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May T, Smith CL, Kelley W, East K, Orlando L, Cochran M, Colletto S, Moss I, Nakano-Okuno M, Korf B, Limdi N. Does genetic testing offer utility as a supplement to traditional family health history intake for inherited disease risk? Fam Pract 2023; 40:760-767. [PMID: 36856778 DOI: 10.1093/fampra/cmad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
CONTENT This study examines the potential utility of genetic testing as a supplement to family health history to screen for increased risk of inherited disease. Medical conditions are often misreported or misunderstood, especially those related to different forms of cardiac disease (arrhythmias vs. structural heart disease vs. coronary artery disease), female organ cancers (uterine vs. ovarian vs. cervical), and type of cancer (differentiating primary cancer from metastases to other organs). While these nuances appear subtle, they can dramatically alter medical management. For example, different types of cardiac failure (structural, arrhythmia, and coronary artery disease) have inherited forms that are managed with vastly different approaches. METHODS Using a dataset of over 6,200 individuals who underwent genetic screening, we compared the ability of genetic testing and traditional family health history to identify increased risk of inherited disease. A further, in-depth qualitative study of individuals for whom risk identified through each method was discordant, explored whether this discordance could be addressed through changes in family health history intake. FINDINGS Of 90 individuals for whom genetic testing indicated significant increased risk for inherited disease, two-thirds (66%) had no corroborating family health history. Specifically, we identify cardiomyopathy, arrhythmia, and malignant hyperthermia as conditions for which discordance between genetic testing and traditional family health history was greatest, and familial hypercholesterolaemia, Lynch syndrome, and hereditary breast and ovarian cancer as conditions for which greater concordance existed. CONCLUSION We conclude that genetic testing offers utility as a supplement to traditional family health history intake over certain conditions.
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Affiliation(s)
- Thomas May
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Crystal L Smith
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Whitley Kelley
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Kelly East
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Lori Orlando
- Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Meagan Cochran
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States
| | - Sierra Colletto
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Irene Moss
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Mariko Nakano-Okuno
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Bruce Korf
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
| | - Nita Limdi
- Department of Genetics, UAB Heersink School of Medicine, Birmingham, AL, United States
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Slavotinek A, Prasad H, Outram S, Scollon S, Rego S, Yip T, Hoban H, Foreman KM, Kelley W, Finnila C, Berg J, Murali P, Bonini KE, Martin LJ, Hott A. Information-seeking preferences in diverse patients receiving a genetic testing result in the Clinical Sequencing Evidence-Generating Research (CSER) study. Genet Med 2023; 25:100899. [PMID: 37212252 PMCID: PMC10524447 DOI: 10.1016/j.gim.2023.100899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 05/03/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE Accurate and understandable information after genetic testing is critical for patients, family members, and professionals alike. METHODS As part of a cross-site study from the Clinical Sequencing Evidence-Generating Research consortium, we investigated the information-seeking practices among patients and family members at 5 to 7 months after genetic testing results disclosure, assessing the perceived utility of a variety of information sources, such as family and friends, health care providers, support groups, and the internet. RESULTS We found that individuals placed a high value on information obtained from genetics professionals and health care workers, independent of genetic testing result case classifications as positive, inconclusive, or negative. The internet was also highly utilized and ranked. Study participants rated some information sources as more useful for positive results compared with inconclusive or negative outcomes, emphasizing that it may be difficult to identify helpful information for individuals receiving an uncertain or negative result. There were few data from non-English speakers, highlighting the need to develop strategies to reach this population. CONCLUSION Our study emphasizes the need for clinicians to provide accurate and comprehensible information to individuals from diverse populations after genetic testing.
