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Guo F, Chen X, Howland S, Danza P, Niu Z, Gauderman WJ, Habre R, McConnell R, Yan M, Whitfield L, Li Y, Hodis HN, Breton CV, Bastain TM, Farzan SF. Perceived Stress From Childhood to Adulthood and Cardiometabolic End Points in Young Adulthood: An 18-Year Prospective Study. J Am Heart Assoc 2024; 13:e030741. [PMID: 38230530 PMCID: PMC11056127 DOI: 10.1161/jaha.123.030741] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/27/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND We investigated how childhood-to-adulthood perceived stress patterns predict adult cardiometabolic risk. METHODS AND RESULTS This study included 276 participants from the Southern California Children's Health Study (2003-2014), and a follow-up assessment (2018-2021). Perceived stress (Perceived Stress Scale) was initially reported by participants' parents for themselves during early childhood (mean age, 6.3 years), and later self-reported during adolescence (13.3 years) and young adulthood (23.6 years). Participants were grouped into 4 stress patterns: consistently high, decreasing, increasing, and consistently low. Cardiometabolic risk was assessed in young adulthood by carotid artery intima-media thickness, systolic and diastolic blood pressure, obesity, percent body fat, android/gynoid ratio, and glycated hemoglobin. A cardiometabolic risk score was generated by summing the clinically abnormal markers. Multivariable linear and logistic regression models were used to (1) examine the associations between Perceived Stress Scale at 3 time points and adult cardiometabolic risk, and (2) assess the impact of stress pattern on adult cardiometabolic risk. Findings suggested that in adulthood, higher Perceived Stress Scale score was associated with increased overall cardiometabolic risk (β=0.12 [95% CI, 0.01-0.22]), carotid artery intima-media thickness (β=0.01 [95% CI, 0.0003-0.02]), systolic blood pressure (β=1.27 [95% CI, 0.09-2.45]), and diastolic blood pressure (β=0.94 [95% CI, 0.13-1.75]). Individuals with a consistently high adolescence-to-adulthood stress pattern had greater overall cardiometabolic risk (β=0.31 [95% CI, 0.02-0.60]), android/gynoid ratio (β=0.07 [95% CI, 0.02-0.13]), percent body fat (β=2.59 [95% CI, 0.01-5.17]), and greater odds of obesity (odds ratio, 5.57 [95% CI, 1.62-19.10]) in adulthood, compared with those with a consistently low Perceived Stress Scale score. CONCLUSIONS Consistently high perceived stress from adolescence to adulthood may contribute to greater cardiometabolic risk in young adulthood.
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Affiliation(s)
- Fangqi Guo
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Xinci Chen
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Steve Howland
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Phoebe Danza
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - W. James Gauderman
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Rob McConnell
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Mingzhu Yan
- Atherosclerosis Research UnitUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Lora Whitfield
- Atherosclerosis Research UnitUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Yanjie Li
- Atherosclerosis Research UnitUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Howard N. Hodis
- Atherosclerosis Research UnitUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
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Lawrence KE, Balcomb C, Flay KJ, Whitfield L. Bone sequestrum in a yearling red deer ( Cervus elaphus) hind in New Zealand. N Z Vet J 2022; 70:297-299. [PMID: 35506302 DOI: 10.1080/00480169.2022.2073919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- K E Lawrence
- School of Veterinary Sciences, Massey University, Palmerston North, New Zealand
| | - C Balcomb
- School of Veterinary Sciences, Massey University, Palmerston North, New Zealand
| | - K J Flay
- Department of Veterinary Clinical Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, People's Republic of China
| | - L Whitfield
- Farm Vet Services, Palmerston North, New Zealand
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Hodis HN, Mack WJ, Meiselman HJ, Kalra V, Liebman H, Hwang-Levine J, Dustin L, Kono N, Mert M, Wenby RB, Huesca E, Rochanda L, Li Y, Yan M, St John JA, Whitfield L. Nattokinase atherothrombotic prevention study: A randomized controlled trial. Clin Hemorheol Microcirc 2021; 78:339-353. [PMID: 33843667 DOI: 10.3233/ch-211147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Described to be antithrombotic and antihypertensive, nattokinase is consumed for putative cardiovascular benefit. However, no large-scale, long-term cardiovascular study has been conducted with nattokinase supplementation. OBJECTIVE To determine the effect of nattokinase on subclinical atherosclerosis progression and atherothrombotic biomarkers. METHODS In this double-blinded trial, 265 individuals of median age 65.3 years, without clinical evidence of cardiovascular disease (CVD) were randomized to oral nattokinase 2,000 fibrinolytic units or matching placebo. Primary outcome was rate of change in subclinical atherosclerosis measured by serial carotid ultrasound every 6 months as carotid artery intima-media thickness (CIMT) and carotid arterial stiffness (CAS). Additional outcomes determined at least every 6 months were clinical parameters including blood pressure and laboratory measures including metabolic factors, blood rheology parameters, blood coagulation and fibrinolysis factors, inflammatory markers and monocyte/macrophage cellular activation markers. RESULTS After median 3 years of randomized treatment, annualized rate of change in CIMT and CAS did not significantly differ between nattokinase supplementation and placebo. Additionally, there was no significant effect of nattokinase supplementation on blood pressure or any laboratory determination. CONCLUSIONS Results of this trial show that nattokinase supplementation has a null effect on subclinical atherosclerosis progression in healthy individuals at low risk for CVD.
