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91.
Gastrointestinal cytomegalovirus infection in heart and heart-lung transplant recipients 总被引:1,自引:0,他引:1
C S Kaplan E A Petersen T B Icenogle J G Copeland H V Villar R Sampliner L Minnich C G Ray 《Archives of internal medicine》1989,149(9):2095-2100
Cytomegalovirus (CMV) causes major morbidity in organ transplant recipients. Gastrointestinal disease was the most prominent manifestation of CMV infection in a population of heart and heart-lung transplant patients, with an incidence of 9.9%, compared with pneumonitis (4.0%) and retinitis (0%), and occurred most frequently in CMV-seronegative recipients of organs from CMV-seropositive donors. Clinical manifestations included gastritis (nine patients), gastric ulceration (four patients), duodenitis (three patients), esophagitis (one patient), pyloric perforation (one patient), and colonic hemorrhage (one patient). Patients with gastrointestinal CMV infection were treated with intravenous ganciclovir sodium therapy, 5 mg/kg twice daily, for 2 to 8 weeks, with positive clinical, endoscopic, histologic, and virologic responses. Relapses occurred in four of nine patients who were followed up for a median period of 18 months. Retreatment resulted in healing of endoscopic lesions and in viral clearing. We conclude that early endoscopic evaluation for CMV is indicated in heart and heart-lung transplant patients with gastrointestinal symptoms. This study further suggests that intravenous ganciclovir therapy is effective for the treatment of gastrointestinal CMV in these patients. 相似文献
92.
Martin Steinau Mona Saraiya Marc T. Goodman Edward S. Peters Meg Watson Jennifer L. Cleveland Charles F. Lynch Edward J. Wilkinson Brenda Y. Hernandez Glen Copeland Maria S. Saber Claudia Hopenhayn Youjie Huang Wendy Cozen Christopher Lyu Elizabeth R. Unger the HPV Typing of Cancers Workgroup 《Emerging infectious diseases》2014,20(5):822-828
We conducted a study to determine prevalence of HPV types in oropharyngeal cancers in the United States and establish a prevaccine baseline for monitoring the impact of vaccination. HPV DNA was extracted from tumor tissue samples from patients in whom cancer was diagnosed during 1995–2005. The samples were obtained from cancer registries and Residual Tissue Repository Program sites in the United States. HPV was detected and typed by using PCR reverse line blot assays. Among 557 invasive oropharyngeal squamous cell carcinomas, 72% were positive for HPV and 62% for vaccine types HPV16 or 18. Prevalence of HPV-16/18 was lower in women (53%) than in men (66%), and lower in non-Hispanic Black patients (31%) than in other racial/ethnic groups (68%–80%). Results indicate that vaccines could prevent most oropharyngeal cancers in the United States, but their effect may vary by demographic variables. 相似文献
93.
Stephen M. Shortell Ph.D. M.P.H. M.B.A. Sean R. McClellan Ph.D. Patricia P. Ramsay M.P.H. Lawrence P. Casalino M.D. Ph.D. Andrew M. Ryan Ph.D. M.A. Kennon R. Copeland Ph.D. M.S. 《Health services research》2014,49(5):1519-1536
Objective
To provide the first nationally based information on physician practice involvement in ACOs.Data Sources/Study Setting
Primary data from the third National Survey of Physician Organizations (January 2012–May 2013).Study Design
We conducted a 40-minute phone survey in a sample of physician practices. A nationally representative sample of practices was surveyed in order to provide estimates of organizational characteristics, care management processes, ACO participation, and related variables for four major chronic illnesses.Data Collection/Extraction Methods
We evaluated the associations between ACO participation, organizational characteristics, and a 25-point index of patient-centered medical home processes.Principal Findings
We found that 23.7 percent of physician practices (n = 280) reported joining an ACO; 15.7 percent (n = 186) were planning to become involved within the next 12 months and 60.6 percent (n = 717) reported no involvement and no plans to become involved. Larger practices, those receiving patients from an IPA and/or PHO, those that were physician-owned versus hospital/health system-owned, those located in New England, and those with greater patient-centered medical home (PCMH) care management processes were more likely to have joined an ACO.Conclusions
Physician practices that are currently participating in ACOs appear to be relatively large, or to be members of an IPA or PHO, are less likely to be hospital-owned and are more likely to use more care management processes than nonparticipating practices. 相似文献94.
Functional disability and death wishes in older Europeans: results from the EURODEP concerted action
Madeleine Mellqvist Fässberg Svante Östling Arjan W. Braam Kristoffer Bäckman John R. M. Copeland Manfred Fichter Sirkka-Liisa Kivelä Brian A. Lawlor Antonio Lobo Halggrimur Magnússon Martin J. Prince Friedel M. Reischies Cesare Turrina Kenneth Wilson Ingmar Skoog Margda Waern 《Social psychiatry and psychiatric epidemiology》2014,49(9):1475-1482
Purpose
Physical illness has been shown to be a risk factor for suicidal behaviour in older adults. The association between functional disability and suicidal behaviour in older adults is less clear. The aim of this study was to examine the relationship between functional disability and death wishes in late life.Methods
Data from 11 population studies on depression in persons aged 65 and above were pooled, yielding a total of 15,890 respondents. Level of functional disability was trichotomised (no, intermediate, high). A person was considered to have death wishes if the death wish/suicidal ideation item of the EURO-D scale was endorsed. Odds ratios for death wishes associated with functional disability were calculated in a multilevel logistic regression model.Results
In total, 5 % of the men and 7 % of the women reported death wishes. Both intermediate (OR 1.89, 95 % CI 1.42; 2.52) and high functional disability (OR 3.22, 95 % CI 2.34; 4.42) were associated with death wishes. No sex differences could be shown. Results remained after adding depressive symptoms to the model.Conclusions
Functional disability was independently associated with death wishes in older adults. Results can help inform clinicians who care for older persons with functional impairment. 相似文献95.
