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PubMed2006

Differences in the prescription patterns of anti-asthmatic medications for children by pediatricians, family physicians and physicians of other specialties.

BACKGROUND: Prescription patterns of anti-asthma medications in children vary among doctors in different disciplines and settings, and may reflect differences in treatment outcome. The purpose of this study was to analyze the prescribing patterns of anti-asthma drugs by pediatricians, family physicians and other practitioners. METHODS: Data for a total of 225,537 anti-asthma prescriptions were collected from the National Health Insurance Research Database for the period from January 1, 2002 to March 31, 2002. These medications included inhaled and oral adrenergics, inhaled and oral corticosteroids, xanthine derivatives, and leukotriene receptor antagonists prescribed by general pediatricians, family physicians and physicians in other disciplines. RESULTS: Oral beta2-agonist was the most commonly prescribed drug used as monotherapy, with prescription rates of 70.4%, 46.9% and 58.0% by pediatricians, family physicians and other physicians, respectively. A xanthine derivative was the next most commonly prescribed monotherapy. Oral corticosteroid combined with oral beta2-agonist, followed by oral beta2-agonist combined with a xanthine derivative were the two most commonly prescribed dual-agent combined therapies by all three physician categories. The prescription rate for inhaled corticosteroid monotherapy was 7.8% by pediatricians, 5.6% by family physicians, and 8.0% by other physicians. The prescription rate for inhaled adrenergic was the highest in family physicians (14.9%), followed by the other physicians (7.2%), and was lowest in pediatricians (3.1%). CONCLUSION: Pediatricians and family physicians appeared to share similar opinions on the medical management of children with asthma in that both most commonly prescribed oral beta2-agonists and xanthine derivatives, either alone or in combination. Family physicians were least likely to prescribe an inhaled corticosteroid and most likely to prescribe an inhaled adrenergic agent.

Anti-Asthmatic Agents↗
PubMed2003

Bone mineral density in acromegaly: the effect of gender, disease activity and gonadal status.

OBJECTIVE: Data on bone mineral density (BMD) in acromegaly are conflicting as most previous studies collectively evaluated eugonadal and hypogonadal patients of both sexes, with or without active disease. We have evaluated BMD in 152 acromegalic patients of both sexes with varying disease activity and gonadal status. DESIGN: Cross-sectional, retrospective. PATIENTS: We studied 152 acromegalic patients (99 women aged 26-72 years, and 53 men aged 21-75 years), 107 with active and 45 with controlled disease. Eighty-five patients had normal gonadal status and 67 were hypogonadal. MEASUREMENTS: In all patients we measured serum GH levels by immunoenzimometric assay, and serum IGF-I levels by radioimmunoassay. BMD was assessed at spine L2-L4 (LS) and at femoral neck (FN) by dual energy X-ray absorptiometry; results are expressed as Z-values. RESULTS: We evaluated the effect of GH excess on bone at different sites in relation to gonadal status, disease activity and gender. At LS, in respect to the reference population, BMD (mean +/- SE) values were higher in eugonadal patients (active: 0.71 +/- 0.29, P < 0.02; controlled: 0.65 +/- 0.28, P < 0.05) and lower in hypogonadal ones (active: -0.64 +/- 0.35, 0.1 < P < 0.05; controlled: -1.05 +/- 0.36, P < 0.01), regardless of disease activity. On the contrary, at FN, BMD was higher than in the reference population, both in eugonadal (1.01 +/- 0.22, P < 0.001) and hypogonadal (0.63 +/- 0.17, P < 0.001) patients only in subjects with active disease, but not in those in which the disease was controlled (eugonadal: 0.31 +/- 0.23, P = ns; hypogonadal 0.04 +/- 0.28, P = ns). We did not observe any difference in BMD values according to gender both at LS (males vs. females -0.02 +/- 0.30 vs. 0.01 +/- 0.24, P = ns) or at FN (0.77 +/- 0.19 vs. 0.63 +/- 0.15, P = ns). CONCLUSIONS: The anabolic effect of GH excess on bone in acromegalic patients is: (i) gender-independent; (ii) evident at the spine only in eugonadal regardless of disease activity; (iii) evident at femoral neck only in the presence of active disease regardless of gonadal status.

