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Gavalda M, Vilchez H, Martin ML, Ruiz E, Ribas MA, Riera M. Endocarditis caused by Neisseria bacilliformis: a case report and review of literature. IDCases 2023; 31:e01725. [PMID: 36923656 PMCID: PMC10009057 DOI: 10.1016/j.idcr.2023.e01725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023] Open
Abstract
A 58-years-old male with history of previous aortic prosthetic endocarditis caused by Enterococcus faecalis was admitted due to dyspnoea and fever. The two sets of blood cultures were positive for Neisseria bacilliformis. Transoesophageal echocardiography did not demonstrate endocarditis signs, but PET-CT scan showed active infection signs in the valvular aortic tube and possible infection in the aortic prosthetic valve. A six-week course of ampicillin was prescribed; gentamicin was added during the first two weeks. The patient continued a favourable clinical course. This is the 3rd described case of N. bacilliformis endocarditis and the first one in a prosthetic valve.
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Affiliation(s)
- M Gavalda
- Internal Medicine Department, Hospital Universitari Son Espases, Spain
| | - H Vilchez
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Spain.,Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
| | - M L Martin
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Spain
| | - E Ruiz
- Microbiology. Hospital Universitari Son Espases, Spain
| | - M A Ribas
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Spain
| | - M Riera
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Spain.,Fundació Institut d'Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
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2
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Catapano AL, Wiklund O, Bushnell DM, Martin ML, Sidelnikov E, Vrablik M. Key aspects of statin intolerance leading to treatment discontinuation: a patient perspective. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2584] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and aims
Statins are the standard of care for patients with dyslipidemia, but some patients develop intolerance to treatment. The experience of statin intolerant (SI) patients is poorly understood. The objective of this study was to identify key aspects of SI that may be associated with treatment discontinuation.
Methods
Using a previously created questionnaire, we conducted a pilot cross-sectional survey to identify items important for describing patient-centric aspects of SI. The study recruited adult (18+) patients with a history of statin-associated side effects from 9 clinics in 6 countries (France, Italy, Norway, Spain, Sweden, and the United Kingdom), who had received statin treatment within the previous two years.
Results
We surveyed 104 patients (mean age 61.5 SD=11.2 years, 63.5% men, 50% currently on statins). Patients most frequently reported muscle-related symptoms: pain (90.9%), cramps (63.7%), and stiffness (58.2%). Using a 0–10 point scale, significant differences were found between those continuing versus discontinuing their statins for being bothered by side effects (7.5 vs 9.2, p=0.001), for an inability to tolerate side effects (6.7 vs 9.0, p<0.001), and those having too much side effects interference with their daily life (5.7 vs 8.6, p<0.001; see figure). For patients whose doctors worked on adjusting statin regimen, 67% stayed on treatment; for those whose doctors did not, only 10% continued treatment.
Conclusions
Results of this pilot survey suggest patients who experience greater side effects severity and interference with daily activity, along with lower efforts by clinicians to work with adjusting their statin regimen, are at greater risk for discontinuing treatment. A wider survey and larger study population is needed to confirm the results of this pilot study.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was sponsored by Amgen Inc.
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Affiliation(s)
| | - O Wiklund
- University of Gothenburg, Gothenburg, Sweden
| | | | - M L Martin
- Evidera, Seattle, United States of America
| | | | - M Vrablik
- Charles University of Prague, Prague, Czechia
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3
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Takashima S, Martin ML, Jansen SA, Fu Y, Bos J, Chandra D, O'Connor MH, Mertelsmann AM, Vinci P, Kuttiyara J, Devlin SM, Middendorp S, Calafiore M, Egorova A, Kleppe M, Lo Y, Shroyer NF, Cheng EH, Levine RL, Liu C, Kolesnick R, Lindemans CA, Hanash AM. T cell-derived interferon-γ programs stem cell death in immune-mediated intestinal damage. Sci Immunol 2020; 4:4/42/eaay8556. [PMID: 31811055 DOI: 10.1126/sciimmunol.aay8556] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/06/2019] [Indexed: 12/15/2022]
Abstract
Despite the importance of intestinal stem cells (ISCs) for epithelial maintenance, there is limited understanding of how immune-mediated damage affects ISCs and their niche. We found that stem cell compartment injury is a shared feature of both alloreactive and autoreactive intestinal immunopathology, reducing ISCs and impairing their recovery in T cell-mediated injury models. Although imaging revealed few T cells near the stem cell compartment in healthy mice, donor T cells infiltrating the intestinal mucosa after allogeneic bone marrow transplantation (BMT) primarily localized to the crypt region lamina propria. Further modeling with ex vivo epithelial cultures indicated ISC depletion and impaired human as well as murine organoid survival upon coculture with activated T cells, and screening of effector pathways identified interferon-γ (IFNγ) as a principal mediator of ISC compartment damage. IFNγ induced JAK1- and STAT1-dependent toxicity, initiating a proapoptotic gene expression program and stem cell death. BMT with IFNγ-deficient donor T cells, with recipients lacking the IFNγ receptor (IFNγR) specifically in the intestinal epithelium, and with pharmacologic inhibition of JAK signaling all resulted in protection of the stem cell compartment. In addition, epithelial cultures with Paneth cell-deficient organoids, IFNγR-deficient Paneth cells, IFNγR-deficient ISCs, and purified stem cell colonies all indicated direct targeting of the ISCs that was not dependent on injury to the Paneth cell niche. Dysregulated T cell activation and IFNγ production are thus potent mediators of ISC injury, and blockade of JAK/STAT signaling within target tissue stem cells can prevent this T cell-mediated pathology.
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Affiliation(s)
- S Takashima
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - M L Martin
- Department of Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - S A Jansen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Division of Pediatrics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, Netherlands
| | - Y Fu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - J Bos
- Division of Pediatrics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, Netherlands
| | - D Chandra
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - M H O'Connor
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - A M Mertelsmann
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - P Vinci
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - J Kuttiyara
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - S M Devlin
- Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - S Middendorp
- Division of Pediatrics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, Netherlands
| | - M Calafiore
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - A Egorova
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - M Kleppe
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Y Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - N F Shroyer
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - E H Cheng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, Cornell University, New York, NY 10065, USA
| | - R L Levine
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - C Liu
- Department of Pathology & Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - R Kolesnick
- Department of Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - C A Lindemans
- Division of Pediatrics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, Netherlands.,Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, Netherlands
| | - A M Hanash
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. .,Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA
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4
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Dworkin JD, Sati P, Solomon A, Pham DL, Watts R, Martin ML, Ontaneda D, Schindler MK, Reich DS, Shinohara RT. Automated Integration of Multimodal MRI for the Probabilistic Detection of the Central Vein Sign in White Matter Lesions. AJNR Am J Neuroradiol 2018; 39:1806-1813. [PMID: 30213803 DOI: 10.3174/ajnr.a5765] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/25/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE The central vein sign is a promising MR imaging diagnostic biomarker for multiple sclerosis. Recent studies have demonstrated that patients with MS have higher proportions of white matter lesions with the central vein sign compared with those with diseases that mimic MS on MR imaging. However, the clinical application of the central vein sign as a biomarker is limited by interrater differences in the adjudication of the central vein sign as well as the time burden required for the determination of the central vein sign for each lesion in a patient's full MR imaging scan. In this study, we present an automated technique for the detection of the central vein sign in white matter lesions. MATERIALS AND METHODS Using multimodal MR imaging, the proposed method derives a central vein sign probability, πij, for each lesion, as well as a patient-level central vein sign biomarker, ψi. The method is probabilistic in nature, allows site-specific lesion segmentation methods, and is potentially robust to intersite variability. The proposed algorithm was tested on imaging acquired at the University of Vermont in 16 participants who have MS and 15 participants who do not. RESULTS By means of the proposed automated technique, participants with MS were found to have significantly higher values of ψ than those without MS (ψMS = 0.55 ± 0.18; ψnon-MS = 0.31 ± 0.12; P < .001). The algorithm was also found to show strong discriminative ability between patients with and without MS, with an area under the curve of 0.88. CONCLUSIONS The current study presents the first fully automated method for detecting the central vein sign in white matter lesions and demonstrates promising performance in a sample of patients with and without MS.
