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Jain V, Al Rifai M, Turpin R, Eken HN, Agrawal A, Mahtta D, Samad Z, Coulter S, Rodriguez F, Petersen LA, Virani SS. Evaluation of Factors Underlying Sex-Based Disparities in Cardiovascular Care in Adults With Self-reported Premature Atherosclerotic Cardiovascular Disease. JAMA Cardiol 2022; 7:341-345. [PMID: 34985497 PMCID: PMC8733863 DOI: 10.1001/jamacardio.2021.5430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE There are limited data regarding sex-based differences in physical and mental health domains and health care access in adults with premature atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE To study the association of sex with physical and mental health domains as well as health care access-related factors among adults with self-reported premature ASCVD. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort analysis of 748 090 adults aged 18 to 55 years in the Behavioral Risk Factor Surveillance System 2016 to 2019 in the US. Data were analyzed from June to July 2021. EXPOSURES Self-reported ASCVD, defined as having a history of coronary artery disease, myocardial infarction, or stroke. MAIN OUTCOMES AND MEASURES Self-reported physical and mental health and measures of health care access, including self-reported cost-related medication nonadherence and inability to see a physician due to cost. RESULTS Between 2016 and 2019, 748 090 adults aged 18-55 years were identified, of whom 28 522 (3.3%) had self-reported premature ASCVD. Of these, 14 358 (47.0%) were women. Compared with men, women with premature ASCVD were more likely to report being clinically depressed (odds ratio [OR], 1.73; 95% CI, 1.41-2.14; P < .001), have cost-related medication nonadherence (OR, 1.42; 95% CI, 1.11-1.82; P = .005), have not seen a physician due to cost-related issues (OR, 4.52; 95% CI, 2.24-9.13; P < .001), and were more likely to report overall poor physical health (OR, 1.39; 95% CI, 1.09-1.78; P = .008) despite being more likely to have health care coverage (85.3% vs 80.8%; P = .04) and a primary care physician (84.2% vs 75.7%; P < .001). CONCLUSIONS AND RELEVANCE Results from this study indicate that women with premature ASCVD were more likely to report worse overall physical and mental health, inability to see a physician due to cost, and cost-related medical nonadherence. Interventions addressing mental health and out-of-pocket costs are needed in adults with premature ASCVD.
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Affiliation(s)
- Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Mahmoud Al Rifai
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Rodman Turpin
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park
| | - Hatice Nur Eken
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Ankit Agrawal
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Dhruv Mahtta
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Zainab Samad
- Department of Cardiovascular Medicine, Aga Khan University, Karachi, Pakistan
| | - Stephanie Coulter
- Center for Women’s Heart & Vascular Health, Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and the Cardiovascular Institute, Stanford University School of Medicine, Stanford, California
| | - Laura A. Petersen
- Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Salim S. Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas,Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas,Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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2
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Kherallah RY, Koneru S, Krajcer Z, Preventza O, Dougherty KG, McCormack ML, Costello BT, Coulter S, Strickman NE, Plana Gomez JC, Mortazavi A, Díez JG, Livesay JJ, Coselli JS, Silva GV. Hemodynamic outcomes after valve-in-valve transcatheter aortic valve replacement: a single-center experience. Ann Cardiothorac Surg 2021; 10:630-640. [PMID: 34733690 DOI: 10.21037/acs-2021-tviv-131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/26/2021] [Indexed: 11/06/2022]
Abstract
Background Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) has emerged as a safe, effective alternative to redo aortic valve surgery in high-risk patients with degenerated surgical bioprosthetic valves. However, ViV-TAVR has been associated high postprocedural valvular gradients, compared with TAVR for native-valve aortic stenosis. Methods We performed a retrospective study of all patients who underwent ViV-TAVR for a degenerated aortic valve bioprosthesis between January 1, 2013 and March 31, 2019 at our center. The primary outcome was postprocedural mean aortic valve gradient. Outcomes were compared across surgical valve type (stented versus stentless), surgical valve internal diameter (≤19 versus >19 mm), and transcatheter aortic valve type (self-expanding vs. balloon-expandable). Results Overall, 89 patients underwent ViV-TAVR. Mean age was 69.0±12.6 years, 61% were male, and median Society of Thoracic Surgeons Predicted Risk of Mortality score was 5.4 [interquartile range, 3.2-8.5]. Bioprosthesis mode of failure was stenotic (58% of patients), regurgitant (24%), or mixed (18%). The surgical valve was stented in 75% of patients and stentless in 25%. The surgical valve's internal diameter was ≤19 mm in 45% of cases. A balloon-expandable transcatheter valve was used in 53% of procedures. Baseline aortic valve area and mean gradients were 0.87±0.31 cm2 and 36±18 mmHg, respectively. These improved after ViV-TAVR to 1.38±0.55 cm2 and 18±11 mmHg at a median outpatient follow-up of 331 [67-394] days. Higher postprocedural mean gradients were associated with surgical valves having an internal diameter ≤19 mm (24±13 versus 16±8, P=0.002) and with stented surgical valves (22±11 versus 12±6, P<0.001). Conclusions ViV-TAVR is an effective option for treating degenerated surgical aortic bioprostheses, with acceptable hemodynamic outcomes. Small surgical valves and stented surgical valves are associated with higher postprocedural gradients.
