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Szot JO, Cuny H, Martin EM, Sheng DZ, Iyer K, Portelli S, Nguyen V, Gereis JM, Alankarage D, Chitayat D, Chong K, Wentzensen IM, Vincent-Delormé C, Lermine A, Burkitt-Wright E, Ji W, Jeffries L, Pais LS, Tan TY, Pitt J, Wise CA, Wright H, Andrews ID, Pruniski B, Grebe TA, Corsten-Janssen N, Bouman K, Poulton C, Prakash S, Keren B, Brown NJ, Hunter MF, Heath O, Lakhani SA, McDermott JH, Ascher DB, Chapman G, Bozon K, Dunwoodie SL. A metabolic signature for NADSYN1-dependent congenital NAD deficiency disorder. J Clin Invest 2024; 134:e174824. [PMID: 38357931 PMCID: PMC10866660 DOI: 10.1172/jci174824] [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: 09/06/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
Nicotinamide adenine dinucleotide (NAD) is essential for embryonic development. To date, biallelic loss-of-function variants in 3 genes encoding nonredundant enzymes of the NAD de novo synthesis pathway - KYNU, HAAO, and NADSYN1 - have been identified in humans with congenital malformations defined as congenital NAD deficiency disorder (CNDD). Here, we identified 13 further individuals with biallelic NADSYN1 variants predicted to be damaging, and phenotypes ranging from multiple severe malformations to the complete absence of malformation. Enzymatic assessment of variant deleteriousness in vitro revealed protein domain-specific perturbation, complemented by protein structure modeling in silico. We reproduced NADSYN1-dependent CNDD in mice and assessed various maternal NAD precursor supplementation strategies to prevent adverse pregnancy outcomes. While for Nadsyn1+/- mothers, any B3 vitamer was suitable to raise NAD, preventing embryo loss and malformation, Nadsyn1-/- mothers required supplementation with amidated NAD precursors (nicotinamide or nicotinamide mononucleotide) bypassing their metabolic block. The circulatory NAD metabolome in mice and humans before and after NAD precursor supplementation revealed a consistent metabolic signature with utility for patient identification. Our data collectively improve clinical diagnostics of NADSYN1-dependent CNDD, provide guidance for the therapeutic prevention of CNDD, and suggest an ongoing need to maintain NAD levels via amidated NAD precursor supplementation after birth.
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Affiliation(s)
- Justin O. Szot
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Hartmut Cuny
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Ella M.M.A. Martin
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Delicia Z. Sheng
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Kavitha Iyer
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Stephanie Portelli
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Queensland, Australia
- Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Vivien Nguyen
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Jessica M. Gereis
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Dimuthu Alankarage
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - David Chitayat
- Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, and
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Karen Chong
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Alban Lermine
- Laboratoire de Biologie Médicale Multisites SeqOIA, FMG2025, Paris, France
| | - Emma Burkitt-Wright
- Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Weizhen Ji
- Yale University School of Medicine, Pediatric Genomics Discovery Program, New Haven, Connecticut, USA
| | - Lauren Jeffries
- Yale University School of Medicine, Pediatric Genomics Discovery Program, New Haven, Connecticut, USA
| | - Lynn S. Pais
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Tiong Y. Tan
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - James Pitt
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Metabolic Laboratory, Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Cheryl A. Wise
- Department of Diagnostic Genomics, PathWest Laboratory Medicine Western Australia, Nedlands, Perth, Western Australia, Australia
| | - Helen Wright
- General Paediatric Department, Perth Children’s Hospital, Perth, Western Australia, Australia
- Rural Clinical School, University of Western Australia, Perth, Western Australia, Australia
| | | | - Brianna Pruniski
- Division of Genetics and Metabolism, Phoenix Children’s Hospital, Phoenix, Arizona, USA
| | - Theresa A. Grebe
- Division of Genetics and Metabolism, Phoenix Children’s Hospital, Phoenix, Arizona, USA
| | - Nicole Corsten-Janssen
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Katelijne Bouman
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Cathryn Poulton
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Supraja Prakash
- Division of Genetics and Metabolism, Phoenix Children’s Hospital, Phoenix, Arizona, USA
| | - Boris Keren
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Natasha J. Brown
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Matthew F. Hunter
- Monash Genetics, Monash Health, Clayton, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Oliver Heath
- Victorian Clinical Genetics Services, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Metabolic Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Saquib A. Lakhani
- Yale University School of Medicine, Pediatric Genomics Discovery Program, New Haven, Connecticut, USA
| | - John H. McDermott
- Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - David B. Ascher
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Queensland, Australia
- Computational Biology and Clinical Informatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Gavin Chapman
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Kayleigh Bozon
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
| | - Sally L. Dunwoodie
- Victor Chang Cardiac Research Institute, Darlinghurst, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
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Janbandhu V, Tallapragada V, Patrick R, Li Y, Abeygunawardena D, Humphreys DT, Martin EM, Ward AO, Contreras O, Farbehi N, Yao E, Du J, Dunwoodie SL, Bursac N, Harvey RP. Hif-1a suppresses ROS-induced proliferation of cardiac fibroblasts following myocardial infarction. Cell Stem Cell 2022; 29:281-297.e12. [PMID: 34762860 PMCID: PMC9021927 DOI: 10.1016/j.stem.2021.10.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/16/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023]
Abstract
We report that cardiac fibroblasts (CFs) and mesenchymal progenitors are more hypoxic than other cardiac interstitial populations, express more hypoxia-inducible factor 1α (HIF-1α), and exhibit increased glycolytic metabolism. CF-specific deletion of Hif-1a resulted in decreased HIF-1 target gene expression and increased mesenchymal progenitors in uninjured hearts and increased CF activation without proliferation following sham injury, as demonstrated using single-cell RNA sequencing (scRNA-seq). After myocardial infarction (MI), however, there was ∼50% increased CF proliferation and excessive scarring and contractile dysfunction, a scenario replicated in 3D engineered cardiac microtissues. CF proliferation was associated with higher reactive oxygen species (ROS) as occurred also in wild-type mice treated with the mitochondrial ROS generator MitoParaquat (MitoPQ). The mitochondrial-targeted antioxidant MitoTEMPO rescued Hif-1a mutant phenotypes. Thus, HIF-1α in CFs provides a critical braking mechanism against excessive post-ischemic CF activation and proliferation through regulation of mitochondrial ROS. CFs are potential cellular targets for designer antioxidant therapies in cardiovascular disease.