96.
Catherine S. Copeland Donald J. Woods Karl G. Hursey 《The International journal of eating disorders》1995,17(1):97-100
The eating behavior of college women scoring within either the above-average or middle ranges on the Restraint Scale was compared following brief social encounters with male students or other female students, or a no-encounter control situation. The eating of average restraint women was significantly depressed following interaction with a partner whom the subjects considered attractive. For high restraint women a nonsignificant tendency towards disinhibition of eating following interaction with an attractive other occurred. Personality ratings by partners indicated that high restraint women presented a distinct social persona to male, but not female, strangers in the brief experimental interaction. © 1995 by John Wiley & Sons, Inc. 相似文献
97.
Laura A. Genovesi Ching Ging Ng Melissa J. Davis Marc Remke Michael D. Taylor David J. Adams Alistair G. Rust Jerrold M. Ward Kenneth H. Ban Nancy A. Jenkins Neal G. Copeland Brandon J. Wainwright 《Proceedings of the National Academy of Sciences of the United States of America》2013,110(46):E4325-E4334
98.
Le Guyader A Pacheco G Seaver N Davis-Gorman G Copeland J McDonagh PF 《Journal of diabetes and its complications》2009,23(1):65-70
Increased aspirin resistance may contribute to the increase in thrombotic events observed in patients with type 2 diabetes. In this study, we examined if acute exposure to increased plasma glucose impaired the inhibitory effects of aspirin on platelet activation. Whole-blood samples were incubated with 100 (euglycemia), 200, 300, and 600 mg/dl glucose followed by incubation with aspirin [acetylsalicylic acid (ASA)]. Using flow cytometry, GPIIb-IIIa and P-selectin were analyzed in unstimulated and arachidonic acid (AA)-stimulated platelets. In euglycemic blood, AA caused a significant increase in platelet GPIIb-IIIa expression [unstimulated: 59.5+/-8.2 total fluorescence intensity (TFI), AA stimulated: 319.6+/-42.7 TFI, P=.002] and P-selectin (4.4+/-0.7 and 179.5+/-38.5 TFI, P<.001). In vitro, ASA significantly inhibited both GPIIb-IIIa expression (36.5%) and P-selectin expression (81%; P<.005). However, increased blood glucose (200 mg/dl) significantly impaired the inhibitory effect of ASA (84% for GPIIb-IIIa, P<.005; 48% for P-selectin, P=NS). Increasing glucose to 600 mg/dl completely overwhelmed the inhibitory effect of ASA. A statistically significant interaction between glucose concentration and ASA dose was found (P<.001 for GPIIb-IIIa and P=.004 for P-selectin). In vitro, concentration-dependent stress hyperglycemia significantly impaired the inhibitory effects of aspirin on human platelet GPIIb-IIIa and P-selectin expression. Under acute hyperglycemic conditions, the effectiveness of ASA to inhibit platelets via the AA-activation pathway may be significantly reduced. 相似文献
99.
100.
W G Henderson T Moritz S Goldman J Copeland J Souchek K Zadina T Ovitt J Doherty R Read E Chesler 《Controlled clinical trials》1988,9(3):189-205
Because most coronary artery bypass patients receive more than one graft at surgery, it is most important to determine whether statistical analysis of graft patency should be performed on the premise that the multiple grafts within patients are dependent or independent experimental units. Veterans Administration Cooperative Study No. 207 was a multicenter clinical trial comparing four different antiplatelet regimens to placebo in the prevention of graft occlusion following coronary artery bypass grafting. Using the results from the 1-week postoperative angiograms from the Veterans Administration Cooperative Study No. 207, in which there were 3.2 distal anastomoses per patient, we have tested the hypothesis that grafts within patients tend to act dependently with respect to patency or occlusion by comparing the graft patency data to a binomial distribution (i.e., that distribution that would have been manifest if grafts were independent). Because the graft patency results in Study No. 207 significantly deviated from the binomial distribution (p = 0.0003), a more appropriate analysis for graft patency data was applied using a ratio estimate as applied to cluster sampling. The statistical methods used in 11 previous clinical trials of antithrombotic therapy after coronary artery bypass grafting were examined. Only one of the previous studies used such an analysis, and three additional reports attempted to correct for dependency of grafts within patients in their analyses using other statistical methods. In seven of the studies the investigators did not address the potential problem of a dependent relationship between multiple grafts within patients. We conclude that grafts within patients act as dependent experimental units and that the ratio estimate as applied to cluster sampling may be appropriately applied to these data. 相似文献