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Bonadonna LV, Guerrero E, McClendon T, Union S, Kabbani D, Wittmann D, Cohn J, Veltman J. Evaluation of an HIV homecare program for lost-to-follow-up populations: a mixed methods study in Detroit, Michigan. AIDS Res Ther 2024; 21:21. [PMID: 38609992 PMCID: PMC11015688 DOI: 10.1186/s12981-024-00608-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Maintaining people living with HIV (PLWHIV) in clinical care is a global priority. In the Metro Detroit area of Michigan, approximately 30% of PLWHIV are out of care. To re-engage lost-to-follow-up patients, Wayne Health Infectious Disease clinic launched an innovative Homecare program in 2017. In addition to home healthcare delivery, the program included links to community resources and quarterly community meetings. We aimed to evaluate Homecare's impact on participants' ability to stay engaged in HIV care and reach viral suppression. We included data from PLWHIV and their healthcare workers. METHODS We used a convergent mixed-methods design, including first year program record review, semi-structured interviews, and a validated Likert scale questionnaire rating illness perception before and after Homecare. Interview data were collected from 15 PLWHIV in Metro Detroit and two healthcare workers responsible for program delivery. Semi-structured interviews focused on obstacles to clinic-based care, support networks, and illness perceptions. Interview data were transcribed and analyzed using a thematic approach. A fully coded analysis was used to create a conceptual framework of factors contributing to Homecare's success. Means in eight categories of the Brief Illness Perception (IPQ) were compared using paired T-tests. RESULTS In the first year of Homecare, 28 of 34 participants (82%) became virally suppressed at least once. The program offered (1) social support and stigma reduction through strong relationships with healthcare workers, (2) removal of physical and resource barriers such as transportation, and (3) positive changes in illness perceptions. PLWHIV worked towards functional coping strategies, including improvements in emotional regulation, acceptance of their diagnosis, and more positive perspectives of control. Brief-IPQ showed significant changes in six domains before and after Homecare. CONCLUSION Homecare offers an innovative system for successfully re-engaging and maintaining lost-to-follow-up PLWHIV in care. These findings have implications for HIV control efforts and could inform the development of future programs for difficult to reach populations.
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Affiliation(s)
- L V Bonadonna
- Emory University School of Medicine, Atlanta, GA, USA.
- Wayne State University School of Medicine, Detroit, MI, USA.
| | - E Guerrero
- Wayne State University, Detroit, MI, USA
| | | | - S Union
- Wayne Health, Detroit, MI, USA
| | - D Kabbani
- Wayne State University School of Medicine, Detroit, MI, USA
| | | | - J Cohn
- Wayne State University School of Medicine, Detroit, MI, USA
| | - J Veltman
- Loma Linda University School of Medicine, Loma Linda, CA, USA
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2
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Hacker C, Mocchi M, Xiao J, Metzger B, Adkinson J, Pascuzzi B, Mathura R, Oswalt D, Watrous A, Bartoli E, Allawala A, Pirtle V, Fan X, Danstrom I, Shofty B, Banks G, Zhang Y, Armenta-Salas M, Mirpour K, Provenza N, Mathew S, Cohn J, Borton D, Goodman W, Pouratian N, Sheth S, Bijanki K. Aperiodic neural activity is a biomarker for depression severity. medRxiv 2023:2023.11.07.23298040. [PMID: 37986996 PMCID: PMC10659509 DOI: 10.1101/2023.11.07.23298040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
A reliable physiological biomarker for Major Depressive Disorder (MDD) is necessary to improve treatment success rates by shoring up variability in outcome measures. In this study, we establish a passive biomarker that tracks with changes in mood on the order of minutes to hours. We record from intracranial electrodes implanted deep in the brain - a surgical setting providing exquisite temporal and spatial sensitivity to detect this relationship in a difficult-to-measure brain area, the ventromedial prefrontal cortex (VMPFC). The aperiodic slope of the power spectral density captures the balance of activity across all frequency bands and is construed as a putative proxy for excitatory/inhibitory balance in the brain. This study demonstrates how shifts in aperiodic slope correlate with depression severity in a clinical trial of deep brain stimulation for treatment-resistant depression (TRD). The correlation between depression severity scores and aperiodic slope is significant in N=5 subjects, indicating that flatter (less negative) slopes correspond to reduced depression severity, especially in the ventromedial prefrontal cortex. This biomarker offers a new way to track patient response to MDD treatment, facilitating individualized therapies in both intracranial and non-invasive monitoring scenarios.
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Affiliation(s)
- C. Hacker
- Baylor College of Medicine Department of Neurosurgery
- Washington University in St. Louis Department of Neurosurgery
| | - M.M Mocchi
- Baylor College of Medicine Department of Neurosurgery
| | - J. Xiao
- Baylor College of Medicine Department of Neurosurgery
| | - B.A. Metzger
- Baylor College of Medicine Department of Neurosurgery
| | - J.A. Adkinson
- Baylor College of Medicine Department of Neurosurgery
| | - B.R. Pascuzzi
- Baylor College of Medicine Department of Neurosurgery
| | - R.C. Mathura
- Baylor College of Medicine Department of Neurosurgery
| | - D. Oswalt
- University of Pennsylvania Department of Neurosurgery
| | - A. Watrous
- Baylor College of Medicine Department of Neurosurgery
| | - E. Bartoli
- Baylor College of Medicine Department of Neurosurgery
| | - A. Allawala
- Brown University Department of Biomedical Engineering and Carney Institute for Brain Science
| | - V. Pirtle
- Baylor College of Medicine Department of Neurosurgery
| | - X. Fan
- Baylor College of Medicine Department of Neurosurgery
| | - I. Danstrom
- Baylor College of Medicine Department of Neurosurgery
| | - B. Shofty
- Baylor College of Medicine Department of Neurosurgery
| | - G. Banks
- Baylor College of Medicine Department of Neurosurgery
| | - Y. Zhang
- Baylor College of Medicine Department of Neurosurgery
| | | | - K. Mirpour
- University of Texas Southwestern, Department of Neurosurgery
| | - N. Provenza
- Baylor College of Medicine Department of Neurosurgery
| | - S. Mathew
- Baylor College of Medicine Department of Psychiatry
| | - J. Cohn
- University of Pittsburgh Department of Psychology
| | - D. Borton
- Brown University Department of Biomedical Engineering and Carney Institute for Brain Science
- Brown University Department of Veterans Affairs Center for Neurorestoration and Neurotechnology
| | - W. Goodman
- Baylor College of Medicine Department of Psychiatry
| | - N. Pouratian
- University of Texas Southwestern, Department of Neurosurgery
| | - S.A. Sheth
- Baylor College of Medicine Department of Neurosurgery
| | - K.R. Bijanki
- Baylor College of Medicine Department of Neurosurgery
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Affiliation(s)
- J Cohn
- Society for Evidence-Based Gender Medicine, Twin Falls, ID, 83301-5235, USA.