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Affiliation(s)
- Howard N Hodis
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Herbert J Meiselman
- Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Vijay Kalra
- Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard Liebman
- Department of Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Juliana Hwang-Levine
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Laurie Dustin
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Naoko Kono
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Melissa Mert
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rosalinda B Wenby
- Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Emiliano Huesca
- Department of Biochemistry and Molecular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Leanne Rochanda
- Department of Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Yanjie Li
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mingzhu Yan
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jan A St John
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lora Whitfield
- Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Wong LC, Ching T, Cupples L, Leigh G, Marnane, Button L, Martin L, Whitfield L, Gunnourie M. Comparing Parent and Teacher Ratings of Emotional and Behavioural Difficulties in 5-year old Children who are Deaf or Hard-of-Hearing. Deafness Educ Int 2018; 22:3-26. [PMID: 32410844 PMCID: PMC7224400 DOI: 10.1080/14643154.2018.1475956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/09/2018] [Indexed: 10/21/2023]
Abstract
Children who are deaf or hard of hearing (DHH) are at higher risk of developing mental health problems. This study reports on the parent and teacher ratings of emotional and behavioural difficulties (EBD) in 5-year old DHH children. It explores the similarities and differences between informants, and the risk and protective factors associated with parent and teacher-ratings of EBD. Parents and teachers of 224 DHH children completed questionnaires on children's EBD and functional auditory behaviour. Children completed standardised assessments of non-verbal cognitive and language abilities. On average, parent- and teacher-rated EBD were 0.42 and 0.20 standard deviations higher than typically developing children. Parents reported more behavioural problems (hyperactivity and conduct), whereas teachers reported poorer prosocial behaviour. Inter-rater correlations were generally low to moderate (0.29 to 0.50). Overall, children with additional disabilities, lower non-verbal cognitive ability, and poor functional auditory behaviour were at higher risk of EBD. Language ability was only a significant predictor of teacher-rated EBD for children with hearing aids but not cochlear implants. Differences in informant-ratings emphasize the need for a multi-informant approach to get a global perspective on the psychopathology of DHH children. The findings indicate that parents may need assistance with managing behavioural problems at home, and teachers should facilitate more opportunities to practice prosocial behaviour at school. Intervention efforts should focus on facilitating good functional listening skills, as this may in turn, improve the mental health of young DHH children.
