Slc2a5 (Glut5) is essential for the absorption of fructose in the intestine and generation of fructose-induced hypertension.

The identity of the transporter responsible for fructose absorption in the intestine in vivo and its potential role in fructose-induced hypertension remain speculative. Here we demonstrate that Glut5 (Slc2a5) deletion reduced fructose absorption by approximately 75% in the jejunum and decreased the concentration of serum fructose by approximately 90% relative to wild-type mice on increased dietary fructose. When fed a control (60% starch) diet, Glut5(-/-) mice had normal blood pressure and displayed normal weight gain.

Diagnostic-therapeutic cascade revisited: coronary angiography, coronary artery bypass graft surgery, and percutaneous coronary intervention in the modern era.

Background: There is wide geographic variation in the use of coronary revascularization in the United States. Rates are closely related to rates of coronary angiography. We assessed the relationship between coronary angiography and coronary artery revascularization by procedure type (coronary artery bypass graft surgery or percutaneous coronary intervention).

Frequency of stress testing to document ischemia prior to elective percutaneous coronary intervention.

Context: Guidelines call for documenting ischemia in patients with stable coronary artery disease prior to elective percutaneous coronary intervention (PCI).

Objective: To determine the frequency and predictors of stress testing prior to elective PCI in a Medicare population.

Design, Setting, And Patients: Retrospective, observational cohort study using claims data from a 20% random sample of 2004 Medicare fee-for-service beneficiaries aged 65 years or older who had an elective PCI (N = 23 887).

Outcomes following coronary stenting in the era of bare-metal vs the era of drug-eluting stents.

Context: Although drug-eluting stents reduce restenosis rates relative to bare-metal stents, concerns have been raised that drug-eluting stents may also be associated with an increased risk of stent thrombosis. Our study focused on the effect of stent type on population-based interventional outcomes.

Objective: To compare outcomes of Medicare beneficiaries who underwent nonemergent coronary stenting before and after the availability of drug-eluting stents.

Pyrazolopyridines as a novel structural class of potent and selective PDE4 inhibitors.

Optimisation of a high-throughput screening hit resulted in the discovery of 4-(substituted amino)-1-alkyl-pyrazolo[3,4-b]pyridine-5-carboxamides as potent and selective inhibitors of Phosphodiesterase 4 (PDE4). Herein, we describe early SAR studies around this novel template highlighting preferred substituents and rationalization of SAR through X-ray crystal structures of analogues bound to the PDE4 active site. Pyrazolopyridine 20a was found to be a potent and selective PDE4 inhibitor which also inhibits LPS induced TNF-alpha production from isolated human peripheral blood mononuclear cells and has an encouraging rat PK profile suitable for oral dosing.

Characterization of a prospective human model for study of the reproductive hormone responses to major illness.

With critical illness, serum testosterone levels fall markedly, whereas estrogen levels rise. Although animal studies suggest adaptive advantages, no prospective model has been available for studies in humans. We hypothesized that coronary artery bypass graft (CABG) surgery would provide such a model by eliciting the same reproductive hormone and other endocrine responses as reported with major nonsurgical illnesses.

Changes in the use of carotid revascularization among the medicare population.

Hypothesis: It remains unknown if the increasing use of carotid artery stenting (CAS) has caused a change in the population-based use of carotid endarterectomy (CEA). We sought to examine national trends in carotid revascularization.

Design: Retrospective cohort study.

Development of fragment-specific osteopontin antibodies and ELISA for quantification in human metastatic breast cancer.

Background: Osteopontin (OPN) is associated with human cancers, and circulating blood OPN may have diagnostic or prognostic value in clinical oncology.

Methods: To evaluate OPN as a cancer biomarker, we generated and characterized five novel mouse monoclonal antibodies against the human full-length OPN (fl-OPN). Epitopes recognized by four antibodies (2C5, 2F10, 2H9, and 2E11) map to N-terminal OPN (aa1-166); one (1F11) maps to C-terminal OPN (aa167-314).

