Relationships between sleep apnea,cardiovascular disease risk factors,and aortic pulse wave velocity over 18 years: the Wisconsin Sleep Cohort

Sleep and Breathing - The purpose of this study is to determine if apnea-hypopnea index (AHI) severity predicts future aortic pulse wave velocity (PWV) in the Wisconsin Sleep Cohort. Applanation...     

Dopaminergic effects on the implicit processing of distractor objects in Parkinson’s disease

The aim of the present study was to assess the effects of dopaminergic medication on the selection-for-action mechanisms in Parkinson's disease (PD). PD subjects were tested after not having taken medication for at least 12 h ("Off' state) and then retested 1-2 h after medication ("On" state). A three-dimensional kinematic system (ELITE, BTS, Italy) was used to record reach-to-grasp movements to a target object placed at a reaching distance of 30 cm. The target was presented alone or in the presence of distractor objects, which could be of either the same size (compatible distractor) or a different size (incompatible distractor). PD subjects in the Off state were significantly more affected by the presence of the incompatible distractor than in the On state. These results indicate that dopaminergic medication is of benefit in reducing interference effects when distractor objects evoke motor programs that differ from the motor program elicited by the target. Results are discussed in light of the role played by the striatal and mesocortical dopaminergic systems for response selection in basal ganglia disorders.     

Iclaprim, a diaminopyrimidine dihydrofolate reductase inhibitor for the potential treatment of antibiotic-resistant staphylococcal infections

Arpida Ltd, under license from Roche AG, is developing the diaminopyrimidine dihydrofolate reductase inhibitor iclaprim for the potential treatment of methicillin-resistant Staphylococcus aureus infections, including complicated skin and skin structure infections and hospital-acquired pneumonia. Phase III cSSSI clinical trials have been completed and an NDA filing process is ongoing. A phase II clinical trial for hospital-acquired pneumonia is ongoing.     

Can Cerebrospinal Fluid Pressure Detect Catheter Complications in Patients Who Experience Loss of Effectiveness With Intrathecal Baclofen Therapy?

ObjectiveThe catheter status of patients who presented with loss of intrathecal baclofen (ITB) therapy effectiveness was investigated using measurements of cerebrospinal fluid (CSF) pressure transmitted through the catheter fluid path to the pump. The aim of the study was to estimate the appropriate threshold separating catheter complications from “normal” catheter function, and to compare catheter status based on CSF pressure with the clinical diagnosis.MethodsThis was a prospective, masked nonsignificant risk, research study. Patients (N = 47) received ITB for the treatment of severe spasticity and presented with symptoms of catheter malfunction. CSF pressure data were recorded using an external sensor connected to a needle inserted into the catheter access port. An algorithm calculated the energy of the variations in CSF pressure caused by respiration and heartbeat within the intrathecal space. These data were evaluated against a threshold that separated normal from abnormal catheter function. Catheter status based on the algorithm was compared with the clinical diagnosis.ResultsComplete data were available for 37 patients. Mean CSF pressure energy was significantly higher (p = 0.025; student t-test) for patients diagnosed with normal catheter function vs. catheters with complications. The CSF pressure algorithm matched the clinical diagnosis in 16 of 18 patients with catheter complications (sensitivity = 89%), and 13 of 19 patients with normal catheter function (specificity = 68%).ConclusionIn-clinic CSF pressure data acquisition is technically feasible. Overall, catheter status based on the algorithm demonstrated concordance with the clinical diagnosis in 29 of 37 patients (78.4%).     

Assessment of Patient Preference for Constant Voltage and Constant Current Spinal Cord Stimulation

Objectives: Spinal cord stimulation devices control energy by generating either constant voltage (CV) pulses or constant current (CC) pulses. This study aimed to investigate: 1) whether patients feel differences between CV and CC stimulation; 2) if patients prefer CV or CC stimulation. Methods: Fourteen patients blinded to the type of pulse generation received 20 randomized pairs of 15‐sec pulse trains (CC‐CV, CV‐CC, CV‐CV, or CC‐CC). Patients identified whether the pairs were the same or different, and if they preferred the first or second train. Results: There was no difference in charge‐per‐pulse input between CV and CC modes. Patients performed at chance level in identifying identical pairs (55.7 ± 24.1% correct, 10 trials), and slightly better in identifying different pairs (67.1 ± 25.2% correct, 10 trials). No patients correctly identified all pairs. Patients were categorized based on their performance in this task. Only three patients fell into a category where preference could be established with some confidence with respect to the group averages. Two of these patients preferred CV, while one patient preferred CC. Conclusion: The lack of patient ability to discriminate in this preliminary investigation suggests that patient preference for a stimulation type should not be the key determining factor in choosing a spinal cord stimulation system.     

Ranking community health status to stimulate discussion of local public health issues: the Wisconsin County Health Rankings

United Health Foundation's America's Health Rankings, which ranks the states from "least healthy" to "healthiest," receives wide press coverage and promotes discussion of public health issues. The University of Wisconsin Population Health Institute used the United Health Foundation's model to develop the Wisconsin County Health Rankings ("Health Rankings") from existing county-level data. The institute first released the rankings in 2004. A survey of the Wisconsin county health officers indicated that they intend to use the rankings for needs assessment, program planning, and discussion with county health boards. The institute implemented many of the health officers' suggestions for improvement of the rankings in subsequent editions. The methods employed to create the rankings should be applicable in other states.