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21.
Fletcher B Berra K Ades P Braun LT Burke LE Durstine JL Fair JM Fletcher GF Goff D Hayman LL Hiatt WR Miller NH Krauss R Kris-Etherton P Stone N Wilterdink J Winston M;Council on Cardiovascular Nursing;Council on Arteriosclerosis Thrombosis Vascular Biology;Council on Basic Cardiovascular Sciences;Council on Cardiovascular Disease in the Young;Council on Clinical Cardiology;Council on Epidemiology Prevention;Council on Nutrition Physical Activity 《Circulation》2005,112(20):3184-3209
Current data and guidelines recommend treating abnormal blood lipids (ABL) to goal. This is a complex process and requires involvement from various healthcare professionals with a wide range of expertise. The model of a multidisciplinary case management approach for patients with ABL is well documented and described. This collaborative approach encompasses primary and secondary prevention across the lifespan, incorporates nutritional and exercise management as a significant component, defines the importance and indications for pharmacological therapy, and emphasizes the importance of adherence. Use of this collaborative approach for the treatment of ABL ultimately will improve cardiovascular and cerebrovascular morbidity and mortality. 相似文献
22.
Christopher E. Kline Lora E. Burke Susan M. Sereika Christopher C. Imes Bonny Rockette-Wagner Dara D. Mendez Patrick J. Strollo Yaguang Zheng Stephen L. Rathbun Eileen R. Chasens 《Mayo Clinic proceedings. Mayo Clinic》2018,93(9):1290-1298
Objective
To examine the bidirectional relationship between weight change and obstructive sleep apnea (OSA) in the context of a behavioral weight loss intervention.Patients and Methods
Adults who were overweight or obese (N=114) participated in a 12-month behavioral weight loss intervention from April 17, 2012, through February 9, 2015. The apnea-hypopnea index (AHI), a marker of the presence and severity of OSA, was assessed at baseline, 6 months, and 12 months. Linear mixed models evaluated the effect of weight change on the AHI and the effect of OSA (AHI ≥5) on subsequent weight loss. Secondary analyses evaluated the effect of OSA on intervention attendance, meeting daily calorie goals, and accelerometer-measured physical activity.Results
At baseline, 51.8% of the sample (n=59) had OSA. Adults who achieved at least 5% weight loss had an AHI reduction that was 2.1±0.9 (adjusted mean ± SE) events/h greater than those with less than 5% weight loss (P<.05). Adults with OSA lost a mean ± SE of 2.2%±0.9% less weight during the subsequent 6-month interval compared with those without OSA (P=.02). Those with OSA were less adherent to daily calorie goals (mean ± SE: 25.2%±3.3% vs 34.8%±3.4% of days; P=.006) and had a smaller increase in daily activity (mean ± SE: 378.3±353.7 vs 1060.1±377.8 steps/d; P<.05) over 12 months than those without OSA.Conclusion
Behaviorally induced weight loss in overweight/obese adults was associated with significant AHI reduction. However, the presence of OSA was associated with blunted weight loss, potentially via reduced adherence to behaviors supporting weight loss. These results suggest that OSA screening before attempting weight loss may be helpful to identify who may benefit from additional behavioral counseling. 相似文献23.
Samuel J. Howarth Lora M. Giangregorio Jack P. Callaghan 《Medical engineering & physics》2013,35(8):1212-1220
Equations used to determine vertebral failure tolerances without the need for destructive testing are useful for scaling applied sub-maximal forces during in vitro repetitive loading studies. However, existing equations that use vertebral bone density and morphology for calculating compressive failure tolerance are unsuitable for calculating vertebral shear failure tolerance since the primary site of failure is the pars interarticularis and not the vertebral body. Therefore, this investigation developed new equations for non-destructively determining vertebral shear failure tolerance from morphological and/or bone density measures. Shear failure was induced in 40 porcine cervical vertebral joints (20 C3-C4 and 20 C5-C6) by applying a constant posterior displacement to the caudal vertebra at 0.15 mm/s. Prior to destructive testing, morphology and bone density of the posterior elements were made with digital calipers, X-rays, and peripheral quantitative computed tomography. Iterative linear regression identified mathematical relationships between shear failure tolerance, and morphological and bone density measurements. Along with vertebral level, pars interarticularis length and lamina height from the cranial vertebra, and inferior facet height from the caudal vertebra collectively explained 61.8% of shear failure tolerance variance. Accuracy for this relationship, estimated using the same group of specimens, was 211.9 N or 9.8% of the measured shear failure tolerance. 相似文献
24.
