bluuebunny/crossref_metadata_2025_split huggingface dataset:
Octopamine promotes rhythmicity but not synchrony in a bilateral pair of bursting motor neurons in the feeding circuit of Aplysia
Authors: Martínez-Rubio C. , Serrano G. E. , Miller M. W. 
Published: March 2010

SUMMARY
Octopamine-like immunoreactivity was localized to a limited number (&lt;40) of neurons in the Aplysia central nervous system, including three neurons in the paired buccal ganglia (BG) that control feeding movements. Application of octopamine (OA) to the BG circuit produced concentration-dependent (10−8–10−4 mol l−1) modulatory actions on the spontaneous burst activity of the bilaterally paired B67 pharyngeal motor neurons (MNs). OA increased B67's burst duration and the number of impulses per burst. These effects reflected actions of OA on the intrinsic tetrodotoxin-resistant driver potential (DP) that underlies B67 bursting. In addition to its effects on B67's burst parameters, OA also increased the rate and regularity of burst timing. Although the bilaterally paired B67 MNs both exhibited rhythmic bursting in the presence of OA, they did not become synchronized. In this respect, the response to OA differed from that of dopamine, another modulator of the feeding motor network, which produces both rhythmicity and synchrony of bursting in the paired B67 neurons. It is proposed that modulators can regulate burst synchrony of MNs by exerting a dual control over their intrinsic rhythmicity and their reciprocal capacity to generate membrane potential perturbations. In this simple system, dopaminergic and octopaminergic modulation could influence whether pharyngeal contractions occur in a bilaterally synchronous or asynchronous fashion.
Risk of Cutting Certain Medication Patches; Warfarin by Generic Name; Why Doctors Must Include Medication Purpose on Prescriptions; Carac-Kuric Mix-Ups
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: March 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800–233–7767 (800–23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Safety and Efficacy of Intensive Insulin Therapy in Patients with Thermal Injury
Authors: Patel Mallika P. , Weant Kyle A. , Ritter Britt A. , Cairns Bruce A. 
Published: March 2010

Purpose To evaluate the safety and efficacy of intensive insulin therapy (IIT) versus traditional corrective insulin management (CIM) for the treatment of hyperglycemia in adult patients with thermal injury who are under intensive care. Methods Using a searchable pharmacy database, a retrospective, observational chart review was conducted of adult patients who were admitted to the surgical burn service intensive care unit (ICU) at the University of North Carolina Hospitals (UNCH) from January 2004 through December 2005 and who had received insulin therapy. Results Seventy-one patients qualified for analysis. The average morning serum blood glucose value while patients were receiving IIT, defined as 80 to 110 mg/dL, was 107 mg/dL compared with 124 mg/dL while patients were receiving CIM ( P < 0.001). Of morning serum blood glucose values taken, 49% were within the target range in patients receiving IIT compared with 34% in patients receiving CIM ( P < 0.001). No significant differences were found between the 2 groups with regard to mortality, ICU stay, or hospital stay. More patients experienced hypoglycemia (blood glucose value less than 50 mg/dL) while receiving IIT compared with CIM (36.4% vs 31.3%; P = 0.732); however, none of the patients had symptomatic hypoglycemia. There was a significantly higher rate of hypoglycemia among nonsurvivors compared with survivors (66.7% vs 26.4%; P = 0.006). Conclusion IIT lowers average morning blood glucose in the thermal injury population when compared with CIM. Differences in hypoglycemic events were observed in this review; however, none of the episodes were symptomatic. Although further study is needed, IIT appears to be a safe and effective method of controlling serum blood glucose values in this specialized population.
A Review of Critical Differences among Loop, Thiazide, and Thiazide-Like Diuretics
Authors: Min Bokyung , White C. Michael 
Published: March 2010