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Cohn J. Elaboration of some points in "The association of gender dysphoria with psychosis". Psychiatry Res 2023; 325:115264. [PMID: 37263087 DOI: 10.1016/j.psychres.2023.115264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/08/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Affiliation(s)
- J Cohn
- Society for Evidence-Based Gender Medicine, Twin Falls, ID 83301 United States.
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Abstract
There is significant disagreement about how to support trans-identified or gender-dysphoric young people. Different experts and expert bodies make strikingly different recommendations based upon the same (limited) evidence. The US-originating "gender-affirmative" model emphasizes social transition and medical intervention, while some other countries, in response to evidence reviews of medical intervention outcomes, have adopted psychological interventions as the first line of treatment. A proposed model of gender-affirming care, comprising only medical intervention for "eligible" youth, is described in Rosenthal (2021). Determining eligibility for these medical interventions is challenging and engenders considerable disagreement among experts, neither of which is mentioned. The review also claims without support that medical interventions have been shown to clearly benefit mental health, and leaves out significant risks and less invasive alternatives. The unreliability of outcome studies and the corresponding uncertainties as to how gender dysphoria develops and responds to treatment are also unreported.
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Affiliation(s)
- J Cohn
- Society for Evidence-based Gender Medicine (SEGM), Twin Falls, ID, USA
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Adetunji O, Mukherjee S, Sacks E, Ciaranello A, Chadambuka A, Mafaune H, McCann N, Cohn J. Human Resource Time Use for Early Infant HIV Diagnosis: A Comparative Time‐Motion Study at Centralized and Point‐of‐Care Health Facilities in Zimbabwe. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- O. Adetunji
- Elizabeth Glaser Pediatric AIDS Foundation Washington DC United States
| | - S. Mukherjee
- Elizabeth Glaser Pediatric AIDS Foundation Washington DC United States
| | - E. Sacks
- Elizabeth Glaser Pediatric AIDS Foundation Washington DC United States
| | - A. Ciaranello
- Massachusetts General Hospital Boston MA United States
| | - A. Chadambuka
- Elizabeth Glaser Pediatric AIDS Foundation Harare Zimbabwe
| | - H. Mafaune
- Elizabeth Glaser Pediatric AIDS Foundation Harare Zimbabwe
| | - N. McCann
- Massachusetts General Hospital Boston MA United States
| | - J. Cohn
- Elizabeth Glaser Pediatric AIDS Foundation Geneva Switzerland
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Safavi-Naini A, Lewis-Swan RJ, Bohnet JG, Gärttner M, Gilmore KA, Jordan JE, Cohn J, Freericks JK, Rey AM, Bollinger JJ. Verification of a Many-Ion Simulator of the Dicke Model Through Slow Quenches across a Phase Transition. Phys Rev Lett 2018; 121:040503. [PMID: 30095931 DOI: 10.1103/physrevlett.121.040503] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/26/2018] [Indexed: 06/08/2023]
Abstract
We use a self-assembled two-dimensional Coulomb crystal of ∼70 ions in the presence of an external transverse field to engineer a simulator of the Dicke Hamiltonian, an iconic model in quantum optics which features a quantum phase transition between a superradiant (ferromagnetic) and a normal (paramagnetic) phase. We experimentally implement slow quenches across the quantum critical point and benchmark the dynamics and the performance of the simulator through extensive theory-experiment comparisons which show excellent agreement. The implementation of the Dicke model in fully controllable trapped ion arrays can open a path for the generation of highly entangled states useful for enhanced metrology and the observation of scrambling and quantum chaos in a many-body system.
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Affiliation(s)
- A Safavi-Naini
- JILA, NIST and University of Colorado, 440 UCB, Boulder, Colorado 80309, USA
- Center for Theory of Quantum Matter, University of Colorado, Boulder, Colorado 80309, USA
| | - R J Lewis-Swan
- JILA, NIST and University of Colorado, 440 UCB, Boulder, Colorado 80309, USA
- Center for Theory of Quantum Matter, University of Colorado, Boulder, Colorado 80309, USA
| | | | - M Gärttner
- JILA, NIST and University of Colorado, 440 UCB, Boulder, Colorado 80309, USA
- Center for Theory of Quantum Matter, University of Colorado, Boulder, Colorado 80309, USA
- Kirchhoff-Institut für Physik, Universität Heidelberg, Im Neuenheimer Feld 227, 69120 Heidelberg, Germany
| | | | | | - J Cohn
- Department of Physics, Georgetown University, Washington, DC 20057, USA
| | - J K Freericks
- Department of Physics, Georgetown University, Washington, DC 20057, USA
| | - A M Rey
- JILA, NIST and University of Colorado, 440 UCB, Boulder, Colorado 80309, USA
- Center for Theory of Quantum Matter, University of Colorado, Boulder, Colorado 80309, USA
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Parker H, O'Connor H, Cohn J, Garg M, Caterson I, George J, Johnson N. Effect of combined fish oil plus coenzyme Q 10 supplementation on Omega-3 Index and cardiovascular risk markers in overweight men. Journal of Nutrition & Intermediary Metabolism 2016. [DOI: 10.1016/j.jnim.2015.12.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Davis SJ, Scott LL, Ordemann G, Philpo A, Cohn J, Pierce-Shimomura JT. Putative calcium-binding domains of the Caenorhabditis elegans BK channel are dispensable for intoxication and ethanol activation. Genes Brain Behav 2016; 14:454-65. [PMID: 26113050 DOI: 10.1111/gbb.12229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 01/17/2023]
Abstract
Alcohol modulates the highly conserved, voltage- and calcium-activated potassium (BK) channel, which contributes to alcohol-mediated behaviors in species from worms to humans. Previous studies have shown that the calcium-sensitive domains, RCK1 and the Ca(2+) bowl, are required for ethanol activation of the mammalian BK channel in vitro. In the nematode Caenorhabditis elegans, ethanol activates the BK channel in vivo, and deletion of the worm BK channel, SLO-1, confers strong resistance to intoxication. To determine if the conserved RCK1 and calcium bowl domains were also critical for intoxication and basal BK channel-dependent behaviors in C. elegans, we generated transgenic worms that express mutated SLO-1 channels predicted to have the RCK1, Ca(2+) bowl or both domains rendered insensitive to calcium. As expected, mutating these domains inhibited basal function of SLO-1 in vivo as neck and body curvature of these mutants mimicked that of the BK null mutant. Unexpectedly, however, mutating these domains singly or together in SLO-1 had no effect on intoxication in C. elegans. Consistent with these behavioral results, we found that ethanol activated the SLO-1 channel in vitro with or without these domains. By contrast, in agreement with previous in vitro findings, C. elegans harboring a human BK channel with mutated calcium-sensing domains displayed resistance to intoxication. Thus, for the worm SLO-1 channel, the putative calcium-sensitive domains are critical for basal in vivo function but unnecessary for in vivo ethanol action.
