Skip to navigation Skip to content
  • Woodruff
  • Business
  • Health Sciences
  • Law
  • MARBL
  • Oxford College
  • Theology
  • Schools
    • Undergraduate

      • Emory College
      • Oxford College
      • Business School
      • School of Nursing

      Community

      • Emory College
      • Oxford College
      • Business School
      • School of Nursing
    • Graduate

      • Business School
      • Graduate School
      • School of Law
      • School of Medicine
      • School of Nursing
      • School of Public Health
      • School of Theology
  • Libraries
    • Libraries

      • Robert W. Woodruff
      • Business
      • Chemistry
      • Health Sciences
      • Law
      • MARBL
      • Music & Media
      • Oxford College
      • Theology
    • Library Tools

      • Course Reserves
      • Databases
      • Digital Scholarship (ECDS)
      • discoverE
      • eJournals
      • Electronic Dissertations
      • EmoryFindingAids
      • EUCLID
      • ILLiad
      • OpenEmory
      • Research Guides
  • Resources
    • Resources

      • Administrative Offices
      • Emory Healthcare
      • Academic Calendars
      • Bookstore
      • Campus Maps
      • Shuttles and Parking
      • Athletics: Emory Eagles
      • Arts at Emory
      • Michael C. Carlos Museum
      • Emory News Center
      • Emory Report
    • Resources

      • Emergency Contacts
      • Information Technology (IT)
      • Outlook Web Access
      • Office 365
      • Blackboard
      • OPUS
      • PeopleSoft Financials: Compass
      • Careers
      • Human Resources
      • Emory Alumni Association
  • Browse
    • Works by Author
    • Works by Journal
    • Works by Subject
    • Works by Dept
    • Faculty by Dept
  • For Authors
    • How to Submit
    • Deposit Advice
    • Author Rights
    • Publishing Your Data
    • FAQ
    • Emory Open Access Policy
    • Open Access Fund
  • About OpenEmory
    • About OpenEmory
    • About Us
    • Citing Articles
    • Contact Us
    • Privacy Policy
    • Terms of Use
 
Contact Us

Filter Results:

Author

  • Alonso, Alvaro (4)
  • Thourani, Vinod (4)
  • Addo, O. (3)
  • Arbiser, Jack (3)
  • Bell, Edward F. (3)
  • Chen, Lin Y. (3)
  • Das, Abhik (3)
  • Higgins, Rosemary D. (3)
  • Mehta, Puja Kiran (3)
  • Poindexter, Brenda B. (3)
  • Rimland, David (3)
  • Shankaran, Seetha (3)
  • Soliman, Elsayed Z. (3)
  • Suchdev, Parminder (3)
  • Tangpricha, Vin (3)
  • Yoon, Young-sup (3)
  • Babaliaros, Vasilis (2)
  • Bunting, Kevin (2)
  • Costa, Adilson (2)
  • Cotten, C. Michael (2)
  • DeMauro, Sara B. (2)
  • Flores-Ayala, Rafael (2)
  • Guidot, David M (2)
  • Han, Ji Woong (2)
  • Hoover Jr, Robert (2)
  • Justice, Amy C. (2)
  • Khoury, H Jean (2)
  • Kugathasan, Subra (2)
  • Laptook, Abbot R. (2)
  • Park, In-Hyun (2)
  • Ressler, Kerry (2)
  • Saber, Wael (2)
  • Schibler, Kurt (2)
  • Serdula, Mary (2)
  • Shaw, Leslee J (2)
  • Shufelt, Chrisandra (2)
  • Sperling, Laurence (2)
  • Stoll, Barbara (2)
  • Taylor, W Robert (2)
  • Tyson, Jon E. (2)
  • Van Meurs, Krisa P. (2)
  • Walsh, Michele C. (2)
  • Wang, Tracy Y. (2)
  • Warshaw, Barry L (2)
  • Watterberg, Kristi L. (2)
  • Wei, Ling (2)
  • Wei, Zheng Zachory (2)
  • Yu, Shan Ping (2)
  • Ziegler, Thomas R (2)
  • Abbott, Brian (1)
  • Abdalla, Adil (1)
  • Abdel-Azim, Hisham (1)
  • Abou Jamra, Rami (1)
  • Abraham, Efrem S. (1)
  • Abshire, Demetrius A. (1)
  • Achenbach, Stephan (1)
  • Adams, Darius J. (1)
  • Adrian, Peter V. (1)
  • Afthinos, A (1)
  • Aggarwal, Rohit (1)
  • Ahmadi, Tahamtan (1)
  • Ahmed, Rafi (1)
  • Ahn, Hyunhee (1)
  • Ailawadi, Gorav (1)
  • Ainsley, Christopher (1)
  • Akgun, KAthleen (1)
  • Akgun, Kathleen M. (1)
  • Al-Mallah, Mouaz (1)
  • Al-Sayegh, Hasan (1)
  • AlBadri, Ahmed (1)
  • Albrich, Werner C. (1)
  • Aldhouse, Natalie V. J. (1)
  • Alexander, John H. (1)
  • Alexander, Peta (1)
  • Ali, Mohammed (1)
  • Aljurf, Mahmoud (1)
  • Almaskeen, Sami (1)
  • Almli, Lynn M. (1)
  • Almond, Christopher SD (1)
  • Alousi, Amin (1)
  • Alu, Maria C. (1)
  • Alvarez, Jessica A. (1)
  • Alvarez, Susana (1)
  • Alvarez, Xavier (1)
  • Amatruda, James F. (1)
  • Ambalavanan, Namasivayam (1)
  • Ambiel, Sarah-Marie (1)
  • Amstadter, Anada B. (1)
  • An, Hyo Jae (1)
  • An, L (1)
  • Ananthakrishnan, Ashwin N. (1)
  • Anderson, Brett R. (1)
  • Anderson, D.C. (1)
  • Anderson, Evan (1)
  • Anderson, Monique L. (1)
  • Anderson, R. David (1)
  • Andersson, Fredrik L. (1)
  • Andreini, Daniele (1)
  • Andukuri, Adinarayana (1)
  • Ansari, Aftab (1)