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Affiliation(s)
- Vaibhao Janbandhu
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia,Correspondence: (V.J.), (R.P.H.)
| | - Vikram Tallapragada
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | - Ralph Patrick
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | - Yanzhen Li
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Dhanushi Abeygunawardena
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW, Australia
| | - David T. Humphreys
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | | | - Alexander O. Ward
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | - Osvaldo Contreras
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | - Nona Farbehi
- Garvan Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research Sydney, NSW 2010, Australia
| | - Ernestene Yao
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia
| | - Junjie Du
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia
| | - Sally L. Dunwoodie
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia
| | - Nenad Bursac
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA,Department of Medicine, Duke University, Durham, NC 27708, USA
| | - Richard P. Harvey
- Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia,St. Vincent’s Clinical School, UNSW Sydney, NSW, Australia,School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW, Australia,Lead contact,Correspondence: (V.J.), (R.P.H.)
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3
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Meakin CJ, Martin EM, Santos HP, Mokrova I, Kuban K, O'Shea TM, Joseph RM, Smeester L, Fry RC. Placental CpG methylation of HPA-axis genes is associated with cognitive impairment at age 10 among children born extremely preterm. Horm Behav 2018; 101:29-35. [PMID: 29477804 PMCID: PMC6354776 DOI: 10.1016/j.yhbeh.2018.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/29/2018] [Accepted: 02/12/2018] [Indexed: 12/14/2022]
Abstract
A major component of the neuroendocrine system is the hypothalamus-pituitary adrenal (HPA) axis. HPA axis genes are also known to play a role in placental physiology. Thus, disruptions in the signaling of HPA axis-associated genes may adversely impact the placenta as well as fetal development, with adverse consequences for health and development of the child. In support of this, recent studies have shown that placental epigenetic methylation of HPA axis genes has an impact on infant behavior. In this study, we evaluated CpG methylation of 14 placental HPA axis-associated genes from a subcohort (n=228) of the Extremely Low Gestational Age Newborns (ELGAN) cohort in relation to cognitive function in mid-childhood (e.g. 10 yrs). Multivariable logistic regression revealed that placental CpG methylation of 10 HPA-axis associated genes were significantly associated with cognition at age 10. Specifically, placental CpG methylation levels of the glucocorticoid receptor gene, Nuclear Receptor Subfamily Group 3 C Member 1 (NR3C1) and Brain-derived Neurotropic Factor (BDNF) were significantly associated with increased odds in developing moderate/severe adverse cognitive impairment at age 10. Methyl-CpG Binding Protein 2 (MECP2) was the major transcriptional regulator of the ten identified HPA genes. The data suggest that placental CpG methylation is associated with cognitive outcomes in mid-childhood.
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Affiliation(s)
- C J Meakin
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - E M Martin
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC, USA
| | - H P Santos
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - I Mokrova
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, NC, USA
| | - K Kuban
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - T M O'Shea
- Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - R M Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - L Smeester
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - R C Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC, USA.
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Fogel J, Rubin LH, Maki P, Keutmann MK, Gonzalez R, Vassileva J, Martin EM. Effects of sex and HIV serostatus on spatial navigational learning and memory among cocaine users. J Neurovirol 2017; 23:855-863. [PMID: 28849352 DOI: 10.1007/s13365-017-0563-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 03/13/2017] [Revised: 07/05/2017] [Accepted: 07/30/2017] [Indexed: 11/26/2022]
Abstract
Spatial learning and memory are critically dependent on the integrity of hippocampal systems. Functional MRI and neuropathological studies show that hippocampal circuitry is prominently affected among HIV-seropositive individuals, but potential spatial learning and memory deficits have not been studied in detail in this population. We investigated the independent and interactive effects of sex and HIV serostatus on performance of a spatial learning and memory task in a sample of 181 individuals with a history of cocaine dependence. We found that men showed faster times to completion on immediate recall trials compared with women and that delayed recall was significantly poorer among HIV-infected compared with HIV-uninfected participants. Additionally, a sex × serostatus effect was found on the total number of completed learning trials. Specifically, HIV-infected men successfully completed more learning trials compared with HIV-infected women. Results are discussed in the context of recent reports of sex and HIV serostatus effects on episodic memory performance.
