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Beeler Asay GR, Woodruff R, Sanderson DM, Fisher CF, Marks SM, Green VD, Tibbs AM, Hill AN, Haptu HH, McManus D, Paradise RK, Auguste-Nelson C, Cochran JJ. Cost-effectiveness of expanded latent TB infection testing and treatment: Lynn City, Massachusetts, USA. Int J Tuberc Lung Dis 2024; 28:21-28. [PMID: 38178297 PMCID: PMC11149049 DOI: 10.5588/ijtld.22.0654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND: Between October 2016 and March 2019, Lynn Community Health Center in Massachusetts implemented a targeted latent TB infection testing and treatment (TTT) program, increasing testing from a baseline of 1,200 patients tested to an average of 3,531 patients tested, or 9% of the population per year.METHODS: We compared pre-implementation TTT, represented by the first two quarters of implementation data, to TTT, represented by 12 quarters of data. Time, diagnostic, and laboratory resources were estimated using micro-costing. Other cost and testing data were obtained from the electronic health record, pharmaceutical claims, and published reimbursement rates. A Markov cohort model estimated future health outcomes and cost-effectiveness from a societal perspective in 2020 US dollars. Monte Carlo simulation generated 95% uncertainty intervals.RESULTS: The TTT program exhibited extended dominance over baseline pre-intervention testing and had an incremental cost-effectiveness ratio (ICER) of US$52,603 (US$22,008â-"US$95,360). When compared to baseline pre-TTT testing, the TTT program averted an estimated additional 7.12 TB cases, 3.49 hospitalizations, and 0.16 deaths per lifetime cohort each year.CONCLUSIONS: TTT was more cost-effective than baseline pre-implementation testing. Lynn Community Health Centerâ-™s experience can help inform other clinics considering expanding latent TB infection testing.
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Andersen CJ, Huang L, Zhai F, Esposito CP, Greco JM, Zhang R, Woodruff R, Sloan A, Van Dyke AR. Consumption of Different Egg-Based Diets Alters Clinical Metabolic and Hematological Parameters in Young, Healthy Men and Women. Nutrients 2023; 15:3747. [PMID: 37686779 PMCID: PMC10490185 DOI: 10.3390/nu15173747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Eggs-particularly egg yolks-are a rich source of bioactive nutrients and dietary compounds that influence metabolic health, lipid metabolism, immune function, and hematopoiesis. We investigated the effects of consuming an egg-free diet, three egg whites per day, and three whole eggs per day for 4 weeks on comprehensive clinical metabolic, immune, and hematologic profiles in young, healthy adults (18-35 y, BMI < 30 kg/m2 or <30% body fat for men and <40% body fat for women, n = 26) in a 16-week randomized, crossover intervention trial. We observed that average daily macro- and micronutrient intake significantly differed across egg diet periods, including greater intake of choline during the whole egg diet period, which corresponded to increased serum choline and betaine without altering trimethylamine N-oxide. Egg white and whole egg intake increased serum isoleucine while whole egg intake reduced serum glycine-markers of increased and decreased risk of insulin resistance, respectively-without altering other markers of glucose sensitivity or inflammation. Whole egg intake increased a subset of large HDL particles (H6P, 10.8 nm) and decreased the total cholesterol:HDL-cholesterol ratio and % monocytes in female participants using combined oral contraceptive (COC) medication (n = 11) as compared to female non-users (n = 10). Whole egg intake further increased blood hematocrit whereas egg white and whole egg intake reduced blood platelet counts. Changes in clinical immune cell counts between egg white and whole egg diet periods were negatively correlated with several HDL parameters yet positively correlated with measures of triglyceride-rich lipoproteins and insulin sensitivity. Overall, the intake of whole eggs led to greater overall improvements in micronutrient diet quality, choline status, and HDL and hematologic profiles while minimally-yet potentially less adversely-affecting markers of insulin resistance as compared to egg whites.
