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Journal Articles

Internal Medicine

2014

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Full-Text Articles in Medicine and Health Sciences

A 129-Kb Deletion On Chromosome 12 Confers Substantial Protection Against Rheumatoid Arthritis, Implicating The Gene Slc2a3, C. D. Veal, K. E. Reekie, J. C. Lorentzen, P. K. Gregersen, L. Padyukov, A. J. Brookes Jan 2014

A 129-Kb Deletion On Chromosome 12 Confers Substantial Protection Against Rheumatoid Arthritis, Implicating The Gene Slc2a3, C. D. Veal, K. E. Reekie, J. C. Lorentzen, P. K. Gregersen, L. Padyukov, A. J. Brookes

Journal Articles

We describe a copy-number variant (CNV) for which deletion alleles confer a protective affect against rheumatoid arthritis (RA). This CNV reflects net unit deletions and expansions to a normal two-unit tandem duplication located on human chr12p13.31, a region with conserved synteny to the rat RA susceptibility quantitative trait loci Oia2. Genotyping, using the paralogue ratio test and SNP intensity data, in Swedish samples (2,403 cases, 1,269 controls) showed that the frequency of deletion variants is significantly lower in cases (P=0.0012, OR=0.442 [95%CI 0.258-0.755]). Reduced frequencies of deletion variants were also seen in replication materials comprising 9,201 UK samples (1,846 cases, …


Acute St-Segment Elevation Myocardial Infarction In A Young Patient With Essential Thrombocythemia: A Case With Long-Term Follow-Up Report, T. Bhat, M. Ahmed, H. Baydoun, Z. Ghandour, A. Bhat, D. Mccord Jan 2014

Acute St-Segment Elevation Myocardial Infarction In A Young Patient With Essential Thrombocythemia: A Case With Long-Term Follow-Up Report, T. Bhat, M. Ahmed, H. Baydoun, Z. Ghandour, A. Bhat, D. Mccord

Journal Articles

Essential thrombocythemia (ET) is a neoplastic proliferation of mature myeloid cells - in particular, megakaryocytes - leading to persistently elevated platelet count. Usual clinical presentation is related to an increase in the risk of hemorrhage and/or thrombosis. Management of ET consists of antiplatelet therapies - mainly aspirin and cytoreductive therapies. Coronary involvement in patients with ET is rare. The optimal treatment strategies for ET patients presenting with acute myocardial infarction remains unclear. Acute interventions like intracoronary thrombolytic therapy, angioplasty, and coronary-artery bypass grafting have been reported in such patients. However, several questions remain unanswered about the acute and long-term management …


Acute Mesenteric Ischemia: A Sequela Of Abdominal Aortography, S. Kedia, V. R. Bhatt, A. Koirala, S. Murukutla, J. Rijal, S. Pant, M. A. Wrzolek, A. Gottesman Jan 2014

Acute Mesenteric Ischemia: A Sequela Of Abdominal Aortography, S. Kedia, V. R. Bhatt, A. Koirala, S. Murukutla, J. Rijal, S. Pant, M. A. Wrzolek, A. Gottesman

Journal Articles

The use of abdominal angiography and transcatheter embolization has increased rapidly in the last few decades. Although improvement in angiographic techniques has made the procedure safe, ischemic colitis is a rare but potentially dreadful complication. We report a case of a 51-year-old woman who developed ischemic colitis following aortography, demonstrating that such angiographic studies may produce substantial morbidity.


A Multicenter Population-Based Effectiveness Study Of Teleintensive Care Unit-Directed Ventilator Rounds Demonstrating Improved Adherence To A Protective Lung Strategy, Decreased Ventilator Duration, And Decreased Intensive Care Unit Mortality, T. Kalb, J. Raikhelkar, S. Meyer, F. Ntimba, J. Thuli, M. J. Gorman, I. Kopec, C. Scurlock Jan 2014

A Multicenter Population-Based Effectiveness Study Of Teleintensive Care Unit-Directed Ventilator Rounds Demonstrating Improved Adherence To A Protective Lung Strategy, Decreased Ventilator Duration, And Decreased Intensive Care Unit Mortality, T. Kalb, J. Raikhelkar, S. Meyer, F. Ntimba, J. Thuli, M. J. Gorman, I. Kopec, C. Scurlock