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Affiliation(s)
- S J Davis
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - L L Scott
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - G Ordemann
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - A Philpo
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - J Cohn
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - J T Pierce-Shimomura
- Waggoner Center for Alcohol and Addiction Research, Institute for Neuroscience, Center for Learning and Memory, Center for Brain, Behavior and Evolution, and Department of Neuroscience, The University of Texas at Austin, Austin, TX, USA
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10
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Beron C, Vidal-Gadea AG, Cohn J, Parikh A, Hwang G, Pierce-Shimomura JT. The burrowing behavior of the nematode Caenorhabditis elegans: a new assay for the study of neuromuscular disorders. Genes Brain Behav 2016; 14:357-68. [PMID: 25868909 DOI: 10.1111/gbb.12217] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 11/28/2022]
Abstract
The nematode Caenorhabditis elegans has been a powerful model system for the study of key muscle genes relevant to human neuromuscular function and disorders. The behavioral robustness of C. elegans, however, has hindered its use in the study of certain neuromuscular disorders because many worm models of human disease show only subtle phenotypes while crawling. By contrast, in their natural habitat, C. elegans likely spends much of the time burrowing through the soil matrix. We developed a burrowing assay to challenge motor output by placing worms in agar-filled pipettes of increasing densities. We find that burrowing involves distinct kinematics and turning strategies from crawling that vary with the properties of the substrate. We show that mutants mimicking Duchenne muscular dystrophy by lacking a functional ortholog of the dystrophin protein, DYS-1, crawl normally but are severely impaired in burrowing. Muscular degeneration in the dys-1 mutant is hastened and exacerbated by burrowing, while wild type shows no such damage. To test whether neuromuscular integrity might be compensated genetically in the dys-1 mutant, we performed a genetic screen and isolated several suppressor mutants with proficient burrowing in a dys-1 mutant background. Further study of burrowing in C. elegans will enhance the study of diseases affecting neuromuscular integrity, and will provide insights into the natural behavior of this and other nematodes.
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Affiliation(s)
- C Beron
- Department of Neuroscience, Center for Brain, Behavior & Evolution; Waggoner Center for Alcohol and Addiction Research, Center for Learning and Memory, The University of Texas at Austin, Austin, TX, 78712, USA
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Cohn J, Moaveni D, Sznol J, Ranasinghe J. Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period. Int J Obstet Anesth 2015; 25:30-6. [PMID: 26421698 DOI: 10.1016/j.ijoa.2015.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 08/03/2015] [Accepted: 08/10/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND A continuous spinal catheter is a reliable alternative to standard neuraxial techniques in obstetric anesthesia. Despite the potential advantages of intrathecal catheters, they remain underutilized due to fear of infection, nerve damage or post-dural puncture headache. In our tertiary care center, intrathecal catheters are either placed intentionally in high-risk obstetric patients or following inadvertent dural puncture using a 19-gauge macrocatheter passed through a 17-gauge epidural needle. METHODS A retrospective review of 761 intrathecal catheters placed from 2001 to 2012 was conducted. An institutional obstetric anesthesia database was used to identify patients with intrathecal catheters. Medical records were reviewed for procedural details and complications. RESULTS There were no serious complications, including meningitis, epidural or spinal abscess, hematoma, arachnoiditis, or cauda equina syndrome, associated with intrathecal catheters. The failure rates were 2.8% (3/108) for intentional placements and 6.1% (40/653) for placements following accidental dural puncture. The incidence of post-dural puncture headache was 41% (312/761) and the epidural blood patch rate was 31% (97/312). CONCLUSIONS This review demonstrates that intrathecal catheters are dependable and an option for labor analgesia and surgical anesthesia for cesarean delivery. Serious long-lasting complications are rare.
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Affiliation(s)
- J Cohn
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
| | - D Moaveni
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - J Sznol
- University of Miami Public Health Sciences, Miami, FL, USA
| | - J Ranasinghe
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
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Moaveni D, Cohn J, Brodt J, Hoctor K, Ranasinghe J. Scleroderma and pulmonary hypertension complicating two pregnancies: use of neuraxial anesthesia, general anesthesia, epoprostenol and a multidisciplinary approach for cesarean delivery. Int J Obstet Anesth 2015; 24:375-82. [PMID: 26119257 DOI: 10.1016/j.ijoa.2015.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 05/01/2015] [Accepted: 05/03/2015] [Indexed: 10/23/2022]
Abstract
Literature regarding the anesthetic care of patients with scleroderma during labor and delivery is limited to remote case reports. No recent publications provide information on the anesthetic management of patients with coexisting pulmonary hypertension. This report describes the anesthetic and multidisciplinary management of two pregnant patients with concomitant scleroderma and pulmonary hypertension undergoing cesarean delivery; one with neuraxial anesthesia and one with general anesthesia. Considerations for neuraxial and general anesthesia in patients with concurrent scleroderma and pulmonary hypertension are discussed.
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Affiliation(s)
- D Moaveni
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
| | - J Cohn
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - J Brodt
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - K Hoctor
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
| | - J Ranasinghe
- University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA
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Chan V, Blazey W, Tegay D, Harper B, Koehler S, Laurent B, Lipka S, Cohn J, Jung MK, Krishnamachari B. Impact of academic affiliation and training on knowledge of hereditary colorectal cancer. Public Health Genomics 2014; 17:76-83. [PMID: 24458016 DOI: 10.1159/000356938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowledge about hereditary colorectal cancer (CRC) can aid cancer screening and prevention in high-risk patients. Genetic testing, once conducted primarily at academic centers, is now routinely performed in a variety of clinics. Nonacademic physicians may not be aware of hereditary CRC standards of care. METHODS From August to November 2012, a survey was administered to predominantly primary care physicians evaluating academic center affiliation, past training in genetics and knowledge regarding hereditary CRC. RESULTS One hundred forty physicians completed the survey. Knowledge of hereditary CRC was neither associated with academic affiliation nor with training during medical school or residency, but with continuing medical education (CME) training. Those with CME training were more likely to know that screening could be enhanced for patients with a hereditary cancer risk (OR = 4.49, 95% CI = 1.40-14.38) and that an individual with hereditary CRC would have different screening recommendations (OR = 7.49, 95% CI = 1.37-40.81). Residency training and CME training were associated with more frequent hereditary risk assessment. CONCLUSION Genetics training may be associated with physicians' knowledge and assessment of hereditary CRC. Training at the CME level in particular may be integral to the delivery of genetic services in clinical practice.
