1
|
Lambert DH, Mustafa W, Rendon LF, Hartman C, Xu L, Canelli R. Awareness During Anesthesia for Trauma: Has Anything Changed? Anesth Analg 2024; 138:e19-e20. [PMID: 38489804 DOI: 10.1213/ane.0000000000006927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Donald H Lambert
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts,
| | - Wissam Mustafa
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Luis F Rendon
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Ciana Hartman
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Lan Xu
- Department of Anesthesiology, Boston Medical Center, Boston, Massachusetts
| | - Robert Canelli
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| |
Collapse
|
2
|
Canelli R, Louca J, Hartman C, Bilotta F. Preoperative carbohydrate load to reduce perioperative glycemic variability and improve surgical outcomes: A scoping review. World J Diabetes 2023; 14:783-794. [PMID: 37383597 PMCID: PMC10294067 DOI: 10.4239/wjd.v14.i6.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/31/2023] [Accepted: 04/25/2023] [Indexed: 06/14/2023] Open
Abstract
The detrimental effects of both diabetes mellitus (DM) and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration (BGC) in a variety of clinical settings. It is now appreciated that acute BGC spikes, hypoglycemia, and high glycemic variability (GV) lead to more endothelial dysfunction and oxidative stress than uncomplicated, chronically elevated BGC. In the perioperative setting, fasting is the primary approach to reducing the risk for pulmonary aspiration; however, prolonged fasting drives the body into a catabolic state and therefore may increase GV. Elevated GV in the perioperative period is associated with an increased risk for postoperative complications, including morbidity and mortality. These challenges pose a conundrum for the management of patients typically instructed to fast for at least 8 h before surgery. Preliminary evidence suggests that the administration of an oral preoperative carbohydrate load (PCL) to stimulate endogenous insulin production and reduce GV in the perioperative period may attenuate BGC spikes and ultimately decrease postoperative morbidity, without significantly increasing the risk of pulmonary aspiration. The aim of this scoping review is to summarize the available evidence on the impact of PCL on perioperative GV and surgical outcomes, with an emphasis on evidence pertaining to patients with DM. The clinical relevance of GV will be summarized, the relationship between GV and postoperative course will be explored, and the impact of PCL on GV and surgical outcomes will be presented. A total of 13 articles, presented in three sections, were chosen for inclusion. This scoping review concludes that the benefits of a PCL outweigh the risks in most patients, even in those with well controlled type 2 DM. The administration of a PCL might effectively minimize metabolic derangements such as GV and ultimately result in reduced postoperative morbidity and mortality, but this remains to be proven. Future efforts to standardize the content and timing of a PCL are needed. Ultimately, a rigorous data-driven consensus opinion regarding PCL administration that identifies optimal carbohydrate content, volume, and timing of ingestion should be established.
Collapse
Affiliation(s)
- Robert Canelli
- Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States
| | - Joseph Louca
- Department of Anesthesiology, Boston University School of Medicine, Boston Medical Center, Boston, MA 02118, United States
| | - Ciana Hartman
- Department of Anesthesiology, Boston Medical Center, Boston, MA 02118, United States
| | - Federico Bilotta
- Department of Anesthesiology, Sapienza University of Rome, Rome 00199, Italy
| |
Collapse
|
3
|
Sarsembayeva D, Schreuder M, Hartman C. Insomnia and eveningness are independent trans-diagnostic markers of poor mental health across the lifespan. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
4
|
Hartman C, Shah S. 655 Combination of cysteamine and isobionic-amide in a new formulation to decrease epidermal pigmentation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
5
|
Groen R, Arizmendi C, Gates K, Schreuder M, Wichers M, Hartman C, Wigman J. Individual-specific and subgroup level associations between stress and psychopathology in daily life: A temporal network investigation. Eur Psychiatry 2021. [PMCID: PMC9471384 DOI: 10.1192/j.eurpsy.2021.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Stress is a risk factor for developing psychopathology. Emerging evidence suggests that daily experiences of stress may also predict symptoms during the day. It is unclear to what extent the influence of stress on psychopathology during the day is the same across individuals (including across diagnostic boundaries), and which effects are individual-specific Objectives This study aims to reveal how stress and symptoms are interrelated in a cross-diagnostic context by modeling individual level temporal networks, and examining subgroups with similar dynamics. Methods Hundred twenty two young adults (43.4% women) with a wide range of psychopathology in terms of severity and type of problems completed a six-month daily diary study. We used a temporal network approach (i.e., group iterative multiple model estimation) to model how stress and ten specific symptoms (e.g., feeling down, paranoia, restlessness) were related across time at the individual-specific, subgroup, and group level. Results After controlling for the lagged influence of stress on itself, stress level predicted the level of restlessness, worrying, nervousness, and feeling down during the same day for >70% of individuals. We observed three larger subgroups with each over 20 individuals, whose temporal networks showed different dynamic patterns involving specific symptoms. Effects of stress on other specific symptoms differed across individuals, and these were not subgroup-specific. Conclusions This study showed important overlap between individuals in terms of impact of stress on psychopathology in daily life. Subtle differences between individuals were also observed. Possibly, such differences are relevant for examining individual-specific vulnerability for future psychopathology. This requires further investigation. Disclosure No significant relationships.
Collapse
|
6
|
Schreuder M, Wigman J, Smit A, Hartman C, Wichers M. Anticipating transitions in mental health in at-risk youth: A large-scale diary study into early warning signals. Eur Psychiatry 2021. [PMCID: PMC9475781 DOI: 10.1192/j.eurpsy.2021.1215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Transitions in mental health, such as the onset or sudden progression of psychopathology, are difficult to foresee. If mental health behaves like other complex systems, drops in mental health may be anticipated by early warning signals (EWS), which manifest in the dynamics of time series data. Objectives This study aimed to establish the sensitivity and specificity of EWS as personalized risk markers for sudden drops mental health. Methods Individuals (N=122, mean age 23.6 ±0.7 years, 57% males) at increased risk for psychopathology completed daily questionnaires on mental states for six consecutive months. Transitions in mental health were identified by change point analyses. EWS, operationalized as rising trends in the autoregressive coefficient of 36 negative mental states, were identified using generalized additive models. Results EWS were found for 59% of individuals with a drop in mental health, and for 47% without such a drop (sensitivity: 0-.12; specificity: .88-1). There were considerable individual differences in the prevalence, strength, and timing of EWS. Conclusions EWS might be informative of impeding transitions, yet they are also highly conservative. Present findings may inspire future research into the prerequisites for detecting EWS in the context of mental health, for instance with respect to the stability of pre- and post-transition phases, the magnitude of transitions, and the timescale at which EWS manifest. An improved understanding of the dynamics that govern psychopathology could ultimately allow us to determine whether a specific individual at a specific moment in time is at risk for a sudden onset or progression of mental health problems.