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Affiliation(s)
- Anne Slavotinek
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA.
| | - Hannah Prasad
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Simon Outram
- Institute for Health & Aging, School of Nursing, University of California San Francisco, San Francisco, CA
| | - Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Shannon Rego
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Tiffany Yip
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Hannah Hoban
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA; Institute for Human Genetics, University of California, San Francisco, San Francisco, CA
| | - Kate M Foreman
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Jonathan Berg
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Priyanka Murali
- Department of Medicine (Medical Genetics), University of Washington Medical Center, Seattle, WA
| | - Katherine E Bonini
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lisa J Martin
- Division of Human Genetics Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Adam Hott
- HudsonAlpha Institute for Biotechnology, Huntsville, AL
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Korf B, Absher D, Asif I, Bateman L, Barsh G, Bowling K, Cooper G, Davis B, East K, Finnila C, Goff B, Kelly M, Kelley W, Latner D, Lawlor J, Limdi N, May T, Might M, Moss I, Nakano M, Osborne T, Sodeke S, Stout A, Thompson M. eP494: Integration of genomics into primary care via the Alabama Genomic Health Initiative. Genet Med 2022. [DOI: 10.1016/j.gim.2022.01.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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4
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Cochran M, East K, Greve V, Kelly M, Kelley W, Moore T, Myers RM, Odom K, Schroeder MC, Bick D. A study of elective genome sequencing and pharmacogenetic testing in an unselected population. Mol Genet Genomic Med 2021; 9:e1766. [PMID: 34313030 PMCID: PMC8457704 DOI: 10.1002/mgg3.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/08/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Genome sequencing (GS) of individuals without a medical indication, known as elective GS, is now available at a number of centers around the United States. Here we report the results of elective GS and pharmacogenetic panel testing in 52 individuals at a private genomics clinic in Alabama. METHODS Individuals seeking elective genomic testing and pharmacogenetic testing were recruited through a private genomics clinic in Huntsville, AL. Individuals underwent clinical genome sequencing with a separate pharmacogenetic testing panel. RESULTS Six participants (11.5%) had pathogenic or likely pathogenic variants that may explain one or more aspects of their medical history. Ten participants (19%) had variants that altered the risk of disease in the future, including two individuals with clonal hematopoiesis of indeterminate potential. Forty-four participants (85%) were carriers of a recessive or X-linked disorder. All individuals with pharmacogenetic testing had variants that affected current and/or future medications. CONCLUSION Our study highlights the importance of collecting detailed phenotype information to interpret results in elective GS.
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Affiliation(s)
- Meagan Cochran
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Kelly East
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Veronica Greve
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Melissa Kelly
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Whitley Kelley
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Troy Moore
- Kailos Genetics, Huntsville, Alabama, USA
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Katherine Odom
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
| | - Molly C Schroeder
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - David Bick
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, USA
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Baker K, Gordon SL, Melland H, Bumbak F, Scott DJ, Jiang TJ, Owen D, Turner BJ, Boyd SG, Rossi M, Al-Raqad M, Elpeleg O, Peck D, Mancini GMS, Wilke M, Zollino M, Marangi G, Weigand H, Borggraefe I, Haack T, Stark Z, Sadedin S, Tan TY, Jiang Y, Gibbs RA, Ellingwood S, Amaral M, Kelley W, Kurian MA, Cousin MA, Raymond FL. SYT1-associated neurodevelopmental disorder: a case series. Brain 2019; 141:2576-2591. [PMID: 30107533 PMCID: PMC6113648 DOI: 10.1093/brain/awy209] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 06/19/2018] [Indexed: 12/25/2022] Open
Abstract
