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Hughey S, Field R, Campbell D, Cole J, Booth G, Stringer M, Stedjelarsen E. Military concerns for chronic pain stimulator devices. BMJ Mil Health 2023:e002366. [PMID: 37336581 DOI: 10.1136/military-2023-002366] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/14/2023] [Indexed: 06/21/2023]
Abstract
Spinal cord stimulators (SCS) and peripheral nerve stimulators (PNS) are increasingly used in the treatment of chronic pain, allowing more patients to resume working and return to activities. Military service members face environmental and occupational hazards that expose them to mechanical and electromagnetic forces, both clinical and industrial, that could potentially alter their function. While there are reports of individual hazards, the risk appears to be nominal based on the large number of devices in use and the limited reported complications with these devices. Since a variety of hazards encountered by military patients have the potential to alter SCS and PNS devices, a brief discussion of each patient's specific exposures and related hazards should occur prior to placement. Overall, these devices have demonstrated safety in hazardous areas and few military patients have contraindications for placement based on these factors alone.
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Affiliation(s)
- Scott Hughey
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Anesthesiology and Pain Medicine, Naval Hospital Okinawa, Okinawa, Japan
| | - R Field
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - D Campbell
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - J Cole
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | - G Booth
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - M Stringer
- NASA Langley Research Center, Hampton, Virginia, USA
| | - E Stedjelarsen
- Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
- Department of Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
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Astell-Burt T, Hipp JA, Gatersleben B, Adlakha D, Marselle M, Olcoń K, Pappas E, Kondo M, Booth G, Bacon S, Lem M, Francois M, Halcomb E, Moxham L, Davidson P, Feng X. Need and Interest in Nature Prescriptions to Protect Cardiovascular and Mental Health: A Nationally-Representative Study With Insights for Future Randomised Trials. Heart Lung Circ 2023; 32:114-123. [PMID: 36588036 DOI: 10.1016/j.hlc.2022.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE "Nature prescriptions" are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, obesity, loneliness, burn-out). METHODS A nationally-representative survey of 3,319 adults across all states and territories of Australia was completed in February 2021 (response 84.0%). Participants were classified across 15 target groups using validated health indicators and surveyed on (1) time and frequency of visits to green and blue spaces (nature spaces), (2) interest in a nature prescription, and (3) potential confounders (e.g. age, income). Analyses were done using weighted logistic regressions. RESULTS The sample was 50.5% female, 52.0% were aged ≥45 years, 15.2% were living alone and 19.3% were born overseas in non-English-speaking countries. Two-thirds of the sample spent 2 hours or more a week in nature, but these levels were generally lower in target groups (e.g. 57.7% in adults with type 2 diabetes). Most participants (81.9%) were interested in a nature prescription, even among those spending fewer than 2 hours a week in nature (76.4%). For example, 2 hours a week or more in nature was lowest among sedentary adults (36.9%) yet interest in nature prescriptions in this group was still high (74.0%). Lower levels of nature contact in target groups was not explained by differences in access to or preference for local nature spaces. CONCLUSIONS High levels of interest in nature prescriptions amid low levels of nature contact in many target health groups provides impetus for developing randomised trials of interventions that enable people to spend more time in nature. These findings can inform intervention co-design processes with a wide range of community stakeholders, end-users in target health groups, and the health professionals who support them.
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Affiliation(s)
- Thomas Astell-Burt
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia.
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, NC State University, Raleigh, NC, USA
| | - Birgitta Gatersleben
- Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, UK
| | - Deepti Adlakha
- Department of Landscape Architecture and Environmental Planning, Natural Learning Initiative, College of Design, NC State University, Raleigh, NC, USA
| | - Melissa Marselle
- Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, UK
| | - Katarzyna Olcoń
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Evangelos Pappas
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Michelle Kondo
- USDA Forest Service, Northern Research Station, Philadelphia Field Station, Philadelphia, PA, USA
| | - Gillian Booth
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Simon Bacon
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, Québec, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Quebec, Canada
| | - Melissa Lem
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Monique Francois
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Lorna Moxham
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia; School of Nursing, University of Wollongong, Wollongong, NSW, Australia; Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Patricia Davidson
- The Vice-Chancellor's Unit (P.M.D.), University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), Sydney, NSW, Australia; School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia; The George Institute of Global Health, Sydney, NSW, Australia.
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Booth G, Howarth A, Stubbs B, Ussher M. The effectiveness of interventions targeting physical activity and sedentary behaviour in people with persistent musculoskeletal pain: Systematic review and meta-analysis. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.313] [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]
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Wiens K, Ronksley P, Hwang S, Booth G, Campbell D. Demographic and Clinical Characteristics of Diabetic Patients With and Without a History of Homelessness. Can J Diabetes 2021. [DOI: 10.1016/j.jcjd.2021.09.066] [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: 11/25/2022]
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De Sequeira S, Presseau J, Booth G, Lipscombe L, Perkins I, Perkins B, Shulman R, Lakhanpal G, Ivers N. Developing a Successful Implementation Plan for a High-Frequency, Low-Touch Care Model at Specialized Type 1 Diabetes Clinics: The Type 1 diabetes virtual self-Management and Education support (T1ME) trial. Can J Diabetes 2021. [DOI: 10.1016/j.jcjd.2021.09.067] [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: 11/26/2022]
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Booth G, Knight R, Harlan R, Peterson K, Jacoby C, Berklich E, Slater S, Allen B, Neumann C, Dela Cruz J, Meyers G, Cook R, Maziarz R, Newell L. Characterization of chronic GVHD after day 4 versus day 5 G-CSF mobilized HLA-matched sibling donor allogeneic hematopoietic cell transplantation. Cytotherapy 2021. [DOI: 10.1016/s1465324921003881] [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: 10/21/2022]
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Neumann C, Knight R, Booth G, Dela Cruz J, Maziarz R, Newell L. Second autologous hematopoietic cell transplantation using long-term cryopreserved cells is associated with increased platelet transfusion support and hospital readmissions, but not delayed engraftment. Cytotherapy 2021. [DOI: 10.1016/s146532492100387x] [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: 10/21/2022]
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Choi J, Booth G, Jung HY, Lapointe-Shaw L, Tang T, Kwan JL, Rawal S, Weinerman A, Verma A, Razak F. Association of diabetes with frequency and cost of hospital admissions: a retrospective cohort study. CMAJ Open 2021; 9:E406-E412. [PMID: 33863799 PMCID: PMC8084549 DOI: 10.9778/cmajo.20190213] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Acute inpatient hospital admissions account for more than half of all health care costs related to diabetes. We sought to identify the most common and costly conditions leading to hospital admission among patients with diabetes compared with patients without diabetes. METHODS We used data from the General Internal Medicine Inpatient Initiative (GEMINI) study, a retrospective cohort study, of all patients admitted to a general internal medicine service at 7 Toronto hospitals between 2010 and 2015. The Canadian Institute for Health Information (CIHI) Most Responsible Diagnosis code was used to identify the 10 most frequent reasons for admission in patients with diabetes. Cost of hospital admission was estimated using the CIHI Resource Intensity Weight. Comparisons were made between patients with or without diabetes using the Pearson χ2 test for frequency and distribution-free confidence intervals (CIs) for median cost. RESULTS Among the 150 499 hospital admissions in our study, 41 934 (27.8%) involved patients with diabetes. Compared with patients without diabetes, hospital admissions because of soft tissue and bone infections were most frequent (2.5% v. 1.9%; prevalence ratio [PR] 1.28, 95% CI 1.19-1.37) and costly (Can$8794 v. Can$5845; cost ratio [CR] 1.50, 95% CI 1.37-1.65) among patients with diabetes. This was followed by urinary tract infections (PR 1.16, 95% CI 1.11-1.22; CR 1.23, 95% CI 1.17-1.29), stroke (PR 1.13, 95% CI 1.07-1.19; CR 1.19, 95% CI 1.14-1.25) and electrolyte disorders (PR 1.11, 95% CI 1.03-1.20; CR 1.20, 95% CI 1.08-1.34). INTERPRETATION Soft tissue and bone infections, urinary tract infections, stroke and electrolyte disorders are associated with a greater frequency and cost of hospital admissions in patients with diabetes than in those without diabetes. Preventive strategies focused on reducing hospital admissions secondary to these disorders may be beneficial in patients with diabetes.