Collapse
|
7
|
Veldkamp SAM, Zondervan-Zwijnenburg MAJ, van Bergen E, Barzeva SA, Tamayo-Martinez N, Becht AI, van Beijsterveldt CEM, Meeus W, Branje S, Hillegers MHJ, Oldehinkel AJ, Hoijtink HJA, Boomsma DI, Hartman C. Parental Age in Relation to Offspring's Neurodevelopment. J Clin Child Adolesc Psychol 2020; 50:632-644. [PMID: 32420762 DOI: 10.1080/15374416.2020.1756298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Advanced parenthood increases the risk of severe neurodevelopmental disorders like autism, Down syndrome and schizophrenia. Does advanced parenthood also negatively impact offspring's general neurodevelopment?Method: We analyzed child-, father-, mother- and teacher-rated attention-problems (N = 38,024), and standardized measures of intelligence (N = 10,273) and educational achievement (N = 17,522) of children from four Dutch population-based cohorts. The mean age over cohorts varied from 9.73-13.03. Most participants were of Dutch origin, ranging from 58.7%-96.7% over cohorts. We analyzed 50% of the data to generate hypotheses and the other 50% to evaluate support for these hypotheses. We aggregated the results over cohorts with Bayesian research synthesis.Results: We mostly found negative linear relations between parental age and attention-problems, meaning that offspring of younger parents tended to have more attention problems. Maternal age was positively and linearly related to offspring's IQ and educational achievement. Paternal age showed an attenuating positive relation with educational achievement and an inverted U-shape relation with IQ, with offspring of younger and older fathers at a disadvantage. Only the associations with maternal age remained after including SES. The inclusion of child gender in the model did not affect the relation between parental age and the study outcomes.Conclusions: Effects were small but significant, with better outcomes for children born to older parents. Older parents tended to be of higher SES. Indeed, the positive relation between parental age and offspring neurodevelopmental outcomes was partly confounded by SES.
Collapse
Affiliation(s)
- S A M Veldkamp
- Department of Biological Psychology, Vrije Universiteit Amsterdam
| | | | - Elsje van Bergen
- Department of Biological Psychology, Vrije Universiteit Amsterdam
| | - S A Barzeva
- Department of Psychiatry, University of Groningen, University Medical Center Groningen
| | - N Tamayo-Martinez
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center
| | - A I Becht
- Department of Youth & Family, Utrecht University.,Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam
| | | | - W Meeus
- Department of Youth & Family, Utrecht University
| | - S Branje
- Department of Youth & Family, Utrecht University
| | - M H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center
| | - A J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Center Groningen
| | - H J A Hoijtink
- Department of Methodology & Statistics, Utrecht University
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam
| | - C Hartman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen
| |
Collapse
|
8
|
Kramer JR, Hartman C, White DL, Royse K, Richardson P, Thrift AP, Raychaudhury S, Desiderio R, Sanchez D, Chiao EY. Validation of HIV-infected cohort identification using automated clinical data in the Department of Veterans Affairs. HIV Med 2019; 20:567-570. [PMID: 31131549 DOI: 10.1111/hiv.12757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The US Department of Veterans Affairs (VA) is the largest integrated health care provider for HIV-infected patients in the USA. VA data for HIV-specific clinical and quality improvement research are an important resource. We sought to determine the accuracy of using the VA Corporate Data Warehouse (CDW), a fully automated medical records database for all VA users nationally, to identify HIV-infected patients compared with a gold-standard VA HIV Clinical Case Registry (CCR). METHODS We assessed the test performance characteristics of each of our CDW criteria-based algorithms (presence of one, two or all of the following: diagnostic codes for HIV, positive HIV laboratory tests, and prescription for HIV medication) by calculating their sensitivity (proportion of HIV-positive patients in the CCR accurately detected as HIV-positive by the CDW algorithm) and positive predictive value (PPV; the proportion of patients identified by the CDW algorithm who were classified as HIV-positive from the CCR). RESULTS We found that using a CDW algorithm requiring two of three HIV diagnostic criteria yielded the highest sensitivity (95.2%) with very little trade-off in PPV (93.5%). CONCLUSIONS A two diagnostic criteria-based algorithm can be utilized to accurately identify HIV-infected cohorts seen in the nationwide VA health care system.