Synaptotagmin 1 (SYT1) is a critical mediator of fast, synchronous, calcium-dependent neurotransmitter release and also modulates synaptic vesicle endocytosis. This paper describes 11 patients with de novo heterozygous missense mutations in SYT1. All mutations alter highly conserved residues, and cluster in two regions of the SYT1 C2B domain at positions Met303 (M303K), Asp304 (D304G), Asp366 (D366E), Ile368 (I368T) and Asn371 (N371K). Phenotypic features include infantile hypotonia, congenital ophthalmic abnormalities, childhood-onset hyperkinetic movement disorders, motor stereotypies, and developmental delay varying in severity from moderate to profound. Behavioural characteristics include sleep disturbance and episodic agitation. Absence of epileptic seizures and normal orbitofrontal head circumference are important negative features. Structural MRI is unremarkable but EEG disturbance is universal, characterized by intermittent low frequency high amplitude oscillations. The functional impact of these five de novo SYT1 mutations has been assessed by expressing rat SYT1 protein containing the equivalent human variants in wild-type mouse primary hippocampal cultures. All mutant forms of SYT1 were expressed at levels approximately equal to endogenous wild-type protein, and correctly localized to nerve terminals at rest, except for SYT1M303K, which was expressed at a lower level and failed to localize at nerve terminals. Following stimulation, SYT1I368T and SYT1N371K relocalized to nerve terminals at least as efficiently as wild-type SYT1. However, SYT1D304G and SYT1D366E failed to relocalize to nerve terminals following stimulation, indicative of impairments in endocytic retrieval and trafficking of SYT1. In addition, the presence of SYT1 variants at nerve terminals induced a slowing of exocytic rate following sustained action potential stimulation. The extent of disturbance to synaptic vesicle kinetics is mirrored by the severity of the affected individuals' phenotypes, suggesting that the efficiency of SYT1-mediated neurotransmitter release is critical to cognitive development. In summary, de novo dominant SYT1 missense mutations are associated with a recognizable neurodevelopmental syndrome, and further cases can now be diagnosed based on clinical features, electrophysiological signature and mutation characteristics. Variation in phenotype severity may reflect mutation-specific impact on the diverse physiological functions of SYT1.
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Affiliation(s)
- Kate Baker
- Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust / MRC Building, Hills Road, Cambridge, UK.,MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, UK
| | - Sarah L Gordon
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - Holly Melland
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - Fabian Bumbak
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - Daniel J Scott
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia.,Department of Biochemistry and Molecular Biology, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - Tess J Jiang
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - David Owen
- Department of Clinical Biochemistry, Cambridge Institute for Medical Research, Hills Road, Cambridge, UK
| | - Bradley J Turner
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, VIC, Australia
| | - Stewart G Boyd
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Mari Rossi
- Ambry Genetics, 15 Argonaut, Aliso Viejo, CA, USA
| | - Mohammed Al-Raqad
- Department of Clinical Genetics, Queen Rania Al-Abdullah Children Hospital, King Hussein Medical Centre, Royal Medical Services, Amman, Jordan
| | - Orly Elpeleg
- Monique and Jacques Roboh Department of Genetic Research, Hadassah, Hebrew University Medical Center, Jerusalem, Israel
| | - Dawn Peck
- University of Missouri Health Care, Columbia, MO, USA
| | - Grazia M S Mancini
- Department of Clinical Genetics, Erasmus Medical Center, 3015 CN Rotterdam, The Netherlands
| | - Martina Wilke
- Department of Clinical Genetics, Erasmus Medical Center, 3015 CN Rotterdam, The Netherlands
| | - Marcella Zollino
- Institute of Genomic Medicine, Catholic University, A. Gemelli Foundation, Roma, Italy
| | - Giuseppe Marangi
- Institute of Genomic Medicine, Catholic University, A. Gemelli Foundation, Roma, Italy
| | - Heike Weigand
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner's Children's Hospital, University of Munich, Munich, Germany
| | - Ingo Borggraefe
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner's Children's Hospital, University of Munich, Munich, Germany
| | - Tobias Haack
- Institute of Human Genetics, Technische Universität München, Munich, Germany.,Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Zornitza Stark
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Flemington Road, Parkville VIC, Australia
| | - Simon Sadedin