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Affiliation(s)
- L C Wong
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | - Tyc Ching
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | | | - G Leigh
- HEARing Cooperative Research Centre
- Royal Institute for Deaf and Blind Children
| | - Marnane
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | - L Button
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | - L Martin
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | - L Whitfield
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
| | - M Gunnourie
- National Acoustic Laboratories
- HEARing Cooperative Research Centre
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Affiliation(s)
- C. J. Bodaan
- Veterinary Teaching Hospital; Institute of Veterinary Animal and Biomedical Sciences; College of Sciences; Massey University; Palmerston North New Zealand
| | - L. Panizzi
- Veterinary Teaching Hospital; Institute of Veterinary Animal and Biomedical Sciences; College of Sciences; Massey University; Palmerston North New Zealand
| | - A. J. Stewart
- Department of Clinical Sciences; College of Veterinary Medicine; Auburn University; Auburn Alabama USA
| | - E. Cypher
- Veterinary Teaching Hospital; Institute of Veterinary Animal and Biomedical Sciences; College of Sciences; Massey University; Palmerston North New Zealand
| | - L. Whitfield
- Veterinary Teaching Hospital; Institute of Veterinary Animal and Biomedical Sciences; College of Sciences; Massey University; Palmerston North New Zealand
| | - C. B. Riley
- Veterinary Teaching Hospital; Institute of Veterinary Animal and Biomedical Sciences; College of Sciences; Massey University; Palmerston North New Zealand
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Musk M, Hopkins P, Kermeen K, Dunning J, Gradwell J, Whitfield L, Godinez C, McNeil K. 223: Quantitative assessment of lipid laden macrophages with oil Red O stain is an effective screening test for GORD. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Whitfield L, Richards AJ, Rimmer DL. Relationships between soil heavy metal concentration and mycorrhizal colonisation in Thymus polytrichus in northern England. Mycorrhiza 2004; 14:55-62. [PMID: 14566485 DOI: 10.1007/s00572-003-0268-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2003] [Accepted: 08/06/2003] [Indexed: 05/24/2023]
Abstract
A study was conducted to establish whether the wild thyme [ Thymus polytrichus A. Kerner ex Borbás ssp. britannicus (Ronn.) Kerguelen (Lamiaceae)] growing in the metal-contaminated soils along the River South Tyne, United Kingdom, is colonised by arbuscular mycorrhizal (AM) fungi, and whether the degree of colonisation increases (perhaps suggesting increasing mycorrhizal dependence) or decreases (indicating possible inhibition of AM growth) with increasing degree of soil contamination. Seasonal changes in AM colonisation were also assessed. The AM fungal communities colonising T. polytrichus were also investigated, using the polymerase chain reaction with restriction fragment length polymorphism and sequencing of fungal DNA to establish whether AM species richness varied between sites, and whether fungal ecotypes specific to sites with different amounts of metal contamination could be identified. All plants examined were heavily colonised by AM fungi, and mean percentage root length colonised did not increase significantly with increasing soil metal contamination. However, AM vesicle abundance (percentage of mycorrhizal root length containing vesicles) at the most contaminated site was significantly greater than at the other sites. No significant seasonal variation in degree of colonisation or vesicle abundance was found. Glomus was the predominant AM genus detected at all sites. The number of AM genotypes colonising T. polytrichus roots was similar at all sites but, although some were common to all sites, certain strains appeared to be specific to either the most- or the least-contaminated site. This variation in species may account for the difference in vesicle abundance between sites. The consistently heavy AM colonisation of T. polytrichus found suggests that these fungi are not inhibited by soil heavy metals at these sites, and that the host derives some benefit from its AM symbiont.
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Affiliation(s)
- L Whitfield
- Department of Agricultural and Environmental Science, University of Newcastle, NE1 7RU, Newcastle upon Tyne, UK.
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Whitfield L, Richards AJ, Rimmer DL. Effects of mycorrhizal colonisation on Thymus polytrichus from heavy-metal-contaminated sites in northern England. Mycorrhiza 2004; 14:47-54. [PMID: 14564560 DOI: 10.1007/s00572-003-0269-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2003] [Accepted: 08/06/2003] [Indexed: 05/24/2023]
Abstract
A study was performed to establish whether colonisation with arbuscular mycorrhizal (AM) fungi is beneficial to wild thyme [ Thymus polytrichus A. Kerner ex Borbás ssp. britannicus (Ronn.) Kerguelen (Lamiaceae)] growing in the heavy-metal-contaminated soils along the River South Tyne, United Kingdom. T. polytrichus plants of the same genotype were grown under controlled conditions with and without Zn contamination, and differences between AM-colonised and -uncolonised plants in mean shoot and root growth (dry weight) and Zn concentration were assessed. When grown in the heavy-metal-contaminated, low-P soil from one of the South Tyne sites, AM-colonised plants grew significantly larger than uncolonised plants; however, there was no significant difference in growth between AM and non-AM plants grown in an artificial substrate with a larger available P concentration, with or without Zn contamination. Mycorrhizal colonisation increased tissue Zn concentrations during the experiments. It is concluded that AM fungi are beneficial, if not essential, to T. polytrichus growing in the low-nutrient soils along the River South Tyne, because of their role in enhancing plant uptake of P (and possibly other nutrients). There was no evidence from this study that the fungi reduce plant uptake of heavy metals at these sites, but rather increase Zn uptake. However, the resulting tissue metal concentrations do not appear to be large enough to be detrimental to plant growth.
