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Osman NA, Soltan MK, Rezq S, Flaherty J, Romero DG, Abdelkhalek AS. Dual COX-2 and 15-LOX inhibition study of novel 4-arylidine-2-mercapto-1-phenyl-1H-imidazolidin-5(4H)-ones: Design, synthesis, docking, and anti-inflammatory activity. Arch Pharm (Weinheim) 2024:e2300615. [PMID: 38315093 DOI: 10.1002/ardp.202300615] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024]
Abstract
Novel arylidene-5(4H)-imidazolone derivatives 4a-r were designed and evaluated as multidrug-directed ligands, that is, inflammatory, proinflammatory mediators, and reactive oxygen species (ROS) inhibitors. All of the tested compounds showed cyclooxygenase (COX)-1 inhibitory effect more than celecoxib and less than indomethacin and also demonstrated an improved inhibitory activity against 15-lipoxygenase (15-LOX). Compounds 4f, 4l, and 4p exhibited COX-2 selectivity comparable to that of celecoxib, while 4k was the most selective COX-2 inhibitor. Interestingly, the screened results showed that compound 4k exhibited a superior inhibition effect against 15-LOX and was found to be the most selective COX-2 inhibitor over celecoxib, whereas compound 4f showed promising COX-2 and 15-LOX inhibitory activities besides its inhibitory effect against ROS production and its lowering effect of both tumor necrosis factor-α and interleukin-6 levels by ∼80%. Moreover, compound 4f attenuated the lipopolysaccharide-mediated increase in NF-κB activation in RAW 264.7 macrophages. The preferred binding affinity of these molecules was confirmed by docking studies. We conclude that arylidene-5(4H)-imidazolone scaffolds provide promising hits for developing new synthons with anti-inflammatory and antioxidant activities.
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Affiliation(s)
- Nermine A Osman
- Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Mostafa K Soltan
- Department of Medicinal Chemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
- Oman College of Health Sciences, Muscat, Oman
| | - Samar Rezq
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Joseph Flaherty
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Damian G Romero
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
- Cardiovascular-Renal Research Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ahmed S Abdelkhalek
- Department of Medicinal Chemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
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Flaherty J, Fakhoury A. Editorial. J Appl Microbiol 2021; 130:528. [PMID: 33528907 DOI: 10.1111/jam.15004] [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: 11/29/2022]
Affiliation(s)
- J Flaherty
- Coker University (Science and Mathematics), Hartsville, SC, USA
| | - A Fakhoury
- South Illinois University (Plant, Soil and Ag Systems), Carbondale, IL, USA
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McHaney-Lindstrom M, Hebert C, Flaherty J, Mangino JE, Moffatt-Bruce S, Dowling Root E. Analysis of intra-hospital transfers and hospital-onset Clostridium difficile infection. J Hosp Infect 2018; 102:168-169. [PMID: 30172746 DOI: 10.1016/j.jhin.2018.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/24/2018] [Indexed: 01/21/2023]
Affiliation(s)
| | - C Hebert
- Department of Biomedical Informatics, Ohio State University, Columbus, OH, USA
| | - J Flaherty
- Department of Clinical Epidemiology, Ohio State University, Columbus, OH, USA
| | - J E Mangino
- Department of Clinical Epidemiology, Ohio State University, Columbus, OH, USA
| | - S Moffatt-Bruce
- Department of Biomedical Informatics, Ohio State University, Columbus, OH, USA
| | - E Dowling Root
- Department of Geography, Ohio State University, Columbus, OH, USA
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Wong F, Khan M, Agarwal K, Furusyo N, Hwang J, Flaherty J, Kim K. A180 IMPROVED RENAL LABORATORY PARAMETERS IN CHB PATIENTS TREATED WITH TAF COMPARED WITH TDF. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.181] [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: 11/14/2022] Open
Affiliation(s)
- F Wong
- Medicine, 9N/983 Toronto General Hospital, Toronto, ON, Canada
| | - M Khan
- Gilead Sciences Canada, Inc, Mississauga, ON, Canada
| | - K Agarwal
- Kings College Hospital NHS Trust, London, United Kingdom
| | - N Furusyo
- Kyushu Medical Center, Fukuoka, Japan
| | - J Hwang
- Keimyung University Dongsan Medical Center, Daegu, Korea (the Republic of)
| | | | - K Kim
- Gilead Sciences, Inc., Foster City, CA
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Fung S, Khan M, Yatsuhashi H, Tak W, Celen M, Flaherty J, Kim K, Myers RP. A179 FEATURES OF THE METABOLIC SYNDROME ARE ASSOCIATED WITH LACK OF SERUM ALT NORMALIZATION DURING THERAPY FOR CHRONIC HEPATITIS B. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/13/2022] Open
Affiliation(s)
- S Fung
- Toronto General Hospital, Toronto, ON, Canada
| | - M Khan
- Gilead Sciences Canada, Inc, Mississauga, ON, Canada
| | - H Yatsuhashi
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - W Tak
- Kyungpook National University Hospital, Daegu, Japan
| | - M Celen
- Dicle University, Diyarbakir, Turkey
| | | | - K Kim
- Gilead Sciences, Inc, Foster City, CA
| | - R P Myers
- Gilead Sciences, Inc, Foster City, CA
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Young P, Rubin J, Angarone M, Flaherty J, Penugonda S, Stosor V, Ison M. Ganciclovir-resistant cytomegalovirus infection in solid organ transplant recipients: a single-center retrospective cohort study. Transpl Infect Dis 2016; 18:390-5. [DOI: 10.1111/tid.12537] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/23/2016] [Accepted: 02/13/2016] [Indexed: 12/20/2022]
Affiliation(s)
- P.G. Young
- The Christ Hospital Infectious Diseases Physicians; Cincinnati Ohio USA
| | - J. Rubin
