1
|
Wray-Lake L, Alvis L, Plummer JA, Shubert J, Syvertsen AK. Adolescents' developing awareness of inequality: Racial and ethnic differences in trajectories. Child Dev 2023; 94:439-457. [PMID: 36321635 DOI: 10.1111/cdev.13870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To advance knowledge of critical consciousness development, this study examined age-related change in awareness of inequality by race and ethnicity, gender, parent education, generation status, and their interactions. With longitudinal data (2013-2017) from 5019 adolescents in grades 6-12 (55.0% female) from California, Minnesota, and West Virginia, multigroup second-order latent growth curves were estimated for Black (13.7%), Latinx (37.0%), Asian (8.1%), and white (41.3%) youth. Black, Latinx, and Asian adolescents increased awareness of inequality longitudinally; white youth showed no change. Multiracial youth accelerated awareness of inequality in mid-adolescence; changes in race and ethnicity predicted decline, followed by increases. Girls with more educated, immigrant-origin parents started out more aware of inequality. Results signal the need for race-specific and intersectional approaches to studying critical consciousness development.
Collapse
Affiliation(s)
- Laura Wray-Lake
- University of California, Los Angeles, Los Angeles, California, USA
| | - Lauren Alvis
- Meadows Mental Health Policy Institute, Dallas, Texas, USA
| | - Jason A Plummer
- University of California, Los Angeles, Los Angeles, California, USA.,California State University, Long Beach, Long Beach, California, USA
| | | | | |
Collapse
|
2
|
Schnitker SA, Shubert J, Ratchford JL, Lumpkin M, Houltberg BJ. Mixed Results on the Efficacy of the CharacterMe Smartphone App to Improve Self-Control, Patience, and Emotional Regulation Competencies in Adolescents. Front Psychol 2021; 12:586713. [PMID: 34093297 PMCID: PMC8173072 DOI: 10.3389/fpsyg.2021.586713] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 03/09/2021] [Indexed: 11/20/2022] Open
Abstract
Unprecedented levels of access to adolescents' time and attention provide opportunities to convert traditional character and socioemotional competencies interventions into behavioral intervention technologies. However, these new tools must be evaluated rather than assuming previously validated activities will be efficacious when converted to a mobile platform. Thus, we sought to design and provide initial data on the effectiveness of the CharacterMe smartphone app to build self-control and patience, which are built on underlying social-emotional regulation competencies, in a sample of 618 adolescents (Mage = 16.07, Female = 56.6%). We also sought to examine whether framing the app activities as having a transcendent (spiritual connection or moral/prosocial) rather than instrumental purpose would increase engagement and change in self-control, patience, and emotion regulation. Finally, we tested the impact of framing activities as building strengths vs. fixing weaknesses. Results highlight the difficulty of translating psychological interventions to behavioral intervention technologies. Overall, the CharacterMe smartphone app was unsuccessful in increasing self-control, patience, or emotion regulation in adolescents, with analyses showing no significant mean changes over time. Framing conditions and user engagement were largely not significant predictors of change in self-control, patience, and emotion regulation.
Collapse
Affiliation(s)
- Sarah A Schnitker
- Science of Virtues Laboratory, Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Jennifer Shubert
- Behavioral Science Department, Utah Valley University, Orem, UT, United States
| | - Juliette L Ratchford
- Science of Virtues Laboratory, Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | | | | |
Collapse
|
3
|
Shubert J, Wray-Lake L, McKay B. Looking Ahead and Working Hard: How School Experiences Foster Adolescents' Future Orientation and Perseverance. J Res Adolesc 2020; 30:989-1007. [PMID: 32910513 DOI: 10.1111/jora.12575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 05/23/2023]
Abstract
The current study examined developmental change in future orientation and perseverance across childhood and adolescence. Drawing from stage-environment fit theory, the study examined how adolescents' perceptions of key school experiences (teacher support, school climate, high-quality organized activities, school transitions) and socioemotional competencies covaried across time. Using an accelerated longitudinal design, a diverse sample of 4,055 youth in grades 6-12 completed assessments at 4 time points. Latent growth curve analyses revealed future orientation and perseverance both followed a quadratic trajectory marked by growth in early adolescence, followed by a leveling off in later adolescence. School experiences positively covaried with socioemotional competencies. Findings provide insight into patterns of age-related change and offer implications for practices aimed at promoting future orientation and perseverance.
