1
|
Starosta A, Adams R, Marwitz J, Monden K, Dams-O'Connor K, Hoffman J. Scoping Review of Opioid Use Following TBI. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.343] [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: 11/16/2022]
|
2
|
Richardson R, Schwartz D, Drasher-Phillips L, Ketchum J, Calero K, Dahdah M, Monden K, Bell K, Hoffman J, Magalang U, Bogner J, Whyte J, Zeitzer J. 0606 Comparative Effectiveness of Sleep Apnea Screening Tools During Inpatient Rehabilitation for Moderate to Severe TBI. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Recent studies highlight prevalent obstructive sleep apnea after moderate to severe TBI during a time of critical neural repair. The purpose of this study is to determine the diagnostic sensitivity, specificity and comparative effectiveness of traditional sleep apnea screening tools in TBI neurorehabilitation admissions.
Methods
This is a prospective diagnostic comparative effectiveness trial of sleep apnea screening tools (STOPBANG, Berlin, MAPI [Multi-Apnea Prediction Index]) relative Level 1 polysomnography at six TBI Model System Inpatient Rehabilitation Centers. Between 05/2017 and 02/2019, 449 of 896 screened were eligible for the trial with 345 consented (77% consented). Additional screening left 263 eligible for and completing polysomnography with final analyses completed on 248. The primary outcome was the Area Under the Curve (AUC) of screening tools relative to total apnea hypopnea index ≥15 (AHI, moderate to severe apnea) measured at a median of 47 days post-TBI (IQR 29-47).
Results
Participants were primarily young to middle age (AGE IQR 28,40,59), male (81%), white (74%), and had primarily severe TBI (IQR GCS 3,6,14). A subset (26%) had a history of military service. Results revealed that the Berlin high risk score (ROC-AUC=0.63) was inferior to the MAPI (ROC-AUC = 0.7802) (p=.0211, CI: 0.0181, 0.2233) and STOPBANG (ROCAUC = 0.7852) (p=.0006, CI: 0.0629, 0.2302); both of which had comparable AUC (p=.7245, CI: -0.0472, 0.0678). Findings were similar for AHI≥30 (severe apnea); however, no differences across scales was observed at AHI>5. The pattern was similar across TBI severity subgroups except for delirium or post-traumatic amnesia status wherein the MAPI outperformed the Berlin and STOPBANG. Youden’s Index to determine risk yielded lower sensitivities but higher specificities relative to non-TBI samples.
Conclusion
This study is the first to provide clinicians with data to support a choice for which sleep apnea screening tools are more effective during inpatient rehabilitation for moderate to severe TBI (STOPBANG, MAPI vs Berlin) to help reduce comorbidity and possibly improve neurologic outcome.
Support
PCORI (CER-1511-33005), GDHS (W91YTZ-13-C-0015; HT0014-19-C-0004)) for DVBIC, NIDILRR (NSDC Grant # 90DPTB00070, #90DP0084, 90DPTB0013-01-00, 90DPTB0008, 90DPT80004-02).
Collapse
Affiliation(s)
| | - D Schwartz
- Medicine Service, James A. Haley Veterans’ Hospital, Tampa, FL
| | | | - J Ketchum
- Research Department, Craig Hospital, Denver, CO
| | - K Calero
- Medicine Service, James A. Haley Veterans’ Hospital, Tampa, FL
| | - M Dahdah
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX; Baylor Scott & White Medical Center, Dallas, TX
| | | | - K Bell
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, TX
| | - J Hoffman
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - U Magalang
- Division of Pulmonary, Critical Care, and Sleep Medicine and Neuroscience Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH
| | - J Bogner
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH
| | - J Whyte
- Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Philadelphia, PA
| | - J Zeitzer
- Psychiatry and Behavioral Service, Stanford University, Palo Alto, CA
| |
Collapse
|
3
|
VandenBussche Jantz A, Nakase-Richardson R, Rabinowitz A, Stevens L, Monden K, Cotner B, Dillahunt-Aspillaga C, Giacino J, Silva M. The Impact of Rehabilitation Needs on Satisfaction With Life: A VA TBIMS Study. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.10.134] [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: 11/29/2022]
|
4
|
Guerrero GY, Schwartz D, Silva MA, Zeitzer JM, Monden K, Wittine L, Bogner J, Reljic T, Nakase-Richardson R. 0944 A Comparison Of Medical-grade Actigraphy Devices With Polysomnography During Inpatient Rehabilitation For Traumatic Brain Injury (TBI). Sleep 2019. [DOI: 10.1093/sleep/zsz067.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Sleep disturbances in TBI population can have negative consequences on physical, psychological and cognitive recovery. While polysomnography (PSG) is the gold standard for evaluating sleep disorders, actigraphy has been widely used to screen for sleep-wake disorders, especially ones that change longitudinally. In a small sample of TBI patients (n=50, single center sample of convenience) during inpatient rehabilitation, we have previously found two models (Philips Actiwatch2/Actiwatch Spectrum) to be feasible and valid for collecting sleep data. Herein, we extend this validation to a prospective study of more than 200 TBI patients and include both the Actigraph Core wGT3X-BT (ACT-Core) and Philips Actiwatch Spectrum Plus (PASP).
Methods
This is a secondary analysis from a six-center, prospective, observational cohort study from the TBI Model System Lifetimes Study where overnight, fully attended polysomnography with concomitant actigraphy were conducted on moderate to severe TBI subjects during acute inpatient rehabilitation as part of an ongoing PCORI-funded clinical trial. Actigraphy variables of total sleep time (TST), sleep efficiency (SE), sleep latency (SL), wake after sleep onset (WASO) were compared between actigraphy devices and with Level 1, fully attended PSG (Phillips Sleepware-G3) to evaluate their concordance (Pearson). PASP-derived sleep was determined with Actiware (sensitivity=Automatic), while ACT-Core-derived sleep was determined with ActiLife (Cole-Kripke algorithm).
Results
Simultaneous collection of PSG and PASP (n=230) and ACT-Core (n=179) were examined. Correlations (p>.01) with PSG were found for both PASP and ACT-Core for TST (r=.70, .69), SE (r=.33, .31), and WASO (r=-.19, -.24) respectively. Comparison of actigraphy devices to one another revealed correlations (p>.01) for TST (r=.80), SE (r=.58), WASO (r=.68), and SL (r=.23).
Conclusion
This larger, prospective study across six-centers supports the use of actigraphy as a proxy measure of sleep quantity (TST, SE) in acute neurorehabilitation admissions with moderate to severe TBI. No relationship was found for SL with mixed findings for WASO. Sensitivity analyses with subsets of TBI survivors with comorbidities (sleep apnea, spasticity, muscle strength) may affect agreement and warrant further study.
Support (If Any)
PCORI (CER-1511-33005), GDHS (W91YTZ-13-C-0015) for DVBIC, NIDILRR.
Collapse
Affiliation(s)
| | - Daniel Schwartz
- James A. Haley Veterans Affairs Medical Center, Tampa, FL, USA
| | - Marc A Silva
- James A. Haley Veterans Affairs Medical Center, Tampa, FL, USA
| | - Jamie Marc Zeitzer
- Psychiatry and Behavioral Sciences, Stanford University, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Lara Wittine
- University of South Florida College of Medicine, Tampa, FL, USA
| | | | - Tea Reljic
- University of South Florida College of Medicine, Tampa, FL, USA
| | | |
Collapse
|
5
|
Rice L, Sung J, Keane K, Peterson E, Sosnoff J, Farkas G, Swartz A, Strath S, Gorgey A, Berg A, Gater D, Dyson-Hudson T, Malanga G, Cherian C, Michalec M, Kirshblum S, Miller C, Garlanger K, Kortes S, Schnorenberg A, Slavens B, Lee K, Potter-Baker K, Frost F, Plow E, Solinsky R, Wilson C, Henry CA, Lombard A, Maher M, Weir J, Saeed S, Cirnigliaro C, Specht A, Garbarini E, Augustine J, Forrest G, Bauman W, Wecht J, Maher M, Weir J, Lombard A, Saeed S, Kirshblum S, Bauman W, Wecht J, Hearn J, Razvi IS, Wilson C, Henry CA, Sikka S, Callender L, Bennett M, Robertson K, Driver S, Kline-Quiroz C, Donovan J, Botticello A, Arnold D, Latham N, Houlihan B, Bickmore T, Trinh H, Shamekhi A, Ellis T, LaVela SL, Burkhart E, Kale I, Bombardier C, Snoxell E, Knezevic S, Hong E, Asselin P, Cirnigliaro C, Kornfeld S, Gorman P, Forrest G, Bauman W, Spungen A, Farkas G, Berg A, Castillo C, Gater D, Cleveland C, Gabet J, Harrington A, Arenth P, Farkas G, Gorgey A, Dolbow D, Berg A, Gater D, Luther S, Finch D, Bouayad L, Cirnigliaro C, Donovan J, Forrest G, Gater D, Kopp M, Watzlawick R, Martus P, Failli V, Finkenstaedt F, Chen Y, DeVivo M, Dirnagl U, Schwab J, LiMonta J, Saeed S, Santiago T, Maher M, Wu YK, Harel N, Monden K, Trost Z, Nguyen N, Morse L, Boals A, Wenzel L, Silveira S, Hughes R, Nosek M, LeDoux T, Taylor H, Diaz L, Robinson-Whelen S, Garshick E, Betz K, Krause J, Cao Y, Li C, Hon B, Kirshblum S, Khong C–M, Dirlikov B, Shem K, Charlifue S, Song S, Burns S. Presentation abstracts. J Spinal Cord Med 2018; 41:599-622. [PMID: 30132748 PMCID: PMC7025696 DOI: 10.1080/10790268.2018.1498262] [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: 10/28/2022] Open
Affiliation(s)
- Laura Rice
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - JongHun Sung
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Kathleen Keane
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Elizabeth Peterson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jacob Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Gary Farkas
- Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Ann Swartz
- Department of Kinesiology, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA
| | - Scott Strath
- Department of Kinesiology, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA
| | - Ashraf Gorgey
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - Arthur Berg
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - David Gater
- Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Trevor Dyson-Hudson
- Kessler Foundation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Gerard Malanga
- Rutgers New Jersey Medical School, Newark, New Jersey, USA,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA,Regenerative Institute of New Jersey, Cedar Knolls, New Jersey, USA
| | - Chris Cherian
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | | | - Steven Kirshblum
- Rutgers New Jersey Medical School, Newark, New Jersey, USA,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Carrie Miller
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin, USA
| | - Kristin Garlanger
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin, USA
| | - Sam Kortes
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin, USA
| | - Alyssa Schnorenberg
- University of Wisconsin-Milwaukee, Department of Occupational Science & Technology, Milwaukee, Wisconsin, USA
| | - Brooke Slavens
- University of Wisconsin-Milwaukee, Department of Occupational Science & Technology, Milwaukee, Wisconsin, USA
| | - Kenneth Lee
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin, USA
| | - Kelsey Potter-Baker
- Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs, Cleveland, Ohio, USA,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Frederick Frost
- Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA,Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA,Department of Rehabilitation and Sports Therapy, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Ela Plow
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA,Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Ryan Solinsky
- Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Alexander Lombard
- James J. Peters VA Medical Center, Bronx, New York, USA,Kessler Foundation, West Orange, New Jersey, USA
| | - Matthew Maher
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Joseph Weir
- James J. Peters VA Medical Center, Bronx, New York, USA,University of Kansas, Lawrence Kansas
| | - Sana Saeed
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Christopher Cirnigliaro
- James J. Peters VA Medical Center, Bronx, New York, USA,Kessler Foundation, West Orange, New Jersey, USA
| | - Adam Specht
- James J. Peters VA Medical Center, Bronx, New York, USA,Kessler Foundation, West Orange, New Jersey, USA
| | | | | | - Gail Forrest
- Kessler Foundation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - William Bauman
- James J. Peters VA Medical Center, Bronx, New York, USA,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jill Wecht
- James J. Peters VA Medical Center, Bronx, New York, USA,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew Maher
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Joseph Weir
- James J. Peters VA Medical Center, Bronx, New York, USA,University of Kansas, Lawrence Kansas
| | - Alexander Lombard
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA,James J. Peters VA Medical Center, Bronx, New York, USA
| | - Sana Saeed
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Steven Kirshblum
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - William Bauman
- James J. Peters VA Medical Center, Bronx, New York, USA,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jill Wecht
- James J. Peters VA Medical Center, Bronx, New York, USA,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jasmine Hearn
- The University of Buckingham Medical School, Hunter Street, Buckingham, UK
| | | | | | | | - Seema Sikka
- Baylor Institute for Rehabilitation, Dallas, Texas, USA
| | | | - Monica Bennett
