Lifestyle and physiological risk factor profiles six weeks after an acute cardiac event: are patients achieving recommended targets for secondary prevention?

Background: People who have had a cardiac event are at increased risk of a subsequent event and death and are, therefore, the priority for preventive cardiology in Australia and elsewhere. Guidelines for physiological and lifestyle risk factors have been developed to encourage risk reduction as a means of secondary prevention. The aim of the present study was to investigate achievement of recommended risk factor targets in a sample of Australian cardiac patients.

Neurocognitive function in head and neck cancer patients prior to treatment.

Purpose: Neurocognitive impairment is a common and clinically important problem in patients with cancer, but few studies have been conducted in head and neck cancer (HNC) patients. Our aims were to (1) determine the prevalence of baseline neurocognitive impairment in patients with newly diagnosed HNC, (2) examine the relationships between neurocognitive performance and self-reported neurocognitive function, and (3) explore relationships between neurocognitive function and sociodemographic, clinical, symptom distress, and mood variables.

Methods: Seventy patients underwent testing with a brief neuropsychological test battery and completed self-report measures before starting treatment.

Advanced pneumatic therapy in self-care of chronic lymphedema of the trunk.

Background: The purpose of this study was to conduct a preliminary, post-market, home study of the Flexitouch(®) system to examine the potential efficacy of the device as a component of self-care in breast cancer survivors with truncal lymphedema.

Methods And Results: A quasi-experimental, pre-treatment, post-treatment design was used. Twelve participants received a total of ten self-administered, consecutive, one hour per day treatments.

Lymphedema in patients with head and neck cancer.

Purpose/objectives: to describe the current state of the science on secondary lymphedema in patients with head and neck cancer.

Data Sources: published journal articles and books and data from the National Cancer Institute, the American Cancer Society, and other healthcare-related professional association Web sites.

Data Synthesis: survivors of head and neck cancer may develop secondary lymphedema as a result of the cancer or its treatment.

Late effects of cancer and cancer therapy on oral health and quality of life.

Persisting and chronic oral complications of cancer therapy are common. Oral complications in cancer survivors are underreported but impact oral function and quality of life. Prevention and management of oral complications in cancer survivors requires interdisciplinary care.

Outcomes of kidney transplantation in HIV-infected recipients.

Background: The outcomes of kidney transplantation and immunosuppression in people infected with human immunodeficiency virus (HIV) are incompletely understood.

Methods: We undertook a prospective, nonrandomized trial of kidney transplantation in HIV-infected candidates who had CD4+ T-cell counts of at least 200 per cubic millimeter and undetectable plasma HIV type 1 (HIV-1) RNA levels while being treated with a stable antiretroviral regimen. Post-transplantation management was provided in accordance with study protocols that defined prophylaxis against opportunistic infection, indications for biopsy, and acceptable approaches to immunosuppression, management of rejection, and antiretroviral therapy.

Cancer pain management in ambulatory care: can we link assessment and action to outcomes?

Purpose: Good cancer pain control requires appropriate assessment and treatment. The purpose of this study was to examine the relationships among physician, nurse practitioner, and nurse knowledge, documentation of assessment, treatment, and pain reduction in cancer patients seen in ambulatory settings.

Method: The study method included an assessment of pain knowledge of providers (physicians, nurse practitioners, and nurses) who worked in cancer clinics and a retrospective review of patients' records treated for cancer-related pain in their clinics.

Regulation of heparin-binding EGF-like growth factor by miR-212 and acquired cetuximab-resistance in head and neck squamous cell carcinoma.

Background: We hypothesized that chronic inhibition of epidermal growth factor receptor (EGFR) by cetuximab, a monoclonal anti-EGFR antibody, induces up-regulation of its ligands resulting in resistance and that microRNAs (miRs) play an important role in the ligand regulation in head and neck squamous cell carcinoma (HNSCC).

Methodology/principal Findings: Genome-wide changes in gene and miR expression were determined in cetuximab-sensitive cell line, SCC1, and its resistant derivative 1Cc8 using DNA microarrays and RT-PCR. The effects of differentially expressed EGFR ligands and miRs were examined by MTS, colony formation, ELISA, and western blot assays.

Circadian regulation of locomotor activity and skeletal muscle gene expression in the horse.

Circadian rhythms are innate 24-h cycles in behavioral and biochemical processes that permit physiological anticipation of daily environmental changes. Elucidating the relationship between activity rhythms and circadian patterns of gene expression may contribute to improved human and equine athletic performance. Six healthy, untrained mares were studied to determine whether locomotor activity behavior and skeletal muscle gene expression reflect endogenous circadian regulation.

Cost-related immunosuppressive medication nonadherence among kidney transplant recipients.

Background And Objectives: Immunosuppressive medications are essential in preventing kidney transplant rejection. Continuous insurance coverage for outpatient immunosuppressive medications remains a major issue. The objective of this study was to establish the prevalence and consequences of cost-related immunosuppressive medication nonadherence.

Islet-expressed TLR2 and TLR4 sense injury and mediate early graft failure after transplantation.