Collapse
|
4
|
Schnitker S, Shubert J, Houltberg B, Fernandez N. Bidirectional Associations across Time between Entitativity, Positive Affect, Generosity, and Religiousness in Adolescents Training with a Religiously Affiliated Charity Marathon Team. Int J Environ Res Public Health 2020; 17:E686. [PMID: 31973070 PMCID: PMC7037786 DOI: 10.3390/ijerph17030686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 11/17/2022]
Abstract
Numerous studies have established that participation in regular physical activity provides physical, cognitive, and affective benefits to adolescents, but fewer studies have examined how athletic involvement might affect character, social, or religious developmental markers of psychosocial functioning. The purpose of this study is to examine the bidirectional associations between entitativity (group closeness), positive affect, generosity, and religiousness across time among adolescents and emerging adults involved in charitable marathon training. We collected data from 396 adolescents and emerging adults who trained for half/full marathons with a religiously affiliated charity team. Participants completed measures at three occasions over 18 weeks (pre-training, mid-training, post-race). We conducted cross-lagged path analysis of latent factors to study concurrent and longitudinal effects of intrinsic religiousness, positive affectivity, and entitativity on interpersonal generosity and fundraising. Participants who reported higher levels of pre-training generosity were more likely to experience positive affect during training, which predicted higher levels of post-race generosity. Likewise, the internalization of religious ideas, reflected in increased intrinsic religiousness during training, was associated with higher post-race generosity. Overall, results support the potential of charitable sporting events to promote positive psychosocial developmental outcomes.
Collapse
Affiliation(s)
- Sarah Schnitker
- Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA;
| | - Jennifer Shubert
- Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA;
| | - Benjamin Houltberg
- Performance Science Institute, University of Southern California, Los Angeles, CA 90007, USA;
| | - Nathaniel Fernandez
- University Counseling Center, Azusa Pacific University, Azusa, CA 91702, USA;
| |
Collapse
|
5
|
Shubert J, Wray-Lake L, Syvertsen AK, Metzger A. The role of family civic context in character development across childhood and adolescence. Applied Developmental Science 2019. [DOI: 10.1080/10888691.2019.1683452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
6
|
Abstract
Despite abundant research on the benefits of dispositional mindfulness and mindfulness-based interventions, little is known about the naturally occurring developmental course of mindful awareness. Given dramatic strides during adolescence in competencies that may support mindfulness (e.g., emotion regulation), the high school years are a suitable window to study developmental changes in mindfulness. Using an accelerated cohort design to examine the longitudinal trajectory of mindfulness from 9th grade through 12th grade, we employed data from a 5-year study of 3,453 U.S. adolescents (55% female; 40% Latinx, 38% White, 13% Black, and 7% Asian) from high schools in three geographical regions in the U.S. Adolescents annually completed self-report surveys measuring mindful awareness and several internal and external factors. Latent growth curve analyses found that, after controlling for cohort, there was no average linear change in mindful awareness from grades 9 through 12, although there was significant interindividual variability in slopes. Within-person analyses found that in grades when needs-supportive climate was higher and discrimination was lower, adolescents reported greater mindful awareness. Unexpectedly, in grades when perspective taking and prosocial behaviors were higher, mindfulness was lower. These findings inform developmental understanding of mindful awareness and the ways that it naturally occurs and is supported during adolescence.
Collapse
|
7
|
Abstract
Character strengths are an integral component of positive youth development that can promote flourishing. Developmental principles posit constructs become increasingly complex with age, yet this process has not been examined with character. Using a socioeconomically and ethnically diverse sample of 2,467 youth ages 9-19, bifactor models were estimated across elementary, middle, and high school-age groups to examine age differences in character structure and function. With successive age, a greater number of specific character strength factors were identified, suggesting character structure becomes more differentiated across adolescence. Results linking character bifactor models to indicators of positive functioning also supported differentiation in character function across ages. Findings point to the need for theoretical and empirical considerations of character structure and function across development.