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Affiliation(s)
- J D Dworkin
- From the Department of Biostatistics, Epidemiology, and Informatics (J.D.D., M.L.M., R.T.S.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - P Sati
- Translational Neuroradiology Section (P.S., M.K.S., D.S.R.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - A Solomon
- Departments of Neurological Sciences (A.S.)
| | - D L Pham
- Center for Neuroscience and Regenerative Medicine (D.L.P.), Henry M. Jackson Foundation, Bethesda, Maryland
| | - R Watts
- Radiology (R.W.), Larner College of Medicine at the University of Vermont, Burlington, Vermont
| | - M L Martin
- From the Department of Biostatistics, Epidemiology, and Informatics (J.D.D., M.L.M., R.T.S.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Ontaneda
- Mellen Center for Multiple Sclerosis Treatment and Research (D.O.), Cleveland Clinic, Cleveland, Ohio
| | - M K Schindler
- Translational Neuroradiology Section (P.S., M.K.S., D.S.R.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - D S Reich
- Translational Neuroradiology Section (P.S., M.K.S., D.S.R.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
- Department of Neurology (D.S.R.), Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - R T Shinohara
- From the Department of Biostatistics, Epidemiology, and Informatics (J.D.D., M.L.M., R.T.S.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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5
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Martin ML, Bateman PW, Auckland CH, Miller DW, Warburton NM, Barnes AL, Fleming PA. Is there evidence for a trade-off between sperm competition traits and forelimb musculature in the western grey kangaroo? Biol J Linn Soc Lond 2018. [DOI: 10.1093/biolinnean/blx151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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6
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Hall SL, Cross J, Selix NW, Patterson C, Segre L, Chuffo-Siewert R, Geller PA, Martin ML. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol 2015; 35 Suppl 1:S29-36. [PMID: 26597803 PMCID: PMC4660046 DOI: 10.1038/jp.2015.147] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/23/2015] [Indexed: 12/25/2022]
Abstract
Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents' functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU staff with education and support are discussed. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby.
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Affiliation(s)
- S L Hall
- Division of Neonatology, St John's Regional Medical Center, Oxnard, CA, USA
| | - J Cross
- Department of Social Work, Widener University, Chester, PA, USA
| | - N W Selix
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - C Patterson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L Segre
- College of Nursing and Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - R Chuffo-Siewert
- Department of Nursing, University of Iowa Children's Hospital, Iowa City, IA, USA
| | - P A Geller
- Departments of Psychology, Obstetrics/Gynecology and Public Health, Drexel University, Philadelphia, PA, USA
| | - M L Martin
- Department of Nursing, McLeod Regional Medical Center, Florence, SC, USA
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7
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Olasolo J, Pellejero S, Artacho JM, Gracia M, Gallardo N, Martin ML, Lozares S, Maneru F, Bragado L, Miquelez S. SU-E-T-444: Gravity Effect On Maximum Leaf Speed in Dynamic IMRT Treatments. Med Phys 2015. [DOI: 10.1118/1.4924806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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8
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Rogers GB, Bruce KD, Martin ML, Burr LD, Serisier DJ. Corrections. The effect of long-term macrolide treatment on respiratory microbiota composition in non-cystic fibrosis bronchiectasis: an analysis from the randomised, double-blind, placebo-controlled BLESS trial. Lancet Respir Med 2015; 3:e15. [PMID: 25890660 DOI: 10.1016/s2213-2600(15)00102-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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9
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McCarrier KP, Bushnell DM, Ramasamy A, Liedgens H, Blum SI, Cano S, Martin ML, Patrick DL. The Pain Assessment for Lower Back Symptoms (Pal-S): Refinement of A New Pro Instrument Through A Mixed Methods Approach. Value Health 2014; 17:A536. [PMID: 27201716 DOI: 10.1016/j.jval.2014.08.1712] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - D M Bushnell
- Health Research Associates, Inc., Seattle, WA, USA
| | - A Ramasamy
- Forest Research Institute, Jersey City, NJ, USA
| | | | - S I Blum
- GlaxoSmithKline, Collegeville, PA, USA
| | - S Cano
- ScaleReport, Stotfold, UK
| | - M L Martin
- Health Research Associates, Inc., Seattle, WA, USA
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10
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Bushnell DM, McCarrier KP, Ramasamy A, Liedgens H, Blum SI, Cano S, Martin ML, Patrick DL. Impacts of Lower Back Pain: Refinement of the Pain Assessment for Lower Back-Impacts Questionnaire (Pal-I) Using a Mixed Methods Approach. Value Health 2014; 17:A536. [PMID: 27201715 DOI: 10.1016/j.jval.2014.08.1713] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- D M Bushnell
- Health Research Associates, Inc., Seattle, WA, USA
| | | | - A Ramasamy
- Forest Research Institute, Jersey City, NJ, USA
| | | | - S I Blum
- GlaxoSmithKline, Collegeville, PA, USA
| | - S Cano
- ScaleReport, Stotfold, UK
| | - M L Martin
- Health Research Associates, Inc., Seattle, WA, USA
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11
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Kingery L, Martin ML, Naegeli AN, Khan S, Viktrup L. Content validity of the Benign Prostatic Hyperplasia Impact Index (BII); a measure of how urinary trouble and problems associated with BPH may impact the patient. Int J Clin Pract 2012; 66:883-90. [PMID: 22897465 DOI: 10.1111/j.1742-1241.2012.02960.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS The objective of this qualitative interview study was to assess the content validity of the Benign Prostatic Hyperplasia Impact Index (BII) in a sample of men with signs and symptoms of Benign Prostatic Obstruction believed to be caused by benign prostatic hyperplasia (BPH lower urinary tract symptoms/BPH-LUTS) using concept elicitation (CE) and cognitive interviewing (CI) methods. METHODS Fifty men with BPH-LUTS participated in the study; 27 completed CE interviews and 23 completed cognitive interviews. RESULTS Patient's average age was 69 years with a mean duration of BPH-LUTS of 6.5 years. IPSS scores ranged from 8 to 33 (higher scores indicating greater symptom severity). Overall, the most frequent symptoms (prevalence of ≥ 75%) reported spontaneously or after further explanation were awakening from sleep, increased daytime voiding (frequency), urgent desire to void (urgency), slow stream, and feeling of incomplete bladder emptying. Symptoms primarily recognized in response to follow up probe questions with a prevalence of ≥ 40% included terminal dribble, splitting of urinary stream, intermittent stream, straining and post-micturition dribble. Especially bothersome [> 5 on the numerical rating scale (NRS) of 0-10] and frequent symptoms included urgency and awakening at night to void. Discomfort or pain while urinating and post-micturition dribble were equally bothersome though less frequent. Five BPH symptom-related impact themes were identified: coping, daily responsibilities, emotion, lifestyle and relationships, and sleep. CONCLUSIONS The BII was found to be easily understood, does capture clinically relevant BPH impacts related to urinary trouble and problems, and does capture most of the important symptom-related impacts as described by participants in this study.
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12
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Abstract
BACKGROUND Benzodiazepines used for transesophageal echocardiography (TEE) sedation may be associated with postprocedural psychomotor effects that are undesirable. HYPOTHESIS We hypothesize that flumazenil can reverse cognitive and motor effects from benzodiazepine, promoting earlier return to baseline function. METHODS We prospectively evaluated the cognitive and motor function of patients who did or did not receive flumazenil following TEE. Patients' gait, level of drowsiness, and recall of items learned before and after benzodiazepine administration were evaluated before TEE, as well as immediately and 30 min after the procedure. RESULTS Of 207 patients (123 men and 84 women), 93 (45%) were given flumazenil 0.2 or 0.4 mg intravenously, and 113 (55%) were not. The baseline characteristics of the patients who received flumazenil were not significantly different from those who did not receive flumazenil, with the exception of a higher mean dosage of midazolam administered to the flumazenil group. In addition, patients in the flumazenil group appeared more drowsy immediately following TEE. When adjusted for age and midazolam dosage, there were no differences, at any time, between the two groups in gait or recall of items learned prior to sedation. however, at 30 min following TEE, the flumazenil group was able to recall a larger number of new items learned immediately after the procedure (1.92/3 vs. 1.61/3, p = 0.02) than did patients in the group not receiving flumazenil. No adverse effects were encountered in any patient. CONCLUSION Flumazenil appears safe and effective in reversing anterograde amnesic effects of benzodiazepine following TEE, but has no effects on retrograde amnesia and does not promote earlier return of motor function to baseline. It is useful in clinical situations where high dosages of benzodiazepine have been used and/or excessive drowsiness is evident following TEE. Routine use of the drug, however, is not necessary.