- University of Illinois at Chicago School of Medicine; Chicago Illinois USA
| | - M. Angarone
- Division of Infectious Diseases Northwestern University Feinberg School of Medicine; Chicago Illinois USA
| | - J. Flaherty
- Division of Infectious Diseases Northwestern University Feinberg School of Medicine; Chicago Illinois USA
| | - S. Penugonda
- Division of Infectious Diseases Northwestern University Feinberg School of Medicine; Chicago Illinois USA
| | - V. Stosor
- Division of Infectious Diseases Northwestern University Feinberg School of Medicine; Chicago Illinois USA
- Division of Organ Transplantation; Northwestern University Feinberg School of Medicine; Chicago Illinois USA
| | - M.G. Ison
- Division of Infectious Diseases Northwestern University Feinberg School of Medicine; Chicago Illinois USA
- Division of Organ Transplantation; Northwestern University Feinberg School of Medicine; Chicago Illinois USA
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Campo R, DeJesus E, Bredeek UF, Henry K, Khanlou H, Logue K, Brinson C, Benson P, Dau L, Wang H, White K, Flaherty J, Fralich T, Guyer B, Piontkowsky D. SWIFT: prospective 48-week study to evaluate efficacy and safety of switching to emtricitabine/tenofovir from lamivudine/abacavir in virologically suppressed HIV-1 infected patients on a boosted protease inhibitor containing antiretroviral regimen. Clin Infect Dis 2013; 56:1637-45. [PMID: 23362296 PMCID: PMC3641864 DOI: 10.1093/cid/cis1203] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 12/07/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In the United States, emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a preferred nucleoside reverse transcriptase inhibitor (NRTI) backbone with lamivudine/abacavir (3TC/ABC) as a commonly used alternative. For patients infected with human immunodeficiency virus (HIV-1) virologically suppressed on a boosted protease inhibitor (PI) + 3TC/ABC regimen, the merits of switching to FTC/TDF as the NRTI backbone are unknown. METHODS SWIFT was a prospective, randomized, open-label 48-week study to evaluate efficacy and safety of switching to FTC/TDF. Subjects receiving 3TC/ABC + PI + ritonavir (RTV) with HIV-1 RNA < 200 c/mL ≥3 months were randomized to continue 3TC/ABC or switch to FTC/TDF. The primary endpoint was time to loss of virologic response (TLOVR) with noninferiority measured by delta of 12%. Virologic failure (VF) was defined as confirmed rebound or the last HIV-1 RNA measurement on study drug ≥200 c/mL. RESULTS In total, 311 subjects were treated in this study (155 to PI + RTV + FTC/TDF, 156 to PI + RTV + 3TC/ABC). Baseline characteristics were similar between the arms: 85% male, 28% black, median age, 46 years; and median CD4 532 cells/mm(3). By TLOVR through week 48, switching to FTC/TDF was noninferior compared to continued 3TC/ABC (86.4% vs 83.3%, treatment difference 3.0% (95% confidence interval, -5.1% to 11.2%). Fewer subjects on FTC/TDF experienced VF (3 vs 11; P = .034). FTC/TDF showed greater declines in fasting low-density lipoproteins (LDL), total cholesterol (TC), and triglycerides (TG) with significant declines in LDL and TC beginning at week 12 with no TC/HDL ratio change. Switching to FTC/TDF showed improved NCEP thresholds for TC and TG and improved 10-year Framingham TC calculated scores. Decreased estimated glomerular filtration rate [corrected] (eGFR) was observed in both arms with a larger decrease in the FTC/TDF arm. CONCLUSIONS Switching to FTC/TDF from 3TC/ABC maintained virologic suppression, had fewer VFs, improved lipid parameters and Framingham scores but decreased eGFR. CLINICALTRIALS.GOV IDENTIFIER: NCT00724711.
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Affiliation(s)
- R Campo
- Department of Infectious Diseases, University of Miami School of Medicine, Miami, FL 33136, USA.
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Chandrasekhar J, Taverner P, Smith F, Simpson K, Squires M, Flaherty J, Montgomery J, Robbie Y, Armstrong R, Butcher K. Early Radial Decompression Protocol Post Transradial Procedures Is Feasible in a Busy Coronary Care Unit. Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.575] [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: 10/26/2022]
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Wu H, Flaherty J, Dong B, Liu G, Deng J, Zhang Y, Wu J, Zeng G, Ren X, Hu J, Wu W, Malmstrom TK. Impact of Geriatric Conditions Versus Medical Diagnoses on ADL Disability Among Nonagenarians and Centenarians. J Aging Health 2012; 24:1298-319. [PMID: 23006424 DOI: 10.1177/0898264312457411] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: The authors investigated the relationship of activities of daily living (ADL) disability with medical diseases and geriatric conditions among nonagenarians and centenarians. Method: Cross-sectional, n = 870 Chinese (age range: 90-108 years). Self-reported medical diseases and geriatric-specific conditions were obtained by face-to-face interviews. Biomedical measurements included systolic/diastolic blood pressure, BMI (body mass index), albumin, fasting glucose, creatinine clearance, hemoglobin, and lipid panel. Results: In bivariate analyses, 4 of 7 geriatric conditions (hearing problems, falls, cognitive impairment, fracture), and 6 of 11 biomedical measurements (fasting glucose, cholesterol, LDL, creatinine clearance, hemoglobin, albumin), but none of 10 medical diseases and no degree of comorbidities, were associated with ADL disability. In four different multivariate logistic regression models, two geriatric conditions (impaired cognition, fracture) were significant in three models, respiratory disease in one model, and fasting glucose in two models. Discussion: This study emphasizes the importance of geriatric conditions and their association with ADL disability among the oldest-old adult population.