Journal Articles

Purpose of the study: The purpose of the study is to determine if teleintensive care unit (ICU)-directed daily ventilator rounds improved adherence to lung protective ventilation (LPV), reduced ventilator duration ratio (VDR), and ICU mortality ratios. Method used: A retrospective observational longitudinal quarterly analysis of adherence to low tidal volume LPV (< 7.5 mL/kg predicted body weight; PaO2/fraction of inspired oxygen < 300), ventilator duration, and ICU mortality ratios (Acute Physiology and Chronic Health Evaluation IV-adjusted). The teleICU practice used Philips (Andover, MA) VISICU eCareManager (TM) (Andover, MA) platform, providing ICU care and process improvement. Results: Before ventilator rounds implementation, there was wide variation in hospital adherence to low tidal volume (29.5 +/- 18.2; range 10%-69%). Longitudinal improvement was seen across hospitals in the 3 Qs after implementation, reaching statistical significance by Q3 postimplementation (44.9 +/- 15.7; P < .002 by 2-tailed Fisher exact test), maintained at 2 subsequent Qs (48% and 52%; P < .001). Ventilator duration ratio also showed preimplementation variability (1.08 +/- .34; range 0.71-1.90). After implementation, absolute and significant mean VDR reduction was observed (0.92 +/- .28; -15.8%, P < .05). Intensive care unit mortality ratio demonstrated longitudinal improvement, reaching significance after the Q3 postimplementation (0.94 vs 0.67; P < .04), and this was sustained in the most recent Q analyzed (0.65; P < .03). Conclusions: Implementation of teleICU-directed ventilator rounds was associated with improved and durable adherence to LPV and significant reductions in both VDR and ICU mortality. (C) 2014 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3ol).


Nf-Kappa B-To-Ap-1 Switch: A Mechanism Regulating Transition From Endothelial Barrier Injury To Repair In Endotoxemic Mice, G. Liu, X. B. Ye, E. J. Miller, S. F. Liu Jan 2014

Nf-Kappa B-To-Ap-1 Switch: A Mechanism Regulating Transition From Endothelial Barrier Injury To Repair In Endotoxemic Mice, G. Liu, X. B. Ye, E. J. Miller, S. F. Liu

Journal Articles

Endothelial barrier disruption is a hallmark of multiple organ injury (MOI). However, mechanisms governing the restoration of endothelial barrier function are poorly understood. Here, we uncovered an NF-kappa B-to-AP-1 switch that regulates the transition from barrier injury to repair following endotoxemic MOI. Endothelial NF-kappa B mediates barrier repair by inhibiting endothelial cell (EC) apoptosis. Blockade of endothelial NF-kappa B pathway activated the activator protein (AP)-1 pathway (NF-kappa B-to-AP-1 switch), which compensated for the anti-apoptotic and barrier-repair functions of NF-kappa B. The NF-kappa B-to-AP-1 switch occurred at 24 hours (injury to repair transition phase), but not at 48 hours (repair phase) …


A Novel Mechanism Of B Cell-Mediated Immune Suppression Through Cd73 Expression And Adenosine Production, H. Kaku, K. F. Cheng, Y. Al-Abed, T. L. Rothstein Jan 2014

A Novel Mechanism Of B Cell-Mediated Immune Suppression Through Cd73 Expression And Adenosine Production, H. Kaku, K. F. Cheng, Y. Al-Abed, T. L. Rothstein

Journal Articles

Immune suppression by regulatory T cells and regulatory B cells is a critical mechanism to limit excess inflammation and autoimmunity. IL-10 is considered the major mediator of B cell induced immune suppression. We report a novel mechanism for immune suppression through adenosine generation by B cells. We identified a novel population of B cells that expresses CD73 as well as CD39, two ectoenzymes that together catalyze the extracellular dephosphorylation of adenine nucleotides to adenosine. Whereas CD39 expression is common among B cells, CD73 expression is not. Approximately 30-50% of B-1 cells (B220(+)CD23(-)) and IL-10 producing B (B10) cells (B220(+)CD5(+)CD1d(hi)) are …


Perforation In A Patient With Stercoral Colitis And Diverticulosis: Who Did It?, V. R. Bhatt, S. Murukutla, J. Dipoce, S. Gustafson, D. Sarkany, K. Mody, W. D. Widmann, A. Gottesman Jan 2014