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Affiliation(s)
- J Fogel
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - L H Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - P Maki
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - M K Keutmann
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
- Department of Psychiatry, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 600, Chicago, IL, 60612, USA
| | - R Gonzalez
- Department of Psychology, Florida International University, Miami, FL, USA
| | - J Vassileva
- Institute for Drug and Alcohol Studies, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - E M Martin
- Department of Psychiatry, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 600, Chicago, IL, 60612, USA.
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5
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Masuku SM, Babu D, Martin EM, Koo OK, O'Bryan CA, Crandall PG, Ricke SC. Cleaning and decontamination efficacy of wiping cloths and silver dihydrogen citrate on food contact surfaces. J Appl Microbiol 2012; 113:89-95. [PMID: 22519296 DOI: 10.1111/j.1365-2672.2012.05318.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To test the efficacy of four wipe cloth types (cotton bar towel, nonwoven, microfibre and blended cellulose/cotton) with either quaternary ammonia cleaning solution or silver dihydrogen citrate (SDC) in cleaning food contact surfaces. METHODS Swab samples collected from untreated, cloth-treated and cloth disinfectant-treated surfaces were subjected to hygiene monitoring using adenosine triphosphate (ATP) bioluminescence and aerobic total plate counting (TPC) assays. RESULTS Adenosine triphosphate measurements taken after wiping the surfaces showed poor cleaning by nonwoven cloths (2·89 RLU 100 cm(-2) ) than the microfibre (2·30 RLU 100 cm(-2) ), cotton terry bar (2·26 RLU 100 cm(-2) ) and blended cellulose/cotton cloth types (2·20 RLU 100 cm(-2) ). The cellulose/cotton cloth showed highest log reduction in ATP-B RLU values (95%) and CFU values (98·03%) when used in combination with SDC disinfectant. CONCLUSIONS Cleaning effect of wiping cloths on food contact surfaces can be enhanced by dipping them in SDC disinfectant. ATP-B measurements can be used for real-time hygiene monitoring in public sector, and testing microbial contamination provides more reliable measure of cleanliness. SIGNIFICANCE AND IMPACT OF THE STUDY Contaminated food contact surfaces need regular hygiene monitoring. This study could help to estimate and establish contamination thresholds for surfaces at public sector facilities and to base the effectiveness of cleaning methods.
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Affiliation(s)
- S M Masuku
- Center for Food Safety and Department of Food Science, University of Arkansas, Fayetteville, AR 72701, USA
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Muthaiyan A, Martin EM, Natesan S, Crandall PG, Wilkinson BJ, Ricke SC. Antimicrobial effect and mode of action of terpeneless cold-pressed Valencia orange essential oil on methicillin-resistant Staphylococcus aureus. J Appl Microbiol 2012; 112:1020-33. [PMID: 22372962 DOI: 10.1111/j.1365-2672.2012.05270.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS The objectives of this study were to evaluate the antistaphylococcal effect and elucidate the mechanism of action of orange essential oil against antibiotic-resistant Staphylococcus aureus strains. METHODS AND RESULTS The inhibitory effect of commercial orange essential oil (EO) against six Staph. aureus strains was tested using disc diffusion and agar dilution methods. The mechanism of EO action on MRSA was analysed by transcriptional profiling. Morphological changes of EO-treated Staph. aureus were examined using transmission electron microscopy. Results showed that 0·1% of terpeneless cold-pressed Valencia orange oil (CPV) induced the cell wall stress stimulon consistent with the inhibition of cell wall synthesis. Transmission electron microscopic observation revealed cell lysis and suggested a cell wall lysis-related mechanism of CPV. CONCLUSIONS CPV inhibits the growth of Staph. aureus, causes gene expression changes consistent with the inhibition of cell wall synthesis, and triggers cell lysis. SIGNIFICANCE AND IMPACT OF THE STUDY Multiple antibiotics resistance is becoming a serious problem in the management of Staph. aureus infections. In this study, the altered expression of cell wall-associated genes and subsequent cell lysis in MRSA caused by CPV suggest that it may be a potential antimicrobial agent to control antibiotic-resistant Staph. aureus.