Absorptiometry, Photon↗
PubMed1995

The occurrence of duplicate lysyl-tRNA synthetase gene homologs in Escherichia coli and other procaryotes.

The lysyl-tRNA synthetase (LysRS) system of Escherichia coli K-12 consists of two genes, lysS, which is constitutive, and lysU, which is inducible. It is of importance to know how extensively the two-gene LysRS system is distributed in procaryotes, in particular, among members of the family Enterobacteriaceae. To this end, the enterics E. coli K-12 and B; E. coli reference collection (ECOR) isolates EC2, EC49, EC65, and EC68; Shigella flexneri; Salmonella typhimurium; Klebsiella pneumoniae; Enterobacter aerogenes; Serratia marcescens; and Proteus vulgaris and the nonenterics Pseudomonas aeruginosa and Bacillus megaterium were grown in AC broth to a pH of 5.5 or less or cultured in SABO medium at pH 5.0. These growth conditions are known to induce LysRS activity (LysU synthesis) in E. coli K-12. Significant induction of LysRS activity (twofold or better) was observed in the E. coli strains, the ECOR isolates, S. flexneri, K. pneumoniae, and E. aerogenes. To demonstrate an association between LysRS induction and two distinct LysRS genes, Southern blotting was performed with a probe representing an 871-bp fragment amplified from an internal portion of the coding region of the lysU gene. In initial experiments, chromosomal DNA from E. coli K-12 strain MC4100 (lysS+ lysU+) was double digested with either BamHI and HindIII or BamHI and SalI, producing hybridizable fragments of 12.4 and 4.2 kb and 6.6 and 5.2 kb, respectively. Subjecting the chromosomal DNA of E. coli K-12 strain GNB10181 (lysS+ delta lysU) to the same regimen established that the larger fragment from each digestion contained the lysU gene. The results of Southern blot analysis of the other bacterial strains revealed that two hybridizable fragments were obtained from all of the E. coli and ECOR collection strains examined and S. flexneri, K. pneumoniae, and E. aerogenes. Only one lysU homolog was found with S. typhimurium and S. marcescens, and none was obtained with P. vulgaris. A single hybridizable band was found with both P. aeruginose and B, megaterium. These results show that the dual-gene LysRS system is not confined to E. coli K-12 and indicate that it may have first appeared in the genus Enterobacter.

Base Sequence↗
PubMed1995

Calcium oscillations and protein synthesis inhibition synergistically activate mouse oocytes.

We have examined the ability of the two parthenogenetic agents, strontium (Sr2+) and cycloheximide, to activate mouse oocytes. We demonstrate that Sr2+ and cycloheximide act synergistically to promote parthenogenetic activation up to the pronuclear stage in oocytes collected immediately after ovulation. These two agents appeared to act independently, since incubation in Sr2+ media triggered a series of intracellular Ca2+ rises without affecting protein synthesis and cycloheximide inhibited protein synthesis without causing any intracellular Ca2+ changes. In addition, cycloheximide did not alter the pattern of Ca2+ oscillations induced by Sr2+. In contrast, we show that another commonly used parthenogenetic activation treatment, the Ca2+ ionophore A23187, has dual effects. Exposure of oocytes to the Ca2+ ionophore, A 23187, in Ca(2+)- and Mg(2+)-free medium leads to the activation of young oocytes. However, as well as generating a Ca2+ increase, the treatment of mouse oocytes with A23187 and Ca(2+)- and Mg(2+)-free media led to a marked inhibition of protein synthesis. Our data show that parthenogenetic agents may have two important loci for activating mammalian oocytes and that the combined effect on Ca2+ release and protein synthesis is most effective.

Animals↗
PubMed2005

Prevalence of intellectual disability and comorbid mental illness in an Australian community sample.