Perforation In A Patient With Stercoral Colitis And Diverticulosis: Who Did It?, V. R. Bhatt, S. Murukutla, J. Dipoce, S. Gustafson, D. Sarkany, K. Mody, W. D. Widmann, A. Gottesman

Journal Articles

Stercoral colitis with perforation of the colon is an uncommon, yet life-threatening cause of the acute abdomen. No one defining symptom exists for stercoral colitis; it may present asymptomatically or with vague symptoms. Diagnostic delay may result in perforation of the colon resulting in complications, even death. Moreover, stercoral perforation of the colon can also present with localized left lower quadrant abdominal pain masquerading as diverticulitis. Diverticular diseases and stercoral colitis share similar pathophysiology; furthermore, they may coexist, further complicating the diagnostic dilemma. The ability to decide the cause of perforation in a patient with both stercoral colitis and diverticulosis …


Pathogenetic Role Of Glomerular Cxcl13 Expression In Lupus Nephritis, K. Worthmann, F. Gueler, S. Von Vietinghoff, A. Davalos-Militz, F. Wiehler, A. Davidson, T. Witte, H. Haller, M. Schiffer, L. Schiffer, +1 Additional Author Jan 2014

Pathogenetic Role Of Glomerular Cxcl13 Expression In Lupus Nephritis, K. Worthmann, F. Gueler, S. Von Vietinghoff, A. Davalos-Militz, F. Wiehler, A. Davidson, T. Witte, H. Haller, M. Schiffer, L. Schiffer, +1 Additional Author

Journal Articles

Podocytes maintain the structure and function of the glomerular filtration barrier. However, podocytes have recently been implicated in the innate immune response, and their function as non-haematopoietic antigen-presenting cells was highlighted. We have shown previously that excessive expression of the chemokine CXCL13 is a distinctive early event for nephritis in a murine model of systemic lupus erythematosus (SLE). Furthermore, we found that CXCL13 is elevated significantly in the serum of patients with SLE-nephritis. In this study, we were able to show for the first time that (i) CXCL13 is expressed locally in glomeruli in a model for SLE-nephritis in mice …


A Post-2011 Time Motion Study--The Authors' Reply, L. Block, R. Habicht, A. W. Wu, S. V. Desai, K. Wang, K. N. Silva, T. Niessen, N. Oliver, L. Feldman Jan 2014

A Post-2011 Time Motion Study--The Authors' Reply, L. Block, R. Habicht, A. W. Wu, S. V. Desai, K. Wang, K. N. Silva, T. Niessen, N. Oliver, L. Feldman

Journal Articles

No abstract provided.


Rare Case Of Coronary To Pulmonary Vein Fistula With Coronary Steal Phenomenon, E. A. Barsoum, F. B. Saiful, D. Asti, R. Morcus, G. Khoueiry, J. Lafferty, D. A. Mccord Jan 2014

Rare Case Of Coronary To Pulmonary Vein Fistula With Coronary Steal Phenomenon, E. A. Barsoum, F. B. Saiful, D. Asti, R. Morcus, G. Khoueiry, J. Lafferty, D. A. Mccord

Journal Articles

Coronary artery fistulas are abnormal connections between coronary artery territories and cardiac chambers or major vessels, most of them are congenital. Patients with coronary artery fistula can be asymptomatic or present with different symptoms like angina. Cardiac computed tomography (CT) is one of the best modalities for diagnosis. We present an elderly patient that presented with angina symptoms, non invasive stress test was positive for ischemic heart disease, coronary angiogram could not reveal any obstructive lesions, but an abnormal branch of the left descending coronary artery (LAD), cardiac CT showed fistula that connect left anterior descending coronary artery to left …


Pleural Innate Response Activator B Cells Protect Against Pneumonia Via A Gm-Csf-Igm Axis, G. F. Weber, B. G. Chousterman, I. Hilgendorf, C. S. Robbins, I. Theurl, L. M. S. Gerhardt, Y. Iwamoto, T. D. Quach, T. L. Rothstein, F. K. Swirski, +4 Additional Authors Jan 2014