Collapse
Affiliation(s)
- J R Kramer
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - C Hartman
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - D L White
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA.,Center for Translational Research in Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - K Royse
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - P Richardson
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - A P Thrift
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - S Raychaudhury
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - R Desiderio
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - D Sanchez
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - E Y Chiao
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
9
|
Schnapp Z, Livnat-Levanon G, Shteinberg M, Hartman C, Elenberg Y. P174 Faecal calprotectin in cystic fibrosis patients during respiratory exacerbation. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
Lamport L, Hartman C, Codipilly C, Weinberger B, Schanler R. Osmolality Changes with Increasing Nutritional Content of Feedings for Premature Infants. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
McDonald N, Lee J, Pahl E, Rosanno J, Daly K, Burnette A, Hartman C, Bastardi H, Peiris V, Almond C. Safety Problems Associated with Extemporaneously-Prepared Liquid Tacrolimus in US Children After Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
12
|
Hoogeman M, Van der Voort S, Perko Z, Van de Water S, Hartman C, Heijmen B, Lathouwers D. PO-0892: Fast and accurate sensitivity analysis of IMPT treatment plans using Polynomial Chaos Expansion. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
Marderfeld L, Poraz I, Rub G, Ashkenazi S, Hartman C, Shamir R. PP247-MON: Validation of the Screening Tool for the Assessment of Malnutrition for Use Upon Hospital Admissions in Pediatrics. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14
|
Thissen AJAM, Rommelse NNJ, Hoekstra PJ, Hartman C, Heslenfeld D, Luman M, van Lieshout M, Franke B, Oosterlaan J, Buitelaar JK. Attention deficit hyperactivity disorder (ADHD) and executive functioning in affected and unaffected adolescents and their parents: challenging the endophenotype construct. Psychol Med 2014; 44:881-892. [PMID: 23721667 DOI: 10.1017/s0033291713001153] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The results of twin and sibling studies suggest that executive functioning is a prime candidate endophenotype in attention deficit hyperactivity disorder (ADHD). However, studies have not assessed the co-segregation of executive function (EF) deficits from parents to offspring directly, and it is unclear whether executive functioning is an ADHD endophenotype in adolescents, given the substantial changes in prefrontal lobe functioning, EF and ADHD symptoms during adolescence. METHOD We recruited 259 ADHD and 98 control families with an offspring average age of 17.3 years. All participants were assessed for ADHD and EF [inhibition, verbal (VWM) and visuospatial working memory (VsWM)]. Data were analysed using generalized estimating equations (GEEs). RESULTS Parental ADHD was associated with offspring ADHD and parental EF was associated with offspring EF but there were no cross-associations (parental ADHD was not associated with offspring EF or vice versa). Similar results were found when siblings were compared. EF deficits were only found in affected adolescents and not in their unaffected siblings or (un)affected parents. CONCLUSIONS The core EFs proposed to be aetiologically related to ADHD, that is working memory and inhibition, seem to be aetiologically independent of ADHD in adolescence. EF deficits documented in childhood in unaffected siblings were no longer present in adolescence, suggesting that children 'grow out' of early EF deficits. This is the first study to document ADHD and EF in a large family sample with adolescent offspring. The results suggest that, after childhood, the majority of influences on ADHD are independent from those on EF. This has potential implications for current aetiological models of causality in ADHD.
Collapse
Affiliation(s)
- A J A M Thissen
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - N N J Rommelse
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - P J Hoekstra
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - C Hartman
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
| | | | - M Luman
- VU University, Amsterdam, The Netherlands
| | | | - B Franke
- Departments of Human Genetics and Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | - J K Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| |
Collapse
|
15
|
Buscher A, Hartman C, Kallen MA, Giordano TP. Impact of antiretroviral dosing frequency and pill burden on adherence among newly diagnosed, antiretroviral-naive HIV patients. Int J STD AIDS 2012; 23:351-5. [PMID: 22648890 DOI: 10.1258/ijsa.2011.011292] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There are few data on the impact of antiretroviral therapy (ART) regimen factors on adherence in ART-naïve HIV patients on contemporary once- or twice-daily regimens. Ninety-nine newly diagnosed patients in a prospective observational cohort study completed a visual analogue scale to assess their ART adherence. Adherence by type of ART and dosing frequency were compared by Brown-Mood median tests. Participants taking once-daily regimens had higher adherence (n = 70, 99.5%) compared with participants taking twice-daily regimens (n = 29, 94%; P = 0.01). Adherence of participants taking the fixed dose combination efavirenz-emtricitabine-tenofovir (n = 34, 100%) compared with those taking once-daily regimens of two or more pills was no different (n = 36, 99.3%; P = 0.34). Among a cohort of newly diagnosed ART-naïve patients, once-daily dosing of ART resulted in higher adherence than twice-daily dosing. Pill burden among once-daily regimens did not predict adherence, suggesting that factors other than pill burden should drive regimen selection.
Collapse
Affiliation(s)
- A Buscher
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | | | | | | |
Collapse
|
16
|
Ratain MJ, Schwartz GK, Oza AM, Rudin CM, Kaye SB, De Jonge MJ, Khayat D, Awada A, Sawyer MB, Obel JC, Medioni J, Evans TRJ, De Greve J, Soetekouw PM, Baurain J, O'Dwyer PJ, Hartman C, Poulart V, Walters IB. Brivanib (BMS-582664) in advanced solid tumors (AST): Results of a phase II randomized discontinuation trial (RDT). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3079] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
17
|
Schwartz GK, Maki RG, Ratain MJ, Undevia SD, Jones RL, Rudin CM, Siu LL, Brockstein B, Khayat D, Gil T, De Jonge MJ, Sawyer MB, Evans TRJ, Medioni J, O'Dwyer PJ, Hartman C, Poulart V, Walters IB. Brivanib (BMS-582664) in advanced soft-tissue sarcoma (STS): Biomarker and subset results of a phase II randomized discontinuation trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10000] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
18
|
Abraham NS, Castillo DL, Hartman C. National mortality following upper gastrointestinal or cardiovascular events in older veterans with recent nonsteroidal anti-inflammatory drug use. Aliment Pharmacol Ther 2008; 28:97-106. [PMID: 18397385 DOI: 10.1111/j.1365-2036.2008.03706.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Upper gastrointestinal events (UGIE), myocardial infarction (MI) and cerebrovascular accident (CVA) are known morbidities among recent NSAID users. AIM To assess all-cause mortality following UGIE, MI or CVA among recent NSAID users. METHODS Veterans >65 prescribed an NSAID at any Veterans Affairs (VA) facility were identified using prescription fill data and their records linked to a merged VA-Medicare database. Each person-day was assessed for NSAID, coxib or proton pump inhibitor (PPI) exposure. Incidence density ratios and hazard rates of death were calculated following UGIE, MI and CVA adjusting for demographics, co-morbidity, prescription channeling, geographic location and pharmacological covariates. RESULTS Among 474 495 patients [97.8% male; 85.3% white; 73.9 years (s.d. 5.6)], death followed at a rate of 5.5 per 1000 person-years (95% CI: 5.4-5.6) post-UGIE, 17.7 per 1000 person-years (95% CI: 17.5-17.9) post-MI and 21.8 per 1000 person-years (95% CI: 21.6-22.0) post-CVA. CVA was associated with greatest risk of death [hazard ratio (HR) 12.4; 95% CI: 10.9-14.3] followed by MI (HR 10.7; 95% CI: 9.2-11.6) and UGIE (HR 3.3; 95% CI: 2.8-3.9). Predictors of mortality were advancing age and co-morbidity, increased use of coxibs and failure to ensure adequate gastroprotection. CONCLUSION Among elderly veterans with recent NSAID use, an UGIE, MI or CVA is a clinically relevant premorbid event.