OBJECTIVE: The aim of this study was to bring to light the high prevalence of Australians affected by intellectual disability and comorbid serious mental illnesses. Results from a broad scale study are used to explore the reasons for this regularly overlooked phenomenon. METHODS: This study was based on secondary analysis of data collected in the national 'Disability, Ageing and Carers Survey, 1998'. The analysed data consisted of an Australian wide sample of 42 664 individuals living at home or in cared accommodation. Classification of intellectual disability and comorbid psychosis, anxiety and depressive disorder was based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). RESULTS: The prevalence of intellectual disability in the sampled population was 1.25%. Of these people 1.3% had a psychotic disorder, 8% had a depressive disorder and 14% had an anxiety disorder that had been present for at least 6 months and was of such severity that it too was disabling. CONCLUSIONS: Findings indicate that people with intellectual disability are at high risk of developing comorbid serious mental illness. Dual diagnosis is however, often overlooked due to difficulties associated with establishing a diagnosis of a mental disorder in people with an intellectual disability, a problem which is heightened when the individual's capacity to participate in a clinical assessment is limited.

Adolescent↗
PubMed2003

Toxicity and degradation of metolachlor (Dual Gold 960 EC) in chicken embryos.

The herbicide formulation Dual Gold 960 EC (960 g/l metolachlor) was applied, ROSS 308 embryonated hen eggs were treated on day 12 of incubation period. The pesticide was diluted in water to a concentration level 0.3% and the emulsion was injected into the air space in a volume of 0.1 ml/egg, or hen's eggs were treated by the immersion technique (30 min). Residues of metolachlor were measured by GC in 14 collected embryo samples on days 13, 15 and 19 of the incubation of chicken embryos, and macro- and microscopic morphological examinations of 49 embryos were performed simultaneously on day 19. Body mass of embryos was weighed on 13th, 15th and 19th day of incubation. After the both treatments the mortality rate of embryos was similar. The average data of body mass showed a significant decrease compared to the control in the immersion study on day 15 and 19 of the hatching period. This phenomenon may only be in connection with the presence of metolachlor over the limit of quantification (LOQ) on day 13 of incubation period. The macroscopic deformations were sporadic in the embryos. No histologically detected alterations were seen.

Abnormalities, Drug-Induced↗
PubMed2003

Molecular evidence for novel chlamydial infections in the koala (Phascolarctos cinereus).

Chlamydia-related disease has a detrimental effect on Australia's free-range koala (Phascolarctos cinereus) populations. The chlamydial species responsible for ocular, urogenital and respiratory disease in the koala have previously been identified as Chlamydophila pecorum and Chlamydophila pneumoniae. Epizootiology studies have therefore used species specific PCR assays to detect chlamydial infections. In the current study, we used a broad range PCR amplification and cloning strategy to identify all strains of Chlamydiales in the koala. Sequencing of 16S rRNA gene PCR products, cloned from Chlamydiales--order positive swab samples identified nine novel koala Chlamydiales genotypes, including multiple novel chlamydial genotypes present in a single sample. The novel koala genotypes are clustered together with other Chlamydia-like bacteria within a second lineage separate from the known Chlamydiaceae species. Two new primer sets UKC-A and UKC-B were designed to detect five of the nine novel Chlamydiales and were applied to swab samples collected from two wild koala populations. Using these new UKC PCR assays, UKC-A type Chlamydiales sequences were more prevalent (72%; 18/25) compared to UKC-B (24%; 6/25). UKC sequences were most commonly found as dual infections with C. pecorum. This report provides the first description of additional members of the order Chlamydiales infecting the koala.

Animals↗
PubMed2001

Paradoxical undersensing at a high sensitivity in dual chamber pacemakers.