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Affiliation(s)
- V Chan
- Department of Medicine, NYIT College of Osteopathic Medicine, Old Westbury, N.Y., USA
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Keating S, Machan E, O’Conner H, Gerofi J, Sainsbury A, Cohn J, Caterson I, Johnson N. Endurance exercise but not high-intensity interval training improves abdominal fat distribution in overweight adults. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cohn J, Song Y, Dunkin D, Wang J, Ceballos C, Hoffstadter-Thal K, Ross J, Benkov K, Li X. Comparison of Serum Cytokine, Chemokine, and Growth Factor Profiles in Crohn's Disease and Food Allergy in Children. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Affiliation(s)
- D Maher
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.
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Cohn J. Just a little scratch? West J Med 2009. [DOI: 10.1136/bmj.b3393] [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: 11/03/2022]
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Cohn J, Tandy S, Wat E, Kamili A, Chung R, Rowney M, Brown A. Abstract: 601 DIETARY MILK PHOSPHOLIPID AS A CARDIOVASCULAR NUTRACEUTICAL. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70350-2] [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: 10/20/2022]
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Cohn J. Abstract: 550 PLASMA TRIGLYCERIDE METABOLISM IN THE FED STATE – CLINICAL AND PATHOPHYSIOLOGICAL SIGNIFICANCE. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cohn J, Bolton A. Optimising virtual training systems. Theoretical Issues in Ergonomics Science 2009. [DOI: 10.1080/14639220802151237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Key Words
- Adolescents
- Adolescents, Male
- Age Factors
- Biology
- Blood Coagulation Effects
- Clinical Research
- Contraception
- Contraceptive Agents, Estrogen--administraction and dosage
- Contraceptive Agents, Estrogen--side effects
- Contraceptive Agents, Estrogen--therapeutic use
- Contraceptive Agents, Female--administraction and dosage
- Contraceptive Agents, Female--side effects
- Contraceptive Agents, Female--therapeutic use
- Contraceptive Agents, Progestin--administraction and dosage
- Contraceptive Agents, Progestin--side effects
- Contraceptive Agents, Progestin--therapeutic use
- Contraceptive Agents--administraction and dosage
- Contraceptive Agents--side effects
- Contraceptive Agents--therapeutic use
- Contraceptive Methods--administraction and dosage
- Contraceptive Methods--side effects
- Contraceptive Methods--therapeutic use
- Demographic Factors
- Family Planning
- Hematological Effects
- Hemic System
- Lynestrenol--administraction and dosage
- Lynestrenol--side effects
- Lynestrenol--therapeutic use
- Mestranol--administraction and dosage
- Mestranol--side effects
- Mestranol--therapeutic use
- Oral Contraceptives, Combined
- Oral Contraceptives--administraction and dosage
- Oral Contraceptives--side effects
- Oral Contraceptives--therapeutic use
- Physiology
- Population
- Population Characteristics
- Research Methodology
- Youth
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Condouret J, Cohn J, Ferret JM, Lemonsu A, Vasconcelos W, Dejour D, Potel JF. Évaluation isocinétique à deux ans de ligamentoplasties du ligament croisé antérieur au tendon rotulien et aux ischiojambiers. ACTA ACUST UNITED AC 2008; 94:375-82. [DOI: 10.1016/j.rco.2008.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Cohn J, Krokan H, Lindqvist BH. Abstracts from XII Tromsø-Seminar in Medicine June 19-22, 1983, University of Tromsø, Norway: Cancer and Genetics. Hereditas 2008. [DOI: 10.1111/j.1601-5223.1984.tb00117.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Schwahn BC, Wang XL, Mikael LG, Wu Q, Cohn J, Jiang H, Maclean KN, Rozen R. Betaine supplementation improves the atherogenic risk factor profile in a transgenic mouse model of hyperhomocysteinemia. Atherosclerosis 2007; 195:e100-7. [PMID: 17689540 DOI: 10.1016/j.atherosclerosis.2007.06.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Revised: 04/13/2007] [Accepted: 06/21/2007] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the lipotropic action of betaine on plasma lipoproteins and tissue lipids. METHODS AND RESULTS Adult mice, wild type (+/+) or heterozygous (+/-) for a disruption of the methylenetetrahydrofolate reductase (Mthfr) gene, were supplemented with betaine for 1 year and compared with mice on control diets. Outcome measures were plasma homocysteine and lipoprotein levels, aortic and liver morphology, and liver staining for 3-nitrotyrosine (oxidative stress marker) and Apolipoprotein A-I (ApoA-I). We also investigated short-term effects of supplemental betaine on plasma lipoproteins in Mthfr +/+ and +/- mice. Both genotypes showed significantly lower plasma homocysteine after long-term betaine supplementation, and lower plasma triglycerides and higher HDL-cholesterol after both short- and long-term betaine. Lipid accumulation in liver and aortic wall tended to be lower in Mthfr+/+ compared to Mthfr+/- mice and in betaine-supplemented compared to unsupplemented mice. Nitrotyrosine staining was higher and ApoA-I staining was lower in livers of Mthfr+/- compared to Mthfr+/+ mice. Betaine did not affect staining of nitrotyrosine but increased ApoA-I staining. A significant negative correlation was observed between plasma homocysteine and liver ApoA-I. CONCLUSIONS Mild MTHFR deficiency in mice is associated with increased risk for atherosclerotic disease. Betaine has a lipotropic effect, which is associated with a reduction in homocysteine, an increase in ApoA-I and an amelioration of the atherogenic risk profile.