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Affiliation(s)
- Jin Choi
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Gillian Booth
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Hae Young Jung
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Lauren Lapointe-Shaw
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Terence Tang
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Janice L Kwan
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Shail Rawal
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Adina Weinerman
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Amol Verma
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont
| | - Fahad Razak
- Department of Medicine (Choi), University of Toronto; Li Ka Shing Knowledge Institute (Booth, Jung, Verma, Razak) and Department of Medicine, Division of Endocrinology (Booth), St. Michael's Hospital; Division of General Internal Medicine (Lapointe-Shaw, Rawal), University Health Network; Program of Medicine and Institute for Better Health (Tang), Trillium Health Partners; Division of General Internal Medicine (Kwan), Mount Sinai Hospital; Division of General Internal Medicine (Weinerman), Sunnybrook Health Sciences Centre; Division of General Internal Medicine (Verma, Razak), St. Michael's Hospital, Toronto, Ont.
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Booth G, Phillips M, McVicar T, Broza A. The active back programme - a model for multidisciplinary persistent lower back pain rehabilitation. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.081] [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]
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Hobin E, Swanson A, Booth G, Russell K, Rosella LC, Smith BT, Manley E, Isaranuwatchai W, Whitehouse S, Brunton N, McGavock J. Physical activity trails in an urban setting and cardiovascular disease morbidity and mortality in Winnipeg, Manitoba, Canada: a study protocol for a natural experiment. BMJ Open 2020; 10:e036602. [PMID: 32075847 PMCID: PMC7045157 DOI: 10.1136/bmjopen-2019-036602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Aspects of the built environment that support physical activity are associated with better population health outcomes. Few experimental data exist to support these observations. This protocol describes the study of the creation of urban trials on cardiovascular disease (CVD)-related morbidity and mortality in a large urban centre. METHODS AND ANALYSIS Between 2008 and 2010, the city of Winnipeg, Canada, built four, paved, multiuse (eg, cycling, walking and running), two-lane trails that are 5-8 km long and span ~60 neighbourhoods. Linking a population-based health data with census and environmental data, we will perform an interrupted time series analysis to assess the impact of this natural experiment on CVD-related morbidity and mortality among individuals 30-65 years of age residing within 400-1200 m of the trail. The primary outcome of interest is a composite measure of incident major adverse CVD events (ie, CVD-related mortality, ischaemic heart disease, stroke and congestive heart failure). The secondary outcome of interest is a composite measure of incident CVD-related risk factors (ie, diabetes, hypertension and dyslipidaemia). Outcomes will be assessed quarterly in the 10 years before the intervention and 5 years following the intervention, with a 4-year interruption. We will adjust analyses for differences in age, sex, ethnicity, immigration status, income, gentrification and other aspects of the built environment (ie, greenspace, fitness/recreation centres and walkability). We will also assess trail use and trail user profiles using field data collection methods. ETHICS AND DISSEMINATION Ethical approvals for the study have been granted by the Health Research Ethics Board at the University of Manitoba and the Health Information Privacy Committee within the Winnipeg Regional Health Authority. We have adopted an integrated knowledge translation approach. Information will be disseminated with public and government partners. TRIAL REGISTRATION NUMBER NCT04057417.
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Affiliation(s)
- Erin Hobin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Gillian Booth
- Department of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
| | - Kelly Russell
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brendan T Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ed Manley
- The Bartlett Centre for Advanced Spatial Analysis (CASA), University College London, London, UK
| | - Wanrudee Isaranuwatchai
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Nicole Brunton
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Weisman A, Young J, Tu K, Jaakimainen L, Lipscombe L, Booth G. SUN-154 Identifying Type 1 Diabetes in Electronic Medical Records and Administrative Health Data in Ontario: A Validation Study. J Endocr Soc 2019. [PMCID: PMC6553113 DOI: 10.1210/js.2019-sun-154] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | | | - Karen Tu
- University of Toronto, Toronto, ON, Canada
| | | | | | - Gillian Booth
- ENDO AND METABOLISM, St. Michael's Hosp, Toronto, ON, Canada
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Lipscombe L, Booth G, Butalia S, Dasgupta K, Eurich DT, Goldenberg R, Khan N, MacCallum L, Shah BR, Simpson S. Erratum to “Pharmacologic Glycemic Management of Type 2 Diabetes in Adults”. Can J Diabetes 2018; 42:575. [DOI: 10.1016/j.jcjd.2018.08.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lipscombe L, Booth G, Butalia S, Dasgupta K, Eurich DT, Goldenberg R, Khan N, MacCallum L, Shah BR, Simpson S. Erratum to "Pharmacologic Glycemic Management of Type 2 Diabetes in Adults": Canadian Journal of Diabetes 2018;42(S1):S88-S103. Can J Diabetes 2018; 42:336. [PMID: 29857811 DOI: 10.1016/j.jcjd.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lipscombe L, Booth G, Butalia S, Dasgupta K, Eurich DT, Goldenberg R, Khan N, MacCallum L, Shah BR, Simpson S. Pharmacologic Glycemic Management of Type 2 Diabetes in Adults. Can J Diabetes 2018; 42 Suppl 1:S88-S103. [DOI: 10.1016/j.jcjd.2017.10.034] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Clemens KK, Shariff S, Richard L, Booth G, Gilliland J, Garg AX. Seasonal variation in hospital encounters with hypoglycaemia and hyperglycaemia. Diabet Med 2017; 34:958-965. [PMID: 28173630 DOI: 10.1111/dme.13327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Accepted: 02/02/2017] [Indexed: 11/28/2022]
Abstract
AIM To assess whether rates of hospital encounters with hypoglycaemia and hyperglycaemia display seasonal variation. METHODS Time series analyses of the monthly rates of hospital encounters (emergency room visits or inpatient admissions) with hypoglycaemia and hyperglycaemia from 2003 to 2012 using linked healthcare databases in Ontario, Canada. RESULTS Over the study period, there were 129 887 hypoglycaemia and 79 773 hyperglycaemia encounters. The characteristics of people at the time of their encounters were similar across the seasons in 2008 (median age 68 years for hypoglycaemia encounters and 53 years for hyperglycaemia encounters; 50% female; 90% with diabetes). We observed moderate seasonality in both types of encounters (R2 autoregression coefficient 0.58 for hypoglycaemia; 0.59 for hyperglycaemia). The rate of hypoglycaemia encounters appeared to peak between April and June, when on average, there was an additional 49 encounters per month (0.36 encounters per 100 000 persons per month) compared with the other calendar months (5% increase). The rate of hyperglycaemia encounters appeared to peak in January, when on average, there was an additional 69 encounters per month (0.50 encounters per 100 000 persons per month) compared with the other calendar months (11% increase). CONCLUSIONS In our region, there is seasonal variation in the rate of hospital encounters with hypoglycaemia and hyperglycaemia. Our findings may help to highlight periods of vulnerability for people, may inform future epidemiological studies and may aid in the appropriate planning of healthcare resources.