In view of the evolving indications for device therapy in atrial arrhythmia the accurate detection of high rate atrial events is a necessity. In a sheep model of atrial fibrillation (AF) we observed a contradictory behavior of the Thera DR pacemaker. The pacemakers were programmed to deliver burst pacing on detection of sinus rhythm (SR). Paradoxically, progressively more inappropriate bursts were delivered during AF, at a higher sensitivity. This implied that the pacemaker interpreted AF as SR. We assessed the atrial detection of the Thera DR, Diamond, Saphir, and Marathon pacemakers during AF, in a sheep model and in vitro using a waveform generator. By counting the annotated atrial-sensed events reported by the pacemaker we charted the behavior of the pacemakers at different sensitivities. At a higher sensitivity both the Thera DR and the Diamond paradoxically reported fewer atrial events during AF. This behavior led to inappropriate mode switching and incorrect diagnostic data collection. It could be reproduced in vitro. The Marathon did not show this paradoxical undersensing in vivo or in vitro. This paradoxical undersensing at a high sensitivity is dependent on the amplitude of the input signal and could not be explained by an overlap of programmable timing parameters. It is caused by ringing of the atrial sensing amplifier. At high atrial rates and a high sensitivity the ringing of the repetitive atrial signal input results in blanking of the atrial amplifier. This observation may be relevant in the device management of patients with paroxysmal AF.

Animals↗
PubMed2006

The association between common vitamin D receptor gene variations and osteoporosis: a participant-level meta-analysis.

BACKGROUND: Polymorphisms of the vitamin D receptor (VDR) gene have been implicated in the genetic regulation of bone mineral density (BMD). However, the clinical impact of these variants remains unclear. OBJECTIVE: To evaluate the relation between VDR polymorphisms, BMD, and fractures. DESIGN: Prospective multicenter large-scale association study. SETTING: The Genetic Markers for Osteoporosis consortium, involving 9 European research teams. PARTICIPANTS: 26,242 participants (18,405 women). MEASUREMENTS: Cdx2 promoter, FokI, BsmI, ApaI, and TaqI polymorphisms; BMD at the femoral neck and the lumbar spine by dual x-ray absorptiometry; and fractures. RESULTS: Comparisons of BMD at the lumbar spine and femoral neck showed nonsignificant differences less than 0.011 g/cm2 for any genotype with or without adjustments. A total of 6067 participants reported a history of fracture, and 2088 had vertebral fractures. For all VDR alleles, odds ratios for fractures were very close to 1.00 (range, 0.98 to 1.02) and collectively the 95% CIs ranged from 0.94 (lowest) to 1.07 (highest). For vertebral fractures, we observed a 9% (95% CI, 0% to 18%; P = 0.039) risk reduction for the Cdx2 A-allele (13% risk reduction in a dominant model). LIMITATIONS: The authors analyzed only selected VDR polymorphisms. Heterogeneity was detected in some analyses and may reflect some differences in collection of fracture data across cohorts. Not all fractures were related to osteoporosis. CONCLUSIONS: The FokI, BsmI, ApaI, and TaqI VDR polymorphisms are not associated with BMD or with fractures, but the Cdx2 polymorphism may be associated with risk for vertebral fractures.

Adult↗
PubMed1996

Development of a dual target-PCR for detection and characterization of measles virus in clinical specimens.

A polymerase chain reaction (PCR) method was developed for detecting measles virus (MV) RNA in a variety of clinical samples using primer pairs in the nucleocapsid (N) and matrix (M) genes in one reaction (dual target-PCR). The dual target-PCR detected MV RNA in tissue culture fluid containing 1 TCID50 of the MV Loss strain, and was as sensitive as a single target-PCR. Specificity was confirmed by the failure of the dual target-PCR to amplify products from the infected tissue culture containing related paramyxoviruses. Thirty-two of 35 (91.4%) samples collected from 23 patients with confirmed measles infection by the detection of measles specific IgM were found to be positive for MV RNA by PCR. Direct sequencing of the PCR amplicons revealed three different genotypes among the MV strains that were detected in 12 patients. The dual target-PCR method is suitable for the diagnosis of measles infection and, based on the sequencing of the PCR product DNA, for investigating the molecular epidemiology of MV strains.

Adult↗
PubMed2003

Cultural specificity and comparison in psychiatric epidemiology: walking the tightrope in American Indian research.

Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences--most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)--to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts.

