Hormone replacement therapy is associated with less coronary atherosclerosis in postmenopausal women.

Most observational studies indicate that hormone replacement therapy (HRT) protects women from cardiovascular disease. Two recent randomized trials, however, showed no reduction in coronary events with HRT in postmenopausal women. A randomized study evaluating subclinical atherosclerosis showed a beneficial effect of estrogen.

N-telopeptide of type II collagen interacts with annexin V on human chondrocytes.

Type II collagen binds to chondrocytes through integrins and annexin V. While the potential integrin binding sites have been identified, it is unclear which domains bind to annexin V. Proteolytic fragments of collagen are known to modulate cell signaling pathways resulting in degradation of articular cartilage; it is unknown whether annexin V binds to the fragments.

Monitoring indirect presentation of alloantigens by utilizing the autologous processing machinery of dendritic cells in-vitro.

Background: Judicious individualization of immunosuppression protocols requires the ability to monitor the recipients' specific immune response towards the allograft. While several indirect presentation studies have been reported, currently there are no consistently reliable means to assess the state of transplant acceptance. A potential explanation might be the lack of established kinetics for in-vitro indirect presentation assays.

EMG remains fractionated in Parkinson's disease, despite practice-related improvements in performance.

Objective: We studied the ability of patients with Parkinson's disease to improve their performance in a motor task requiring both speed and accuracy in the execution of elbow flexion movements. Our goal was to investigate the changes in electromyographic activity associated with the changes in movement performance.

Methods: Eleven patients on anti-Parkinsonian medication were tested.

Total hip arthroplasty using the minimally invasive two-incision approach.

A new approach to total hip replacement, a minimally invasive two-incision technique, was developed; one incision is used for the acetabular component and the other incision is used for the femoral component. The first 100 minimally invasive two-incision THAs done at my hospital are reported. The complication rate in the first 100 cases was 1%: one proximal femoral fracture.

Revision total hip arthroplasty: the limits of fully coated stems.

Femoral revision with a 7-inch or 8-inch fully porous-coated stem may not provide reliable long-term results in patients with moderate bone loss. The purpose of this study was to evaluate the limits of fully porous-coated stems and to create a treatment algorithm for femoral deficiencies. Fifty-one patients with either a 10-inch or 9-inch calcar fully porous-coated stem, 10 patients with impaction bone grafting, and 10 patients with a modular tapered stem were evaluated at an average 4.

Mycophenolate mofetil for myasthenia gravis: an analysis of efficacy, safety, and tolerability.

The authors report a retrospective analysis of the use of mycophenolate mofetil (MyM) in 85 patients with autoimmune myasthenia gravis. The Myasthenia Gravis Foundation of America (MGFA) postintervention status (PIS) was used to characterize the treatment response in each patient. Sixty-two patients (73%) achieved a PIS status indicating improvement.

Rate of cognitive decline and mortality in Alzheimer's disease.

Background: Alzheimer's disease (AD) is associated with increased mortality, but survival in those with the disease varies widely. It is uncertain how much of the variation in survival is due to individual differences in rate of disease progression.

Methods: During a 4-year period, 354 persons with AD underwent annual clinical evaluations that included administration of 17 cognitive function tests, from which global and specific measures of cognitive function were derived.

Interactions between NADPH oxidase and voltage-gated proton channels: why electron transport depends on proton transport.

Leukocytes kill microbes by producing reactive oxygen species, using a multi-component enzyme complex, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase. Electrons pass from intracellular NADPH through a redox chain within the enzyme, to reduce extracellular O2 to O2-. Electron flux is electrogenic, and rapidly depolarizes the membrane potential.

Health care chaplaincy as a research-informed profession: how we get there.

Health care chaplaincy should become a research-informed profession in the next ten years. This article describes my rationale for this statement and outlines a plan for accomplishing it. This means that all professional health care chaplains will value the contributions that research can make to their ministry and some chaplains will be engaged in research that informs the profession.

Insurance status and patient behavior with asthma medications.

Few studies have measured patients' asthma medication compliance, medication costs, and insurance status. We used a questionnaire assessing details of asthma, medications used, patient costs, and methods used to reduce medication costs to assess these factors. Patients in outpatient clinics, emergency rooms, and inpatient units of two urban Chicago hospitals who had a history of asthma and an age of 18 years or older were eligible for the study.

Lactate depresses sarcolemmal permeability of Ca2+ in intact arterial smooth muscle.

Elevation of ambient lactate concentration has been shown to alter contractile reactivity of vascular smooth muscle. We tested the hypothesis that lactate affects the disposition of intracellular free Ca2+. Porcine carotid artery strips were incubated in normal medium and in medium containing 10 mM sodium lactate or 10 mM sodium pyruvate.

