Facilitators and Barriers to Breastfeeding Among Veterans Using Veterans Affairs Maternity Care Benefits.

Introduction: U.S. veterans of childbearing age represent one of the fastest growing populations using Veterans Affairs (VA) health care.

Clinical Outcomes of Intravenous Ketamine Treatment for Depression in the VA Health System.

Intravenous (IV) ketamine is effective for reducing symptoms of major depressive disorder in short-term clinical trials; this study characterized clinical outcomes of repeated infusions in routine clinical practice and the frequency and number of infusions used to sustain symptom improvement. Records of IV ketamine infusions for depression and associated Patient Health Questionnaire-9 (PHQ-9) scores were identified from Veterans Health Administration (VA) electronic medical records for patients treated in Fiscal Year 2020 and up to 12 months following the date of their first infusion. Sample patients (n = 215) had a mean baseline PHQ-9 score of 18.

Active case-finding of pulmonary TB in an urban emergency department.

The WHO recommends systematic screening of TB in high TB prevalence settings. We evaluated an active case-finding strategy using sputum screening regardless of symptoms in a high TB prevalence Emergency Department (ED) in Peru. This was a cross-sectional study conducted at the Hospital Nacional Dos de Mayo ED, which serves low-income populations in downtown Lima, Peru.

Brief Cognitive Behavioral Therapy For Chronic Pain: Results From a Clinical Demonstration Project in Primary Care Behavioral Health.

Objectives: Although cognitive behavioral therapy is an effective intervention for chronic pain, it is a lengthy treatment typically applied only in specialty care settings. The aim of this project was to collect preliminary effectiveness data for Brief Cognitive Behavioral Therapy for Chronic Pain (Brief CBT-CP), an abbreviated, modular form of treatment designed for use in primary care.

Methods: A clinical demonstration project was conducted in which Brief CBT-CP was delivered to primary care patients by 22 integrated care providers practicing in the Primary Care Behavioral Health model of Veterans Health Administration primary care clinics.

The secreted effector protein EspZ is essential for virulence of rabbit enteropathogenic Escherichia coli.

Attaching and effacing (A/E) pathogens adhere intimately to intestinal enterocytes and efface brush border microvilli. A key virulence strategy of A/E pathogens is the type III secretion system (T3SS)-mediated delivery of effector proteins into host cells. The secreted protein EspZ is postulated to promote enterocyte survival by regulating the T3SS and/or by modulating epithelial signaling pathways.

The relationship between retinal nerve fiber layer thickness and optic nerve head neuroretinal rim tissue in glaucoma.

Purpose: The purpose of this study was to determine the relationship between optical coherence tomography (OCT) measures of retinal nerve fiber layer (RNFL) and neuroretinal rim (NRR) in a nonhuman primate experimental glaucoma model, and in a population of clinical patients.

Methods: For nonhuman primates, normative data were collected from 44 healthy monkeys, and nine animals with unilateral experimental glaucoma that were followed longitudinally. Cross-sectional human subjects data were collected from 89 healthy, 74 glaucoma suspects, and 104 glaucoma patients.

Reconciling primary care and specialist perspectives on prostate cancer screening.

When specialists propose screening guidelines for primary care clinicians to implement, differences in perspectives between the 2 groups can create conflicts. Two recent specialty organization guidelines illustrate this issue. The American Urological Association guideline panel and National Comprehensive Cancer Network recommend that average-risk men first be counseled about the risks and benefits of prostate-specific antigen screening for prostate cancer at age 40 rather than at the previously recommended age of 50 years.

Relative importance of factors affecting corneal hysteresis measurement.

Purpose: To evaluate the relative influences of several demographic, ocular, and systemic parameters on corneal hysteresis (CH).

Methods: This is a prospective, observational, cross-sectional study using subjects recruited from consecutive Albuquerque VAMC eye clinic patients. We classified eligible subjects as primary open-angle glaucoma (POAG), ocular hypertension, glaucoma suspect, or normal.

Factors influencing intermethod agreement between goldmann applanation, pascal dynamic contour, and ocular response analyzer tonometry.