Pleural Innate Response Activator B Cells Protect Against Pneumonia Via A Gm-Csf-Igm Axis, G. F. Weber, B. G. Chousterman, I. Hilgendorf, C. S. Robbins, I. Theurl, L. M. S. Gerhardt, Y. Iwamoto, T. D. Quach, T. L. Rothstein, F. K. Swirski, +4 Additional Authors

Journal Articles

Pneumonia is a major cause of mortality worldwide and a serious problem in critical care medicine, but the immunophysiological processes that confer either protection or morbidity are not completely understood. We show that in response to lung infection, B1a B cells migrate from the pleural space to the lung parenchyma to secrete polyreactive emergency immunoglobulin M ( IgM). The process requires innate response activator (IRA) B cells, a transitional B1a-derived inflammatory subset which controls IgM production via autocrine granulocyte/macrophage colony-stimulating factor (GM-CSF) signaling. The strategic location of these cells, coupled with the capacity to produce GM-CSF-dependent IgM, ensures effective early …


Recognition Of Antigen-Specific B-Cell Receptors From Chronic Lymphocytic Leukemia Patients By Synthetic Antigen Surrogates, M. Sarkar, Y. Liu, J. Morimoto, H. Peng, C. Aquino, C. Rader, N. Chiorazzi, T. Kodadek Jan 2014

Recognition Of Antigen-Specific B-Cell Receptors From Chronic Lymphocytic Leukemia Patients By Synthetic Antigen Surrogates, M. Sarkar, Y. Liu, J. Morimoto, H. Peng, C. Aquino, C. Rader, N. Chiorazzi, T. Kodadek

Journal Articles

In patients with chronic lymphocytic leukemia (CLL), a single neoplastic antigen-specific B cell accumulates and overgrows other B cells, leading to immune deficiency. CLL is often treated with drugs that ablate all B cells, leading to further weakening of humoral immunity, and a more focused therapeutic strategy capable of targeting only the pathogenic B cells would represent a significant advance. One approach to this would be to develop synthetic surrogates of the CLL antigens allowing differentiation of the CLL cells and healthy B cells in a patient. Here, we describe nonpeptidic molecules capable of targeting antigen-specific B cell receptors with …


Relationship Between Alcohol Use Categories And Noninvasive Markers Of Advanced Hepatic Fibrosis In Hiv-Infected, Chronic Hepatitis C Virus-Infected, And Uninfected Patients, J. K. Lim, J. P. Tate, S. L. Fultz, J. L. Goulet, J. Conigliaro, K. J. Bryant, A. J. Gordon, C. Gibert, D. Rimland, V. Lo Re, +4 Additional Authors Jan 2014

Relationship Between Alcohol Use Categories And Noninvasive Markers Of Advanced Hepatic Fibrosis In Hiv-Infected, Chronic Hepatitis C Virus-Infected, And Uninfected Patients, J. K. Lim, J. P. Tate, S. L. Fultz, J. L. Goulet, J. Conigliaro, K. J. Bryant, A. J. Gordon, C. Gibert, D. Rimland, V. Lo Re, +4 Additional Authors

Journal Articles

Background. It is unclear if the risk of liver disease associated with different levels of alcohol consumption is higher for patients infected with human immunodeficiency virus (HIV) or chronic hepatitis C virus (HCV). We evaluated associations between alcohol use categories and advanced hepatic fibrosis, by HIV and chronic HCV status. Methods. We performed a cross-sectional study among participants in the Veterans Aging Cohort Study who reported alcohol consumption at enrollment (701 HIV/HCV-coinfected; 1410 HIV-monoinfected; 296 HCV-monoinfected; 1158 HIV/HCV-uninfected). Alcohol use category was determined by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire and alcohol-related diagnoses and was classified as nonhazardous …


Reply: To Pmid 23929808, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. L. Schilsky, W. M. Lee, R. S., Jr. Brown Jan 2014

Reply: To Pmid 23929808, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. L. Schilsky, W. M. Lee, R. S., Jr. Brown

Journal Articles

No abstract provided.