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Affiliation(s)
- A Muthaiyan
- Center for Food Safety and Department of Food Science, University of Arkansas, Fayetteville, AR 72704, USA
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Martin EM, Devidze N, Shelley DN, Westberg L, Fontaine C, Pfaff DW. Molecular and neuroanatomical characterization of single neurons in the mouse medullary gigantocellular reticular nucleus. J Comp Neurol 2011; 519:2574-93. [PMID: 21456014 DOI: 10.1002/cne.22639] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Medullary gigantocellular reticular nucleus (mGi) neurons have been ascribed a variety of behaviors, many of which may fall under the concepts of either arousal or motivation. Despite this, many details of the connectivity of mGi neurons, particularly in reference to those neurons with ascending axons, remain unknown. To provide a neuroanatomical and molecular characterization of these cells, with reference to arousal and level-setting systems, large medullary reticular neurons were characterized with retrograde dye techniques and with real-time reverse transcriptase PCR (RT-PCR) analyses of single-neuron mRNA expression in the mouse. We have shown that receptors consistent with participation in generalized arousal are expressed by single mGi neurons and that receptors from different families of arousal-related neurotransmitters are rarely coexpressed. Through retrograde labeling, we have shown that neurons with ascending axons and neurons with descending axons tend to form like-with-like clusters, a finding that is consistent across age and gender. In comparing the two groups of retrogradely labeled neurons in neonatal animals, those neurons with axons that ascend to the midbrain show markers for GABAergic or coincident GABAergic and glutamatergic function; in contrast, approximately 60% of the neurons with axons that descend to the spinal cord are glutamatergic. We discuss the mGi's relationship to the voluntary and emotional motor systems and speculate that neurons in the mGi may represent a mammalian analogue to Mauthner cells, with a separation of function for neurons with ascending and descending axons.
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Affiliation(s)
- E M Martin
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, New York 10065, USA.
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Abstract
The development of resistance in response to interferon depends on cellular RNA synthesis and probably also on cellular protein synthesis. The evidence for these requirements is reviewed, as well as the proposal that this evidence indicates the existence of a specific response of the cell to interferon, involving the induced synthesis of an antiviral protein. Direct evidence for such an interpretation has not been obtained, and alternative explanations are discussed which do not require quantitative or qualitative differences in the RNA and protein made in cells exposed to interferon. The possible role of the ribosome in the antiviral action of interferon is also discussed.
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Affiliation(s)
- J A Sonnabend
- Department of Microbiology, Mount Sinai School of Medicine, New York 10029, and the National Institute for Medical Research, Mill Hill, London, England
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Nankervis CA, Martin EM, Crane ML, Samson KS, Welty SE, Nelin LD. Implementation of a multidisciplinary guideline-driven approach to the care of the extremely premature infant improved hospital outcomes. Acta Paediatr 2010; 99:188-93. [PMID: 19863632 DOI: 10.1111/j.1651-2227.2009.01563.x] [Citation(s) in RCA: 16] [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: 11/30/2022]
Abstract
AIM To test the hypothesis that implementing guidelines for the standardized care of the extremely premature infant (<27 weeks) in the first week of life would improve patient outcomes in an all referral NICU. METHODS Data were collected on all infants <27 weeks gestational age and <7 days of age on admission cared for using these small baby guidelines (SBG), as well as on all age-matched infants admitted the year prior (comparison). RESULTS Thirty-seven patients were cared for utilizing the SBG and 40 patients were in the comparison group. There were no differences between the groups in gestational age, birthweight or age on admission. There was no difference in survival to discharge (73% SBG, 70% comparison). The mean length of stay for survivors was 112 +/- 38 days SBG and 145 +/- 76 days (p < 0.05) comparison group. Survival without BPD was greater in the SBG group (24%) than in the comparison group (9%; p < 0.05), and survival without severe IVH was greater in the SBG group (65%) than in the comparison group (38%; p < 0.01). CONCLUSIONS These data demonstrate that applying a unified approach to the care of the extremely premature infant in the first week of life resulted in a decrease in the length of hospitalization and improved patient outcomes.
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Affiliation(s)
- C A Nankervis
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
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Kunkel A, Deppe R, Faiss J, Hoffmann F, Klauer T, Köhler W, Lippert J, Martin EM, Schilling H, Tiffert C, Voigt K, Zettl UK, Faiss JH. Psychoedukatives Training für Patienten mit Multipler Sklerose: Inhalte und Evaluation. Akt Neurol 2009. [DOI: 10.1055/s-0029-1238762] [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: 10/20/2022]
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Zhou J, Kow LM, Vannucci SJ, Pfaff D, Martin EM. Arousal-related reticular neurons during reduced oxygen tension: resilience and recovery of electrical activity. Dev Neurosci 2009; 31:255-8. [PMID: 19546562 DOI: 10.1159/000216536] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 01/03/2009] [Indexed: 11/19/2022] Open
Abstract
Whole-cell patch clamp recordings of the electrical activity of large medullary reticular formation neurons, in nucleus gigantocellularis, were performed under control conditions and under conditions of hypoxia or anoxia. Neurons were discovered whose activity was remarkably resilient during and after the reduction or loss of oxygen. Such cells may relate to the ability of the newborn brain to survive hypoxia/anoxia, and also may demonstrate the preservation of neurons involved in generalized CNS arousal, as would be appropriate for activating behavioral responses to the reduction or loss of oxygen.