Subject

  • Health Sciences, Medicine and Surgery (31)
  • Health Sciences, Oncology (19)
  • Health Sciences, Public Health (15)
  • Health Sciences, Immunology (9)
  • Health Sciences, Pathology (9)
  • Health Sciences, Epidemiology (7)
  • Biology, Microbiology (4)
  • Biology, Neuroscience (4)
  • Chemistry, Biochemistry (4)
  • Health Sciences, Radiology (4)
  • Biology, Biostatistics (3)
  • Biology, Physiology (3)
  • Engineering, Biomedical (3)
  • Health Sciences, Human Development (3)
  • Health Sciences, Pharmacology (3)
  • Biology, Molecular (2)
  • Biology, Virology (2)
  • Environmental Sciences (2)
  • Health Sciences, Health Care Management (2)
  • Health Sciences, Nursing (2)
  • Health Sciences, Nutrition (2)
  • Psychology, General (2)
  • Biology, Bioinformatics (1)
  • Biology, Cell (1)
  • Biology, General (1)
  • Education, Social Sciences (1)
  • Education, Technology (1)
  • Engineering, Mechanical (1)
  • Health Sciences, Obstetrics and Gynecology (1)
  • Health Sciences, Opthamology (1)
  • Health Sciences, Rehabilitation and Therapy (1)
  • Library Science (1)
  • Mathematics (1)
  • Psychology, Behavioral (1)

Journal

  • Journal of the American Heart Association (4)
  • Oncotarget (4)
  • PLoS ONE (4)
  • Scientific Reports (4)
  • Frontiers in Immunology (3)
  • American Journal of Clinical Nutrition (2)
  • Annals of Thoracic Surgery (2)
  • Cancer (2)
  • Circulation Research (2)
  • Clinical Infectious Diseases (2)
  • Critical Care Medicine (2)
  • EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging (2)
  • Genome Medicine (2)
  • JAMA Cardiology (2)
  • Journal of Clinical Microbiology (2)
  • Journal of Medical Genetics (2)
  • Journal of Pediatrics (2)
  • Nature Communications (2)
  • Oncogene (2)
  • Patient Preference and Adherence (2)
  • Pediatric Research (2)
  • Proceedings of the National Academy of Sciences (2)
  • AIDS (1)
  • AIDS and Behavior (1)
  • ASAIO Journal (1)
  • Alcohol Research Current Reviews (1)
  • Alcoholism: Clinical and Experimental Research (1)
  • Alzheimer's and Dementia (1)
  • American Heart Journal (1)
  • American Journal of Cardiology (1)
  • American Journal of Men's Health (1)
  • American Journal of Preventive Medicine (1)
  • American Journal of Respiratory Cell and Molecular Biology (1)
  • American Journal of Transplantation (1)
  • Annals of the American Thoracic Society (1)
  • Annals of the Rheumatic Diseases (1)
  • Archives of Medical Science (1)
  • Arquivos Brasileiros de Cardiologia (1)
  • BMC Cancer (1)
  • BMC Health Services Research (1)
  • Bone Marrow Transplantation (1)
  • Bulletin of the World Health Organization (1)
  • Cancer Causes and Control (1)
  • Catheterization and Cardiovascular Interventions (1)
  • Cell Transplantation (1)
  • Circulation (1)
  • Clinical Cardiology (1)
  • Clinical Pharmacokinetics (1)
  • Clinical and Translational Oncology (1)
  • Conflict and Health (1)
  • Contemporary Clinical Trials (1)
  • Current Opinion in Critical Care (1)
  • Emerging Microbes and Infections (1)
  • Environmental Toxicology and Pharmacology (1)
  • European Journal of Immunology (1)
  • Frontiers in Computational Neuroscience (1)
  • Frontiers in Psychiatry (1)
  • Gastroenterology Report (1)
  • Haematologica (1)
  • Heart Rhythm (1)
  • Hepatology (1)
  • Hypertension (1)
  • International Forum of Allergy and Rhinology (1)
  • International Journal of Cardiovascular Imaging (1)
  • International Journal of Dermatology (1)
  • International Journal of Environmental Research and Public Health (1)
  • International Journal of Radiation Oncology - Biology - Physics (1)
  • JAMA Dermatology (1)
  • JAMA Internal Medicine (1)
  • JAMA Pediatrics (1)
  • JAMA Surgery (1)
  • JNCI: Journal of the National Cancer Institute (1)
  • Journal of Acquired Immune Deficiency Syndromes (1)
  • Journal of Allergy and Clinical Immunology: In Practice (1)
  • Journal of Applied Clinical Medical Physics (1)
  • Journal of Child and Adolescent Substance Abuse (1)
  • Journal of Clinical Oncology (1)
  • Journal of Infectious Diseases (1)
  • Journal of Lipid Research (1)
  • Journal of Neuro-Oncology (1)
  • Journal of Neuroinflammation (1)
  • Journal of Nuclear Cardiology (1)
  • Journal of Parenteral and Enteral Nutrition (1)
  • Journal of Pediatric Gastroenterology and Nutrition (1)
  • Journal of Steroid Biochemistry and Molecular Biology (1)
  • Journal of Thoracic and Cardiovascular Surgery (1)
  • Journal of Virology (1)
  • Journal of the American College of Cardiology (1)
  • Journal of the American Medical Association (1)
  • Lancet Gastroenterology and Hepatology (1)
  • MMWR. Morbidity and mortality weekly report (1)
  • Maternal and Child Nutrition (1)
  • Medical Reference Services Quarterly (1)
  • Molecular Oncology (1)
  • Mucosal Immunology (1)
  • Nature Genetics (1)
  • Nature Microbiology (1)
  • Neural Regeneration Research (1)
  • Neurobiology of Disease (1)
  • Nutrition in Clinical Practice (1)