The Role Of Skin Trauma In The Distribution Of Morphea Lesions: A Cross-Sectional Survey Of The Morphea In Adults And Children Cohort Iv, D. Grabell, C. Hsieh, R. Andrew, K. Martires, A. Kim, R. Vasquez, H. Jacobe Jan 2014

The Role Of Skin Trauma In The Distribution Of Morphea Lesions: A Cross-Sectional Survey Of The Morphea In Adults And Children Cohort Iv, D. Grabell, C. Hsieh, R. Andrew, K. Martires, A. Kim, R. Vasquez, H. Jacobe

Journal Articles

Background: Skin trauma may play a role in the development of morphea lesions. The association between trauma and the distribution of cutaneous lesions has never been examined to our knowledge. Objective: We sought to determine whether patients enrolled in the Morphea in Adults and Children (MAC) cohort exhibit skin lesions distributed in areas of prior (isotopic) or ongoing (isomorphic) trauma. Methods: This was a cross-sectional analysis of the MAC cohort. Results: Of 329 patients in the MAC cohort, 52 (16%) had trauma-associated lesions at the onset of disease. Patients with lesions in an isotopic distribution had greater clinical severity as …


A Role For Noncoding Variation In Schizophrenia, P. Roussos, A. C. Mitchell, G. Voloudakis, J. F. Fullard, V. M. Pothula, J. Tsang, E. A. Stahl, A. Georgakopoulos, P. K. Gregersen, P. Sklar, +15 Additional Authors Jan 2014

A Role For Noncoding Variation In Schizophrenia, P. Roussos, A. C. Mitchell, G. Voloudakis, J. F. Fullard, V. M. Pothula, J. Tsang, E. A. Stahl, A. Georgakopoulos, P. K. Gregersen, P. Sklar, +15 Additional Authors

Journal Articles

A large portion of common variant loci associated with genetic risk for schizophrenia reside within noncoding sequence of unknown function. Here, we demonstrate promoter and enhancer enrichment in schizophrenia variants associated with expression quantitative trait loci (eQTL). The enrichment is greater when functional annotations derived from the human brain are used relative to peripheral tissues. Regulatory trait concordance analysis ranked genes within schizophrenia genome-wide significant loci for a potential functional role, based on colocalization of a risk SNP, eQTL, and regulatory element sequence. We identified potential physical interactions of noncontiguous proximal and distal regulatory elements. This was verified in prefrontal …


Splenic B-1a Cells Expressing Cd138 Spontaneously Secrete Large Amounts Of Immunoglobulin In Naive Mice, N. E. Holodick, T. Vizconde, T. L. Rothstein Jan 2014

Splenic B-1a Cells Expressing Cd138 Spontaneously Secrete Large Amounts Of Immunoglobulin In Naive Mice, N. E. Holodick, T. Vizconde, T. L. Rothstein

Journal Articles

B-1a cells constitutively secrete natural antibody that provides immediate protection against microbial pathogens and functions homeostatically to speed removal of apoptotic cell debris. Although B-1a cells are especially prominent in the peritoneal and pleural cavities, some B-1a cells reside in the spleen. A small subset of splenic B-1a cells in naive, unimmunized mice express CD138, a recognized plasma cell antigen, whereas the bulk of splenic B-1a cells are CD138 negative. Splenic B-1a cells in toto have been shown to generate much more antibody per cell than peritoneal B-1a cells; however, specific functional information regarding CD138(+) splenic B-1a cells has been …


Steroid Use In Acute Liver Failure, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. Schilsky, W. M. Lee, R. S., Jr. Brown Jan 2014

Steroid Use In Acute Liver Failure, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. Schilsky, W. M. Lee, R. S., Jr. Brown

Journal Articles

Drug-induced and indeterminate acute liver failure (ALF) might be due to an autoimmune-like hepatitis that is responsive to corticosteroid therapy. The aim of this study was to evaluate whether corticosteroids improve survival in fulminant autoimmune hepatitis, drug-induced, or indeterminate ALF, and whether this benefit varies according to the severity of illness. We conducted a retrospective analysis of autoimmune, indeterminate, and drug-induced ALF patients in the Acute Liver Failure Study Group from 1998-2007. The primary endpoints were overall and spontaneous survival (SS, survival without transplant). In all, 361 ALF patients were studied, 66 with autoimmune (25 steroids, 41 no steroids), 164 …


Structure And Function Of Renal Macrophages And Dendritic Cells From Lupus-Prone Mice, R. Sahu, R. Bethunaickan, S. Singh, A. Davidson Jan 2014

Structure And Function Of Renal Macrophages And Dendritic Cells From Lupus-Prone Mice, R. Sahu, R. Bethunaickan, S. Singh, A. Davidson