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Affiliation(s)
- Hongmei Wu
- West China Hospital, Sichuan University, Chengdu, China
| | | | - Birong Dong
- West China Hospital, Sichuan University, Chengdu, China
| | - Guanjian Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - Juelin Deng
- West China Hospital, Sichuan University, Chengdu, China
| | - Yanling Zhang
- West China Hospital, Sichuan University, Chengdu, China
| | - Jinhui Wu
- West China Hospital, Sichuan University, Chengdu, China
| | - Guo Zeng
- Sichuan University, Chengdu, China
| | | | - Junmei Hu
- School of Basic Science & Forensic Medicine, Sichuan University, Chengdu, China
| | - Weili Wu
- West China Hospital, Sichuan University, Chengdu, China
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10
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Afdhal N, Buti M, Fung S, Gane E, Flaherty J, Martins E, Bekele N, Bornstein J, Marcellin P. 497 FACTORS ASSOCIATED WITH REGRESSION OF CIRRHOSIS IN PATIENTS WITH CHORNIC HEPATITIS B (CHB) INFECTION TREATED WITH TENOFOVIR DISOPROXIL FUMARATE (TDF). J Hepatol 2012. [DOI: 10.1016/s0168-8278(12)60510-8] [Citation(s) in RCA: 2] [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: 03/28/2023]
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Abstract
BACKGROUND Studies have indicated that sharing of self-monitoring of blood glucose (SMBG) data and subsequent feedback from the health care provider (HCP) can help achieve glycemic goals such as a reduction in glycated hemoglobin. Electronic SMBG data management and sharing tools for the PC and smartphones may help in reducing the effort to manage SMBG data. METHODS We reviewed software and top-ranking applications (Apps) for the iPhone platform to document the variety of useful features. Additionally, in an attempt to assess metrics such as task analysis and user friendliness of diabetes Apps, we observed and surveyed patients with diabetes as they recorded and relayed sample SMBG results to their hypothetical HCP using three Apps. RESULTS Observation and survey demonstrated that the WaveSense Diabetes Manager allowed the participants to complete preselected SMBG data entry and relay tasks faster than other Apps. The survey revealed patient behavior patterns that would be useful in future App development. CONCLUSION Being able to record, analyze, seamlessly share, and obtain feedback on the SMBG data using an iPhone/iTouch App might potentially benefit patients. Trends in SMBG data management and the possibility of having interoperability of blood glucose monitors and smartphones may open up new avenues of diabetes management for the technologically savvy patient.
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Affiliation(s)
- Anoop Rao
- AgaMatrix Inc., Salem, New Hampshire 03079, USA.
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12
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Boockvar K, Shay K, Edes T, Stein J, Kamholz B, Flaherty J, Morley J, Shaughnessy M, Bronson B, Shapiro R. The mental status vital sign. J Am Geriatr Soc 2009; 56:2358-9. [PMID: 19093943 DOI: 10.1111/j.1532-5415.2008.02029.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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LeRouge C, Ma J, De Leo G, Flaherty J. Patient-centered design: conceptually modeling the health care consumer. AMIA Annu Symp Proc 2008:1035. [PMID: 18998875] [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] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Accepted: 06/17/2008] [Indexed: 05/27/2023]
Abstract
Traditional information systems (IS) development adopts a systematic approach without necessarily using a specific user model that personalizes the system to one or more user groups. This field study demonstrates the value and application of two user-centered design tools user -- profiles and personas -- as a part of the methodology to develop a smart phone application to assist elderly diabetes patients in self-management of their chronic condition.
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Lukban J, Erickson T, Virelles M, Flaherty J, Beyer R, Moore R, Hodroff M. A Prospective Multi-Center Clinical Trial Evaluating the Apogee System for the Treatment of Posterior Vaginal Wall and Apical Prolapse: A Sub-Analysis of Apical Extrusions with or without Concomitant Hysterectomy. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.138] [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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15
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Brown KM, Flaherty J, Ciocca V, Ehya H, Scott W, Goldberg M. Touch prep (TP) cytology as a tool for determining pulmonary parenchymal resection margin status. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18095] [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
18095 Background: Accurate determination of parenchymal resection margins is critical in excision of primary and metastatic lung cancers. Complete microscopic examination of the entire margin is difficult and may not give timely results. Staple-line excision may compromise the accuracy of histologic margin exam (HME). TP offers a novel method to obtain pulmonary parenchymal margin status intraoperatively. Methods: Patients undergoing wedge resection for a known malignant lung lesion were studied prospectively. At the time of resection, the specimen stapled margin underwent TP on 3 glass slides for cytological analysis. The presence or absence of malignant cells on TP was correlated to final HME. Local recurrence and overall survival by TP and HME status were compared using logrank test. Results: Thirty specimens from 29 patients were studied between December 2002 and April 2006. Fifteen specimens (50%) were right- sided; 9/29 patients (31%) were male. Median age was 66 years (range 28 - 81). Histologies included non-small cell lung cancer (NSCLC) in 22 (73%), and metastases from colorectal cancer (4/30, 13%), sarcoma (2/20, 7%), and breast (1/30, 3%). All TP negative specimens had negative HME. TP was positive in 10 of 30 (33%) specimens, 6 of which had negative HME. These included 4 NSCLC and metastases from sarcoma (1) and colon (1). Mean margin distance was 4 ± 1.7 mm for TP/HME negative specimens, 0.5 ± 0 mm for TP/HME positive specimens, and 5 ± 1.7 mm for TP positive/HME negative patients. There was no difference in time to local recurrence between patients with positive margins by TP vs HME (18.6 and 18.63 months), or in TP and HME negative patients (30.1 and 30.6 months). Conclusion: TP analysis of lung parenchymal margins is safe and feasible. A negative TP is highly predictive of negative HME. Factors contributing to false-positive TP remain unresolved. Multi-institutional prospective studies are indicated for further characterization of this promising tool. No significant financial relationships to disclose.