Collapse
Affiliation(s)
- N S Abraham
- Houston Center for Quality of Care & Utilization Studies, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX 77030, USA.
| | | | | |
Collapse
|
19
|
Jabbi M, Korf J, Kema IP, Hartman C, van der Pompe G, Minderaa RB, Ormel J, den Boer JA. Convergent genetic modulation of the endocrine stress response involves polymorphic variations of 5-HTT, COMT and MAOA. Mol Psychiatry 2007; 12:483-90. [PMID: 17453062 DOI: 10.1038/sj.mp.4001975] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Highly prevalent stress-related disorders such as major depression (MD) are characterised by a dysregulation of the neuroendocrine system. Although heritability for these disorders is high, the role of genes in the underlying pathophysiology is poorly understood. Here, we show that polymorphic variations in genes coding for serotonin transporter (5-HTT), catechol-O-methyl transferase (COMT) and monoamine oxidase A (MAOA) as well as sex differences influence the regulation of hypothalamic-pituitary-adrenal (HPA)-axis response to acute psychological and endocrine challenges. In our sample, the effects of COMT on the release of adrenocorticotrophin hormone (ACTH) depend on the presence of the low-expression MAOA variant in the same individual. By including individuals varying in their degree of susceptibility to MD, we showed evidence of interactions between 5-HTT and MD susceptibility in baseline cortisol, and between MAOA and MD susceptibility in baseline ACTH measures, indicating a role for these genotypes in stable-state endocrine regulation. Collectively, these results indicate that the simultaneous investigation of multiple monoaminergic genes in interaction with gender have to be measured to understand the endocrine regulation of stress. These findings point towards a genetic susceptibility to stress-related disorders.
Collapse
Affiliation(s)
- M Jabbi
- Department of Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Abraham NS, El-Serag HB, Hartman C, Richardson P, Deswal A. Cyclooxygenase-2 selectivity of non-steroidal anti-inflammatory drugs and the risk of myocardial infarction and cerebrovascular accident. Aliment Pharmacol Ther 2007; 25:913-24. [PMID: 17402995 DOI: 10.1111/j.1365-2036.2007.03292.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIM To assess degree of cyclooxygenase-2 (COX-2) selectivity of a non-steroidal anti-inflammatory drug (NSAID) and risk of myocardial infarction (MI) or cerebrovascular accident (CVA). METHODS Prescription fill data were linked to medical records of a merged VA-Medicare dataset. NSAIDs were categorized by Cox-2 selectivity. Incidence of CVA and MI within 180 days of index prescription was assessed using Cox-proportional hazards models adjusted for gender, race, cardiovascular and pharmacological risk factors and propensity for prescription of highly COX-2 selective NSAIDs. RESULTS Of 384,322 patients (97.5% men and 85.4% white), 79.4% were prescribed a poorly selective, 16.4% a moderately selective and 4.2% a highly selective NSAID. There were 985 incident cases of MI and 586 cases of CVA in >145 870 person-years. Highly selective agents had the highest rate of MI (12.3 per 1000 person-years; [95% CI: 12.2-12.3]) and CVA (8.1 per 1000 person-years; [95% CI: 8.0-8.2]). Periods without NSAID exposure were associated with lowest risk. In adjusted models, highly selective COX-2 selective NSAIDs were associated with a 61% increase in CVA and a 47% increase in MI, when compared with poorly selective NSAIDs. CONCLUSIONS The risk of MI and CVA increases with any NSAID. Highly COX-2 selective NSAIDs confer the greatest risk.
Collapse
Affiliation(s)
- N S Abraham
- Houston Center for Quality of Care and Utilization Studies, and Deparment of Gastroenterology, Michael E. DeBakey VAMC and Baylor College of Medicine, Houston, TX 77030, USA.
| | | | | | | | | |
Collapse
|
21
|
Abstract
OBJECTIVES Upper endoscopy (esophagogastroduodenoscopy [EGD]) has a limited role, if any, in the evaluation of functional abdominal pain (FAP). Nevertheless, children with intractable FAP are occasionally referred to EGD to rule out intestinal pathology. We evaluated the role of wireless video capsule endoscopy (VCE) in children referred for EGD with a diagnosis of FAP. PATIENTS AND METHODS Ten children older than 10 years of age were prospectively enrolled. Children were first studied with the PillCam SB (VCE; Given Imaging, Yokneam, Israel) followed by standard EGD within 2 weeks. After the completion of the study, a questionnaire of tolerance and content regarding the 2 procedures was completed by the patients. RESULTS Physical examinations and laboratory tests were within normal limits in all of the patients. Patients swallowed the endoscopic capsules without difficulty. There were no complications. VCE identified gastritis in 4 patients (confirmed by biopsies), whereas EGD detected erosive gastritis in only 1 of the 4 children. EGD detected no duodenal abnormalities. VCE detected Crohn disease in the small intestine and cecum in 1 patient. VCE was ranked by 8 patients as convenient and as a preferable procedure compared with EGD. CONCLUSION The results of this small cohort suggest that in children with FAP, VCE is more sensitive than EGD for detection of macroscopic gastric and small bowel pathologies.