Keyword

  • scienc (149)
  • life (139)
  • biomedicin (136)
  • diseas (52)
  • system (35)
  • cell (34)
  • cardiovascular (32)
  • factor (29)
  • cardiac (26)
  • risk (26)
  • cardiolog (25)
  • health (23)
  • care (22)
  • medicin (22)
  • outcom (20)
  • associ (18)
  • heart (18)
  • trial (18)
  • oncolog (17)
  • protein (17)
  • biolog (16)
  • children (16)
  • immunolog (16)
  • infect (16)
  • pediatr (16)
  • therapi (16)
  • surviv (15)
  • topic (15)
  • control (14)
  • other (14)
  • stem (14)
  • syndrom (14)
  • activ (13)
  • express (13)
  • general (13)
  • 1 (12)
  • in (12)
  • intern (12)
  • model (12)
  • multidisciplinari (12)
  • acut (11)
  • blood (11)
  • gene (11)
  • human (11)
  • mortal (11)
  • patient (11)
  • preval (11)
  • receptor (11)
  • respiratori (11)
  • stemcel (11)
  • surgeri (11)
  • transplant (11)
  • alpha (10)
  • cancer (10)
  • environment (10)
  • failur (10)
  • growth (10)
  • molecular (10)
  • public (10)
  • random (10)
  • virus (10)
  • chronic (9)
  • clinic (9)
  • coronari (9)
  • genet (9)
  • inflamm (9)
  • medic (9)
  • occup (9)
  • research (9)
  • 2 (8)
  • american (8)
  • analysi (8)
  • arteri (8)
  • bind (8)
  • biochemistri (8)
  • function (8)
  • hered (8)
  • hiv (8)
  • invitro (8)
  • manag (8)
  • microbiolog (8)
  • qualiti (8)
  • vitro (8)
  • adult (7)
  • b (7)
  • beta (7)
  • brain (7)
  • c (7)
  • comput (7)
  • controlledtri (7)
  • immun (7)
  • immunodefici (7)
  • injuri (7)
  • ischemia (7)
  • metabol (7)
  • mice (7)
  • neurolog (7)
  • neurosci (7)
  • nuclear (7)

Author affiliation

  • Adjunct Professor, SOM: Department of Medicine, Division of Cardiology (1)
  • Atlanta Center for Microsystems Enabled Point-of-Care Technologies (ACME POCT) (1)
  • Atlanta VA Medical Center (1)
  • Baptist Health South Florida (1)
  • Emory Critical Care Center (1)
  • Emory/Georgia Tech Predictive Health Institute (1)
  • Florida international University, Miami (1)
  • Georgia Clinical and Translational Science Alliance (1)
  • Winship Cancer Institute (1)