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Affiliation(s)
- L Whitfield
- Department of Agricultural and Environmental Science, University of Newcastle, NE1 7RU, Newcastle upon Tyne, UK.
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Whitfield L. Card sharp. Health Serv J 2001; 111:suppl 8-9. [PMID: 11715922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Whitfield L. e-novation: managing with new technology. Mind the gap. Health Serv J 2001; 111:suppl 2-3. [PMID: 11398659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Whitfield L. IT training. Fine delivery. Health Serv J 2001; 111:suppl 20. [PMID: 11256122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Whitfield L. Catering. Fancy that. Health Serv J 2001; 111:suppl 4-5. [PMID: 11215096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Boyd RA, Stern RH, Stewart BH, Wu X, Reyner EL, Zegarac EA, Randinitis EJ, Whitfield L. Atorvastatin coadministration may increase digoxin concentrations by inhibition of intestinal P-glycoprotein-mediated secretion. J Clin Pharmacol 2000; 40:91-8. [PMID: 10631627 DOI: 10.1177/00912700022008612] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The effect of atovarstatin on digoxin pharmacokinetics was assessed in 24 healthy volunteers in two studies. Subjects received 0.25 mg digoxin daily for 20 days, administered alone for the first 10 days and concomitantly with 10 mg or 80 mg atorvastatin for the last 10 days. Mean steady-state plasma digoxin concentrations were unchanged by administration of 10 mg atorvastatin. Mean steady-state plasma digoxin concentrations following administration of digoxin with 80 mg atorvastatin were slightly higher than concentrations following administration of digoxin alone, resulting in 20% and 15% higher Cmax and AUC(0-24) values, respectively. Since tmax and renal clearance were not significantly affected, the results are consistent with an increase in the extent of digoxin absorption in the presence of atorvastatin. Digoxin is known to undergo intestinal secretion mediated by P-glycoprotein. Since atorvastatin is a CYP3A4 substrate and many CYP3A4 substrates are also substrates for P-glycoprotein transport, the influence of atorvastatin and its metabolites on P-glycoprotein-mediated digoxin transport in monolayers of the human colon carcinoma (Caco-2) cell line was investigated. In this model system, atorvastatin exhibited efflux or secretion kinetics with a K(m) of 110 microM. Atorvastatin (100 microM) inhibited digoxin secretion (transport from the basolateral to apical aspect of the monolayer) by 58%, equivalent to the extent of inhibition observed with verapamil, a known inhibitor of P-glycoprotein transport. Thus, the increase in steady-state digoxin concentrations produced by 80 mg atorvastatin coadministration may result from inhibition of digoxin secretion into the intestinal lumen.