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Affiliation(s)
- B C Schwahn
- Departments of Human Genetics and Pediatrics, McGill University Health Center-Montreal Children's Hospital, Montreal, Canada
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Cohn J, Patterson B, Uffelman K, Davignon J, Steiner G. W09.200 Insulin resistance is associated with increased VLDL triglyceride and VLDL apoC-III production. ATHEROSCLEROSIS SUPP 2004. [DOI: 10.1016/s1567-5688(04)90199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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MacPhail RC, O'Callaghan JP, Cohn J. Acquisition, steady-state performance, and the effects of trimethyltin on the operant behavior and hippocampal GFAP of Long-Evans and Fischer 344 rats. Neurotoxicol Teratol 2003; 25:481-90. [PMID: 12798965 DOI: 10.1016/s0892-0362(03)00012-6] [Citation(s) in RCA: 3] [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]
Abstract
Strain differences represent an overlooked variable that may play an important role in neurotoxic outcomes that can impact regulatory decision making. Here, we examined the strain-dependent effects of trimethyltin (TMT), a compound used as a positive control for behavioral and neurochemical assessments of neurotoxicity. Adult male Long-Evans (LE) and Fischer 344 (F344) rats (n=12 each) were trained to respond under a multiple, fixed-interval 3-min fixed-ratio 10-response (multi FI 3-min FR10) schedule of milk reinforcement. Acquisition was characterized by time-dependent changes in several behavioral endpoints in both strains, although rate of acquisition of the fixed-interval pattern of responding was slower in F344 rats. Steady-state (baseline) performance was characterized by slower overall rates of responding in F344 rats. There was little evidence of strain differences in many of the other baseline performance measures. Rats of each strain were then divided into two equal groups that received either 1 ml/kg saline or 8.0 mg/kg iv TMT approximately 18 h before the next test session. TMT produced transient changes in the performance of LE and F344 rats that lasted for several sessions. For many behavioral measures, F344 rats were more affected by TMT than were LE rats. TMT-induced reactive gliosis, as assessed by assaying glial fibrillary acidic protein (GFAP), was also greater in F344 rats than in LE rats. These results suggest F344 rats may be more susceptible to TMT-induced neurotoxicity than are LE rats.
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Affiliation(s)
- R C MacPhail
- Neurotoxicology Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
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Israel E, Cohn J, Meltzer E, McCarty J, Zheng B, Carroll A. Omalizumab does not induce thrombocytopenia in the treatment of asthma. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80469-4] [Citation(s) in RCA: 2] [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: 10/24/2022]
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Cohn J. [Torture survivors in Norway--physician's responsibility]. Tidsskr Nor Laegeforen 2001; 121:3383-5. [PMID: 11826781] [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] Open
Abstract
BACKGROUND Many political refugees who seek asylum in Norway have been imprisoned and subjected to torture. This review is based on the author's personal experience since 1976. MATERIAL AND METHODS 44 men (22-45 years of age) and 9 women (23-32 years of age), all of them exposed to physical torture, were included in the study. The methods of torture are described. They were all given a full clinical examination by the author, including photos of possible injuries. RESULTS The survivors showed physical and sexual sequelae, for instance multiple fractures of bones and teeth, tinnitus, broken testicles. INTERPRETATION In my opinion, the most important therapist for torture victims is their general practitioner, who should work with nurses, physiotherapists, dentists and psychologists.
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Affiliation(s)
- J Cohn
- Institutt for klinisk medisin Universitetet i Tromsø, MH-Breivika 9037 Tromsø
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Kovacs A, Wasserman SS, Burns D, Wright DJ, Cohn J, Landay A, Weber K, Cohen M, Levine A, Minkoff H, Miotti P, Palefsky J, Young M, Reichelderfer P. Determinants of HIV-1 shedding in the genital tract of women. Lancet 2001; 358:1593-601. [PMID: 11716886 DOI: 10.1016/s0140-6736(01)06653-3] [Citation(s) in RCA: 185] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Plasma HIV-1 RNA concentration has been the best predictor for risk of heterosexual and perinatal transmission. However, direct contact with HIV-1 present locally in the genital tract might be necessary for transmission. We aimed to assess the relation between HIV-1 shedding (RNA or culturable virus) in female genital secretions and other factors that might affect HIV-1 shedding. METHODS This was a cross-sectional study within the Women's Interagency HIV Study (WIHS), a prospective longitudinal cohort study of HIV-infected women. We enrolled 311 HIV positive women from Jan 30, 1997 to July 1, 1998. We did clinical assessments, cultured HIV-1, and measured RNA in peripheral blood mononuclear cells (PBMC) and genital secretions. We compared the results with univariate and multivariate analyses. Presence of HIV-1 RNA or culturable virus in genital secretions was defined as HIV-1 shedding. FINDINGS HIV-1 RNA was present in genital secretions of 57% (152/268) of women whereas infectious virus was detected only in 6% (17/271). Genital tract HIV-1 shedding was found in 80% (130/163) of women with detectable plasma RNA and 78% (116/148) of women with positive PBMC cultures. 33% (27/83) of women with less than 500 copies/mL plasma RNA and 39% (35/90) of those with negative PBMC cultures also had genital tract shedding. INTERPRETATION Plasma RNA concentration, both qualitatively and quantitatively, was the most important factor in predicting genital HIV-1 shedding, even among women receiving potent antiretroviral therapy. However, HIV-1 shedding did occur in women with less than 500 copies/mL plasma HIV-1 RNA. This finding suggests that a separate reservoir of HIV-1 replication may exist in some women.
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Affiliation(s)
- A Kovacs
- Maternal-Child and Adolescent HIV Management and Research Center, University of Southern California School of Medicine, Los Angeles, CA 90033, USA.
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Coombs RW, Wright DJ, Reichelderfer PS, Burns DN, Cohn J, Cu-Uvin S, Baron PA, Cohen MH, Landay AL, Lewis S, Kovacs A. Variation of human immunodeficiency virus type 1 viral RNA levels in the female genital tract: implications for applying measurements to individual women. J Infect Dis 2001; 184:1187-91. [PMID: 11598843 DOI: 10.1086/323660] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [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: 09/15/2000] [Revised: 06/29/2001] [Indexed: 11/03/2022] Open
Abstract
The short-term detection and variability of human immunodeficiency virus type 1 (HIV-1) RNA level was assessed in the blood plasma and genital tracts of 55 HIV-1-infected women. Specimens were collected weekly for 8 weeks from the endocervical canal with wicks and cytobrushes and from the ectocervix and vagina with cervicovaginal lavage. In all, 48 women (87.3%) had detectable genital tract HIV-1 RNA at > or =1 collection times. HIV-1 RNA levels varied least in specimens from endocervical canal wick and most in cervicovaginal lavage samples. The within-subject variation for genital-tract virus level was greater than that for blood. Overall, the odds for viral RNA detection in the genital tract approximately tripled for each 10-fold increase in plasma viral RNA concentration (P<.001) or with concomitant genital tract infection (P=.003). Endocervical canal wicks should be considered as an adjunct to cervicovaginal lavage, to improve the sensitivity and precision of HIV-1 RNA detection.
