Preliminary evaluation of urinary soluble Met as a biomarker for urothelial carcinoma of the bladder.

Background: Among genitourinary malignancies, bladder cancer (BCa) ranks second in both prevalence and cause of death. Biomarkers of BCa for diagnosis, prognosis and disease surveillance could potentially help prevent progression, improve survival rates and reduce health care costs. Among several oncogenic signaling pathways implicated in BCa progression is that of hepatocyte growth factor (HGF) and its cell surface receptor, Met, now targeted by 25 experimental anti-cancer agents in human clinical trials.

First in line: prioritizing receipt of Social Security disability benefits based on likelihood of death during adjudication.

Background: Given the complexity of the adjudication process and volume of applications to Social Security Administration's (SSA) disability programs, many individuals with serious medical conditions die while awaiting an application decision. Limitations of traditional survival methods called for a new empirical approach to identify conditions resulting in rapid mortality.

Objective: To identify health conditions associated with significantly higher mortality than a key reference group among applicants for SSA disability programs.

Results of a two-year pilot study of clinical outcome measures in collagen VI- and laminin alpha2-related congenital muscular dystrophies.

Potential therapies are currently under development for two congenital muscular dystrophy (CMD) subtypes: collagen VI-related muscular dystrophy (COL6-RD) and laminin alpha 2-related dystrophy (LAMA2-RD). However, appropriate clinical outcome measures to be used in clinical trials have not been validated in CMDs. We conducted a two-year pilot study to evaluate feasibility, reliability, and validity of various outcome measures, particularly the Motor Function Measure 32, in 33 subjects with COL6-RD and LAMA2-RD.

Efficient Blockwise Permutation Tests Preserving Exchangeability.

In this paper, we present a new blockwise permutation test approach based on the moments of the test statistic. The method is of importance to neuroimaging studies. In order to preserve the exchangeability condition required in permutation tests, we divide the entire set of data into certain exchangeability blocks.

Targeted prevention of excess weight gain and eating disorders in high-risk adolescent girls: a randomized controlled trial.

Background: The high prevalence and incidence of obesity and eating disorders in US adolescent girls are serious health problems. Because of the shared risk factors for obesity and eating disorders, a targeted prevention of both conditions is a priority.

Objective: We determined whether an adapted interpersonal psychotherapy prevention program is more efficacious for reducing excess weight gain and worsening disordered eating than health education in adolescent girls at high risk of obesity and eating disorders.

English cross-cultural translation and validation of the neuromuscular score: a system for motor function classification in patients with neuromuscular diseases.

Objective: To develop and validate an English version of the Neuromuscular (NM)-Score, a classification for patients with NM diseases in each of the 3 motor function domains: D1, standing and transfers; D2, axial and proximal motor function; and D3, distal motor function.

Design: Validation survey.

Setting: Patients seen at a medical research center between June and September 2013.

Combining agreement and frequency rating scales to optimize psychometrics in measuring behavioral health functioning.

Objective: The goal of this article was to investigate optimal functioning of using frequency vs. agreement rating scales in two subdomains of the newly developed Work Disability Functional Assessment Battery: the Mood & Emotions and Behavioral Control scales.

Study Design And Setting: A psychometric study comparing rating scale performance embedded in a cross-sectional survey used for developing a new instrument to measure behavioral health functioning among adults applying for disability benefits in the United States was performed.

Do claimants over-report behavioral health dysfunction when filing for work disability benefits?

Backgrond: Questions exist related to the best way to use medical evidence relative to self-report as part of the SSA disability determination process.

Objective: To examine concordance between provider and claimant responses along the four dimensions of work related behavioral health functioning: Social Interactions, Mood and Emotions, Behavioral Control, and Self-Efficacy.

Methods: Using secondary data from a larger study, which collected data on individuals reporting difficulties with work (claimants) due to mental conditions, 39 items were completed by claimants and their healthcare provider.

Bisphosphonate treatment for children with disabling conditions.

Fractures are a frequent source of morbidity in children with disabling conditions. The assessment of bone density in this population is challenging, because densitometry is influenced by dynamic forces affecting the growing skeleton and may be further confounded by positioning difficulties and surgical hardware. First-line treatment for pediatric osteoporosis involves conservative measures, including optimizing the management of underlying conditions, maintaining appropriate calcium and vitamin D intake, encouraging weight-bearing physical activity, and monitoring measurements of bone mineral density.

Serum leptin and loss of control eating in children and adolescents.

Background: Both insufficiency and resistance to the actions of the adipocyte-derived hormone leptin promote hunger, increased food intake and greater body weight. Some studies suggest that adults reporting binge eating have increased serum leptin compared with those without binge eating, even after adjusting for the greater adiposity that characterizes binge eaters. Pediatric binge or loss of control (LOC) eating are prospective risk factors for excessive weight gain and may predict development of metabolic abnormalities, but whether LOC eating is associated with higher leptin among children is unknown.

A pilot study of the effect of spironolactone therapy on exercise capacity and endothelial dysfunction in pulmonary arterial hypertension: study protocol for a randomized controlled trial.

Background: Pulmonary arterial hypertension is a rare disorder associated with poor survival. Endothelial dysfunction plays a central role in the pathogenesis and progression of pulmonary arterial hypertension. Inflammation appears to drive this dysfunctional endothelial phenotype, propagating cycles of injury and repair in genetically susceptible patients with idiopathic and disease-associated pulmonary arterial hypertension.