Diuretics are a drug class with heterogeneous assortments. This article reviews general pharmacologic mechanisms and clinical implications of loop, thiazide, and thiazide-like diuretics.Loop diuretics act in the loop of Henle by blocking the sodium-potassium-chloride (Na+-K+-2Cl-) symport. They are effective in relieving congestive symptoms and edematous signs of heart failure. Activation of the neurohormonal system and subsequent pathologic myocardial remodeling limit the use of loop diuretics unless fluid balance is not met to relieve patients' symptoms with life-saving pharmacologic modalities. Adverse effects on electrolyte balance may cause life-threatening consequences. The combination of K+-sparing diuretics or angiotensin-converting enzyme inhibitors with loop diuretics may not only prevent life-threatening complications caused by electrolyte imbalance, but also may delay progression of the disease with proven mortality benefit. Recent findings of worsening renal function and higher mortality rate with the use of oral and intravenous loop diuretics further demands appropriate use of these drugs.Thiazide diuretics and thiazide-like diuretics act in the distal convoluted tubule by blocking Na+-Cl-symport. Thiazide diuretics reduce cardiovascular mortality by achieving target blood pressure in patients with hypertension. Compared with other antihypertensive drugs, thiazide diuretics have less desirable metabolic effects. However, it has not yet been shown that the negative metabolic effects of these drugs are associated with negative mortality and morbidity. Based on the need for a multidrug regimen to reach target blood pressure in most patients with hypertension, thiazide diuretics may be used in addition to a drug or drugs without metabolic complications.
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers
Authors: Sturgeon Catharine M , Duffy Michael J , Hofmann Barry R , Lamerz Rolf , Fritsche Herbert A , Gaarenstroom Katja , Bonfrer Johannes , Ecke Thorsten H , Grossman H Barton , Hayes Peter , Hoffmann Ralf-Thorsten , Lerner Seth P , Löhe Florian , Louhimo Johanna , Sawczuk Ihor , Taketa Kazuhisa , Diamandis Eleftherios P 
Published: March 2010

AbstractBackground: Updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed.Methods: Published reports relevant to use of tumor markers for 4 cancer sites—liver, bladder, cervical, and gastric—were critically reviewed.Results: α-Fetoprotein (AFP) may be used in conjunction with abdominal ultrasound for early detection of hepatocellular carcinoma (HCC) in patients with chronic hepatitis or cirrhosis associated with hepatitis B or C virus infection. AFP concentrations &gt;200 μg/L in cirrhotic patients with typical hypervascular lesions &gt;2 cm in size are consistent with HCC. After a diagnosis of HCC, posttreatment monitoring with AFP is recommended as an adjunct to imaging, especially in the absence of measurable disease.Although several urine markers have been proposed for bladder cancer, none at present can replace routine cystoscopy and cytology in the management of patients with this malignancy. Some may, however, be used as complementary adjuncts to direct more effective use of clinical procedures.Although carcinoembryonic antigen and CA 19-9 have been proposed for use gastric cancer and squamous cell carcinoma antigen for use in cervical cancer, none of these markers can currently be recommended for routine clinical use.Conclusions: Implementation of these recommendations should encourage optimal use of tumor markers for patients with liver, bladder, cervical, or gastric cancers.
Comparison of Cystatin C and Creatinine as Predictors of Cardiovascular Events in a Community-Based Elderly Population
Authors: Beilby John , Divitini Mark L , Knuiman Matthew W , Rossi Enrico , Hung Joseph 
Published: March 2010