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Affiliation(s)
- R W Coombs
- Department of Laboratory Medicine, University of Washington, Seattle, WA 98104-2499, USA.
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Cohn J. [Abuse and maltreatment of children - then and now]. Dan Medicinhist Arbog 2001:158-68. [PMID: 11628830] [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: 02/21/2023]
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Boujaoude LC, Bradshaw-Wilder C, Mao C, Cohn J, Ogretmen B, Hannun YA, Obeid LM. Cystic fibrosis transmembrane regulator regulates uptake of sphingoid base phosphates and lysophosphatidic acid: modulation of cellular activity of sphingosine 1-phosphate. J Biol Chem 2001; 276:35258-64. [PMID: 11443135 DOI: 10.1074/jbc.m105442200] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.0] [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] [Indexed: 11/06/2022] Open
Abstract
Sphingolipids have been implicated in the regulation of cell growth, differentiation, and programmed cell death. Sphingosine 1-phosphate (SPP) has recently emerged as an important lipid messenger and a ligand for the endothelial differentiation gene receptor family of proteins through which it mediates its biologic effects. Recent studies in Saccharomyces cerevisiae in our laboratory implicated the yeast oligomycin resistance gene (YOR1), a member of the ATP binding cassette family of proteins, in the transport of SPP. The cystic fibrosis transmembrane regulator is a unique member of the ATP binding cassette transporter family and has high homology with YOR1. We therefore set out to investigate if this member of the family can regulate SPP transport. We demonstrate that C127/cystic fibrosis transmembrane regulator (CFTR) cells, expressing wild type CFTR, exhibited significantly higher uptake of sphingosine 1-phosphate than either cells expressing a mutant CFTR C127/DeltaF508 or C127/mock-transfected cells. This effect was specific, dose-dependent, and competed off by dihydrosphingosine 1-phosphate and lysophosphatidic acid. There was no difference in uptake of sphingosine, C(16)-ceramide, sphingomyelin, lysophingomyelin, phosphatidylcholine, lysophosphatidylcholine, or phosphatidic acid among the different cell lines. Pretreatment with forskolin or isobutylmethylxanthine to stimulate cAMP did not affect the uptake in any of the cell lines. Moreover, we found that mitogen-activated protein kinase activation by SPP was less responsive in C127/CFTR as compared with C127/mock-transfected cells, suggesting that uptake of SPP by CFTR may divert it from interacting with its cell surface receptors and attenuate signaling functions. Taken together, these data implicate CFTR in uptake of SPP and the related phosphorylated lipids dihydrosphingosine 1-phosphate and lysophosphatidic acid. This uptake influences the availability of SPP to modulate biologic activity via endothelial differentiation gene receptors. These studies may have important implications to cystic fibrosis.
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Affiliation(s)
- L C Boujaoude
- Division of General Internal Medicine, Ralph H. Johnson Veterans Administration Hospital, Charleston, South Carolina 29401-5799, USA
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Al-Harthi L, Kovacs A, Coombs RW, Reichelderfer PS, Wright DJ, Cohen MH, Cohn J, Cu-Uvin S, Watts H, Lewis S, Beckner S, Landay A. A menstrual cycle pattern for cytokine levels exists in HIV-positive women: implication for HIV vaginal and plasma shedding. AIDS 2001; 15:1535-43. [PMID: 11504986 DOI: 10.1097/00002030-200108170-00011] [Citation(s) in RCA: 57] [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: 01/22/2023]
Abstract
OBJECTIVES To evaluate the effect of the menstrual cycle in HIV-positive women on plasma and genital cytokine levels, interrelationships between vaginal and plasma cytokines, CD4 and CD8 T cell fluctuations, and genital and plasma viral loads. METHODS Plasma and cervicovaginal lavage specimens were collected from 55 HIV-positive women with CD4 cell counts < 350 cells/microl during phases of the menstrual cycle. Samples were assayed for IL-1beta, IL-6, IL-4, IL-8, IL-10, TGFbeta, TNFalpha, INFgamma, MIP1alpha, MIP1beta, RANTES, and TNFR-II using enzyme-linked immunosorbent assays. CD4 and CD8 T cell expression was evaluated by flow cytometry. Repeated measures regression models were used to assess the effect of the menstrual cycle on cytokines and viral load. Multivariate repeated regression models were used to assess the correlation among selected cytokines and between selected cytokines and HIV viral load. RESULTS Vaginal IL-1beta, IL-4, IL-6, IL-8, IL-10, MIP1beta, RANTES, TGFbeta, and TNFR-II were significantly elevated during menses but were not altered during other phases. Plasma cytokine levels were not altered during the menstrual cycle. A positive Candida culture increased vaginal IL-8 during menses, whereas vaginal discharge was associated with a reduction in vaginal IL-4, IL-10, and RANTES. CD4 and CD8 cell numbers did not vary with the menstrual cycle. Vaginal cytokine levels correlated only with vaginal viral load, in a sampling method-dependent manner. CONCLUSION We provide evidence of elevated vaginal cytokine levels during menses, which appear to regulate vaginal and not plasma HIV shedding, suggesting that a menstrual cycle pattern exists for cytokine production in HIV-positive women impacting vaginal shedding of HIV.
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Affiliation(s)
- L Al-Harthi
- Department of Immunology/Microbiology at Rush-Presbyterian St Luke's Medical Center, Chicago, IL 60612, USA
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Abstract
Mammary epithelial 31EG4 cells (MEC) were grown as monolayers on filters to analyze the apical membrane mechanisms that help mediate ion and fluid transport across the epithelium. RT-PCR showed the presence of cystic fibrosis transmembrane conductance regulator (CFTR) and epithelial Na(+) channel (ENaC) message, and immunomicroscopy showed apical membrane staining for both proteins. CFTR was also localized to the apical membrane of native human mammary duct epithelium. In control conditions, mean values of transepithelial potential (apical-side negative) and resistance (R(T)) are -5.9 mV and 829 Omega x cm(2), respectively. The apical membrane potential (V(A)) is -40.7 mV, and the mean ratio of apical to basolateral membrane resistance (R(A)/R(B)) is 2.8. Apical amiloride hyperpolarized V(A) by 19.7 mV and tripled R(A)/R(B). A cAMP-elevating cocktail depolarized V(A) by 17.6 mV, decreased R(A)/R(B) by 60%, increased short-circuit current by 6 microA/cm(2), decreased R(T) by 155 Omega x cm(2), and largely eliminated responses to amiloride. Whole cell patch-clamp measurements demonstrated amiloride-inhibited Na(+) currents [linear current-voltage (I-V) relation] and forskolin-stimulated Cl(-) currents (linear I-V relation). A capacitance probe method showed that in the control state, MEC monolayers either absorbed or secreted fluid (2--4 microl x cm(-2) x h(-1)). Fluid secretion was stimulated either by activating CFTR (cAMP) or blocking ENaC (amiloride). These data plus equivalent circuit analysis showed that 1) fluid absorption across MEC is mediated by Na(+) transport via apical membrane ENaC, and fluid secretion is mediated, in part, by Cl(-) transport via apical CFTR; 2) in both cases, appropriate counterions move through tight junctions to maintain electroneutrality; and 3) interactions among CFTR, ENaC, and tight junctions allow MEC to either absorb or secrete fluid and, in situ, may help control luminal [Na(+)] and [Cl(-)].
