Rosso D,Bolzonella D
Department of Civil and Environmental Engineering, University of California, Irvine CA 92697-2175, USA. bidui@uci.edu
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Carbon footprint of aerobic biological treatment of winery wastewater.
Water Sci Technol. 2009;60(5):1185-9
The carbon associated with wastewater and its treatment accounts for approximately 6% of the global carbon balance. Within the wastewater treatment industry, winery wastewater has a minor contribution, although it can have a major impact on wine-producing regions. Typically, winery wastewater is treated by biological processes, such as the activated sludge process. Biomass produced during treatment is usually disposed of directly, i.e. without digestion or other anaerobic processes. We applied our previously published model for carbon-footprint calculation to the areas worldwide producing yearly more than 10(6) m(3) of wine (i.e., France, Italy, Spain, California, Argentina, Australia, China, and South Africa). Datasets on wine production from the Food and Agriculture Organisation were processed and wastewater flow rates calculated with assumptions based on our previous experience. Results show that the wine production, hence the calculated wastewater flow, is reported as fairly constant in the period 2005-2007. Nevertheless, treatment process efficiency and energy-conservation may play a significant role on the overall carbon-footprint. We performed a sensitivity analysis on the efficiency of the aeration process (alphaSOTE per unit depth, or alphaSOTE/Z) in the biological treatment operations and showed significant margin for improvement. Our results show that the carbon-footprint reduction via aeration efficiency improvement is in the range of 8.1 to 12.3%.
PMID: 19717904
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Sarnecka BW,Lee MD
Department of Cognitive Sciences, University of California, Irvine, CA 92697, USA. sarnecka@uci.edu
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Levels of number knowledge during early childhood.
J Exp Child Psychol. 2009 Jul;103(3):325-37
Researchers have long disagreed about whether number concepts are essentially continuous (unchanging) or discontinuous over development. Among those who take the discontinuity position, there is disagreement about how development proceeds. The current study addressed these questions with new quantitative analyses of children's incorrect responses on the Give-N task. Using data from 280 children, ages 2 to 4 years, this study showed that most wrong answers were simply guesses, not counting or estimation errors. Their mean was unrelated to the target number, and they were lower-bounded by the numbers children actually knew. In addition, children learned the number-word meanings one at a time and in order; they treated the number words as mutually exclusive; and once they figured out the cardinal principle of counting, they generalized this principle to the rest of their count list. Findings support the 'discontinuity' account of number development in general and the 'knower-levels' account in particular.
PMID: 19345956
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Swanson JM,Entringer S,Buss C,Wadhwa PD
Department of Pediatrics, University of California, Irvine, School of Medicine, 19722 MacArthur Boulevard, Irvine, CA 92612-4480, USA. jmswanso@uci.edu
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Developmental origins of health and disease: environmental exposures.
Semin Reprod Med. 2009 Sep;27(5):391-402
The developmental origins of health and disease (DOHaD) approach has evolved over the past 20 years, and the current hypothesis proposes that fetal adaptations to intrauterine and maternal conditions during development shape structure and function of organs. Here we present a review of some environmental exposures that may trigger fetal maladaptations in these processes, including three examples: exposures to tobacco smoke, antidepressant medication, and folic acid deficits in the food supply. We provide a selected review of current research on the effects of each of these exposures on fetal development and birth outcomes, and use the DOHaD approach to suggest how these exposures may alter long-term outcomes. In the interpretation of this literature, we review the evidence of gene-environment interactions based on evaluation of biological pathways and evidence that some exposures to the fetus may be moderated by maternal and fetal genotypes. Finally, we use the design of the National Children's Study (now in progress) to propose how the DOHaD approach could be used to address questions that have emerged in this area that are relevant to reproductive medicine and subsequent health outcomes.