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Affiliation(s)
| | | | - V. Ciocca
- Fox Chase Cancer Center, Philadelphia, PA
| | - H. Ehya
- Fox Chase Cancer Center, Philadelphia, PA
| | - W. Scott
- Fox Chase Cancer Center, Philadelphia, PA
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Abstract
In response to the Surgeon General's request for more research on racial disparities in mental health care, especially research that includes high-need populations (e.g., the homeless, incarcerated, children in foster care, and substance abusers), we examined racial disparities in the provision of mental health counseling, psychotherapy, and pharmacotherapy in hospital outpatient settings using nationally representative data from the 1997 National Hospital Ambulatory Medical Care Survey (NHAMCS). After controlling for diagnosis and other factors, we found that African Americans were less likely than whites to receive mental health counseling and psychotherapy, but more likely than whites to receive pharmacotherapy. We also found that substance abuse clinics were more likely than primary care and specialty mental health clinics to provide mental health counseling and psychotherapy. However, specialty mental health clinics were the only clinics to provide pharmacotherapy. Future research should examine racial disparities in a variety of settings, controlling for diagnosis as well as other factors.
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Affiliation(s)
- Jerome Richardson
- Department of Psychiatry, University of Illinois at Chicago, 60612, USA.
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Abstract
OBJECTIVES To develop and validate an instrument to assess medical students' attitudes toward home care. DESIGN Survey administration before and following participation in a home care training program. SETTING Five medical schools in the United States. PARTICIPANTS 326 third and fourth year medical students. MEASUREMENTS Factor analysis was performed on all posttests. Domains were tested for internal reliability (Chronbach's alpha). Interdomain correlation was tested. One-way analysis of variance (ANOVA) was used to determine whether the results for each domain differed among the five programs. RESULTS Using exploratory factor analysis, the original 20-item survey was revised to yield a 14-item survey consisting of four domains (general attitudes, home-based therapies, home care training, and time and reimbursement). Domain intra-item reliability ranged from 0.60 to 0.82. Interdomain correlations were found to be significant with the exception of one comparison (time and reimbursement and home care training). One-way ANOVA showed significant differences between the training programs for two of the four domains (home-based therapies and home care training). For a third domain, time and reimbursement, there was a trend toward differences across the schools (P = 0.06). CONCLUSION The instrument described in this paper is a reliable and valid instrument for assessing the impact of home care training on medical student attitudes across a series of important domains.
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Affiliation(s)
- J Boal
- Department of Medicine, The Mount Sinai School of Medicine, New York, New York 10029, USA
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Linden PK, Moellering RC, Wood CA, Rehm SJ, Flaherty J, Bompart F, Talbot GH. Treatment of vancomycin-resistant Enterococcus faecium infections with quinupristin/dalfopristin. Clin Infect Dis 2001; 33:1816-23. [PMID: 11668430 DOI: 10.1086/323899] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2001] [Revised: 06/08/2001] [Indexed: 11/03/2022] Open
Abstract
Clinicians caring for patients with vancomycin-resistant Enterococcus faecium (VREF) infections face severe constraints in the selection of treatment. Quinupristin/dalfopristin (Synercid) is active in vitro against VREF, with a MIC(90) of 1.0 microg/mL. We investigated the clinical efficacy and safety of this agent in a multicenter, prospective, noncomparative, emergency-use study of 396 patients. Patients were included if they had signs and symptoms of active infection, including bacteremia of unknown origin, intra-abdominal infection, and skin and skin-structure infection, with no alternative antibiotic therapy available. The mean duration of treatment was 20 days (range, 4-40 days). The clinical response rate was 68.8% in the evaluable subset, and the overall response rate was 65.6%. The most common adverse events related to quinupristin/dalfopristin were arthralgias and myalgias. Related laboratory abnormalities were rare. In this severely ill patient population, quinupristin/dalfopristin was efficacious and demonstrated an acceptable safety profile in the treatment of VREF infection.
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Affiliation(s)
- P K Linden
- University of Pittsburgh Medical Center, Division of Critical Care Medicine, Pittsburgh, PA 15213, USA.