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Affiliation(s)
- S Blaug
- Department of Molecular and Cell Biology, University of California, Berkeley, California 94720-3200, USA
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Abstract
Studies of receptors and signal-transduction components that play a role in plant disease resistance have revealed remarkable similarities with innate immunity pathways in insects and mammals. In plants, specific receptors encoded by disease-resistance genes interact with products of microbial effector genes to activate defence responses. Resistance proteins have been found to have motifs in common with components of immune response pathways in mammals and invertebrates, and to rely on similar downstream signalling components. In the future, the sharing of ideas among plant and animal biologists is likely to broaden our understanding of defence responses in diverse organisms.
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Affiliation(s)
- J Cohn
- Boyce Thompson Institute for Plant Research, Cornell University, Ithaca, NY 14853, USA
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Cu-Uvin S, Wright DJ, Anderson D, Kovacs A, Watts DH, Cohn J, Landay A, Reichelderfer PS. Hormonal levels among HIV-1-seropositive women compared with high-risk HIV-seronegative women during the menstrual cycle. Women's Health Study (WHS) 001 and WHS 001a Study Team. J Womens Health Gend Based Med 2000; 9:857-63. [PMID: 11074951 DOI: 10.1089/152460900750020883] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is a paucity of normative data on hormonal levels among HIV-infected women. Hormonal levels may influence fertility and HIV-related immunological and virological factors. The objective of this study was to determine progesterone and estradiol levels during the menstrual cycle in HIV-seropositive women compared with high-risk seronegative women. The study enrolled 55 HIV-infected and 10 high-risk uninfected women with self-reported regular menstrual cycles (25-30-day cycles). Progesterone and estradiol levels were determined on a weekly basis for 8 weeks. The analysis included evaluations from the first complete menstrual cycle for the 54 HIV-infected and 9 uninfected women who had at least one complete cycle. The median age was 35 years for HIV-infected women and 36 years for uninfected women. The median CD4+ count for HIV-seropositive women was 210 cells/mm3. The median menstrual cycle length was 28 days (range 22-49 days) for HIV-infected women and 25 days (range 24-44 days) for uninfected women. The maximum progesterone level during the luteal phase was normal (>3.0 ng/ml) for 52 (96%) of 54 HIV-seropositive women and 7 (78%) of 9 HIV-seronegative women (p = 0.09, Fisher's exact test). The median maximum progesterone level was 12.2 ng/ml in HIV-seropositive women and 7.2 ng/ml in HIV-seronegative women (p = 0.07, Wilcoxon test). The median maximum estradiol value during the follicular phase was 148 pg/ml for HIV-seropositive women and 111 pg/ml for HIV-seronegative women (p = 0.04, Wilcoxon test). Among HIV-infected women, there were no significant differences in progesterone and estradiol levels by antiretroviral therapy, baseline plasma viral load, or median CD4+ cell count. We conclude that HIV-infected women with self-reported normal menstrual cycles have normal levels of progesterone and estradiol during the menstrual cycle.
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Affiliation(s)
- S Cu-Uvin
- Brown University, Providence, Rhode Island, USA
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Reichelderfer PS, Coombs RW, Wright DJ, Cohn J, Burns DN, Cu-Uvin S, Baron PA, Coheng MH, Landay AL, Beckner SK, Lewis SR, Kovacs AA. Effect of menstrual cycle on HIV-1 levels in the peripheral blood and genital tract. WHS 001 Study Team. AIDS 2000; 14:2101-7. [PMID: 11061650 DOI: 10.1097/00002030-200009290-00005] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [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: 11/25/2022]
Abstract
OBJECTIVE To assess the variation in HIV-1 over the menstrual cycle, including RNA levels in the female genital tract, plasma HIV-1-RNA levels, CD4 cell counts, and culturable virus. DESIGN A prospective analysis of 55 HIV-1-infected women. METHODS Blood and genital tract specimens were collected weekly over 8 weeks, spanning two complete menstrual cycles. Applying repeated-measures models that used menses as the reference level, the variation in viral RNA levels was compared in endocervical canal fluid and cells (collected by Sno-strips and cytobrush, respectively) and ectocervicovaginal lavage (CVL) fluid. Repeated-measures models were also used to assess the variation in plasma CD4 cell counts and viral load. RESULTS Shedding patterns differed among the three sampling methods, independent of genital tract co-infections. Genital tract HIV-1-RNA levels from CVL fluid and endocervical canal cytobrush specimens were highest during menses and lowest immediately thereafter (P = 0.001 and P = 0.04). The HIV-1-RNA level in endocervical canal fluid was highest in the week preceding menses (P = 0.003). The menstrual cycle had no effect on blood levels of RNA (P = 0.62), culturable virus (P = 0.34), or CD4 cell counts (P = 0.55). HIV-1-RNA levels were higher in endocervical canal fluid than in peripheral blood plasma during the late luteal phase (P = 0.03). CONCLUSION HIV-1-RNA levels vary with the menstrual cycle in the female genital tract but not the blood compartment. HIV-1-RNA levels are higher in endocervical canal fluid than in blood plasma. These findings may have important implications for sex-specific pathogenesis, heterosexual transmission, and contraceptive hormone interventions in HIV-1-infected women.
