Exploring essential tremor: Results from a large online survey.

Introduction: Essential tremor (ET) is one of the most common movement disorders; however, many patients are misdiagnosed and do not receive effective treatment. It is important to better understand the diagnosis, symptoms and treatment patterns to improve care for those with ET.

Methods: Persons in the International Essential Tremor Foundation database were invited to complete an online survey, focusing on symptoms, diagnosis, and treatment of ET.

Association of Formulary Exclusions and Restrictions for Opioid Alternatives With Opioid Prescribing Among Medicare Beneficiaries.

Importance: Although there are many pharmacologic alternatives to opioids, it is unclear whether the structure of Medicare Part D formularies discourages use of the alternatives.

Objectives: To quantify the coverage of opioid alternatives and prevalence of prior authorization, step therapy, quantity limits, and tier placement for these drugs, and test whether these formulary exclusions and restrictions are associated with increased opioid prescribing to older adults at the county level.

Design, Setting, And Participants: County fixed-effect models were estimated using a panel of counties across the 50 US states and the District of Columbia over calendar years 2015 and 2016.

Measuring Mass-Based Hygroscopicity of Atmospheric Particles through in Situ Imaging.

Quantifying how atmospheric particles interact with water vapor is critical for understanding the effects of aerosols on climate. We present a novel method to measure the mass-based hygroscopicity of particles while characterizing their elemental and carbon functional group compositions. Since mass-based hygroscopicity is insensitive to particle geometry, it is advantageous for probing the hygroscopic behavior of atmospheric particles, which can have irregular morphologies.

Surgical, oncologic, and cosmetic differences between oncoplastic and nononcoplastic breast conserving surgery in breast cancer patients.

Background: There is a lack of information regarding the safety, complication rate, and cosmetic outcome of oncoplastic breast conserving surgery. The purpose of this study is to evaluate and compare oncoplastic and nononcoplastic procedures.

Methods: A retrospective review was conducted of patients treated with oncoplastic or nononcoplastic lumpectomies.

Monitoring energy balance: metabolites of fatty acid synthesis as hypothalamic sensors.

Because energy balance is important for survival, a system is required to monitor energy status and to make appropriate adjustments in energy intake and energy expenditure. In higher animals, a centrally located system has evolved to accomplish this task. When caloric intake exceeds expenditure, the surplus is channeled into energy storage pathways, primarily the synthesis of fatty acids, which are converted into fat and stored in adipose tissue.

C/EBPalpha reverses the anti-adipogenic effects of the HIV protease inhibitor nelfinavir.

Nelfinavir and other HIV protease inhibitors effectively suppress morbidity and mortality in HIV-infected patients. However, therapeutic use of HIV protease inhibitors has been temporally associated with the development of a lipodystrophy/insulin resistance syndrome and some evidence suggests that HIV protease inhibitors may be the causative agent. We report here that nelfinavir promotes loss of cytoplasmic triglyceride from fully differentiated adipocytes and inhibits preadipocyte differentiation at biologically relevant concentrations.

The British Society of Periodontology referral policy and parameters of care.

This referral policy and parameters of care document was commissioned by the Council of the British Society of Periodontology to provide guidance for practitioners, given the changing environment of primary and secondary care dentistry in the UK. These changes included the provision of the so-called 'high street' specialists in various mono-specialties and engendered a new paradigm of openness and information giving from the profession outwards. This was in turn necessitated by both dento-legal requirements and an increasing demand from the public for the provision of more advanced periodontal care.

Olf-1/early B cell factor is a regulator of glut4 gene expression in 3T3-L1 adipocytes.

A negative regulatory element in the 5'-flanking region of the murine glut4 gene mediates chronic insulin- and cAMP-induced repression in 3T3-L1 adipocytes. Previous work demonstrated that members of the nuclear factor 1 (NF1) family of transcription factors and an unidentified factor bind to and mediate repression from this regulatory element. By using a yeast one-hybrid screen, Olf-1/Early B cell factor (O/E-1) was isolated as a candidate for this unidentified factor.

Management of molar teeth with periodontal disease.