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Affiliation(s)
- T S Tsang
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
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13
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Martin ML, Vidal EE, de la Canal L. Expression of a lipid transfer protein in Escherichia coli and its phosphorylation by a membrane-bound calcium-dependent protein kinase. Protein Pept Lett 2007; 14:793-9. [PMID: 17979821 DOI: 10.2174/092986607781483697] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ha-AP10 is a basic antifungal peptide from sunflower seeds (Helianthus annuus antifungal peptide of 10 kDa) belonging to the family of plant lipid transfer proteins. We report here its expression in E. coli [Glutathione S-transferase (GST) system] and its phosphorylation by endogenous membrane-bound calcium-dependent protein kinases.
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Affiliation(s)
- M L Martin
- Instituto de Investigaciones Biológicas, Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Mar del Plata, Casilla de Correo 1245, Mar del Plata, Argentina.
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14
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Craver L, Marco MP, Sarro F, Martin ML, Borras M, Valdivielso JM, Fernández E. Mineral metabolism influences pulse pressure increase provoked by chronic kidney disease. Clin Nephrol 2007; 68:87-92. [PMID: 17722707 DOI: 10.5414/cnp68087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pulse pressure (PP) increase has been associated with hypertension, ageing and chronic kidney disease. Although hyperparathyroidism and phosphate imbalance have been suspect in PP increase in hemodialysis patients, the link between these parameters and pulse pressure, in renal disease before dialysis, has not been established. METHODS AND PATIENTS 1966 chronic kidney disease (CKD) patients. STATISTICS ANOVA, Student's t-and Chi-square, rank correlations (Spearman) and multivariate analysis, with PP as the dependent variable, while adjusting for other covariables. RESULTS There was an increase of pulse pressure parallel to renal function deterioration, and a significant influence of age, diabetes, hypertension, phosphate and PTH on pulse pressure in the whole population, as well as in patients with glomerular filtration rate < 60 ml/min. The impact of phosphate was particularly high after the age of 50. CONCLUSION PP increase present in renal disease patients might be primarily due to the underlying mineral metabolism disturbances.
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Affiliation(s)
- L Craver
- Hospital Universitari Arnau de Vilanova, Lleida, Spain
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15
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Martin ML, Ronco AE. Effect of mixtures of pesticides used in the direct seeding technique on nontarget plant seeds. Bull Environ Contam Toxicol 2006; 77:228-36. [PMID: 16977524 DOI: 10.1007/s00128-006-1054-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Accepted: 07/16/2006] [Indexed: 05/11/2023]
Affiliation(s)
- M L Martin
- Environmental Research Center, Faculty of Sciences, National University of La Plata, CONICET-ANPCYT, Calle 47 y 115, La Plata, Argentina
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16
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Scanlon PH, Martin ML, Bailey C, Johnson E, Hykin P, Keightley S. Reported symptoms and quality-of-life impacts in patients having laser treatment for sight-threatening diabetic retinopathy. Diabet Med 2006; 23:60-6. [PMID: 16409567 DOI: 10.1111/j.1464-5491.2005.01736.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To explore the patient experience of symptoms of eye disease related to diabetes and its treatment, including increase of symptoms over time and their relation to severity of the condition and the effect of multiple treatments and symptoms on quality of life. METHODS A qualitative interview study was implemented at four eye clinics in the UK. This study design was intended to yield 240 interviews in patients having their first laser treatment or first follow-up and in multi-treatment patients with a clinically documented loss of visual function in at least one eye (VA </= 6/12). The intention was to have an approximately equal number of patients with proliferative diabetic retinopathy (PDR) or macular oedema (MO). RESULTS A total of 227 interviews were completed (54% PDR and 46% MO). The most frequently reported symptom prior to initial treatment was blurred vision (55%). First-time-treatment patients reported fewer symptoms than the multi-treatment patients. After a pronounced reduction of quality-of-life impacts after the first laser treatment, results all demonstrate an increasing impact as patients move from first treatment to multiple treatments. The main responses regarding satisfaction with laser treatment were that, although patient expectations were basically met, the treatment had less of an impact than they hoped for, and they would have the treatment again if needed. CONCLUSIONS The current study provides a qualitative exploration of visual symptoms, levels of self-reported visual impairment, and general description of the areas of impact or restriction that patients experienced due to their eye disease, both pre- and post-laser treatment.
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Affiliation(s)
- P H Scanlon
- Gloucestershire Eye Unit, Cheltenham General Hospital, Gloucestershire, UK.
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Bailey A, Martin ML, Girman C, McNaughton-Collins M, Barry MJ. DEVELOPMENT OF A MULTIREGIONAL UNITED STATES SPANISH VERSION OF THE INTERNATIONAL PROSTATE SYMPTOM SCORE AND THE BENIGN PROSTATIC HYPERPLASIA IMPACT INDEX. J Urol 2005; 174:1896-901; discussion 1901. [PMID: 16217332 DOI: 10.1097/01.ju.0000177072.59090.f7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The International Prostate Symptom Score (I-PSS) and Benign Prostatic Hyperplasia Impact Index (BII) have gained widespread use in clinical practice and clinical trials. Although Spanish translations of the I-PSS are available, to our knowledge none was developed for the Spanish speaking population in the United States using a methodology to ensure appropriateness for the diverse United States Spanish speaking population. An existing translation intended for another Spanish speaking country, such as Mexico, or a translation developed without input from each language group may not be understood by those who immigrated from other Latin American regions. Hence, the development of a Spanish translation for the United States should involve input from translators from each region of Latin America. MATERIALS AND METHODS We reviewed and modified an existing United States Spanish translation of I-PSS using a multiregional reconciliation panel comprised of representatives from each of the major Spanish language groups in the United States. For BII full translation methodology was used to develop a translation for the United States, including 2 forward translations using translators from more than 1 region, a multiregional reconciliation panel meeting, a back translation evaluation, cognitive debriefing interviews with representatives from each language group, developer review, a final evaluation for consistency and proofreading. RESULTS The revised I-PSS better reflects common Spanish wording in the United States, while the BII translation was confirmed to be comprehended by Spanish speakers in the United States originating from multiple regions of Latin America. CONCLUSIONS United States Spanish translations of patient reported outcome measures should consider the diversity of the growing Spanish speaking population in the United States to ensure comprehension across the broad population originating from the multiple regions of Latin America.
