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51.
Deepa Maheswari Narasimhulu Scarlett Karakash Jeremy Weedon Howard Minkoff 《Maternal and child health journal》2016,20(12):2502-2509
Objective To assess patterns of e-health use in pregnancy in an underserved racially diverse inner-city population, and to assess the accuracy of pregnancy-related information obtained from the Internet. Methods A cross sectional study of 503 pregnant/postpartum women belonging to an underserved racially diverse inner-city population who completed a survey regarding e-health use. To assess accuracy, four independent expert-reviewers rated the first 10 webpages on Google searches for each of five questions based upon those in ACOG bulletins. Results 70.8 % of pregnant/postpartum women belonging to an underserved racially diverse inner-city population were e-health users. E-health users were younger (mean age 29.4 vs. 31.2, P = 0.009), more likely to be nulliparous (50.3 vs. 21.3 %, P < 0.001), have English as their primary language (62.3 vs. 49.1 %, P = 0.014) and have a college/graduate education (78 vs. 26.6 %, P < 0.001). While 60 % of these women said e-health influenced decision making, only 71.3 % of them discussed their searches with their provider. Expert reviewers determined that the online information was fairly accurate (mean score: +1.48 to +4.33 on a scale of ?5 to +5) but not uniformly accurate, and there was at least one webpage with inaccurate information for every question. Conclusions for practice Pregnant women frequently use e-health resources but do not routinely share their findings with their providers. Most, but not all, information obtained is accurate. Therefore it is important for providers to discuss their patients’ use, and help to guide them to reliable information. 相似文献
52.
KA Seely LK Brents LN Franks M Rajasekaran SM Zimmerman WE Fantegrossi PL Prather 《Neuropharmacology》2012,63(5):905-915
Mu-opioid and CB1-cannabinoid agonists produce analgesia; however, adverse effects limit use of drugs in both classes. Additive or synergistic effects resulting from concurrent administration of low doses of mu- and CB1-agonists may produce analgesia with fewer side effects. Synergism potentially results from interaction between mu-opioid receptors (MORs) and CB1 receptors (CB1Rs). AM-251 and rimonabant are CB1R antagonist/inverse agonists employed to validate opioid–cannabinoid interactions, presumed to act selectively at CB1Rs. Therefore, the potential for direct action of these antagonists at MORs is rarely considered. This study determined if AM-251 and/or rimonabant directly bind and modulate the function of MORs. Surprisingly, AM-251 and rimonabant, but not a third CB1R inverse agonist AM-281, bind with mid-nanomolar affinity to human MORs with a rank order of affinity (Ki) of AM-251 (251 nM) > rimonabant (652 nM) > AM281 (2135 nM). AM-251 and rimonabant, but not AM-281, also competitively antagonize morphine induced G-protein activation in CHO-hMOR cell homogenates (Kb = 719 or 1310 nM, respectively). AM-251 and rimonabant block morphine inhibition of cAMP production, while only AM-251 elicits cAMP rebound in CHO-hMOR cells chronically exposed to morphine. AM-251 and rimonabant (10 mg/kg) attenuate morphine analgesia, whereas the same dose of AM-281 produces little effect. Therefore, in addition to high CB1R affinity, AM-251 and rimonabant bind to MORs with mid-nanomolar affinity and at higher doses may affect morphine analgesia via direct antagonism at MORs. Such CB1-independent actions of these antagonists may contribute to reported inconsistencies when CB1/MOR interactions are examined via pharmacological methods in CB1-knockout versus wild-type mice. 相似文献
53.