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Abstract
Two studies were conducted in HIV-infected subjects to assess the potential for azithromycin to interact with zidovudine and dideoxyinosine. Both studies used 12 subjects. The zidovudine study dosed subjects with 1200 mg/day of azithromycin (n = 7) (later changed to 600 mg/day [n = 5]) for Days 8 to 21 of a 21-day course of 100 mg, five times/day of zidovudine. Subjects treated with 200 mg of dideoxyinosine twice daily for 21 days received 1200 mg of azithromycin or an equivalent amount of placebo/day for Days 8 to 21. Antiretroviral plasma and urine sampling were conducted on Days 1, 7, and 21 for zidovudine and on Days 7 and 21 for dideoxyinosine. Peripheral mononuclear cells were also collected for quantitation of phosphorylated zidovudine. Azithromycin had no significant impact on the Cmax and AUC of zidovudine, although it significantly decreased the zidovudine tmax by 44% and increased the intracellular exposure to phosphorylated zidovudine by 110%. Azithromycin had no significant effect on dideoxyinosine pharmacokinetics. Based on the results of these studies, it is concluded that azithromycin may be safely coadministered with both zidovudine and dideoxyinosine.
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Affiliation(s)
- G Amsden
- Clinical Pharmacology Research Center, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326, USA
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Abstract
CONCLUSIONS Polyarteritis nodosa (PAN) must be considered as one of the rare causes of "idiopathic" acute necrotizing pancreatitis. BACKGROUND PAN is characterized by panmural inflammation of arterioles causing arteriolar ectasia, aneurysm formation, and thrombosis, resulting in organ ischemia. METHODS We report a case of necrotizing pancreatitis associated with segmental necrosis of the liver and spleen due to polyarteritis nodosa. RESULTS Five previously reported cases of documented acute pancreatitis secondary to PAN have been identified from the English literature. The mechanism through which pancreatic ischemia results in acute pancreatitis is unknown. Although limited pancreatic infarction is common in PAN, necrotizing pancreatitis is rare, and the poor overall prognosis of PAN is owing largely to other organ complications.
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Affiliation(s)
- J Flaherty
- Department of Surgery, State University of New York at Buffalo, USA
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Perry HM, Bernard M, Horowitz M, Miller DK, Fleming S, Baker MZ, Flaherty J, Purushothaman R, Hajjar R, Kaiser FE, Patrick P, Morley JE. The effect of aging on bone mineral metabolism and bone mass in Native American women. J Am Geriatr Soc 1998; 46:1418-22. [PMID: 9809765 DOI: 10.1111/j.1532-5415.1998.tb06010.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [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: 02/05/2023]
Abstract
OBJECTIVE To examine the effect of age on mineral metabolism and bone mineral density (BMD) of the hip and spine in Native American women. DESIGN A cross-sectional study. SETTING The Sac and Fox Nation in rural Oklahoma MEASUREMENTS Serum measurements were made of 25 hydroxyvitamin D (25OHD), osteocalcin, and immunoreactive parathyroid hormone. Bone mineral density of the hip and spine was assessed by dual energy X-ray absorptiometry. PARTICIPANTS A total of 77 Native American women aged 19 to 85 years. RESULTS Serum 25 hydroxyvitamin D was related inversely to age (r = -0.32; P < .05) and was less than 15 ng/mL in 7% of the subjects. Serum osteocalcin was higher (P < .001) in postmenopausal than in premenopausal subjects. In postmenopausal subjects, serum osteocalcin was related to age (r = .59, P < .001). BMD was lower (P < .001) in postmenopausal than in premenopausal subjects. There was no evidence of bone loss before age 50 in either the femur or the spine. Age (r > or = -0.48, P < .001) and body mass index (BMI) (r > or = 0.41, P < .005) were independent determinants of both femoral and lumbar BMD. Serum 25OHD was a significant independent determinant of both lumbar (r = .26, P < .05) and femoral (r = .41, P < .01) BMD. Age, BMI, and serum 25OHD together accounted for 70% of the variance in BMD at these sites. The use of t scores indicated femoral bone density was higher (P < .05) in premenopausal Native American women, and lower (P < 0.05) in postmenopausal subjects, compared with white women. CONCLUSIONS In Native American women, there is a reduction in bone density and a sustained increase in bone turnover postmenopausally. BMI and serum 25OHD are significant determinants of BMD. Peak BMD may be higher, and the postmenopausal rate of bone loss greater, than that in white women.
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Affiliation(s)
- H M Perry
- GRECC, St. Louis VA Medical Center, Jefferson Barracks, St. Louis University Medical School, Missouri, USA
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Abstract
Congenital coronary arteriovenous fistula is an unusual, but not rare, coronary anomaly. Management of asymptomatic fistulas is controversial because of great variability in natural history. We describe an 82-year-old female patient with spontaneous rupture of a previously undetected left main coronary artery-to-pulmonary artery coronary arteriovenous fistula, with resulting hemopericardium and cardiac tamponade. Emergent surgical exploration and repair provided successful treatment.