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Woodruff R, Jiang J, Esposito CP, Andersen C. Egg Consumption Modulates Expression of Genes Involved in T Cell Activation and Differentiation That Correlate With HDL Profiles. Curr Dev Nutr 2022. [PMCID: PMC9194313 DOI: 10.1093/cdn/nzac068.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives HDL is known to be an important modulator of T cell activity. We have previously demonstrated that whole eggs modulate HDL profiles when compared to egg whites; thus, we investigated whether different egg-based diets affect expression of genes involved in T cell activation and differentiation in a manner that correlates with changes in HDL profiles. Methods A 16-week randomized, crossover intervention trial was conducted in which healthy, young adult men and women (18–35 y, n = 26) completed a 4-week egg-free dietary period, followed by random assignment to a 4-week 3 whole egg/day or 3 egg white/day diet period. Participants then entered a 4-week egg-free washout period before switching to the alternative egg treatment for 4 weeks. Fasting HDL profiles and peripheral blood mononuclear cell (PBMC) gene expression immune arrays were measured at the conclusion of each dietary period. Results Our data showed that whole egg intake had the greatest impact on PBMC expression of genes related to T cell activation and differentiation. Compared to the egg-free diet, expression of CD4, CD34, and CD68 were significantly reduced following the whole egg period. We similarly observed trends toward decreased expression of HLA-DRA, CCL2, TGF-beta, and CCR4 following the whole egg diet, and increased expression of IL-12 beta, CLTA4, and PF4. When analyzing changes in gene expression between the egg white and whole egg diet periods, we identified a total of 25 and 21 genes related to immunity and inflammation that significantly correlated with changes in the number of large HDL particles and apolipoprotein A1 (apoA1) concentrations in serum, respectively. 68% and 76% of genes that correlated with large HDL and apoA1, respectively, were related to modulation of T cell activity, suggesting that egg-induced changes in HDL profiles may have stronger modulatory effects on T cells compared to other immune cell subtypes within PBMC samples. Conclusions Our findings suggest that whole eggs promote anti-inflammatory and modulatory changes in gene expression related to T cell activation and differentiation, which directly correlate with changes in HDL profiles. Funding Sources This study was funded by an Agriculture and Food Research Initiative Grant from the USDA National Institute of Food and Agriculture.
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Bambrick H, Woodruff R. P2-365 Climate change impacts on Ross river virus in Australia. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bambrick H, Woodruff R, Hanigan I. P2-364 Climate change threatens blood supply through altering the distribution of vector-borne disease: an Australian Case-Study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976k.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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McElroy PD, Rothenberg RB, Varghese R, Woodruff R, Minns GO, Muth SQ, Lambert LA, Ridzon R. A network-informed approach to investigating a tuberculosis outbreak: implications for enhancing contact investigations. Int J Tuberc Lung Dis 2003; 7:S486-93. [PMID: 14677842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND To elucidate networks of Mycobacterium tuberculosis transmission, it may be appropriate to characterize the types of relationships among tuberculosis (TB) cases and their contacts (with and without latent TB infection) in addition to relying on traditional efforts to distinguish 'close' from 'casual' contacts. SETTING A TB outbreak in a US low incidence state. OBJECTIVE To evaluate whether social network analysis can provide insights into transmission settings that might otherwise go unrecognized by routine practices. DESIGN All adult outbreak-associated cases (n = 19) and a convenience sample of their contacts with and without latent TB infection (LTBI) (n = 26) were re-interviewed in 2001 using a structured questionnaire. Network analysis software was used to create diagrams illustrating important persons within the outbreak network, as well as types of activities TB cases engaged in with their contacts. RESULTS Drug use and drug sharing were more commonly reported among cases and their infected contacts than among contacts without LTBI. TB cases central to the outbreak network used crack cocaine, uncovering the need to focus control efforts on specific sites and persons involved in illicit drug use. CONCLUSION Outbreaks occur even in areas with low TB incidence, frequently among groups whose drug use or other illegal activities complicate control efforts. TB programs should consider the use of network analysis as a supplement to routine contact investigations to identify unrecognized patterns of M. tuberculosis transmission.