Badami CD Senthil M Caputo FJ Rupani BJ Doucet D Pisarenko V Xu DZ Lu Q Feinman R Deitch EA 《Shock (Augusta, Ga.)》2008,30(6):680-685
The goal of this study was to test the hypothesis that factors released from the gut and carried in the mesenteric lymph contribute to mortality in a lethal gut I/R model. To test this hypothesis, a lethal splanchnic artery occlusion (SAO) shock model was used in male Sprague-Dawley rats. In the first set of experiments, ligation of the mesenteric lymph duct (LDL), which prevents gut-derived factors carried in the intestinal lymphatics from reaching the systemic circulation, significantly improved 24-h survival after a 20-min SAO insult (0% vs. 60% survival; P < 0.05). This increase in survival in the LDL-treated rats was associated with a blunted hypotensive response. Because increased iNOS-induced NO levels have been implicated in SAO-induced shock, we measured plasma nitrite/nitrate levels and liver iNOS protein levels in a second group of animals. Ligation of the mesenteric lymph duct significantly abrogated the SAO-induced increase in plasma nitrite/nitrate levels and the induction of hepatic iNOS (P < 0.05). In an additional series of studies, we documented that LDL increased not only 24-h but also long-term 7-day survival. During the course of these studies, we made the unexpected finding that Sprague-Dawley rats from different animal vendors had differential resistance to SAO, and that the time of the year that the experiments were carried out also influenced the results. Nonetheless, in conclusion, these studies support the hypothesis that factors carried in the mesenteric lymph significantly contribute to the development of irreversible shock after SAO. 相似文献
54.
Joseph Kim MD Brian Mailey MD Maheswari Senthil MD Avo Artinyan MD MS Can-Lan Sun MD PhD Smita Bhatia MD MPH 《Annals of surgical oncology》2009,16(9):2433-2441
Background Survival for gastric cancer is reportedly higher in Asians than for other races. It is unclear whether differences in outcome
exist among Asian ethnicities. Our objective was to assess gastric cancer survival in Asian ethnic groups in a large heterogeneous
population.
Methods Asian-Americans treated for gastric adenocarcinoma between 1988 and 2006 were identified from the Los Angeles County Cancer
Surveillance Program. Patients were stratified and compared by ethnicity (Korean, Japanese, Chinese, Vietnamese or Filipino).
Results Of the 1,817 Asian-Americans in the study cohort, 45% (n = 810) were Korean, 25% (n = 462) were Chinese, 11% (n = 193) were Japanese, 10% (n = 188) were Filipino, and 9% (n = 164) were Vietnamese. For the entire cohort Koreans and Filipinos had the longest and shortest median survival (MS), respectively
(22.4 and 10.3 months, respectively; P < 0.001). Multivariate analysis demonstrated that Japanese and Filipino ethnicity independently predicted worse survival
compared with Korean ethnicity [hazard ratio (HR) 1.37, 95% confidence interval (CI) 1.08–1.73, P = 0.008; and HR 1.71, 95% CI 1.37–2.13, P < 0.001, respectively]. In the surgical cohort, Koreans and Filipinos had the longest and shortest survival, respectively
(MS of 57.8 and 21.7 months, respectively; P < 0.001). Multivariate analysis of the surgical cohort also demonstrated that Japanese and Filipino ethnicity independently
predicted worse survival compared with Korean ethnicity (HR 1.61, 95% CI 1.22–2.13, P < 0.001; and HR 1.66, 95% CI 1.24–2.22, P < 0.001, respectively).
Conclusion There are differences in gastric cancer survival among Asian ethnicities. Future studies addressing varying environmental
exposures and molecular expression patterns in gastric cancer are warranted to better understand these disparities in outcome.
This study was presented at the Society of Surgical Oncology’s 62nd Annual Cancer Symposium on March 7, 2009. 相似文献
55.
