Pharmacotherapy of Autism Spectrum Disorder: Results from the Randomized BAART Clinical Trial.

The objective of this trial, Biomarkers in Autism of Aripiprazole and Risperidone Treatment (BAART), was to provide support and guidance for an evidence-based approach for the selection and monitoring of initial pharmacotherapy in patients with autism by assessing predictors of efficacy, tolerability, and safety. This randomized double-blind parallel-group study was conducted in three academic medical centers and a single private pediatric practice. Eighty children or adolescents (aged 6-17 yrs) with autistic disorder were enrolled, and 61 patients were randomized to the study drug.

Gender differences in traumatic event exposure and mental health among veteran primary care patients.

Objective: This study evaluated gender differences in lifetime traumatic events, PTSD, and depression among VA primary care patients.

Method: Participants were 865 adults attending primary care at one of four VA health centers (n = 681 males, 184 females).

Results: Mental health findings included: male PTSD 12.

Aripiprazole brain concentration is altered in P-glycoprotein deficient mice.

P-glycoprotein (P-gp) is a transporter that mediates the tissue disposition of numerous drugs. To evaluate the role of P-glycoprotein (P-gp) in aripiprazole tissue distribution and penetration across the blood-brain barrier, mice deficient in the P-gp gene (Abcb1a/b-/-) were dosed intraperitoneally with 2 microg/g mouse of the antipsychotic drug aripiprazole. Wildtype FVB mice were administered the same dose as transgenic animals.

Variation in L-arginine intake follow demographics and lifestyle factors that may impact cardiovascular disease risk.

Little is known regarding the patterns of dietary intake of the amino acid L-arginine in the general population and, particularly, whether intake varies according to race or the presence of cardiovascular risk factors. This study is an analysis of adults 18 years and older who participated in the Third National Health and Nutrition Examination Survey, a national public-use nutrition survey of noninstitutionalized persons. Mean arginine intake for the US adult population was 4.

Factors influencing physician referrals of patients to clinical trials.

Purpose: Initial trials in the NIH Parkinson's disease (PD) network (NET-PD) included 91% Caucasian non-Latino patients, although PD is thought to be as common among African Americans and Latinos. Our purpose was to assess physicians' attitudes and beliefs about patient recruitment, particularly minorities, into clinical trials.

Methods: We surveyed 200 physicians from areas near the NET-PD clinics with > or =40% African Americans or Latinos.

Acculturation and healthy lifestyle among Latinos with diabetes.

Purpose: Latinos have a high prevalence of diabetes and disproportionately experience diabetic complications. We sought to examine the association of acculturation on healthy lifestyle habits among the Latino population in the United States with diabetes.

Methods: We studied Latino adults (aged >or=20 years) with previously diagnosed diabetes in the 1999-2004 National Health and Nutrition Examination Survey (unweighted N = 467; weighted N = 1,957,778).

Effect of psyllium fiber supplementation on C-reactive protein: the trial to reduce inflammatory markers (TRIM).

Purpose: Recent evidence supports a significant association between the intake of dietary fiber and levels of inflammatory markers. The objective of this study was to determine whether daily fiber supplementation would reduce levels of inflammatory markers.

Methods: This study was a prospective randomized controlled trial at a single university medical center.

Adopting moderate alcohol consumption in middle age: subsequent cardiovascular events.

Purpose: Moderate alcohol use is part of a healthy lifestyle, yet current guidelines caution nondrinkers against starting to drink alcohol in middle age. The purpose of this study was to evaluate whether adopting moderate alcohol consumption in middle age would result in subsequent lower cardiovascular risk.

Methods: This study examined a cohort of adults aged 45-64 years participating in the Atherosclerosis Risk in Communities study over a 10-year period.

Prenatal care initiation among pregnant teens in the United States: an analysis over 25 years.

Purpose: To examine changes in the initiation of prenatal care by teenage girls in the United States between 1978 and 2003.

Methods: Using birth certificate data collected by the National Center for Health Statistics from 1978, 1983, 1988, 1993, 1998, and 2003 we described initiation of prenatal care in preteens (aged 10-14 years), young adolescents (aged 15-16), and older adolescents (aged 17-19) by the trimester in which care began.

Results: Although all three age groups showed trends toward earlier prenatal care, shifts to earlier prenatal care were mainly the result of more girls starting care in the first trimester and fewer in the second trimester.

Inpatient care in a community hospital: comparing length of stay and costs among teaching, hospitalist, and community services.

Introduction: Specific patient care measures and cost of hospitalization are being studied as health care providers and payers are seeking methods to improve the hospital care of patients. This study's purpose was to examine the length of stay and cost of inpatient care by a family medicine teaching service in comparison with the hospitalists' and community physicians' services in the same community hospital.

Methods: We analyzed inpatient admissions to either a family medicine teaching service (FMTS), hospitalist physician group, or the patient's own primary care community physician in a 290-bed, for-profit, community hospital over a 12-month period.

Factors affecting research participation in African American college students.

Background And Objectives: African American participation in research trials must increase. This study evaluates factors affecting participation of African American college students in medical research.

Methods: A total of 200 students attending South Carolina State University (SCSU), a historically black college, completed surveys evaluating the likelihood of participation within 6 months in three types of noninvasive research studies (surveys with or without questions regarding sensitive information and collection of DNA with a buccal swab).

Influence of residency training on procedures performed by South Carolina family medicine graduates.

Background And Objectives: Guidelines regarding procedure training in family medicine residencies are nonspecific. This study describes procedure practices of South Carolina family medicine residency graduates.