- Center for Clinical Effectiveness, Baylor Scott and White Health, Dallas, Texas, USA
| | | | - Simon Driver
- Baylor Institute for Rehabilitation, Dallas, Texas, USA
| | - Cristina Kline-Quiroz
- Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, New Jersey, USA,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Jayne Donovan
- Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, New Jersey, USA,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Amanda Botticello
- Kessler Foundation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, New Jersey, USA
| | - Dannae Arnold
- Baylor Institute for Rehabilitation, Dallas, Texas, USA
| | - Nancy Latham
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bethlyn Houlihan
- Spaulding New England Regional SCI Center, Charlestown, Massachusetts, USA
| | - Timothy Bickmore
- Relational Agents Group, Center for Computers and Information Science, Northeastern University, Boston, Massachusetts, USA
| | - Ha Trinh
- Relational Agents Group, Center for Computers and Information Science, Northeastern University, Boston, Massachusetts, USA
| | - Ameneh Shamekhi
- Relational Agents Group, Center for Computers and Information Science, Northeastern University, Boston, Massachusetts, USA
| | - Teresa Ellis
- Sargent College, Boston University, Boston, Massachusetts, USA
| | - Sherri L. LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Elizabeth Burkhart
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA,Marcella Niehoff School of Nursing, Loyola University, Chicago, Illinois, USA
| | - Ibuola Kale
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Charles Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Ellen Snoxell
- Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA
| | - Steven Knezevic
- Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - EunKyoung Hong
- Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Pierre Asselin
- Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | | | - Stephen Kornfeld
- Spinal Cord Injury Service, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Peter Gorman
- University of Maryland School of Medicine, University of Maryland Rehabilitation and Orthopedic Institute, Baltimore, Maryland, USA
| | - Gail Forrest
- Kessler Foundation, West Orange, New Jersey, USA
| | - William Bauman
- Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, New York, USA,Spinal Cord Injury Service, James J. Peters VA Medical Center, Bronx, New York, USA,Kessler Foundation, West Orange, New Jersey, USA,Departments of Medicine and Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ann Spungen
- Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, New York, USA,Departments of Medicine and Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gary Farkas
- Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Arthur Berg
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Camilo Castillo
- Department of Physical Medicine and Rehabilitation, University of Louisville Hospital, Louisville, Kentucky, USA
| | - David Gater
- Department of Physical Medicine and Rehabilitation, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Joelle Gabet
- UPMC Rehabilitation Institute, Pittsburgh, Pennsylvania, USA
| | | | - Patricia Arenth
- UPMC Rehabilitation Institute, Pittsburgh, Pennsylvania, USA
| | - Gary Farkas
- Department of Physical Medicine and Rehabilitation, Penn State Hershey College of Medicine, Hershey, Pennsylvania, USA
| | - Ashraf Gorgey
- Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA
| | - David Dolbow
- School of Kinesiology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Arthur Berg
- Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, Pennsylvania
| | - David Gater
- Department of Physical Medicine and Rehabilitation, Penn State Hershey College of Medicine, Hershey, Pennsylvania, USA
| | - Stephen Luther
- VA HSR&D Center of Innovation on Disabilities and Rehabilitation Research (CINDRR), Tampa, Florida, USA,The University of South Florida, Tampa, Florida, USA
| | - Dezon Finch
- VA HSR&D Center of Innovation on Disabilities and Rehabilitation Research (CINDRR), Tampa, Florida, USA
| | - Lina Bouayad
- VA HSR&D Center of Innovation on Disabilities and Rehabilitation Research (CINDRR), Tampa, Florida, USA,Florida International University, Miami, Florida, USA
| | | | - Jayne Donovan
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Gail Forrest
- Kessler Foundation, West Orange, New Jersey, USA
| | - David Gater
- Penn State Health Milton S. Hershey Medical Center, Department of Physical Medicine and Rehabilitation, Hummelstown, Pennsylvania, USA
| | - Marcel Kopp
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité - Universitätsmedizin Berlin, Germany
| | - Ralf Watzlawick
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité - Universitätsmedizin Berlin, Germany
| | - Peter Martus
- Department of Clinical Epidemiology and Applied Biostatistics, Eberhard Karls Universität Tübingen, Germany
| | - Vieri Failli
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité - Universitätsmedizin Berlin, Germany
| | - Felix Finkenstaedt
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité - Universitätsmedizin Berlin, Germany
| | - Yuying Chen
- National Spinal Cord Injury Statistical Center, Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael DeVivo
- National Spinal Cord Injury Statistical Center, Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ulrich Dirnagl
- Center for Stroke Research Berlin, Charité – Universitätsmedizin, Berlin, Germany
| | - Jan Schwab
- Department of Neurology and Experimental Neurology, Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology), Charité - Universitätsmedizin Berlin, Germany,Paraplegiology (Spinal Cord Injury Division), Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA,Department of Neuroscience and Center for Brain and Spinal Cord Repair, Department of Physical Medicine and Rehabilitation, The Neurological Institute, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA
| | - James LiMonta
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Sana Saeed
- James J. Peters VA Medical Center, Bronx, New York, USA
| | | | - Matthew Maher
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Yu-Kuang Wu
- James J. Peters VA Medical Center, Bronx, New York, USA
| | - Noam Harel
- James J. Peters VA Medical Center, Bronx, New York, USA,Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Zina Trost
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | | | | | - Lisa Wenzel
- TIRR Memorial Hermann, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA
| | - Stephanie Silveira
- TIRR Memorial Hermann, Houston, Texas, USA,University of Houston, Houston, Texas, USA
| | | | - Margaret Nosek
- TIRR Memorial Hermann, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA
| | | | | | | | - Susan Robinson-Whelen
- TIRR Memorial Hermann, Houston, Texas, USA,Baylor College of Medicine, Houston, Texas, USA
| | - Eric Garshick
- VA Boston Healthcare System, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Kendra Betz
- VA National Center for Patient Safety, Ann Arbor, Michigan, USA
| | - James Krause
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Yue Cao
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chao Li
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Beverly Hon
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Steven Kirshblum
- Kessler Foundation, West Orange, New Jersey, USA,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Cria –May Khong
- Santa Clara Valley Medical Center, Rehabilitation Research Center, San Jose, California, USA
| | - Ben Dirlikov
- Santa Clara Valley Medical Center, Rehabilitation Research Center, San Jose, California, USA
| | - Kazuko Shem
- Santa Clara Valley Medical Center, Rehabilitation Research Center, San Jose, California, USA,Santa Clara Valley Medical Center, Department of Physical Medicine and Rehabilitation, San Jose, California, USA
| | | | - Shawn Song
- VA Puget Sound Health Care System, Seattle, Washington, USA,University of Washington, Department of Rehabilitation Medicine, Seattle, Washington, USA
| | - Stephen Burns
- VA Puget Sound Health Care System, Seattle, Washington, USA,University of Washington, Department of Rehabilitation Medicine, Seattle, Washington, USA
| |
Collapse
|
6
|
Hamilton R, Driver S, Noorani S, Callender L, Bennett M, Monden K. Utilization and access to healthcare services among community-dwelling people living with spinal cord injury. J Spinal Cord Med 2017; 40:321-328. [PMID: 27221396 PMCID: PMC5472020 DOI: 10.1080/10790268.2016.1184828] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Describe the utilization, accessibility, and satisfaction of primary and preventative health-care services of community-dwelling individuals with spinal cord injury (SCI). DESIGN Cross sectional, in-person or telephonic survey, utilizing a convenience sample. SETTING Community. PARTICIPANTS Individuals with SCI greater than 12-months post injury. INTERVENTIONS N/A. OUTCOME MEASURES Demographic, injury related, and 34-item questionnaire of healthcare utilization, accessibility, and satisfaction with services. RESULTS The final sample consisted of 142 participants (50 female, 92 male). Ninety-nine percent of respondents had a healthcare visit in the past 12-months with primary care physicians (79%), with SCI physiatrists (77%) and urologists (50%) being the most utilized. 43% of the sample reported an ER visit within the past 12-months, with 21% reporting multiple visits. People who visited the ER had completed significantly less secondary education (P = 0.0386) and had a lower estimate of socioeconomic status (P = 0.017). The majority of individuals (66%) were satisfied with their primary care physician and 100% were satisfied with their SCI physiatrist. Individuals who did not visit an SCI physiatrist were significantly more likely to live in a rural area (P = 0.0075), not have private insurance (P = 0.0001), and experience a greater decrease in income post injury (P = 0.010). CONCLUSION The delivery of care for people with SCI with low socioeconomic status may be remodeled to include patient-centered medical homes where care is directed by an SCI physiatrist. Further increased telehealth efforts would allow for SCI physiatrists to monitor health conditions remotely and focus on preventative treatment.
Collapse
Affiliation(s)
- Rita Hamilton
- Baylor Institute for Rehabilitation, Dallas, TX, USA
| | - Simon Driver
- Baylor Institute for Rehabilitation, Dallas, TX, USA
| | | | | | | | | |
Collapse
|
7
|
Nakano K, Idani H, Asami S, Ookawa H, Yoshimoto M, Ito A, Monden K, Kurose Y, Hioki M, Ishii T, Sadamori H, Oono S, Kin H, Takakura N. Topic: Abdominal Wall Hernia - Abdominal wall closure. Hernia 2015; 19 Suppl 1:S342. [PMID: 26518836 DOI: 10.1007/bf03355382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K Nakano
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - H Idani
- Department of Surgery, Hiroshima City Hospital, Hiroshima, Japan
| | - S Asami
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - H Ookawa
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - M Yoshimoto
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - A Ito
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - K Monden
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Y Kurose
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - M Hioki
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - T Ishii
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - H Sadamori
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - S Oono
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - H Kin
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - N Takakura
- Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan
| |
Collapse
|
8
|