Collapse
|
8
|
Wray-Lake L, DeHaan CR, Shubert J, Ryan RM. Examining links from civic engagement to daily well-being from a self-determination theory perspective. The Journal of Positive Psychology 2017. [DOI: 10.1080/17439760.2017.1388432] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Laura Wray-Lake
- Department of Social Welfare, University of California, Los Angeles, CA, USA
| | - Cody R. DeHaan
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA
| | - Jennifer Shubert
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA
| | - Richard M. Ryan
- Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
| |
Collapse
|
9
|
Wray-Lake L, Schulenberg J, Keyes KM, Shubert J. The developmental course of community service across the transition to adulthood in a national U.S. sample. Dev Psychol 2017; 53:2397-2408. [PMID: 28933877 DOI: 10.1037/dev0000377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the importance of community service for the well-being of individuals and communities, relatively little is known about the developmental course of community service during the transition to adulthood (TTA). This study tested competing hypotheses about change in community service across the TTA by estimating latent growth models from Ages 18 to 26 in a national U.S. SAMPLE Analyses tested for cohort differences in community service and for individual differences in developmental trajectories by socioeconomic status, gender, grades, religiosity, race/ethnicity, college expectations, and college degree attainment. Using Monitoring the Future data from 1976 to 2011, the best-fitting latent growth model for community service was quadratic: Community service declined from Ages 18 to 24 and leveled off thereafter. Cohort differences in intercepts indicated that Age 18 community service increased over historical time; developmental declines in community service were consistent over 4 decades. Parent education predicted higher Age 18 community service but not growth parameters. Community service trajectories varied by gender, high school grades, religiosity, college expectations, and educational attainment, although all groups declined. Findings contribute to civic developmental theory by clarifying age and cohort effects in community service. Rising levels of community service at Age 18 may reflect heightened focus on service in high schools or the role of other socialization forces, yet these increases do not mitigate the decline across the TTA. We highlight the need for rethinking the ways in which institutions and communities can better support youth community service during the TTA. (PsycINFO Database Record
Collapse
Affiliation(s)
- Laura Wray-Lake
- Department of Social Welfare, University of California, Los Angeles
| | - John Schulenberg
- Institute for Social Research and Department of Psychology, University of Michigan
| | | | - Jennifer Shubert
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| |
Collapse
|
10
|
Wray-Lake L, Shubert J, Lin L, Starr LR. Examining associations between civic engagement and depressive symptoms from adolescence to young adulthood in a national U.S. sample. Applied Developmental Science 2017. [DOI: 10.1080/10888691.2017.1326825] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
| | | | - Lin Lin
- Claremont Graduate University
| | | |
Collapse
|
11
|
Warren MT, Wray-Lake L, Rote WM, Shubert J. Thriving while engaging in risk? Examining trajectories of adaptive functioning, delinquency, and substance use in a nationally representative sample of U.S. adolescents. Dev Psychol 2015; 52:296-310. [PMID: 26569564 DOI: 10.1037/a0039922] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent advances in positive youth development theory and research explicate complex associations between adaptive functioning and risk behavior, acknowledging that high levels of both co-occur in the lives of some adolescents. However, evidence on nuanced overlapping developmental trajectories of adaptive functioning and risk has been limited to 1 sample of youth and a single conceptualization of adaptive functioning. We build on prior work by utilizing a nationally representative sample of U.S. adolescents (N = 1,665) followed from 7th grade until after high school and using a measure of adaptive functioning that was validated in a secondary sample of older adolescents (N = 93). In using dual trajectory growth mixture modeling to investigate links between developmental trajectories of adaptive functioning and delinquency and substance use, respectively, results provided evidence of heterogeneity in the overlap between adaptive functioning and risk trajectories. Males were more likely to be in the highest adaptive functioning group as well as the most at-risk delinquency class. The magnitude of negative associations between adaptive functioning and both risk behaviors decreased at Wave 3, indicating a decoupling of adaptive functioning and risk as youth aged. These findings converge in underscoring the need to generate a cohesive theory that specifies factors that promote adaptive functioning and risk in concert.