Intravenous injection of trauma-hemorrhagic shock mesenteric lymph causes lung injury that is dependent upon activation of the inducible nitric oxide synthase pathway 总被引:1,自引:0,他引:1 下载免费PDF全文
Senthil M Watkins A Barlos D Xu DZ Lu Q Abungu B Caputo F Feinman R Deitch EA 《Annals of surgery》2007,246(5):822-830
OBJECTIVE: To test the hypothesis that gut-derived factors carried in trauma-hemorrhagic shock (T/HS) lymph is sufficient to induce lung injury. Additionally, because our previous studies showed that T/HS-induced nitric oxide production was associated with lung injury, we examined whether T/HS lymph-induced lung injury occurs via an inducible nitric oxide synthase (iNOS)-dependent pathway. BACKGROUND: We have previously shown that T/HS-induced lung injury is mediated by gut-derived humoral factors carried in the mesenteric lymph. However, it remains unclear whether T/HS lymph itself is sufficient to induce lung injury, or requires the activation of other factors during the T/HS period to exert its effect. METHODS: Mesenteric lymph collected from T/HS or trauma-sham shock (T/SS) animals was injected intravenously into male rats at a rate of 1 mL/h for 3 hours. At the end of infusion, lung injury was assessed by lung permeability and lung histology. The effect of iNOS inhibition on T/HS lymph-induced lung injury was studied and this was further confirmed in iNOS knockout mice. Finally, iNOS immunohistochemistry was performed to identify the cells of origin of iNOS. RESULTS: The injection of T/HS lymph, but not sham shock lymph, caused lung injury. This was associated with increased plasma nitrite/nitrate levels as well as induction of iNOS protein in the lung, liver, and gut. Treatment with the selective iNOS inhibitor aminoguanidine prevented T/HS lymph-induced lung injury. iNOS knockout mice, but not their wild-type controls, were resistant to T/HS lymph-induced lung injury. By immunohistochemistry, neutrophils and macrophages, rather than parenchymal cells, were the source of T/HS lymph-induced lung iNOS. CONCLUSIONS: These results indicate that T/HS lymph is sufficient to induce acute lung injury and that lymph-induced lung injury occurs via an iNOS-dependent pathway. 相似文献
56.
Surya Nagarajan Kalaiarasi Sivaji Sridharan Krishnaswamy Brindha Pemiah Kalpoondi Sekar Rajan Uma Maheswari Krishnan Swaminathan Sethuraman 《Journal of ethnopharmacology》2014
Ethnopharmacological relevance
Herbal and herbo-mineral preparations are being traditionally used in Indian medicines. The herbo-mineral preparations have several benefits that have been instrumental in their widespread use in treatment of different disorders by traditional medicinal practitioners. These include better stability, lower dosage, ease of storability and sustained availability. Naga bhasma (lead sulphide ash), a traditional Indian herbo-mineral medication prepared using lead and several herbal ingredients, has been used as an oral medicine in India for many years for the treatment of diabetes, spleen enlargement, diarrhoea and various skin diseases. The elaborate preparation protocol involved in the traditional medicines is believed to modify the toxic nature of the precursor (metal) and adds therapeutic value. But modern scientists claim that these preparations are toxic to health as they contain large amount of metal. Many factors such as preparation based factors, chemical nature based factors, vehicle used, therapy associated factors, pharmacological factors, etc, determine whether the traditional medicines are toxic or not. This review focuses on the safety and critical issues associated with Naga bhasma—a lead based ayurvedic medicine.Materials and methods
The detailed review of literature about Naga bhasma apart from other lead based formulations are carried out by utilizing the resources including, classical Indian text books, databases such as Pub med, Scopus, Science direct and few other web sources.Results
Though metallic lead is known to be toxic to the biological system, no compelling evidence has been put forth to suggest any toxic manifestations of Naga bhasma. The elemental characterization of preparations containing Naga bhasma has shown extremely high levels of lead content and various parameters must be taken into consideration in deciding the safety and critical issues present in traditional medicines. As there are no molecular targets available for most of the traditional medicine, it is difficult to assure the safety in using this traditional preparation. Highly intensive research encompassing physico-chemical, engineering as well as biological aspects need to be carried out to understand the applicability of such preparations in a modern context.Conclusion
As there are no molecular targets available for most of the traditional medicine, it is difficult to assure the safety in using this traditional preparation. Highly intensive research encompassing physico–chemical, engineering as well as biological aspects need to be carried out to understand the applicability of such preparations in a modern context. 相似文献57.