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Gust DA, Woodruff R, Kennedy A, Brown C, Sheedy K, Hibbs B. Parental perceptions surrounding risks and benefits of immunization. SEMINARS IN PEDIATRIC INFECTIOUS DISEASES 2003; 14:207-12. [PMID: 12913833 DOI: 10.1016/s1045-1870(03)00035-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In recent years, parental concerns about vaccine safety have increased as the threat of disease has decreased. A national survey showed that, in general, parents agree that vaccines benefit their children and that their children may be at risk for contracting a disease if unvaccinated. When asked about understanding the benefits and risks of vaccines, most parents (57%) found numbers and statistics most helpful. A substantial minority (17%) of parents were somewhat or not confident in vaccine safety. Parents less confident in vaccine safety agreed less with the statement that they usually followed the advice of their child's doctor. Incomes and education levels affected responses. This positive relationship between confidence in vaccine safety and reliance on doctors for advice may indicate the need for healthcare providers to identify opportunities to (1) solicit questions about vaccine safety, (2) address vaccine safety-related questions in a way meaningful to parents, and (3) strengthen doctor-patient relationships. A parent communication tool is proposed.
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Woodruff R, Marini J, Fackler, Jr J. Correction. The Reaction Product of Bis(2,4-pentanediono)titanium(IV) Dichloride with Anhydrous Iron(III) Chloride. Inorg Chem 2002. [DOI: 10.1021/ic50022a602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zhong X, Malhotra R, Woodruff R, Guidotti G. Mammalian plasma membrane ecto-nucleoside triphosphate diphosphohydrolase 1, CD39, is not active intracellularly. The N-glycosylation state of CD39 correlates with surface activity and localization. J Biol Chem 2001; 276:41518-25. [PMID: 11546800 DOI: 10.1074/jbc.m104415200] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
CD39 is a member of the membrane-bound ecto-nucleoside triphosphate diphosphohydrolase family. The active site for native CD39 is located on the outer surface of the cellular plasma membrane; however, it is not yet known at what stage this enzyme becomes active along the secretory pathway to the plasma membrane. In this study, sucrose density fractionations performed on CD39-transfected COS-7 cell membranes suggest that CD39 activity resides primarily in the plasma membrane. Furthermore, we have created recombinant, soluble versions of CD39, one that is secreted and others that are retained in the endoplasmic reticulum, to demonstrate that CD39 is not active until it reaches the plasma membrane both in yeast and COS-7 cells. Moreover, the secreted active soluble CD39 in COS-7 cells is found to receive a higher degree of N-glycan addition than the inactive form retained intracellularly. When COS-7 cells were treated with tunicamycin to prevent N-glycosylation, soluble CD39 was not detected in the extracellular medium and remained inactive intracellularly. Surface biotinylation analysis also revealed that surface-expressed wild type CD39 receives a higher degree of N-glycosylation than intracellular forms and that inhibition of N-glycosylation prevents its plasma membrane localization. In addition, both intact and digitonin-permeablized COS-7 cells transfected with CD39 possess similar ecto-ATPase activities, further supporting the conclusion that only surface-expressed CD39 is enzymatically active. All of these data suggest that intracellular CD39 is inactive and that only a fully glycosylated CD39 has apyrase activity and is localized at the cell surface.
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Woodruff R, Doyle D, De Lima L, Bruera E, Farr WC. The International Association for Hospice and Palliative Care (IAHPC): history, description, and future direction. J Palliat Med 2001; 4:5-7. [PMID: 11291395 DOI: 10.1089/109662101300051861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Haboubi NH, Heelis M, Woodruff R, Al-Khawaja I. The effect of body weight and age on frequency of repairs in lower-limb prostheses. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2001; 38:375-7. [PMID: 11563489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
INTRODUCTION Overweight patients sometimes present a practical problem for provision of lower-limb prostheses. Most information about the effect of body weight on the endurance of prostheses is based on laboratory tests. This is a retrospective study based on an audit to study the effect of body weight and age on the frequency of repairs. SUBJECTS One hundred and sixteen patients were involved (98 male), age 16-96 years, mean=58.7 years; weight 47-140 kg, mean=88 kg; 68 were transtibial amputees and 48 were transfemoral amputees. Causes of amputation were trauma (49), peripheral vascular disease (29), and others (38). Amputation was done 1-66 years prior to assessment, mean=13.66 years. Period of use of current prostheses was 0.5-28 years, mean=3.5 years. RESULTS One hundred and one repairs were done in a period of 6 months. The number of repairs was found to correlate significantly with weight (P value<0.001) and inversely with age (P value=0.003). No significant correlation was found between repairs and gender, cause of amputation, or level of amputation. CONCLUSION Body weight and age of amputee are determining factors in the frequency of repairs of lower-limb prostheses. However, a larger study for a longer period will be needed to confirm our finding.