PMID: 19711249
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Wadhwa PD,Buss C,Entringer S,Swanson JM
Department of Pediatrics, University of California, Irvine, School of Medicine, 3117 GillespieNeuroscience Research Facility, Irvine, CA 92697-4260, USA. pwadhwa@uci.edu
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Developmental origins of health and disease: brief history of the approach and current focus on epigenetic mechanisms.
Semin Reprod Med. 2009 Sep;27(5):358-68
"Barker's hypothesis" emerged almost 25 years ago from epidemiological studies of birth and death records that revealed a high geographic correlation between rates of infant mortality and certain classes of later adult deaths as well as an association between birthweight and rates of adult death from ischemic heart disease. These observations led to a theory that undernutrition during gestation was an important early origin of adult cardiac and metabolic disorders due to fetal programming that permanently shaped the body's structure, function, and metabolism and contributed to adult disease. This theory stimulated interest in the fetal origins of adult disorders, which expanded and coalesced approximately 5 years ago with the formation of an international society for developmental origins of health and disease (DOHaD). Here we review a few examples of the many emergent themes of the DOHaD approach, including theoretical advances related to predictive adaptive responses of the fetus to a broad range of environmental cues, empirical observations of effects of overnutrition and stress during pregnancy on outcomes in childhood and adulthood, and potential epigenetic mechanisms that may underlie these observations and theory. Next, we discuss the relevance of the DOHaD approach to reproductive medicine. Finally, we consider the next steps that might be taken to apply, evaluate, and extend the DOHaD approach.
PMID: 19711246
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Christley S,Nie Q,Xie X
Department of Mathematics, University of California Irvine, Irvine, CA, USA. scott.christley@uci.edu
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Incorporating existing network information into gene network inference.
PLoS One. 2009;4(8):e6799
One methodology that has met success to infer gene networks from gene expression data is based upon ordinary differential equations (ODE). However new types of data continue to be produced, so it is worthwhile to investigate how to integrate these new data types into the inference procedure. One such data is physical interactions between transcription factors and the genes they regulate as measured by ChIP-chip or ChIP-seq experiments. These interactions can be incorporated into the gene network inference procedure as a priori network information. In this article, we extend the ODE methodology into a general optimization framework that incorporates existing network information in combination with regularization parameters that encourage network sparsity. We provide theoretical results proving convergence of the estimator for our method and show the corresponding probabilistic interpretation also converges. We demonstrate our method on simulated network data and show that existing network information improves performance, overcomes the lack of observations, and performs well even when some of the existing network information is incorrect. We further apply our method to the core regulatory network of embryonic stem cells utilizing predicted interactions from two studies as existing network information. We show that including the prior network information constructs a more closely representative regulatory network versus when no information is provided.
PMID: 19710931
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Wohlford-Lenane CL,Meyerholz DK,Perlman S,Zhou H,Tran D,Selsted ME,McCray PB
Departments of Pediatrics, Pathology, Internal Medicine, Microbiology, and Carver College of Medicine, University of Iowa, Iowa City, IA 52242; Department of Pathology & Laboratory Medicine, University of California Irvine, Irvine, CA 92697.
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Rhesus Theta-Defensin Prevents Death in a Mouse Model of SARS Coronavirus Pulmonary Disease.
J Virol. 2009 Aug 26;:
We evaluated the efficacy of rhesus theta-defensin 1 (RTD-1), a novel cyclic antimicrobial peptide, as a prophylactic antiviral in a mouse model of SARS coronavirus (CoV) lung disease. BALB/c mice exposed to a mouse-adapted strain of SARS-CoV demonstrated 100% survival and modest reductions in lung pathology without reductions in virus titer when treated with two intranasal doses of RTD-1, while mortality in untreated mice was approximately 75%. RTD-1 treated, SARS-CoV infected mice displayed altered lung tissue cytokine responses 2 and 4 days post-infection compared to untreated animals, suggesting one possible mechanism of action for RTD-1 is immunomodulatory.