Cross-Cultural Comparison↗
PubMed1999

Prostaglandin production in response to a bacterial infection in true armyworm larvae

Prostaglandin levels were determined by fluorometric HPLC analysis of hemolymph collected from larvae of the true armyworm, Pseudaletia unipuncta, that had been injected with bacteria. Prostaglandins were extracted and derivatized with the fluorogenic compound 9-anthryldiazomethane and detected by fluorescence-HPLC. One of the prostaglandins produced was identified as prostaglandin F(2alpha) based on HPLC retention time. The chemical identity of prostaglandin F(2alpha) was confirmed by isolation and derivatization followed by gas chromatography mass spectrometry analysis. Larvae injected with heat-killed bacteria, Serratia marcescens, produced about 4 times as much prostaglandin F(2alpha) as larvae injected with saline. In a separate experiment, larvae injected with bacteria and the prostaglandin precursor arachidonic acid produced still higher levels of prostaglandin F(2alpha). The production of prostaglandin was inhibited with phenidone, a dual cyclooxygenase and lipoxygenase inhibitor. These data indicate that bacterial injections stimulate increased eicosanoid biosynthesis in true armyworms, particularly biosynthesis of prostaglandin F(2alpha). Our findings add considerable support to the hypothesis that eicosanoids mediate insect cellular immune reactions to bacterial infections. Arch. Copyright 1999 Wiley-Liss, Inc.

Journal Article↗
PubMed1985

Cholesterol absorption and turnover in hypercholesterolemic dogs.

Cholesterol absorption was measured in chronically hypercholesterolemic dogs by four methods: the fecal recovery method of Borgström (1969, J. Lipid Res. 10: 331-337), the dual isotope method of Zilversmit and Hughes (1974, J. Lipid Res. 15: 465-473), the recovery of cholesterol in thoracic duct lymph collected continuously for 16 hr after a meal, and the recovery of isotopic cholesterol from the liver and plasma 24 hr after the animals consumed an isotope-containing meal. The four methods showed excellent agreement and indicated that dogs fed a cholesterol-rich synthetic diet absorb 5.2 +/- 0.5 g (mean +/- SD) of cholesterol per day and that cholesterol absorption is reasonably constant from week to week in these animals. Separate estimates of cholesterol excretion indicated that these dogs excreted 4.7 +/- 0.5 g of cholesterol per day, and thus were at or near the steady-state with regard to cholesterol input-output. These data, taken together with a previous report (1981, J. Lipid Res. 22: 598-609), indicate that the canine liver can clear up to 300 mg of chylomicron cholesterol/hr, and support the concept that chylomicron remnants do not contribute significantly to the hypercholesterolemia in these animals.

Animals↗
PubMedDate not supplied

Gene expression in prostate cancer cells treated with the dual 5 alpha-reductase inhibitor dutasteride.

We sought preclinical data on the cellular and molecular effects of dutasteride in androgen-responsive, human prostate cancer (PCa) cells to better understand the mechanisms of action of 5 alpha-reductase inhibition in these cells. We used the human prostate cancer cell line LNCaP, which exhibits most features of PCa cells including androgen responsiveness. Our findings show that dutasteride kills PCa cells in vitro; it dramatically reduced viability and proliferation and disrupted genes and cellular pathways involved in metabolic, cell cycle, and apoptotic responses besides those expected in androgen-signaling pathways. Microchip gene array expression analysis revealed activation of genes in the FasL/tumor necrosis factor alpha (TNF-alpha) apoptotic and cell-survival pathways, correlating with the growth and survival effects in the LNCaP cells. Real-time polymerase chain reaction confirmed expression level changes seen by microarray analysis of candidate genes such as PLA2G2A, CDK8, CASP7, MDK, and NKX3.1. Collectively, our findings delineate the cellular and molecular effects of dutasteride in androgen-responsive PCa cells in vitro and may lead to its better therapeutic and chemopreventive use in PCa.

Apoptosis↗
PubMed1998

Computer-controlled endoscopic performance assessment system.