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Affiliation(s)
- A Bailey
- Health Research Associates, Inc. Seattle, Washington, USA
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Keller CA, Yuan X, Panzanelli P, Martin ML, Alldred M, Sassoè-Pognetto M, Lüscher B. The gamma2 subunit of GABA(A) receptors is a substrate for palmitoylation by GODZ. J Neurosci 2004; 24:5881-91. [PMID: 15229235 PMCID: PMC2366890 DOI: 10.1523/jneurosci.1037-04.2004] [Citation(s) in RCA: 191] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The neurotransmitter GABA activates heteropentameric GABA(A) receptors, which are composed mostly of alpha, beta, and gamma2 subunits. Regulated membrane trafficking and subcellular targeting of GABA(A) receptors is important for determining the efficacy of GABAergic inhibitory function. Of special interest is the gamma2 subunit, which is mostly dispensable for assembly and membrane insertion of functional receptors but essential for accumulation of GABA(A) receptors at synapses. In a search for novel receptor trafficking proteins, we have used the SOS-recruitment system and isolated a Golgi-specific DHHC zinc finger protein (GODZ) as a novel gamma2 subunit-interacting protein. GODZ is a member of the superfamily of DHHC cysteine-rich domain (DHHC-CRD) polytopic membrane proteins shown recently in yeast to represent palmitoyltransferases. GODZ mRNA is found in many tissues; however, in brain the protein is detected in neurons only and highly concentrated and asymmetrically distributed in the Golgi complex. GODZ interacts with a cysteine-rich 14-amino acid domain conserved specifically in the large cytoplasmic loop of gamma1-3 subunits but not in other GABA(A) receptor subunits. Coexpression of GODZ and GABA(A) receptors in heterologous cells results in palmitoylation of the gamma2 subunit in a cytoplasmic loop domain-dependent manner. Neuronal GABA(A) receptors are similarly palmitoylated. Thus, GODZ-mediated palmitoylation represents a novel posttranslational modification that is selective for gamma subunit-containing GABA(A) receptor subtypes, a mechanism that is likely to be important for regulated trafficking of these receptors in the secretory pathway.
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Affiliation(s)
- Cheryl A Keller
- Department of Biology, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
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19
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Abstract
The use of electronic data capture (EDC) to assess health-related quality of life (HRQOL) using validated questionnaires is increasing; however, it must be determined how data collected electronically correlate with the original mode of administration used in validation. Our objective was to compare paper and electronic administration of the standardized Asthma Quality of Life Questionnaire (AQLQ(S)), Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)), and Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ). Using a crossover design, adults and children with asthma and caregivers of children with asthma were recruited from clinics. Subjects were asked to complete both forms of the appropriate HRQOL measures at enrollment and 24-48 hours later. In addition, 30 subjects from each group were asked to participate in a 1-week reproducibility assessment of the electronic versions of the three questionnaires. Psychometric properties were assessed for each of the EDC versions. Intraclass correlation coefficients (ICC) and Pearson correlations were calculated to compare EDC and paper versions. A total of 51 adults (mean age 37, 73% females), 52 children (mean age 13, 38% females), and 51 caregivers (mean age 43, 92% females) were evaluated. Internal consistency (Cronbach's alpha) for the overall score of each questionnaire was: 0.96 for the AQLQ(S) and the PAQLQ(S), and 0.92 for the PACQLQ. Overall ICCs comparing paper with EDC were: 0.96 for the AQLQ(S), 0.91 for the PAQLQ(S), and 0.82 for the PACQLQ. Pearson's correlations were identical. One-week reproducibility (ICC) of the EDC versions was: 0.88 for the AQLQ(S), 0.78 for the PAQLQ(S), and 0.85 for the PACQLQ. When asked which method subjects preferred, the electronic version was chosen by 69% of adults, 77% of children, and 73% of caregivers. Additionally, 14% of adults, 14% of children, and 18% of caregivers reported no difference in preference. As in previous studies comparing electronic with paper questionnaires, this study revealed statistical evidence to support the use of EDC of the AQLQ(S), PAQLQ(S), and PACQLQ for populations with asthma.
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Affiliation(s)
- D M Bushnell
- Health Research Associates, Inc., Seattle, Washington, USA.
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20
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Martin ML. Rapid-cycle improvement in pediatric health care: a solution for patients with similar or same last names. J SPEC PEDIATR NURS 2003; 8:148-50, 154. [PMID: 14677321 DOI: 10.1111/j.1088-145x.2003.00148.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Michelle L Martin
- Holtz Children's Hospital, Jackson Memorial Hospital, Miami, FL, USA.
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Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, Buesching DP. Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med 2002; 32:889-902. [PMID: 12171383 DOI: 10.1017/s003329170200586x] [Citation(s) in RCA: 136] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Screening surveys of depressive symptoms were conducted among primary care patients at six sites in different countries. The LIDO Study was designed to assess quality of life and economic correlates of depression and its treatment in culturally diverse primary health care settings. This paper describes: (1) the association between depressive symptoms and functional status, global health-related quality of life (QoL), and use of general health services across different cultural settings; and (2) among subjects with depressive symptoms, the factors associated with recent treatment for depression. METHODS Subjects aged 18 to 75 were recruited from participating primary care facilities in Be'er Sheva (Israel), Porto Alegre (Brazil), Melbourne (Australia), Barcelona (Spain), St Petersburg (Russian Federation) and Seattle (USA). Depressive symptoms were measured using the CES-D. Also administered were the SF-12, global questions on QoL, selected demographic and social measures, and questions on recent treatment for depression, use of health care services, and lost workdays. RESULTS A total of 18,489 patients were screened, of whom 37% overall (range 24-55%) scored > or = 16 on the CES-D and 28% (range 17-42%) scored > or = 20. Overall, 13% reported current treatment for depression (range 4 to 23%). Patients with higher depressive symptom scores had worse health, functional status, QoL, and greater use of health services across all sites. Among those with a CES-D score > or = 16, subjects reporting treatment for depression were more likely than those reporting no treatment to be dissatisfied with their health (except in St Petersburg), and to have higher depressive symptom scores. CONCLUSIONS Higher depressive symptom scores in primary care patients were consistently associated with poorer health, functional status and QoL, and increased health care use, but not with demographic variables. The likelihood of treatment for depression was associated with perceptions of health, as well as severity of the depression.
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Affiliation(s)
- H Herrman
- University of Melbourne and St Vincent's Mental Health Service, VIC, Australia
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22
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Beltran B, Cuadrado C, Martin ML, Carbajal A, Moreiras O. Activities of daily living in the Spanish elderly. Association with mortality. J Nutr Health Aging 2002; 5:259-60. [PMID: 11753490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The ability to manage basic activities of daily living (ADL) is a significant predictor for being housebound, placement in a nursing home and death. The aim of the study was to assess the capacity to perform activities of daily living in the Spanish sample (30 men and 49 women aged 80-85 y) from SENECA's Finale study (1999) and changes respect to the same sample ten years ago. The total ADL score (assessed by 16 questions) and the partials (mobility ADLm and self-care ADLc) show that the total ADL average in 1999 has been 23.9+/-10.2 (p<0.05) and 25.3+/-9.6 (p<0.001), being in 1989, 18.8+/-4.4 and 19.9+/-4.8 for men and women respectively. The ADL score from deceased subjects participating in 1989 was significantly worse (p<0.01 in men and p<0.001 in women) than ADL score from survivor subjects. Activities of daily living as a measurement of functionality decline with increasing age and in our study a better ADL score was found as survival factor.
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Affiliation(s)
- B Beltran
- Departamento de Nutrición. Facultad de Farmacia (UCM), Madrid, Spain.
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Abstract
Fracture susceptibility depends jointly on bone mineral content (BMC), gross bone anatomy, and bone microarchitecture and quality. Overall, it has been estimated that 50-70% of bone strength is determined genetically. Because of the difficulty of performing studies of the genetics of bone strength in humans, we have used the HcB/Dem series of recombinant congenic (RC) mice to investigate this phenotype. We performed a comprehensive phenotypic analysis of the HcB/Dem strains including morphological analysis of long bones, measurement of ash percentage, and biomechanical testing. Body mass, ash percentage, and moment of inertia each correlated moderately but imperfectly with biomechanical performance. Several chromosome regions, on chromosomes 1, 2, 8, 10, 11, and 12, show sufficient evidence of linkage to warrant closer examination in further crosses. These studies support the view that mineral content, diaphyseal diameter, and additional nonmineral material properties contributing to overall bone strength are controlled by distinct sets of genes. Moreover, the mapping data are consistent with the existence of pleiotropic loci for bone strength-related phenotypes. These findings show the importance of factors other than mineral content in determining skeletal performance and that these factors can be dissected genetically.
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Affiliation(s)
- Y Yershov
- Mineralized Tissue Section, The Hospital for Special Surgery, New York, New York, USA
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24
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Abstract
Endoleaks are defined as persistent perfusion of an abdominal aortic aneurysm (AAA) after endovascular stent-graft deployment. The authors describe their experience treating six endoleaks with the liquid embolic agent Onyx (ethylene-vinyl-alcohol copolymer). Complete endoleak occlusion was achieved in five of six cases. Follow-up imaging has demonstrated decreased aneurysm diameter in all patients 7-29 weeks (mean = 19.2 weeks) after treatment.