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Affiliation(s)
- R Yazan Kherallah
- Division of Internal Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Srikanth Koneru
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Zvonimir Krajcer
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA
| | - Ourania Preventza
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.,Department of Cardiovascular Surgery, Texas Heart Institute and CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, TX, USA
| | - Kathryn G Dougherty
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA
| | - Melissa L McCormack
- Division of Internal Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Briana T Costello
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA
| | | | - Neil E Strickman
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.,Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA
| | - Juan Carlos Plana Gomez
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ali Mortazavi
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Department of Cardiology, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Houston, TX, USA
| | - Jose G Díez
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James J Livesay
- Department of Cardiovascular Surgery, Texas Heart Institute and CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, TX, USA
| | - Joseph S Coselli
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.,Department of Cardiovascular Surgery, Texas Heart Institute and CHI St Luke's Health-Baylor St Luke's Medical Center, Houston, TX, USA
| | - Guilherme V Silva
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA.,Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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3
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Angelini P, Muthupillai R, Lopez A, Cheong B, Uribe C, Hernandez E, Coulter S, Perin E, Molossi S, Gentile F, Flamm S, Lorenz G, D'Ascenzi F, Tobis J, Sarnari R, Corno A, Furgerson J, Chiribiri A, Villa ADM, Orzan F, Brugada P, Jefferies J, Aubry P, Towbin J, Thiene G, Tomanek R. Young athletes: Preventing sudden death by adopting a modern screening approach? A critical review and the opening of a debate. Int J Cardiol Heart Vasc 2021; 34:100790. [PMID: 34124338 PMCID: PMC8175289 DOI: 10.1016/j.ijcha.2021.100790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/07/2021] [Accepted: 04/23/2021] [Indexed: 10/29/2022]
Abstract
Preventing sudden cardiac death (SCD) in athletes is a primary duty of sports cardiologists. Current recommendations for detecting high-risk cardiovascular conditions (hr-CVCs) are history and physical examination (H&P)-based. We discuss the effectiveness of H&P-based screening versus more-modern and accurate methods. In this position paper, we review current authoritative statements and suggest a novel alternative: screening MRI (s-MRI), supported by evidence from a preliminary population-based study (completed in 2018), and a prospective, controlled study in military recruits (in development). We present: 1. Literature-Based Comparisons (for diagnosing hr-CVCs): Two recent studies using traditional methods to identify hr-CVCs in >3,000 young athletes are compared with our s-MRI-based study of 5,169 adolescents. 2. Critical Review of Previous Results: The reported incidence of SCD in athletes is presently based on retrospective, observational, and incomplete studies. H&P's screening value seems minimal for structural heart disease, versus echocardiography (which improves diagnosis for high-risk cardiomyopathies) and s-MRI (which also identifies high-risk coronary artery anomalies). Electrocardiography is valuable in screening for potentially high-risk electrophysiological anomalies. 3. Proposed Project : We propose a prospective, controlled study (2 comparable large cohorts: one historical, one prospective) to compare: (1) diagnostic accuracy and resulting mortality-prevention performance of traditional screening methods versus questionnaire/electrocardiography/s-MRI, during 2-month periods of intense, structured exercise (in military recruits, in advanced state of preparation); (2) global costs and cost/efficiency between these two methods. This study should contribute significantly toward a comprehensive understanding of the incidence and causes of exercise-related mortality (including establishing a definition of hr-CVCs) while aiming to reduce mortality.
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Affiliation(s)
- Paolo Angelini
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA
| | - Raja Muthupillai
- Department of Radiology, University of Houston, Houston, TX, USA
| | - Alberto Lopez
- Electrophysiology Laboratory, Department of Cardiology, Texas Heart Institute, Houston, TX, USA
| | - Benjamin Cheong
- Department of Radiology, Texas Heart Institute, Houston, TX, USA
| | - Carlo Uribe
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA
| | | | | | - Emerson Perin
- Department of Cardiology, Texas Heart Institute, Houston, TX, USA
| | - Silvana Molossi
- Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States
| | | | - Scott Flamm
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Giovanni Lorenz
- Department of Radiology, Wilford Hall Ambulatory Center, San Antonio Military Health System, Joint Base San Antonio, San Antonio, TX, USA
| | | | - Jonathan Tobis
- Department of Cardiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Roberto Sarnari
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Antonio Corno
- Department of Congenital Cardiac Surgery, Children's Memorial Hermann Hospital, UTHealth, Houston, TX, USA
| | - James Furgerson
- Department of Cardio-Radiology, US Air Force Lackland Hospital, San Antonio, TX, USA
| | - Amedeo Chiribiri
- Department of Cardiovascular Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom
| | - Adriana D M Villa
- Department of Radiology, St. Thomas Hospital, King's College London, United Kingdom
| | - Fulvio Orzan
- Division of Cardiology, Department of Medical Sciences, University of Turin, Italy
| | - Pedro Brugada
- Cardiovascular Division, Free University of Brussels (UZ Brussel) VUB, Brussels, Belgium
| | - John Jefferies
- The Cardiac Institute, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Pierre Aubry
- Department of Cardiology, Bichat Hospital, Paris, France
| | - Jeffrey Towbin
- Division of Adult Cardiovascular Diseases, Methodist University of Tennessee Cardiovascular Institute and Department of Preventive Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Gaetano Thiene
- Department of Pathologic Anatomy, University of Padua, Italy
| | - Robert Tomanek
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, USA
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4
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Wozniak TM, Cuningham W, Buchanan S, Coulter S, Baird RW, Nimmo GR, Blyth CC, Tong SYC, Currie BJ, Ralph AP. Geospatial epidemiology of Staphylococcus aureus in a tropical setting: an enabling digital surveillance platform. Sci Rep 2020; 10:13169. [PMID: 32759953 PMCID: PMC7406509 DOI: 10.1038/s41598-020-69312-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/03/2020] [Indexed: 01/21/2023] Open
Abstract
Delivery of information to clinicians on evolving antimicrobial susceptibility needs to be accurate for the local needs, up-to-date and readily available at point of care. In northern Australia, bacterial infection rates are high but resistance to first- and second-line antibiotics is poorly described and currently-available datasets exclude primary healthcare data. We aimed to develop an online geospatial and interactive platform for aggregating, analysing and disseminating data on regional bacterial pathogen susceptibility. We report the epidemiology of Staphylococcus aureus as an example of the power of digital platforms to tackle the growing spread of antimicrobial resistance in a high-burden, geographically-sparse region and beyond. We developed an online geospatial platform called HOTspots that visualises antimicrobial susceptibility patterns and temporal trends. Data on clinically-important bacteria and their antibiotic susceptibility profiles were sought from retrospectively identified clinical specimens submitted to three participating pathology providers (96 unique tertiary and primary healthcare centres, n = 1,006,238 tests) between January 2008 and December 2017. Here we present data on S. aureus only. Data were available on specimen type, date and location of collection. Regions from the Australian Bureau of Statistics were used to provide spatial localisation. The online platform provides an engaging visual representation of spatial heterogeneity, demonstrating striking geographical variation in S. aureus susceptibility across northern Australia. Methicillin resistance rates vary from 46% in the west to 26% in the east. Plots generated by the platform show temporal trends in proportions of S. aureus resistant to methicillin and other antimicrobials across the three jurisdictions of northern Australia. A quarter of all, and up to 35% of methicillin-resistant S. aureus (MRSA) blood isolates in parts of the northern Australia were resistant to inducible-clindamycin. Clindamycin resistance rates in MRSA are worryingly high in regions of northern Australia and are a local impediment to empirical use of this agent for community MRSA. Visualising routinely collected laboratory data with digital platforms, allows clinicians, public health physicians and guideline developers to monitor and respond to antimicrobial resistance in a timely manner. Deployment of this platform into clinical practice supports national and global efforts to innovate traditional disease surveillance systems with the use of digital technology and to provide practical solutions to reducing the threat of antimicrobial resistance.