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Affiliation(s)
- J Zhou
- Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, N.Y. 10065, USA
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12
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Osaili TM, Griffis CL, Martin EM, Beard BL, Keener AE, Marcy JA. Thermal inactivation of Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes in breaded pork patties. J Food Sci 2007; 72:M56-61. [PMID: 17995843 DOI: 10.1111/j.1750-3841.2006.00264.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Decimal reduction times (D-values) and thermal resistance constants (z-values) for 3 foodborne pathogenic bacteria in formulated ready-to-eat breaded pork patties were determined with thermal inactivation studies. Meat samples, inoculated with Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes cultures or uninoculated controls, were packaged in sterile bags, immersed in circulated water bath, and held at 55, 57.5, 60, 62.5, 65, 67.5, and 70 degrees C for different durations of time. The D- and z-values were determined by using a linear regression model. Average calculated D-values for E. coli O157:H7, Salmonella, and L. monocytogenes at a temperature range of 55 to 70 degrees C were 32.11 to 0.08 min, 69.48 to 0.29 min, and 150.46 to 0.43 min, respectively. Calculated z-values for E. coli O157:H7, Salmonella, and L. monocytogenes were 5.4, 6.2, and 5.9 degrees C, respectively. The results of this study will be useful to food processors to validate thermal lethality of the studied foodborne pathogens in ready-to-eat breaded pork patties.
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Affiliation(s)
- T M Osaili
- Dept. of Nutrition and Food Technology, Jordan Univ. of Science and Technology, Irbid, Jordan
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Cole MA, Margolick JB, Cox C, Li X, Selnes OA, Martin EM, Becker JT, Aronow HA, Cohen B, Sacktor N, Miller EN. Longitudinally preserved psychomotor performance in long-term asymptomatic HIV-infected individuals. Neurology 2007; 69:2213-20. [PMID: 17914066 DOI: 10.1212/01.wnl.0000277520.94788.82] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Recent case reports have suggested that some asymptomatic HIV-infected individuals can develop CNS disturbances despite intact immunologic functioning and long-term suppression of plasma HIV concentrations to undetectable levels. This possibility has not yet been systematically studied longitudinally. METHODS Using longitudinal data from the Multicenter AIDS Cohort Study, we investigated neuropsychological performance in long-term asymptomatic HIV-infected men who have sex with men. Performance over a 5-year period on the Symbol Digit Modalities test and the Trail Making Tests were compared in three HIV-positive asymptomatic groups [defined as 1) highly active antiretroviral therapy (HAART) treated with undetectable viral loads (n = 83), 2) AIDS-free for more than 15 years without HAART (n = 29), and 3) absence of clinical AIDS or CD4(+) lymphocyte count below 200 cells/muL at the beginning and end of the study period (n = 233)] and in HIV-negative controls (n = 237). Data were analyzed using linear mixed models and proportional odds logistic regression modeling with generalized estimating equations. RESULTS There was no evidence of performance differences or performance declines over the 5-year period of study in any of the three long-term asymptomatic groups as compared with the HIV-negative group in the Symbol Digit Modalities test or the Trail Making Tests. Performance decrements were, however, observed with increasing age in each of the tests administered, demonstrating that performance declines could be detected by these methods. CONCLUSIONS Regardless of how long-term asymptomatic status was defined immunologically or virologically, neuropsychological test performances remained stable. These findings suggest that psychomotor speed is preserved over many years in HIV-infected individuals with controlled HIV viremia.
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Affiliation(s)
- M A Cole
- Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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14
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Osaili T, Griffis CL, Martin EM, Beard BL, Keener A, Marcy JA. Thermal inactivation studies of Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes in ready-to-eat chicken-fried beef patties. J Food Prot 2006; 69:1080-6. [PMID: 16715808 DOI: 10.4315/0362-028x-69.5.1080] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Thermal inactivation studies were used to determine the D- and z-values of Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes in ready-to-eat chicken-fried beef patties. Inoculated meat was packaged in sterile bags, which were immersed in a circulated water bath and held at 55, 57.5, 60, 62.5, 65, 67.5, and 70 degrees C for different lengths of time. D- and z-values were determined with a linear regression model. Average D-values at temperatures 55 to 70 degrees C were 27.62 to 0.04 min for E. coli 0157:H7, 67.68 to 0.22 min for Salmonella, and 81.37 to 0.31 min for L. monocytogenes. The z-values were 5.2 degrees C for E. coli O157:H7, 6.0 degrees C for Salmonella, and 6.1 degrees C for L. monocytogenes. The results of this study can be used by food processors to validate their processes and help eliminate pathogenic bacteria associated with chicken-fried beef products.