Author department

  • Medicine: Cardiology (18)
  • Global Health (12)
  • Medicine: Pulmonary (8)
  • HMO: Hematology (7)
  • Medicine: Endocrinology (6)
  • Peds: Infectious Disease (6)
  • Epidemiology (5)
  • Pathology: Admin (5)
  • Surgery: Thoracic (5)
  • Anesthesiology: Admin (4)
  • Gastroenterology (4)
  • Medicine: Infectious Dis (4)
  • Neonatology (4)
  • Nephrology (4)
  • Peds: Administration (4)
  • Peds: Children's Hrt Ctr (4)
  • Peds: Gastroenterology (4)
  • Dermatology: Admin (3)
  • Environmental Health (3)
  • Ophthal: Admin (3)
  • Peds: Leukemia Lymphoma (3)
  • Academic Advancement (2)
  • Biostatistics (2)
  • HMO: Med Onc (2)
  • Health Policy and Mngmnt (2)
  • Medicine: Digestive Dis (2)
  • Medicine: Nephrology (2)
  • Peds: Emory LOBP (2)
  • Peds: Neonatology (2)
  • Physiology: Admin (2)
  • Psych: Admin (2)
  • Rad Onc: Admin (2)
  • Surgery: General (2)
  • BMI: Admin (1)
  • BMT (1)
  • Behav/Soc/Health Educ Sci (1)
  • Biochem: Admin (1)
  • Cell Biology: Admin (1)
  • Critical Care (1)
  • Dean's Office Operating F (1)
  • EVP Health Affairs (1)
  • Emerg Med: Admin (1)
  • FPM: PA Program (1)
  • FPM: Preventive Medicine (1)
  • GYN OB: Admin (1)
  • Hematology (1)
  • Hum Gen: Admin (1)
  • Hum Gen: Medical Genetics (1)
  • Infectious Disease (1)
  • Marcus Center (1)
  • Medicine: Admin (1)
  • Medicine: General Med (1)
  • Medicine: Geriatrics (1)
  • Medicine: Primary Care (1)
  • Medicine: Rheumatology (1)
  • Micro/Immun: Admin (1)
  • Microbiology & Immunology (1)
  • Neuro-Oncology (1)
  • Neurology: Cog Neurobehav (1)
  • Neurology: Sleep (1)
  • Neurosurgery: Admin (1)
  • Orthopaedics: Admin (1)
  • Otolaryngology:Admin (1)
  • Peds: Marcus Center (1)
  • Peds: Neuro-Oncology (1)
  • Peds: Pulmonology (1)
  • Pharmacology: Admin (1)
  • Physics (1)
  • Rad: Admin (1)
  • Rad: Cardio Thoracic (1)
  • Rad: Interventional (1)
  • Rehab: Admin (1)
  • Rheumatology (1)
  • SR Hem/Onc Profee (1)
  • Sickle Cell (1)
  • Sr Vice President For Research (1)
  • Surgery: Transplant (1)
  • Urology: Admin (1)
  • WHSC Library (1)
  • Winship Cancer Institute (1)

Search Results for all work with filters:

  • 2017
  • Health Sciences, General
  • technolog

Work 1-10 of 150

Sorted by relevance
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. ...
>

Article

An Aggregate Biomarker Risk Score Predicts High Risk of Near-Term Myocardial Infarction and Death: Findings From BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes)

by Nima Ghasemzadeh; Maria M. Brooks; Helen Vlachos; Regina Hardison; Sergey Sikora; Laurence Sperling; Arshed Quyyumi; Stephen E. Epstein

2017

Subjects
  • Health Sciences, Public Health
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

Background-In a previous study, we found that a biomarker risk score (BRS) comprised of C-reactive protein, fibrin-degradation products, and heat shock protein-70 predicts risk of myocardial infarction and death in coronary artery disease patients. We sought to: (1) validate the BRS in the independent BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) cohort, (2) investigate whether 1 year of intensive medical therapy is associated with improved BRS, and (3) elucidate whether an altered BRS parallels altered risk. Methods and Results-Two thousand thirty-two subjects with coronary artery disease were followed for 5.3±1.1 years for cardiovascular events. Biomarkers were measured at baseline and retested in 1304 subjects at 1 year. BRS was determined as the biomarker number above previously defined cut-off values (C-reactive protein > 3 mg/L, heat shock protein-70 > 0.313 ng/mL, and fibrin-degradation products > 1 lg/mL). After adjustment for covariates, those with a BRS of 3 had a 4-fold increased risk of allcause death and a 6.8-fold increased risk of cardiac death compared with those with a BRS of 0 (95% CI, 2.9-16.0; P < 0.0001). All individual biomarkers decreased by 1 year, with ≈80% of patients decreasing their BRS. BRS recalibrated at 1 year also predicted risk. Those with 1-year BRS of 2 to 3 had a 4-year mortality rate of 21.1% versus 7.4% for those with BRS of 0 to 1 (P < 0.0001). Conclusions-Our results validate the ability of the BRS to identify coronary artery disease patients at very high near-term risk of myocardial infarction/death. After 1 year of intensive medical therapy, the BRS decreased significantly, and the reclassified BRS continued to track with risk. Our results suggest that repeated BRS measurements might be used to assess risk and recalibrate therapy.

Article

Economics of Self-Measured Blood Pressure Monitoring: A Community Guide Systematic Review

by Verughese Jacob; Sajal K. Chattopadhyay; Krista K. Proia; David P. Hopkins; Jeffrey Reynolds; Anilkrishna B. Thota; Christopher D. Jones; Daniel T. Lackland; Kimberly J Rask; Nicolaas P. Pronk; John M. Clymer; Ron Z. Goetzel

2017

Subjects
  • Health Sciences, Public Health
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

Context The health and economic burden of hypertension, a major risk factor for cardiovascular disease, is substantial. This systematic review evaluated the economic evidence of self-measured blood pressure (SMBP) monitoring interventions to control hypertension. Evidence acquisition The literature search from database inception to March 2015 identified 22 studies for inclusion with three types of interventions: SMBP used alone, SMBP with additional support, and SMBP within team-based care (TBC). Two formulae were used to convert reductions in systolic BP (SBP) to quality-adjusted life years (QALYs) to produce cost per QALY saved. All analyses were conducted in 2015, with estimates adjusted to 2014 U.S. dollars. Evidence synthesis Median costs of intervention were $60 and $174 per person for SMBP alone and SMBP with additional support, respectively, and $732 per person per year for SMBP within TBC. SMBP alone and SMBP with additional support reduced healthcare cost per person per year from outpatient visits and medication (medians $148 and $3, respectively; median follow-up, 12–13 months). SMBP within TBC exhibited an increase in healthcare cost (median, $369 per person per year; median follow-up, 18 months). SMBP alone varied from cost saving to a maximum cost of $144,000 per QALY saved, with two studies reporting an increase in SBP. The two translated median costs per QALY saved were $2,800 and $4,000 for SMBP with additional support and $7,500 and $10,800 for SMBP within TBC. Conclusions SMBP monitoring interventions with additional support or within TBC are cost effective. Cost effectiveness of SMBP used alone could not be determined.