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Affiliation(s)
- K K Clemens
- Department of Medicine, Division of Endocrinology and Metabolism, Western University, London, Ontario, Canada
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
| | - S Shariff
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
| | - L Richard
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
| | - G Booth
- Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - J Gilliland
- Department of Geography, Western University, London, Ontario, Canada
- Department of Pediatrics, Western University, London, Ontario, Canada
- School of Health Studies, Western University, London, Ontario, Canada
- Children's Health Research Institute, Western University, London, Ontario, Canada
- Lawson Health Research Institute, Western University, London, Ontario, Canada
| | - A X Garg
- Department of Medicine, Division of Nephrology, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
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Booth G, Lipscombe L, Butalia S, Dasgupta K, Eurich D, Goldenberg R, Khan N, MacCallum L, Shah B, Simpson S, Houlden RL. Pharmacologic Management of Type 2 Diabetes: 2016 Interim Update. Can J Diabetes 2016; 40:484-486. [DOI: 10.1016/j.jcjd.2016.09.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 11/27/2022]
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Agha MM, Glazier RH, Moineddin R, Booth G. Congenital abnormalities in newborns of women with pregestational diabetes: A time-trend analysis, 1994 to 2009. ACTA ACUST UNITED AC 2016; 106:831-839. [DOI: 10.1002/bdra.23548] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Mohammad M. Agha
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Centre for Research on Inner City Health, St. Michael's Hospital, University of Toronto; Canada
- Paediatric Oncology Group of Ontario, University of Toronto; Toronto Canada
- Dalla Lana School of Public Health, University of Toronto; Toronto Canada
| | - Richard H. Glazier
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Centre for Research on Inner City Health, St. Michael's Hospital, University of Toronto; Canada
- Dalla Lana School of Public Health, University of Toronto; Toronto Canada
- Department of Family and Community Medicine; University of Toronto; Toronto Canada
| | - Rahim Moineddin
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Centre for Research on Inner City Health, St. Michael's Hospital, University of Toronto; Canada
- Department of Family and Community Medicine; University of Toronto; Toronto Canada
| | - Gillian Booth
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Centre for Research on Inner City Health, St. Michael's Hospital, University of Toronto; Canada
- University of Toronto, Department of endocrinology; Toronto Canada
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Ravi AK, Plumb J, Mason S, Booth G, Vestbo J, Singh SD. P105 Identification of ‘large’ alveolar macrophages and pulmonary intra-vascular macrophages in COPD patients: Abstract P105 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.242] [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: 11/04/2022]
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Ravi A, Khurana S, Banyard A, Plumb J, Booth G, Catley M, Healy L, Smith E, Vestbo J, Singh D. S47 Enhanced Il-6/ccl3 Signalling In The Plasma Of Patients With Copd. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.53] [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: 11/04/2022]
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Rosella LC, Lebenbaum M, Fitzpatrick T, Booth G. Population-Based Estimates of Undiagnosed and Prediabetes in Canada (2007-2011) According to Various Clinical Diagnostic Guidelines. Ann Epidemiol 2014. [DOI: 10.1016/j.annepidem.2014.06.075] [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]
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Morinis J, Lebovic G, Gozdyra P, Khovratovich M, Carsley S, Creatore M, Moheddin R, Booth G, Maguire J, Parkin P, Glazier R, Birken C. 12: The Weight of Place – The Role of the Neighbourhood in Childhood Obesity. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-12] [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: 11/14/2022] Open
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Booth G, Cheng AYY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Methods. Can J Diabetes 2013; 37 Suppl 1:S4-7. [PMID: 24070961 DOI: 10.1016/j.jcjd.2013.01.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Chan WW, Fischer H, Yun L, Austin P, Rochon PA, Booth G, Jaakkimainen L, Krzyzanowska M, Lipscombe LL. The Impact of Socioeconomic Status on Mammogram Use in Women with Diabetes. Can J Diabetes 2012. [DOI: 10.1016/j.jcjd.2012.07.453] [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: 11/15/2022]
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25
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Meredith S, Ward M, Booth G, Fisher A, Gamble C, House H, Landray M. Risk-adapted approaches to the management of clinical trials: guidance from the Department of Health (DH)/Medical Research Council(MRC)/Medicines and Healthcare Products Regulatory Agency (MHRA) Clinical Trials Working Group. Trials 2011. [PMCID: PMC3287754 DOI: 10.1186/1745-6215-12-s1-a39] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Armstrong J, Harbron C, Lea S, Booth G, Cadden P, Wreggett KA, Singh D. Synergistic effects of p38 mitogen-activated protein kinase inhibition with a corticosteroid in alveolar macrophages from patients with chronic obstructive pulmonary disease. J Pharmacol Exp Ther 2011; 338:732-40. [PMID: 21610141 DOI: 10.1124/jpet.111.180737] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Corticosteroids partially suppress cytokine production by chronic obstructive pulmonary disease (COPD) alveolar macrophages. p38 mitogen-activated protein kinase (MAPK) inhibitors are a novel class of anti-inflammatory drug. We have studied the effects of combined treatment with a corticosteroid and a p38 MAPK inhibitor on cytokine production by COPD alveolar macrophages, with the aim of investigating dose-sparing and efficacy-enhancing effects. Alveolar macrophages from 10 patients with COPD, six smokers, and six nonsmokers were stimulated with lipopolysaccharide (LPS) after preincubation with five concentrations of dexamethasone alone, five concentrations of the p38 MAPK inhibitor 1-(5-tert-butyl-2-p-tolyl-2H-pyrazol-3-yl)-3(4-(2-morpholin-4-yl-ethoxy)naphthalen-1-yl)urea (BIRB-796) alone, and all combinations of these concentrations. After 24 h, the supernatants were analyzed for interleukin (IL)-8, IL-6, tumor necrosis factor α (TNFα), granulocyte macrophage-colony-stimulating factor (GM-CSF), IL-1α, IL-1β, IL-1ra, IL-10, monocyte chemoattractant protein 3, macrophage-derived chemokine (MDC), and regulated on activation normal T cell expressed and secreted (RANTES). The effect of dexamethasone on p38 MAPK activation was analyzed by Western blotting. Dexamethasone and BIRB-796 both reduced LPS-induced cytokine production in a dose-dependent manner in all subject groups, with no differences between groups. Increasing the concentration of BIRB-796 in combination with dexamethasone produced progressively greater inhibition of cytokine production than dexamethasone alone. There were significant efficacy-enhancing benefits and synergistic dose-sparing effects (p < 0.05) for the combination treatment for IL-8, IL-6, TNFα, GM-CSF, IL-1ra, IL-10, MDC, and RANTES in one or more subject groups. Dexamethasone had no effect on LPS-induced p38 MAPK activation. We conclude that p38 MAPK activation in alveolar macrophages is corticosteroid-insensitive. Combining a p38 MAPK inhibitor with a corticosteroid synergistically enhances the anti-inflammatory effects on LPS-mediated cytokine production by alveolar macrophages from patients with COPD and controls.
