Neuropsychologic and quality-of-life outcomes after coronary artery bypass surgery with and without cardiopulmonary bypass: a prospective randomized trial.

Objectives: The objective of this study was to compare neuropsychologic and quality-of-life outcomes of patients undergoing off-pump coronary artery bypass surgery to those undergoing coronary artery bypass graft surgery using conventional cardiopulmonary bypass.

Design: A prospective randomized trial of coronary artery bypass graft surgery with and without the use of cardiopulmonary bypass.

Setting: A cardiothoracic surgery unit at a tertiary hospital.

Sodium-hydrogen exchange inhibition by cariporide to reduce the risk of ischemic cardiac events in patients undergoing coronary artery bypass grafting: results of the EXPEDITION study.

Background: The EXPEDITION study addressed the efficacy and safety of inhibiting the sodium hydrogen exchanger isoform-1 (NHE-1) by cariporide in the prevention of death or myocardial infarction (MI) in patients undergoing coronary artery bypass graft surgery. The premise was that inhibition of NHE-1 limits intracellcular Na accumulation and thereby limits Na/Ca-exchanger-mediated calcium overload to reduce infarct size.

Methods: High-risk coronary artery bypass graft surgery patients (n = 5,761) were randomly allocated to receive either intravenous cariporide (180 mg in a 1-hour preoperative loading dose, then 40 mg per hour over 24 hours and 20 mg per hour over the subsequent 24 hours) or placebo.

Anxiety and depression as risk factors for mortality after coronary artery bypass surgery.

Objective: This retrospective study examined the association between symptoms of depression, anxiety, and mortality risk following coronary artery bypass graft (CABG) surgery.

Methods: We assessed 440 CABG surgery patients' scores on the Depression Anxiety and Stress Scale (DASS) and followed up mortality status for a median of 5 years, 10 months.

Results: There were 67 (15%) deaths overall during the follow-up period.

Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) Trial: rationale and design.

Background: Despite some concern that recent aspirin ingestion increases blood loss after coronary artery surgery, there is some evidence that this may reduce thrombotic complications. In contrast, antifibrinolytic drugs can reduce blood loss in this setting, but there is concern that they may increase thrombotic complications. Published guidelines are limited by a lack of large randomized trials addressing the risks and benefits of each of these commonly used therapies in cardiac surgery.

The role of parental consent in adolescent substance use research.

Purpose: The objective of our study was to assess the effects of requiring parental consent upon study participation and self-reported substance-related problems among 14-18-year-olds.

Methods: This was a secondary analysis of combined data from two similar studies of adolescent substance use that recruited participants from the same adolescent clinic at Children's Hospital Boston. Study 1 waived parental consent, whereas Study 2 required parental consent.

Antineoplastic agents. 558. Ampelocissus sp. cancer cell growth inhibitory constituents.

An investigation of the Phillippine Ampelocissus sp. roots for cancer cell growth inhibitory components led to the isolation of a new acetogenin characterized as 22-epicalamistrin (1) employing primarily 2D NMR and high-resolution mass spectral analysis. Two other antineoplastic constituents proved to be the known acetogenin uvaribonin (2) and chalcone 3.

Screening, brief intervention, and referral to treatment for adolescents.

Drug, alcohol, and tobacco use is highly prevalent among high school students in United States, and adolescents, even those without a substance use disorder, are at high risk of morbidity and mortality related to use of these substances. The primary care setting provides access to adolescents, and the health maintenance visit provides a private, confidential setting in which patients expect to discuss health-related behaviors and receive advice. This article reviews guidelines for identifying and managing adolescent substance use in the primary care setting, including screening, brief intervention, and referral to treatment.

Adolescents' preference for substance abuse screening in primary care practice.

Objective: To assess adolescents' preferences for substance abuse screening in primary medical care settings.

Design/methods: Twelve- to 18-year-old patients (N = 2133) arriving for routine care at a network of primary care sites completed an interview that included demographic items, the CRAFFT screen, and a questionnaire assessing preferences for screening method (paper questionnaire, computer, oral interview by nurse or doctor). A subgroup (n = 222) completed the CRAFFT directly on the computer.

The role of schools in combating illicit substance abuse.

Disturbingly high levels of illicit drug use remain a problem among American teenagers. As the physical, social, and psychological "home away from home" for most youth, schools naturally assume a primary role in substance abuse education, prevention, and early identification. However, the use of random drug testing on students as a component of drug prevention programs requires additional, more rigorous scientific evaluation.

Inner-city asthma: the role of the community.

Asthma morbidity and mortality are disproportionately high in low-income minority populations. Variations in environmental exposures, stress, and access to appropriate health care all contribute to these disparities. The complex nature of asthma with strong contributions from environmental, psychosocial, and biological factors suggest that community-based approaches focused on the unique needs of high-risk populations may be effective.

Prevalence of positive substance abuse screen results among adolescent primary care patients.

Objectives: To measure the prevalence of positive substance use screen results among adolescent primary care patients and to estimate the prevalence of substance-related problems and disorders.

Design: Cross-sectional survey.

Setting: A network of primary care practices in New England.

Variability of Oxalobacter formigenes and oxalate in stool samples.

Purpose: The intestinal organism Oxalobacter formigenes is unique in using oxalate as its primary carbon and energy source. Intestinal colonization with O. formigenes may have clinical significance by decreasing intestinal oxalate and its absorption, thereby influencing the concentration of oxalate in plasma and urine, and the development of calcium oxalate stone disease.