Parke E, Hart J, Baldock D, Barchard K, Etcoff L, Allen D, Stolberg P, Nardi N, Cohen J, Jones W, Loe S, Etcoff L, Delgaty L, Tan A, Bunner M, Delgaty L, Tan A, Bunner M, Tan A, Delgaty L, Bunner M, Tan A, Delgaty L, Bunner M, Goodman G, Kim W, Nolty A, Marion S, Davis A, Finch W, Piehl J, Moss L, Nogin R, Dean R, Davis J, Lindstrom W, Poon M, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fields K, Hill B, Corley E, Russ K, Boettcher A, Musso M, Rohling M, Rowden A, Downing K, Benners M, Miller D, Maricle D, Dugbartey T, Anum A, Anderson J, Daniel M, Hoskins L, Gillis K, Khen S, Carter K, Ayers C, Neeland I, Cullum M, Weiner M, Rossetti H, Buddin W, Mahal S, Schroeder R, Baade L, Macaluso M, Phelps K, Evans C, Clark J, Vickery C, Chow J, Stokic D, Phelps K, Evans C, Watson S, Odom R, Clark J, Clark J, Odom R, Evans C, Vickery C, Thompson J, Noggle C, Kane C, Kecala N, Lane E, Raymond M, Woods S, Iudicello J, Dawson M, Ghias A, Choe M, Yudovin S, McArthur D, Asarnow R, Giza C, Babikian T, Tun S, O'Neil M, Ensley M, Storzbach D, Ellis R, O'Neil M, Carlson K, Storzbach D, Brenner L, Freeman M, Quinones A, Motu'apuaka M, Ensley M, Kansagara D, Brickell T, Grant I, Lange R, Kennedy J, Ivins B, Marshall K, Prokhorenko O, French L, Brickell T, Lange R, Bhagwat A, French L, Weber E, Nemeth D, Songy C, Gremillion A, Lange R, Brubacher J, Shewchuk J, Heran M, Jarrett M, Rauscher A, Iverson G, Woods S, Ukueberuwa D, Medaglia J, Hillary F, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Levan A, Gale S, Atkinson J, Boettcher A, Hill B, Rohling M, Stolberg P, Hart J, Allen D, Mayfield J, Ellis M, Marion SD, Houshyarnejad A, Grant I, Akarakian R, Kernan C, Babikian T, Asarnow R, Bens M, Fisher M, Garrett C, Vinogradov S, Walker K, Torstrick A, Uderman J, Wellington R, Zhao L, Fromm N, Dahdah M, Salisbury D, Monden K, Lande E, Wanlass R, Fong G, Smith K, Miele A, Novakovic-Agopian T, Chen A, Rome S, Rossi A, Abrams G, Murphy M, Binder D, Muir J, Carlin G, Loya F, Rabinovitz B, Bruhns M, Adler M, Schleicher-Dilks S, Messerly J, Babika C, Ukpabi C, Golden C, Schleicher-Dilks S, Coad S, Messerly J, Schaffer S, Babika C, Golden C, Cowad S, Paisley S, Fontanetta R, Messerly J, Golden C, Holder C, Kloezeman K, Henry B, Burns W, Patt V, Minassian A, Perry W, Cooper L, Allen D, Vogel S, Woolery H, Ciobanu C, Simone A, Bedard A, Olivier T, O'Neill S, Rajendran K, Halperin J, Rudd-Barnard A, Steenari M, Murry J, Le M, Becker T, Mucci G, Zupanc M, Shapiro E, Santos O, Cadavid N, Giese E, Londono N, Osmon D, Zamzow J, Culnan E, D'Argenio D, Mosti C, Spiers M, Schleicher-Dilks S, Kloss J, Curiel A, Miller K, Olmstead R, Gottuso A, Saucier C, Miller J, Dye R, Small G, Kent A, Andrews P, Puente N, Terry D, Faraco C, Brown C, Patel A, Siegel J, Miller L, Lee B, Joan M, Thaler N, Fontanetta R, Carla F, Allen D, Nguyen T, Glass L, Coles C, Julie K, May P, Sowell E, Jones K, Riley E, Demsky Y, Mattson S, Allart A, Freer B, Tiersky L, Sunderaraman P, Sylvester P, Ang J, Schultheis M, Newton S, Holland A, Burns K, Bunting J, Taylor J, Muetze H, Coe M, Harrison D, Putnam M, Tiersky L, Freer B, Holland A, Newton S, Sakamoto M, Bunting J, Taylor J, Coe M, Harrison D, Musso M, Hill B, Barker A, Pella R, Gouvier W, Davis J, Woods S, Wall J, Etherton J, Brand T, Hummer B, O'Shea C, Segovia J, Thomlinson S, Schulze E, Roskos P, Gfeller J, Loftis J, Fogel T, Barrera K, Sherzai A, Chappell A, Harrison A, Armstrong I, Flaro L, Pedersen H, Shultz LS, Roper B, Huckans M, Basso M, Silk-Eglit G, Stenclik J, Miele A, Lynch J, McCaffrey R, Silk-Eglit G, Stenclik J, Miele A, Lynch J, Musso M, McCaffrey R, Martin P, VonDran E, Baade L, Heinrichs R, Schroeder R, Hunter B, Calloway J, Rolin S, Akeson S, Westervelt H, Mohammed S, An K, Jeffay E, Zakzanis K, Lynch A, Drasnin D, Ikanga J, Graham O, Reid M, Cooper D, Long J, Lange R, Kennedy J, Hopewell C, Lukaszewska B, Pachalska M, Bidzan M, Lipowska M, McCutcheon L, Kaup A, Park J, Morgan E, Kenton J, Norman M, Martin P, Netson K, Woods S, Smith M, Paulsen J, Hahn-Ketter A, Paxton J, Fink J, Kelley K, Lee R, Pliskin N, Segala L, Vasilev G, Bozgunov K, Naslednikova R, Raynov I, Gonzalez R, Vassileva J, Bonilla X, Fedio A, Johnson K, Sexton J, Blackstone K, Weber E, Moore D, Grant I, Woods S, Pimental P, Welch M, Ring M, Stranks E, Crowe S, Jaehnert S, Ellis C, Prince C, Wheaton V, Schwartz D, Loftis J, Fuller B, Hoffman W, Huckans M, Turecka S, McKeever J, Morse C, Schultheis M, Dinishak D, Dasher N, Vik P, Hachey D, Bowman B, Van Ness E, Williams C, Zamzow J, Sunderaraman P, Kloss J, Spiers M, Swirsky-Sacchetti T, Alhassoon O, Taylor M, Sorg S, Schweinsburg B, Stricker N, Kimmel C, Grant I, Alhassoon O, Taylor M, Sorg S, Schweinsburg B, Stephan R, Stricker N, Grant I, Hertza J, Tyson K, Northington S, Loughan A, Perna R, Davis A, Collier M, Schroeder R, Buddin W, Schroeder R, Moore C, Andrew W, Ghelani A, Kim J, Curri M, Patel S, Denney D, Taylor S, Huberman S, Greenberg B, Lacritz L, Brown D, Hughes S, Greenberg B, Lacritz L, Vargas V, Upshaw N, Whigham K, Peery S, Casto B, Barker L, Otero T, La D, Nunan-Saah J, Phoong M, Gill S, Melville T, Harley A, Gomez R, Adler M, Tsou J, Schleicher-Dilks S, Golden C, Tsou J, Schleicher-Dilks S, Adler M, Golden C, Cowad S, Link J, Barker T, Gulliver K, Golden C, Young K, Moses J, Lum J, Vik P, Legarreta M, Van Ness E, Williams C, Dasher N, Williams C, Vik P, Dasher N, Van Ness E, Bowman B, Nakhutina L, Margolis S, Baek R, Gonzalez J, Hill F, England H, Horne-Moyer L, Stringer A, DeFilippis N, Lyon A, Giovannetti T, Fanning M, Heverly-Fitt S, Stambrook E, Price C, Selnes O, Floyd T, Vogt E, Thiruselvam I, Quasney E, Hoelzle J, Grant N, Moses J, Matevosyan A, Delano-Wood L, Alhassoon O, Hanson K, Lanni E, Luc N, Kim R, Schiehser D, Benners M, Downing K, Rowden A, Miller D, Maricle D, Kaminetskaya M, Moses J, Tai C, Kaminetskaya M, Melville T, Poole J, Scott R, Hays F, Walsh B, Mihailescu C, Douangratdy M, Scott B, Draffkorn C, Andrews P, Schmitt A, Waksmunski C, Brady K, Andrews A, Golden C, Olivier T, Espinoza K, Sterk V, Spengler K, Golden C, Olivier T, Spengler K, Sterk V, Espinoza K, Golden C, Gross J, DeFilippis N, Neiman-Kimel J, Romers C, Isaacs C, Soper H, Sordahl J, Tai C, Moses J, D'Orio V, Glukhovsky L, Beier M, Shuman M, Spat J, Foley F, Guatney L, Bott N, Moses J, Miranda C, Renteria MA, Rosario A, Sheynin J, Fuentes A, Byrd D, Mindt MR, Batchelor E, Meyers J, Patt V, Thomas M, Minassian A, Geyer M, Brown G, Perry W, Smith C, Kiefel J, Rooney A, Gouaux B, Ellis R, Grant I, Moore D, Graefe A, Wyman-Chick K, Daniel M, Beene K, Jaehnert S, Choi A, Moses J, Iudicello J, Henry B, Minassian A, Perry W, Marquine M, Morgan E, Letendre S, Ellis R, Woods S, Grant I, Heaton R, Constantine K, Fine J, Palewjala M, Macher R, Guatney L, Earleywine M, Draffkorn C, Scott B, Andrews P, Schmitt A, Dudley M, Silk-Eglit G, Stenclik J, Miele A, Lynch J, McCaffrey R, Scharaga E, Gomes W, McGinley J, Miles-Mason E, Colvin M, Carrion L, Romers C, Soper H, Zec R, Kohlrus S, Fritz S, Robbs R, Ala T, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Edwards M, Hall J, O'Bryant S, Miller J, Dye R, Miller K, Baerresen K, Small G, Moskowitz J, Puente A, Ahmed F, Faraco C, Brown C, Evans S, Chu K, Miller L, Young-Bernier M, Tanguay A, Tremblay F, Davidson P, Duda B, Puente A, Terry D, Kent A, Patel A, Miller L, Junod A, Marion SD, Harrington M, Fonteh A, Gurnani A, John S, Gavett B, Diaz-Santos M, Mauro S, Beaute J, Cronin-Golomb A, Fazeli P, Gouaux B, Rosario D, Heaton R, Moore D, Puente A, Lindbergh C, Chu K, Evans S, Terry D, Duda B, Mackillop J, Miller S, Greco S, Klimik L, Cohen J, Robbins J, Lashley L, Schleicher-Dilks S, Golden C, Kunkes I, Culotta V, Kunkes I, Griffits K, Loughan A, Perna R, Hertza J, Cohen M, Northington S, Tyson K, Musielak K, Fine J, Kaczorowski J, Doty N, Braaten E, Shah S, Nemanim N, Singer E, Hinkin C, Levine A, Gold A, Evankovich K, Lotze T, Yoshida H, O'Bryan S, Roberg B, Glusman M, Ness A, Thelen J, Wilson L, Feaster T, Bruce J, Lobue C, Brown D, Hughes S, Greenberg B, Lacritz L, Bristow-Murray B, Andrews A, Bermudez C, Golden C, Moore R, Pulver A, Patterson T, Bowie C, Harvey P, Jeste D, Mausbach B, Wingo J, Fink J, Lee R, Pliskin N, Legenkaya A, Henry B, Minassian A, Perry W, McKeever J, Morse C, Thomas F, Schultheis M, Ruocco A, Daros A, Gill S, Grimm D, Saini G, Relova R, Hoblyn J, Lee T, Stasio C, Mahncke H, Drag L, Grimm D, Gill S, Saini G, Relova R, Hoblyn J, Lee T, Stasio C, Mahncke H, Drag L, Verbiest R, Ringdahl E, Thaler N, Sutton G, Vogel S, Reyes A, Ringdahl E, Vogel S, Freeman A, Call E, Allen D, March E, Salzberg M, Vogel S, Ringdahl E, Freeman A, Dadis F, Allen D, Sisk S, Ringdahl E, Vogel S, Freeman A, Allen D, DiGangi J, Silva L, Pliskin N, Thieme B, Daniel M, Jaehnert S, Noggle C, Thompson J, Kecala N, Lane E, Kane C, Noggle C, Thompson J, Lane E, Kecala N, Kane C, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Olson S, Melville T, Harley A, La D, Phoong M, Gill S, Jocson VA, Nunan-Saah J, Keller J, Gomez R, Melville T, Kaminetskaya M, Poole J, Vernon A, Van Vleet T, DeGutis J, Chen A, Marini C, Dabit S, Gallegos J, Zomet A, Merzenich M, Thaler N, Linck J, Heyanka D, Pastorek N, Miller B, Romesser J, Sim A, Allen D, Zimmer A, Marcinak J, Hibyan S, Webbe F, Rainwater B, Francis J, Baum L, Sautter S, Donders J, Hui E, Barnes K, Walls G, Erikson S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Ramirez C, Oganes M, Gold S, Tanner S, Pina D, Merritt V, Arnett P, Heyanka D, Linck J, Thaler N, Pastorek N, Miller B, Romesser J, Sim A, Parks A, Roskos P, Gfeller J, Clark A, Isham K, Carter J, McLeod J, Romero R, Dahdah M, Barisa M, Schmidt K, Barnes S, Dubiel R, Dunklin C, Harper C, Callender L, Wilson A, Diaz-Arrastia R, Shafi S, Jacquin K, Bolshin L, Jacquin K, Romers C, Gutierrez E, Messerly J, Tsou J, Adler M, Golden C, Harmell A, Mausbach B, Moore R, Depp C, Jeste D, Palmer B, Hoadley R, Hill B, Rohling M, Mahdavi S, Fine J, daCruz K, Dinishak D, Richardson G, Vertinski M, Allen D, Mayfield J, Margolis S, Miele A, Rabinovitz B, Schaffer S, Kline J, Boettcher A, Hill B, Hoadley R, Rohling M, Eichstaedt K, Vale F, Benbadis S, Bozorg A, Rodgers-Neame N, Rinehardt E, Mattingly M, Schoenberg M, Fares R, Fares R, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Rach A, Baughman B, Young C, Bene E, Irwin C, Li Y, Poulin R, Jerram M, Susmaras T, Gansler D, Ashendorf L, Miarmi L, Fazio R, Cantor J, Fernandez A, Godoy-Garcete G, Marchetti P, Harrison A, Armstrong I, Harrison L, Iverson G, Brinckman D, Ayaz H, Schultheis M, Heinly M, Vitelli K, Russler K, Sanchez I, Jones W, Loe S, Raines T, Hart J, Bene E, Li Y, Irwin C, Baughman B, Rach A, Bravo J, Schilling B, Weiss L, Lange R, Shewchuk J, Heran M, Rauscher A, Jarrett M, Brubacher J, Iverson G, Zink D, Barney S, Gilbert G, Allen D, Martin P, Schroeder R, Klas P, Jeffay E, Zakzanis K, Iverson G, Lanting S, Saffer B, Koehle M, Palmer B, Barrio C, Vergara R, Muniz M, Pinto L, Jeste D, Stenclik J, Lynch J, McCaffrey R, Shultz LS, Pedersen H, Roper B, Crouse E, Crucian G, Dezhkam N, Mulligan K, Singer R, Psihogios A, Davis A, Stephens B, Love C, Mulligan K, Webbe F, West S, McCue R, Goldin Y, Cicerone K, Ruchinskas R, Seidl JT, Massman P, Tam J, Schmitter-Edgecombe M, Baerresen K, Hanson E, Miller K, Miller J, Yeh D, Kim J, Ercoli L, Siddarth P, Small G, Noback M, Noback M, Baldock D, Mahmoud S, Munic-Miller D, Bonner-Jackson A, Banks S, Rabin L, Emerson J, Smith C, Roberts R, Hass S, Duhig A, Pankratz V, Petersen R, Leibson C, Harley A, Melville T, Phoong M, Gill S, Nunan-Saah J, La D, Gomez R, Lindbergh C, Puente A, Gray J, Chu K, Evans S, Sweet L, MacKillop J, Miller L, McAlister C, Schmitter-Edgecombe M, Baldassarre M, Kamm J, Wolff D, Dombrowski C, Bullard S, Edwards M, Hall J, Parsons T, O'Bryant S, Lawson R, Papadakis A, Higginson C, Barnett J, Wills M, Strang J, Dominska A, Wallace G, Kenworthy L, Bott N, Kletter H, Carrion V, Ward C, Getz G, Peer J, Baum C, Edner B, Mannarino A, Casnar C, Janke K, van der Fluit F, Natalie B, Haberman D, Solomon M, Hunter S, Klein-Tasman B, Starza-Smith A, Talbot E, Hart A, Hall M, Baker J, Kral M, Lally M, Zisk A, Lo T, Ross P, Cuevas M, Patel S, Lebby P, Mouanoutoua A, Harrison J, Pollock M, Mathiowetz C, Romero R, Boys C, Vekaria P, Vasserman M, MacAllister W, Stevens S, Van Hecke A, Carson A, Karst J, Schohl K, Dolan B, McKindles R, Remel R, Reveles A, Fritz N, McDonald G, Wasisco J, Kahne J, Hertza J, Tyson K, Northington S, Loughan A, Perna R, Newman A, Garmoe W, Clark J, Loughan A, Perna R, Hertza J, Cohen M, Northington S, Tyson K, Whithers K, Puente A, Dedmon A, Capps J, Lindsey H, Francis M, Weigand L, Steed A, Puente A, Edmed S, Sullivan K, Puente A, Lindsey H, Dedmon A, Capps J, Whithers K, Weigand L, Steed A, Kark S, Lafleche G, Brown T, Bogdanova Y, Strongin E, Spickler C, Drasnin D, Strongin C, Poreh A, Houshyarnejad A, Ellis M, Babikian T, Kernan C, Asarnow R, Didehbani N, Cullum M, Loneman L, Mansinghani S, Hart J, Fischer J. POSTER SESSIONS SCHEDULE. Arch Clin Neuropsychol 2013. [DOI: 10.1093/arclin/act054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Tanaka K, Hata A, Kaji R, Fujita S, Takeshita J, Matsumoto T, Monden K, Nagata K, Nanjo S, Otsuka K, Tachikawa R, Otsuka K, Hayashi M, Tomii K, Katakami N. Cytokeratin 19 Fragment (CYFRA21-1) Predicts the Efficacy of the Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI) in Non-Small-Cell Lung Cancer (NSCLC) Harboring EGFR Mutation. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32406-6] [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: 12/01/2022] Open
|
10
|
Hata A, Katakami N, Yoshioka H, Tanaka K, Nishiyama A, Nanjo S, Kaji R, Fujita S, Monden K, Matsumoto T, Nagata K, Otsuka K, Tachikawa R, Tomii K, Iwasaku M. Rebiopsy of Non-Small-Cell Lung Cancer Patients with Acquired Resistance to EGFR-TKI: Comparison Between T790M Mutation-Positive and -Negative Populations. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32322-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: 11/24/2022] Open
|
11
|