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Affiliation(s)
- T M Wozniak
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - W Cuningham
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - S Buchanan
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia
| | - S Coulter
- Queensland Health, Communicable Diseases Branch, Brisbane, Queensland, Australia
| | - R W Baird
- Territory Pathology, Northern Territory Government, Darwin, Northern Territory, Australia
| | - G R Nimmo
- Pathology Queensland Central Laboratory, Griffith University School of Medicine, Brisbane, Queensland, Australia
| | - C C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.,PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - S Y C Tong
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Victorian Infectious Disease Service, The Royal Melbourne Hospital and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - B J Currie
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - A P Ralph
- Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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5
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Drescher C, Moore K, Liu J, O’Malley D, Wang E, Wang JZ, Subbiah V, Wilky B, Yuan G, Dupont C, Gonzalez A, Savitsky D, Coulter S, Shebanova O, Dow E, Ortuzar W, Buell J, Stein R, Youssoufian H. Phase I/II, open-label, multiple ascending dose trial of AGEN2034, an anti–PD-1 monoclonal antibody, in advanced solid malignancies: Results of dose escalation in advanced cancer and expansion cohorts in subjects with relapsed/refractory cervical cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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6
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Coulter S, Girgis M. Use of Optiflow™ nasal high-flow oxygen in a patient with malignant hyperthermia. Br J Anaesth 2018; 121:680. [DOI: 10.1016/j.bja.2018.05.006] [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] [Received: 04/04/2018] [Revised: 04/12/2018] [Accepted: 05/08/2018] [Indexed: 11/16/2022] Open
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7
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Basu Ray I, Khalid K, Khan K, Monlezun D, Shanoon F, Lam W, Coulter S, Cheng J, Strickman N, Mathuria N, Giorgberidze I, Hamid A, Razavi M, Rasekh A, Saeed M. P3623Anti-arrhythmic effects seen with lariat is not associated with reverse remodeling. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3623] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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Basu Ray I, Schwing G, Middour T, Monlezun D, Allencherril J, Martin-Schild S, Koranne K, Razavi M, Cheng J, Coulter S, Rasek A, Saeed M. P4365Heart failure with preserved ejection fraction is associated with cardioembolic stroke independent of history of atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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9
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Dougherty K, Krajcer Z, Strickman N, Mortazavi A, Fish R, Silva G, Diez J, Paul AL, Stainback R, Coulter S, Navarijo J, Cheong B, Reul R, Coselli J, Ott D, Livesay J. TRANSCATHETER AORTIC VALVE IMPLANTATION IN PATIENTS WITH PREVIOUS EXTERNAL BEAM RADIOTHERAPY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32171-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Kumar K, Coulter S, Cheong B. Thoracic Outlet Syndrome. Methodist Debakey Cardiovasc J 2015; 11:145. [DOI: 10.14797/mdcj-11-2-145] [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: 11/08/2022] Open
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11
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Affiliation(s)
- Stephanie Coulter
- Center for Women's Heart & Vascular Health, Texas Heart Institute at St. Luke's Episcopal Hospital, 6624 Fannin, Suite 2780, Houston, TX, 77030, USA,
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12
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Alam M, Lee VV, Elayda MA, Shahzad SA, Yang EY, Nambi V, Jneid H, Pan W, Coulter S, Wilson JM, Ramanathan KB, Ballantyne CM, Virani SS. Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis. Int J Cardiol 2013; 167:180-4. [DOI: 10.1016/j.ijcard.2011.12.047] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 12/17/2011] [Indexed: 11/17/2022]
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13
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Vanwijngaerden YM, Langouche L, Gielen M, Debaveye Y, Casaer M, Liddle C, Coulter S, Brunner R, Wouters P, Wilmer A, Van den Berghe G, Mesotten D. Withholding parenteral nutrition during the first week of critical illness increases plasma bilirubin but lowers the incidence of cholestasis and gallbladder sludge. Crit Care 2013. [PMCID: PMC3642572 DOI: 10.1186/cc12192] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Gondi S, Debbarma S, Hernandez AI, Cheng J, Cheong BY, Coulter S. ACCURACY OF COMPUTED TOMOGRAPHY FOR DETECTION OF LEFT ATRIAL THROMBUS PRIOR TO CATHETER ABLATION OF ATRIAL FIBRILLATION. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)61266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Parashar S, Palmer A, O'Brien N, Chan K, Shen A, Coulter S, Montaner J, Hogg R. P5-S4.06 Sticking to it: the effect of maximally assisted therapy on antiretroviral treatment adherence among a cohort of unstably housed people living with HIV in BC, Canada. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.547] [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: 11/04/2022]