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Affiliation(s)
- J Armstrong
- Medicines Evaluation Unit, National Institute for Health Research Translational Research Facility, University Hospital of South Manchester Foundation Trust, University of Manchester, Manchester, United Kingdom
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Creatore MI, Moineddin R, Booth G, Manuel DH, DesMeules M, McDermott S, Glazier RH. Age- and sex-related prevalence of diabetes mellitus among immigrants to Ontario, Canada. CMAJ 2010; 182:781-9. [PMID: 20403889 DOI: 10.1503/cmaj.091551] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The majority of immigrants to Canada originate from the developing world, where the most rapid increase in prevalence of diabetes mellitus is occurring. We undertook a population-based study involving immigrants to Ontario, Canada, to evaluate the distribution of risk for diabetes in this population. METHODS We used linked administrative health and immigration records to calculate age-specific and age-adjusted prevalence rates among men and women aged 20 years or older in 2005. We compared rates among 1,122,771 immigrants to Ontario by country and region of birth to rates among long-term residents of the province. We used logistic regression to identify and quantify risk factors for diabetes in the immigrant population. RESULTS After controlling for age, immigration category, level of education, level of income and time since arrival, we found that, as compared with immigrants from western Europe and North America, risk for diabetes was elevated among immigrants from South Asia (odds ratio [OR] for men 4.01, 95% CI 3.82-4.21; OR for women 3.22, 95% CI 3.07-3.37), Latin America and the Caribbean (OR for men 2.18, 95% CI 2.08-2.30; OR for women 2.40, 95% CI: 2.29-2.52), and sub-Saharan Africa (OR for men 2.31, 95% CI 2.17-2.45; OR for women 1.83, 95% CI 1.72-1.95). Increased risk became evident at an early age (35-49 years) and was equally high or higher among women as compared with men. Lower socio-economic status and greater time living in Canada were also associated with increased risk for diabetes. INTERPRETATION Recent immigrants, particularly women and immigrants of South Asian and African origin, are at high risk for diabetes compared with long-term residents of Ontario. This risk becomes evident at an early age, suggesting that effective programs for prevention of diabetes should be developed and targeted to immigrants in all age groups.
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Affiliation(s)
- Maria Isabella Creatore
- Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Universityof Toronto, Toronto, Ont
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Gucciardi E, DeMelo M, Booth G, Tomlinson G, Stewart DE. Individual and contextual factors associated with follow-up use of diabetes self-management education programmes: a multisite prospective analysis. Diabet Med 2009; 26:510-7. [PMID: 19646191 DOI: 10.1111/j.1464-5491.2009.02713.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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: 11/29/2022]
Abstract
AIMS Although a considerable body of research supports the efficacy of diabetes self-management education (DSME), these programmes are often challenged by high attrition rates. Little is known about factors influencing follow-up use of DSME services, thus the aim of this study was to identify these factors. METHODS In this multisite prospective analysis, adults with Type 2 diabetes (n = 268) who attended one of two diabetes management centres (DMCs) were followed over a 1-year period from their initial visit. The influence of individual and contextual factors on the number of contacts with DMC providers was examined. Data were analysed within the context of the Health Behavioral Model of Health Services Utilization. RESULTS In a multivariable negative binomial regression model, the number of contacts over 1 year was greater for those who were female, non-smokers, unemployed, self-referred to the DMC, lived closer to the DMC, had a lower body mass index, or had a longer known duration of diabetes. Follow-up use of services differed significantly between the two sites. Provider contacts were greater at the centre that offered flexible hours of services and a variety of optional educational modules. CONCLUSIONS Healthcare professionals need to encourage ongoing use of DSME, particularly for individuals prone to lower follow-up use of these services. Providing services that are accessible, convenient, and can easily fit into patients' schedules may increase follow-up use. Further exploration into how operations and delivery of these services influence utilization patterns is strongly recommended.
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Affiliation(s)
- E Gucciardi
- School of Nutrition, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
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Creatore M, Moineddin R, Booth G, Manuel D, DesMeules M, McDermott S, Ruddick E, Glazier R. Prevalence of diabetes among immigrants to canada. Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33240-2] [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: 11/25/2022]
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Abstract
Intensive multifactorial intervention reduces end points in patients with diabetic nephropathy. Traditional clinics struggle to provide the intensity of care required to meet targets for this growing patient group. We designed a pharmacist-led, protocol driven clinic to offer stepwise intensive treatment to patients with diabetic nephropathy picked up at the traditional secondary care clinic. One hundred and sixteen individuals received more than one review. The clinic achieved significant improvements in blood pressure (BP): systolic 151±19 mmHg vs.133±15 mmHg (p<0.001), diastolic 80±10 mmHg vs. 68±10 mmHg (p<0.001) and total cholesterol 4.56 mmol/L±1.05 mmol/L vs. 4.03±1.07 mmol/L (p<0.001). Albumin:creatinine ratio also improved 27±44 vs. 20±31 (p=0.02). Structured intervention within a pharmacist-led clinic has led to a rapid and significant reduction in BP and cholesterol in microalbuminuric patients. This format of care can form the basis of patient focused, target driven, care.
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Affiliation(s)
| | - Gillian Booth
- Diabetes Unit, Stirling Royal Infirmary, Livilands, Stirling, UK
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Kingry C, Bastien A, Booth G, Geraci TS, Kirpach BR, Lovato LC, Margolis KL, Rosenberg Y, Sperl-Hillen JM, Vargo L, Williamson JD, Probstfield JL. Recruitment strategies in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Am J Cardiol 2007; 99:68i-79i. [PMID: 17599427 DOI: 10.1016/j.amjcard.2007.03.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [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: 11/21/2022]
Abstract
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial is a randomized, multicenter clinical trial using a double 2 x 2 factorial design in 10,251 participants with type 2 diabetes mellitus at high risk for cardiovascular disease (CVD) events. ACCORD is testing 3 complementary medical treatment strategies that may reduce high rates of major CVD morbidity and mortality in patients with type 2 diabetes. The ACCORD vanguard phase, conducted at 59 clinics in the United States and Canada, recruited 1,174 participants in 20 weeks from January through June 1, 2001, with a recruitment efficiency (R-factor) of 0.65. The recruitment strategies used in this vanguard phase were almost exclusively chart and database review within clinical practices and institutions. Recruitment for the main trial began in February 2003, involved 77 clinics, and resulted in an additional 9,077 participants by October 29, 2005 (total, 10,251). The R-factor during main trial recruitment was 0.96. Although new and refined recruitment strategies were formulated from the vanguard experience, the most powerful determinant of improved recruitment efficiency was the immediate start of enrollment by most clinics at the beginning of the main trial. Recruitment in the main trial required only a brief extension of 3 months and facilitated the nearly complete capture of the expected number of person-years of observation. Described herein are vanguard and main trial recruitment activities, including strategy implementation, screening procedures, randomization results, problems encountered, and lessons learned.
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Affiliation(s)
- Connie Kingry
- Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle, Washington 98103, USA.