Psychiatric comorbidity and physicians with substance use disorders: a comparison between the 1980s and 1990s.

The assessment and treatment of physicians with substance use disorders has been of considerable interest over the past twenty years. This study compares two cohorts of addicted physicians treated at a single program. Data from 101 physicians treated during 1985 to 1987 were compared with 73 physicians treated from 1995 to 1997.

Effect of loading rate on endplate and vertebral body strength in human lumbar vertebrae.

Previous studies have implied that increases in loading rate resulted in changes in vertebral mechanical properties and these changes were causative factors in the different fracture types seen with high-speed events. Thus many researchers have explored the vertebral body response under various loading rate conditions. No other study has investigated the role of the endplate in high-speed vertebral injuries.

Effects of perioperative administration of a selective cyclooxygenase 2 inhibitor on pain management and recovery of function after knee replacement: a randomized controlled trial.

Context: Controlling postoperative pain after knee replacement while reducing opioid-induced adverse effects and improving outcomes remains an important challenge.

Objective: To assess the effect of combined preoperative and postoperative administration of a selective inhibitor of cyclooxygenase 2 on opioid consumption and outcomes after total knee arthroplasty (TKA).

Design, Setting, And Patients: Randomized, placebo-controlled, double-blind trial conducted June 2001 through September 2002, enrolling 70 patients aged 40 to 77 years and undergoing TKA at a university hospital in the United States.

Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation.

Background Context: A relatively high pseudarthrosis rate is associated with multilevel anterior cervical discectomy and fusion (ACDF). Anterior plate fixation increases fusion rate in multilevel ACDF. A debate still exists between the effectiveness of allograft versus autograft in plated multilevel ACDF.

Idiopathic congenital central hypoventilation syndrome: analysis of genes pertinent to early autonomic nervous system embryologic development and identification of mutations in PHOX2b.

Idiopathic congenital central hypoventilation syndrome (CCHS) has been linked to autonomic nervous system dysregulation and/or dysfunction (ANSD) since it was first described in 1970. A genetic basis of CCHS has been proposed because of the reports of four families with two affected children, because of mother-child transmission, and because of a recent report of a polyalanine expansion mutation in PHOX2b in a subset of CCHS subjects. We, therefore, studied genes pertinent to early embryologic development of the ANS including mammalian achaete-scute homolog-1 (MASH1), bone morphogenic protein-2 (BMP2), engrailed-1 (EN1), TLX3, endothelin converting enzyme-1 (ECE1), endothelin-1 (EDN1), PHOX2a, and PHOX2b in 67 probands with CCHS, and gender- and ethnicity-matched controls.

Health-related quality of life in hyperparathyroidism measurably improves after parathyroidectomy.

Background: Hyperparathyroidism is associated with subjective feelings of fatigue and depression as well as limitations in physical activity from musculoskeletal complaints. These quality of life symptoms are not widely accepted as an indication for parathyroidectomy. This study quantifies and compares subjective symptoms of patients with hyperparathyroidism before and after surgery.

Are there gender differences in choosing a surgical career?

Background: Interest in general surgery has declined among US medical students, with the increasing number of female medical students being cited as a causative factor. This study evaluates factors related to choosing a general surgery career and determines if they differ between men and women.

Methods: A survey assessing factors that contributed to career choice was distributed to a 2002 graduating medical school class to be returned with their match lists.

Aging or osteoarthritis: which is the problem?

OA is not an inevitable consequence of aging, but aging-related changes in the musculoskeletal system increase the risk of developing OA if other risk factors are also present. The joint is a functioning biomechanical unit of the neuromuscular system. Factors that contribute to the development of joint pain and loss of joint function include those associated with aging, those associated with underuse or misuse of the musculoskeletal system, and those associated directly with the development of OA.

Management of hypertension emergencies.

Although they have become less common, hypertensive emergencies occur with an incidence of approximately 1 to 2/100,000 people per year. Our knowledge about this problem, its pathophysiology, risk factors, and appropriate treatment options has expanded during the past decade. A hypertensive emergency can be declared when an elevated blood pressure is associated with acute target-organ damage.

Mycophenolate mofetil for myasthenia gravis: a double-blind, placebo-controlled pilot study.

Mycophenolate mofetil (MM) is an immunosuppressive agent developed and originally used to prevent acute rejection of solid-organ transplantation. There have been preliminary reports of its successful use in the treatment of autoimmune myasthenia gravis (MG). We conducted a double-blind, placebo-controlled pilot trial of MM in the treatment of suboptimally controlled, stable MG.