Article

Long-term Sustainability of Diabetes Prevention Approaches A Systematic Review and Meta-analysis of Randomized Clinical Trials

by J. Sonya Haw; Karla Galaviz Arredondo; Audrey N. Straus; Alysse J. Kowalski; Matthew Magee; Mary Beth Weber; Jingkai Wei; Kabayam Venkat Narayan; Mohammed Ali

2017

Subjects
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

IMPORTANCE Diabetes prevention is imperative to slowworldwide growth of diabetes-related morbidity and mortality. Yet the long-term efficacy of prevention strategies remains unknown. OBJECTIVE To estimate aggregate long-term effects of different diabetes prevention strategies on diabetes incidence. DATA SOURCES Systematic searches of MEDLINE, EMBASE, Cochrane Library, andWeb of Science databases. The initial search was conducted on January 14, 2014, and was updated on February 20, 2015. Search terms included prediabetes, primary prevention, and risk reduction. STUDY SELECTION Eligible randomized clinical trials evaluated lifestyle modification (LSM) and medication interventions (>6 months) for diabetes prevention in adults (age ≥18 years) at risk for diabetes, reporting between-group differences in diabetes incidence, published between January 1, 1990, and January 1, 2015. Studies testing alternative therapies and bariatric surgery, as well as those involving participants with gestational diabetes, type 1 or 2 diabetes, and metabolic syndrome, were excluded. DATA EXTRACTION AND SYNTHESIS Reviewers extracted the number of diabetes cases at the end of active intervention in treatment and control groups. Random-effects meta-analyses were used to obtain pooled relative risks (RRs), and reported incidence rates were used to compute pooled risk differences (RDs). MAIN OUTCOMES AND MEASURES The main outcomewas aggregate RRs of diabetes in treatment vs control participants. Treatment subtypes (ie, LSM components, medication classes) were stratified. To estimate sustainability, post-washout and follow-up RRs for medications and LSM interventions, respectively, were examined. RESULTS Forty-three studies were included and pooled in meta-analysis (49 029 participants; mean [SD] age, 57.3 [8.7] years; 48.0% [n = 23 549] men): 19 tested medications; 19 evaluated LSM, and 5 tested combined medications and LSM. At the end of the active intervention (range, 0.5-6.3 years), LSM was associated with an RR reduction of 39% (RR, 0.61; 95% CI, 0.54-0.68), and medications were associated with an RR reduction of 36% (RR, 0.64; 95% CI, 0.54-0.76). The observed RD for LSM and medication studies was 4.0 (95% CI, 1.8-6.3) cases per 100 person-years or a number-needed-to-treat of 25. At the end of the washout or follow-up periods, LSM studies (mean follow-up, 7.2 years; range, 5.7-9.4 years) achieved an RR reduction of 28% (RR, 0.72; 95% CI, 0.60-0.86); medication studies (mean follow-up, 17 weeks; range, 2-52 weeks) showed no sustained RR reduction (RR, 0.95; 95% CI, 0.79-1.14). CONCLUSIONS AND RELEVANCE In adults at risk for diabetes, LSM and medications (weight loss and insulin-sensitizing agents) successfully reduced diabetes incidence. Medication effects were short lived. The LSM interventions were sustained for several years; however, their effects declined with time, suggesting that interventions to preserve effects are needed.

Article

Association of Guideline-Adherent Antibiotic Treatment With Readmission of Children With Sickle Cell Disease Hospitalized With Acute Chest Syndrome

by David G. Bundy; Troy E. Richardson; Matthew Hall; Jean L. Raphael; David C. Brousseau; Staci Arnold; Ram V. Kalpatthi; Angela M. Ellison; Suzette O. Oyeku; Samir S. Shah

2017

Subjects
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

IMPORTANCE: Acute chest syndrome (ACS) is a common, serious complication of sickle cell disease (SCD) and a leading cause of hospitalization and death in both children and adults with SCD. Little is known about the effectiveness of guideline-recommended antibiotic regimens for the care of children hospitalized with ACS. OBJECTIVES: To use a large, national database to describe patterns of antibiotic use for children with SCD hospitalized for ACS and to determine whether receipt of guideline-adherent antibiotics was associated with lower readmission rates. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study including 14 480 hospitalizations in 7178 children (age 0-22 years) with a discharge diagnosis of SCD and eithe ACS or pneumonia. Information was obtained from 41 children’s hospitals submitting data to the Pediatric Health Information System from January 1, 2010, to December 31, 2016. EXPOSURES: National Heart, Lung, and Blood Institute guideline-adherent (macrolide with parenteral cephalosporin) vs non–guideline-adherent antibiotic regimens. MAIN OUTCOMES AND MEASURES: Acute chest syndrome–related and all-cause 7- and 30-day readmissions. RESULTS: Of the 14 480 hospitalizations, 6562 (45.3%) were in girls; median (interquartile range) age was 9 (4-14) years. Guideline-adherent antibiotics were provided in 10 654 of 14 480 hospitalizations for ACS (73.6%). Hospitalizations were most likely to include guideline-adherent antibiotics for children aged 5 to 9 years (3230 of 4047 [79.8%]) and declined to the lowest level for children 19 to 22 years (697 of 1088 [64.1%]). Between-hospital variation in antibiotic regimens was wide, with use of guideline-adherent antibiotics ranging from 24% to 90%. Children treated with guideline-adherent antibiotics had lower 30-day ACS-related (odds ratio [OR], 0.71; 95% CI, 0.50-1.00) and all-cause (OR, 0.50; 95% CI, 0.39-0.64) readmission rates vs children who received other regimens (cephalosporin and macrolide vs neither drug class). CONCLUSIONS AND RELEVANCE: Current approaches to antibiotic treatment in children with ACS vary widely, but guideline-adherent therapy appears to result in fewer readmissions compared with non–guideline-adherent therapy. Efforts to increase the dissemination and implementation of SCD treatment guidelines are warranted as is comparative effectiveness research to strengthen the underlying evidence base.