PMID: 19710146
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Zender R,Olshansky E
Program in Nursing Science, College of Health Sciences, University of California, Irvine, CA 92697, USA. rzender@uci.edu
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Women's mental health: depression and anxiety.
Nurs Clin North Am. 2009 Sep;44(3):355-64
Sex ratios for selected mental disorders such as major depressive disorder and anxiety disorder are much higher in women than men. Anxiety disorders constitute the most prevalent mental disorder in adults, and affect twice as many women as men. Depression and anxiety exist comorbidly and along with other mental disorders. This article focuses on depression and anxiety in women, and other conditions comorbid with depression or anxiety: cardiac disease, obesity, vitamin D deficiency, and irritable bowel syndrome.
PMID: 19683096
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Knudtson M,Tiso S,Phillips S
Program in Nursing Science, Department of Nursing, University of California, Irvine, Irvine, CA 92697, USA. mdknudts@uci.edu
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Human papillomavirus and the HPV vaccine: are the benefits worth the risks?
Nurs Clin North Am. 2009 Sep;44(3):293-9
Human papillomavirus (HPV) is the most commonly sexually transmitted infection in the United States. This article gives an overview and discussion of HPV virus types and transmission, and the quadrivalent vaccine now available to protect against it. Included are the nursing implications for the HPV vaccine related to education and counseling of parents, patients, and young adult women regarding HPV vaccination, for whom the vaccine is indicated.
PMID: 19683091
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Zender R,Olshansky E
Program in Nursing Science, College of Health Sciences, University of California, Irvine, CA 92697, USA. rzender@uci.edu
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Promoting wellness in women across the life span.
Nurs Clin North Am. 2009 Sep;44(3):281-91
For the purposes of this article, wellness is defined as an individual's subjective experience of overall life satisfaction in relation to physical, mental, emotional, spiritual, social, economic, occupational, and environmental dimensions. Women's wellness focuses on those aspects of well-being that pertain disproportionately, or solely, to women. Wellness includes but is not limited to physical, emotional and social aspects and disruptions that alter a woman's quality of life, such as reproductive and hormonal issues, bone health, gastrointestinal stress, and urinary incontinence. This article discusses women's wellness through the life span, from preconception through death, and considers the implications of these issues for the nursing profession.
PMID: 19683090
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Olshansky E
Program in Nursing Science, College of Health Sciences, University of California, Irvine, CA 92697, USA. e.olshansky@uci.edu
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Women's health. Preface.
Nurs Clin North Am. 2009 Sep;44(3):ix-x
PMID: 19683088
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Marchal-Crespo L,Reinkensmeyer DJ
Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA. lmarchal@uci.edu
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Review of control strategies for robotic movement training after neurologic injury.
J Neuroeng Rehabil. 2009;6:20
There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies.
PMID: 19531254
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Mukamel DB,Cai S,Temkin-Greener H
University of California, Irvine, Center for Health Policy Research, Irvine, CA, USA. dmukamel@uci.edu
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Cost implications of organizing nursing home workforce in teams.
Health Serv Res. 2009 Aug;44(4):1309-25
OBJECTIVE: To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. DATA SOURCES/STUDY SETTING: Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. STUDY DESIGN: A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. DATA COLLECTION: Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. PRINCIPAL FINDINGS: Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. CONCLUSIONS: Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.
PMID: 19486181
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Blitz IL,Cho KW
Department of Developmental and Cell Biology and the Developmental Biology Center, University of California, Irvine, California, USA. ilblitz@uci.edu
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Finding partners: how BMPs select their targets.