Molecular evaluation of the incidence of Ehrlichia canis, Anaplasma platys and Babesia spp. in dogs from Ribeirão Preto, Brazil.

Canine monocytic ehrlichiosis caused by Ehrlichiacanis is endemic in many regions of Brazil. Since thrombocytopenia is a common finding in infected dogs, many clinicians tend to use it as an indication for antibiotic treatment. Polymerase chain reaction (PCR) and nested PCR were used to study the presence of E.

Differences in cardiac stress testing by sex and race among Medicare beneficiaries.

Background: Although there is a wide literature demonstrating sex and race differences in the receipt of invasive cardiac tests and treatments, much less is known about the influence of such characteristics on receipt of a stress test, the first event in the diagnostic/treatment cascade for many patients. We explored the influence of patient characteristics on receipt of a stress test, with special attention to sex and race.

Methods: We performed a nested case-control study of Medicare beneficiaries who were aged 66 years and older during 1999-2001 and were free of cardiac diagnoses and procedures for at least 1 year.

Initial presentation of older injured patients to high-volume hospitals is not associated with lower 30-day mortality in Medicare data.

Objective: To evaluate whether survival of older patients with severe injuries is positively associated with initial presentation to high-volume trauma hospitals.

Design: Historical cohort study.

Setting: We analyzed Medicare fee-for-service records.

Do race-specific models explain disparities in treatments after acute myocardial infarction?

Background: Racial differences in healthcare are well known, although some have challenged previous research where risk-adjustment assumed covariates affect whites and blacks equally. If incorrect, this assumption may misestimate disparities. We sought to determine whether clinical factors affect treatment decisions for blacks and whites equally.

Physiological effects of nonthyroidal illness syndrome in patients after cardiac surgery.

In a prospective randomized placebo-controlled study, we assessed potential physiological effects of nonthyroidal illness syndrome (NTIS) in acute illness. Coronary artery bypass graft surgery was employed as a prospective model of acute illness and NTIS. Triiodothyronine (T(3)) or placebo was infused for 24 h after surgery, with a T(3) dose selected to maintain postoperative serum T(3) concentrations at preoperative levels.

Predicting hospital mortality, length of stay, and transfer to long-term care for injured patients.

Background: Using hospital length of stay (LOS) to measure trauma care efficiency is complicated by short LOS resulting from early mortality or transfer to long-term care (LTC).

Methods: Records from the 1999 to 2003 National Trauma Data Bank were used to create a multistate model divided into four time periods, each with constant rates of death, discharge home, and LTC transfer. Estimated hospital mortality and LOS for patient subgroups were calculated from this model, and time-varying covariate effects were estimated.

U.S. trends in CABG hospital volume: the effect of adding cardiac surgery programs.

Hospital coronary artery bypass graft (CABG) volume is inversely related to mortality--with low-volume hospitals having the highest mortality. Medicare data (1992-2003) show that the number of CABG procedures increased from 158,000 in 1992 to a peak of 190,000 in 1996 and then fell to 152,000 in 2003, while the number of hospitals performing CABG increased steadily. Predictably, the proportion of CABG procedures performed at low-volume hospitals increased, and the proportion in high-volume hospitals declined.

[Analysis of antiretroviral drugs-induced adverse effects].

In 1999, The Regional Center of Pharmacogilance and the Department of Infectious Disease of the Toulouse University Hospital set up a system to improve the data collection about antiretroviral-induced adverse reactionss (ADRs). From November 1999 to April 2003, a resident of pharmacovigilance collected ADRs reported with antiretroviral drugs during 2 weekly medical consultations. A total of 613 ADRs corresponding to 428 patients were reported, classified as "non serious" in 88.

The rising prevalence of androgen deprivation among older American men since the advent of prostate-specific antigen testing: a population-based cohort study.

Objective: To investigate the effect of efforts in the early detection of prostate cancer using prostate-specific antigen (PSA) testing in the USA, by estimating the regional prevalence of androgen deprivation therapy (ADT) among older men in 1993-2000, and correlating the prevalence with early detection and aggressive treatment rates in 1987-91, as some authors predicted that ADT, a treatment traditionally reserved for advanced prostate cancer, would become less common over time as a result of such efforts.

