Neurocognitive deficits increase risk of poor retention in care among older adults with newly diagnosed HIV infection.

Objective: To evaluate the role of neurocognitive impairment on retention in care across the lifespan in antiretroviral-naïve persons newly diagnosed with HIV.

Design: A prospective observational study of 138 antiretroviral-naive newly diagnosed HIV-positive participants who presented to an urban clinic between August 2010 and April 2013.

Methods: All participants underwent a baseline evaluation that included a neuromedical examination and brief neuropsychological test battery.

Recent evidence exploring the associations between physical activity and menopausal symptoms in midlife women: perceived risks and possible health benefits.

Although the health benefits of physical activity are well established, the prevalence of midlife women accumulating sufficient physical activity to meet current physical activity guidelines is strikingly low, as shown in United States (U.S.) based surveillance systems that utilize either (or both) participant-reported and device-based (i.

Accelerometer determined sedentary behavior and dietary quality among US adults.

Objective: Scant evidence exists pertaining to objectively measured sedentary time and dietary quality among adults. Therefore, we examined the relationships between sedentary time, physical activity, and dietary quality.

Methods: Cross-sectional analyses of a 4,910 US adults from two cycles (2003-2006) of the National Health and Nutrition Examination Survey.

Management of steroid-induced hyperglycemia in hospitalized patients with cancer: a review.

Problem Identification: Glucocorticoids are prescribed for hospitalized patients with cancer for a variety of reasons, including cerebral edema, treatment and prevention of nausea, and as part of cancer treatment regimens. Glucocorticoids are known to cause hyperglycemia. The purpose of this study was to integrate the published research on the management and the effects of steroid-induced hyperglycemia in hospitalized adult patients with cancer with or without preexisting diabetes.

Alternative splicing impairs soluble guanylyl cyclase function in aortic aneurysm.

Nitric oxide (NO) receptor soluble guanylyl cyclase (sGC) is a key regulator of several important vascular functions and is important for maintaining cardiovascular homeostasis and vascular plasticity. Diminished sGC expression and function contributes to pathogenesis of several cardiovascular diseases. However, the processes that control sGC expression in vascular tissue remain poorly understood.

Predictors of agitation in critically ill adults.

Background: Agitation in critically ill adults is a frequent complication of hospitalization and results in multiple adverse outcomes. Potential causes of agitation are numerous; however, data on factors predictive of agitation are limited.

Objectives: To identify predictors of agitation by examining demographic and clinical characteristics of critically ill patients.

Epidemiology of bacterial meningitis in the USA from 1997 to 2010: a population-based observational study.

Background: Bacterial meningitis continues to be a substantial cause of morbidity and mortality, but the epidemiological trends after adjunctive dexamethasone recommendations are unknown in the USA. We aimed to describe the changing patterns among the most common bacterial causes in the USA after conjugate vaccination and to assess the association between adjunctive dexamethasone and mortality.

Methods: For this population-based observational study, we searched information available from hospital discharges about incidence and inpatient mortality for the most important causes of community and nosocomial bacterial meningitis based on International Classification of Diseases coding across all hospitals in the USA between 1997 and 2010 with the HealthCare Cost Utilization Project (HCUP) network database.

Chronic abdominal pain after ventral hernia due to mesh migration and erosion into the sigmoid colon from a distant site: a case report and review of literature.

Hernia repair is one of the most commonly performed procedures in general surgery. Use of mesh has been shown to decrease the overall recurrence rate. Mesh implantation, however, carries its own risks and complications.

Risk score for identifying adults with CSF pleocytosis and negative CSF Gram stain at low risk for an urgent treatable cause.

Background: We aimed to derive and validate a risk score that identifies adults with cerebrospinal fluid (CSF) pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause.

Methods: Patients with CSF pleocytosis and a negative CSF Gram stain were stratified into a prospective derivation (n = 193) and a retrospective validation (n = 567) cohort. Clinically related baseline characteristics were grouped into three composite variables, each independently associated with a set of predefined urgent treatable causes.

Adolescent and young adult exposure to physical activity and breast density.

Purpose: The objective of this study is to examine the role of early lifetime exposure to physical activity on magnetic resonance imaging-determined breast density measures.

Methods: Associations of adolescent (high school (ages 14-17 yr) and early adulthood, post-high school (ages 18-21 yr) and past year) leisure-time physical activity, as well as a principal component score including all three estimates, were examined with percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) in a cross-sectional analysis of 182 healthy women, ages 25-29 yr, enrolled in the Dietary Intervention Study in Children Follow-up Study (DISC06). Generalized linear mixed models were used to examine associations after adjustment for relevant covariates for the entire analytic sample.

Duplicate patient records--implication for missed laboratory results.

Introduction: Although duplicate records are a potential patient safety hazard, the actual clinical harm associated with these records has never been studied. We hypothesized that duplicate records will be associated with missed abnormal laboratory results.

Methods: A retrospective, matched, cohort study of 904 events of abnormal laboratory result (HgbA1c, TSH, Vitamin B(12), LDL).

Synthesis of New Hydrophilic and Hydrophobic Cobinamides as NO-Independent sGC Activators.