Dev Dyn. 2009 Jun;238(6):1321-31
The bone morphogenetic protein (BMP) signaling pathway is a conserved and evolutionarily ancient regulatory module affecting a large variety of cellular behaviors. The evolutionary flexibility in using BMP responses presumably arose by co-option of a canonical BMP signaling cascade to regulate the transcription of diverse batteries of target genes. This begs the question of how seemingly interchangeable BMP signaling components elicit widely different outputs in different cell types, an important issue in the context of understanding how BMP signaling integrates with gene regulatory networks to control development. Because a molecular understanding of how BMP signaling activates different batteries of target genes is an essential prerequisite to comprehending the roles of BMPs in regulating cellular responses, here we review the current knowledge of how BMP-regulated target genes are selected by the signal transduction machinery. We highlight recent studies suggesting the evolutionary conservation of BMP target gene regulation signaling by Schnurri family zinc finger proteins. Developmental Dynamics 238:1321-1331, 2009. (c) 2009 Wiley-Liss, Inc.
PMID: 19441058
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Noymer A
Department of Sociology, University of California, 3151 Social Sciences Plaza, Irvine, CA 92697-5100, USA. noymer@uci.edu
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Testing the influenza-tuberculosis selective mortality hypothesis with Union Army data.
Soc Sci Med. 2009 May;68(9):1599-608
Using Cox regression, this paper shows a weak association between having tuberculosis and dying from influenza among Union Army veterans in late nineteenth-century America. It has been suggested elsewhere [Noymer, A. and M. Garenne (2000). The 1918 influenza epidemic's effects on sex differentials in mortality in the United States. Population and Development Review 26(3), 565-581.] that the 1918 influenza pandemic accelerated the decline of tuberculosis, by killing many people with tuberculosis. The question remains whether individuals with tuberculosis were at greater risk of influenza death, or if the 1918/post-1918 phenomenon arose from the sheer number of deaths in the influenza pandemic. The present findings, from microdata, cautiously point toward an explanation of Noymer and Garenne's selection effect in terms of age-overlap of the 1918 pandemic mortality and tuberculosis morbidity, a phenomenon I term "passive selection". Another way to think of this is selection at the cohort, as opposed to individual, level.
PMID: 19304361
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Prause J,Dooley D,Huh J
Department of Psychology and Social Behavior, School of Social Ecology, University of California, Irvine, CA, 92697, USA. japrause@uci.edu
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Income volatility and psychological depression.
Am J Community Psychol. 2009 Mar;43(1-2):57-70
Income volatility appears to be increasing especially among lower income workers. Such volatility may reflect the ongoing shift of economic risk from employers to employees as marked by decreasing job security and employer-provided benefits. This study tests whether absolute volatility or downward volatility in income predict depression controlling for prior depression. A sample (n = 4,493) from the National Longitudinal Survey of Youth (NLSY79) with depression (CESD) measured at age 40 and prior depression measured eight to 10 years earlier was utilized. Downward volatility (frequency of income loss) was positively associated with depression; adjusting for downward volatility and other covariates, absolute volatility was negatively associated with depression. An interaction indicated a positive association between downward volatility and depression only when absolute volatility was high. These findings apply to respondents in a narrow age range (30 s) and the results warrant replication to identify the mediators linking absolute volatility and income loss to depression.
PMID: 19130213
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Hsieh AT,Hori N,Massoudi R,Pan PJ,Sasaki H,Lin YA,Lee AP
Department of Biomedical Engineering, University of California at Irvine, Irvine, CA 92697, USA. tsung@uci.edu aplee@uci.edu
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Nonviral gene vector formation in monodispersed picolitre incubator for consistent gene delivery.