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Affiliation(s)
- T Osaili
- Department of Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
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15
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Murphy RY, Martin EM, Duncan LK, Beard BL, Marcy JA. Thermal process validation for Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes in ground turkey and beef products. J Food Prot 2004; 67:1394-402. [PMID: 15270492 DOI: 10.4315/0362-028x-67.7.1394] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
At 55 to 70 degrees C, thermal inactivation D-values for Escherichia coli O157:H7, Salmonella, and Listeria monocytogenes were 19.05 to 0.038, 43.10 to 0.096, and 33.11 to 0.12 min, respectively, in ground turkey and 21.55 to 0.055, 37.04 to 0.066, and 36.90 to 0.063 min, respectively, in ground beef. The z-values were 5.73, 5.54, and 6.13 degrees C, respectively, in ground turkey and 5.43, 5.74, and 6.01 degrees C, respectively, in ground beef. In both ground turkey and beef, significant (P < 0.05) differences were found in the D-values between E. coli O157:H7 and Salmonella or between E. coli O157:H7 and L. monocytogenes. At 65 to 70 degrees C, D-values for E. coli O157:H7, Salmonella, and L. monocytogenes were also significantly (P < 0.05) different between turkey and beef. The obtained D- and z-values were used in predicting process lethality of the pathogens in ground turkey and beef patties cooked in an air impingement oven and confirmed by inoculation studies for a 7-log (CFU/g) reduction of E. coli O157:H7, Salmonella, and L. monocytogenes.
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Affiliation(s)
- R Y Murphy
- Department of Biological and Agricultural Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA.
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16
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Martin EM, Cho JD, Kim JS, Goeke SC, Kim KS, Gergerich RC. Novel cytopathological structures induced by mixed infection of unrelated plant viruses. Phytopathology 2004; 94:111-9. [PMID: 18943827 DOI: 10.1094/phyto.2004.94.1.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
ABSTRACT When two unrelated plant viruses infect a plant simultaneously, synergistic viral interactions often occur resulting in devastating diseases. This study was initiated to examine ultrastructural virus-virus interactions of mixed viral infections. Mixed infections were induced using potyviruses and viruses from other plant virus families. Novel ultrastructural paracrystalline arrays composed of co-infecting viruses, referred to as mixed virus particle aggregates (MVPAs), were noted in the majority of the mixed infections studied. When the flexuous rod-shaped potyvirus particles involved in MVPAs were sectioned transversely, specific geometrical patterns were noted within some doubly infected cells. Although similar geometrical patterns were associated with MVPAs of various virus combinations, unique characteristics within patterns were consistent in each mixed infection virus pair. Centrally located virus particles within some MVPAs appeared swollen (Southern bean mosaic virus mixed with Blackeye cowpea mosaic virus, Cucumber mosaic virus mixed with Blackeye cowpea mosaic virus, and Sunn hemp mosaic virus mixed with Soybean mosaic virus). This ultrastructural study complements molecular studies of mixed infections of plant viruses by adding the additional dimension of visualizing the interactions between the coinfecting viruses.
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Huff GR, Zheng Q, Newberry LA, Huff WE, Balog JM, Rath NC, Kim KS, Martin EM, Goeke SC, Skeeles JK. Viral and bacterial agents associated with experimental transmission of infectious proventriculitis of broiler chickens. Avian Dis 2001; 45:828-43. [PMID: 11785888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Proventriculitis of broilers can be reproduced by oral inoculation of day-old chicks with a proventricular homogenate from affected 3-wk-old broilers. The objective of the following studies was to isolate from this homogenate viral and bacterial isolates that could produce proventriculitis. A monoclonal antibody to infectious bursal disease virus (IBDV) was used to precipitate virus from the homogenate. A primary chicken digestive tract cell culture system was also used to isolate virus from a 0.2-microm filtrate of the homogenate, and a bacterium was also isolated from the homogenate. In trial 1, day-old birds were orally inoculated with either proventriculus homogenate or monoclonal antibody immunoprecipitated IBDV (MAB-IBDV). At 4, 7, 14, and 21 days postinfection (PI), 12 birds from each treatment group were subjected to necropsy. In trial 2, day-old birds were orally inoculated with either infectious proventriculus homogenate, suspect virus isolated in cell culture and propagated in embryo livers and spleens, or a bacterial isolate. Twelve birds from each treatment were subjected to necropsy at days 7, 14, 21, and 28 PI. In trial 3, treatments were maintained in negative pressure isolation chambers, and an additional treatment included virus plus bacterial isolate. Twenty-four birds from each treatment were subjected to necropsy at day 21 PI. In trial 1, infectious homogenate decreased body weight and relative gizzard weights at 4, 7, 14, and 21 days PI. Proventriculus relative weight was increased at days 7, 14, and 21 PI, and proventriculus lesion scores were increased at days 14 and 21 PI. Bursa/spleen weight ratios were decreased at day 14, and feed conversion was increased at days 4 and 21. The MAB-IBDV treatment decreased proventriculus and gizzard relative weights at day 4 PI, increased proventriculus lesion scores and bursa/spleen weight ratios at day 14, and decreased heterophil/lymphocyte ratios at day 21. In trial 2, all infected birds had significantly higher mean relative proventriculus weights at 21 days PI and had higher 4-wk mean proventriculus scores as compared with both control groups. In trial 3, birds treated with homogenate and birds treated with both suspect virus and the bacterial isolate had significantly higher proventriculus lesion scores; higher relative weights of proventriculus, gizzard, liver, and heart; lower body weights; and lower relative bursa weights compared with the saline control group. These studies suggest that infectious proventriculitis has a complex etiology involving both viral and bacterial infection.