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Affiliation(s)
- M L Martin
- Department of Radiology, University of British Columbia Hospital, Vancouver, British Columbia, Canada.
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Abstract
The objective of this study was to determine the electrocardiographic diagnoses of chest pain patients with ST segment elevation (STE) on the 12-lead electrocardiogram (ECG). This study was a retrospective ECG review of adult chest pain patients in a university hospital emergency department (ED) over a 3-month period (January 1, 1996 to March 31, 1996). STE was determined if the ST segment was elevated >/=1 mm in the limb leads and >/=2 mm in the precordial leads in at least two anatomically contiguous leads. Results showed 902 patients who met entry criteria and of whom 202 (22.4%) had STE. Thirty-one (15%) patients had STE acute myocardial infarction (AMI) as the final hospital diagnosis which caused the STE; 171 (85%) patients with STE had non-AMI diagnosis responsible for the ST segment elevation, including left ventricular hypertrophy (LVH) 51 (25%), left bundle branch block (LBBB) 31 (15%), benign early repolarization (BER) 25 (12%), right bundle branch block 10 (5%), nonspecific bundle branch block 10 (5%), left ventricular aneurysm 5 (3%), acute pericarditis 2 (1%), ventricular paced rhythm 2 (1%), and undefined ST segment elevation 35 (17%). Forty-four patients had AMI as the final diagnosis of whom 31 showed STE on presentation to the ED. In 2 of 31 (6%) cases of STE AMI, the ST segment waveform was atypical for acute infarction. We concluded that AMI is not the most common cause of STE in ED chest pain patients. LVH is most often responsible for electrocardiographic STE followed by AMI and LBBB which occur at equal frequencies.
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Affiliation(s)
- W J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
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Brady WJ, Hwang V, Sullivan R, Chang N, Beagle C, Carter CT, Martin ML, Aufderheide TP. A comparison of 12- and 15-lead ECGS in ED chest pain patients: impact on diagnosis, therapy, and disposition. Am J Emerg Med 2000; 18:239-43. [PMID: 10830674 DOI: 10.1016/s0735-6757(00)90112-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 11/18/2022] Open
Abstract
The objective of this study was to investigate the diagnostic and therapeutic impact of the 15-lead electrocardiogram (15ECG) on the emergency department (ED) management of chest pain (CP) patients. The design was prospective use of 15ECG with real-time physician survey and retrospective comparison to 12-lead ECG (12ECG). The study took place in a University hospital ED. Adult CP patients participated. During the 15ECG period (June 1996 to July 1996), 595 patients (92% of CP patients) had 15ECG analysis. Diagnoses of acute coronary ischemic syndromes (ACIS) were as follows: 13 acute myocardial infarction (AMI, 7 anterior [ANT], 5 inferior [INF], 1 lateral [LAT], 2 posterior [POST], 1 right ventricular [RV]) and 136 unstable angina (USA) with 47% exhibiting ECG abnormality; the 2 POST and 1 RV AMI occurred in the setting of coexisting INF AMI. The following management strategies were used: 6 fibrinolytic therapy (TT), 4 primary angioplasty (PTCA), 67 rule-out myocardial infarction (ROMI), and 144 admission to critical care unit (CCU). During the 12ECG period (June 1995 to July 1995), 599 patients were encountered. The diagnoses of ACIS were as follows: 11 AMI (5 ANT, 4 INF, 2 LAT) and 146 USA with 51% exhibiting ECG abnormality (P = NS for diagnostic comparisons to 15ECG). The following management strategies were used: 5 TT, 5 PTCA, 59 ROMI, and 137 admission to CCU (P = NS for all treatment comparisons to 15ECG). Of 15ECG cases 81% had completed real-time physician survey, showing that the diagnosis and management ACIS were not altered by the 15ECG; physicians felt, however, that the 15ECG provided a more complete anatomic picture of the ACIS. No false-positive cases of additional lead STE were noted in this investigation except in cases involving abnormal intraventricular conduction such as the bundle branch block scenario. The 15ECG provided a more complete description of myocardial injury without altering the ED diagnosis, ED-based therapy, or hospital disposition in adult CP patients. Further study is required to identify patient subset(s) which may benefit from the 15ECG.
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Affiliation(s)
- W J Brady
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, USA
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Jackson EM, Arnette JA, Martin ML, Tahir WM, Frost-Arner L, Edlich RF. A global inventory of hospitals using powder-free gloves: a search for principled medical leadership. J Emerg Med 2000; 18:241-6. [PMID: 10699530 DOI: 10.1016/s0736-4679(99)00202-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [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: 11/18/2022]
Abstract
Scientific experimental and clinical studies have demonstrated that cornstarch on surgical and examination gloves promotes disease by acting as a reactive foreign body in tissue and serving as a vector for latex allergy. Consequently, hospitals have selected an innovative glove selection program utilizing only powder-free gloves. Healthcare workers in emergency medical systems are now wearing powder-free, latex-free gloves to care for the growing number of patients sensitized to latex. A global Internet search has now identified 70 hospitals in the United States and three hospitals in Europe that use only powder-free gloves.
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Affiliation(s)
- E M Jackson
- Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville 22908, USA
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Patrick DL, Martin ML, Bushnell DM, Marquis P, Andrejasich CM, Buesching DP. Cultural adaptation of a quality-of-life measure for urinary incontinence. Eur Urol 1999; 36:427-35. [PMID: 10516455 DOI: 10.1159/000020026] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [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: 11/19/2022]
Abstract
OBJECTIVES To translate and validate a urinary incontinence-specific measure of quality of life (I-QOL) in French, Spanish, Swedish, and German and provide translations only into seven other languages and variants of these languages. METHODS Quality of life and linguistic experts prepared two forward translations from American English to their native languages and helped to harmonize these translations at a meeting. In the four European countries, the adapted versions of the I-QOL were administered to 259 women with stress, urge, and mixed incontinence. Principal component analyses were used to confirm the proposed measurement model suggested by patient interviews. Psychometric testing was conducted using standardized procedures. RESULTS Translation procedures resulted in a change in the original instrument's Likert response scale from 4 to 5 points. Principal component analyses confirmed three patient-derived subscales and higher-order factor analysis confirmed a total summary score. In all countries, the internal consistency (alpha) and reproducibility (ICC) were high (alpha ranged between 0.87 and 0.93); (ICC ranged between 0.92 and 0.95). In all countries, I-QOL scores were significantly worse (p < 0.001) as perceived severity of incontinence, use of services, and number of incontinent episodes increased. CONCLUSIONS The I-QOL has been adapted successfully into eleven languages and six variants of these languages. The cross-sectional psychometric properties of the US version were confirmed in four European countries. The I-QOL fills the need for a valid, international quality-of-life instrument for incorporation in clinical trials covering patients with varying types and severity of urinary incontinence.
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Affiliation(s)
- D L Patrick
- University of Washington, Seattle, Wash., USA.
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Rosner MH, Brady WJ, Kefer MP, Martin ML. Electrocardiography in the patient with the Wolff-Parkinson-White syndrome: diagnostic and initial therapeutic issues. Am J Emerg Med 1999; 17:705-14. [PMID: 10597097 DOI: 10.1016/s0735-6757(99)90167-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [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: 10/26/2022] Open
Abstract
The Wolff-Parkinson-White syndrome (WPW), estimated to occur in approximately 0.1% to 3% of the general population, is a form of ventricular preexcitation involving an accessory conduction pathway. The definition of WPW relies on the following electrocardiographic features: (1) a PR interval less than 0.12 seconds (2) with a slurring of the initial segment of the QRS complex, known as a delta wave, (3) a QRS complex widening with a total duration greater than 0.12 seconds, and (4) secondary repolarization changes reflected in ST segment-T wave changes that are generally directed opposite (discordant) to the major delta wave and QRS complex changes. The accessory pathway bypasses the atrioventricular (AV) node, creating a direct electrical connection between the atria and ventricles. The majority of patients with preexcitation syndromes remain asymptomatic throughout their lives. When symptoms do occur they are usually secondary to tachyarrhythmias; the importance of recognizing this syndrome is that these patients may be at risk to develop a variety of supraventricular tachyarrhythmias which cause disabling symptoms and, in the extreme, sudden cardiac death. The tachyarrhythmias encountered in the WPW patient include paroxysmal supraventricular tachycardia (both the narrow QRS and wide QRS complex varieties), atrial fibrillation, atrial flutter, and ventricular fibrillation. Diagnostic and urgent, initial therapeutic issues based on initial electrocardiographic information are presented via 5 illustrative cases.