Lab Chip. 2009 Sep 21;9(18):2638-43
A novel picolitre incubator based microfluidic system for consistent nonviral gene carrier formulation is presented. A cationic lipid-based carrier is the most attractive nonviral solution for delivering plasmid DNA, shRNA, or drugs for pharmaceutical research and RNAi applications. The size of the cationic lipid and DNA complex (CL-DNA), or the lipoplex, is one of the important variations for consistency of gene transfection. CL-DNA size, in turn, may be controlled by factors such as the cationic lipid and DNA mixing order, mixing rate, and mixture incubation time. The Picolitre Microfluidic Reactor and Incubator (PMRI) system described here is able to control these parameters in order to create homogeneous CL-DNA. Compared with conventional CL-DNA preparation techniques involving hand-shaking or vortexing, the PMRI system demonstrates a greater ability to constantly and uniformly mix cationic lipids and DNA simultaneously. After mixing in the picolitre droplet reactors, the cationic lipid and DNA is incubated within the picolitre incubator to form CL-DNA. The PMRI generates a narrower size distribution band, while also turning the sample loading, mixing and incubation steps into an integrated process enabling the consistent formation of CL-DNA. The coefficient of variation (CV) of transfection efficiency is 0.05 and 0.30 for PMRI-based and conventional methods, respectively. In addition, this paper demonstrates that the gene transfection efficiency of lipoplex created in the PMRI is more reproducible.
PMID: 19704978
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Lie D,Bereknyei S,Braddock CH,Encinas J,Ahearn S,Boker JR
Research/Faculty Development, Department of Family Medicine, University of California, Irvine, School of Medicine, Irvine, California 92868, USA. dalie@uci.edu
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Assessing medical students' skills in working with interpreters during patient encounters: a validation study of the Interpreter Scale.
Acad Med. 2009 May;84(5):643-50
PURPOSE: Interpreted patient encounters require distinct communication skills. The absence of available reliable, valid, and practical measures hinders the assessment of these skills; therefore, the authors aimed to construct and validate the Interpreter Scale (IS). METHOD: The authors constructed the IS based on expert consensus and prior studies. They administered the IS to two classes (n = 182) in an interpreted standardized patient (SP) case setting. Standardized interpreters in the examination room assessed, using the IS, students' communication skills. Concurrently, SPs, using the validated Patient-Physician Interaction scale (PPI) and the Interpreter Impact Rating Scale (IIRS), also assessed students' skills. Trained observers watched DVDs and used the Faculty Observer Rating Scale (FORS) to assess student performance. A prior study documented the qualities of the IIRS and FORS. The authors determined the internal consistency reliability and examined construct validity of IS scores through factor analysis and concordance with other measures' scores. RESULTS: IS reliability analysis yielded Cronbach alpha = 0.77. Factor analysis demonstrated two IS dimensions. Nine items, "managing the encounter," and four items, "setting the stage," explained 76% and 15% of score variance, respectively. IS and FORS scores significantly correlated (r = 0.385; P < .0001). IS factor 1 scores significantly correlated (all P < .0001) with FORS (r = 0.402), IIRS (r = 0.277), and PPI (r = 0.332) scores. CONCLUSIONS: The IS has reasonable internal consistency reliability and construct validity to warrant use for formatively measuring student communication skills in interpreted SP encounters, and it needs testing in actual patient encounters.
PMID: 19704202
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Wigal SB
Child Development Center, University of California-Irvine, Irvine, California 92162, USA.
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Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults.