Purpose: To examine factors that influence intraocular pressure (IOP) measurement agreement between Goldmann applanation (GAT), Ocular Response Analyzer (ORA), and Pascal Dynamic Contour tonometers (DCT).

Patients And Methods: In subjects who were diagnosed with primary open-angle glaucoma, ocular hypertension, glaucoma suspect, and normal, we used ORA, DCT, and GAT to obtain corneal hysteresis (CH), corneal resistance factor (CRF), ocular pulse amplitude, and 4 IOP values (ORA-IOPcc; ORA-IOPg; DCT-IOP; and GAT-IOP.) We also obtained corneal curvature, corneal thickness, axial length, retinal nerve fiber layer thickness, visual field parameters, diabetes diagnostic status, and topical IOP-lowering treatment data.

Brimonidine hypersensitivity when switching between 0.2% and 0.15% formulations.

Purpose: To investigate hypersensitivity rates in patients switched from brimonidine-purite 0.15% to generic brimonidine 0.2%, and to then investigate hypersensitivity rates to re-initiated brimonidine-purite 0.

Repeatability and reproducibility for intraocular pressure measurement by dynamic contour, ocular response analyzer, and goldmann applanation tonometry.

Purpose: To evaluate and compare the intraocular pressure measurement variability between Goldmann applanation tonometry (GAT), Pascal dynamic contour tonometry (DCT), and ocular response analyzer (ORA) tonometry.

Methods: Subjects were prospectively recruited from consecutive Albuquerque VA Medical Center eye clinic patients that were previously diagnosed with ocular hypertension, glaucoma suspect, primary open-angle, or normal pressure glaucoma. Two sets of intraocular pressure measurements (3-4 ORA, 2 DCT, and 2 GAT) were obtained approximately 15 minutes apart.

Ocular Response Analyzer in subjects with and without glaucoma.

Purpose: The Ocular Response Analyzer (ORA) is a newly introduced tonometer that uniquely measures and then integrates corneal biomechanical data into its intraocular pressure (IOP) estimates in an effort to improve accuracy of IOP assessment. This study was devised to investigate whether ORA-derived IOP and corneal biomechanical variables might be useful in discriminating between subjects with and without primary open-angle glaucoma (GLC).

Methods: All patients seen in the Albuquerque VAMC eye clinic over a 10-week period who demonstrated acceptable ORA signal profiles were retrospectively identified.

Clinical comparison of pascal dynamic contour tonometry and goldmann applanation tonometry in asymmetric open-angle glaucoma.

Purpose: To investigate and compare the relationships between glaucomatous visual field loss and intraocular pressure (IOP) as measured by both Pascal dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT).

Patients And Methods: All primary open-angle glaucoma and normal tension glaucoma patients seen between July 2005 and June 2006 with at least 2 sets of good-quality, bilateral DCT and GAT measurements were retrospectively identified. Additional inclusion criteria required that all subjects had repeatable, asymmetric glaucomatous visual field loss that corresponded with asymmetric glaucomatous optic neuropathy.

Relationship between asymmetric central corneal thickness and glaucomatous visual field loss within the same patient.

Purpose: Considering that thinner central corneal thickness (CCT) has been identified as a significant glaucoma risk factor, this study was designed to determine whether patients with glaucoma with asymmetric CCT demonstrate greater visual field loss in their thinner CCT eye compared with their thicker CCT eye.

Methods: Patient logs were used to retrospectively identify patients with primary open-angle glaucoma (POAG) and patients with normal-tension glaucoma (NTG) with CCT asymmetry of 10 microm or greater. Severity of glaucoma was determined using Advanced Glaucoma Intervention Study (AGIS) visual field scoring criteria.

Central corneal thickness and normal tension glaucoma: a cross-sectional study.

Background: Recently published evidence has identified thinner central corneal thickness (CCT) as a strong predictive factor for the conversion from ocular hypertension (OHT) to primary open-angle glaucoma (POAG). The association between CCT and development of normal-tension glaucoma (NTG), however, is less clear. Accordingly, we designed this cross-sectional study to further explore the relationship between CCT and NTG.