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Sawka AM, Boulos P, Talib AS, Gafni A, Thabane L, Papaioannou A, Booth G, Gerstein HC. Low Socioeconomic Status and Increased Risk of Severe Hypoglycemia in Type 1 Diabetes: A Systematic Literature Review. Can J Diabetes 2007. [DOI: 10.1016/s1499-2671(07)13010-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sandhu M, Zagorski B, Sykora K, Booth G, Brezden-Masley C. Autoimmune hypothyroidism protects against breast cancer development in the elderly. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
588 Background: An association between breast cancer and autoimmune hypothyroidism has been suggested. While a biological role for thyroid hormone in breast tumorigenesis has been demonstrated in vitro, epidemiological evidence is lacking. Methods: A retrospective, population-based cohort study was conducted to examine the risk of postmenopausal breast cancer (BRCA) in women with or without autoimmune hypothyroidism, identified on the basis of prescriptions for levothyroxine (LT4). Administrative health records were used to capture information on all women aged 66 and older living in Ontario, Canada at baseline (April 1, 1993 to March 31, 1996) and during a 10-year follow up. Propensity scores were used to create a matched cohort of LT4 and non-LT4 users. Cox proportional hazards modeling was used to evaluate the impact of LT4 use on the 5-year incidence of BRCA and benign breast disease, and on all-cause mortality rates among women diagnosed with breast cancer during follow-up. Results: LT4 users (N=89,093) and non-LT4 users (N=89,093) were well-matched with respect to baseline sociodemographics, estrogen use, comorbidity, and health care utilization, including the likelihood of receiving mammography or a breast biopsy. The 5-year incidence of BRCA was 0.86% in LT4 users compared to 0.97% in non-LT4 users (p=0.002). Adjustment for baseline characteristics did not alter these results (hazard ratio [HR] 0.86; 95% confidence interval [CI] 0.77–0.95; p= 0.004). Among women who developed BRCA, all cause mortality was significantly lower in LT4 users than in non-users (43.9% vs. 56.1%; adjusted HR 0.82; 95% CI 0.70–0.96; p= 0.01). The incidence of benign breast disease did not vary between groups. Conclusions: Elderly women with autoimmune hypothyroidism appeared to have a protective advantage in the incidence of BRCA and in mortality following a breast cancer diagnosis. These results suggest a biological role for thyroid hormone in the development of breast cancer, with a modulating effect of treated autoimmune hypothyroidism in promoting a less aggressive disease course. Further studies exploring the effect of thyroid hormone in breast cancer development are needed and may uncover novel therapeutic targets in the management of breast cancer in the future. No significant financial relationships to disclose.
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Affiliation(s)
- M. Sandhu
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; Institute of Clinical Evaluative Science, Toronto, ON, Canada
| | - B. Zagorski
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; Institute of Clinical Evaluative Science, Toronto, ON, Canada
| | - K. Sykora
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; Institute of Clinical Evaluative Science, Toronto, ON, Canada
| | - G. Booth
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; Institute of Clinical Evaluative Science, Toronto, ON, Canada
| | - C. Brezden-Masley
- St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada; Institute of Clinical Evaluative Science, Toronto, ON, Canada
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Jackson G, Jones S, Booth G, Champod C, Evett IW. The nature of forensic science opinion—a possible framework to guide thinking and practicce in investigation and in court proceedings. Sci Justice 2006; 46:33-44. [PMID: 16878783 DOI: 10.1016/s1355-0306(06)71565-9] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.6] [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: 11/21/2022]
Abstract
The questions that are asked of forensic scientists during the course of a criminal investigation, and during subsequent court proceedings, are of varied form. This paper attempts to place these questions into broad generic types and explores the difference in the inferential process that a scientist may employ when forming opinions that help answer these questions. From this model, a working definition of different roles and attributes for forensic scientists is described which may offer greater clarity for both practitioners and users of forensic science.
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Affiliation(s)
- G Jackson
- Advance Forensic Science, Dundee, UK.
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35
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Booth G, Hux J. Chronic complications of diabetes: cardiovascular and kidney disease. Hosp Q 2003; 6:35-7. [PMID: 12737026 DOI: 10.12927/hcq..16648] [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] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Gillian Booth
- Institute for Clinical Evaluative Sciences, St. Michael's Hospital, Department of Medicine, University of Toronto
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Abstract
PURPOSE To determine the long-term effect of the ketogenic diet (KD) on carnitine levels and whether carnitine depletion is a significant cause of clinical complications during KD initiation or treatment. METHODS Carnitine levels at 0, 1, 6, 12, and 24 months of diet treatment, carnitine antiepileptic drug (AED) history, lowest blood glucose and time to achieve ketosis during diet initiation, and diet complications were analyzed for 38 consecutive patients who initiated the KD from May 1997 to March 2000. Carnitine levels at follow-up were analyzed for eight patients started on the diet before to May 1997. RESULTS Total carnitine (TC) at diet initiation correlated negatively with the number of AEDs at diet initiation but not with number of past AEDs, lowest blood glucose, or time to ketosis. TC decreased in the first months of diet treatment and then stabilized or increased slightly with long term treatment. Only 19% of patients were supplemented with carnitine for low TC. No patient showed clinical signs of carnitine deficiency. CONCLUSIONS Multiple AED exposure lowers TC, but actual TC deficiency in patients initiating the KD is not common, and TC levels do not appear to predict hypoglycemia or problems achieving ketosis. Mild carnitine depletion may occur early in KD treatment and occasionally TC decreases out of the normal range, without clinical symptoms. TC stabilizes or increases back toward baseline with long-term treatment, and most patients do not require carnitine supplementation.
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Affiliation(s)
- E Berry-Kravis
- Department of Pediatrics, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
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Abstract
We employed intravital microscopy of the rat mesenteric microvasculature to study the effects of local hyperglycemia on leukocyte-endothelial cell interactions. Intraperitoneal injection of 6, 12.5, and 25 mmol/l D-glucose to the rat significantly and time-dependently increased leukocyte rolling and leukocyte adherence in, and leukocyte transmigration through mesenteric venules compared with control rats injected with Krebs-Henseleit (K-H) solution alone or given 25 mmol/l L-glucose intraperitoneally. The response elicited by D-glucose was associated with significant attenuation of endothelial nitric oxide (NO) release, as demonstrated by direct measurement of NO release in inferior vena caval segments isolated from rats exposed to 25 mmol/l D-glucose for 4 h (P < 0.01 vs. vena caval segments from control rats). Local application of 0.05 U/min insulin for 90 min significantly attenuated glucose-induced leukocyte rolling, adherence, and migration (P < 0.01 from 25 mmol/l D-glucose alone). Immunohistochemical localization of P-selectin expressed on endothelial surface was significantly increased 4 h after exposure of the mesenteric tissue to high ambient glucose (P < 0.01 vs. ileal venules from rats injected with K-H solution alone or 25 mmol/l L-glucose). Insulin markedly inhibited endothelial cell surface expression of P-selectin in ileal venules exposed to elevated ambient glucose in vivo (P < 0.01 vs. control rats injected with 25 mmol/l L-glucose). These data demonstrate that acute increases in ambient glucose comparable to those seen in diabetic patients are able to initiate an inflammatory response within the microcirculation. This inflammatory response to glucose is associated with upregulation of the endothelial cell adhesion molecule P-selectin and can be blocked by local application of insulin.