Collapse
Affiliation(s)
- R Shamir
- Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital of Haifa, Haifa, Israel.
| | | | | | | | | | | |
Collapse
|
22
|
Koul M, Hartman C, Hempel J, Gatalica Z, Loggie B, Wu BL, Lilleberg S. Comprehensive analysis of human mitochondrial genome in peritoneal mesothelioma tumor samples by DHPLC, surveyor nuclease and DNA sequencing. Mitochondrion 2006. [DOI: 10.1016/j.mito.2006.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
23
|
Hino B, Eliakim R, Levine A, Sprecher H, Berkowitz D, Hartman C, Eshach-Adiv O, Shamir R. Comparison of invasive and non-invasive tests diagnosis and monitoring of Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2004; 39:519-23. [PMID: 15572892 DOI: 10.1097/00005176-200411000-00013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND There are few reports which the tests used for diagnosing Helicobacter pylori infection and monitoring its eradication in children. STUDY AIMS Prospective evaluation of invasive (gastric histology, rapid urease test [RUT]) and non-invasive (stool antigen [FemtoLab H. pylori], urea breath test [UBT]) tests in the diagnosis of H. pylori infection and post-treatment eradication in children and adolescents. METHODS Ninety-two patients (50 male, 42 female) referred for upper gastrointestinal endoscopy were prospectively enrolled. UBT was performed and stool specimens collected for monoclonal enzyme immunoassay for H. pylori antigen (FemtoLab) 1 to 4 days before endoscopy. H. pylori in gastric biopsies was evaluated by RUT and staining with hematoxylin-eosin and giemsa. Eradication therapy was given to children with abdominal pain and H. pylori gastritis. FemtoLab H. pylori and UBT were repeated 6 weeks after the end of triple therapy. RESULTS Histology identified H. pylori in 49 of 92 (53%) subjects. Concordance between histology and RUT was found in 78 of 92 children. FemtoLab H. pylori was positive in 41 of 78 (52.6%) children with sensitivity, specificity, positive and negative predictive values of 97.5%, 94.7%, 95.1% and 97.3%, respectively. For UBT, these values were 100%, 96.9%, 97.5% and 100%, respectively. Twenty-six of 36 patients who received triple therapy returned for eradication evaluation. Tests for H. pylori antigen in stool were positive in 10 of 26 and for UBT in 11 of 26. CONCLUSION Stool antigen (FemtoLab) and UBT were equally effective in diagnosing and confirming eradication of H. pylori infection in children.
Collapse
Affiliation(s)
- B Hino
- Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital of Haifa, Haifa, Israel
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Hartman C, Brik R, Tamir A, Merrick J, Shamir R. Bone quantitative ultrasound and nutritional status in severely handicapped institutionalized children and adolescents. Clin Nutr 2004; 23:89-98. [PMID: 14757397 DOI: 10.1016/s0261-5614(03)00096-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Children with cerebral palsy (CP) have a high prevalence of pathologic fractures. Bone quantitative ultrasonography (QUS) has emerged as a radiation-free method for the assessment of bone quality and fracture risk. In this study, we applied QUS technique in order to investigate bone status in handicapped institutionalized children and adolescents. METHODS This cross-sectional study included 87 handicapped institutionalized patients. Measurements of the velocity of ultrasound wave, speed of sound (SOS), at distal radius and midshaft tibia, were performed using Omnisense 7000S analyser (Sunlight Ltd., Tel Aviv, Israel). In addition, all the participants had a thorough evaluation of nutritional status, demographic and clinical characteristics. RESULTS Forty-five of patients had either radius or tibia bone SOS lower than -1 SD, and 21% had either radius or tibia bone SOS lower than -2.5 SD. Using step-wise regression analysis, female gender (P=0.003) and stature (P=0.008) were correlated with radius SOS. Age (P=0.03) and fracture history (P=0.04) were negatively correlated with tibia SOS. CONCLUSION In this group of children and adolescents with CP one-fifth had poor bone status as suggested by low tibia/radius SOS assessed by QUS. Female gender, stature, age and fracture history were significantly correlated with poor bone status.
Collapse
Affiliation(s)
- C Hartman
- Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital, Israel
| | | | | | | | | |
Collapse
|
25
|
Mandel H, Szargel R, Labay V, Elpeleg O, Saada A, Shalata A, Anbinder Y, Berkowitz D, Hartman C, Barak M, Eriksson S, Cohen N. Correction: The deoxyguanosine kinase gene is mutated in individuals with depleted hepatocerebral mitochondrial DNA. Nat Genet 2001. [DOI: 10.1038/ng1201-491a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
26
|
Mandel H, Szargel R, Labay V, Elpeleg O, Saada A, Shalata A, Anbinder Y, Berkowitz D, Hartman C, Barak M, Eriksson S, Cohen N. The deoxyguanosine kinase gene is mutated in individuals with depleted hepatocerebral mitochondrial DNA. Nat Genet 2001; 29:337-41. [PMID: 11687800 DOI: 10.1038/ng746] [Citation(s) in RCA: 438] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mitochondrial DNA (mtDNA)-depletion syndromes (MDS; OMIM 251880) are phenotypically heterogeneous, autosomal-recessive disorders characterized by tissue-specific reduction in mtDNA copy number. Affected individuals with the hepatocerebral form of MDS have early progressive liver failure and neurological abnormalities, hypoglycemia and increased lactate in body fluids. Affected tissues show both decreased activity of the mtDNA-encoded respiratory chain complexes (I, III, IV, V) and mtDNA depletion. We used homozygosity mapping in three kindreds of Druze origin to map the gene causing hepatocerebral MDS to a region of 6.1 cM on chromosome 2p13, between markers D2S291 and D2S2116. This interval encompasses the gene (DGUOK) encoding the mitochondrial deoxyguanosine kinase (dGK). We identified a single-nucleotide deletion (204delA) within the coding region of DGUOK that segregates with the disease in the three kindreds studied. Western-blot analysis did not detect dGK protein in the liver of affected individuals. The main supply of deoxyribonucleotides (dNTPs) for mtDNA synthesis comes from the salvage pathway initiated by dGK and thymidine kinase-2 (TK2). The association of mtDNA depletion with mutated DGUOK suggests that the salvage-pathway enzymes are involved in the maintenance of balanced mitochondrial dNTP pools.