AbstractBackground: Reduced renal function is an established risk factor for cardiovascular events. We compared 3 measures of renal function—serum cystatin C, serum creatinine, and calculated creatinine clearance—as predictors of subsequent cardiovascular events in a community-based population of elderly individuals.Methods: Comprehensive cardiovascular risk factor data were available for 1410 surviving participants of previous Busselton health surveys who were ≥60 years old. Hazard ratios for risk of incident coronary heart disease and cardiovascular disease over 10 years of follow-up were derived for each baseline measure of renal function by use of Cox regression.Results: All measures of renal function were significantly related to risks of morbidity and mortality from coronary heart disease and cardiovascular disease. There were 453 incident cardiovascular disease events; and the age- and sex-adjusted hazard ratios (95% CIs) were 1.34 (1.23–1.46), 1.32 (1.20–1.45), and 1.22 (1.06–1.41) per 1-SD deterioration in cystatin C, creatinine, and creatinine clearance, respectively. All 3 measures gave approximately the same age-adjusted relative risk estimates. After further adjustment for established cardiovascular risk factors, the relative risk estimates were all reduced but remained statistically significant (P &lt; 0.05). Cystatin C was not a significant predictor for cardiovascular disease after adjustment for creatinine clearance.Conclusions: In relation to predicting risk for coronary heart disease or cardiovascular disease over a 10-year follow-up in a community-based population of elderly subjects, there was no evidence that cystatin C was a better risk predictor than creatinine or creatinine clearance.
Recovery of pituitary function in the late-postoperative phase after pituitary surgery: results of dynamic testing in patients with pituitary disease by insulin tolerance test 3 and 12 months after surgery
Authors: Berg C , Meinel T , Lahner H , Mann K , Petersenn S 
Published: March 2010

The insulin tolerance test (ITT) is considered the gold standard for assessment of GH and ACTH reserve in patients with pituitary disease following pituitary surgery and is usually performed after 6–12 weeks. However, abnormal axes may not be completely recovered by then. The aim of this study was to evaluate dynamic testing 3 and 12 months after transsphenoidal pituitary surgery.Design and patientsSerial dynamic testing was performed in 36 patients (13 women, age 18–78) at 3 and 12 months after transsphenoidal surgery.ResultsCompared with 3-month results, median GH peak levels during ITT after 12 months increased by 38% (P<0.05). In patients initially classified as GH deficiency (GHD), median GH peak increased after 12 months by 23% (P<0.05). At 3 and 12 months, 36% (13/36) and 47% (17/36) were GH sufficient respectively. Median cortisol peak levels after 12 months increased by 17% (P<0.01) compared with 3-month ITT. In ACTH-insufficient (AI) patients, peak cortisol levels increased significantly by 12% (P<0.05) at 12 months, and in ACTH-sufficient patients, peak cortisol levels increased significantly by 13% (P<0.05). At 12 months, there was recovery from AI in 11% of the patients, and recovery from GHD in 11% of patients.ConclusionsSerial dynamic testing results in a change in classification by ITT results in a relevant proportion of patients. Dynamic testing should be repeated during follow-up.
Diagnosis and localisation of insulinoma: the value of modern magnetic resonance imaging in conjunction with calcium stimulation catheterisation
Authors: Druce Maralyn R , Muthuppalaniappan Vasantha M , O'Leary Benjamin , Chew Shern L , Drake William M , Monson John P , Akker Scott A , Besser Michael , Sahdev Anju , Rockall Andrea , Vyas Soumil , Bhattacharya Satya , Matson Matthew , Berney Daniel , Grossman Ashley B 
Published: March 2010

ContextPreoperative localisation of insulinoma improves cure rate and reduces complications, but may be challenging.ObjectiveTo review diagnostic features and localisation accuracy for insulinomas.DesignCross-sectional, retrospective analysis.SettingA single tertiary referral centre.PatientsPatients with insulinoma in the years 1990–2009, including sporadic tumours and those in patients with multiple endocrine neoplasia syndromes.InterventionsPatients were identified from a database, and case notes and investigation results were reviewed. Tumour localisation by computed tomography (CT), magnetic resonance imaging (MRI), octreotide scanning, endoscopic ultrasound (EUS) and calcium stimulation was evaluated.Main outcome measure(s)Insulinoma localisation was compared to histologically confirmed location following surgical excision.ResultsThirty-seven instances of biochemically and/or histologically proven insulinoma were identified in 36 patients, of which seven were managed medically. Of the 30 treated surgically, 25 had CT (83.3%) and 28 had MRI (90.3%), with successful localisation in 16 (64%) by CT and 21 (75%) by MRI respectively. Considered together, such imaging correctly localised 80% of lesions. Radiolabelled octreotide scanning was positive in 10 out of 20 cases (50%); EUS correctly identified 17 lesions in 26 patients (65.4%). Twenty-seven patients had calcium stimulation testing, of which 6 (22%) did not localise, 17 (63%) were correctly localised, and 4 (15%) gave discordant or confusing results.ConclusionsPreoperative localisation of insulinomas remains challenging. A pragmatic combination of CT and especially MRI predicts tumour localisation with high accuracy. Radionuclide imaging and EUS were less helpful but may be valuable in selected cases. Calcium stimulation currently remains useful in providing an additional functional perspective.
Correlates of Picuriste Use in a Sample of Health-Seeking Haitian Immigrants and Adult Children of Immigrants in Miami–Dade County, Florida
Authors: Rahill Guitele J. , Rice Christopher 
Published: March 2010