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Affiliation(s)
- G R Huff
- Poultry Production and Product Safety Research, United States Department of Agriculture, Agricultural Research Service, Center of Excellence for Poultry Science, Fayetteville, Arkansas 72701, USA
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Abstract
This research studied hypotheses that positive thought disorder in schizophrenia is influenced by patients' not taking in immediate target contextual material, thereby losing vital cues that guide thought processes. We assessed 164 acute inpatients (including 55 schizophrenia and 31 bipolar disorder patients), using standardized measures of thought disorder. We also used new measures that assessed (1) total ignoring of context, and (2) straying from the context. Results were as follows: (1) only 9 percent of the schizophrenia patients showed strong evidence of completely ignoring the external context; (2) straying from the external context while simultaneously maintaining part of the context was significantly more common than complete absence of context (p < 0.01); (3) patients with thought disorder strayed from the context significantly more than patients without thought disorder (p < 0.001); and (4) straying from the context was involved in the thought disorder of some, but not all, schizophrenia and mania patients. The data suggest that thought disorder in schizophrenia is not typically due to a failure to "hear" or to take in the relevant contextual material necessary for an appropriate response. Loss of context is involved in some, but not all, thought disorder in schizophrenia and mania.
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Affiliation(s)
- M Harrow
- Department of Psychiatry, University of Illinois, Chicago 60612-7327, USA.
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19
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Abstract
We evaluated auditory working memory in 41 HIV-seropositive (HIV+) and 37 HIV-seronegative (HIV-) male drug users, employing a modified version of the Letter-Number Span Task developed by Gold and colleagues. We added a control condition to the standard task in order to evaluate more directly the contribution of the processing component to the working memory deficits with the effects of storage demands minimized. HIV+ subjects performed significantly more poorly compared to controls on an index of working memory processing derived from raw scores obtained under the two testing conditions. These findings are consistent with our previous reports that HIV-related working memory deficits are evident across multiple informational domains; further, the deficit appears to involve multiple-component functions of working memory. Converging findings from recent working memory studies and from primate and neuroimaging investigations suggest that functional abnormalities of prefrontal cortex should receive greater emphasis in models of neurocognitive aspects of HIV-1 infection, which have typically emphasized "subcortical" deficits.
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Affiliation(s)
- E M Martin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago 60612, USA.
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Warden DL, Salazar AM, Martin EM, Schwab KA, Coyle M, Walter J. A home program of rehabilitation for moderately severe traumatic brain injury patients. The DVHIP Study Group. J Head Trauma Rehabil 2000; 15:1092-102. [PMID: 10970930 DOI: 10.1097/00001199-200010000-00003] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We have recently reported the results of a prospective controlled randomized trial comparing home versus inpatient cognitive rehabilitation for patients with moderate to severe head injury. That study showed no overall difference in outcomes between the two groups.(1) In this article, we provide further details of the home program arm of the study. All patients in the home program received medical treatment as needed, a multidisciplinary in-hospital evaluation, and TBI counseling before entering the eight-week home program, which then included guidance on home activities, as well as weekly telephone calls from a psychiatric nurse.
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Affiliation(s)
- D L Warden
- Uniformed Services University of the Health Sciences, Walter Reed AMC, Defense and Veterans Head Injury Program at Walter Reed AMC, Washington, DC, USA
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21
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Abstract
Recent evidence suggests that HIV-seropositive drug users are impaired on tasks of visuospatial working memory compared with drug users seronegative for HIV. In the current study we evaluated the performance of 30 HIV-seropositive male drug users and 30 risk-matched seronegative controls on two measures of verbal working memory, the Listening Span and the verbal Self Ordered Pointing Task. Impaired working memory performance was significantly more common among HIV-seropositive persons compared to controls, with the highest incidence of deficit among symptomatic participants. These findings indicate that working memory deficits in persons with HIV are not domain-specific and can be demonstrated reliably in drug users.