CNS Drugs. 2009;23 Suppl 1:21-31
There have been major advances in the treatment and understanding of attention-deficit hyperactivity disorder (ADHD) in the last decade. Among these are the availability of newer stimulant formulations, an appreciation of the combined effects of medication and behavioural therapies, and a better understanding of the neurobiology of the disorder in children (aged 6-12 years), adolescents and adults. This article focuses on the evaluation of the efficacy and safety profiles of medications used for the management of ADHD. In assessing the various medical treatments for ADHD, certain issues and analyses have become important to address. The diagnosis, characterization and quantification of ADHD symptoms are crucial to assessing treatment effectiveness. A standardized setting for measuring the severity of ADHD symptoms is the laboratory school protocol, which simulates a school environment with tightly controlled timing of measurements. This method has been adapted successfully to the adult workplace environment to help with the evaluation of adult ADHD symptoms. Statistical analyses, such as effect size and number needed to treat, may aid in the comparison and interpretation of ADHD study results. Although an objective approach to evaluating the efficacy and safety profiles of the available medications provides necessary details about the medical options, typical clinical decisions are often based on trial and error and may be individualized based on a patient's daily routine, comorbidities and risk factors. Stimulants remain the US FDA-approved medical treatment of choice for patients with ADHD and are associated with an exceptional response rate. Findings of the Multimodal Treatment of Children With ADHD study suggest that the combination of behavioural and medical therapy may benefit most patients. Nonstimulant agents, such as atomoxetine (FDA-approved), and several non-approved agents, bupropion, guanfacine and clonidine, may offer necessary alternatives to the stimulants. This is especially important for patients who have comorbidities that are contraindicated for stimulant use based on medical issues and/or risk for stimulant abuse. Typical psychiatric comorbidities in patients with ADHD include oppositional defiant disorder, conduct disorder, major depressive disorder, bipolar disorder, anxiety, substance abuse disorder, tic disorder, and Tourette's syndrome. Although relatively safe, both stimulants and atomoxetine have class-related warnings and contraindications and are associated with adverse effects that require consideration when prescribing. Polypharmacy is a common psychiatric approach to address multiple symptoms or emergent adverse effects of necessary treatments. Future research may provide an improved understanding of polypharmacy and better characterization of the factors that influence the diagnosis and successful treatment of patients with ADHD.
PMID: 19621975
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Bennett AF,Hughes BS
Dept. of Ecology and Evolutionary Biology, Univ. of California, Irvine, CA 92697-2525, USA. abennett@uci.edu
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Microbial experimental evolution.
Am J Physiol Regul Integr Comp Physiol. 2009 Jul;297(1):R17-25
Microbes have been widely used in experimental evolutionary studies because they possess a variety of valuable traits that facilitate large-scale experimentation. Many replicated populations can be cultured in the laboratory simultaneously along with appropriate controls. Short generation times and large population sizes make microbes ideal experimental subjects, ensuring that many spontaneous mutations occur every generation and that adaptive variants can spread rapidly through a population. Another highly useful experimental feature is the ability to preserve and store ancestral and evolutionarily derived clones. These can be revived in parallel to allow the direct measurement of the competitive fitness of a descendant compared with its ancestor. The extent of adaptation can thereby be measured quantitatively and compared statistically by direct competition among derived groups and with the ancestor. Thus, fitness and adaptation need not be matters of qualitative speculation, but are quantitatively measurable variables in these systems. Replication allows the quantification of heterogeneity in responses to imposed selection and thereby statistical distinction between changes that are systematic responses to the selective regimen and those that are specific to individual populations.
PMID: 19403860
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Davis EP,Granger DA
Department of Psychiatry and Human Behavior, University of California, Irvine, USA. edavis@uci.edu
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Developmental differences in infant salivary alpha-amylase and cortisol responses to stress.
Psychoneuroendocrinology. 2009 Jul;34(6):795-804
This study examined developmental differences in infants' salivary alpha-amylase (sAA) and cortisol levels and responses to the well-baby exam/inoculation stress protocol at 2, 6, 12, and 24 months of age. Mother-infant pairs (n=85; 45 girls) were assessed during well-baby visits and saliva was sampled before the well-baby exam/inoculation procedure (pre-test) and at 5, 10, and 20 min post-inoculation stress. Older infants (24 months) had higher levels of sAA than younger infants (2, 6 and 12 months). Stress-related sAA increases were evident at 6 and 12 months, but not at 2 or 24 months of age. Stress-related cortisol increases were present at 2 and 6 months, but not at older ages. Mothers had higher sAA levels than their infants, but did not show sAA or cortisol increases to their infants' inoculation. Pre-test, maternal and infant sAA levels were positively correlated (rs .47 to .65) at 6, 12, and 24 months of age, but not at 2 months. These findings suggest that the association between the sympathetic branch of the autonomic nervous system and the secretion of sAA develops between 2 and 6 months of age, when levels of sAA are responsive to exposure to a painful stressor.