Collapse
Affiliation(s)
- H Mandel
- Metabolic Disease Unit, Department of Pediatrics, Rambam Medical Center, Technion-Israel Institute of Technology, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Mitochondrial respiratory chain disorders are an established cause of liver failure in early childhood. In some patients, the levels of mitochondrial DNA are markedly reduced, a condition referred to as mtDNA depletion syndrome (MDS). We report here on the ultrastructural changes in the livers of 10 infants with the hepatic form of this syndrome. All patients displayed progressive liver failure, neurological abnormalities, hypoglycemia, and lactic acidosis that warranted investigation of respiratory chain disorder in liver tissue, specifically expressing the disease. Decreased activity of respiratory chain complexes containing mtDNA-encoded subunits (complexes I, III, IV) was shown in 5 patients. Mitochondrial DNA depletion was confirmed by Southern blot analysis in the livers of 6 patients. We found hepatocytes filled with mitochondria having aspects of "oncocytic transformation," associated with numerous changes in shape, size, cristae, and matrix. The changes were virtually identical in all specimens. In many hepatocytes, microvesicular steatosis was the salient feature. Additional findings included cholestasis and focal cytoplasmic biliary necrosis (CBN), as well as cytosiderosis in hepatocytes and sinusoidal cells. In some hepatocytes the damage appeared extreme, but fibrosis was identified only in the few patients who died beyond 6 months of age. Although individual ultrastructural findings are not specific, when taken together, they show a diagnostic pattern highly suggestive of a respiratory chain disorder. In the appropriate clinical context, these findings can direct the clinician towards the diagnosis of hepatic MDS.
Collapse
Affiliation(s)
- H Mandel
- Metabolic Disease Unit, Rambam Medical Center, Israel
| | | | | | | | | | | |
Collapse
|
28
|
Affiliation(s)
- C Hartman
- Division of Pediatric Gastroenterology and Nutrition, Rambam Medical Center, Bruce Rappaport School of Medicine, Technion-lsrael Institute of Technology, Haifa
| | | | | | | | | | | |
Collapse
|
29
|
Roussos A, Karantanos G, Richardson C, Hartman C, Karajiannis D, Kyprianos S, Lazaratou H, Mahaira O, Tassi M, Zoubou V. Achenbach's Child Behavior Checklist and Teachers' Report Form in a normative sample of Greek children 6-12 years old. Eur Child Adolesc Psychiatry 1999; 8:165-72. [PMID: 10550697 DOI: 10.1007/s007870050125] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Achenbach's Child Behavior Checklist (CBCL) and Teachers' Report Form (TRF) were administered to 6-12 year old school children comprising a large random community sample (n = 1200) drawn from the whole of Greece. These are the first data on the TRF in Greece and the first nation-wide data on the CBCL. Appropriate cutoff points for the behavioral problems and competence scales of both questionnaires were obtained for boys and girls. These were considerably higher than USA cutoffs for the CBCL but not for the TRF. Analysis of scores in relation to degree of urbanization showed that it was not necessary to define different cutoffs in different strata. Parents' and teachers' ratings of the same child were most highly correlated for Externalizing and Aggressive behavior for boys and for Attention problems for both sexes.
Collapse
Affiliation(s)
- A Roussos
- Attiki Child Psychiatry Hospital, 4 Garefi Street, 115 25 Athens, Greece.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Howarth GR, Pistorius LR, Combrink W, Hartman C. Management of early onset severe twin-twin transfusion syndrome in the absence of fetoscopic equipment by exteriorisation, ligation and replacement of the umbilical cord of the sacrificed twin. S Afr Med J 1998; 88:286. [PMID: 9608304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
31
|
Howarth GR, Pistoruis LR, Combrink W, Hartman C. Exteriorisation, ligation and replacement of the umbilical cord in the management of early onset severe twin-twin transfusion syndrome. J OBSTET GYNAECOL 1998; 18:278. [PMID: 15512080 DOI: 10.1080/01443619867524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- G R Howarth
- Department of Obstetrics and Gynaecology, Kalafong Hospital and University of Pretoria, South Africa
| | | | | | | |
Collapse
|
32
|
O'Connor CM, Meese R, Carney R, Smith J, Conn E, Burks J, Hartman C, Roark S, Shadoff N, Heard M. A randomized trial of intravenous heparin in conjunction with anistreplase (anisoylated plasminogen streptokinase activator complex) in acute myocardial infarction: the Duke University Clinical Cardiology Study (DUCCS) 1. J Am Coll Cardiol 1994; 23:11-8. [PMID: 8277068 DOI: 10.1016/0735-1097(94)90496-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES We designed a randomized trial to evaluate the effects of heparin administration in conjunction with anistreplase (anisoylated plasminogen streptokinase activator complex [APSAC]) on arterial patency and clinical end points. BACKGROUND The role of conjunctive intravenous heparin therapy with APSAC has not been tested despite the recommendations that intravenous heparin should be used. METHODS Four hours after APSAC administration, 250 patients with acute myocardial infarction were randomly assigned to receive 325 mg of either aspirin alone or aspirin and a continuous infusion of heparin (15 IU/kg body weight per h). Clinical ischemic events and bleeding complications were monitored. On hospital day 5, coronary arteriography and left ventriculography were performed. RESULTS The primary end point of the trial (the combined outcome of death, reinfarction, recurrent ischemia and occlusion of the infarct-related artery) occurred in 42% of the heparin-treated group versus 43% of the group treated without heparin (p = 0.94). A patent infarct-related artery was present in 80% of the patients treated with heparin and in 73% of those treated without heparin (p = 0.26). Left ventricular function, as measured by ejection fraction, was well preserved in both groups (52% vs. 50.5%, respectively, p = 0.29). The overall bleeding rate was higher in patients with (32%) than without (17.2%) heparin (p = 0.006). CONCLUSIONS Weight-adjusted intravenous heparin therapy after APSAC in acute myocardial infarction does not reduce the combined incidence of death, reinfarction, recurrent ischemia and occlusion of the infarct-related artery. Furthermore, withholding intravenous heparin therapy is associated with a 46% reduction in bleeding complications. Our findings do not support the addition of intravenous heparin after APSAC therapy, as currently recommended, and suggest that a strategy of withholding heparin is simpler and safer and does not place the patient at increased risk for ischemic complications after myocardial infarction.