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Tekki-Kessaris N, Woodruff R, Hall AC, Gaffield W, Kimura S, Stiles CD, Rowitch DH, Richardson WD. Hedgehog-dependent oligodendrocyte lineage specification in the telencephalon. Development 2001; 128:2545-54. [PMID: 11493571 DOI: 10.1242/dev.128.13.2545] [Citation(s) in RCA: 214] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the caudal neural tube, oligodendrocyte progenitors (OLPs) originate in the ventral neuroepithelium under the influence of Sonic hedgehog (SHH), then migrate throughout the spinal cord and brainstem before differentiating into myelin-forming cells. We present evidence that oligodendrogenesis in the anterior neural tube follows a similar pattern. We show that OLPs in the embryonic mouse forebrain express platelet-derived growth factor alpha-receptors (PDGFRA), as they do in more caudal regions. They first appear within a region of anterior hypothalamic neuroepithelium that co-expresses mRNA encoding SHH, its receptor PTC1 (PTCH) and the transcription factors OLIG1, OLIG2 and SOX10. Pdgfra-positive progenitors later spread through the forebrain into areas where Shh is not expressed, including the cerebral cortex. Cyclopamine inhibited OLP development in cultures of mouse basal forebrain, suggesting that hedgehog (HH) signalling is obligatory for oligodendrogenesis in the ventral telencephalon. Moreover, Pdgfra-positive progenitors did not appear on schedule in the ventral forebrains of Nkx2.1 null mice, which lack the telencephalic domain of Shh expression. However, OLPs did develop in cultures of Nkx2.1−/− basal forebrain and this was blocked by cyclopamine. OLPs also developed in neocortical cultures, even though Shh transcripts could not be detected in the embryonic cortex. Here, too, the appearance of OLPs was suppressed by cyclopamine. In keeping with these findings, we detected mRNA encoding SHH and Indian hedgehog (IHH) in both Nkx2.1−/− basal forebrain cultures and neocortical cultures. Overall, the data are consistent with the idea that OLPs in the telencephalon, possibly even some of those in the cortex, develop under the influence of SHH in the ventral forebrain.
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Barreto AM, Schwartz GG, Woodruff R, Cramer SD. 25-Hydroxyvitamin D3, the prohormone of 1,25-dihydroxyvitamin D3, inhibits the proliferation of primary prostatic epithelial cells. Cancer Epidemiol Biomarkers Prev 2000; 9:265-70. [PMID: 10750664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
The hormonal metabolite of vitamin D, 1alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3] is known to inhibit the proliferation of prostatic epithelial cells. This has stimulated interest in vitamin D compounds as therapeutic agents for prostate cancer. However, the therapeutic use of 1,25(OH)2D3 is limited because elevations in serum 1,25(OH)2D3 can cause dangerous elevations in serum calcium levels. We wondered whether the prohormone of 1,25(OH)2D3, 25-hydroxyvitamin D3 (25-OH-D3), which is much less calcemic, could also achieve antiproliferative effects in prostatic cells. 25-OH-D3 is converted to 1,25(OH)2D3 by the mitochondrial enzyme 1-alpha-hydroxylase. We have recently shown that human prostatic cells also possess significant 1-alpha-hydroxylase activity (Schwartz et al., Cancer Epidemiol. Biomark. Prev., 7: 391-395, 1998). We studied 1-alpha-hydroxylase gene expression in four strains of primary human prostatic epithelial cells by reverse transcription PCR amplification (RT-PCR) of 1-alpha-hydroxylase. Human prostatic stromal cells were negative for 1-alpha-hydroxylase by RT-PCR. This led us to hypothesize that 25-OH-D3 would inhibit the proliferation of prostatic epithelial cells because 25-OH-D3 would be converted to 1,25(OH)2D3 intracellularly. We studied the effects of 25-OH-D3 and 1,25(OH)2D3 on the proliferation of prostatic epithelial cells using high density growth and clonal growth assays on two different primary cell strains derived from normal human prostatic peripheral zone. 25-OH-D3 and 1,25(OH)2D3 each inhibited growth in a dose- and time-dependent manner. Growth inhibition was evident at 1 nM, and maximal inhibition was observed at 100 nM within 10-12 days of exposure. The potencies of 25-OH-D3 and 1,25(OH)2D3 were not significantly different. These data demonstrate that 25-OH-D3, which previously was thought to have little biological activity, can become a potent antiproliferative hormone for prostatic cells that express 1-alpha-hydroxylase. Because 25-OH-D3 exhibits similar potency to 1,25(OH)2D3 but is less calcemic, 25-OH-D3 may offer a safer option than 1,25(OH)2D3 for prostate cancer therapy. Moreover, because 25-OH-D3 is produced endogenously from vitamin D, these findings support a potential role for vitamin D in the chemoprevention of prostate cancer.
