Medicine and Health Sciences Commons^™

Patient- And Population-Level Health Consequences Of Discontinuing Antiretroviral Therapy In Settings With Inadequate Hiv Treatment Availability, April D. Kimmel, Stephen C. Resch, Xavier Anglaret, Norman Daniels, Sue J. Goldie, Christine Daniel, Angela Y. Wong, Kenneth A. Freedberg, Milton C. Weinstein

Health Behavior and Policy Publications

Background

In resource-limited settings, HIV budgets are flattening or decreasing. A policy of discontinuing antiretroviral therapy (ART) after HIV treatment failure was modeled to highlight trade-offs among competing policy goals of optimizing individual and population health outcomes.

Methods

In settings with two available ART regimens, we assessed two strategies: (1) continue ART after second-line failure (Status Quo) and (2) discontinue ART after second-line failure (Alternative). A computer model simulated outcomes for a single cohort of newly detected, HIV-infected individuals. Projections were fed into a population-level model allowing multiple cohorts to compete for ART with constraints on treatment capacity. In the …

Geriatric Home Makeover, Edward F. Ansello

Director's Editorials from Age in Action

Houses pose substantial risks for falling. Over half of all falls by older adults happen in their homes. Reducing hazards in the home addresses just one set of contributing risk factors involved in older adults falling.

Preserved Ex Vivo Inflammatory Status In Decidual Cells From Women With Preterm Labor And Subclinical Intrauterine Infection, Violeta Castro-Leyva, Aurora Espejel-Nunez, Gerardo Barroso, Veronica Zaga-Clavellina, Arturo Flores-Pliego, Iyari Morales-Mendez, Silvia Giono-Cerezo, Scott W. Walsh, Guadalupe Estrada-Gutierrez

Obstetrics and Gynecology Publications

Objective

To compare the inflammatory response preserved ex vivo by decidual cells isolated from women who experienced preterm labor with and without subclinical intrauterine infection.

Methods

Fetal membranes were obtained after cesarean section from 35 women who delivered before 37 weeks of gestation following spontaneous preterm labor, with no clinical evidence of intrauterine infection. Decidua was microbiologically tested and cultured. Concentrations of anti-inflammatory cytokines (IL-2, IL-4, IL-10), pro-inflammatory cytokines (IL-6, IL-8, IL-1β and TNF-α), and matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9) were measured in the supernatants using Bio-Plex, and prostaglandin E2 (PGE2) was measured by enzyme immunoassay.

Results …

Cholesterol Side-Chain Cleavage Gene Expression In Theca Cells: Augmented Transcriptional Regulation And Mrna Stability In Polycystic Ovary Syndrome, Jessica K. Wickenheisser, Jessica M. Biegler, Valen L. Nelson-Degrave, Richard S. Legro, Jerome F. Strauss Iii, Jan M. Mcallister

Obstetrics and Gynecology Publications

Hyperandrogenism is characteristic of women with polycystic ovary syndrome (PCOS). Ovarian theca cells isolated from PCOS follicles and maintained in long-term culture produce elevated levels of progestins and androgens compared to normal theca cells. Augmented steroid production in PCOS theca cells is associated with changes in the expression of genes for several steroidogenic enzymes, including CYP11A1, which encodes cytochrome P450 cholesterol side-chain cleavage. Here, we further examined CYP11A1 gene expression, at both the transcriptional and post-transcriptional level in normal and PCOS theca cells propagated in long-term culture utilizing quantitative RT-PCR, functional promoter analyses, and mRNA degradation studies. The minimal …

Care Seeking For Neonatal Illness In Low- And Middle-Income Countries: A Systematic Review, Hadley K. Herbert, Anne C. C. Lee, Aruna Chandran, Igor Rudan, Abdullah H. Baqui

Surgery Publications

Background

Despite recent achievements to reduce child mortality, neonatal deaths continue to remain high, accounting for 41% of all deaths in children under five years of age worldwide, of which over 90% occur in low- and middle-income countries (LMICs). Infections are a leading cause of death and limitations in care seeking for ill neonates contribute to high mortality rates. As estimates for care-seeking behaviors in LMICs have not been studied, this review describes care seeking for neonatal illnesses in LMICs, with particular attention to type of care sought.

Methods and Findings

We conducted a systematic literature review of studies that …

Adenovirus-36 Is Associated With Obesity In Children And Adults In Sweden As Determined By Rapid Elisa, Malin Almgren, Richard Atkinson, Jia He, Agenta Hilding, Emilia Hagman, Alicia Wolk, Anders Thorell, Claude Marcus, Erik Naslund, Claes-Goren Ostenson, Martin Schalling, Catherina Lavebratt

Pathology Publications

Background

Experimental and natural human adenovirus-36 (Adv36) infection of multiple animal species results in obesity through increasing adipogenesis and lipid accumulation in adipocytes. Presence of Adv36 antibodies detected by serum neutralization assay has previously been associated with obesity in children and adults living in the USA, South Korea and Italy, whereas no association with adult obesity was detected in Belgium/the Netherlands nor among USA military personnel. Adv36 infection has also been shown to reduce blood lipid levels, increase glucose uptake by adipose tissue and skeletal muscle biopsies, and to associate with improved glycemic control in non-diabetic individuals.