Journal Articles

Objective. To characterize renal macrophages and dendritic cells (DCs) in 2 murine models of lupus nephritis. Methods. We used a bead-based enrichment step followed by cell sorting to isolate populations of interest from young mice and nephritic mice. Cell morphology was examined by microscopy. Arginase and nitrite production was examined using biochemical assays. The antigen-presenting functions of the cells were determined using mixed lymphocyte reactions. Selected cytokine, chemokine, and Toll-like receptor (TLR) profiles were examined using real-time quantitative polymerase chain reaction. Results. We identified 2 populations of macrophages and 3 populations of DCs in both of our murine models of …


User Centered Clinical Decision Support Tools: Adoption Across Clinician Training Level, L. J. Mccullagh, A. Sofianou, J. Kannry, D. M. Mann, T. G. Mcginn Jan 2014

User Centered Clinical Decision Support Tools: Adoption Across Clinician Training Level, L. J. Mccullagh, A. Sofianou, J. Kannry, D. M. Mann, T. G. Mcginn

Journal Articles

BACKGROUND: Dissemination and adoption of clinical decision support (CDS) tools is a major initiative of the Affordable Care Act's Meaningful Use program. Adoption of CDS tools is multipronged with personal, organizational, and clinical settings factoring into the successful utilization rates. Specifically, the diffusion of innovation theory implies that 'early adopters' are more inclined to use CDS tools and younger physicians tend to be ranked in this category. OBJECTIVE: This study examined the differences in adoption of CDS tools across providers' training level. PARTICIPANTS: From November 2010 to 2011, 168 residents and attendings from an academic medical institution were enrolled into …


Angiopoietin-2: A Key To Understanding Sepsis And Its Pulmonary Sequelae?, J. Y. Lee, E. J. Miller Jan 2014

Angiopoietin-2: A Key To Understanding Sepsis And Its Pulmonary Sequelae?, J. Y. Lee, E. J. Miller

Journal Articles

No abstract provided.


B-1a Cell Diversity: Nontemplated Addition In B-1a Cell Ig Is Determined By Progenitor Population And Developmental Location, N. E. Holodick, T. Vizconde, T. L. Rothstein Jan 2014

B-1a Cell Diversity: Nontemplated Addition In B-1a Cell Ig Is Determined By Progenitor Population And Developmental Location, N. E. Holodick, T. Vizconde, T. L. Rothstein

Journal Articles

Natural Abs produced by B-1a cells are required for immediate protection against infection. The protective capacity of natural Abs is attributed to germline-like structure, which includes the relative absence of N-region addition. Previous studies have shown B-1a cell Ig from aged mice contains abundant nontemplated (N)-additions. B-1a cells have been shown to derive from a specific lineage-negative (Lin(-)) CD45R(low/-) CD19(+) progenitor found both in fetal liver and adult bone marrow. In this study, we report identification of a fetal liver population characterized phenotypically as Lin(-)CD45R(-)CD19(-), which gives rise to IgM(+)IgD(low)CD45R(low)CD5(+)Mac-1(+)CD19(high)CD43(+)CD23(low) B-1a cells upon adoptive transfer to SCID recipients. These B-1a …


Breast Cancer And Aging: Results Of The U13 Conference Breast Cancer Panel, M. F. Barginear, H. Muss, G. Kimmick, C. Owusu, E. Mrozek, A. Shahrokni, K. Ballman, A. Hurria Jan 2014

Breast Cancer And Aging: Results Of The U13 Conference Breast Cancer Panel, M. F. Barginear, H. Muss, G. Kimmick, C. Owusu, E. Mrozek, A. Shahrokni, K. Ballman, A. Hurria

Journal Articles

Breast cancer is predominantly a disease of older women, yet there is a knowledge gap due to the persisting misalignment between the age distribution of women with breast cancer and the age distribution of participants in clinical trials. The purpose of this report is to state the U13 conference breast cancer panel's recommendations regarding therapeutic clinical trials that will fill gaps in knowledge regarding the care of older patients with breast cancer. The U13 conference was a collaboration between the Cancer and Aging Research Group and the National Institute on Aging and the National Cancer Institute (NCI). Clinical trials should …


