 DI 10.1016/j.schres.2007.08.019 PG 8 WC Psychiatry SC Psychiatry GA 242RA UT WOS:000251742000027 PM 17890058 ER PT J AU Li, WJ Wei, J Zhou, DF Tan, YL Cao, YL Zhang, XY Wu, GY Kosten, TA Kosten, TR AF Li, Wenjun Wei, Jun Zhou, Dong Feng Tan, Yun Long Cao, Yuan Lian Zhang, Xiang Yang Wu, Guiying Kosten, Therese A. Kosten, Thomas R. TI Lack of association between the BDNF C270T polymorphism and schizophrenia in a Chinese Han population SO SCHIZOPHRENIA RESEARCH LA English DT Letter ID NEUROTROPHIC FACTOR GENE C1 [Zhang, Xiang Yang; Wu, Guiying; Kosten, Therese A.; Kosten, Thomas R.] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, VA Med Ctr, Houston, TX 77030 USA. [Li, Wenjun; Wei, Jun] Jilin Univ, Res Ctr Neurosci & MH, Radiobiol Res Unit, Changchun 130021, Peoples R China. [Zhou, Dong Feng] Peking Univ, Inst Mental Hlth, Beijing 100083, Peoples R China. [Tan, Yun Long; Cao, Yuan Lian; Zhang, Xiang Yang] Beijing Hui Long Guan Hosp, Ctr Biol Psychiat, Beijing 100083, Peoples R China. RP Zhang, XY (reprint author), Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, VA Med Ctr, Res Bldg 109,Room 130,2002 Holcombe BLVD, Houston, TX 77030 USA. EM xyzhang@bcm.edu NR 6 TC 2 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD DEC PY 2007 VL 97 IS 1-3 BP 297 EP 298 DI 10.1016/j.schres.2007.07.005 PG 2 WC Psychiatry SC Psychiatry GA 242RA UT WOS:000251742000036 PM 17669628 ER PT J AU Muder, RR AF Muder, Robert R. TI Optimizing therapy for Stenotrophomonas maltophilia SO SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Review DE Stenotrophomonas (Xanthomonas) maltophilia; nosocomial infections; antimicrobial resistance ID GRAM-NEGATIVE BACILLI; IN-VITRO ACTIVITIES; XANTHOMONAS-MALTOPHILIA; PSEUDOMONAS-MALTOPHILIA; CYSTIC-FIBROSIS; BETA-LACTAMASE; ANTIMICROBIAL SUSCEPTIBILITY; CATARACT-EXTRACTION; PERITONEAL-DIALYSIS; CANCER-PATIENTS AB Stenotrophomonas (Xanthomonas) maltophilia is a nonfermentative, gram-negative bacillus that is widely distributed in natural and humanmade environments. In the nonhospital setting it is an uncommon pathogen, typically causing soft tissue infection of contaminated wounds. In the hospital setting, particularly among critical care and oncology patients, S. maltophilia may cause catheter-related bacteremia, pneumonia, soft tissue infection, meningitis, prosthetic valve endocarditis, and ocular infections. S. maltophilia is usually resistant to multiple antimicrobials, including expanded-spectrum penicillins, third-generation cephalosporins, carbapenems, aminoglycosides, and quinolones. Trimethoprim-sulfamethoxazole is the antimicrobial agent of choice for this pathogen but is bacteriostatic. Further, resistance to this agent is increasing. Certain combinations of antibiotics are synergistic and may be appropriate for patients harboring resistant organisms or with life-threatening infections. C1 [Muder, Robert R.] VA Pittsburgh Healthcare Syst, Infect Dis Sect, Pittsburgh, PA 15240 USA. [Muder, Robert R.] Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. RP Muder, RR (reprint author), VA Pittsburgh Healthcare Syst, Infect Dis Sect 111E U, Univ Dr C, Pittsburgh, PA 15240 USA. EM Robert.muder@va.gov NR 64 TC 15 Z9 17 U1 3 U2 4 PU THIEME MEDICAL PUBL INC PI NEW YORK PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA SN 1069-3424 EI 1098-9048 J9 SEMIN RESP CRIT CARE JI Semin. Respir. Crit. Care Med. PD DEC PY 2007 VL 28 IS 6 BP 672 EP 677 DI 10.1055/s-2007-996414 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 248VV UT WOS:000252186100012 PM 18095231 ER PT J AU Morgenthaler, TI Kapur, VK Brown, T Swick, TJ Alessi, C Aurora, N Boehlecke, B Chesson, AL Friedman, L Maganti, R Owens, J Pancer, J Zak, R AF Morgenthaler, Timothy I. Kapur, Vishesh K. Brown, Terry Swick, Todd J. Alessi, Cathy Aurora, Nisha Boehlecke, Brian Chesson, Andrew L., Jr. Friedman, Leah Maganti, Rama Owens, Judith Pancer, Jeffrey Zak, Rochelle CA Stand Practice Comm AASM TI Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin SO SLEEP LA English DT Article DE narcolepsy; idiopathic hypersomnia; recurrent hypersomnia; Parkinson's disease; myotonic dystrophy; multiple sclerosis; modafinil; sodium oxybate; amphetamine; methamphetamine; dextroamphetamine; methylphenidate; selegiline; tricyclic antidepressants; fluoxetine ID EXCESSIVE DAYTIME SLEEPINESS; ADMINISTERED SODIUM OXYBATE; DOUBLE-BLIND; PARKINSONS-DISEASE; MULTIPLE-SCLEROSIS; OPEN-LABEL; MODAFINIL; PLACEBO; TRIAL; WAKEFULNESS AB These practice parameters pertain to the treatment of hypersomnias of central origin. They serve as both an update of previous practice parameters for the therapy of narcolepsy and as the first practice parameters to address treatment of other hypersomnias of central origin. They are based on evidence analyzed in the accompanying review paper. The specific disorders addressed by these parameters are narcolepsy (with cataplexy, without cataplexy, due to medical condition and unspecified), idiopathic hypersomnia (with long sleep time and without long sleep time), recurrent hypersomnia and hypersomnia due to medical condition. Successful treatment of hypersomnia of central origin requires an accurate diagnosis, individual tailoring of therapy to produce the fullest possible return of normal function, and regular follow-up to monitor response to treatment. Modafinil, sodium oxybate, amphetamine, methamphetamine, dextroamphetamine, methylphenidate, and selegiline are effective treatments for excessive sleepiness associated with narcolepsy, while tricyclic antidepressants and fluoxetine are effective treatments for cataplexy, sleep paralysis, and hypnagogic hallucinations; but the quality of published clinical evidence supporting them varies. Scheduled naps can be beneficial to combat sleepiness in narcolepsy patients. Based on available evidence, modafinil is an effective therapy for sleepiness due to idiopathic hypersomnia, Parkinson's disease, myotonic dystrophy, and multiple sclerosis. Based on evidence and/or long history of use in the therapy of narcolepsy committee consensus was that modafinil, amphetamine, methamphetamine, dextroamphetamine, and methylphenidate are reasonable options for the therapy of hypersomnias of central origin. C1 [Stand Practice Comm AASM] Amer Acad Sleep Med, Westbrook Corp Ctr 1, Westchester, IL 60154 USA. [Kapur, Vishesh K.] Univ Washington, Seattle, WA 98195 USA. [Brown, Terry] Murfreesboro Med Ctr, Murfreesboro, TN USA. [Swick, Todd J.] Houston Sleep Ctr, Houston, TX USA. [Alessi, Cathy] VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. [Alessi, Cathy] Univ Calif Los Angeles, Los Angeles, CA USA. [Aurora, Nisha; Zak, Rochelle] Mt Sinai Med Ctr, New York, NY 10029 USA. [Boehlecke, Brian] Univ N Carolina, Chapel Hill, NC USA. [Chesson, Andrew L., Jr.] Louisiana State Univ, Shreveport, LA 71105 USA. [Friedman, Leah] Stanford Univ, Stanford, CA 94305 USA. [Maganti, Rama] Barrow Neurol Inst, Phoenix, AZ 85013 USA. [Owens, Judith] Rhode Isl Hosp, Providence, RI USA. RP Morgenthaler, TI (reprint author), Mayo Clin, Rochester, MN 55905 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 35 TC 146 Z9 150 U1 0 U2 3 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 DEC 1 PY 2007 VL 30 IS 12 BP 1705 EP 1711 PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 243OM UT WOS:000251807200010 PM 18246980 ER PT J AU Monserrate, I Basile, JN AF Monserrate, Ivan Basile, Jan N. TI Cardiovascular disease is an independent risk factor for chronic kidney disease SO SOUTHERN MEDICAL JOURNAL LA English DT Letter C1 [Monserrate, Ivan; Basile, Jan N.] Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Monserrate, I (reprint author), Med Univ S Carolina, Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM Ivan.Monserrate@med.va.gov NR 5 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0038-4348 J9 SOUTH MED J JI South.Med.J. PD DEC PY 2007 VL 100 IS 12 BP 1185 EP 1186 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 239ZQ UT WOS:000251557200003 ER PT J AU Basile, JN AF Basile, Jan N. TI Clinical considerations and practical recommendations for the primary care practitioner in the management of anemia of chronic kidney disease SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE cardiovascular disease; chronic kidney disease; end-stage renal disease; erythropoiesis-stimulating agent; erythropoietin; hemoglobin; left ventricular hypertrophy ID CONGESTIVE-HEART-FAILURE; CHRONIC-RENAL-FAILURE; HUMAN-ERYTHROPOIETIN THERAPY; LEFT-VENTRICULAR MASS; RED-CELL APLASIA; EPOETIN-ALPHA; UNITED-STATES; PREDIALYSIS PATIENTS; CARDIOVASCULAR EVENTS; MEDICARE POPULATION AB Anemia is prevalent in patients with. chronic kidney disease (CKD) and is a risk factor for poor disease outcome. Anemia acts as a risk multiplier, significantly increasing the risk of death in anemic versus nonanemic CKD patients with similar comorbidities. Erythropoiesis-stimulating agents (ESA) are a mainstay for the treatment of anemia in renal patients on dialysis, but recent data suggests that earlier treatment of anemia in CKD may delay the onset of end-stage renal disease (ESRD) and decrease mortality. Nonetheless, anemia of CKD is under-recognized and undertreated during the period before initiation of dialysis, when anemia correction may have the greatest impact on disease outcome. This report describes anemia in CKD and its association with diabetes, cardiovascular disease, and poor disease outcome, and offers suggestions for the recognition and treatment of anemia of CKD in the primary care setting. C1 [Basile, Jan N.] Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. [Basile, Jan N.] Med Univ S Carolina, Charleston, SC USA. RP Basile, JN (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM Jan.Basile@med.va.gov NR 43 TC 7 Z9 9 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 DEC PY 2007 VL 100 IS 12 BP 1200 EP 1207 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 239ZQ UT WOS:000251557200008 PM 18090962 ER PT J AU Toro, JJ Morales, M Loberiza, F Ochoa-Bayona, JL Freytes, CO AF Toro, Juan J. Morales, Manuel Loberiza, Fausto Ochoa-Bayona, Jose L. Freytes, Cesar O. TI Patterns of use of vascular access devices in patients undergoing hematopoietic stem cell transplantation: results of an international survey SO SUPPORTIVE CARE IN CANCER LA English DT Article; Proceedings Paper CT 46th Annual Meeting of the American-Society-of-Hematology CY DEC 04-07, 2004 CL San Diego, CA SP Amer Soc Hematol DE central venous catheter; catheter-related thrombosis; catheter-related infection; hematopoietic stem cell transplantation; health care surveys ID CENTRAL VENOUS CATHETER; CANCER-PATIENTS; PREVENTION; INFECTIONS; THROMBOSIS; HARVEST; VEIN AB Introduction There is limited information regarding of use of vascular access devices (VAD) in patients undergoing hematopoietic stem cell transplantation (HSCT). The frequent use of VAD in HSCT and its potential to cause morbidity requires understanding of the general use of VAD in HSCT. Materials and methods A World Wide Web-based 19-item questionnaire was designed to determine the patterns of use of VAD in patients undergoing HSCT. The questionnaire was sent via electronic mail to the directors of HSCT programs throughout the world. Results Of the 445 centers surveyed, 163 centers replied for a response rate of 37%. The most commonly used catheter for autologous peripheral blood stem cell (PBSC) harvest is the dual-lumen plasmapheresis/hemodialysis (62%). Of the institutions, 58% utilize the same catheter used for PBSC harvest to provide vascular access support during the transplant. Catheter-related blood stream infection (36%) and withdrawal occlusion (31%) were the most frequently encountered complications of VAD. Of the centers, 65% have established criteria for VAD removal when infection is suspected and 48% when occlusion is suspected. Discussion Our study demonstrated that there are similarities in the utilization of VAD but also wide differences in the standard procedures for the insertion and care of VAD in the transplant setting. More comprehensive studies are needed to assess the use of central venous catheters in transplant recipients. Important areas for future research include the impact of VAD utilization on the quality of life of transplant recipients and the final consequences of VAD complications. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Hematol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, Bone Marrow Transplant Unit, Dept Med, Div Hematol, San Antonio, TX 78229 USA. Hosp Univ N S de Candelaria, Dept Med, Med Oncol Serv, Santa Cruz de Tenerife 38010, Canary Isl, Spain. Univ Nebraska, Med Ctr, Dept Internal Med, Hematol Oncol Sect, Omaha, NE 68198 USA. RP Toro, JJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Hematol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM toro@uthscsa.edu NR 14 TC 4 Z9 4 U1 0 U2 3 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 DEC PY 2007 VL 15 IS 12 BP 1375 EP 1383 DI 10.1007/s00520-007-0261-8 PG 9 WC Oncology; Health Care Sciences & Services; Rehabilitation SC Oncology; Health Care Sciences & Services; Rehabilitation GA 229HR UT WOS:000250794400006 PM 17486374 ER PT J AU Stavrakis, AI Ituarte, PHG Ko, CY Yeh, MW AF Stavrakis, Alexandra I. Ituarte, Philip H. G. Ko, Clifford Y. Yeh, Michael W. TI Surgeon volume as a predictor of outcomes in inpatient and outpatient endocrine surgery SO SURGERY LA English DT Article ID UNITED-STATES; PARATHYROID SURGERY; THYROID-SURGERY; COMPLICATIONS; PREVENTION; MANAGEMENT; MORTALITY; PATIENT; FUTURE AB Background. Surgeon experience correlates with improved outcomes for complex operations. Endocrine operations are increasingly performed in the outpatient setting, where outcomes have not been systematically studied. We examined the effect of surgeon volume on clinical and economic outcomes for thyroid, parathyroid, and adrenal surgery across inpatient and outpatient settings. Methods. New York and Florida state discharge data (2002) were studied. Surgeons were grouped by annual endocrine operative volume: Group A, I to 3 operations; B, 4 to 8;,C, 9 to 19; D, 20 to 50; E, 51 to 99; and F, >= 100. Multiple regression analyses were applied to analyze complications, length of stay (LOS), and total charges (TC), while controlling for comorbidity, economic factors, and hospital-centric variables. Results. We identified 13,997 discharges, with 28 % of operations performed on an outpatient basis (admission/discharge on same calendar day). For all cases, group A contributed disproportionately more complications (observed/expected [O/E] 1.65, P < .001) and Group F contributed disproportionately less (0.52; P < .001). High surgeon volume was associated with decreased LOS and reduced TC. Hospital volume had a negligible effect on outcomes. Conclusions. Surgeon volume correlates inversely with complication rates, LOS, and TC, in endocrine surgery. The lowest complication rates are achieved by surgeons performing >= 100 endocrine operations annually. C1 [Stavrakis, Alexandra I.; Ituarte, Philip H. G.; Ko, Clifford Y.; Yeh, Michael W.] Univ Calif Los Angeles, David Geffen Sch Med, Div Gen Surg, Endocrine Surg Unit,Dept Surg, Los Angeles, CA 90095 USA. [Stavrakis, Alexandra I.; Ituarte, Philip H. G.; Ko, Clifford Y.; Yeh, Michael W.] Univ Calif Los Angeles, David Geffen Sch Med, Ctr Surg Outcomes & Qual, Dept Surg, Los Angeles, CA 90095 USA. [Ko, Clifford Y.] VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP Yeh, MW (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Gen Surg, Endocrine Surg Unit,Dept Surg, 10833 Le Conte Ave 72-228 CHS, Los Angeles, CA 90095 USA. EM myeh@mednet.ucla.edu NR 19 TC 133 Z9 135 U1 0 U2 2 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0039-6060 J9 SURGERY JI Surgery PD DEC PY 2007 VL 142 IS 6 BP 887 EP 894 DI 10.1016/j.surg.2007.09.003 PG 8 WC Surgery SC Surgery GA 242QV UT WOS:000251741500019 PM 18063073 ER PT J AU Bilimoria, KY Bentrem, DJ Linn, JG Freel, A Yeh, JJ Stewart, AK Winchester, DP Ko, CY Talamonti, MS Sturgeon, C AF Bilimoria, Karl Y. Bentrem, David J. Linn, John G. Freel, Andrew Yeh, Jen Jen Stewart, Andrew K. Winchester, David P. Ko, Clifford Y. Talamonti, Mark S. Sturgeon, Cord TI Utilization of total thyroidectomy for papillary thyroid cancer in the United States SO SURGERY LA English DT Article; Proceedings Paper CT 28th Annual Meeting of the American-Association-of-Endocrine-Surgeons CY APR 28-MAY 01, 2007 CL Tucson, AZ SP Amer Assoc Endocrine Surg ID DATA-BASE; SURGERY; CARCINOMA; MANAGEMENT; SURVIVAL; OUTCOMES; QUALITY; VOLUME; TRENDS; EXTENT AB Background. Despite guidelines that recommend total thyroidectomy for Papillary thyroid cancer (PTC) greater than or equal to 1 cm, the extent Of surgery remains controversial. We examined surgical practice patterns for PTC greater than or equal to 1 cm and identified factors that predict the use of total thyroidectomy. Methods. Of 90,382 patients in the National Cancer Center Data Base (NCDB) with PTC from 1985 to 2003, 5 7,243 patients had tumors greater than or equal to 1 cm and underwent total thyroidectomy or lobectomy. Trends in extent Of surgery for PTC were examined over 2 decades. Logistic regression was used to identify factors that predict use of total thyroidectomy compared with lobectomy. Results. Use of total thyroidectomy increased from 70.8% in 1985 to 90.4% in 2003 (P < .0001). Patients were less likely to undergo total thyroidectomy if they were black, older than 45 years, had Medicare, had lower household incomes, or had Less education (P < .0001). Moreover, patients treated at high-volume or academic centers were more likely to undergo total thyroidectomy than were patients examined at low-volume or community hospitals (P < .0001). Conclusions. Use of total thyroidectomy for PTC greater than or equal to I cm increased over time. Differences in use of total thyroidectomy are related to Patient, tumor, and hospital factors and likely reflect disparities in access to care. C1 [Bilimoria, Karl Y.; Bentrem, David J.; Linn, John G.; Talamonti, Mark S.; Sturgeon, Cord] Northwestern Univ, NW Mem Hosp, Dept Surg, Div Surg Oncol, Chicago, IL 60611 USA. [Bilimoria, Karl Y.; Freel, Andrew; Stewart, Andrew K.; Winchester, David P.; Ko, Clifford Y.] Amer Coll Surgeons, Canc Program, Chicago, IL USA. [Yeh, Jen Jen] Univ N Carolina, Lineberger Comprehens Canc Ctr, Dept Surg, Chapel Hill, NC USA. [Ko, Clifford Y.] Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. [Ko, Clifford Y.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Winchester, David P.] Evanston NW Healthcare, Dept Surg, Evanston, IL USA. RP Sturgeon, C (reprint author), Northwestern Univ, NW Mem Hosp, Dept Surg, Div Surg Oncol, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. EM csturgeo@nmh.org NR 27 TC 41 Z9 46 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0039-6060 J9 SURGERY JI Surgery PD DEC PY 2007 VL 142 IS 6 BP 906 EP 913 DI 10.1016/j.surg.2007.09.002 PG 8 WC Surgery SC Surgery GA 242QV UT WOS:000251741500022 PM 18063075 ER PT J AU Curtis, CS Kudsk, KA AF Curtis, Caitlin S. Kudsk, Kenneth A. TI Nutrition support in pancreatitis SO SURGICAL CLINICS OF NORTH AMERICA LA English DT Article ID TOTAL PARENTERAL-NUTRITION; RANDOMIZED CONTROLLED-TRIAL; EARLY ENTERAL NUTRITION; DIABETES-MELLITUS; DIAGNOSIS; SAFETY AB Nutrition support is especially important in patients who have pancreatitis, as these patients have high metabolic needs and are usually unable to ingest sufficient calories from an oral diet because of pain or intestinal dysfunction. Clinicians must assess severity of the disease carefully, as initiation and timing of nutrition support are crucial. Depending on the severity, early nutrition support may be unnecessary, while late support ultimately may lead to worse outcomes. Route of nutrition support also plays an important role in treatment. The clinician has many alternatives from which to choose, including enteral nutrition given nasogastrically or nasojejunally, or parenteral nutrition given through a central line. This article explores the role of nutrition support in the outcome of pancreatitis and provides guidelines to aid the clinician in caring for patients who have acute and chronic pancreatitis. C1 [Kudsk, Kenneth A.] Univ Wisconsin Hosp & Clin, Dept Surg, Madison, WI 53792 USA. [Curtis, Caitlin S.] Univ Wisconsin Hosp & Clin, Dept Pharm, Madison, WI 53792 USA. [Kudsk, Kenneth A.] William S Middleton Mem Vet Adm Med Ctr, Dept Surg, Vet Adm Surg Serv, Madison, WI USA. RP Kudsk, KA (reprint author), Univ Wisconsin Hosp & Clin, Dept Surg, 600 Highland Ave,CSC H4-734, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu NR 35 TC 7 Z9 9 U1 0 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0039-6109 J9 SURG CLIN N AM JI Surg. Clin.-North Am. PD DEC PY 2007 VL 87 IS 6 BP 1403 EP + DI 10.1016/j.suc.2007.08.010 PG 14 WC Surgery SC Surgery GA 247CS UT WOS:000252055300008 PM 18053838 ER PT J AU Subramanian, A Dente, CJ Feliciano, DV AF Subramanian, Anuradha Dente, Christopher J. Feliciano, David V. TI The management of pancreatic trauma in the modern era SO SURGICAL CLINICS OF NORTH AMERICA LA English DT Article ID SEVERE DUODENAL INJURIES; DUCT INJURY; COMPUTED-TOMOGRAPHY; PYLORIC EXCLUSION; BLUNT INJURY; DIAGNOSIS; GASTROJEJUNOSTOMY; EXPERIENCE; WOUNDS AB Pancreatic trauma presents challenging diagnostic and therapeutic dilemmas to trauma surgeons. Injuries to the pancreas have been associated with reported morbidity rates approaching 45%. If treatment is delayed, these rates may increase to 60%. The integrity of the main pancreatic duct is the most important determinant of outcome after injury to the pancreas. Undiagnosed ductal disruptions produce secondary infections, fistulas, fluid collections, and prolonged stays in the intensive care unit and hospital. This article analyzes the epidemiology, diagnostic approaches, options for nonoperative and operative management, and outcome after blunt and penetrating pancreatic trauma. C1 [Subramanian, Anuradha] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, Houston, TX 77030 USA. [Dente, Christopher J.; Feliciano, David V.] Emory Univ, Sch Med, Grady Mem Hosp, Dept Surg, Atlanta, GA 30303 USA. RP Subramanian, A (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM anu.mouse@gmail.com NR 31 TC 45 Z9 54 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0039-6109 J9 SURG CLIN N AM JI Surg. Clin.-North Am. PD DEC PY 2007 VL 87 IS 6 BP 1515 EP + DI 10.1016/j.suc.2007.08.007 PG 19 WC Surgery SC Surgery GA 247CS UT WOS:000252055300015 PM 18053845 ER PT J AU Huddle, TS AF Huddle, Thomas S. TI The limits of objective assessment of medical practice SO THEORETICAL MEDICINE AND BIOETHICS LA English DT Article DE clinical judgment; pay for performance; performance assessment; quality of care; rule-following; social practice ID QUALITY IMPROVEMENT; PERFORMANCE; PAY AB Medical work is increasingly being subjected to objective assessment as those who pay for it seek to grasp the quality of that work and how best to improve it. While objective measures have a role in the assessment of health care, I argue that this role is currently overestimated and that no human practice such as medicine can be fully comprehended by objective assessment. I suggest that the character of practices, in which formalizations are combined with judgment, requires that valid assessment involve the perspective of the skilled practitioner. Relying exclusively on objective measures in assessing health care will not only distort our assessments of it but lead to damage as the incentives of health care workers are directed away from the important aspects of their work that are not captured by objective measures. C1 [Huddle, Thomas S.] Univ Alabama, Div Gen Internal Med, Sch Med, Birmingham, AL 35294 USA. [Huddle, Thomas S.] Birmingham VA Med Ctr, Birmingham, AL USA. RP Huddle, TS (reprint author), Univ Alabama, Div Gen Internal Med, Sch Med, 1530 3rd Ave S,FOT 720, Birmingham, AL 35294 USA. EM thuddle@uab.edu NR 22 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 1386-7415 J9 THEOR MED BIOETH JI Theor. Med. Bioeth. PD DEC PY 2007 VL 28 IS 6 BP 487 EP 496 DI 10.1007/s11017-007-9054-9 PG 10 WC Ethics; Social Issues; Social Sciences, Biomedical SC Social Sciences - Other Topics; Social Issues; Biomedical Social Sciences GA 278DD UT WOS:000254262800002 PM 18322821 ER PT J AU Ameri, A Machiah, DK Tran, TT Channell, C Crenshaw, V Fernstrom, K Khachidze, M Duncan, A Fuchs, S Howard, TE AF Ameri, Afshin Machiah, Deepa K. Tran, Thuy T. Channell, Cynthia Crenshaw, Valerie Fernstrom, Karl Khachidze, Manana Duncan, Alexander Fuchs, Sebastien Howard, Tom E. TI A nonstop mutation in the factor (F)X gene of a severely haemorrhagic patient with complete absence of coagulation FX SO THROMBOSIS AND HAEMOSTASIS LA English DT Article DE autosomal recessive; congenital bleeding disorder; mRNA surveillance; F10-Augusta ID MESSENGER-RNA SURVEILLANCE; TERMINATION CODON; FACTOR-X; TRANSLATION; LACKING; TRANSCRIPTS; EUKARYOTES; DATABASE; 3'-END; YEAST AB We identified a previously unknown mutation by sequencing the factor (F)X gene in a severely haemorrhagic 14-year-old maleAfrican-American individual with undetectable plasma FX-activity and -antigen levels. This mutation, called F10-Augusta, was homozygote and is a combination of an 8bp insertion in flanking 3'-genomic-DNA and a 5bp terminal exon-8 deletion involving codons 437 and 438. Sequencing of RT-PCR and 3'-RACE products showed that the F10-Augusta transcript is normally processed but lacks an in-frame stop codon. An allele specific 3'-RACE-based RFLP assay demonstrated that the steady-state concentration of the mutant transcript was markedly lower than that of the wild-type message in total-RNA samples from the patient's unaffected heterozygous parents. The recently discovered nonstop decay mechanism, a component pathway of the mRNA surveillance system, is a possible explanation for the reduced concentration of the mutant FX transcript. This is the first report implying such a mechanism in the pathogenesis of inherited bleeding disorders. C1 [Howard, Tom E.] Vet Affairs Greater Los Angeles Healthcare Syst, Lab Med, Los Angeles, CA 90073 USA. [Ameri, Afshin; Crenshaw, Valerie] Med Coll Georgia, Dept Pediat, Div Hematol & Oncol, Augusta, GA 30912 USA. [Machiah, Deepa K.; Tran, Thuy T.; Channell, Cynthia; Fernstrom, Karl; Khachidze, Manana; Duncan, Alexander; Fuchs, Sebastien; Howard, Tom E.] Emory Univ, Sch Med, Dept Pathol, Atlanta, GA 30322 USA. [Machiah, Deepa K.; Tran, Thuy T.; Channell, Cynthia; Fernstrom, Karl; Khachidze, Manana; Duncan, Alexander; Fuchs, Sebastien; Howard, Tom E.] Emory Univ, Sch Med, Lab Med, Atlanta, GA 30322 USA. [Howard, Tom E.] SW Fdn Biomed Res, Dept Genet, San Antonio, TX 78284 USA. RP Howard, TE (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Pathol, 11301 Wilshire Blvd,Bldg 500,Room 1254, Los Angeles, CA 90073 USA. EM tom.howard@va.gov FU NHLBI NIH HHS [K08-HL071130, R01-HL072533] NR 15 TC 10 Z9 13 U1 0 U2 3 PU SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN PI STUTTGART PA HOLDERLINSTRASSE 3, D-70174 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD DEC PY 2007 VL 98 IS 6 BP 1165 EP 1169 DI 10.1160/TH07-02-0125 PG 5 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 241WV UT WOS:000251687400004 PM 18064309 ER PT J AU Woods, SS Haskins, AE AF Woods, Susan Swartz Haskins, Amy E. TI Increasing reach of quitline services in a US state with comprehensive tobacco treatment SO TOBACCO CONTROL LA English DT Article ID MASS-MEDIA CAMPAIGN; TELEPHONE QUITLINE; THERAPY; SMOKERS AB Objective: The population reach of tobacco quitlines is an important measure of treatment seeking and penetration of services. Maine offers an opportunity to examine temporal changes in quitline reach and referral sources in the context of a comprehensive tobacco treatment programme. The impact of a $ 1.00 cigarette tax increase is also examined. Methods: This is a descriptive analysis of Maine Tobacco Helpline call volume September 2001 to December 2006. Annual reach was estimated using a cross sectional state surveillance survey. Weekly call volume was examined during 2005, a year of marked changes in tobacco taxes and quitline resources. Referral patterns were analysed yearly. Results: Maine's Tobacco Helpline observed more than a threefold increase in population reach during a four year interval, from 1.9% to over 6% per year. Calls increased substantially in 2005, concurrent with added hours of operation and a rise in the cigarette tax. Over time, callers increasingly reported hearing about the quitline from health professionals, from 10% in 2001 to 38% in 2006. Conclusions: Tobacco treatment programmes offering free nicotine therapy and professional medical education can drive quitline utilisation over time. Call volume can also be affected by quitline operational and policy changes that promote the reduction of tobacco use. C1 Maine Med Ctr, Ctr Tobacco Independence, Portland, ME 04102 USA. RP Woods, SS (reprint author), Portland VA Med Ctr, 3710 SW,US Vet Hosp Rd, Portland, OR 97239 USA. EM woodssus@ohsu.edu NR 13 TC 16 Z9 17 U1 1 U2 3 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0964-4563 J9 TOB CONTROL JI Tob. Control PD DEC PY 2007 VL 16 SU 1 BP I33 EP I36 DI 10.1136/tc.2007.019935 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 236DS UT WOS:000251283800008 PM 18048629 ER PT J AU Komers, R Schutzer, W Xue, H Oyama, TT Lindsley, JN Anderson, S AF Komers, Radko Schutzer, William Xue, Hong Oyama, Terry T. Lindsley, Jessie N. Anderson, Sharon TI Effects of p38 mitogen-activated protein kinase inhibition on blood pressure, renal hemodynamics, and renal vascular reactivity in normal and diabetic rats SO TRANSLATIONAL RESEARCH LA English DT Article ID ANGIOTENSIN-II; MAP-KINASE; CYCLOOXYGENASE-2 EXPRESSION; SMOOTH-MUSCLE; ORGAN DAMAGE; GLUCOSE; KIDNEY; HYPERTROPHY; CONTRACTION; PATHWAYS AB p38 mitogen-activated protein kinase (p38) has been implicated in mediating vascular smooth muscle and mesangial cell contraction in response to several vasoactive factors, including angiotensin II. Early stages of diabetic nephropathy are associated with renal hemodynamic changes that are, at least in part, attributable to the dysbalance of vasoactive factors that control afferent and efferent arteriolar tone resulting in increased glomerular capillary pressure. Vascular and renal p38 have been found to be activated in diabetes. Therefore, p38 may be involved in the control of systemic and renal hemodynamics in diabetes. To address this issue, mean arterial blood pressure (MAP), glomerular filtration rate (GFR, inulin clearance), renal plasma flow (RPF, PAH clearance), metabolic parameters, and plasma renin concentrations (PRC) were determined in streptozotocin-diabetic rats (DM), and in age-matched non-diabetic controls (C), administered with the p38 inhibitor SB 239063 (SB, 50 mg/bwt, p.o.) or with vehicle. Furthermore, renal vascular responses to p38 inhibition (SB 202190, 25 mu M) before and after stimulation with the endothelium-dependent vasodilator acetylcholine (ACh) were studied in vitro in tertiary branches of the renal artery from separate groups of DM and C rats, using a fixed support and a force transducer in a myograph system. SB treatment was associated with marked reductions in MAP and GFR in both C and DM rats, whereas RPF remained unchanged, as compared with vehicle-treated animals. Observed differences in MAP and renal hemodynamics were not associated with changes in urinary sodium excretion or PRC. Incubation of KCI-contracted renal arteries from both C and DM rats with the p38 inhibitor resulted in progressive and significant vasorelaxation. Also, vessels from control and diabetic rats treated with the p38 inhibitor exhibited enhancement of ACh-induced vasorelaxation. These data indicate the role of p38 in the control of systemic and renal hemodynamics both in normal and in diabetic rats. The observed effects of p38 inhibition could be mediated at least in part by enhancement of endothelium-dependent vasodilation. C1 Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland VA Med Ctr, Res Serv, Portland, OR USA. Ctr Diabet, Inst Clin & Expt Med, Prague, Czech Republic. RP Komers, R (reprint author), Oregon Hlth & Sci Univ, Div Nephrol & Hypertens, PP262,3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM komersr@ohsu.edu FU NIDDK NIH HHS [DK 063231] NR 27 TC 17 Z9 17 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1931-5244 J9 TRANSL RES JI Transl. Res. PD DEC PY 2007 VL 150 IS 6 BP 343 EP 349 DI 10.1016/j.trsl.2007.07.001 PG 7 WC Medical Laboratory Technology; Medicine, General & Internal; Medicine, Research & Experimental SC Medical Laboratory Technology; General & Internal Medicine; Research & Experimental Medicine GA 236BZ UT WOS:000251279300003 PM 18022596 ER PT J AU Uschakov, A Gong, H McGinty, D Szymusiak, R AF Uschakov, A. Gong, H. McGinty, D. Szymusiak, R. TI Efferent projections from the median preoptic nucleus to sleep- and arousal-regulatory nuclei in the rat brain SO NEUROSCIENCE LA English DT Article DE locus coeruleus; hypothalamus; dorsal raphe; magnocellular preoptic area; basal forebrain ID BODY-FLUID HOMEOSTASIS; HYPOTHALAMIC PARAVENTRICULAR NUCLEUS; WAKING DISCHARGE PATTERNS; MONOAMINERGIC CELL GROUPS; SUBFORNICAL ORGAN; LAMINA-TERMINALIS; SUPRAOPTIC NUCLEUS; ANGIOTENSIN-II; C-FOS; AFFERENT CONNECTIONS AB The median preoptic nucleus (MnPO) has been implicated in the regulation of hydromineral balance and cardiovascular regulation. The MnPO also contains neurons that are active during sleep and in response to increasing homeostatic pressure for sleep. The potential role of these neurons in the regulation of arousal prompted an analysis of the efferent projections from the MnPO. Anterograde and retrograde neuroanatomical tracers were utilized to characterize the neural connectivity from the MnPO to several functionally important sleep- and arousal-regulatory neuronal systems in the rat brain. Anterograde terminal labeling from the MnPO was confirmed within the core and extended ventrolateral preoptic nucleus. Within the lateral hypothalamus, labeled axons were observed in close apposition to proximal and distal dendrites of hypocretin/orexin immunoreactive (IR) cells. Projections from the MnPO to the locus coeruleus were observed within and surrounding the tyrosine hydroxylase-IR cell cluster. Labeled axons from the MnPO were mostly observed within the lateral division of the dorsal raphe nucleus and heavily within the ventrolateral periaqueductal gray. Few anterogradely labeled appositions were present juxtaposed to choline acetyltransferase-IR somata within the magnocellular preoptic area. The use of retrogradely transported neuroanatomical tracers placed within the prospective efferent terminal fields supported and confirmed findings from the anterograde tracer experiments. These anatomical findings support the hypothesis that MnPO neurons function to promote sleep by inhibition of orexinergic and monoaminergic arousal systems and disinhibition of sleep regulatory neurons in the ventrolateral preoptic area. (c) 2007 IBRO. Published by Elsevier Ltd. All rights reserved. C1 [Uschakov, A.; Gong, H.; McGinty, D.; Szymusiak, R.] VA Greater Los Angeles Hlth Care Syst, Res Serv 151A3, North Hills, CA 91344 USA. [Gong, H.; McGinty, D.] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90095 USA. [Uschakov, A.; Szymusiak, R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90025 USA. [Szymusiak, R.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90025 USA. RP Szymusiak, R (reprint author), VA Greater Los Angeles Hlth Care Syst, Res Serv 151A3, 16111 Plummer St, North Hills, CA 91344 USA. EM rszym@ucla.edu RI Sanguansri, Luz/B-6630-2011 OI Sanguansri, Luz/0000-0003-1908-7604 FU NHLBI NIH HHS [HL60296, P50 HL060296, P50 HL060296-100011]; NIMH NIH HHS [MH63323, R01 MH063323, R01 MH063323-06] NR 57 TC 51 Z9 53 U1 0 U2 7 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PD NOV 30 PY 2007 VL 150 IS 1 BP 104 EP 120 DI 10.1016/j.neuroscience.2007.05.055 PG 17 WC Neurosciences SC Neurosciences & Neurology GA 242AI UT WOS:000251696500013 PM 17928156 ER PT J AU Jaffe, HW Valdiserri, RO De Cock, KM AF Jaffe, Harold W. Valdiserri, Ronald O. De Cock, Kevin M. TI The reemerging HIV/AIDS epidemic in men who have sex with men SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID UNITED-STATES; HIV-INFECTION; RISK BEHAVIORS; INTERVENTIONS; PREVENTION; RECOMMENDATIONS; TRENDS C1 Univ Oxford, Dept Publ Hlth, Oxford OX3 7LF, England. US Dept Vet Affairs, Off Publ Hlth & Environm Hazards, Washington, DC USA. WHO, Dept HIV AIDS, CH-1211 Geneva, Switzerland. RP Jaffe, HW (reprint author), Univ Oxford, Dept Publ Hlth, Old Rd Campus, Oxford OX3 7LF, England. EM harold.jaffe@dphpc.ox.ac.uk NR 23 TC 104 Z9 106 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 NOV 28 PY 2007 VL 298 IS 20 BP 2412 EP 2414 DI 10.1001/jama.298.20.2412 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 234KR UT WOS:000251163400023 PM 18042919 ER PT J AU Loewenstein, G Brennan, T Volpp, KG AF Loewenstein, George Brennan, Troyen Volpp, Kevin G. TI Asymmetric paternalism to improve health behaviors SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID SMOKING-CESSATION; ADHERENCE; ECONOMICS C1 Carnegie Mellon Univ, Dept Social & Decis Sci, Pittsburgh, PA 15213 USA. Aetna Inc, Hartford, CT USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. RP Loewenstein, G (reprint author), Carnegie Mellon Univ, Dept Social & Decis Sci, Pittsburgh, PA 15213 USA. EM gl20@andrew.cmu.edu NR 18 TC 175 Z9 177 U1 6 U2 28 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD NOV 28 PY 2007 VL 298 IS 20 BP 2415 EP 2417 DI 10.1001/jama.298.20.2415 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 234KR UT WOS:000251163400024 PM 18042920 ER PT J AU Gunzler, SA Shakil, S Carlson, NE Nutt, JG Meshul, CK AF Gunzler, Steven A. Shakil, Saate Carlson, Nichole E. Nutt, John G. Meshul, Charles K. TI Low doses of apomorphine transiently reduce locomotor activity in MPTP-treated mice SO NEUROSCIENCE LETTERS LA English DT Article DE Parkinson disease; 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine; apomorphine; levodopa; locomotion ID RECEPTOR KNOCKOUT MICE; PARKINSONS-DISEASE; L-DOPA; C57BL/6 MICE; LEVODOPA; AGONISTS; MOTOR; 1-METHYL-4-PHENYL-1,2,3,6-TETRAHYDROPYRIDINE; AMPHETAMINE; SENSITIVITY AB Parkinson's disease patients sometimes experience deterioration of motor function to below their baseline "off" state, termed the "super-off" state. We used low subthreshold (0.05 mg/kg) to threshold (0.10 and 0.20 mg/kg) doses of apomorphine to demonstrate the "super-off" state in MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)-lesioned mice. Twenty-four mice were randomized to receive apomorphine or vehicle. Within 20 min of administration, 0.10 and 0.20 mg/kg apomorphine-treated mice had less locomotion than controls. At the 100 min time point, 0.10 mg/kg apomorphine-treated mice had greater locomotion than controls. One week of suprathreshold levodopa pretreatment did not alter the response to these low apomorphine doses. Our results Suggest that low doses of apomorphine can initially depress locomotion and subsequently stimulate locomotion, in a manner similar to what is seen in Parkinson's disease patients. (C) 2007 Elsevier Ireland Ltd. All rights reserved. C1 Univ Hosp, Case Med Ctr, Movemet Disorder Ctr, Neurol Inst, Cleveland, OH 44106 USA. Case Western Reserve Univ, Sch Med, Cleveland, OH 44106 USA. Portland VA Med Ctr, Parkinson Disease Res Educ & Clin Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Parkinson Ctr Oregon, Portland, OR 97201 USA. Portland VA Med Ctr, Res Serv, Neurocytol Lab, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Div Biostat, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Behav Neurosci & Pathol, Portland, OR 97201 USA. RP Gunzler, SA (reprint author), Univ Hosp, Case Med Ctr, Movemet Disorder Ctr, Neurol Inst, 111000 Euclid Ave, Cleveland, OH 44106 USA. EM gunzlers@ohsu.edu FU NCRR NIH HHS [UL1 RR024140 01] NR 18 TC 3 Z9 3 U1 0 U2 0 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 NOV 27 PY 2007 VL 428 IS 2-3 BP 64 EP 67 DI 10.1016/j.neulet.2007.09.049 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 237EA UT WOS:000251355100003 PM 17964074 ER PT J AU Fan, VS Ramsey, SD Giardino, ND Make, BJ Emery, CF Diaz, PT Benditt, JO Mosenifar, Z McKenna, R Curtis, JL Fishman, AP Martinez, FJ AF Fan, Vincent S. Ramsey, Scott D. Giardino, Nicholas D. Make, Barry J. Emery, Charles F. Diaz, Phillip T. Benditt, Joshua O. Mosenifar, Zab McKenna, Robert, Jr. Curtis, Jeffrey L. Fishman, Alfred P. Martinez, Fernando J. CA NETT Res Grp TI Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID AIR-FLOW OBSTRUCTION; QUALITY-OF-LIFE; MYOCARDIAL-INFARCTION; SOCIAL SUPPORT; HEALTH-STATUS; LUNG-VOLUME; REDUCTION SURGERY; RANDOMIZED-TRIAL; SEVERE EMPHYSEMA; UNSTABLE ANGINA AB Background: We sought to determine whether depressive or anxiety symptoms are associated with chronic obstructive pulmonary disease (COPD) hospitalization or mortality. These data were collected as part of the National Emphysema Treatment Trial (NETT), a randomized controlled trial of lung volume reduction surgery vs continued medical treatment conducted at 17 clinics across the United States between January 29, 1998, and July 31, 2002. Methods: Prospective cohort study among participants in the NETT with emphysema and severe airflow limitation who were randomized to medical therapy. Primary outcomes were 1- and 3-year mortality, as well as COPD or respiratory-related hospitalization or emergency department visit during the 1-year follow-up period. Of 610 patients randomized to medical therapy, complete data on hospitalization and mortality were available for 3 years of follow-up for 603 patients (98.9%). Results: Depressive symptoms were assessed using the Beck Depression Inventory (BDI) questionnaire, and anxiety was assessed using the State-Trait Anxiety Inventory. Among 610 subjects, 40.8% had at least mild to moderate depressive symptoms. Patients in the highest quintile of BDI score (BDI score, >= 15) had an increased risk of respiratory hospitalization in unadjusted analysis compared with patients in the lowest quintile (BDI score, < 5) (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.30-3.93). After adjustment for disease severity, this relationship was no longer statistically significant. The adjusted risk of 3-year mortality was increased among those in the highest quintile of BDI score (OR, 2.74; 95% CI, 1.42-5.29) compared with those in the lowest quintile. Anxiety was not associated with hospitalization or mortality in this population. Conclusions: Depressive symptoms are common in patients with severe COPD and are treated in few subjects. Depressive symptoms are associated with increased risk for 3-year mortality but not 1-year mortality or hospitalization. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, Seattle, WA USA. Univ Washington, Fred Hutchinson Canc Res Ctr, Canc Technol Assesment Grp, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA. Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA. Univ Michigan, Ann Arbor, MI 48109 USA. Univ Colorado, Div Pulm & Crit Care Med, Denver, CO 80309 USA. Ohio State Univ, Dept Psychol, Columbus, OH 43210 USA. Ohio State Univ, Dept Internal Med, Columbus, OH 43210 USA. Cedars Sinai Med Ctr, Dept Med, Los Angeles, CA 90048 USA. Cedars Sinai Med Ctr, Dept Surg, Los Angeles, CA 90048 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Fan, VS (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Ctr Excellence, 1660 S Columbian Way, Seattle, WA 98108 USA. EM vfan@u.washington.edu OI Curtis, Jeffrey/0000-0001-5191-4847 FU NHLBI NIH HHS [N01HR76112, N01HR76101, N01HR76102, N01HR76103, N01HR76104, N01HR76105, N01HR76106, N01HR76107, N01HR76108, N01HR76109, N01HR76110, N01HR76111, N01HR76113, N01HR76114, N01HR76115, N01HR76116, N01HR76118, N01HR76119] NR 51 TC 84 Z9 87 U1 0 U2 5 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 NOV 26 PY 2007 VL 167 IS 21 BP 2345 EP 2353 DI 10.1001/archinte.167.21.2345 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 235EU UT WOS:000251217100012 PM 18039994 ER PT J AU Weng, Z Signore, AP Gao, Y Wang, S Zhang, F Hastings, T Yin, XM Chen, J AF Weng, Zhongfang Signore, Armando P. Gao, Yanqin Wang, Suping Zhang, Feng Hastings, Teresa Yin, Xiao-Ming Chen, Jun TI Leptin protects against 6-hydroxydopamine-induced dopaminergic cell death via mitogen-activated protein kinase signaling SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID RECEPTOR MESSENGER-RNA; JAK-STAT PATHWAY; NEUROTROPHIC FACTOR; PARKINSONS-DISEASE; SUBSTANTIA-NIGRA; RAT-BRAIN; CEREBRAL-ISCHEMIA; NEURONAL SURVIVAL; INDUCED APOPTOSIS; GENE DELIVERY AB The death of midbrain dopaminergic neurons in sporadic Parkinson disease is of unknown etiology but may involve altered growth factor signaling. The present study showed that leptin, a centrally acting hormone secreted by adipocytes, rescued dopaminergic neurons, reversed behavioral asymmetry, and restored striatal catecholamine levels in the unilateral 6-hydroxydopamine (6-OHDA) mouse model of dopaminergic cell death. In vitro studies using the murine dopaminergic cell line MN9D showed that leptin attenuated 6-OHDA-induced apoptotic markers, including caspase-9 and caspase-3 activation, internucleosomal DNA fragmentation, and cytochrome c release. ERK1/2 phosphorylation (pERK1/2) was found to be critical for mediating leptin-induced neuroprotection, because inhibition of the MEK pathway blocked both the pERK1/2 response and the pro-survival effect of leptin in cultures. Knockdown of the downstream messengers JAK2 or GRB2 precluded leptin-induced pERK1/2 activation and neuroprotection. Leptin/pERK1/2 signaling involved phosphorylation and nuclear localization of CREB (pCREB), a well known survival factor for dopaminergic neurons. Leptin induced a marked MEK-dependent increase in pCREB that was essential for neuroprotection following 6-OHDA toxicity. Transfection of a dominant negative MEK protein abolished leptin-enhanced pCREB formation, whereas a dominant negative CREB or decoy oligonucleotide diminished both pCREB binding to its target DNA sequence and MN9D survival against 6-OHDA toxicity. Moreover, in the substantia nigra of mice, leptin treatment increased the levels of pERK1/2, pCREB, and the downstream gene product BDNF, which were reversed by the MEK inhibitor PD98059. Collectively, these data provide evidence that leptin prevents the degeneration of dopaminergic neurons by 6-OHDA and may prove useful in the treatment of Parkinson disease. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Pittsburgh Inst Neurodegenerat Dis, Pittsburgh, PA 15261 USA. Fudan Univ, Sch Med, State Key Lab Med Neurobiol, Shanghai 200032, Peoples R China. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15261 USA. RP Chen, J (reprint author), Univ Pittsburgh, Dept Neurol, Sch Med, S-507,Biomed Sci tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu RI Gao, Yanqin/I-6790-2016 OI Gao, Yanqin/0000-0002-4915-9819 FU NINDS NIH HHS [NS 43802, NS 44178, NS 45048] NR 62 TC 77 Z9 79 U1 0 U2 6 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 23 PY 2007 VL 282 IS 47 BP 34479 EP 34491 DI 10.1074/jbc.M705426200 PG 13 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 234FI UT WOS:000251145700063 PM 17895242 ER PT J AU Lyamin, O Pryaslova, J Kosenko, P Siegel, J AF Lyamin, Oleg Pryaslova, Julia Kosenko, Peter Siegel, Jerome TI Behavioral aspects of sleep in bottlenose dolphin mothers and their calves SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE bottlenose dolphin; postpartum behavior; calf; rest; sleep; EEG; cetaceans ID SLOW-WAVE SLEEP; TURSIOPS-TRUNCATUS; ANESTHESIA; ASYMMETRY; CETACEANS; WHALE; STATE AB Adult dolphins are capable of sleeping with one eye open and exhibiting slow wave activity in the electroencephalogram (EEG) of one hemisphere at a time. The aim of this study was to examine the postpartum sleep behavior of bottlenose dolphin calves and their mothers. The behavior of three dolphin mother-calf pairs was monitored from birth to 13 months postpartum. Dolphin mothers and their calves exhibited a complete disappearance of rest at the surface for a minimum of 2 months postpartum, swimming in echelon formation on average in 97-100% of the observation time. Calves surfaced to breathe more often than their mothers between the postpartum age of 2 and 8 weeks. During the first postpartum month two dolphin mothers surfaced with both eyes open on average in 93 and 98% of the time while in their calves both eyes were open in 90 and 60% of the cases. In calves, the eye directed toward the mother was open more often (on average in 95% of all observations in calf 1 and 99% in calf 2) than the eye directed to the opposite side (82% in calf 1 and 60% in calf 2). Our data indicate that dolphin mothers and calves are highly active and vigilant during the initial period of the calf's life, continuously monitoring their position relative to each other by sight during wakefulness and sleep. We hypothesize that episodes of EEG slow wave activity at this time are likely to be brief, fragmenting EEG defined sleep into short episodes. (C) 2007 Elsevier Inc. All rights reserved. C1 VA GLAHS Sepulveda, North Hills, CA 91343 USA. Univ Calif Los Angeles, North Hills, CA USA. Utrish Dolphinarium Ltd, Moscow, Russia. RP Lyamin, O (reprint author), VA GLAHS Sepulveda, Neurobiol Res 151A3,16111 Plummer St, North Hills, CA 91343 USA. EM olyamin@ucla.edu FU NIMH NIH HHS [R01 MH064109]; NINDS NIH HHS [NS42947, R01 NS042947, R01 NS069640] NR 36 TC 13 Z9 15 U1 0 U2 17 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD NOV 23 PY 2007 VL 92 IS 4 BP 725 EP 733 DI 10.1016/j.physbeh.2007.05.064 PG 9 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 237XI UT WOS:000251409300023 PM 17599365 ER PT J AU Banez, LL Hamilton, RJ Partin, AW Vollmer, RT Sun, L Rodriguez, C Wang, YT Terris, MK Aronson, WJ Presti, JC Kane, CJ Amling, CL Moul, JW Freedland, SJ AF Banez, Lionel L. Hamilton, Robert J. Partin, Alan W. Vollmer, Robin T. Sun, Leon Rodriguez, Carmen Wang, Yiting Terris, Martha K. Aronson, William J. Presti, Joseph C., Jr. Kane, Christopher J. Amling, Christopher L. Moul, Judd W. Freedland, Stephen J. TI Obesity-related plasma hemodilution and PSA concentration among men with prostate cancer SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID BODY-MASS INDEX; RADICAL PROSTATECTOMY; POSTMENOPAUSAL WOMEN; RACIAL-DIFFERENCES; AFRICAN-AMERICAN; UNITED-STATES; WEIGHT CHANGE; SERUM-LEVELS; ANTIGEN PSA; US ADULTS AB Context Recent studies have suggested that obese men have lower serum prostate-specific antigen (PSA) concentrations than nonobese men. Because men with higher body mass index (BMI) have greater circulating plasma volumes, lower PSA concentrations among obese men may be due to hemodilution. Objective To determine the association between hemodilution and PSA concentration in obese men with prostate cancer. Design, Setting, and Participants Retrospective study of men who underwent radical prostatectomy for prostate adenocarcinoma from 1988 to 2006, using data from the databases of the Shared Equal Access Regional Cancer Hospital (n=1373), Duke Prostate Center (n=1974), and Johns Hopkins Hospital (n=10 287). Multivariate linear regression models adjusting for clinicopathological characteristics were used to analyze the main outcome measures. Main Outcome Measures Associations between BMI and mean adjusted PSA concentrations, mean plasma volume, and mean adjusted PSA mass ( total circulating PSA protein, calculated as PSA concentration multiplied by plasma volume), assessed by determining P values for trend. Results After controlling for clinicopathological characteristics, higher BMI was significantly associated with higher plasma volume ( P < .001 for trend) and lower PSA concentrations ( P <= .02 for trend) in all cohorts. In 2 of the 3 cohorts, PSA mass did not change significantly with increasing BMI. In the third cohort, higher BMI was associated with increased PSA mass ( P <. 001 for trend), but only between BMI category less than 25 and the other categories. Conclusions In men undergoing radical prostatectomy, higher BMI was associated with higher plasma volume hemodilution may therefore be responsible for the lower serum PSA concentrations among obese men with prostate cancer. Prospective studies are needed to evaluate this association in screened populations. C1 Duke Univ, Med Ctr, Div Urol Surg, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Surg, Duke Prostate Ctr, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Pathol, Durham, NC 27710 USA. Vet Affairs Med Ctr, Urol Sect, Durham, NC USA. Vet Affairs Med Ctr, Dept Pathol, Durham, NC USA. Univ Toronto, Dept Surg, Div Urol, Toronto, ON, Canada. Johns Hopkins Med Inst, James Buchanan Brady Urol Inst, Dept Urol, Baltimore, MD 21205 USA. Amer Canc Soc, Dept Epidemiol & Surveillance Res, Atlanta, GA 30329 USA. Vet Affairs Med Ctr, Urol Sect, Augusta, GA USA. Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA USA. Stanford Univ, Sch Med, Dept Urol, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Urol Sect, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Urol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Univ Alabama, Dept Urol, Birmingham, AL USA. RP Freedland, SJ (reprint author), Duke Univ, Med Ctr, Div Urol Surg, Box 2626, Durham, NC 27710 USA. EM steve.freedland@duke.edu FU NCI NIH HHS [P50 CA58236, P50 CA92131-01A1, R01CA100938] NR 37 TC 186 Z9 192 U1 0 U2 6 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 NOV 21 PY 2007 VL 298 IS 19 BP 2275 EP 2280 DI 10.1001/jama.298.19.2275 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 232XV UT WOS:000251055900027 PM 18029831 ER PT J AU Farber, J Siu, A Bloom, P AF Farber, Jeffrey Siu, Albert Bloom, Patricia TI How much time do physicians spend providing care outside of office visits? SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID TELEPHONE AB Background: People with chronic illness require care outside of office visits, much of which is not reimbursed under current Medicare guidelines. Objective: To describe the amount of time geriatricians spend and the nature of care they provide outside of office visits. Design: Cross-sectional study on the time spent by physicians in clinical interactions outside of patient visits during 3 randomly sampled, 1-week periods. Setting: An academic geriatric medicine ambulatory practice. Participants: 16 physicians. Measurements: Information on the method, content, outcome, and participants in clinical interactions outside of office visits was collected on a structured form. Results: There were 472 discrete interactions, representing 296 episodes of care for 226 patients. Fifty-four percent of interactions were linked as multistep episodes, whose mean duration (range; 25th, 75th percentiles) was 18.9 minutes (3 to 70 minutes; 9, 21 minutes). Thirty-six percent of episodes involving a new medical symptom resulted in medication use, 27% resulted in an office visit, and 9% resulted in a referral to another physician. Mean time spent per physician per week was 112.2 minutes (range, 36 to 260 minutes), which represents an additional 6.7 minutes (range, 1.7 to 13.8) of care provided outside of office visits for every 30 minutes of time spent scheduled to see ambulatory patients. For a full-time physician scheduled to see 14 patients per day in 30-minute visits over a 5-day workweek, this would represent an extra 7.8 hours of clinical work per week. Limitation: Data were self-reported and were limited to an academic geriatric medicine practice. Conclusion: Physicians spend a considerable amount of time providing care outside of office visits for patients with chronic illness. This study suggests that collecting empirical data on the amount and nature of nonreimbursed care activities is feasible and should be done in more generalizable settings to inform debates about reimbursement reform. C1 Mt Sinai Sch Med, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. RP Farber, J (reprint author), Mt Sinai Sch Med, Box 1070, New York, NY 10029 USA. EM jeffrey.farber@mssm.edu NR 9 TC 44 Z9 46 U1 0 U2 2 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 20 PY 2007 VL 147 IS 10 BP 693 EP U119 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 235UJ UT WOS:000251259500003 PM 18025445 ER PT J AU Gibbons, RJ Fihn, SD AF Gibbons, Raymond J. Fihn, Stephan D. TI Coronary revascularization: New evidence, new challenges SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material ID ACUTE MYOCARDIAL-INFARCTION; BYPASS-SURGERY; RANDOMIZED TRIALS; ANGIOPLASTY; DISEASE; THERAPY; MORTALITY; SURVIVAL C1 Mayo Clin, Rochester, MN 55905 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98101 USA. RP Gibbons, RJ (reprint author), Mayo Clin, Gonda 5,200 1st St SW, Rochester, MN 55905 USA. EM gibbons.raymond@mayo.edu NR 19 TC 5 Z9 5 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 20 PY 2007 VL 147 IS 10 BP 732 EP U140 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 235UJ UT WOS:000251259500009 PM 17938384 ER PT J AU Pugh, MJV Berlowitz, DR Montouris, G Bokhour, B Cramer, JA Bohm, V Bollinger, M Helmers, S Ettinger, A Meador, KJ Fountain, N Boggs, J Tatum, WO Knoefel, J Harden, C Mattson, RH Kazis, L AF Pugh, M. J. V. Berlowitz, D. R. Montouris, G. Bokhour, B. Cramer, J. A. Bohm, V. Bollinger, M. Helmers, S. Ettinger, A. Meador, K. J. Fountain, N. Boggs, J. Tatum, W. O., IV Knoefel, J. Harden, C. Mattson, R. H. Kazis, L. TI What constitutes high quality of care for adults with epilepsy? SO NEUROLOGY LA English DT Article ID TECHNOLOGY-ASSESSMENT SUBCOMMITTEE; ACADEMY-OF-NEUROLOGY; AMERICAN-ACADEMY; STANDARDS-SUBCOMMITTEE; ANTIEPILEPTIC DRUGS; PRACTICE PARAMETER; HEALTH-CARE; SOCIETY; THERAPEUTICS; EFFICACY AB Background: Providers are increasingly being held accountable for the quality of care provided. While quality indicators have been used to benchmark the quality of care for a number of other disease states, no such measures are available for evaluating the quality of care provided to adults with epilepsy. In order to assess and improve quality of care, it is critical to develop valid quality indicators. Our objective is to describe the development of quality indicators for evaluating care of adults with epilepsy. As most care is provided in primary and general neurology care, we focused our assessment of quality on care within primary care and general neurology clinics. Methods: We reviewed existing national clinical guidelines and systematic reviews of the literature to develop an initial list of quality indicators; supplemented the list with indicators derived from patient focus groups; and convened a 10-member expert panel to rate the appropriateness, reliability, and necessity of each quality indicator. Results: From the original 37 evidence-based and 10 patient-based quality indicators, the panel identified 24 evidence-based and 5 patient-based indicators as appropriate indicators of quality. Of these, the panel identified 9 that were not necessary for high quality care. Conclusion: There is, at best, a poor understanding of the quality of care provided for adults with epilepsy. These indicators, developed based on published evidence, expert opinion, and patient perceptions, provide a basis to assess and improve the quality of care for this population. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div 11C6, VERDICT HSR&D, Dept Vet Affairs, San Antonio, TX 78229 USA. Univ Texas Hlth Sci Ctr, San Antonio, TX USA. Bedford VA Hosp, Dept Internal Med, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Boston Univ, Sch Med, Dept Neurol, Boston, MA USA. Yale Univ, Dept Psychiat, West Haven, CT USA. Boston Univ, Sch Publ Hlth, Ctr Assessment Pharmaceut Practices, Dept Hlth Policy & Management, Boston, MA 02215 USA. Emory Univ, Sch Med, Atlanta, GA USA. Long Isl Jewish Med Ctr, Dept Neurol, New Hyde Pk, NY 11042 USA. Univ Florida, Sch Med, Dept Neurol, Gainesville, FL USA. Univ Virginia, Sch Med, Dept Neurol, Charlottesville, VA 22908 USA. Orlando Reg Healthcare, Orlando, FL USA. Univ S Florida, Tampa Gen Healthcare Outpatient Epilepsy Clin, Tampa, FL 33620 USA. Univ New Mexico, Vet Adm Hosp, Sch Med, Albuquerque, NM 87131 USA. Cornell Univ, New York Hosp, Weill Med Coll, Comprehens Epilepsy Ctr, New York, NY USA. Yale Univ, Sch Med, New Haven, CT USA. RP Pugh, MJV (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div 11C6, VERDICT HSR&D, Dept Vet Affairs, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM PughM@uthscsa.edu FU PHS HHS [S3492-23/23] NR 40 TC 33 Z9 34 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD NOV 20 PY 2007 VL 69 IS 21 BP 2020 EP 2027 DI 10.1212/01.WNL.0000291947.29643.9f PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 232XM UT WOS:000251054500009 PM 17928576 ER PT J AU Wu, YN Martella, G Johnson, SW AF Wu, Yan-Na Martella, Giuseppina Johnson, Steven W. TI Rotenone enhances N-methyl-D-aspartate currents by activating a tyrosine kinase in rat dopamine neurons SO NEUROREPORT LA English DT Article DE brain slice; excitotoxicity; hydrogen peroxide; N-methyl-D-aspartate; patch clamp; reactive oxygen species; rotenone; substantia nigra; tyrosine kinase ID NMDA RECEPTOR; PARKINSONS-DISEASE; MODULATION; SRC; PHOSPHORYLATION; PHOSPHATASES; REDUCTION; INHIBITOR; RESPONSES; INVITRO AB Our previous work showed that the pesticide rotenone increases the amplitude of inward currents evoked by N-methyl-D-aspartate (NMDA) in substantia nigra dopamine neurons. Using patch pipettes to record whole-cell currents in rat brain slices, we report that the rotenone-induced potentiation of NMDA current is blocked by the tyrosine kinase inhibitors genistein and PPI. This action of rotenone is mimicked by H2O2, which is also blocked by genistein. Our results suggest that the rotenone-dependent increase in NMDA current is mediated by release of reactive oxygen species that activates a protein tyrosine kinase. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Univ Roma Tor Vergata, Dept Neurosci, Rome, Italy. RP Johnson, SW (reprint author), Portland VA Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM johnsost@ohsu.edu 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 0959-4965 J9 NEUROREPORT JI Neuroreport PD NOV 19 PY 2007 VL 18 IS 17 BP 1813 EP 1816 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 230UO UT WOS:000250901700012 PM 18090317 ER PT J AU Schittenhelm, MM Kampa, KM Yee, KWH Kanz, L Heinrich, MC AF Schittenhelm, Marcus M. Kampa, Kerstin M. Yee, Kevin W. H. Kanz, Lothar Heinrich, Michael C. TI In vitro modeling of the use of FLT3 inhibitors to reduce chemotherapy doses for elderly patients with AML SO BLOOD LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-of-Hematology CY DEC 08-11, 2007 CL Atlanta, GA SP Amer Soc Hematol C1 [Schittenhelm, Marcus M.; Kampa, Kerstin M.; Kanz, Lothar] Med Univ Klin, Dept Hematol Oncol Rheumatol Immunol & Pulmonol, Tubingen, Germany. Oregon Hlth & Sci Univ, Inst Canc, Dept Med, Div Hematol Oncol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Inst Canc, Dept Cell & Dev Biol, Div Hematol Oncol, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2007 VL 110 IS 11 MA 4213 BP 120B EP 121B PN 2 PG 2 WC Hematology SC Hematology GA 233OV UT WOS:000251101100469 ER PT J AU Hiruma, Y Kurihara, N Roodman, D AF Hiruma, Yuko Kurihara, Noriyoshi Roodman, David TI P62 signaling is increased in multiple myeloma microenvironment SO BLOOD LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-of-Hematology CY DEC 08-11, 2007 CL Atlanta, GA SP Amer Soc Hematol C1 [Hiruma, Yuko; Kurihara, Noriyoshi; Roodman, David] Univ Pittsburgh, Pittsburgh, PA USA. [Roodman, David] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 1 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2007 VL 110 IS 11 MA 669 BP 206A EP 206A PN 1 PG 1 WC Hematology SC Hematology GA 233OS UT WOS:000251100800670 ER PT J AU Frost, PJ Shi, Y Bardalaban, C Hoang, B Lichtenstein, A AF Frost, Patrick J. Shi, YiJiang Bardalaban, Carolyne Hoang, Bao Lichtenstein, Alan TI The role of AKT and ERK in regulating D-cyclin translation inhibition and G1 arrest in multiple myeloma cells treated with mTOR inhibitors: rationale for combination thereapy SO BLOOD LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-of-Hematology CY DEC 08-11, 2007 CL Atlanta, GA SP Amer Soc Hematol C1 [Frost, Patrick J.; Shi, YiJiang; Bardalaban, Carolyne; Hoang, Bao; Lichtenstein, Alan] Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2007 VL 110 IS 11 MA 4795 BP 272B EP 272B PN 2 PG 1 WC Hematology SC Hematology GA 233OV UT WOS:000251101102087 ER PT J AU Toro, JJ Arango, JI Westbrook, SD Jewell, PS Shuko, L Ochoa-Bayona, JL Freytes, CO AF Toro, Juan J. Arango, Jorge I. Westbrook, Steven D. Jewell, Pamela S. Shuko, Lee Ochoa-Bayona, Jose L. Freytes, Cesar O. TI Oral mucositis measured by the oral mucositis assessment scale (OMAS), but not by the world health organization (WHO) scoring system, correlates with nutritional changes after autologous peripheral blood stem cell transplantation. SO BLOOD LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-of-Hematology CY DEC 08-11, 2007 CL Atlanta, GA SP Amer Soc Hematol C1 [Toro, Juan J.; Arango, Jorge I.; Westbrook, Steven D.; Ochoa-Bayona, Jose L.; Freytes, Cesar O.] Univ Texas Hlth Sci Ctr, San Antonio, TX USA. [Toro, Juan J.; Westbrook, Steven D.; Jewell, Pamela S.; Shuko, Lee; Ochoa-Bayona, Jose L.; Freytes, Cesar O.