Patients And Methods: A sample of 5% of men who were Medicare beneficiaries was used in this prospective population-based cohort study. The main outcome measures were the overall prevalence of ADT (medical and surgical) in the cohort from 1993 to 2000, and correlations between rates of prostate procedures in the 306 USA hospital referral regions in 1987-91 and prevalence of ADT in those regions from 1993 to 2000.

[Not Available].

Analysis of Antiretroviral Drugs-Induced Adverse Elfects. In 1999, The Regional Center of Pharmacogilance and the Department of Infectious Disease of the Toulouse University Hospital set up a system to improve the data collection about antiretroviral-induced adverse reactionss (ADRs). From November 1999 to April 2003, a resident of pharmacovigilance collected ADRs reported with antiretroviral drugs during 2 weekly medical consultations.

Radium content in ground water from a granitic batholith of the metamorphic basement, eastern São Paulo State, Brazil.

The radon emanation method was applied to measure the activity of 226Ra, dissolved and associated with suspended solids, in the ground waters from two wells drilled in the Morungaba Batholith fractured granites, intruded in the metamorphic basement, eastern border of the Paraná basin in São Paulo State, Brazil. The water samples were collected from March 2003,to April 2004, with a time interval of about one month between sampling campaigns. The mean observed dissolved 226Ra activity concentrations in the two wells were 47.

Race and surgical mortality in the United States.

Objective: This study describes racial differences in postoperative mortality following 8 cardiovascular and cancer procedures and assesses possible explanations for these differences.

Summary Background Data: Although racial disparities in the use of surgical procedures are well established, relationships between race and operative mortality have not been assessed systematically.

Methods: We used national Medicare data to identify all patients undergoing one of 8 cardiovascular and cancer procedures between 1994 and 1999.

Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993-2001.

Background: Rates of invasive testing and treatment for coronary artery disease have increased over time. Less is known about trends in the utilization of noninvasive cardiac testing for coronary artery disease. The objective of this study was 2-fold: to explore temporal trends in the utilization of noninvasive and invasive cardiac services in relation to changes in the prevalence of cardiac disease, and to examine whether temporal increases have been targeted to potentially underserved populations.

The relation between patients' outcomes and the volume of cardioverter-defibrillator implantation procedures performed by physicians treating Medicare beneficiaries.

Objectives: The purpose of this study is to determine if implantable cardioverter-defibrillator (ICD) implantation should be limited to physicians with high procedural volume.

Background: Expanding indications for ICDs will result in an increasing number of physicians implanting these devices.

Methods: Using the 20% Part B Medicare files for 1999 through 2001, we identified new ICD implantations and the corresponding denominator files.

Progression of the renal graft: treatment of acute rejection based on a biopsy against a presumptive diagnosis.

The aim of this study was to compare the progression of renal grafts following treatment of an acute rejection event based on the histological diagnosis of a graft biopsy compared to a presumptive (clinical and laboratory) diagnosis. A historical cohort was used to study 44 patients undergoing a living haploidentical related donor renal transplant, using a similar immunosuppressive treatment: cyclosporine, azathioprine, and prednisone. Acute rejection events were treated with methylprednisolone (250 mg for 3 to 5 days) based on a histological diagnosis (biopsy group = 14) or on a clinical and laboratory diagnosis (presumptive group = 30), which consisted of an elevation over 20% in plasma creatinine in 24 hours and renal ultrasound or scintigraphy findings.

Flavor preference conditioning as a function of fat source.

Rats learn to prefer foods based, in part, on postingestive nutrient actions. This study compared the effectiveness of intragastric (IG) infusions of fat emulsions which varied in their fatty acid composition (chain length and saturation) to condition preferences for flavored saccharin solutions. In Experiment 1, food-restricted rats were trained (30 min/day) with one flavor (CS+CO) paired with IG corn oil (CO) and a second flavor (CS+MCT) paired with IG medium chain triglyceride (MCT); the fats were prepared as isocaloric emulsions.