Fayolle G, Levick W, Lajiness-O'Neill R, Fastenau P, Briskin S, Bass N, Silva M, Critchfield E, Nakase-Richardson R, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Anderson A, Peery S, Chafetz M, Maris M, Ramezani A, Sylvester C, Goldberg K, Constantinou M, Karekla M, Hall J, Edwards M, Balldin V, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, lacritz L, Reisch J, Massman P, Royall D, Barber R, Younes S, Wiechmann A, O'Bryant S, Patel K, Suhr J, Patel K, Suhr J, Chari S, Yokoyama J, Bettcher B, Karydas A, Miller B, Kramer J, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Gifford K, Cantwell N, Romano R, Jefferson A, Holland A, Newton S, Bunting J, Coe M, Carmona J, Harrison D, Puente A, Terry D, Faraco C, Brown C, Patel A, Watts A, Kent A, Siegel J, Miller S, Ernst W, Chelune G, Holdnack J, Sheehan J, Duff K, Pedraza O, Crawford J, Terry D, Puente A, Brown C, Faraco C, Watts A, Patel A, Kent A, Siegel J, Miller L, Younes S, Hobson Balldin V, Benavides H, Johnson L, Hall J, Tshuma L, O'Bryant S, Dezhkam N, Hayes L, Love C, Stephens B, Webbe F, Allen C, Lemann E, Davis A, Pierson E, Lutz J, Piehl J, Holler K, Kavanaugh B, Tayim F, Llanes S, Mulligan K, Poston K, Riccio C, Beathard J, Cohen M, Stolberg P, Hart J, Jones W, Mayfield J, Allen D, Weller J, Dunham K, Demireva P, McInerney K, Suhr J, Dykstra J, Riddle T, Suhr J, Primus M, Riccio C, Highsmith J, Everhart D, Shadi S, Lehockey K, Sullivan S, Lucas M, Mandava S, Murphy B, Donovick P, Lalwani L, Rosselli M, Coad S, Carrasco R, Sofko C, Scarisbrick D, Golden C, Coad S, Zuckerman S, Golden C, Perna R, Loughan A, Hertza J, Brand J, Rivera Mindt M, Denney R, Schaffer S, Alper K, Devinsky O, Barr W, Langer K, Fraiman J, Scagliola J, Roman E, Martinez A, Cohen M, Dunham K, Riccio C, Martin P, Robbins J, Golden C, Axelrod B, Etherton J, Konopacki K, Moses J, Juliano A, Whiteside D, Rolin S, Widmann G, Franzwa M, Sokal B, Mark V, Doyle K, Morgan E, Weber E, Bondi M, Delano-Wood L, Grant I, Sibson J, Woods S, Andrews P, McGregor S, Golden C, Etherton J, Allen C, Cormier R, Cumley N, Elek M, Green M, Ogbeide S, Kruger A, Pacheco L, Robinson G, Welch H, Etherton J, Allen C, Cormier R, Cumley N, Kruger A, Pacheco L, Glover M, Parriott D, Jones W, Loe S, Hughes L, Natta L, Moses J, Vincent A, Roebuck-Spencer T, Bryan C, Padua M, Denney R, Moses J, Quenicka W, McGoldirck K, Bennett T, Soper H, Collier S, Connolly M, Hanratty A, Di Pinto M, Magnuson S, Dunham K, Handel E, Davidson K, Livers E, Frantz S, Allen J, Jerard T, Moses J, Pierce S, Sakhai S, Newton S, Warchol A, Holland A, Bunting J, Coe M, Carmona J, Harrison D, Barney S, Thaler N, Sutton G, Strauss G, Allen D, Hunter B, Bennett T, Quenicka W, McGoldrick K, Soper H, Sordahl J, Torrence N, John S, Gavett B, O'Bryant S, Shadi S, Denney R, Nichols C, Riccio C, Cohen M, Dennison A, Wasserman T, Schleicher-Dilks S, Adler M, Golden C, Olivier T, Schleicher-Dilks S, Golden C, LeMonda B, McGinley J, Pritchett A, Chang L, Cloak C, Cunningham E, Lohaugen G, Skranes J, Ernst T, Parke E, Thaler N, Etcoff L, Allen D, Andrews P, McGregor S, Golden C, Northington S, Daniels R, Loughan A, Perna R, Hertza J, Hochsztein N, Miles-Mason E, Granader Y, Vasserman M, MacAllister W, Casto B, Peery S, Patrick K, Hurewitz F, Chute D, Booth A, Koch C, Roid G, Balkema N, Kiefel J, Bell L, Maerlender A, Belkin T, Katzenstein J, Semerjian C, Culotta V, Band E, Yosick R, Burns T, Arenivas A, Bearden D, Olson K, Jacobson K, Ubogy S, Sterling C, Taub E, Griffin A, Rickards T, Uswatte G, Davis D, Sweeney K, Llorente A, Boettcher A, Hill B, Ploetz D, Kline J, Rohling M, O'Jile J, Holler K, Petrauskas V, Long J, Casey J, Long J, Petrauskas V, Duda T, Hodsman S, Casey J, Stricker S, Martner S, Hansen R, Ferraro F, Tangen R, Hanratty A, Tanabe M, O'Callaghan E, Houskamp B, McDonald L, Pick L, Guardino D, Pick L, Pietz T, Kayser K, Gray R, Letteri A, Crisologo A, Witkin G, Sanders J, Mrazik M, Harley A, Phoong M, Melville T, La D, Gomez R, Berthelson L, Robbins J, Lane E, Golden C, Rahman P, Konopka L, Fasfous A, Zink D, Peralta-Ramirez N, Perez-Garcia M, Puente A, Su S, Lin G, Kiely T, Gomez R, Schatzberg A, Keller J, Dykstra J, Suhr J, Feigon M, Renteria L, Fong M, Piper L, Lee E, Vordenberg J, Contardo C, Magnuson S, Doninger N, Luton L, Balkema N, Drane D, Phelan A, Stricker W, Poreh A, Wolkenberg F, Spira J, Lin G, Su S, Kiely T, Gomez R, Schatzberg A, Keller J, DeRight J, Jorgensen R, Fitzpatrick L, Crowe S, Woods S, Doyle K, Weber E, Cameron M, Cattie J, Cushman C, Grant I, Blackstone K, Woods S, Weber E, Grant I, Moore D, Roberg B, Somogie M, Thelen J, Lovelace C, Bruce J, Gerstenecker A, Mast B, Litvan I, Hargrave D, Schroeder R, Buddin W, Baade L, Heinrichs R, Thelen J, Roberg B, Somogie M, Lovelace C, Bruce J, Boseck J, Berry K, Koehn E, Davis A, Meyer B, Gelder B, Sussman Z, Espe-Pfeifer P, Musso M, Barker A, Jones G, Gouvier W, Weber E, Woods S, Grant I, Johnson V, Zaytsev L, Freier-Randall M, Sutton G, Thaler N, Ringdahl E, Allen D, Olsen J, Byrd D, Rivera-Mindt M, Fellows R, Morgello S, Wheaton V, Jaehnert S, Ellis C, Olavarria H, Loftis J, Huckans M, Pimental P, Frawley J, Welch M, Jennette K, Rinehardt E, Schoenberg M, Strober L, Genova H, Wylie G, DeLuca J, Chiaravalloti N, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Hertza J, Loughan A, Perna R, Northington S, Boyd S, Ibrahim E, Seiam A, Ibrahim E, Bohlega S, Rinehardt E, Lloyd H, Goldberg M, Marceaux J, Fallows R, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Fulton R, Stevens P, Erickson S, Dodzik P, Williams R, Dsurney J, Najafizadeh L, McGovern J, Chowdhry F, Acevedo A, Bakhtiar A, Karamzadeh N, Amyot F, Gandjbakhche A, Haddad M, Taub E, Johnson M, Wade J, Harper L, Rickards T, Sterling C, Barghi A, Uswatte G, Mark V, Balkema N, Christopher G, Marcus D, Spady M, Bloom J, Wiechmann A, Hall J, Loughan A, Perna R, Hertza J, Northington S, Zimmer A, Webbe F, Miller M, Schuster D, Ebner H, Mortimer B, Webbe F, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Meyers J, Lange R, Brickell T, French L, Lange R, Iverson G, Shewchuk J, Madler B, Heran M, Brubacher J, Brickell T, Lange R, Ivins B, French L, Baldassarre M, Paper T, Herrold A, Chin A, Zgaljardic D, Oden K, Lambert M, Dickson S, Miller R, Plenger P, Jacobson K, Olson K, Sutherland E, Glatts C, Schatz P, Walker K, Philip N, McClaughlin S, Mooney S, Seats E, Carnell V, Raintree J, Brown D, Hodges C, Amerson E, Kennedy C, Moore J, Schatz P, Ferris C, Roebuck-Spencer T, Vincent A, Bryan C, Catalano D, Warren A, Monden K, Driver S, Chau P, Seegmiller R, Baker M, Malach S, Mintz J, Villarreal R, Peterson A, Leininger S, Strong C, Donders J, Merritt V, Vargas G, Rabinowitz A, Arnett P, Whipple E, Schultheis M, Robinson K, Iacovone D, Biester R, Alfano D, Nicholls M, Vargas G, Rabinowitz A, Arnett P, Rabinowitz A, Vargas G, Arnett P, Klas P, Jeffay E, Zakzanis K, Vandermeer M, Jeffay E, Zakzanis K, Womble M, Rohling M, Hill B, Corley E, Considine C, Fichtenberg N, Harrison J, Pollock M, Mouanoutoua A, Brimager A, Lebby P, Sullivan K, Edmed S, Silva M, Nakase-Richardson R, Critchfield E, Kieffer K, McCarthy M, Wiegand L, Lindsey H, Hernandez M, Puente A, Noniyeva Y, Lapis Y, Padua M, Poole J, Brooks B, McKay C, Mrazik M, Meeuwisse W, Emery C, Brooks B, Mazur-Mosiewicz A, Sherman E, Brooks B, Mazur-Mosiewicz A, Kirkwood M, Sherman E, Gunner J, Miele A, Silk-Eglit G, Lynch J, McCaffrey R, Stewart J, Tsou J, Scarisbrick D, Chan R, Bure-Reyes A, Cortes L, Gindy S, Golden C, Hunter B, Biddle C, Shah D, Jaberg P, Moss R, Horner M, VanKirk K, Dismuke C, Turner T, Muzzy W, Dunnam M, Miele A, Warner G, Donnelly K, Donnelly J, Kittleson J, Bradshaw C, Alt M, Margolis S, Ostroy E, Rolin S, Higgins K, Denney R, Rolin S, Eng K, Biddle C, Akeson S, Wall J, Davis J, Hansel J, Hill B, Rohling M, Wang B, Womble M, Gervais R, Greiffenstein M, Denning J, Denning J, Schroeder R, Buddin W, Hargrave D, VonDran E, Campbell E, Brockman C, Heinrichs R, Baade L, Buddin W, Hargrave D, Schroeder R, Teichner G, Waid R, Buddin W, Schroeder R, Teichner G, Waid R, Buican B, Armistead-Jehle P, Bailie J, Dilay A, Cottingham M, Boyd C, Asmussen S, Neff J, Schalk S, Jensen L, DenBoer J, Hall S, DenBoer J, Schalk S, Jensen L, Hall S, Miele A, Lynch J, McCaffrey R, Holcomb E, Axelrod B, Demakis G, Rimland C, Ward J, Ross M, Bailey M, Stubblefield A, Smigielski J, Geske J, Karpyak V, Reese C, Larrabee G, Suhr J, Silk-Eglit G, Gunner J, Miele A, Lynch J, McCaffrey R, Allen L, Celinski M, Gilman J, Davis J, Wall J, LaDuke C, DeMatteo D, Heilbrun K, Swirsky-Sacchetti T, Lindsey H, Puente A, Dedman A, Withers K, Chafetz M, Deneen T, Denney R, Fisher J, Spray B, Savage R, Wiener H, Tyer J, Ningaonkar V, Devlin B, Go R, Sharma V, Tsou J, Golden C, Fontanetta R, Calderon C, Coad S, Golden C, Calderon C, Fontaneta R, Coad S, Golden C, Ringdahl E, Thaler N, Sutton G, Vertinski M, Allen D, Verbiest R, Thaler N, Snyder J, Kinney J, Allen D, Rach A, Young J, Crouse E, Schretlen D, Weaver J, Buchholz A, Gordon B, Macciocchi S, Seel R, Godsall R, Brotsky J, DiRocco A, Houghton-Faryna E, Bolinger E, Hollenbeck C, Hart J, Thaler N, Vertinski M, Ringdahl E, Allen D, Lee B, Strauss G, Adams J, Martins D, Catalano L, Waltz J, Gold J, Haas G, Brown L, Luther J, Goldstein G, Kiely T, Kelley E, Lin G, Su S, Raba C, Gomez R, Trettin L, Solvason H, Schatzberg A, Keller J, Vertinski M, Thaler N, Allen D, Gold J, Buchanan R, Strauss G, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Fallows R, Marceaux J, McCoy K, Yehyawi N, Luther E, Hilsabeck R, Etherton J, Phelps T, Richmond S, Tapscott B, Thomlinson S, Cordeiro L, Wilkening G, Parikh M, Graham L, Grosch M, Hynan L, Weiner M, Cullum C, Hobson Balldin V, Menon C, Younes S, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum M, Lacritz L, Reisch J, Massman P, Royall D, Barber R, O'Bryant S, Castro-Couch M, Irani F, Houshyarnejad A, Norman M, Peery S, Fonseca F, Bure-Reyes A, Browne B, Alvarez J, Jiminez Y, Baez V, Cortes L, Golden C, Fonseca F, Bure-Reyes A, Coad S, Alvarez J, Browne B, Baez V, Golden C, Resendiz C, Scott B, Farias G, York M, Lozano V, Mahoney M, Strutt A, Hernandez Mejia M, Puente A, Bure-Reyes A, Fonseca F, Baez V, Alvarez J, Browne B, Coad S, Jiminez Y, Cortes L, Golden C, Bure-Reyes A, Pacheco E, Homs A, Acevedo A, Ownby R, Nici J, Hom J, Lutz J, Dean R, Finch H, Pierce S, Moses J, Mann S, Feinberg J, Choi A, Kaminetskaya M, Pierce C, Zacharewicz M, Axelrod B, Gavett B, Horwitz J, Edwards M, O'Bryant S, Ory J, Gouvier W, Carbuccia K, Ory J, Carbuccia K, Gouvier W, Morra L, Garcon S, Lucas M, Donovick P, Whearty K, Campbell K, Camlic S, Donovick P, Edwards M, Balldin V, Hall J, Strutt A, Pavlik V, Marquez de la Plata C, Cullum C, Lacritz L, Reisch J, Massman P, Barber R, Royall D, Younes S, O'Bryant S, Brinckman D, Schultheis M, Ehrhart L, Weisser V, Medaglia J, Merzagora A, Reckess G, Ho T, Testa S, Gordon B, Schretlen D, Woolery H, Farcello C, Klimas N, Thaler N, Allen D, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Womble M, Rohling M, Hill B, Corley E, Drayer K, Rohling M, Ploetz D, Womble M, Hill B, Baldock D, Ringdahl E, Sutton G, Thaler N, Allen D, Galusha J, Schmitt A, Livingston R, Stewart R, Quarles L, Pagitt M, Barke C, Baker A, Baker N, Cook N, Ahern D, Correia S, Resnik L, Barnabe K, Gnepp D, Benjamin M, Zlatar Z, Garcia A, Harnish S, Crosson B, Rickards T, Mark V, Taub E, Sterling C, Vaughan L, Uswatte G, Fedio A, Sexton J, Cummings S, Logemann A, Lassiter N, Fedio P, Gremillion A, Nemeth D, Whittington T, Hansen R, Reckow J, Ferraro F, Lewandowski C, Cole J, Lewandowski A, Spector J, Ford-Johnson L, Lengenfelder J, Genova H, Sumowski J, DeLuca J, Chiaravalloti N, Loughan A, Perna R, Hertza J, Morse C, McKeever J, Zhao L, Leist T, Schultheis M, Marcinak J, Piecora K, Al-Khalil K, Webbe F, Mulligan K, Robbins J, Berthelson L, Martin P, Golden C, Piecora K, Marcinak J, Al-Khalil K, Webbe F, Mulligan K, Stewart J, Acevedo A, Ownby R, Thompson L, Kowalczyk W, Golub S, Davis A, Lemann E, Piehl J, Rita N, Moss L, Davis A, Boseck J, Berry K, Koehn E, Meyer B, Gelder B, Davis A, Nogin R, Moss L, Drapeau C, Malm S, Davis A, Lemann E, Koehn E, Drapeau C, Malm S, Boseck J, Armstrong L, Glidewell R, Orr W, Mears G. Grand Rounds. Arch Clin Neuropsychol 2012. [DOI: 10.1093/arclin/acs070] [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: 11/15/2022] Open
|
12
|
Serrano N, Molander R, Monden K, Grosshans A, Krahn DD. Exemplars in the use of technology for management of depression in primary care. WMJ 2012; 111:112-118. [PMID: 22870556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Depression care management as part of larger efforts to integrate behavioral health care into primary care has been shown to be effective in helping patients and primary care clinicians achieve improved outcomes within the primary care environment. Central to care management systems is the use of registries which enable effective clinic population management. The aim of this article is to detail the methods and utility of technology in depression care management processes while also highlighting the real-world variations and barriers that exist in different clinical environments, namely a federally qualified health center and a Veterans Administration clinic. METHODS We analyzed descriptive data from the registries of Access Community Health Centers and the William S. Middleton Veterans Administration clinics along with historical reviews of their respective care management processes. RESULTS Both registry reviews showed trend data indicating improvement in scores of depression and provided baseline data on important system variables, such as the number of patients who are not making progress, the percentage of patients who are unreachable by phone, and the kind of actions needed to ensure evidence-based and efficient care. Both sites also highlighted systemic technical barriers to more complete implementation of care management processes. CONCLUSIONS Care management processes are an effective and efficient part of population-based care for depression in primary care. Implementation depends on available resources including hardware, software, and clinical personnel. Additionally, care management processes and technology have evolved over time based on local needs and are part of an integrated method to support the work of primary care clinicians in providing care for patients with depression.