PMID: 19268476
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Scherger JE
Department of Family Medicine, University of California, Irvine, College of Medicine, Orange, CA 92868, USA. scherger@uci.edu
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The impact of antihypertensive drug therapy on quality of life.
Postgrad Med. 2000 Oct;108(5 Suppl):25-9
Optimal pharmacologic management of hypertension cannot be limited to the consideration of physiologic and metabolic profiles. The impact of antihypertensive drug treatment on quality of life is also of primary concern because it affects patient compliance and therapeutic outcome. Fortunately, quality-of-life measures are increasingly being used in clinical trials of antihypertensive agents (and other drugs). Such studies have revealed that on the whole, antihypertensive drug therapy has a slightly favorable impact on sleep, psychomotor skills, general well-being, and mood. Individually, however, antihypertensive agents from the same class have subtly different effects on various quality-of-life parameters. Interestingly, patients' perception of changes in their quality of life often diverges widely from their physician's perception and those of their spouse, relatives, and friends- so who administers the measures to whom is an important consideration. Refinement of quality-of-life measures plus a wide selection of antihypertensive agents promises increased flexibility in drug regimen design to physicians who treat hypertensive patients.
PMID: 19667538
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Ou SH,Zell JA
*Division of Hematology/Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, California; daggerGenetic Epidemiology Research Institute; and double daggerDepartment of Epidemiology, School of Medicine, University of California Irvine, Irvine, California.
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Carcinoma NOS is a Common Histologic Diagnosis and is Increasing in Proportion Among Non-small Cell Lung Cancer Histologies.
J Thorac Oncol. 2009 Aug 20;:
BACKGROUND:: Recent clinical trials have demonstrated differential survival benefit from chemotherapy regimens according to nonsmall cell lung cancer (NSCLC) histology. We investigated whether the distribution of carcinoma NOS (not otherwise specified) among NSCLC cases in California have changed over time and determined the prognostic significance of carcinoma NOS. METHODS:: Retrospective population-based study of 175,298 NSCLC patients diagnosed histologically or cytologically from the statewide California Cancer Registry from 1989 to 2006. RESULTS:: Carcinoma NOS accounted for 22.1% of all NSCLC patients, was the most commonly diagnosed cytologically (37.0%), and had the poorest 5-year survival estimates (5.8%) and median overall survival (OS, 5 months) among all NSCLC histologies. The proportion of carcinoma NOS had increased significantly from 1989 to 2006 in both males and females, in both histologically and cytologically diagnosed NSCLC, among all four major ethnicities (whites, African American, Hispanic, and Asian), among all age categories, and among all American Joint Committee on Cancer stages. The very elderly (80+ years) had the highest proportion of carcinoma NOS and cytologically diagnosed NSCLC regardless of period of diagnosis. Cytologically diagnosed NSCLC had significantly decreased OS than histologically diagnosed NSCLC (p < 0.0001). Cox proportional hazards regression analysis applied to stage 4 NSCLC patients indicated carcinoma NOS (vs. adenocarcinoma; hazard ratio 1.061, 95% confidence interval 1.039-1.083, p < 0.0001) and cytologically diagnosed NSCLC (versus histologically diagnosed NSCLC, hazard ratio 1.043, 95% confidence interval 1.024-1.062, p < 0.0001) were independent unfavorable prognostic factors for OS. CONCLUSIONS:: Carcinoma NOS was a common histologic diagnosis, had been increasing over time among NSCLC, and carried an independent unfavorable prognosis among stage 4 NSCLC patients.
PMID: 19701111
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Simkhovich BZ,Kleinman MT,Kloner RA
aHeart Institute, Good Samaritan Hospital, USA bDivision of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA cDivision of Occupational and Environmental Medicine, Department of Medicine, University of California-Irvine, Irvine, California, USA.