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16
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Weber AE, Tyndall MW, Spittal PM, Li K, Coulter S, O'Shaughnessy MV, Schechter MT. High pregnancy rates and reproductive health indicators among female injection-drug users in Vancouver, Canada. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.8.1.52.58] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Vela DC, Silva GV, Assad JAR, Sousa ALS, Coulter S, Fernandes MR, Perin EC, Willerson JT, Buja LM. Histopathological study of healing after allogenic mesenchymal stem cell delivery in myocardial infarction in dogs. J Histochem Cytochem 2008; 57:167-76. [PMID: 19001635 DOI: 10.1369/jhc.2008.952507] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this histological study, we assessed the role of mesenchymal stem cells (MSCs) in the healing process that takes place during the subacute phase of myocardial infarction in dogs. Seven days after occlusion of the left anterior descending coronary artery, adult mongrel dogs received 100 x 10(6) 4'-6-diamidino-2-phenylindole (DAPI)-labeled allogenic bone marrow-derived MSCs by the transendocardial (TE, n=6) and intracoronary (IC, n=4) routes; control dogs (n=6) received no infusion. The dogs were euthanized at 21 days after occlusion. Hearts were excised and sliced from apex to base into four transverse sections, which were divided into nine segments. Paraffin sections from each segment were stained with hematoxylin and eosin, trichrome, picrosirius red, and antibodies against several extracellular matrix components. Frozen sections were immunostained for host cardiac phenotypical markers and analyzed by epifluorescence and deconvolution fluorescence microscopy (DFM). We found less unresolved necrotic myocardium and more extracellular matrix deposition in MSC-treated dogs than in controls 2 weeks after cell delivery. By DFM, no DAPI+ MSC nuclei were observed within native cardiac cells. MSCs delivered during the subacute phase of acute myocardial infarction positively affect healing, apparently by mechanisms other than differentiation into mature native cardiac cells.
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Affiliation(s)
- Deborah C Vela
- Cardiovascular Pathology Research Department, Texas Heart Institute, Houston, TX 77030, USA.
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19
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Perin EC, Silva GV, Assad JAR, Vela D, Buja LM, Sousa ALS, Litovsky S, Lin J, Vaughn WK, Coulter S, Fernandes MR, Willerson JT. Comparison of intracoronary and transendocardial delivery of allogeneic mesenchymal cells in a canine model of acute myocardial infarction. J Mol Cell Cardiol 2007; 44:486-95. [PMID: 18061611 DOI: 10.1016/j.yjmcc.2007.09.012] [Citation(s) in RCA: 188] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 08/30/2007] [Accepted: 09/27/2007] [Indexed: 01/16/2023]
Abstract
This study assessed safety of transendocardial (TE) electromechanical-guided delivery of bone marrow mesenchymal stem cells (MSCs) after acute myocardial infarction (AMI) and compared intracoronary (IC) delivery with TE delivery. In a canine acute myocardial ischemia model, 100 x 10(6) MSCs were delivered 7 days after AMI via IC and TE routes. Functional assessment was performed by 2D echocardiogram, and detailed histopathologic analyses were performed to assess the impact of cell therapy in vascular density and fibrosis. Patterns of cell distribution in both delivery methods were also compared. There was a statistically significant reduction in the amount of myocardial ischemia in the TE group (P=0.007). Left ventricular ejection fraction (LVEF) increased 13% (mean) in the TE group (21-day follow-up) and was significantly better than that of the controls (P=0.01), but did not improve in the IC-delivery group. Dissimilar patterns of cell distribution were noted between the IC and TE groups. This study suggests that MSC treatment is probably safe and effective after AMI. In the comparison of TE and IC delivery, the TE group showed higher cell retention (clusters even in the injury center of the infarct) with an increased vascularity and greater functional improvement than did the IC group (no clusters; cells at the border of the infarct). The higher local cell density in the TE group may be important for therapeutic effectiveness.