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Flemington Road, Parkville VIC, Australia.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Tiong Yang Tan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Flemington Road, Parkville VIC, Australia
| | - Yunyun Jiang
- Human Genome Sequencing Center, Baylor College of Medicine, Texas, USA
| | - Richard A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Texas, USA
| | - Sara Ellingwood
- Maine Medical Partners Pediatric Specialty Care, Congress St, Portland ME, USA
| | - Michelle Amaral
- HudsonAlpha Institute for Biotechnology, 601 Genome Way NW, Huntsville, AL, USA
| | - Whitley Kelley
- HudsonAlpha Institute for Biotechnology, 601 Genome Way NW, Huntsville, AL, USA
| | - Manju A Kurian
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, UK
| | - Michael A Cousin
- Centre for Discovery Brain Sciences, Hugh Robson Building, George Square, University of Edinburgh, Edinburgh, UK
| | - F Lucy Raymond
- Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust / MRC Building, Hills Road, Cambridge, UK
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Green R, Goddard K, Jarvik G, Amendola L, Appelbaum P, Berg J, Bernhardt B, Biesecker L, Biswas S, Blout C, Bowling K, Brothers K, Burke W, Caga-anan C, Chinnaiyan A, Chung W, Clayton E, Cooper G, East K, Evans J, Fullerton S, Garraway L, Garrett J, Gray S, Henderson G, Hindorff L, Holm I, Lewis M, Hutter C, Janne P, Joffe S, Kaufman D, Knoppers B, Koenig B, Krantz I, Manolio T, McCullough L, McEwen J, McGuire A, Muzny D, Myers R, Nickerson D, Ou J, Parsons D, Petersen G, Plon S, Rehm H, Roberts J, Robinson D, Salama J, Scollon S, Sharp R, Shirts B, Spinner N, Tabor H, Tarczy-Hornoch P, Veenstra D, Wagle N, Weck K, Wilfond B, Wilhelmsen K, Wolf S, Wynn J, Yu JH, Amaral M, Amendola L, Appelbaum P, Aronson S, Arora S, Azzariti D, Barsh G, Bebin E, Biesecker B, Biesecker L, Biswas S, Blout C, Bowling K, Brothers K, Brown B, Burt A, Byers P, Caga-anan C, Calikoglu M, Carlson S, Chahin N, Chinnaiyan A, Christensen K, Chung W, Cirino A, Clayton E, Conlin L, Cooper G, Crosslin D, Davis J, Davis K, Deardorff M, Devkota B, De Vries R, Diamond P, Dorschner M, Dugan N, Dukhovny D, Dulik M, East K, Rivera-Munoz E, Evans B, Evans J, Everett J, Exe N, Fan Z, Feuerman L, Filipski K, Finnila C, Fishler K, Fullerton S, Ghrundmeier B, Giles K, Gilmore M, Girnary Z, Goddard K, Gonsalves S, Gordon A, Gornick M, Grady W, Gray D, Gray S, Green R, Greenwood R, Gutierrez A, Han P, Hart R, Heagerty P, Henderson G, Hensman N, Hiatt S, Himes P, Hindorff L, Hisama F, Ho C, Hoffman-Andrews L, Holm I, Hong C, Horike-Pyne M, Hull S, Hutter C, Jamal S, Jarvik G, Jensen B, Joffe S, Johnston J, Karavite D, Kauffman T, Kaufman D, Kelley W, Kim J, Kirby C, Klein W, Knoppers B, Koenig B, Kong S, Krantz I, Krier J, Lamb N, Lambert M, Le L, Lebo M, Lee A, Lee K, Lennon N, Leo M, Leppig K, Lewis K, Lewis M, Lindeman N, Lockhart N, Lonigro B, Lose E, Lupo P, Rodriguez L, Lynch F, Machini K, MacRae C, Manolio T, Marchuk D, Martinez J, Masino A, McCullough L, McEwen J, McGuire A, McLaughlin H, McMullen C, Mieczkowski P, Miller J, Miller V, Mody R, Mooney S, Moore E, Morris E, Murray M, Muzny D, Myers R, Ng D, Nickerson D, Oliver N, Ou J, Parsons W, Patrick D, Pennington J, Perry D, Petersen G, Plon S, Porter K, Powell B, Punj S, Breitkopf C, Raesz-Martinez R, Raskind W, Rehm H, Reigar D, Reiss J, Rich C, Richards C, Rini C, Roberts S, Robertson P, Robinson D, Robinson J, Robinson M, Roche M, Romasko E, Rosenthal E, Salama J, Scarano M, Schneider J, Scollon S, Seidman C, Seifert B, Sharp R, Shirts B, Sholl L, Siddiqui J, Silverman E, Simmons S, Simons J, Skinner D, Spinner N, Stoffel E, Strande N, Sunyaev S, Sybert V, Taber J, Tabor H, Tarczy-Hornoch P, Taylor D, Tilley C, Tomlinson A, Trinidad S, Tsai E, Ubel P, Van Allen E, Vassy J, Vats P, Veenstra D, Vetter V, Vries R, Wagle N, Walser S, Walsh R, Weck K, Werner-Lin A, Whittle J, Wilfond B, Wilhelmsen K, Wolf S, Wynn J, Yang Y, Young C, Yu JH, Zikmund-Fisher B. Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine. Am J Hum Genet 2016; 99:246. [PMID: 27392080 DOI: 10.1016/j.ajhg.2016.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bechtel J, Kelley W, Coons T, Mohler P, Mohler A, Klein G, Petty T. P-237 Lung cancer detection in high risk patients with airflow obstruction; An ongoing study. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bechtel JJ, Kelley W, Coons T, Klein G, Slagel D, Petty TL. Lung cancer detection in asymptomatic patients with airflow obstruction. Chest 2004; 125:163S. [PMID: 15136488 DOI: 10.1378/chest.125.5_suppl.163s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Joel J Bechtel
- Saccomanno Research Institute, St Mary's Hospital, Grand Junction, Denver, CO, USA.