Principal Findings

Using …

Cardiorespiratory Fitness, Alcohol Intake, And Metabolic Syndrome Incidence In Men, Kerem Shuval, Carrie E. Finley, Karen G. Chartier, Bijal A. Balasubramanian, Kelley Pettee Gabriel, Carolyn E. Barlow

Social Work Publications

Purpose

To prospectively examine the independent and joint effects of alcohol consumption and cardiorespiratory fitness on the incidence of metabolic syndrome in a cohort of men.

Methods

A prospective examination of 3,411 apparently healthy men at baseline, who came to the Cooper Clinic (Dallas, Texas) for at least 2 preventive visits (1979–2010). Primary exposure variables were cardiorespiratory fitness and alcohol intake; the outcome measure was metabolic syndrome (MetS) and the components thereof. Cox proportional hazard models were computed to assess the relationship between the exposure variables and the incidence of MetS while adjusting for confounders.

Results

Over a mean follow-up …

Is Aging A Disability?, Edward F. Ansello

Director's Editorials from Age in Action

Growing older is not predictable decline, and the overwhelming majority age without acquiring disabilities. Because age does not equal disability, the Virginia Commission on Government Reform and Restructuring should not fold the Virginia Department of the Aging, the Department of Rehabilitative Services, and the Department for the Deaf and Hard of Hearing into one agency.

All The World's A Stage, Edward F. Ansello

Director's Editorials from Age in Action

Population aging is occurring worldwide because of success in attacking causes of infant mortality, improved public hygiene, and falling fertility rates; health care in later life itself has had only marginal impact in the numbers. Societies should appreciate the differences associated with being older but also deem to later life the value and protections given to other ages.

Walkability, Edward F. Ansello

Director's Editorials from Age in Action

A starting point for assessing how friendly or livable a community is, is to consider its walkability. Walkability has different dimensions, for it implies not only that there be amenities in the community to which one would want to go, but also that one can move about safely; that the person motivated would have the health status or needed support to move about; that there would be means of transportation within and outside of the community, such as public transportation and taxis.

We Are Family: When Elder Abuse, Neglect, And Financial Exploitation Hit Home, Jeannie J. Beidler

Case Studies from Age in Action

Educational Objectives

1. To describe a case, from discovery to prosecution, of familial abuse, neglect, and financial exploitation.

2. To demonstrate gaps in elder care policy.

3. To share my experience in order to help protect the vulnerable older adults.

The Fairfax County Hoarding Task Force, Michael Congleton

Case Studies from Age in Action

Educational Objectives

1. Describe the reasons for forming the Fairfax County Hoarding Task Force.

2. Explain the organizational makeup of the Hoarding Task Force.

3. Understand the risk factors in hoarding and what is being done to address them.

Hoarding Behavior In The Elderly, Henriette Kellum

Case Studies from Age in Action

Educational Objectives

1. Identify the medical and mental health factors that contribute to hoarding behavior.

2. Describe the unique aspects of hoarding in the elderly.

3. Examine intervention and treatment strategies.

Arthritis And Physical Activity In Mid- And Later-Life, Nicholas Turkas

Case Studies from Age in Action

Educational Objectives

1. Describe some of the more common types of arthritic conditions.

2. Discuss co-morbidities or coexisting conditions often occurring with arthritis.

3. Describe the Arthritis Foundation as a relevant resource when dealing with arthritic conditions.

Mouse Rc/Btb2, A Member Of The Rcc1 Superfamily, Localizes To Spermatid Acrosomal Vesicles, Jiannan Wang, Maria E. Teves, Xuening Shen, David R. Nagarkatti-Gude, Rex A. Hess, Scott C. Henderson, Jerome F. Strauss Iii, Zhibing Zhang

Obstetrics and Gynecology Publications

Mouse RC/BTB2 is an unstudied protein of the RCC1 (Regulator of Chromosome Condensation) superfamily. Because of the significant remodeling of chromatin that occurs during spermiogenesis, we characterized the expression and localization of mouse RC/BTB2 in the testis and male germ cells. The Rc/btb2 gene yields two major transcripts: 2.3 kb Rc/btb2-s, present in most somatic tissues examined; and 2.5 kb Rc/btb2-t, which contains a unique non-translated exon in its 5′-UTR that is only detected in the testis. During the first wave of spermatogenesis, Rc/btb2-t mRNA is expressed from day 8 after birth, reaching highest levels of expression at day …