Corticospinal activity during a single-leg stance in people with chronic ankle instability.

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls.

Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.

Potential Corticomotor Plasticity in Those with and without Chronic Ankle Instability.

Introduction: Quantifying corticomotor alterations is important to understand the neurophysiological mechanisms that likely contribute to the neuromuscular control deficits observed in patients with chronic ankle instability (CAI). Corticomotor output mapping provides further insight into the changes within the motor cortex and identifies potential changes in the area of the motor cortex associated with selected muscles. Therefore, this investigation compared the corticomotor map output for the fibularis longus (FL) muscle in patients with and without CAI.

The risk of esophageal obstruction associated with an anti-allergy medication (Claritin-D 24-Hour--original formulation).

Purpose: To investigate a possible increased risk of esophageal obstruction among users of loratadine and pseudoephedrine (Claritin-D 24-Hour [C-D 24], the original, round, extended-release formulation) compared to two other tablet formulations of loratadine.

Methods: Pharmacy data of 12 managed care plans were screened to identify users in the three groups from 1 September 1996 to 31 December 1998. Users with a medical claim following their first loratadine prescription (Index prescription) indicating an esophageal obstruction or endoscopic procedure were considered claims-identified cases.

Incidence of idiopathic acute liver failure and hospitalized liver injury in patients treated with troglitazone.

Objective: Troglitazone, a thiazolidinedione antidiabetic agent, was withdrawn from the U.S. market in March, 2000, after 94 cases of acute liver failure (ALF) were reported with its use.

A study of compliance with FDA recommendations for pemoline (Cylert).

Objective: To assess compliance with product labeling recommendations to use pemoline as second-line therapy for attention-deficit/hyperactivity disorder (ADHD) and to obtain baseline and biweekly liver enzyme tests.

Method: Retrospective cohort study using administrative claims data to identify first-line therapies and liver enzyme tests among pemoline users between January 1, 1998, and March 31, 2000. Prescriptions for first-line therapy were searched for 90 days prior to the first pemoline claim.

Ambulatory use of psychotropics by employer-insured children and adolescents in a national managed care organization.

Objective: To provide a description of the ambulatory use of psychotropic medications by children and adolescents in a large, geographically diverse employer-insured population.

Design: This retrospective observational study used administrative claims data for 1995-1999 for members under age 20 in 6 Independent Practice Association health plans affiliated with UnitedHealth Group. We calculated the prevalences of use for 4 major therapeutic drug classes: central nervous system stimulants (CNSSs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other antidepressants (OADs).

Liver enzyme monitoring in patients treated with troglitazone.

Context: Soon after initial marketing in March 1997, troglitazone, the first thiazolidinedione antidiabetic agent, was found to cause life-threatening acute liver failure. The drug was removed from the market in March 2000.

Objective: To evaluate the effect of US Food and Drug Administration (FDA) risk management efforts, including repeated labeling changes and "Dear Healthcare Professional" letters, on periodic liver enzyme monitoring of patients taking troglitazone.

Postmarketing surveillance of medications and pregnancy outcomes: clarithromycin and birth malformations.

Purpose: This retrospective surveillance study used linked administrative claims data and medical records to determine the rate and types of birth malformations in infants born to women exposed to the antibiotic, clarithromycin (Biaxin), during the first trimester of pregnancy.

Methods: Pharmacy and hospital claims from eight geographically diverse health plans were used to identify women who had a delivery claim within 270 days of a clarithromycin prescription over a 5-year period (1991-1995). Hospital delivery admission medical records for 143 mothers and their 149 infants were abstracted to identify birth malformations.

Healthy pregnancy program in a national managed care organization: evaluation of satisfaction and health behavior outcomes.

Objective: To evaluate satisfaction with the Healthy Pregnancy Program (HPP), which was developed to educate and coordinate the care of pregnant women in a managed care setting.

Study Design: Telephone survey.

Patients And Methods: A random sample of program participants at 3 large health plans were contacted by telephone to evaluate their satisfaction with the program overall and with its components, including an educational booklet and telephone contact with a HPP nurse as needed.

Tramadol and seizures: a surveillance study in a managed care population.

Study Objective: To investigate the occurrence of tramadol-associated seizures.

Design: Retrospective cohort and case-control studies.

Setting: UnitedHealth Group-affiliated independent practice model health plans, from different regions of the United States, contracting with large networks of physicians.

Medical records and privacy: empirical effects of legislation.

Objective: To determine the effects of state legislation requiring patient informed consent prior to medical record abstraction by external researchers for a specific study.

Data Sources/study Setting: Informed consent responses obtained from November 1997 through April 1998 from members of a Minnesota-based IPA model health plan.

Study Design: Descriptive case study of consent to gain access to medical records for a pharmaco-epidemiologic study of seizures associated with use of a pain medication that was conducted as part of the FDA's post-marketing safety surveillance program to evaluate adverse events associated with approved drugs.

Association between family history of cancer and breast cancer defined by estrogen and progesterone receptor status.