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Affiliation(s)
- R A Boyd
- Department of Pharmacokinetics, Parke-Davis Pharmaceutical Research Division of Warner-Lambert Company, Ann Arbor, Michigan 48105, USA
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Whitfield L. On the rampage. Health Serv J 1999; 109:10-1. [PMID: 10662308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Whitfield L. Disclosure. Posit Aware 1998; 9:49. [PMID: 11366484] [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: 04/16/2023]
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Whitfield L. Ten myths. Posit Aware 1998; 9:39-40. [PMID: 11366480] [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: 04/16/2023]
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Whitfield L. Basic prevention: condoms and safer sex. Posit Aware 1998; 9:41. [PMID: 11366481] [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: 04/16/2023]
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Whitfield L. Immune reconstitution: conference reports. Posit Aware 1998; 9:36-9, 41-3. [PMID: 11365894] [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: 04/16/2023]
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Whitfield L. Lessons on rural sensitivity. Posit Aware 1998; 9:44-5. [PMID: 11365631] [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: 04/16/2023]
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Whitfield L. Surviving HIV in small town U.S.A. Posit Aware 1998; 9:28-9, 51. [PMID: 11365628] [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: 04/16/2023]
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Whitfield L. Health care strategies in rural America. Posit Aware 1998; 9:38-40. [PMID: 11365630] [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: 04/16/2023]
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Whitfield L. Investigational interleukins: the cutting edge of immune reconstitution. Posit Aware 1998; 9:35-7. [PMID: 11365485] [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: 04/16/2023]
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Whitfield L. Rebuilding immunity with Remune. Posit Aware 1998; 9:39-40. [PMID: 11365486] [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: 04/16/2023]
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24
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Whitfield L. Stimulating your appetite. Posit Aware 1998; 9:27. [PMID: 11365223] [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: 04/16/2023]
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Whitfield L. Half a league onward. Not everyone welcomes government plans to compare hospitals' performance. Health Serv J 1998; 108:10-1. [PMID: 10176642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Whitfield L. HIV antiviral drug guide 1998. Posit Aware 1998; 9:28, 30-42. [PMID: 11364998] [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: 04/16/2023]
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Roberts B, Hook K, Whitfield L, Carter C, Elliott W. Clinically relevant suramin dosing regimen in mice with no effects against PC-3 prostate xenografts. Oncol Rep 1997; 4:1361-6. [PMID: 21590254 DOI: 10.3892/or.4.6.1361] [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: 11/05/2022] Open
Abstract
The goal of these studies was to develop a suramin dosing schedule that would maintain suramin plasma concentrations in mice in the 150-250 mu g/ml range. A high pressure liquid chromatography method was used to determine suramin plasma concentrations in mice. For pharmacokinetic studies CD2F(1) mice were treated intraperitoneally with 140 mg/kg of suramin. These pharmacokinetic data were used to develop a clinically relevant dosing regimen. To test the efficacy of this dosing regimen, athymic nude mice were implanted orthotopically with PC-3 prostate carcinoma cells, randomized, and treated intraperitoneally. The pharmacokinetically derived dosing regimen resulted in no antitumor effect against PC-3 prostate tumors. Suramin plasma concentrations ranged from 155 to 258 mu g/ml over the 14-day therapy period with tumor concentrations in the 53-241 mu g/g wet weight range.
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Vazquez E, Whitfield L. Seldane warnings. Posit Aware 1997; 8:12. [PMID: 11364851] [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: 04/16/2023]
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Whitfield L. Cells for sale. Posit Aware 1997; 8:27-9, 33. [PMID: 11364858] [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: 04/16/2023]
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Vazquez E, Whitfield L. New triple combo trial opens. Posit Aware 1997; 8:12. [PMID: 11364852] [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: 04/16/2023]
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Vazquez E, Whitfield L. Names in vain. Posit Aware 1997; 8:13. [PMID: 11364853] [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: 04/16/2023]
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Vazquez E, Whitfield L. DMP 266 (Sustiva) expanded access. Posit Aware 1997; 8:12. [PMID: 11364850] [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: 04/16/2023]
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Whitfield L. Black plague. Posit Aware 1997; 8:40-3, 45-6. [PMID: 11364640] [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: 04/16/2023]
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Abstract
This article describes the process of implementing a New England model of case management in a rural hospital and the modifications necessary in adapting an urban model to a rural setting. Nursing case management at this institution has been associated with a decrease in the length of stay by 1.7 days at an estimated cost savings of $65,932 for the 16-month study period. Case management has also been instrumental in improving quality of care through a program of continuous quality improvement and in redesigning the RN role. The vision for the future is to extend the nurse case manager role outside the hospital walls to the community in a collaborative plan that would bill nursing services through physicians' offices.
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Abstract
A collaborative strategy between a college of nursing and a specialist nursing service was devised using outcomes driven by the ENB Higher Award. The successful implementation of this strategy has shown that the expectations of increased clinical-based innovation, resulting from this new approach to practitioner development, are achievable.