Elevated anxiety and antidepressant-like responses in serotonin 5-HT1A receptor mutant mice 总被引:12,自引:0,他引:12
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Lora K. Heisler Hung-Ming Chu Thomas J. Brennan Jean A. Danao Preetpaul Bajwa Loren H. Parsons Laurence H. Tecott 《Proceedings of the National Academy of Sciences of the United States of America》1998,95(25):15049-15054
The brain serotonin (5-hydroxytryptamine; 5-HT) system is a powerful modulator of emotional processes and a target of medications used in the treatment of psychiatric disorders. To evaluate the contribution of serotonin 5-HT1A receptors to the regulation of these processes, we have used gene-targeting technology to generate 5-HT1A receptor-mutant mice. These animals lack functional 5-HT1A receptors as indicated by receptor autoradiography and by resistance to the hypothermic effects of the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT). Homozygous mutants display a consistent pattern of responses indicative of elevated anxiety levels in open-field, elevated-zero maze, and novel-object assays. Moreover, they exhibit antidepressant-like responses in a tail-suspension assay. These results indicate that the targeted disruption of the 5-HT1A receptor gene leads to heritable perturbations in the serotonergic regulation of emotional state. 5-HT1A receptor-null mutant mice have potential as a model for investigating mechanisms through which serotonergic systems modulate affective state and mediate the actions of psychiatric drugs. 相似文献
25.
Hao QL George AA Zhu J Barsky L Zielinska E Wang X Price M Ge S Crooks GM 《Blood》2008,111(3):1318-1326
The identity and lineage potential of the cells that initiate thymopoiesis remain controversial. The goal of these studies was to determine, at a clonal level, the immunophenotype and differentiation pathways of the earliest progenitors in human thymus. Although the majority of human CD34(+)lin(-) thymocytes express high levels of CD7, closer analysis reveals that a continuum of CD7 expression exists, and 1% to 2% of progenitors are CD7(-). CD34(+)lin(-) thymocytes were fractionated by CD7 expression and tested for lineage potential in B-lymphoid, T-lymphoid, and myeloid-erythroid conditions. Progressive restriction in lineage potential correlated with CD7 expression, that is, the CD7(hi) fraction produced T and NK cells but lacked B and myelo-erythroid potential, the CD7(int) (CD10(+)) fraction produced B, T, and NK cells, but lacked myelo-erythroid potential. The CD7(-) fraction produced all lymphoid and myelo-erythroid lineages and expressed HSC-associated genes. However, CD34(+)lin(-)CD7(-) thymocytes also expressed early T lymphoid genes Tdt, pTalpha, and IL-7Ralpha and lacked engraftment capacity, suggesting the signals that direct lymphoid commitment and corresponding loss of HSC function are rapidly initiated on arrival of HSC in the human thymus. Thus, differential levels of CD7 identify the progressive stages of lineage commitment in human thymus, initiated from a primitive CD7(-) lympho-myeloid thymic progenitor. 相似文献
26.
Salvatori R Aguiar-Oliveira MH Monte LV Hedges L Santos NL Pereira RM Phillips JA 《Clinical endocrinology》2002,57(1):77-80
OBJECTIVE: Mutations in the gene encoding for the GH-releasing hormone receptor (GHRHR) have been recently described in patients with familial isolated GH deficiency (IGHD) type IB. To date, all reported mutations have been found in kindreds sharing common ancestors. The only exception is a T to A transversion which causes a substitution of histidine for leucine in codon 144 (L144H) and creates a DraIII restriction site. This mutation was described in two families with different ethnic background residing in two different continents (Europe and North America). DESIGN: We searched for GHRHR mutations in a new family with IGHD from a third continent (South America) and found the affected individuals to be homozygous for the same L144H change. We performed linkage analysis with intra- and para-genic polymorphisms to determine if the three families carrying the L144H allele are related. RESULTS: Linkage analysis studies demonstrated that one of the three families does not share the same para- and intragenic GHRHR polymorphisms with the other two. CONCLUSIONS: The L144H mutation has arisen at least twice and should be considered for initial genetic analysis in patients with familial IGHD in whom the a GHRHR mutation is suspected. 相似文献
27.
Breck A. Duerkop Charmaine V. Clements Darcy Rollins Jorge L. M. Rodrigues Lora V. Hooper 《Proceedings of the National Academy of Sciences of the United States of America》2012,109(43):17621-17626
The mammalian intestine is home to a dense community of bacteria and its associated bacteriophage (phage). Virtually nothing is known about how phages impact the establishment and maintenance of resident bacterial communities in the intestine. Here, we examine the phages harbored by Enterococcus faecalis, a commensal of the human intestine. We show that E. faecalis strain V583 produces a composite phage (ϕV1/7) derived from two distinct chromosomally encoded prophage elements. One prophage, prophage 1 (ϕV1), encodes the structural genes necessary for phage particle production. Another prophage, prophage 7 (ϕV7), is required for phage infection of susceptible host bacteria. Production of ϕV1/7 is controlled, in part, by nutrient availability, because ϕV1/7 particle numbers are elevated by free amino acids in culture and during growth in the mouse intestine. ϕV1/7 confers an advantage to E. faecalis V583 during competition with other E. faecalis strains in vitro and in vivo. Thus, we propose that E. faecalis V583 uses phage particles to establish and maintain dominance of its intestinal niche in the presence of closely related competing strains. Our findings indicate that bacteriophages can impact the dynamics of bacterial colonization in the mammalian intestinal ecosystem. 相似文献
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