Telomere length and cognitive function among middle-aged and older participants from communities underrepresented in aging research: A preliminary study.

Objective: Accelerated biological aging is a plausible and modifiable determinant of dementia burden facing minoritized communities, but is not well-studied in these historically underrepresented populations. Our objective was to preliminarily characterize relationships between telomere length and cognitive health among American Indian/Alaska Native (AI/AN) and Black/African American (B/AA) middle-aged and older adults.

Methods: This study included data on telomere length and cognitive test performance from 187 participants, enrolled in one of two community-based cognitive aging cohorts and who identified their primary race as AI/AN or B/AA.

Direct innominate artery access for transcatheter aortic valve replacement.

Hostile vascular disease can pose a challenge for transcatheter aortic valve replacement, for which the preferred access is via a common femoral artery. However, extensive peripheral arterial disease may also preclude traditional points of alternative access in some patients. Herein, we describe two patients in whom successful transcatheter aortic valve replacement was performed via direct innominate artery access.

The Hospital Readmissions Reduction Program and Observation Hospitalizations.

The Centers for Medicare & Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP) penalizes hospitals having excess inpatient rehospitalizations within 30 days of index inpatient stays for targeted conditions. Observation hospitalizations are increasing in frequency and may clinically resemble inpatient hospitalizations, yet HRRP excludes observation in index and 30-day rehospitalization counts. Using 100% 2014 Medicare fee-for-service claims and CMS's 30-day rehospitalization methodology, we modeled how observation hospitalizations impact HRRP metrics when counted as index (denominator) and 30-day (numerator) rehospitalizations.

Colon Cancer Staging in Vulnerable Older Adults: Adherence to National Guidelines and Impact on Survival.

Background: There is concern that elders are not adequately evaluated prior to colon cancer surgery. We sought to determine adherence with ACOVE-3 (Assessing Care of Vulnerable Elders) quality indicators for pre-operative staging prior to colectomy for colon cancer utilizing the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database (1992-2005).

Methods: We determined the proportion of patients aged 75 and older who had preoperative staging prior to colectomy for colon adenocarcinoma.

Uncertainties in the prevention and treatment of glucocorticoid-induced osteoporosis.

Much knowledge has accrued since the 2001 American College of Rheumatology (ACR) guidelines were published to assist clinicians in the prevention and treatment of glucocorticoid-induced osteoporosis (GIO). Therefore, the ACR undertook a comprehensive effort to review the literature and update the GIO guidelines [Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis.

Hormone replacement therapy in prevention of morbidity and mortality in the older woman: part III: potential adverse effects of hormone replacement therapy.

Objectives: The objective of this four part series is to review for the practicing clinician the extensive and sometimes contradictory literature on the effects of estrogen replacement therapy (ERT) and hormone replacement therapy (HRT) in the postmenopausal woman. This third article reviews HRT and the potential excess morbidity from breast cancer, endometrial cancer, venous thromboembolism (VTE), and coronary heart disease (CHD).

Design: Studies reviewed were obtained through Medline searches, examination of citations in the articles reviewed from those searches,interviews with local experts in geriatrics, cardiology, and women's health.

Hormone replacement therapy in prevention of morbidity and mortality in the older woman. Part IV: HRT and the aging brain, overall mortality, and individual decision-making.

Objectives: The objective of this four part series is to review for the practicing clinician the extensive and sometimes contradictory literature on the effects of estrogen replacement therapy and hormone replacement therapy (HRT) in the postmenopausal woman. This final article reviews the role of long-term HRT in stroke, Alzheimer's disease (AD), and overall mortality as well as strategies to guide decision-making for the individual patient.

Design: Studies reviewed were obtained through Medline searches, examination of citations in the articles reviewed from those searches, interviews with local experts in geriatrics, cardiology, and women's health.

Mechanisms of asthma.

Airway inflammation is a key factor in the mechanisms of asthma. Articles published in the Journal of Allergy and Clinical Immunology this past year have highlighted the utility of investigative bronchoscopy with segmental antigen challenge and induced sputum analyses to evaluate features of airway inflammation in relationship to asthma severity. Peripheral blood cell generation of cytokines IFN-gamma (T(H)1) and IL-5 (T(H)2) was used to evaluate the relationship of the balance of T(H)1/T(H)2 cytokines to asthma persistence and severity in a 42-year, longitudinal study.

Cardiovascular disease and the aging woman: overcoming barriers to lifestyle changes.