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Abstract
One of the more surprising recent discoveries in glial biology has been that oligodendrocytes (OLs) originate from very restricted regions of the embryonic neural tube. This was surprising because myelinating OLs are widespread in the mature central nervous system, so there was no reason to suspect that their precursors should be restricted. What we now know about early OL development suggests that they might have as much (or more) in common with ventral neurons-specifically motor neurons (MNs)-as with other types of glia. This has implications for the way we think about glial development, function, and evolution. In this article we review the evidence for a shared MN-OL lineage and debate whether this is the only lineage that generates OLs. We decide in favour of a single embryonic lineage with regional variations along the anterior-posterior neuraxis.
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Sexton C, Buss D, Powell B, O'Connor M, Rainer R, Woodruff R, Cruz J, Pettenati M, Rao PN, Case LD. Usefulness and limitations of serum and urine lysozyme levels in the classification of acute myeloid leukemia: an analysis of 208 cases. Leuk Res 1996; 20:467-72. [PMID: 8709618 DOI: 10.1016/0145-2126(96)00001-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The revised French-American-British (FAB) classification system for acute myeloid leukemia (AML) recommends the determination of serum lysozyme (SL) or urine lysozyme (UL) levels as an aid in distinguishing acute myeloblastic leukemia with maturation (FAB M2) from acute myelomonocytic leukemia (M4). We reviewed retrospectively 208 cases of adult leukemia in which SL and/or UL were obtained. Elevated lysozyme levels were not found in any of the M0, M3, or M7 cases, but were increased (false positive) in three (14%) M1 cases, 18 (19%) M2 cases and one (20%) M6 case. Although a UL value in excess of 3x normal was found in most cases of AML M4 and M5, only five (11%) M4 cases and three (20%) M5 cases had SL elevations of this magnitude. Lysozyme levels need to be interpreted in conjunction with other parameters for FAB classification.
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MESH Headings
- Aged
- Female
- Humans
- Leukemia, Erythroblastic, Acute/classification
- Leukemia, Erythroblastic, Acute/enzymology
- Leukemia, Megakaryoblastic, Acute/classification
- Leukemia, Megakaryoblastic, Acute/enzymology
- Leukemia, Monocytic, Acute/classification
- Leukemia, Monocytic, Acute/enzymology
- Leukemia, Myeloid/classification
- Leukemia, Myeloid/enzymology
- Leukemia, Myeloid, Acute/classification
- Leukemia, Myeloid, Acute/enzymology
- Leukemia, Promyelocytic, Acute/classification
- Leukemia, Promyelocytic, Acute/enzymology
- Male
- Middle Aged
- Muramidase/blood
- Muramidase/urine
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Roberts DR, Paris JF, Manguin S, Harbach RE, Woodruff R, Rejmankova E, Polanco J, Wullschleger B, Legters LJ. Predictions of malaria vector distribution in Belize based on multispectral satellite data. Am J Trop Med Hyg 1996; 54:304-8. [PMID: 8600771 DOI: 10.4269/ajtmh.1996.54.304] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Use of multispectral satellite data to predict arthropod-borne disease trouble spots is dependent on clear understandings of environmental factors that determine the presence of disease vectors. A blind test of remote sensing-based predictions for the spatial distribution of a malaria vector, Anopheles pseudopunctipennis, was conducted as a follow-up to two years of studies on vector-environmental relationships in Belize. Four of eight sites that were predicted to be high probability locations for presence of An. pseudopunctipennis were positive and all low probability sites (0 of 12) were negative. The absence of An. pseudopunctipennis at four high probability locations probably reflects the low densities that seem to characterize field populations of this species, i.e., the population densities were below the threshold of our sampling effort. Another important malaria vector, An. darlingi, was also present at all high probability sites and absent at all low probability sites. Anopheles darlingi, like An. pseudopunctipennis, is a riverine species. Prior to these collections at ecologically defined locations, this species was last detected in Belize in 1946.