Objectives. We explored covariates of the use of picuristes (traditional health workers with no formal medical training who provide intramuscular, subcutaneous, and intravenous injections, typically with nonsterile needles) in the Haitian community of Miami–Dade County, Florida. Methods. We surveyed a community-based sample of 205 Haitian immigrants and adult children of Haitian immigrants. Through logistic regression analysis, we sought to corroborate the correlates of picuriste use identified in previous qualitative interviews of picuristes and their clients. Results. Picuriste injections had been obtained by 17.6% of our respondents. After control for demographic characteristics, we found that participants who reported that a trusted person recommended a picuriste were 3.9 times as likely as participants without a recommendation to have used a picuriste. Similarly, participants who believed that the benefits associated with picuriste use were worth any resulting problems were 4.5 times as likely as those without this belief to have patronized a picuriste. Conclusions. A significant minority of our sample patronized picuristes. Our data identified factors associated with picuriste use and shed light on a frequently hidden cultural health behavior.
Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Migrant Status
Authors: Gomez Scarlett Lin , Quach Thu , Horn-Ross Pamela L. , Pham Jane T. , Cockburn Myles , Chang Ellen T. , Keegan Theresa H. M. , Glaser Sally L. , Clarke Christina A. 
Published: March 2010

Objectives. We estimated trends in breast cancer incidence rates for specific Asian populations in California to determine if disparities exist by immigrant status and age. Methods. To calculate rates by ethnicity and immigrant status, we obtained data for 1998 through 2004 cancer diagnoses from the California Cancer Registry and imputed immigrant status from Social Security Numbers for the 26% of cases with missing birthplace information. Population estimates were obtained from the 1990 and 2000 US Censuses. Results. Breast cancer rates were higher among US- than among foreign-born Chinese (incidence rate ratio [IRR] = 1.84; 95% confidence interval [CI] = 1.72, 1.96) and Filipina women (IRR = 1.32; 95% CI = 1.20, 1.44), but similar between US- and foreign-born Japanese women. US-born Chinese and Filipina women who were younger than 55 years had higher rates than did White women of the same age. Rates increased over time in most groups, as high as 4% per year among foreign-born Korean and US-born Filipina women. From 2000–2004, the rate among US-born Filipina women exceeded that of White women. Conclusions. These findings challenge the notion that breast cancer rates are uniformly low across Asians and therefore suggest a need for increased awareness, targeted cancer control, and research to better understand underlying factors.
HIV Counseling and Testing Among Hispanics at CDC-Funded Sites in the United States, 2007
Authors: Duran Denise , Usman Hussain R. , Beltrami John , Alvarez Maria E. , Valleroy Linda , Lyles Cynthia M. 
Published: March 2010