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Affiliation(s)
- Emerson C Perin
- The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, TX 77030, USA
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Perin EC, Assad JA, Silva GV, Coulter S, Ober J, Lin J, Sousa AL, Litowski S, Geng Y, Martin BJ, Vaughn WK, Willerson JT. 1100-56 Comparison between intracoronary infusion and direct transendocardial injection of mesenchymal stem cell in a dog acute ischemia model. J Am Coll Cardiol 2004. [DOI: 10.1016/s0735-1097(04)90266-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weber AE, Tyndall MW, Spittal PM, Coulter S, Schechter MT, O'Shaughnessy MV. 135 HIGH PREGNANCY RATES AND REPRODUCTIVE HEALTH INDICATORS AMONG FEMALE INJECTION DRUG USERS IN VANCOUVER, CANADA. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-135] [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: 11/04/2022]
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Schooley CC, Gilbert JH, Harlan M, Bracey A, Coulter S, Wilson JM. Kinetics of intravenously administered dalteparin. J Am Coll Cardiol 2003. [DOI: 10.1016/s0735-1097(03)80108-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Civitello AB, Woodruff A, Mahmood H, Doughtery K, Askins C, Krajcer Z, Coulter S. Contrast enhanced duplex ultrasound improves endoleak detection following endovascular abdominal aortic aneurysm repair. J Am Coll Cardiol 2003. [DOI: 10.1016/s0735-1097(03)80166-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Weber AE, Tyndall MW, Spittal PM, Li K, Coulter S, O'Shaughnessy MV, Schechter MT. High pregnancy rates and reproductive health indicators among female injection-drug users in Vancouver, Canada. EUR J CONTRACEP REPR 2003; 8:52-8. [PMID: 12725675] [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: 03/02/2023]
Abstract
OBJECTIVE To determine the incidence of pregnancy among active injection-drug users and to identify factors associated with becoming pregnant. METHODS The Vancouver Injection Drug User Study (VIDUS) is a prospective cohort study that began in 1996. Women who had completed a baseline and at least one follow-up questionnaire between June 1996 and January 2002 were included in the study. Parametric and non-parametric methods were used to compare characteristics of women who reported pregnancy over the study period with those who did not over the same time period. RESULTS A total of 104 women reported a primary pregnancy over the study period. The incidence of pregnancy over the follow-up period was 6.46 (95% confidence interval (CI) 5.24-7.87) per 100 person-years. The average age of women who reported pregnancy was younger than that of women who did not report pregnancy (27 vs. 32 years, p < 0.001). Women of Aboriginal ethnicity were more likely to report pregnancy (odds ratio 1.6, 95% CI 1.0-2.5). Comparison of drug use showed no significant differences in pregnancy rate with respect to the use of heroin, cocaine or crack (p > 0.05). In examining sexual behavior, women who reported having had a regular partner in the previous 6 months were three times more likely to have reported pregnancy. Despite the fact that 67% of women in this study reported using some form of contraception, the use of reliable birth control was low. Only 5% of women in our study reported the use of hormonal contraceptives. CONCLUSION There were a high number of pregnancies among high-risk women in this cohort. This corresponded with very low uptake of reliable contraception. Innovative strategies to provide reproductive health services to at-risk women who are injecting drugs is a public health priority.
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Affiliation(s)
- A E Weber
- Vancouver Injection Drug User Study (VIDUS), BC Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada
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Nemeth MA, Coulter S, Flamm SD. Pericarditis after myocardial infarction. Tex Heart Inst J 2003; 30:246-7. [PMID: 12959214 PMCID: PMC197329] [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: 03/04/2023]
Affiliation(s)
- Margit A Nemeth
- Department of Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
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Abstract
AIMS To investigate inhibition of recombinant CYP2C8 by: (i) prototypic CYP isoform selective inhibitors (ii) imidazole/triazole antifungal agents (known inhibitors of CYP), and (iii) certain CYP3A substrates (given the apparent overlapping substrate specificity of CYP2C8 and CYP3A). METHODS CYP2C8 and NADPH-cytochrome P450 oxidoreductase were coexpressed in Spodoptera frugiperda (Sf21) cells using the baculovirus expression system. CYP isoform selective inhibitors, imidazole/triazole antifungal agents and CYP3A substrates were screened for their inhibitory effects on CYP2C8-catalysed torsemide tolylmethylhydroxylation and, where appropriate, the kinetics of inhibition were characterized. The conversion of torsemide to its tolylmethylhydroxy metabolite was measured using an h.p.l.c. procedure. RESULTS At concentrations of the CYP inhibitor 'probes' employed for isoform selectivity, only diethyldithiocarbamate and ketoconazole inhibited CYP2C8 by > 10%. Ketoconazole, at an added concentration of 10 microM, inhibited CYP2C8 by 89%. Another imidazole, clotrimazole, also potently inhibited CYP2C8. Ketoconazole and clotrimazole were both noncompetitive inhibitors of CYP2C8 with apparent Ki values of 2.5 microM. The CYP3A substrates amitriptyline, quinine, terfenadine and triazolam caused near complete inhibition (82-91% of control activity) of CYP2C8 at concentrations five-fold higher than the known CYP3A Km. Kinetic studies with selected CYP3A substrates demonstrated that most inhibited CYP2C8 noncompetitively. Apparent Ki values for midazolam, quinine, terfenadine and triazolam ranged from 5 to 25 microM. CONCLUSIONS Inhibition of CYP2C8 occurred at concentrations of ketoconazole and diethyldithiocarbamate normally employed for selective inhibition of CYP3A and CYP2E1, respectively. Some CYP3A substrates have the capacity to inhibit CYP2C8 activity and this may have implications for inhibitory drug interactions in vivo.
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Affiliation(s)
- C E Ong
- Department of Clinical Pharmacology, Flinders Medical Centre and Flinders University, Adelaide, Australia
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Affiliation(s)
- J O Miners
- Department of Clinical Pharmacology, Flinders Medical Centre and Flinders University School of Medicine, Adelaide, Australia.
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Brown RS, Shalhoub V, Coulter S, Alex S, Joris I, De Vito W, Lian J, Stein GS. Developmental regulation of thyrotropin receptor gene expression in the fetal and neonatal rat thyroid: relation to thyroid morphology and to thyroid-specific gene expression. Endocrinology 2000; 141:340-5. [PMID: 10614656 DOI: 10.1210/endo.141.1.7258] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The TSH receptor plays a pivotal role in thyroid gland function, growth, and differentiation, but little is known about its role or regulation in the fetus and neonate. To explore these questions, we systematically evaluated TSH receptor gene expression at the level of messenger RNA (mRNA) in thyroid glands obtained from rat fetuses and neonates, from 14 days gestation to day 5 of postnatal life. Results were compared with histological evidence of differentiation and to thyroid-specific gene expression. Northern blot and RT-PCR analysis revealed that TSH mRNA was first detected at low levels on fetal day 15, but it increased 3- to 15-fold on fetal days 17-18. Up-regulation of TSH receptor mRNA on fetal day 17-18 was accompanied by the first appearance of colloid formation and of follicular development on morphological examination. It was also paralleled by increased expression of the thyroid-specific genes thyroglobulin (Tg) and thyroid peroxidase. Unexpectedly, TSH mRNA abundance was 2- to 3-fold higher in pregnant dams than in nonpregnant adult females or adult males. In view of the 8-day lapse between the first appearance of the thyroid diverticulum and up-regulation of TSH receptor gene expression, we conclude that pituitary TSH, acting through its receptor, plays an important role in terminal thyroid maturation, but it is not involved earlier in gestation. Similarly, these data support previous evidence that the weak thyrotropic activity of human CG could not be of significance in early fetal thyroid gland development. The increased TSH receptor mRNA on fetal day 17-18 may be attributable to up-regulation by TSH, which is first secreted into the fetal circulation at this time. The significance of the increased TSH receptor expression during pregnancy remains to be explored.