There are recent data to suggest that risk factors for breast cancer may differ according to whether the tumor expresses detectable levels of the estrogen receptor (ER) and progesterone receptor (PR). While a family history of breast cancer is one of the most consistent predictors of the disease, we recently reported a modest inverse association with ER+PR- tumors. However, the definition of a family history of cancer did not consider second-degree relatives or cancer sites that may be etiologically related.

Association of body mass index and body fat distribution with risk of lung cancer in older women.

Obesity has been associated with an increased risk of cancer at a number of sites. A notable exception appears to be lung cancer, for which several studies suggest a modest inverse association. However, cigarette smoking is directly associated with lung cancer and inversely associated with body mass index.

Progesterone and estrogen receptors and mammary neoplasia in the Iowa Women's Health Study: how many kinds of breast cancer are there?

Characterization of breast tumors on both estrogen receptor (ER) and progesterone receptor (PR) status suggests distinct biological and clinical profiles. We hypothesized that these tumor subtypes might also show specific differences in their relations with epidemiologic risk factors. Risk factors were assessed via a questionnaire mailed in January 1986 to 37,105 cancer-free women, ages 55-69 years: the Iowa Women's Health Study.

Synergistic effect between alcohol and estrogen replacement therapy on risk of breast cancer differs by estrogen/progesterone receptor status in the Iowa Women's Health Study.

Two cohort studies have reported that alcohol and estrogen replacement therapy (ERT) act synergistically to increase the incidence of breast cancer. Possible interactions between alcohol consumption and family history of breast cancer or body mass index were also reported in the Iowa Women's Health Study data. In the Iowa Women's Health Study cohort, alcohol appears to be associated only with estrogen receptor-negative (ER-)/progesterone receptor-negative (PR-) breast cancers.

Dietary fat and risk of breast cancer according to hormone receptor status.

The association of dietary fat with breast cancer in prospective cohort studies has generally been weak and not statistically significant. However, these studies have not considered whether the risk related to fat intake may differ according to estrogen or progesterone receptor status. Dietary habits and other breast cancer risk factors were assessed by mailed questionnaire in January 1986 in 34,388 postmenopausal Iowa women.

Familial clustering of breast and prostate cancers and risk of postmenopausal breast cancer.

Background: Previous studies have suggested that cancers of the breast and prostate cluster in families and that the presence of both diseases in a family may be associated with increased risk of breast cancer.

Purpose: Our purpose was to evaluate whether 1) prostate cancer aggregates in families with postmenopausal breast cancer, 2) families with cancers of the breast and prostate are the same ones as families with cancers of the breast and ovary, and 3) a family history of prostate cancer is associated with increased risk of postmenopausal breast cancer.

Methods: We analyzed data from a large prospective cohort study of Iowa women that were (at baseline) aged 55-69 years in 1986.

Familial aggregation and heritability of waist-to-hip ratio in adult women: the Iowa Women's Health Study.

The aim of this study was to assess evidence that genetic factors influence body fat distribution. First-degree relatives of 324 cancer-free females in a population-based prospective study of 41,837 women (99% white) between the ages of 55 and 69 at baseline in 1986 were studied. A total of 396 living sisters (mean age 65.

Periodontal status of individuals in early stages of human immunodeficiency virus infection.

The purpose of this study was to evaluate the association of periodontal health and human immunodeficiency virus infection among individuals in the early stages of disease who were participating in randomized placebo-controlled clinical trials of zidovudine. Previous reports have described a rapidly progressive periodontitis and atypical gigivitis associated with late stages of infection by the human immunodeficiency virus. A health history was completed by each subject.

A comparison of the effects of continuous and periodic fluoride delivery on fluoride levels in plasma, enamel, and bones of nursing rats.

The purpose of this study was to determine and compare the F levels in plasma, enamel, and bones of nursing rat pups that received the same daily dose of F by continuous or periodic delivery during enamel development. The hypothesis was that F delivered continuously would result in enamel F levels higher than those attained when F was delivered periodically. For continuous delivery, copolymer devices (Southern Research Institute) that provide slow release of F were implanted in the backs of four-day-old rat pups.

Enamel fluoride in nursing rats with mothers drinking water with high fluoride concentrations.

The purpose of this study was to determine the F levels in plasma and molar enamel from rat pups whose mothers had received various levels of F during pregnancy and/or lactation. Rats were started on water containing 0 (Group I), 50 (Group II), or 100 (Group III) ppm F at the beginning of pregnancy or on the day of delivery. The mothers and pups were killed 13 days after delivery, and plasma F levels, milk F levels, and pup molar enamel F levels were determined.

The effect of fluoride on the electrophoretic patterns of developing rat molar enamel.

Rat pups were given 4 micrograms F/g X day from 3-7 days of age by intraperitoneal injection of NaF. Demineralized enamel matrix from 8- to 15-day-old rats was subjected to SDS-polyacrylamide gel electrophoresis. The results showed that there was a decrease in the relative proportion of high molecular-weight proteins with maturation.