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Abstract
Research indicates claimant malingering of cognitive deficits to be common in personal injury litigation. Efforts have been made to either detect such tendencies or deter efforts at malingering. The present study examined whether warning people that feigned malingering efforts would be detected results in more valid profiles on the Wechsler Adult Intelligence Scale-Revised. Undergraduates (N = 48) were randomly assigned to one of three conditions: feigned malingerers without warning, feigned malingerers with warning, and controls. Analysis indicated both feigned malingerer groups performed significantly worse than the control group; however, feigned malingerers with warning did not perform significantly better than those without warning. Unlike previous research using the Wechsler Memory Scale-Revised, results did not support effectiveness of warning in reducing feigned malingering scores.
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Affiliation(s)
- J L Johnson
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston 71272, USA
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Glueck CJ, Kelley W, Gupta A, Fontaine RN, Wang P, Gartside PS. Prospective 10-year evaluation of hypobetalipoproteinemia in a cohort of 772 firefighters and cross-sectional evaluation of hypocholesterolemia in 1,479 men in the National Health and Nutrition Examination Survey I. Metabolism 1997; 46:625-33. [PMID: 9186296 DOI: 10.1016/s0026-0495(97)90004-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our specific aim in a 10-year prospective study of 772 Cincinnati firemen (predominantly aged 26 to 46 years) was to determine the prevalence, attributes, and etiology of persistent hypobetalipoproteinemia, defined by entry low-density lipoprotein cholesterol (LDLC) less than 75 mg/dL. A second specific aim was to cross-sectionally assess hypocholesterolemia (defined by total serum cholesterol [TC] < 130 mg/dL) in 1,314 white and 165 black men aged 26 to 46 years in the National Health and Nutrition Examination Survey (NHANES I). The 141 black and 631 white firemen had 4,973 person-years of follow-up time (median, 7.1 yr/man). Of 772 men, 44 (5.7%) had entry LDL levels less than 75 mg/dL; they had a mean follow-up time of 7.3 yr/man. Of these 44 men, there were 12 (1.8% of the cohort) with entry LDLC less than 75 mg/dL, and at least 67% of their follow-up LDLC levels were less than 75. Their mean entry TC and LDLC levels were low (130 and 58 mg/dL), mean triglyceride (TG) was low (63 mg/dL), and mean high-density lipoprotein cholesterol (HDLC) was high (60 mg/dL), LDLC remained at less than 75 mg/dL in 81% of their follow-up samples. Their mean entry and follow-up cholesterol and LDLC did not differ (P > .1, 130 v 133 mg/dL and 58 v 63 mg/dL). Compared with 32 men with entry LDLC less than 75 mg/dL but with less than 87% of follow-up LDLC less than 75 mg/dL, the 12 men with persistently low LDLC had lower mean Quetelet indices and diastolic blood pressure at entry (2.36 v 2.58, P = .056; 73 v 80 mm Hg, P = .03) and on follow-up study (2.45 v 2.69, P = .04; 72 v 79 mm Hg, P = .05). Of 12 men with persistently low LDLC, two had truncated apolipoprotein (apo) B (familial hypobetalipoproteinemia, two had the apo E genotype 2/3, and two had acquired hypobetalipoproteinemia that antedated mortality from melanoma by 9 years and from alcoholism by 2 years. Comparable to white and black firemen aged 26 to 46 years, 