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 4 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2007 VL 110 IS 11 MA 4944 BP 312B EP 312B PN 2 PG 1 WC Hematology SC Hematology GA 233OV UT WOS:000251101102236 ER PT J AU Nakamae, H Storer, B Chauncey, T Pulsipher, M Petersen, F Wade, JC Maris, M Bruno, B Petersdorf, E Maloney, D Storb, R Sandmaier, BM AF Nakamae, Hirohisa Storer, Barry Chauncey, Thomas Pulsipher, Michael Petersen, Finn Wade, James C. Maris, Michael Bruno, Ben Petersdorf, Effie Maloney, David Storb, Rainer Sandmaier, Brenda M. TI Low-dose total body irradiation (TBI) and fludarabine conditioning for hematopoietic cell transplantation (HCT) in patients with HLA-class I mismatched donors SO BLOOD LA English DT Meeting Abstract CT 49th Annual Meeting of the American-Society-of-Hematology CY DEC 08-11, 2007 CL Atlanta, GA SP Amer Soc Hematol C1 [Nakamae, Hirohisa; Storer, Barry; Chauncey, Thomas; Petersdorf, Effie; Maloney, David; Storb, Rainer; Sandmaier, Brenda M.] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. [Storer, Barry; Chauncey, Thomas; Petersdorf, Effie; Maloney, David; Storb, Rainer; Sandmaier, Brenda M.] Univ Washington, Seattle, WA 98195 USA. [Chauncey, Thomas] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Pulsipher, Michael] Univ Utah, Salt Lake City, UT USA. [Petersen, Finn] Intermountain Blood & Marrow Transplant Program, Salt Lake City, UT USA. [Wade, James C.] Med Coll Wisconsin, Milwaukee, WI 53226 USA. [Maris, Michael] Rocky Mountain Blood & Marrow Transplantat, Denver, CO USA. [Bruno, Ben] Univ Turin, Turin, Italy. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD NOV 16 PY 2007 VL 110 IS 11 BP 902A EP 902A PN 1 PG 1 WC Hematology SC Hematology GA 233OS UT WOS:000251100804104 ER PT J AU Cadle, RM Mansouri, MD Logan, N Kudva, DR Musher, DA AF Cadle, Richard M. Mansouri, Mohammad D. Logan, Nancy Kudva, Denise R. Musher, Daniel A. TI Association of proton-pump inhibitors with outcomes in Clostridium difficile colitis SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article DE antiinfective agents; clostridium infections; combined therapy; enterocolitis; gastrointestinal drugs; toxicity ID DIARRHEA; DISEASE; RISK; METRONIDAZOLE; NITAZOXANIDE; DIAGNOSIS; THERAPY AB Purpose. The role of concurrent use of proton-pump inhibitors (PPIs) in the outcomes of treatment for Clostridium difficile colitis was studied. Methods. The records of inpatients at a large Veterans Affairs medical center in whom C. difficile colitis was diagnosed between June 2004 and July 2005 were retrospectively reviewed. Data collected included patient characteristics at baseline, antibiotic therapy prescribed before and during therapy for C. difficile colitis, concurrent treatment with a PPI, response to therapy for C. difficile colitis, and recurrence of the disease in the 90 days after symptoms resolved. Outcomes of therapy were classified as cures, treatment failures, or disease recurrences. Results. A total of 140 patients (138 men and 2 women) were included in the study. Ninety-seven (69%) of patients received a PPI and 43 (31%) did not. Of patients receiving a PPI, 37 (38%) were cured of C. difficile colitis, 20 (21%) did not respond to therapy, and 40 (41%) had disease recurrence. Among the non-PPI patients, 27 (63%) were cured, 9 (21%) did not respond, and 7 (16%) had recurrence. Patients receiving PPIs were 4.17 times as likely to have recurrence as their counterparts who did not. Conclusion. PPI therapy was associated with an increased risk of recurrent C. difficile colitis. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Infect Dis Sect, Houston, TX USA. Univ Texas Austin, Austin, TX USA. Univ Houston, Sch Pharm, Houston, TX USA. Baylor Coll Med, Dept Phys Med & Rehabilitat, MEDVAMC, Houston, TX USA. MD Anderson Hosp, Sect Infect Dis, MEDVAMC, Houston, TX USA. MD Anderson Hosp, Serv Pharm, Houston, TX USA. RP Cadle, RM (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Serv Pharm, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM cadle.richardmark@med.va.gov NR 19 TC 59 Z9 63 U1 1 U2 6 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 NOV 15 PY 2007 VL 64 IS 22 BP 2359 EP 2363 DI 10.2146/ajhp060629 PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 234XO UT WOS:000251198000013 PM 17989446 ER PT J AU Carpenter, LL Carvalho, JP Tyrka, AR Wier, LM Mello, AF Mello, MF Anderson, GM Wilkinson, CW Price, LH AF Carpenter, Linda L. Carvalho, John P. Tyrka, Audrey R. Wier, Lauren M. Mello, Andrea F. Mello, Marcelo F. Anderson, George M. Wilkinson, Charles W. Price, Lawrence H. TI Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment SO BIOLOGICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT 44th Annual Meeting of the American-College-Neuropsychopharmacology CY DEC 11-15, 2005 CL Waikoloa, HI SP Vanderbilt Univ, Sch Med, Dept Psychiat DE abuse; ACTH; childhood; cortisol; enclophenotype; HPA axis; reactivity; trier social stress test ID PITUITARY-ADRENAL AXIS; MAJOR DEPRESSIVE DISORDER; EARLY ADVERSE EXPERIENCE; CHRONIC VARIABLE STRESS; PSYCHOSOCIAL STRESS; SOCIAL STRESS; NEUROENDOCRINE ACTIVITY; PSYCHOLOGICAL STRESS; PERCEIVED STRESS; CHALLENGE TESTS AB Background: Preclinical research findings suggest that exposure to stress and concomitant hypothalamus-pituitary-ad renal (HPA) axis activation during early development can have permanent and potentially deleterious effects. A history of early-life abuse or neglect appears to increase risk for mood and anxiety disorders. Abnormal HPA response to stress challenge has been reported in adult patients with major depressive disorder and posttraumatic stress disorder. Methods: Plasma adrenocorticotropin hormone (ACTH) and cortisol reactivity to the Trier Social Stress Test were examined in healthy adults (n = 50) without current psychopathology. Subjects with a self-reported history of moderate to severe childhood maltreatment (MAL) (n = 23) as measured by the Childhood Trauma Questionnaire were compared with subjects without such a history (CTL) (n = 27). Results: Compared with CTLs, MAL subjects exhibited significantly lower cortisol and ACTH baseline-to-peak deltas. A significant group effect was seen in the (repeated measures) cortisol response to the stress challenge, reflecting lower concentrations among MAL subjects. A significant group X time effect characterized the relatively blunted ACTH response of the MAL group. Emotional neglect (-.34, p = .02) and sexual abuse (.31, p = .03) strongly predicted maximal cortisol release. Conclusions: In adults without diagnosable psychopathology, childhood maltreatment is associated with diminished HPA axis response to a psychosocial stressor. Possible explanations for the finding are discussed. C1 Butler Hosp, Mood Disorders Res Program, Providence, RI 02906 USA. Butler Hosp, Lab Clin Neurosci, Providence, RI 02906 USA. Brown Univ, Sch Med, Dept Psychiat & Human Behav, Providence, RI 02912 USA. Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06510 USA. Univ Washington, Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Carpenter, LL (reprint author), Butler Hosp, Mood Disorders Res Program, 345 Blackstone Blvd, Providence, RI 02906 USA. RI Tyrka, Audrey/L-2504-2014; Mello, Andrea/Q-1795-2015; Mello, Marcelo/D-9565-2011 OI Mello, Marcelo/0000-0002-0475-4729 FU NIMH NIH HHS [R01 MH068767-01A1, R01 MH068767, R01 MH068767-01, R01 MH068767-02] NR 79 TC 207 Z9 210 U1 6 U2 34 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 NOV 15 PY 2007 VL 62 IS 10 BP 1080 EP 1087 DI 10.1016/j.biopsych.2007.05.002 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 230WB UT WOS:000250905800003 PM 17662255 ER PT J AU Golier, JA Schmeidler, J Legge, J Yehuda, R AF Golier, Julia A. Schmeidler, James Legge, Juliana Yehuda, Rachel TI Twenty-four hour plasma cortisol and adrenocorticotropic hormone in Gulf War Veterans: Relationships to posttraumatic stress disorder and health symptoms SO BIOLOGICAL PSYCHIATRY LA English DT Article DE ACTH; Gulf War illness; medically unexplained illnesses; PTSD; stress ID CORTICOTROPIN-RELEASING HORMONE; OPERATION DESERT-STORM; MULTISYMPTOM ILLNESS; URINARY CORTISOL; DEXAMETHASONE; EXPOSURES; EXCRETION AB Background: We aim to characterize the baseline functioning of the hypothalamic-pituitary-adrenal (HPA) axis in Gulf War veterans (GWV) and examine the extent to which posttraumatic stress disorder (PTSD) and unexplained health symptoms-which commonly co-occur-have similar or different biological correlates. Methods: Thirty-one GWV, 20 with current PTSD and 11 without current or lifetime PTSD, and 16 healthy nondeployed subjects not exposed to the Gulf War theater underwent medical and psychiatric examination followed by blood sampling every half-hour over 24 hours for the measurement of cortisol and adrenocorticotropic hormone (ACTH). Results: Gulf War veterans without PTSD or another psychiatric disorder had significantly lower 24-hour plasma ACTH levels, a significantly higher cortisol:ACTH ratio, and no difference in cortisol levels compared to nondeployed subjects and to GWV with PTSD, controlling for body mass index (BMI). Among GWV, health symptoms (mood and cognitive symptoms) were positively associated with, and hyperarousal symptoms were negatively associated with, the cortisol:ACTH ratio. Additionally, the self-reported acute effects of pesticides and of pyridostigmine bromide during deployment were associated with lower ACTH levels, controlling for BMI and PTSD. Conclusions: The data provide evidence of HPA axis dysregulation in Gulf War veterans, which may be related to Gulf War deployment exposures. Despite the overlap of chronic unexplained health symptoms and PTSD in GWV, these symptom constellations appear to be biologically distinct. C1 OOMH, James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. RP Golier, JA (reprint author), OOMH, James J Peters VA Med Ctr, Dept Psychiat, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM Julia.golier@va.gov FU NCRR NIH HHS [5 M01 RR00071] NR 30 TC 35 Z9 38 U1 0 U2 4 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 NOV 15 PY 2007 VL 62 IS 10 BP 1175 EP 1178 DI 10.1016/j.biopsych.2007.04.027 PG 4 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 230WB UT WOS:000250905800016 PM 17612507 ER PT J AU Thompson, GR Lawrence, VA Crawford, GE AF Thompson, George R., III Lawrence, Valerie A. Crawford, George E. TI HIV infection increases the risk of heparin-induced thrombocytopenia SO CLINICAL INFECTIOUS DISEASES LA English DT Editorial Material ID HUMAN-IMMUNODEFICIENCY-VIRUS; AUTOIMMUNITY; AUTOANTIBODIES; HEPATITIS; AIDS AB The incidence of heparin-induced thrombocytopenia in human immunodeficiency virus (HIV)-infected inpatients was compared with that in a control group that was not known to be infected with HIV in a retrospective cohort study. HIV-infected patients receiving heparin therapy, especially unfractionated heparin therapy, were at increased risk of developing heparin-induced thrombocytopenia, compared with HIV-uninfected patients. C1 Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Internal Med, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Div Gen Med, Dept Med, San Antonio, TX 78229 USA. RP Thompson, GR (reprint author), Univ Texas, Hlth Sci Ctr, Div Infect Dis, Dept Internal Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM thompsong2@uthscsa.edu NR 22 TC 8 Z9 8 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD NOV 15 PY 2007 VL 45 IS 10 BP 1393 EP 1396 DI 10.1086/522761 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222RY UT WOS:000250315900024 PM 17968841 ER PT J AU Roman, GC Reis, J Defer, GL Prockop, LD AF Roman, G. C. Reis, J. Defer, G. L. Prockop, L. D. TI Introduction to the special issue on environmental neurology SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Editorial Material C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. Audie L Murphy Mem Vet Adm Med Ctr, Vet Adm, San Antonio, TX 78284 USA. Univ Strasbourg, Fac Med, Strasbourg, France. Univ Hosp, Neurol Serv, Caen, France. Univ S Florida, Coll Med, Dept Neurol, Tampa, FL USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, 6900 North Loop 1604 W, San Antonio, TX 78249 USA. EM romang@uthscsa.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-510X J9 J NEUROL SCI JI J. Neurol. Sci. PD NOV 15 PY 2007 VL 262 IS 1-2 BP 1 EP 1 DI 10.1016/j.jns.2007.06.015 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 221RL UT WOS:000250244900001 ER PT J AU Reis, J Roman, GC AF Reis, Jacques Roman, Gustavo C. TI Environmental neurology: A promising new field of practice and research SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article; Proceedings Paper CT Meeting of the Environmental-Neurology-Club CY FEB 07, 2007 CL Metz, FRANCE SP French Soc Neurol, Univ Metz, Enviornm Neruol Res Grp, WFN, Environm Neurol Club DE environment; hazard; risk; adaptation; vulnerability; gene-environment ID ALZHEIMERS-DISEASE; MEDITERRANEAN DIET; OPTIC NEUROPATHY; HEALTH; RISK; GUAM; SCLEROSIS; EPIDEMIC; CASSAVA; BLOOD AB The environment has profound influences on human health. Environment is the combination of natural (physical, chemical, biological) and cultural (sociological) conditions in which living organisms, man in particular, develop. Adaptation is the human physiological response to external factors including mechanisms such as circadian rhythms (sleep and wakefulness), biorhythms, thermoregulation, and others to adjust to changes in natural conditions (night and day, cosmic rhythms, climatic changes). Man remains vulnerable due to a number of factors: genetic, physiological, age, sex, impaired reparative or protective mechanisms, or acquired factors (risky behaviors and lifestyle, nutritional habits). Hazard is the potential of a particular factor to have a negative impact on health. Risk is the probability of that hazard occurring; it defines and measures the predictability of that hazard. A number of environmental factors have a profound influence on the pathogenesis of neurological disorders. Environmental neurology follows the classical diagnostic precepts: from symptom to syndrome in the search for etiology and individualized treatment of the patient. It also utilizes principles of epidemiology and public health, toxicology and occupational medicine; i.e., an approach by "milieu" and by specific factors or "agents." Environmental neurology offers a promising new field of practice and research. (c) 2007 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. Audie Murphy Hosp, Vet Adm, San Antonio, TX 78284 USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. EM romang@uthscsa.edu NR 27 TC 3 Z9 3 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-510X J9 J NEUROL SCI JI J. Neurol. Sci. PD NOV 15 PY 2007 VL 262 IS 1-2 BP 3 EP 6 DI 10.1016/j.jns.2007.06.017 PG 4 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 221RL UT WOS:000250244900003 PM 17651758 ER PT J AU Roman, GC AF Roman, Gustavo C. TI Autism: Transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article; Proceedings Paper CT Meeting of the Environmental-Neurology-Club CY FEB 07, 2007 CL Metz, FRANCE SP French Soc Neurol, Univ Metz, Enviornm Neruol Res Grp, WFN, Environm Neurol Club DE autism; hypothyroxinemia; pregnancy; antithyroid agents; iodine; endemic cretinism; herbicides; neuronal migration; soy; mercury; polyphenols ID FETAL-BRAIN DEVELOPMENT; REELIN GENE ALLELES; THYROID-HORMONE; SPECTRUM DISORDERS; IODINE DEFICIENCY; UNITED-STATES; ORGANOCHLORINE COMPOUNDS; CHLORALKALI WORKERS; MERCURIC-CHLORIDE; ENDEMIC CRETINISM AB The incidence and prevalence of autism have increased during the past two decades. Despite comprehensive genetic studies the cause of autism remains unknown. This review emphasizes the potential importance of environmental factors in its causation. Alterations of cortical neuronal migration and cerebellar Purkinje cells have been observed in autism. Neuronal migration, via reelin regulation, requires triiodothyronine (T3) produced by deiodination of thyroxine (T4) by fetal brain deiodinases. Experimental animal models have shown that transient intrauterine deficits of thyroid hormones (as brief as 3 days) result in permanent alterations of cerebral cortical architecture reminiscent of those observed in brains of patients with autism. 1 postulate that early maternal hypothyroxinetnia resulting in low T3 in the fetal brain during the period of neuronal cell migration (weeks 8-12 of pregnancy) may produce morphological brain changes leading to autism. Insufficient dietary iodine intake and a number of environmental antithyroid and goitrogenic agents can affect maternal thyroid function during pregnancy. The most common causes could include inhibition of deiodinases D2 or D3 from maternal ingestion of dietary flavonoids or from antithyroid environmental contaminants. Some plant isoflavonoids have profound effects on thyroid hormones and on the hypothalamus-pituitary axis. Genistein and daidzein from soy (Glycine max) inhibit thyroperoxidase that catalyzes iodination and thyroid hormone biosynthesis. Other plants with hypothyroid effects include pearl millet (Pennisetum glaucum) and fonio millet (Digitaria exilis); thiocyanate is found in Brassicae plants including cabbage, cauliflower, kale, rutabaga, and kohlrabi, as well as in tropical plants such as cassava, lima beans, linseed, bamboo shoots, and sweet potatoes. Tobacco smoke is also a source of thiocyanate. Environmental contaminants interfere with thyroid function including 60% of all herbicides, in particular 2,4-dichlorophenoxyacetic acid (2,4-D), acetochlor, aminotriazole, atmitrole, bromoxynil, pendamethalin, mancozeb, and thioureas. Other antithyroid agents include polychlorinated biphenyls (PCBs), perchlorates, mercury, and coal derivatives such as resorcinol, phthalates, and anthracenes. A leading ecological study in Texas has correlated higher rates of autism in school districts affected by large environmental releases of mercury from industrial sources. Mercury is a well known antithyroid substance causing inhibition of deiodinases and thyroid peroxidase. The current surge of autism could be related to transient maternal hypothyroxinemia resulting from dietary and/or environmental exposure to antithyroid agents. Additional multidisciplinary epidemiological studies will be required to confirm this environmental hypothesis of autism. (c) 2007 Elsevier B.V All rights reserved. C1 Vet Adm Hosp, San Antonio, TX USA. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. EM romang@uthscsa.edu NR 143 TC 57 Z9 61 U1 3 U2 25 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-510X J9 J NEUROL SCI JI J. Neurol. Sci. PD NOV 15 PY 2007 VL 262 IS 1-2 BP 15 EP 26 DI 10.1016/j.jns.2007.06.023 PG 12 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 221RL UT WOS:000250244900005 PM 17651757 ER PT J AU Bernal-Pacheco, O Roman, GC AF Bernal-Pacheco, Oscar Roman, Gustavo C. TI Environmental vascular risk factors: New perspectives for stroke prevention SO JOURNAL OF THE NEUROLOGICAL SCIENCES LA English DT Article; Proceedings Paper CT Meeting of the Environmental-Neurology-Club CY FEB 07, 2007 CL Metz, FRANCE SP French Soc Neurol, Univ Metz, Enviornm Neruol Res Grp, WFN, Environm Neurol Club DE stroke; obesity; vascular risk factors; education; socioeconomic factors; sleep apnea; periodontal disease; diet ID OBSTRUCTIVE SLEEP-APNEA; CORONARY-HEART-DISEASE; C-REACTIVE PROTEIN; SYSTOLIC BLOOD-PRESSURE; 1ST ISCHEMIC-STROKE; OF-THE-LITERATURE; CARDIOVASCULAR-DISEASE; PERIODONTAL-DISEASE; METABOLIC SYNDROME; PHYSICAL-ACTIVITY AB Despite intensive evaluation of acute stroke patients, perhaps only half of the attributable stroke risk is usually identified. In addition to traditional and non-traditional vascular risk factors-including most recently homocysteine, inflammation, and alterations of coagulation-a number of environmental risk factors for stroke have been identified in the last decade. In this update we review the following: lower education and poor socioeconomic status (probable surrogates for exposure to traditional high-risk behaviors such as smoking, poor nutrition, lack of prenatal control, absence of preventive medical and dental care, and non-compliance of treatment of conditions such as hypertension); depression, stress and affective disorders; obstructive sleep apnea; passive smoking and environmental pollution; infections, in particular periodontal diseases that increase C-reactive protein (CRP); raised body mass index (obesity); exercise, and diet. The possible role of high-fructose corn syrup in the epidemic of obesity in the USA is reviewed. Protective diets include higher consumption of fish, olive oil, grains, fruits and vegetables (Mediterranean diet), as well as probiotic bacteria in yogurt and dairy products. Careful attention should be given to the patient's environment looking for modifiable factors. The effects of clean environmental air and water, adequate diet and appropriate nutrition, healthy teeth, exercise, and refreshing sleep in the prevention of stroke and cardiovascular disease appear to be quite compelling. Although some of these modifiable risk factors lack evidence-based information, judicious clinical sense should be used to counteract the potentially damaging effects of adverse environmental vascular risk factors. (c) 2007 Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. Vet Adm Hosp, San Antonio, TX USA. Cent Mil Hosp, Bogota, Colombia. RP Roman, GC (reprint author), Univ Texas, Hlth Sci Ctr, San Antonio, TX 78249 USA. EM romang@uthscsa.edu NR 161 TC 23 Z9 25 U1 5 U2 10 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-510X J9 J NEUROL SCI JI J. Neurol. Sci. PD NOV 15 PY 2007 VL 262 IS 1-2 BP 60 EP 70 DI 10.1016/j.jns.2007.06.026 PG 11 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 221RL UT WOS:000250244900010 PM 17655871 ER PT J AU Sinha, S Subramanian, S Proctor, TM Kaler, LJ Grafe, M Dahan, R Huan, J Vandenbark, AA Burrows, GG Offner, H AF Sinha, Sushmita Subramanian, Sandhya Proctor, Thomas M. Kaler, Laurie J. Grafe, Marjorie Dahan, Rony Huan, Jianya Vandenbark, Arthur A. Burrows, Gregory G. Offner, Halina TI A promising therapeutic approach for multiple sclerosis: recombinant T-cell receptor ligands modulate experimental autoimmune encephalomyelitis by reducing interleukin-17 production and inhibiting migration of encephalitogenic cells into the CNS SO JOURNAL OF NEUROSCIENCE LA English DT Article DE EAE; RTL; CNS; IL-17; chemokines/receptors; SH ID CENTRAL-NERVOUS-SYSTEM; TUMOR-NECROSIS-FACTOR; EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; CXC CHEMOKINE RECEPTORS; MICE LACKING; FACTOR-ALPHA; SPINAL-CORD; EXPRESSION; INFLAMMATION; EAE AB Recombinant T-cell receptor ligands (RTLs) can prevent and reverse clinical and histological signs of experimental autoimmune encephalomyelitis (EAE) in an antigen-specific manner and are currently in clinical trials for treatment of subjects with multiple sclerosis (MS). To evaluate regulatory mechanisms, we designed and tested RTL551, containing the alpha 1 and beta 1 domains of the I-A(b) class II molecule covalently linked to the encephalitogenic MOG-35-55 peptide in C57BL/6 mice. Treatment of active or passive EAE with RTL551 after disease onset significantly reduced clinical signs and spinal cord lesions. Moreover, RTL551 treatment strongly and selectively reduced secretion of interleukin-17 and tumor necrosis factor alpha by transferred green fluorescent protein-positive (GFP+) MOG-35-55-reactive T-cells and almost completely abrogated existent GFP+ cellular infiltrates in affected spinal cord sections. Reduced inflammation in spinal cords of RTL551-treated mice was accompanied by a highly significant downregulation of chemokines and their receptors and inhibition of VCAM-1 (vascular cell adhesion molecule-1) and ICAM-1 (intercellular adhesion molecule-1) expression by endothelial cells. Thus, RTL therapy cannot only inhibit systemic production of encephalitogenic cytokines by the targeted myelin oligodendrocyte glycoprotein-reactive T-cells but also impedes downstream local recruitment and retention of inflammatory cells in the CNS. These findings indicate that targeted immunotherapy of antigen-specific T-cells can result in a reversal of CNS lesion formation and lend strong support to the application of the RTL approach for therapy in MS. C1 Portland VA Med Ctr, Neuroimmunol Res R&D 31, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Pathol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Anesthesiol & Periopert Med, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Biochem & Mol Biol, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Tykeson MS Res Lab, Portland, OR 97239 USA. RP Offner, H (reprint author), Portland VA Med Ctr, Neuroimmunol Res R&D 31, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM offnerva@ohsu.edu FU NIAID NIH HHS [AI43960]; NINDS NIH HHS [NS46877, NS41965, NS47661] NR 49 TC 33 Z9 34 U1 0 U2 0 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD NOV 14 PY 2007 VL 27 IS 46 BP 12531 EP 12539 DI 10.1523/JNEUROSCI.3599-07.2007 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 231NA UT WOS:000250952700012 PM 18003831 ER PT J AU Stevenson, B Choy, HA Pinne, M Rotondi, ML Miller, MC DeMoll, E Kraiczy, P Cooley, AE Creamer, TP Suchard, MA Brissette, CA Verma, A Haake, DA AF Stevenson, Brian Choy, Henry A. Pinne, Marija Rotondi, Matthew L. Miller, M. Clarke DeMoll, Edward Kraiczy, Peter Cooley, Anne E. Creamer, Trevor P. Suchard, Marc A. Brissette, Catherine A. Verma, Ashutosh Haake, David A. TI Leptospira interrogans Endostatin-Like Outer Membrane Proteins Bind Host Fibronectin, Laminin and Regulators of Complement SO PLOS ONE LA English DT Article AB The pathogenic spirochete Leptospira interrogans disseminates throughout its hosts via the bloodstream, then invades and colonizes a variety of host tissues. Infectious leptospires are resistant to killing by their hosts' alternative pathway of complement-mediated killing, and interact with various host extracellular matrix (ECM) components. The LenA outer surface protein (formerly called LfhA and Lsa24) was previously shown to bind the host ECM component laminin and the complement regulators factor H and factor H-related protein-1. We now demonstrate that infectious L. interrogans contain five additional paralogs of lenA, which we designated lenB, lenC, lenD, lenE and lenF. All six genes encode domains predicted to bear structural and functional similarities with mammalian endostatins. Sequence analyses of genes from seven infectious L. interrogans serovars indicated development of sequence diversity through recombination and intragenic duplication. LenB was found to bind human factor H, and all of the newly-described Len proteins bound laminin. In addition, LenB, LenC, LenD, LenE and LenF all exhibited affinities for fibronectin, a distinct host extracellular matrix protein. These characteristics suggest that Len proteins together facilitate invasion and colonization of host tissues, and protect against host immune responses during mammalian infection. C1 [Stevenson, Brian; Cooley, Anne E.; Brissette, Catherine A.; Verma, Ashutosh] Univ Kentucky, Coll Med, Dept Microbiol Mol Genet & Immunol, Lexington, KY 40506 USA. [Choy, Henry A.; Pinne, Marija; Haake, David A.] Vet Affairs Greater Los Angeles Hlth Care Syst, Div Infect Dis, Los Angeles, CA USA. [Choy, Henry A.; Pinne, Marija; Haake, David A.] Univ Calif Los Angeles, Dept Med, Sch Med, Los Angeles, CA 90024 USA. [Rotondi, Matthew L.; Miller, M. Clarke; DeMoll, Edward] Univ Kentucky, Dept Chem, Lexington, KY 40506 USA. [Kraiczy, Peter] Univ Hosp Frankfurt, Inst Med Microbiol & Infect Control, Frankfurt, Germany. [Creamer, Trevor P.] Univ Kentucky, Coll Med, Dept Mol & Cellular Biochem, Lexington, KY USA. [Suchard, Marc A.] Univ Calif Los Angeles, Sch Med, Dept Biomath, Los Angeles, CA 90024 USA. [Verma, Ashutosh] Univ Kentucky, Dept Vet Sci, Lexington, KY 40546 USA. RP Stevenson, B (reprint author), Univ Kentucky, Coll Med, Dept Microbiol Mol Genet & Immunol, Lexington, KY 40506 USA. EM brian.stevenson@uky.edu RI Miller, Clarke/C-9483-2011 OI Miller, Montie/0000-0002-9877-6581 FU VA Medical Research funds; National 10 Institute of Allergy and Infectious Diseases [AI-34431]; Paul Mellon Fellowship FX This work was funded in part by VA Medical Research funds and National 10 Institute of Allergy and Infectious Diseases grant AI-34431 to D. Haake. M. Suchard is an Alfred P. Sloan Research Fellow. A. Verma was supported by a Paul Mellon Fellowship in Equine Studies. NR 71 TC 115 Z9 117 U1 2 U2 11 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD NOV 14 PY 2007 VL 2 IS 11 AR e1188 DI 10.1371/journal.pone.0001188 PG 11 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA V10JA UT WOS:000207459100026 PM 18000555 ER PT J AU Nallamothu, BK Wang, YF Cram, P Birkmeyer, JD Ross, JS Normand, SLT Krumholz, HM AF Nallamothu, Brahmajee K. Wang, Yongfei Cram, Peter Birkmeyer, John D. Ross, Joseph S. Normand, Sharon-Lise T. Krumholz, Harlan M. TI Acute myocardial infarction and congestive heart failure outcomes at specialty cardiac hospitals SO CIRCULATION LA English DT Article DE cardiac care facilities; myocardial infarction; heart failure, congestive; outcomes research ID REVASCULARIZATION; QUALITY; CARE AB Background-Outcomes of patients with acute myocardial infarction (AMI) and congestive heart failure (CHF) at specialty cardiac hospitals are uncertain. Methods and Results-From 2003 Medicare data, we used hierarchical regression to calculate 30-day standardized mortality ratios and risk-standardized mortality rates for AMI and CHF at 16 cardiac and 121 peer general hospitals in 15 healthcare markets. We then compared cardiac and general hospitals by determining (1) the proportion of facilities with statistically higher, no different, or lower than expected mortality based on 95% interval estimates of standardized mortality ratios and (2) differences in risk-standardized mortality rates between the types of facilities after stratification within healthcare markets. We identified 1912 patients with AMI and 1275 patients with CHF at cardiac hospitals and 13 158 patients with AMI and 18 295 patients with CHF at general hospitals. Patients at cardiac hospitals were younger, were more likely to be male, and had a much lower prevalence of noncardiovascular diseases. After adjustment for patient differences, standardized mortality ratios were significantly better than expected for 4 (25%) and 5 (31%) cardiac hospitals for AMI and CHF, respectively, compared with 5 (4%) and 6 (5%) general hospitals. Risk-standardized mortality rates were modestly lower at cardiac hospitals (15.0% versus 16.2% for AMI, P<0.001, and 10.7% versus 11.3% for CHF, P<0.01). Conclusions-Patients with AMI and CHF at cardiac hospitals differ considerably from those at peer general hospitals. Although outcomes were modestly better at cardiac hospitals, substantial variation was noted across individual facilities. C1 Univ Michigan, Sch Med, Hlth Serv Res & Dev Ctr Excellence, Ann Arbor VA Med Ctr,Dept Internal Med, Ann Arbor, MI 48109 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT USA. Univ Iowa, Dept Med, Iowa City, IA USA. Univ Michigan, Dept Surg, Ann Arbor, MI 48109 USA. Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. James J Peters VA Med Ctr, HSR&D Targeted Res Enhancement Program & Geriatr, Bronx, NY USA. Harvard Med Sch, Dept Biostat, Boston, MA USA. Harvard Sch Publ Hlth, Dept Biostat, Boston, MA USA. Yale Univ, Yale New Haven Hosp, Sch Med, Ctr Outcomes Res & Evaluat,Robert Wood Johnson C, New Haven, CT USA. RP Nallamothu, BK (reprint author), 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. EM bnallamo@umich.edu RI Cram, Peter/K-4472-2014 OI Cram, Peter/0000-0002-1910-346X FU AHRQ HHS [1R01HS015571-01A1] NR 13 TC 18 Z9 18 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD NOV 13 PY 2007 VL 116 IS 20 BP 2280 EP 2287 DI 10.1161/CIRCULATIONAHA.107.709220 PG 8 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 230IT UT WOS:000250870900008 PM 17967975 ER PT J AU Das, F Mahimainathan, L Ghosh-Choudhury, N Venkatesan, B Kasinath, BS Abboud, HE Choudhury, GG AF Das, Falguni Mahimainathan, Lenin Ghosh-Choudhury, Nandini Venkatesan, Balachandar Kasinath, Balakuntalam S. Abboud, Hanna E. Choudhury, Goutam Ghosh TI TGF beta intercepts nuclear glycogen synthase kinase 3 beta to inhibit PDGF-induced DNA synthesis in mesangial cells SO FEBS LETTERS LA English DT Article DE Akt kinase; GSK3 beta; cyclin D1; CDK2; mitogenesis; glomerulonephritis ID GROWTH-FACTOR; KINASE 3-BETA; CYCLIN D1; AKT; PHOSPHORYLATION; PROLIFERATION; ACTIVATION; MECHANISM; LOCALIZATION; DOWNSTREAM AB Here, we demonstrate a mechanism of TGF beta-mediated inhibition of PDGF-induced DNA synthesis in mesangial cells. TGFb significantly inhibited nuclear Akt phosphorylation without any effect on PDGF-stimulated phosphorylation of PDGFR at PI 3 kinase binding site (Tyr-751). Remarkably, TGFb inhibited cyclin D1 and cyclin E expression with concomitant decrease in CDK2 activity induced by PDGF. More importantly, we demonstrate that TGFb significantly abolished Akt-mediated serine-9 phosphorylation of glycogen synthase kinase 3 beta (GSK3 beta), thus prevented its inactivation. Expression of inactive GSK3 beta K85R mutant increased cyclin D1 expression and DNA synthesis similar to PDGF. These results provide the first evidence that TGFb intercepts Akt kinase activity in the nucleus to block inactivation of GSK3b, leading to attenuation of PDGF-induced CDK2 activity and DNA synthesis. (C) 2007 Federation of European Biochemical Societies. Published by Elsevier B. V. All rights reserved. C1 [Das, Falguni; Mahimainathan, Lenin; Venkatesan, Balachandar; Kasinath, Balakuntalam S.; Abboud, Hanna E.; Choudhury, Goutam Ghosh] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA. [Ghosh-Choudhury, Nandini] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78284 USA. [Ghosh-Choudhury, Nandini; Kasinath, Balakuntalam S.; Abboud, Hanna E.; Choudhury, Goutam Ghosh] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Choudhury, Goutam Ghosh] Educ & Clin Ctr, San Antonio, TX USA. RP Choudhury, GG (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Med, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM choudhuryg@uthscsa.edu FU NIAMS NIH HHS [R01 AR52425]; NIDDK NIH HHS [R01 DK077295, R01 DK33665, R01 DK50190] NR 34 TC 7 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0014-5793 J9 FEBS LETT JI FEBS Lett. PD NOV 13 PY 2007 VL 581 IS 27 BP 5259 EP 5267 DI 10.1016/j.febslet.2007.10.014 PG 9 WC Biochemistry & Molecular Biology; Biophysics; Cell Biology SC Biochemistry & Molecular Biology; Biophysics; Cell Biology GA 267CU UT WOS:000253487700015 PM 17961557 ER PT J AU Caetano, SC Fonseca, M Hatch, JP Olvera, RL Nicoletti, M Hunter, K Lafer, B Pliszka, SR Soares, JC AF Caetano, Sheila C. Fonseca, Manoela Hatch, John P. Olvera, Rene L. Nicoletti, Mark Hunter, Kristina Lafer, Beny Pliszka, Steven R. Soares, Jair C. TI Medial temporal lobe abnormalities in pediatric unipolar depression SO NEUROSCIENCE LETTERS 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 major depressive disorder; children; adolescents; hippocampus; amygdala; MRI ID RECURRENT MAJOR DEPRESSION; HIPPOCAMPAL VOLUME LOSS; DISORDER; AMYGDALA; ADOLESCENTS; DURATION; REDUCTION; BRAIN; PREDICTORS; SEVERITY AB In vivo anatomical magnetic resonance imaging (MRI) studies in adults with major depressive disorder (MDD) have implicated neurocircuitries involved in mood regulation in the pathophysiology of mood disorders. Specifically, abnormalities in the medial temporal lobe structures have been reported. This study examined a sample of children and adolescents with major depressive disorder to investigate anatomical abnormalities in these key medial temporal brain regions. Nineteen children and adolescents with DSM-IV major depression (mean age +/- S.D. = 13.0 +/- 2.4 years; 10 unmedicated) and 24 healthy comparison subjects (mean age +/- S.D. = 13.9 +/- 2.9 years) were studied using a 1.5 T Philips MRI scanner. We measured hippocampus and amygdala gray matter volumes. MRI structural volumes were compared using analysis of covariance with age and total brain volumes as covariates. Pediatric depressed patients had significantly smaller left hippocampal gray matter volumes compared to healthy controls (1.89 +/- 0.16 cm(3) versus 1.99 +/- 0.18 cm(3), respectively; F= 5.0, d.f. = 1/39, p = 0.03; effect size: eta(2)(p) = 0.11). Unmedicated depressed patients showed a trend towards smaller left hippocampal volumes compared to medicated patients and healthy subjects (F=2.8, d.f. = 2/38, p = 0.07; effect size: eta(2)(p) = 0.13). There were no statistically significant differences in mean volumes for left or right amygdala. Smaller left hippocampal volumes in children and adolescents with MDD are in agreement with findings from adult studies and suggest that such abnormalities are present early in the course of the illness. Amygdala volumes are not abnormal in this age group. Smaller hippocampal volumes may be related to an abnormal developmental process or HPA axis dysfunction. (c) 2007 Published by Elsevier Ireland Ltd. C1 Univ N Carolina, Sch Med, Dept Psychiat, CERT BD, Chapel Hill, NC 27599 USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, Div Mood & Anxiety Disorders, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Psychiat Serv, Audie L Murphy Div, San Antonio, TX USA. Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Fed Rio Grande do Sul, Sch Med, Psychiat Res Unit, Porto Alegre, RS, Brazil. Univ Texas Hlth Sci Ctr San Antonio, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, Div Child & Adolescent Psychiat, San Antonio, TX 78229 USA. RP Soares, JC (reprint author), Univ N Carolina, Sch Med, Dept Psychiat, CERT BD, 10616 Neurosci Hosp,CB 7160, Chapel Hill, NC 27599 USA. EM jsoares@med.unc.edu RI Lafer, Beny/C-1055-2012; Caetano, Sheila/H-5010-2012; Lafer, Beny/F-9390-2015 OI Lafer, Beny/0000-0002-6132-9999; Caetano, Sheila/0000-0001-8403-7078; Lafer, Beny/0000-0002-6132-9999 FU NCRR NIH HHS [M01 RR01346, RR020571]; NIMH NIH HHS [K23 MH068280, MH068662, MH69774] NR 42 TC 35 Z9 49 U1 4 U2 13 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 NOV 12 PY 2007 VL 427 IS 3 BP 142 EP 147 DI 10.1016/j.neulet.2007.06.014 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 237ON UT WOS:000251384800005 PM 17949901 ER PT J AU Howe, WR Dellavalle, R AF Howe, William R. Dellavalle, Robert TI Vitamin D deficiency SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Univ Colorado, Sch Med, Aurora, CO 80045 USA. Denver VA Med Ctr, Denver, CO 80220 USA. RP Howe, WR (reprint author), Univ Colorado, Sch Med, Aurora, CO 80045 USA. EM william.howe@uchsc.edu RI Dellavalle, Robert/L-2020-2013 OI Dellavalle, Robert/0000-0001-8132-088X NR 4 TC 3 Z9 8 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 NOV 8 PY 2007 VL 357 IS 19 BP 1981 EP 1981 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 228LX UT WOS:000250732500027 PM 17992735 ER PT J AU McMurray, JJV Teerlink, JR Cotter, G Bourge, RC Cleland, JGF Jondeau, G Krum, H Metra, M O'Connor, CM Parker, JD Torre-Amione, G van Veldhuisen, DJ Lewsey, J Frey, A Rainisio, M Kobrin, I AF McMurray, John J. V. Teerlink, John R. Cotter, Gadi Bourge, Robert C. Cleland, John G. F. Jondeau, Guillaume Krum, Henry Metra, Marco O'Connor, Christopher M. Parker, John D. Torre-Amione, Guillermo van Veldhuisen, Dirk J. Lewsey, Jim Frey, Aline Rainisio, Maurizio Kobrin, Isaac CA VERITAS Investigators TI Effects of tezosentan on symptoms and clinical outcomes in patients with acute heart failure - The VERITAS Randomized controlled trials SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ENDOTHELIN RECEPTOR ANTAGONIST; COLLEGE-OF-CARDIOLOGY; DOUBLE-BLIND; INTRAVENOUS TEZOSENTAN; SCIENTIFIC SESSIONS; BIG ENDOTHELIN-1; NESIRITIDE; UPDATE; LEVOSIMENDAN; MULTICENTER AB Context Plasma concentrations of the vasoconstrictor peptide endothelin-1 are increased in patients with heart failure, and higher concentrations are associated with worse outcomes. Tezosentan is an intravenous short-acting endothelin receptor antagonist that has favorable hemodynamic actions in heart failure. Objective To determine if tezosentan improves outcomes in patients with acute heart failure. Design, Setting, and Participants The Value of Endothelin Receptor Inhibition With Tezosentan in Acute Heart Failure Studies, 2 independent, identical, and concurrent randomized, double-blind, placebo-controlled, parallel-group trials conducted from April 2003 through January 2005 at sites in Australia, Europe, Israel, and North America. Patients admitted within the previous 24 hours with persisting dyspnea and a respiratory rate of 24/min or greater were eligible provided they fulfilled 2 of 4 criteria: (1) elevated plasma concentrations of B-type or N-terminal pro-B-type natriuretic peptide, (2) clinical pulmonary edema, (3) radiologic pulmonary congestion or edema, or (4) left ventricular systolic dysfunction. Intervention Infusion of tezosentan (5 mg/h for 30 minutes, followed by 1 mg/h for 24 to 72 hours [n = 730]) or placebo (n = 718). Main Outcome Measures The coprimary end points were change in dyspnea (measured at 3, 6, and 24 hours using a visual analog scale from 0-100) over 24 hours (as area under the curve) in the individual trials and incidence of death or worsening heart failure at 7 days in both trials combined. Results Of the 1435 patients who received treatment as assigned, 855 (60%) were men; mean age was 70 years. Mean left ventricular ejection fraction (measured in 779 patients [54%]) was 29% (SD, 11%). Baseline dyspnea scores were similar in the 2 treatment groups. Tezosentan did not improve dyspnea more than placebo in either trial, with a mean treatment difference of -12 (95% confidence interval [CI], -105 to 81) mm . h (P = .80) in the first trial and -25 (95% CI, -119 to 69) mm . h (P = .60) in the second. The incidence of death or worsening heart failure at 7 days in the combined trials was 26% in each treatment group (odds ratio, 0.99; 95% confidence interval, 0.82-1.21; P = .95). Conclusion The endothelin receptor antagonist tezosentan did not improve symptoms or clinical outcomes in patients with acute heart failure. C1 Univ Glasgow, Western Infirm, Dept Cardiol, Glasgow G12 8QQ, Lanark, Scotland. San Francisco VA Med Ctr, Cardiol Sect, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Duke Univ, Med Ctr, Dept Med, Div Cardiol, Durham, NC 27710 USA. Duke Clin Res Inst, Durham, NC USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Hull, Castlehill Hosp, Dept Cardiol, Kingston Upon Hull HU6 7RX, N Humberside, England. Hop Ambroise Pare, Dept Cardiol, Boulogne, France. Monash Univ, Cent & Eastern Clin Sch, Dept Med, Melbourne, Vic 3004, Australia. Monash Univ, Cent & Eastern Clin Sch, Dept Epidemiol, Melbourne, Vic 3004, Australia. Monash Univ, Cent & Eastern Clin Sch, Dept Cardiol, Melbourne, Vic 3004, Australia. Univ Brescia, Dept Expt & Appl Med, Sect Cardiovasc Dis, Brescia, Italy. Mt Sinai & Univ Hlth Network Hosp, Toronto, ON, Canada. Baylor Coll Med, Winters Ctr Heart Failure Res, Methodist DeBakey Heart Ctr, Houston, TX 77030 USA. Univ Groningen Hosp, Ctr Thorax, Dept Cardiol, Groningen, Netherlands. Univ Glasgow, Dept Publ Hlth & Hlth Policy, Glasgow, Lanark, Scotland. Actelion Pharmaceut Ltd, Allschwil, Switzerland. RP McMurray, JJV (reprint author), Univ Glasgow, Western Infirm, Dept Cardiol, Glasgow G12 8QQ, Lanark, Scotland. EM j.mcmurray@bio.gla.ac.uk RI Lewsey, James/F-7546-2010; Teerlink, John/D-2986-2012; van Veldhuisen, Dirk Jan/E-8967-2014 OI Cleland, John/0000-0002-1471-7016; Parker, John/0000-0003-1949-2669; Metra, Marco/0000-0001-6691-8568; mcmurray, john/0000-0002-6317-3975 NR 33 TC 191 Z9 195 U1 0 U2 10 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 NOV 7 PY 2007 VL 298 IS 17 BP 2009 EP 2019 DI 10.1001/jama.298.17.2009 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 228GP UT WOS:000250718200021 PM 17986694 ER PT J AU Alley, DE Chang, VW AF Alley, Dawn E. Chang, Virginia W. TI The changing relationship of obesity and disability, 1988-2004 SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID BODY-MASS-INDEX; OLD-AGE DISABILITY; UNITED-STATES; RISK-FACTORS; US ADULTS; TRENDS; PREVALENCE; OVERWEIGHT; MORTALITY; HEALTH AB Context Recent studies suggest that the obese population may have been growing healthier since the 1960s, as indicated by a decrease in mortality and cardiovascular risk factors. However, whether these improvements have conferred decreased risk for disability is unknown. The obese population may be living longer with better-controlled risk factors but paradoxically experiencing more disability. Objective To determine whether the association between obesity and disability has changed over time. Design, Setting, and Participants Adults aged 60 years and older (N = 9928) with measured body mass index from 2 waves of the nationally representative National Health and Nutrition Examination Surveys (NHANES III [1988-1994] and NHANES 19992004). Main Outcome Measures Reports of much difficulty or inability to perform tasks in 2 disability domains: functional limitations (walking one-fourth mile, walking up 10 steps, stooping, lifting 10 lb, walking between rooms, and standing from an armless chair) and activities of daily living (ADL) limitations (transferring, eating, and dressing). Results Among obese individuals, the prevalence of functional impairment increased 5.4% (from 36.8%-42.2%; P = .03) between the 2 surveys, and ADL impairment did not change. At time 1 (1988-1994), the odds of functional impairment for obese individuals were 1.78 times greater than for normal-weight individuals (95% confidence interval [CI], 1.47-2.16). At time 2 (1999-2004), this odds ratio increased to 2.75 (95% CI, 2.39-3.17), because the odds of functional impairment increased by 43% (OR 1.43; 95% CI, 1.18-1.75) among obese individuals during this period, but did not change among nonobese individuals. With respect to ADL impairment, odds for obese individuals were not significantly greater than for individuals with normal weight (OR, 1.31; 95% CI, 0.92-1.88) at time 1, but increased to 2.05 (95% CI, 1.45-2.88) at time 2. This was because the odds of ADL impairment did not change for obese individuals but decreased by 34% among nonobese individuals (OR, 0.66; 95% CI, 0.50-0.88). Conclusions Recent cardiovascular improvements have not been accompanied by reduced disability within the obese older population. Rather, obese participants surveyed during 1999-2004 were more likely to report functional impairments than obese participants surveyed during 1988-1994, and reductions in ADL impairment observed for nonobese older individuals did not occur in those who were obese. Over time, declines in obesity-related mortality, along with a younger age at onset of obesity, could lead to an increased burden of disability within the obese older population. C1 Univ Penn, Robert Wood Johnson Hlth & Soc Scholars Program, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia Vet Affairs Med Ctr, Dept Med,Sch Med, Dept Sociol, Philadelphia, PA 19104 USA. RP Alley, DE (reprint author), Univ Penn, Robert Wood Johnson Hlth & Soc Scholars Program, 3641 Locust Walk,Ste 302, Philadelphia, PA 19104 USA. EM alley@wharton.upenn.edu FU NICHD NIH HHS [K12-HD043459] NR 32 TC 229 Z9 230 U1 3 U2 8 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 NOV 7 PY 2007 VL 298 IS 17 BP 2020 EP 2027 DI 10.1001/jama.298.17.2020 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 228GP UT WOS:000250718200022 PM 17986695 ER PT J AU Qaseem, A Snow, V Shekelle, P Sherif, K Wilt, TJ Weinberger, S Owens, DK AF Qaseem, Amir Snow, Vincenza Shekelle, Paul Sherif, Katherine Wilt, Timothy J. Weinberger, Steven Owens, Douglas K. CA C E A S A C P TI Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline from the American college of physicians SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; INHALED ANTICHOLINERGIC BRONCHODILATOR; LOW LUNG-FUNCTION; FLUTICASONE PROPIONATE; OXYGEN-THERAPY; MEDICAL HISTORY; HEALTH OUTCOMES; BETA-AGONISTS; AIR-FLOW; COPD AB Recommendation 1: In patients with respiratory symptoms, particularly dyspnea, spirometry should be performed to diagnose airflow obstruction. Spirometry should not be used to screen for airflow obstruction in asymptomatic individuals. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 2: Treatment for stable chronic obstructive pulmonary disease (COPD) should be reserved for patients who have respiratory symptoms and FEV1 less than 60% predicted, as documented by spirometry. (Grade: strong recommendation, moderate-quality evidence.) Recommendation 3: Clinicians should prescribe 1 of the following maintenance monotherapies for symptomatic patients with COPD and FEV1 less than 60% predicted: long-acting inhaled beta-agonists, long-acting inhaled anticholinergics, or inhaled corticosteroids. (Grade: strong recommendation, high-quality evidence.) Recommendation 4: Clinicians may consider combination inhaled therapies for symptomatic patients with COPD and FEV1 less than 60% predicted. (Grade: weak recommendation, moderate-quality evidence.) Recommendation 5: Clinicians should prescribe oxygen therapy in patients with COPD and resting hypoxemia (Pao(2) <= 55 mm Hg). (Grade: strong recommendation, moderate-quality evidence.) Recommendation 6: Clinicians should consider prescribing pulmonary rehabilitation in symptomatic individuals with COPD who have an FEV1 less than 50% predicted. (Grade: weak recommendation, moderate-quality evidence.) C1 Amer Coll Physicians, Philadelphia, PA 19106 USA. Drexel Univ, Coll Med, Philadelphia, PA 19104 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Santa Monica, CA USA. RAND, Santa Monica, CA USA. Vet Affairs Palo Alto Hlth Care Syst, Stanford, CA USA. Stanford Univ, Stanford, CA 94305 USA. Minnesota Vet Affairs Med Ctr, Minneapolis, MN USA. RP Qaseem, A (reprint author), Amer Coll Physicians, 190 N Independence Mall W, Philadelphia, PA 19106 USA. EM aqaseem@acponline.org NR 52 TC 115 Z9 120 U1 1 U2 6 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 6 PY 2007 VL 147 IS 9 BP 633 EP 638 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 227QM UT WOS:000250672900006 PM 17975186 ER PT J AU Fried, L AF Fried, Linda TI Elevated creatinine levels and quality of care in heart failure SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Fried, L (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. NR 3 TC 0 Z9 0 U1 0 U2 1 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD NOV 6 PY 2007 VL 147 IS 9 BP 672 EP 672 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 227QM UT WOS:000250672900013 PM 17975193 ER PT J AU Mielke, MM Rosenberg, PB Tschanz, J Cook, L Corcoran, C Hayden, KM Norton, M Rabins, PV Green, RC Welsh-Bohmer, KA Breitner, JCS Munger, R Lyketsos, CG AF Mielke, M. M. Rosenberg, P. B. Tschanz, J. Cook, L. Corcoran, C. Hayden, K. M. Norton, M. Rabins, P. V. Green, R. C. Welsh-Bohmer, K. A. Breitner, J. C. S. Munger, R. Lyketsos, C. G. TI Vascular factors predict rate of progression in Alzheimer disease SO NEUROLOGY LA English DT Article ID E EPSILON-4 ALLELE; CACHE COUNTY; DIABETES-MELLITUS; TOTAL CHOLESTEROL; APOLIPOPROTEIN-E; BLOOD-PRESSURE; RISK-FACTORS; COGNITIVE DECLINE; DEMENTIA; POPULATION AB Background: While there is considerable epidemiologic evidence that cardiovascular risk factors increase risk of incident Alzheimer disease ( AD), few studies have examined their effect on progression after an established AD diagnosis. Objective: To examine the effect of vascular factors, and potential age modification, on rate of progression in a longitudinal study of incident dementia. Methods: A total of 135 individuals with incident AD, identified in a population-based sample of elderly persons in Cache County, UT, were followed with in-home visits for a mean of 3.0 years ( range: 0.8 to 9.5) and 2.1 follow-up visits ( range: 1 to 5). The Clinical Dementia Rating ( CDR) Scale and Mini-Mental State Examination ( MMSE) were administered at each visit. Baseline vascular factors were determined by interview and physical examination. Generalized least-squares random-effects regression was performed with CDR Sum of Boxes ( CDR-Sum) or MMSE as the outcome, and vascular index or individual vascular factors as independent variables. Results: Atrial fibrillation, systolic hypertension, and angina were associated with more rapid decline on both the CDR-Sum and MMSE, while history of coronary artery bypass graft surgery, diabetes, and antihypertensive medications were associated with a slower rate of decline. There was an age interaction such that systolic hypertension, angina, and myocardial infarction were associated with greater decline with increasing baseline age. Conclusion: Atrial fibrillation, hypertension, and angina were associated with a greater rate of decline and may represent modifiable risk factors for secondary prevention in Alzheimer disease. The attenuated decline for diabetes and coronary artery bypass graft surgery may be due to selective survival. Some of these effects appear to vary with age. C1 Johns Hopkins Univ Sch Med, Dept Psychiat, Div Geriatr Psychiat & Behav Sci, Baltimore, MD 21205 USA. Utah State Univ, Logan, UT 84322 USA. Duke Univ, Med Ctr, Durham, NC USA. Boston Univ, Sch Med, Boston, MA 02215 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA USA. RP Mielke, MM (reprint author), Johns Hopkins Univ Sch Med, Dept Psychiat, Div Geriatr Psychiat & Behav Sci, 550 N Broadway,Suite 308, Baltimore, MD 21205 USA. EM mmielke1@jhmi.edu RI Corcoran, Chris/F-2155-2010; Tschanz, JoAnn/E-5986-2010; Hayden, Kathleen/B-6442-2012 OI Hayden, Kathleen/0000-0002-7745-3513 FU NCRR NIH HHS [M01 RR000533]; NIA NIH HHS [R01 AG011380, P01 AG05146, R01 AG11380, R01 AG18712, R01 AG21136] NR 41 TC 173 Z9 178 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD NOV 6 PY 2007 VL 69 IS 19 BP 1850 EP 1858 DI 10.1212/01.wnl.0000279520.59792.fe PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 228CH UT WOS:000250704200008 PM 17984453 ER PT J AU Wang, Y Rosen, H Madtes, DK Shao, B Martin, TR Heinecke, JW Fu, X AF Wang, Yi Rosen, Henry Madtes, David K. Shao, Baohai Martin, Thomas R. Heinecke, Jay W. Fu, Xiaoyun TI Myeloperoxidase inactivates TIMP-1 by oxidizing its N-terminal cysteine residue - An oxidative mechanism for regulating proteolysis during inflammation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID RESPIRATORY-DISTRESS SYNDROME; MATRIX METALLOPROTEINASES; HYPOCHLOROUS ACID; TISSUE INHIBITOR; METHIONINE RESIDUES; HYDROGEN-PEROXIDE; PROTEINS; OXIDANTS; PEPTIDE; SYSTEM AB An imbalance between the proteolytic activity of matrix metalloproteinases (MMPs) and the activity of tissue inhibitors of metalloproteinases (TIMPs) is implicated in tissue injury during inflammation. The N-terminal cysteine of TIMP-1 plays a key role in the inhibitory activity of the protein because it coordinates the essential catalytic Zn2+ of the MMP, preventing the metal ion from functioning. An important mechanism for controlling the interaction of TIMPs with MMPs might involve hypochlorous acid (HOCl), a potent oxidant produced by the myeloperoxidase (MPO) system of phagocytes. Here, we show that HOCl generated by the MPO-H2O2-chloride system inactivates TIMP-1 by oxidizing its N-terminal cysteine. The product is a novel 2-oxo acid. Liquid chromatography-mass spectrometry and tandem mass spectrometry analyses demonstrated that methionine and N-terminal cysteine residues were rapidly oxidized by MPO-derived HOCl but only oxidation of the N-terminal cysteine of TIMP-1 correlated well with loss of inhibitory activity. Importantly, we detected the signature 2-oxo-acid N-terminal peptide in tryptic digests of bronchoalveolar lavage fluid from patients with acute respiratory distress syndrome, demonstrating that TIMP-1 oxidation occurs in vivo. Loss of the N-terminal amino group and disulfide structure are crucial for preventing TIMP-1 from inhibiting MMPs. Our findings suggest that pericellular production of HOCl by phagocytes is a pathogenic mechanism for impairing TIMP-1 activity during inflammation. C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Vet Affairs Puget Sound Hlth Care Syst, Med Res Serv, Seattle, WA 98108 USA. RP Fu, X (reprint author), Univ Washington, Dept Med, Box 356426, Seattle, WA 98195 USA. EM xyfu@u.washington.edu RI Wang, Yi/C-2871-2013 OI Shao, Baohai/0000-0001-8832-2845 FU NHLBI NIH HHS [R01 HL063994, HL063994, HL075381, HL078527, P01 HL030086, P50 HL073996, P50HL073996, R01 HL075381, R01 HL078527]; NIEHS NIH HHS [P30 ES007033, P30ES07033] NR 51 TC 51 Z9 52 U1 2 U2 6 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD NOV 2 PY 2007 VL 282 IS 44 BP 31826 EP 31834 DI 10.1074/jbc.M704894200 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 224WY UT WOS:000250480300002 PM 17726014 ER PT J AU Ismail, H Wotring, M Kimmie, C Palmer, J Brooks-Worrell, B AF Ismail, H. Wotring, M. Kimmie, C. Palmer, J. Brooks-Worrell, B. TI "T cell-positive antibody-negative" phenotypic type 2 patients, a unique subgroup of autoimmune diabetes SO ACTA DIABETOLOGICA LA English DT Meeting Abstract C1 [Ismail, H.; Wotring, M.; Kimmie, C.; Palmer, J.; Brooks-Worrell, B.] Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0940-5429 J9 ACTA DIABETOL JI Acta Diabetol. PD NOV PY 2007 VL 44 SU 1 BP S24 EP S24 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 240WD UT WOS:000251618000077 ER PT J AU Durazzo, TC Rothlind, JC Cardenas, VA Studholme, C Weiner, MW Meyerhoff, DJ AF Durazzo, Timothy C. Rothlind, Johannes C. Cardenas, Valerie A. Studholme, Colin Weiner, Michael W. Meyerhoff, Dieter J. TI Chronic cigarette smoking and heavy drinking in human immunodeficiency virus: consequences for neurocognition and brain morphology SO ALCOHOL LA English DT Review DE HIV; alcohol use disorders; chronic cigarette smoking; neuroimaging; neurocognition ID MAGNETIC-RESONANCE SPECTROSCOPY; HIV-INFECTED PATIENTS; CEREBRAL-BLOOD-FLOW; QUALITY-OF-LIFE; ALCOHOL-USE; COGNITIVE PERFORMANCE; NEUROPSYCHOLOGICAL PERFORMANCE; FEMALE ALCOHOLICS; OXIDATIVE DAMAGE; RISK-FACTORS AB Alcohol use disorders (AUD) and chronic cigarette smoking are common among individuals with human immunodeficiency virus infection (HIV). Concurrent AUD in HIV is related to greater abnormalities in brain morphology and neurocognition than either condition alone. However, the potential influence of chronic smoking on brain morphology and neurocognition in those concurrently afflicted with AUD and HIV has not been examined. The goal of this retrospective analysis was to determine if chronic smoking affected neurocognition and brain morphology in a subsample of HIV-positive non-treatment-seeking heavy drinking participants (HD+) from our earlier work. Regional volumetric and neurocognitive comparisons were made among age-equivalent smoking HD+(n = 17), nonsmoking HD+ (n = 27), and nonsmoking HIV-negative light drinking controls (n = 27) obtained from our original larger sample. Comprehensive neuropsychological assessment evaluated multiple neurocognitive domains of functioning and for potential psychiatric comorbidities. Quantitative volumetric measures of neocortical gray matter (GM), white matter (WM), subcortical structures, and sulcal and ventricular cerebral spinal fluid (CSF) were derived from high-resolution magnetic resonance images. The main findings were (1) smoking HD+ performed significantly worse than nonsmoking HD+ on measures of auditory-verbal (AV) learning, AV memory, and cognitive efficiency; (2) relative to controls, smoking HD+ demonstrated significantly lower neocortical GM volumes in all lobes except the occipital lobe, while nonsmoking HD+ showed only lower frontal GM volume compared with controls; (3) in the HD+ group, regional brain volumes and neurocognition were not influenced by viremia, highly active antiretroviral treatment, or Center for Disease Control symptom status, and no interactions were apparent with these variables or smoking status. Overall, the findings suggested that the direct and/or indirect effects of chronic cigarette smoking created an additional burden on the integrity of brain neurobiology and neurocognition in this cohort of HIV-positive heavy drinkers. (c) 2007 Elsevier Inc. All rights reserved. C1 San Francisco Vet Adm Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. RP Durazzo, TC (reprint author), San Francisco Vet Adm Med Ctr, Ctr Imaging Neurodegenerat Dis, 114 M, 4150 Clement St, San Francisco, CA 94121 USA. EM timothy.durazzo@ucsf.edu FU NIA NIH HHS [P01 AG019724, P01 AG019724-050002]; NIAAA NIH HHS [L30 AA017007-01, L30 AA017007, P01 AA011493, P01 AA11493, R01 AA010788, R01 AA10788]; NIMH NIH HHS [R01 MH065392, R01 MH65392] NR 115 TC 28 Z9 28 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-8329 J9 ALCOHOL JI Alcohol PD NOV PY 2007 VL 41 IS 7 BP 489 EP 501 DI 10.1016/j.alcohol.2007.07.007 PG 13 WC Substance Abuse; Pharmacology & Pharmacy; Toxicology SC Substance Abuse; Pharmacology & Pharmacy; Toxicology GA 232VD UT WOS:000251047300003 PM 17923369 ER PT J AU Wilhelm, CJ Reeves, JM Phillips, TJ Mitchell, SH AF Wilhelm, Clare J. Reeves, Jamie M. Phillips, Tamara J. Mitchell, Suzanne H. TI Mouse lines selected for alcohol consumption differ on certain measures of impulsivity SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE impulsivity; inhibition; delay discounting; Go/No-Go task; selected mouse lines ID ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; BEHAVIORAL DISINHIBITION; FAMILY-HISTORY; MICE; ETHANOL; DRINKING; RECEPTORS; LESIONS; CHOICE; TASK AB Background: Alcoholics and heavy drinkers score higher on measures of impulsivity than nonalcoholics and light drinkers. This may be due to factors that predate drug exposure (e.g. genetics) or to neuroadaptations associated with exposure to alcohol. The aim of this study was to examine the role of genetics by comparing impulsivity in short-term selected lines of mice bred to voluntarily drink either high (STDRHI2) or low (STDRLO2) amounts of 10% ethanol. Methods: Independent sets of mice completed 2 experiments designed to measure impulsivity. Using the adjusting amount procedure, we examined preference for smaller, sooner rewards over larger but delayed rewards (delay discounting). This task determines the amount of immediate sucrose equivalent to the discounted value of a 20 mu l sucrose reward given following a specific delay (0, 2, 4, 8, or 12 seconds). Using a Go/No-go task, we examined the ability of mice to inhibit nose-poking in response to specific cues. These tasks are commonly used to assess different aspects of impulsive behavior, and provide measures that are not highly correlated. Results: No significant differences were found between STDRHI2 and STDRLO2 mice in delay discounting. In the Go/No-go task, STDRHI2 mice made more responses during the pre-cue period without committing more false alarms, compared with STDRLO2 mice. Conclusions: The results suggest that short-term selective breeding for high relative alcohol consumption may also select for animals that have impaired response inhibition. 