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Affiliation(s)
- H H Bauer
- Division of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, USA
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Cundy KC, Petty BG, Flaherty J, Fisher PE, Polis MA, Wachsman M, Lietman PS, Lalezari JP, Hitchcock MJ, Jaffe HS. Clinical pharmacokinetics of cidofovir in human immunodeficiency virus-infected patients. Antimicrob Agents Chemother 1995; 39:1247-52. [PMID: 7574510 PMCID: PMC162721 DOI: 10.1128/aac.39.6.1247] [Citation(s) in RCA: 130] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The pharmacokinetics of cidofovir (HPMPC; (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine) were examined at five dose levels in three phase I/II studies in a total of 42 human immunodeficiency virus-infected patients (with or without asymptomatic cytomegalovirus infection). Levels of cidofovir in serum following intravenous infusion were dose proportional over the dose range of 1.0 to 10.0 mg/kg of body weight and declined biexponentially with an overall mean +/- standard deviation terminal half-life of 2.6 +/- 1.2 h (n = 25). Approximately 90% of the intravenous dose was recovered unchanged in the urine in 24 h. The overall mean +/- standard deviation total clearance of the drug from serum (148 +/- 25 ml/h/kg; n = 25) approximated renal clearance (129 +/- 42 ml/h/kg; n = 25), which was significantly higher (P < 0.001) than the baseline creatinine clearance in the same patients (83 +/- 21 ml/h/kg; n = 12). These data indicate that active tubular secretion played a significant role in the clearance of cidofovir. The steady-state volume of distribution of cidofovir was approximately 500 ml/kg, suggesting that the drug was distributed in total body water. Repeated dosing with cidofovir at 3.0 and 10.0 mg/kg/week did not alter the pharmacokinetics of the drug. Concomitant administration of intravenous cidofovir and oral probenecid to hydrated patients had no significant effect on the pharmacokinetics of cidofovir at a 3.0-mg/kg dose. At higher cidofovir doses, probenecid appeared to block tubular secretion of cidofovir and reduce its renal clearance to a level approaching glomerular filtration.
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Affiliation(s)
- K C Cundy
- Gilead Sciences, Inc., Foster City, California 94404, USA
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25
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Lalezari JP, Drew WL, Glutzer E, James C, Miner D, Flaherty J, Fisher PE, Cundy K, Hannigan J, Martin JC. (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine (cidofovir): results of a phase I/II study of a novel antiviral nucleotide analogue. J Infect Dis 1995; 171:788-96. [PMID: 7706804 DOI: 10.1093/infdis/171.4.788] [Citation(s) in RCA: 148] [Impact Index Per Article: 5.1] [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: 01/26/2023] Open
Abstract
Cidofovir, (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine, is a novel antiviral nucleotide analogue with potent in vitro and in vivo activity against cytomegalovirus (CMV) and other herpesviruses. Thirty-one human immunodeficiency virus-seropositive patients with asymptomatic CMV excretion were evaluated in a phase I/II study with 2 regimens of cidofovir: cidofovir alone at doses of 0.5, 1.0, 3.0, or 10.0 mg/kg/week (20 patients) and cidofovir at 3.0, 5.0, or 7.5 mg/kg with concomitant oral probenecid, saline prehydration, extended dosing intervals, and drug interruption for proteinuria (19 patients). Prolonged and dose-dependent anti-CMV effect was observed with all cidofovir regimens > or = 3.0 mg/kg. The dose-limiting toxicity of cidofovir was dose- and schedule-dependent nephrotoxicity. Four of 20 patients had serum creatinine levels > or = 2.0 mg/dL after a mean cumulative exposure of 14.8 mg/kg cidofovir alone; however, none of 19 patients receiving the modified regimen had elevated creatinine (mean cidofovir exposure, 32.2 mg/kg). The clinical efficacy of cidofovir and its potential for cumulative nephrotoxicity needs further study in patients with end-organ CMV disease.
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Affiliation(s)
- J P Lalezari
- Department of Medicine, Mount Zion Medical Center, University of California, San Francisco 94115
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26
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Owley T, Flaherty J. New-onset narcolepsy and paroxetine. Psychosomatics 1994; 35:585. [PMID: 7809362 DOI: 10.1016/s0033-3182(94)71731-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Abstract
Homeless individuals have limited social support systems. Not clearly defined, however, is the relationship between homelessness, gender, and social agencies. In our study 102 homeless individuals were interviewed in shelters. This included administration of the SADS and the subject's rating their perceived level of support from friends, family and social agencies. Significant findings in the analysis showed a higher level of perceived support by males than by females (p < 0.05). More precisely, this was true in the area of support from social agencies, where females rated support from these organizations as significantly lower than did males (p < 0.05). The findings were unchanged when age, presence of psychiatric illness or length of time homeless were factored in. Important implications for public policy are clear since existing social service agencies working with the homeless are less likely to be perceived as supportive by females than by males.
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Affiliation(s)
- J Stovall
- Department of Psychiatry, Westside Veterans Administration Medical Center, Chicago, IL 60612
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Flaherty J. Drug-induced renal insufficiency. Hosp Pract (Off Ed) 1993; 28:14. [PMID: 8305076 DOI: 10.1080/21548331.1993.11442882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Pons VG, Denlinger SL, Guglielmo BJ, Octavio J, Flaherty J, Derish PA, Wilson CB. Ceftizoxime versus vancomycin and gentamicin in neurosurgical prophylaxis: a randomized, prospective, blinded clinical study. Neurosurgery 1993; 33:416-22; discussion 422-3. [PMID: 8413872 DOI: 10.1227/00006123-199309000-00010] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [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: 01/30/2023] Open
Abstract
In a prospective, randomized, blinded study, 826 patients undergoing clean neurosurgical procedures received single intravenous doses of ceftizoxime (2 g) (n = 422) or a combination of vancomycin (1 g) and gentamicin (80 mg) (n = 404) 1 hour before an incision was made. Patients with infected or contaminated wounds and those receiving shunts or other implants were excluded. Primary wound infections occurred within 30 days in five patients in each group and were most common after spinal surgery and procedures through previous incisions. Secondary infections (pneumonias, urinary tract infections, and intravenous line-related bacteremia) occurred in 24 patients in the ceftizoxime group and 25 in the vancomycin/gentamicin group. The infection rates after transsphenoidal procedures (n = 129) were remarkably low in both groups. Ceftizoxime caused no adverse drug reactions, but six patients in the vancomycin/gentamicin group had clinically significant infusion-related hypotension or flushing. Placement of a temporary external drain, use of an operating microscope, preoperative steroids, and diabetes were not associated with increased infection rates. Analysis of routinely encountered ventricular cerebrospinal fluid and simultaneously obtained peripheral blood showed low but detectable levels of all three antibiotics within 2 hours; only ceftizoxime, however, achieved cerebrospinal fluid levels sufficient to inhibit the staphylococcus and Gram-negative bacilli most often associated with postneurosurgical infections. We conclude that ceftizoxime is as effective as vancomycin and gentamicin in neurosurgical prophylaxis but is less toxic and penetrates cerebrospinal fluid better.