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Affiliation(s)
- R S Brown
- Department of Pediatrics, University of Massachusetts Medical School, Worcester 01655, USA.
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Stefan AM, Coulter S, Gray B, LaMorte W, Nikelaeson S, Edge AS, Afdhal NH. Xenogeneic transplantation of porcine hepatocytes into the CCl4 cirrhotic rat model. Cell Transplant 1999; 8:649-59. [PMID: 10701494 DOI: 10.1177/096368979900800611] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 12/12/2022] Open
Abstract
Liver support using extracorporeal devices and hepatocyte transplantation has received renewed interest for the management of acute and chronic liver failure. The aim of this study was to determine whether xenogeneic porcine hepatocytes could integrate into the liver parenchyma of cirrhotic Lewis rats when administered by an intrasplenic route. Cirrhosis was induced by carbon tetrachloride (CCl4) inhalation and confirmed histologically. Freshly isolated porcine hepatocytes were infused directly into the splenic pulp at laparotomy over a 5-15-min interval. Using (111)In-labeled hepatocytes, the degree of localization of porcine hepatocytes to the spleen and liver was found to be greater than 60% in both control and cirrhotic rats. Integration of porcine hepatocytes into the rat liver parenchyma was determined by immunohistochemical staining for porcine albumin in rat liver sections. Further confirmation was provided by in situ hybridization using a porcine-specific probe that binds to a distinct repetitive element (PRE) in porcine DNA. Evidence of integrated porcine hepatocytes was seen for over 50 days in animals under cyclosporine immunosuppression. These data demonstrate the integration of xenogeneic porcine hepatocytes into the liver of the cirrhotic rat and their ability to produce porcine albumin for up to 50 days.
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Affiliation(s)
- A M Stefan
- Department of Medicine, Boston Medical Center and Boston University School of Medicine, MA 02118, USA
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Abstract
Cyclooxygenase-1 (Cox-1) and Cox-2 convert arachidonic acid to prostaglandin H(2), the precursor of other prostaglandins and thromboxanes, eicosanoids important in vascular pathophysiology. However, knowledge of the expression of cyclooxygenases within atherosclerotic lesions is scant. This study tested the hypothesis that human atheroma and nonatherosclerotic arteries express the two Cox isoforms differentially. Cox-1 mRNA and protein localized on endothelial and medial smooth muscle cells of normal arteries (n = 5), whereas Cox-2 expression was not detectable. In contrast, atheromatous (n = 7) lesions contained both Cox-1 and Cox-2, colocalizing mainly with macrophages of the shoulder region and lipid core periphery, whereas smooth muscle cells showed lower levels, as demonstrated by immunohistochemical and in situ hybridization analysis. Furthermore, microvascular endothelium in plaques showed notable staining for both isoforms. In accord with immunohistochemical studies, Western blot analysis of protein extracts from normal arteries revealed constitutive Cox-1, but not Cox-2, expression. Extracts of atheromatous lesions, however, contained both Cox-1 and Cox-2 protein, detected as two immunoreactive proteins of approximately 70 and 50 kd. Macrophages expressed the short form of Cox-1/-2 constitutively after several days of in vitro culture, rather than the 70-kd protein. These results shed new light on the inflammatory pathways that operate in human atheroma. In particular, the expression of Cox-2 in atheromatous, but not in unaffected, arteries has therapeutic implications, given the advent of selective Cox-2 inhibitors.
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Affiliation(s)
- U Schönbeck
- Vascular Medicine, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Coulter S, Picard MH. Contrast echocardiography in coronary artery disease. Coron Artery Dis 1998; 9:391-8. [PMID: 9822858 DOI: 10.1097/00019501-199809070-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- S Coulter
- Cardiac Unit, Massachusetts General Hospital, Boston 02114, USA
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Arnold L, Bakhtarina I, Brooks AM, Coulter S, Hurt L, Lewis C, Weinstein S, Younger J. Nursing in the newly independent states of the former Soviet Union: an international partnership for nursing development. J Obstet Gynecol Neonatal Nurs 1998; 27:203-8. [PMID: 9549707 DOI: 10.1111/j.1552-6909.1998.tb02612.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- L Arnold
- Ernst & Young, Philadelphia, PA, USA
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Abstract
Single nucleotide substitutions are known to result in a different amino acid at one of four sites in cytochrome P4502C9 (CYP2C9) namely: residue 144: Arg/Cys; residue 358: Tyr/Cys; residue 359: Ile/Leu and residue 417: Gly/Asp. Polymerase chain reaction (PCR)-based amplification of the nucleotide fragments encompassing the four residues (144, 358-359 and 417) in 18 samples of human genomic DNA from a liver bank and one sample of DNA extracted from the blood of a known poor metabolizer of tolbutamide has been carried out. The products of PCR amplification were analysed by either allele-specific restriction endonucleases or probed with radioactively labelled allele-specific oligonucleotides in dot blot hybridizations. Fourteen individuals were homozygous for Arg144 and four were heterozygous Arg/Cys144. All individuals analysed were homozygous for Tyr358 (n = 17) and for Gly417 (n = 18). With the exception of one heterozygote the other 17 subjects were homozygous for Ile359. The genotype of the known poor metabolizer of tolbutamide was homozygous for Arg144, Leu359 and Gly417. The relative levels of expression of the Cys and Arg144 alleles was studied in the heterozygotes. A relative 5- to 10-fold greater expression of the Cys- over the Arg144 allele was noted in two heterozygotes. There was no apparent correlation of genotype to the hydroxylation of the known CYP2C9 substrates phenytoin, tolbutamide, torasemide and diclofenac. Apparent K(m) values for the cDNA-expressed Arg144/Ile359, Cys144/ Ile359 and Arg144/Leu359 variants towards tolbutamide were 91 microM, 62 microM and 229 microM, respectively. It is likely that functional changes occurring as a result of the Ile359Leu transition are responsible for the tolbutamide poor metabolizer phenotype.