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Affiliation(s)
- G Booth
- Department of Physiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
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Abstract
Excessive bruising is a symptom noted by parents of some children treated with the ketogenic diet for epilepsy control, although this side effect is not reported in the literature. We evaluated our cohort of current and past diet-treated patients for symptoms of bruising or bleeding through chart review and prospective screening at clinic follow-up visits. A significant increase in bruising or other minor bleeding was reported and/or observed in 16 of 51 patients (31.4%). There were no differences in sex distribution or number of anticonvulsants used between patients with bruising/bleeding and those without this symptom, although the group with bruising/bleeding was significantly younger. No specific anticonvulsant was associated with bruising/bleeding. Six patients with diet-induced bruising/bleeding underwent an investigation for bleeding diathesis. Five of these patients had prolonged bleeding times and all had diminished responsiveness to various platelet aggregating agents, with no evidence of a release defect. The abnormalities all normalized in the 1 patient tested after ceasing the diet. No patients had serious hemorrhage. One patient had mild von Willebrand disease, which had been asymptomatic before diet initiation. Some patients were Stimate responsive, suggesting a treatment for more severe bouts of symptoms. These data suggest that a ketogenic diet-related bleeding tendency occurs in about one third of treated patients owing to preexisting factors defining susceptibility in combination with diet-induced depression of platelet responsiveness, possibly related to changes in platelet membrane lipid composition and/or concentration and resultant effects on function of membrane-embedded proteins. Patients on the diet undergoing anticoagulation or surgery should be evaluated carefully for symptoms of bleeding tendency.
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Affiliation(s)
- E Berry-Kravis
- Department of Pediatrics, RUSH-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA.
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Scalia R, Coyle KM, Levine BJ, Booth G, Lefer AM. C-peptide inhibits leukocyte-endothelium interaction in the microcirculation during acute endothelial dysfunction. FASEB J 2000; 14:2357-64. [PMID: 11053258 DOI: 10.1096/fj.00-0183com] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [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: 12/20/2022]
Abstract
C-peptide is a cleavage product that comes from processing proinsulin to insulin that induces nitric oxide (NO) -mediated vasodilation. NO modulates leukocyte-endothelium interaction. We hypothesized that C-peptide might inhibit leukocyte-endothelium interaction via increased release of endothelial NO. Using intravital microscopy of the rat mesentery, we measured leukocyte-endothelium interactions after administration of C-peptide to the rat. Superfusion of the rat mesentery with either thrombin or L-NAME consistently and significantly increased the number of rolling, adhering, and transmigrated leukocytes. C-peptide significantly attenuated either thrombin- or L-NAME-induced leukocyte-endothelium interactions in rat mesenteric venules. A control scrambled sequence of C-peptide characterized by the same amino acid composition in a randomized sequence failed to inhibit leukocyte-endothelium interactions. These effects of C-peptide were associated with decreased surface expression of the cell adhesion molecules P-selectin and ICAM-1 on the microvascular endothelium. Endothelial nitric oxide synthase (eNOS) mRNA levels were increased in rats injected with C-peptide. This enhanced eNOS expression was associated with a marked increase in basal NO release from the aorta of C-peptide-treated rats. We conclude that C-peptide is a potent inhibitor of leukocyte-endothelium interaction and that this effect is specifically related to inhibition of endothelial cell adhesion molecules via maintenance of NO release from the vascular endothelium.
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Affiliation(s)
- R Scalia
- Department of Physiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Londono LP, Jones HB, Vie AT, McPheat WL, Booth G, Gao XM, Dougan G. Characterisation of Candida albicans infections of haematogenous and mucosal origin in mice lacking the interferon gamma receptor protein. FEMS Immunol Med Microbiol 2000; 27:117-25. [PMID: 10640606 DOI: 10.1111/j.1574-695x.2000.tb01421.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mice harbouring a null deletion mutation in the IFNgamma receptor gene were used to study the role of IFNgamma responsiveness during experimental systemic candidiasis of mucosal or haematogenous origin. After intravenous (i.v.) or intranasal (i.n.) challenge with Candida albicans the progression of infection and concomitant cellular and antibody anti-C. albicans immune responses were analysed. During the week following i.v. challenge, the rate of C. albicans multiplication in kidneys, liver and spleen was faster in IFNgammaR (-/-) than IFNgammaR (+/+) mice. As a result, IFNgammaR (-/-) mice perished earlier than IFNgammaR (+/+) mice when challenged with equal numbers of live yeast cells. However, the overall susceptibility of the two mouse strains, in terms of survival against different C. albicans challenge doses over a 60-day period, was similar. No differences were found in the cellular anti-C. albicans response generated by i.v. challenge in both mouse strains. In contrast the kinetics and strength of the serum anti-C. albicans antibody responses were markedly different. Significantly stronger, predominantly IgG2a antibody responses accompanied the eventual control of C. albicans infection in IFNgammaR (-/-) mice. Following intranasal challenge, there was no difference in the rate of C. albicans clearance from the lungs of IFNgammaR (-/-) and IFNgammaR (+/+) mice. However, 48 h after challenge, large, conspicuous abscesses appeared in the lungs, liver, kidneys and spleen of IFNgammaR (-/-) mice. These abscesses were characterised by the presence of C. albicans and abundant neutrophilic infiltrates, but very few macrophages. No such abscesses developed in i.n. challenged IFNgammaR (+/+) mice. In both mouse strains, i.n. challenge induced strong systemic anti-C. albicans cellular responses, but relatively low titre systemic antibody responses. Mucosal anti-C. albicans antibody responses were detected in IFNgammaR (+/+), but not IFNgammaR (-/-) mice. Splenic adherent macrophages obtained from IFNgammaR (-/-) mice exhibited a significantly lower candidacidal activity than those of IFNgammaR (+/+) mice, and as expected, were not responsive to IFNgamma. In summary, these data suggest that IFNgamma has a role in limiting C. albicans multiplication during the early stages of infection, as well as in preventing the development of C. albicans-associated abscesses. Activation of macrophages by IFNgamma might be pivotal in mediating this role.
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Affiliation(s)
- L P Londono
- Biochemistry Department, Imperial College of Science, Technology and Medicine, Exhibition Road, London, UK
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Scalia R, Booth G, Lefer DJ. Vascular endothelial growth factor attenuates leukocyte-endothelium interaction during acute endothelial dysfunction: essential role of endothelium-derived nitric oxide. FASEB J 1999; 13:1039-46. [PMID: 10336886 DOI: 10.1096/fasebj.13.9.1039] [Citation(s) in RCA: 58] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Vascular endothelial growth factor (VEGF) is an endothelium-specific secreted protein that induces vasodilation and increases endothelial release of nitric oxide (NO). NO is also reported to modulate leukocyte-endothelium interaction. Therefore, we hypothesized that VEGF might inhibit leukocyte-endothelium interaction via increased release of NO from the vascular endothelium. We used intravital microscopy of the rat mesenteric microcirculation to measure leukocyte-endothelium interactions 2, 4, and 24 h after systemic administration of VEGF to the rat (120 microg/kg, i.v., bolus). Superfusion of the rat mesentery with either 0.5 U/ml thrombin or 50 microM L-NAME consistently increased the number of rolling, adhering, and transmigrated leukocytes (P<0.01 vs. control mesenteries superfused with Krebs-Henseleit buffer). At 4 and 24 h posttreatment, VEGF significantly attenuated thrombin-induced and L-NAME-induced leukocyte rolling, adherence, and transmigration in rat mesenteric venules. In addition, adherence of isolated rat PMNs to thrombin-stimulated mesenteric artery segments in vitro was significantly reduced in mesenteric arteries isolated from VEGF-treated rats (P<0.001 vs. control rats). Direct measurement of NO demonstrated a threefold increase in basal NO release from aortic tissue of rats injected with VEGF, at 4 and 24 h posttreatment (P<0. 01 vs. aortic tissue from control rats). Finally, systemic administration of VEGF to ecNOS-deficient mice failed to inhibit leukocyte-endothelium interactions observed in peri-intestinal venules. We concluded that VEGF is a potent inhibitor of leukocyte-endothelium interaction, and this effect is specifically correlated to augmentation of NO release from the vascular endothelium.--Scalia, R., Booth, G., Lefer, D. J. Vascular endothelial growth factor attenuates leukocyte-endothelium interaction during acute endothelial dysfunction: essential role of endothelium-derived nitric oxide.