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, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. RP Wilhelm, CJ (reprint author), Oregon Hlth & Sci Univ, Dept Behav Neurosci, L470,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM wilhelmc@ohsu.edu OI Mitchell, Suzanne/0000-0002-0225-7200 FU NIAAA NIH HHS [AA013518, AA10760, P60 AA010760, AA007468]; NIDA NIH HHS [DA016727] NR 27 TC 34 Z9 34 U1 1 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD NOV PY 2007 VL 31 IS 11 BP 1839 EP 1845 DI 10.1111/j.1530-0277.2007.00508.x PG 7 WC Substance Abuse SC Substance Abuse GA 221TG UT WOS:000250249600009 PM 17850219 ER PT J AU Price, CJ McBride, B Hyerle, L Kivlahan, DR AF Price, Cynthia J. McBride, Brittney Hyerle, Lynne Kivlahan, Daniel R. TI MINDFUL AWARENESS IN BODY-ORIENTED THERAPY FOR FEMALE VETERANS WITH POST-TRAUMATIC STRESS DISORDER TAKING PRESCRIPTION ANALGESICS FOR CHRONIC PAIN: A FEASIBILITY STUDY SO ALTERNATIVE THERAPIES IN HEALTH AND MEDICINE LA English DT Article AB Context Preliminary studies of body therapy for women in trauma recovery suggest positive results but are not specific to women with post-traumatic stress disorder (PTSD) and chronic pain. Objective and Participants To examine the feasibility and acceptability of body-oriented therapy for female veterans with PTSD and chronic pain taking prescription analgesics. Design and Setting: A 2-group, randomized, repeated-measures design was employed. Female veterans (N=14) were recruited from a Veterans Affairs (VA) healthcare system in the Northwest United States (VA Puget Sound Health Care System, Seattle, Washington). Participants were assigned to either treatment as usual (TAU) or treatment as usual and 8 weekly individual body-oriented therapy sessions (mindful awareness in body-oriented therapy group). Measures Written. questionnaires and interviews were used to assess intervention acceptability; reliable and valid measures were administered at 3 time points to evaluate measurement acceptability and performance; and within-treatment process measures and a participant post-intervention questionnaire assessed treatment fidelity. Intervention A body-oriented therapy protocol, "Mindful Awareness in Body-oriented Therapy" (MABT) was used. This is a mind-body approach that incorporates massage, mindfulness, and the emotional processing of psychotherapy. Results Over 10 weeks of recruitment, 31 women expressed interest in study participation. The primary reason for exclusion was the lack of prescription analgesic use for chronic pain. Study participants adhered to study procedures, and 100% attended at least 7 of 8 sessions; all completed in-person post-treatment assessment. Written questionnaires about intervention experience suggest increased tools for pain relief/relaxation, increased body/mind connection, and increased trust/safety. Ten of 14 responded to mailed 3-month follow-up. The response-to-process measures indicated the feasibility of implementing the manualized protocol and point to the need for longer sessions and a longer intervention period with this population. (Altern Ther Health Med. 2007;13(6):32-40.) C1 [Price, Cynthia J.; Kivlahan, Daniel R.] Univ Washington, Seattle, WA 98195 USA. [McBride, Brittney; Hyerle, Lynne] VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Price, CJ (reprint author), Univ Washington, Seattle, WA 98195 USA. FU University of Washington School of Nursing [T32-DAO7257-15]; Mental Illness Research, Education, and Clinical Center at the VA FX This study was a part of the training and education for the primary author, who was supported by a postdoctoral fellowship on NIDA training grant (#T32-DAO7257-15) offered through the University of Washington School of Nursing, for which she would like to acknowledge the support and mentorship of Daniel Kivlahan, PhD, and Kathryn Bradley, MD, in relationship to this study The authors would like to acknowledge the study participants for their willingness to engage in this study and for sharing their thoughts and experiences with the research team, as well as the funding for study participation that was provided by the Mental Illness Research, Education, and Clinical Center at the VA. NR 42 TC 19 Z9 20 U1 3 U2 10 PU INNOVISION COMMUNICATIONS PI ALISO VIEJO PA 101 COLUMBIA, ALISO VIEJO, CA 92656 USA SN 1078-6791 J9 ALTERN THER HEALTH M JI Altern. Ther. Health Med. PD NOV-DEC PY 2007 VL 13 IS 6 BP 32 EP 40 PG 9 WC Integrative & Complementary Medicine SC Integrative & Complementary Medicine GA V12YO UT WOS:000207634700004 PM 17985809 ER PT J AU Michael, P Fihn, SD Wang, L Bryson, CL Lowy, E Maynard, C Magid, DJ Peterson, ED Jesse, RL Rumsfeld, JS AF Michael, P. Fihn, Stephan D. Wang, Li Bryson, Chris L. Lowy, Elliott Maynard, Charles Magid, David J. Peterson, Eric D. Jesse, Robert L. Rumsfeld, John S. TI Clopidogrel and long-term outcomes after stent implantation for acute coronary syndrome SO AMERICAN HEART JOURNAL LA English DT Article ID DRUG-ELUTING STENTS; ACUTE MYOCARDIAL-INFARCTION; UNCOATED STENTS; THROMBOSIS; THERAPY; TRIAL; INTERVENTION; MEDICATION; PREVALENCE; MORTALITY AB Background Little is known about the association between clopidogrel use and long-term outcomes after stent implantation for acute coronary syndromes (ACS) in clinical practice. Methods This retrospective cohort study included patients with ACS receiving drug-eluting stent (DES) or bare-metal stent (BMS) and discharged from all Veterans Health Administration hospitals from 2003 to 2004. Clopidogrel use was assessed by pharmacy dispensing data. Multivariable Cox regression assessed the association between clopidogrel discontinuation and outcomes with clopidogrel use as a time-varying covariate and adjusting for demographics, comorbidities, hospital presentation, and treatment variables. Median follow-up was 538 days. Results Of 1455 patients with ACS, 65.8% received BMS and 34.2% received DES. The median number of days of clopidogrel use was 299. In multivariable analysis, clopidogrel discontinuation was associated with higher all-cause mortality (hazard ratio [HR] 2.40, 95% confidence interval [Cl] 1.61-3.58). The findings were consistent for patients receiving BMS (HR 2.65, 95% Cl 1.59-4.42) or DES (HR 2.00, 95% Cl 1.06-3.75) and for the outcomes of acute myocardial infarction (AMI) and AMI or mortality. When follow-up was divided into 6-month intervals, the association between clopidogrel discontinuation and higher mortality remained consistent up to 18 months after hospital discharge. In secondary analysis of patients who were event-free at 6 months, clopidogrel discontinuation was associated with higher risk for AMI among patients receiving DES (HR 3.57, 95% Cl 1. 13-11.3) compared with BMS (HR 1.26, 95% Cl 0.58-2.74). Conclusion Clopidogrel discontinuation after extended use was still associated with increased mortality risk. Clinical trials are urgently needed to define the optimal duration of clopidogrel therapy after stent implantation for ACS. C1 Denver VA Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Ischem Heart Dis Qual Enhancement Res Initiat, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Kaiser Permanente, Clin Res Unit, Aurora, CO USA. Duke Clin Res Inst, Durham, NC USA. Richmond VA Med Ctr, Richmond, VA USA. RP Michael, P (reprint author), Denver VA Med Ctr, 1055 Clermont St,Cardiol 111B, Denver, CO 80220 USA. EM michael.ho@uchsc.edu RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 34 TC 0 Z9 0 U1 1 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 EI 1097-5330 J9 AM HEART J JI Am. Heart J. PD NOV PY 2007 VL 154 IS 5 BP 846 EP 851 DI 10.1016/j.ahj.2007.08.028 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 234FT UT WOS:000251146800008 ER PT J AU Vinson, DR Magid, DJ Brand, DW Masoudi, FA Ho, PM Lyons, EE Crounse, L van der Vlugt, TM Padgett, TG Tricomi, AJ Go, AS Rumsfeld, JS AF Vinson, David R. Magid, David J. Brand, David W. Masoudi, Frederick A. Ho, P. Michael Lyons, Ella E. Crounse, Laurie van der Vlugt, Theresa M. Padgett, Thomas G. Tricomi, Albert J. Go, Alan S. Rumsfeld, John S. TI Patient sex and quality of ED care for patients with myocardial infarction SO AMERICAN JOURNAL OF EMERGENCY MEDICINE LA English DT Article ID ASSOCIATION TASK-FORCE; GENDER-DIFFERENCES; NATIONAL REGISTRY; AMERICAN-COLLEGE; ELDERLY-PATIENTS; UNSTABLE ANGINA; ST-ELEVATION; OF-CARE; AGE; WOMEN AB Objective: The aim of the study was to assess the quality of care between male and female emergency department (ED) patients with acute myocardial infarction (AMI). Methods: A 2-year retrospective cohort study of 2215 patients with AMI presenting immediately to 5 EDs from July 1, 2000, through June 30, 2002 was conducted. Data on patient characteristics, clinical presentation, and ED processes of care were obtained from chart and electrocardiogram reviews. Multivariable regression models were used to assess the independent association between sex and the ED administration of aspirin, beta-blockers, and reperfusion therapy to eligible patients with AMI. Results: There were 849 women and 1366 men in the study. Female patients were older than male patients (74.3 years for women vs 66.8 years for men, P < .001). Among ideal patients, women were less likely than men to receive aspirin (76.3% of women vs 81.3% of men, P < .01), beta-blockers (51.7% of women vs 61.4% of men, P < .01), and reperfusion therapy (64.0% of women vs 72.8% of men, P < .05). However, after adjustment for age, there was no longer a significant relationship between sex and the use of aspirin (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.95-1.03), beta-blockers (OR, 0.94; 95% CI, 0.82-1.04), or reperfusion therapy (OR, 1.01; 95% CI, 0.89-1.09). In models adjusting for additional demographic, clinical, and hospital characteristics, there remained no association between sex and the processes of care. Conclusion: Women with AMI treated in the ED have a lower likelihood of receiving aspirin, beta-blocker, and reperfusion therapy. However, this association appears to be explained by the age difference between men and women with AMI. Although there are no apparent sex disparities in care, ED AMI management remains suboptimal for both sexes. (C) 2007 Elsevier Inc. All rights reserved. C1 [Vinson, David R.; van der Vlugt, Theresa M.; Padgett, Thomas G.] So Calif Permanente Med Grp, Sacramento, CA USA. [Magid, David J.; Brand, David W.; Lyons, Ella E.; Crounse, Laurie] Kaiser Permanente Clin Res Unit, Denver, CO USA. [Magid, David J.] Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. [Magid, David J.] Univ Colorado, Hlth Sci Ctr, Div Emergency Med, Denver, CO USA. [Masoudi, Frederick A.; Ho, P. Michael; Tricomi, Albert J.; Rumsfeld, John S.] Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. [Go, Alan S.] Kaiser Permanente No Calif, Div Res, Oakland, CA USA. [Ho, P. Michael; Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. [Masoudi, Frederick A.] Denver Hlth Med Ctr, Dept Med, Denver, CO USA. RP Vinson, DR (reprint author), Kaiser Permanente Med Ctr, Dept Emergency Med, 1600 Eureka Rd, Roseville, CA 95661 USA. OI Vinson, David/0000-0001-6559-1858 FU NIA NIH HHS [K08-AG01011] NR 27 TC 3 Z9 3 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 0735-6757 J9 AM J EMERG MED JI Am. J. Emerg. Med. PD NOV PY 2007 VL 25 IS 9 BP 996 EP 1003 DI 10.1016/j.ajem.2007.02.049 PG 8 WC Emergency Medicine SC Emergency Medicine GA 240DS UT WOS:000251568000002 PM 18022492 ER PT J AU Moody-Ayers, S Lindquist, K Sen, S Covinsky, KE AF Moody-Ayers, Sandra Lindquist, Karla Sen, Saunak Covinsky, Kenneth E. TI Childhood social and economic well-being and health in older age SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE activities of daily living; frail elderly; health status; mobility limitation; social class ID SELF-RATED HEALTH; BLACK-WHITE DIFFERENCES; BRITISH WOMENS HEART; SOCIOECONOMIC-STATUS; UNITED-STATES; LIFE-COURSE; ADULT MORTALITY; MEXICAN-AMERICANS; LIVING-CONDITIONS; MENS MORTALITY AB Childhood socioeconomic status (SES) acts over a lifetime to influence adult health outcomes. Whether the impact of childhood SES differs by age or race/ethnicity is unclear. The authors studied 20,566 community-living US adults aged >= 50 years. Parental education was the main predictor. Outcomes evaluated (1998-2002) included self-reported health and functional limitation. The influence of childhood SES on later-life health was also examined in groups stratified by age and race/ethnicity, with adjustment for demographic factors and current SES. Participants' mean age was 67 years; 57% were women. By race/ethnicity, 76% were White, 14% were Black, and 8% were Latino. The relation between low parental education and fair/poor self-rated health declined with advancing age (age 50-64 years: adjusted odds ratio (AOR) = 1.42, 95% confidence interval (Cl): 1.24, 1.63; age >= 80 years: AOR = 1.14, 95% Cl: 0.96, 1.36). The relation between low parental education and fair/poor self-rated health differed across racial/ethnic groups and was significant in White (AOR = 1.33,95%Cl: 1.21,1.47) and Black (AOR = 1.37, 95% Cl: 1.14, 1.64) participants but not Latinos. These findings suggest that childhood SES affects health status through midlife but the effects may abate in late life; its effects also may be weaker in Latinos than in Whites or Blacks. C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Med, Div Geriatr, San Francisco, CA USA. Univ Calif San Francisco, Sch Med, Dept Epidemiol & Biostat, San Francisco, CA USA. RP Moody-Ayers, S (reprint author), San Francisco VA Med Ctr, 4150 Clement St, San Francisco, CA 94121 USA. EM sandra.moody@va.gov; Ken.Covinsky@ucsf.edu FU NIA NIH HHS [1R01AG019827-01, K24 AG029812] NR 53 TC 20 Z9 20 U1 0 U2 6 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD NOV 1 PY 2007 VL 166 IS 9 BP 1059 EP 1067 DI 10.1093/aje/kwm185 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 223VN UT WOS:000250400700010 PM 17720682 ER PT J AU Borrell, LN Jacobs, DR Williams, DR Pletcher, MJ Houston, TK Kiefe, CI AF Borrell, Luisa N. Jacobs, David R., Jr. Williams, David R. Pletcher, Mark J. Houston, Thomas K. Kiefe, Catarina I. TI Self-reported racial discrimination and substance use in the coronary artery risk development in adults study SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE adaptation; psychological; African Americans; alcohol drinking; amphetamines; cannabis; cocaine; prejudice; smoking ID DETROIT METROPOLITAN-AREA; AFRICAN-AMERICAN WOMEN; BLOOD-PRESSURE; SKIN COLOR; PERCEIVED DISCRIMINATION; HEALTH CONSEQUENCES; MENTAL-HEALTH; YOUNG-ADULTS; DRUG-USE; CARDIA AB The authors investigated whether substance use and self-reported racial discrimination were associated in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Smoking status, alcohol consumption, and lifetime use of marijuana, amphetamines, and opiates were ascertained in 2000-2001, 15 years after baseline (1985-1986). Most of the 1,507 African Americans reported having experienced racial discrimination, 79.5% at year 7 and 74.6% at year 15, compared with 29.7% and 23.7% among the 1,813 Whites. Compared with African Americans experiencing no discrimination, African Americans reporting any discrimination had more education and income, while the opposite was true for Whites (all p < 0.001). African Americans experiencing racial discrimination in at least three of seven domains in both years had 1.87 (95% confidence interval (Cl): 1.18, 2.96) and 2.12 (95% Cl: 1.42, 3.17) higher odds of reporting current tobacco use and having any alcohol in the past year than did their counterparts experiencing no discrimination. With control for income and education, African Americans reporting discrimination in three or more domains in both years had 3.31 (95% Cl: 1.90, 5.74) higher odds of using marijuana 100 or more times in their lifetime, relative to African Americans reporting no discrimination. These associations were similarly positive in Whites but not significant. Substance use may be an unhealthy coping response to perceived unfair treatment for some individuals, regardless of their race/ethnicity. C1 Columbia Univ, Mailman Sch Public Hlth, Dept Epidemiol, New York, NY 10027 USA. Univ Minnesota, Sch Publ Hlth, Div Epidemiol, Minneapolis, MN USA. Univ Oslo, Dept Nutr, Oslo, Norway. Harvard Univ, Sch Publ Hlth, Dept African & American Studies Sociol, Boston, MA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA USA. Birmingham Vet Affairs Med Ctr, Deep S ctr Effectiveness, Birmingham, AL USA. Univ Alabama, Div Gen Internal Med, Birmingham, AL USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. RP Borrell, LN (reprint author), Columbia Univ, Mailman Sch Public Hlth, Dept Epidemiol, New York, NY 10027 USA. EM Inb2@columbia.edu RI Houston, Thomas/F-2469-2013 FU NHLBI NIH HHS [N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050, N01-HC-95095]; NIDCR NIH HHS [K22-DE-15317] NR 47 TC 123 Z9 123 U1 4 U2 14 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD NOV 1 PY 2007 VL 166 IS 9 BP 1068 EP 1079 DI 10.1093/aje/kwm180 PG 12 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 223VN UT WOS:000250400700011 PM 17698506 ER PT J AU Mintzer, JE Tune, LE Breder, CD Swanink, R Marcus, RN McQuade, RD Forbes, A AF Mintzer, Jacobo E. Tune, Larry E. Breder, Christopher D. Swanink, Rene Marcus, Ronald N. McQuade, Robert D. Forbes, Andy TI Aripiprazole for the treatment of psychoses in institutionalized patients with Alzheimer dementia: A multicenter, randomized, double-blind, placebo-controlled assessment of three fixed doses SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT 17th Congress of the European-College-of-Neuropsychopharmacology (ECNP) CY OCT 09-13, 2004 CL Stockholm, SWEDEN SP European Coll Neuropsychopharmacol DE psychosis; Alzheimer dementia; atypical; antipsychotic; aripiprazole ID MANSFIELD AGITATION INVENTORY; CEREBROVASCULAR EVENTS; NEUROPSYCHIATRIC INVENTORY; BEHAVIORAL DISTURBANCES; CONTROLLED TRIALS; PARTIAL AGONIST; NURSING-HOME; DISEASE; RISPERIDONE; RISK AB Objective: To assess the efficacy and safety of aripiprazole for psychosis associated with Alzheimer dementia (AD). Methods: In this double-blind, multicenter study, 487 institutionalized patients with psychosis associated with AD were randomized to placebo or aripiprazole, 2, 5 or 10 mg/day. Primary efficacy assessment was the mean change from baseline to week 10 on the Neuropsychiatric Inventory-Nursing Home ( NPI-NH) version Psychosis Subscale score. Secondary measures included NPI-NH Total, Clinical Global Impression-Severity of Illness ( CGI-S), Brief Psychiatric Rating Scale ( BPRS) Core and Total, and the Cohen-Mansfield Agitation Inventory ( CMAI) scores. Results: Aripiprazole 10 mg/day showed significantly greater improvements ( mean change [2 x SD]) than placebo on the NPI-NH Psychosis Subscale (-6.87 [8.6] versus -5.13 [10.0]; F = 6.29, df = 1, 422, p = 0.013 by analysis of covariance [ANCOVA]); CGI-S (-0.72 [1.8] versus -0.46 [1.6]; F = 4.68, df = 1, 419, p = 0.031 [ANCOVA]); BPRS Total (-7.12 [18.4] versus -4.17 [21.6]; F = 4.72, df = 1, 399, p = 0.030 [ANCOVA]); BPRS Core (-3.07 [6.9] versus -1.74 [7.8]; F = 7.30, df = 1, 407, p = 0.007 [ANCOVA]); CMAI (-10.96 [22.6] versus -6.64 [28.6]; F = 5.23, df = 1, 410, p = 0.023 [ANCOVA]), and NPI-NH Psychosis response rate ( 65 versus 50%; chi(2) = 5.52, df = 1, p = 0.019 [CMH]). Aripiprazole 5 mg/day showed significant improvements versus placebo on BPRS and CMAI scores. Aripiprazole 2 mg/day was not efficacious. Cerebrovascular adverse events were reported: aripiprazole 2 mg/day, N = 1; 5 mg/day, N = 2; 10 mg/day, N = 4; placebo, N = 0. No deaths in any group ( aripiprazole 2 mg/day, 3%; 5 mg/day, 2%; 10 mg/day, 7%; placebo, 3%) were considered to be treatment-related. Conclusion: Aripiprazole 10 mg/day was efficacious and safe for psychosis associated with AD, significantly improving psychotic symptoms, agitation, and clinical global impression. However, clinicians should be aware of the safety considerations of atypical antipsychotic uses in this population. C1 Med Univ S Carolina, Alzheimers Res & Clin Programs, N Charleston, SC 29406 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Emory Univ, Dept Psychiat, Atlanta, GA 30322 USA. Bristol Myers Squibb Co, Wallingford, CT 06492 USA. Bristol Myers Squibb Co, Braine Lalleud, Belgium. Otsuka Pharmaceut Dev & Commercializat, Princeton, NJ USA. Bristol Myers Squibb Co, Princeton, NJ USA. RP Mintzer, JE (reprint author), Med Univ S Carolina, Alzheimers Res & Clin Programs, 5900 Core Rd,Suite 203, N Charleston, SC 29406 USA. EM mintzerj@musc.edu NR 39 TC 52 Z9 52 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD NOV PY 2007 VL 15 IS 11 BP 918 EP 931 DI 10.1097/JGP.0b013e3181557b47 PG 14 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 226VY UT WOS:000250617800002 PM 17974864 ER PT J AU Bowles, AO Kevorkian, CG Rintala, DH AF Bowles, Amy O. Kevorkian, C. George Rintala, Diana H. TI Gender differences regarding career issues and promotion in academic physical medicine and rehabilitation SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE gender; tenure; attitude; rehabilitation ID WOMEN PHYSICIANS; FACULTY; RECOGNITION; SUCCESS; FEMALE AB Objective: To assess gender differences in academic progress and attitudes toward promotion in academic physical medicine and rehabilitation (PM&R). Design: A survey was sent to members of the Association of Academic Physiatrists (AAP). Questions addressed demographics, job description, hours worked, childcare responsibilities, publications, career aspirations, mentoring, and familiarity with promotion and tenure policies. Respondents were also asked about the relative importance of career aspects including the perceived benefits of and obstacles to promotion. Responses were anonymous. Results: Women spent less time on scholarly activities. Women considered the fact that they disliked writing and did not know how to do research to be more important obstacles to promotion than did men. Women were more likely to have part-time appointments and lower academic rank. They had fewer children at home but greater responsibility for child care. Women were less likely to aspire to become full professor, they met less often with their department chair/supervisor, and they published fewer papers. Men and women reported equal career satisfaction. Conclusions: There are several gender differences in the values, attitudes, and priorities in academic PM&R. Women respondents were generally less interested in traditional academic pursuits than were their male counterparts. C1 Univ Texas, Hlth Sci Ctr, Dept Rehabil Med, San Antonio, TX 78229 USA. Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Bowles, AO (reprint author), Univ Texas, Hlth Sci Ctr, Dept Rehabil Med, Mail Code 7798,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 20 TC 13 Z9 13 U1 1 U2 6 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 NOV PY 2007 VL 86 IS 11 BP 918 EP 925 DI 10.1097/PHM.0b013e31815205f7 PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 226UQ UT WOS:000250614400008 PM 18049138 ER PT J AU Hull, RL Zraika, S Udayasankar, J Kisilevsky, R Szarek, WA Wight, TN Kahn, SE AF Hull, Rebecca L. Zraika, Sakeneh Udayasankar, Jayalakshmi Kisilevsky, Robert Szarek, Walter A. Wight, Thomas N. Kahn, Steven E. TI Inhibition of glycosaminoglycan synthesis and protein glycosylation with WAS-406 and azaserine result in reduced islet amyloid formation in vitro SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE islet amyloid polypeptide; heparan sulfate; proteoglycan; beta-cell mass; beta-cell dysfunction ID FIBRIL FORMATION; APOLIPOPROTEIN-E; HEPARAN-SULFATE; TRANSGENIC MICE; HEXOSAMINE PATHWAY; ALZHEIMERS-DISEASE; DIABETES-MELLITUS; POLYPEPTIDE; BETA; CELLS AB Deposition of islet amyloid polypeptide ( IAPP) as amyloid in the pancreatic islet occurs in similar to 90% of individuals with Type 2 diabetes and is associated with decreased islet beta-cell mass and function. Human IAPP (hIAPP), but not rodent IAPP, is amyloidogenic and toxic to islet beta-cells. In addition to IAPP, islet amyloid deposits contain other components, including heparan sulfate proteoglycans (HSPGs). The small molecule 2-acetamido-1,3,6-tri-O-acetyl-2,4-dideoxy-alpha-D-xylo-hexopyranose (WAS-406) inhibits HSPG synthesis in hepatocytes and blocks systemic amyloid A deposition in vivo. To determine whether WAS-406 inhibits localized amyloid formation in the islet, we incubated hIAPP transgenic mouse islets for up to 7 days in 16.7 mM glucose ( conditions that result in amyloid deposition) plus increasing concentrations of the inhibitor. WAS-406 at doses of 0, 10, 100, and 1,000 mu M resulted in a dose-dependent decrease in amyloid deposition (% islet area occupied by amyloid: 0.66 +/- 0.14%, 0.10 +/- 0.06%, 0.09 +/- 0.07%, and 0.004 +/- 0.003%, P < 0.001) and an increase in beta-cell area in hIAPP transgenic islets (55.0 +/- 2.6 vs. 60.6 +/- 2.2% islet area for 0 vs. 100 mu M inhibitor, P = 0.05). Glycosaminoglycan, including heparan sulfate, synthesis was inhibited in both hIAPP transgenic and nontransgenic islets ( the latter is a control that does not develop amyloid), while O-linked protein glycosylation was also decreased, and WAS-406 treatment tended to decrease islet viability in nontransgenic islets. Azaserine, an inhibitor of the rate-limiting step of the hexosamine biosynthesis pathway, replicated the effects of WAS-406, resulting in reduction of O-linked protein glycosylation and glycosaminoglycan synthesis and inhibition of islet amyloid formation. In summary, interventions that decrease both glycosaminoglycan synthesis and O-linked protein glycosylation are effective in reducing islet amyloid formation, but their utility as pharmacological agents may be limited due to adverse effects on the islet. C1 Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Queens Univ, Dept Pathol & Mol Med, Kingston, ON, Canada. Queens Univ, Dept Biochem, Kingston, ON K7L 3N6, Canada. Queens Univ, Dept Chem, Kingston, ON K7L 3N6, Canada. Univ Washington, Benaroya Res Inst Virginia Mason, Hope Heart Program, Seattle, WA 98195 USA. RP Hull, RL (reprint author), VA Puget Sound Hlth Care Syst 151, 1660 S Columbian Way, Seattle, WA 98108 USA. EM rhull@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002 FU NCRR NIH HHS [K23 RR016066, RR-16066]; NIDDK NIH HHS [P30 DK017047, DK-74404, K01 DK074404, K01 DK074404-02] NR 38 TC 29 Z9 31 U1 0 U2 3 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 NOV PY 2007 VL 293 IS 5 BP C1586 EP C1593 DI 10.1152/ajpcell.00208.2007 PG 8 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 228EF UT WOS:000250709500018 PM 17804609 ER PT J AU Burns, AR Zheng, Z Soubra, SH Chen, J Rumbaut, RE AF Burns, Alan R. Zheng, Zhilan Soubra, Said H. Chen, Jie Rumbaut, Rolando E. TI Transendothelial flow inhibits neutrophil transmigration through a nitric oxide-dependent mechanism: potential role for cleft shear stress SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE endothelium; neutrophils; hydraulic conductivity; diapedesis; permeability ID SYNTHASE-DEFICIENT MICE; NECROSIS-FACTOR-ALPHA; HYDRAULIC CONDUCTIVITY; ENDOTHELIAL-CELLS; TIGHT JUNCTIONS; INDUCED INCREASE; L-NAME; MIGRATION; MONOLAYERS; ADHESION AB Transendothelial flow inhibits neutrophil transmigration through a nitric oxide-dependent mechanism: potential role for cleft shear stress. Am J Physiol Heart Circ Physiol 293: H2904-H2910, 2007. First published August 24, 2007; doi:10.1152/ajpheart.00871.2007. - Endothelial cells in vivo are well known to respond to parallel shear stress induced by luminal blood flow. In addition, fluid filtration across endothelium (transendothelial flow) may trigger nitric oxide ( NO) production, presumably via shear stress within intercellular clefts. Since NO regulates neutrophil-endothelial interactions, we determined whether transendothelial flow regulates neutrophil transmigration. Interleukin1 beta-treated human umbilical vein endothelial cell ( HUVEC) monolayers cultured on a polycarbonate filter were placed in a custom chamber with or without a modest hydrostatic pressure gradient (Delta P, 10 cmH(2)O) to induce transendothelial flow. In other experiments, cells were studied in a parallel plate flow chamber at various transendothelial flows (Delta P = 0, 5, and 10 cmH(2)O) and luminal flows ( shear stress of 0, 1, and 2 dyn/cm(2)). In the absence of luminal flow, transendothelial flow reduced transmigration of freshly isolated human neutrophils from 57% to 14% ( P < 0.05) and induced an increase in NO detected with a fluorescent assay (DAF-2DA). The NO synthase inhibitor L-NAME prevented the effects of transendothelial flow on neutrophil transmigration, while a NO donor (DETA/NO, 1 mM) inhibited neutrophil transmigration. Finally, in the presence of luminal flow ( 1 and 2 dyn/cm(2)), transendothelial flow also inhibited transmigration. On the basis of HUVEC morphometry and measured transendothelial volume flow, we estimated cleft shear stress to range from 49 to 198 dyn/cm(2). These shear stress estimates, while substantial, are of similar magnitude to those reported by others with similar analyses. These data are consistent with the hypothesis that endothelial cleft shear stress inhibits neutrophil transmigration via a NO-dependent mechanism. C1 Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA. Baylor Coll Med, Dept Anesthesiol, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Rumbaut, RE (reprint author), Baylor Coll Med, Dept Med, CNRC Bldg,Rm 6014,1100 Bates St, Houston, TX 77030 USA. EM rrumbaut@bcm.tmc.edu FU NHLBI NIH HHS [HL-079368, HL-42550, R01 HL079368-01A1, HL-070537, R01 HL079368]; NIAID NIH HHS [AI-46773] NR 31 TC 9 Z9 9 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD NOV PY 2007 VL 293 IS 5 BP H2904 EP H2910 DI 10.1152/ajpheart.00871.2007 PG 7 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 237TU UT WOS:000251400100034 PM 17720767 ER PT J AU Bratti, IM Kane, JM Marder, SR AF Bratti, Irene M. Kane, John M. Marder, Stephen R. TI Chronic restlessness with antipsychotics SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID NEUROLEPTIC-INDUCED AKATHISIA; DRUG-INDUCED AKATHISIA; TARDIVE-DYSKINESIA; CONTROLLED-TRIAL; CONVENTIONAL ANTIPSYCHOTICS; SCHIZOPHRENIC-PATIENTS; LEGS SYNDROME; RATING-SCALE; HALOPERIDOL; CLOZAPINE AB Mr. B is a 34-year-old man with a 13-year history of schizophrenia. His early treatment consisted of brief trials of first-generation antipsychotics, which he refused to take for any significant period of time. He was then started on rispericlone at an average of 5 mg/day. Within a few months, he and his mother noticed that he had upper and lower extremity tremor and profound motor restlessness, especially of the legs. These symptoms worsened until Mr. B was taken off rispericlone and started on olanzapine, after which the tremor resolved, but the restlessness persisted. Mr. B's discomfort was so severe that he was unable to sit through a 15-minute medication management appointment without getting up and pacing the room. His mother noted that the restlessness lasted throughout the day, relenting only when he slept. Mr. B stated that he could not stay still for more than a few minutes at a time and that he had an irresistible urge to move, which led him to pace the house and neighborhood until the soles of his feet were bleeding. Mr. B's mother also reported that when the restlessness was at its worst, he was extremely irritable, easily agitated, and sometimes violent. C1 W Los Angels VA, VAHCS, Los Angeles, CA 90073 USA. San Diego Va Ment Illness Res Educ & Clin Ctr, San Diego, CA USA. Zucker Hillside Hosp, Glen Oaks, NY USA. RP Bratti, IM (reprint author), W Los Angels VA, VAHCS, 11301 Wilshire Blvd, B151-H, Los Angeles, CA 90073 USA. EM ibratti@med-net.ucla.edu NR 58 TC 19 Z9 20 U1 2 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD NOV PY 2007 VL 164 IS 11 BP 1648 EP 1654 DI 10.1176/appi.ajp.2007.07071150 PG 7 WC Psychiatry SC Psychiatry GA 229NP UT WOS:000250811200008 PM 17974927 ER PT J AU Yehuda, R Friedman, M Rosenbaum, TY Labinsky, E Schmeidler, J AF Yehuda, Rachel Friedman, Michelle Rosenbaum, Talli Y. Labinsky, Ellen Schmeidler, James TI History of past sexual abuse in married observant Jewish women SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID MENTAL-HEALTH; PREVALENCE; ASSAULT; PSYCHOPATHOLOGY; VETERANS; RELIGION AB Objective: The authors examined instances of past sexual abuse and related demographic characteristics in the self-reports of a select group of married observant Jewish women. Methods: Orthodox Jewish married women (N = 380) ages 19 to 58 responded to advertisements asking them to complete an anonymous questionnaire about sexual experiences, including sexual abuse. Results: Sexual abuse was reported by 26% of the respondents surveyed, with 16% reporting abuse occurring by the age of 13. More ultra-Orthodox Jews reported abuse than modern-Orthodox Jews. Women who were raised observant reported significantly less childhood sexual abuse than those who became observant later in life. Sexual abuse was associated with increased treatment-seeking for depression, marital counseling, or other emotional or psychological problems. Conclusion: While observant Jewish women live in a culture defined by a high degree of adherence to specific laws of conduct, including rules designed to regulate sexual contact, sexual abuse of various types still exists among them. C1 James J Peters VA Med Ctr, Psychait OOMH, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, Div Traumat Stress Studies, New York, NY USA. RP Yehuda, R (reprint author), James J Peters VA Med Ctr, Psychait OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@.va.gov NR 19 TC 5 Z9 5 U1 0 U2 2 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD NOV PY 2007 VL 164 IS 11 BP 1700 EP 1706 DI 10.1176/appi.ajp.2007.06122030 PG 7 WC Psychiatry SC Psychiatry GA 229NP UT WOS:000250811200016 PM 17974935 ER PT J AU Liu, M Yang, SC Sharma, S Luo, J Cui, XY Peebles, KA Huang, M Sato, M Ramirez, RD Shay, JW Minna, JD Dubinett, SM AF Liu, Ming Yang, Seok-Chul Sharma, Sherven Luo, Jie Cui, Xiaoyan Peebles, Katherine A. Huang, Min Sato, Mitsuo Ramirez, Ruben D. Shay, Jerry W. Minna, John D. Dubinett, Steven M. TI EGFR signaling is required for TGF-beta 1-Mediated COX-2 induction in human bronchial epithelial cells SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article DE cyclooxygenase-2; transforming growth factor-beta 1; epidermal growth factor receptor; lung cancer; Smad3 ID GROWTH-FACTOR RECEPTOR; LUNG-CANCER CELLS; OBSTRUCTIVE PULMONARY-DISEASE; TGF-BETA; CYCLOOXYGENASE-2 EXPRESSION; TRANSFORMING GROWTH-FACTOR-BETA-1; MAP KINASE; INTERFERON-GAMMA; CARCINOMA-CELLS; FACTOR-ALPHA AB Cyclooxygenase-2 (COX-2) is a key enzyme in the production of Prostaglandins and thromboxanes from free arachidonic acid. Increasing evidence suggests that COX-2 plays a role in tumorigenesis. A variety of stimuli induce COX-2 and it is overexpressed in many tumors, including non-small cell lung cancer (NSCLC). We studied the regulation of COX-2 expression in immortalized human bronchial epithelial cells (HBECs) by transforming growth factor-beta 1 (TGF-beta 1) and epidermal growth factor (EGF) because these two growth factors are present in both the pulmonary milieu of those at risk for lung cancer as well as in the tumor microenvironment. EGF significantly enhanced TGF-beta 1-mediated induction of COX-2 and corresponding prostaglandin E2 (PGE2) production. TGF-beta 1 and EGF induced COX-2 at the transcriptional and post-transcriptional levels. EGF receptor (EGFR) inhibition, neutralizing antibody against amphiregulin, or mitogen-activated protein kinase kinase (MEK) inhibition blocked TGF-beta 1-mediated COX-2 induction. COX-2 induction by TGF-beta 1 depended upon Smad3 signaling and required the activity of EGFR or its downstream mediators. Autocrine amphiregulin signaling maintains EGFR in a constitutively active state in HBECs, allowing for COX-2 induction by TGF-beta 1. Thus, EGFR ligands, which are abundant in the pulmonary microenvironment of those at risk for lung cancer, potentiate and are required for COX-2 induction by TGF-beta 1 in HBEC. These findings emphasize the central role of EGFR signaling in COX-2 induction by TGF-PI and suggest that inhibition of EGFR signaling should be investigated further for lung cancer prevention. C1 Univ Calif Los Angeles, Lung Canc Res Program, David Geffen Sch Med, Jonsson Comprehens Canc Ctr, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Ctr, Los Angeles, CA USA. Univ Texas, SW Med Ctr, Hamon Ctr Therapeut Oncol Res, Dallas, TX USA. Dallas Vet Affairs Med Ctr, Dallas, TX USA. Univ Texas, SW Med Ctr, Dept Cell Biol, Dallas, TX USA. Univ Calif Los Angeles, Dept Pathol & Lab Med, David Geffen Sch Med, Los Angeles, CA USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Lung Canc Res Program, David Geffen Sch Med, Jonsson Comprehens Canc Ctr, 37-131 CHS,10833 Conte Ave,Room 37-131 CHS, Los Angeles, CA 90095 USA. EM sdubinett@mednet.ucla.edu RI Shay, Jerry/F-7878-2011; Sato, MITSUO/I-7280-2014 FU NCI NIH HHS [P50 CA070907, P50 CA70907, P50 CA90388] NR 67 TC 24 Z9 25 U1 0 U2 1 PU AMER THORACIC SOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019-4374 USA SN 1044-1549 J9 AM J RESP CELL MOL JI Am. J. Respir. Cell Mol. Biol. PD NOV PY 2007 VL 37 IS 5 BP 578 EP 588 DI 10.1165/rcmb.2007-0100OC PG 11 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 228OC UT WOS:000250738200010 PM 17600311 ER PT J AU Bilimoria, KY Bentrem, DJ Tomlinson, JS Merkow, RP Stewart, AK Ko, CY Prystowsky, JB Talamonti, MS AF Bilimoria, Karl Y. Bentrem, David J. Tomlinson, James S. Merkow, Ryan P. Stewart, Andrew K. Ko, Clifford Y. Prystowsky, Jay B. Talamonti, Mark S. TI Quality of pancreatic cancer care at Veterans Administration compared with non-Veterans Administration hospitals SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 31st Annual Surgical Symposium of the Association-of-VA-Surgeons CY MAY 10-12, 2007 CL Little Rock, AR SP Assoc VA Surg DE national cancer data base; pancreatectomy; pancreatic neoplasms; surgery; veterans administration; medical center ID LONG-TERM SURVIVAL; SURGICAL QUALITY; OPERATIVE MORTALITY; CONSECUTIVE PANCREATICODUODENECTOMIES; DUCTAL ADENOCARCINOMA; IMPROVEMENT PROGRAM; GENERAL-POPULATION; UNITED-STATES; LAST DECADE; RESECTION AB Background: National efforts are underway to monitor the quality of patient care at Veterans Administration (VA) hospitals. The objective of this study was to examine treatment utilization and outcomes for localized pancreatic cancer at VA compared with non-VA hospitals. Methods: Using the National Cancer Data Base, patients with pretreatment clinical stage I/II pancreatic adenocarcinorna were identified. Treatment utilization and outcomes were assessed at VA compared with academic and community hospitals. Results: Of 35,009 patients, 2% were seen at VA, 38% at academic, and 54% at community hospitals. VA hospitals were more likely to use surgery (odds ratio 2.20, 95% confidence interval 1.73-2.79) and to administer adjuvant chemotherapy (odds ratio 1.77, confidence interval 1.28-2.46) compared with community hospitals. Adjusted perioperative mortality and 3-year survival rates after surgery were similar at VA and academic hospitals. Conclusions: For localized pancreatic cancer, patients treated at VA hospitals receive stage-specific treatments and have risk-adjusted perioperative and long-term survival rates that are comparable with those for patients treated at academic centers. (C) 2007 Excerpta Medica Inc. All rights reserved. C1 Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. Amer Coll Surg, Dept Surg, Chicago, IL 60611 USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. RP Talamonti, MS (reprint author), Northwestern Univ, Feinberg Sch Med, Dept Surg, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. EM mtalamonti@nmff.org NR 49 TC 14 Z9 14 U1 0 U2 2 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2007 VL 194 IS 5 BP 588 EP 593 DI 10.1016/j.amjsurg.2007.07.012 PG 6 WC Surgery SC Surgery GA 223GW UT WOS:000250358900003 PM 17936418 ER PT J AU Chu, D Bakaeen, FG Shenaq, SA Ribati, M Atluri, PV Holmes, SA Berger, DH Huh, J AF Chu, Danny Bakaeen, Faisal G. Shenaq, Salwa A. Ribati, Miran Atluri, Prasad V. Holmes, Sally A. Berger, David H. Huh, Joseph TI Open-heart operations in patients with a spinal cord injury SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 31st Annual Surgical Symposium of the Association-of-VA-Surgeons CY MAY 10-12, 2007 CL Little Rock, AR SP Assoc VA Surg DE cardiac; surgery; spinal cord injury; outcomes ID CORONARY-ARTERY-DISEASE; CARDIAC ISCHEMIA; RISK-FACTORS; PARAPLEGIA AB Background: The objective of our study was to evaluate the outcomes of open-heart surgery in patients with a spinal cord injury. Methods: A retrospective analysis of all patients (n = 8) with a spinal cord injury who underwent open-heart operations in a single institution from April 1994 to November 2006 was conducted. Results: All patients had a permanent spinal cord injury with levels ranging from T3 to L2 with a mean age of 62 years (range, 47-72). Seven coronary artery bypass operations and 2 aortic valve replacements were performed. The mean cardiac ejection fraction was 44% (range, 20-60). Seventy-five percent of the patients were extubated within 24 hours of the operation. A decubitus ulcer occurred in only I patient. The acute hospital stay averaged 14 days (range, 6-36). One patient died from multiorgan failure on postoperative day 13 giving an in-hospital 30-day mortality of 12.5%. The 5-year survival was 75% with a mean follow-up of 67 months (range,.5-129). Conclusions: Open-heart operations in patients with a spinal cord injury can be performed safely with acceptable early and late outcomes. (C) 2007 Excerpta Medica Inc. All rights reserved. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Div Cardiothorac Surg, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Anesthesiol, Houston, TX 77030 USA. RP Bakaeen, FG (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Div Cardiothorac Surg, 2002 Holcombe Blvd,OCL 112, Houston, TX 77030 USA. EM dchumd@gmail.com NR 17 TC 3 Z9 4 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 0002-9610 J9 AM J SURG JI Am. J. Surg. PD NOV PY 2007 VL 194 IS 5 BP 663 EP 667 DI 10.1016/j.amjsurg.2007.07.015 PG 5 WC Surgery SC Surgery GA 223GW UT WOS:000250358900016 PM 17936431 ER PT J AU Anstead, GM Zhang, Q Melby, PC AF Anstead, Gregory M. Zhang, Qiong Melby, Peter C. TI Adiponectin and leptin - Yin and Yang mediators of the macrophage inflammatory response, dependent on host nutritional status SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Meeting Abstract CT 56th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY NOV 04-08, 2007 CL Philadelphia, PA SP Amer Soc Trop Med & Hyg C1 S Texas Vet Healthcare Syst, San Antonio, TX USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD NOV PY 2007 VL 77 IS 5 SU S MA 739 BP 212 EP 212 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 228UN UT WOS:000250758201200 ER PT J AU Kelly, JX Smilkstein, M Winter, R Doclean, R Ager, A Hinrichs, D Riscoe, M AF Kelly, Jane X. Smilkstein, Martin Winter, Rolf Doclean, Rosie Ager, Arba Hinrichs, Dave Riscoe, Mike TI New insight on orally-active acridone antimalarials: Structural and functional diversity SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Meeting Abstract CT 56th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY NOV 04-08, 2007 CL Philadelphia, PA SP Amer Soc Trop Med & Hyg C1 [Kelly, Jane X.; Smilkstein, Martin; Winter, Rolf; Doclean, Rosie; Hinrichs, Dave; Riscoe, Mike] Portland VA Med Ctr, Portland, OR USA. [Ager, Arba] Univ Miami, Miami, FL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD NOV PY 2007 VL 77 IS 5 SU S MA 823 BP 236 EP 236 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 228UN UT WOS:000250758201281 ER PT J AU Pines, JM Locallo, AR Hollander, JE Baxt, WG Lee, H Phillips, C Metlay, JP AF Pines, Jesse M. Locallo, A. Russell Hollander, Judd E. Baxt, William G. Lee, Hol Phillips, Carolyn Metlay, Joshua P. TI The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID LENGTH-OF-STAY; MYOCARDIAL-INFARCTION; AMBULANCE DIVERSION; CARE; QUALITY; ACCESS; PERFORMANCE; CAPACITY; MEDICINE; OUTCOMES AB Study objective: We seek to determine the impact of emergency department (ED) crowding on delays in antibiotic administration for patients with community-acquired pneumonia. Methods: We performed a retrospective cohort study of adult patients admitted with community-acquired pneumonia from January 1, 2003, to April 31, 2005, at a single, urban academic ED. The main outcome was a delay (> 4 hours from arrival) or nonreceipt of antibiotics in the ED. Eight ED crowding measures were assigned at triage. Multivariable regression and bootstrapping were used to test the adjusted impact of ED crowding measures of delayed (or no) antibiotics. Predicted probabilities were then calculated to assess the magnitude of the impact of ED crowding on the probability of delayed (or no) antibiotics. Results: In 694 patients, 44% (95% confidence interval [CI] 40% to 48%) received antibiotics within 4 hours and 92% (95% CI 90% to 94%) received antibiotics in the ED. Increasing levels of ED crowding were associated with delayed (or no) antibiotics, including waiting room number (odds ratio [OR] 1.05 for each additional waiting room patient [95% CI 1.01 to 1.10]) and recent ED length of stay for admitted patients (OR 1.14 for each additional hour [95% CI 1.04 to 1.25]). When the waiting room and recent length of stay were both at the lowest quartiles (ie, not crowded), the predicted probability of delayed (or no) antibiotics within 4 hours was 31% (95% CI 21% to 42%); when both were at the highest quartiles, the predicted probability was 72% (95% CI 61% to 81%). Conclusion: ED crowding is associated with delayed and nonreceipt of antibiotics in the ED for patients admitted with community-acquired pneumonia. C1 Univ Penn, Sch Med, Dept Emergency Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Dept 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 Pines, JM (reprint author), 3400 Spruce St,Ground Ravdin, Philadelphia, PA 19104 USA. EM pinesjes@uphs.upenn.edu OI Hollander, Judd/0000-0002-1318-2785 NR 34 TC 140 Z9 142 U1 0 U2 7 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 NOV PY 2007 VL 50 IS 5 BP 510 EP 516 DI 10.1016/j.annemergmed.2007.07.021 PG 7 WC Emergency Medicine SC Emergency Medicine GA 227OV UT WOS:000250668400005 PM 17913298 ER PT J AU Greenwood, TA Braff, DL Light, GA Cadenhead, KS Calkins, ME Dobie, DJ Freedman, R Green, MF Gur, RE Gur, RC Mintz, J Nuechterlein, KH Olincy, A Radant, AD Seidman, LJ Siever, LJ Silverman, JM Stone, WS Swerdlow, NR Tsuang, DW Tsuang, MT Turetsky, BI Schork, NJ AF Greenwood, Tiffany A. Braff, David L. Light, Gregory A. Cadenhead, Kristin S. Calkins, Monica E. Dobie, Dorcas J. Freedman, Robert Green, Michael F. Gur, Raquel E. Gur, Ruben C. Mintz, Jim Nuechterlein, Keith H. Olincy, Ann Radant, Allen D. Seidman, Larry J. Siever, Larry J. Silverman, Jeremy M. Stone, William S. Swerdlow, Neal R. Tsuang, Debby W. Tsuang, Ming T. Turetsky, Bruce I. Schork, Nicholas J. TI Initial heritability analyses of endophenotypic measures for schizophrenia - The consortium on the genetics of schizophrenia SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID VARIANCE-COMPONENTS MODELS; AUDITORY-EVOKED-RESPONSES; QUANTITATIVE-TRAIT LOCI; WORKING-MEMORY; ANTISACCADE PERFORMANCE; BIOLOGICAL RELATIVES; SUSTAINED ATTENTION; PREPULSE INHIBITION; P50 SUPPRESSION; NEUROCOGNITIVE ENDOPHENOTYPES AB Context: Exploration of the genetic architecture of specific endophenotypes may be a powerful strategy for understanding the genetic basis of schizophrenia. Objective: To characterize the genetic architecture of some key endophenotypic measures selected for their reported heritabilities in schizophrenia. Design: Family-based heritability study. Setting: Seven sites across the United States. Participants: At the time of these initial data analyses, the members of 183 nuclear families ascertained through probands with schizophrenia had been assessed for these endophenotypes. Main Outcome Measures: Variance component models were used to assess the heritability of and the environmental and genetic correlations among the endophenotypes. The Consortium on the Genetics of Schizophrenia assesses the neurophysiologic measures of prepulse inhibition of acoustic startle, P50 event-related potential suppression, and the antisaccade task for eye movements and the neurocognitive measures of the Continuous Performance Test (Degraded Stimulus version), the California Verbal Learning Test, the Letter-Number Sequencing test, and 6 measures from the University of Pennsylvania Computerized Neurocognitive Battery. The heritabilities of these 12 measures are the focus of this article. Results: All of the endophenotypes and the University of Pennsylvania Computerized Neurocognitive Battery measures were found to be significantly heritable (P <=. 005), with heritabilities ranging from 24% to 55%. Significant environmental and genetic correlations were also observed between many of the endophenotypic measures. Conclusion: This is the first large-scale, multisite, family-based heritability study of a collection of endophenotypes for schizophrenia and suggests that endophenotypes are important measures to consider in characterizing the genetic basis of schizophrenia. C1 Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. Univ Calif San Diego, Ctr Human Genet & Genom, La Jolla, CA 92093 USA. Univ Calif San Diego, Dept Biostat, La Jolla, CA 92093 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Neuropsychiat Inst Biostat Core, Los Angeles, CA 90024 USA. Beth Israel Deaconess Med Ctr, Publ Psychiat Div, Massachusetts Mental Hlth Ctr, Boston, MA 02215 USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. Harvard Inst Psychiat Epidemiol & Genet, Boston, MA USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. James J Peters VA Med Ctr, New York, NY USA. Educ Clin Ctr, Vet Integrated Serv Network Mental Illness Res 3, New York, NY USA. RP Schork, NJ (reprint author), Scripps Hlth & Scripps Res Inst, 10550 N Torrey Pines Rd, La Jolla, CA 92037 USA. EM nschork@scripps.edu RI Greenwood, Tiffany/F-6356-2012; Tsuang, Debby/L-7234-2016; Mintz, Jim/N-7385-2014 OI Greenwood, Tiffany/0000-0002-6080-6503; Tsuang, Debby/0000-0002-4716-1894; Mintz, Jim/0000-0002-8299-5851 FU NIMH NIH HHS [R01 MH65578, R01 MH42228, R01 MH65554, R01 MH65558, R01 MH65562, R01 MH65571, R01 MH65588, R01 MH65707] NR 83 TC 230 Z9 237 U1 2 U2 12 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD NOV PY 2007 VL 64 IS 11 BP 1242 EP 1250 DI 10.1001/archpsyc.64.11.1242 PG 9 WC Psychiatry SC Psychiatry GA 228BK UT WOS:000250701700003 PM 17984393 ER PT J AU Chao, LL Schuff, N Clevenger, EM Mueller, SG Rosen, HJ Gorno-Tempini, ML Kramer, JH Miller, BL Weiner, MW AF Chao, Linda L. Schuff, Norbert Clevenger, Erin M. Mueller, Susanne G. Rosen, Howard J. Gorno-Tempini, Maria L. Kramer, Joel H. Miller, Bruce L. Weiner, Michael W. TI Patterns of white matter atrophy in frontotemporal lobar degeneration SO ARCHIVES OF NEUROLOGY LA English DT Article ID RHESUS-MONKEY; SEMANTIC DEMENTIA; ALZHEIMERS-DISEASE; BRAIN ATROPHY; MR-IMAGES; CORTICAL AFFERENTS; CORTEX; SEGMENTATION; CONNECTIONS; MORPHOMETRY AB Background: Structural magnetic resonance imaging (MRI) has been used to investigate the in vivo pathology of frontotemporal lobar degeneration. However, few neuroimaging studies have focused on white matter(WM) alterations in this disease. Objectives: To use volumetric MRI techniques to identify the patterns of WM atrophy in vivo in 2 clinical variants of frontotemporal lobar degeneration - frontotemporal dementia (FTD) and semantic dementia - and to compare the patterns of WM atrophy with those of gray matter ( GM) atrophy in these diseases. Design: Structural MRIs were obtained from patients with FTD (n = 12) and semantic dementia (n = 13) and in cognitively healthy age-matched controls (n= 24). Regional GM and WM were classified automatically from high-resolution T1-, T2-, and proton density-weighted MRIs with Expectation-Maximization Segmentation and compared between the groups using a multivariate analysis of covariance model that included age and WM lesion volumes as covariates. Results: Patients with FTD had frontal WM atrophy and frontal, parietal, and temporal GM atrophy compared with controls, who had none. Patients with semantic dementia had temporal WM and GM atrophy and patients with FTD had frontal GM atrophy. Adding temporal WM volume to temporal GM volume significantly improved the discrimination between semantic dementia and FTD. Conclusions: These results show that patients with frontotemporal lobar degeneration who are in relatively early stages of the disease (Clinical Dementia Rating score, 1.0-1.2) have WM atrophy that largely parallels the pattern of GM atrophy typically associated with these disorders. C1 Univ Calif San Francisco, Dept Vet Affairs Med Ctr, Dept Radiol, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA USA. RP Chao, LL (reprint author), Univ Calif San Francisco, Dept Vet Affairs Med Ctr, Dept Radiol, 4150 Clement St 114M, San Francisco, CA 94121 USA. EM linda.chao@ucsf.edu RI Gorno-Tempini, Maria Luisa/E-7203-2012 FU NIA NIH HHS [P01 AG019724, P01 AG019724-050002, P01 AG19724] NR 39 TC 17 Z9 18 U1 0 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 NOV PY 2007 VL 64 IS 11 BP 1619 EP 1624 DI 10.1001/archneur.64.11.1619 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 229YZ UT WOS:000250843800008 PM 17998444 ER PT J AU Turner, AP Kivlahan, DR Kazis, LE Haselkorn, JK AF Turner, Aaron P. Kivlahan, Daniel R. Kazis, Lewis E. Haselkorn, Jodie K. TI Smoking among veterans with multiple sclerosis: Prevalence correlates, quit attempts, and unmet need for services SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT Consortium of Multiple Sclerosis 2006 CY JUN 01-03, 2006 CL Scottsdale, AZ DE mental health; multiple sclerosis; pain; rehabilitation; smoking; smoking cessation ID CIGARETTE-SMOKING; ORAL-CONTRACEPTIVES; BACK-PAIN; CESSATION; DEPRESSION; RISK; ANXIETY; PHYSICIANS; INITIATION; NICOTINE AB Turner AP, Kivlahan DR, Kazis LE, Haselkorn JK. Smoking among veterans with multiple sclerosis: prevalence, correlates, quit attempts, and unmet need for services. Arch Phys Med Rehabil 2007;88:1394-9. Objective: To describe the prevalence and correlates of smoking as well as quit attempts and unmet need for smoking cessation services in a national sample of veterans with multiple sclerosis (MS). Design: Cross-sectional cohort study linking computerized medical record information to mailed survey data from 1999. Setting: Veterans Health Administration (VHA). Participants: Sixty-four percent (2994/4685) of veterans with MS who received services in VHA and also returned survey questionnaires, as well as a 20% random subsample (n=569) who completed a more extensive assessment of smoking. Interventions: Not applicable. Main Outcome Measures: Items assessing smoking, quit attempts, and unmet need for smoking services. Results: Among all survey respondents with MS, 28.5% (95% confidence interval [CI], 26.9-30.2) endorsed current smoking. Of extended survey respondents, 54.5% (95% CI, 46.6 - 62. 1) reported a quit attempt in the past year, and 59.0% (95% CI, 51.1-66.4) reported not getting needed services for smoking in the past year. In fully adjusted logistic regression, smoking was associated with younger age, lower levels of education, being unmarried, higher levels of physical pain, and poorer mental health. A quit attempt was associated with higher levels of education and greater pain intensity. Conclusions: Smoking among veterans with NIS is common, with rates similar to those for other veterans. There is substantial need for cessation services. Cessation interventions should address correlates of smoking including pain, poorer mental health, and social isolation. C1 VA Puget Sound Hlth Care Syst, Rehabil Care Serv, Seattle, WA 98108 USA. VA MS Ctr Excellence W, Seattle, WA USA. VA Ctr Excellence Substance Abuse Treatment & Edu, Seattle, WA USA. Boston Univ, Dept Publ Hlth, Boston, MA 02215 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. VA ctr Hlth Qual Outcomes & Econ Res, Boston, MA USA. RP Turner, AP (reprint author), VA Puget Sound Hlth Care Syst, Rehabil Care Serv, S-117-RCS,1660 S Columbian Way, Seattle, WA 98108 USA. EM Aaron.Turner@va.gov OI Turner, Aaron/0000-0001-6897-8003 NR 61 TC 11 Z9 11 U1 1 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2007 VL 88 IS 11 BP 1394 EP 1399 DI 10.1016/j.apinr.2007.08.003 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 229AT UT WOS:000250774400004 PM 17964878 ER PT J AU Monga, U Garber, SL Thornby, J Vallbona, C Kerrigan, AJ Monga, TN Zimmermann, KP AF Monga, Uma Garber, Susan L. Thornby, John Vallbona, Carlos Kerrigan, Anthony J. Monga, Trilok N. Zimmermann, Kuno P. TI Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE exercise; prostate cancer; quality of life; rehabilitation ID BECK DEPRESSION INVENTORY; BREAST-CANCER; FUNCTIONAL ASSESSMENT; THERAPY; SURVIVORS; OUTCOMES; WOMEN; REHABILITATION; VALIDATION; RADIATION AB Monga U, Garber SL, Thornby J, Vallbona C, Kerrigan AJ, Monga TN, Zimmermann KP. Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Arch Phys Med Rehabil 2007;88: 1416-22. Objective: To show fatigue prevention and quality of life (QOL) improvement from cardiovascular exercise during radiotherapy. Design: Prospective enrollment (n=21), randomized to exercise (n =11) and control groups (n =10), with pre- and post-radiotherapy between- and within-group comparisons. Setting: Academic medical center. Participants: Localized prostate cancer patients undergoing radiotherapy. Interventions: The interventional group received radiotherapy plus aerobic exercise 3 times a week for 8 weeks whereas the control group received radiotherapy without exercise. Main Outcome Measures: Pre- and post-radiotherapy differences in cardiac fitness, fatigue, depression, functional status, physical, social, and functional well-being, leg strength, and flexibility were examined within and between 2 groups. Results: No significant differences existed between 2 groups at pre-radiotherapy assessment. At post-radiotherapy assessment, the exercise group showed significant within group improvements in: cardiac fitness (P<001), fatigue (P=.02), Functional Assessment of Cancer Therapy-Prostate (FACT-P) (P=.04), physical well-being (P=.002), social well-being (P=.02), flexibility (P=.006), and lea strength (P=.000). Within the control group, there was a significant increase in fatigue score (P=.004) and a decline in social well-being (P<05) at post-radiotherapy assessment. Between-group differences at post-radiotherapy assessment were significant in cardiac fitness (P=.006), strength (P=.000), flexibility (P<01), fatigue (P<001), FACT-P (P=.006), physical wellbeing (P<001), social well-being (P=.002), and functional well-being (P=.04). Conclusions: An 8-week cardiovascular exercise program in patients with localized prostate cancer undergoing radiotherapy improved cardiovascular fitness, flexibility, muscle strength., and overall QOL and prevented fatigue. C1 Michael E DeBakey Dept Vet Affairs Med Ctr, Rehabil Care Line 117, Houston, TX 77030 USA. Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Diagnost & Therapeut Care Line, Houston, TX USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Res Care Line, Houston, TX USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Rehabil Care Line, Houston, TX USA. Michael E DeBakey Dept Vet Affairs Med Ctr, Mental Hlth Care Line, Houston, TX USA. RP Zimmermann, KP (reprint author), Michael E DeBakey Dept Vet Affairs Med Ctr, Rehabil Care Line 117, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM zimmermann.kunop@med.va.gov NR 48 TC 71 Z9 72 U1 5 U2 18 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD NOV PY 2007 VL 88 IS 11 BP 1416 EP 1422 DI 10.1016/j.apmr.2007.08.110 PG 7 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 229AT UT WOS:000250774400007 PM 17964881 ER PT J AU Kitagaki, H Cowart, LA Matmati, N de Avalos, SV Novgorodov, SA Zeidan, YH Bielawski, J Obeid, LM Hannun, YA AF Kitagaki, Hiroshi Cowart, L. Ashley Matmati, Nabil de Avalos, Silvia Vaena Novgorodov, Sergei A. Zeidan, Youssef H. Bielawski, Jacek Obeid, Lina M. Hannun, Yusuf A. TI Isc 1 regulates sphingolipid metabolism in yeast mitochondria SO BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES LA English DT Article DE mitochondria; sphingolipid; sphingomyelinase; lipidomics; ISC1; yeast ID PHOSPHOSPHINGOLIPID PHOSPHOLIPASE-C; RAT-LIVER MITOCHONDRIA; SACCHAROMYCES-CEREVISIAE; ANIONIC PHOSPHOLIPIDS; ENDOPLASMIC-RETICULUM; ALKALINE CERAMIDASE; LIPID-COMPOSITION; OUTER-MEMBRANE; CONTACT SITES; CELL-SURFACE AB The Saccharomyces cerevisiae inositol sphingolipid phospholipase C (Ise 1 p), a homolog of mammalian neutral sphingomyelinases, hydrolyzes complex sphingolipids to produce ceramide in vitro. Epitope-tagged Ise I p associates with the mitochondria, in the post-diauxic phase of, east growth. In this report, the mitochondrial localization of Isclp and its role in regulating sphingolipid metabolism were investigated. First, endogenous Iscip activity was enriched in highly purified mitochondria, and western blots using highly purified mitochondrial membrane fractions demonstrated that epitope-tagged Isc 1p localized to the outer mitochondrial membrane as an integral membrane protein. Next, LC/MS was employed to determine the sphingolipid composition of highly purified mitochondria which were found to be significantly enriched in alpha-hydroxylated phytoceramides (21.7 fold) relative to the whole cell. Mitochondria, on the other hand, were significantly depleted in sphingoid bases. Compared to the parental strain, mitochondria from isc1 Delta in the post-diauxic phase showed drastic reduction in the levels of alpha-hydroxylated phytoceramide (93.1% loss; compared to WT mitochondria with only 2.58 fold enrichment in mitochondria compared to whole cell). Functionally, isc1 Delta showed a higher rate of respiratory-deficient cells after incubation at high temperature and was more sensitive to hydrogen peroxide and ethidium bromide, indicating that isc1 Delta exhibits defects related to mitochondrial function. These results suggest that Isc1p generates ceramide in mitochondria, and the generated ceramide contributes to the normal function of mitochondria. This study provides a first insight into the specific composition of ceramides in mitochondria. (c) 2007 Elsevier B.V. All rights reserved. C1 Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. Minist Educ Culture Sports Sci & Technol, Chiyoda Ku, Tokyo, Japan. Natl Res Inst Brewing, Higashihiroshima, Hiroshima, Japan. RP Hannun, YA (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, 173 Ashley Ave, Charleston, SC 29425 USA. EM hannun@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [R01 AG016583]; NIGMS NIH HHS [R01 GM043825, R01 GM43825, R37 GM043825, R37 GM043825-18] NR 62 TC 49 Z9 51 U1 0 U2 5 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0005-2736 J9 BBA-BIOMEMBRANES JI Biochim. Biophys. Acta-Biomembr. PD NOV PY 2007 VL 1768 IS 11 BP 2849 EP 2861 DI 10.1016/j.bbamem.2007.07.019 PG 13 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 239BT UT WOS:000251493700020 PM 17880915 ER PT J AU Miller, YE Blatchford, P Hyun, DS Keith, RL Kennedy, TC Wolf, H Byers, T Bunn, PA Lewis, MT Franklin, WA Hirsch, FR Kittelson, J AF Miller, York E. Blatchford, Patrick Hyun, Dae Sung Keith, Robert L. Kennedy, Timothy C. Wolf, Holly Byers, Tim Bunn, Paul A., Jr. Lewis, Marina T. Franklin, Wilbur A. Hirsch, Fred R. Kittelson, John TI Bronchial epithelial Ki-67 index is related to histology, smoking, and gender, but not lung cancer or chronic obstructive pulmonary disease SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID PRENEOPLASTIC LESIONS; PROMOTER HYPERMETHYLATION; RESPIRATORY EPITHELIUM; SMOKERS; RISK; PROLIFERATION; CHEMOPREVENTION; EXPRESSION; CARCINOMA; COHORT AB Purpose: To determine whether increased bronchial epithelial proliferation is associated with histology, smoking status, gender, age, chronic obstructive pulmonary disease (COPD), or lung cancer. Experimental Design: Cross-sectional study of 113 subjects undergoing white light and autofluorescence bronchoscopy: 27 never smokers; 27 current or ex-smokers with normal spirometry; 31 current or ex-smokers with COPD; and 28 current, ex-, or never smokers with lung cancer. Ki-67 expresssion was determined by immunohistochemistry on all evaluable biopsy sites without carcinoma. Relationships between Ki-67 index (percentage of epithelial cells expressing Ki-67), demographic variables, smoking, histology, and the presence of COPD and/or lung cancer were determined. Results: Results for both maximal and mean Ki-67 index are similar, so only the former are reported. Average maximal Ki-67 index was higher in current smokers than either ex-smokers or never smokers (48.0% versus 30.6% versus 22.6%; P < 0.001). Males had higher Ki-67 index than females (39.9% versus 23.6%; P < 0.001). Compared with subjects without disease (Ki-67 index = 30.0%), maximal Ki-67 index was not significantly elevated (P = 0.44) in subjects with either lung cancer (Ki-67 = 39.1%) or COPD (Ki-67 = 38.9%). Conclusions: Smoking status, bronchial histology, and gender were significantly associated with Ki-67 index. No increase in Ki-67 index was found in the nonmalignant epithelium of patients with lung cancer or COPD. Although Ki-67 index may provide insight into the short-term effects of chemoprevention agents on cell proliferation, its lack of association with lung cancer or COPD raises question regarding its utility as a lung cancer risk biomarker. C1 Univ Colorado, Ctr Comprehens Canc, Univ Colorado Denver & Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80202 USA. Univ Colorado, Ctr Comprehens Canc, Univ Colorado Denver & Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Univ Colorado, Ctr Comprehens Canc, Univ Colorado Denver & Hlth Sci Ctr, Div Med Oncol,Dept Med, Denver, CO 80202 USA. Univ Colorado, Ctr Comprehens Canc, Univ Colorado Denver & Hlth Sci Ctr, Dept Pathol, Denver, CO 80202 USA. Univ Colorado, Univ Colorado Denver & Hlth Sci Ctr, Dept Med,Div Pulm Sci & Crit, Denver Vet Affairs Med Ctr,Comprehens Canc Ctr, Denver, CO 80220 USA. Catholic Univ Daegu, Taegu, South Korea. RP Miller, YE (reprint author), Univ Colorado, Univ Colorado Denver & Hlth Sci Ctr, Dept Med,Div Pulm Sci & Crit, Denver Vet Affairs Med Ctr,Comprehens Canc Ctr, Pulm 111A,1055 Clermont St, Denver, CO 80220 USA. EM york.miller@uchsc.edu FU NCI NIH HHS [P30CA46934, P50CA58187] NR 29 TC 16 Z9 16 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD NOV PY 2007 VL 16 IS 11 BP 2425 EP 2431 DI 10.1158/1055-9965.EPI-07-0220 PG 7 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 233XL UT WOS:000251123500035 PM 18006932 ER PT J AU Alimenoff, P Sales, A Rounds, S Miller, M Schroeder, K Lentz, K Perlin, J AF Alimenoff, Peter Sales, Anne Rounds, Sharon Miller, Michael Schroeder, Kelly Lentz, Karen Perlin, Jonathan TI Intensive care services in the veterans health administration SO CHEST LA English DT Article DE critical care; hospitals; veterans; organization and administration ID UNITED-STATES 1985-2000; PROFESSIONAL SOCIETIES; DESCRIPTIVE ANALYSIS; CRITICALLY ILL; COMPLICATIONS; MEDICINE; CRISIS; RECOMMENDATIONS; POPULATION; GUIDELINES AB Objective: We describe the national organization and distribution of intensive care services within the Veterans Health Administration (VHA), the largest single integrated health-care system in the United States. Data Sources: Data come primarily from the 2004 Survey of Intensive Care Units in VHA, an electronically distributed survey of all ICUs in the VHA. Medical directors and nurse managers from all 213 ICUs in the VHA responded to the survey. In addition, we extracted data on the number of ICU admissions and unique veterans served from national VHA databases. Results: The VHA has a geographically dispersed, multilevel system of care with variation in geographic access for eligible veterans (varying from 3.1 to 3.5 ICU beds per 1,000 patient discharges) and variation in service provision (from 10 to 19 level 1 ICUs across four regions). Level I ICUs are the highest tertiary-level ICUs, with the full range of subspecialty care. The proportion of beds associated with VHA-developed ICU levels of care ranges from 55% level I beds in the Northeast to 73% in the South, while level 4 beds represent 4% of all ICU beds in the South and 10% in the Midwest. Conclusions: Overall, the VHA system has a fair amount of regional variation, but level 1 ICUs are available in all geographic regions, and there are regional clusters of all levels. Adopting a four-level system for rating ICUs may assist in monitoring and assessing the quality of care provided in the smallest, most rural facilities. C1 Univ Alberta, Edmonton, AB T6G 3G2, Canada. VA Heartland Network, Kansas City, MO USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Prov VAMC, Providence, RI USA. VISN 1, Boston, MA USA. St Louis VA Med Ctr, St Louis, MO USA. VA Hlthcare Anal & Informat Grp, Milwaukee, WI USA. Dept Vet Affairs, Washington, DC USA. RP Sales, A (reprint author), Univ Alberta, 3-114 Clin Sci Bldg, Edmonton, AB T6G 3G2, Canada. EM anne.sales@ualberta.ca OI Sales, Anne/0000-0001-9360-3334 NR 35 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD NOV PY 2007 VL 132 IS 5 BP 1455 EP 1462 DI 10.1378/chest.06-3083 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 231TU UT WOS:000250972700010 ER PT J AU Corominas, H Clayburne, G Diaz-Lopez, C Schumacher, HR AF Corominas, H. Clayburne, G. Diaz-Lopez, C. Schumacher, H. R. TI Apatite crystal identification in dried smears and synovial fluid pellets with alizarin red staining SO CLINICAL AND EXPERIMENTAL RHEUMATOLOGY LA English DT Letter ID ARTHRITIS C1 [Corominas, H.] Hosp Dos Maig, Serv Reumatol, Barcelona 30108025, Spain. [Corominas, H.; Clayburne, G.; Schumacher, H. R.] Univ Penn, Sch Med, Philadelphia, PA 19104 USA. [Corominas, H.; Clayburne, G.] Arthritis Immunol Ctr, Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. [Corominas, H.; Diaz-Lopez, C.] Hosp Santa Creu & Sant Pau, Unitat Reumatol, Barcelona, Catalonia, Spain. RP Corominas, H (reprint author), Hosp Dos Maig, Serv Reumatol, Barcelona 30108025, Spain. EM vancor@yahoo.com NR 10 TC 1 Z9 1 U1 0 U2 0 PU CLINICAL & EXPER RHEUMATOLOGY PI PISA PA VIA SANTA MARIA 31, 56126 PISA, ITALY SN 0392-856X J9 CLIN EXP RHEUMATOL JI Clin. Exp. Rheumatol. PD NOV-DEC PY 2007 VL 25 IS 6 BP 935 EP 935 PG 1 WC Rheumatology SC Rheumatology GA 253FF UT WOS:000252503400028 PM 18173938 ER PT J AU Emejuaiwe, N Jones, AC Ibrahim, SA Kwoh, CK AF Emejuaiwe, N. Jones, A. C. Ibrahim, S. A. Kwoh, C. K. TI Disparities in joint replacement utilization: a quality of care issue SO CLINICAL AND EXPERIMENTAL RHEUMATOLOGY LA English DT Article DE quality of care; osteoarthritis; joint replacement; racial disparities ID TOTAL HIP-ARTHROPLASTY; TOTAL KNEE ARTHROPLASTY; SURGEON PROCEDURE VOLUME; UNITED-STATES; ETHNIC-DIFFERENCES; RHEUMATOID-ARTHRITIS; MEDICARE POPULATION; RACIAL DISPARITIES; FUNCTIONAL STATUS; INDICATOR SET AB Although total joint replacement is an effective treatment option for end-stage lower extremity osteoarthritis, racial disparities in joint replacement utilization have been well documented. These disparities may be due in part to patient-level factors such as willingness to consider joint replacement and worse expectations of joint replacement outcomes. In addition, African-Americans may have worse outcomes after total joint replacement and are more likely to have surgery performed by surgeons with lower volumes or in hospitals with lower volumes. All of these issues may be considered concerns with the quality of care delivered to African-Americans with osteoarthritis. C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA 15261 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Kwoh, CK (reprint author), Univ Pittsburgh, Sch Med, BST S702,3500 Terrace St, Pittsburgh, PA 15261 USA. EM kwoh@pitt.edu NR 71 TC 3 Z9 3 U1 2 U2 2 PU CLINICAL & EXPER RHEUMATOLOGY PI PISA PA VIA SANTA MARIA 31, 56126 PISA, ITALY SN 0392-856X J9 CLIN EXP RHEUMATOL JI Clin. Exp. Rheumatol. PD NOV-DEC PY 2007 VL 25 IS 6 SU 47 BP S44 EP S49 PG 6 WC Rheumatology SC Rheumatology GA 235QA UT WOS:000251248200009 ER PT J AU Kramer, JR Giordano, TP El-Serag, HB AF Kramer, Jennifer R. Giordano, Thomas P. EL-Serag, Hashem B. TI Effect of human immunodeficiency virus and antiretrovirals on outcomes of hepatitis C: A systematic review from an epidemiologic perspective SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID LIVER FIBROSIS PROGRESSION; HIV-INFECTED PATIENTS; HIV/HCV-COINFECTED PATIENTS; HEPATOCELLULAR-CARCINOMA; NATURAL-HISTORY; HEMOPHILIC PATIENTS; RISK-FACTORS; DRUG-USERS; DISEASE; IMPACT AB Background & Aims: We systematically reviewed the literature examining the association of human immunodeficiency virus (HIV) and antiretroviral therapy (ART) with liver disease in patients with hepatitis C virus (HCV) infection. Methods: PubMed was searched for studies examining hepatic fibrosis, cirrhosis, decompensated liver disease, hepatocellular carcinoma, and liver-related death. Thirty-nine reports (describing 34 unique studies) met inclusion criteria. Information was abstracted on study design, sampling frame, inclusion/exclusion criteria, sample size, results, and covariates used for adjustment. Because of the heterogeneity among study designs, a meta-analysis was not conducted. Results: Nine of the 12 cross-sectional studies showed a statistically significant association between HIV co-infection and fibrosis or cirrhosis, whereas 7 retrospective cohort studies were inconsistent. Six studies examined decompensated liver disease as the outcome: 5 of these found a significantly increased risk in patients with HIV co-infection. The 7 studies examining liver-related death showed a trend toward an association with HIV co-infection, although only 4 were statistically significant. Four studies examined the effect of HIV on hepatocellular carcinoma, 2 of which found no association. Of 10 studies that investigated the effect of ART on the risk of liver disease, half reported a significant protective association. Conclusions: HIV co-infection is associated with an increased risk of advanced liver disease in hepatitis C virus-infected patients. Data on hepatocellular carcinoma are sparse, but an association is plausible given the increased risk of advanced liver disease. In contrast, data for an effect of ART are plentiful, but findings are inconsistent. More robust studies are needed on this topic. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Dept Med, Gastroenterol Sect, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Infect Dis Sect, Houston, TX 77030 USA. RP Kramer, JR (reprint author), 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM jkramer@bcm.tmc.edu FU NIDDK NIH HHS [K24DK078154-01]; NIMH NIH HHS [K23MH67505] NR 54 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 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD NOV PY 2007 VL 5 IS 11 BP 1321 EP 1328 DI 10.1016/j.cgh.2007.08.006 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 231KF UT WOS:000250944900016 PM 17981246 ER PT J AU McFarland, LV Clarridge, JE Beneda, HW Raugi, GJ AF McFarland, Lynne V. Clarridge, Jill E. Beneda, Henry W. Raugi, Gregory J. TI Fluoroquinolone use and risk factors for Clostridium difficile - Associated disease within a veterans administration health care system SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID DIARRHEA; ANTIBIOTICS; COMMUNITY; OUTBREAK AB Background. Prompted by the changing profile of Clostridium difficile infection and the impact of formulary policies in hospitals, we performed this study when an increase in the incidence of C. difficile - associated disease was noted at our health care center (Veterans Administration Puget Sound Health Care System, Seattle, Washington). Methods. A retrospective, matched case- control study of patients presenting to the Veterans Administration Puget Sound Health Care System, Seattle, Washington during 2004 was performed. Conditional logistic analysis determined risk factors for case patients, defined as individuals with diarrhea and test results ( i. e., culture or toxin assay results) positive for C. difficile, and control subjects, defined as individuals with diarrhea and test results negative for C. difficile. Results. C. difficile - associated disease incidence was 29.2 cases per 10,000 inpatient- days. The increase in the incidence of C. difficile - associated diarrhea that paralleled increased gatifloxacin use was not attributable to use of the antimicrobial but was a reflection of seasonal variation in the rate of C. difficile - associated disease. Multivariate analysis controlling for the time at which the assay was performed, the age of the patient, ward, and source of acquisition ( community- acquired vs. nosocomial disease) found 6 significant risk factors for C. difficile - associated diarrhea: receipt of clindamycin ( adjusted odds ratio [ aOR], 29.9; 95% confidence interval [ CI], 3.58 - 249.4), receipt of penicillin ( aOR, 4.1; 95% CI, 1.2 - 13.9), having a lower intestinal condition ( aOR, 2.8; 95% CI, 1.3-6.1), total number of antibiotics received ( aOR, 1.4; 95% CI, 1.1 - 1.7), number of prior hospital admissions ( aOR, 1.3; 95% CI, 1.1 - 1.6), and number of comorbid conditions ( aOR, 1.3; 95% CI, 1.1 - 1.5). Conclusions. The increase in the number of cases of C. difficile - associated disease was not attributable to a formulary change of fluoroquinolones; instead, the incidence was within expected seasonal variations for C. difficile associated disease. Recognition of community- acquired cases and the use of culture may help to identify additional cases of C. difficile - associated disease. Early diagnosis and treatment of C. difficile cases may shorten the duration of hospital stays and reduce the number of outbreaks and readmissions, mortality, and other consequences of C. difficile infection. C1 VA Puget Sound Hlth Care Syst, Dept Hlth Serv Res & Dev, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Dept Infect Control, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Lab Serv, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Dermatol Sect, Primary & Specialty Serv, Seattle, WA 98101 USA. Univ Washington, Sch Pharm, Dept Med Chem, Seattle, WA 98195 USA. Univ Washington, Dept Lab Med, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Dermatol, Seattle, WA 98195 USA. RP McFarland, LV (reprint author), VA Puget Sound Hlth Care Syst, Dept Hlth Serv Res & Dev, S152,1100 Olive Way 1400, Seattle, WA 98101 USA. EM Lynne.McFarland@va.gov NR 14 TC 69 Z9 73 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD NOV 1 PY 2007 VL 45 IS 9 BP 1141 EP 1151 DI 10.1086/522187 PG 11 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 217BP UT WOS:000249923700004 PM 17918075 ER PT J AU Johansen, KL AF Johansen, Kirsten L. TI Value of quality improvement reporting SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Editorial Material C1 San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Nephrol Sect, 111J,4150 Clement St, San Francisco, CA 94121 USA. EM kirsten.johansen@ucsf.edu NR 9 TC 2 Z9 2 U1 1 U2 1 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-9041 J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD NOV PY 2007 VL 2 IS 6 BP 1104 EP 1105 DI 10.2215/CJN.03800907 PG 2 WC Urology & Nephrology SC Urology & Nephrology GA 225TC UT WOS:000250539400004 PM 17928462 ER PT J AU Hotchkiss, JR Holley, P Crooke, PS AF Hotchkiss, John R. Holley, Paul Crooke, Philip S. TI Analyzing pathogen transmission in the dialysis unit: Time for a (schedule) change? SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID VANCOMYCIN-RESISTANT ENTEROCOCCI; ACUTE RESPIRATORY SYNDROME; STAPHYLOCOCCUS-AUREUS; METHICILLIN-RESISTANT; PANDEMIC INFLUENZA; INANIMATE SURFACES; PREDICTION RULE; HUMAN HANDS; HEMODIALYSIS; SURVIVAL AB Background and objectives: Infectious diseases and antimicrobial-resistant microorganisms are a growing problem for the dialysis population. The frequency of patient visits and intimate, prolonged physical contact with the inanimate environment during dialysis treatments make these facilities potentially efficient venues for nosocomial pathogen transmission. Isolation measures and infection control practices can be inconvenient and consume limited resources. Quantitative tools for analyzing the effects of different containment strategies can help to identify optimal strategies for further study. However, spatial and temporal considerations germane to the dialysis unit greatly complicate analyses relying on conventional mathematical approaches. Design, setting, participants, & measurements: A stochastic, individual-based, Monte Carlo simulation tool that predicts the effects of various infection control strategies on pathogen dissemination through the dialysis unit in the face of diagnostic uncertainty was developed. The model was configured to emulate a medium-sized dialysis unit. The predicted consequences of various policies for scheduling patients who were suspected of being infectious were then explored, using literature-based estimates of pathogen transmissibility, prevalence, and diagnostic uncertainty. Results: Environmental decontamination was predicted to be of paramount importance in limiting pathogen dissemination. Temporal segregation (scheduling patients who were suspected of being infectious to dialysis shifts that are later in the day) was predicted to have the greatest effectiveness in reducing transmission, given adequate environmental decontamination between successive days. Conclusions: Decontamination of the patient's environment (chair) can markedly attenuate pathogen dissemination. Temporal segregation could be a simple, low-cost, system-level intervention with significant potential to reduce nosocomial transmission in the dialysis unit. C1 Univ Pittsburgh, Dept Crit Care Med, Pittsburgh, PA 15261 USA. Vet Affairs Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA USA. Holley Associates, Ashburn, VA USA. Vanderbilt Univ, Dept Math, Nashville, TN USA. RP Hotchkiss, JR (reprint author), Univ Pittsburgh, Dept Crit Care Med, 646 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA. EM HotchkissJR@upmc.edu RI Crooke, Philip/B-5406-2008 OI Crooke, Philip/0000-0003-3872-3290 FU NIAID NIH HHS [1R21AI55818] NR 45 TC 4 Z9 4 U1 0 U2 0 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-9041 J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD NOV PY 2007 VL 2 IS 6 BP 1176 EP 1185 DI 10.2215/CJN.00130107 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 225TC UT WOS:000250539400016 PM 17962421 ER PT J AU Felsenfeld, AJ Rodriguez, M Aguilera-Tejero, E AF Felsenfeld, Arnold J. Rodriguez, Mariano Aguilera-Tejero, Escolastico TI Dynamics of parathyroid hormone secretion in health and secondary hyperparathyroidism SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Review ID CALCIUM-SENSING RECEPTOR; VITAMIN-D DEFICIENCY; SERUM IONIZED CALCIUM; ZEALAND WHITE-RABBIT; BASAL PLASMA CALCIUM; SET-POINT; HEMODIALYSIS-PATIENTS; RENAL-FAILURE; PTH SECRETION; IN-VITRO AB This review examines the dynamics of parathyroid hormone secretion in health and in various causes of secondary hyperparathyroidism. Although most studies of parathyroid hormone and calcium have focused on the modification of parathyroid hormone secretion by serum calcium, the relationship between parathyroid hormone and serum calcium is bifunctional because parathyroid hormone also modifies serum calcium. In normal animals and humans, factors such as phosphorus and vitamin D modify the basal parathyroid hormone level and the maximal parathyroid hormone response to hypocalcemia. Certain medications, such as lithium and estrogen, in normal individuals and sustained changes in the serum calcium concentration in hemodialysis patients change the set point of calcium, which reflects the serum calcium concentration at which parathyroid hormone secretion responds. Hypocalcemia increases the basal/maximal parathyroid hormone ratio, a measure of the relative degree of parathyroid hormone stimulation. The phenomenon of hysteresis, defined as a different parathyroid hormone value for the same serum calcium concentration during the induction of and recovery from hypo- and hypercalcemia, is discussed because it provides important insights into factors that affect parathyroid hormone secretion. In three causes of secondary hyperparathyroidism-chronic kidney disease, vitamin D deficiency, and aging-factors that affect the dynamics of parathyroid hormone secretion are evaluated in detail. During recovery from vitamin D deficiency, the maximal parathyroid hormone remains elevated while the basal parathyroid hormone value rapidly becomes normal because of a shift in the set point of calcium. Much remains to be learned about the dynamics of parathyroid hormone secretion in health and secondary hyperparathyroidism. C1 VA Greater Los Angeles Healthcare, Dept Med, Nephrol Sect 111L, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Hosp Univ Reina Sofia, Dept Nefrol, Cordoba, Spain. Hosp Univ Reina Sofia, Unidad Invest, Cordoba, Spain. Univ Cordoba, Dept Med & Cirugia Anim, Cordoba, Spain. RP Felsenfeld, AJ (reprint author), VA Greater Los Angeles Healthcare, Dept Med, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Arnold.Felsenfeld@med.va.gov RI Rodriguez, teresa/H-5452-2011 NR 146 TC 36 Z9 37 U1 0 U2 7 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-905X J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD NOV PY 2007 VL 2 IS 6 BP 1283 EP 1305 DI 10.2215/CJN.01520407 PG 23 WC Urology & Nephrology SC Urology & Nephrology GA 225TC UT WOS:000250539400032 PM 17942777 ER PT J AU Wagner, AW Zatzick, DF Ghesquiere, A Jurkovich, GJ AF Wagner, Amy W. Zatzick, Douglas F. Ghesquiere, Angela Jurkovich, Gregory J. TI Behavioral activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors SO COGNITIVE AND BEHAVIORAL PRACTICE LA English DT Article ID RANDOMIZED EFFECTIVENESS TRIAL; MUTUAL MAINTENANCE; SYMPTOMS; PAIN; PTSD; COMORBIDITY; ACCIDENT; PROGRESS; THERAPY; VICTIMS AB This paper describes an adaptation of behavioral activation (BA)for the early intervention of posttraumatic stress disorder (PTSD) and depression among physically injured survivors of traumatic injury, and presents pilot data on a small randomized effectiveness trial (N = 8). The application of BA to PTSD is based on the theory that increases in guided activity may break patterns of avoidance that can maintain PTSD. Compared to treatment as usual (TA U), those who received BA showed improvement in PTSD symptom severity from. Pre- to posttreatment, and there was a trend for the BA group to score better than the TAU group on physical functioning. Contrary to expectation, this brief adaptation did not have an impact on depression. Implications of these results for the effective early intervention after trauma are discussed. C1 Univ Washington, Seattle, WA 98195 USA. RP Wagner, AW (reprint author), Portland VA Med Ctr, POB 1035,V3-SATP, Portland, OR 97207 USA. EM amy.wagner@va.gov NR 47 TC 51 Z9 52 U1 3 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1077-7229 J9 COGN BEHAV PRACT JI Cogn. Behav. Pract. PD NOV PY 2007 VL 14 IS 4 BP 341 EP 349 DI 10.1016/j.cbpra.2006.05.002 PG 9 WC Psychology, Clinical SC Psychology GA 322WZ UT WOS:000257407300001 ER PT J AU Xiang, Z Thomas, S Pasinetti, G AF Xiang, Zhongmin Thomas, Sunil Pasinetti, Giulio TI Increased neuronal injury in transgenic mice with neuronal overexpression of human cyclooxygenase-2 is reversed by hypothermia and rofecoxib treatment SO CURRENT NEUROVASCULAR RESEARCH LA English DT Article DE COX-2; ischemia; hypothermia; rofecoxib; stroke ID FOCAL CEREBRAL-ISCHEMIA; NITRIC-OXIDE SYNTHASE; CELL-CYCLE ACTIVITY; MILD HYPOTHERMIA; MESSENGER-RNA; INHIBITOR ROFECOXIB; GLOBAL-ISCHEMIA; BRAIN-INJURY; INFLAMMATORY RESPONSE; ALZHEIMERS-DISEASE AB Cyclooxygenase-2 (COX-2) is up-regulated during ischemia. However, the role of COX-2 in neuronal injury is still unclear. in this study we tested whether neuronal overexpression of human COX-2 in a transgenic mouse model potentiates neuronal injury after global ischemic insult. Further, we tested whether the neuronal injury could be ameliorated by intra-ischemic mild hypothermia (33-34 degrees C) alone or in combination with diet treatment of rofecoxib, a COX-2 specific inhibitor. Global ischemia with intra-ischemic normothermia (36-37 degrees C) resulted in significantly higher neuronal damage in the CA1 region of hippocampus of transgenic mice than in wild type controls, confirming a deleterious role of COX-2 in ischemic neuronal damage. Hypothermia significantly reduced neuronal damage in both transgenic mice and wild type controls to the same extent, suggesting that the aggravating effect of COX-2 could be largely eliminated by hypothermia. When hypothermia was combined with rofecoxib treatment, neuronal damage was further reduced in response to global ischemia. The results suggest that COX-2 inhibition by prophylactic treatment with rofecoxib coupled with hypothermia at the time of acute stroke insult could be an effective therapeutic approach in early stages of stroke treatment in high risk patients. C1 [Xiang, Zhongmin; Thomas, Sunil; Pasinetti, Giulio] Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. [Pasinetti, Giulio] Mt Sinai Sch Med, Dept Neurosci, New York, NY USA. [Thomas, Sunil; Pasinetti, Giulio] James J Peters Vet Aff Med Ctr, Geriat Res & Clin Ctr, Bronx, NY 10468 USA. RP Pasinetti, G (reprint author), Mt Sinai Sch Med, Dept Psychiat, E Bldg Rm 10-70,One Gustav L,Levy Pl, New York, NY 10029 USA. EM giulio.pasinetti@mssm.edu FU NIA NIH HHS [AG13799] NR 46 TC 18 Z9 18 U1 0 U2 1 PU BENTHAM SCIENCE PUBL LTD PI SHARJAH PA EXECUTIVE STE Y26, PO BOX 7917, SAIF ZONE, 1200 BR SHARJAH, U ARAB EMIRATES SN 1567-2026 J9 CURR NEUROVASC RES JI Curr. Neurovasc. Res. PD NOV PY 2007 VL 4 IS 4 BP 274 EP 279 DI 10.2174/156720207782446342 PG 6 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 242OB UT WOS:000251733900007 PM 18045153 ER PT J AU Ham, M Kaunitz, JD AF Ham, Maggie Kaunitz, Jonathan D. TI Gastroduodenal defense SO CURRENT OPINION IN GASTROENTEROLOGY LA English DT Article DE cyclooxygenase; defense; duodenum; esophagus; glucocorticoid; injury ID GASTRIC-MUCOSAL INTEGRITY; INDUCED INTESTINAL DAMAGE; GROWTH-FACTOR-ALPHA; HYDROGEN-SULFIDE; GASTROINTESTINAL INFLAMMATION; SIGNALING PATHWAYS; TREFOIL PEPTIDES; EPITHELIAL-CELLS; COX-2 INHIBITOR; TFF2 EXPRESSION AB Purpose of review The gastroduodenum resists mucosal injury despite continuous exposure to concentrated gastric acid. The mucosal barrier consists of a preepithelial mucus HCO3 layer, intercellular tight junctions connecting the epithelial cells, and submucosal acid sensors, prostaglandins, cytokines, enteric nerves and blood flow. In the past year, study of these defensive mechanisms has revealed new insight into the observed sex differences in ulcer prevalence, the protective role of transforming growth factor, the role of serotonin in regulating HCO3- secretion, the role of mechanisms in ulcer healing, the interaction of trefoil factors with the mucus gel, the interaction of glucocorticoids with cyclooxygenase and the characterization of novel, mucosal sparing antiinflammatory agents. Recent findings Transforming growth factor, melatonin, serotonin, trefoil factors and H2S all enhance mucosal barrier function or accelerate ulcer healing. Newer coxibs may have safety and advantages over existing compounds. Existing nonsteroidal antiinflammatory drugs may be safer than originally thought. Summary The continued elucidation of basic defense mechanisms has led to the development of several new compounds designed to enhance barrier function and repair mechanisms. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. WLAVA Med Ctr, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. Div Digest Dis, Los Angeles, CA USA. Digest Dis Res Ctr, CURE, Los Angeles, CA USA. Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, MD Bldg 114,Suite 217, Los Angeles, CA 90073 USA. EM jake@ucla.edu FU PHS HHS [R01 54221] NR 70 TC 30 Z9 30 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0267-1379 J9 CURR OPIN GASTROEN JI Curr. Opin. Gastroenterol. PD NOV PY 2007 VL 23 IS 6 BP 607 EP 616 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 223IR UT WOS:000250364000004 PM 17906436 ER PT J AU Parchman, ML Pugh, JA Wang, CP Romero, RL AF Parchman, Michael L. Pugh, Jacqueline A. Wang, Chen-Pin Romero, Raquel L. TI Glucose control, self-care behaviors, and the presence of the chronic care model in primary care clinics SO DIABETES CARE LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the North-American-Primary-Care-Research-Group CY OCT 15-18, 2005 CL Quebec City, CANADA SP N Amer Primary Care Res Grp ID IMPROVING PRIMARY-CARE; CHRONIC ILLNESS; DIABETES-MELLITUS; QUALITY IMPROVEMENT; UNITED-STATES; IMPLEMENTATION; COMPLICATIONS; METAANALYSIS; THERAPY; COMPLEX AB OBJECTIVE - The purpose of this study was to examine the relationship between AlC and the extent to which care delivered to patients with type 2 diabetes in primary care clinics is consistent with the chronic care model (CCM), after controlling for self-care behaviors. RESEARCH DESIGN AND METHODS - This was a cross-sectional, observational study of care provided to 618 patients with type 2 diabetes across 20 small, autonomous primary care clinics in South Texas. Subjects completed an exit survey. The medical record was abstracted for AlC values. Clinicians completed the Assessment of Chronic Illness Care (ACIC) survey, a validated measure of the extent to which care delivered is consistent with the CCM. RESULTS - There was a significant relationship between ACIC score and AlC, but this relationship varied according to self-care behavior for exercise and was strongest for those who did not adhere to exercise recommendations: for every 1-point increase in ACIC score, AlC was 0.144% lower (P < 0.001). The relationship between ACIC score and AlC for those who adhered to their diet was similar to that for those who did not, after adjusting for exercise, but the overall level of control was better for those who adhered to their diet. CONCLUSIONS - Characteristics of the primary care clinic where one receives care are an important predictor of glucose control. If resources for implementing the CCM are limited, one might want to focus on clinics with low ACIC scores that serve a population of patients who are sedentary because this population may be likely to realize the most benefit from improved glucose control. C1 S Texas Vet Hlth Care Syst, VERDICT Hlth Serv Res Ctr, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. RP Parchman, ML (reprint author), S Texas Vet Hlth Care Syst 11C6, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM parchman@uthscsa.edu OI Pugh, Jacqueline/0000-0003-4933-141X; Parchman, Michael/0000-0001-7129-2889 FU AHRQ HHS [K08 HS013008-02] NR 39 TC 29 Z9 32 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD NOV PY 2007 VL 30 IS 11 BP 2849 EP 2854 DI 10.2337/dc06-2516 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 228CI UT WOS:000250704300017 PM 17682121 ER PT J AU Hill-Briggs, F Gernmell, L AF Hill-Briggs, Felicia Gernmell, Leigh TI Problem solving in diabetes self-management and control - A systematic review of the literature SO DIABETES EDUCATOR LA English DT Review ID OFFICE-BASED INTERVENTION; DECISION-MAKING; METABOLIC-CONTROL; CONTROLLED-TRIAL; ANCHORED INSTRUCTION; INTENSIVE THERAPY; BEHAVIOR-THERAPY; GLYCEMIC CONTROL; OLDER PATIENTS; ADOLESCENTS AB Purpose The purpose of this systematic review is to assess the published literature on problem solving and its associations with diabetes self-management and control, as the state of evidence exists. Data Sources PubMed, PsychINFO, and ERIC electronic databases were searched for the years 1900 to the present and for English-language articles, and reference lists from included studies were reviewed to capture additional studies. Study Selection Quantitative and qualitative studies that addressed problem solving as a process or strategy for diabetes selfmanagement were included. Fifty-two studies met the criteria for inclusion. Data Extraction Study design, sample characteristics, measures, and results were reviewed. Data Synthesis Thirty-six studies were quantitative; 16 were conceptual or qualitative. Studies were classified as addressing the problem-solving definition/framework, assessment, intervention, or health care professional issues. Conclusions Problem solving is a multidimensional construct encompassing verbal reasoning/rational problem solving, quantitative problem solving, and coping. Aspects of problem solving can be assessed using newly developed diabetesspecific problem-solving measures for children/adolescents and adults. Cross-sectional studies in adults, but not children/adolescents, provide consistent evidence of associations between problem solving and A1C level. Only 25% of problem-solving intervention studies with children/ adolescents and 50% of interventions with adults reported improvement in A1C. Most intervention studies reported an improvement in behaviors, most commonly global adherence in children/adolescents and dietary behavior in adults. Methodological limitations (noninclusion of problem-solving measures, inadequate descriptions of problem-solving interventions, homogenous samples) need to be addressed in future research to clarify the effect of problem solving on diabetes outcomes, identify characteristics of effective interventions, and determine the utility across age and racial/ethnic groups. C1 Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Behav & Soc, Baltimore, MD USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Hill-Briggs, F (reprint author), Div Gen Internal Med, 2024 E Monument St,Suite 2-600, Baltimore, MD 21205 USA. EM fbriggs3@jhmi.edu FU NHLBI NIH HHS [1 K01 HL076644] NR 64 TC 59 Z9 61 U1 2 U2 22 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD NOV-DEC PY 2007 VL 33 IS 6 BP 1032 EP 1050 DI 10.1177/0145721707308412 PG 19 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 238LL UT WOS:000251449000011 PM 18057272 ER PT J AU Leung, FW Chan, CC AF Leung, Felix W. Chan, Chi Chung TI Involvement of alpha(2)-adrenoceptors in the gastric protective effect of nitroglycerin against acidified ethanol-induced mucosal injury SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE nitroglycerin; gastric volume; gastric mucosal injury; acidified ethanol; yohimbine ID INTRAGASTRIC NICOTINE PROTECTION; OXIDE-RELEASING ASPIRIN; NITRIC-OXIDE; RELAXING FACTOR; RAT STOMACH; DAMAGE; CYTOPROTECTION; MECHANISM; PROSTAGLANDIN-E2; GASTROPROTECTION AB Clinical observations reveal that alcohol intake is associated with an increase in upper gastrointestinal hemorrhage requiring hospitalization and that nitroglycerin or long-acting nitrates lower this risk. Nitroglycerin, a gastric vasodilator that can increase gastric fluid volume, protects the rodent stomach against damage, including that caused by 70% ethanol. Blockade of alpha(2)-adrenoceoptors attenuates gastric protection by intragastric nicotine against 40% ethanol. We tested the hypothesis that the protective effect of nitroglycerin is mediated by an increase in gastric fluid volume and alpha(2)-adrenoceoptors. Nitroglycerin, 5 mg/kg, vehicle, or acidified ethanol was administered intragastrically. In study 1 acidified ethanol-induced mucosal injury was measured. In study 2 the effect of increasing gastric volume (1 ml/kg) on mucosal injury was assessed. In study 3 the effect of yohimbine (alpha(2)-adrenoceoptor antagonist), 5 mg/kg subcutaneously, on the nitroglycerein-mediated protective effect was determined. Results showed that nitroglycerin significantly attenuated the number and length of mucosal lesions induced by acidified ethanol. Increase in gastric fluid volume by exogenously administered saline did not alter the protective effect. Yohimbine blocked the nitroglycerin-mediated protection. These experimental data are consistent with the observation that nitrates lower the risk of ethanol-induced gastrointestinal complications. alpha(2)-Adrenoceoptors are responsible in part for the protective effect of nitroglycerin. C1 Sepulveda Ambulatory Care Ctr, Div Gastroenterol, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Res & Med Serv, Los Angeles, CA USA. Merck Frosst Ctr Therapeut Res, Dept Pharmacol, Kirkland, PQ, Canada. RP Leung, FW (reprint author), Sepulveda Ambulatory Care Ctr, Div Gastroenterol, 111G,16111 Plummer St, Sepulveda, CA 91343 USA. EM felix.leung@va.gov NR 33 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD NOV PY 2007 VL 52 IS 11 BP 3070 EP 3074 DI 10.1007/s10620-006-9692-1 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216ZJ UT WOS:000249917400028 PM 17394070 ER PT J AU Tran, T Hampel, H Qureshi, WA Shaib, Y AF Tran, Thomas Hampel, Howard Qureshi, Waqar A. Shaib, Yasser TI Successful endoscopic management of bronchobiliary fistula due to radiofrequency ablation SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE bronchobiliary fistula; radiofrequency ablation; hepatic iminodiacetic acid; endoscopic retrograde cholangiopancreatography; endoscopic sphincterectomy; biliary stent ID THORACOBILIARY FISTULA; CHOLANGIOGRAPHY C1 Michael E DeBakey Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Tran, T (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Gastroenterol Sect, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM tungthomastran@yahoo.com NR 15 TC 5 Z9 6 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD NOV PY 2007 VL 52 IS 11 BP 3178 EP 3180 DI 10.1007/s10620-006-9331-x PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216ZJ UT WOS:000249917400050 PM 17638080 ER PT J AU Wilson, AC Meethal, SV Bowen, RL Atwood, CS AF Wilson, Andrea C. Meethal, Sivan Vadakkadath Bowen, Richard L. Atwood, Craig S. TI Leuprolide acetate: a drug of diverse clinical applications SO EXPERT OPINION ON INVESTIGATIONAL DRUGS LA English DT Review DE Alzheimer's disease; central precocious puberty; contraception; endometriosis; functional bowel disease; GnRH analog; gonadotropin-releasing hormone; gonadotropin-releasing hormone receptor; in vitro fertilization; leuprolide acetate; polycystic ovary syndrome; premenstrual syndrome; prostate cancer; short stature; uterine leiomyomata ID GONADOTROPIN-RELEASING-HORMONE; CENTRAL PRECOCIOUS PUBERTY; ADVANCED PROSTATE-CANCER; POLYCYSTIC-OVARY-SYNDROME; FUNCTIONAL BOWEL-DISEASE; RAT MAMMARY-TUMORS; IN-VITRO FERTILIZATION; LONG-TERM TREATMENT; LUTEINIZING-HORMONE; DEPOT LEUPROLIDE AB Leuprolide acetate is a synthetic nonapeptide that is a potent gonadotropin-releasing hormone receptor (GnRHR) agonist used for diverse clinical applications, including the treatment of prostate cancer, endometriosis, uterine fibroids, central precocious puberty and in vitro fertilization techniques. As its basic mechanism of action, leuprolide acetate suppresses gonadotrope secretion of luteinizing hormone and follicle-stimulating hormone that subsequently suppresses gonadal sex steroid production. In addition, leuprolide acetate is presently being tested for the treatment of Alzheimer's disease, polycystic ovary syndrome, functional bowel disease, short stature, premenstrual syndrome and even as an alternative for contraception. Mounting evidence suggests that GnRH agonist suppression of serum gonadotropins may also be important in many of the clinical applications described above. Moreover, the presence of GnRHR in a multitude of non-reproductive tissues including the recent discovery of GnRHR expression in the hippocampi and cortex of the human brain indicates that GnRH analogs such as leuprolide acetate may also act directly via tissue GnRHRs to modulate (brain) function. Thus, the molecular mechanisms underlying the therapeutic effect of GnRH analogs in the treatment of these diseases may be more complex than originally thought. These observations also suggest that the potential uses of GnRH analogs in the modulation of GnRH signaling and treatment of disease has yet to be fully realized. C1 Univ Wisconsin, William S Middleton Mem Vet Adm Hosp, Educ Clin Ctr, Dept Med Geriatr Res, Madison, WI 53705 USA. RP Atwood, CS (reprint author), Univ Wisconsin, William S Middleton Mem Vet Adm Hosp, Educ Clin Ctr, Dept Med Geriatr Res, 2500 Overlook Terrace, Madison, WI 53705 USA. EM csa@medicine.wisc.edu NR 127 TC 48 Z9 50 U1 1 U2 5 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1354-3784 EI 1744-7658 J9 EXPERT OPIN INV DRUG JI Expert Opin. Investig. Drugs PD NOV PY 2007 VL 16 IS 11 BP 1851 EP 1863 DI 10.1517/13543784.16.11.1851 PG 13 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 233UY UT WOS:000251117000009 PM 17970643 ER PT J AU Lee, JK Edderkaoui, M Truong, P Ohno, I Jang, KT Berti, A Pandol, SJ Gukovskaya, AS AF Lee, Jong Kyun Edderkaoui, Mouad Truong, Patrick Ohno, Izumi Jang, Kee-Taek Berti, Andrea Pandol, Stephen J. Gukovskaya, Anna S. TI NADPH oxidase promotes pancreatic cancer cell survival via inhibiting JAK2 dephosphorylation by tyrosine phosphatases SO GASTROENTEROLOGY LA English DT Article ID EARLY GENE-PRODUCTS; NF-KAPPA-B; REACTIVE OXYGEN; REDOX REGULATION; SIGNAL-TRANSDUCTION; NAD(P)H OXIDASE; P53 STATUS; KINASE; ACTIVATION; APOPTOSIS AB Background & Alms: Growth factors, such as insulin-like growth factor-1 (IGF-I), protect pancreatic cancer (PaCa) cells from death. We recently showed that reactive oxygen species (ROS) produced by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase Nox4 mediate the antiapoptotic effect of growth factors. Here, we examine the mechanisms of the antiapoptotic role of NADPH oxidase. We hypothesized that ROSS produced by NADPH oxidase inhibit key protein tyrosine phosphatases (PTPs) and thus sustain the activation of kinases mediating antiapoptotic pathways in PaCa cells. Methods: Transfections and pharmacologic inhibition were used to assess the effects of NADPH oxidase on Janus kinase 2 (JAK2) kinase, the low molecular weight-protein tyrosine phosphatase (LMW-PTP), and apoptosis. Results: We found that 1 target of ROSS is JAK2, an important antiapoptotic kinase in PaCa cells. Both serum-induced and IGF-I biphasic JAK2 phosphorylation, with a rapid (minutes) and transient first phase, and a slow and sustained (24-72 hours) second phase. Nox4 mediated the sustained phase of JAK2 phosphorylation, which was required for the antiapoptotic effects of IGF-I and serum. Transfection experiments identified the LMW-PTP as a negative regulator of sustained JAK2 phosphorylation. Growth factors inhibited LMW-PTP through its oxidation by NADPH oxidase. LMW-PTP colocalizes with Nox4 both in PaCa cells and in human pancreatic adenocarcinoma. Conclusions: The results suggest a novel signaling pathway, in which NADPH oxidase activation results in inhibition of PTPs, such as LMW-PTP, leading, in turn, to enhanced and sustained phosphorylation of kinases, such as JAK2, and suppression of apoptosis. This pathway mediates the prosurvival effect of ROSs and suggests new targets for pancreatic cancer treatment. C1 Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Sungkyunkwan Univ, Samsung Med Ctr, Seoul, South Korea. Univ Florence, I-50121 Florence, Italy. RP Gukovskaya, AS (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, Bldg 258,Room 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NCI NIH HHS [R01-CA119025-01] NR 43 TC 79 Z9 80 U1 0 U2 2 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD NOV PY 2007 VL 133 IS 5 BP 1637 EP 1648 DI 10.1053/j.gastro.2007.08.022 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 229QV UT WOS:000250820100030 PM 17983808 ER PT J AU Ponder, CA Kliethermes, CL Drew, MR Muller, J Das, K Risbrough, VB Crabbe, JC Gilliam, TC Palmer, AA AF Ponder, C. A. Kliethermes, C. L. Drew, M. R. Muller, J. Das, K. Risbrough, V. B. Crabbe, J. C. Gilliam, T. Conrad Palmer, A. A. TI Selection for contextual fear conditioning affects anxiety-like behaviors and gene expression SO GENES BRAIN AND BEHAVIOR LA English DT Article DE anxiety; behavioral genetics; contextual fear conditioning; correlated traits; emotionality; gene expression; selective breeding ID OPEN-FIELD ACTIVITY; POTENTIATED STARTLE PARADIGM; TRAIT LOCUS ANALYSIS; MATERNAL-BEHAVIOR; FREEZING BEHAVIOR; LABORATORY MICE; ANIMAL-MODELS; RAT; MOUSE; ETHANOL AB Conditioned fear and anxiety-like behaviors have many similarities at the neuroanatomical and pharmacological levels, but their genetic relationship is less well defined. We used short-term selection for contextual fear conditioning (FC) to produce outbred mouse lines with robust genetic differences in FC. The high and low selected lines showed differences in fear learning that were stable across various training parameters and were not secondary to differences in sensitivity to the unconditioned stimulus (foot shock). They also showed a divergence in fear potentiated startle, indicating that differences induced by selection generalized to another measure of fear learning. However, there were no differences in performance in a Pavlovian approach conditioning task or the Morris water maze, indicating no change in general learning ability. The high fear learning line showed greater anxiety-like behavior in the open field and zero maze, confirming a genetic relationship between FC and anxiety-like behavior. Gene expression analysis of the amygdala and hippocampus identified genes that were differentially expressed between the two lines. Quantitative trait locus (QTL) analysis identified several chromosomal regions that may underlie the behavioral response to selection; cis-acting expression QTL were identified in some of these regions, possibly identifying genes that underlie these behavioral QTL. These studies support the validity of a broad genetic construct that includes both learned fear and anxiety and provides a basis for further studies aimed at gene identification. C1 Univ Chicago, Dept Human Genet, Chicago, IL 60637 USA. Columbia Univ, Dept Genet & Dev, New York, NY USA. Univ Calif San Francisco, Ernest Gallo Clin & Res Ctr, Emeryville, CA USA. Columbia Univ, Ctr Neurobiol & Behav, Dept Psychiat, New York, NY 10032 USA. New York State Psychiat Inst & Hosp, Dept Dev Neurosci, New York, NY USA. Columbia Univ, Gertrude H Sergievsky Ctr, New York, NY USA. Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA. Oregon Hlth & Sci Univ, Portland Alcohol Res Ctr, Dept Behav Neurosci, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Univ Chicago, Dept Human Genet, Chicago, IL 60637 USA. Univ Chicago, Dept Human Genet & Psychiat, Chicago, IL 60637 USA. RP Ponder, CA (reprint author), Univ Chicago, Dept Human Genet, 920 E 58th St,CLSC 507D, Chicago, IL 60637 USA. EM aap@uchicago.edu RI Palmer, Abraham/L-2158-2014; Drew, Michael/M-4787-2016 OI Palmer, Abraham/0000-0003-3634-0747; Drew, Michael/0000-0002-3883-1542 FU NIAAA NIH HHS [P60 AA010760, AA10270, AA12714]; NIMH NIH HHS [MH70933] NR 61 TC 58 Z9 64 U1 3 U2 12 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1601-1848 J9 GENES BRAIN BEHAV JI Genes Brain Behav. PD NOV PY 2007 VL 6 IS 8 BP 736 EP 749 DI 10.1111/j.1601-183X.2007.00306.x PG 14 WC Behavioral Sciences; Neurosciences SC Behavioral Sciences; Neurosciences & Neurology GA 225XZ UT WOS:000250552900006 PM 17309658 ER PT J AU Rahman, S Lundkvist, A Xu, C Sumathipala, R Fujisawa, T Wijelath, E Patel, Y Kanaganayagum, G Sobel, M Gerhardt, H AF Rahman, S. Lundkvist, A. Xu, C. Sumathipala, R. Fujisawa, T. Wijelath, E. Patel, Y. Kanaganayagum, G. Sobel, M. Gerhardt, H. TI ADAM 15 is essential for regulated angiogenesis and VEGF signalling to Akt through proteolytic processing of the urokinase-type plasminogen activator receptor (uPAR) SO HEART LA English DT Meeting Abstract CT Spring Meeting of the British-Society-for-Cardiovascular-Research CY MAR 29-30, 2007 CL Univ Reading, Reading, ENGLAND SP British Soc Cardiovasc Res HO Univ Reading C1 Kings Coll London, Sch Med, Div Cardiovasc Med, Lab Thrombos & Vasc Remodel, London, England. Canc Res UK, Lab Vasc Biol, London, England. Univ Washington, Sch Med, Dept Surg, Vet Affairs Puget Sound Hlth Care Syst,Div Vasc S, Seattle, WA 98195 USA. 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 1355-6037 J9 HEART JI Heart PD NOV PY 2007 VL 93 IS 11 MA 003 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 220HP UT WOS:000250148100040 ER PT J AU Lipsky, BA Weigelt, JA Gupta, V Killian, A Peng, MM AF Lipsky, Benjamin A. Weigelt, John A. Gupta, Vikas Killian, Aaron Peng, Michael M. TI Skin, soft tissue, bone, and joint infections in hospitalized patients: Epidemiology and microbiological, clinical, and economic outcomes SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID RESISTANT STAPHYLOCOCCUS-AUREUS; ANTIMICROBIAL SUSCEPTIBILITY PATTERNS; PROGRAM UNITED-STATES; LARGE US DATABASE; METHICILLIN-RESISTANT; FOOT INFECTIONS; MANAGEMENT; SURVEILLANCE; PNEUMONIA; DIAGNOSIS AB BACKGROUND. Infections involving skin, soft tissue, bone, or joint (SSTBJ) are common and often require hospitalization. There are currently few published studies on the epidemiology and clinical and economic outcomes of these infections, whether acquired in the community or healthcare setting, in a large population. OBJECTIVE. To characterize outcomes of culture-proven SSTBJ infection in hospitalized patients, using information from a large database. DESIGN. We identified patients hospitalized in 134 institutions during 2002-2003 for whom specific International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and a culture-positive SSTBJ specimen were recorded. Patients were classified into 4 clinical groups based on the type and clinical severity of infection. Patients in each group were further classified on the basis of whether their infection was community acquired or healthcare associated and whether it was complicated or uncomplicated. RESULTS. We identified 12,506 patients with culture-positive infections and categorized them as having cellulitis (37.3%), osteomyelitis or septic arthritis (22.4%), surgical wound infection (26.1%), device-associated or prosthesis infection (7.2%), or other SSTBJ infection (6.9%). Monomicrobial infection was reported for 59% of patients, 54.6% of whom had Staphylococcus aureus as the etiologic agent. Of all S. aureus isolates recovered, 1,121 (28.0%) of 4,007 were resistant to methicillin. Healthcare-associated infections accounted for 27.2% of cases and were associated with a significantly greater mortality rate, a longer length of stay, and greater hospital charges, compared with community-acquired infections. Patients with a complicated infection (78.4%) had a significantly greater mortality rate, a longer length of stay, and greater hospital charges, compared with patients with an uncomplicated infection. CONCLUSIONS. SSTBJ infections are frequent among hospitalized patients. S. aureus caused infection in more than 50% of the patients studied, and 28.0% of the S. aureus isolates recovered were resistant to methicillin. Healthcare-associated and complicated infections are associated with a significantly higher mortality rate and more prolonged and expensive hospitalizations. These findings could assist in projects to revise current management strategies in order to optimize outcomes while restraining costs. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Med Coll Wisconsin, Milwaukee, WI USA. Cardinal Hlth Clin Res Grp, Marlborough, MA USA. RP Lipsky, BA (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. EM balipsky@u.washington.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 38 TC 72 Z9 75 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD NOV PY 2007 VL 28 IS 11 BP 1290 EP 1298 DI 10.1086/520743 PG 9 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 222OO UT WOS:000250307000012 PM 17926281 ER PT J AU Suppes, T Kelly, DI Keck, PE McElroy, SL Altshuler, LL Mintz, J Frye, MA Nolen, WA Luckenbaugh, DA Post, RM Leverich, GS Kupka, RW Grunze, H AF Suppes, Trisha Kelly, Dorothy I. Keck, Paul E., Jr. McElroy, Susan L. Altshuler, Lori L. Mintz, Jim Frye, Mark A. Nolen, Willem A. Luckenbaugh, David A. Post, Robert M. Leverich, Gabriele S. Kupka, Ralph W. Grunze, Heinz TI Quetiapine for the continuation treatment of bipolar depression: naturalistic prospective case series from the Stanley Bipolar Treatment Network SO INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY LA English DT Article DE bipolar disorder; bipolar depression; cycling; quetiapine ID TREATMENTS CANMAT GUIDELINES; PLACEBO-CONTROLLED TRIAL; I-DISORDER; DOUBLE-BLIND; ADJUNCTIVE QUETIAPINE; CANADIAN NETWORK; MOOD STABILIZER; FOLLOW-UP; OLANZAPINE; MAINTENANCE AB Continuation treatment for bipolar disorder often consists of a mood stabilizer and a second-generation antipsychotic. Quetiapine has been shown to be an effective treatment for acute mania and acute bipolar depression, but there are limited data for its use in continuation treatment. This study examined the effectiveness of open-label adjunctive quetiapine therapy for continuation treatment in patients with bipolar disorder. Prospectively collected life chart data from 63 outpatients with bipolar disorders, most recent episodes depressed, manic, or cycling, who received adjunctive quetiapine therapy as part of standard acute treatment were analyzed. Patients had 4 or more weeks of prequetiapine baseline data and at least 2 weeks of quetiapine treatment with no other medication changes. Patients were grouped by baseline symptoms; depression only, mania only, or both mania and depression (cycling group). Owing to small mania and well groups (n=4), differences between depression and cycling groups were examined and mania and well groups excluded. Fifty-five patients were included in the analyses. The primary outcome measure was change in mood severity from baseline to change in treatment regimen, as measured by the NIMH Life Charting Method. Patients received adjunctive quetiapine for a mean of 122 (SD=149) days. Both groups showed significant improvement in depression ratings and time spent depressed by week 10. Both groups showed significant improvement in overall mood. No between-group differences in improvement were found. Adjunctive quetiapine may be useful as continuation treatment in bipolar populations with both pure depressive and cycling symptoms. Further controlled studies are warranted. C1 Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75390 USA. Univ Cincinnati, Coll Med, Cincinnati, OH USA. Cincinnati Vet Affairs Med Ctr, Cincinnati, OH USA. VA Greater Los Angles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Mayo Coll Med, Rochester, MI USA. Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands. Penn State Coll Med, Hershey, PA USA. NIMH, NIH, New York, NY USA. Altrecht Inst Mental Hlth Care, Utrecht, Netherlands. Ludwig Maximilians Univ Munchen, Munich, Germany. RP Suppes, T (reprint author), Univ Texas, SW Med Ctr, Dept Psychiat, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. EM Trisha.Suppes@UTSouthwestern.edu RI Nolen, Willem/E-9006-2014; Mintz, Jim/N-7385-2014 OI Mintz, Jim/0000-0002-8299-5851 FU NIMH NIH HHS [R01 MH079261] NR 32 TC 10 Z9 10 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0268-1315 J9 INT CLIN PSYCHOPHARM JI Int. Clin. Psychopharmacol. PD NOV PY 2007 VL 22 IS 6 BP 376 EP 381 PG 6 WC Pharmacology & Pharmacy; Psychiatry SC Pharmacology & Pharmacy; Psychiatry GA 222RP UT WOS:000250315000009 PM 17917557 ER PT J AU Habeenzu, C Mitarai, S Lubasi, D Mudenda, V Kantenga, T Mwansa, J Maslow, JN AF Habeenzu, C. Mitarai, S. Lubasi, D. Mudenda, V. Kantenga, T. Mwansa, J. Maslow, J. N. TI Tuberculosis and multidrug resistance in Zambian prisons, 2000-2001 SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE prisons; tuberculosis; surveillance; Zambia ID PULMONARY TUBERCULOSIS; MALAWI; PREVALENCE; HIV; TB AB BACKGROUND: Data on prevalence of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in Zambian prisons are lacking. METHODS: Between January 2000 and July 2001, a case-finding study was performed in 13 Zambian prisons for pulmonary TB. Prisoners were administered a questionnaire to obtain demographic information. Information regarding housing density and diet was also collected. Three consecutive first morning sputum specimens were cultured for Mycobacterium tuberculosis. Antimicrobial resistance testing was performed by the resistance ratio method. RESULTS: A total of 10 8 0 prisoners were recruited: 105 5 were males and 25 females. Sputum from 245 (22.7%) prisoners yielded M. tuberculosis, including 168 (15.6%) with smear-positive disease. Based on a total prison population of 6118, the minimal prevalence of TB was 4.0%. There was a linear relationship between the proportion of prisoners evaluated and the prevalence of TB (R-2 = 0.9366) across facilities, suggesting that the true prevalence of TB may approach 15-20%. Resistance to at least one anti-tuberculosis drug was detected for 40 (23.8%) isolates, while MDR-TB was identified for 16 (9.5%) isolates. CONCLUSION: There is a high rate of pulmonary TB in Zambian prisons, with significant rates of drug resistance and MDR-TB, highlighting the need for active surveillance and treatment programs. C1 Univ Teaching Hosp, Dept Pathol & Microbiol, Lusaka, Zambia. Japan Int Cooperat Agcy, Tokyo, Japan. Univ Teaching Hosp, Ctr Infect Dis, TB Lab, Lusaka, Zambia. Univ Penn, Dept Vet Affairs Med Ctr, Div Infect Dis, Infect Dis Sect, Philadelphia, PA 19104 USA. RP Maslow, JN (reprint author), Dept Vet Affairs Med Ctr, Univ & Woodland Aves, Philadelphia, PA 19104 USA. EM joel.maslow@va.gov FU NIAID NIH HHS [AI450008, 5 U01 AI32783] NR 16 TC 38 Z9 40 U1 0 U2 1 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD NOV PY 2007 VL 11 IS 11 BP 1216 EP 1220 PG 5 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 230UL UT WOS:000250901400011 PM 17958984 ER PT J AU Rohrer, B Guo, Y Kunchithapautham, K Gilkeson, GS AF Rohrer, Baerbel Guo, Yao Kunchithapautham, Kannan Gilkeson, Gary S. TI Eliminating complement factor D reduces photoreceptor susceptibility to light-induced damage SO INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE LA English DT Article ID INDUCED RETINAL DEGENERATION; FACTOR-H POLYMORPHISM; 2 APOPTOTIC PATHWAYS; MACULAR DEGENERATION; CHOROIDAL NEOVASCULARIZATION; CELL-DEATH; ROD PHOTORECEPTORS; GENE-EXPRESSION; PHOTIC INJURY; RAT RETINAS AB PURPOSE. Genetic risk factors such as variations in complement factors H ( CFH) and B ( CFB) have been implicated in the etiology of age- related macular degeneration. It has been hypothesized that inadequate control of complement- driven inflammation may be a major factor in disease pathogenesis. The authors tested the involvement of the complement system in an experimental model for oxidative stress- mediated photoreceptor degeneration, the light- damage mouse model. METHODS. Changes in gene expression were assessed in BALB/ c retinas in response to constant- light ( CL) exposure using microarrays and real- time PCR. Susceptibility to CL exposure was tested in CFD-/- mice on a BALB/ c background. Eyes were analyzed using electrophysiologic and histologic techniques. RESULTS. Genes encoding for proteins involved in complement activation were significantly upregulated after CL. The altered gene profiles were similar to proteins accumulated in drusen and to genes identified in the retina and RPE/ choroid of patients with age- related macular degeneration. Cyclic- light reared CFD-/- and CFD-/- mice had indistinguishable rod function and number; however, after CL challenge, CFD-/- photoreceptors were significantly protected. CONCLUSIONS. These results suggest that rod degeneration in the CL- damaged retina involves the activity of the alternative complement pathway and that eliminating the alternative pathway is neuroprotective. Thus, the light damage albino mouse model may be a good model to study complement- mediated photoreceptor degeneration. C1 Med Univ S Carolina, Dept Ophthalmol, Charleston, SC 29425 USA. Med Univ S Carolina, Div Res, Dept Neurosci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Rheumatol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson VAMC, Med Res Serv, Charleston, SC USA. RP Rohrer, B (reprint author), Med Univ S Carolina, Dept Ophthalmol, 167 Ashley Ave, Charleston, SC 29425 USA. EM rohrer@musc.edu FU NCI NIH HHS [R24 CA95841]; NCRR NIH HHS [RR16434, C06 RR015455]; NEI NIH HHS [EY13520, EY14793] NR 41 TC 53 Z9 54 U1 0 U2 10 PU ASSOC RESEARCH VISION OPHTHALMOLOGY INC PI ROCKVILLE PA 12300 TWINBROOK PARKWAY, ROCKVILLE, MD 20852-1606 USA SN 0146-0404 J9 INVEST OPHTH VIS SCI JI Invest. Ophthalmol. Vis. Sci. PD NOV PY 2007 VL 48 IS 11 BP 5282 EP 5289 DI 10.1167/iovs.07-0282 PG 8 WC Ophthalmology SC Ophthalmology GA 228MU UT WOS:000250734800055 PM 17962484 ER PT J AU Holmes, WC Bilker, WB Wang, H Chapman, J Gross, R AF Holmes, William C. Bilker, Warren B. Wang, Hao Chapman, Jennifer Gross, Robert TI HIV/AIDS-Specific quality of life and adherence to Antiretroviral therapy over time SO JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE adherence; AIDS; HIV; quality of life ID HUMAN-IMMUNODEFICIENCY-VIRUS; MULTICENTER AIDS COHORT; SELF-REPORTED ADHERENCE; HIV-INFECTED ADULTS; HAT-QOL INSTRUMENT; MEDICATION ADHERENCE; VIRAL LOAD; UNITED-STATES; DRUG-USE; PREDICTORS AB Objective: To determine if HIV/AIDS-specific quality of life (QOL) predicts adherence to antiretroviral therapy (ART). Methods: HIV-infected outpatients on efavirenz plus 2 or 3 nucleoside analogue reverse transcriptase inhibitors and with HIV viral loads <75 copies/mL were followed until the censoring event of detectable viremia or 1 year of follow-up. QOL was assessed at baseline with the HIV/AIDS-Targeted Quality of Life instrument (HAT-QoL), as were depression symptoms, stress levels, social support, and substance use. Follow-up high (>= 95%) versus low (<95%) adherence was measured for 90 days before the censoring event. Results: Fifty-six (48%) of 116 recruited participants had low adherence. Baseline financial worries (from the HAT-QoL) were greater in those with low versus high adherence (P = 0.02). Those with low versus high adherence also were more likely to use alcohol (P = 0.01) and other drugs (P = 0.02) currently at baseline. Regression analysis led to a model that included only current alcohol use (odds ratio [OR] = 2.65, 95% confidence interval [Cl]: 1.20 to 5.87)) and financial worries (OR = 1.16, 95% CI: 1.03 to 1.310, for each 10-unit rise). Conclusions: Baseline financial worries were associated with antiretroviral adherence later in time. Questions about paying bills and financial ability to care for oneself may be clinically useful inidentifyinf patienst who will have suboptimal adherence. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Philadellphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. RP Holmes, WC (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 733 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM holmeswc@mail.med.upenn.edu FU AHRQ HHS [HS10399]; NIAID NIH HHS [P30-AI45008]; NIMH NIH HHS [K08MH01584] NR 42 TC 28 Z9 29 U1 1 U2 5 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 NOV 1 PY 2007 VL 46 IS 3 BP 323 EP 327 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 226RZ UT WOS:000250607500011 PM 17846560 ER PT J AU Yerevanian, BI Ralph, JK Mintz, J AF Yerevanian, Boghos I. Koek, Ralph J. Mintz, Jim TI Bipolar pharmacotherapy and suicidal behavior. Part I: Lithium, divalproex and carbamazepine SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE suicide; suicide attempt; lithium; divalproex; carbamazepine; bipolar disorder; veterans; longitudinal study; public health ID PRIMARY AFFECTIVE-DISORDERS; MOOD DISORDERS; RISK; MORTALITY; PREVENTION; REGISTER; TRIALS AB Introduction: The anti-suicidal benefit of lithium on suicidal behavior in bipolar disorder is well-established. Data are mixed on the effects of divalproex and carbamazepine. Methods: Retrospective chart review study of 405 veterans with bipolar disorder followed for a mean of 3 years, with month by month review of clinical progress notes, and systematic assessment of current pharmacotherapy and suicide completion, attempt or hospitalization for suicidality. Comparison of suicide event rates (events/100 patient years) between mood stabilizers and during-vs-after discontinuation of mood stabilizers, with linear regression analysis for influence of potential confounding variables, and robust bootstrap confirmation analysis. Results: No completed suicides occut red during or after discontinuation of monotherapy. Rates of non-lethal suicidal behavior were similar during lithium (2.49), divalproex (4.67) and carbamazepine (3.80) monotherapies. There was a sixteen fold greater, highly statistically significant non-lethal suicidal event rate after discontinuation compared with during mood stabilizer monotherapy (55.89 vs. 3.48 events/100 patient years,- Chi(2) = 13.95; df= 1; p < 0.0002). On compared with off treatment differences were similar for the three different agents. Limitations: Treatments were uncontrolled in this naturalistic setting, and data were analyzed retrospectively. Conclusions: Lithium and the anticonvulsants may show similar benefits in protecting bipolar patients from non-lethal suicidal behavior when careful analysis of clinical data is done to confirm medication adherence/non-adherence. Findings in this study were similar to those of a previous study that applied the same methodology in a private practice setting. Published by Elsevier B.V. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA 90073 USA. RP Yerevanian, BI (reprint author), 16111 Plummer St 116A-11, North Hills, CA 91343 USA. EM byerevan@ucla.edu NR 23 TC 47 Z9 51 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD NOV PY 2007 VL 103 IS 1-3 BP 5 EP 11 DI 10.1016/jjad.2007.05.019 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 223UC UT WOS:000250396800002 PM 17628692 ER PT J AU Boghos, IY Koek, RJ Mintz, J Akiskal, HS AF Boghos, I. Yerevanian Koek, Ralph J. Mintz, Jim Akiskal, Hagop S. TI Bipolar pharmacotherapy and suicidal behavior - Part 2. The impact of antidepressants SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE suicide; suicide attempt; antidepressants; bipolar disorder; veterans; longitudinal study; public health ID WEEKLY SYMPTOMATIC STATUS; DEPRESSIVE MIXED STATES; STEP-BD; UNIPOLAR DEPRESSION; NATURAL-HISTORY; DISORDER; RISK; TRIALS; IDEATION; PROGRAM AB Antidepressant-induced mania and cycle acceleration is a potential risk in bipolar patients. Another serious risk of antidepressants, that of increasing suicidal behavior, has been identified in some affectively ill populations. However, there is a dearth of knowledge about the effects of antidepressants on suicidal behavior specifically in bipolar patients. Methods: Retrospective chart review of 405 veterans with bipolar disorder followed for a mean of three years, with month by month systematic assessment of current pharmacotherapy and suicide completion, attempt or hospitalization for suicidality. Chi-squared comparison of (log) rates of suicidal events during mood stabilizer monotherapy, antidepressant monotherapy, and combination of mood stabilizer and antidepressant. Results: Suicidal behavior event rates (per 100 patient years) were greatest during treatment with antidepressant monotherapy (25.92), least during mood stabilizer monotherapy (3.48), and intermediate during mood stabilizer + antidepressant combination treatment (9.75). These differences were statistically significant. Limitations: In a clinical setting, antidepressants may have been prescribed because patients were deemed at greater risk of suicidality. Conclusions: During treatment with antidepressants (even when coupled with mood stabilizers), patients with bipolar disorder have significantly higher rates of non-lethal suicidal behavior compared to those on mood stabilizers without antidepressants, and thus require careful monitoring. Published by Elsevier B.V. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, North Hills, CA 91343 USA. VA Greater Los Angeles Hlth Care Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA 90073 USA. Univ Calif San Diego, Int Mood Ctr, La Jolla, CA 92093 USA. Ctr Vet Med, La Jolla, CA USA. RP Boghos, IY (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, 16111 Plummer St 116A-11, North Hills, CA 91343 USA. EM byerevan@ucla.edu NR 35 TC 0 Z9 0 U1 1 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 EI 1573-2517 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD NOV PY 2007 VL 103 IS 1-3 BP 13 EP 21 DI 10.1016/jjad.2007.05.017 PG 9 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 223UC UT WOS:000250396800003 ER PT J AU Yerevanian, BI Koek, RJ Mintz, J AF Yerevanian, Boghos I. Koek, Ralph J. Mintz, Jim TI Bipolar pharmacotherapy and suicidal behavior - Part 3: Impact of antipsychotics SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE suicide; suicide attempt; bipolar disorder; antipsychotic drugs; longitudinal study; public health ID PLACEBO-CONTROLLED TRIAL; ATYPICAL ANTIPSYCHOTICS; DISORDER; SCHIZOPHRENIA; DEPRESSION; RISK; ARIPIPRAZOLE; CLOZAPINE; IDEATION AB Introduction: Antipsychotics, particularly second generation agents, are widely used in bipolar disorder, but their effect on suicidal behavior in this population has not been systematically studied. Methods: Retrospective chart review of 405 veterans with bipolar disorder followed for a mean of three years, with month-by-month systematic assessment of current pharmacotherapy and suicide completion, attempt or hospitalization for suicidality. Comparison of rates of suicidal events during mood stabilizer monotherapy, antipsychotic monotherapy, and combination of mood stabilizer and antipsychotic. Results: Non-lethal suicide event rates were 9.4 times greater (x(2) =28.29, p<.0001) during antipsychotic monotherapy and 3.5 times greater during mood stabilizer+ antipsychotic (x(2) = 15.13, p=0.0001) than during mood stabilizer monotherapy. Limitations: Antipsychotics may have been prescribed because patients were at greater risk of suicidal behavior. First and second generation antipsychotics were not distinguished. Conclusions: Treatment of bipolar patients with antipsychotics is associated with an increase in non-lethal suicidal behavior. Thus, use of antipsychotics for bipolar patients requires careful monitoring for suicidal behavior. Further studies are urgently needed to better characterize this relationship. Published by Elsevier B.V. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, North Hills, CA 91343 USA. VA Greater Los Angeles Hlth Care Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA 90073 USA. RP Yerevanian, BI (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, David Geffen Sch Med, 16111 Plummer St 116A-11, North Hills, CA 91343 USA. EM byerevan@ucla.edu NR 24 TC 26 Z9 28 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD NOV PY 2007 VL 103 IS 1-3 BP 23 EP 28 DI 10.1016/jjad.2007.05.018 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 223UC UT WOS:000250396800004 PM 17604119 ER PT J AU Morasco, BJ Rifai, MA Jennifer, ML Indest, DW Moles, JK Hauser, P AF Morasco, Benjamin J. Rifai, Muhamad Aly Jennifer, M. Loftis Indest, David W. Moles, James Kelly Hauser, Peter TI A randomized trial of paroxetine to prevent interferon-alpha-induced depression in patients with hepatitis C SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE depression; hepatitis c; prevention; viral response; antiviral therapy; interferon ID INDUCED MOOD DISORDER; PLUS RIBAVIRIN; MAJOR DEPRESSION; THERAPY; RISK; SYMPTOMS; NORTRIPTYLINE; COMORBIDITY; POPULATION; CITALOPRAM AB Background: Interferon-alpha-(IFN-alpha) induced depression presents a challenge when treating patients with the hepatitis C virus (HCV). Depression occurs in approximately one-third of patients during antiviral therapy and can lead to reduction in treatment dosage or discontinuation of treatment, thus reducing the likelihood of clearing HCV infection. This study examined the efficacy of paroxetine in preventing the development of depression during antiviral therapy. Methods: In a double-blind, placebo-controlled study, 33 patients with HCV were randomly assigned to paroxetine or placebo prior to antiviral therapy. Patients were evaluated for psychiatric symptoms prior, during, and six months after antiviral therapy. Results: The rate of IFN-alpha-induced depression for the entire sample was 33.3%. The prophylactic use of paroxetine did not decrease the likelihood of IFN-a-induced depression (35.7% in the paroxetine group vs. 31.6% in the placebo group). However, in 10 of 11 patients who developed IFN-alpha-induced depression and entered the rescue arm of the study, open-label treatment with paroxetine helped reduce symptoms of depression. Group assignment did not appear to impact antiviral therapy completion rates, as a similar proportion of patients from each group completed treatment. Limitations: The antiviral treatment was changed during the trial and aspects of the sample limit the general izabi lity of the results. Conclusion: A prophylactic approach to interferon-alpha-induced depression may not be indicated in patients with HCV infection. (C) 2007 Elsevier B.V. All rights reserved. C1 Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Behav Hlth & Clin Neurosci Div, Portland, OR 97239 USA. Salem VA Med Ctr, Salem, VA 24153 USA. Univ Virginia, Sch Med, Roanoke Salem, VA USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Portland VA Med Ctr, JENS Lab, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Dept Internal Med, Portland, OR 97201 USA. RP Hauser, P (reprint author), Portland VA Med Ctr, NW Hepatitis C Resource Ctr, Behav Hlth & Clin Neurosci Div, 3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. EM peter.hauser2@med.va.gov NR 49 TC 63 Z9 65 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD NOV PY 2007 VL 103 IS 1-3 BP 83 EP 90 DI 10.1016/j.jad.2007.01.007 PG 8 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 223UC UT WOS:000250396800010 PM 17292481 ER PT J AU Moorman, AJ Mozaffarian, D Wilkinson, CW Lawler, RL Mcdonald, GB Crane, BA Spertus, JA Russo, JE Stempien-Otero, AS Sullivan, MD Levy, WC AF Moorman, Alec J. Mozaffarian, Dariush Wilkinson, Charles W. Lawler, Richard L. Mcdonald, George B. Crane, Barbara A. Spertus, John A. Russo, Joan E. Stempien-Otero, April S. Sullivan, Mark D. Levy, Wayne C. TI In patients with heart failure elevated soluble TNF-receptor 1 is associated with higher risk of depression SO JOURNAL OF CARDIAC FAILURE LA English DT Article DE heart failure; depression; cytokines; inflammation ID HEALTH-STATUS; SYSTEMIC INFLAMMATION; MAJOR DEPRESSION; RATING-SCALE; CYTOKINES; SYMPTOMS; TRANSPLANT; MEDIATORS; DISEASE; DEATH AB Background: Pro-inflammatory cytokines may contribute to the development and progression of heart failure (HF) and are also implicated in depressive disorders. In this cross-sectional study, we investigated whether systemic inflammation, as assessed by circulating levels of inflammatory cytokines, was associated with comorbid depression in patients with heart failure. Methods and Results: Baseline clinical variables, depression status, and inflammatory marker levels were measured in 129 ambulatory HF patients. We hypothesized that pro-inflammatory cytokines, specifically tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, and IL-6, would be elevated in HF patients with comorbid depression. In unadjusted analyses, levels of soluble TNF-alpha receptor1 (sTNFr1) were significantly higher among depressed (1.6 ng/mL), compared with nondepressed (1.1 ng/mL), HF patients (P = .01). After multivariate adjustment, compared with patients in the lowest quartile of sTNFr1 levels, those in the highest quartile had an adjusted near 5-fold higher risk of depression (OR 4.6, 95% CI 1.2-17.3; P for trend .008). The subgroup of patients on antidepressants but not currently depressed had a trend toward higher levels of sTNFr1, suggesting that antidepressants may not lower cytokine levels even when adequately treating depressive symptoms. IL-10 and IL-6 levels were not significantly different among depressed versus nondepressed HF patients. Conclusions: In this cross-sectional analysis, HF patients with comorbid depression, compared with nondepressed HF patients, had higher levels of sTNFr1 and trend toward higher levels of sTNFr1 even when adequately treated for depression. C1 [Moorman, Alec J.; Crane, Barbara A.; Russo, Joan E.; Stempien-Otero, April S.; Sullivan, Mark D.; Levy, Wayne C.] Univ Washington, Dept Internal Med, Dept Psychiat & Behav Sci, Div Cardiol, Seattle, WA USA. [Mozaffarian, Dariush] Brigham & Womens Hosp, Harvard Med Sch, Harvard Sch Publ Hlth, Boston, MA 02115 USA. [Wilkinson, Charles W.] Univ Washington, Educ & Clin Ctr, Vet Affairs Puget Sound Hlth Care Syst, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. [Lawler, Richard L.; Mcdonald, George B.] Fred Hutchinson Canc Res Ctr, Gastroenterol Hepatol Sect, Seattle, WA 98104 USA. [Spertus, John A.] Univ Missouri, Mid Amer Heart Inst Ctr, Kansas City, KS USA. RP Levy, WC (reprint author), Univ Washington, 1959 NE Pacific St, Seattle, WA 98195 USA. RI Mozaffarian, Dariush/B-2276-2008 FU NCI NIH HHS [CA18029]; NCRR NIH HHS [M01-RR-00037] NR 25 TC 30 Z9 31 U1 1 U2 2 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 1071-9164 J9 J CARD FAIL JI J. Card. Fail. PD NOV PY 2007 VL 13 IS 9 BP 738 EP 743 DI 10.1016/j.cardfail.2007.06.301 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 240NB UT WOS:000251593200008 PM 17996822 ER PT J AU Dougherty, CM Pyper, GP Au, DH Levy, WC Sullivan, MD AF Dougherty, Cynthia M. Pyper, Gail P. Au, David H. Levy, Wayne C. Sullivan, Mark D. TI Drifting in a shrinking future - Living with advanced heart failure SO JOURNAL OF CARDIOVASCULAR NURSING LA English DT Article DE congestive heart failure; palliative care; quality of life; qualitative research; shared decision making ID HEALTH-PROFESSIONALS; PALLIATIVE CARE; LIFE; CANCER; END; PREFERENCES; SKILLS AB Background: Patients with advanced heart failure (HF) have an uncertain prognosis and low rates of advance care planning and hospice use. The purpose of this study was to describe how patients view and plan for their future. Methods: Twenty-four (IN = 24) patients took part in a semistructured interview in which they were asked to describe their experiences in living with heart disease and their understanding and planning for their future. Interviews were transcribed and analyzed using the constant comparative method to generate a grounded theory. Results: The core category, "Living with HF," encompassed the subcategories of "My Experience of HF," "Help with HF," and "My Future with HF." This article reports on "My Future with HF." Patients wanted to discuss how HF affected their future with their providers, but initiation of these discussions was difficult and the absence of discussion led to frustration. Patients did not find specific life expectancy estimates helpful in coping or planning their future care. Conclusions: Patients with advanced HF do not plan well for end-of-life care and tend to drift along while vaguely hoping for the best. End-of-life care in advanced HF should address difficulties in decision making and provider communication. C1 Univ Washington, Sch Nursing, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. RP Dougherty, CM (reprint author), Univ Washington, Sch Nursing, Box 357266,1959 NE Pacific St,Room T608D, Seattle, WA 98195 USA. EM cindyd@u.washington.edu NR 22 TC 13 Z9 13 U1 1 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0889-4655 J9 J CARDIOVASC NURS JI J. Cardiovasc. Nurs. PD NOV-DEC PY 2007 VL 22 IS 6 BP 480 EP 487 PG 8 WC Cardiac & Cardiovascular Systems; Nursing SC Cardiovascular System & Cardiology; Nursing GA 230BK UT WOS:000250850100016 PM 18090189 ER PT J AU Brambilla, DJ O'Donnell, AB Matsumoto, AM McKinlay, JB AF Brambilla, Donald J. O'Donnell, Amy B. Matsumoto, Alvin M. McKinlay, John B. TI Lack of seasonal variation in serum sex hormone levels in middle-aged to older men in the Boston area SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID FOLLICLE-STIMULATING-HORMONE; TO-HIP RATIO; LUTEINIZING-HORMONE; TESTOSTERONE LEVELS; PLASMA TESTOSTERONE; CIRCANNUAL RHYTHMS; CIRCADIAN-RHYTHMS; BINDING GLOBULIN; CORTISOL; MALES AB Context: Previous studies of seasonal variation of testosterone and other hormones in men have produced mixed results regarding the number and timing of peaks and nadirs and whether hormones vary seasonally at all. Wide variation in study designs, sample sizes, analytical methods, and characteristics of the study populations may account for the heterogeneity of results. Objective: The objective of the study was to determine whether serum total, free, and bioavailable testosterone, dihydrotestosterone, SHBG, LH, dehydroepiandrosterone, dehydroepiandrosterone sulfate, estrone, estradiol, and cortisol vary seasonally in men. Design: Two blood samples were drawn 1-3 d apart at study entry and again 3 and 6 months later ( maximum six samples per subject). Hormone levels 1-3 d apart were averaged to reduce short-term intrasubject variation. Setting: The study population consisted of a community-dwelling population ( Boston, MA). Study Participants: One hundred thirty-four men 30-79 yr old were randomly selected from the respondents to the Boston Area Community Health Survey. One hundred twenty-one men who completed all six visits were included in the analysis. Main Outcome Measures: In a repeated-measures analysis, 3-month change in hormone levels, measured twice per subject, and in a sinusoidal nonlinear regression with random subject effects, average hormone level in samples 1-3 d apart were measured. Results: Aside from cortisol, no evidence of seasonal variation in hormone levels was found. The amplitude of seasonal variation was much smaller than total intraindividual variation for all hormones considered. Conclusions: Seasonal variation is likely an unimportant source of variation clinically and in epidemiological studies of hormone levels. C1 New England Res Inst, Watertown, MA 02472 USA. Univ Washington, Sch Med, Seattle, WA 98108 USA. Univ Washington, Ctr Clin, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Brambilla, DJ (reprint author), New England Res Inst, 9 Galen St, Watertown, MA 02472 USA. EM dbrambilla@neriscience.com RI Perez , Claudio Alejandro/F-8310-2010 OI Perez , Claudio Alejandro/0000-0001-9688-184X FU NIA NIH HHS [AG23027] NR 35 TC 19 Z9 19 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD NOV PY 2007 VL 92 IS 11 BP 4224 EP 4229 DI 10.1210/jc.2007-1303 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 228WR UT WOS:000250763800023 PM 17684044 ER PT J AU Shaib, YH Davila, JA Henderson, L McGlynn, KA El-Serag, HB AF Shaib, Yasser H. Davila, Jessica A. Henderson, Louise McGlynn, Katherine A. El-Serag, Hashem B. TI Endoscopic and surgical therapy for intrahepatic Cholangiocarcinoma in the united states - A population-based study SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE intrahepatic cholangiocarcinoma; outcomes AB Background: Intrahepatic cholangiocarcinoma (W-C) is a highly fatal disease with limited therapeutic options. The determinants, trends, and outcomes of different therapies for ICC are largely unknown in the United States. Methods: Using data from the Surveillance, Epidemiology, and End-Results-(SEER) Medicare database, we compared ICC patients receiving different therapies between 1992 and 1999. Univariate and multivariate analyses were performed and adjusted odds ratios (AORs) were calculated. Hazard ratios were calculated for the survival analysis. Results: Eight hundred sixty-two cases were included. The mean age at diagnosis was 77.9 years (SD = 7. 1). Only 6.3 % received surgical resection, 65.5% received palliative interventions (16.1 % surgical, 44.0% endoscopic), 24.4% received only chemo or radiation therapy whereas 3.8% did not receive any treatment. The median survival was 708 days [95% confidence interval (CI): 458-945] for surgical resection, 227 days (95% CI: 182-294) for surgical palliation, and 123 days (95% CI: 108-148) for endoscopic palliation. Patients receiving surgical resection were younger (AOR = 5.6, 95% CI: 2.9-11. 1), more likely to be diagnosed later in the study period (AOR 2.2, 95% CI: 1.1-4.2), and had better mortality (hazard ratio 0.3, 95% CI: 0.2-0.4). Patients receiving surgical palliation were younger (AOR = 1.6, 95% CI: 1.1-2.3), more likely to be diagnosed in the early time period (AOR = 1.5, 95% CI: 1.1-2.2), and had similar mortality to those receiving endoscopic palliation. Conclusions: Only a minority of patients with ICC receives potentially curative therapy. Young age is the strongest predictor of receiving potentially curative treatment. Older patients and those diagnosed in recent time periods are more likely to receive endoscopic palliation. Surgical resection was associated with improved survival. There was no difference in survival between surgical and endoscopic palliation. C1 Baylor Coll Med, Sect Hlth Serv Res, Houston Vet Affairs Med Ctr, NIH,DHHS, Bethesda, MD USA. Baylor Coll Med, Gastroenterol Sect, Houston Vet Affairs Med Ctr, Bethesda, MD USA. NCI, NIH, DHHS, Bethesda, MD 20892 USA. RP Shaib, YH (reprint author), Baylor Coll Med, Sect Hlth Serv Res, Houston Vet Affairs Med Ctr, NIH,DHHS, Bethesda, MD USA. EM yshaib@bcm.tmc.edu NR 17 TC 22 Z9 23 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD NOV-DEC PY 2007 VL 41 IS 10 BP 911 EP 917 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 228XF UT WOS:000250765200008 PM 18090160 ER PT J AU Li, J Sejas, DP Zhang, XL Qiu, YH Nattamai, KJ Rani, R Rathbun, KR Geiger, H Williams, DA Bagby, GC Pang, QS AF Li, June Sejas, Daniel P. Zhang, Xiaoling Qiu, Yuhui Nattamai, Kalpana J. Rani, Reena Rathbun, Keaney R. Geiger, Hartmut Williams, David A. Bagby, Grover C. Pang, Qishen TI TNF-alpha induces leukemic clonal evolution ex vivo in Fanconi anemia group C murine stem cells SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID NECROSIS-FACTOR-ALPHA; WILD-TYPE CELLS; HEMATOPOIETIC-CELLS; DNA-DAMAGE; IFN-GAMMA; REPOPULATING ABILITY; ENHANCES ENGRAFTMENT; INDUCED APOPTOSIS; NUCLEAR-COMPLEX; DEFICIENT CELLS AB The molecular pathogenesis of the myeloid leukemias that frequently occur in patients with Fanconi anemia (FA) is not well defined. Hematopoietic stem cells bearing inactivating mutations of FA complementation group C (FANCC) are genetically unstable and hypersensitive to apoptotic cytokine cues including IFN-gamma and TNF-alpha, but neoplastic stem cell clones that arise frequently in vivo are resistant to these cytokines. Reasoning that the combination of genetic instability and cytokine hypersensitivity might create an environment supporting the emergence of leukemic stem cells, we tested the leukemia-promoting effects of TNF-alpha in murine stem cells. TNF-alpha exposure initially profoundly inhibited the growth of Fancc(-/-) stem cells. However, longer-term exposure of these cells promoted the outgrowth of cytogenetically abnormal clones that, upon transplantation into congenic V/T mice, led to acute myelogenous leukemia. TNF-alpha. induced ROS-dependent genetic instability in Fancc(-/-) but not in WT cells. The leukemic clones were TNF-alpha resistant but retained their characteristic hypersensitivity to mitomycin C and exhibited high levels of chromosomal instability. Expression of FANCC cDNA in Fancc(-/-) stem cells protected them from TNF-alpha-induced clonal. evolution. We conclude that TNF-alpha exposure creates an environment in which somatically mutated preleukemic stem cell clones are selected and from which unaltered TNF-alpha-hypersensitive Fancc(-/-) stem cells are purged. C1 Childrens Hosp, Med Ctr, Div Expt Hematol, Cincinnati, OH 45229 USA. Oregon Hlth & Sci Univ, Sch Med, OHSU Canc Inst, Portland, OR 97201 USA. Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati, OH USA. Portland VA Med Ctr, Portland, OR USA. RP Bagby, GC (reprint author), Childrens Hosp, Med Ctr, Div Expt Hematol, Cincinnati, OH 45229 USA. EM grover@ohsu.edu; qishen.pang@cchmc.org OI Bagby, Grover/0000-0001-6830-2046 FU NCI NIH HHS [R01 CA109641]; NCRR NIH HHS [M01 RR000334]; NHLBI NIH HHS [P01 HL048546, R01 HL076712] NR 58 TC 76 Z9 78 U1 0 U2 4 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD NOV PY 2007 VL 117 IS 11 BP 3283 EP 3295 DI 10.1172/JCI31772 PG 13 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 227RR UT WOS:000250676000021 PM 17960249 ER PT J AU Yang, CL Zhu, XM Ellison, DH AF Yang, Chao-Ling Zhu, Xiaoman Ellison, David H. TI The thiazide-sensitive Na-Cl cotransporter is regulated by a WNK kinase signaling complex SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID PSEUDOHYPOALDOSTERONISM TYPE-II; BLOOD-PRESSURE; MOLECULAR PATHOGENESIS; POTASSIUM EXCRETION; SURFACE EXPRESSION; PROTEIN-KINASES; HYPERTENSION; SODIUM; TRANSPORT; TUBULE AB The pathogenesis of essential hypertension remains unknown, but thiazide diuretics are frequently recommended as first-fine treatment. Recently, familial hyperkalemic hypertension (FHHt) was shown to result from activation of the thiazide-sensitive Na-Cl cotransporter (NCC) by mutations in WNK4, although the mechanism for this effect remains unknown. WNK kinases are unique members of the human kinome, intimately involved in maintaining electrolyte balance across cell membranes and epithelia. Previous work showed that WNK1, WNK4, and a kidney-specific isoform of WNK1 interact to regulate NCC activity, suggesting that WNK kinases form a signaling complex. Here, we report that WNK3, another member of the WNK kinase family expressed by distal tubule cells, interacts with WNK4 and WNK1 to regulate NCC in both human kidney cells and Xenopus oocytes, further supporting the WNK signaling complex hypothesis. We demonstrate that physiological regulation of NCC in oocytes results from antagonism between WNK3 and WNK4 and that FHHt-causing WNK4 mutations exert a dominant-negative effect on wild-type (WT) WNK4 to mimic a state of WNK3 excess. The results provide a mechanistic explanation for the divergent effects of WT and FHHt-mutant WNK4 on NCC activity, and for the dominant nature of FHHt in humans and genetically modified mice. C1 Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Heart Res Ctr, Portland, OR 97201 USA. RP Yang, CL (reprint author), Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, 3314 SW US Vet Hosp Rd, Portland, OR 97239 USA. OI Ellison, David/0000-0003-2915-265X FU NIDDK NIH HHS [DK51496, R01 DK051496] NR 41 TC 92 Z9 100 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 NOV PY 2007 VL 117 IS 11 BP 3403 EP 3411 DI 10.1172/JC132033 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 227RR UT WOS:000250676000032 PM 17975670 ER PT J AU Zeng, JS Sutton, DA Fothergill, AW Rinaldi, MG Harrak, MJ de Hoog, GS AF Zeng, J. S. Sutton, D. A. Fothergill, A. W. Rinaldi, M. G. Harrak, M. J. de Hoog, G. S. TI Spectrum of clinically relevant Exophiala species in the United States SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID WANGIELLA-DERMATITIDIS; CYSTIC-FIBROSIS; CEREBRAL PHEOHYPHOMYCOSIS; NUTRITIONAL PHYSIOLOGY; ANTIFUNGAL AGENTS; SPINIFERA CLADE; JEANSELMEI; FUNGEMIA; CHROMOBLASTOMYCOSIS; SUSCEPTIBILITIES AB Numerous members of the genus Exophiala are potential agents of human and animal mycoses. The majority of these infections are cutaneous and superficial, but also fatal systemic infections are known. We re-identified 188 clinical isolates from the United States, which had a preliminary morphological identification of Exophiala species, by sequencing internal transcribed spacer (ITS) region of the rRNA. Molecular identifications of the strains were as follows, in order of frequency: 55 E. dermatitidis (29.3%), 37 E. xenobiotica (19.7%), 35 E. oligosperma (18.6%), 13 E. lecanii-corni (6.9%), 12 E. phaeomuriformis (6.4%), 7 E. jeanselmei (3.7%), 7 E. bergeri (3.7%), 6 E. mesophila (3.2%), 5 E. spinifera (2.7%), 3 Exophiala sp. 1 (1.6%), 3 E. attenuata (1.6%), 3 Phialophora europaea (1.3%), 1 E. heteromorpha (0.5%), and 1 Exophiala sp. 2 (0.5%) strains. Exophiala strains were repeatedly isolated from deep infections (39.9%) involving lung, pleural fluid, sputum, digestive organs (stomach, intestines, bile), heart, brain, spleen, bone marrow, blood, dialysis fluid, lymph node, joint, breast, middle ear, throat, and intraocular tissues. About 38.3% of the Exophiala spp. strains were agents of cutaneous infections including skin, mucous membranes, nail, and corneal epithelium lesions. The other strains caused superficial infections (0.5%, including hair) or subcutaneous infection (12.0%, including paranasal sinusitis, mycetoma, and subcutaneous cyst). The systemic infections were preponderantly caused by E. dermatitidis, E. oligosperma, E. phaeomuriformis, E. xenobiotica, and E. lecanii-corni. Strains of E. bergeri, E. spinifera, E. jeanselmei, E. mesophila, and E. attenuata mainly induced cutaneous and subcutaneous infections. Since relatively few unknown ITS motifs were encountered, we suppose that the list of opportunistic Exophiala species in temperate climates is nearing completion, but a number of species still have to be described. C1 Cent Bur Schimmelcultures, NL-3508 AD Utrecht, Netherlands. Inst Biodivers & Ecosyst Dynam, Amsterdam, Netherlands. Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Dermatol & Venerol, Union Hosp, Wuhan 430074, Hebei, Peoples R China. Univ Texas, Hlth Sci Ctr, Fungus Testing Lab, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. RP de Hoog, GS (reprint author), Cent Bur Schimmelcultures, POB 85167, NL-3508 AD Utrecht, Netherlands. EM de.hoog@cbs.knaw.nl NR 40 TC 103 Z9 105 U1 0 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD NOV PY 2007 VL 45 IS 11 BP 3713 EP 3720 DI 10.1128/JCM.02012-06 PG 8 WC Microbiology SC Microbiology GA 231FU UT WOS:000250932700035 PM 17596364 ER PT J AU Singh, H Sethi, S Raber, M Petersen, LA AF Singh, Hardeep Sethi, Saurabh Raber, Martin Petersen, Laura A. TI Errors in cancer diagnosis: Current understanding and future directions SO JOURNAL OF CLINICAL ONCOLOGY LA English DT Review ID SCREENING MAMMOGRAPHY INTERPRETATION; POPULATION-BASED ANALYSIS; FALSE-NEGATIVE MAMMOGRAM; BARIUM ENEMA EXAMINATION; COLONOSCOPIC MISS RATES; CHEST X-RAYS; LUNG-CANCER; BREAST-CANCER; COLORECTAL-CANCER; CLINICAL DIAGNOSES AB Purpose Errors in cancer diagnosis are likely the most harmful and expensive types of diagnostic errors. We reviewed the literature to understand the prevalence, origins, and prevention of errors in cancer diagnosis, focusing on common cancers for which early diagnosis offers clear benefit (melanoma and cancers of the breast, colon, and lung). Methods We searched the Cochrane Library and PubMed from 1966 until April 2007 for publications that met our review criteria and manually searched references of key publications. Our search yielded 110 studies, of which nine were prospective studies and the remaining were retrospective studies. Results Errors in cancer diagnosis were not uncommon in autopsy studies and were associated with significant harm and expense in malpractice claims. Literature on prevalence was scant. For each type of cancer, we classified preventable errors according to their origins in patient-physician encounters in the clinic setting, diagnostic test or procedure performance, pathologic confirmation of diagnosis, follow-up of patient or test result, or patient-related delays. Conclusion The literature reflects advanced knowledge of contributory factors and prevention for diagnostic errors related to the performance of procedures and imaging tests and emerging understanding of pathology errors. However, prospective studies are few, as are studies of diagnostic errors arising from the clinical encounter and patient follow-up. Future research should examine further the system and cognitive problems that lead to the many contributory factors we identified, and address interdisciplinary interventions to prevent errors in cancer diagnosis. C1 Baylor Coll Med, Dept Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Univ Texas, Sch Publ Hlth, Houston, TX USA. RP Singh, H (reprint author), VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hardeeps@bcm.tmc.edu FU NCI NIH HHS [K23CA125585] NR 164 TC 47 Z9 48 U1 0 U2 4 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 NOV 1 PY 2007 VL 25 IS 31 BP 5009 EP 5018 DI 10.1200/JCO.2007.13.2142 PG 10 WC Oncology SC Oncology GA 233EV UT WOS:000251074100024 PM 17971601 ER PT J AU Moore, TA Buchanan, RW Buckley, PF Chiles, JA Conley, RR Crismon, ML Essock, SM Finnerty, M Marder, SR Miller, DD McEvoy, JP Robinson, DG Schooler, NR Shon, SP Stroup, IS Miller, AL AF Moore, Troy A. Buchanan, Robert W. Buckley, Peter F. Chiles, John A. Conley, Robert R. Crismon, M. Lynn Essock, Susan M. Finnerty, Molly Marder, Stephen R. Miller, Del D. McEvoy, Joseph P. Robinson, Delbert G. Schooler, Nina R. Shon, Steven P. Stroup, I. Scott Miller, Alexander L. TI The texas medication algorithm project antipsychotic algorithm for schizophrenia: 2006 update SO JOURNAL OF CLINICAL PSYCHIATRY LA English DT Article ID ACTING INJECTABLE RISPERIDONE; TREATMENT-RESISTANT SCHIZOPHRENIA; NEW-GENERATION ANTIPSYCHOTICS; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; TARDIVE-DYSKINESIA; SCHIZOAFFECTIVE DISORDER; 2ND-GENERATION ANTIPSYCHOTICS; 1ST-EPISODE SCHIZOPHRENIA AB Background: A panel of academic psychiatrists and pharmacists, clinicians from the Texas public mental health system, advocates, and consumers met in June 2006 in Dallas, Tex., to review recent evidence in the pharmacologic treatment of schizophrenia. The goal of the consensus conference was to update and revise the Texas Medication Algorithm Project (TMAP) algorithm for schizophrenia used in the Texas Implementation of Medication Algorithms, a statewide quality assurance program for treatment of major psychiatric illness. Method: Four questions were identified via premeeting teleconferences. (1) Should antipsychotic treatment of first-episode schizophrenia be different from that of multiepisode schizophrenia? (2) In which algorithm stages should first-generation antipsychotics (FGAs) be an option? (3) How many antipsychotic trials should precede a clozapine trial? (4) What is the status of augmentation strategies for clozapine? Subgroups reviewed the evidence in each area and presented their findings at the conference. Results: The algorithm was updated to incorporate the following recommendations. (1) Persons with first-episode schizophrenia typically require lower antipsychotic doses and are more sensitive to side effects such as weight gain and extrapyramidal symptoms (group consensus). Second-generation antipsychotics (SGAs) are preferred for treatment of first-episode schizophrenia (majority opinion). (2) FGAs should be included in algorithm stages after first episode that include SGAs other than clozapine as options (group consensus). (3) The recommended number of trials of other antipsychotics that should precede a clozapine trial is 2, but earlier use of clozapine should be considered in the presence of persistent problems such as suicidality, comorbid violence, and substance abuse (group consensus). (4) Augmentation is reasonable for persons with inadequate response to clozapine, but published results on augmenting agents have not identified replicable positive results (group consensus). Conclusions: These recommendations are meant to provide a framework for clinical decision making, not to replace clinical judgment. As with any algorithm, treatment practices will evolve beyond the recommendations of this consensus conference as new evidence and additional medications become available. C1 Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. Univ Maryland, Sch Med, Maryland Psychiat Res Ctr, Baltimore, MD 21201 USA. Med Coll Georgia, Dept Psychiat, Augusta, GA 30912 USA. Univ Washington, Dept Psychiat, Sch Med, Seattle, WA 98195 USA. Univ Texas Austin, Coll Pharm, Austin, TX 78712 USA. New York State Psychiat Inst & Hosp, Dept Mental Hlth Serv & Policy Res, New York, NY 10032 USA. New York Off State Mental Hlth, New York, NY USA. W Los Angeles VA Hlth Care Ctr, Los Angeles, CA USA. Univ Iowa, Dept Psychiat, Carver Coll Med, Iowa City, IA 52242 USA. Duke Univ, Dept Psychiat & Behav Sci, Durham, NC USA. Zucker Hillside Hosp N Shore Long Isl Jewish Hlth, Dept Psychiat, Glen Oaks, NY USA. Feinstein Inst Med Res, Manhasset, NY USA. Albert Einstein Coll Med, Dept Psychiat & Behav Sci, Bronx, NY 10467 USA. Georgetown Univ, Sch Med, Dept Psychiat, Washington, DC USA. VISN5 MIRECC, Dept Vet Affairs, Washington, DC USA. Univ N Carolina, Dept Psychiat, Chapel Hill, NC 27515 USA. RP Moore, TA (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Dept Psychiat, San Antonio, TX 78229 USA. EM mooret3@uthscsa.edu RI Stroup, Thomas/F-9188-2014 OI Stroup, Thomas/0000-0002-3123-0672 NR 78 TC 130 Z9 131 U1 4 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 PD NOV PY 2007 VL 68 IS 11 BP 1751 EP 1762 PG 12 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 234QQ UT WOS:000251179200015 PM 18052569 ER PT J AU Ioannou, GN Bryson, CL Boyko, EJ AF Ioannou, George N. Bryson, Chris L. Boyko, Edward J. TI Prevalence and trends of insulin resistance, impaired fasting glucose, and diabetes SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article ID US ADULTS; MELLITUS; RISK; DIAGNOSIS; OBESITY; HEALTH AB Objective: Our aim was to measure the prevalence and time trends of diabetes, impaired fasting glucose, and insulin resistance in the United States during the periods 1988-1994 and 1999-2002. Materials and methods: Data were derived from two nationally representative samples of the adult U.S. population collected as part of the National Health and Nutrition Examination Surveys of 1988-1994 (n=18,800) and 1999-2002 (n=10,283). We compared these two samples with respect to the following outcomes: previously diagnosed diabetes defined by self-report; undiagnosed diabetes defined as fasting plasma glucose >= 126 mg/dl; impaired fasting glucose defined as fasting plasma glucose 100-125 mg/dl; and insulin resistance calculated using the homeostasis model assessment as {[fasting serum insulin (mu U/ml)] X [fasting plasma glucose (mmol/L)]/22.5}. Results: The age- and sex-adjusted prevalence of diagnosed diabetes increased from 5.5% in 1988-1994 to 6.8% in 1999-2002 (change 1.3%, 95% confidence interval 0.5-2.1). Little change occurred in the adjusted prevalence of undiagnosed diabetes (from 3.0 to 3.0%) and impaired fasting glucose (from 26.2 to 26.9%). Mean insulin resistance and the proportion with high insulin resistance increased significantly both among normoglycemic persons (mean: from 2.0 to 2.2; proportion > 2.35: from 26.2 to 32.2%) and among persons with undiagnosed diabetes or impaired fasting glucose (mean: from 4.0 to 4.5; proportion > 4.4: from 24.8 to 31.1%). In 1999 to 2002, diagnosed and undiagnosed diabetes were most common in non-Hispanic blacks, whereas impaired fasting glucose was most common in Mexican Americans. Conclusions: Diabetes, impaired fasting glucose, and insulin resistance are common in the United States and their prevalence continues to increase. (c) 2007 Elsevier Inc. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Dept Med, Res Enhancement Award Program, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Med, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Med, Div Gen Internal Med, Seattle, WA 98108 USA. RP Ioannou, GN (reprint author), VA Puget Sound Hlth Care Syst, Dept Med, Res Enhancement Award Program, S-111-Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. EM georgei@medicine.washington.edu OI Boyko, Edward/0000-0002-3695-192X NR 25 TC 27 Z9 29 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1056-8727 J9 J DIABETES COMPLICAT JI J. Diabetes Complications PD NOV-DEC PY 2007 VL 21 IS 6 BP 363 EP 370 DI 10.1016/j.jdiacomp.2006.07.005 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 229NR UT WOS:000250811500005 PM 17967708 ER PT J AU Tatum, RP Wong, JA Figueredo, EJ Martin, V Oelschlager, BK AF Tatum, Roger P. Wong, Jamie A. Figueredo, Edgar J. Martin, Valeria Oelschlager, Brant K. TI Return of esophageal function after treatment for Achalasia as determined by impedance-manometry SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 48th Annual Meeting of the Society-for-Surgery-of-the-Alimentary-Tract CY MAY 19-23, 2007 CL Washington, DC SP Soc Surg Alimentary Tract DE Achalasia; Heller myotomy; esophageal motility; multichannel intraluminal impedance ID MULTICHANNEL INTRALUMINAL IMPEDANCE; IDIOPATHIC ACHALASIA; HELLERS MYOTOMY; PNEUMATIC DILATATION; FORCEFUL DILATATION; PERISTALSIS; ESOPHAGOMYOTOMY; ABNORMALITIES; MOTILITY; MODEL AB Background Treatment for Achalasia is aimed at the lower esophageal sphincter (LES), although little is known about the effect, if any, of these treatments on esophageal body function (peristalsis and clearance). We sought to measure the effect of various treatments using combined manometry (peristalsis) with Multichannel Intraluminal Impedance (MII) (esophageal clearance). Methods We enrolled 56 patients with Achalasia referred to the University of Washington Swallowing Center between January 2003 and January 2006. Each was grouped according to prior treatment: 38 were untreated (untreated achalasia), 10 had undergone botox injection or balloon dilation (endoscopic treatment), and 16 a laparoscopic Heller myotomy. The preoperative studies for 8 of the myotomy patients were included in the untreated achalasia group. Each patient completed a dysphagia severity questionnaire (scale 0-10). Peristalsis was analyzed by manometry and esophageal clearance of liquid and viscous material by MII. Results Mean dysphagia severity scores were significantly better in patients after Heller Myotomy than in either of the other groups (2.0 vs. 5.3 in the endoscopic group and 6.5 in untreated achalasia, p < 0.05). Peristaltic contractions were observed in 63% of patients in the Heller myotomy group, compared with 40% in the endoscopic group and 8% in untreated achalasia (p < 0.05 for both treatment groups vs. untreated achalasia). Liquid clearance rates were significantly better in both treatment groups: 28% in Heller myotomy and 16% in endoscopic treatment compared to only 5% in untreated achalasia (p < 0.05). Similarly, viscous clearance rates were 19% in Heller myotomy and 11% in endoscopic treatment, vs. 2% in untreated achalasia (p < 0.05). In the subset of patients who underwent manometry/MII both pre- and postoperatively, peristalsis was observed more frequently postoperatively than in preop studies (63% of patients exhibiting peristalsis vs. 12%), as was complete clearance of liquid (35% of swallows vs. 14%) and viscous boluses (22% of swallows vs. 14%). These differences were not significant, however. In the patients who had a myotomy the return of peristalsis correlates with effective esophageal clearance (liquid bolus: r=0.46, p=0.09 and viscous bolus: r=0.63, < 0.05). There is no correlation between peristalsis and bolus clearance in the endoscopic treatment group. Conclusions With treatment Achalasia patients exhibit some restoration in peristalsis as well as improved bolus clearance. After Heller Myotomy, the return of peristalsis correlates with esophageal clearance, which may partly explain its superior relief of dysphagia. C1 Univ Washington, Dept Surg, VA Puget Sound HCS, Seattle, WA 98108 USA. RP Tatum, RP (reprint author), Univ Washington, Dept Surg, VA Puget Sound HCS, 1660 S Columbian Way,S-112-Gs, Seattle, WA 98108 USA. EM rtatum@u.washington.edu NR 27 TC 13 Z9 14 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD NOV PY 2007 VL 11 IS 11 BP 1403 EP 1409 DI 10.1007/s11605-007-0293-x PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 217XF UT WOS:000249979900006 PM 17786525 ER PT J AU Bilimoria, KY Tomlinson, JS Merkow, RP Stewart, AK Ko, CY Talamonti, MS Bentrem, DJ AF Bilimoria, Karl Y. Tomlinson, James S. Merkow, Ryan P. Stewart, Andrew K. Ko, Clifford Y. Talamonti, Mark S. Bentrem, David J. TI Clinicopathologic features and treatment trends of pancreatic neuroendocrine tumors: Analysis of 9,821 patients SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article DE pancreatic neuroendocrine tumors; surgery; pancreatectomy; National Cancer Data Base ID ISLET-CELL-CARCINOMA; PROGNOSTIC-FACTORS; CONSECUTIVE PANCREATICODUODENECTOMIES; ENDOCRINE TUMORS; HOSPITAL VOLUME; SURVIVAL; SURGERY; CANCER; EXPERIENCE; ADENOCARCINOMA AB The natural history of pancreatic neuroendocrine tumors ( PNET) remains poorly defined. Our objectives were to examine the clinicopathologic features of PNETs, to assess treatment trends over time, and to identify factors associated with undergoing resection. From the National Cancer Data Base (1985-2004), 9,821 patients were identified with PNETs. Clinicopathologic features and treatment trends were examined. Multivariable logistic regression was used to assess factors associated with undergoing resection. Of 9,821 patients with PNETs, 85% were nonfunctional, 7.1% were functional, and 7.9% were carcinoid tumors. Of the 3,851 (39.0%) patients who underwent pancreatectomy, 449 (11.7%) received adjuvant chemotherapy, and 254 (6.6%) received adjuvant radiation. From 1985 to 2004, utilization of pancreatectomy increased from 39.4 to 44.3% (P < 0.0001). Patients were less likely to undergo resection if they were > 55 years old, had tumors in the head of the pancreas, tumors >= 4 cm, or had distant metastases (P < 0.0001). Patients treated at NCCN/NCI, academic, or high-volume hospitals were more likely to undergo resection. There are disparities in the utilization of pancreatectomy for PNETs. As PNETs have a better prognosis than adenocarcinoma, concerns regarding the morbidity and mortality of pancreatic surgery and neoplasms should not preclude resection. C1 Northwestern Univ, Northwestern Mem Hosp, Feinberg Sch Med, Dept Surg,Div Surg Oncol, Chicago, IL 60611 USA. Amer Coll Surg, Canc Programs, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Bentrem, DJ (reprint author), Northwestern Univ, Northwestern Mem Hosp, Feinberg Sch Med, Dept Surg,Div Surg Oncol, 675 N St Clair,Galter 10-105, Chicago, IL 60611 USA. EM dbentrem@nmff.org NR 41 TC 62 Z9 72 U1 0 U2 8 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD NOV PY 2007 VL 11 IS 11 BP 1460 EP 1467 DI 10.1007/s11605-007-0263-3 PG 8 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 217XF UT WOS:000249979900019 PM 17846854 ER PT J AU Cheng, EM Chen, A Cunningham, W AF Cheng, Eric M. Chen, Alex Cunningham, William TI Primary language and receipt of recommended health care among Hispanics in the United States SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE disparities; Hispanic health; language barriers ID MEDICARE BENEFICIARIES; PREVENTIVE SERVICES; WOMEN; VACCINATION; DISPARITIES; POPULATION; BARRIERS; ACCESS AB Background: Disparities in health care services between Hispanics and whites in the United States are well documented. Objective: The objective of the study was to determine whether language spoken at home identifies Hispanics at risk for not receiving recommended health care services. Design. The design of the study was cross-sectional, nationally representative survey of households. Patients: The patients were non-Hispanic white and Hispanic adults participating in the 2003 Medical Expenditure Panel Survey. Measurements: We compared receipt of ten recommended health care services by ethnicity and primary language adjusting for demographic and socioeconomic characteristics, health status, and access to care. Results: The sample included 12,706 whites and 5,500 Hispanics. In bivariate comparisons, 57.0% of whites received all eligible health care services compared to 53.6% for Hispanics who spoke English at home, 44.9% for Hispanics who did not speak English at home but who were comfortable speaking English, and 35.0% for Hispanics who did not speak English at home and were uncomfortable speaking English (p <.001). In multivariate logistic models, compared to non-Hispanic whites, Hispanics who did not speak English at home were less likely to receive all eligible health care services, whether they were comfortable speaking English (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.74-0.97) or not (RR 0.84, 95% Cl 0.68-0.95). Conclusions: Speaking a language other than English at home identified Hispanics at risk for not receiving recommended health care services, whether they were comfortable in speaking English or not. Identifying the mechanism for disparities by language usage may lead to interventions to reduce ethnic disparities. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. VA Greater Los Angeles, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ So Calif, Dept Pediat, Los Angeles, CA 90089 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Cheng, EM (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,B500 ML 127, Los Angeles, CA 90073 USA. EM eric.cheng@va.gov FU NIMHD NIH HHS [P20 MD000182, P20MD000148, P20 MD000148, P20MD000182] NR 24 TC 84 Z9 84 U1 1 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 NOV PY 2007 VL 22 SU 2 BP 283 EP 288 DI 10.1007/s11606-007-0346-6 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 230HI UT WOS:000250866700004 PM 17957412 ER PT J AU Gregg, J Saha, S AF Gregg, Jessica Saha, Somnath TI Communicative competence: A framework for understanding language barriers in health care SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material C1 Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, Gen Internal Med Sect, Portland VA Med Ctr, Portland, OR USA. RP Gregg, J (reprint author), Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, 3181 SW Sam Jackson Pk Rd L-475, Portland, OR 97201 USA. EM greggj@ohsu.edu NR 30 TC 17 Z9 17 U1 0 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 NOV PY 2007 VL 22 SU 2 BP 368 EP 370 DI 10.1007/s11606-007-0364-4 PG 3 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 230HI UT WOS:000250866700020 PM 17957428 ER PT J AU Lown, BA Chou, CL Clark, WD Haidet, P Kemp, M Krupat, E Pelletier, S Weissmann, P Anderson, MB AF Lown, Beth A. Chou, Calvin L. Clark, William D. Haidet, Paul Kemp, Maysel Krupat, Edward Pelletier, Stephen Weissmann, Peter Anderson, M. Brownell TI Caring attitudes in medical education: Perceptions of deans and curriculum leaders SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 117th Annual Meeting of the Association-of-American-Medical-Colleges CY OCT 30, 2006 CL Seattle, WA SP Assoc Amer Med Coll DE caring attitudes; medical education; hidden curriculum; professionalism ID PHYSICIAN-PATIENT COMMUNICATION; PRIMARY-CARE PHYSICIANS; INFORMAL CURRICULUM; PERSONAL AWARENESS; HIDDEN CURRICULUM; STUDENTS; BEHAVIOR; SCHOOLS; VALUES; EXPERIENCES AB BACKGROUND: Systems of undergraduate medical education and patient care can create barriers to fostering caring attitudes. OBJECTIVE: The aim of this study is to survey associate deans and curriculum leaders about teaching and assessment of caring attitudes in their medical schools. PARTICIPANTS: The participants of this study include 134 leaders of medical education in the USA and Canada. METHODS: We developed a survey with 26 quantitative questions and 1 open-ended question. In September to October 2005, the Association of American Medical Colleges distributed it electronically to curricular leaders. We used descriptive statistics to analyze quantitative data, and the constant comparison technique for qualitative analysis. RESULTS: We received 73 responses from 134 medical schools. Most respondents believed that their schools strongly emphasized caring attitudes. At the same time, 35% thought caring attitudes were emphasized less than scientific knowledge. Frequently used methods to teach caring attitudes included small-group discussion and didactics in the preclinical years, role modeling and mentoring in the clinical years, and skills training with feedback throughout all years. Barriers to fostering caring attitudes included time and productivity pressures and lack of faculty development. Respondents with supportive learning environments were more likely to screen applicants' caring attitudes, encourage collaborative learning, give humanism awards to faculty, and provide faculty development that emphasized teaching of caring attitudes. CONCLUSIONS: The majority of educational leaders value caring attitudes, but overall, educational systems inconsistently foster them. Schools may facilitate caring learning environments by providing faculty development and support, by assessing students and applicants for caring attitudes, and by encouraging collaboration. C1 Mt Auburn Hosp, Dept Med, Cambridge, MA 02238 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Amer Acad Commun Healthcare, Chesterfield, MO USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Vet Adm Med Ctr, San Francisco, CA 94121 USA. Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. LLC, Healthcare Qual & Commun Improvement, Chester, CT USA. Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA. Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA. Assoc Amer Med Coll, Washington, DC USA. RP Lown, BA (reprint author), Mt Auburn Hosp, Dept Med, Cambridge, MA 02238 USA. EM blown@mah.harvard.edu NR 39 TC 18 Z9 19 U1 3 U2 12 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 NOV PY 2007 VL 22 IS 11 BP 1514 EP 1522 DI 10.1007/s11606-007-0318-x PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 220EH UT WOS:000250139200005 PM 17786522 ER PT J AU Berg, KM Gill, TM Brown, AF Zerzan, J Elmore, JG Wilson, IB AF Berg, Karina M. Gill, Thomas M. Brown, Arleen F. Zerzan, Judy Elmore, Joann G. Wilson, Ira B. TI Demystifying the NIH grant application process SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE clinical research; academic medicine; NIH; funding; grants ID CLINICAL-RESEARCH AB The process of applying to the National Institutes of Health (NIH) for grant funding can be daunting. The objective of this article is to help investigators successfully navigate the NIH grant application process. We focus on the practical aspects of this process, which are commonly learned through trial and error. Our target audience is generalist faculty and fellows who are applying for NIH funding to support their career development or a clinical research project. C1 Tufts Univ New England Med Ctr, Dept Med, Boston, MA 02111 USA. Albert Einstein Coll Med, Div Gen Internal Med, Bronx, NY 10467 USA. Montefiore Med Ctr, Bronx, NY 10467 USA. Yale Univ, Sch Med, New Haven, CT USA. Univ Calif Los Angeles, Div Gen Internal Med, Los Angeles, CA USA. Univ Calif Los Angeles, Hlth Serv Res, Los Angeles, CA USA. VA Puget Sound Health Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. Univ Washington, Harborview Med Ctr, Sch Med, Seattle, WA 98104 USA. Tufts Univ New England Med Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA USA. RP Wilson, IB (reprint author), Tufts Univ New England Med Ctr, Dept Med, 750 Washington St,Box 345, Boston, MA 02111 USA. EM iwilson@tufts-nemc.org RI Wilson, Ira/F-9190-2016 OI Wilson, Ira/0000-0002-0246-738X FU NCI NIH HHS [K05 CA104699, K05 CA104699-07]; NCRR NIH HHS [K24 RR020300]; NIA NIH HHS [K23 AG 026748, K23 AG026748, K24 AG021507, K24AG021507]; NIDA NIH HHS [K23 DA 021087, K23 DA021087] NR 25 TC 5 Z9 5 U1 0 U2 6 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 NOV PY 2007 VL 22 IS 11 BP 1587 EP 1595 DI 10.1007/s11606-007-0301-6 PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 220EH UT WOS:000250139200017 PM 17687616 ER PT J AU Benton, N Harvath, TA Flaherty-Robb, M Medcraft, M Mcwhorter, K Mcclelland, F Joseph, C Mambourg, F AF Benton, Nancy Harvath, Theresa A. Flaherty-Robb, Marna Medcraft, Marijo Mcwhorter, Karen Mcclelland, Faith Joseph, Carol Mambourg, Floris TI Managing - Chronic, nonhealing wounds SO JOURNAL OF GERONTOLOGICAL NURSING LA English DT Article ID CHRONIC VENOUS INSUFFICIENCY; LEG ULCERS AB The physical, emotional, and financial costs of caring for patients with chronic, nonhealing leg wounds are substantial. In fiscal year 200, the home care department of a large Veterans Affairs medical center in the Pacific Northwest spent nearly half of its annual budget on veterans needing wound care. In this article, the authors describe a practice improvement project designed to improve the wound care management of homebound veterans with chronic, nonnealing lower extremity wound using a research-based protocol and consultation by a certified wound care specialist. as well as the effect of this program on home care expenditures. C1 Oregon Hlth & Sci Univ, Sch Nursing, Portland, OR 97239 USA. Portland VA Med Ctr, Nursing Skilled Care Unit, Portland, OR 97239 USA. Portland VA Med Ctr, Home & Community Based Serv, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Hosp & Clin, Portland, OR 97201 USA. RP Harvath, TA (reprint author), Oregon Hlth & Sci Univ, Sch Nursing, 3455 SW US Vet Rd,SN-6S, Portland, OR 97239 USA. EM harvatbt@ohsu.edu NR 19 TC 7 Z9 7 U1 1 U2 3 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0098-9134 J9 J GERONTOL NURS JI J. Gerontol. Nurs. PD NOV PY 2007 VL 33 IS 11 BP 38 EP 45 PG 8 WC Geriatrics & Gerontology; Gerontology; Nursing SC Geriatrics & Gerontology; Nursing GA 230NX UT WOS:000250884300006 PM 18019117 ER PT J AU Crandall, LG White, DL Schuldheis, S Talerico, KA AF Crandall, Lynda G. White, Diana L. Schuldheis, Sherrie Talerico, Karen Amann TI Initiating Person-Centered care practices in long-term care facilities SO JOURNAL OF GERONTOLOGICAL NURSING LA English DT Article ID NURSING-HOME; TRIAL; MODEL AB Person-centered care is a key concept guiding efforts to improve long-term care. Elements of person-centered care include personhood, knowing the person, maximizing choice and autonomy, comfort, nurturing relationships, and a supportive physical and organizational environment. The Oregon Health & Science University Hartford Center of Geriatric Nursing Excellence and the state agency that oversees health care for older adults worked in partnership with 9 long-term care facilities. Each developed and implemented person-centered care practices, including those focused on bathing, dining, or gardening. This article describes the processes used to develop and support these practices. Three exemplary facilities made significant practice changes, 4 made important but more moderate changes, and 2 made minimal progress. These facilities differed in terms of existing culture, management practices, staff involvement, and attention to sustainability. C1 Oregon Hlth & Sci Univ, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. Amann Talerico Consulting, Portland, OR USA. RP White, DL (reprint author), Oregon Hlth & Sci Univ, 3455 SW US Vet Rd,SN-6S, Portland, OR 97239 USA. EM whitedi@ohsu.edu NR 29 TC 38 Z9 38 U1 0 U2 14 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0098-9134 J9 J GERONTOL NURS JI J. Gerontol. Nurs. PD NOV PY 2007 VL 33 IS 11 BP 47 EP 56 PG 10 WC Geriatrics & Gerontology; Gerontology; Nursing SC Geriatrics & Gerontology; Nursing GA 230NX UT WOS:000250884300007 PM 18019118 ER PT J AU Harte, BJ Dhaliwal, G Armstrong, W Pile, JC AF Harte, Brian J. Dhaliwal, Gurpreet Armstrong, Wendy Pile, James C. TI A rash decision SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material ID HUMAN-IMMUNODEFICIENCY-VIRUS; UNKNOWN ORIGIN; SECONDARY SYPHILIS; FEVER; DIAGNOSIS C1 [Harte, Brian J.] Cleveland Clin, Dept Hosp Med, Cleveland, OH 44195 USA. [Dhaliwal, Gurpreet] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Dhaliwal, Gurpreet] San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. [Armstrong, Wendy] Emory Univ, Sch Med, Dept Infect Dis, Atlanta, GA USA. [Pile, James C.] Case Western Reserve Univ, Dept Med, Cleveland, OH 44106 USA. RP Harte, BJ (reprint author), Cleveland Clin, Dept Hosp Med, Desk S70,9500 Euclid Ave, Cleveland, OH 44195 USA. EM harteb@ccf.org RI Armstrong, Wendy/N-3623-2013 NR 15 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD NOV-DEC PY 2007 VL 2 IS 6 BP 433 EP 438 DI 10.1002/jhm.253 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 292IA UT WOS:000255258500012 PM 18081174 ER PT J AU Hyle, EP Gasink, LB Linkin, DR Bilker, WB Lautenbach, E AF Hyle, Emily P. Gasink, Leanne B. Linkin, Darren R. Bilker, Warren B. Lautenbach, Ebbing TI Use of different thresholds of prior antimicrobial use in defining exposure: Impact on the association between antimicrobial use and antimicrobial resistance SO JOURNAL OF INFECTION LA English DT Article DE resistance; antimicrobial; FQRPA; fluoroquinolones; methodology ID RISK-FACTORS; KLEBSIELLA-PNEUMONIAE; LIMITATIONS; INFECTION AB Objectives: Although many studies have explored the association between antimicrobial use and antimicrobial resistance, definitions of "exposure" (i.e., prior antimicrobial use) differ across such studies. Specifically, it has been noted that some studies define "exposure" as any antimicrobial use, while others require the administration of at least 24 or 48 h of an antimicrobial to constitute "exposure." The impact of different definitions of exposure on final study results is unknown. We conducted the current study to determine the impact of varying the minimum threshold of prior antimicrobial use to define exposure status in studies of antimicrobial resistance. Methods: We used a dataset from a prior study of risk factors for fluoroquinolone (FQ) resistant Pseudomonas aeruginosa (FQRPA) to address the study aim. Four separate multivariable models of risk factors for FQRPA were built. Each model defined a different threshold for the duration of antimicrobial administration to determine "exposure" to that antimicrobial: (1) no threshold (i.e., a subject is considered exposed if any use of the antimicrobial was documented); (2) > 24 h of use of the antimicrobial is necessary to be considered exposed; (3) > 48 h of use is required; and (4) > 72 h of use is required. Except for these definitions, the four multivariable models were built in exactly the same way, each using prior FQ use as the primary risk factor of interest. Results: Among 872 P. aeruginosa isolates included in the original dataset, 332 (38.2%) were FQ-resistant. Each of the four multivariable models identified prior FQ use as an independent risk factor for FQRPA. However, as increasingly strict thresholds were used, the association between FQ use and FQRPA increased. Furthermore, prior use of an agent with activity against anaerobic bacteria was associated with FQRPA in models 2, 3 and 4, but not in model 1. Conclusions: The use of different thresholds to define prior "exposure" to antimicrobials altered the associations between antimicrobial use and resistance. Stricter thresholds resulted in a higher estimate of the association between antimicrobial use and resistance. Furthermore, different risk factors may be identified depending on how exposure is defined. Greater attention to this issue is necessary to optimize identification of modifiable risk factors for resistance as well as accurately compare results across studies. (c) 2007 Published by Elsevier Ltd on behalf of The British Infection Society. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Div Infect Dis, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Lautenbach, E (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 825 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM ebbing@mail.med.upenn.edu OI Linkin, Darren R./0000-0002-2408-0987 FU NIAID NIH HHS [K23-AI-060887-01, T32 AI055435]; NIDDK NIH HHS [DK-02987-01] NR 16 TC 8 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 NOV PY 2007 VL 55 IS 5 BP 414 EP 418 DI 10.1016/j.jinf.2007.07.005 PG 5 WC Infectious Diseases SC Infectious Diseases GA 234KM UT WOS:000251160300005 PM 17850877 ER PT J AU Dellavalle, RP Freeman, SR Williams, HC AF Dellavalle, Robert P. Freeman, Scott R. Williams, Hywel C. TI Clinical evidence epistemology SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Letter ID TRIALS C1 Univ Colorado, Hlth Sci Ctr, Dept Dermatol, Denver, CO USA. Denver VA Med Ctr, Denver, CO USA. Univ Nottingham Hosp, Ctr Evidence Based Dermatol, Natl Hlth Serv Trust, Nottingham NG7 2UH, England. RP Dellavalle, RP (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Dermatol, Denver, CO 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] NR 10 TC 2 Z9 2 U1 1 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD NOV PY 2007 VL 127 IS 11 BP 2668 EP 2669 DI 10.1038/sj.jid.5700894 PG 2 WC Dermatology SC Dermatology GA 221KS UT WOS:000250226800025 PM 17508017 ER PT J AU Rutkute, K Asmis, RH Nikolova-Karakashian, MN AF Rutkute, Kristina Asmis, Reto H. Nikolova-Karakashian, Mariana N. TI Regulation of neutral sphingomyelinase-2 by GSH: a new insight to the role of oxidative stress in aging-associated inflammation SO JOURNAL OF LIPID RESEARCH LA English DT Article DE ceramide; calorie restriction; interleukin-1 receptor-associated kinase-1; c-Jun N-terminal kinase; reduced glutathione ID RECEPTOR-ASSOCIATED KINASE; CYTOCHROME-P450 2C11 CYP2C11; AGE-ASSOCIATED INCREASE; KAPPA-B ACTIVITY; ANTIOXIDANT ENZYMES; LIVER GLUTATHIONE; PLASMA-MEMBRANE; RAT HEPATOCYTES; CELL-DEATH; CERAMIDE AB Oxidative stress and inflammation are fundamental for the onset of aging and appear to be causatively linked. Previously, we reported that hepatocytes from aged rats, compared with young rats, are hyperresponsive to interleukin-1 beta (IL-1 beta) stimulation and exhibit more potent c-Jun N-terminal kinase ( JNK) activation and attenuated interleukin-1 receptor-associated kinase-1 ( IRAK-1) degradation. An age-related increase in the activity of neutral sphingomyelinase-2 ( NSMase-2), a plasma membrane enzyme, was found to be responsible for the IL-1 beta hyperresponsiveness. The results reported here show that increased NSMase activity during aging is caused by a 60-70% decrease in hepatocyte GSH levels. GSH, at concentrations typically found in hepatocytes from young animals, inhibits NSMase activity in a biphasic dose-dependent manner. Inhibition of GSH synthesis in young hepatocytes activates NSMase, causing increased JNK activation and IRAK-1 stabilization in response to IL-1 beta, mimicking the hyperresponsiveness typical for aged hepatocytes. Vice versa, increased GSH content in hepatocytes from aged animals by treatment with N-acetylcysteine inhibits NSMase activity and restores normal IL-1 beta response. Importantly, the GSH decline, NSMase activation, and IL-1 beta hyperresponsiveness are not observed in aged, calorie-restricted rats. In summary, this report demonstrates that depletion of cellular GSH during aging plays an important role in regulating the hepatic response to IL-1 beta by inducing NSMase-2 activity. C1 Univ Kentucky, Albert B Chandler Med Ctr, Dept Physiol, Lexington, KY 40536 USA. Univ Texas, Hlth Sci Ctr, Audie L Murphy Vet Hosp, Div Nephrol, San Antonio, TX 78284 USA. RP Nikolova-Karakashian, MN (reprint author), Univ Kentucky, Albert B Chandler Med Ctr, Dept Physiol, Lexington, KY 40536 USA. EM mnikolo@uky.edu FU NIA NIH HHS [R01 AG026711, R01 AG019223, R01 AG026711-01A2] NR 51 TC 33 Z9 34 U1 0 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD NOV PY 2007 VL 48 IS 11 BP 2443 EP 2452 DI 10.1194/jlr.M700227-JLR200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 220HT UT WOS:000250148500012 PM 17693623 ER PT J AU Shahidi, A Montalvan, I Perozo, I Fernandes, H AF Shahidi, A. Montalvan, I. Perozo, I. Fernandes, H. TI Comparison of invader and LIPA in the determination of hepatitis C virus genotype using COBAS TaqMan amplicons SO JOURNAL OF MOLECULAR DIAGNOSTICS LA English DT Meeting Abstract CT 13th Annual Meeting of the Association-for-Molecular-Pathology CY NOV 07-10, 2007 CL Los Angeles, CA SP Assoc Mol Pathol C1 [Shahidi, A.; Perozo, I.] James J Peters Vet Affairs Med Ctr, Bronx, NY USA. [Montalvan, I.] Univ Med & Dent New Jersey, Sch Med, Newark, NJ 07103 USA. [Fernandes, H.] Univ Med & Dent New Jersey, Newark, NJ 07103 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 1525-1578 J9 J MOL DIAGN JI J. Mol. Diagn. PD NOV PY 2007 VL 9 IS 5 BP 697 EP 698 PG 2 WC Pathology SC Pathology GA 230BC UT WOS:000250849300221 ER PT J AU Won, JS Singh, AK Singh, I AF Won, Je-Seong Singh, Avtar K. Singh, Inderjit TI Lactosylceramide: a lipid second messenger in neuroinflammatory disease SO JOURNAL OF NEUROCHEMISTRY LA English DT Article; Proceedings Paper CT 2nd ISN Special Neurochemistry Conference CY DEC 01-05, 2006 CL ANTIGUA & BARBU SP Int Soc Neurochem DE glucosylceramide : UDPgaltransferase (beta 4GalTVI); lactosylceramide; mitogen-activated protein kinases; NF kappa B; PI3Kinase; Ras GTPase; sphingomyelinase ID NITRIC-OXIDE SYNTHASE; TUMOR-NECROSIS-FACTOR; RICH MEMBRANE RAFTS; NEUTRAL SPHINGOMYELINASE ACTIVATION; RAT PRIMARY ASTROCYTES; NIEMANN-PICK DISEASE; NF-KAPPA-B; ACID SPHINGOMYELINASE; NADPH OXIDASE; GLYCOSPHINGOLIPID BIOSYNTHESIS AB Inflammatory disease plays a critical role in the pathogenesis of many neurological disorders. Astrogliosis and induction of pro-inflammatory mediators such as chemokines, cytokines and inducible nitric oxide synthase (iNOS) are the 'hallmarks' of inflammatory disease. Increased activity of lactosylceramide (LacCer) synthase and increased synthesis of LacCer during glial proliferation, and induction of pro-inflammatory cytokines and iNOS suggests a role for LacCer in these cellular signaling pathways. Studies using complementary techniques of inhibitors and antisense reported that inhibition of LacCer synthesis inhibits glial proliferation, as well as the induction of pro-inflammatory mediators (cytokines and iNOS). This inhibition was bypassed by exogenous LacCer, but not by other related lipids (e.g. glucosylceramide, galactocerebroside, GD1, GM1), indicating a role for LacCer in inflammatory signaling pathways. Furthermore, inhibition of glial proliferation and induction of inflammatory mediators by antisense to Ras GTPase, PI3Kinase and inhibitors of mitogen-activated protein kinase indicate the participation of the phosphoinositide 3-kinase (PI3Kinas)/Ras/mitogen-activated protein kinase/nuclear factor-kappa B (NF-kappa B) signaling pathways in LacCer-mediated inflammatory events thus exposing additional targets for therapeutics for inflammatory disease conditions. C1 Med Univ S Carolina, Charles P Darby Childrens Res Inst, Dept Pediat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pathol & Lab Med, Charleston, SC 29425 USA. Ralph H Johnson Vet Adm Med Ctr, Lab Med Serv, Charleston, SC USA. RP Singh, I (reprint author), Childrens Res Inst, Dept Pediat, 173 Ashley Ave, Charleston, SC 29425 USA. EM singhi@musc.edu FU NIA NIH HHS [AG25307]; NINDS NIH HHS [NS-37766, NS-22576, NS-34741] NR 124 TC 14 Z9 14 U1 1 U2 3 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-3042 EI 1471-4159 J9 J NEUROCHEM JI J. Neurochem. PD NOV PY 2007 VL 103 SU 1 BP 180 EP 191 DI 10.1111/j.1471-4159.2007.04822.x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 225XU UT WOS:000250552400022 PM 17986153 ER PT J AU Ma, QL Harris-White, ME Ubeda, OJ Simmons, M Beech, W Lim, GP Teter, B Frautschy, SA Cole, GM AF Ma, Qiu-Lan Harris-White, Marni E. Ubeda, Oliver J. Simmons, Mychica Beech, Walter Lim, Giselle P. Teter, Bruce Frautschy, Sally A. Cole, Greg M. TI Evidence of A beta- and transgene-dependent defects in ERK-CREB signaling in Alzheimer's models SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE alzheimer disease; cAMP-response element-binding protein; extracellular-signal regulated kinase; immunization; signal transduction; Tg2576 mice ID ACTIVATED PROTEIN-KINASE; LONG-TERM POTENTIATION; GROWTH-FACTOR-I; AMYLOID-BETA; MOUSE MODEL; NMDA RECEPTOR; HIPPOCAMPAL-NEURONS; NEUROTROPHIC FACTOR; CORTICAL-NEURONS; UP-REGULATION AB Extracellular-signal regulated kinase (ERK) signaling is critical for memory and tightly regulated by acute environmental stimuli. In Alzheimer disease transgenic models, active ERK is shown to first be increased, then later reduced, but whether these baseline changes reflect disruptions in ERK signaling is less clear. We investigated the influence of the familial Alzheimer's disease transgene APPsw and beta-amyloid peptide (Ab) immunoneutralization on cannulation injury-associated (i. c. v. infusion) ERK activation. At both 12 and 22 months of age, the trauma-associated activation of ERK observed in Tg(-)) mice was dramatically attenuated in Tg(+). In cortices of 22-month-old non-infused mice, a reduction in ERK activation was observed in Tg+, relative to Tg(-)) mice. Intracerebroventricular (i. c. v.) anti-Ab infusion significantly increased phosphorylated ERK, its substrate cAMP-response element-binding protein (CREB) and a downstream target, the NMDA receptor subunit. We also demonstrated that Ab oligomer decreased active ERK and subsequently active CREB in human neuroblastoma cells, which could be prevented by oligomer immunoneutralization. Ab oligomers also inhibited active ERK and CREB in primary neurons, in addition to reducing the downstream post- synaptic protein NMDA receptor subunit. These effects were reversed by anti- oligomer. Our data strongly support the existence of an APPsw transgene- dependent and Ab oligomer- mediated defect in regulation of ERK activation. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Affairs Healthcare Syst, VA Med Ctr, Geriatr Res & Clin Ctr, North Hills, CA 91343 USA. RP Ma, QL (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, Alzheimers Res, 151,Bldg 7,Room A101,16111 Plummer St, North Hills, CA 91343 USA. FU NIA NIH HHS [AG022080, R01 AG016793-05, R01 AG021975-01A2, R01 AG010685-13, AG021975, R01 AG010685-09, R01 AG016793-03, R01 AG010685-10, R01 AG010685-11, R01 AG016793-04, R01 AG021975-03, R01 AG010685-14, R01 AG021975-04, R01 AG010685-12, R01 AG010685, R01 AG021975-02, R01 AG021975, R01 AG016793, R01 AG022080]; NINDS NIH HHS [NS43946, R01 NS043946, R01 NS043946-05, R01 NS043946-02, R01 NS043946-04, R01 NS043946-03, R01 NS043946-01] NR 64 TC 63 Z9 65 U1 1 U2 7 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD NOV PY 2007 VL 103 IS 4 BP 1594 EP 1607 DI 10.1111/j.1471-4159.2007.04869.x PG 14 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 223WH UT WOS:000250403500030 PM 17760871 ER PT J AU Kudsk, KA Gomez, FE Kang, W Ueno, C AF Kudsk, Kenneth A. Gomez, F. Enrique Kang, Woodae Ueno, Chikara TI Enteral feeding of a chemically defined diet preserves pulmonary immunity but not intestinal immunity: The role of lymphotoxin beta receptor SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID RESPIRATORY-TRACT IMMUNITY; LYMPHOID-TISSUE; MUCOSAL IMMUNITY; PARENTERAL-NUTRITION; EXPRESSION; BLOCKADE; ROUTE AB Background: Compared with chow or a complex enteral diet (CED), IV administration of a parenteral nutrition solution (IV-PN) impairs intestinal and respiratory mucosal immunity, resulting in cellular and immunoglobulin A (IgA) defects in the intestine and impaired respiratory antiviral and antibacterial defenses. PN given intragastrically (IG-PN) impairs intestinal immunity similar to IV-PN but preserves antiviral defences and partially preserves antibacterial defenses. Lymphotoxin 0 receptor (LT beta R) is a molecule essential for development and organization of lymphoid tissue. It controls many molecules important in mucosal immune integrity. This study examines effects of route (IV or enteral) and type (PN, CED, or chow) on murine intestine and lung LT beta R expression. Methods: Forty-three mice randomly received IV-PN (n = 12), IG-PN (n = 11), IV saline + chow (chow; n = 11), or a CED (n = 9). After 5 days of feeding, intestinal and lung samples were obtained and processed for levels of LT beta R by Western blot. Results: IV-PN significantly reduced intestinal and lung LT beta R compared with CED and chow; IG-PN reduced LT beta R levels only in the intestine but preserved lung levels. Conclusions: Route and type of nutrition differentially influence molecular events in the intestinal and respiratory mucosal immune systems. Enteral feeding with any diet (complex or chemically defined) maintains lung LT beta R expression, whereas intestinal LT beta R levels are maintained only with CEDs (chow and CED). We hypothesize that LT beta R is responsible for the observed preservation of respiratory tract immunity with administration of a noncomplex, chemically defined enteral diet, whereas intestinal immunity is compromised with this diet. C1 William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. Univ Wisconsin, Dept Surg, Coll Med & Publ Hlth, Madison, WI 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 18 TC 6 Z9 6 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 NOV-DEC PY 2007 VL 31 IS 6 BP 477 EP 481 DI 10.1177/0148607107031006477 PG 5 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 227VU UT WOS:000250686700005 PM 17947602 ER PT J AU Gordon, PL Sakkas, GK Doyle, JW Shubert, T Johansen, KL AF Gordon, Patricia L. Sakkas, Giorgos K. Doyle, Julie W. Shubert, Tiffany Johansen, Kirsten L. TI Relationship between vitamin D and muscle size and strength in patients on hemodialysis SO JOURNAL OF RENAL NUTRITION LA English DT Article ID CHRONIC-RENAL-FAILURE; SKELETAL-MUSCLE; 1,25-DIHYDROXYVITAMIN-D LEVELS; CARDIOVASCULAR MORTALITY; D METABOLITES; D-DEFICIENT; DISEASE; RATS; PERFORMANCE; 1,25-DIHYDROXYCHOLECALCIFEROL AB Objective: Vitamin D has various actions in skeletal muscle. The purpose of this study was to compare lower-limb muscle size and strength in hemodialysis (HD) patients being treated with 1,25-dihydroxyvitamin D (calcitriol) or a 1,25-dihydroxyvitamin D analogue (paricalcitol) with lower-limb muscle size and strength in HD patients who were receiving none. Design: This was a retrospective, cross-sectional study. Setting: This study was performed in outpatient HD centers. Patients: Hemodialysis patients receiving calcitriol or paricalcitol (active vitamin D) for control of secondary hyperparathyroidism (VitD, n = 49) were compared with HD patients who were not (n = 30). Main Outcome Measures: The main outcome measures included the cross-sectional areas (CSAs) of the thigh and tibialis anterior muscles by magnetic resonance imaging, and three measures of strength: the three-repetition maximum (3RM) for knee extension (isotonic), the peak torque of knee extensors (isokinetic), and maximal voluntary contraction of the ankle dorsiflexor muscles (isometric). Results: There were no differences in age, weight, dialysis vintage, or intact parathyroid hormone levels between groups, although serum albumin was higher in the VitD group (P < .05). Patients in the VitD group had a larger thigh-muscle CSA (P < .05) and were stronger across all strength measures (P < .05) after controlling for age and gender (by analysis of covariance). When all analyses were subsequently adjusted for serum albumin concentration, only the difference in 3RM knee-extension strength lost significance. There were no significant differences in any measurements between patients who received calcitriol or paricalcitol. Conclusion: Treatment with active vitamin D was associated with greater muscle size and strength in this cohort of HD patients. (C) 2007 by the National Kidney Foundation, Inc. C1 Univ Calif San Francisco, Sch Nursing, Dept Physiol Nursing, San Francisco, CA 94143 USA. No California Inst Res & Educ, San Francisco, CA USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA. Univ Thessaly, Sch Hlth Sci, Larisa, Greece. Univ N Carolina, Sch Med, Chapel Hill, NC USA. San Francisco Vet Adm Med Ctr, Nephrol Sect, San Francisco, CA USA. RP Gordon, PL (reprint author), Univ Calif San Francisco, Sch Nursing, Dept Physiol Nursing, 2 Koret Way, San Francisco, CA 94143 USA. EM patricia.gordon@nursing.ucsf.edu OI Sakkas, Giorgos/0000-0002-2462-995X FU NCRR NIH HHS [M01 RR000083, M01 RR000083-430502]; NIDDK NIH HHS [R01 DK056182, R01 DK056182-01, R01 DK056182-02, R01 DK056182-03, R01 DK056182-04, R01-DK56182] NR 42 TC 18 Z9 19 U1 2 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1051-2276 J9 J RENAL NUTR JI J. Renal Nutr. PD NOV PY 2007 VL 17 IS 6 BP 397 EP 407 DI 10.1053/j.jrn.2007.06.001 PG 11 WC Nutrition & Dietetics; Urology & Nephrology SC Nutrition & Dietetics; Urology & Nephrology GA 234FQ UT WOS:000251146500005 PM 17971312 ER PT J AU Gallun, FJ Mason, CR Kidd, G AF Gallun, Frederick J. Mason, Christine R. Kidd, Gerald, Jr. TI The ability to listen with independent ears SO JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA LA English DT Article; Proceedings Paper CT 29th Midwinter Meeting of the Association-for-Research-in-Otolaryngology CY FEB 05-08, 2006 CL Baltimore, MD SP Assoc Res Otolaryngol ID MASKING-LEVEL DIFFERENCES; INFORMATIONAL MASKING; SPEECH IDENTIFICATION; CANCELLATION THEORY; MONAURAL DETECTION; CONTRALATERAL CUE; WITHIN-EAR; INTERFERENCE; TASK; EQUALIZATION AB In three experiments, listeners identified speech processed into narrow bands and presented to the right ("target") ear. The ability of listeners to ignore (or even use) conflicting contralateral stimulation was examined by presenting various maskers to the target ear ("ipsilateral") and nontarget ear ("contralateral"). Theoretically, an absence of contralateral interference would imply selectively attending to only the target ear; the presence of interference from the contralateral stimulus would imply that listeners were unable to treat the stimuli at the two ears independently; and improved performance in the presence of informative contralateral stimulation would imply that listeners can process the signals at both ears and keep them separate rather than combining them. Experiments showed evidence of the ability to selectively process (or respond to) only the target ear in some, but not all, conditions. No evidence was found for improved performance due to contralateral stimulation. The pattern of interference found across experiments supports an interaction of stimulus-based factors (auditory grouping) and task-based factors (demand for processing resources) and suggests that listeners may not always be able to listen to the "better" ear even when it would be beneficial to do so. (c) 2007 Acoustical Society of America. C1 Boston Univ, Dept Speech Language & Hearing Sci, Boston, MA 02215 USA. Boston Univ, Hearing Res Ctr, Boston, MA 02215 USA. RP Gallun, FJ (reprint author), Natl Ctr Rehabil Auditory Res, Portland VA Med Ctr, 3710 SW US Vet Hosp Rd NCRAR, Portland, OR 97239 USA. EM Frederick.Gallun@va.gov RI Gallun, Frederick/G-3792-2012 OI Gallun, Frederick/0000-0002-4145-2199 FU NIDCD NIH HHS [F32 DC006526, DC00100, DC04545, DC04663, R01 DC004545] NR 39 TC 8 Z9 8 U1 0 U2 2 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 NOV PY 2007 VL 122 IS 5 BP 2814 EP 2825 DI 10.1121/1.2780143 PN 1 PG 12 WC Acoustics; Audiology & Speech-Language Pathology SC Acoustics; Audiology & Speech-Language Pathology GA 224MT UT WOS:000250451800033 PM 18189571 ER PT J AU Levy, C Palat, SIT Kramer, AM AF Levy, Cari Palat, Sing-I T. Kramer, Andrew M. TI Physician practice patterns in nursing homes SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Review DE physician practices; practice models; nursing home; physician role ID HEALTH-CARE UTILIZATION; FEE-FOR-SERVICE; MANAGED CARE; NATIONAL-SURVEY; UNITED-STATES; RESIDENTS; PRACTITIONERS; HOSPITALIZATION; EDUCATION; EVERCARE AB This review of the literature describes models of physician practice in nursing homes including the barriers to increasing physician workforce in nursing homes and the impact of various physician practice models on quality of care in nursing homes. Traditional nursing home practice is first described followed by a review of the literature pertaining to nurse practitioners and physician assistants in nursing home practices, closed staffing models, managed care, and nursing home specialist models. Literature describing barriers to increasing the physician workforce in nursing homes is then presented including training, reimbursement, and malpractice insurance for physicians who work in nursing homes. Finally, the impact of physician practice models on quality of care is reviewed with a focus on frequency of visits, hospitalizations, cost-effectiveness, communication, and patient satisfaction. C1 Univ Colorado, Hlth Sci Ctr, Aurora, CO 80045 USA. Univ Colorado, Denver VA Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Div Hlthcare Policy & Res, Denver, CO USA. Denver Vet Affairs Med Ctr, Aurora, CO USA. Univ Colorado, Denver Hlth Sci Ctr, Div Geriatr Med, Denver, CO USA. RP Levy, C (reprint author), Univ Colorado, Hlth Sci Ctr, 13611 E Colfax Ave, Suite 100, Aurora, CO 80045 USA. EM Cari.Levy@uchsc.edu NR 76 TC 14 Z9 14 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD NOV PY 2007 VL 8 IS 9 BP 558 EP 567 DI 10.1016/j.jamda.2007.06.015 PG 10 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 236YC UT WOS:000251338400003 PM 17998111 ER PT J AU Wagner, B Ricono, JM Gorin, Y Block, K Arar, M Riley, D Choudhury, GG Abboud, HE AF Wagner, Brent Ricono, Jill M. Gorin, Yves Block, Karen Arar, Mazen Riley, Dan Choudhury, Goutarn Ghosh Abboud, Hanna E. TI Mitogenic signaling via platelet-derived growth factor beta in metanephric mesenchymal cells SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID SMOOTH-MUSCLE-CELLS; AKT/PROTEIN KINASE-B; MESANGIAL CELLS; NAD(P)H OXIDASE; FACTOR-RECEPTOR; PHOSPHATIDYLINOSITOL 3'-KINASE; PDGF-RECEPTOR; DNA-SYNTHESIS; ACTIVATION; EXPRESSION AB Mice deficient in either platelet-derived growth factor (PDGF) B chain or PDGF receptor (PDGFR) beta lack mesangial cells. PDGF stimulates proliferation and migration of metanephric mesenchymal cells, from which mesangial cells are derived. Binding of PDGF to PDGFR-p induces autophosphorylation at specific tyrosine residues and activates various effector proteins, including phosphatidylinositol-3-kinase (PI3-K). This study explored the role of PI 3-K and reactive oxygen species (ROS) in PDGF-mediated signaling using cells established from wild-type and PDGFR-beta -/- metanephric blastemas at 11.5 days post-conception. PDGF-induced effects that were dependent on PI3-K activation were determined using PDGFR-beta -/- cells made to express "add-back" mutant PDGFR-beta capable of binding PI3-K. We found that PDGF is mitogenic for mesenchymal cells expressing PDGFR-beta, and PI3-K is an important regulator of PDGF-induced DNA synthesis. Activation of ERK1/2 is partially dependent on PI3-K, and both the PI3-K and MEK-ERK1/2 pathways contribute to PI3-K-dependent mitogenesis. In addition, PDGF-induced DNA synthesis in wild-type cells was found to be dependent on ROS that are generated downstream of PI3-K activation. Using antisense oligonucleotides and small interfering RNA, we determined that the NAD(P)H oxidase Nox4 produces these ROS that activate Akt and the MEK-ERK1/2 mitogenic cascade. In conclusion, the present study demonstrates Nox4 involvement in PDGF-induced DNA synthesis in metanephric mesenchymal cells and provides the first evidence that PDGF-induced PI3-K activity enhances production of ROS by Nox4. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pediat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Inst Biotechnol, Dept Mol Med, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Wagner, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol, 7703 Floyd Curl Dr,MC 7882, San Antonio, TX 78229 USA. EM wagnerb@uthscsa.edu OI Gorin, Yves/0000-0003-4048-6925; Wagner, Brent/0000-0002-7063-0142 FU NIDDK NIH HHS [R01 DK50190, DK-33665] NR 39 TC 18 Z9 19 U1 0 U2 2 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD NOV PY 2007 VL 18 IS 11 BP 2903 EP 2911 DI 10.1681/ASN.2006111229 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 228NW UT WOS:000250737600018 PM 17942966 ER PT J AU Johansen, KL Chertow, GM Jin, C Kutner, NG AF Johansen, Kirsten L. Chertow, Glenn M. Jin, Chengshi Kutner, Nancy G. TI Significance of frailty among dialysis patients SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID KIDNEY-DISEASE; WOMENS HEALTH; OLDER; DISABILITY AB The construct of frailty has been associated with adverse outcomes among elderly individuals, but the prevalence and significance of frailty among patients with end-stage renal disease have not been established. The aim of the current study was to determine the prevalence and predictors of frailty among a cohort of incident dialysis patients and to determine the degree to which frailty was associated with death and hospitalization. We studied a cohort of 2275 adults who participated in the Dialysis Morbidity and Mortality Wave 2 study, of whom two-thirds met our definition of frailty: a composite construct that incorporated poor self-reported physical functioning, exhaustion/fatigue, low physical activity, and undernutrition. Multivariable logistic regression analysis suggested that older age, female sex, and hemodialysis (rather than peritoneal dialysis) were independently associated with frailty. Cox proportional hazards modeling indicated that frailty was independently associated with higher risk of death (adjusted hazard ratio [HR] 2.24, 95% confidence interval [CI] 1.60-3.15) and with the combined outcome of death or hospitalization (adjusted HR 1.63, 95% CI 1.41-1.87). Frailty is extremely common and is associated with adverse outcomes among incident dialysis patients. Given its prevalence and consequences, increased research efforts should focus on interventions aimed to prevent or attenuate frailty in the dialysis population. C1 Univ Calif San Francisco, San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Div Nephrol, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Emory Univ, Dept Rehabil Med, Atlanta, GA 30322 USA. RP Johansen, KL (reprint author), Univ Calif San Francisco, San Francisco VA Med Ctr, Nephrol Sect, 111J,4150 Clement St, San Francisco, CA 94121 USA. EM kirsten.johansen@ucsf.edu FU NIDDK NIH HHS [N01-DK-1-2450, N01-DK-1-2471] NR 19 TC 172 Z9 175 U1 0 U2 4 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD NOV PY 2007 VL 18 IS 11 BP 2960 EP 2967 DI 10.1681/ASN.2007020221 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 228NW UT WOS:000250737600025 PM 17942958 ER PT J AU Choi, AI Rodriguez, RA Bacchetti, P Bertenthal, D Volberding, PA O'Hare, AM AF Choi, Andy I. Rodriguez, Rudolph A. Bacchetti, Peter Bertenthal, Daniel Volberding, Paul A. O'Hare, Ann M. TI Racial differences in end-stage renal disease rates in HIV infection versus diabetes SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; CHRONIC KIDNEY-DISEASE; SOCIOECONOMIC-STATUS; UNITED-STATES; ADMINISTRATIVE DATA; VETERAN POPULATION; SERUM CREATININE; NEPHROPATHY; DISPARITIES AB Few studies have compared the incidence of end-stage renal disease (ESRD) among individuals with the human immunodeficiency virus (HIV) and diabetes. We followed a national sample of 2,015,891 US veterans over a median peroid of 3.7 years for progression to ESRD. The age- and sex-adjusted incidence of ESRD (per 1000 person-years) among HIV-infected black patients was nearly an order of magnitude higher than among HIV-positive white patients, almost twice that of diabetic whites, and similar to that among diabetic blacks. In multivariate Cox proportional hazards analysis, diabetes was associated with an increased risk of ESRD among white patients, but HIV was not. Among black individuals, however, both HIV and diabetes conferred a similar increase in the risk of ESRD (4- to 5-fold increase compared to white individuals without HIV or diabetes). HIV and diabetes carry a similar risk of ESRD among black patients, highlighting the importance of developing strategies to prevent and treat renal disease among HIV-infected black individuals. C1 Univ Calif San Francisco, Renal Ctr, Dept Med, San Francisco Gen Hosp, San Francisco, CA 94110 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94110 USA. San Francisco VA Med Ctr, VA Res Enhancement Award Program, San Francisco, CA USA. Univ Washington, Seattle, WA 98195 USA. VA Puget Healthcare Syst, Dept Med, Seattle, WA USA. RP Choi, AI (reprint author), Univ Calif San Francisco, Renal Ctr, Dept Med, San Francisco Gen Hosp, Box 1341,Bldg 100,Room 350,1001 Potrero Ave, San Francisco, CA 94110 USA. EM andy.choi@ucsf.edu FU NIA NIH HHS [K23-AG028980-01]; NIAID NIH HHS [P30-AI27763]; NIDDK NIH HHS [T32-DK07219] NR 43 TC 75 Z9 76 U1 2 U2 4 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD NOV PY 2007 VL 18 IS 11 BP 2968 EP 2974 DI 10.1681/ASN.2007040402 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 228NW UT WOS:000250737600026 PM 17942954 ER PT J AU Weisbord, SD Fried, LF Mor, MK Resnick, AL Kimmel, PL Palevsky, PM Fine, MJ AF Weisbord, Steven D. Fried, Linda F. Mor, Maria K. Resnick, Abby L. Kimmel, Paul L. Palevsky, Paul M. Fine, Michael J. TI Associations of race and ethnicity with anemia management among patients initiating renal replacement therapy SO JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION LA English DT Article DE health disparities; end-stage renal disease; kidney; race/ethnicity ID CHRONIC KIDNEY-DISEASE; RECOMBINANT-HUMAN-ERYTHROPOIETIN; RACIAL-DIFFERENCES; UNITED-STATES; HEMODIALYSIS; DIALYSIS; HEMOGLOBIN; TRENDS; CARE; POPULATION AB Background : Many patients initiate renal replacement therapy with suboptimal anemia management. The factors contributing to this remain largely unknown. The aim of this study was to assess the associations of race and ethnicity with anemia care prior to the initiation of renal replacement therapy. Methods: Using data from the medical evidence form filed for patients who initiated renal replacement therapy between 1995-2003, we assessed racial and ethnic differences in pre-end-stage renal disease hematocrit levels, the use of erythropoiesis stimulation agents (ESAs), the proportion of patients with hernatocrit levels >= 33% and the proportion of patients with hernatocrit levels < 33% that did not receive ESA. We also examined secular trends in racial and ethnic differences in these parameters. Results: In multivariable analyses, non-Hispanic blacks had lower hematocrit levels (A hematocrit = -0.97%, 95% Cl: -1.00-0.94%), and were less likely to receive ESA (OR=0.82, 95% Cl: 0.81-0.84), to initiate renal replacement therapy with hematocit >= 33% (OR=0.78, 95% Cl: 0.77-0.79) or to receive ESA if the hematocrit was < 33% (OR=0.79, 95% Cl: 0.77-0.80) than non-Hispanic whites. White Hispanics also had lower hematocrit levels (A hematocrit = -0.42%, 95% Cl:-0.47% to -0.37%), and were less likely to receive ESA (OR=0.86, 95% Cl: 0.85-0.88), to have hematocrit levels >= 33% (OR=0.91, 95% Cl: 0.89-0.93) or to receive ESA if the hematocrit was < 33% (OR=0.85, 95% Cl: 0.83-0.87) than non-Hispanic whites. These disparities persisted over the eight-year study period. Conclusions: African-American race and Hispanic ethnicity are associated with suboptimal pre-end-stage renal disease anemia management. Efforts to improve anemia care should incorporate targeted interventions to decrease these disparities. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Med Specialty Serv Line, Renal Sect, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. George Washington Univ, Med Ctr, Dept Med, Div Renal Dis & Hypertens, Washington, DC 20037 USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Mailstop 111F-U,7E Room 120, Pittsburgh, PA USA. EM weisbordsd@upmc.edu FU NIAID NIH HHS [K24 AI001769] NR 29 TC 10 Z9 10 U1 1 U2 1 PU NATL MED ASSOC PI WASHINGON PA 1012 10TH ST, N W, WASHINGON, DC 20001 USA SN 0027-9684 J9 J NATL MED ASSOC JI J. Natl. Med. Assoc. PD NOV PY 2007 VL 99 IS 11 BP 1218 EP 1226 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 231GW UT WOS:000250935600001 PM 18020096 ER PT J AU Lin, PH Zhou, W Kougias, P El Sayed, HF Barshes, NR Huynh, TT AF Lin, Peter H. Zhou, Wei Kougias, Panagiotis El Sayed, Hosam F. Barshes, Neal R. Huynh, Tam T. TI Factors associated with hypotension and bradycardia after carotid angioplasty and stenting SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 31st Annual Meeting of the Southern-Association-for-Vascular-Surgery CY JAN 17-20, 2007 CL Rio Grande, PR SP So Assoc Vasc Surg ID HIGH-RISK PATIENTS; HEMODYNAMIC INSTABILITY; CLINICAL-OUTCOMES; CIGARETTE-SMOKING; ARTERY STENOSIS; BLOOD-PRESSURE; ENDARTERECTOMY; PREDICTORS; PREVENTION; PROTECTION AB Background: Acute procedurally induced hemodynamic depression can occur after carotid angioplasty and stenting (CAS). This study was performed to determine the frequency and risk factors for hypotension and bradycardia after the CAS procedure. Methods: The study reviewed clinical variables and angiographic data of all patients undergoing elective CAS with neuroprotection during a recent 5-year period. Intravenous atropine was given selectively in cases of bradycardia (heart rate <60 beats/min or a decrease of >20 beats/min). We further defined hemodynamic depression as bradycardia or severe hypotension (systolic blood pressure fall >30 turn Hg). Frequency and potential risk factors for hemodynamic depression were analyzed by logistic regression. Results: During the study period, 416 patients (99% male; mean age, 74 +/- 11 years) underwent the CAS procedure. The median degree of stenosis was 93% (range, 60% to 99%). The frequencies of post-CAS hemodynamic depression include hypotension in 58 (14%), bradycardia in 112 (27%), or both in 21 (5%). All patients with bradycardia received intraprocedural atropine, and all heart rates returned to the baseline level. Persistent hypotension occurred in 45 patients (11%). Increased age was associated with CAS-induced bradycardia or hypotension. Adjusted risk factors associated with hemodynamic depression include age >78 years (odds ratio [OR], 5.25; 95% confidence interval [CI], 2.32 to 15.25; P = .01) and ejection fraction of <25% (OR, 3.25; 95% CI, 0.58 to 6.58; P = .02). CEA-related restenosis was associated with a reduced risk of hemodynamic depression (OR, 0.21; 95% CI, 0.12 to 0.69, P = .001). Persistent hypotension after CAS was associated with an increased risk of an adverse clinical event (44%, P = .001). Conclusions: Hemodynamic depression, including hypotension and bradycardia, is frequent after CAS. However, CAS-induced hemodynamic depression is rare in patients with postendarterectomy stenosis. Patients with compromised ejection fraction and increased age are at a higher risk of presenting with CAS-induced hemodynamic instability, and persistent hypotension after CAS is associated with an increased postprocedural complication rate. C1 Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. RP Lin, PH (reprint author), Baylor Coll Med, Dept Surg, VAMC 112,2002 Holcomb Blvd, Houston, TX 77030 USA. EM plin@bcm.edu NR 35 TC 26 Z9 32 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD NOV PY 2007 VL 46 IS 5 BP 846 EP 854 DI 10.1016/j.jvs.2007.07.020 PG 9 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 227RO UT WOS:000250675700003 PM 17980268 ER PT J AU Bean-Mayberry, B Yano, EM Bayliss, N Navratil, J Weisman, CS Scholle, SH AF Bean-Mayberry, Bevanne Yano, Elizabeth M. Bayliss, Nichole Navratil, Judith Weisman, Carol S. Scholle, Sarah Hudson TI Federally funded comprehensive women's health centers: Leading innovation in women's healthcare delivery SO JOURNAL OF WOMENS HEALTH LA English DT Article ID AFFAIRS MEDICAL-CENTER; QUALITY-OF-CARE; NATIONAL CENTERS; EXCELLENCE; SYSTEM AB Aims: Women's healthcare has historically been fragmented, given the artificial separation of reproductive care from general medical care. Aiming to advance new care models for delivery of comprehensive, integrated clinical care for women, two federal agencies-the U. S. Department of Health and Human Services (DHHS) and Department of Veterans Affairs (VA)-launched specialized women's health centers (WHCs). Exemplars of comprehensive service delivery, these originally federally funded centers have served as foundations for innovations in delivering comprehensive care to women in diverse practice settings. Little is known, however, about details of their organization, staffing, practice arrangements, and service availability that might inform adoption of similar models in the community. Methods: Using comparable key informant surveys, we collected organizational data from the DHHS National Centers of Excellence (CoE) (n = 13) and the original VA comprehensive WHC's (n = 8). We abstracted supplemental data (e. g., academic affiliation) from the 2001 American Hospital Association (AHA) survey. Results: All DHHS and VA women's health programs served urban areas, and nearly all had academic partnerships. DHHS centers had three times the average caseload as did VA centers. Preventive cancer screening and general reproductive services were uniformly available at all centers, although DHHS centers offered extensive reproductive services on-site more frequently, and VA centers more often had on-site mental healthcare. Conclusions: The DHHS and VA comprehensive WHCs share similar missions and comparable organization, education, and clinical services, demonstrating their commitment to reducing fragmented service delivery. Their common structural components present opportunities for further advancing women's quality of care across other systems of care. C1 VA Greater Los Angeles Healthcare Syst, VA HSR&D Ctr Excellence Study Healthcare Provider, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. VA Pittsburgh Healthcare Syst, CHERP, Pittsburgh, PA USA. Univ Pittsburgh, Dept Sociol, Pittsburgh, PA USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. Penn State Univ, Coll Med, Dept Hlth Evaluat Sci, Hershey, PA USA. Penn State Univ, Coll Med, Dept Obstet & Gynaecol, Hershey, PA USA. Natl Comm Qual Assurance Res & Anal, Washington, DC USA. RP Bean-Mayberry, B (reprint author), VA Greater Los Angeles Healthcare Syst, VA HSR&D Ctr Excellence Study Healthcare Provider, 16111 Plummer St,Mailcode 152, Sepulveda, CA 91343 USA. EM Bevanne.bean-mayberry@va.gov NR 26 TC 23 Z9 23 U1 0 U2 3 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 NOV PY 2007 VL 16 IS 9 BP 1281 EP 1290 DI 10.1089/jwh.2006.0284 PG 10 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 234PB UT WOS:000251174900005 PM 18001184 ER PT J AU Du, YP Chu, R Hwang, D Brown, MS Kleinschmidt-DeMasters, BK Singel, D Simon, JH AF Du, Yiping P. Chu, Renxin Hwang, Dosik Brown, Mark S. Kleinschmidt-DeMasters, Bette K. Singel, Debra Simon, Jack H. TI Fast multislice mapping of the myelin water fraction using multicompartment analysis of T-2* decay at 3T: A preliminary postmortem study SO MAGNETIC RESONANCE IN MEDICINE LA English DT Article DE myelin water fraction; multicompartment analysis; demyelination; multiple sclerosis; postmortem ID IN-VIVO MEASUREMENT; MULTIPLE-SCLEROSIS; WHITE-MATTER; MAGNETIC-RESONANCE; BRAIN; T-2; RELAXATION; MODEL; REDUCTION; COMPONENT AB Quantitative mapping of the myelin water content can provide significant insight into the pathophysiology of several white matter diseases, such as multiple sclerosis and leukoencephalopathies, and can potentially become a useful clinical tool for early diagnosis of these diseases. In this study, multicompartment analysis of T-2(*) decay (MCAT2(*)) was used for the quantitative mapping of myelin water fraction (MWF). T-2(*) decay of each voxel at multiple slice locations was acquired in fixed human brains using a multigradient-echo (MGRE) pulse sequence with alternating readout gradient polarities. Compared to prior techniques using Carr-Purcell-Meiboom-Gill (CPMG) acquisition, the MGRE acquisition approach has: 1) a very short first echo time (approximate to 2 ms) and echo-spacing (approximate to 1 ms), which allows for the acquisition of multiple sampling points during the fast decay of the myelin water signal; 2) a low RF duty cycle, which is especially important for achieving acceptable specific absorption rate (SAR) levels at high field strengths. Multicompartment analysis was then applied to the T-2(*) decay in each pixel using a 3-pool model of white matter to detect the signal arising from the myelin water, myelinated axonal water, and mixed water compartments. C1 Univ Colorado, Hlth Sci Ctr, Dept Radiol, Aurora, CO 80010 USA. Univ Colorado, Hlth Sci Ctr, Dept Pathol, Aurora, CO 80010 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurol, Aurora, CO 80010 USA. Univ Colorado, Hlth Sci Ctr, Dept Neurosurg, Aurora, CO 80010 USA. Portland VA Med Ctr, Dept Imaging, Portland, OR USA. RP Du, YP (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Bldg 400,12469 E 17th Pl, Aurora, CO 80010 USA. EM Yiping.Du@UCHSC.edu NR 18 TC 58 Z9 58 U1 0 U2 5 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0740-3194 J9 MAGN RESON MED JI Magn. Reson. Med. PD NOV PY 2007 VL 58 IS 5 BP 865 EP 870 DI 10.1002/mrm.21409 PG 6 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 226AQ UT WOS:000250560000002 PM 17969125 ER PT J AU Yu, F Houston, TK Bay, MN Garner, DQ Berner, ES AF Yu, Feliciano Houston, Thomas K. Bay, Midge N. Garner, Duriel Q. Berner, Eta S. TI Patterns of use of handheld clinical decision support tools in the clinical setting SO MEDICAL DECISION MAKING LA English DT Article; Proceedings Paper CT 26th Annual Meeting of the Society-for-Medical-Decision-Making CY OCT 17-20, 2004 CL Atlanta, GA SP Soc Med Decis Making DE decision support systems; clinical; computers; handheld; decision making; computer assisted; internal medicine ID PERSONAL DIGITAL ASSISTANT; COMPUTER USE; RESIDENCY PROGRAMS; HEALTH-CARE; PHYSICIANS; ATTITUDES; EXPERIENCE; KNOWLEDGE; EDUCATION; SYSTEMS AB Objectives. To assess the patterns of use of handheld clinical decision support tools by internal medicine residents in clinical settings. Methods. Eighty-two internal medicine residents were given personal digital assistants (PDAs) containing a suite of clinical decision support (CDS) programs. A tracking program was used to prospectively track program use during the study period, and a follow-up survey regarding self-reported program use was administered after the study period. Patterns of program use from the tracking data were compared to the data from the self-report survey. Results. Sixty-eight residents were followed using the tracking data. Residents used an average of 1.81 CDS programs (SD: 1.57; range, 0-5) per month, Fortynine residents completed the self-report survey. Residents reported using an average of 3.15 (SD: 1.61) and 3.92 (SD: 1.40) CDS programs during a typical clinic session and inpatient day, respectively. In both inpatient and outpatient settings and for both methods of assessing program use, 2 programs (Epocrotes and MedCalc) were used more often than the other programs. No association was observed between age, gender, race, and PGY level with the use of handheld clinical decision support tools for either tracked or self-report data. The self-report data show higher estimates of CDS program use than the tracking data in the clinical setting. Conclusions. The data show that physicians prefer to use certain handheld CDS tools in clinical settings. Drug references and medical calculators have been consistently used more than clinical prediction rules and diagnostic systems. Self-report survey instruments may overestimate recorded use of CDS programs. C1 Univ Alabama, Div Emergency Med, Dept Pediat, Birmingham, AL 35233 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL USA. Univ Alabama, Dept Med, Birmingham, AL USA. Univ Alabama, Dept Hlth Serv Adm, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Deep S Ctr Effectiveness Res, Birmingham, AL USA. Univ Alabama, Hlth Serv & Outcomes Res Training Program, Birmingham, AL USA. RP Yu, F (reprint author), Univ Alabama, Div Emergency Med, Dept Pediat, 1600 7th Ave S,Informat Technol,Suite 200-14, Birmingham, AL 35233 USA. EM fyu@peds.uab.edu RI Houston, Thomas/F-2469-2013 OI Berner, Eta/0000-0003-4319-2949 FU AHRQ HHS [R18 HS011820] NR 39 TC 5 Z9 5 U1 1 U2 4 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 NOV-DEC PY 2007 VL 27 IS 6 BP 744 EP 753 DI 10.1177/0272989X07305321 PG 10 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 236QN UT WOS:000251318600004 PM 17873262 ER PT J AU Karlamangla, AS Singer, BH Chodosh, J McEwen, BS Seeman, TE AF Karlamangla, Arun S. Singer, Burton H. Chodosh, Joshua McEwen, Bruce S. Seeman, Teresa E. TI Urinary cortisol excretion: Is it really a predictor of incident cognitive impairment? - Response SO NEUROBIOLOGY OF AGING LA English DT Letter DE urine free cortisol C1 Univ Calif Los Angeles, Div Geriatr, David Geffen Sch Med, Los Angeles, CA 90095 USA. Princeton Univ, Off Populat Res, Princeton, NJ 08544 USA. VA Greater Los Angeles Hlth Syst, Hlth Serv Res, Los Angeles, CA USA. Rockefeller Univ, Neuroendocrinol Lab, New York, NY 10021 USA. RP Karlamangla, AS (reprint author), Univ Calif Los Angeles, Div Geriatr, David Geffen Sch Med, 10945 Le Conte 2339, Los Angeles, CA 90095 USA. EM akarlamangla@mednet.ucla.edu OI Chodosh, Joshua/0000-0001-7784-4306 NR 2 TC 0 Z9 0 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0197-4580 J9 NEUROBIOL AGING JI Neurobiol. Aging PD NOV PY 2007 VL 28 IS 11 BP 1793 EP 1793 DI 10.1016/j.neurobiolaging.2006.09.017 PG 1 WC Geriatrics & Gerontology; Neurosciences SC Geriatrics & Gerontology; Neurosciences & Neurology GA 217KI UT WOS:000249946400019 ER PT J AU Yuan, PQ Million, M Wu, SV Rivier, J Tache, Y AF Yuan, P. -Q. Million, M. Wu, S. V. Rivier, J. Tache, Y. TI Peripheral corticotropin releasing factor (CRF) and a novel CRF1 receptor agonist, stressin(1)-A activate CRF1 receptor expressing cholinergic and nitrergic myenteric neurons selectively in the colon of conscious rats SO NEUROGASTROENTEROLOGY AND MOTILITY LA English DT Article DE colonic motility; corticotropin releasing factor; CRF1 receptor; enteric nervous system; Fos; peripheral choline acetyltransferase; stressin(1)-A ID ENTERIC NERVOUS-SYSTEM; GIANT MIGRATING CONTRACTIONS; IRRITABLE-BOWEL-SYNDROME; FOS EXPRESSION; GUINEA-PIG; SIGNALING PATHWAYS; TYPE-1 RECEPTOR; MESSENGER-RNA; BRAIN-STEM; C-FOS AB Intraperitoneal (i.p.)corticotropin releasing factor (CRF) induced a CRF1 receptor-dependent stimulation of myenteric neurons and motility in the rat proximal colon. We characterize the colonic enteric nervous system response to CRF in conscious rats. Laser capture microdissection combined with reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry in longitudinal muscle myenteric plexus whole-mount colonic preparations revealed CRF1 receptor expression in myenteric neurons. CRF (i.p., 10 mu g kg(-1)) induced Fos immunoreactivity (IR) (cells per ganglion) selectively in myenteric plexus of proximal (18.3 +/- 2.4 vs vehicle: 0.0 +/- 0.0) and distal colon (16.8 +/- 1.2 vs vehicle: 0.0 +/- 0.0), but not in that of gastric corpus, antrum, duodenum, jejunum and ileum. The selective CRF1 agonist, stressin(1)-A (i.p., 10 mu g kg(-1)) also induced Fos IR in myenteric but not in submucosal plexus of the proximal and distal colon. Fos IR induced by CRF was located in 55 +/- 1.9% and 53 +/- 5.1% of CRF1 receptor-IR myenteric neurons and in 44 +/- 2.8% and 40 +/- 3.9% of cholinergic neurons with Dogiel type I morphology, and in 20 +/- 1.6% and 80 +/- 3.3% of nitrergic neurons in proximal and distal colon respectively. CRF and stressin(1)-A elicit defecation and diarrhoea. These data support that one mechanism through which peripherally injected CRF ligands stimulate colonic function involves a direct action on colonic cholinergic and nitrergic myenteric neurons expressing CRF1 receptor. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, VA Greater Los Angeles Healthcare Syst, Div Digest Dis,Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Prot Biol, La Jolla, CA 92037 USA. RP Yuan, PQ (reprint author), Bldg 115,Rm 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM pqyuan@mednet.ucla.edu FU NIDDK NIH HHS [DK 41301, P01 DK 026741, R01 DK- 57238, R21 DK-068155] NR 65 TC 45 Z9 46 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1350-1925 J9 NEUROGASTROENT MOTIL JI Neurogastroenterol. Motil. PD NOV PY 2007 VL 19 IS 11 BP 923 EP 936 DI 10.1111/j.1365-2982.2007.00978.x PG 14 WC Gastroenterology & Hepatology; Clinical Neurology; Neurosciences SC Gastroenterology & Hepatology; Neurosciences & Neurology GA 228KU UT WOS:000250729600008 PM 17973638 ER PT J AU Franklin, TR Wang, Z Wang, J Sciortino, N Harper, D Li, Y Ehrman, R Kampman, K O'Brien, CP Detre, JA Childress, AR AF Franklin, Teresa R. wang, Ze Wang, Jiongjiong Sciortino, Nathan Harper, Derek Li, Yin Ehrman, Ron Kampman, Kyle O'Brien, Charles P. Detre, John A. Childress, Anna Rose TI Limbic activation to cigarette smoking cues independent of nicotine withdrawal: A perfusion fMRI study SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE cigarette smoking; craving; neuroimaging; ventral striatum; amygdala; DLPFC ID INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW; SUSTAINED-RELEASE BUPROPION; VENTRAL TEGMENTAL AREA; PREFRONTAL CORTEX; NUCLEUS-ACCUMBENS; DSM-IV; SMOKERS; ADDICTION; CESSATION; AVAILABILITY AB Exposure to cigarette smoking cues can trigger physiological arousal and desire to smoke. The brain substrates of smoking cue-induced craving (CIC) are beginning to be elucidated; however, it has been difficult to study this state independent of the potential contributions of pharmacological withdrawal from nicotine. Pharmacological withdrawal itself may have substantial effects on brain activation to cues, either by obscuring or enhancing it, and as CIC is not reduced by nicotine replacement strategies, its neuro-anatomical substrates may differ. Thus, characterizing CIC is critical for developing effective interventions. This study used arterial spin-labeled (ASL) perfusion fMRI, and newly developed and highly appetitive, explicit smoking stimuli, to examine neural activity to cigarette CIC in an original experimental design that strongly minimizes contributions from pharmacological withdrawal. Twenty-one smokers ( 12 females) completed smoking and nonsmoking cue fMRI sessions. Craving self-reports were collected before and after each session. SPM2 software was employed to analyze data. Blood flow ( perfusion) in a priori-selected regions was greater during exposure to smoking stimuli compared to nonsmoking stimuli (p < 0.01; corrected) in ventral striatum, amygdala, orbitofrontal cortex, hippocampus, medial thalamus, and left insula. Perfusion positively correlated with intensity of cigarette CIC in both the dorsolateral prefrontal cortex (r(2) = 0.54) and posterior cingulate (r(2) = 0.53). This pattern of activation that includes the ventral striatum, a critical reward substrate, and the interconnected amygdala, cingulate and OFC, is consistent with decades of animal research on the neural correlates of conditioned drug reward. C1 Univ Penn, Dept Psychiat, Addict Treatment Res Ctr, Philadelphia, PA 19104 USA. Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Franklin, TR (reprint author), Univ Penn, Dept Psychiat, Addict Treatment Res Ctr, 3900 Chestnut St, Philadelphia, PA 19104 USA. EM franklin_t@mail.trc.upenn.edu RI Wang, Ze/A-1043-2007 FU NCRR NIH HHS [RR02305]; NIDA NIH HHS [5-P60-DA-005186-18, DA015149, K01 DA 015426-011A1, K01 DA015426, P60 DA005186, R21 DA025882]; NINDS NIH HHS [NS045839]; PHS HHS [BCS-0224007] NR 46 TC 181 Z9 190 U1 2 U2 17 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD NOV PY 2007 VL 32 IS 11 BP 2301 EP 2309 DI 10.1038/sj.npp.1301371 PG 9 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 221KL UT WOS:000250226000006 PM 17375140 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 Second generation antipsychotic drugs: Is there a common mechanism in the development of obesity? Reply SO NEUROPSYCHOPHARMACOLOGY LA English DT Letter ID ATYPICAL ANTIPSYCHOTICS; SCHIZOPHRENIA; WEIGHT; SERUM 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, 1675 Univ Blvd, Birmingham, AL 35294 USA. EM helliner@uab.edu NR 13 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD NOV PY 2007 VL 32 IS 11 BP 2433 EP 2434 DI 10.1038/sj.npp.1301367 PG 2 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 221KL UT WOS:000250226000020 ER PT J AU Fu, SS McFall, M Saxon, AJ Beckham, JC Carmody, TP Baker, DG Joseph, AM AF Fu, Steven S. McFall, Miles Saxon, Andrew J. Beckham, Jean C. Carmody, Timothy P. Baker, Dewleen G. Joseph, Anne M. TI Post-traumatic stress disorder and smoking: A systematic review SO NICOTINE & TOBACCO RESEARCH LA English DT Review ID VIETNAM COMBAT VETERANS; SUBSTANCE USE DISORDERS; CORTICOTROPIN-RELEASING-FACTOR; MENTAL-HEALTH-CARE; NICOTINE DEPENDENCE; CIGARETTE-SMOKING; NEW-YORK; RISK-FACTORS; PSYCHIATRIC-DISORDERS; TERRORIST ATTACKS AB We conducted a systematic review of what is known about the relationship between post-traumatic stress disorder (PTSD) and smoking to guide research on underlying mechanisms and to facilitate the development of evidence-based tobacco treatments for this population of smokers. We searched Medline, PsychINFO, and the Cochrane Central Register of Controlled Trials and identified 45 studies for review that presented primary data on PTSD and smoking. Smoking rates were high among clinical samples with PTSD (40%-86%) as well as nonclinical populations with PTSD (34%-61%). Most studies showed a positive relationship between PTSD and smoking and nicotine dependence, with odds ratios ranging between 2.04 and 4.52. Findings also suggest that PTSD, rather than trauma exposure itself, is more influential for increasing risk of smoking. A small but growing literature has examined psychological factors related to smoking initiation and maintenance and the overlapping neurobiology of PTSD and nicotine dependence. Observational studies indicate that smokers with PTSD have lower quit rates than do smokers without PTSD. Yet a few tobacco cessation treatment trials in smokers with PTSD have achieved quit rates comparable with controlled trials of smokers without mental disorders. In conclusion, the evidence points to a causal relationship between PTSD and smoking that may be bidirectional. Specific PTSD symptoms may contribute to smoking and disrupt cessation attempts. Intervention studies that test behavioral and pharmacological interventions designed specifically for use in patients with PTSD are needed to reduce morbidity and mortality in this population. C1 VA Med Ctr, Ctr Chron Dis Outcomes Res, Minneapolis, MN 55417 USA. Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA. Univ Washington, NW Network Mental Illness Res Educ & Clin Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Durham VA Med Ctr, Durham, NC USA. Duke Univ, Med Ctr, Durham, NC USA. VISN 6 Mental Illness Res Educ & Clin Ctr, Durham, NC USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Vet Affairs Med Ctr, Mental Hlth Serv, San Francisco, CA 94121 USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RP Fu, SS (reprint author), VA Med Ctr, Ctr Chron Dis Outcomes Res, 152-2E,1 Vet Dr, Minneapolis, MN 55417 USA. EM steven.fu@va.gov NR 89 TC 116 Z9 117 U1 2 U2 18 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1462-2203 J9 NICOTINE TOB RES JI Nicotine Tob. Res. PD NOV PY 2007 VL 9 IS 11 BP 1071 EP 1084 DI 10.1080/14622200701488418 PG 14 WC Substance Abuse; Public, Environmental & Occupational Health SC Substance Abuse; Public, Environmental & Occupational Health GA 236WS UT WOS:000251334700003 PM 17978982 ER PT J AU Gourcerol, G Coskun, T Craft, LS Mayer, JP Heiman, ML Wang, L Million, M Pierre, DH Tache, Y AF Gourcerol, Guillaume Coskun, Tamer Craft, Libbey S. Mayer, John P. Heiman, Mark L. Wang, Lixin Million, Mulugeta St.-Pierre, David H. Tache, Yvette TI Preproghrelin-derived peptide, obestatin, fails to influence food intake in lean or obese rodents SO OBESITY LA English DT Article DE ghrelin; gastric motility; high-fat diet; glucose; gut-brain axis ID CORTICOTROPIN-RELEASING-FACTOR; GROWTH-HORMONE-SECRETION; NERVOUS-SYSTEM; ENERGY-BALANCE; WEIGHT-GAIN; GHRELIN; RATS; MOTILITY; MICE; SOMATOSTATIN AB Objectives: Obestatin has been initially characterized as a new peptide derived from the ghrelin precursor, which suppresses food intake and inhibits the orexigenic and prokinetic actions of ghrelin when injected peripherally or centrally in lean mice. However, reproducing these data remains controversial. Reasons for the disparity may be the use of different doses, routes, and animal models. We aimed to investigate the effects of peripheral and intracisternal (IQ injection of obestatin on feeding, gastric motility, and blood glucose in rats as well as in diet-induced obese (DIO) mice. Research Methods and Procedures: Food intake and gastric emptying of a semi-liquid caloric meal were measured after intraperitoneal (IP) injection of obestatin in rats and DID mice. Gastric phasic motility and blood glucose were monitored in urethane-anesthetized rats after IC or intravenous (IV) injection of obestatin. Results: Obestatin injected intraperitoneally at doses ranging from 0. 1 to 3 mg/kg influenced neither acute food intake nor gastric emptying in rats. Obestatin injected intravenously at 0.3 or 3 mg/kg and IC at 7.5 or 30 mu g/rat modified neither fasted gastric phasic motility nor blood glucose levels, while ghrelin (30 mu g/kg, IV) increased and vagotomy suppressed gastric motility, and an oligosomatostatin analog (3 mu g/rat, IQ decreased blood glucose. Obestatin, injected intraperitoneally (0.3 mg/kg) in DID mice, did not alter feeding response to a fast, while urocortin 1 (10 mu g/kg, IP) induced a 73.3 % inhibition at 2 hours. Discussion: Our data demonstrate that peripheral administration of obestatin did not modify food intake in rats or obese mice or gastric motor function in rats. C1 [Gourcerol, Guillaume; Wang, Lixin; Million, Mulugeta; Tache, Yvette] Univ Calif Los Angeles, Ctr Ulcer Res & Educ CURE, Digest Dis Res Ctr, Ctr Neurovisceral Sci & Womens Hlth Dept Med, Los Angeles, CA USA. [Tache, Yvette] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Coskun, Tamer; Craft, Libbey S.; Mayer, John P.; Heiman, Mark L.] Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA. [St.-Pierre, David H.] Univ Montreal, Dept Nutr, Montreal, PQ H3C 3J7, Canada. RP Tache, Y (reprint author), Ctr Neurovisceral Sci & Womens Hlth, VA Greater Los Angeles Healthcare Syst, CURE Bldg 115,Room 117,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM ytache@mednet.ucla.edu FU NIDDK NIH HHS [DK-41,301, R01 DK-33,061] NR 42 TC 53 Z9 55 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1930-7381 J9 OBESITY JI Obesity PD NOV PY 2007 VL 15 IS 11 BP 2643 EP 2652 DI 10.1038/oby.2007.316 PG 10 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 243EX UT WOS:000251779000017 PM 18070755 ER PT J AU Burgio, KL Richter, HE Clements, RH Redden, DT Goode, PS AF Burgio, Kathryn L. Richter, Holly E. Clements, Ronald H. Redden, David T. Goode, Patricia S. TI Changes in urinary and fecal incontinence symptoms with weight loss surgery in morbidity obese women SO OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 33rd Annual Meeting of the Society-of-Gynecological-Surgeons CY APR 13, 2007 CL Orlando, FL SP Soc Gynecol Surg ID Y-GASTRIC-BYPASS; PROLAPSE; QUALITY; COHORT; LIFE AB Objective: To examine changes in the prevalence and severity of urinary incontinence (UI) and fecal incontinence in morbidly obese women undergoing laparoscopic weight loss surgery. Methods: In a prospective cohort study, 101 women (aged 20-55 years) with body mass index (BMI) of 40 or more underwent laparoscopic Roux-en-Y gastric bypass and were followed to 6 and 12 months. Presence, severity, and effect of UI were assessed using the Medical, Epidemiological, and Social Aspects of Aging Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Fecal incontinence was assessed by self-report of anal leakage. Results: Mean BMI decreased from 48.9 +/- 7.2 presurgery to 35.3 +/- 6.5 at 6 months and 30.2 +/- 5.7 at 12 months postsurgery. Prevalence of Ul decreased from 66.7% presurgery to 41.0% at 6 months and 37.0% at 12 months (P<.001; 95% confidence interval [CI] for change 18.640.0%). Reduction in prevalence of Ul was significantly tinent women who lost 18 or more BMI points, 71% regained urinary continence at 12 months. Medical, Epidemiological, and Social Aspects of Aging Questionnaire urge and stress scores decreased (both P<.001; 95% CI 0.5-1.85 and 2.71-5.34, respectively), as did scores on the Urogenital Distress Inventory (P<.001; 95% CI 8.3116.21) and Incontinence Impact Questionnaire (P<.001; 95% CI 4.71-14.60), indicating reduction in severity. Prevalence of fecal incontinence (solid or liquid stool) decreased from 19.4% to 9.1% at 6 months and 8.6% at 12 months (P=.018; 95% Cl 2.1-19.4%). Conclusion: Prevalence of Ul and fecal incontinence decreased after bariatric surgery. Magnitude of weight loss was associated with reduction in Ul prevalence, strengthening the inference that improvements are attributable to weight loss. C1 Univ Alabama, Birmingham VA Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Div Gerontol Geriatr & Palliat Care, Birmingham, AL 35294 USA. Univ Alabama, Dept Obstet & Gynecol, Div Womens Pelv Med & Reconstruct Surg, Birmingham, AL 35294 USA. Univ Alabama, Dept Surg, Birmingham, AL 35294 USA. Univ Alabama, Dept Biostat, Birmingham, AL 35294 USA. RP Burgio, KL (reprint author), Univ Alabama, Birmingham VA Med Ctr, Ctr Geriatr Res Educ & Clin, 11G,700 S 19th St, Birmingham, AL 35294 USA. EM kburgio@aging.uab.edu FU NIDDK NIH HHS [DK068389] NR 26 TC 89 Z9 90 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD NOV PY 2007 VL 110 IS 5 BP 1034 EP 1040 DI 10.1097/01.AOG.0000285483.22898.9c PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 223HM UT WOS:000250360800014 PM 17978117 ER PT J AU Quang, TS Wallner, KE Herstein, PR Palo, BM Walker, JB Sutlief, S AF Quang, Tony S. Wallner, Kent E. Herstein, Paul R. Palo, B. Marie Walker, Joseph B. Sutlief, Steven TI Technologic evolution in the treatment of prostate cancer - Clinical, financial, and legal implications for managed care organizations SO ONCOLOGY-NEW YORK LA English DT Editorial Material ID RADICAL PROSTATECTOMY; RECTAL COMPLICATIONS; BRACHYTHERAPY; I-125; RISK; RADIOTHERAPY; MORBIDITY; PD-103; LIKELIHOOD; CARCINOMA C1 [Quang, Tony S.; Wallner, Kent E.; Herstein, Paul R.; Walker, Joseph B.; Sutlief, Steven] Univ Washington, Med Ctr, Dept Radiat Oncol,Radiat Oncol Serv, Dept Vet Affairs,Radiat Oncol Grp Hlth Cooperat, Seattle, WA 98195 USA. [Palo, B. Marie] Univ Calif Davis, Med Ctr, Dept Radiat Oncol, Sacramento, CA 95817 USA. RP Quang, TS (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 35 TC 2 Z9 2 U1 0 U2 0 PU P R R INC PI MELVILLE PA 48 SOUTH SERVICE RD, MELVILLE, NY 11747 USA SN 0890-9091 J9 ONCOLOGY-NY JI Oncology-NY PD NOV PY 2007 VL 21 IS 13 BP 1598 EP + PG 6 WC Oncology SC Oncology GA 270RV UT WOS:000253738800008 PM 18179049 ER PT J AU Odinokova, IV Sung, KF Hermann, K Mareninova, OA Gukovsky, I Gukovskaya, AS AF Odinokova, I. V. Sung, K. F. Hermann, K. Mareninova, O. A. Gukovsky, I. Gukovskaya, A. S. TI Bcl-xL and Bcl-2 prosurvival proteins protect against necrosis in pancreatitis SO PANCREAS LA English DT Meeting Abstract C1 [Odinokova, I. V.; Sung, K. F.; Hermann, K.; Mareninova, O. A.; Gukovsky, I.; Gukovskaya, A. S.] Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Odinokova, I. V.; Sung, K. F.; Hermann, K.; Mareninova, O. A.; Gukovsky, I.; Gukovskaya, A. S.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. NR 0 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2007 VL 35 IS 4 BP 420 EP 420 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 248TS UT WOS:000252179100121 ER PT J AU Osgood, S Kolodecik, TR Reeve, J Pandol, SJ Gorelick, FS Thrower, EC AF Osgood, S. Kolodecik, T. R. Reeve, J. Pandol, S. J. Gorelick, F. S. Thrower, E. C. TI Differential roles of protein kinase C isoforms in acute pancreatitis SO PANCREAS LA English DT Meeting Abstract C1 [Osgood, S.; Kolodecik, T. R.; Gorelick, F. S.; Thrower, E. C.] Vet Adm Connecticut Healthcare, Dept Internal Med, Sect Digest Dis, West Haven, CT USA. [Gorelick, F. S.] Vet Adm Connecticut Healthcare, Dept Cell Biol, West Haven, CT USA. [Gorelick, F. S.] Yale Univ, Sch Med, New Haven, CT USA. [Reeve, J.; Pandol, S. J.] VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. [Reeve, J.; Pandol, S. J.] Univ Calif Los Angeles, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2007 VL 35 IS 4 BP 420 EP 420 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 248TS UT WOS:000252179100123 ER PT J AU Zhao, G Reyes, CN Hermann, K Sung, KF Gukovskaya, AS Hoffmann, A Pandol, SJ Gukovsky, I AF Zhao, G. Reyes, C. N. Hermann, K. Sung, K. F. Gukovskaya, A. S. Hoffmann, A. Pandol, S. J. Gukovsky, I. TI Genetic deletions of NF-kappa B proteins ameliorate cerulein-induced pancreatitis SO PANCREAS LA English DT Meeting Abstract C1 [Zhao, G.; Reyes, C. N.; Hermann, K.; Sung, K. F.; Gukovskaya, A. S.; Pandol, S. J.; Gukovsky, I.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Zhao, G.; Reyes, C. N.; Hermann, K.; Sung, K. F.; Gukovskaya, A. S.; Pandol, S. J.; Gukovsky, I.] Univ Calif Los Angeles, Los Angeles, CA USA. [Zhao, G.] Beijing Hosp, Beijing, Peoples R China. [Sung, K. F.] Chang Gung Mem Hosp, Taipei 10591, Taiwan. [Hoffmann, A.] Univ Calif San Diego, La Jolla, CA 92093 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD NOV PY 2007 VL 35 IS 4 BP 438 EP 438 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 248TS UT WOS:000252179100184 ER PT J AU Szulc, ZM Obeid, LM Hannun, YA Bielawska, A AF Szulc, Z. M. Obeid, L. M. Hannun, Y. A. Bielawska, A. TI Highly efficient and regioselective phosphorylation of sphingolipids by phase-transfer catalysis SO POLISH JOURNAL OF CHEMISTRY LA English DT Article DE phosphorylation; trimethyl phosphite; 1,2-dibromotetrachloroethane; phase-transfer catalysis; sphingosine; ceramide; sphingosine 1-phosphate; ceramide 1-phosphate ID SPHINGOSINE 1-PHOSPHATE; CERAMIDE 1-PHOSPHATE; SPHINGOSINE-1-PHOSPHATE; ANALOGS; TRIPHENYLPHOSPHINE; SPHINGOMYELIN; NUCLEOPHILES; PHOSPHONATE; ACTIVATION; PROTECTION AB Phosphorylation of D-erythro-sphingosine and its N-BOC or N-palmitoyl derivatives with trimethyl phosphite was carried out in 72-92% yield at room temperature for 20 min in a biphasic system comprised of dichloromethane/aqueous solutions of NaOH or K(2)CO(3) using 1,2-dibromotetrachloroethane as a source of halogen and cetyl pyridinium bromide as a phase-transfer catalyst. These are the first reported examples of a highly selective 0- and N-phosphorylation of sphingolipids by the phase-transfer catalysis. Our studies show that the developed phosphorylation protocol works as a modular process, in which the synthetic outcome is controlled by a type of the used base, catalyst and solvent system. C1 [Szulc, Z. M.; Hannun, Y. A.; Bielawska, A.] Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. [Obeid, L. M.] Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. [Obeid, L. M.] Med Univ S Carolina, Ralph H Johnson Vet Adm Med Ctr, Charleston, SC 29425 USA. RP Szulc, ZM (reprint author), Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. EM szulcz@musc.edu OI obeid, lina/0000-0002-0734-0847 NR 57 TC 2 Z9 2 U1 0 U2 3 PU POLISH CHEMICAL SOC PI WARSAW PA C/O POLISH ACAD SCIENCES, INST PHYSICAL CHEMISTRY, UL KASPRZAKA 44/52, 01-224 WARSAW, POLAND SN 0137-5083 J9 POL J CHEM JI Pol. J. Chem. PD NOV PY 2007 VL 81 IS 11 BP 1899 EP 1909 PG 11 WC Chemistry, Multidisciplinary SC Chemistry GA 243HI UT WOS:000251787000007 ER PT J AU Goodfriend, TL Pedersen, TL Grekin, RJ Hammock, BD Ball, DL Vollmer, A AF Goodfriend, T. L. Pedersen, T. L. Grekin, R. J. Hammock, B. D. Ball, D. L. Vollmer, A. TI Heparin, lipoproteins, and oxygenated fatty acids in blood: A cautionary note SO PROSTAGLANDINS LEUKOTRIENES AND ESSENTIAL FATTY ACIDS LA English DT Article; Proceedings Paper CT 8th Workshop on Fatty Acids and Cell Signaling CY 2007 CL Quebec City, CANADA ID LOW-DENSITY-LIPOPROTEIN; LINOLEIC-ACID; LIPID-PEROXIDATION; STRONG INCREASE; QUANTIFICATION; LIPOLYSIS; DISEASES; PLASMA AB We measured 16 nonesterified oxygenated fatty acid derivatives (oxylipids) in plasmas from seven human subjects. Two arterial samples from each subject were analyzed, drawn approximately 2 h apart. We observed a marked increase in levels of most oxylipids in the second sample, as high as 470-fold. Between the first and second samples, subjects received approximately 800-1000 IU of heparin to prevent clotting in intravascular catheters. We postulate that heparin activated lipoprotein lipases, which, in turn, released oxylipids from triglycerides and phospholipids in plasma lipoproteins. Some of that lipolysis may have occurred during sample storage. Measurements of nonesterified lipids in human plasma may be distorted if heparin is administered to subjects before blood is drawn and if lipase inhibitors are omitted from stored samples. Published by Elsevier Ltd. C1 [Goodfriend, T. L.; Ball, D. L.] William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. [Goodfriend, T. L.; Ball, D. L.] Univ Wisconsin, Madison, WI 53705 USA. [Grekin, R. J.; Vollmer, A.] Univ Michigan, Ann Arbor, MI 48109 USA. [Pedersen, T. L.; Hammock, B. D.] Univ Calif Davis, Dept Entomol, Davis, CA 95616 USA. RP Goodfriend, TL (reprint author), William S Middleton Mem Vet Adm Med Ctr, 2500 Overlook Terrace, Madison, WI 53705 USA. EM theodre.goodfriend@med.va.gov FU NHLBI NIH HHS [R01 HL076238-01A1]; NIEHS NIH HHS [P42 ES004699, R37 ES02710] NR 14 TC 11 Z9 11 U1 0 U2 3 PU CHURCHILL LIVINGSTONE PI EDINBURGH PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND SN 0952-3278 J9 PROSTAG LEUKOTR ESS JI Prostaglandins Leukot. Essent. Fatty Acids PD NOV-DEC PY 2007 VL 77 IS 5-6 BP 363 EP 366 DI 10.1016/j.plefa.2007.10.012 PG 4 WC Biochemistry & Molecular Biology; Cell Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Cell Biology; Endocrinology & Metabolism GA 257ZT UT WOS:000252838900019 PM 18036802 ER PT J AU Guzik, LH Wirshing, DA AF Guzik, Lisa H. Wirshing, Donna A. TI Behavioral weight loss classes for patients with severe mental illness SO PSYCHIATRIC SERVICES LA English DT Editorial Material C1 [Guzik, Lisa H.; Wirshing, Donna A.] VA Greater Los Angeles Healthcare Ctr, Dept Psychiat, Los Angeles, CA 90073 USA. [Wirshing, Donna A.] Univ Calif Los Angeles, Sch Med, Dept Psychiat, Los Angeles, CA 90024 USA. RP Guzik, LH (reprint author), VA Greater Los Angeles Healthcare Ctr, Dept Psychiat, 11301 Wilshire Blvd,Bldg 210, Los Angeles, CA 90073 USA. EM lisa.guzik@gmail.com NR 0 TC 2 Z9 2 U1 0 U2 0 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD NOV PY 2007 VL 58 IS 11 BP 1498 EP 1498 DI 10.1176/appi.ps.58.11.1498 PG 1 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 265LQ UT WOS:000253360800021 PM 17978266 ER PT J AU Dobscha, SK Corson, K Gerrity, MS AF Dobscha, Steven K. Corson, Kathryn Gerrity, Martha S. TI Depression treatment preferences of VA primary care patients SO PSYCHOSOMATICS LA English DT Article ID RANDOMIZED-TRIAL; MONITORING DEPRESSION; PHQ-9; MANAGEMENT; ADHERENCE; SYMPTOMS; OUTCOMES; IMPACT AB The authors identified veterans' depression treatment preferences and explored relationships between preferences, process of care, and clinical outcomes. Patients entering a collaborative depression intervention trial in primary care completed an assessment of treatment preferences. Medical record review was used to identify treatments offered and received over a 12-month period. Of 314 patients, 32% preferred antidepressants; 19%, individual counseling; 18%, antidepressants plus counseling; 7%, group counseling; and 25%, "watchful waiting." Although the treatment that was offered was associated with treatment preferences, being offered preferred treatment was not associated with receiving treatment or with changes in depression severity or satisfaction over time. C1 Portland VA Med Ctr, Ctr Study Chron Comorbid Mental & Phys Disorders, Portland, OR 97207 USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Ctr Study Chron Comorbid Mental & Phys Disorders, POB 1034,R&D 66, Portland, OR 97207 USA. EM steven.dobscha@va.gov NR 32 TC 17 Z9 17 U1 4 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD NOV-DEC PY 2007 VL 48 IS 6 BP 482 EP 488 DI 10.1176/appi.psy.48.6.482 PG 7 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 228OK UT WOS:000250739100004 PM 18071094 ER PT J AU Parker, LE de Pillis, E Altschuler, A Rubenstein, LV Meredith, LS AF Parker, Louise E. de Pillis, Emmeline Altschuler, Andrea Rubenstein, Lisa V. Meredith, Lisa S. TI Balancing participation and expertise: A comparison of locally and centrally managed health care quality improvement within primary care practices SO QUALITATIVE HEALTH RESEARCH LA English DT Article DE participation; expertise; quality improvement; depression; primary care ID TRANSFORMATION; SATISFACTION; PERFORMANCE; DEPRESSION; PHYSICIANS; DECISIONS; MEDICINE; BEHAVIOR; AUTONOMY; WORK AB In a longitudinal qualitative study, the authors evaluated two health care quality improvement (QI) methods that emphasized either participation (local approach) or expertise (central approach). They followed teams using these approaches to develop depression care QI programs for primary care practices over several years, observing their processes and outcomes and learning about participants' perceptions, beliefs, and experiences. Concordant with the literature, most participants preferred the local approach, but some were willing to relinquish some decision making to experts. Participants identified unique advantages of both the local (e.g., maximizes buy-in and local fit) and central (e.g., maximizes efficiency, reduces burden) approaches. The authors propose a hybrid model in which experts make strategic decisions about what practices to adopt and local site personal make tactical decisions about implementation. They believe that balancing participation and expertise provides the best formula for producing lasting QI for health care organizations across a wide variety of circumstances. C1 Ctr Mental Healthcare & Outcomes Res, Little Rock, AR USA. RAND Corp, Santa Monica, CA USA. Univ Hawaii, Coll Business & Econ, Hilo, HI 96720 USA. Kaiser Permanente, Div Res, Oakland, CA USA. VA Greater Los Angles, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Excellence Study Healthcare Provider Behav, VA Hlth Serv Res & Dev Ctr, Los Angeles, CA USA. RP Parker, LE (reprint author), Ctr Mental Healthcare & Outcomes Res, Little Rock, AR USA. EM parkerlouise@earthlink.net FU NIMH NIH HHS [U01-MH-50732] NR 39 TC 31 Z9 31 U1 0 U2 3 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1049-7323 J9 QUAL HEALTH RES JI Qual. Health Res. PD NOV PY 2007 VL 17 IS 9 BP 1268 EP 1279 DI 10.1177/1049732307307447 PG 12 WC Information Science & Library Science; Social Sciences, Interdisciplinary; Social Sciences, Biomedical SC Information Science & Library Science; Social Sciences - Other Topics; Biomedical Social Sciences GA 224WN UT WOS:000250479000011 PM 17968043 ER PT J AU Ullrich, P Jensen, M Loeser, J Cardenas, D AF Ullrich, Phil Jensen, Mark Loeser, John Cardenas, Diana TI Catastrophizing mediates associations between pain severity, psychological distress, and functional disability among persons with spinal cord injury SO REHABILITATION PSYCHOLOGY LA English DT Article DE pain; spinal cord injury; catastrophizing; distress; functioning ID COPING STRATEGIES; DEPRESSION; VALIDITY; QUESTIONNAIRE; INTERFERENCE; INDIVIDUALS; RELIABILITY; ADJUSTMENT; INTENSITY; IMPACT AB Objective: To examine associations between pain severity, psychological distress, catastrophizing, and indices of functional disability in a sample of persons with spinal cord injury (SCI). Catastrophizing was examined as a potential mediator of associations between pain severity, psychological distress, and functional disability. Design and Participants: Questionnaires assessing pain severity, psychological distress, catastrophizing, pain interference, and community integration were completed by 237 persons with SCI. Results: Psychological distress and pain severity were associated significantly with greater functional disability. Moreover, the association between pain severity and functional disability was strongest among persons with high psychological distress. Catastrophizing appeared to mediate the associations between pain severity, psychological distress, and functional disability. Conclusions: Pain severity and psychological distress have the potential for both direct and interactive effects on functional disability, possibly through the mediating effects of catastrophizing. C1 Vet Affairs Puget Sound Healthcare Syst, Dept Vet Affairs, Spinal Cord Injury Qual Enhancement Res Initiat, Spinal Cord Injury & Disorders Strateg Healthcare, Seattle, WA 98101 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. Univ Miami, Dept Rehabil Med, Coral Gables, FL 33124 USA. RP Ullrich, P (reprint author), Vet Affairs Puget Sound Healthcare Syst, Dept Vet Affairs, Spinal Cord Injury Qual Enhancement Res Initiat, Spinal Cord Injury & Disorders Strateg Healthcare, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM philip.ullrich@va.gov NR 36 TC 4 Z9 4 U1 2 U2 5 PU EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 0090-5550 J9 REHABIL PSYCHOL JI Rehabil. Psychol. PD NOV PY 2007 VL 52 IS 4 BP 390 EP 398 DI 10.1037/0090-5550.52.4.390 PG 9 WC Psychology, Clinical; Rehabilitation SC Psychology; Rehabilitation GA 233QG UT WOS:000251104800004 ER PT J AU Kreider, ME Grippi, MA AF Kreider, Mary Elizabeth Grippi, Michael A. TI Impact of the new ATS/ERS pulmonary function test interpretation guidelines SO RESPIRATORY MEDICINE LA English DT Article DE diagnosis; guideline adherence; lung diseases; obstructive; pulmonary function tests ID LUNG-FUNCTION TESTS; STANDARDIZATION; STRATEGIES AB Rationale: In November 2005, the American Thoracic and European Respiratory Societies jointly published a statement proposing a new interpretation scheme for pulmonary function tests. The practical effect of adoption of these new guidelines has not yet been studied. The purpose of the current study was to address the effects of the new interpretation strategy on the relative distribution of obstructive and restrictive diagnoses in patients evaluated at a single academic medical center laboratory. Patients/Methods: Pulmonary functions tests from 319 patients were analyzed according to four different interpretation schemes. The number of patients classified according to each as obstructed, restricted, neither, or both were compared, and factors associated with a change in classification using the different approaches were examined. Results: Although similar proportions of patients were identified as restricted using either the "GOLD" scheme (23%) or new approaches (22%), significantly more (P<0.005) were defined as obstructed using the newly proposed scheme (44% versus 33%). Additionally, 36% of subjects defined as obstructed using either the traditional or new schemes were classified differently (i.e., either "gained" or "lost" the diagnosis of obstruction) using the new approach. Women were significantly more likely than men to have a change in classification. Conclusions: The new interpretation scheme leads to a diagnosis of obstruction in a greater proportion of patients undergoing pulmonary function testing. The clinical significance of this finding has not yet been validated, and its economic impact remains to be assessed. (C) 2007 Elsevier Ltd. All rights reserved. C1 Hosp Univ Penn, Dept Med, Div Pulm Allergy & Crit Care Med, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Kreider, ME (reprint author), Univ Penn, Sch Med, Div Pulm Allergy & Crit Care Med, 828 Gates Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. EM kreiderm@mail.med.upenn.edu; grippi@mail.med.upenn.edu NR 13 TC 12 Z9 12 U1 2 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 NOV PY 2007 VL 101 IS 11 BP 2336 EP 2342 DI 10.1016/j.rmed.2007.06.019 PG 7 WC Cardiac & Cardiovascular Systems; Respiratory System SC Cardiovascular System & Cardiology; Respiratory System GA 223BH UT WOS:000250344100015 PM 17686622 ER PT J AU Morgenthaler, TI Lee-Chiong, T Alessi, C Friedman, L Aurora, RN Boehlecke, B Brown, T Chesson, AL Kapur, V Maganti, R Owens, J Pancer, J Swick, TJ Zak, R AF Morgenthaler, Timothy I. Lee-Chiong, Teofilo Alessi, Cathy Friedman, Leah Aurora, R. Nisha Boehlecke, Brian Brown, Terry Chesson, Andrew L., Jr. Kapur, Vishesh Maganti, Rama Owens, Judith Pancer, Jeffrey Swick, Todd J. Zak, Rochelle CA Stand Practice Comm AASM TI Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders SO SLEEP LA English DT Review DE circadian; light therapy; melatonin; naps; jet lag; shift work ID SIMULATED NIGHT-SHIFT; BRIGHT LIGHT TREATMENT; DOUBLE-BLIND TRIAL; PLACEBO-CONTROLLED TRIAL; 5 TIME ZONES; JET-LAG; PHASE SYNDROME; MELATONIN TREATMENT; WAKE SYNDROME; ALZHEIMERS-DISEASE AB The expanding science of circadian rhythm biology and a growing literature in human clinical research on circadian rhythm sleep disorders (CRSDs) prompted the American Academy of Sleep Medicine (AASM) to convene a task force of experts to write a review of this important topic. Due to the extensive nature of the disorders covered, the review was written in two sections. The first review paper, in addition to providing a general introduction to circadian biology, addresses "exogenous" circadian rhythm sleep disorders, including shift work disorder (SWD) and jet lag disorder (JLD). The second review paper addresses the "endogenous" circadian rhythm sleep disorders, including advanced sleep phase disorder (ASPD), delayed sleep phase disorder (DSPD), irregular sleep-wake rhythm (ISWR), and the non-24-hour sleep-wake syndrome (nonentrained type) or free-running disorder (FRD). These practice parameters were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the AASM to present recommendations for the assessment and treatment of CRSDs based on the two accompanying comprehensive reviews. The main diagnostic tools considered include sleep logs, actigraphy, the Morningness-Eveningness Questionnaire (MEQ), circadian phase markers, and polysomnography. Use of a sleep log or diary is indicated in the assessment of patients with a suspected circadian rhythm sleep disorder (Guideline). Actigraphy is indicated to assist in evaluation of patients suspected of circadian rhythm disorders (strength of recommendation varies from "Option" to "Guideline," depending on the suspected CRSD). Polysomnography is not routinely indicated for the diagnosis of CRSDs, but may be indicated to rule out another primary sleep disorder (Standard). There is insufficient evidence to justify the use of MEQ for the routine clinical evaluation of CRSDs (Option). Circadian phase markers are useful to determine circadian phase and confirm the diagnosis of FRD in sighted and unsighted patients but there is insufficient evidence to recommend their routine use in the diagnosis of SWD, JLD, ASPD, DSPD, or ISWR (Option). Additionally, actigraphy is useful as an outcome measure in evaluating the response to treatment for CRSDs 1 Guideline). A range of therapeutic interventions were considered including planned sleep schedules, timed light exposure, timed melatonin doses, hypnotics, stimulants, and alerting agents. Planned or prescribed sleep schedules are indicated in SWD (Standard) and in JLD, DSPD, ASPD, ISWR (excluding elderly-demented/nursing home residents), and FRD (Option). Specifically dosed and timed light exposure is indicated for each of the circadian disorders with variable success (Option). Timed melatonin administration is indicated for JLD (Standard); SWD, DSPD, and FRD) in unsighted persons (Guideline); and for ASPD, FRD in sighted individuals, and for ISWR in children with moderate to severe psychomotor retardation (Option). Hypnotic medications may be indicated to promote or improve daytime sleep among night shift workers (Guideline) and to treat jet lag-induced insomnia (Option). Stimulants may be indicated to improve alertness in JLD and SWD (Option) but may have risks that must be weighed prior to use. Modafinil may be indicated to improve alertness during the night shift for patients with SWD (Guideline). C1 Mayo Clin, Mayo Sleep Disorders Ctr, Rochester, MN USA. Natl Jewish Med & Res Ctr, Denver, CO USA. Univ Calif Los Angeles, Greater Los Angeles VA Healthcare Syst, Sepulveda, CA USA. Stanford Univ, Sch Med, Dept Psychiat, Stanford, CA 94305 USA. Mt Sinai Med Ctr, Ctr Sleep Med, New York, NY 10029 USA. Louisiana State Univ, Med Ctr, Dept Neurol, Shreveport, LA 71105 USA. Univ Washington, Sleep Disorders Ctr Harborview, Seattle, WA 98195 USA. Barrow Neurol Inst, Dept Neurol, Phoenix, AZ 85013 USA. Rhode Isl Hosp, Dept Ped Ambulatory Pediatr, Providence, RI USA. Methodist Hosp, Methodist Neurol Inst, Houston, TX 77030 USA. RP Morgenthaler, TI (reprint author), Amer Acad Sleep Med, Standards Practice Committee, Westbrook Corp Ctr 1, 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 133 TC 195 Z9 200 U1 10 U2 46 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 NOV 1 PY 2007 VL 30 IS 11 BP 1445 EP 1459 PG 15 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 228IW UT WOS:000250724600006 PM 18041479 ER PT J AU Katiyar, SK AF Katiyar, Santosh K. TI Interleukin-12 and photocarcinogenesis SO TOXICOLOGY AND APPLIED PHARMACOLOGY LA English DT Review DE interleukin-12; photocarcinogenesis; cyclobutane pyrimidine dimers; UV radiation ID RADIATION-INDUCED IMMUNOSUPPRESSION; CELL STIMULATORY FACTOR; ANTIGEN-PRESENTING CELLS; IFN-GAMMA PRODUCTION; SKIN-CANCER; ULTRAVIOLET-RADIATION; DNA-REPAIR; TUMOR-REGRESSION; IN-VIVO; T-CELL AB UV radiation induces immunosuppression and inflammatory responses, as well as oxidative stress and DNA damage, in skin cells and these various effects have been implicated in melanoma and nonmelanoma skin cancers, i.e., photocarcinogenesis. The cytokine interleukin (IL)-12 has been shown to possess potent antitumor activity in a wide variety of murine tumor models. In this review, we summarize the evidence that IL-12 plays a role in preventing photocarcinogenesis, and present a model of its possible mechanisms of action. Treatment of mice with IL-12 prevents UV-induced immunosuppression in a process mediated by repair of UV-induced damaged DNA. After exposure to the photocarcinogenesis protocol, the development of UV-induced tumors is more rapid and the tumor multiplicity and tumor size are significantly greater in IL-12deficient or knockout (KO) mice than their wild-type counterparts. IL-12-deficiency in mice enhances the proliferation potential of tumor cells, and this may be one of the reasons for the rapid growth of the tumors and their greater size. The rate of malignant transformation of UV-induced papillomas to carcinomas also is higher in the IL-12 KO mice than in their wild-type counterparts in terms of carcinoma incidence and carcinoma multiplicity. UV-induced DNA damage in the form of cyclobutane pyrimidine dimers (CPDs) and sunburn cells is lower, or repaired more rapidly, in wild-type mice than IL-12 KO mice. The IL-12-associated reduction in UV-specific CPDs is due to induction of DNA repair, and particularly enhancement of nucleotide-excision repair. We suggest that endogenous stimulation of IL-12 may protect the skin from UV-induced immunosuppression, DNA damage, and, ultimately, the risk of photocarcinogenesis. Taken together, this information suggests that augmentation of IL-12 should be considered as a strategy for the prevention and treatment of photocarcinogenesis. (c) 2006 Elsevier Inc. All rights reserved. C1 Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Katiyar, SK (reprint author), Univ Alabama, Dept Dermatol, 1670 Univ Blvd,Volker Hall 557,POB 202, Birmingham, AL 35294 USA. EM skatiyar@uab.edu FU NCCIH NIH HHS [AT002536, R01 AT002536, R01 AT002536-01A2, R01 AT002536-02]; NCI NIH HHS [R21 CA104428, CA089738, CA104428, CA105368, R03 CA089738, R03 CA089738-02, R03 CA105368, R03 CA105368-01, R03 CA105368-02, R21 CA104428-01A2, R21 CA104428-02]; NIAMS NIH HHS [AR050948-01, P30 AR050948]; NIEHS NIH HHS [ES11421] NR 61 TC 21 Z9 21 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0041-008X J9 TOXICOL APPL PHARM JI Toxicol. Appl. Pharmacol. PD NOV 1 PY 2007 VL 224 IS 3 BP 220 EP 227 DI 10.1016/j.taap.2006.11.017 PG 8 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA 227EF UT WOS:000250639300004 PM 17239911 ER PT J AU Keilin, WG Baker, J McCutcheon, S Peranson, E AF Keilin, W. Gregory Baker, Jeff McCutcheon, Stephen Peranson, Elliott TI A Growing Bottleneck: The Internship Supply-Demand Imbalance in 2007 and Its Impact on Psychology Training SO TRAINING AND EDUCATION IN PROFESSIONAL PSYCHOLOGY LA English DT Article DE predoctoral internship training; internship supply and demand; internship match AB This article provides a comprehensive analysis of the growing imbalance between the supply of predoctoral internship positions in psychology and the demand for such positions by graduate students. Data from the 2007 Match sponsored by the Association of Psychology Postdoctoral and Internship Centers (APPIC) are provided along with the results from several surveys of applicants from that year. An overview of applicant and program participation for the nine APPIC Matches that occurred between 1999 and 2007 is also provided. Implications of the increasing supply-demand imbalance for applicants, graduate and internship programs, and the profession are discussed. C1 [Keilin, W. Gregory] Univ Texas Austin, Counseling & Mental Hlth Ctr, Austin, TX 78712 USA. [Baker, Jeff] Univ Texas Med Branch Galveston, Div Rehabil Serv, Galveston, TX USA. [McCutcheon, Stephen] Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. [Peranson, Elliott] Natl Matching Serv Inc, Toronto, ON, Canada. RP Keilin, WG (reprint author), Univ Texas Austin, Counseling & Mental Hlth Ctr, 1 Univ Stn A3500, Austin, TX 78712 USA. EM gkeilin@mail.utexas.edu NR 11 TC 16 Z9 16 U1 0 U2 0 PU EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 1931-3918 J9 TRAIN EDUC PROF PSYC JI Train. Educ. Prof. Psychol. PD NOV PY 2007 VL 1 IS 4 SI SI BP 229 EP 237 DI 10.1037/1931-3918.1.4.229 PG 9 WC Psychology, Educational SC Psychology GA V29EA UT WOS:000208730500002 ER PT J AU Baker, J McCutcheon, S Keilin, WG AF Baker, Jeff McCutcheon, Stephen Keilin, W. Gregory TI The Internship Supply-Demand Imbalance: The APPIC Perspective SO TRAINING AND EDUCATION IN PROFESSIONAL PSYCHOLOGY LA English DT Article DE internship; supply-demand; APPIC; imbalance AB The internship has long been considered the capstone experience in the sequence of doctoral education in professional psychology. Since at least 1999, the number of available internship positions in the United States and Canada has been outstripped by the number of students seeking these positions. The resulting imbalance between supply and demand for internship positions has grown substantially since 2002 and now should be considered to have reached crisis proportions. Although no complete solution to this imbalance is imminently feasible, a comprehensive approach to addressing the crisis requires that both the supply of internships and the growth in demand be addressed. C1 [Baker, Jeff] Univ Texas Med Branch, Div Rehabil Sci, Galveston, TX 77555 USA. [McCutcheon, Stephen] VA Puget Sound Hlth Care Syst, Seattle, WA USA. [Keilin, W. Gregory] Univ Texas Austin, Counseling & Mental Hlth Ctr, Austin, TX 78712 USA. RP Baker, J (reprint author), Univ Texas Med Branch, UTMB Psychol Training Program, 301 Univ Blvd, Galveston, TX 77555 USA. EM jeff.baker@utmb.edu NR 6 TC 19 Z9 19 U1 1 U2 2 PU EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 1931-3918 J9 TRAIN EDUC PROF PSYC JI Train. Educ. Prof. Psychol. PD NOV PY 2007 VL 1 IS 4 SI SI BP 287 EP 293 DI 10.1037/1931-3918.1.4.287 PG 7 WC Psychology, Educational SC Psychology GA V29EA UT WOS:000208730500009 ER PT J AU Zhu, B Montgomery, W Ascher-Svanum, H Faries, D Stephenson, DA McKendrick, J Brnabic, A Marder, SR AF Zhu, B. Montgomery, W. Ascher-Svanum, H. Faries, D. Stephenson, D. A. McKendrick, J. Brnabic, A. Marder, S. R. TI Treatment duration with oral and long acting injectable formulations of typical antipsychotics in the treatment of schizophrenia: Results across world geographies SO VALUE IN HEALTH LA English DT Meeting Abstract C1 [Zhu, B.; Ascher-Svanum, H.; Faries, D.] Eli Lilly & Co, Indianapolis, IN 46285 USA. [Montgomery, W.] Eli Lilly & Co, Sydney, NSW, Australia. [Stephenson, D. A.; McKendrick, J.] Eli Lilly & Co, Windlesham, Surrey, England. [Brnabic, A.] Eli Lilly & Co, N Ryde, NSW, Australia. [Marder, S. R.] Vet Affairs 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 1098-3015 J9 VALUE HEALTH JI Value Health PD NOV-DEC PY 2007 VL 10 IS 6 BP A289 EP A289 DI 10.1016/S1098-3015(10)65057-7 PG 1 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 239HH UT WOS:000251508900215 ER PT J AU Ochoa, O Torres, FM Shireman, PK AF Ochoa, Oscar Torres, Francis M. Shireman, Paula K. TI Chemokines and diabetic wound healing SO VASCULAR LA English DT Article DE chemokines; chronic wounds; diabetes mellitus; inflammation ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; GROWTH-FACTOR EXPRESSION; FOOT ULCERS; INTERLEUKIN-8 RECEPTOR; ENDOTHELIAL-CELLS; GENE-EXPRESSION; IN-VITRO; ANGIOGENESIS; REPAIR; DISEASE AB Chemokines are critical for white blood cell recruitment to injured tissues and play an important role in normal wound healing processes. In contrast, impaired wound healing in diabetic patients is accompanied by decreased early inflammatory cell infiltration but persistence of neutrophils and macrophages in the chronic, nonhealing wounds. These changes in inflammatory cell recruitment occur in conjunction with alterations in chemokine and growth factor expression. In addition to leukocyte trafficking, many different cell types, including endothelial cells, fibroblasts, and keratinocytes, produce and respond to chemokines, and these interactions are altered in diabetic wounds. Thus, the chemokine system may have both direct and inflammatory-mediated effects on many different aspects of diabetic wound healing. The potential roles of chemokines and inflammatory or immune cells in nonhealing diabetic wounds, including impairments in growth factor expression, angiogenesis, extracellular matrix formation, and reepithelialization, are examined. C1 Univ Texas Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. [Shireman, Paula K.] Univ Texas Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. [Shireman, Paula K.] Univ Texas Hlth Sci Ctr, Sam & Ann Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [Shireman, Paula K.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Shireman, PK (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Div Vasc Surg, MC 7741,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM Shireman@UTHSCSA.edu FU NHLBI NIH HHS [HL074236, HL070158] NR 60 TC 46 Z9 50 U1 0 U2 9 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1G 0AE, ENGLAND SN 1708-5381 J9 VASCULAR JI Vascular PD NOV-DEC PY 2007 VL 15 IS 6 BP 350 EP 355 DI 10.2310/6670.2007.00056 PG 6 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 241LU UT WOS:000251658700005 PM 18053419 ER PT J AU Becker, JB Monteggia, LM Perrot-Sinal, TS Romeo, RD Taylor, JR Yehuda, R Bale, TL AF Becker, Jill B. Monteggia, Lisa M. Perrot-Sinal, Tara S. Romeo, Russell D. Taylor, Jane R. Yehuda, Rachel Bale, Tracy L. TI Stress and disease: Is being female a predisposing factor? SO JOURNAL OF NEUROSCIENCE LA English DT Article DE addiction; depression; HPA axis; animal models; sex; stress ID CORTICOTROPIN-RELEASING-FACTOR; DISCRETE TRIAL PROCEDURE; SEX-DIFFERENCES; GENDER-DIFFERENCES; HORMONE RECEPTOR-2; DEPRESSED-PATIENTS; DISORDER SYMPTOMS; BIOLOGICAL BASIS; TRAUMA EXPOSURE; PRENATAL STRESS C1 Univ Penn, Dept Anim Biol, Philadelphia, PA 19104 USA. Univ Michigan, Dept Psychol, Ann Arbor, MI 48109 USA. Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75390 USA. Dalhousie Univ, Dept Psychol, Halifax, NS B3H 4R2, Canada. Columbia Univ Barnard Coll, Dept Psychol, New York, NY 10027 USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06510 USA. James J Peters VA Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. RP Bale, TL (reprint author), Univ Penn, Dept Anim Biol, 201E Vet 6046,3800 Spruce St, Philadelphia, PA 19104 USA. EM tbale@vet.upenn.edu FU NIDA NIH HHS [DA012677, DA11717, DA016556]; NIMH NIH HHS [MH070727, MH073030, R01 MH073030] NR 64 TC 81 Z9 84 U1 6 U2 11 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 OCT 31 PY 2007 VL 27 IS 44 BP 11851 EP 11855 DI 10.1523/JNEUROSCI.3565-07.2007 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 226HB UT WOS:000250577600012 PM 17978023 ER PT J AU Lapierre, JL Kosenko, PO Lyamin, OI Kodama, T Mukhametov, LM Siegel, JM AF Lapierre, Jennifer L. Kosenko, Peter O. Lyamin, Oleg I. Kodama, Tohru Mukhametov, Lev M. Siegel, Jerome M. TI Cortical acetylcholine release is lateralized during asymmetrical slow-wave sleep in Northern fur seals SO JOURNAL OF NEUROSCIENCE LA English DT Article DE sleep-wake cycle; acetylcholine; microdialysis; cerebral cortex; asymmetry; Callorhinus ursinus ID NUCLEUS BASALIS MAGNOCELLULARIS; CEREBRAL-CORTEX; FOREBRAIN; RAT; STIMULATION; ACTIVATION; DOLPHIN; EEG AB Fur seals are unique in that they display both bilateral slow-wave sleep (BSWS), as seen in all terrestrial mammals, and slow-wave sleep with interhemispheric electroencephalogram ( EEG) asymmetry, resembling the unihemispheric slow waves of cetaceans. Little is known about the underlying mechanisms of this phenomenon, which is also termed asymmetrical slow wave sleep (ASWS). However, we may begin to understand the expression of ASWS by studying the neurotransmitter systems thought to be involved in the generation and maintenance of sleep-wake states in terrestrial mammals. We examined bilaterally the release of cortical acetylcholine (ACh), a neurotransmitter implicated in the regulation of cortical EEG and behavioral arousal, across the sleep-wake cycle in four juvenile northern fur seals (Callorhinus ursinus). In vivo microdialysis and high-performance liquid chromatography coupled with electrochemical detection were used to measure cortical ACh levels during polygraphically defined behavioral states. Cortical ACh release was state-dependent, showing maximal release during active waking (AW), similar levels during quiet waking (QW), and rapid eye movement ( REM) sleep, and minimal release during BSWS. When compared with BSWS, cortical ACh levels increased similar to 300% during AW, and similar to 200% during QW and REM sleep. During these bilaterally symmetrical EEG states, ACh was synchronously released from both hemispheres. However, during ASWS, ACh release was lateralized with greater release in the hemisphere displaying lower voltage activity, at levels approximating those seen in QW. These findings demonstrate that cortical ACh release is tightly linked to hemispheric EEG activation. C1 Univ Calif Los Angeles, Sch Med, Dept Psychiat, Vet Affairs Greater Los Angeles Healthcare Syst, North Hills, CA 91343 USA. Utrish Dolphinarium Ltd, Moscow 119071, Russia. Tokyo Metropolitan Inst Neurosci, Dept Psychol, Tokyo 1838526, Japan. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Sch Med, Dept Psychiat, Vet Affairs Greater Los Angeles Healthcare Syst, 16111 Plummer St, North Hills, CA 91343 USA. EM jsiegel@ucla.edu FU NINDS NIH HHS [NS42947] NR 22 TC 17 Z9 17 U1 1 U2 11 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 OCT 31 PY 2007 VL 27 IS 44 BP 11999 EP 12006 DI 10.1523/JNEUROSCI.2968-07.2007 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 226HB UT WOS:000250577600030 PM 17978041 ER PT J AU Lichtman, JH Spertus, JA Reid, KJ Radford, MJ Rumsfeld, JS Allen, NB Masoudi, FA Weintraub, WS Krumholz, HM AF Lichtman, Judith H. Spertus, John A. Reid, Kimberly J. Radford, Martha J. Rumsfeld, John S. Allen, Norrina B. Masoudi, Frederick A. Weintraub, William S. Krumholz, Harlan M. TI Acute noncardiac conditions and in-hospital mortality in patients with acute myocardial infarction SO CIRCULATION LA English DT Article DE comorbidity; mortality; myocardial infarction; prognosis ID TIMI RISK SCORE; INTERNATIONAL TRIAL; PRACTICE GUIDELINES; THROMBOLYSIS; PREDICTORS; REGISTRY; EVENTS; COMORBIDITY; COMMITTEE; SURVIVAL AB Background - Acute myocardial infarction may be accompanied by acute, severe, concomitant, noncardiac conditions, but their prevalence and prognostic importance is not well defined. We sought to evaluate the prevalence of acute, severe, noncardiac conditions present at the time of hospital admission with acute myocardial infarction and to assess the association of these conditions with in-hospital mortality. Methods and Results - A total of 3907 patients admitted with an acute myocardial infarction were prospectively enrolled in 19 US centers between January 2003 and June 2004. Acute noncardiac conditions present at admission with imminent threat to life were identified from medical record review within 24 hours of admission. Using multivariable analyses, we evaluated the relationship between these conditions and in- hospital mortality. We documented a concomitant acute, severe, noncardiac condition in 6.8% ( n = 267) of the study sample. The most common concomitant conditions were severe pneumonia ( potentially requiring intubation; 18.4%), severe gastrointestinal bleeding/anemia ( 15.7%), stroke ( 9.7%), and sepsis ( 9.4%). These patients were less likely to be ideal for or to receive evidence-based therapies at the time of admission. The in- hospital mortality was 21.3% ( 57 of 267) for patients with concomitant conditions versus 2.7% ( 100 of 3640) for those without these conditions. The presence of an acute noncardiac condition was associated with an increased risk of in- hospital mortality after adjustment for demographic and clinical characteristics and disease severity ( odds ratio, 5.0; 95% confidence interval, 3.3 to 7.7). Conclusions - Concomitant, acute, noncardiac conditions are common and associated with a marked increase in the risk of in- hospital mortality. C1 Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Chron Dis Epidemiol, New Haven, CT 06510 USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. Univ Missouri, Kansas City, MO 64110 USA. NYU, Med Ctr, Dept Med, Div Cardiol, New York, NY 10016 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver Hlth Med Ctr, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Colorado Hlth Outcomes Program, Denver, CO 80202 USA. Christiana Care Hlth Syst, Newark, DE USA. Jefferso Univ, Dept Med, Philadelphia, PA USA. Yale Univ, Sch Med, Dept Med, Sect Cardiovasc Med, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Med, Robert Wood Johnson Clin Scholars Program, New Haven, CT 06510 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06510 USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA. RP Krumholz, HM (reprint author), 333 Cedar St,Room I-456 SHM,POB 208088, New Haven, CT 06520 USA. EM harlan.krumholz@yale.edu OI Radford, Martha/0000-0001-7503-9557 FU NCCDPHP CDC HHS [K01 DP000085-03] NR 22 TC 29 Z9 31 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 23 PY 2007 VL 116 IS 17 BP 1925 EP 1930 DI 10.1161/CIRCULATIONAHA.107.722090 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 225KX UT WOS:000250517900011 PM 17923572 ER PT J AU Singh, H Thomas, EJ Petersen, LA Studdert, DM AF Singh, Hardeep Thomas, Eric J. Petersen, Laura A. Studdert, David M. TI Medical errors involving trainees - A study of closed malpractice claims from 5 insurers SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 30th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 25-28, 2007 CL Toronto, CANADA SP Soc Gen Internal Med ID ADVERSE EVENTS; PATIENT SAFETY; COMMUNICATION FAILURES; TEACHING HOSPITALS; DIAGNOSTIC ERRORS; INTERNAL-MEDICINE; RESIDENCY PROGRAM; CONTROLLED-TRIAL; HEALTH-CARE; TEAMWORK AB Background: Despite wide recognition that the delivery of medical care by trainees involves special risks, information about the types and causes of medical errors involving trainees is limited. To describe the characteristics of and factors contributing to trainee errors, we analyzed malpractice claims in which trainees were judged to have played an important role in harmful errors. Methods: The claims were closed between 1984 and 2004, and the errors occurred between 1979 and 2001. Specialist physicians reviewed random samples of closed malpractice claim files at 5 liability insurers from 2002 to 2004 and determined whether injuries had occurred, and if so, whether they were due to error. We described the clinical circumstances and contributing factors associated with harmful errors involving trainees ("cases"). We also compared the characteristics of cases with their nontrainee counterparts and probed trainee errors attributed to teamwork problems and lack of technical competence or knowledge. Results: Among 240 cases, errors in judgment (173 of 240 [72%]), teamwork breakdowns (167 of 240 [70%]), and lack of technical competence (139 of 240 [58%]) were the most prevalent contributing factors. Lack of supervision and handoff problems were most prevalent types of teamwork problems, and both were disproportionately more common among errors that involved trainees than those that did not (respectively, 54% vs 7% [P <.001] and 20% vs 12% [P=.009]). The most common task during which failures of technical competence occurred were diagnostic decision making and monitoring of the patient or situation. Trainee errors appeared more complex than nontrainee errors (mean of 3.8 contributing factors vs 2.5 [P <.001]). Conclusions: In addition to problems with handoffs, house staff are particularly vulnerable to medical errors owing to teamwork failures, especially lack of supervision. Graduate medical education reform should focus on strengthening these aspects of training. C1 Baylor Coll Med, Dept Med, Hlth Policy & Qual Program, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Ctr Inquiry Improve Outpatient Safety Through Eff, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Sect Hlth Serv Res, 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 USA. Univ Melbourne, Sch Populat Hlth, Parkville, Vic 3052, Australia. Univ Melbourne, Melbourne Law Sch, Parkville, Vic 3052, Australia. RP Studdert, DM (reprint author), Univ Melbourne, Sch Populat Hlth, 207 Bouverie St, Parkville, Vic 3052, Australia. EM d.studdert@unimelb.edu.au FU AHRQ HHS [1P01HS1154401, HS011886-03, KO2HS11285]; NCI NIH HHS [K23CA125585] NR 55 TC 187 Z9 189 U1 2 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 OCT 22 PY 2007 VL 167 IS 19 BP 2030 EP 2036 DI 10.1001/archinte.167.19.2030 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 222VX UT WOS:000250326900003 PM 17954795 ER PT J AU Lambrecht, NWG Yakubov, I Sachs, G AF Lambrecht, Nils W. G. Yakubov, Iskandar Sachs, George TI Fasting-induced changes in ECL cell gene expression SO PHYSIOLOGICAL GENOMICS LA English DT Article DE enterochromaffin-like cell; oligonucleotide expression microarray; transcriptome; histamine; secretion ID VESICULAR MONOAMINE TRANSPORTER-2; GASTRIC-ACID SECRETION; HISTIDINE-DECARBOXYLASE; RAT; HISTAMINE; IDENTIFICATION; ACTIVATION; SITE; MUCOSA; FUNDUS AB Gastric enterochromaffin-like (ECL) cells release histamine in response to food because of elevation of gastrin and neural release of pituitary adenylate cyclase-activating peptide (PACAP). Acid secretion is at a basal level in the absence of food but is rapidly stimulated with feeding. Rats fasted for 24 h showed a significant decrease of mucosal histamine despite steady-state expression of the histamine-synthesizing enzyme histamine decarboxylase (HDC). Comparative transcriptomal analysis using gene expression oligonucleotide micro-arrays of 95% pure ECL cells from fed and 24-h fasted rats, thereby eliminating mRNA contamination from other gastric mucosal cell types, identified significantly increased gene expression of the enzymes histidase and urocanase catabolizing the HDC substrate L-histidine but significantly decreased expression of the cellular L-histidine uptake transporter SN2 and of the vesicular monoamine transporter 2 (VMAT-2) responsible for histamine uptake into secretory vesicles. This was confirmed by reverse transcriptase-quantitative polymerase chain reaction of gastric fundic mucosal samples from fed and 24-h fasted rats. The decrease of VMAT-2 gene expression was also shown by a decrease in VMAT-2 protein content in protein extracts from fed and 24-h fasted rats compared with equal amounts of HDC protein and Na-K- ATPase alpha(1)-subunit protein content. These results indicate that rat gastric ECL cells regulate their histamine content during 24-h fasting not by a change in HDC gene or protein expression but by regulation of substrate concentration for HDC and a decreased histamine secretory pool. C1 Wadsworth VA Hosp, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Physiol, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. Med Ctr, W Los Angeles Dept Vet Affairs, Membrane Biol Lab, Los Angeles, CA USA. RP Lambrecht, NWG (reprint author), Wadsworth VA Hosp, Bldg 113 Rm 325A, Los Angeles, CA 90073 USA. EM nilslam@ucla.edu NR 25 TC 8 Z9 10 U1 1 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1094-8341 J9 PHYSIOL GENOMICS JI Physiol. Genomics PD OCT 22 PY 2007 VL 31 IS 2 BP 183 EP 192 DI 10.1152/physiolgenomics.00252.2006 PG 10 WC Cell Biology; Genetics & Heredity; Physiology SC Cell Biology; Genetics & Heredity; Physiology GA 222ZX UT WOS:000250340100004 PM 17536021 ER PT J AU Burjonroppa, SC Varosy, P Ou, FS Rao, SV Peterson, E Roe, M Shunk, KA AF Burjonroppa, Sukesh C. Varosy, Paul Ou, Fang-Shu Rao, Sunil V. Peterson, Eric Roe, Matthew Shunk, Kendrick A. CA Natl Cardiovascular Data Registry TI Incidence and predictors of bleeding among patients undergoing rescue percutaneous coronary intervention after failed fibrinolysis for ST-elevation myocardial infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Meeting Abstract CT 19th Annual Transcatheter Cardiovascular Therapeutics Symposium CY OCT 20-25, 2007 CL Washington, DC C1 [Burjonroppa, Sukesh C.; Varosy, Paul; Shunk, Kendrick A.] Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. [Ou, Fang-Shu; Rao, Sunil V.; Peterson, Eric; Roe, Matthew] Duke Univ, Med Ctr, Durham, NC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 20 PY 2007 VL 100 IS 8A SU S BP 192L EP 192L PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 223SZ UT WOS:000250393900481 ER PT J AU Cannon, CP Roe, MT Chen, AY Rumsfeld, JS Brindis, RG Ohman, EM Gibler, WB Fonarow, GC Lambrew, CT Penney, J Peterson, ED AF Cannon, Christopher P. Roe, Matthen T. Chen, Anita Y. Rumsfeld, John S. Brindis, Ralph G. Ohman, E. Magnus Gibler, W. Brian Fonarow, Gregg C. Lambrew, Costas T. Penney, Janice Peterson, Eric D. TI Temporal improvements in door-to-balloon times for primary percutaneous coronary intervention_results from the CRUSADE and ACTION registries SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Meeting Abstract CT 19th Annual Transcatheter Cardiovascular Therapeutics Symposium CY OCT 20-25, 2007 CL Washington, DC C1 [Cannon, Christopher P.] Brigham & Womens Hosp, Boston, MA 02115 USA. [Roe, Matthen T.; Chen, Anita Y.; Ohman, E. Magnus; Peterson, Eric D.] Duke Clin Res Inst, Durham, NC USA. [Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. [Brindis, Ralph G.] Oakland Med Ctr, Oakland, CA USA. [Gibler, W. Brian] Univ Cincinnati, Coll Med, Cincinnati, OH USA. [Fonarow, Gregg C.] Univ Calif Los Angeles, Cardiomyopathy Ctr, Los Angeles, CA USA. [Lambrew, Costas T.] Maine Med Ctr, Portland, ME 04102 USA. [Penney, Janice] MidMichigan Reg Med Ctr, Midland, MI USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI BRIDGEWATER PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 20 PY 2007 VL 100 IS 8A SU S BP 209L EP 209L PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 223SZ UT WOS:000250393900528 ER PT J AU Sas, AR Rimonte-Nelson, HA Tyor, WR AF Sas, Andrew R. Rimonte-Nelson, Heather A. Tyor, William R. TI Cognitive dysfunction in HIV encephalitic SCID mice correlates with levels of interferon-alpha in the brain SO AIDS LA English DT Article DE animal model; cytokines; HIV; neurological; viral infections ID HUMAN-IMMUNODEFICIENCY-VIRUS; ACTIVE ANTIRETROVIRAL THERAPY; CENTRAL-NERVOUS-SYSTEM; AIDS DEMENTIA COMPLEX; TYPE-1 ENCEPHALITIS; FRONTAL-CORTEX; MOUSE MODEL; LONG-TERM; PATHOGENESIS; RAT AB Background: Interferon alpha (IFN alpha) is an antiviral cytokine produced in response to viral infection. IFN alpha also acts as a neuromodulatory molecule in the central nervous system (CNS). Elevated IFN alpha in the CNS causes cognitive deficits. Objective: To determine if elevated levels of IFN alpha in an HIV encephalitis mouse model correlate with cognitive deficits. Methods: C57BL/6J SCID mice were inoculated intracerebrally (i.c.) with HIV infected or uninfected (control) macrophages and cognitively tested in a water escape radial arm maze. After behavioral testing was completed, immunohistochemistry and ELISA were used to examine brain pathology and IFN alpha expression. Results: Mice injected i.c. with HIV infected macrophages exhibited significantly more working memory errors, particularly in trials with the highest memory load. Immunohistochemistry indicated increased mouse IFN alpha staining prevalent on neurons and glial cells in the brains of mice with HIV infected macrophages compared to mice with uninfected control macrophages. In addition, IFN alpha levels in the brain correlated directly with working memory errors for mice with HIV infected macrophages. Conclusions: These data suggest that the cognitive deficit noted for the C57BL/6J SCID mice with HIV infected macrophages is mediated by the infection induced increase in IFN alpha. (C) 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins. C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Arizona State Univ, Dept Psychol, Tempe, AZ 85287 USA. Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29401 USA. RP Tyor, WR (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. EM William.Tyor@va.gov FU NCRR NIH HHS [C06 RR015455]; NIMH NIH HHS [R01 MH62697-03] NR 48 TC 30 Z9 35 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD OCT 18 PY 2007 VL 21 IS 16 BP 2151 EP 2159 PG 9 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 228ZX UT WOS:000250772200004 PM 18090041 ER PT J AU Gilden, DH Tyler, KL AF Gilden, Donald H. Tyler, Kenneth L. TI Bell's palsy - Is glucocorticoid treatment enough?. SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID ACYCLOVIR C1 Univ Colorado, Sch Med, Dept Neurol, Denver, CO 80202 USA. Univ Colorado, Sch Med, Dept Microbiol, Denver, CO USA. Univ Colorado, Sch Med, Dept Med, Denver, CO USA. Denver Vet Affairs Med Ctr, Neurol Serv, Denver, CO USA. RP Gilden, DH (reprint author), Univ Colorado, Sch Med, Dept Neurol, Denver, CO 80202 USA. OI Tyler, Kenneth/0000-0003-3294-5888 NR 14 TC 25 Z9 29 U1 0 U2 1 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD OCT 18 PY 2007 VL 357 IS 16 BP 1653 EP 1655 DI 10.1056/NEJMe078188 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 221AY UT WOS:000250200500013 PM 17942879 ER PT J AU Wodchis, WP Ross, JS Detsky, AS AF Wodchis, Walter P. Ross, Joseph S. Detsky, Allan S. TI Is P4P really FFS? SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID PAY-FOR-PERFORMANCE; CLINICAL-PRACTICE GUIDELINES; HEALTH-CARE; QUALITY; IMPROVE; PLAN C1 Mt Sinai Hosp, Dept Med, Toronto, ON M5G 1X5, Canada. Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto Rehabil Inst, Inst Clin Evaluat Sci, Toronto, ON, Canada. Univ Toronto, Dept Med, Toronto Rehabil Inst, Inst Clin Evaluat Sci, Toronto, ON, Canada. Univ Hlth Network, Toronto, ON, Canada. Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA. Mt Sinai Sch Med, Dept Med, New York, NY USA. James J Peters Vet Adm Med Ctr, Hlth Serv Res & Dev Targeted Res Enhancement Prog, Bronx, NY USA. James J Peters Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY USA. RP Detsky, AS (reprint author), Mt Sinai Hosp, Dept Med, 600 Univ Ave,Room 427, Toronto, ON M5G 1X5, Canada. EM allan.detsky@uhn.on.ca NR 16 TC 24 Z9 24 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 17 PY 2007 VL 298 IS 15 BP 1797 EP 1799 DI 10.1001/jama.298.15.1797 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 220WF UT WOS:000250187300024 PM 17940237 ER PT J AU Colston, JT de la Rosa, SD Bailey, SR Chandraselkar, B AF Colston, James T. de la Rosa, Sam D. Bailey, Steven R. Chandraselkar, Bysani TI Novel regulation of Wnt-inducible secreted protein 1 by TNF-alpha in primary human cardiac fibroblasts SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Colston, James T.; de la Rosa, Sam D.; Bailey, Steven R.] Univ Texas Hlth Sci Ctr, San Antonio, TX USA. [Chandraselkar, Bysani] Dept Vet Affairs, S Texas Vet Hlth Care Syst, San Antonio, TX 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 OCT 16 PY 2007 VL 116 IS 16 SU S BP 211 EP 212 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394300940 ER PT J AU Jensen, BC Swigart, PM Myagmar, BE Shah, S DeMarco, T Hoopes, C Simpson, PC AF Jensen, Brian C. Swigart, Philip M. Myagmar, Bat-Erderre Shah, Sanjay DeMarco, Teresa Hoopes, Charles Simpson, Paul C. TI The alpha-1a is the predominant alpha-1-adrenergic receptor in the human heart at the mRNA but not the protein level SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Jensen, Brian C.; Simpson, Paul C.] Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA USA. [Swigart, Philip M.] San Francisco VA Med Ctr, San Francisco, CA USA. [Myagmar, Bat-Erderre] Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA USA. [Shah, Sanjay; DeMarco, Teresa; Hoopes, Charles] Univ Calif San Francisco, San Francisco, CA USA. NR 0 TC 2 Z9 2 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 MA 1405 BP 289 EP 289 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394301332 ER PT J AU Taylor, MV Bohachick, P Sereika, SM Schlenk, EA Brown, C Burke, LE AF Taylor, Melissa V. Bohachick, Patricia Sereika, Susan M. Schlenk, Elizabeth A. Brown, Charlotte Burke, Lora E. TI Social support, personal control, and psychological functioning among individuals with heart failure SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Taylor, Melissa V.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Bohachick, Patricia; Sereika, Susan M.; Schlenk, Elizabeth A.; Burke, Lora E.] Univ Pittsburgh, Sch Nursing, Pittsburgh, PA 15261 USA. [Brown, Charlotte] Univ Pittsburgh, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 1731 BP 365 EP 365 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394301652 ER PT J AU Corvera-Tindel, T Doering, LV Mody, FV Roper, J AF Corvera-Tindel, Teresita Doering, Lynn V. Mody, Freny V. Roper, Janice TI Diabetes reduces reactivation of vagal tone after peak exercise in heart failure patients SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Corvera-Tindel, Teresita] VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. [Doering, Lynn V.; Mody, Freny V.; Roper, Janice] Univ Calif Los Angeles, Los Angeles, CA 90024 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 MA 1816 BP 387 EP 387 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394301736 ER PT J AU Zenati, M Sonel, A Bjerke, R Shroyer, L Collins, J AF Zenati, Marco Sonel, Ali Bjerke, Richard Shroyer, Laurie Collins, Joseph CA ROOBY Invest TI Safety of aprotinin in CABG patients: Results of the VA multicenter prospective randomized ROOBY trial SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Zenati, Marco] Univ Pittsburgh, Pittsburgh, PA USA. [Sonel, Ali; Bjerke, Richard] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Shroyer, Laurie] VA Denver, Denver, CO USA. [Collins, Joseph] VA Cooperat Study Program, Perry Point, MD USA. RI Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 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 OCT 16 PY 2007 VL 116 IS 16 SU S BP 396 EP 396 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394301771 ER PT J AU Harris, KM Pastorius, CA Harwood, EM Duval, S Hirsch, AT Carabello, BA AF Harris, Kevin M. Pastorius, Catherine A. Harwood, Eileen M. Duval, Sue Hirsch, Alan T. Carabello, Blase A. TI How do cardiologists and cardiothoracic surgeons treat asymptomatic mitral regurgitation in clinical practice? An international survey SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Harris, Kevin M.; Pastorius, Catherine A.; Harwood, Eileen M.; Duval, Sue; Hirsch, Alan T.] Abbott NW Hosp, Minneapolis Heart Inst Fdn, Minneapolis, MN 55407 USA. [Carabello, Blase A.] Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 2663 BP 590 EP 590 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394302664 ER PT J AU Kolm, P Boden, WE Spertus, JA Maron, DJ O'Rourke, R Dada, M Zhang, W Hartigan, PM Weintraub, WS AF Kolm, Paul Boden, William E. Spertus, John A. Maron, David J. O'Rourke, Robert Dada, Marcin Zhang, Wei Hartigan, Pamela M. Weintraub, William S. TI Sex differences in quality of life and health status in the COURAGE trial SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Kolm, Paul; Zhang, Wei; Weintraub, William S.] Christiana Care Hlth Syst, Newark, DE USA. [Boden, William E.] Kaleida Hlth, Buffalo, NY USA. [Spertus, John A.] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA. [Maron, David J.] Vanderbilt Univ, Nashville, TN USA. [O'Rourke, Robert] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Dada, Marcin] Hartford Hosp, Hartford, CT 06115 USA. [Hartigan, Pamela M.] VA Connecticut Hlth Care Syst, West Haven, CT USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 2983 BP 666 EP 667 PG 2 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303081 ER PT J AU Kolm, P Boden, WE Spertus, JA Maron, DJ O'Rourke, R Teo, KK Zhao, LP Hartigan, PM Weintraub, WS AF Kolm, Paul Boden, William E. Spertus, John A. Maron, David J. O'Rourke, Robert Teo, Koon K. Zhao, Liping Hartigan, Pamela M. Weintraub, William S. TI Age-related quality of life and health status outcomes of COURAGE trial patients during long-term follow-up SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Kolm, Paul; Zhao, Liping; Weintraub, William S.] Christiana Care Hlth Syst, Newark, DE USA. [Boden, William E.] Kaleida Hlth, Buffalo, NY USA. [Spertus, John A.] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA. [Maron, David J.] Vanderbilt Univ, Nashville, TN USA. [O'Rourke, Robert] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Teo, Koon K.] McMaster Univ, Hamilton, ON L8S 4L8, Canada. [Hartigan, Pamela M.] VA Connecticut Hlth Care Syst, West Haven, CT USA. NR 0 TC 0 Z9 0 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 2984 BP 667 EP 667 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303082 ER PT J AU Maron, DJ Spertus, JA Mancini, GBJ Hartigan, PM Dacia, M Teo, KK O'Rourke, RA Weintraub, WS Boden, WE AF Maron, David J. Spertus, John A. Mancini, G. B. John Hartigan, Pamela M. Dacia, Marcin Teo, Koon K. O'Rourke, Robert A. Weintraub, William S. Boden, William E. TI Impact of PCI in patients with recent onset severe angina or stabilized ACS treated with optimal medical therapy: a COURAGE trial high risk subset SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Maron, David J.] Vandervilt Heart & Vasc Inst, Nashville, TN USA. [Spertus, John A.] Mid Amer Heart Inst, Kansas City, MO USA. [Mancini, G. B. John] Vancouver Hosp & Hlth Syst Sci Ctr, Vancouver, BC, Canada. [Hartigan, Pamela M.] Cooperat Studies Program Coordinating Ctr, West Haven, CT USA. [Dacia, Marcin] Hartford Hosp, Hartford, CT 06115 USA. [Teo, Koon K.] McMaster Univ, Med Ctr, Hamilton, ON L8S 4L8, Canada. [O'Rourke, Robert A.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Weintraub, William S.] Christiana Care Hlth Syst, Newark, DE USA. [Boden, William E.] SUNY Buffalo, Buffalo Gen Hosp, Buffalo, NY 14260 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 OCT 16 PY 2007 VL 116 IS 16 BP 667 EP 667 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303083 ER PT J AU Burjonroppa, SC Varosy, PD Rao, SV Ou, FS Peterson, E Roe, M Shunk, KA AF Burjonroppa, Sukesh C. Varosy, Paul D. Rao, Sunil V. Ou, Fang-Shu Peterson, Eric Roe, Matthew Shunk, Kendrick A. CA Amer Coll Cardiol Natl CDR TI Incidence and predictors of mortality among patients undergoing rescue percutaneous coronary intervention after failed filbrinolysis for ST-elevation myocardial infarction SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Burjonroppa, Sukesh C.; Varosy, Paul D.; Shunk, Kendrick A.] Univ Calif San Francisco, San Francisco VA Med Ctr, San Francisco, CA 94143 USA. [Rao, Sunil V.; Ou, Fang-Shu; Peterson, Eric; Roe, Matthew] Duke Univ, Duke Clin Res Inst, Durham, NC 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 OCT 16 PY 2007 VL 116 IS 16 SU S MA 3011 BP 674 EP 674 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303109 ER PT J AU Aggarwal, A Dal, D Rumsfeld, JS Klein, L Roe, MT AF Aggarwal, Atul Dal, David Rumsfeld, John S. Klein, LloydW Roe, Matthew T. CA AMCC NCDR TI Characteristics and outcomes of patients taking warfarin prior to percutaneous coronary intervention SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Aggarwal, Atul] Nebraska Inst Heart, Hastings, NE USA. [Dal, David; Roe, Matthew T.] Duke Clin Res Inst, Durham, NC USA. [Rumsfeld, John S.] Univ Colorado, Denver VA Med Ctr, Denver, CO USA. [Klein, LloydW] Rush Med Coll, Chicago, IL 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 OCT 16 PY 2007 VL 116 IS 16 SU S BP 702 EP 702 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303228 ER PT J AU Sedlis, SP Jurkovitz, CT Hartigan, PM Lorin, JD Dada, M Maron, DJ Teo, BK O'Rourke, RA Boden, WE AF Sedlis, Steven P. Jurkovitz, Claudine T. Hartigan, Pamela M. Lorin, Jeffrey D. Dada, Mancin Maron, David J. Teo, Koon K. O'Rourke, Robert A. Boden, William E. TI Optimal medical therapy with or without percutaneous coronary intervention for stable coronary artery disease is effective in patients with chronic kidney disease SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Sedlis, Steven P.; Lorin, Jeffrey D.] New York VA Med Ctr, New York, NY USA. [Jurkovitz, Claudine T.] Christiana Care Hlth Syst, Newark, DE USA. [Hartigan, Pamela M.] VA Cooperat Studies Program, West Haven, CT USA. [Dada, Mancin] Hartford Hosp, Hartford, CT 06115 USA. [Maron, David J.] Vanderbilt Univ, Med Ctr, Nashville, TN USA. [Teo, Koon K.] McMaster Univ, Med Ctr, Hamilton, ON, Canada. [O'Rourke, Robert A.