Relationship between central corneal thickness and severity of glaucomatous visual field loss in a primary care population.

Background: Although the ability of central corneal thickness (CCT) to predict development of primary open-angle glaucoma has become increasingly well recognized, the ability of CCT to predict severity of glaucoma remains uncertain. This study was designed to expand the available knowledge about the relationship between CCT and glaucoma severity.

Methods: Retrospective identification of all patients with a clinical diagnosis of either primary open angle glaucoma (POAG) or ocular hypertension who were seen from September 2002 through May 2003 at the Albuquerque VA Medical Center eye clinic was completed.

The relationship between central corneal thickness-adjusted intraocular pressure and glaucomatous visual-field loss.

Background: Although measurement of central corneal thickness (CCT) is increasingly becoming an important component of glaucoma risk analysis, significant controversy exists regarding the benefit of calculating a corrected intraocular pressure (IOP) value from measured IOP and CCT data.

Methods: Three hundred forty-four male subjects were identified from a VA eye clinic with one of the following clinical diagnoses: ocular hypertension (OHT), primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and normal tension glaucoma suspect (NTGS). Using one eye per subject, multivariate logistic regression and correlational analyses were performed to determine relationships between glaucomatous visual-field loss and several glaucoma risk factors, including adjusted IOP values.

The role of MIP-1alpha in experimental hypersensitivity pneumonitis.

S. rectivirgula (SR) causes Farmer's Lung Disease, a classic example of hypersensitivity pneumonitis (HP). We utilized a model of experimental hypersensitivity pneumonitis (EHP), antibody to MIP-1alpha and MIP-1alpha -/- mice, to test the hypothesis that MIP-1alpha is essential in the development of EHP.

Caloric stimulation in neglect: evaluation of response as a function of neglect type.

Contralesional neglect may be induced by either unawareness of contralesional stimuli (attentional neglect, AN) or failure to act in contralesional space (intentional neglect, IN). We examined whether contralesional cold caloric stimulation differentially affects AN versus IN. Patients with left-sided neglect (n = 16) from right-hemisphere lesions performed target cancellation and line bisection tasks.

Correspondence of Tono-Pen intraocular pressure measurements performed at the central cornea and mid-peripheral cornea.

Background: As the awareness of the influence of central corneal thickness (CCT) on Goldmann tonometry has increased, many publications have questioned the accuracy of Goldmann intraocular pressure (IOP) measurement. The Tono-Pen, because it indents a much smaller surface area when compared to a Goldmann probe, may be less affected by corneal thickness variations when compared with Goldmann tonometry.

Methods: Forty human subjects with no history of refractive surgery participated in this study.

Using multiple cutpoints for the free-to-total prostate specific antigen ratio improves the accuracy of prostate cancer detection.

Background: Using a single cutpoint for the free-to-total (F/T) prostate specific antigen (PSA) ratio loses important diagnostic information. We evaluated the performance of multiple F/T PSA cutpoints in detecting prostate cancer in men with nonspecific PSA values.

Methods: We extracted sensitivity and specificity data from 12 studies reporting on >or=30 cancer patients with PSA values between 2.

Is IL12 necessary in experimental hypersensitivity pneumonitis?

Inhalation of Saccharopolyspora rectivirgula (SR) can cause the disease Farmer's Lung, a classic example of hypersensitivity pneumonitis. Th1, but not Th2, cell lines can adoptively transfer experimental hypersensitivity pneumonitis (EHP). Substantial amounts of IL12 appear in bronchoalveolar lavage fluid (BALF) after a single intratracheal (IT) injection of SR, and SR-induced IL12 secretion by both a macrophage cell line and alveolar macrophages.

Effect of superficial heat, deep heat, and active exercise warm-up on the extensibility of the plantar flexors.

Background And Purpose: Warm-up prior to static stretching enhances muscle extensibility. The relative effectiveness of different modes of warm-up, however, is unknown. The purpose of this study was to evaluate the effectiveness of superficial heat, deep heat, and active exercise warm-up prior to stretching compared with stretching alone on the extensibility of the plantar-flexor muscles.