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Bélanger K, Jolivet J, Maroun J, Stewart D, Grillo-Lopez A, Whitfield L, Wainman N, Eisenhauer E. Phase I pharmacokinetic study of DUP-937, a new anthrapyrazole. Invest New Drugs 1993; 11:301-8. [PMID: 8157472 DOI: 10.1007/bf00874428] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/29/2023]
Abstract
DUP-937 is a new anthrapyrazole intercalator that inhibits DNA synthesis. A phase I trial was conducted in which DUP-937 was given in an intravenous bolus weekly for 3 weeks. Cycles were repeated every 5 weeks. Twenty men and 13 women with median ECOG performance status of 1 completed 74 cycles. The starting dose was 0.55 mg/m2/week and doses were escalated to 16 mg/m2/week. Non-hematological toxicity was generally mild or moderate and consisted mainly of gastro-intestinal effects, fatigue, alopecia and local reactions. Grade 3 neutropenia was first documented at 7.36 mg/m2 and became more common at higher dose levels. Three of four patients had > or = grade 3 neutropenia at the 16 mg/m2 dose level. Thrombocytopenia was minimal. The dose-limiting toxicity was neutropenia and the maximum tolerated dose was 16 mg/m2 weekly for 3 weeks. Mean area under the curve (AUC) values increased with dose. Linear pharmacokinetics were observed as total body clearance (CLtb), half-life (t1/2) and volume of distribution (Vss) did not change with increasing doses. One partial remission in a patient with prostate carcinoma was documented.
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Affiliation(s)
- K Bélanger
- Department of Medicine, Hôpital Notre-Dame, University of Montréal, Canada
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O'Dwyer PJ, Hudes GR, Walczak J, Schilder R, LaCreta F, Rogers B, Cohen I, Kowal C, Whitfield L, Boyd RA. Phase I and pharmacokinetic study of the novel platinum analogue CI-973 on a 5-daily dose schedule. Cancer Res 1992; 52:6746-53. [PMID: 1458462] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CI-973, a platinum(II) derivative with a 2-methyl-1,4-butanediamine carrier ligand, has activity in cisplatin-resistant tumor models in vitro and in vivo. In a Phase I pharmacokinetic study, 31 patients were treated with CI-973 (24 to 50 mg/m2/day for 5 days; 28-day cycles) given i.v. over 30 min without routine antiemetic prophylaxis or hydration. Of the 29 patients evaluable for maximum tolerated dose determination, most had a performance status of 0 or 1, and most had received prior chemotherapy. Neutropenia was dose limiting at 40 and 50 mg/m2/day. Recovery from neutropenia was generally rapid with nadir counts and recovery usually occurring by Days 15 and 22, respectively. Drug-associated thrombocytopenia was uncommon and never severe, even in patients with Grade 4 neutropenia. Anemia was common, but did not appear dose related. Drug-related nausea and vomiting and changes in renal function were relatively infrequent and mild. No clinically evident ototoxicity was reported, although changes in audiograms were noted in several patients. CI-973 concentrations were measured in plasma ultrafiltrate and urine by high-pressure liquid chromatography. The harmonic mean terminal half-life was 2.0 h. The mean CI-973 renal and nonrenal clearance values were 42.3 and 37.4 ml/min/m2, respectively. The mean recovery of CI-973 in urine was 53% of the administered dose. The mean ratio of CI-973 renal clearance to creatinine clearance was 0.92. Total clearance correlated with creatinine clearance (r2 = 0.63). A relationship between toxicity, expressed as the percentage of reduction in absolute granulocyte count, and area under the CI-973 plasma concentration-time curve was found in a subgroup of "good-risk" patients. This relationship, described well by a sigmoidal Emax pharmacodynamic model, did not hold for patients with extensive prior therapy or poor performance status. A model for toxicity prediction based on dose and creatinine clearance has been derived and will be validated in future studies. The recommended Phase II dose of CI-973 is 30 mg/m2/day for 5 days.
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Affiliation(s)
- P J O'Dwyer
- Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111
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Wong B, Nordblom G, Chang T, Whitfield L. Lack of dose proportional pharmacokinetics for CI-937, an anthrapyrazole DNA intercalator, in mice. Res Commun Chem Pathol Pharmacol 1989; 66:191-202. [PMID: 2602655] [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: 01/01/2023]
Abstract
The time course of CI-937, an anthrapyrazole DNA intercalator, was studied in plasma of mice after single intravenous doses of 1.2, 8, 12, and 15 mg/kg (1/10 the LD10, 2/3 the LD10, LD10, and LD50). CI-937 concentrations in plasma were determined by a sensitive radioimmunoassay capable of quantifying 0.1 ng/ml. Area under the plasma concentration-time curve increased less than proportionally to dose. Time-averaged plasma clearance was dose-dependent, increasing from 31.1 to 63.6 ml/min/kg over the 1.2 to 12 mg/kg dose range. Terminal half-life in plasma ranged from 11 to 25 days. Fraction plasma protein bound was 69 to 76% from 10 to 10,000 ng/ml, which suggests the nonlinear behavior was not due to saturable protein binding. Potential mechanisms include autoinduction of metabolism and dose-dependent reabsorption from the gastrointestinal tract or kidneys.