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Kern MJ, Pearson A, Woodruff R, Deligonul U, Vandormael M, Labovitz A. Hemodynamic and echocardiographic assessment of the effects of diltiazem during transient occlusion of the left anterior descending coronary artery during percutaneous transluminal coronary angioplasty. Am J Cardiol 1989; 64:849-55. [PMID: 2679030 DOI: 10.1016/0002-9149(89)90830-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The effects of diltiazem during transient myocardial ischemia were studied in 17 patients (age 58 +/- 11 years, 12 men, 5 women) undergoing 1-vessel left anterior descending percutaneous transluminal coronary angioplasty (PTCA). After hemodynamic, echocardiographic and electrocardiographic data were obtained during the control ischemic periods, diltiazem (10 mg intravenous bolus with 500 micrograms/min infusion) was given and 15 minutes later ischemia reinduced. Diltiazem reduced mean arterial pressure (113 +/- 16 to 95 +/- 15 mm Hg, p less than 0.05) and heart rate-pressure product (p less than 0.05) with no change in heart rate, pulmonary pressures or coronary (sinus, thermodilution technique) blood flow at rest. After diltiazem, times to ischemia-induced 1.0 mm ST-segment elevation (28 +/- 10 to 42 +/- 17 seconds, p less than 0.05) and new left ventricular wall motion abnormalities (by 2-dimensional echocardiography, 24 +/- 8 to 36 +/- 12 seconds, p less than 0.001) were prolonged without significant augmentation of great cardiac vein flow during coronary occlusion. Left ventricular (LV) ejection fraction decreased from 51 +/- 7 to 41 +/- 12% (p less than 0.05) during control ischemia, but declined less after diltiazem (54 +/- 12 to 47 +/- 14%, difference not significant; 47 +/- 14 vs 41 +/- 12%, p less than 0.01). Diltiazem can attenuate, but not abolish, some of the effects of myocardial ischemia on LV function during transient coronary artery occlusion. These data support the use of diltiazem as a beneficial adjunct that may be used acutely and safely during routine PTCA.
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Tatineni S, Barner HB, Pearson AC, Halbe D, Woodruff R, Labovitz AJ. Rest and exercise evaluation of St. Jude Medical and Medtronic Hall prostheses. Influence of primary lesion, valvular type, valvular size, and left ventricular function. Circulation 1989; 80:I16-23. [PMID: 2766522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
To compare St. Jude Medical and Medtronic Hall mechanical prosthetic heart valves, we prospectively randomized 90 consecutive patients requiring mechanical valve replacement and studied their rest and exercise hemodynamics by Doppler echocardiography. Fifty-six aortic and 42 mitral valves were implanted. All patients were examined preoperatively and postoperatively, and follow-up studies were obtained at rest and immediately after upright, treadmill exercise at 6 months (n = 68). Clinical parameters (mortality, morbidity, and congestive heart failure classification), as well as rest and exercise hemodynamics (valvular area, gradients, and left ventricular ejection fraction), were examined, and their relation to exercise duration was defined. Mortality (perioperative, 8.8% and late, 2.4%) was similar between patients in the two valve groups (five in each group). There was one late thromboembolic episode with each valve. Improvement in New York Heart Association congestive heart failure class was seen in 85% of patients at 6 months. There were no significant differences in calculated aortic valve areas (2.2 vs. 2.0 cm2), resting (24 vs. 21 mm Hg) and exercise (41 vs. 35 mm Hg) peak aortic gradients, and exercise duration between patients with the St. Jude Medical and Medtronic Hall aortic prostheses. In patients with aortic prostheses, valvular size was correlated with exercise duration (r = 0.41, p less than 0.05). In patients with mitral prostheses, we observed no significant differences between St. Jude Medical and Medtronic Hall prostheses in calculated mitral valve areas (3.4 cm2 vs. 3.4 cm2) and rest (2.5 vs. 3.0 mm Hg) and exercise (5.1 vs. 7.0 mm Hg) mean gradients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ben-Ezra J, Burke JS, Swartz WG, Brownell MD, Brynes RK, Hill LR, Nathwani BN, Oken MM, Wolf BC, Woodruff R. Small lymphocytic lymphoma: a clinicopathologic