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Affiliation(s)
- R Scalia
- Department of Physiology, Jefferson Medical College Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
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Gaine SP, Booth G, Otterbein L, Flavahan NA, Choi AM, Wiener CM. Induction of heme oxygenase-1 with hemoglobin depresses vasoreactivity in rat aorta. J Vasc Res 1999; 36:114-9. [PMID: 10213906 DOI: 10.1159/000025633] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/19/2022] Open
Abstract
Septic shock induced by lipopolysaccharide (LPS) produces systemic hypotension and decreased responsiveness to vasoconstrictors. Recently, intravenous injection of hemoglobin (HGB) into rats was found to be protective from a subsequent lethal dose of LPS and was correlated with induction of the enzyme heme oxygenase-1 (HO-1). To determine whether the HGB modulated the vasomotor tone of systemic arteries, we evaluated the effect of in vivo treatment with HGB and LPS on vasoconstrictor responses to phenylephrine (PE) in the isolated rat aorta. Rats (n = 4, for each group) were injected intravenously with rat HGB (200 mg/kg i.v.) or normal saline control (CON) 16 h before sacrifice, and/or LPS (20 mg/kg) or CON 4 h before sacrifice. The descending aorta was dissected into rings and suspended in a modified Krebs solution where vasoconstrictor responses were determined to KCl (60 mM) and PE (10(-8) to 10(-5) M). LPS, but not HGB, inhibited the vasoconstrictor response to KCl. LPS, HGB, and HGB+LPS inhibited the maximal vasoconstrictor response to PE (PEmax). Induction of HO-1 RNA in the aorta by HGB and by LPS was demonstrated by Northern blot analysis. To determine if induction of HO-1 was related to the effect of LPS or HGB on vascular reactivity, vessels were treated with the HO-1 inhibitor, SnPP9 (30 microM). PEmax in SnPP9+HGB vessels was not different from control, whereas SnPP9+LPS vessels had a marked decrease in PEmax. We conclude that induction of HO-1 does not protect the rat aorta from the vasodepressor effects of LPS in vitro. Our results demonstrate, however, that the induction of HO-1 causes vasodepression, possibly via increased production of carbon monoxide.
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Affiliation(s)
- S P Gaine
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Md., USA
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Ali SM, Booth G, Monteiro E. Test of cure following treatment of genital Chlamydia trachomatis infection in male and female patients. Genitourin Med 1997; 73:223. [PMID: 9306907 PMCID: PMC1195829 DOI: 10.1136/sti.73.3.223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Abstract
OBJECTIVES To determine whether the sisters of women with premature ovarian failure (POF) showed a response to gonadotropin stimulation comparable to that of anonymous ovum donors. DESIGN Historical cohort study. SETTING Records of 228 consecutive ovum recipients in an academic assisted reproductive technology program. PATIENT(S) Criteria for inclusion were oocyte recipients age < or = 40 years, FSH > 18 mIU/mL (conversion factor to SI unit, 1.00), and/or failure to respond appropriately to controlled ovarian hyperstimulation (COH). Seventy-nine recipients were classified on the basis of whether they received oocytes from anonymous donors (group I, n = 66) or sister donors (group II, n = 13). MAIN OUTCOME MEASURE(S) Controlled ovarian hyperstimulation response, pregnancy rates (PRs), and implantation rates. RESULT(S) The ages of the donors to groups I and II were comparable (31.1 +/- 16.7 versus 29.8 +/- 7.2 years), but those in group II exhibited a higher baseline FSH level (12.8 +/- 2.1 versus 8.6 +/- 5.8 mIU/mL). Group II versus I had a relative risk of 5.1 for cancellation (4 of 13 [30.8%] versus 4 of 66 [6.1%], respectively). In completed cycles of groups I and II, respectively, there was no difference in serum E2 on the day of hCG administration (2,356 +/- 826 versus 1,847 +/- 843 pg/mL; conversion factor to SI unit, 3,671), number of oocytes retrieved (25 +/- 14 versus 22 +/- 13), number of embryos transferred (4.4 +/- 2.1 versus 4.0 +/- 1.0), spontaneous abortion rate (22.7% versus 25.0%), PR (35.5% versus 36.4%), and implantation rate (16.2% versus 16.4%). CONCLUSION(S) There is an increased cancellation rate and, consequently, an overall trend toward decreased ovarian response to gonadotropin stimulation in the sisters of patients with POF. Despite these factors, the implantation rates and PRs of embryos derived from patients reaching retrieval were similar to those from anonymous donors. We recommend counseling women with POF that their sisters may not be ideal ovum donors.
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Affiliation(s)
- L Sung
- Department of Obstetrics and Gynecology, Mount Sinai School of Medicine, New York, New York 10029, USA
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Semenza GL, Agani F, Booth G, Forsythe J, Iyer N, Jiang BH, Leung S, Roe R, Wiener C, Yu A. Structural and functional analysis of hypoxia-inducible factor 1. Kidney Int 1997; 51:553-5. [PMID: 9027737 DOI: 10.1038/ki.1997.77] [Citation(s) in RCA: 219] [Impact Index Per Article: 8.1] [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: 02/07/2023]
Abstract
Hypoxia-inducible factor 1 (HIF-1) is a basic helix-loop-helix protein that activates transcription of hypoxia-inducible genes, including those encoding: erythropoietin, vascular endothelial growth factor, heme oxygenase-1, inducible nitric oxide synthase, and the glycolytic enzymes aldolase A, enolase 1, lactate dehydrogenase A, phosphofructokinase I, and phosphoglycerate kinase 1. Hypoxia response elements from these genes consist of a HIF-1 binding site (that contains the core sequence 5'-CGTG-3') as well as additional DNA sequences that are required for function, which in some elements include a second HIF-1 binding site. HIF-1 is a heterodimer. The HIF-1 alpha subunit is unique to HIF-1, whereas HIF-1 beta (ARNT) can dimerize with other bHLH-PAS proteins. Structural analysis of HIF-1 alpha revealed that dimerization with HIF-1 beta (ARNT) requires the HLH and PAS domains, DNA binding is mediated by the basic domain, and that HIF-1 alpha contains a carboxyl-terminal transactivation domain. Co-transfection of HIF-1 alpha and HIF-1 beta (ARNT) expression vectors and a reporter gene containing a wild-type hypoxia response element resulted in increased transcription in non-hypoxic cells and a superinduction of transcription in hypoxic cells, whereas HIF-1 expression vectors had no effect on the transcription of reporter genes containing a mutation in the HIF-1 binding site. HIF-1 alpha and HIF-1 beta (ARNT) protein levels were induced by hypoxia in all primary and transformed cell lines examined. In HeLa cells, the levels of HIF-1 alpha and HIF-1 beta protein and HIF-1 DNA-binding activity increased exponentially as cellular oxygen tension decreased, with maximum values at 0.5% oxygen and half-maximal values at 1.5 to 2% oxygen. HIF-1 alpha and HIF-1 beta (ARNT) mRNAs were detected in all human, mouse, and rat organs assayed and mRNA expression was modestly induced in rodents subjected to hypoxia. HIF-1 alpha protein levels were induced in vivo when animals were subjected to anemia or hypoxia. The HIF1A gene was mapped to human chromosome 14q21-q24 and mouse chromosome 12.