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Affiliation(s)
- B Wong
- Pharmacokinetics/Drug Metabolism Department, Parke-Davis Pharmaceutical Research Division, Warner-Lambert Company, Ann Arbor, MI 48105
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Tuck ML, Sowers JR, Dornfeld L, Whitfield L, Maxwell M. Reductions in plasma catecholamines and blood pressure during weight loss in obese subjects. Acta Endocrinol (Copenh) 1983; 102:252-7. [PMID: 6338673 DOI: 10.1530/acta.0.1020252] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract.
The effect of weight reduction on levels of upright plasma norepinephrine (NE) and epinephrine (E) was studied in 20 obese patients maintained on a hypocaloric protein diet. Subjects were divided into 2 groups on either a constant 120 (N=13) or 40 (N=7) mmole sodium intake. Initial upright NE levels were higher (P < 0.001) in obese subjects (610 ± 52 pg/ml) than in non-obese controls (325 ± 25 pg/ml). Initial NE in obese subjects correlated (r=0.6, P < 0.01) with mean arterial pressure. Weight loss in both sodium intake groups was accompanied by a progressive decline in upright NE and by 8 weeks levels were decreased in all study subjects by a mean of 42 per cent (P < 0.01) from baseline. Reductions in upright E from baseline were not as pronounced but were significant (P < 0.05) at 8 weeks on both sodium intakes. We have previously shown that mean arterial pressure and PRA decrease significantly in obese subjects during supplemented fasting independent of sodium intake. In the present study reductions in body weight correlated (r=58, P < 0.05) with both the fall in NE levels at 8 weeks (r=0.5, P < 0.05) and with reduction in upright PRA (r=0.49, P < 0.05) at weeks 4 to 8. Changes in upright E did not correlate with weight and blood pressure reductions. We conclude that reduction in caloric intake in obese patients is accompanied by significant reductions in upright NE and E that may contribute to the decline in resting blood pressure. The decrease in upright PRA with weight loss could result from depression in sympathetic nervous system activity.
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Whitfield L, Sowers JR, Tuck ML, Golub MS. Dopaminergic control of plasma catecholamine and aldosterone responses to acute stimuli in normal man. J Clin Endocrinol Metab 1980; 51:724-9. [PMID: 6252224 DOI: 10.1210/jcem-51-4-724] [Citation(s) in RCA: 70] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study examines the influence of dopamine on catecholamine and aldosterone secretion in normotensive individuals. The responses of plasma aldosterone (PA), norepinephrine (NE), and PRA to upright posture and isometric handgrip were studied in five normal males on a constant 50-meq Na intake before and after 4 days of administration of the dopamine agonist, bromergocriptine (BEC; 2.5 mg three times a day). In addition, the PA responses to graded angiotensin II and ACTH infusions were examined before and during BEC. Supine PA and PRA were not altered by BEC, but basal NE was reduced significantly (P < 0.01) from 204 +/- 29 to 98 +/- 12 pg/ml after BEC. There was an accompanying significant reduction in upright mean arterial pressure during BEC administration. The PA and NE during upright posture and isometric handgrip were significantly suppressed by BEC, but PRA responses were unaltered. BEC produced a significiant (P < 0.025) suppression of the PA response to graded angiotensin II infusions but did not alter the PA response to graded ACTH. Our findings indicate that in normal man there is a pronounced inhibitory effect of dopaminergic pathways on catecholamine scretion and regulation of upright mean arterial pressure. Results of the posture study would suggest that dopamine-mediated PA alterations occur independently of changes in the levels of PRA. The finding that BEC suppressed PA responses to angiotensin II and posture but not to ACTH would imply that dopamine selectively exerts its effect or adrenal angiotensin II-mediated aldosterone secretion.
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