Over the years patients' attitudes towards maintaining a functional and aesthetic masticatory apparatus have improved, and their expectations of delivery of care by the dental professional have risen. With the advance of new techniques and materials, the periodontist can now offer an ever-expanding range of treatments in the management of molar teeth with periodontal disease. This paper considers such treatment in relation to the levels of disease present and within the overall context of adult restorative dental healthcare.

Suppression of preadipocyte differentiation and promotion of adipocyte death by HIV protease inhibitors.

Many human immunodeficiency virus (HIV)-infected patients taking combination antiretroviral therapy that includes HIV protease inhibitors experience atrophy of peripheral subcutaneous adipose tissue. We investigated the effects of HIV protease inhibitors on adipogenesis and adipocyte survival using the 3T3-L1 preadipocyte cell line. Several HIV protease inhibitors were found either to inhibit preadipocyte differentiation or to promote adipocyte cell death.

Interaction of GRASP, a protein encoded by a novel retinoic acid-induced gene, with members of the cytohesin family of guanine nucleotide exchange factors.

A novel, retinoic acid-induced gene, GRP1-associated scaffold protein (GRASP), was isolated from P19 embryonal carcinoma cells using a subtractive screening strategy. GRASP was found to be highly expressed in brain and exhibited lower levels of expression in lung, heart, embryo, kidney, and ovary. The predicted amino acid sequence of GRASP is characterized by several putative protein-protein interaction motifs, suggesting that GRASP may be a component of a larger protein complex in the cell.

The human p53 negative regulatory domain mediates inhibition of reporter gene transactivation in yeast lacking thioredoxin reductase.

Stimulation of target gene transcription by human p53 is inhibited in budding yeast lacking the TRR1 gene encoding thioredoxin reductase. LexA/p53 fusion proteins were used to study the basis for thioredoxin reductase dependence. A fusion protein containing all 393 of the residues of p53 efficiently and specifically stimulated transcription of a LexOP-LacZ reporter gene in wild-type yeast but was several-fold less effective in delta trr1 yeast lacking the thioredoxin reductase gene.

Identification of nuclear receptor corepressor as a peroxisome proliferator-activated receptor alpha interacting protein.

Nuclear receptor corepressor (NCoR) was demonstrated to interact strongly with peroxisome proliferator-activated receptor alpha (PPARalpha), and PPARalpha ligands suppressed this interaction. In contrast to the interaction of PPARalpha with the coactivator protein, p300, association of the receptor with NCoR did not require any part of the PPARalpha ligand binding domain. NCoR was found to suppress PPARalpha-dependent transcriptional activation in the context of a PPARalpha.

Heterodimeric interactions between chicken ovalbumin upstream promoter-transcription factor family members ARP1 and ear2.

Members of the chicken ovalbumin upstream promoter-transcription factor (COUP-TF) subfamily of orphan nuclear receptors, which minimally includes COUP-TFI and ARP1, are highly expressed in brain and are generally considered to be constitutive repressors of transcription. We have used a yeast two-hybrid system to isolate proteins expressed in brain that interact with ARP1. One of the proteins isolated in this screen was Ear2, another orphan receptor that has been suggested to be a member of the COUP-TF subfamily.

p300 functions as a coactivator for the peroxisome proliferator-activated receptor alpha.

The integrator protein, p300, was demonstrated to interact with mouse peroxisome proliferator-activated receptor alpha in a ligand-enhanced manner. The PPARalpha-interacting domain of p300 was mapped to amino acids 39-117 which interacted strongly with PPARalpha but did not interact with retinoic acid receptor-gamma or retinoid X receptor-alpha. Amino acids within the carboxyl terminus of PPARalpha as well as residues within the hinge region were required for ligand-dependent interaction with p300.

Ligand-induced peroxisome proliferator-activated receptor alpha conformational change.

Structurally diverse peroxisome proliferators and related compounds that have been demonstrated to induce the ligand-dependent transcriptional activation function of mouse peroxisome proliferator-activated receptor alpha (mPPARalpha) in transfection experiments were tested for the ability to induce conformational changes within mPPARalpha in vitro. WY-14,643, 5,8,11,14-eicosatetraynoic acid, LY-171883, and clofibric acid all directly induced mPPARalpha conformational changes as evidenced by a differential protease sensitivity assay. Carboxyl-terminal truncation mutagenesis of mPPARalpha differentially affected the ability of these ligands to induce conformational changes suggesting that PPAR ligands may make distinct contacts with the receptor.