Herein, the synthesis of novel hydrophobic and hydrophilic cobinamides via aminolysis of vitamin B12 derivatives that activate soluble guanyl cyclase (sGC) is presented. Unlike other sGC regulators, they target the catalytic domain of sGC and show higher activity than (CN)2Cbi.

Deriving transcriptional programs and functional processes from gene expression databases.

Motivation: A system-wide approach to revealing the underlying molecular state of a cell is a long-standing biological challenge. Developed over the last decade, gene expression profiles possess the characteristics of such an assay. They have the capacity to reveal both underlying molecular events as well as broader phenotypes such as clinical outcomes.

Cobinamides are novel coactivators of nitric oxide receptor that target soluble guanylyl cyclase catalytic domain.

Soluble guanylyl cyclase (sGC), a ubiquitously expressed heme-containing receptor for nitric oxide (NO), is a key mediator of NO-dependent processes. In addition to NO, a number of synthetic compounds that target the heme-binding region of sGC and activate it in a NO-independent fashion have been described. We report here that dicyanocobinamide (CN2-Cbi), a naturally occurring intermediate of vitamin B(12) synthesis, acts as a sGC coactivator both in vitro and in intact cells.

Dynamic ligand exchange in soluble guanylyl cyclase (sGC): implications for sGC regulation and desensitization.

Accumulating evidence indicates that the functional properties of soluble guanylyl cyclase (sGC) are affected not only by the binding of NO but also by the NO:sGC ratio and a number of cellular factors, including GTP. In this study, we monitored the time-resolved transformations of sGC and sGC-NO complexes generated with stoichiometric or excess NO in the presence and absence of GTP. We demonstrate that the initial five-coordinate sGC-NO complex is highly activated by stoichiometric NO but is unstable and transforms into a five-coordinate sGC-2 state.

Tropical storm and hurricane recovery and preparedness strategies.

The goal of this article is to present lessons learned from the devastating effects of two specific natural disasters in Texas: Tropical Storm Allison, which flooded Houston in June 2001, and Hurricane Ike, which caused severe damage in Galveston in September 2008. When a disaster is predictable, good predisaster planning can help to save animals lives. However, as disasters are usually not predictable and tend not to follow a script, that plan needs to be easily adaptable and flexible.

Diagnosis and treatment of inherited factor X deficiency.

Factor X is a vitamin K-dependent, liver-produced serine protease that serves a pivotal role in coagulation as the first enzyme in the common pathway to fibrin formation. Inherited factor X deficiency is a rare autosomal recessive bleeding disorder that is estimated to occur in 1:1,000,000 individuals up to 1:500 carriers. Several international registries of FX-deficient patients have greatly expanded the knowledge of clinical phenotype.

Challenges to the care of the critically ill: novel staffing paradigms.

The current shortage in intensive care unit (ICU) physician staffing coupled with Leapfrog initiatives has lead to novel ICU staffing paradigms including the use of nonsurgeon intensivists in surgical ICUs, increased development of telemedicine, and ICU regionalization.

Immunohistological detection of growth factors and cytokines in tissue mast cells.

The relative rarity of mast cells (MCs) and the rich content of heparin in the cytoplasmic granules of MCs pose technical challenges in reliably detecting growth factors (GFs) or cytokines in MCs by conventional immunohistological stain (IHS) methods. A variety of polypeptide growth factors are characterized by high-affinity to heparin. Binding of GFs to MC granules during detection can lead to highly specific yet falsely positive results that cannot be easily discovered by conventional procedure controls.

Biliary and pancreatic stents.

The use of biliary and pancreatic stents has increased significantly during the last 2 decades because of improvements in available endoscopes and endoscopic accessories, as well as better techniques. The number of endoscopists who can successfully complete these demanding procedures has also increased, as have the indications for stent therapy in biliary and pancreatic diseases. Stents are now made in various shapes and configurations from different types of polymers (plastics), various expandable metallic alloys, and bioabsorbable materials.

Experience of a Reiki session.

Context: Touch therapies, including Reiki, are increasingly popular complementary therapies. Previous studies of touch therapies have yielded equivocal findings.

Objective: Exploring the experiences of Reiki recipients contributes to understanding the popularity of touch therapies and possibly elucidates variables for future studies.

Molecular cloning and analysis of the Cryptosporidium parvum aminopeptidase N gene.

Cryptosporidium parvum proteases have been associated with release of infective sporozoites from oocysts, and their specific inhibition blocks parasite excystation in vitro. Additionally, proteases have been implicated in the processing of parasite adhesion molecules found on the surface of sporozoites and merozoites. In this study, we cloned and expressed the C.

Traveler's diarrhea due to intestinal protozoa.

Intestinal protozoa account for a minority of cases of acute traveler's diarrhea, but they are common pathogens in travelers who experience protracted diarrhea during or after travel. Evaluation of the traveler with chronic diarrhea should include a careful examination for typical infecting organisms, such as Giardia and Entamoeba species, as well as for emerging parasites, such as Cryptosporidium species, Cyclospora species, and microsporidia. The microbiology, epidemiology, clinical presentation, and treatment of the most common intestinal parasites found in travelers are presented in this minireview.