Brief Motivational Enhancement Intervention To Prevent Or Reduce Postpartum Alcohol Use: A Single-Blinded, Randomized Controlled Effectiveness Trial, D. M. Rubio, N. L. Day, J. Conigliaro, B. H. Hanusa, C. Larkby, M. Mcneil, E. Cohen, B. Jones, M. Watt-Morse, K. L. Kraemer, +2 Additional Authors Jan 2014

Brief Motivational Enhancement Intervention To Prevent Or Reduce Postpartum Alcohol Use: A Single-Blinded, Randomized Controlled Effectiveness Trial, D. M. Rubio, N. L. Day, J. Conigliaro, B. H. Hanusa, C. Larkby, M. Mcneil, E. Cohen, B. Jones, M. Watt-Morse, K. L. Kraemer, +2 Additional Authors

Journal Articles

AIMS: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DESIGN: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. SETTING: The setting is in a large, urban, obstetrics clinic. PARTICIPANTS: Participants were women who were >/= 18 years old,gestation, and consumed alcohol during pregnancy. Of 3438 women screened, …


C1q-Mediated Repression Of Human Monocytes Is Regulated By Lair-1, M. Son, B. Diamond Jan 2014

C1q-Mediated Repression Of Human Monocytes Is Regulated By Lair-1, M. Son, B. Diamond

Journal Articles

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by abnormal function of both the innate and the adaptive immune system, leading to a loss of tolerance to self-antigens. Monocytes are a key component of the innate immune system and are efficient producers of multiple cytokines. In SLE, inappropriate activation of monocytes is thought to contribute to the loss of self-tolerance. In this study, we demonstrate that type 1 interferon (IFN) production by CpG-challenged monocytes can be suppressed by C1q through activate leukocyte-associated Ig-like receptor-1 (LAIR-1), which contains ITIM motifs. The phosphorylation of LAIR-1 and the interaction of LAIR-1 …


D-Dimer As A Predictor Of Venous Thromboembolism In Acutely Ill, Hospitalized Patients: A Subanalysis Of The Randomized Controlled Magellan Trial, A. T. Cohen, T. E. Spiro, A. C. Spyropoulos, Y. H. Desanctis, M. Homering, H. R. Buller, L. Haskell, D. Hu, R. Hull, P. Burton, +4 Additional Authors Jan 2014

D-Dimer As A Predictor Of Venous Thromboembolism In Acutely Ill, Hospitalized Patients: A Subanalysis Of The Randomized Controlled Magellan Trial, A. T. Cohen, T. E. Spiro, A. C. Spyropoulos, Y. H. Desanctis, M. Homering, H. R. Buller, L. Haskell, D. Hu, R. Hull, P. Burton, +4 Additional Authors

Journal Articles

Background D-dimer concentrations have not been evaluated extensively as a predictor of increased venous thromboembolism (VTE) risk in acutely ill, hospitalized medical patients. Objectives To analyze the relationships between D-dimer concentration, VTE and bleeding in the MAGELLAN trial (NCT00571649). Patients/methods This was a multicenter, randomized, controlled trial. Patients aged >= 40years, hospitalized for acute medical illnesses with risk factors for VTE received subcutaneous enoxaparin 40mg once daily for 10 +/- 4days then placebo up to day 35, or oral rivaroxaban 10mg once daily for 35 +/- 4days. Patients (n=7581) were grouped by baseline D-dimer2xthe upper limit of normal. VTE and …


D-Dimer And Risk Of Thromboembolic And Bleeding Events In Patients With Atrial Fibrillation - Observations From The Aristotle Trial, C. Christersson, L. Wallentin, U. Andersson, J. H. Alexander, J. Ansell, R. De Caterina, B. J. Gersh, C. B. Granger, M. Hanna, A. Siegbahn, +5 Additional Authors Jan 2014

D-Dimer And Risk Of Thromboembolic And Bleeding Events In Patients With Atrial Fibrillation - Observations From The Aristotle Trial, C. Christersson, L. Wallentin, U. Andersson, J. H. Alexander, J. Ansell, R. De Caterina, B. J. Gersh, C. B. Granger, M. Hanna, A. Siegbahn, +5 Additional Authors