Methods: Of 1,416 surveys mailed to graduates of South Carolina Area Health Education Consortium (SC AHEC) family medicine residency programs, 144 were undeliverable.

Heterogeneity in management of diabetes mellitus among Latino ethnic subgroups in the United States.

Background: Recent debate suggests that general racial/ethnic categories may obscure potentially important subgroup differences within minority groups. The purpose of this study was to examine the quality of diabetes care among ethnic subgroups of the Latino population in the United States while accounting for aspects of acculturation and access to care.

Methods: We evaluated adults (> or =18 years old) with previously diagnosed diabetes in the 2003 National Health Interview Survey (n = 2136; United States population estimate = 13,471,587).

Psychosocial factors and progression from prehypertension to hypertension or coronary heart disease.

Purpose: This study explored the influence of trait anger and long-term psychological stress on progression to hypertension and incident coronary heart disease (CHD) in persons with prehypertension.

Methods: A secondary data analysis was performed using the Atherosclerosis Risk in Communities (ARIC) study, a cohort of men and women aged 45 to 64 years at enrollment. Participants with blood pressures in the prehypertension range at the second visit conducted between 1990 and 1992, free of heart disease or stroke, and observed through the end of the ARIC study (1996-1998) were included (N = 2,334).

Use of statins and blood pressure.

Background: Markers of inflammation such as high-sensitivity C-reactive protein (CRP) were shown to be elevated in patients with hypertension. Small trials using statin therapy showed blood-pressure (BP) reductions, but it is unknown whether this association extends to larger populations. The objective of this study was to determine whether statin use was associated with better blood-pressure control in adults with hypertension and whether inflammation levels mediated this relationship.

Insulin resistance in adolescents.

Objectives: To investigate the relationship of other body mass index (BMI) ranges with Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), a surrogate marker for insulin resistance in adolescents.

Study Design: Cross-sectional analysis of a nationally representative sample of 1837 nondiabetic, nonpregnant 12 to 19 year old persons from the National Health and Nutrition Examination Survey, 1999-2002. The main outcome measurement of insulin resistance was calculated as HOMA-IR > 3.

Turning back the clock: adopting a healthy lifestyle in middle age.

Purpose: To determine the frequency of adopting a healthy lifestyle (5 or more fruits and vegetables daily, regular exercise, BMI 18.5-29.9 kg/m2, no current smoking) in a middle-aged cohort, and determine the subsequent rates of cardiovascular disease (CVD) and mortality among those who adopt a healthy lifestyle.

Magnesium intake and serum C-reactive protein levels in children.

The objective of this study was to determine whether magnesium consumption is associated with inflammation (C-reactive protein [CRP]) in children. The study was an analysis of child (age 6-17 years) participants in the cross-sectional, nationally representative National Health and Nutrition Examination Survey (NHANES). Children consuming less than 75% of RDA were 1.

Competing impact of excess weight versus cardiorespiratory fitness on cardiovascular risk.

Obesity is a risk factor for cardiovascular disease, whereas high cardiorespiratory fitness (CRF) is cardioprotective. This study evaluated the competing effect of weight and fitness on biomarkers of cardiovascular risk in a nationally representative sample of 2,112 adults (20 to 49 years of age; body mass index [BMI] > or =18.5 kg/m(2)) without previously diagnosed cardiovascular disease from the National Health and Nutrition Examination Survey 1999 to 2002.

Performance outcomes associated with medical school community service.

Background: Providing medical students with community service opportunities during medical school is believed to foster altruism. Little is known whether voluntary community service is associated with students' academic and clinical skill performance. This study examined the relationship between students' volunteer community service hours during medical school and their medical school academic performance, measures of clinical skills, and residency performance.

Development of a measure to assess patient trust in medical researchers.

Purpose: Many researchers find it difficult to recruit individuals, particularly minorities, for participation in studies. Mistrust of research and researchers may act as a barrier to participation. The purpose of this study was to develop a scale for assessing trust in medical researchers.

The effect of extended-release metoprolol succinate on C-reactive protein levels in persons with hypertension.

The objective of this study was to determine whether 3 months of treatment with extended-release metoprolol succinate would reduce C-reactive protein (CRP) levels. Seventy-five patients aged 30-65 years with uncontrolled hypertension were treated with extended-release metoprolol at 25-50 mg, titrated up to 100-200 mg daily. CRP was evaluated at baseline and at 1 and 3 months.

Combining serum biomarkers: the association of C-reactive protein, insulin sensitivity, and homocysteine with cardiovascular disease history in the general US population.

Background: Elevated levels of serum biomarkers such as C-reactive protein (CRP) and homocysteine have been independently associated with cardiovascular risk. However, the prevalence of concurrent elevations of these biomarkers in the general population is unknown, as is their association with cardiovascular disease (CVD).

Methods: Data from adults (n = 4900) in the National Health and Nutrition Examination Survey were used to investigate the relationship between combinations of serum biomarkers of inflammation (CRP), atherosclerosis (homocysteine), and insulin sensitivity [homeostatic model assessment (HOMA) fasting insulin] and CVD.

Rural residence and Hispanic ethnicity: doubly disadvantaged for diabetes?

Context: Hispanics are at increased risk for diabetes, while rural residents have historically had decreased access to care.

Purpose: To determine whether living in a rural area and being Hispanic confers special risks for diagnosis and control of diabetes.

Methods: We analyzed the Third National Health and Nutrition Examination Survey (1988-1994).