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Affiliation(s)
- M H Rosner
- Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, USA
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Hickey CW, Golding LA, Martin ML, Croker GF. Chronic Toxicity of Ammonia to New Zealand Freshwater Invertebrates: A Mesocosm Study. Arch Environ Contam Toxicol 1999; 37:338-351. [PMID: 10473790 DOI: 10.1007/s002449900523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Freshwater macroinvertebrate communities were established within 12 artificial streams or "toroidal" mesocosms and exposed to three replicated concentrations of ammonia for 29 days at constant temperature (16 degrees C) and pH (median 8.4). The criterion units (CU = measured [ammonia]/US EPA 1985 chronic criterion value) of total ammonia in the LOW, MED, and HIGH treatments were 2.0, 4.8, and 13 CUs respectively, and 1.9, 5.8, and 12 CUs for the unionized ammonia. Macroinvertebrates were tolerant of the ammonia exposures with no significant (p > 0.1) effect on taxa richness; number of taxa in the orders Ephemeroptera, Plecoptera, and Trichoptera (EPT); or the quantitative macroinvertebrate community index (QMCI), a biotic index proposed for assessing effects of organic enrichment in New Zealand streams. Significant differences (p < 0.05) occurred for the mean abundance and the numbers of EPT individuals (QEPT), with the HIGH treatment significantly lower (-41%) than the control for both abundance and QEPT. Of the major species, only the mayflies Deleatidium sp. (Ephemeroptera: Leptophlebiidae) and Coloburiscus humeralis (Ephemeroptera: Oligoneuriidae) showed significant reductions in abundance, with only the caddisflies Beraeoptera roria (Trichoptera: Conoesucidae) and Confluens sp. (Trichoptera: Conoesucidae) showing significant increases in abundance. The abundance of juvenile Deleatidium sp. had a negative concentration-response relationship that resulted in an 82% decrease in abundance in the HIGH treatment. Drift of invertebrates showed no response to ammonia treatments. The 29-day EC(50) values for Deleatidium sp. for total and unionized ammonia were 2.15 mg (N)/L (pH 8.4) and 0.145 mg (NH(3)-N)/L. No observed effect concentration (NOEC) values were 0.95 mg (N)/L and 0.066 mg (NH(3)-N)/L, and the threshold effect concentration (TEC) was 1.49 mg (N)/L and 0.102 mg (NH(3)-N)/L. Comparison of the Deleatidium sp. chronic ammonia sensitivity data with the US EPA 1985 chronic criterion value (CCC = 0.45 mg [N]/L, pH 8.4, 16 degrees C) showed the TEC value for total ammonia was 3.3x CCC, and 2.2x higher than the updated US EPA 1998 criteria. The findings suggest that use of the US EPA criteria would provide minimal protection for Deleatidium for chronic ammonia exposure, and that development of site-specific criteria, covering a wide range of environmental conditions, may be required to adequately protect this species.http://link.springer-ny.com/link/service/journals/00244/bibs/37n3p338.html
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Affiliation(s)
- CW Hickey
- National Institute of Water and Atmospheric Research, Ltd., PO Box 11-115, Hamilton, New Zealand
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Abstract
Parkinson's disease is a common progressive neurodegenerative disorder affecting an estimated 4 million people worldwide. A number of general health status measures exist but few fully capture the subjective evaluation of life quality associated with Parkinson's disease. We report here the results of: (1) translating the British PDQ-39 into a US version, (2) validity and reliability of the new US PDQ-39 questionnaire, and (3) parallel validation analyses following the method published in the development of the British version of the PDQ-39. Data were collected by postal survey on 150 patients recruited from neurology clinics in the Seattle area. A short, generic health status measure (SF-36) was used to test convergent validity, and a three-day test-retest assessed the reliability of the PDQ-39. The US version of the PDQ-39 demonstrated acceptable internal consistency (alpha = 0.51 to 0.96) and proved to be reproducible (0.86 to 0.96). Subscales of the PDQ-39 showed convergence with like scales of the SF-36 and was able to discriminate between levels of symptom severity.
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Affiliation(s)
- D M Bushnell
- Health Research Associates, Inc., Seattle, WA, USA.
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Abstract
The purpose of this report is to describe the emergency medical response to a disaster caused by the collapse of a balcony in Pavilion I on the Lawn of the University of Virginia during graduation. The emergency medical response to rescue of the injured was hindered by five major factors: (1) a metal linked chain blocked access of rescue vehicles, (2) inability to identify an emergency medical command officer, (3) failure to transfer injured patients with stable vital signs and secured to backboards to a triage area away from the scene of the accident, (4) ineffective crowd control, and (5) the failure to delay procession until completion of patient transport from the disaster site. Sixteen people were injured in the accident and one patient died. The cause of the accident was the absence of a redundant architectural support system for the balcony.
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Affiliation(s)
- J S O'Keefe
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville 22908, USA
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Crater SE, Peters EJ, Martin ML, Murphy AW, Platts-Mills TA. Expired nitric oxide and airway obstruction in asthma patients with an acute exacerbation. Am J Respir Crit Care Med 1999; 159:806-11. [PMID: 10051254 DOI: 10.1164/ajrccm.159.3.9805103] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Expired nitric oxide (eNO) is a marker of airway inflammation that is increased in asthma. The present study was undertaken to examine the clinical utility of eNO as an aid in the assessment of asthma in the emergency department (ED). Fifty-two adult patients with acute asthma, 53 age- and sex-matched controls, and eight patients with stable asthma were enrolled. Subjects performed spirometry, their eosinophil counts and serum total IgE were measured, and a sample of mixed VC expirate was collected for measurement of NO. Mixed expired NO was 8.2 +/- 0.5 ppb in controls, 8.8 +/- 1.5 ppb in patients with stable asthma, and 15.0 +/- 1.0 ppb in patients with acute asthma. A significant difference in eNO was observed in patients with acute asthma and controls (p < 0.001). Twenty-three of the 52 patients with acute asthma versus two of 53 controls had an eNO >/= 15 ppb (p < 0.001). Expired NO concentration correlated with FEV1% (r = -0.42, p < 0.001) and with the peripheral blood eosinophil count (r = 0.34, p < 0.001) in the group of 60 patients with acute and stable asthma. The sensitivity of eNO > 10 ppb and eosinophilia (> 200 cells/microliter) was 90% in predicting airway obstruction (FEV1/FVC < 0. 8). No relationship of eNO was found to serum IgE, self- reported smoking, or glucocorticoid use. Measurement of eNO is a promising clinical tool for assessing acute asthma.