Article

Regulation of actions and habits by ventral hippocampal trkB and adolescent corticosteroid exposure

by Elizabeth T. Barfield; Kyle J. Gerber; Kelsey S. Zimmermann; Kerry Ressler; Ryan G. Parsons; Shannon L Gourley

2017

Subjects
  • Health Sciences, General
  • Health Sciences, Pharmacology
  • Biology, Neuroscience
  • File Download
  • View Abstract

Abstract:Close

In humans and rodents, stress promotes habit-based behaviors that can interfere with action—outcome decision-making. Further, developmental stressor exposure confers long-term habit biases across rodent—primate species. Despite these homologies, mechanisms remain unclear. We first report that exposure to the primary glucocorticoid corticosterone (CORT) in adolescent mice recapitulates multiple neurobehavioral consequences of stressor exposure, including long-lasting biases towards habit-based responding in a food-reinforced operant conditioning task. In both adolescents and adults, CORT also caused a shift in the balance between full-length tyrosine kinase receptor B (trkB) and a truncated form of this neurotrophin receptor, favoring the inactive form throughout multiple corticolimbic brain regions. In adolescents, phosphorylation of the trkB substrate extracellular signal-regulated kinase 42/44 (ERK42/44) in the ventral hippocampus was also diminished, a long-term effect that persisted for at least 12 wk. Administration of the trkB agonist 7,8-dihydroxyflavone (7,8-DHF) during adolescence at doses that stimulated ERK42/44 corrected long-lasting corticosterone-induced behavioral abnormalities. Meanwhile, viral-mediated overexpression of truncated trkB in the ventral hippocampus reduced local ERK42/44 phosphorylation and was sufficient to induce habit-based and depression-like behaviors. Together, our findings indicate that ventral hippocampal trkB is essential to goal-directed action selection, countering habit-based behavior otherwise facilitated by developmental stress hormone exposure. They also reveal an early-life sensitive period during which trkB—ERK42/44 tone determines long-term behavioral outcomes.

Article

Association of Public Health Initiatives With Outcomes for Out-of-Hospital Cardiac Arrest at Home and in Public Locations

by Christopher B. Fordyce; Carolina M. Hansen; Kristian Kragholm; Matthew E. Dupre; James G. Jollis; Mayme L. Roettig; Lance B. Becker; Steen M. Hansen; Tomoya T. Hinohara; Claire C. Corbett; Lisa Monk; R. Darrell Nelson; David A. Pearson; Clark Tyson; Sean van Diepen; Monique L. Anderson; Bryan McNally; Christopher B. Granger

2017

Subjects
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

IMPORTANCE: Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor. OBJECTIVE: To describe temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes. DESIGN, SETTING, AND PARTICIPANTS: This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.3%] in public) for whom resuscitation was attempted using data from the Cardiac Arrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina. EXPOSURES: Patients were stratified by home vs public OHCA. Public health initiatives to improve bystander and first-responder interventions included training members of the general population in CPR and in the use of automated external defibrillators, teaching first responders about team-based CPR (eg, automated external defibrillator use and high-performance CPR), and instructing dispatch centers on recognition of cardiac arrest. MAIN OUTCOMES AND MEASURES: Association of resuscitation efforts with survival and neurological outcomes from 2010 through 2014. RESULTS: Among home OHCA patients (n = 5602), the median age was 64 years, and 62.2% were male; among public OHCA patients (n = 2667), the median age was 68 years, and 61.5% were male. After comprehensive public health initiatives, the proportion of patients receiving bystander CPR increased at home (from 28.3% [275 of 973] to 41.3% [498 of 1206], P < .001) and in public (from 61.0% [275 of 451] to 70.5% [424 of 601], P = .01), while first-responder defibrillation increased at home (from 42.2% [132 of 313] to 50.8% [212 of 417], P = .02) but not significantly in public (from 33.1% [58 of 175] to 37.8% [93 of 246], P = .17). Survival to discharge improved for arrests at home (from 5.7% [60 of 1057] to 8.1% [100 of 1238], P = .047) and in public (from 10.8% [50 of 464] to 16.2% [98 of 604], P = .04). Compared with emergency medical services–initiated CPR and resuscitation, patients with home OHCA were significantly more likely to survive to hospital discharge if they received bystander-initiated CPR and first-responder defibrillation (odds ratio, 1.55; 95% CI, 1.01-2.38). Patients with arrests in public were most likely to survive if they received both bystander-initiated CPR and defibrillation (odds ratio, 4.33; 95% CI, 2.11-8.87). CONCLUSIONS AND RELEVANCE: After coordinated and comprehensive public health initiatives, more patients received bystander CPR and first-responder defibrillation at home and in public, which was associated with improved survival.