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Affiliation(s)
- C R Bhasker
- Department of Clinical Pharmacology, Flinders University of South Australia, Australia
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VanDevanter DR, Warrener P, Bennett L, Schultz ER, Coulter S, Garber RL, Rose TM. Detection and analysis of diverse herpesviral species by consensus primer PCR. J Clin Microbiol 1996; 34:1666-71. [PMID: 8784566 PMCID: PMC229091 DOI: 10.1128/jcm.34.7.1666-1671.1996] [Citation(s) in RCA: 561] [Impact Index Per Article: 20.0] [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: 02/02/2023] Open
Abstract
A consensus primer PCR method which amplifies a region of herpesviral DNA-directed DNA polymerase (EC 2.7.7.7) and which uses degenerate primers in a nested format was developed. Primers were designed to target sequences coding for highly conserved amino acid motifs covering a region of approximately 800 bp. The assay was applied to 22 species of herpesviruses (8 human and 14 animal viruses), with PCR products obtained for 21 of 22 viruses. In the process, 14 previously unreported amino acid-coding sequences from herpesviral DNA polymerases were obtained, including regions of human herpesviruses 7 and 8. The 50 to 60 amino acid-coding sequences recovered in the present study were determined to be unique to each viral species studied, with very little sequence variation between strains of a single species when studied. Template dilution studies in the presence of human carrier DNA demonstrated that six human herpesviruses (herpesviruses 1, 2, 3, 4, 5, and 6B) could be detected at levels at or below 100 genome equivalents per 100 ng of carrier DNA. These data suggest that consensus primer PCR targeted to herpesviral DNA polymerase may prove to be useful in the detection and identification of known herpesviruses in clinical samples and the initial characterization of new herpesviral genomes.
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Miners JO, Coulter S, Tukey RH, Veronese ME, Birkett DJ. Cytochromes P450, 1A2, and 2C9 are responsible for the human hepatic O-demethylation of R- and S-naproxen. Biochem Pharmacol 1996; 51:1003-8. [PMID: 8866821 DOI: 10.1016/0006-2952(96)85085-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A preliminary report implicated cytochrome P450 (CYP) 2C9 in the human liver microsomal O-demethylation of S-naproxen, suggesting that this pathway may be suitable for investigation of human hepatic CYP2C9 in vitro. Kinetic and inhibitor studies with human liver microsomes and confirmatory investigations with cDNA-expressed enzymes were undertaken here to define the role of CYP2C9 and other isoforms in the O-demethylation of R- and S-naproxen. All studies utilised a newly developed sensitive and specific HPLC assay that measured the respective O-desmethyl metabolites of R- and S-naproxen in incubations of human liver microsomes and in COS cell lysates. Microsomal R- and S-naproxen O-demethylation kinetics followed Michaelis-Menten kinetics, with respective mean apparent Km values of 123 microM and 143 microM. Sulfaphenazole, a specific inhibitor of CYP2C9, reduced the microsomal O-demethylation of R- and S-naproxen by 43% and 47%, respectively, and the CYP1A2 inhibitor furafylline decreased R- and S-naproxen O-demethylation by 38% and 28%, respectively. R,S-Mephenytoin was a weak inhibitor of R- and S-naproxen O-demethylation, but other CYP isoform specific inhibitors (e.g., coumarin, diethyldithiocarbamate, quinidine, troleandomycin) had little or no effect on these reactions. cDNA-expressed CYP2C9 and CYP1A2 were both shown to O-demethylate R- and S-naproxen. Apparent Km values (92-156 microM) for the reactions catalysed by the recombinant enzymes were similar to those observed for human liver microsomal R- and S-naproxen O-demethylation. The data demonstrate that CYP2C9 and CYP1A2 together account for the majority of human liver R- and S-naproxen O-demethylation, precluding the use of either R- or S-naproxen as a CYP isoform-specific substrate in vitro and in vivo.
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Affiliation(s)
- J O Miners
- Department of Clinical Pharmacology, Flinders Medical Centre, Bedford Park, Australia
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Weinstock MA, Coulter S, Bates J, Bogaars HA, Larson PL, Burmer GC. Human papillomavirus and widespread cutaneous carcinoma after PUVA photochemotherapy. Arch Dermatol 1995; 131:701-4. [PMID: 7778923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Oral psoralen with UV-A (PUVA) photochemotherapy is known to cause cutaneous malignancies and has been associated with cutaneous immunosuppression. Human papillomavirus infection has also been associated with cutaneous malignancies and with immunosuppressed individuals. We therefore sought evidence of human papillomavirus infection in a patient with a long history of PUVA therapy and multiple cutaneous malignancies. OBSERVATIONS During a 15-year period, an otherwise healthy patient with psoriasis who had undergone a 10-year course of PUVA photochemotherapy developed 13 squamous cell carcinomas, eight lesions diagnosed as "squamous cell carcinoma vs keratoacanthoma," 14 other keratoacanthomas, six basal cell carcinomas, one melanoma in situ, and 18 other keratinocytic dysplasias. Twenty-two of the 30 lesions tested for human papillomavirus DNA by polymerase chain reaction were positive for type 16/18, including six of the seven basal or squamous cell carcinomas tested. CONCLUSION We hypothesize that PUVA therapy-induced immunosuppression may play an important role in PUVA-related carcinogenesis by affecting the extent and pathogenicity of human papillomavirus infection.