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Boden, William E.] Buffalo Gen Hosp, Western New York Vet Affairs Healthcare Network, Buffalo, NY 14203 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 OCT 16 PY 2007 VL 116 IS 16 BP 794 EP 794 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303600 ER PT J AU Frutkin, AD Mehta, SK House, J Cohen, DJ Spertus, JA Rumsfeld, J Marso, SP AF Frutkin, Andrew D. Mehta, Sameer K. House, John Cohen, David J. Spertus, John A. Rumsfeld, John Marso, Steven P. TI The use of percutaneous coronary intervention in patients with class I indications for coronary artery bypass graft surgery: Data from the national cardiovascular data registry SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Frutkin, Andrew D.; Mehta, Sameer K.; House, John; Cohen, David J.; Spertus, John A.; Marso, Steven P.] Mid Amer Heart Inst, Kansas City, MO USA. [Rumsfeld, John] Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Denver, CO USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 3510 BP 795 EP 795 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303603 ER PT J AU Maron, DJ Spertus, JA Kolm, PG Sedlis, SP Mancini, GBJ Hartigan, PM Shaw, LJ Dada, M Teo, KK O'Rourke, RA Boden, WE Weintraub, WS AF Maron, David J. Spertus, John A. Kolm, Paul G. Sedlis, Steven P. Mancini, G. B. John Hartigan, Pamela M. Shaw, Leslee J. Dada, Marcin Teo, Koon K. O'Rourke, Robert A. Boden, William E. Weintraub, William S. TI Quality of life in COURAGE trial patients with diabetes SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Maron, David J.] Vanderbilt Heart & Vasc Inst, Nashville, TN USA. [Spertus, John A.] Mid Amer Heart Inst, Kansas City, MO USA. [Kolm, Paul G.; Weintraub, William S.] Christiana Care Hlth Syst, Newark, DE USA. [Sedlis, Steven P.] VA Hlth Care Syst, New York, NY USA. [Mancini, G. B. John] Vancouver Hosp, Hlth Sci Ctr, Vancouver, BC, Canada. [Hartigan, Pamela M.] VA Cooperat Studies Program Coordinating Ctr, West Haven, CT USA. [Shaw, Leslee J.] Emory Univ, Div Cardiol, Atlanta, GA 30322 USA. [Dada, Marcin] Hartford Hosp, Hartford, CT 06115 USA. [Teo, Koon K.] McMaster Univ, Med Ctr, Hamilton, ON, Canada. [O'Rourke, Robert A.] S Texas Vet Hlth Care Syst, San Antonio, TX USA. [Boden, William E.] SUNY Buffalo, Gen Hosp, Buffalo, NY 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 OCT 16 PY 2007 VL 116 IS 16 SU S MA 3511 BP 795 EP 795 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303604 ER PT J AU Ho, PM Magid, DJ Shetterly, SM Olson, KL Maddox, TM Peterson, PN Masoudi, FA Rumsfeld, JS AF Ho, P. Michael Magid, David J. Shetterly, Susan M. Olson, Karl L. Maddox, Thomas M. Peterson, Pamela N. Masoudi, Frederick A. Rumsfeld, John S. TI Medication non-adherence is associated with a broad range of adverse outcomes in patients with coronary artery disease SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Ho, P. Michael; Maddox, Thomas M.; Rumsfeld, John S.] Denver VA Med Ctr, Denver, CO USA. [Magid, David J.; Shetterly, Susan M.; Olson, Karl L.] Kaiser Permanente, Denver, CO USA. [Masoudi, Frederick A.] Denver Hlth Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 16 PY 2007 VL 116 IS 16 SU S MA 3526 BP 798 EP 798 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303619 ER PT J AU Maddox, TM Reid, KJ Sperlus, JA Parashar, S Krumholz, HM Ho, M Rumsfeld, JS AF Maddox, Thomas M. Reid, Kimberly J. Sperlus, John A. Parashar, Susmita Krumholz, Harlan M. Ho, Michael Rumsfeld, John S. TI The prevalence and factors associated with 1-year angina among post-ml patients SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Maddox, Thomas M.; Ho, Michael; Rumsfeld, John S.] Univ Colorado, Hlth Sci Ctr, Denver VAMC, Denver, CO 80202 USA. [Reid, Kimberly J.; Sperlus, John A.] Univ Missouri, Mid Amer Heart Inst, Kansas City, MO 64110 USA. [Parashar, Susmita] Emory Univ, Atlanta, GA 30322 USA. [Krumholz, Harlan M.] Yale Univ, New Haven, CT 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 OCT 16 PY 2007 VL 116 IS 16 BP 811 EP 811 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303676 ER PT J AU Asselbergs, FW Mozaffarian, D Katz, R Kestenbaum, B Fried, LF Gottidener, JS Shlipak, MG Siscovick, DS AF Asselbergs, Folkert W. Mozaffarian, Dariush Katz, Ronit Kestenbaum, Bryan Fried, Linda F. Gottidener, John S. Shlipak, Michael G. Siscovick, David S. TI Cystatin C is associated with mitral annular calcification in elderly adults: Results from the cardiovascular health study SO CIRCULATION LA English DT Meeting Abstract CT 80th Annual Scientific Session of the American-Heart-Association CY NOV 04-07, 2007 CL Orlando, FL SP Amer Heart Assoc C1 [Asselbergs, Folkert W.] Univ Groningen, Med Ctr, Groningen, Netherlands. [Mozaffarian, Dariush] Harvard Sch Publ Hlth, Boston, MA USA. [Katz, Ronit; Kestenbaum, Bryan; Siscovick, David S.] Univ Washington, Seattle, WA 98195 USA. [Fried, Linda F.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [Gottidener, John S.] St Francis Hosp, Roslyn, NY USA. [Shlipak, Michael G.] Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RI Mozaffarian, Dariush/B-2276-2008 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 OCT 16 PY 2007 VL 116 IS 16 SU S MA 3744 BP 851 EP 851 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 223TD UT WOS:000250394303835 ER PT J AU Givertz, MM Massie, BM Fields, TK Pearson, LL Dittrich, HC AF Givertz, Michael M. Massie, Barry M. Fields, Tara K. Pearson, Leeanne L. Dittrich, Howard C. CA CKI-201 CKI-202 Investigators TI The effects of KW-3902, an adenosine A1-receptor antagonist, on diuresis and renal function in patients with acute decompensated heart failure and renal impairment or diuretic resistance SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID RECEPTOR ANTAGONIST; ANESTHETIZED DOGS; ADENOSINE; ACTIVATION; OUTCOMES; IMPACT; MODEL; CREATININE; EPILEPSY; KIDNEY AB Objectives: This study sought to evaluate the dose-dependent effects of adenosine A1-receptor blockade on diuresis and renal function in patients with acute decompensated heart failure (ADHF) and renal impairment or diuretic resistance. Background: Intravenous loop diuretics are the mainstay of therapy for patients with ADHF. Treatment, however, may be complicated by diuretic resistance and/or worsening renal function. Methods: We carried out a pair of randomized, double-blind, placebo-controlled, proof-of-concept studies in 2 clinically challenging ADHF populations. Results In the ADHF protocol, 146 patients with volume overload and an estimated creatinine clearance (CrCI) of 20 to 80 ml/mln were randomized to placebo or I of 4 doses of KW-3902 (rolofylline) infused over 2 h daily for up to 3 days. On day 1, KW-3902 monotherapy increased urine output during the first 6 h (445, 531, 631, and 570 ml in the 2.5-, 15-, 30-, and 60-mg groups, respectively) compared with placebo (374 ml; p = 0.02). On day 2, serum creatinine decreased in all KW-3902 groups and increased with placebo (p = 0.04). By day 4 or day of discharge if earlier, intravenous furosemide administration tended to be lower in the KW-3902 groups compared with placebo (p = 0.10). In the diuretic-resistant protocol, 35 patients with an average CrCl of 34 ml/min were randomized to a single infusion of placebo, 10, 30, or 60 mg of KW-3902. Compared with placebo, KW-3902 increased hourly urine volume and estimated CrCl with peak effects occurring at 2 to 3 h and at 24 h, respectively. Adverse events were not different between placebo and KW-3902. Conclusions: In patients with ADHF and volume overload, KW-3902, an adenosine A1-receptor antagonist, enhances the response to loop diuretics and may have a renal protective effect. C1 Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA. San Francisco VA Med Ctr, Div Cardiol, San Francisco, CA USA. NovaCardia Inc, San Diego, CA USA. Univ Calif San Diego, San Diego, CA 92103 USA. RP Givertz, MM (reprint author), Brigham & Womens Hosp, Div Cardiovasc, 75 Francis St, Boston, MA 02115 USA. EM mgivertz@partners.org NR 21 TC 105 Z9 112 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD OCT 16 PY 2007 VL 50 IS 16 BP 1551 EP 1560 DI 10.1016/j.jacc.2007.07.019 PG 10 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 223ZX UT WOS:000250415900005 PM 17936154 ER PT J AU Huang, E Esrailian, E Spiegel, BMR AF Huang, E. Esrailian, E. Spiegel, B. M. R. TI The cost-effectiveness and budget impact of competing therapies in hepatic encephalopathy - a decision analysis SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID PORTAL-SYSTEMIC ENCEPHALOPATHY; PROTON PUMP INHIBITORS; RANDOMIZED CLINICAL-TRIAL; DOUBLE-BLIND; CIRRHOTIC-PATIENTS; NATURAL-HISTORY; HEPATOCELLULAR-CARCINOMA; TREATMENT ALTERNATIVES; LIVER-TRANSPLANTATION; PROGNOSTIC INDICATORS AB Background Treatment options for hepatic encephalopathy have disparate risks and benefits. Non-absorbable disaccharides and neomycin are limited by uncertain efficacy and common dose-limiting side effects. In contrast, rifaximin is safe and effective in hepatic encephalopathy, but is more expensive. Methods We conducted a decision analysis to calculate the cost-effectiveness of six strategies in hepatic encephalopathy: (i) no hepatic encephalopathy treatment, (ii) lactulose monotherapy, (iii) lactitol monotherapy, (iv) neomycin monotherapy, (v) rifaximin monotherapy and (vi) up-front lactulose with crossover to rifaximin if poor response or intolerance of lactulose ('rifaximin salvage'). The primary outcome was cost per quality-adjusted life-year gained. Results Under base-case conditions, 'do nothing' was least effective and rifaximin salvage was most effective. Lactulose monotherapy was least expensive, and rifaximin monotherapy was most expensive. When balancing cost and effectiveness, lactulose monotherapy and rifaximin salvage dominated alternative strategies. Compared to lactulose monotherapy, rifaximin salvage cost an incremental US$2315 per quality-adjusted life-year-gained. The cost of rifaximin had to fall below US$1.03/tab in order for rifaximin monotherapy to dominate lactulose monotherapy. Conclusions Rifaximin monotherapy is not cost-effective in the treatment of chronic hepatic encephalopathy at current average wholesale prices. However, a hybrid salvage strategy, reserving rifaximin for lactulose-refractory patients, may be highly cost-effective. C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Outcomes Res & Educ, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. CURE Digest Dis Res Ctr, Los Angeles, CA USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Outcomes Res & Educ, VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,Bldg 115 Rm 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu FU NIDDK NIH HHS [P30 DK 041301-17] NR 98 TC 38 Z9 40 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD OCT 15 PY 2007 VL 26 IS 8 BP 1147 EP 1161 DI 10.1111/j.1365-2036.2007.03464.x PG 15 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 213XD UT WOS:000249699700007 PM 17894657 ER PT J AU Diaz-Torne, C Schumacher, HR Yu, X Gomez-Vaquero, C Dai, L Chen, LX Clayburne, G Einhorn, E Sachdeva, RM Singh, JA Pessler, F AF Diaz-Torne, C. Schumacher, H. R. Yu, X. Gomez-Vaquero, C. Dai, L. Chen, L. X. Clayburne, G. Einhorn, E. Sachdeva, R. M. Singh, J. A. Pessler, F. TI Absence of histologic evidence of synovitis in patients with Gulf War veterans' illness with joint pain SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article ID HISTOPATHOLOGICAL GRADING SYSTEM; RHEUMATOID-ARTHRITIS; SQUALENE; TISSUE; HEALTH AB Objective. An unexplained multisymptom illness, Gulf War veterans' illness (GWVI), has been described among allied force veterans of the first Gulf War (1990-1991). It has been proposed that some of its symptoms reflect an immune dysfunction, and rheumatologic symptoms including joint pain and stiffness are reported frequently. However, it is unknown whether synovial inflammation causes the articular symptoms. We examined synovial tissue from individuals with GWVI and joint pain for evidence of inflammation. Methods. We compared synovial biopsy samples from 6 individuals with GWVI and joint pain with samples from 9 clinically asymptomatic controls (hematoxylin and eosin [H&E] stains only) and biopsy samples or surgically obtained specimens from 10 patients with rheumatoid arthritis (RA) and 12 with osteoarthritis (OA). Inflammatory changes were quantified in H&E stained sections with a modified synovitis score by immunostaining for CD3, CD20, CD38, CD68, Ki-67, and von Willebrand factor, and with a composite inflammation score based on these markers. Results. Normal histology was seen in the GWVI specimens, except for mild focal lining hyperplasia and rare low-grade perivascular infiltrates in 1 specimen each. Mean SEM synovitis scores were lowest and nearly identical in control (1.38 +/- 0.30) and GWVI specimens (1.41 +/- 0.29), intermediate in OA specimens (2.64 +/- 0.39), and highest in RA specimens (6.0 +/- 0.19). Likewise, inflammatory cells, cell division, vascular density, and composite inflammation score were lowest in the GWVI specimens. Conclusion. Despite significant joint pain, the GWVI synovia did not differ from normal controls. These results agree with other studies that have failed to document inflammatory or immunologic etiologies in GWVI. C1 Childrens Hosp Philadelphia, Div Rheumatol, Philadelphia, PA 19104 USA. Hosp Univ Bellvitge, Barcelona, Spain. Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Tradit Chinese Med Western Med Hosp, Cangzhou, Hebei, Peoples R China. Sun Yat Sen Univ, Guangzhou, Peoples R China. Univ Minnesota, Minneapolis, MN USA. RP Pessler, F (reprint author), Childrens Hosp Philadelphia, Div Rheumatol, 3405 Civ Ctr Blvd, Philadelphia, PA 19104 USA. EM pessler@email.chop.edu OI Cesar, Diaz-Torne/0000-0001-6275-7699; singh, jasvinder/0000-0003-3485-0006 FU NCI NIH HHS [T32-CA-09140]; NIAMS NIH HHS [T32-AR-007442] NR 25 TC 15 Z9 15 U1 0 U2 1 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 OCT 15 PY 2007 VL 57 IS 7 BP 1316 EP 1323 DI 10.1002/art.23006 PG 8 WC Rheumatology SC Rheumatology GA 221ZF UT WOS:000250265200027 PM 17907214 ER PT J AU Kaplan, RC Kingsley, LA Sharrett, AR Li, XH Lazar, J Tien, PC Mack, WJ Cohen, MH Jacobson, L Gange, SJ AF Kaplan, Robert C. Kingsley, Lawrence A. Sharrett, A. Richey Li, Xiuhong Lazar, Jason Tien, Phyllis C. Mack, Wendy J. Cohen, Mardge H. Jacobson, Lisa Gange, Stephen J. TI Ten-year predicted coronary heart disease risk in HIV-infected men and women SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIRETROVIRAL THERAPY; MYOCARDIAL-INFARCTION; PROTEASE INHIBITORS; INTERAGENCY HIV; ASSOCIATION; EVENTS; COHORT; LIPIDS; HAART AB Background. Highly active antiretroviral therapy (HAART), in addition to traditional vascular risk factors, may affect coronary heart disease (CHD) risk in individuals with human immunodeficiency virus (HIV) infection. Methods. Among HIV-infected (931 men and 1455 women) and HIV-uninfected (1099 men and 576 women) adults, the predicted risk of CHD was estimated on the basis of age, sex, lipid and blood pressure levels, the presence of diabetes, and smoking status. Results. Among HIV-infected men, 2% had moderate predicted risk of CHD (10-year CHD risk, 15%-25%), and 17% had high predicted risk (10-year CHD risk of >= 25% or diabetes). Among HIV-infected women, 2% had moderate predicted CHD risk, and 12% had high predicted CHD risk. Compared with users of protease inhibitor based HAART, the adjusted odds ratio (OR) for moderate-to-high risk of CHD was significantly lower among HAART-naive individuals (OR, 0.57; 95% confidence interval [CI], 0.36-0.89). Users of HAART that was not protease inhibitor based (OR, 0.74; 95% CI, 0.53-1.01) and former HAART users (OR, 0.68; 95% CI, 0.46-1.03) were also less likely than users of protease inhibitor-based HAART to have moderate-to-high CHD risk, although 95% CIs overlapped the null. Low income was associated with increased likelihood of moderate-to-high CHD risk (for annual income <$10,000 vs. >$40,000: OR, 2.32; 95% CI, 1.51-3.56). Elevated body mass index (calculated as weight in kilograms divided by the square of height in meters) predicted increased likelihood of moderate-to-high CHD risk (for BMI of 18.5-24.9 vs. BMI of 25-30: OR, 1.41 [95% CI, 1.03-1.93]; for BMI of 18.5-24.9 vs. BMI >= 30: OR, 1.79 [95% CI, 1.25-2.56]). Conclusions. Among HIV-infected adults, in addition to antiretroviral drug exposures, being overweight and having a low income level were associated with increased predicted CHD risk. This suggests a need to target HIV-infected men and women with these characteristics for vascular risk factor screening. C1 Yeshiva Univ Albert Einstein Coll Med, Dept Epidemiol, Bronx, NY 10461 USA. Suny Downstate Med Ctr, Dept Med, Brooklyn, NY 11203 USA. Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Prevent Med, Los Angeles, CA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Infect Dis & Microbiol, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. Stroger House, CORE Ctr, Chicago, IL 60612 USA. Stroger House, Dept Med, Chicago, IL 60612 USA. Rush Med Coll, Dept Med, Chicago, IL 60612 USA. RP Kaplan, RC (reprint author), Yeshiva Univ Albert Einstein Coll Med, Dept Epidemiol, 1300 Morris Pk Ave, Bronx, NY 10461 USA. EM rkaplan@aecom.yu.edu RI Kaplan, Robert/A-2526-2011 OI Gange, Stephen/0000-0001-7842-512X FU NCRR NIH HHS [5-MO1-RR-00722, M01-RR00079, M01-RR00083]; NHLBI NIH HHS [1R01HL083760-01]; NIAID NIH HHS [U01-AI-34989, K23 AI066943, K23 AI066943-05, U01-AI-31834, U01-AI-34993, U01-AI-34994, U01-AI-35004, U01-AI-42590, UO1-AI-35039, UO1-AI-35040, UO1-AI-35041, UO1-AI-35042, UO1-AI-35043, UO1-AI-37613, UO1-AI-37984]; NICHD NIH HHS [U01-HD-32632] NR 30 TC 89 Z9 92 U1 0 U2 6 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD OCT 15 PY 2007 VL 45 IS 8 BP 1074 EP 1081 DI 10.1086/521935 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 211YT UT WOS:000249560900026 PM 17879928 ER PT J AU Choudhury, A Cohen, PL Eisenberg, RA AF Choudhury, Arpita Cohen, Philip L. Eisenberg, Robert A. TI Mature B cells preferentially lose tolerance in the chronic graft-versus-host disease model of systemic lupus erythematosus SO JOURNAL OF IMMUNOLOGY LA English DT Article ID CD4 T-CELLS; MARGINAL-ZONE; AUTOANTIBODY PRODUCTION; NEGATIVE SELECTION; LYMPHOCYTES-B; CHAIN GENE; MICE; EXPRESSION; RECEPTORS; PATHOGENESIS AB Chronic graft-vs-host (cGVH) disease is a well-characterized systemic lupus crythematosus (SLE) model. Induction of cGVH in anti-DNA H chain knockin (3H9KI) transgenic mice results in specific activation of anti-dsDNA B cells. In this study, we show that B cells from 3119KI mice were activated by cGVH even when adoptively transferred into irradiated JHT-/- recipients that lack endogenous B cells. This process of activation was reflected by high autoantibody titers and changes in phenotypic markers. We have used this system to characterize the particular B cell subsets that were responsible for secreting autoantibodies during cGVH response. We isolated splenic B cell subsets based on their expression of specific cell surface markers and used them in our adoptive transfer studies. We found that mature B cells were the most vulnerable to the allostimulus and were the major source of autoantibodies compared with immature B cells. The greater susceptibility of mature B cells to become activated and thereby lose tolerance was unanticipated and has implications for maintenance of peripheral tolerance and for the development of autoimmunity. Furthermore, of the mature B cells, marginal zone B cells were particularly responsible for mounting the initial response to the cGVH stimulus. This observation underscores the critical role of marginal zone B cells in activation and production of autoantibodies. C1 Univ Penn, Div Rheumatol, Dept Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Eisenberg, RA (reprint author), Univ Penn, Div Rheumatol, Dept Med, 421 Curie Blvd, Philadelphia, PA 19104 USA. EM raemd@mail.med.upenn.edu FU NIAID NIH HHS [U19-AI-46358, R01-AI063626]; NIAMS NIH HHS [R01-AR34156, R01 AR034156] NR 33 TC 5 Z9 5 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD OCT 15 PY 2007 VL 179 IS 8 BP 5564 EP 5570 PG 7 WC Immunology SC Immunology GA 219QJ UT WOS:000250099400065 PM 17911643 ER PT J AU Ostrem, JL Marks, WJ Volz, MM Heath, SL Starr, PA AF Ostrem, Jill L. Marks, William J. Volz, Monica M. Heath, Susan L. Starr, Philip A. TI Pallidal deep brain stimulation in patients with cranial-cervical dystonia (Meige syndrome) SO MOVEMENT DISORDERS LA English DT Article DE dystonia; deep brain stimulation; Meige syndrome; globus pallidus; cranial-cervical dystonia ID GLOBUS-PALLIDUS; GENERALIZED DYSTONIA; PARKINSONS-DISEASE; OROMANDIBULAR DYSTONIA; SPASMODIC TORTICOLLIS; SUBTHALAMIC NUCLEUS; TECHNICAL APPROACH; BOTULINUM-TOXIN; FOLLOW-UP; INTERNUS AB Idiopathic cranial-cervical dystonia (ICCD) is an adult-onset dystonia syndrome affecting orbicularis oculi, facial, oromandibular, and cervical musculature. ICCD is frequently difficult to treat medically. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a highly effective treatment for idiopathic generalized dystonia, however less is known about the effect of GPi DBS on ICCD. In this article, we present the results from a pilot study assessing the effect of GPi DBS in a series of patients with ICCD. Six patients underwent bilateral stereotactic implantation of DBS leads into the sensorimotor GPi. Patients were evaluated with the Burke-Fahn-Marsden dystonia rating scale (BFMDRS) and Toronto western spamodic torticollis rating scale (TWSTRS) before surgery and 6 months postoperatively. At 6 months, patients showed a 72% mean improvement in the. BFMDRS total movement score (P < 0.028, Wilcoxin signed rank test). The mean BFMDRS disability score showed a trend toward improvement (P < 0.06). The total TWSTRS score improved 54% (P < 0.043). Despite improvement in dystonia, mild worsening of motor function was reported in previously nondystonic body regions with stimulation in 4 patients. Although GPi DBS was effective in these patients, the influence of GPi DBS on nondystonic body regions deserves further investigation. (C) 2007 Movement Disorder Society. C1 Univ Calif San Francisco, Ctr Med, Dept Neurol, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, PADRECC, San Francisco, CA USA. Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA. RP Ostrem, JL (reprint author), Univ Calif San Francisco, Ctr Med, Dept Neurol, 400 Parnassus Ave,Box 0348, San Francisco, CA 94143 USA. EM jill.ostrem@ucsf.edu FU PHS HHS [K08] NR 29 TC 76 Z9 81 U1 1 U2 3 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD OCT 15 PY 2007 VL 22 IS 13 BP 1885 EP 1891 DI 10.1002/mds.21580 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 228NR UT WOS:000250737100008 PM 17618522 ER PT J AU El-Serag, HB Lau, M Eschbach, K Davila, J Goodwin, J AF El-Serag, Hashem B. Lau, Melvin Eschbach, Karl Davila, Jessica Goodwin, James TI Epidemiology of hepatocellular carcinoma in Hispanics in the United States SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID INCREASING INCIDENCE; MORTALITY; RATES AB Background: To our knowledge, no detailed analysis exists of the incidence and mortality of hepatocellular carcinoma (HCC) among Hispanics in the United States. In previous studies, the rates for Hispanics have not been reported separately from other racial or ethnic groups. Methods: We used information on patients diagnosed as having HCC from 13 registries in the Surveillance Epidemiology and End Results (SEER) database of the National Cancer Institute to calculate race-specific, age-adjusted incidence rates (AIR) between 1992 and 2002. We also used California and Texas state death records from between 1979 and 2001 to calculate race-specific, age-adjusted mortality rates for liver cancer excluding intrahepatic cholangiocarcinoma. For Hispanics and Asians/ Pacific Islanders, the rates were calculated for native-born subjects and immigrants separately. Results: In SEER, the yearly AIRs were higher by 1.2-fold in Hispanics than in blacks (6.3 vs 5.0 per 100 000 person-years of the underlying US population) and by 2.7-fold than in non-Hispanic whites (2.4 per 100 000 person-years) but lower than in Asians/Pacific Islanders (10.8 per 100 000 person-years). The median age at HCC diagnosis in Hispanics (64 years) was intermediate between whites (the oldest) and blacks (the youngest). Between the periods 1992-1995 and 2000-2002, there was a 31% increase in the incidence of HCC in Hispanic men and a 63% increase in Hispanic women. The race-specific, age-adjusted mortality rates were remarkably similar in California and Texas and were highest in immigrant Asian/Pacific Islanders followed by native Hispanics. The rates for native Hispanic men were more than twice as high as those for immigrant Hispanic men. For Texas, the rates for native Hispanic men were 65% higher than those for immigrant Hispanic men. Conclusion: Hispanics in the United States have high rates of HCC that are second only to Asians/Pacific Islanders. C1 Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX 77030 USA. Houston Dept Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Texas, Med Branch, Dept Internal Med, Div Geriatr, Galveston, TX 77550 USA. RP El-Serag, HB (reprint author), Houston Dept Vet Affairs Med Ctr, Gastroenterol Sect, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu FU NCI NIH HHS [P50 CA 10563-03] NR 18 TC 64 Z9 64 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 OCT 8 PY 2007 VL 167 IS 18 BP 1983 EP 1989 DI 10.1001/archinte.167.18.1983 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 217LC UT WOS:000249948400010 PM 17923599 ER PT J AU Gordon, AJ Trafton, JA Saxon, AJ Gifford, AL Goodman, F Calabrese, VS McNicholas, L Liberto, J AF Gordon, Adam J. Trafton, Jodie A. Saxon, Andrew J. Gifford, Allen L. Goodman, Francine Calabrese, Vincent S. McNicholas, Laura Liberto, Joseph TI Implementation of buprenorphine in the Veterans Health administration: Results of the first 3 years SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article ID OFFICE-BASED TREATMENT; OPIOID DEPENDENCE; PRIMARY-CARE; ADDICTION; NALOXONE AB Background: Compared to non-veterans, veterans are disproportionately diagnosed with opioid dependence. Sublingual buprenorphine provides greater access to opioid agonist therapy. To understand the diffusion of this innovative treatment within a large healthcare system, we describe the introduction of buprenorphine, within the Veterans Health Administration (VHA) during the first 3 years of its approval as a VHA non-formulary medication. Methods: Using VHA pharmacy databases, we examined the number of physicians who have prescribed buprenorphine and the number of veterans who have received office-based buprenorphine within VHA veterans integrated service networks (VISN) from fiscal years (FY) 2003 through FY 2005 (October 2002 through September 2005). Results: From FY2003 through FY2005 the number of veterans with opioid dependence increased from 25,031 to 26,859 (>7.3%) and the number of veterans prescribed office-based buprenorphine increased from 53 to 739. During this interval, 16 of 21 VISNs had prescribed buprenorphine. In FY2005, two VISNs accounted for 31% of buprenorphine prescriptions. The number of buprenorphine prescriptions varied widely by VISN, but increased from 212 to 7076 from FY2003 through FY2005. During this interval, prescriptions per patient increased from 4.0 to 9.6 and physicians prescribing buprenorphine increased from 14 to 170. The ratio of patients prescribed buprenorphine to providers prescribing buprenorphine increased from 3.8 to 4.3 with an average increase of 15.1-41.6 of prescriptions per provider. Conclusions: VHA increased, but not uniformly, the non-formulary use of office-based buprenorphine during the first 3 years of availability. Published by Elsevier Ireland Ltd. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, VISN Mental Illness Res Educ & Clin Ctr 4, Pittsburgh, PA 15240 USA. VA Palo Alto Hlth Care Syst, Program Evaluat & Resource Ctr, Menlo Pk, CA 94025 USA. VA Puget Sound Hlth Care Syst S 116 ATC, Seattle, WA 98108 USA. VA New England Healthcare, VA Bedford Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA 01730 USA. VACO Pharm Benefits Management Strateg Healthcare, Hines, IL 60141 USA. Philadelphia VAMC, Philadelphia, PA 19104 USA. VA Maryland Hlth Care Syst, Mental Hlth Clin Ctr, Baltimore, MD 21201 USA. RP Gordon, AJ (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, VISN Mental Illness Res Educ & Clin Ctr 4, Mailcode 151-C,Univ Dr C, Pittsburgh, PA 15240 USA. EM adam.gordon@va.gov; Jodie.Trafton@va.gov; asaxon@u.washington.edu; allen.gifford@va.gov; Francine.Goodman@va.gov; vincent.calabrese@va.gov; Laura.McNicholas@va.gov; joseph.liberto@va.gov NR 17 TC 21 Z9 21 U1 1 U2 2 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD OCT 8 PY 2007 VL 90 IS 2-3 BP 292 EP 296 DI 10.1016/j.drugalcdep.2007.03.010 PG 5 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 213GD UT WOS:000249653600022 PM 17493771 ER PT J AU Shenoy, SK Barak, LS Xiao, KH Ahn, S Berthouze, M Shukla, AK Luttrell, LM Lefkowitz, RJ AF Shenoy, Sudha K. Barak, Larry S. Xiao, Kunhong Ahn, Seungkirl Berthouze, Magali Shukla, Arun K. Luttrell, Louis M. Lefkowitz, Robert J. TI Ubiquitination of beta-arrestin links seven-transmembrane receptor endocytosis and ERK activation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PROTEIN-COUPLED RECEPTORS; BETA(2)-ADRENERGIC RECEPTOR; ADRENERGIC-RECEPTOR; DEPENDENT ENDOCYTOSIS; CLATHRIN ADAPTER; VISUAL ARRESTIN; CELL; BETA-ARRESTIN2; KINASE; MONOUBIQUITINATION AB beta-Arrestin2 and its ubiquitination play crucial roles in both internalization and signaling of seven-transmembrane receptors (7TMRs). To understand the connection between ubiquitination and the endocytic and signaling functions of beta-arrestin, we generated a beta-arrestin2 mutant that is defective in ubiquitination (beta-arrestin2(OK)), by mutating all of the ubiquitin acceptor lysines to arginines and compared its properties with the wild type and a stably ubiquitinated beta-arrestin2-ubiquitin (Ub) chimera. In vitro translated beta-arrestin2 and beta-arrestin2(OK) displayed equivalent binding to recombinant beta(2)-adrenergic receptor (beta(2)AR) reconstituted in vesicles, whereas beta-arrestin2-Ub bound similar to 4-fold more. In cellular coimmunoprecipitation assays, beta-arrestin2(OK) bound nonreceptor partners, such as AP-2 and c-Raf and scaffolded phosphorylated ERK robustly but displayed weak binding to clathrin. Moreover, beta-arrestin2(OK) was recruited only transiently to activated receptors at the membrane, did not enhance receptor internalization, and decreased the amount of phosphorylated ERK assimilated into isolated beta(2)AR complexes. Although the wild type beta-arrestin2 formed ERK signaling complexes with the beta(2)AR at the membrane, a stably ubiquitinated beta-arrestin2-Ub chimera not only stabilized the ERK signalosomes but also led to their endosomal targeting. Interestingly, in cellular fractionation assays, the ubiquitination state of beta-arrestin2 favors its distribution in membrane fractions, suggesting that ubiquitination increases the propensity of beta-arrestin for membrane association. Our findings suggest that although beta-arrestin ubiquitination is dispensable for beta-arrestin cytosol to membrane translocation and its "constitutive" interactions with some cytosolic proteins, it nevertheless is a prerequisite both for the formation of tight complexes with 7TMRs in vivo and for membrane compartment interactions that are crucial for downstream endocytic and signaling processes. C1 Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Duke Univ, Med Ctr, Howard Hughes Med Inst, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Biochem, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Cell Biol, Durham, NC 27710 USA. Med Univ S Carolina, Dept Med Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Res Serv, Charleston, SC 29401 USA. RP Shenoy, SK (reprint author), Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. EM sudha@receptor-biol.duke.edu FU NHLBI NIH HHS [HL080525, HL16037, R01 HL016037, R01 HL080525, R01 HL080525-02]; NIDDK NIH HHS [DK55524, R01 DK055524, R56 DK055524] NR 45 TC 64 Z9 66 U1 0 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 5 PY 2007 VL 282 IS 40 BP 29549 EP 29562 DI 10.1074/jbc.M700852200 PG 14 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 215DH UT WOS:000249788000052 PM 17666399 ER PT J AU Yehuda, R Ledoux, J AF Yehuda, Rachel Ledoux, Joseph TI Response variation following trauma: A translational neuroscience approach to understanding PTSD SO NEURON LA English DT Review ID POSTTRAUMATIC-STRESS-DISORDER; MEDIAL PREFRONTAL CORTEX; NATIONAL COMORBIDITY SURVEY; SPRAGUE-DAWLEY RATS; ANIMAL-MODEL; HIPPOCAMPAL VOLUME; RISK-FACTORS; INDIVIDUAL-DIFFERENCES; ANXIETY DISORDERS; FEAR EXTINCTION AB Exposure to traumatic stress is a requirement for the development of posttraumatic stress disorder (PTSD). However, because the majority of trauma-exposed persons do not develop PTSD, examination of the typical effects of a stressor will not identify the critical components of PTSD risk or pathogenesis. Rather, PTSD represents a specific phenotype associated with a failure to recover from the normal effects of trauma. Thus, research must focus on identifying pre- and posttraumatic risk factors that explain the development of the disorder and the failure to reinstate physiological homeostasis. In this review, we summarize what is known about the clinical and biological characteristics of PTSD and articulate some of the gaps in knowledge that can be addressed by basic neuroscience research. We emphasize how knowledge about individual differences related to genetic and epigenetic factors in behavioral and brain responses to stress offers the hope of a deeper understanding of PTSD. C1 Mt Sinai Sch Med, James J Peters Vet Affairs, Div Traumat Stress Studies, Bronx, NY 10468 USA. NYU, Ctr Neural Sci, New York, NY 10003 USA. RP Yehuda, R (reprint author), Mt Sinai Sch Med, James J Peters Vet Affairs, Div Traumat Stress Studies, Bronx, NY 10468 USA. EM rachel.yehuda@med.va.gov FU NIMH NIH HHS [K05 MH067048, P50 MH58911, R01 MH064675-02, R01 MH46516, R01 MH64104-01, R37 MH38774, R56 MH077321] NR 130 TC 270 Z9 278 U1 17 U2 50 PU CELL PRESS PI CAMBRIDGE PA 600 TECHNOLOGY SQUARE, 5TH FLOOR, CAMBRIDGE, MA 02139 USA SN 0896-6273 J9 NEURON JI Neuron PD OCT 4 PY 2007 VL 56 IS 1 BP 19 EP 32 DI 10.1016/j.neuron.2007.09.006 PG 14 WC Neurosciences SC Neurosciences & Neurology GA 222IN UT WOS:000250289800007 PM 17920012 ER PT J AU Cornia, PB Lipsky, BA Saint, S Gonzales, R AF Cornia, Paul B. Lipsky, Benjamin A. Saint, Sanjay Gonzales, Ralph TI Nothing to cough at SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID UNITED-STATES; PERTUSSIS; ADULTS; EPIDEMIOLOGY; OUTBREAKS; INFANTS C1 Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Ann Arbor Vet Affairs Med Ctr, Ann Arbor, MI USA. Univ Michigan Hlth Syst, Dept Internal Med, Ann Arbor, MI USA. Univ Michigan Hlth Syst, Patient Safety Enhancement Program, Ann Arbor, MI USA. Univ Calif San Francisco, Dept Med, Div Gen Internal Med, San Francisco, CA 94143 USA. RP Cornia, PB (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, 1660 S Columbian Way S-111, Seattle, WA 98108 USA. EM paul.cornia@med.va.gov RI Lipsky, Benjamin/B-4645-2013 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 18 TC 7 Z9 7 U1 0 U2 1 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD OCT 4 PY 2007 VL 357 IS 14 BP 1432 EP 1437 DI 10.1056/NEJMcps062357 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 216QA UT WOS:000249892900010 PM 17914045 ER PT J AU Wu, WC Schifftner, TL Henderson, WG AF Wu, Wen-Chih Schifftner, Tracy L. Henderson, William G. TI Preoperative hematocrit levels and outcomes after noncardiac surgery - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Providence Vet Affairs Med Ctr, Providence, RI 02908 USA. Denver Vet Affairs Med Ctr, Denver Data Anal Ctr, Natl Surg Qual Improvement Program, Denver, CO USA. RP Wu, WC (reprint author), Providence Vet Affairs Med Ctr, Providence, RI 02908 USA. EM wen-chih.wu@va.gov NR 2 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 OCT 3 PY 2007 VL 298 IS 13 BP 1513 EP 1514 DI 10.1001/jama.298.13.1513 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 216EE UT WOS:000249860500014 ER PT J AU Baumann, BM McCans, K Stahmer, SA Leonard, MB Shults, J Holmes, WC AF Baumann, Brigitte M. McCans, Kathryn Stahmer, Sarah A. Leonard, Mary B. Shults, Justine Holmes, William C. TI Caregiver and health care provider satisfaction with volumetric bladder ultrasound SO ACADEMIC EMERGENCY MEDICINE LA English DT Article DE ultrasound; bladder; catheterization; pediatrics; nurse; emergency medicine; satisfaction ID CATHETERIZATION AB Objectives: Conventional (nonimaged) bladder catheterization has lower first-attempt success rates (67%-72%) when compared with catheterization aided by volumetric bladder ultrasonography (US) (92%-100%), yet the total time to urine sample collection with US can be quite lengthy. Given the advantage and disadvantages, the authors assessed caregiver and health care provider satisfaction with these two methods. Methods: Caregivers and health care providers of children enrolled in a prospective, randomized, controlled trial examining the first-attempt urine collection success rates with these two methods completed standardized questionnaires. Each child's caregiver, nurse, and physician noted their perceptions, satisfaction, and future preferences using Likert-scale assessments. Results: Of 93 caregivers, 45 had children randomized to the conventional arm and 48 to the US arm. Nine physicians and three nurses participated. Both caregiver groups had similar previous catheterization experience; none had children undergo volumetric bladder sonography. Caregivers in the conventional group rated their children's discomfort higher (4.4 vs. 3.4; p = 0.02) and were less satisfied (4.5 vs. 6.4; p < 0.0001) than those in the US group. Nurses' satisfaction with catheterization in the conventional group was lower than in the US group (3.0 vs. 5.5), as was physicians' satisfaction (4.3 vs. 5.7; p < 0.0001). Both nurses and physicians indicated that they would be less likely to use conventional catheterization in future attempts. Conclusions: Caregivers in the conventional group rated their children's discomfort higher than did caregivers in the US group. Both caregivers and health care providers expressed greater satisfaction with US and were more likely to prefer this imaging modality with future catheterization attempts. C1 Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Emergency Med, Camden, NJ 08103 USA. Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Biostat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. RP Baumann, BM (reprint author), Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Dept Emergency Med, Camden, NJ 08103 USA. EM baumann-b@cooperhealth.edu NR 5 TC 6 Z9 6 U1 0 U2 1 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 OCT PY 2007 VL 14 IS 10 BP 903 EP 907 DI 10.1197/j.aem.2007.06.041 PG 5 WC Emergency Medicine SC Emergency Medicine GA 218MX UT WOS:000250020700012 PM 17898252 ER PT J AU Weisbord, SD McGill, JB Kimmel, PL AF Weisbord, Steven D. McGill, Janet B. Kimmel, Paul L. TI Psychosocial factors in patients with chronic kidney disease SO ADVANCES IN CHRONIC KIDNEY DISEASE LA English DT Editorial Material ID STAGE RENAL-DISEASE; QUALITY-OF-LIFE; CHRONIC-HEMODIALYSIS PATIENTS; SYMPTOM ASSESSMENT SYSTEM; PALLIATIVE CARE; SURVIVAL; DEPRESSION; OUTCOMES; MORTALITY C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Mailstop 111F-U,7E Rm 120, Pittsburgh, PA 15240 USA. EM weisbordsd@upmc.edu NR 24 TC 6 Z9 6 U1 0 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1548-5595 J9 ADV CHRONIC KIDNEY D JI Adv. Chronic Kidney Dis. PD OCT PY 2007 VL 14 IS 4 BP 316 EP 318 DI 10.1053/j.ackd.2007.07.012 PG 3 WC Urology & Nephrology SC Urology & Nephrology GA 220PS UT WOS:000250169300002 PM 17904497 ER PT J AU Weisbord, SD AF Weisbord, Steven D. TI Symptoms and their correlates in chronic kidney disease SO ADVANCES IN CHRONIC KIDNEY DISEASE LA English DT Article DE symptoms; quality of life; pain; sexual dysfunction; sleep disturbance ID QUALITY-OF-LIFE; STAGE RENAL-DISEASE; CHRONIC-HEMODIALYSIS PATIENTS; RANDOMIZED CONTROLLED-TRIAL; DIALYSIS PATIENTS; ERECTILE DYSFUNCTION; BEHAVIORAL COMPLIANCE; PSYCHOSOCIAL FACTORS; TRANSPLANT PATIENTS; ASSESSMENT SYSTEM AB While there is a significant body of literature documenting the impairments in health-related quality of life (HRQOL) experienced by patients with end-stage renal disease (ESRD), recent work has helped to elucidate the mediators of impaired well-being in this patient group. Physical and emotional symptoms have been shown to be common, frequently severe, and directly linked with impaired HRQOL. The following review explores the process of symptom assessment in patients with chronic kidney disease (CKD), presents an overview of the composite burden and importance of symptoms in patients with ESRD, highlights particularly common and distressing symptoms for which existing treatment strategies may be applicable, and discusses future directions for efforts to address and alleviate symptoms in the growing population of patients who suffer from CKD. (C) 2007 by the National Kidney Foundation, Inc. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equi Res & Promot, Renal Sect, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Mailstop 111F-U,7E Rm 120, Pittsburgh, PA 15240 USA. EM weisbordsd@upmc.edu NR 51 TC 11 Z9 11 U1 0 U2 5 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1548-5595 J9 ADV CHRONIC KIDNEY D JI Adv. Chronic Kidney Dis. PD OCT PY 2007 VL 14 IS 4 BP 319 EP 327 DI 10.1053/j.ackd.2007.07.004 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 220PS UT WOS:000250169300003 PM 17904498 ER PT J AU Lee, D Benson, CA Lewis, CE Grunfeld, C Scherzer, R AF Lee, Daniel Benson, Constance A. Lewis, Cora E. Grunfeld, Carl Scherzer, Rebecca TI Prevalence and factors associated with dry skin in HIV infection: the FRAM study SO AIDS LA English DT Article DE complication; dermatology; opportunistic infection; protease inhibitors; retinoid ID IMMUNODEFICIENCY-SYNDROME AIDS; CUTANEOUS MANIFESTATIONS; DERMATOLOGICAL FINDINGS; INGROWN TOENAILS; INDINAVIR; PARONYCHIA; DISEASE; GRANULOMA; THERAPY; XEROSIS AB Objective: Complaints of dry skin in HIV-infected individuals were reported after the advent of HAART. The objective of the study was to evaluate the prevalence of dry skin and associated factors in HIV-infected and control subjects. Design: Cross-sectional. Methods: A total of 1026 HIV-infected subjects and 274 controls [from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based study of cardiovascular risk assessment] in the Study of Fat Redistribution and Metabolic Change in HIV infection (FRAM) had skin assessed by self-report and examination. Multivariable logistic regression identified factors associated with dry skin. Results: Self-reported dry skin was more prevalent in HIV-infected subjects than controls. In multivariable analysis, HIV infection was associated with self-reported dry skin. In HIV-infected men, current indinavir use, CD4 cell count less than 200 cells/mu l and recent opportunistic infections were associated with dry skin. Indinavir use had an elevated risk in men with CD4 cell counts of 200 cells/mu l or greater but not with CD4 cell counts less than 200 cells/mu l. In HIV-infected women, a CD4 cell count less than 200 cells/mu l was associated with dry skin; indinavir use did not reach statistical significance but, as in men, indinavir use had an elevated risk in those with higher CD4 cell counts than in those with CD4 cell counts less than 200 cells/mu l. Conclusion: Dry skin is more common in HIV-infected individuals than controls. In HIV-infected individuals, low CD4 cell counts and indinavir use in those with higher CD4 cell counts are associated with dry skin. (C) 2007 Lippincott Williams & Wilkins. C1 Univ Calif San Francisco, Vet Affairs Med Ctr, Off Principle Investigator, Dept Med,FRAM Study,Metab Sect 111F, San Francisco, CA 94121 USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. San Francisco VA Med Ctr, Metab Sect, San Francisco, CA USA. RP Grunfeld, C (reprint author), Univ Calif San Francisco, Vet Affairs Med Ctr, Off Principle Investigator, Dept Med,FRAM Study,Metab Sect 111F, 4150 Clement St, San Francisco, CA 94121 USA. EM carl.grunfeld@ucsf.edu FU NCRR NIH HHS [RR 00054, RR 00052, RR 00083, M01 RR000083, M01 RR000865, RR 0636, M01 RR000052, M01 RR000051, RR 00865, RR 00051, M01 RR000054, M01 RR 00036, M01 RR000036]; NHLBI NIH HHS [HL 74814, R01 HL074814, HL 53359, R01 HL074814-06, R01 HL074814-07, R01 HL074814-04, R01 HL074814-05]; NIDDK NIH HHS [R01 DK057508-02, R01 DK057508-03S2, R01 DK057508-01S1, R01 DK 57508, R01 DK057508, R01 DK057508-03, R01 DK057508-01, R01 DK057508-03S1] NR 25 TC 6 Z9 7 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 OCT 1 PY 2007 VL 21 IS 15 BP 2051 EP 2057 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 217OL UT WOS:000249957100007 PM 17885295 ER PT J AU Mayben, JK Giordano, TP AF Mayben, J. K. Giordano, T. P. TI Internet use among low-income persons recently diagnosed with HIV infection SO AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV LA English DT Article ID HEALTH INFORMATION; HIV/AIDS; ADULTS; AIDS; MAIL; CARE AB Patients are increasingly using the Internet to obtain health-related information, communicate with providers and access research. Use of the Internet to obtain health-related information by low-income patients recently diagnosed with HIV infection has not been examined. In 2005, we surveyed 126 low-income patients diagnosed with HIV infection within the last three years. Eighty-five percent of the patients were <50 years old, 63% were male, 68% were minority race, 27% were Hispanic and 61% acquired HIV through heterosexual intercourse. Twenty-eight percent never completed high school and 74% earned <$15,000 in 2004. While 89% indicated they would like to use the Internet to access information about HIV, 52% had ever used the Internet, 28% had ever used it to obtain health-related information and only 18% had done so at least monthly for the last six months. Two-thirds of the population studied would need instruction on how to use the Internet. In multivariable regression, 2004 income :$15,000 predicted monthly Internet use to obtain health-related information. Older age, heterosexual intercourse as HIV risk factor and inadequate health literacy were independent predictors of needing instruction. The low-income population with HIV infection lags behind the general population in Internet access and may not benefit from Internet-dependent advances in health communication, including HIV-related interventions. C1 [Mayben, J. K.] Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. [Giordano, T. P.] Baylor Coll Med, Dept Med, Houston, TX 77030 USA. [Mayben, J. K.; Giordano, T. P.] Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. [Mayben, J. K.] Women & Children First Hill Country Med Clin, Frederick, TX USA. RP Giordano, TP (reprint author), Michael E Debakey VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX USA. EM tpg@bcm.tmc.edu FU NIMH NIH HHS [MH067505]; PHS HHS [HP10031] NR 16 TC 14 Z9 14 U1 4 U2 7 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 0954-0121 J9 AIDS CARE JI Aids Care-Psychol. Socio-Med. Asp. Aids-Hiv PD OCT PY 2007 VL 19 IS 9 BP 1182 EP 1187 DI 10.1080/09540120701402806 PG 6 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychology, Multidisciplinary; Respiratory System; Social Sciences, Biomedical SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychology; Respiratory System; Biomedical Social Sciences GA 251TN UT WOS:000252398200016 PM 18058404 ER PT J AU Lieber, CS Cao, Q DeCarli, LM Leo, MA Mak, KM Ponomarenko, A Ren, CL Wang, XL AF Lieber, Charles S. Cao, Qi DeCarli, Leonore M. Leo, Maria A. Mak, Ki M. Ponomarenko, Anatoly Ren, Chaoling Wang, Xiaolei TI Role of medium-chain triglycerides in the alcohol-mediated cytochrome p450 2E1 induction of mitochondria SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol; CYP2E1; mitochondria; long-chain triglycerides; medium-chain triglycerides ID ETHANOL-OXIDIZING SYSTEM; NONALCOHOLIC STEATOHEPATITIS; DIMINISHED DEPOSITION; OXIDATIVE STRESS; LIVER-DISEASE; RATS; FAT; THERMOGENESIS; ACETALDEHYDE; HEPATOCYTES AB Chronic alcohol consumption is known to induce cytochrome P450 2E1 (CYP2E1) leading to lipid peroxidation, mitochondrial dysfunction and hepatotoxicity. We showed that replacement of dietary long-chain triglycerides (LCT) by medium-chain triglycerides (MCT) could be protective. We now wondered whether the induction of mitochondrial CYP2E1 plays a role and whether liver injury could be avoided through mitochondrial intervention. Rats were fed 4 different isocaloric liquid diets. The control group received our standard dextrin-maltose diet with intake limited to the average consumption of the 3 alcohol groups fed ad libitum the alcohol containing Lieber-DeCarli liquid diet. The fat was either 32% of calories as LCT (alcohol), or 16% as LCT + 16% as MCT (alcohol-MCT 16%), or 32% as MCT only (alcohol-MCT 32%). After 21 days, compared to the controls, the alcohol and both alcohol-MCT groups had a significant increase in mitochondrial CYP2E1 (p < 0.05 for both). As shown before, the same was found for the microsomal CYP2E1. When MCT replaced all the fat, like in the alcohol-MCT 32% group, CYP2E1 was significantly reduced by 40% in mitochondria (p < 0.05) and 30% in microsomes (p < 0.01). In mitochondria, 4-hydroxynonenal (4-HNE), a parameter of oxidative stress, paralleled CYP2E1. Compared to controls, alcohol and alcohol-MCT 16% significantly raised mitochondrial 4-HNE (p < 0.001), whereas the alcohol-MCT 32% diet brought it down to control levels (p < 0.001). Mitochondrial reduced glutathione (GSH) was also significantly lowered by alcohol consumption (p < 0.05), and it increased to almost normal levels with alcohol-MCT 32% (p = 0.006). These changes in the mitochondria reflected the reduction observed in total liver in which alcohol-MCT 32% decreased the alcohol-induced steatosis with a diminution of triglycerides (p < 0.001) and of the pro-inflammatory cytokine tumor necrosis factor-alpha (p < 0.001). Mitochondria participate in the induction of CYP2E1 by alcohol and contribute to lipid peroxidation and GSH depletion. Thus, lipid composition of the diet is an important determinant for the beneficial effect of MCT, with a diet containing a mixture of LCT/MCT being ineffective. C1 James J Peters VA Med Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Lieber, CS (reprint author), James J Peters VA Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM liebercs@aol.com FU NIAAA NIH HHS [R01 AA011115] NR 40 TC 21 Z9 21 U1 0 U2 2 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 OCT PY 2007 VL 31 IS 10 BP 1660 EP 1668 DI 10.1111/j.1530-0277.2007.00475.x PG 9 WC Substance Abuse SC Substance Abuse GA 209GH UT WOS:000249376500006 PM 17681033 ER PT J AU Esrailian, E Spiegel, BMR Targownik, LE Dubinsky, MC Targan, SR Gralnek, IM AF Esrailian, E. Spiegel, B. M. R. Targownik, L. E. Dubinsky, M. C. Targan, S. R. Gralnek, I. M. TI Differences in the management of Crohn's disease among experts and community providers, based on a national survey of sample case vignettes SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID INFLAMMATORY-BOWEL-DISEASE; STANDARDIZED PATIENTS; CHART ABSTRACTION; MEASURING QUALITY; CARE; METAANALYSIS; PERSPECTIVE; PATTERNS; ADULTS AB Background When faced with the same set of facts, healthcare providers often make different diagnoses, employ different tests and prescribe disparate therapies. Aim To perform a national survey to measure process of care and variations in decision-making in Crohn's disease, and the compared results between experts and community providers. Methods We constructed a survey with five vignettes to elicit provider beliefs regarding the appropriateness of diagnostic tests and therapies in Crohn's disease. We measured agreement between community gastroenterologists and Crohn's disease experts, and measured variation within each group using the RAND Disagreement Index (DI), which is a validated measure of provider variation. Results We received 186 responses (42% response rate). Experts and community providers generally agreed on diagnostic testing decisions in Crohn's disease. However, there was a significant disagreement between groups for several decisions (use of 5-aminosalicylate in particular), and there was evidence of 'extreme variation' (defined as DI > 1.0) within groups across a range of decisions. Conclusions Although experts and community providers are in general consensus about diagnostic decision-making in Crohn's disease, extreme variation exists both between and within groups for key therapeutic decisions in Crohn's disease. We must understand and decrease this variation prior to future efforts of creating explicit quality indicators in Crohn's disease. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Los Angeles, CA 90095 USA. CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Ctr outcomes Res & Educat, Los Angeles, CA USA. VA Greater Los Angeles Hltcare Syst, Dept Gastroenterol & Hepatol, Los Angeles, CA USA. Univ Manitoba, Div Gastroenterol, Winnipeg, MB, Canada. Cedars Sinai Med Ctr, Ctr Inflammatory Bowel Dis, Los Angeles, CA 90048 USA. Technion Israel Inst Technol, Rambam Med Ctr, Dept Gastroenterol, GI Outcomes Unit, Haifa, Israel. RP Esrailian, E (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, 100 UCLA Med Plaza,Suite 265, Los Angeles, CA 90095 USA. EM eesrailian@mednet.ucla.edu FU NIDDK NIH HHS [T32 DK07180-30, P30 DK 041301-17] NR 32 TC 32 Z9 34 U1 0 U2 0 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 OCT 1 PY 2007 VL 26 IS 7 BP 1005 EP 1018 DI 10.1111/j.1365-2036.2007.03445.x PG 14 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 210UV UT WOS:000249482000004 PM 17877507 ER PT J AU Ho, V Ross, JS Nallamothu, BK Krumholz, HM AF Ho, Vivian Ross, Joseph S. Nallamothu, Brahmajee K. Krumholz, Harlan M. TI Cardiac Certificate of Need regulations and the availability and use of revascularization services SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; HEALTH-CARE-SYSTEMS; MARKET FORCES; SURGERY; ANGIOPLASTY; MORTALITY; DISEASE; STATES AB Background Many states enforce Certificate of Need (CON) regulations for cardiac procedures, but little is known about how CON affects utilization. We assessed the association between cardiac CON regulations, availability of revascularization facilities, and. revascularization rates. Methods We determined when state cardiac CON regulations were active and obtained data for Medicare beneficiaries >= 65 years old who received coronary artery bypass graft surgery (CABG) or a percutaneous coronary intervention (PCI) between 1989 and 2002. We compared the number of hospitals performing revascularization and patient utilization in states with and without CON regulations, and in states which discontinued CON regulations during 1989 to 2002. Results Each year, the per capita number of hospitals performing CABG and PCI was higher in states without CON (3.7 per 100000 elderly for CABG, 4.5 for PCI in 2002), compared with CON states (2.5 for CABG, 3.0 for PCI in 2002). Multivariate regressions that adjusted for market and population characteristics found no difference in CABG utilization rates between states with and without CON (P = .7). However, CON was associated with 19.2% fewer PCIs per 1000 elderly (P = .01), equivalent to 322 526 fewer PCIs for 1989 to 2002. Among most states that discontinued CON, the number of hospitals performing PCI rose in the mid 1990s, but there were no consistent trends in the number of hospitals performing CABG or in PCIs or CABGs per capita. Conclusions Certificate of Need restricts the number of cardiac facilities, but its effect on utilization rates may vary by procedure. C1 Rice Univ, BIPP, Houston, TX 77005 USA. Rice Univ, Baker Inst Public Policy, Houston, TX 77251 USA. Baylor Coll Med, Mt Sinai Sch Med, Dept Med, Dept Geriatr & Adult Dev, New York, NY USA. Educ & Clin Ctr, James J Peters VA Med Ctr, Bronx, NY USA. Ann Arbor VA Med Ctr, Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA. Robert Wood Johnson Clin Sch Program, Dept Med, Sect Cardiovasc Med, New Haven, CT USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT 06510 USA. Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT USA. RP Ho, V (reprint author), Rice Univ, BIPP, MS 40,6100 Main St, Houston, TX 77005 USA. RI Ho, Vivian/A-2827-2008 FU NCI NIH HHS [R21 CA118452-01A1, R21 CA118452]; NHLBI NIH HHS [R01 HL073825-01A1, R01 HL073825] NR 22 TC 11 Z9 11 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 OCT PY 2007 VL 154 IS 4 BP 767 EP 775 DI 10.1016/j.ahj.2007.06.031 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 217KR UT WOS:000249947300034 PM 17893007 ER PT J AU Batcher, EL Tang, XC Singh, BN Singh, SN Reda, DJ Hershman, JM AF Batcher, Elizabeth L. Tang, X. Charlene Singh, Bramah N. Singh, Steven N. Reda, Domenic J. Hershman, Jerome M. CA SAFE-T Inves TI Thyroid function abnormalities during amiodarone therapy for persistent atrial fibrillation SO AMERICAN JOURNAL OF MEDICINE LA English DT Article DE Amiodarone; hypothyroidism; Sotalol; thyroid ID CARDIOVASCULAR-DISEASE; INDUCED HYPOTHYROIDISM; INDUCED THYROTOXICOSIS; RISK-FACTOR; DYSFUNCTION; SOTALOL AB BACKGROUND: Many patients receiving amiodarone therapy are male. The long-term risk for amiodarone-induced thyroid dysfunction in these patients has not been systematically and prospectively investigated. The purpose of this study was to determine the extent of amiodarone-induced thyroid dysfunction in a large male cohort. METHODS: This is a substudy of a prospective randomized controlled trial (SAFE-Trial) in which amiodarone, sotalol, and placebo for persistent atrial fibrillation were evaluated. For the purpose of this substudy, sotalol and placebo groups were combined into a control group. Serial thyroid function tests were performed over 1-4.5 years. Of the 665 patients enrolled in the SAFE-Trial, 612 patients were included in this sub-study. RESULTS: Subclinical hypothyroidism, thyroid-stimulating hormone (TSH) level 4.5-10 mU/L, was seen among 25.8% of the amiodarone-treated patients and only 6.6% of controls (P < .0001). Overt hypothyroidism, TSH level > 10 mU/L, was seen among 5.0% of the amiodarone-treated patients, and only 0.3% of controls (P < .001). By 6 months, 93.8% of the patients who developed TSH elevations above 10 mU/L on amiodarone had been detected. There was a trend toward a greater proportion of hyperthyroidism, defined as a TSH < 0.35 mU/L, in the amiodarone group compared with the control group (5.3% vs 2.4%, P = .07). CONCLUSIONS: Hypothyroidism developed in 30.8% of older males treated with amiodarone and in only 6.9% of the controls. Hypothyroidism presented at an early stage of therapy. Hyperthyroidism occurred in 5.3% of amiodarone treated patients, and was a subclinical entity in all but 1 case. (c) 2007 Elsevier Inc. All rights reserved. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Dept Vet Affairs Med Ctr, Washington, DC USA. Vet Affairs Edward Hines Jr Hosp, Hines, IL USA. RP Batcher, EL (reprint author), Olive View UCLA Med Ctr, Dept Med, 14445 Olive View Dr, Sylmar, CA 91342 USA. EM batcherb@gmail.com NR 25 TC 28 Z9 30 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD OCT PY 2007 VL 120 IS 10 BP 880 EP 885 DI 10.1016/j.amjmed.2007.04.022 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 215HE UT WOS:000249798100013 PM 17904459 ER PT J AU Spruill, LS Lowry, AS Stroud, RE Squires, CE Mains, IM Flack, EC Beck, C Ikonomidis, JS Crumbley, AJ McDermott, PJ Spinale, FG AF Spruill, Laura S. Lowry, Abigail S. Stroud, Robert E. Squires, Christina E. Mains, Ira M. Flack, English C. Beck, Christy Ikonomidis, John S. Crumbley, A. Jackson McDermott, Paul J. Spinale, Francis G. TI Membrane-type-1 matrix metalloproteinase transcription and translation in myocardial fibroblasts from patients with normal left ventricular function and from patients with cardiomyopathy SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE heart failure; extracellular matrix; proteases ID FAILING HUMAN HEART; CARDIAC FIBROBLASTS; EXTRACELLULAR-MATRIX; 1-MATRIX METALLOPROTEINASE; GENE-EXPRESSION; POSTTRANSCRIPTIONAL REGULATION; DILATED CARDIOMYOPATHY; IV COLLAGENASE; UP-REGULATION; CELL-SURFACE AB Past studies have identified that a unique type of matrix metalloproteinase, the membrane-type-1 MMP (MT1-MMP), is increased within the left ventricle (LV) of patients with dilated cardiomyopathy (DCM). However, the cellular and molecular basis for this induction of MT1-MMP with DCM is unknown. LV myocardial biopsies from nonfailing, reference normal patients (defined as LV ejection fraction >50%, elective coronary bypass surgery, no perfusion defect at biopsy site, n = 6) and DCM patients (LV ejection fraction <20%, at transplant, n = 5) were used to establish fibroblast cultures (FIBROS). Confluent LV FIBROS from culture passages 2-5 were measured with respect to MT1-MMP mRNA and protein levels and the distribution of the MT1-MMP mRNA pool in ribosomal fractions. Total MT1-MMP mRNA within DCM FIBROS increased by over 140%, and MT1-MMP protein increased by over 190% from reference normal FIBROS (both P < 0.05). MT1-MMP mRNA in monosome fractions decreased by over twofold in DCM FIBROS compared with reference normal (P < 0.05) and remained lower in polyribosomal fractions (i.e., 15.7 +/-5.2 vs. 1.4 +/-0.6% in polysomal fraction 6, P < 0.05). These differences in DCM MT1-MMP FIBROS transcription and translation persisted throughout passages 2-5. The unique findings from this study demonstrated that elevated steady-state MT1-MMP mRNA and protein levels occurred in DCM FIBROS despite a decline in translational deficiency. These phenotypic changes in DCM fibroblasts may provide the basis for developing cell specific pharmacological targets for control of MT1-MMP expression. C1 Med Univ S Carolina, Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Surg, Div Cardiothorac Surg, Charleston, SC 29425 USA. RP Spinale, FG (reprint author), Med Univ S Carolina, Ralph H Johnson Dept Vet Affairs Med Ctr, Rm 625,Thurmond Res Bldg,770 MUSC Complex,114 Dou, Charleston, SC 29425 USA. EM wilburnm@musc.edu FU NHLBI NIH HHS [P01 HL48788, R01 HL59165] NR 51 TC 17 Z9 17 U1 2 U2 3 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 OCT PY 2007 VL 293 IS 4 BP C1362 EP C1373 DI 10.1152/ajpcell.00545.2006 PG 12 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 218YR UT WOS:000250052400018 PM 17670887 ER PT J AU Weintraub, D Hurtig, HI AF Weintraub, Daniel Hurtig, Howard I. TI Presentation and management of psychosis in Parkinson's disease and dementia with Lewy bodies SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID DRUG-INDUCED PSYCHOSIS; DOPAMINERGIC-INDUCED HALLUCINATIONS; NURSING-HOME PLACEMENT; DOUBLE-BLIND; NEUROLEPTIC SENSITIVITY; VISUAL HALLUCINATIONS; COGNITIVE IMPAIRMENT; CONTROLLED-TRIAL; BODY DEMENTIA; RISK-FACTORS C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Parkinsons Dis Res & Mental Illness Res Educ & Cl, Philadelphia, PA USA. RP Weintraub, D (reprint author), Univ Penn, Dept Psychiat, 3535 Market St,Rm 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [K23 MH067894, K23 MH067894-04, K23MH067894] NR 58 TC 46 Z9 47 U1 1 U2 6 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD OCT PY 2007 VL 164 IS 10 BP 1491 EP 1498 DI 10.1176/appi.ajp.2007.07040715 PG 8 WC Psychiatry SC Psychiatry GA 218XP UT WOS:000250049600010 PM 17898337 ER EF