Coronary heart disease (CHD) is the leading cause of death in women aged 60 years and older, yet 40% of this group believe they are unlikely to have a heart attack. Recent data show that the lack of a low-risk lifestyle may account for approximately 82% of coronary events in women. Underappreciation of CHD risk may prevent aging women from making significant changes in dietary habits, activity levels, and tobacco use to decrease their risk.

Gender differences in acute myocardial infarction: the University of Wisconsin experience.

Objective: To investigate gender differences in baseline characteristics, presentation, and treatment of patients with acute myocardial infarction (MI) admitted to the University of Wisconsin Hospital Coronary Care Unit (CCU) over a 1-year period.

Methods: A retrospective review was performed on the charts of all patients (n = 293) admitted to the CCU in 1996 with a discharge diagnosis of acute MI. In 83 women and 187 men with analyzable data (n = 270), 42 factors related to baseline characteristics, presentation, treatment, and outcomes were identified and analyzed for gender differences.

Potentiation of platinum antitumor effects in human lung tumor xenografts by the angiogenesis inhibitor squalamine: effects on tumor neovascularization.

Squalamine is a novel anti-angiogenic aminosterol that is postulated to inhibit neovascularization by selectively inhibiting the sodium-hydrogen antiporter exchanger. To determine how to most effectively use this agent in patients with cancer, we examined the antitumor effects of squalamine with or without cytotoxic agents in human lung cancer xenografts and correlated these observations with the degree of tumor neovascularization. No direct cytotoxic effects of squalamine against tumor cells were observed in vitro with or without cisplatin.

Detecting iron deficiency in anemic patients with concomitant medical problems.

Objective: To determine the sensitivity and specificity of mean corpuscular volume, transferrin saturation, total iron-binding capacity, and ferritin level in determining iron deficiency in a population of anemic veterans with a wide variety of general medical diagnoses.

Design: Retrospective chart review.

Setting: Hospitals of the Department of Veterans Affairs in Madison and Milwaukee, Wisconsin.

Long-term outcome of diabetic patients receiving peritoneal dialysis.

Objective: Data from the United States Renal Data Systems (USRDS) suggest that older diabetic patients with end-stage renal disease will have improved survival if they receive hemodialysis versus peritoneal dialysis. Younger diabetic patients have equal survival on either treatment modality. To address more specifically the risk factors for long-term survival of diabetic patients receiving peritoneal dialysis, we analyzed the long-term outcome of 118 diabetics receiving peritoneal dialysis over a decade and compared them to 165 nondiabetic patients.

Decay of globin mRNA during megakaryocytic differentiation of erythroleukemic cell line is accomplished through shortening of the poly(A) tail and degradation from the 3' end of the transcript.

Human erythroleukemic cell line K562 normally co-expresses erythroid and megakaryocytic genes, but treatment with an activator of the protein kinase C (PKC), tumor-promoting phorbol ester 12-myristate 13-acetate (PMA) shifts these cells toward megakaryocytic pathway of differentiation. This shift results in silencing of erythroid genes and in additional activation of megakaryocytic genes. It was shown that destabilization of the most abundant erythroid mRNA of K562 cells coding for fetal globin (gamma-globin,) is partially responsible for its silencing in phorbol ester-induced K562 cells.

In vivo effects of nonsteroidal antiinflammatory drugs on rat skin and synovial mast cell-induced vasopermeability.

Using our animal model of synovial mast cell-mediated arthritis in rats, we tested the effects of 3 nonsteroidal antiinflammatory drugs (NSAIDs) (aspirin, indomethacin, and ketoprofen) and an H1 and an H2 histamine receptor antagonist (diphenhydramine and cimetidine, respectively) on synovial and dermal mast cell-induced vasopermeability. Drug effects were assessed by quantifying the leakage of radiolabeled albumin into tissues following specific antigen-initiated activation of passively sensitized dermal and synovial mast cells. The 3 NSAIDs tested had different effects on synovial and dermal mast cell-induced vasopermeability.

The appearance of hypodense eosinophils during interleukin-2 treatment.

Based on membrane receptors, metabolic activity, and cell density, human eosinophils (EOSs) are a heterogeneous population of leukocytes. EOS heterogeneity translates into biologic significance, since low density cells can be metabolically more active and thus more capable of causing tissue injury. Efforts to identify mechanisms that lead to the development of hypodense EOSs have found that an in vitro exposure to cytokines reduces cell density and is associated with increased cell activity.