analysis of 268 cases. Blood 1989; 73:579-87. [PMID: 2644979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We analyzed specimens from 268 patients with small lymphocytic lymphoma (SL) to identify prognostic factors significant for survival. These patients were staged and treated according to the protocols of the Cancer and Leukemia Group B, Eastern Cooperative Oncology Group, Southeastern Cancer Study Group, and the Southwest Oncology Group. Univariate analysis showed that a large-cell grade greater than I, WBC greater than 10,000/microL, hemoglobin (Hgb) less than 11 g/dL, age greater than or equal to 55 years, and failure to respond to treatment were all poor prognostic factors. Multivariate analysis showed that large-cell grade, age, degree of capsular invasion, and symptom type were independently associated with survival. Separate analyses of cases with and without leukocytosis indicated differences in survival. In patients without leukocytosis, age, presence or absence of anemia, and treatment response were significant prognostic variables; in patients with leukocytosis, large-cell grade, presence or absence of anemia, symptom type, and treatment response were significantly related to survival. Multivariate analysis showed that age was the only significant independent prognostic variable in patients without leukocytosis; in patients with leukocytosis, symptom type, large-cell grade, and bone marrow involvement were independently associated with survival. We conclude that several parameters, both clinical and pathologic, should be assessed at the initial diagnosis of SL to predict prognosis better.
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MESH Headings
- Age Factors
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymph Nodes/pathology
- Lymphocytes/classification
- Lymphocytes/pathology
- Male
- Middle Aged
- Neoplasm Invasiveness
- Prognosis
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Hunter JC, Birchmore B, Woodruff R, Hughes J. Kappa opioid binding sites in the dog cerebral cortex and spinal cord. Neuroscience 1989; 31:735-43. [PMID: 2556660 DOI: 10.1016/0306-4522(89)90437-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In the dog cerebral cortex and spinal cord, [3H]bremazocine and [3H]U69593 both bound with high affinity to an apparent single population of binding sites under kappa-selective conditions. In the cortex similar Bmax values for both radioligands in the saturation studies and the high affinity of the kappa-selective agents PD117302 and U69593 for both [3H]bremazocine and [3H]U69593 labelled sites in the competition studies suggested a predominance of U69593-sensitive sites previously described as kappa 1 in the guinea-pig and rat brain. The lower slope values for the inhibition curves of PD117302 and U69593 against [3H]bremazocine but not against [3H]U69593 suggested that [3H]bremazocine could also be binding to a relatively minor proportion of additional, possibly kappa 2, sites while [3H]U69593 would appear to be selective for the kappa 1 site. In contrast, in the dog spinal cord, [3H]U69593 appeared to recognize only a proportion (approximately 35%) of the [3H]bremazocine labelled binding site. The significantly lower affinities and slope values of U69593 and PD117302 against [3H]bremazocine were consistent with the additional sites representing the k2 (benzomorphan) sites previously described in guinea-pig and rat spinal cord. Alternatively, the low (micromolar) affinity of the mu-selective ligand, [D-Ala2, MePhe4, Gly-ol5]enkephalin, implied that these additional sites might not be kappa 2 but possibly a low affinity mu site normally expressed under more physiological conditions.
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23
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Woodruff R. Cytomorphology in myeloma. Blood 1985; 65:1292-3. [PMID: 3995175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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24
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Jackson DV, Cruz JM, Woodruff R. Small cell carcinoma of the lung: rapid development of acute leukemia. N C Med J 1983; 44:475-6. [PMID: 6314156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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25
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