Collapse
Affiliation(s)
- C M O'Connor
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Roguin N, Greif Z, Schneeweiss A, Yahalom M, Hartman C, Saab K, Glusman A, Milgram E, Shasha S. Transient mitral regurgitation in acute glomerulonephritis. Pediatr Cardiol 1993; 14:86-8. [PMID: 8469637 DOI: 10.1007/bf00796985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
During an epidemic of acute glomerulonephritis (AGN) 15 patients were studied by M-mode, cross-sectional, and Doppler echocardiography. All 15 patients had the classical signs of the disease including hematuria, proteinuria, edema, and consistent laboratory findings. There were 10 boys and five girls with a mean age of 8 years. Ten of the 15 patients had an enlarged left atrium and five of these 10 also had transient mild to moderate mitral regurgitation. In the five patients with mitral regurgitation the ratio of left atrium/aorta was 1.48; in the five patients with an enlarged left atria without evidence of mitral regurgitation the left atrium/aorta ratio was 1.34. All the patients had normal left ventricular dimensions, as well as ejection and shortening fractions. The findings of left atrial enlargement and mitral regurgitation disappeared gradually in all patients within 3 months. There was no correlation between the level of systemic blood pressure and the development of mitral regurgitation. A possible cause for these changes is fluid overload in the oliguric phase of the acute glomerulonephritis. The changes are transient and probably functional. There was no significant mitral valve or left atrial anomaly 3 and 6 months after hospital discharge.
Collapse
Affiliation(s)
- N Roguin
- Department of Cardiology, Western Galilee Regional Hospital, Nahariya, Israel
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Lazarus LW, Winemiller DR, Lingam VR, Neyman I, Hartman C, Abassian M, Kartan U, Groves L, Fawcett J. Efficacy and side effects of methylphenidate for poststroke depression. J Clin Psychiatry 1992; 53:447-9. [PMID: 1487474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression after stroke impedes the rehabilitation process and causes additional suffering to patient and family. Few studies have systematically examined pharmacologic treatments of poststroke depression. In the present paper, the use of the stimulant methylphenidate is studied in a depressed, elderly stroke population. METHOD Ten subjects (mean age = 73.2 years) meeting DSM-III-R criteria for major depression were followed-up during a 3-week efficacy and side effect trial involving methylphenidate. Subjects were selected from rehabilitation patients referred for psychiatric consultation. RESULTS A total of 80% (8 of 10) of the subjects showed either a full or partial response as measured by Hamilton Rating Scale for Depression scores. The incidence of problematic side effects was low, and no subjects had to be discontinued from the study. CONCLUSION Results of this methylphenidate trial for poststroke depression in elderly patients suggest that it is a safe and effective treatment for poststroke depression. Future studies are called for in which methylphenidate is compared with placebo controls and antidepressant medication.
Collapse
Affiliation(s)
- L W Lazarus
- Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill. 60612
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Hartman C, Lazarus LW. Psychotherapy with elderly depressed patients. Clin Geriatr Med 1992; 8:355-62. [PMID: 1600485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Although psychotherapy outcome research is not without controversy, available evidence suggests that elderly patients benefit from an active, structured relationship with a therapist who provides a helpful therapeutic setting for comprehending and mastering problems that contribute to depression. Until research can evaluate better the various types of therapies, it is reasonable to integrate aspects of different therapies in the clinician's approach to depressed elderly patients, depending on the clinician's understanding of the patient's diagnosis, ego strengths and weaknesses, and capacity to cope and change. The therapist can use psychodynamic, cognitive, behavioral, interpersonal, and supportive techniques in a flexible manner, individualizing therapy to meet the patient's specific needs. Antidepressants are helpful in conjunction with psychotherapy, particularly for patients with major depression and for patients with prominent neurovegetative signs of depression. A tailored, individualized approach that considers the patient's unique needs can strengthen the therapeutic relationship, which may be the primary "nonspecific factor" through which all psychotherapies appear to benefit patients.
Collapse
Affiliation(s)
- C Hartman
- Department of Psychiatry, Rush Medical College, Chicago, Illinois
| | | |
Collapse
|
36
|
Abstract
Studies were performed with an interest in determining a pressure threshold for extracorporeal shock wave induced renal damage. Histological evidence of intraparenchymal hemorrhage was used as an indicator of tissue trauma. Depilated C3H mice were anesthetized and placed on a special frame to enhance visualization and treatment of the kidneys in situ. A Wolf electrohydraulic generator and 9 French probe designed for endoscopic use were utilized to expose the kidneys to 10 double spherically divergent shock waves. Measurements of the shock waves revealed two positive pressure peaks of similar magnitude for each spark discharge. The kidneys were exposed to different peak pressures by choice of distance from the spark source and were removed immediately after treatment for histologic processing. A dose response was noted with severe corticomedullary damage apparent following 15 to 20 MPa shocks. Hemorrhage was more apparent in the medulla where evidence of damage could be seen following pressures as low as three to five MPa. When a latex membrane was interposed to prevent possible collapse of the initial bubble from the spark source against the skin surface, histological evaluation revealed substantial reduction of severe tissue damage associated with the highest pressures tested, 20 MPa. However, the threshold level for evidence of hemorrhage remained about three to five MPa. Hydrophonic measurements indicated that the membrane allowed transmission of the acoustic shock waves and suggested that collapse of the bubble generated by electrohydraulic probes may have local effects due to a cavitation-like mechanism.
Collapse
Affiliation(s)
- R Mayer
- Department of Urology, University of Rochester, New York
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
Threshold pressures for hemorrhage in mouse lung exposed to the fields of an electrohydraulic lithotripter appear to be less than 2 MPa with as few as 10 pulses and with severe damage occurring at levels between 5 and 6 MPa. This is very much smaller than the fields required to fragment kidney and gallstones and smaller than the thresholds for damage to kidney tissues. Fetal lung, in contrast, did not show signs of damage at 20 MPa. The lower sensitivity of fetal lung is consistent with a cavitation-related mechanism for lung damage by shock waves. Since the pressures in these exposures are almost entirely positive, it suggests that the value of negative pressures as predictors of the behavior of gas bodies in tissues should be reconsidered.
Collapse
Affiliation(s)
- C Hartman
- Department of Electrical Engineering, University of Rochester, NY 14627
| | | | | | | | | |
Collapse
|
38
|
Abstract
The authors examined the role of fantasy as an internal drive mechanism for repetitive acts of sexual violence. A sample of 25 serial sexual murderers with three or more known victims each was compared with a sample of 17 single sexual murderers, with only one known victim each. The drive mechanism was hypothesized to be an intrusive fantasy life manifested in higher prevalences of paraphilias, documented or self-reported violent fantasies, and organized crime scenes in the serial murderers. All three hypotheses were supported.