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Affiliation(s)
- S E Crater
- Asthma and Allergic Diseases Center, University of Virginia, Department of Emergency Medicine, Charlottesville, USA. sec4w/2virginia.edu
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Ksiazek TG, Rollin PE, Williams AJ, Bressler DS, Martin ML, Swanepoel R, Burt FJ, Leman PA, Khan AS, Rowe AK, Mukunu R, Sanchez A, Peters CJ. Clinical virology of Ebola hemorrhagic fever (EHF): virus, virus antigen, and IgG and IgM antibody findings among EHF patients in Kikwit, Democratic Republic of the Congo, 1995. J Infect Dis 1999; 179 Suppl 1:S177-87. [PMID: 9988182 DOI: 10.1086/514321] [Citation(s) in RCA: 271] [Impact Index Per Article: 10.8] [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: 12/23/2022] Open
Abstract
Ebola hemorrhagic fever (EHF) patients treated at Kikwit General Hospital during the 1995 outbreak were tested for viral antigen, IgG and IgM antibody, and infectious virus. Viral antigen could be detected in virtually all patients during the acute phase of illness, while antibody was not always detectable before death. Virus was also isolated from patients during the course of their febrile illness, but attempts to quantify virus in Vero E6 cells by standard plaque assay were often unsuccessful. IgG and IgM antibody appeared at approximately the same time after disease onset (8-10 days), but IgM persisted for a much shorter period among the surviving convalescent patients. IgG antibody was detectable in surviving patients through about 2 years after onset, the latest time that samples were obtained. Detection of Ebola virus antigens or virus isolation appears to be the most reliable means of diagnosis for patients with suspected acute EHF, since patients with this often-fatal disease (80% mortality) may not develop detectable antibodies before death.
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Affiliation(s)
- T G Ksiazek
- Special Pathogens Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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39
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Abstract
The chronic toxicity of total ammonium and unionized ammonia (NH3) to the native New Zealand freshwater fingernail clam Sphaerium novaezelandiae was assessed in soft water under laboratory conditions. Control survival after 60 days was high (93%) and concentration-response relationships showed the sensitivity of S. novaezelandiae survival was markedly greater to both total and unionized ammonia (6.4x and 4.6x) after 60 days compared with the 30-day exposure at 20 degrees C. Chronic mortality and number moribund (inability to rebury) showed similar sensitivities, but reproduction was a more sensitive endpoint based on a concentration-response analysis. The survival LC50 values for total and unionized ammonia were 3.8 mg (N)/L (pH 7.5) and 0.037 mg (NH3-N)/L, and reproductive values 0.80 mg (N)/L (pH 7.5) and 0.013 mg (NH3-N)/L at 60 days. No observed effect concentration (NOEC) values for both survival and reproduction were 0.97 mg (N)/L and 0. 011 mg (NH3-N)/L, and the lowest observed effect concentration (LOEC) values were 5.4 mg (N)/L and 0.046 mg (NH3-N)/L for survival after 60 days, giving a calculated threshold effect concentration (TEC) of 2.3 mg (N)/L and 0.022 mg (NH3-N)/L. Comparison of the S. novaezelandiae chronic ammonia sensitivity data with the US EPA criteria showed the survival and reproduction TEC values for total ammonia were 1.9x higher than the chronic criterion, and the lethality value 1.4x above the unionized ammonia criterion. The findings suggest that use of the US EPA criteria would provide minimal protection for S. novaezelandiae for chronic ammonia exposure, and that development of site-specific criteria, covering a wide range of environmental conditions, may be required to adequately protect all life stages of this species.
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Affiliation(s)
- C W Hickey
- National Institute of Water and Atmosphere Research Ltd, PO Box 11-115, Hamilton, New Zealand
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Patrick DL, Martin ML, Bushnell DM, Yalcin I, Wagner TH, Buesching DP. Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology 1999; 53:71-6. [PMID: 9886591 DOI: 10.1016/s0090-4295(98)00454-3] [Citation(s) in RCA: 370] [Impact Index Per Article: 14.8] [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: 12/28/2022]
Abstract
OBJECTIVES To report on the further development of the Incontinence Quality of Life Instrument (I-QOL), a self-report quality of life measure specific to urinary incontinence (UI), including its measurement model, responsiveness, and effect size. METHODS Incontinent female patients (141 with stress, 147 with mixed UI) completed the I-QOL and comparative measures at screening, pretreatment, and four subsequent follow-up visits during participation in a multicenter, double-blind, placebo-controlled, randomized trial assessing the efficacy of duloxetine. Psychometric testing followed standardized procedures. RESULTS Factor analysis confirmed an overall score and three subscale scores (avoidance and limiting behaviors, psychosocial impacts, and social embarrassment). All scores were internally consistent (alpha = 0.87 to 0.93) and reproducible (ICC = 0.87 to 0.91). The pattern of previously reported correlations with the Short-Form 36-item Health Survey and Psychological Well-Being Schedule were confirmed. Responsiveness statistics using changes in the independent measures of stress test pad weight, number of incontinent episodes, and patient global impression of improvement ranged from 0.4 to 0.8. Minimally important changes ranged from 2% to 5% in association with these measures and effect sizes. CONCLUSIONS In a clinical trial, the I-QOL proved to be valid, reproducible, and responsive to treatment for UI in women.
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Affiliation(s)
- D L Patrick
- Department of Health Services, University of Washington, Seattle 98195-7660, USA
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Evans ML, Martin ML, Winslow EH. Nursing care and patient satisfaction. Am J Nurs 1998; 98:57-9. [PMID: 9875184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- M L Evans
- Nursing Service, Presbyterian Hospital of Dallas, TX, USA
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42
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Fowles LF, Martin ML, Nelsen L, Stacey KJ, Redd D, Clark YM, Nagamine Y, McMahon M, Hume DA, Ostrowski MC. Persistent activation of mitogen-activated protein kinases p42 and p44 and ets-2 phosphorylation in response to colony-stimulating factor 1/c-fms signaling. Mol Cell Biol 1998; 18:5148-56. [PMID: 9710599 PMCID: PMC109100 DOI: 10.1128/mcb.18.9.5148] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.0] [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] [Received: 12/22/1997] [Accepted: 06/25/1998] [Indexed: 11/20/2022] Open
Abstract
An antibody that specifically recognized phosphothreonine 72 in ets-2 was used to determine the phosphorylation status of endogenous ets-2 in response to colony-stimulating factor 1 (CSF-1)/c-fms signaling. Phosphorylation of ets-2 was detected in primary macrophages, cells that normally express c-fms, and in fibroblasts engineered to express human c-fms. In the former cells, ets-2 was a CSF-1 immediate-early response gene, and phosphorylated ets-2 was detected after 2 to 4 h, coincident with expression of ets-2 protein. In fibroblasts, ets-2 was constitutively expressed and rapidly became phosphorylated in response to CSF-1. In both cell systems, ets-2 phosphorylation was persistent, with maximal phosphorylation detected 8 to 24 h after CSF-1 stimulation, and was correlated with activation of the CSF-1 target urokinase plasminogen activator (uPA) gene. Kinase assays that used recombinant ets-2 protein as a substrate demonstrated that mitogen-activated protein (MAP) kinases p42 and p44 were constitutively activated in both cell types in response to CSF-1. Immune depletion experiments and the use of the MAP kinase kinase inhibitor PD98059 indicate that these two MAP kinases are the major ets-2 kinases activated in response to CSF-1/c-fms signaling. In the macrophage cell line RAW264, conditional expression of raf kinase induced ets-2 expression and phosphorylation, as well as uPA mRNA expression. Transient assays mapped ets/AP-1 response elements as critical for basal and CSF-1-stimulated uPA reporter gene activity. These results indicate that persistent activation of the raf/MAP kinase pathway by CSF-1 is necessary for both ets-2 expression and posttranslational activation in macrophages.
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Affiliation(s)
- L F Fowles
- Departments of Microbiology and Biochemistry and the Centre for Molecular and Cellular Biology, University of Queensland, Queensland Q4072, Australia
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Martin ML, Bhargava R, Ashforth RA, Russell DB. Mastoid pneumocele causing atlantooccipital pneumatization. AJNR Am J Neuroradiol 1998; 19:1231-3. [PMID: 9726460 PMCID: PMC8332210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 49-year-old woman had a palpable mass in her occipital region. Plain radiographs and CT examination revealed extensive atlantooccipital pneumatization with findings consistent with the diagnosis of mastoid pneumocele. Decompression was achieved with placement of a myringotomy tube, resulting in prompt symptomatic relief. On a follow-up CT examination, the pneumatized areas had become opacified and new bone formation was present.
