Shifting the care paradigm for opioid-exposed newborns in Southern Colorado.

Objective: Compare Eat, Sleep, Console (ESC) and limited opioid treatment on birth length of stay (LOS), postnatal opioid exposure, and 30-day re-hospitalizations in opioid-exposed newborns (OENs) in two hospital systems.

Study Design: Quality improvement teams supported change from scheduled methadone using Finnegan scores to standardized non-pharmacologic support using ESC. Intermittent morphine was used only if needed.

Response to catecholamine stimulation of polymorphisms of the beta-1 and beta-2 adrenergic receptors.

Previous studies have demonstrated that β-adrenergic receptor polymorphisms affect outcomes in patients with heart failure or after an acute coronary syndrome. Whether β-adrenergic polymorphisms influence catecholamine responses in patients with cardiovascular disease is not known. Cardiovascular responses to the β1-receptor agonist dobutamine and the β2-receptor agonist terbutaline were studied using gated blood pool scintigraphy in 21 patients on long-term β-blocker therapy.

Ethics for the pediatrician: obstetric conflict: when fetal and maternal interests are at odds.

The interests of the fetus generally are aligned with those of the pregnant woman. When they are not, the fetal best interests should be discussed, but respect for the autonomy of the pregnant woman and her bodily integrity should prevail. Gender bias and discrimination toward women should be avoided, and the circumstance of pregnancy should not be used as a reason to infringe upon or limit a competent woman’s rights.

L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial.

Context: The amino acid L-arginine is a substrate for nitric oxide synthase and is increasingly used as a health supplement. Prior studies suggest that L-arginine has the potential to reduce vascular stiffness.

Objective: To determine whether the addition of L-arginine to standard postinfarction therapy reduces vascular stiffness and improves ejection fraction over 6-month follow-up in patients following acute ST-segment elevation myocardial infarction.

Recidivism in medication-noncompliant serious juvenile offenders with bipolar disorder.

Objective: To determine whether the recidivism rate varies for adolescent serious juvenile offenders with bipolar disorder in response to compliance with antimanic medication.

Method: Probation records were reviewed for all adolescents (N = 31) released during a 1-year period (April 1, 1993-March 31, 1994) from a county juvenile corrections treatment facility who had DSM-III-R bipolar disorder, were stabilized on medication, and had agreed to continue treatment at an adolescent psychiatry clinic. New offenses and probation violations committed during the 12-month period after release were tallied.

Discovery of human antibodies against the C5aR target using phage display technology.

Phage display technologies have been increasingly utilized for the generation of therapeutic, imaging and purification reagents for a number of biological targets. Using a variety of different approaches, we have developed antibodies with high specificity and affinity for various targets ranging from small peptides to large proteins, soluble or membrane-associated as well as to activated forms of enzymes. We have applied this approach to G-protein coupled receptors (GPCRs), often considered difficult targets for antibody therapeutics and targeting.

Attenuated cardiovascular reserve during prolonged submaximal cycle exercise in healthy older subjects.

Objective: The goal of this study was to determine the effect of age on the hemodynamic response to prolonged submaximal aerobic exercise in healthy volunteers.

Background: Reductions in peak work rate, heart rate (HR), and left ventricular (LV) emptying but higher blood pressure (BP) and systemic vascular resistance occur in healthy older versus younger humans during short bursts of graded maximal aerobic exercise. However, the effect of aging on the cardiovascular response to prolonged exercise at submaximal work rates typical of daily aerobic activities remains unknown.

Development of coagulation regulatory proteins in the fetal and neonatal lamb.

To investigate the development of coagulation regulatory proteins-protein C (PC), protein S (PS), and antithrombin (AT)-in relationship to the procoagulant protein factor X (FX), a chronically catheterized fetal ovine model was used. Infusion and sampling catheters were placed into pregnant ewes and their fetuses and maintained from mid-gestation. From a total of 110 fetuses, 17 lambs, and 63 ewes that were studied on one to 15 occasions, 212 fetal, 88 neonatal, and 157 maternal samples were obtained.

Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina.

Objectives: We tested whether acute hormone therapy reduces ambulatory electrocardiographic ischemia in postmenopausal (PMP) women with unstable angina (UA).

Background: Endothelial dysfunction contributes to the pathophysiology of UA. Acute estrogen administration improves endothelial function in PMP women with coronary artery disease and increases coronary artery blood flow.