Article

Enhanced Therapeutic and Long-Term Dynamic Vascularization Effects of Human Pluripotent Stem Cell-Derived Endothelial Cells Encapsulated in a Nanomatrix Gel

by Shin-Jeong Lee; Young Doug Sohn; Adinarayana Andukuri; Sangsung Kim; Jaemin Byun; Ji Woong Han; In-Hyun Park; Ho-Wook Jun; Young-sup Yoon

2017

Subjects
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

BACKGROUND: Human pluripotent stem cell (hPSC)-derived endothelial cells (ECs) have limited clinical utility because of undefined components in the differentiation system and poor cell survival in vivo. Here, we aimed to develop a fully defined and clinically compatible system to differentiate hPSCs into ECs. Furthermore, we aimed to enhance cell survival, vessel formation, and therapeutic potential by encapsulating hPSC-ECs with a peptide amphiphile (PA) nanomatrix gel. METHODS: We induced differentiation of hPSCs into the mesodermal lineage by culturing on collagen-coated plates with a glycogen synthase kinase 3β inhibitor. Next, vascular endothelial growth factor, endothelial growth factor, and basic fibroblast growth factor were added for endothelial lineage differentiation, followed by sorting for CDH5 (VE-cadherin). We constructed an extracellular matrix-mimicking PA nanomatrix gel (PA-RGDS) by incorporating the cell adhesive ligand Arg-Gly-Asp-Ser (RGDS) and a matrix metalloproteinase-2-degradable sequence. We then evaluated whether the encapsulation of hPSC-CDH5+ cells in PA-RGDS could enhance long-term cell survival and vascular regenerative effects in a hind-limb ischemia model with laser Doppler perfusion imaging, bioluminescence imaging, real-time reverse transcription-polymerase chain reaction, and histological analysis. RESULTS: The resultant hPSC-derived CDH5+ cells (hPSC-ECs) showed highly enriched and genuine EC characteristics and proangiogenic activities. When injected into ischemic hind limbs, hPSC-ECs showed better perfusion recovery and higher vessel-forming capacity compared with media-, PA-RGDS-, or human umbilical vein EC-injected groups. However, the group receiving the PARGDS-encapsulated hPSC-ECs showed better perfusion recovery, more robust and longer cell survival (> 10 months), and higher and prolonged angiogenic and vascular incorporation capabilities than the bare hPSC-EC-injected group. Surprisingly, the engrafted hPSC-ECs demonstrated previously unknown sustained and dynamic vessel-forming behavior: initial perivascular concentration, a guiding role for new vessel formation, and progressive incorporation into the vessels over 10 months. CONCLUSIONS: We generated highly enriched hPSC-ECs via a clinically compatible system. Furthermore, this study demonstrated that a biocompatible PA-RGDS nanomatrix gel substantially improved long-term survival of hPSC-ECs in an ischemic environment and improved neovascularization effects of hPSC-ECs via prolonged and unique angiogenic and vessel-forming properties. This PA-RGDS-mediated transplantation of hPSC-ECs can serve as a novel platform for cell-based therapy and investigation of long-term behavior of hPSC-ECs.

Article

Role of RPL39 in Metaplastic Breast Cancer

by Bhuvanesh Dave; Daniel D. Gonzalez; Zhi-Bin Liu; Xiaoxian Li; Helen Wong; Sergio Granados; Nadeer E. Ezzedine; Douglas H. Sieglaff; Joe E. Ensor; Kathy D. Miller; Milan Radovich; Agda KarinaEtrovic; Steven S. Gross; Olivier Elemento; Gordon B. Mills; Michael Z. Gilcrease; Jenny C. Chang

2017

Subjects
  • Health Sciences, Pathology
  • Health Sciences, General
  • File Download
  • View Abstract

Abstract:Close

Background: Metaplastic breast cancer is one of the most therapeutically challenging forms of breast cancer because of its highly heterogeneous and chemoresistant nature. We have previously demonstrated that ribosomal protein L39 (RPL39) and its gain-of-function mutation A14V have oncogenic activity in triple-negative breast cancer and this activity may be mediated through inducible nitric oxide synthase (iNOS). The function of RPL39 and A14V in other breast cancer subtypes is currently unknown. The objective of this study was to determine the role and mechanism of action of RPL39 in metaplastic breast cancer.Methods: Both competitive allele-specific and droplet digital polymerase chain reaction were used to determine the RPL39 A14V mutation rate in metaplastic breast cancer patient samples. The impact of RPL39 and iNOS expression on patient overall survival was estimated using the Kaplan-Meier method. Co-immunoprecipitation and immunoblot analyses were used for mechanistic evaluation of RPL39.Results: The RPL39 A14V mutation rate was 97.5% (39/40 tumor samples). High RPL39 (hazard ratio = 0.71, 95% confidence interval = 0.55 to 0.91, P = 006) and iNOS expression (P = 003) were associated with reduced patient overall survival. iNOS inhibition with the pan-NOS inhibitor NG-methyl-L-arginine acetate decreased in vitro proliferation and migration, in vivo tumor growth in both BCM-4664 and BCM-3807 patient-derived xenograft models (P = 04 and P = 02, respectively), and in vitro and in vivo chemoresistance. Mechanistically, RPL39 mediated its cancer-promoting actions through iNOS signaling, which was driven by the RNA editing enzyme adenosine deaminase acting on RNA 1.Conclusion: NOS inhibitors and RNA editing modulators may offer novel treatment options for metaplastic breast cancer.