Objectives. We sought to determine whether Hispanic–White HIV testing disparities exist and to identify characteristics associated with newly diagnosed HIV among Hispanics. Methods. We used 2007 HIV Counseling and Testing System data to compare test-level records of Hispanics and non-Hispanic Whites, and we conducted a multivariate logistic regression analysis to identify characteristics associated with newly diagnosed HIV. Results. Relative to Whites, Hispanics were more likely to have had a positive HIV test result (1.2% versus 0.8%), to have newly diagnosed HIV (0.8% versus 0.6%), and to have test results returned and receive posttest counseling more than 2 weeks after testing (24.3% versus 21.5%). Newly diagnosed HIV among Hispanics was most strongly associated with being a man who has sex with men (MSM; adjusted odds ratio [AOR] = 6.8; 95% confidence interval [CI] = 6.1, 7.6), being both an MSM and an injection drug user (AOR = 3.7; 95% CI = 2.6, 5.3), and being aged 40 to 49 years (AOR = 6.4; 95% CI = 4.9, 8.2). Conclusions. Hispanic–White disparities exist with respect to rates of positive HIV test results and late return of results. HIV prevention strategies such as rapid testing should focus on Hispanic MSM.
Finding Synergy: Reducing Disparities in Health by Modifying Multiple Determinants
Authors: Freudenberg Nicholas , Olden Kenneth 
Published: March 2010

Although researchers acknowledge that health disparities have multiple determinants, most recommendations for reducing inequities focus on a single approach. We suggest integrating 2 approaches for reducing disparities: improving access to primary care and updating and more vigorously enforcing consumer and environmental protection laws. This strategy could reduce the main causes of disparities, such as chronic diseases and injuries; win public and policymaker support; and provide a cost-effective start for achieving equity. Most of the scientific knowledge needed to implement this strategy exists, thus years of additional research would not be needed. Developing targeted regulatory and health care policies to reduce deaths from chronic diseases and injuries would be a major step forward in eliminating health disparities in the United States.
Using Motivational Interviewing in HIV Field Outreach With Young African American Men Who Have Sex With Men: A Randomized Clinical Trial
Authors: Outlaw Angulique Y. , Naar-King Sylvie , Parsons Jeffrey T. , Green-Jones Monique , Janisse Heather , Secord Elizabeth 
Published: March 2010

Objectives. We sought to determine whether field outreach with motivational interviewing, as compared with traditional field outreach, leads to increases in HIV counseling and testing and rates of return for test results among young African American men who have sex with men (MSM). Methods. In a randomized, 2-group, repeated-measures design, 96 young African American MSM completed a motivational interviewing—based field outreach session and 92 young African American MSM completed a traditional field outreach session. The percentages of participants agreeing to traditional HIV counseling and testing (an oral swab of the cheek) and returning for test results were the primary outcome measures. Results. More of the participants in the motivational interviewing condition than the control condition received HIV counseling and testing (49% versus 20%; χ21 = 17.94; P = .000) and returned for test results (98% versus 72%; χ21 = 10.22; P = .001). Conclusions. The addition of motivational interviewing to field outreach is effective in encouraging high-risk young African American MSM to learn their HIV status. Also, peer outreach workers can be effectively trained to reduce health disparities by providing evidence-based brief counseling approaches targeting high-risk minority populations.
Results of a Pilot Diabetes Prevention Intervention in East Harlem, New York City: Project HEED
Authors: Parikh Punam , Simon Ellen P. , Fei Kezhen , Looker Helen , Goytia Crispin , Horowitz Carol R. 
Published: March 2010

Objectives. Our community–academic partnership employed community-based participatory research to develop and pilot a simple, peer-led intervention to promote weight loss, which can prevent diabetes and eliminate racial/ethnic disparities in incident diabetes among overweight adults with prediabetes.Methods. We recruited overweight adults at community sites, performed oral glucose tolerance testing to identify persons with blood glucose levels in the prediabetes range, and randomized eligible people to a peer-led lifestyle intervention group or delayed intervention in 1 year. Outcomes, including weight, blood pressure, and health behaviors, were measured at baseline and 3, 6, and 12 months.Results. More than half of those tested (56%, or 99 of 178) had prediabetes and enrolled in the study. Participants were predominantly Spanish-speaking, low-income, undereducated women. The intervention group lost significantly more weight than the control group and maintained weight loss at 12 months (7.2 versus 2.4 pounds; P < .01). One fourth (24 of 99) of participants progressed to diabetes.Conclusions. In underserved minority communities, prediabetes prevalence may be higher than previously reported. Low-cost, community-based interventions can succeed in encouraging weight loss to prevent diabetes.