Health coaching via an internet portal for primary care patients with chronic conditions: a randomized controlled trial.

Background: Efforts to enhance patient-physician communication may improve management of underdiagnosed chronic conditions. Patient internet portals offer an efficient venue for coaching patients to discuss chronic conditions with their primary care physicians (PCP).

Objectives: We sought to test the effectiveness of an internet portal-based coaching intervention to promote patient-PCP discussion about chronic conditions.

Obesity and the likelihood of sexual behavioral risk factors for HPV and cervical cancer.

Obesity is associated with higher cervical cancer mortality, but its relationship with sexual behavioral risk factors that predispose women to human papilloma virus (HPV) and cervical cancer is unclear. We used data from 3,329 women participants, aged 20-59 years, of the 1999-2004 National Health and Nutrition Examination Survey, to analyze the relationship between BMI and age at first intercourse, number of sexual partners, condom use during sexual activity, history of sexually transmitted disease (STD), herpes simplex virus 2 (HSV-2) seropositivity, and HPV prevalence. BMI was not associated with the prevalence of HPV.

Internet-based coaching to improve patient-clinician communication in primary care.

Internet use in healthcare has grown quickly, but nursing has not explored its use in ambulatory settings. We developed an innovative internet-based coaching intervention conducted by nurses, aimed at improving patient communication with clinicians about 3 chronic conditions: pain, depression and impaired mobility. The intervention utilized a secure patient portal to deliver coaching and other information.

Obesity and undiagnosed diabetes in the U.S.

Objective: To study whether obese individuals, who are at higher risk for diabetes and disparities in care than nonobese individuals, are more likely to have undiagnosed diabetes.

Research Design And Methods: We performed an analysis of 5,514 adult participants in the 1999-2004 National Health and Nutrition Examination Survey. Participants were interviewed about sociodemographic and medical data, including whether they had been diagnosed with diabetes, and were examined for height, weight, and fasting plasma glucose level >or=126 mg/dl or by previous physician diagnosis.

Obesity and C-reactive protein levels among white, black, and hispanic US adults.

Objective: Studies suggest that obesity's adverse impact on cardiovascular mortality may be reduced in African Americans relative to white Americans. We examined whether obesity's association with novel cardiovascular risk factors such as C-reactive protein (CRP) also varies by race and ethnicity.

Methods And Procedures: We analyzed data from 10,492 white, African-American, and Hispanic-American participants of the 1999-2004 National Health and Nutrition Examination Survey, who were aged 20 years and older, with a BMI > or =18.

Screening for chronic conditions using a patient internet portal: recruitment for an internet-based primary care intervention.

Background: Patient Internet portals have created new opportunities for assessment and management of chronic conditions.

Objective: To conduct an online screening survey for a study recruitment using a secure patient Internet portal to identify primary care patients with untreated depression, chronic pain, or mobility difficulty before nonurgent office visits.

Design: Internet-based screening survey for a randomized trial.

Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention.

Background: Studies show that patients who have higher self-efficacy and participate actively in their care have better disease management. Patient-provider Internet portals offer an exciting new venue for empowering and engaging patients in better management of chronic conditions.

Objectives: To describe development of an Internet-based health coaching intervention.

Cytokine-stimulated GTP cyclohydrolase I expression in endothelial cells requires coordinated activation of nuclear factor-kappaB and Stat1/Stat3.

Endothelial production of nitric oxide (NO) is dependent on adequate cellular levels of tetrahydrobiopterin (BH4), an important cofactor for the nitric oxide synthases. Vascular diseases are often characterized by vessel wall inflammation and cytokine treatment of endothelial cells increases BH4 levels, in part through the induction of GTP cyclohydrolase I (GTPCH I), the rate-limiting enzyme for BH4 biosynthesis. However, the molecular mechanisms of cytokine-mediated GTPCH I induction in the endothelium are not entirely clear.

Hypochlorous acid impairs endothelium-derived nitric oxide bioactivity through a superoxide-dependent mechanism.

Objective: To determine how hypochlorous acid (HOCl), the principal product of myeloperoxidase, modulates vascular function.

Methods And Results: Rabbit arterial rings exposed to HOCl (0 to 500 micromol/L) exhibited dose- and time-dependent impairment of endothelium-dependent arterial relaxation to acetylcholine and A23187, but not the NO donor, diethylamine NONOate, suggesting that HOCl targets the endothelium. This effect was not because of cytotoxicity, as HOCl treatment produced no significant change in endothelial cell morphology or lactate dehydrogenase release.

Measurements of redox control of nitric oxide bioavailability.

The assay outlined in this article have been employed successfully by ourselves and many other investigators to assess endothelial NO production under conditions in which the redox status of the cell has been manipulated. Table I contains expected changes in each of the assays (compared to the control state) that one would expect to see for specific perturbations in the NO-cGMP axis in endothelial cells. Used in combination, these assays can provide considerable insight into the effect of cellular redox status on NO bioactivity and provide the investigator with a good starting point for further mechanistic studies.

Expression of 5-lipoxygenase in pulmonary artery endothelial cells.

Increased expression of 5-lipoxygenase (5LO) in pulmonary artery endothelial cells (PAECs) has been observed in disease states such as pulmonary hypertension and allergen challenge. To understand the function of endothelial 5LO, we examined the expression of this enzyme in normally cultured human PAECs and its characteristics when overexpressed. A small amount of 5LO message and protein was detected by reverse-transcriptase-mediated PCR (RT-PCR) and Western blotting in PAECs.