Ted C. Ling Jason M. Slater Maheswari Senthil Kevork Kazanjian Frank Howard Carlos A. Garberoglio Jerry D. Slater Gary Y. Yang 《Journal of gastrointestinal oncology.》2014,5(1):E7-E12
Background
Melanoma of the anorectal mucosa is a rare but highly aggressive tumor. Its presenting symptoms are frequently confused with hemorrhoids, thereby causing a delay in diagnosis. Anorectal melanoma carries with it a very poor prognosis. There is a paucity of data investigating management options for anorectal melanoma, and even fewer data reporting recurrent or refractory cases.Case presentation
This case documents a 41-year-old female with a long history of hemorrhoids presenting with anorectal discharge. She was incidentally found have anorectal melanoma following surgical resection. Systemic diagnostic work-up demonstrated PET-avid lymphadenopathy in her right groin. She underwent right groin dissection. However, seven months later she recurred in her right groin and a new recurrent mass was found in her pelvis. She underwent a second groin dissection and resection of the pelvic recurrence. This was followed by a course of hypofractionated radiation therapy then systemic immunotherapy.Discussion
Surgery has been the mainstay of treatment. However, the extent of surgery has been the topic of investigation. Historically, radical resections have been performed but they result in high rates of post-operative morbidity. Newer studies have compared radical resection with wide local excisions and found comparable outcomes. Anorectal melanoma is frequently a systemic disease. The ideal systemic therapy regimen has not yet been determined but numerous studies show a benefit to multi-agent treatments. Radiation therapy is typically given in the post-operative or palliative setting.Conclusions
Anorectal mucosal melanoma is a very rare but aggressive disease with a poor prognosis. The overall treatment goal should strive to optimize quality of life and tumor control while minimizing treatment-related morbidities. 相似文献58.
Arancha Prada‐Villaverde MD Jesus Esquivel MD Andrew M. Lowy MD Maurie Markman MD Terence Chua MD Joerg Pelz MD Dario Baratti MD Joel M. Baumgartner MD Richard Berri MD Pedro Bretcha‐Boix MD Marcello Deraco MD Guillermo Flores‐Ayala MD Olivier Glehen MD Alberto Gomez‐Portilla MD Santiago González‐Moreno MD Martin Goodman MD Evgenia Halkia MD Shigeki Kusamura MD Mecker Moller MD Guillaume Passot MD Marc Pocard MD George Salti MD Armando Sardi MD Maheswari Senthil MD John Spiliotis MD Juan Torres‐Melero MD Kiran Turaga MD Richard Trout PhD 《Journal of surgical oncology》2014,110(7):779-785
59.
Maheswari Ekambaram Matilde Irigoyen Johelin DeFreitas Sharina Rajbhandari Jessica Lynn Geaney Leonard Edward Braitman 《World journal of pediatrics : WJP》2018,14(4):357-363
Background
In adolescents, there is limited evidence on the independent and additive effect of prepregnancy body mass index (BMI) and gestational weight gain on infant birth weight. Data also show that this effect may vary by race. We sought to examine the impact of maternal prepregnancy BMI and gestational weight gain on birth weight and risk of large for gestational age (LGA) in term newborns of minority adolescent mothers.Methods
This was a retrospective cohort study of 411 singleton live term infants born to mothers ≤ 18 years. Data were abstracted from electronic medical records.Results
Gestational weight gain was related to infant birth weight (ρ = 0.36, P < 0.0001), but BMI was not (ρ = 0.025, P = 0.61). On regression analysis, gestational weight gain, gestational age and Hispanic ethnicity were independent predictors of birth weight, controlling for maternal age, BMI, parity, tobacco/drug use and preeclampsia. The probability of having an LGA infant increased with weight gain [adjusted odds ratio (aOR) 1.14, 95% confidence interval (CI) 1.07–1.21] but not with BMI. Mothers who gained weight in excess of 2009 Institute of Medicine (IOM) recommendations had a greater risk of having an LGA infant compared to those who gained within recommendations (aOR 5.7, 95% CI 1.6–19.5).Conclusions
Minority adolescents with greater gestational weight gain had infants with higher birth weight and greater risk of LGA; BMI was not associated with either outcome. Further studies are needed to examine the applicability of the 2009 BMI-specific IOM gestational weight gain recommendations to adolescents in minority populations.60.