We have devised an advanced computer-controlled system (ADEPT) for the objective evaluation of endoscopic task performance. The system's hardware consists of a dual gimbal mechanism that accepts a variety of 5.0-mm standard endoscopic instruments for manipulation in a precisely mapped and enclosed work space. The target object consists of a sprung base plate incorporating various tasks. It is covered by a sprung perforated transparent top plate that has to be moved and held in the correct position by the operator to gain access to the various tasks. Standard video endoscope equipment provides the visual interface between the operator and the target-instrument field. Different target modules can be used, and the level of task difficulty can be adjusted by varying the manipulation, elevation, and azimuth angles. The system's software is designed to (a) prompt the surgeon with the information necessary to perform the task, (b) collect and collate data on performance during execution of specified tasks, and (c) save the data for future analysis. The system was alpha and beta tested to ensure that all functions operated correctly.

Endoscopy↗
PubMed1998

Pollen and fungal spores indoor and outdoor of mobile homes.

BACKGROUND: Allergenic diseases triggered by aeroallergens extract a health cost in quality of life and in economic impact. People generally spend 90% to 95% of their time indoors, so understanding the environmental factors that affect the presence of aeroallergens indoors are important in understanding health impact and potential intervention methods. OBJECTIVE: Describe the relationship of indoor airborne pollen and fungal spores in occupied mobile homes with outdoor concentrations and other environmental factors within geographically diverse areas of Texas. METHODS: Airborne pollen and fungal spores were collected during the daytime with RotoRod samplers indoor and outdoor of mobile homes in Houston and El Paso, Texas. Samples were counted simultaneously with a dual eyepiece microscope and identified morphologically and through staining techniques. RESULTS: Geometric mean concentrations (counts/m3) indoors and outdoors for pollen, respectively, were Houston 7.1 and 196.4; and El Paso 17.5 and 71.5. Geometric mean concentrations (counts/m3) indoors and outdoors for spore, respectively, were Houston 98.5 and 196.4; and El Paso 36.9 and 71.5. Indoor to outdoor ratios (I/O) for pollen and fungal spores were found to be higher on average than has been previously reported. Modeling of predictive factors in Houston demonstrate that 62% and 41% of indoor levels of pollen and fungal spores, respectively, can be explained by their corresponding outdoor levels. These data suggest that the many factors associated with individual exposure to airborne pollen and fungal spores indoors are under the control of the occupant, and may additionally be influenced by the physical characteristics of mobile homes, in particular the high surface area to volume ratio and restricted flow patterns.

Air Pollution, Indoor↗
PubMed1997

A localised oral health study based on the School Dental Inspection system, and its implications for the proposed national oral health database.

From 1989 to 1994, the author carried out a dental health study on all children examined in two age groups during the routine annual School Dental Inspection. Dual criteria were applied; the first a clinical diagnosis to prioritise each child for follow-up dental treatment, and the second using standardised criteria for use in an epidemiological study. The two sets of information were kept separately. Analysis showed that the methodology was capable of eliciting differences in dental disease levels between adjacent localised geographical areas, and trends in disease levels over time. Fluctuations in the uptake of dental treatment, but not in actual caries levels. Although epidemiological information collected in this way may not be as reproducible as that collected in highly organised epidemiological point prevalence studies, it has several advantages in that large numbers of subjects may be examined with relatively little extra resources. The School Dental Inspection system may be a template on which localised data may be collected to form part of the proposed national oral health database. A follow-up study is proposed to assess how the twin track approach of an improved system of localised information collection based on the School Dental Inspection system coupled with standardised epidemiological studies might provide a framework for a system which would provide useful data at different levels of what is essentially a multi level dental service.

Child↗
PubMed1993

Estimating heterogeneity in the probabilities of enumeration for dual-system estimation.

"We show how conditional logistic regression can be used to estimate the probability of being enumerated in a census and apply the model to the 1990 Post-Enumeration Survey (PES) in the United States.... We discuss some special problems caused by the fact that the PES sample area is open to migration between the captures. We also consider the effect of data errors in estimation. We characterize hard-to-enumerate populations and give some tentative estimates of correlation bias."

Americas↗