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Affiliation(s)
- V G Pons
- Department of Neurological Surgery, School of Medicine, University of California, San Francisco
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Pons VG, Denlinger SL, Guglielmo BJ, Octavio J, Flaherty J, Derish PA, Wilson CB. Comment; ceftizoxime versus vancomycin and gentamicin in neurosurgical prophylaxis. Neurosurgery 1993; 33:537. [PMID: 8413895 DOI: 10.1097/00006123-199309000-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Gatti G, Flaherty J, Bubp J, White J, Borin M, Gambertoglio J. Comparative study of bioavailabilities and pharmacokinetics of clindamycin in healthy volunteers and patients with AIDS. Antimicrob Agents Chemother 1993; 37:1137-43. [PMID: 8517703 PMCID: PMC187917 DOI: 10.1128/aac.37.5.1137] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [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: 01/31/2023] Open
Abstract
The absolute oral bioavailability and pharmacokinetics of clindamycin administered to 16 healthy volunteers and 16 patients with AIDS were compared. Clindamycin was given intravenously (i.v.) (Cleocin phosphate) at a dose of 600 mg as a 25-min infusion and orally (Cleocin hydrochloride) by use of a crossover design in both study groups. Plasma samples were analyzed by gas-liquid chromatography. Plasma drug clearance and volume of distribution at the steady state following the i.v. dose differed between study groups. The clearances were 0.27 +/- 0.06 liter/h/kg in healthy volunteers and 0.21 +/- 0.06 liter/h/kg in AIDS patients (P = 0.014; Mann-Whitney U test); the volumes of distribution at the steady state were 0.79 +/- 0.13 and 0.66 +/- 0.12 liter/kg in healthy volunteers and AIDS patients, respectively (P = 0.005). The elimination half-life did not differ between the two groups. The bioavailability of clindamycin capsules in AIDS patients was approximately 1.5 times that in healthy volunteers (0.53 +/- 0.14 versus 0.75 +/- 0.20; P = 0.002). Peak concentrations following the oral dose were higher in AIDS patients as well (7.7 +/- 2.5 versus 5.3 +/- 1.0 mg/liter; P = 0.0008). Three AIDS patients experienced severe diarrhea following the oral dose; four patients had mild diarrhea following the i.v. dose. No adverse effects were reported by the healthy volunteers. The pharmacokinetic parameters observed in this study for AIDS patients may be useful for the consideration of clindamycin dosage regimens in patients treated for toxoplasmic encephalitis. These findings suggest that the effect of AIDS on drug disposition deserves further investigation, particularly for orally administered drugs.
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Affiliation(s)
- G Gatti
- Division of Clinical Pharmacy, School of Pharmacy, University of California-San Francisco 94143
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Amenta CA, Dayal VS, Flaherty J, Weil RJ. Luetic endolymphatic hydrops: diagnosis and treatment. Am J Otol 1992; 13:516-24. [PMID: 1449177] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Luetic endolymphatic hydrops (LEH) is an effectively treatable disorder that requires astute clinical judgment to suspect, confirm, and treat. We provide a review of the literature as well as recommendations regarding the clinical management of LEH with discussion of several illustrative cases. We also give an overview of laboratory testing for the diagnosis and monitoring of the infectious process. Ultimately, the control of the otologic symptoms in LEH requires acumen on the part of the clinician.
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Affiliation(s)
- C A Amenta
- Department of Surgery, Pritzker School of Medicine, University of Chicago, Illinois
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Wurtz R, Sahm D, Flaherty J. Gentamicin-resistant, streptomycin-susceptible Enterococcus (Streptococcus) faecalis bacteremia. J Infect Dis 1991; 163:1393-4. [PMID: 1903802 DOI: 10.1093/infdis/163.6.1393] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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35
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Flaherty J, Nathan C, Kabins SA, Weinstein RA. Pilot trial of selective decontamination for prevention of bacterial infection in an intensive care unit. J Infect Dis 1990; 162:1393-7. [PMID: 2230272 DOI: 10.1093/infdis/162.6.1393] [Citation(s) in RCA: 69] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Selective decontamination of the oropharynx and gastrointestinal tract with nonabsorbable antimicrobials and sucralfate, a stress ulcer prophylactic that maintains the normal gastric acid bacterial barrier, were compared for prevention of pneumonia in a cardiac surgery intensive care unit. Over 8 months, 51 patients received selective decontamination and 56 received sucralfate. The selective decontamination regimen included polymyxin, gentamicin, and nystatin given as an oral paste and as a solution; patients also received standard antacid or histamine2 blocker stress ulcer prophylaxis. Patients in the selective decontamination group had significantly less colonization of the oropharynx and stomach by gram-negative bacilli (12% vs. 55%, P less than .001), significantly fewer infections due to gram-negative bacilli (6% vs. 20%, P = .02), and fewer infections overall (12% vs. 27%, P = .04). There was one episode of pneumonia in the selective decontamination group and five in the sucralfate group. Mortality and length of stay did not differ between the groups, but those receiving selective decontamination had less than one-third as many days of systemic antibiotic therapy with no increase in colonization or infection with resistant gram-negative bacilli. Thus, selective decontamination appeared to reduce both extrapulmonary and pulmonary infections.