Although islet transplantation is an effective treatment for Type 1 diabetes, primary engraftment failure contributes to suboptimal outcomes. We tested the hypothesis that islet isolation and transplantation activate innate immunity through TLR expressed on islets. Murine islets constitutively express TLR2 and TLR4, and TLR activation with peptidoglycan or LPS upregulates islet production of cytokines and chemokines.

Changes in mood states after coronary artery bypass graft surgery.

Few studies have investigated the change in mood states, such as anger, fatigue and confusion, after coronary artery bypass graft surgery (CABGS). The aim of this study was to describe the progression of these mood states over time and to determine the factors associated with these trajectories. The Profile of Mood States (POMS) was administered to 182 CABGS patients prior to surgery and at two and six months post-operatively.

Insulin-like growth factor-1 receptor inhibitor, AMG-479, in cetuximab-refractory head and neck squamous cell carcinoma.

Background: Recurrent head and neck squamous cell carcinoma (HNSCC) remains a difficult cancer to treat. Here, we describe a patient with HNSCC who had complete response to methotrexate (MTX) after progressing on multiple cytotoxic agents, cetuximab, and AMG-479 (monoclonal antibody against insulin-like growth factor-1 receptor [IGF-1R]).

Methods: The clinical information was collected by a retrospective medical record review under an Institutional Review Board-approved protocol.

Immune cell-derived c3 is required for autoimmune diabetes induced by multiple low doses of streptozotocin.

Objective: The complement system contributes to autoimmune injury, but its involvement in promoting the development of autoimmune diabetes is unknown. In this study, our goal was to ascertain the role of complement C3 in autoimmune diabetes.

Research Design And Methods: Susceptibility to diabetes development after multiple low-dose streptozotocin treatment in wild-type (WT) and C3-deficient mice was analyzed.

A single nucleotide polymorphism of Toll-like receptor 4 identifies the risk of developing graft failure after liver transplantation.

Background & Aims: While studies in animal models have linked Toll-like receptor (TLR) 4 signaling to the pathophysiology of ischemia/reperfusion (IR) injury and liver fibrosis, the relevance of TLR4 activation after human liver transplantation is unknown. The TLR4 single nucleotide polymorphism (SNP) D299G is situated within the extracellular domain and diminishes receptor binding to danger-associated molecular patterns.

Methods: We studied the influence of TLR4 D299G on IR injury and graft survival in 430 deceased donor LT recipients.

Complement component C3 allotypes and outcomes in liver transplantation.

The complement system has been implicated in the pathogenesis of liver diseases. Human complement component C3 (C3) exists as 2 allotypes, fast (F) and slow (S). We conducted a study to address the influence of these alleles on ischemia-reperfusion (IR) injury and graft survival in liver transplant recipients.

The variable pathology of kidney disease after liver transplantation.

Background: Chronic kidney disease is a frequent complication in orthotopic liver transplant (OLT) recipients, observed in 10% to 60% after 5 years.

Patients And Methods: We analyzed clinical and pathological data from 81 OLT recipients who developed impaired kidney function with a serum creatinine greater than or equal to 1.5 mg/dL or new proteinuria on dipstick urinalysis.

Primary ocular presentation of sinonasal undifferentiated carcinoma.

The authors describe 2 consecutive patients who presented to Vanderbilt University Medical Center with primary orbital presentation of sinonasal undifferentiated carcinoma and were treated from July 2005 to April 2009. The patients were a 39-year-old woman and 54-year-old woman who both presented to the ophthalmology service due to complaints of diplopia. Imaging studies demonstrated large soft tissue masses originating in the sinuses with extension in the orbit in both cases.

Detection of tumor epidermal growth factor receptor pathway dependence by serum mass spectrometry in cancer patients.

Background: We hypothesized that a serum proteomic profile predictive of survival benefit in non-small cell lung cancer patients treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) reflects tumor EGFR dependency regardless of site of origin or class of therapeutic agent.

Methods: Pretreatment serum or plasma from 230 patients treated with cetuximab, EGFR-TKIs, or chemotherapy for recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) or colorectal cancer (CRC) were analyzed by mass spectrometry. Each sample was classified into "good" or "poor" groups using VeriStrat, and survival analyses of each cohort were done based on this classification.

Tubular expression of KIM-1 does not predict delayed function after transplantation.

Injured epithelial cells of the proximal tubule upregulate the glycoprotein kidney injury molecule 1 (KIM-1), suggesting its potential as a biomarker of incipient kidney allograft injury. It is unknown whether KIM-1 expression changes in kidney allografts with delayed graft function (DGF), which often follows ischemia-reperfusion injury. Here, we prospectively measured KIM-1 RNA and protein expression in preperfusion biopsies of 30 living- and 85 deceased-donor kidneys and correlated the results with histologic and clinical outcomes after transplantation.

Biomarkers Predict p53 Gene Therapy Efficacy in Recurrent Squamous Cell Carcinoma of the Head and Neck.

PURPOSE: Most recurrent squamous cell carcinomas of the head and neck have a dysfunctional p53 tumor suppressor pathway contributing to treatment resistance. We hypothesized that tumor p53 biomarkers may predict the efficacy of normal p53 delivered by gene therapy in these patients. EXPERIMENTAL DESIGN: Tumor p53 biomarkers were evaluated in 116 patients, including 29 treated with methotrexate in a phase III randomized controlled trial.