2.9% and 3.6% of whom had entry serum TC less than 130 mg/dL, of 1,314 white and 165 black men in the NHANES I study (aged 26 to 46), 1.8% and 3.6% had hypocholesterolemia (entry TC < 130 mg/dL). Daily mean calorie, fat, and protein intake (grams per day) did not differ (P > .05) in men with entry TC less than 130 mg/dL compared with those with TC 130 to 230 or greater than 230 mg/dL. Hypocholesterolemia in white and black men in NHANES I could not be attributed to hypocaloric intake or to protein, fat, or carbohydrate undernutrition. There appear to be racial differences in the prevalence of hypocholesterolemia. Blacks comprised 18% of the firemen's cohort but 42% of those with persistent hypobetalipoproteinemia; among NHANES I subjects, 3.6% of blacks were hypocholesterolemic versus 1.8% of whites. Unless persistent hypobetalipoproteinemia reflects an underlying disease, alcoholism, etc., it is often heritable, and may be associated with a reduced likelihood of coronary heart disease (CHD) and with increased longevity.
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Affiliation(s)
- C J Glueck
- Cholesterol Center, Jewish Hospital of Cincinnati, OH 45229, USA
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11
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Abstract
Since 1984, coronary heart disease (CHD) risk factors have been prospectively assessed among Cincinnati firefighters free of CHD at study entry. In total, 806 firemen with a mean age of 37 years at entry have been followed for 6.4 years on average, contributing 5,173 person-years. CHD risk factors were measured every 1-4 years and included weight, blood pressure, cigarette use, fasting glucose, and lipid profile. When, in aggregate, these CHD risk factors were found to be in a high risk range, suggestions were made serially to reduce CHD risk. A composite high CHD risk factor score led to an exercise electrocardiogram (ECG) with thallium scan, which was repeated every 1-4 years. Myocardial infarction (MI) occurred in 7 men, with 1.35 MIs/1,000 man-years; 15 others developed CHD, with 4.25 MI + CHD/1,000 man-years. The firefighters' MI event rate (1.35 MIs/1,000 man-years) was lower (but not significantly, p > 0.1) than that for employed 30- to 39-year-old men free of CHD at entry (2.07/1,000 man years), who had an average follow-up of 5.4 years in the NHANES I study. At study entry, the 22 men who later developed CHD (vs. the 784 who did not develop CHD) were older (p = .0001), smoked more (p = .0001), and were more likely to have first degree relatives with CHD before age 60 (p = .017). After covariance adjusting for age, race, and Quetelet index, men with CHD (vs. those CHD free) had higher systolic and diastolic blood pressures (p = .0001, .0001), higher LDL cholesterol (p = .04), higher total cholesterol (p = .014), and higher triglycerides (p = .03). By Poisson regression, significant independent predictors of CHD events were age (p = .0007), cigarette smoking (p = .001), diastolic blood pressure (p = .056), and family history of CHD at age < or = 60 (p = .048). Men who later developed CHD and those without CHD did not differ by history of smoke inhalation (p > 0.3). The calculated ratio of savings to cost attributable to the program per year was 5.9/1 ($258,500/$43,600). In the current study, firefighting as an occupation was not associated with increased CHD event rates. CHD events that did develop were, for the most part, associated with modifiable CHD risk factors.