Collapse
Affiliation(s)
- Michael T Warren
- Division of Behavioral and Organizational Sciences, Claremont Graduate University
| | - Laura Wray-Lake
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Wendy M Rote
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| | - Jennifer Shubert
- Department of Clinical and Social Sciences in Psychology, University of Rochester
| |
Collapse
|
12
|
Wray-Lake L, Flanagan CA, Benavides CM, Shubert J. A Mixed Methods Examination of Adolescents' Reports of the Values Emphasized in Their Families. Social Development 2013. [DOI: 10.1111/sode.12065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
13
|
O'Reilly M, Fragale C, Gainey S, Kang S, Koch H, Shubert J, Zein FE, Longino D, Chung M, Xu Z, White P, Lang R, Davis T, Rispoli M, Lancioni G, Didden R, Healy O, Kagohara D, van der Meer L, Sigafoos J. Examination of an antecedent communication intervention to reduce tangibly maintained challenging behavior: a controlled analog analysis. Res Dev Disabil 2012; 33:1462-1468. [PMID: 22543058 DOI: 10.1016/j.ridd.2012.03.017] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 03/08/2012] [Indexed: 05/31/2023]
Abstract
We examined the influence of an antecedent communication intervention on challenging behavior for three students with developmental disorders. Students were taught to request tangible items that were identified as reinforcers for challenging behavior in a prior functional analysis. Individual participant multielement and reversal designs were used to compare the effects of the antecedent communication intervention versus a no antecedent communication intervention condition. Immediately following the antecedent manipulations students were exposed to the tangible condition of the functional analysis. Results indicate that the antecedent communication intervention reduced challenging behavior in the subsequent tangible test condition for all three students. The importance of examining antecedent interventions to treat challenging behavior from a function analytic perspective is discussed.
Collapse
Affiliation(s)
- Mark O'Reilly
- Department of Special Education, 1 University Station D5300, The University of Texas at Austin, Austin, TX 78712, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Sukhacheva EA, Fomicheva VV, Efimova NA, Shubert J. [Immunodetection of RNA-dependent RNA polymerase from turnip yellow luteovirus using monoclonal antibodies]. Bioorg Khim 2004; 30:25-9. [PMID: 15040300 DOI: 10.1023/b:rubi.0000015769.71363.71] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Monoclonal antibodies (MAs) to the RNA-dependent RNA polymerase from turnip yellow luteovirus (TYV) were prepared using a recombinant protein as immunogen and were shown to be directed to C-terminal part of the viral replicase. These MAs were found to interact with a 70-kDa protein found in extracts from TYV-infected plants. Our result is the first successful attempt at detecting the RNA-dependent RNA polymerase of a luteovirus in infected plant extracts. We also found that the protein is not processed further and its accumulation and content in the infected plant obey a definite dynamics during the infection. The English version of the paper: Russian Journal of Bioorganic Chemistry, 2004, vol. 30, no. 1; see also http://www.maik.ru.
Collapse
Affiliation(s)
- E A Sukhacheva
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, ul. Miklukho-Maklaya 16/10, GSP Moscow, 117997 Russia.
| | | | | | | |
Collapse
|
15
|
Sun J, Paddock C, Shubert J, Zhang HB, Amin K, Newman PJ, Albelda SM. Contributions of the extracellular and cytoplasmic domains of platelet-endothelial cell adhesion molecule-1 (PECAM-1/CD31) in regulating cell-cell localization. J Cell Sci 2000; 113 ( Pt 8):1459-69. [PMID: 10725228 DOI: 10.1242/jcs.113.8.1459] [Citation(s) in RCA: 61] [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: 11/20/2022] Open
Abstract
PECAM-1/CD31, a vascular cell adhesion/signaling molecule that has been implicated in a number of vascular functions (including angiogenesis and the transmigration of leukocytes through endothelium) is highly enriched at the cell-cell borders of adjacent endothelial cells. To identify the mechanisms responsible for this localization, a series of PECAM-1 mutants and chimeric PECAM-1 molecules were transfected into non-PECAM-expressing cells and the ability of the constructs to move to cell-cell borders of adjacent cells was determined using immunohistochemistry and confocal microscopy. Although neither the extracellular domain, by itself, nor the cytoplasmic domain, by itself, was sufficient to direct cell-cell localization, the combination of the extracellular and transmembrane domains with a small group of highly charged amino acids in a membrane proximal region of the cytoplasmic domain was sufficient to direct efficient localization of the molecule to cell-cell borders. Importantly, only constructs that supported PECAM-1 mediated adhesion localized to cell-cell borders. Our data are consistent with a ‘diffusion trapping’ model in which movement of PECAM-1 in the cell membrane occurs relatively freely until the ‘stablized’ extracellular domain of the molecule encounters its ligand on an adjacent cell. When this occurs, the complex is ‘captured’ at the cell-cell interface leading to localization at cell-cell borders.