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Affiliation(s)
- P S Reichelderfer
- National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
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Abstract
OBJECTIVE This study compared the HIV-risk-related behaviors and attitudes of adolescents with and without a history of sexual abuse who were in intensive psychiatric treatment. METHOD Adolescent patients (N=208) completed measures of psychological functioning and HIV-related knowledge, attitudes, and behaviors. RESULTS Among sexually active adolescents in psychiatric treatment (N=116), those with a history of abuse reported significantly less condom self-efficacy (emotional ability to use condoms), less knowledge of HIV, less impulse control, less frequent use and purchase of condoms, and significantly higher rates of sexually transmitted diseases than their peers. Multiple logistic regression indicated that a history of sexual abuse was strongly associated with inconsistent condom use. CONCLUSIONS Sexual abuse was associated with HIV-risk-related attitudes and behaviors among adolescents in psychiatric treatment. Clinicians should thus view a history of sexual abuse as a marker for sexual behavior that puts adolescents at risk for HIV.
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Affiliation(s)
- L K Brown
- Child and Family Psychiatry, Rhode Island Hospital, Providence, RI 02903, USA.
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Al-Harthi L, Wright DJ, Anderson D, Cohen M, Matity Ahu D, Cohn J, Cu-Unvin S, Burns D, Reichelderfer P, Lewis S, Beckner S, Kovacs A, Landay A. The impact of the ovulatory cycle on cytokine production: evaluation of systemic, cervicovaginal, and salivary compartments. J Interferon Cytokine Res 2000; 20:719-24. [PMID: 10954915 DOI: 10.1089/10799900050116426] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.6] [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: 11/13/2022] Open
Abstract
To understand the impact of the menstrual cycle on immunologic parameters, we measured the level of cytokines and chemokines from plasma, cervicovaginal lavage (CVL), and saliva samples of 6 premenopausal women during the follicular and luteal phases of the ovulatory cycle. We demonstrate that the level of plasma interleukin-8 (IL-8) was 4-fold higher during the follicular phase than the luteal phase (p = 0.004), whereas plasma IL-1beta, IL-4, IL-6, IL-10, interferon-gamma (IFN-gamma), transforming growth factor-beta (TGF-beta), tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-1alpha (MIP-1alpha), and TNF receptor II (TNFR II) were not altered during the ovulatory cycle. In the vaginal compartment, as measured from CVL samples, the levels of IL-6 and IL-1beta were both 5-fold higher in the follicular than the luteal phase (p = 0.0002 and 0.03, respectively). Salivary cytokine and chemokine samples were similar when measured during the luteal and the follicular phases. Additional analysis of lymphocyte subsets for phenotypic and functional markers indicated that they were not influenced by the ovulatory cycle. Collectively, these data suggest that IL-6, IL-8, and IL-1beta are differentially regulated during the ovulatory cycle.
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Affiliation(s)
- L Al-Harthi
- Department of Immunology/Microbiology, Rush-Presbyterian St. Luke's Medical Center, Chicago, IL 60612, USA.
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Cohn J, Lyons M, Fink R, Marker JH. A case study in assessing an ethnically diverse community-based aging population: a multimethod approach. Am J Med Qual 2000; 15:157-66. [PMID: 10948788 DOI: 10.1177/106286060001500406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Obtaining useful information to improve services for older, multi-ethnic populations requires a nontraditional approach to assessing needs that can overcome both cultural barriers and natural suspicions about research. This case study describes a multimethod needs assessment conducted in a large senior housing facility, where 58% of residents were non-English-speaking. Methods of data collection were both qualitative and quantitative. Data were gathered by focus groups, interviews, and a written survey (N = 874) on topics of need for personal care assistance, level of assistance required for instrumental activities of daily living, and mobility. Qualitative inquiry yielded information about facilities and safety, and culturally specific needs, particularly communication. The case study concludes by discussing how the research findings translated into on-site programmatic changes, and delineating the factors that contributed to the success of this approach.
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Majahalme S, Tognoni G, Cohn J, Spormann D. Val-HeFT-valsartan in heart failure trial - Gender differences and similarities. Eur J Heart Fail 2000. [DOI: 10.1016/s1388-9842(00)80069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- S. Majahalme
- On behalf of the Val-HeFT Investigators, Tampere University Hospital; Tampere Finland
| | | | - J. Cohn
- Cardiovascular Division; University of Minnesota Medical School; Minneapolis Minnesota United States
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Cohn J, Heywood J, Tavazzi L, Glazer R, Spormann D. Val-HeFT-valsartan in heart failure trial: A comparison of patients based on left ventricular ejection fraction. Eur J Heart Fail 2000. [DOI: 10.1016/s1388-9842(00)80070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- J. Cohn
- On behalf of the Val-HeFT Investigators, Cardiovascular Division; University of Minnesota Medical School; Minneapolis Minnesota United States
| | - J.T. Heywood
- Loma Linda University Medical Center; Loma Linda California United States
| | | | - R. Glazer
- Novartis Pharmaceuticals Corporation; East Hanover New Jersey United States
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Gressen EL, Werner-Wasik M, Cohn J, Topham A, Curran WJ. Thoracic reirradiation for symptomatic relief after prior radiotherapeutic management for lung cancer. Am J Clin Oncol 2000; 23:160-3. [PMID: 10776977 DOI: 10.1097/00000421-200004000-00011] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [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: 11/26/2022]
Abstract
Limited information is available in the medical literature on thoracic reirradiation for patients with recurrent/persistent lung carcinoma or new primary lung tumors. Controversy exists regarding the retreatment because of concerns regarding the risk of radiation toxicity. The medical and radiotherapeutic records of more than 1,500 patients with lung cancer seen in the Department of Radiation Oncology at Thomas Jefferson University Hospital from 1982 through 1997 were searched. Twenty-three patients with history of previous thoracic radiation therapy underwent thoracic reirradiation for either biopsy-proven and/or radiographically evident tumor recurrence, metastasis, or second lung primary. Most patients were reirradiated because of progressive dyspnea, cough, thoracic pain, or hemoptysis. Each of these symptoms was evaluated separately with regard to the subjective response to reirradiation. The median follow-up time from completion of reirradiation to last correspondence with the patient and/or family was 3.2 months, with a range of 0 to 17.5 months. In six patients with hemoptysis, a decrease or resolution of this symptom was noted. Of five patients with thoracic pain attributed to carcinoma, four noted an improvement in pain after reirradiation. Of 15 patients with cough, 9 had an improvement in cough, and of 15 patients with dyspnea, 11 had an improvement. Thoracic reirradiation is an effective modality in patients with hemoptysis, thoracic pain, cough, and dyspnea attributed to a radiographically defined recurrence and/or progression of lung cancer.
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Affiliation(s)
- E L Gressen
- Department of Radiation Oncology and Medicine, Kimmel Cancer Center of Jefferson Medical College, Philadelphia, Pennsylvania, USA
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