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Affiliation(s)
- M A Weinstock
- Dermatoepidemiology Unit, Veterans Affairs Medical Center, Providence, RI, USA
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Gu JD, Coulter S, Eberiel D, McCarthy SP, Gross RA. A respirometric method to measure mineralization of polymeric materials in a matured compost environment. ACTA ACUST UNITED AC 1993. [DOI: 10.1007/bf01458296] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Coulter S, Rodbell M. Heterotrimeric G proteins in synaptoneurosome membranes are crosslinked by p-phenylenedimaleimide, yielding structures comparable in size to crosslinked tubulin and F-actin. Proc Natl Acad Sci U S A 1992; 89:5842-6. [PMID: 1631066 PMCID: PMC49393 DOI: 10.1073/pnas.89.13.5842] [Citation(s) in RCA: 33] [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: 12/28/2022] Open
Abstract
We have treated rat brain synaptoneurosomes with the crosslinking agent N,N'-1,4-phenylenedimaleimide under conditions that cause extensive crosslinking of tubulin, F-actin, and the alpha and beta subunits of three major types of heterotrimeric GTP-binding regulatory proteins (G(o), Gs, Gi) present in brain membranes. The major crosslinked products are coeluted from Bio-Gel sizing columns as very large structures that do not penetrate stacking gels during SDS/PAGE. The alpha subunits but not the beta subunits of Gs, G(o) and Gi also yield crosslinked products of intermediate sizes. None of the products are as small as the heterotrimeric G proteins extracted from brain by cholate or Lubrol. However, the large and intermediate crosslinked structures are strikingly similar to the large, polydisperse structures of the alpha subunits of Gs, Gi, and G(o) extracted from synaptoneurosomes by the detergent octyl glucoside, which have sedimentation properties of multimeric proteins. Several ways in which multimeric forms of G proteins can explain the dynamic and pleiotropic actions of hormones and GTP on signal-transducing systems are discussed.
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Affiliation(s)
- S Coulter
- Laboratory of Cellular and Molecular Pharmacology, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709
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Walsh SW, Coulter S. Increased placental progesterone may cause decreased placental prostacyclin production in preeclampsia. Int J Gynaecol Obstet 1990. [DOI: 10.1016/0020-7292(90)90022-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Walsh SW, Coulter S. Increased placental progesterone may cause decreased placental prostacyclin production in preeclampsia. Int J Gynaecol Obstet 1990. [DOI: 10.1016/0020-7292(90)90643-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
UNLABELLED Placentas obtained from women with preeclampsia produce more thromboxane and less prostacyclin than normal. They also produce more progesterone than normal. This study tested whether a progesterone concentration equivalent to that in the medium after in vitro incubation of placentas from women with preeclampsia (greater than or equal to 1.5 x 10(-5) mol/L) could cause an imbalance of increased thromboxane and decreased prostacyclin production by normal placentas. Fresh term placental tissues were incubated for 48 hours in the absence or presence of various concentrations of progesterone and/or estradiol. Prostacyclin and thromboxane were determined by radioimmunoassay of their stable metabolites, 6-keto-prostaglandin F1 alpha and thromboxane B2. A progesterone concentration of 1.5 x 10(-5) mol/L significantly (p less than 0.001) inhibited prostacyclin production, compared with control, but lower concentrations did not. Estradiol at concentrations present in the medium after incubation of either normal or preeclamptic placental tissue did not significantly affect prostacyclin production, nor did it prevent progesterone at 1.5 x 10(-5) mol/L from inhibiting prostacyclin. Thromboxane production was not affected by either progesterone or estradiol. CONCLUSION In vitro addition of progesterone at a concentration equivalent to that in the medium after incubation of preeclamptic placentas inhibited prostacyclin production by normal placentas to a rate characteristic of preeclampsia. However, it did not increase thromboxane. SPECULATION Increased trophoblast progesterone in preeclampsia may act by a paracrine mechanism to inhibit prostacyclin synthesis in placental vasculature. Progesterone's selective inhibition of prostacyclin without affecting thromboxane may be due to the compartmentalization of thromboxane production to trophoblast and stroma and prostacyclin production to placental vasculature.
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Affiliation(s)
- S W Walsh
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Medical School, Houston
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Abstract
It has been shown previously by an immunofluorescence technique, that whole serum from patients who have anti-Ro/SSA autoantibodies reacts with a component or components of the epidermis. We have now demonstrated by immunoblotting that the antigen identified in human epidermis by anti-Ro/SSA sera is Ro/SSA antigen, and that Ro/SSA antigen is present both in adult and in neonatal epidermis. The presence of this antigen in tissues which are injured in the anti-Ro/SSA-associated syndromes subacute cutaneous lupus erythematosus and neonatal lupus erythematosus supports the hypothesis that anti-Ro/SSA antibodies react with Ro/SSA antigen in the skin and are important in the initiation of tissue damage.
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Affiliation(s)
- S K Jones
- Department of Dermatology, University of Colorado School of Medicine, Denver 80262
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43
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Abstract
Isolated congenital complete heart block is frequently found in offspring of mothers who have IgG anti-Ro/SSA autoantibodies. IgG deposition was reported in the heart of a baby who died from heart block and heart failure. The pattern of antibody deposition observed was the same as that reproduced in animal models for anti-Ro/SSA binding. The IgG deposition was present in, but not limited to, the conduction system. Scattered small infiltrates of mononuclear cells and a limited, patchy deposition of complement were also observed. These findings support the possibility that isolated congenital heart block may be causally related to autoantibodies.
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Affiliation(s)
- L A Lee
- Department of Dermatology, University of Colorado School of Medicine, Denver 80262
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