Use of emergency departments among working age adults with disabilities: a problem of access and service needs.

Objective: To examine the relationship between emergency department (ED) use and access to medical care and prescription medications among working age Americans with disabilities.

Data Source: Pooled data from the 2006-2008 Medical Expenditure Panel Survey (MEPS), a U.S.

Does postacute care site matter? A longitudinal study assessing functional recovery after a stroke.

Objective: To determine the impact of postacute care site on stroke outcomes.

Design: Prospective cohort study.

Setting: Four northern California hospitals that are part of a single health maintenance organization.

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery.

The objective of this study are (1) to determine if upper extremity function, as represented by shoulder ROM, self-reported symptoms and upper extremity functional limitations in activities of daily living could be predictively related to demographic and cancer characteristics post-surgery for breast cancer. And (2) to examine if variables related to early onset impairment contribute to late onset impairments in women after breast cancer surgery. Subjects were assessed preoperatively and 1, 3, 6, 9, and 12+ months post breast cancer surgery for impairments and symptoms and at 12+ months for shoulder functional limitations using a physical therapy surveillance model.

The microRNA expression changes associated with malignancy and SDHB mutation in pheochromocytoma.

Currently, the diagnosis of malignant pheochromocytoma can only be made when there is clinical evidence of metastasis or extensive local invasion. Thus, there is a need for new diagnostic marker(s) to identify tumors with malignant potential. The purpose of this study was to identify microRNAs (miRNAs) that are differentially expressed between benign and malignant pheochromocytomas and assess their diagnostic accuracy.

Children's binge eating and development of metabolic syndrome.

Background: Binge eating predisposes children to excessive weight gain. However, it is unknown if pediatric binge eating predicts other obesity-associated adverse health outcomes.

Objective: The objective of this study was to investigate the relationship between binge eating and metabolic syndrome (MetS) in children.

Delay in seeing a doctor due to cost: disparity between older adults with and without disabilities in the United States.

Objective: To examine the disparity in delaying seeing a doctor due to cost between older adults with and without disabilities, and whether the disparity could be explained by health and financial variables.

Data Sources: Nationally representative sample of community-dwelling adults aged ≥65 who have health insurance and a usual source of care from the 2006 Behavioral Risk Factor Surveillance System (n = 85,015).

Study Design: This cross-sectional study used sequential logistic regression models to examine the associations of delaying seeing a doctor due to cost with disability status, including demographic, health, and financial variables.

NEURO-ONCOLOGIC PHYSICAL THERAPY FOR THE OLDER PERSON.

Due to the uncertainty of the course of diagnoses, patients with neuro-oncological malignancies present challenges to the physical therapist. At times, the presentation of impairments and disabilities of these patients with neuro-oncological diagnoses do not necessarily coincide with the involved area of the brain or spinal cord. It is our intention to provide guidance to the physical therapist who will be working with these patients with neuro-oncological diagnoses, in hopes that their encounters will be more productive and meaningful.

Pediatric obesity: etiology and treatment.

This article reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Most of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis.

Melanoma vaccines.

There is much renewed activity in the testing of vaccines that target metastatic melanoma, driven by successes in other areas, most notably prostate cancer. Yet, sound evidence that any stand-alone vaccination approach has clinical benefit against melanoma remains lacking. With phase III studies showing no efficacy of promising whole-cell vaccines and heat shock proteins, peptide and dendritic cell vaccines remain the most common approaches.

The complex web of health: relationships among chronic conditions, disability, and health services.

Objectives: A critical issue in health-care reform concerns how to realign health-care delivery systems to manage medical care services for people with ongoing and costly needs for care. We examined the overlapping health-care needs of two such population groups among the U.S.

Brief assessment of motor function: content validity and reliability of the upper extremity gross motor scale.

Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and diagnosis, it is intended for use for infants through young adults.

Tumor-induced osteomalacia.

Tumor-induced osteomalacia (TIO) is a rare and fascinating paraneoplastic syndrome in which patients present with bone pain, fractures, and muscle weakness. The cause is high blood levels of the recently identified phosphate and vitamin D-regulating hormone, fibroblast growth factor 23 (FGF23). In TIO, FGF23 is secreted by mesenchymal tumors that are usually benign, but are typically very small and difficult to locate.

Ongoing coverage for ongoing care: access, utilization, and out-of-pocket spending among uninsured working-aged adults with chronic health care needs.

Objectives: We sought to determine how part-year and full-year gaps in health insurance coverage affected working-aged persons with chronic health care needs.

Methods: We conducted multivariate analyses of the 2002-2004 Medical Expenditure Panel Survey to compare access, utilization, and out-of-pocket spending burden among key groups of persons with chronic conditions and disabilities. The results are generalizable to the US community-dwelling population aged 18 to 64 years.

Correlation between bioelectrical spectroscopy and perometry in assessment of upper extremity swelling.

Lymphedema is a common side effect of breast cancer treatment and is associated with increased upper extremity volume, functional impairment, and pain. While there is no cure for lymphedema, physical therapy treatment can often alleviate symptoms. To measure the efficacy of treatment, accurate assessment of the limbs is important.