Generalizability of trial results to elderly Medicare patients with advanced solid tumors (Alliance 70802).

Background: In the United States, patients who enroll in chemotherapy trials seldom reflect the attributes of the general population with cancer, as they are often younger, more functional, and have less comorbidity. We compared survival following three chemotherapy regimens according to the setting in which care was delivered (ie, clinical trial vs usual care) to determine the generalizability of clinical trial results to unselected elderly Medicare patients.

Methods: Using SEER-Medicare data, we estimated survival for elderly patients (ie, age 65 years or older, n = 14097) with advanced pancreatic or lung cancer following receipt of one of three guideline-recommended first-line chemotherapy regimens.

Diagnostic accuracy of behavioral, activity, ferritin, and clinical indicators of restless legs syndrome.

Study Objectives: Lack of a valid diagnostic measure of restless legs syndrome (RLS) for persons with dementia, who do not have the cognitive ability to report complex symptoms, impedes RLS treatment and research in this population. The aim of this study was to determine the sensitivity and specificity of a combination of indicators for identifying RLS that could eventually be used to diagnose RLS in persons with dementia.

Design: 3-day, prospective instrument validation.

The effects of a MAP2K5 microRNA target site SNP on risk for anxiety and depressive disorders.

Functional variants that contribute to genomewide association study (GWAS) signals are difficult to identify. MicroRNAs could contribute to some of these gene-trait relationships. We compiled a set of GWAS trait gene SNPs that were predicted to affect microRNA regulation of mRNA.

Yeast sirtuins and the regulation of aging.

The sirtuins are a phylogenetically conserved family of NAD(+) -dependent protein deacetylases that consume one molecule of NAD(+) for every deacetylated lysine side chain. Their requirement for NAD(+) potentially makes them prone to regulation by fluctuations in NAD(+) or biosynthesis intermediates, thus linking them to cellular metabolism. The Sir2 protein from Saccharomyces cerevisiae is the founding sirtuin family member and has been well characterized as a histone deacetylase that functions in transcriptional silencing of heterochromatin domains and as a pro-longevity factor for replicative life span (RLS), defined as the number of times a mother cell divides (buds) before senescing.

Restless legs syndrome in an appalachian primary care population: prevalence, demographic and lifestyle correlates, and burden.

Background: Restless legs syndrome (RLS) is a common and distressing sensorimotor disorder of unknown etiology. While the epidemiology of RLS has been examined in several North American and European studies, research on RLS and RLS burden in poor, rural populations, including those residing in Appalachia, remains sparse. In this study, we investigated RLS prevalence in an Appalachian primary care population and examined the association of RLS to demographic factors, lifestyle characteristics, sleep quality, and mood disorders.

Risk of lower and upper gastrointestinal bleeding, transfusions, and hospitalizations with complex antithrombotic therapy in elderly patients.

Background: Complex antithrombotic therapy (CAT) prescribed to elderly patients increases the risk of gastrointestinal bleeding. We quantified upper (UGIE) and lower gastrointestinal (LGIE) events, transfusions, and hospitalizations in a national cohort of elderly veterans prescribed CAT.

Methods And Results: Veterans ≥60 years of age prescribed anticoagulant-antiplatelet, aspirin (ASA)-antiplatelet, ASA-anticoagulant, or triple therapy (ie, TRIP, anticoagulant-antiplatelet-ASA) were identified from the national pharmacy database (October 1, 2002 to September 30, 2008).

Stroke Genetics Network (SiGN) study: design and rationale for a genome-wide association study of ischemic stroke subtypes.

Background And Purpose: Meta-analyses of extant genome-wide data illustrate the need to focus on subtypes of ischemic stroke for gene discovery. The National Institute of Neurological Disorders and Stroke SiGN (Stroke Genetics Network) contributes substantially to meta-analyses that focus on specific subtypes of stroke.

Methods: The National Institute of Neurological Disorders and Stroke SiGN includes ischemic stroke cases from 24 genetic research centers: 13 from the United States and 11 from Europe.

Pharmacologic therapy for primary restless legs syndrome: a systematic review and meta-analysis.

Importance: Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and a distressing, irresistible urge to move them. We conducted a systematic review to evaluate efficacy, safety, and comparative effectiveness of pharmacologic treatments for primary RLS.

Evidence Acquisition: We included randomized controlled trials (RCTs), published in English, reporting efficacy outcomes and harms of pharmacologic treatments for primary RLS of at least 4 weeks' duration.

Bottlenecks in the emergency department: the psychiatric clinicians' perspective.

Objective: To ask psychiatric clinicians for their perspectives on the rate-limiting steps (RLS) in patient care in the Emergency Department (ED) and to compare them to the patient's actual length of stay.

Method: Prospective cohort study of clinicians' perspectives on the RLS among 1092 adult ED patients. Medical records were abstracted for ED time and other data.

Incidence of restless legs syndrome and its correlates.

Background: Restless legs syndrome (RLS) is a common sensorimotor disorder whose incidence is not known. The aim of the study was to determine the incidence and correlates of RLS in a population-based sample.

Methods: We obtained data from the Tucson Cohort of the Sleep Heart Health Study, a prospective multicenter study.

Gabapentin enacarbil for treatment of restless legs syndrome in adults.