Collapse
|
13
|
Serrano N, Monden K. The effect of behavioral health consultation on the care of depression by primary care clinicians. WMJ 2011; 110:113-118. [PMID: 21748995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE The aim of this study is to assess the impact of an integrated care model, called the Behavioral Health Consultation model, in the delivery of care for depression in an urban Federally Qualified Health Center, and to gauge the receptiveness of primary care clinicians to increasing their responsibility for the mental health care of their patients. METHODS We reviewed electronic medical records to measure referral rates to mental health specialty care, patient engagement in care, management of psychotropic medications, and initiation of antidepressant medication, comparing data from the year prior to program implementation to that from the third year post-implementation. Clinician attitudes were assessed using an online anonymous questionnaire. RESULTS Statistically significant findings included post-implementation increases in the use of standardized measures of depression, documentation of behavioral goals and patient visits to the primary care clinician (increased engagement), decreases in initiation rates of antidepressant medications, and decreases in referrals to mental health specialty care. No significant difference was found in rates of dosage changes or change to new medications among patients who were already on psychiatric medications. Clinicians reported near universal acceptance of the behavioral health consultation program and willingness to increase their role in managing patient mental health issues. CONCLUSIONS This study demonstrates that a behavioral health consultation program in an urban community health center can improve adherence to evidence-based indicators in the care of depression, making it possible to manage the majority of patients presenting with depression in the primary care setting.
Collapse
|
14
|
Takao A, Saika T, Uehara S, Monden K, Abarzua F, Nasu Y, Kumon H. Indications for Ureteropyeloscopy Based on Radiographic Findings and Urine Cytology in Detection of Upper Urinary Tract Carcinoma. Jpn J Clin Oncol 2010; 40:1087-91. [DOI: 10.1093/jjco/hyq096] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Uehara S, Watanabe T, Saika T, Araki M, Monden K, Tsugawa M, Kobayashi Y, Ono N, Nasu Y, Kumon H. UP-2.101: Endoscopic Management for Upper Tract Urothelial Carcinoma: Long-Term Follow-Up in a Single Center. Urology 2009. [DOI: 10.1016/j.urology.2009.07.320] [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: 10/20/2022]
|
16
|
Araki M, Uehara S, Monden K, Watanabe T, Saika T, Nasu Y, Kumon H. UP-3.170: Retrograde Ureteropyeloscopic Treatment of Large Upper Urinary Tract and Staghorn Calculi with Aquaguide. Urology 2009. [DOI: 10.1016/j.urology.2009.07.175] [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: 10/20/2022]
|
17
|
Watanabe T, Wada K, Inoue M, Uehara S, Monden K, Saika T, Nasu Y, Kumon H, Akazawa N, Togami I. UP-02.46. Urology 2006. [DOI: 10.1016/j.urology.2006.08.788] [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: 11/29/2022]
|
18
|
Kumamoto Y, Tsukamoto T, Ogihara M, Ishibashi K, Hirose T, Matsukawa M, Takahashi S, Kunishima Y, Shigeta S, Yoshida H, Imafuku Y, Ooe H, Nishikawa M, Murai M, Watanabe K, Kobayashi Y, Oka T, Kitamura M, Uchida H, Takano Y, Matsuoka Y, Matsuda S, Sato S, Furuhama T, Fujime M, Fujita K, Kumon H, Monden K, Igari J, Oguri T, Kohno S, Miyazaki Y, Yamaguchi T, Matsumoto K, Izumikawa K, Yamaguchi T, Kashitani F, Mochida C. [Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1999). III. Secular changes in susceptibility]. Jpn J Antibiot 2001; 54:231-322. [PMID: 11525192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The bacteria (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined and the results were compared with those obtained between 1991 and 1998. Comparison was made by classifying strains isolated from patients into those with uncomplicated UTIs and those with complicated UTIs (including with or without indwelling catheter). About E. faecalis, increase of low sensitive strains noted in the former year showed a decreasing tendency, however, one strain each with MIC of 4 micrograms/ml to vancomycin (VCM) was detected in patients with both uncomplicated and complicated UTIs. As for S. aureus, many sensitive strains to cephems, imipenem (IPM) and VCM were noted, and each MIC50 was better than that in the former years. S. aureus strains showing low susceptibility to arbekacin (ABK) were detected in patients with complicated UTIs in this year as well as in the former year, and one strain each with MIC of 16 micrograms/ml and 32 micrograms/ml was detected. Susceptibilities of E. coli were effective to all drugs except for penicillins and minocycline (MINO). Decrease of low sensitive strains was also noted in all drugs except for quinolones. Each MIC90 of ciprofloxacin (CPFX) and sparfloxacin (SPFX) in patients with complicated UTIs against E. coli was 3 degrees classes lower than that in patients with uncomplicated UTIs. As for Klebsiella pneumoniae, decrease of low sensitive strains to cephems was noted in patients with uncomplicated UTIs in 1998. In 1999, low sensitive strains decreased also in patients with complicated UTIs, and few were detected. Susceptibilities of K. pneumoniae to quinolones were effective as compared with those in the former years with the MIC80s of 0.125 microgram/ml or below without detection of low sensitive strains. One low sensitive strain of K. pneumoniae with MIC of 8 micrograms/ml was detected for gentamicin (GM). Susceptibilities of P. aeruginosa to carbapenems were notable. The MIC90 of meropenem (MEPM) and IPM was 4 micrograms/ml each which was 2 degrees better than that in 1998. Resistant P. aeruginosa strains to other drugs except for monobactams decreased in 1999.
Collapse
Affiliation(s)
- Y Kumamoto
- Department of Urology, Sapporo Medical University, School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Kumamoto Y, Tsukamoto T, Hirose T, Matsukawa M, Takahashi S, Kunishima Y, Fujime M, Fujita K, Ogihara M, Ishibashi K, Igari J, Shigeta S, Oguri T, Yamaguchi K, Matsumoto T, Kashitani F, Yoshida H, Imafuku Y, Murai M, Ooe H, Nishikawa M, Watanabe K, Kobayashi Y, Uchida H, Oka T, Kitamura M, Takano Y, Matsuoka Y, Matsuda S, Sato S, Furuhama T, Kumon H, Monden K, Izumikawa K, Yamaguchi T, Mochida C, Kohno S, Miyazaki Y. [Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1999). II. Background of patients]. Jpn J Antibiot 2001; 54:217-29. [PMID: 11510119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Five-hundred forty four bacterial strains isolated from 412 patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the clinical background of patients were investigated such as sex, age and type of infections, infections and kind of bacteria, frequency of isolation of bacteria by age and infections, bacteria and infections by timing of administration of antibiotics, and bacteria and infections by surgical procedures. About the relationship between age and sex of patients and type of infections, the number of male patients aged less than 50 years was few, and complicated UTIs without indwelling catheter was the most frequent. In females, the number of patients aged less than 20 years was few. Complicated UTIs without indwelling catheter was the most frequent among female patients aged between 40 to 59 years, in other age groups, uncomplicated UTIs was most frequent. As for type of infections and kind of bacteria, Escherichia coli decreased when the infections became complicated, and Pseudomonas aeruginosa and Enterococcus faecalis increased when the infection became complicated. Considering this result by age of patients, isolation frequency of E. coli was gradually decreased with aging in patients aged more than 20 years with uncomplicated UTIs or complicated UTIs without indwelling catheter. The isolation frequencies of E. faecalis and Staphylococcus aureus were gradually increased with aging in complicated UTIs without indwelling catheter. In patients with complicated UTIs with indwelling catheter, there was no difference between age group, and P. aeruginosa and E. faecalis were frequently isolated. As for type of causative organisms in UTIs before and after the administration of antibiotics, the isolation of bacteria was remarkably decreased after administration in patients with uncomplicated UTIs and complicated UTIs without indwelling catheter. E. coli decreased after administration of antibiotics, and P. aeruginosa and E. faecalis increased after administration in patients with all infections. As for type of causative organisms in UTIs and surgical procedures, E. coli were more frequently isolated in patients with uncomplicated UTIs when surgical procedures were experienced. Also, Klebsiella spp. and E. faecalis were more frequently isolated in patients with surgical procedures. However, in complicated UTIs, type of causative organisms had no relationship with surgical procedures.
Collapse
Affiliation(s)
- Y Kumamoto
- Department of Urology, Sapporo Medical University, School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Kumamoto Y, Tsukamoto T, Watanabe K, Kobayashi Y, Hirose T, Matsukawa M, Uchida H, Takahashi S, Kunishima Y, Matsuda S, Sato S, Ogihara M, Ishibashi K, Shigeta S, Fujime M, Fujita K, Yoshida H, Imafuku Y, Igari J, Murai M, Oguri T, Yamaguchi K, Matsumoto T, Kashitani F, Furuhama T, Kumon H, Monden K, Ooe H, Nishikawa M, Kohno S, Miyazaki Y, Izumikawa K, Yamaguchi T, Mochida C, Oka T, Kitamura M, Takano Y, Matsuoka Y. [Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1999). I. Susceptibility distribution]. Jpn J Antibiot 2001; 54:185-216. [PMID: 11510118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 499 strains. The breakdown of these strains was Gram-positive bacteria as 31.3% and Gram-negative bacteria as 68.7%. Susceptibilities of these bacteria to antimicrobial agents were as follows; vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. The increase of low-susceptible strains which was noticed in the former year showed a slight recovery in this year. VCM showed a strong activity against MRSA preventing growth of all strains with 1 microgram/ml. In addition, the activity of arbekacin (ABK) was also strong with the MIC90 of 2 micrograms/ml against MRSA. However, MSSA and MRSA showing low susceptibilities were detected in one strain each (MIC: 16 micrograms/ml and 32 micrograms/ml, respectively). Carbapenems showed high activities against Citrobacter freundii and Escherichia coli. Meropenem (MEPM) prevented growth of all strains within 0.125 microgram/ml. Quinolone resistant E. coli decreased in this year compared with those in the last year, that percentage was less than 5%. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis. MEPM and carumonam (CRMN) prevented growth of all strains within 0.125 microgram/ml. On the other hand, one strain of K. pneumoniae showing resistance to cefaclor (CCL) and one strain of P. mirabilis showing low susceptibility to most of cephems were detected. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90s of carbapenems were 8 micrograms/ml and those of all other drugs were more than 16 micrograms/ml.
Collapse
Affiliation(s)
- Y Kumamoto
- Department of Urology, Sapporo Medical University, School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Kumon H, Hashimoto H, Nishimura M, Monden K, Ono N. Catheter-associated urinary tract infections: impact of catheter materials on their management. Int J Antimicrob Agents 2001; 17:311-6. [PMID: 11295414 DOI: 10.1016/s0924-8579(00)00360-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Infection associated with an indwelling catheter is a representative type of biofilm infection occurring in the urinary tract. Since the most effective way to control this intractable infection is the prevention of bacterial attachment and subsequent biofilm formation on the catheter, the importance of catheter materials and anti-bacterial coating cannot be underestimated. The difference in the degree of bacterial attachment among standard catheter materials, the efficacy of silver-coating of catheters in preventing infection and the potency and effectiveness of a new lecithin/silver coating are discussed.
Collapse
Affiliation(s)
- H Kumon
- Department of Urology, Okayama University Medical School, 2-5-1, Shikata, Okayama 700-8558, Japan.
| | | | | | | | | |
Collapse
|
22
|
Hashimoto H, Ono N, Monden K, Kumon H, Shiba T, Adachi T, Kaneko K. [Basic study on anti-bacterial urethral catheter. II. Potency of a new anti-bacterial catheter and its durability in experimental models]. Kansenshogaku Zasshi 2000; 74:441-9. [PMID: 10860356 DOI: 10.11150/kansenshogakuzasshi1970.74.441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The potency and effectiveness of an anti-bacterial catheter coated with a mixture of silver citrate, soybean lecithin and liquid silicon at the ratio of 2:2:8 were compared with those of commercially available anti-bacterial and conventional urethral catheters. This new anti-bacterial catheter showed a strong activity and excellent durability in ordinary in vitro experimental studies. In the present series we have developed new in vitro experimental models for the evaluation of anti-bacterial catheters in inhibiting bacterial ascent via intraluminal or extraluminal route. The characteristic features of the silver citrate/lecithin catheter, namely strong activity and excellent durability, were confirmed using these new models that mimic urinary catheter-associated clinical infections.