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Particulate air pollution and coronary heart disease.
Curr Opin Cardiol. 2009 Aug 19;:
PURPOSE OF REVIEW: Air pollution poses a significant health risk. The article focuses on the adverse effects of air pollution on the cardiovascular system. RECENT FINDINGS: Short-term and long-term studies clearly indicate that relatively modest exposures to particulate matter in the ambient air are associated with increased morbidity and mortality due to coronary heart disease. In humans, inhalational exposure to particulate air pollutants decreases heart rate variability, causes ST-segment depression and endothelial dysfunction, increases blood pressure and blood coagulability, and accelerates the progression of atherosclerosis. Mechanisms of air pollution-induced cardiotoxicity include increased generation of reactive oxygen species followed by activation of proinflammatory and prothrombotic pathways. In experimental settings, ultrafine air pollutants instilled directly into the cardiac vasculature depress cardiac contractility and decrease coronary flow. Both effects are attenuated by the use of a free radical scavenger. SUMMARY: Reactive oxygen species-related mechanisms of air pollution cardiotoxicity might become a valid target in developing new pharmacological strategies aimed at decreasing adverse effects of air pollution during extreme episodes (fires, earthquakes, industrial accidents, acts of terrorism). Educating patients and the general population on the negative cardiovascular effects of air pollution might be helpful in decreasing the risk of developing air pollution-related coronary heart disease.
PMID: 19696664
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Khoury A
Department of Urology, University of California-Irvine, Irvine, California.
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Editorial Comment.
J Urol. 2009 Aug 18;:
PMID: 19695645
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Young JL,Louie MK,Ortiz-Vanderdys CG,McCormick DW,Huynh VB,Kaplan AG,Jain NS,Pick DL,Andrade LA,Osann KE,Kolla SB,Sountoulides P,Kaufmann OG,McDougall EM,Clayman RV
Department of Urology, University of California Irvine, Orange, California, USA. jlyoung@uci.edu
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Impact of pneumoperitoneum on renal cryotherapy.
J Endourol. 2009 Sep;23(9):1451-5
PURPOSE: Pneumoperitoneum is known to decrease blood flow to the kidney during laparoscopy. We investigated if this change in blood flow would increase the size of the cryolesion. MATERIALS AND METHODS: Twelve Yorkshire swine underwent laparoscopy-guided percutaneous cryoablation of the upper and lower pole of each kidney at four randomized pneumoperitoneum pressures (10, 15, 20, and 25 mm Hg). Cryolesions were made with a 1.47-mm IceRod (Galil Medical, Plymouth Meeting, PA). Each site underwent two 10-minute freeze cycles separated by a 5-minute active thaw with pressurized helium gas. At the conclusion of each freeze cycle, the iceball volume was measured with intraoperative ultrasound. After completion of the four cryolesions, the kidneys were harvested, and the cryolesion surface area was calculated. The lesions were fixed in 10% buffered formalin and then excised with a 1-mm margin to obtain a volume measurement using fluid displacement. RESULTS: Iceball volume was 3.41, 2.85, 3.44, and 2.36 cm(3) for freeze cycle 1 (p = 0.16) and 3.67, 3.34, 4.88, 3.95 cm(3) for freeze cycle 2 (p = 0.20) at 10, 15, 20, and 25 mm Hg, respectively. Cryolesion volume by fluid displacement was 4.06, 3.77, 3.97, and 3.93 cm(3) (p = 0.86) and cryolesion surface area was 4.55, 4.38, 4.39, and 4.20 cm(2) (p = 0.71) at 10, 15, 20, and 25 mm Hg, respectively. CONCLUSIONS: In this study, pneumoperitoneum pressure between 10 and 25 mm Hg did not affect iceball size as measured by intraoperative ultrasound, cryolesion volume by fluid displacement, or cryolesion surface.
PMID: 19694533
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