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Affiliation(s)
- J Flaherty
- Department of Medicine, Michael Reese Hospital and Medical Center, Chicago, Illinois 60616
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Abstract
To determine how the children of Holocaust survivors in Israel and the U.S. differ on measures of parental communication and psychological distress, we performed a comparative study on 140 subjects in the U.S. and 54 in Israel using a written questionnaire. Respondents in Israel reported more communication by their parents, but also a higher level of demoralization; this may be due to more demoralization among the general population. In both populations, parents' general communication correlated negatively with anxiety, depression and demoralization and positively with guilt. Parents' Holocaust communication resulted in similar findings; however, in Israel only a negative correlation with demoralization reached significance. Parental communication about the Holocaust thus seems to be of less importance in Israel in determining the children's psychological outcome. This may be due to a greater role by Israeli society in forming children's perception of the Holocaust.
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Affiliation(s)
- D F Okner
- Northwestern University-McGaw Medical Center in Chicago, Illinois
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Abstract
The authors contend that women are the more supportive, nurturing and affectively-connected sex. They argue that these gender differences result from socialization experiences which may be modified by social and occupational roles. Theoretical perspectives and research addressing this proposition are reviewed. Empirical data on support-eliciting and support-providing behaviors in a cohort of medical students are then provided to test their thesis. The data suggest that women have developed a greater sensitivity to the needs of themselves and others, leading to a greater capacity to provide support and a greater dependence upon social support for psychological well-being. Personality and developmental factors that may account for these differences are examined. The implications of these findings for gender differences in mental health are discussed.
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Affiliation(s)
- J Flaherty
- Department of Psychiatry, University of Illinois, Chicago 60612
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Abstract
College women were asked a series of open-ended questions about their conceptions of menstruation prior to menarche as part of a retrospective study. Their responses were rated as indicating correct information, misinformation, or lack of information. A conceptual analysis of these descriptive data reveals some of the emotional and cognitive limitations of pre-adolescence that lead ostensibly well-informed girls to harbor misconceptions about menstruation. Based on this conceptual analysis, a revised approach to menstrual education is suggested.
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Abstract
This study addresses two questions relevant to psychiatric epidemiological models of the stress-distress relationship: Are personality and social support resources independent phenomena or highly correlated? and What are the relative contributions of these two types of resources in protecting against the development of depressive symptomatology? A cohort of beginning medical students was administered self-report questionnaires measuring social supports, locus of control, interpersonal dependency, and depressive symptomatology. On the basis of correlation and regression analysis, the data show that the personality characteristics more strongly predict depressive symptomatology than do social supports, and that social supports are unrelated to locus of control but directly correlated with interpersonal dependency. The authors discuss these findings in the context of a life cycle transition.
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Teare JA, Flaherty J. Tea--the best drink of the day? Nurs Times 1982; 78:1681-2. [PMID: 6923293] [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: 01/22/2023]
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Gaviria M, Flaherty J, Val E. A comparison of bipolar patients with and without a borderline personality disorder. Psychiatr J Univ Ott 1982; 7:190-5. [PMID: 6758006] [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: 01/21/2023]
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Flaherty J, O'Riordan J, Khuri S, Gott V. Transmural gradients in myocardial gas tensions in regionally ischemic canine left ventricle. Recent Adv Stud Cardiac Struct Metab 1976; 12:219-25. [PMID: 1031974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Previous studies from this laboratory have demonstrated the usefulness of myocardial gas tensions as measured by mass spectrometry for the quantitative assessment of regional myocardial ischemia (Khuri et al., 1975a). Progressive increases in myocardial carbon dioxide tensions were noted when progressive reduction in coronary blood flow was created by means of a variable constrictor. The present study was designed to determine if changes in myocardial oxygen and carbon dioxide tension were greater in deep, compared to more superficial, myocardial layers. In eight anesthetized dogs, progressive reduction in circumflex coronary flow was associated with a progressive reduction in myocardial oxygen tension and a progressive increase in myocardial carbon dioxide tension and intramyocardial ST-segment voltage. Evidence of a transmural gradient in the severity of ischemia was present at all degrees of flow reduction. These results confirm the findings of previous metabolic studies, which demonstrated gradients in lactate and high-energy phosphates. Myocardial carbon dioxide tension, which can be monitored continuously by mass spectrometry, would appear to provide a useful means of quantitatively assessing changes in regional myocardial metabolism.
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Flaherty J. Professional obligations with effective rewards. AARN News Lett 1975; 31:1-2. [PMID: 1039843] [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: 12/25/2022]
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Flaherty J. The present of today was the future of yesterday. RNAO News 1972; 28:11-3. [PMID: 4483199] [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: 01/10/2023]
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