A comparative clinical study: the use of human type I collagen with and without the addition of metronidazole in the GTR method of treatment of periodontal disease.

This investigation was undertaken to evaluate cross-linked human type I collagen, with and without added metronidazole, when used as a barrier membrane in the guided tissue regeneration (GTR) principle of treatment for periodontal disease. 16 patients suffering from moderate to severe periodontitis with 78 bilaterally matched periodontal defects underwent similar contralateral surgical flap procedures after preliminary scaling, polishing and oral hygiene instruction. At the experimental sites, which were selected at random, the flap was closed over metronidazole impregnated collagen as a GTR membrane, the contralateral sites receiving a plain collagen barrier as control.

Clinical trial of cross-linked human type I collagen as a barrier material in surgical periodontal treatment.

This study was undertaken to evaluate freeze-dried cross-linked human type I collagen when used as a barrier membrane for guided tissue regeneration (GTR) in periodontal surgery. 14 patients with radiographic evidence of bone loss and residual pocketing of > 6 mm on bilaterally matched sites were given preliminary scaling, polishing and oral hygiene instruction before undergoing contralateral flap surgery. At the experimental sites, a collagen membrane was adapted to the root surfaces, extending from 2 mm apical to the bone crest to just subgingival, before replacing the flap and closing with sutures.

The pharmacokinetics of suriclone after single- and multiple-dose administration in healthy elderly volunteers.

Healthy elderly people aged 70 or more should receive a starting dosage of the anxiolytic drug suriclone half that recommended for younger people; frail or ill elderly people may require further dosage reduction. These conclusions were based on a study of the pharmacokinetics and tolerability of orally administered suriclone after a single dose of 0.2mg and after multiple doses of 0.

Evaluation of functional analogs of CC-1065 and the duocarmycins incorporating the cross-linking 9a-chloromethyl-1,2,9,9a-tetrahydrocyclopropa[c]benz[e]indol-4-on e (C2BI) alkylation subunit.

The DNA alkylation properties and in vitro cytotoxic activity of a series of analogs of CC-1065 and the duocarmycins incorporating the 9a-chloromethyl-1,2,9,9a-tetrahydrocyclopropa[c]benz[e]indol-4-one (C2BI) alkylation subunit are detailed. The C2BI-based agents have been shown to alkylate DNA within the minor groove in a fashion analogous to CC-1065 or duocarmycin. The stereoelectronically-controlled adenine N3 addition to the least substituted cyclopropane carbon occurs with a selectivity that represents a composite of the two enantiomers of the corresponding CBI-based agents.

Freeze-dried, cross-linked bovine type I collagen: analysis of properties.

This study was undertaken to assess the physical and biological properties of freeze-dried cross-linked bovine type I collagen and to assess its potential for use in the guided tissue regeneration method of treatment of periodontal disease in human adult subjects. The modulus of elasticity, swelling ratio, and biodegradation rate were investigated. The collagen sponge was implanted subdermally into Sprague-Dawley rats and a histological study carried out at 2, 7, 21, 35, and 49 days post implantation.

Guided tissue regeneration.

One of the main goals of periodontal therapy is the predictable regeneration of the periodontium by allowing repopulation of periodontal ligament cells into the wound area after surgery and preventing the colonisation of the exposed root surface with epithelial, gingival, and bone cells. In order to achieve this, emphasis has been placed on the use of barrier materials in the form of semipermeable membranes which are interposed between the mucoperiosteal flap and the bone and tooth surfaces during surgery. This technique is known as 'guided tissue regeneration' (GTR) and this article looks at the theory and practice of GTR, as well as reviewing the use of non-resorbable membrane materials such as expanded polytetrafluor-ethylene and ethyl cellulose, and resorbable materials such as collagen and polylactic acid.

Dentine hypersensitivity: effect of interactions between metal salts, fluoride and chlorhexidine on the uptake by dentine.

A large number of compounds may be applied to the teeth for preventive or therapeutic purposes, most notably in dentine hypersensitivity. The uptake of any one compound by tooth substances may clearly be affected by another to produce synergistic, additive or antagonistic effects. This study determined whether uptake interactions occurred between fluoride, chlorhexidine, strontium, tin and zinc.