Collapse
Affiliation(s)
- R A Prentky
- Research Department, Massachusetts Treatment Center, Bridgewater 02324
| | | | | | | | | | | | | |
Collapse
|
39
|
Sussman MD, Vary PS, Hartman C, Setlow P. Integration and mapping of Bacillus megaterium genes which code for small, acid-soluble spore proteins and their protease. J Bacteriol 1988; 170:4942-5. [PMID: 3139641 PMCID: PMC211542 DOI: 10.1128/jb.170.10.4942-4945.1988] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Four genes (ssp genes) coding for small, acid-soluble spore proteins of Bacillus megaterium and the gene for the protease that cleaves them during germination were cloned in the integratable plasmid pJH101. Each plasmid was integrated into the B. megaterium chromosome by a Campbell-type mechanism, allowing mapping of all five genes. The gene for the small, acid-soluble spore protein-specific protease (gpr) mapped near rib, and the sspA gene mapped between argA and hisA. The three other genes of the spp gene family (sspB, -D, and -F) all mapped near metC/D, with the order: sspF-sspD-metC/D-hemA-argO-sspB. While neither gpr nor sspF has been mapped in B. subtilis, the positions of the sspA, -B, and -D loci are similar in B. megaterium and B. subtilis, suggesting that the members of this multigene family have not recently undergone significant movement on the chromosome. It appears that more gene rearrangement has occurred in the flanking genes than has occurred in the ssp family of genes producing the small, acid-soluble spore proteins.
Collapse
Affiliation(s)
- M D Sussman
- Department of Biochemistry, University of Connecticut Health Center, Farmington 06032
| | | | | | | |
Collapse
|
40
|
Heuman DM, Hernandez CR, Hylemon PB, Kubaska WM, Hartman C, Vlahcevic ZR. Regulation of bile acid synthesis. I. Effects of conjugated ursodeoxycholate and cholate on bile acid synthesis in chronic bile fistula rat. Hepatology 1988; 8:358-65. [PMID: 3356417 DOI: 10.1002/hep.1840080228] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Bile acid synthesis is thought to be regulated by a negative feedback mechanism which is presumably dependent upon the flux of bile acids in the enterohepatic circulation. To characterize further the role of bile acids in regulation of bile acid synthesis, we have administered pure taurine or glycine conjugates of ursodeoxycholic acid or cholic acid to chronic bile fistula rats by continuous intraduodenal infusion, thus simulating restoration of the enterohepatic circulation. The effects of these bile salt infusions on bile acid synthesis, biliary cholesterol and phospholipid secretion and on the activities of the hepatic microsomal enzymes cholesterol 7 alpha-hydroxylase and HMG-CoA reductase were evaluated. Because the rate of biliary bile salt secretion in rats with intact exteriorized enterohepatic circulation averaged 27.1 +/- 1.4 mumoles per 100 gm rat per hr, infusion rates for bile fistula studies were chosen to match (24 to 36 mumoles per 100 gm rat per hr) or exceed (48 mumoles per 100 gm rat per hr) this physiological flux. Infusion of tauroursodeoxycholic acid for 48 hr at 24 and 48 mumoles per 100 gm rat per hr failed to suppress cholic acid synthesis. Bile flow and biliary cholesterol and phospholipid secretion exhibited small, dose-dependent increases with tauroursodeoxycholic acid infusions. No suppression of cholesterol 7 alpha-hydroxylase or HMG-CoA reductase activity was observed. By contrast, taurocholic acid inhibited synthesis of chenodeoxycholate and its metabolites alpha- and beta-muricholate by 10% (NS), 66% (p less than 0.05) and 75% (p less than 0.05) at infusion rates of 24, 36 and 48 mumoles per 100 gm rat per hr, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- D M Heuman
- Division of Gastroenterology, McGuire Veterans Administration Medical Center, Richmond, Virginia 23249
| | | | | | | | | | | |
Collapse
|
41
|
|
42
|
|
43
|
Hartman C. Dilemmas of community organizing: Mission Hill in Boston--the context. Soc Policy 1978; 9:41-2. [PMID: 10308571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
44
|
|
45
|
Abstract
Fifty-six diabetic mothers and their infants were studied prospectively from birth. Twenty-one of 56 IDM had serum Mg less than or equal to 1.5 mg/dl, on at least one occasion during the first 3 days. Serum Mg in these hypomagnesemic infants did not demonstrate the normal increase with postnatal age that was present in normomagnesemic infants. Decreased neonatal serum Mg was related to increased severity of maternal diabetes, young mothers, mothers for lower gravidity, and prematurity. Decreased serum Mg, alone or with decreased ionized or total Ca, did not correlate with neuromuscular irritability in the infants. Decreased serum Mg in IDM was associated with decreased maternal serum Mg, decreased neonatal ionized and total Ca, increased serum P, and decreased parathyroid function. Serum Mg was not related to dietary P intake, or urinary Ca or P excretion. Thus, transitory neonatal hypomagnesemia occurs in IDM; it is speculated that factors causing HM might include maternal HM or neonatal hyperphosphatemia, and that the HM is related to the hypocalcemia and functional hypoparathyroidism of IDM.
Collapse
|
46
|
Fernandez BB, Hartman C. Thymoma, erythroid hypoplasia and myasthenia gravis. Report of a case with ultrastructural study. IMJ Ill Med J 1974; 145:121-4 passim. [PMID: 4149862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
47
|
|
48
|
Abstract
The key jingler is the staff person in any institution who uses his power in a manner that is debilitating to the inmates. He is a confidence man, bureaucrat, buck passer, someone putting up a front. Quite often it is the norms of the institution that impose this kind of behavior on the staff. The key jingling process then serves to place the inmate in a double bind, cool him out or institutionalize him into the system. The thoughts on the double bind process, cooling out process, and dysfunctional bureaucracy merge into one concept of key jingling.
Collapse
|
49
|
Hartman C. Bowmanville Low-Water Stage of Glacial Lake Chicago. Science 1926; 64:249. [PMID: 17837202 DOI: 10.1126/science.64.1654.249-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
50
|
Hartman C. Nicotine Sulphate, an Effective Vermicide for Sheep. Science 1923; 57:149-50. [PMID: 17831584 DOI: 10.1126/science.57.1466.149-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|