Article

Acetylcholine versus cold pressor testing for evaluation of coronary endothelial function

by Ahmed AlBadri; Janet Wei; Puja Kiran Mehta; Sofy Landes; John W. Petersen; R. David Anderson; Bruce Samuels; Babak Azarbal; Eileen M. Handberg; Quanlin Li; Margo Minissian; Chrisandra Shufelt; Carl J. Pepine; C. Noel Bairey Merz

2017

Subjects
  • Health Sciences, General
  • Biology, Bioinformatics
  • File Download
  • View Abstract

Abstract:Close

Background Assessment of coronary endothelial function with intracoronary acetylcholine (IC-Ach) provides diagnostic and prognostic data in patients with suspected coronary microvascular dysfunction (CMD), but is often not feasible due in part to the time and expertise needed for pharmacologic mixing. Cold pressor testing (CPT) is a simple and safe stimulus useful for either invasive or non-invasive endothelial function testing and myocardial perfusion imaging but has not been specifically evaluated among symptomatic women with signs of ischemic heart disease (IHD) who have no obstructive coronary artery disease (CAD). Methods 163 women with signs and symptoms of IHD and no obstructive CAD from the NHLBIWomen's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) study underwent coronary reactivity testing with a Doppler flow wire (FloWire® Volcano, San Diego, CA) in the proximal left anterior descending artery. Coronary artery diameter and coronary blood flow (CBF) assessed by core lab using QCA before and after IC-Ach (18.2 μg/ ml infused over 3 minutes) and during CPT. Results Mean age was 55 ± 12 years. Rate pressure product (RPP) in response to IC-Ach did not change (baseline to peak, P = 0.26), but increased during CPT (363±1457; P = 0.0028). CBF in response to CPT was poorly correlated to IC-Ach CBF. Change in coronary artery diameter after IC-Ach correlated with change after CPT (r = 0.59, P < 0.001). The correlation coefficient was stronger in subjects with coronary dilation to IC-Ach (r = 0.628, P < 0.001) versus those without dilation (r = 0.353, P = 0.002), suggesting that other factors may be important to this relationship when endothelium is abnormal. Conclusions In women with no obstructive CAD and suspected CMD, coronary diameter changes with IC-Ach and CPT are moderately-well correlated suggesting that CPT testing may be of some use, particularly among patients with normal endothelial function, however, not an alternative to IC-Ach for diagnosis of coronary endothelial dysfunction.

Article

Meditation and Cardiovascular Risk Reduction A Scientific Statement From the American Heart Association

by Glenn Levine; Richard A. Lange; CC. Noel Bairey-Merz; Richard J. Davidson; Kenneth Jamerson; Puja Kiran Mehta; Erin D. Michos; Keith Norris; Indranill Basu Ray; Karen L. Saban; Tina Shah; Richard Stein; Sidney C. Smith

2017

Subjects
  • Health Sciences, General
  • Health Sciences, Health Care Management
  • File Download
  • View Abstract

Abstract:Close

Despite numerous advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains a leading cause of morbidity and mortality. Novel and inexpensive interventions that can contribute to the primary and secondary prevention of cardiovascular disease are of interest. Numerous studies have reported on the benefits of meditation. Meditation instruction and practice is widely accessible and inexpensive and may thus be a potential attractive cost-effective adjunct to more traditional medical therapies. Accordingly, this American Heart Association scientific statement systematically reviewed the data on the potential benefits of meditation on cardiovascular risk. Neurophysiological and neuroanatomical studies demonstrate that meditation can have long-standing effects on the brain, which provide some biological plausibility for beneficial consequences on the physiological basal state and on cardiovascular risk. Studies of the effects of meditation on cardiovascular risk have included those investigating physiological response to stress, smoking cessation, blood pressure reduction, insulin resistance and metabolic syndrome, endothelial function, inducible myocardial ischemia, and primary and secondary prevention of cardiovascular disease. Overall, studies of meditation suggest a possible benefit on cardiovascular risk, although the overall quality and, in some cases, quantity of study data are modest. Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline-directed cardiovascular risk reduction by those interested in this lifestyle modification, with the understanding that the benefits of such intervention remain to be better established. Further research on meditation and cardiovascular risk is warranted. Such studies, to the degree possible, should utilize randomized study design, be adequately powered to meet the primary study outcome, strive to achieve low drop-out rates, include long-term follow-up, and be performed by those without inherent bias in outcome.
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. ...
>
Site Statistics
  • 28,513
  • Total Works
  • 7,481,406
  • Downloads
  • 98,345
  • Downloads This Year
  • 6,807
  • Faculty Profiles

Copyright © 2016 Emory University - All Rights Reserved
540 Asbury Circle, Atlanta, GA 30322-2870
(404) 727-6861
Privacy Policy | Terms & Conditions

v2.2.8-dev

Contact Us Recent and Popular Items
Download now