Objective: To review the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, precautions, dosing recommendations, and patient counseling for gabapentin enacarbil for the treatment of restless legs syndrome (RLS) in adults.

Data Sources: A literature search was conducted using the terms gabapentin enacarbil, XP13512/GSK1838262, and restless legs syndrome. MEDLINE, Books@Ovid, Journals@Ovid Full Text, BIOSIS Previews, and EMED databases were the primary search sites (2004-October 2011).

Sleep disturbances and nocturnal agitation behaviors in older adults with dementia.

Study Objectives: To examine nighttime sleep patterns of persons with dementia showing nocturnal agitation behaviors and to determine whether restless legs syndrome (RLS), periodic limb movements in sleep (PLMS), and obstructive sleep apnea (OSA) are associated with nocturnal agitation behaviors.

Design: Cross-sectional.

Setting: General community.

Gender differences in the association between antidepressant use and restless legs syndrome.

Contradictory results have been reported for the association between antidepressant use and Restless Legs Syndrome (RLS). Our aim was to clarify the relationship and examine possible gender differences. We interviewed 1,693 veterans receiving primary care from the Cleveland VA Medical Center and obtained prescription drug information from their medical records.

Bupropion as a possible treatment option for restless legs syndrome.

Objective: To describe a case of restless legs syndrome (RLS) successfully managed with bupropion.

Case Summary: A 45-year-old female presented to a Veterans Affairs primary care clinic with a history of chronic insomnia. Her complicated history of treatment failure to sedative-hypnotic agents, continued sleep disturbances, and complaints of intolerable leg sensations fostered collaboration between a psychiatrist and pharmacist to identify effective treatment.

Adverse effects of ropinirole-treated restless leg syndrome (RLS) during smoking cessation.

The impact of nicotine on drug metabolism should be carefully considered, including its impact on ropinirole. The author presents a case in which a patient with RLS effectively treated with ropinirole (Requip) experienced profound side effects from ropinirole when she stopped smoking.

Neurotoxic lesions at the ventral mesopontine junction change sleep time and muscle activity during sleep: an animal model of motor disorders in sleep.

There is no adequate animal model of restless legs syndrome (RLS) and periodic leg movements disorder (PLMD), disorders affecting 10% of the population. Similarly, there is no model of rapid eye movement (REM) sleep behavior disorder (RBD) that explains its symptoms and its link to Parkinsonism. We previously reported that the motor inhibitory system in the brainstem extends from the medulla to the ventral mesopontine junction (VMPJ).

Development of a Tool to Assess the Team Leadership Skills of Medical Residents.

Purpose: To develop a tool to assess the team leadership skills of internal medicine residents.

Method: A 27-item pilot instrument developed by two authors was distributed to interns on ward and intensive care unit teams at the end of rotations from a single institution's internal medicine residency program. These items were factor analyzed and reduced to a seven-item resident leadership scale (RLS).

Restless legs syndrome: manifestations, treatment and dental implications.

Background: The authors reviewed the clinical features, epidemiology, pathogenesis and risk factors, medical management, dental findings and dental management of patients with restless legs syndrome (RLS).

Types Of Studies Reviewed: The authors conducted a MEDLINE search for the years 2000 through 2004 using the key terms "restless legs syndrome," "epidemiology," "pathophysiology," "treatment" and "dentistry." They selected articles published in English in peer-reviewed journals for further review, and they gave preference to articles reporting randomized controlled trials.

Sleep problems and the risk for sleep disorders in an outpatient veteran population.

We used a self-report questionnaire to identify outpatients with chronic symptoms of sleep disorders and/or high pretest probability for sleep apnea as well as for restless legs syndrome (RLS), insomnia, and narcolepsy. Surveys were presented to patients waiting for an appointment in Veterans Administration (VA) Medical Center clinics in Northeast Ohio, USA. Items addressed the frequency of snoring behavior; wake time sleepiness or fatigue and history of obesity/hypertension for high risk for sleep apnea (Netzer et al.

Cognitive and behavioral anomalies among insomnia patients with mixed restless legs and periodic limb movement disorder.

This study examined whether patients who have periodic limb movement disorder (PLMD), with or without comorbid restless legs syndrome (RLS), display the sleep-disruptive cognitive and behavioral anomalies found among primary insomnia sufferers. Archival data from a Sleep History Questionnaire, home-based polysomnography, and a sleep log were obtained for matched RLS/PLMD, primary insomnia, and noncomplaining volunteer samples. Statistical comparisons showed that the RLS/PLMD and primary insomnia samples differed significantly from the normal sleepers in regard to their propensities for certain sleep disruptive habits, perceived difficulties controlling pre-sleep cognitive activity, and their subjective sleep appraisals.

Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder.

Dopaminergic agents, particularly dopamine agonists, have been used with increasing frequency in the treatment of restless legs syndrome and periodic limb movement disorder. These evidence-based practice parameters are complementary to the Practice Parameters for the Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder, published in 1999. These practice parameters were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine.

Restless legs syndrome: a case study.

Restless legs syndrome (RLS) is a sensory motor neurological movement disorder affecting 12 million Americans. Few healthcare providers know of the existence of this syndrome. Often underdiagnosed and unrecognized because of comorbid conditions, RLS is a lifelong condition with worsening symptoms.