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Affiliation(s)
- G L Semenza
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
An individual-based simulation system, named Gecko, is presented for modeling multiple species at multiple trophic levels, on a spatially explicit, continuous two-dimensional landscape. Biologically motivated rules are specified at an individual level, and resulting behaviors are observed at an ecosystem level. Individuals are represented by circles with free range on a resource-producing plane. These circles grow allometrically with biomass of fixed resources. Resource acquisition behaviors include competition by area overlap for producers, and movement based on perception and intent. Individual-level energetics are explicitly modeled with inefficient assimilation, resource transformation, and allometrically specified metabolic costs. Individual growth and reproduction requires a history of successful resource acquisition. Terrestrial producer, herbivore, and carnivore species classes are included, extensible to further classes. A grassland food chain model of "plants," "grasshoppers," and "spiders" is used to demonstrate ecosystem-level results of given individual-level behaviors. Ecosystem-level behaviors include a trophic cascade of indirect carnivore-producer interaction effects; stable persistence of all populations; a near-realistic biomass pyramid; and spatial competition and coexistence of multiple producer species. Initial Gecko results show promise for application in both theoretical and natural ecosystem modeling.
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Affiliation(s)
- G Booth
- Center for Computational Ecology, Yale Institute for Biospheric Studies, New Haven, CT 06520-8104, USA.
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Abstract
Hypoxia-inducible factor 1 (HIF-1) is a heterodimeric basic helix-loop-helix transcription factor that regulates genes whose products play key roles in maintaining O2 homeostasis. We have previously demonstrated that HIF-1 mRNA, protein, and DNA-binding activity are induced when mammalian tissue culture cells are subjected to hypoxia. In this paper, we report our analysis of HIF-1 mRNA expression in vivo. We demonstrate expression of HIF-1 alpha and HIF-1 beta (ARNT) mRNA in all human, rat, and mouse organs assayed and show for the first time that HIF-1 mRNA expression was induced in brain, kidney, and lung when rats or mice were exposed to reduced ambient O2 concentrations for 30 to 60 min. The ubiquitous in vivo expression of HIF-1 alpha and HIF-1 beta (ARNT) mRNA is consistent with the proposed role of HIF-1 in coordinating adaptive transcriptional responses to hypoxia.
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Affiliation(s)
- C M Wiener
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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Neumeyer JL, Baindur N, Yuan J, Booth G, Seeman P, Niznik HB. Development of a high affinity and stereoselective photoaffinity label for the D-1 dopamine receptor: synthesis and resolution of 7-[125I]iodo-8-hydroxy-3-methyl-1-(4'-azidophenyl)-2,3,4,5-tetrahydro- 1H-3-benzazepine. J Med Chem 1990; 33:521-6. [PMID: 2405157 DOI: 10.1021/jm00164a009] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In an earlier paper, we reported the development of (+-)-7-iodo-8-hydroxy-3-methyl-1-(4'-azidophenyl)-2,3,4,5-tetrahydro- 1H-3-benzazepine (I-MAB) and its 125I analogue ([125I]I-MAB) as selective, high affinity photoaffinity labels for the D-1 dopamine receptor. In this report, we now describe the complete synthesis and resolution of I-MAB and the pharmacological characterization of the stereoisomers in canine striatal membranes. R-(+)-I-MAB showed highly specific dopamine D-1 receptor binding (KD = 0.28 nM) and binds selectively and stereoselectively to the D-1 receptor. These results further confirm the previous suggestion that, in the benzazepine series of DA agonists and antagonists, the activity principally resides in the R-(+) enantiomer, the S-(-) enantiomer being considerably less potent or inactive. Moreover, R-(+)-[125I]I-MAB, upon photolysis, identifies the ligand-binding subunits of the neuronal D-1 receptor, with an apparent Mr of 74,000, 62,000, and 51,000 as assessed by autoradiography following sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Photoincorporation of R-(+)-[125I]I-MAB into these polypeptides was stereoselectively blocked by D-1 dopaminergic ligands with an appropriate pharmacologic profile for the receptor. R-(+)-[125I]I-MAB should thus prove to be a useful stereoselective photoaffinity label for the further characterization of the D-1 receptors.
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Affiliation(s)
- J L Neumeyer
- Research Biochemicals Inc., Natick, Massachusetts 01760
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Jarvie KR, Booth G, Brown EM, Niznik HB. Glycoprotein nature of dopamine D1 receptors in the brain and parathyroid gland. Mol Pharmacol 1989; 36:566-74. [PMID: 2682204] [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: 01/02/2023] Open
Abstract
Dopamine D1 receptors can be covalently labeled with the photo-affinity ligand (+-)-7-[125I]iodo-8-hydroxy-3-methyl-1-(4-azidophenyl)-2,3,4,5-tetrah yd ro-1H-3-benzazepine ([125I]IMAB) and visualized following sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. In brain membranes, [125I]IMAB labels a polypeptide of apparent Mr approximately equal to 74,000 as the major ligand binding subunit of D1 receptors and two minor polypeptides of Mr approximately equal to 64,000 and 52,000. In contrast, [125I]IMAB labels a single polypeptide of apparent Mr approximately equal to 64,000 in bovine parathyroid glands. In this study, the carbohydrate nature of dopamine D1 receptors from the brain and parathyroid gland were examined using specific exo- and endoglycosidases and lectin affinity chromatography. [125I]IMAB-labeled brain and parathyroid D1 receptors were sensitive to treatment with the exoglycosidases neuraminidase or alpha-mannosidase, suggestive of the existence of terminal sialic acid and oligomannose residues. Photolabeled D1 receptor polypeptides are not however, associated with distinct populations of complex-type or high mannose-containing carbohydrate chains because 1) wheat germ agglutinin and concanavalin A lectin chromatography of solubilized and photolabeled neuronal D1 receptors followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography revealed no differences in the electrophoretic mobility of column pass-through and specifically eluted [125I]IMAB-labeled polypeptides, and 2) [125I]IMAB-labeled D1 receptors specifically bound to and eluted from concanavalin A-Sepharose were neuraminidase sensitive, indicative of the colocalization of oligomannose- and complex-type glycans. Removal of these terminal glycan residues did not affect the binding of [3H]SCH 23390 to dopamine D1 receptors. Complete N-linked deglycosylation of photolabeled D1 receptors from both the brain and parathyroid with peptide N-glycosidase F resulted in the migration of a single major labeled polypeptide of apparent Mr approximately equal to 46,000. These data suggest that, despite differences observed in the electrophoretic mobility and glycosylation patterns of brain and parathyroid D1 receptor polypeptides, the protein backbones of central and peripheral dopamine D1 receptors display similar if not identical molecular weights.
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Affiliation(s)
- K R Jarvie
- Department of Pharmacology, University of Toronto, Ontario, Canada
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