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Affiliation(s)
- M L Martin
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
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Patton SE, Martin ML, Nelsen LL, Fang X, Mills GB, Bast RC, Ostrowski MC. Activation of the ras-mitogen-activated protein kinase pathway and phosphorylation of ets-2 at position threonine 72 in human ovarian cancer cell lines. Cancer Res 1998; 58:2253-9. [PMID: 9605774] [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: 02/07/2023]
Abstract
The activation status of the ras pathway was studied in eight ovarian tumor cell lines. Three biochemical parameters indicative of ras activation were tested: (a) the ratio of the ras-GTP:ras-GDP complex; (b) the activity of mitogen-activated protein kinases p42/p44; and (c) ets-2 phosphorylation at position threonine 72, a mitogen-activated protein kinase phosphorylation site in vivo. Four of the ovarian tumor cell lines had an activated ras pathway by these three parameters, whereas only one of these contained a mutated ras gene. In addition, ras/ets-2 responsive genes such as the urokinase plasminogen activator (uPA) were activated in these four cell lines. Transient transfection assays indicated that the compound ets-AP1 oncogene responsive enhancer present in the uPA gene was the target of ras signaling in ovarian tumor cells and that the combination of activated ras and ets-2 could superactivate the uPA enhancer element. Coexpression of the dominant-negative ras-Asn17 cDNA gene abrogated activity of this uPA element in ovarian tumor cells. These data indicate that ets-2 is a nuclear target of ras action in ovarian tumor cell lines and that ras signaling pathways may be activated in ovarian cancer by mechanisms independent of direct genetic damage to ras genes.
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Affiliation(s)
- S E Patton
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
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Forchuk C, Chan L, Schofield R, Martin ML, Sircelj M, Woodcox V, Jewell J, Valledor T, Overby B. Bridging the discharge process. Can Nurse 1998; 94:22-6. [PMID: 9633317] [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: 02/07/2023]
Abstract
Current mental health initiatives are decreasing the number of psychiatric beds and thus increasing the number of clients with serious mental illness who are being served in the community. Such changes have implications for clients' quality of life and health care economics. To implement the changes while addressing the unique needs of psychiatric clients, appropriate models of discharge planning and community integration are critical.
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Affiliation(s)
- C Forchuk
- University of Western Ontario, London
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Forchuk C, Westwell J, Martin ML, Azzapardi WB, Kosterewa-Tolman D, Hux M. Factors influencing movement of chronic psychiatric patients from the orientation to the working phase of the nurse-client relationship on an inpatient unit. Perspect Psychiatr Care 1998; 34:36-44. [PMID: 9847826 DOI: 10.1111/j.1744-6163.1998.tb00998.x] [Citation(s) in RCA: 43] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PROBLEM To identify factors influencing movement of nurse-patient dyads from Peplau's orientation phase to the working phase of the nurse-client relationship in a tertiary care psychiatric setting. METHODS Ten nurse-client dyads were interviewed after the initial nurse-client assignment until a consensus was reached between client, nurse, and investigator/CNS that the relationship was in the working phase. FINDINGS Factors causing the relationship to progress, from the clients' perspective, were the perceived attitude of the nurse, the nature of the planned therapeutic sessions, and what happened between therapeutic sessions. Factors hindering the development of the relationship included a nurse's or client's unavailability, a sense of distance/inequity, differences in realities/values, and mutual withdrawal. The relationship was perceived as supportive and "powerful" when it progressed to the working phase, but as very negative and like "limbo" if instead it moved to a phase of mutual withdrawal. CONCLUSIONS Nurses can help clients move from the orientation phase to the working phase by remaining available, consistent, and acting in a way that promotes trust. When the relationship does not progress to the working phase within 6 months, a therapeutic transfer should be considered.
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Affiliation(s)
- C Forchuk
- University of Western Ontario, Canada
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Buchner DM, Nicola RM, Martin ML, Patrick DL. Physical activity and health promotion for older adults in public housing. Am J Prev Med 1997; 13:57-62. [PMID: 9455595] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Designing health promotion and disease prevention (HPDP) programs for older residents of public housing is hampered by a lack of information about residents' needs and interests. This study addressed whether residents have greater needs for lifestyle modification or for preventive care and assessed interest in programs emphasizing physical activity. METHODS Older residents (n = 199) of public housing facilities in Seattle were surveyed to assess HPDP needs. A comparison of residents with older HMO enrollees (n = 2,289) identified which needs were relatively greater in residents of public housing. Residents' interest in physical activity programs was assessed by interviewing residents and by observing their interest in an exercise class. RESULTS The majority of residents could benefit from physical activity programs (75% of residents reported less than 60 minutes per week of exercise); fewer residents could benefit from smoking cessation programs (21%) and alcohol counseling (4%). The largest difference between residents and HMO enrollees was the greater need of residents for physical activity promotion. Residents and HMO enrollees reported similar use of preventive care services. Though residents seldom identified physical inactivity as a major concern, residents demonstrated interest in physical activity programs. Eighteen (41%) of 44 residents participated regularly or irregularly in an exercise class offered at their facility. When the class was scheduled to be discontinued, residents successfully lobbied city government to sustain the class. CONCLUSIONS The results suggest promoting physical activity should be a major goal of HPDP programs for older residents of public housing.
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Affiliation(s)
- D M Buchner
- Northwest Prevention Effectiveness Center, Seattle, WA, USA.
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Abstract
Individuals with schizophrenia have a high prevalence of smoking compared with the general population and little is known about why so many people with schizophrenia smoke. This paper reviews suggestions of differences in motivation for smoking. Possible explanations for smoking include psychological reasons, together with possible effects on positive and negative symptoms of schizophrenia and reduced side-effects of neuroleptics. Understanding complex issues related to smoking and schizophrenia is important prior to developing health promotion strategies.
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Affiliation(s)
- C Forchuk
- London Health Sciences Centre, Research Institute, Ontario, Canada
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Ksiazek TG, Nichol ST, Mills JN, Groves MG, Wozniak A, McAdams S, Monroe MC, Johnson AM, Martin ML, Peters CJ, Rollin PE. Isolation, genetic diversity, and geographic distribution of Bayou virus (Bunyaviridae: hantavirus). Am J Trop Med Hyg 1997; 57:445-8. [PMID: 9347961 DOI: 10.4269/ajtmh.1997.57.445] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Bayou hantavirus, previously implicated in human hantavirus pulmonary syndrome in Louisiana, was isolated from a rice rat (Oryzomys palustris) captured in Georgia. The presence of antibody among rice rats captured throughout the southeastern United States and the extent of diversity among the genetic variants of Bayou viruses suggest that the rice rat is the most likely natural reservoir of the virus and that both virus and host have probably co-evolved for some years.
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Affiliation(s)
- T G Ksiazek
- Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Ramakrishnan S, Sharma HW, Farris AD, Kaufman KM, Harley JB, Collins K, Pruijn GJ, van Venrooij WJ, Martin ML, Narayanan R. Characterization of human telomerase complex. Proc Natl Acad Sci U S A 1997; 94:10075-9. [PMID: 9294165 PMCID: PMC23309 DOI: 10.1073/pnas.94.19.10075] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Telomerase, a ribonucleoprotein complex, adds hexameric repeats called "telomeres" to the growing ends of chromosomal DNA. Characterization of mammalian telomerase has been elusive because of its low level of expression. We describe a bioinformatics approach to enrich and characterize the human telomerase complex. Using local sequence homology search methods, we detected similarity of the Tetrahymena p80 subunit of telomerase with the autoantigen Ro60. Antibodies to Ro60 immunoprecipitated the telomerase activity. Ro60 and p80 proteins were cross-recognizable by antibodies to either protein. Telomerase activity and the RNA component of telomerase complex were localized to a doublet in a native gel from the Ro60 antibody-precipitated material. The enriched material showed specific binding to a TTA GGG probe in vitro in an RNA template-dependent manner. Polyclonal antibodies to the doublet also immunoprecipitated the telomerase activity. These results suggest an evolutionary conservation of the telomerase proteins.
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Affiliation(s)
- S Ramakrishnan
- Department of Oncology, Hoffmann-La Roche, 340 Kingsland Street, Nutley, NJ 07110, USA
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