Collapse
Affiliation(s)
- J Sun
- Pulmonary and Critical Care Division, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104-4283, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
Milfred-LaForest SK, Shubert J, Mendoza B, Flores I, Eisen HJ, Piña IL. Tolerability of extended duration intravenous milrinone in patients hospitalized for advanced heart failure and the usefulness of uptitration of oral angiotensin-converting enzyme inhibitors. Am J Cardiol 1999; 84:894-9. [PMID: 10532506 DOI: 10.1016/s0002-9149(99)00461-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Milrinone is a phosphodiesterase inhibitor that has been shown to improve hemodynamic parameters in patients with class III to IV heart failure when administered intravenously for < or =48 hours. This study examines the tolerability of long-term intravenous milrinone therapy and assesses its utility in allowing upward titration of oral vasodilator agents. A retrospective review of hospital records identified 63 patients who underwent hemodynamic monitoring and received intravenous milrinone for >24 hours in a critical care setting. Hemodynamics and medications were recorded before and after 24 hours of milrinone therapy. Additional medications, as well as any adverse events, were recorded throughout milrinone therapy. The mean dose of milrinone was 0.43 +/- 0.10 microg/kg/min, with a mean duration of 12 +/- 15 days (range 1 to 70). Therapy was continued for >48 hours in 89% of patients. After 24 hours of milrinone therapy, patients exhibited significant improvements in pulmonary artery pressures, pulmonary capillary wedge pressures, and cardiac index. When compared with baseline, significantly more patients received angiotensin-converting enzyme (ACE) inhibitors after 24 hours of milrinone and at the end of milrinone therapy (67% vs 86%, p <0.01). Likewise, significantly more patients also received oral hydralazine and/or nitrates at the end of milrinone therapy (38% vs 65%, p <0.01) when compared with baseline. The mean doses of most oral medications at the 3 time periods were similar. The ACE inhibitor dose was significantly higher at the end of milrinone therapy when compared with baseline, and hydralazine dose was significantly higher at the end of therapy when compared with 24 hours. Few adverse effects were noted, with only 10% of patients experiencing symptomatic ventricular tachycardia and 2 patients with significant hypotension requiring discontinuation of the drug. The adverse events were similar in the group of patients who received milrinone for > or =7 days compared with the entire cohort. Milrinone was well tolerated over the long term in a controlled inpatient setting, and allowed uptitration of oral vasodilator therapy.
Collapse
Affiliation(s)
- S K Milfred-LaForest
- School of Pharmacy, Cardiomyopathy and Transplant Center, Temple University, Philadelphia, Pennsylvania 19140, USA
| | | | | | | | | | | |
Collapse
|
17
|
Goldberg SL, Shubert J, Rao AK, Redei I, Klumpp TR, Mangan KF. Treatment of hepatic veno-occlusive disease with low-dose tissue plasminogen activator: impact on coagulation profile. Bone Marrow Transplant 1996; 18:633-6. [PMID: 8879629] [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: 02/02/2023]
Abstract
An 18-year-old white male developed severe hepatic veno-occlusive disease (VOD) during an autologous bone marrow transplant for primary refractory nodular sclerosing Hodgkin's disease. As a result of VOD-induced hepatic dysfunction, coagulation studies revealed depression of vitamin K dependent procoagulant factor VII. Intravenous recombinant tissue plasminogen activator 20 mg over h on 4 consecutive days and continuous heparin infusion (1000 unit bolus followed by 150 units/kg/day) resulted in rapid reversal of the VOD syndrome. During treatment, procoagulant factors II, VII, IX and X levels increased indicating the return of hepatic synthesizing capacity. Factor V levels, which were elevated pre-therapy, also rose dramatically. Plasma antigen levels of protein C, a natural anticoagulant, remained severely depressed. No clinical evidence of bleeding and only minimal systemic fibrinolysis was noted. Despite concerns regarding the use of lytic therapy in a thrombocytopenic post-BMT patient, serial measurements of coagulation parameters during severe VOD suggested that low dose rt-PA improved portions of the systemic hemostatic profile.
Collapse
Affiliation(s)
- S L Goldberg
- Bone Marrow Transplant Program, Temple University Health Science Center, Philadelphia, PA, USA
| | | | | | | | | | | |
Collapse
|
18
|
Shubert J, Mancano MA, Pina IL, Milfred SK. Criteria for use of intravenous milrinone in adult inpatients. Am J Health Syst Pharm 1995; 52:1918-9. [PMID: 8528858 DOI: 10.1093/ajhp/52.17.1918] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- J Shubert
- Department of Pharmacy, Temple University Hospital, Philadelphia, PA 19140, USA
| | | | | | | |
Collapse
|