Collapse
Affiliation(s)
- H Hashimoto
- Department of Urology, Okayama University School of Medicine
| | | | | | | | | | | | | |
Collapse
|
23
|
Hashimoto H, Ono N, Monden K, Kumon H, Shiba T, Adachi T, Kaneko K. [Basic study on anti-bacterial urethral catheter. I. Development of a new anti-bacterial coating material for silicon catheters]. Kansenshogaku Zasshi 2000; 74:431-40. [PMID: 10860355 DOI: 10.11150/kansenshogakuzasshi1970.74.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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
In order to develop a new anti-bacterial urethral catheter, we studied anti-bacterial and anti-adherent coating material suitable for silicon catheters. Several aspects of various silver compounds were examined, including anti-bacterial activity, chemical property and toxicity. Among silver citrate, silver phosphate and silver oxide, which were found to have excellent anti-bacterial activities, silver citrate was regarded as the material of choice for anti-bacterial coating in terms of durable activity and biological safety. It was also found that several surfactants inhibited bacterial adherence to the surface of silicon catheters. Among them soybean lecithin exhibited excellent anti-adherent activity in a dose dependent manner. Finally, a mixture of silver citrate, soybean lecithin and liquid silicon at the ratio of 2:2:8 was regarded as an ideal anti-bacterial coating material for silicon catheters.
Collapse
Affiliation(s)
- H Hashimoto
- Department of Urology, Okayama University School of Medicine
| | | | | | | | | | | | | |
Collapse
|
24
|
Suwa H, Hosotani R, Okino T, Monden K, Arii S, Inoue K, Kogire M, Ohshio G, Fukumoto M, Imamura M. Detection of multiple hepatic micrometastases in pancreatic adenocarcinoma with a solitary liver metastasis by direct sequencing of the K-ras gene: a case report. Surgery 1999; 125:113-6. [PMID: 9889807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- H Suwa
- Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Abstract
BACKGROUND There has been a great deal of discussion regarding the necessity of the prophylactic use of antibiotics in transurethral procedures. In order to clarify this complicated issue, a randomized prospective study was performed for patients undergoing urethrocystoscopy or urethrocystography. PATIENTS AND METHODS Patients who underwent urethrocystoscopy or urethrocystography and did not have pyuria and bacteriuria were included and divided randomly into 2 groups, either receiving a prophylactic antibiotic or no antibiotic. For antibiotic prophylaxis, 200 mg of sparfloxacin or fleroxacin were administered within a 1-hour period before the urethrocystoscopic or urethrocystographic examination, respectively. Analyses were performed on patients who were seen within 1 month after the examination, using the appearance of pyuria, bacteriuria, or a febrile infection as the endpoint. RESULTS Of 47 patients undergoing urethrocystoscopy, 45 were eligible for analysis, and of these, sparfloxacin was administered to 21 patients. Thirty-three of 37 patients undergoing urethrocystography were eligible for analysis with fleroxacin administered to 16 patients. There were no significant differences in the background factors between the 2 groups undergoing either transurethral examination. None of the patients in either group developed pyuria, bacteriuria or a febrile infection after the examination. CONCLUSIONS Prophylactic administration of antibiotics is not necessarily essential in urethrocystoscopy or urethrocystography in patients with sterile urine.
Collapse
Affiliation(s)
- M Tsugawa
- Department of Urology, Okayama University Medical School, Shikata, Japan
| | | | | | | | | |
Collapse
|
26
|
Arii S, Monden K, Niwano M, Furutani M, Mori A, Mizumoto M, Imamura M. Results of surgical treatment for recurrent hepatocellular carcinoma; comparison of outcome among patients with multicentric carcinogenesis, intrahepatic metastasis, and extrahepatic recurrence. J Hepatobiliary Pancreat Surg 1998; 5:86-92. [PMID: 9683759 DOI: 10.1007/pl00009956] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
No consensus has been reached on the indications for and effectiveness of surgery for secondary intrahepatic hepatocellular carcinoma (HCC) and extrahepatic metastasis after macroscopically complete removal of primary HCC. Secondary intrahepatic HCCs, usually regarded as recurrence are classified into those arising as a result of multicentric carcinogenesis or intrahepatic metastases derived from the primary HCC. The present study was designed to evaluate the utility of surgical treatment in relation to the pathogenesis of the secondary HCC: classified as multicentric carcinogenesis (MC), intrahepatic metastasis (IM), and extrahepatic metastasis. Thirty patients underwent extirpation of secondary HCC: 22 patients had secondary HCCs in the remnant liver (MC group; n = 8; IM group, n = 14), 6 patients had extrahepatic metastases, and 2 patients had both intrahepatic and extrahepatic metastases. Survival rates after the re-resection in the 22 patients with the secondary intrahepatic HCCs were 94.7% at 1 year, and 50.2% at 3 years postoperatively, and the 8 patients with extrahepatic metastasis had survival rates of 62.5% at 1 year, 37.5% at 3 years, and at 5 years. The survival rates after re-resection in the MC group were 100% at 1 year and 80.0% at 3 years, whereas those in the IM group were 91.7% at 1 year, and 38.1% at 3 years. Surgery can be indicated not only in patients with localized intrahepatic secondary HCCs but also in those with extrahepatic metastasis. In particular, patients with secondary HCCs arising as a result of multicentric carcinogenesis are expected to have a good prognosis.
Collapse
Affiliation(s)
- S Arii
- Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, 54 Kawara-Cho, Shogoin, Sakyo-Ku, Kyoto 606-01, Japan
| | | | | | | | | | | | | |
Collapse
|
27
|
Nakamura T, Arii S, Monden K, Furutani M, Takeda Y, Imamura M, Tominaga M, Okada Y. Expression of the Na+/Ca2+ exchanger emerges in hepatic stellate cells after activation in association with liver fibrosis. Proc Natl Acad Sci U S A 1998; 95:5389-94. [PMID: 9560286 PMCID: PMC20271 DOI: 10.1073/pnas.95.9.5389] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Activation of hepatic stellate (Ito) cells is a final common pathway of liver fibrosis. The findings presented in this paper indicate that expression of Na+/Ca2+ exchanger (NCX) emerges in rat hepatic stellate cells after activation in vitro during primary culture or in vivo in response to intoxication with CCl4. NCX mRNA became detectable by Northern blot analysis in cultured stellate cells on day 3, as was alpha-smooth muscle actin, an indicator not only of smooth muscle differentiation but also of stellate cell activation. Western blot analysis showed expression of the exchanger protein in the activated stellate cells. Functional expression of the exchanger, monitored by Ni2+-sensitive, verapamil-insensitive intracellular free Ca2+ increases in response to reduction of extracellular Na+ concentration, became sizable by using Fura-2 in stellate cells by 7 days in culture. Furthermore, increased expression of the exchanger mRNA was found predominantly in stellate cells freshly isolated from the CCl4 model rat of hepatic fibrosis. Thus, it is concluded that NCX expression is closely associated with activation of hepatic stellate cells in vitro and in vivo. Because, even at the whole liver level, increased expression of NCX mRNA became observable after induction of liver fibrosis, it is suggested that NCX expression serves a useful diagnostic marker of liver fibrosis or cirrhosis.
Collapse
Affiliation(s)
- T Nakamura
- First Department of Surgery, Kyoto University, Shogoin Kawara-cho 54, Kyoto 606-8501, Japan
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
OBJECTIVE A prospective trial was performed to propose a suitable antimicrobial prophylaxis in patients undergoing transurethral resection of the prostate (TUR-P). SUBJECTS AND METHODS Patients who underwent TUR-P due to symptomatic prostatic hyperplasia between April 1995 and February 1996 were included. Based on the results of urinalysis obtained within preoperative 3 days, the patients were classified into Group I (less than 5 WBC/hpf and bacterial count of less than 10(4) CFU/ml in urine specimen), and Group II (5 or more WBC/hpf or bacterial count of 10(4) or more CFU/ml in urine specimen). Furthermore, each group was randomly subdivided into Group A and Group B according to the period of antimicrobial administration. As prophylactic antimicrobials, cefazolin (CEZ) was used in Group I and CEZ or cefotiam (CTM) in Group II. The antimicrobial was administered only on the day of operation in Group IA (n = 92), for 3 days in Group IB (n = 96), 2 days in Group IIA (n = 37), and 4 days in Group IIB (n = 30). On the day of operation, the antimicrobial was infused immediately before the operation. The presence or absence of pyuria, bacteriuria and febrile infection, and the period required for normalization of the urinalysis were the major points evaluated here. RESULTS No significant differences were observed in any parameters with respect to the period of administration of antimicrobial between the groups, but in both Group I and Group II, the incidence of febrile infection was higher in the groups with shorter antimicrobial administration periods. The mean period for normalization of the urinalysis required 68.4, 68.6, 65.2 and 58.2 days in Group IA, Group IB, Group IIA and Group IIB, respectively. CONCLUSION It is concluded that 3 or 4-day administration of first or second generation parenteral cephems is generally acceptable regimen for antimicrobial prophylaxis in patients undergoing TUR-P.
Collapse
Affiliation(s)
- M Tsugawa
- Department of Urology, Okayama University Medical School
| | | | | | | | | |
Collapse
|
29
|
Kumon H, Tsugawa M, Ozawa H, Monden K, Ohmori H. Endoscopic correction of vesicoureteral reflux by subureteric Teflon (polytetrafluoroethylene) injection: review of 6-year experience. Int J Urol 1997; 4:541-5. [PMID: 9477180 DOI: 10.1111/j.1442-2042.1997.tb00305.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Endoscopic correction of vesicoureteral reflux (VUR) was first proposed in 1981 and the first series of patients treated by subureteric polytetrafluoroethylene paste injection (STING) was reported in 1984. Although many successful studies, primarily European, have been undertaken since then, this technique has recently been rejected in the United States. In this paper, we report our 6-year experience and discuss indications for this technique. PATIENTS AND METHODS Since February 1990, we have used the STING technique to endoscopically correct VUR. In this analysis, 38 ureters in 24 patients (mean age, 47.3 years; range, 7 to 79 years), with at least 1 year of follow-up were included. RESULTS The first injection resulted in disappearance of VUR in 34 ureters (89.5%). A second injection was done for 2 failed and 3 recurrent ureters during follow-up, resulting in disappearance of VUR in the 3 recurrent ureters. The final success rates were 100% for both primary VUR and secondary VUR due to neurogenic bladder, but only 55.6% (5/9) for secondary VUR following transurethral resection of bladder tumors. No postoperative early or delayed complications were noted in any case. CONCLUSION The procedure is simple and effective for the treatment of all grades of VUR. However, the procedure should be performed after careful consideration of the indications, since theoretically the risk of distant migration of the paste cannot be ignored.
Collapse
Affiliation(s)
- H Kumon
- Department of Urology, Okayama University Medical School, Shikata, Japan
| | | | | | | | | |
Collapse
|
30
|
Niwano M, Arii S, Monden K, Ishiguro S, Nakamura T, Mizumoto M, Takeda Y, Fujioka M, Imamura M. Amelioration of sinusoidal endothelial cell damage by Kupffer cell blockade during cold preservation of rat liver. J Surg Res 1997; 72:36-48. [PMID: 9344712 DOI: 10.1006/jsre.1997.5162] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recent studies have shown that Kupffer cell function is enhanced in the cold-preserved liver, and blockade of Kupffer cells attenuates the injury induced by cold preservation with subsequent reperfusion. This study was designed to investigate the contribution of Kupffer cell blockade with gadolinium chloride (GdCl3) to the rescue of sinusoidal endothelial cell (SEC) damage by comparing the time-related morphological and ultrastructural changes. GdCl3 injection reduced the number of Kupffer cells reactive with monoclonal antibodies ED2 and Ki-M2R directed against macrophage. Scanning electron microscopy revealed the prominent string-like appearance of the SEC processes at 24 hr of preservation in the control; the SECs were better preserved in the GdCl3-pretreated group. Transmission electron microscopy showed detachment of the sinusoidal epithelia at 12 hr of preservation in the control; it was not seen in the GdCl3-pretreated group. At 24 hr of preservation, the SECs were better preserved in the GdCl3-pretreated group. Microvascular casts from the control group showed a disturbance in the radial arrangement of the sinusoids, significant dilation of the sinusoidal caliber at 24 hr, and discontinuity of the sinusoids with extravasation of the casting material at 36 hr of preservation. These changes were also minimized in the GdCl3-pretreated group. In conclusion, the present study demonstrates that Kupffer cells are strongly involved in the morphological integrity of SECs and that blockade of the activation of Kupffer cells would be effective for the prevention of damage to SECs and maintenance of the sinusoidal architecture during cold preservation of the liver tissure.
Collapse
Affiliation(s)
- M Niwano
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Mizumoto M, Arii S, Furutani M, Nakamura T, Ishigami S, Monden K, Ishiguro S, Fujita S, Imamura M. NO as an indicator of portal hemodynamics and the role of iNOS in increased NO production in CCl4-induced liver cirrhosis. J Surg Res 1997; 70:124-33. [PMID: 9245560 DOI: 10.1006/jsre.1997.5105] [Citation(s) in RCA: 26] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
It is well known that nitric oxide, a vasodilator, is overproduced in liver cirrhosis. This study was designed to elucidate the role of nitric oxide (NO) in portal hemodynamics and to determine the mechanism underlying the increased serum NO levels in rats with liver cirrhosis induced by the oral intake of CCl4. Using rats, liver cirrhosis was induced by oral administration of CCl4. The serum levels of NO2-/NO3-(NOx) were measured, and portal hemodynamic parameters were evaluated with and without the administration of the NO synthase inhibitor N omega-nitro-L-arginine (NNA). Furthermore, Northern blot analysis was used to detect iNOS and cNOS mRNA, and immunohistochemical methods were used to detect iNOS-like immunoreactivity. In cirrhotic rats, the portal flow had increased significantly and the portal resistance had decreased significantly when compared with normal control rats. Hepatic capillary flow in the cirrhotic rats was similar to the control rats. NNA decreased portal flow and increased portal resistance in both groups, but the change was greater in the cirrhotic rats than in controls. The serum levels of NOx were significantly higher in cirrhotic rats than in normal control rats and were positively correlated with portal flow and negatively correlated with portal resistance. The expression of iNOS mRNA, which was barely detectable in control rats, had increased in all organs of the cirrhotic rats, whereas no significant increase in cNOS mRNA was found in any of the organs from cirrhotic rats. The immunohistochemical analysis was generally consistent with the results of the Northern blot analysis. In the control rats, only the bronchial epithelial cells were stained with the anti-iNOS antibody, but in cirrhotic rats, the bronchial cells in the lungs as well as the histiocytic mesenchymal cells in all organs, and the alveolar epithelial cells of the lungs, were stained. This study demonstrated that NO plays a significant role in portal hypertensive hemodynamics in CCl4-induced liver cirrhosis, and that NO is a useful indicator for the evaluation of portal hypertension. Furthermore, the increased serum levels of NO were found to be derived at least in part from the increased expression of iNOS mRNA in the liver, spleen, and lung.