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Affiliation(s)
- C J Glueck
- Cholesterol Center, Jewish Hospital of Cincinnati, OH 45229, USA
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Morrow BR, Maier GJ, Kelley W. Dying with Dignity: Hospice Care on the Unit. J Psychosoc Nurs Ment Health Serv 1989; 27:10-3. [PMID: 2810153 DOI: 10.3928/0279-3695-19891101-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- B R Morrow
- Community Preparation Service, Mendota Mental Health Institution, Madison, Wisconsin
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Kelley W, Bastia D. Replication initiator protein of plasmid R6K autoregulates its own synthesis at the transcriptional step. Proc Natl Acad Sci U S A 1985; 82:2574-8. [PMID: 3857600 PMCID: PMC397606 DOI: 10.1073/pnas.82.9.2574] [Citation(s) in RCA: 63] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The replication initiator protein of plasmid R6K preferentially repressed transcription initiated in vitro from the promoter of the initiator protein cistron. DNase I protection experiments revealed that the sequences in the region of the promoter recognized by the initiator protein partially overlapped the sequences of the same promoter recognized by RNA polymerase of Escherichia coli. Competitive DNase I protection experiments revealed that the initiator not only prevented the RNA polymerase from binding to the promoter sequence but also displaced RNA polymerase from preformed enzyme-promoter binary complexes. Thus, the initiator protein acts as a transcriptional repressor of its own cistron by either preventing RNA polymerase from binding to the promoter or by displacing RNA polymerase from promoter-enzyme complexes.
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Messer JW, Leslie JE, Houghtby GA, Peeler JT, Barnett JE, Appelt A, Boone E, Bryant H, Burroughs L, Coleman K, Cupery M, Cyr R, Dombrowski P, Donahue P, Farmer S, Ginn R, Grant H, Hawkins J, Heady J, Herbst D, Kelley W, Misup M, Morris L, Mullen R, Ondrus N, Payton C, Seiz D, Share R, Stern M, Williams R. Bacillus stearothermophilus Disc Assay for Detection of Inhibitors in Milk: Collaborative Study. J AOAC Int 1982. [DOI: 10.1093/jaoac/65.5.1208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A 2-part (A and B) collaborative study was conducted on a Bacillus stearothermophilus paper disc (12.7 mm) method to detect residual inhibitors in milk. The 18 participating collaborators assayed raw milk samples spiked with a beta-lactam (penicillin G). Of the 18 collaborators, 14 participated in part A and 16 in part B. Part A demonstrated that either Antibiotic Medium No. 4 or PM Indicator Agar is suitable for use in the assay. The lowest concentration detectable, not significantly different from 100% at the α = 0.05 level, was 0.008 unit/mL with either medium. Part B demonstrated that the sensitivity of the method is equal to that of the current AOAC method (16.131- 16.136). The concentration of beta-lactam detected by 50% of the analysts was 0.003-0.005 unit/mL in this study, compared with 0.005 unit/mL reported in an earlier collaborative study on the current AOAC method. No false positive results were reported in part A or part B. All samples found positive by the confirmatory test in part B were correctly identified as a beta-lactam with commercial Penase discs. The lowest concentration detectable by the method, not significantly different from 100% at the α = 0.05 level, was 0.008 unit/mL. The method was adopted official first action.
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Affiliation(s)
- James W Messer
- Food and Drug Administration, Division of Microbiology, 1090 Tusculum Ave, Cincinnati, OH 45226
| | - James E Leslie
- Food and Drug Administration, Division of Microbiology, 1090 Tusculum Ave, Cincinnati, OH 45226
| | - Gary A Houghtby
- Food and Drug Administration, Division of Microbiology, 1090 Tusculum Ave, Cincinnati, OH 45226
| | - James T Peeler
- Food and Drug Administration, Division of Microbiology, 1090 Tusculum Ave, Cincinnati, OH 45226
| | - Jerald E Barnett
- Food and Drug Administration, Division of Microbiology, 1090 Tusculum Ave, Cincinnati, OH 45226
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Goldenberg DL, Kelley W, Gibbons RB. Metastatic adenocarcinoma of synovium presenting as an acute arthritis. Diagnosis by closed synovial biopsy. Arthritis Rheum 1975; 18:107-10. [PMID: 1131279 DOI: 10.1002/art.1780180202] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
An acute arthritis may accompany the onset of cancer. A case of metastatic adenocarcinoma of the synovium presenting as an acute arthritis is described. The diagnostic importance of a careful synovial fluid analysis and the use of closed synovial biopsy are emphasized.
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