Journal Articles

BackgroundD-dimer is related to adverse outcomes in arterial and venous thromboembolic diseases. ObjectivesTo evaluate the predictive value of D-dimer level for stroke, other cardiovascular events, and bleeds, in patients with atrial fibrillation (AF) treated with oral anticoagulation with apixaban or warfarin; and to evaluate the relationship between the D-dimer levels at baseline and the treatment effect of apixaban vs. warfarin. MethodsIn the ARISTOTLE trial, 18201 patients with AF were randomized to apixaban or warfarin. D-dimer was analyzed in 14878 patients at randomization. The cohort was separated into two groups; not receiving vitaminK antagonist (VKA) treatment and receiving VKA treatment at …


Coupling To A Glioblastoma-Directed Antibody Potentiates Antitumor Activity Of Curcumin, P. Langone, P. R. Debata, J. D. Inigo, S. Dolai, S. Mukherjee, P. Halat, K. Mastroianni, G. M. Curcio, M. R. Castellanos, K. Raja, P. Banerjee Jan 2014

Coupling To A Glioblastoma-Directed Antibody Potentiates Antitumor Activity Of Curcumin, P. Langone, P. R. Debata, J. D. Inigo, S. Dolai, S. Mukherjee, P. Halat, K. Mastroianni, G. M. Curcio, M. R. Castellanos, K. Raja, P. Banerjee

Journal Articles

Current therapies for glioblastoma are largely palliative, involving surgical resection followed by chemotherapy and radiation therapy, which yield serious side effects and very rarely produce complete recovery. Curcumin, a food component, blocked brain tumor formation but failed to eliminate established brain tumors in vivo, probably because of its poor bioavailability. In the glioblastoma GL261 cells, it suppressed the tumor-promoting proteins NF-kappa B, P-Akt1, vascular endothelial growth factor, cyclin D1 and BClXL and triggered cell death. Expression of exogenous p50 and p65 subunits of NF-kappa B conferred partial protection on transfected GL261 cells against curcumin insult, indicating that NF-kappa B played …


Direct Oral Anticoagulants New Drugs And New Concepts, J. H. Levy, A. C. Spyropoulos, C. M. Samama, J. Douketis Jan 2014

Direct Oral Anticoagulants New Drugs And New Concepts, J. H. Levy, A. C. Spyropoulos, C. M. Samama, J. Douketis

Journal Articles

Direct oral anticoagulants (DOACs) are approved for multiple thromboembolic disorders and provide advantages over existing agents. As with all anticoagulants, management protocols for the eventuality of bleeding are important. Randomized phase III studies generally show that DOACs have a similar risk of clinically relevant bleeding compared with standard anticoagulants, with reductions in major bleeding in some cases. This may be particularly important in patients with atrial fibrillation, for whom the rate of intracranial hemorrhage was approximately halved with DOACs compared with warfarin. Conversely, the risk of gastrointestinal bleeding may be increased. Specific patient characteristics, such as renal impairment, comedications, and …


Drivers Of Hospitalization For Patients With Atrial Fibrillation: Results From The Outcomes Registry For Better Informed Treatment Of Atrial Fibrillation (Orbit-Af), B. A. Steinberg, S. Kim, G. C. Fonarow, L. Thomas, J. Ansell, P. R. Kowey, K. W. Mahaffey, B. J. Gersh, E. Hylek, Informed Outcomes Registry Better, +6 Additional Authors Jan 2014

Drivers Of Hospitalization For Patients With Atrial Fibrillation: Results From The Outcomes Registry For Better Informed Treatment Of Atrial Fibrillation (Orbit-Af), B. A. Steinberg, S. Kim, G. C. Fonarow, L. Thomas, J. Ansell, P. R. Kowey, K. W. Mahaffey, B. J. Gersh, E. Hylek, Informed Outcomes Registry Better, +6 Additional Authors

Journal Articles

Background Atrial fibrillation (AF) is the most common cardiac dysrhythmia and contributes significantly to health care expenditures. We sought to assess the frequency and predictors of hospitalization in patients with AF. Methods The ORBIT-AF registry is a prospective, observational study of outpatients with AF enrolled from June 29, 2010, to August 9, 2011. The current analysis included 9,484 participants with 1-year follow-up. Multivariable, logistic regression was used to identify baseline characteristics that were associated with first cause-specific hospitalization. Results Overall, 31% of patients with AF studied (n = 2,963) had 1 or more hospitalizations per year and 10% (n = …