Collapse
Affiliation(s)
- M Mizumoto
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Fujiwara M, Nagao N, Monden K, Misumi M, Kageyama K, Yamamoto K, Miwa N. Enhanced protection against peroxidation-induced mortality of aortic endothelial cells by ascorbic acid-2-O-phosphate abundantly accumulated in the cell as the dephosphorylated form. Free Radic Res 1997; 27:97-104. [PMID: 9269584 DOI: 10.3109/10715769709097842] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bovine aortic endothelial BAE-2 cells exposed to the peroxidizing agent, tert-butylhydroperoxide (t-BuOOH) or 2,4-nonadienal (NDE), suffered from disruption of cell membrane integrity and from reduction of mitochondrial dehydrogenase activity as assessed by fluorometry using ethidium homodimer and photometry using WST-1, respectively. The cells were protected from t-BuOOH-induced injury more markedly by L-ascorbic acid-2-O-phosphate (Asc2P) stably masked at the 2,3-enediol moiety, which is responsible for the antioxidant ability of L-ascorbic acid (Asc), than by Asc itself. In contrast, NDE-induced membrane disruption but not mitochondrial dysfunction was prevented by Asc2P, whereas Asc exhibited no prevention against both types of injury. The amount of intracellular Asc was 7.2- to 9.0-fold larger in Asc2P-administered BAE-2 cells, where the intact from Asc2P was not detected, than in Asc-administered cells as assessed by HPLC of cell extract with detection by coulometric ECD and UV. During transmembrane influx into the cell, Asc2P was concentrated as highly as 70- to 90-fold relative to the extracellular Asc2P concentration, whereas Asc was 8- to 13-fold concentrated as estimated based on an intracellular water content of 0.59 pL/cell determined by [14C]PEG/gas chromatography. Thus, Asc2P but not Asc is highly concentrated in the aqueous phase of the cell after prompt dephosphorylation, and may thereby render the cell more resistant to t-BuOOH-peroxidation assumedly via scavenging of intracellular reactive oxygen species than to peroxidation with the less hydrophilic agent NDE.
Collapse
Affiliation(s)
- M Fujiwara
- Division of Cell Biochemistry, Hiroshima Prefectural University School of BioScience, Japan
| | | | | | | | | | | | | |
Collapse
|
33
|
Funaki NO, Tanaka J, Itami A, Kasamatsu T, Ohshio G, Onodera H, Monden K, Okino T, Imamura M. Detection of colorectal carcinoma cells in circulating peripheral blood by reverse transcription-polymerase chain reaction targeting cytokeratin-20 mRNA. Life Sci 1997; 60:643-52. [PMID: 9048967 DOI: 10.1016/s0024-3205(96)00700-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
For the detection of circulating colorectal carcinoma cells, we investigated the presence of cytokeratin 20 (CK 20) mRNA in the peripheral blood of colorectal carcinoma patients. Application of our published technique resulted in analysis by reverse transcription followed by three-step nested polymerase chain reaction. This analysis could detect a single Colo 205 colon cancer cell mixed with 1 ml of blood. Our system also successfully detected the presence of CK 20 mRNA in actual patients' peripheral blood samples. Our highly sensitive and specific system for the detection of CK-20 mRNA from patients' peripheral blood thus seems to be useful for screening for circulating colorectal carcinoma cells.
Collapse
MESH Headings
- Adult
- Aged
- Base Sequence
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Colorectal Neoplasms/blood
- Colorectal Neoplasms/genetics
- Colorectal Neoplasms/secondary
- DNA Primers/genetics
- DNA, Complementary/genetics
- DNA, Neoplasm/genetics
- Female
- Humans
- Intermediate Filament Proteins/genetics
- Keratin-20
- Male
- Middle Aged
- Neoplastic Cells, Circulating
- Polymerase Chain Reaction/methods
- Polymerase Chain Reaction/statistics & numerical data
- RNA, Messenger/blood
- RNA, Messenger/genetics
- RNA, Neoplasm/blood
- RNA, Neoplasm/genetics
- Sensitivity and Specificity
- Tumor Cells, Cultured
Collapse
Affiliation(s)
- N O Funaki
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Funaki N, Arii S, Monden K, Higashitsuji H, Furutani M, Mise M, Tanaka J, Imamura M. Chemical mediators released by primary-cultured human hepatic macrophages in patients with and without cirrhosis: a study in tumor-bearing patients. Hepatology 1996; 23:1353-8. [PMID: 8675151 DOI: 10.1053/jhep.1996.v23.pm0008675151] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To elucidate the possible role of chemical mediators in modulating the host-defense activity of patients with cirrhosis, primary-cultured human hepatic macrophages (HHMphi) were obtained from cirrhotic and noncirrhotic patients who received liver resections because of the presence of malignant liver tumors. The cirrhotic and noncirrhotic groups consisted of patients with similar malignancies: noncirrhotic patients had normal liver function and normal liver histology for nontumorous portions. The cultured HHMphi were analyzed for their ability to release chemical mediators with specific activities in the host defense system. Dose-dependent increases in superoxide release, interleukin-1 (IL-1) release, and, within a relatively narrow range, prostaglandin-E2 (PGE2) release were observed in opsonized zymosan (oz)-stimulated HHMphi derived from both cirrhotic and noncirrhotic patients. The release of O2- and PGE2 from HHMphi derived from cirrhotic patients was significantly less than HHMphi derived from noncirrhotic patients, whereas the release of IL-1 was significantly greater. Although, because of the limited sample availability, only tumor-bearing patients were studied, the mediator-releasing ability of HHMphi derived from cirrhotic patients was significantly different from the ability of HHMphi derived from noncirrhotic patients with similar malignancies. This phenomenon may be related to altered host defenses in patients with cirrhosis.
Collapse
Affiliation(s)
- N Funaki
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Nakamura T, Arii S, Monden K, Sasaoki T, Adachi Y, Ishiguro S, Fujita S, Mizumoto M, Imamura M. Amelioration by Kupffer cell blockade in hepatic damage induced by cold preservation with subsequent plasma-supplemented perfusion. J Surg Res 1996; 62:207-15. [PMID: 8632641 DOI: 10.1006/jsre.1996.0197] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The effects of Kupffer cell blockade with gadolinium chloride (GdCl3) on hepatic injury in the cold preservation with subsequent perfusion was investigated. The condition of the liver grafts which were cold-preserved in University of Wisconsin solution was evaluated by measuring the uptake rates of indocyanine green and hyaluronic acid (IUR and HUR), two indices of liver damage. Perfusion injuries after cold storage occurred in 24-hr-preserved liver and progressed further in 36-hr-preserved liver. GdCl3 prevented the decrease in IUR and ameliorated perfusion injuries in the 36-hr-preserved liver, although GdCl3 did not inhibit the decrease in HUR. The HURs were remarkably decreased in the livers stored even for 6 hr, for which the cold-preserved livers were quite viable, whereas IURs were significantly decreased in livers stored for 24 hr or more when perfusion injury was apparently developed. These results suggest that the IUR is an indicator of hepatic perfusion injury in preserved livers and that Kupffer cell blockade may be a promising strategy for the prevention of hepatic injury after cold preservation with subsequent perfusion.
Collapse
Affiliation(s)
- T Nakamura
- Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Fujita S, Arii S, Monden K, Ishiguro S, Nakamura T, Mizumoto M, Imamura M. The preventive effects of OK432 on endotoxin-induced liver injury: liver protection by the modulation of hepatic macrophage function. Surg Today 1996; 26:29-35. [PMID: 8680117 DOI: 10.1007/bf00311988] [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: 02/01/2023]
Abstract
The present study was conducted to clarify whether endotoxin-induced liver injury could be improved by modulating the function of hepatic macrophages using OK432, an immunostimulant derived from Streptococcus. OK432 elevated the capacity of hepatic macrophages to produce superoxide and tumor necrosis factor (TNF), and enhanced the mRNA expression of interleukin-1-alpha, -beta, and TNF-alpha in liver nonparenchymal cells (NPC). However, intravenous (iv) preadministration of OK432 reduced the mRNA expression of TNF-alpha in liver NPC enhanced by the endotoxin injection, decreased the serum level of GOT and lactic dehydrogenase (LDH), and improved the survival rate of endotoxin-injected rats. Histological examination revealed a significant reduction in cell vacuolization and focal necrosis in the livers of the endotoxin-injected rats pretreated with OK432. These results indicate that hepatic macrophages play a crucial role in endotoxin-induced liver injury, and that TNF-alpha is one of the factors most likely to be implicated in the development of endotoxin-induced liver injury. Thus, it is suggested that the administration of OK432 provides liver protection by modulating the responsiveness of hepatic macrophages against endotoxin.
Collapse
Affiliation(s)
- S Fujita
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | |
Collapse
|
37
|
Funaki N, Arii S, Monden K, Tanaka J, Imamura M. HLA-DR antigen and interleukin-2 receptor expression on primary-cultured human hepatic macrophages in relation to liver cirrhosis and hepatitis virus infection. Life Sci 1996; 58:551-9. [PMID: 8632708 DOI: 10.1016/0024-3205(95)02324-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We analyzed primary-cultured human hepatic macrophages (HHMphi) from 12 patients with non-cirrhotic and cirrhotic livers for cell surface expression of HLA-DR antigen and interleukin-2 receptor (IL-2R). Compared to the relatively abundant HLA-DR antigen, IL-2R expression was generally low. No significant difference was observed between HLA-DR antigen expression nor IL-2 receptor expression. HHMphi from patients with serum hepatitis viral markers, however, expressed significantly more HLA-DR antigen than did HHMphi of patients without viral markers, which suggest a possible role of HHMphi as antigen-presenting cells (APC) in viral hepatitis. This direct, quantitative measurement of cell surface molecule expression on hepatic macrophages of human may provide an important clue to the pathophysiology of human liver disorders.
Collapse
Affiliation(s)
- N Funaki
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | |
Collapse
|
38
|
Nasu Y, Watanabe T, Monden K, Sakuramoto K, Ono A, Tsugawa M, Kumon H, Ohmori H, Yasui T. [Drug sensitivity and expression of beta-lactamase in enterococci isolated at Okayama University Hospital]. Kansenshogaku Zasshi 1995; 69:919-23. [PMID: 7594786 DOI: 10.11150/kansenshogakuzasshi1970.69.919] [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: 01/26/2023]
Abstract
The following results were obtained from a study of Enterococci isolated at the Okayama University Hospital from 1990 to 1994. 1) The isolation frequency of Enterococci was about 6% for each year. 2) The percentage of Enterococcus faecalis (E. faecalis) among Enterococci decreased each year, but the percentage of Enterococcus faecium (E. faecium), and Enterococcus avium (E. avium) increased each year. 3) Results of drug sensitivity tests revealed that the incidence of ofloxacin (OFLX) resistant E. faecalis and E. avium increased each year. Also, the resistance of E. faecalis to ampicillin (ABPC), the primary medication choice for treating E. faecalis, increased each year. 4) A few vancomycin (VCM) non-sensitive Enterococci were isolated. These bacteria showed low-sensitivity toward ABPC, imipenem (IPM), gentamicin (GM), and OFLX, and the extent of multiple drug resistance increased each year. 5) One hundred strains of Enterococci were selected to examine the expression of beta-lactamase using the broth method and the iodine-starch method. However, beta-lactamase producing strains were not detected.
Collapse
Affiliation(s)
- Y Nasu
- Department of Urology, Okayama University Medical School
| | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Fujita S, Arii S, Monden K, Adachi Y, Funaki N, Higashitsuji H, Furutani M, Mise M, Ishiguro S, Kitao T. Participation of hepatic macrophages and plasma factors in endotoxin-induced liver injury. J Surg Res 1995; 59:263-70. [PMID: 7637342 DOI: 10.1006/jsre.1995.1163] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The present study was designed to investigate the mechanism responsible for endotoxin-induced liver injury, based on the working hypothesis that hepatic macrophages activated by endotoxin play a key role in the development of this injury. At both the protein and the transcription levels, the intravenous administration of endotoxin was shown to have increased the capacity of hepatic macrophages to produce chemical mediators. To inhibit the function of hepatic macrophages, gadolinium chloride (GdCl3), a specific inhibitor of resident hepatic macrophages, was preadministered to rats before endotoxin injection. GdCl3 reduced the elevated glutamic oxaloacetic transamiase and lactate dehydrogenase serum levels produced by endotoxin treatment, suppressed the increased mRNA expression of tumor necrosis factor (TNF-alpha) produced in liver nonparenchymal cells by endotoxin, and then improved the survival rate of lipopolysaccharide-injected rats. These results indicated that hepatic macrophages played a crucial role in liver injury and that TNF-alpha was the most likely factor implicated in the development of endotoxin-induced liver injury. Furthermore, we found that liver injury did not progress during perfusion of endotoxin-pretreated extirpated liver with lactate Ringer's solution, whereas liver perfused with plasma developed remarkable hepatic impairment, which was inhibited almost completely by GdCl3-pretreatment; moreover, addition of heparin to the perfusate also prevented this deterioration. Thus, the present study showed that the activation of hepatic macrophages and factors in the plasma were two essential elements in the occurrence and development of endotoxin-induced liver injury.
Collapse
Affiliation(s)
- S Fujita
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Ishiguro S, Arii S, Monden K, Fujita S, Nakamura T, Niwano M, Harada T, Ushikubi F, Narumiya S, Imamura M. Involvement of thromboxane A2-thromboxane A2 receptor system of the hepatic sinusoid in pathogenesis of cold preservation/reperfusion injury in the rat liver graft. Transplantation 1995; 59:957-61. [PMID: 7709455 DOI: 10.1097/00007890-199504150-00006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study was designed to investigate the possible involvement of the thromboxane A2 (TXA2)-TXA2 receptor (TXA2R) system of the hepatic sinusoid in cold preservation/reperfusion injury in liver grafts. Rat livers were preserved in cold University of Wisconsin solution for either 6 or 24 hr. The number of TXA2Rs in sinusoidal endothelial cells isolated from 0-, 6-, and 24-hr preserved liver specimens was 22.50 +/- 1.80 x 10(3)/cell, 12.66 +/- 1.00 x 10(3)/cell, and 4.17 +/- 0.65 x 10(3)/cell, respectively. Kd and Bmax at 0 hr, 6 hr, and 24 hr of preservation were 8.54 +/- 1.26 nM and 37.34 +/- 3.01 fmol/10(6) cells, 7.08 +/- 1.14 nM and 12.66 +/- 1.00 fmol/10(6) cells, and 1.91 +/- 0.10 nM and 3.88 +/- 0.59 fmol/10(6) cells, respectively. The administration of OKY-046 (inhibitor of TXA2 synthesis) to the University of Wisconsin solution suppressed this reduction in TXA2R number. Furthermore, the concentration of TXA2 in hepatic sinusoid was decreased by OKY-046. In a reperfusion experiment, liver tissue preserved for 24 hr exhibited a higher reperfusion pressure, and effluent levels of both aspartate aminotransferase and lactate dehydrogenase were markedly elevated. The addition of OKY-046 to the preservation solution, however, prevented the rise in reperfusion pressure almost completely and the increase in effluent enzyme levels. This study showed that the TXA2Rs in sinusoidal endothelial cells were internalized through binding with TXA2 during cold preservation, causing activation of the TXA2-TXA2R system. This activation apparently induces an increase in reperfusion pressure, possibly due to sinusoidal contraction, resulting in microcirculatory disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- S Ishiguro
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Higashitsuji H, Arii S, Furutani M, Mise M, Monden K, Fujita S, Ishiguro S, Kitao T, Nakamura T, Nakayama H. Expression of cytokine genes during liver regeneration after partial hepatectomy in rats. J Surg Res 1995; 58:267-74. [PMID: 7885023 DOI: 10.1006/jsre.1995.1042] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In the present study to demonstrate the relationship between cytokines and liver regeneration we investigated by Northern blot hybridization the cytokine gene induction in the regenerating liver and several other organs (spleen, lung, and kidney) in the rat after partial hepatectomy (PH). We also examined whether Kupffer cells and the spleen are involved in the induction of cytokine mRNA in the regenerating liver. Both IL-1 alpha and beta mRNA increased transiently 1/2 to 1 hr after PH in nonparenchymal cells (NPC) of the regenerating liver; they reached a maximum before the peak of hepatocyte DNA synthesis. PH also induced a slight, but significant, gene expression of IL-1 in lung and kidney in the early postoperative period. TNF-alpha mRNA increased gradually in the spleen, but not the liver, of partially hepatectomized rats at 3 to 12 hr and then reached a peak at 24 hr after PH. IL-6 transcripts were not detected in the regenerating liver, spleen, lung, or kidney during liver regeneration. In contrast, no cytokine gene expression was induced in any of these four organs during the first 3 days after sham operation or unilateral nephrectomy. When Kupffer cell activity was suppressed by gadolinium chloride pretreatment, or when splenectomy was performed 24 hr before PH, the constitutive IL-1 alpha and beta mRNA expressions in NPC of the normal rat liver were completely suppressed. In conclusion, the present study demonstrates, for the first time, the specific kinetics of cytokine gene expression in the liver, spleen, lung, and kidney after PH.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- H Higashitsuji
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Monden K, Arii S, Ishiguro S, Nakamura T, Fujita S, Mise M, Niwano M, Sasaoki T, Imamura M. Involvement of ICAM-1 expression on sinusoidal endothelial cell and neutrophil adherence in the reperfusion injury of cold-preserved livers. Transplant Proc 1995; 27:759-61. [PMID: 7879174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- K Monden
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Arii S, Monden K, Adachi Y, Furutani M, Mise M, Fujita S, Ishiguro S, Nakamura T, Harada T, Niwano M. Suppression of the reperfusion injury of cold-preserved livers by Kupffer cell blockade. Transplant Proc 1995; 27:765-7. [PMID: 7879176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S Arii
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Arii S, Monden K, Adachi Y, Zhang W, Higashitsuji H, Furutani M, Mise M, Fujita S, Nakamura T, Imamura M. Pathogenic role of Kupffer cell activation in the reperfusion injury of cold-preserved liver. Transplantation 1994; 58:1072-7. [PMID: 7974713] [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: 01/28/2023]
Abstract
The present study was designed to investigate the possible participation of Kupffer cells in the development of reperfusion injury of the cold-stored liver graft. In the cold preservation of Kupffer cells with Euro-Collins solution, the proportion of asialo-GM1-positive cells was significantly increased at 12 and 24 hr of storage, and the TNF alpha-producing activity in these cells was approximately fivefold greater than control. Northern blot analysis demonstrated that TNF alpha mRNA was remarkably elevated in the reperfusion of the cold-preserved liver, although that of the prereperfused graft was only slightly induced. The reperfusion experiments of the cold-stored liver graft showed that addition of anti-TNF alpha antibody to the perfusate suppressed the elevation of the effluent levels of GOT and LDH significantly, and that pretreatment with a Kupffer cell inhibitor, gadolinium chloride, inhibited the increase of these enzymes in the effluents almost completely. Histological study revealed deposition of a fibrinlike substance in the sinusoid and the central veins extensively in the reperfused liver graft, whereas no apparent deposition was observed in the gadolinium-pretreated liver. Thus, the present study showed that Kupffer cells were primed by cold preservation with Euro-Collins solution, and then activated when the reperfusion was done. It seems likely that the Kupffer cell activation induced by cold preservation/reperfusion plays a major role in reperfusion injury with sinusoidal microcirculatory disturbance, and that TNF alpha is responsible for the impairment of the reperfused liver graft.
Collapse
Affiliation(s)
- S Arii
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Arii S, Monden K, Ishiguro Y, Fujita S, Nakamura T, Kitao T, Mizumoto M, Imamura M. Pathological role of hepatic sinusoidal cells in the liver transplantation -with special reference to cold preservation/reperfusion injury. Pathophysiology 1994. [DOI: 10.1016/0928-4680(94)90532-0] [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: 10/27/2022] Open
|
46
|
Ishiguro S, Arii S, Monden K, Adachi Y, Funaki N, Higashitsuji H, Fujita S, Furutani M, Mise M, Kitao T. Identification of the thromboxane A2 receptor in hepatic sinusoidal endothelial cells and its role in endotoxin-induced liver injury in rats. Hepatology 1994; 20:1281-6. [PMID: 7927263] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
The presence of the thromboxane A2 receptor in sinusoidal endothelial cells was investigated and its pathogenic role in endotoxin-induced liver injury examined. The receptor was measured with a binding assay using a specific thromboxane A2 receptor antagonist, [3H]S-145. Scatchard analysis of the binding indicated the presence of a single class of high-affinity binding sites with a dissociation constant of 5.00 +/- 0.96 nmol/L, a maximal binding of 22.85 +/- 2.71 fmol/10(6) cells and 13.80 +/- 1.60 x 10(3) binding sites per cell. The addition of a cyclooxygenase inhibitor, indomethacin, during the cell preparation increased the maximal binding value and the number of binding sites of 37.34 +/- 3.01 and 22.50 +/- 1.80 x 10(3) sites/cell, respectively. The binding was displaced by various thromboxane A2 analogs such as ONO-3708 and STA2 but was not effectively competed for by other prostaglandins. Endotoxin injection reduced dissociation constant, maximal binding and the number of binding sites in sinusoidal endothelial cells to 3.49 +/- 0.87 nmol/L, 6.03 +/- 0.64 fmol/10(6) cells and 3.65 +/- 0.39 x 10(3) sites/cell, respectively. A cyclooxygenase inhibitor and a Kupffer cell inhibitor added before endotoxin treatment significantly prevented the reduction in the number of thromboxane A2 receptors. It is possible that these effects were due to a reduction in the agonist-induced internalization of the thromboxane A2 receptor brought about by the prevention of thromboxane A2 production. Preadministration of both a cyclooxygenase inhibitor and a thromboxane A2 receptor antagonist attenuated the degree of endotoxin-induced liver injury.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- S Ishiguro
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Furutani M, Arii S, Monden K, Adachi Y, Funaki N, Higashitsuji H, Fujita S, Mise M, Ishiguro S, Kitao T. Immunologic activation of hepatic macrophages in septic rats: a possible mechanism of sepsis-associated liver injury. J Lab Clin Med 1994; 123:430-6. [PMID: 8133156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To investigate the pathogenesis of liver dysfunction accompanying intra-abdominal sepsis, we used rats with cecal ligation and punctures (CLP) and examined the expression of the inflammatory cytokines IL-1-alpha, IL-1-beta, and TNF-alpha, as well as the expression of a cell adhesion molecule, ICAM-1, in the liver. We also examined the expression of Ia antigen and interleukin-2 receptor (IL-2R) on hepatic macrophages. Hepatic macrophages isolated from rats 24 hours after CLP exhibited significantly higher IL-1 and TNF activity than those from control rats. Hepatic macrophages isolated from rats 72 hours after CLP exhibited the maximal IL-1 and TNF activity. In the hepatic nonparenchymal cells, IL-1-alpha mRNA was induced 1 hour after CLP, increasing to the maximal level 3 hours after CLP, whereas IL-1-beta mRNA was induced gradually, reaching a peak 6 hours after CLP. ICAM-1 mRNA reached a peak 3 hours after CLP. Induction of TNF-alpha mRNA was not detected by the present Northern blot analysis. Seventy-two hours after CLP, the proportions of hepatic macrophages expressing Ia antigens and IL-2R were increased significantly, as revealed by the flow cytometric analysis. In conclusion, the present study showed that hepatic macrophages are in an activated state in sepsis as indicated by their increased production of inflammatory monokines and their increased expression of immunomodulatory surface molecules. Further, we demonstrated the sequential induction of the mRNA of the various inflammatory cytokines and ICAM-1. These findings strengthen the notion that these cytokines are relevant to the pathogenesis of liver injury associated with sepsis.
Collapse
Affiliation(s)
- M Furutani
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Funaki N, Arii S, Monden K, Sasaoki T, Adachi Y, Higashitsuji H, Tanaka J, Imamura M. Chemical mediator release and surface marker expression of hepatic macrophages in rats with CCl4-induced liver cirrhosis. Life Sci 1994; 54:2071-82. [PMID: 8208064 DOI: 10.1016/0024-3205(94)00716-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The present study was performed to analyze possible functional alterations of hepatic macrophages (HM phi) in rats with carbon tetrachloride (CCl4)-induced liver cirrhosis. HM phi from rats injected with CCl4 for 13 weeks and cultured for 24 hours released less than normal amounts of prostaglandin E2 (PGE2) and tumor necrosis factor (TNF) and very large amounts of interleukin-1 (IL-1). In rats injected with CCl4 for 9 weeks, only PGE2 production was reduced. Interleukin-2 receptor (IL-2R), Ia antigen and asialo GM1 antigen expressions on HM phi from both the 9- and 13-week groups were significantly decreased. IL-2R and Ia antigen expressions showed larger decreases in the 13-week group. Thus, it is concluded that HM phi derived from CCl4-induced cirrhotic livers show a functional alteration in the release of cytokines (except for IL-1) and a decrease in surface marker expression, as cirrhosis advances. These results should provide a basis for further investigation into the host-compromised status in the presence of liver cirrhosis.
Collapse
Affiliation(s)
- N Funaki
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Mise M, Arii S, Higashitsuji H, Furutani M, Monden K, Adachi Y, Funaki N, Fujita S, Ishiguro S. Augmented local immunity in the liver by a streptococcal preparation, OK432, related to antitumor activity of hepatic macrophages. Immunopharmacology 1994; 27:31-41. [PMID: 8206752 DOI: 10.1016/0162-3109(94)90005-1] [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] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to investigate the augmentative effect of a streptococcal preparation, OK432, on the immunological competence of hepatic macrophages. We found that OK432 was distributed predominantly to hepatic macrophages after intravenous injection, and Northern blot analysis revealed that OK432 induced the gene expression of IL-1 alpha, beta, and TNF alpha in the liver. The induction of mRNAs was evident 1 h after the intravenous injection of OK432 and their accumulation reached a maximal level at 3 h. TNF production of hepatic macrophages was also increased by the intravenous injection of OK432. Furthermore, OK432 significantly increased the proportion of IL-2 receptor-positive hepatic macrophages. As for antitumor activity in the liver being augmented by OK432, the cytotoxic and cytostatic activity of hepatic macrophages from OK432-treated rats against tumor cells was significantly increased and OK432 markedly reduced the number of tumor nodules in the liver after the inoculation of tumor cells via the portal vein. These findings, which indicate that OK432 has various immuno-stimulating actions on hepatic macrophages, leading to the augmentation of antitumor activity in the liver, suggest that OK432 may be of some benefit in helping to prevent hepatic metastasis, at least in part, via its activation of hepatic macrophages.
Collapse
Affiliation(s)
- M Mise
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Funaki N, Arii S, Monden K, Itai S, Sasaoki T, Adachi Y, Higashitsuji H, Tanaka J, Tobe T. Chemical mediators released from hepatic macrophages in primary culture--basic characteristics of human hepatic macrophages and changes in liver cirrhosis. J Surg Res 1993; 54:222-9. [PMID: 8386286 DOI: 10.1006/jsre.1993.1035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Chemical mediators released from human hepatic macrophages (HHM phi) in primary cultures were analyzed for their secretory function and probable contribution to the modulation of the host defense system and metabolism in liver cirrhosis. In our basic studies, HHM phi increased dose dependently the release of superoxide (O2-) and interleukin-1 (IL-1) when stimulated by opsonized zymosan, up to 1000 micrograms/dish. PGE2 production showed a relatively narrow range of dose dependency, and larger doses led to a reduction of PGE2 yield in some samples. Next, we compared the mediator release from the HHM phi of patients with liver cirrhosis with that from HHM phi in normal liver. O2- released from HHM phi of 8 patients with liver cirrhosis was significantly decreased (controls, n = 20) (P < 0.01). IL-1 released from the HHM phi of 6 cirrhotic patients tended to be higher than that from the HHM phi of 10 control patients, but the difference was not statistically significant (P < 0.10). PGE2 production, however, was about the same in the two groups. These results suggest that cultured HHM phi have certain basic characteristics in releasing mediators with highly potent specific activities and also that these secretory abilities may change in liver cirrhosis. In conclusion, the analysis of cultured HHM phi may be a very practical way to clarify their inherent abilities and participation in the complicated clinical features of liver cirrhosis.
Collapse
Affiliation(s)
- N Funaki
- First Department of Surgery, Faculty of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|