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Affiliation(s)
- R Farinpour
- VA Chicago Health Care System-West Side Division, Chicago, Illinois, USA
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22
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Salazar AM, Warden DL, Schwab K, Spector J, Braverman S, Walter J, Cole R, Rosner MM, Martin EM, Ecklund J, Ellenbogen RG. Cognitive rehabilitation for traumatic brain injury: A randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group. JAMA 2000; 283:3075-81. [PMID: 10865301 DOI: 10.1001/jama.283.23.3075] [Citation(s) in RCA: 249] [Impact Index Per Article: 10.4] [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: 11/14/2022]
Abstract
CONTEXT Traumatic brain injury (TBI) is a principal cause of death and disability in young adults. Rehabilitation for TBI has not received the same level of scientific scrutiny for efficacy and cost-efficiency that is expected in other medical fields. OBJECTIVE To evaluate the efficacy of inpatient cognitive rehabilitation for patients with TBI. DESIGN AND SETTING Single-center, parallel-group, randomized trial conducted from January 1992 through February 1997 at a US military medical referral center. PATIENTS One hundred twenty active-duty military personnel who had sustained a moderate-to-severe closed head injury, manifested by a Glasgow Coma Scale score of 13 or less, or posttraumatic amnesia lasting at least 24 hours, or focal cerebral contusion or hemorrhage on computed tomography or magnetic resonance imaging. INTERVENTIONS Patients were randomly assigned to an intensive, standardized, 8-week, in-hospital cognitive rehabilitation program (n=67) or a limited home rehabilitation program with weekly telephone support from a psychiatric nurse (n=53). MAIN OUTCOME MEASURES Return to gainful employment and fitness for military duty at 1-year follow-up, compared by intervention group. RESULTS At 1-year follow-up, there was no significant difference between patients who had received the intensive in-hospital cognitive rehabilitation program vs the limited home rehabilitation program in return to employment (90% vs 94%, respectively; P=.51; difference, 4% [95% confidence interval ¿CI¿, -5% to 14%]) or fitness for duty (73% vs 66%, respectively; P=. 43; difference, 7% [95% CI, -10% to 24%]). There also were no significant differences in cognitive, behavioral, or quality-of-life measures. In a post-hoc subset analysis of patients who were unconscious for more than 1 hour (n = 75) following TBI, the in-hospital group had a greater return-to-duty rate (80% vs 58%; P=. 05). CONCLUSIONS In this study, the overall benefit of in-hospital cognitive rehabilitation for patients with moderate-to-severe TBI was similar to that of home rehabilitation. These findings emphasize the importance of conducting randomized trials to evaluate TBI rehabilitation interventions. JAMA. 2000;283:3075-3081
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Affiliation(s)
- A M Salazar
- Defense and Veterans Head Injury Program, Bldg 1, Room B210, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
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23
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Liu CC, Theodorou DJ, Theodorou SJ, Andre MP, Sartoris DJ, Szollar SM, Martin EM, Deftos LJ. Quantitative computed tomography in the evaluation of spinal osteoporosis following spinal cord injury. Osteoporos Int 2000; 11:889-96. [PMID: 11199194 DOI: 10.1007/s001980070049] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 11/29/2022]
Abstract
Disuse osteoporosis occurs in the lower extremities of patients with spinal cord injury (SCI). However, spinal osteoporosis is not usually observed in these patients. We investigated lumbar spine bone mineral density (BMD) in SCI patients using single energy quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA). Our study population consisted of 64 patients with long-standing SCI. Spine BMD (g/cm3) was assessed by QCT at four vertebrae ranging from T11 to L4 with single mid-vertebral CT slices 1 cm thick parallel to the vertebral end-plates. Confounding variables affecting normal trabecular bone pattern, such as compression fractures, surgical hardware or fat replacement, were excluded. For a subset of 29 patients, DXA values of the spine and femoral neck were also measured, and QCT and DXA Z-scores were compared On the average, the 64 SCI patients had Z-scores 2.0 +/- 1.2 below those of age-matched controls. In the subset of 29 patients with both QCT and DXA measurements, the QCT and DXA Z-scores were 2.4 +/- 1.1 below and 1.3 +/- 2.3 above the mean, respectively (p < 0.0001). Our results indicate that QCT reveals osteoporosis of the spine after SCI, in contrast to DXA. We postulate that QCT is more valuable for evaluating spinal osteoporosis following SCI than DXA and thus recommend QCT for spinal BMD studies in SCI.
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Affiliation(s)
- C C Liu
- Department of Medicine, University of California San Diego and Veterans Affairs Medical Center, 3350 La Jolla Village Drive, Room 3172, Mail Code 9111C, San Diego, CA 92161, USA
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Morris PP, Martin EM, Regan J, Braden G. Intracranial deployment of coronary stents for symptomatic atherosclerotic disease. AJNR Am J Neuroradiol 1999; 20:1688-94. [PMID: 10543642 PMCID: PMC7056176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Intracranial percutaneous transluminal balloon angioplasty (PTA) has been used as a technique of last resort in the treatment of intracranial atherosclerotic disease when medical and surgical alternatives have failed or cannot be applied. The major risks associated with PTA include intracranial vessel rupture and abrupt vessel dissection causing occlusion. Angioplasty techniques in the extracranial circulation have been improved by the development of safe stent technology in combination with potent antiplatelet agents. We report three successful cases of symptomatic intracranial atherosclerotic disease in middle-aged adults treated by endovascular PTA followed by deployment of coronary stents.
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Affiliation(s)
- P P Morris
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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25
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Martin EM, Pitrak DL, Novak RM, Pursell KJ, Mullane KM. Reaction times are faster in HIV-seropositive patients on antiretroviral therapy: A preliminary report. J Clin Exp Neuropsychol 1999; 21:730-5. [PMID: 10572290 DOI: 10.1076/jcen.21.5.730.867] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We evaluated subclinical mental and motor slowing in 142 HIV-seropositive patients without dementia, using computerized simple and choice reaction time tasks and self-report measures of psychological distress. Patients on antiretroviral therapy at the time of testing (n = 79) had significantly faster choice reaction times (p < 0.05), indicating faster mental processing speed, than untreated patients (n = 63). These faster RTs could not be attributed to differences in age, education, risk factors, degree of immunosuppression, substance abuse history, peripheral neuropathy, or psychological distress. Reaction time tasks should be investigated further as potential outcome measures in clinical trials, particularly for subjects with few or no overt cognitive deficits.
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Affiliation(s)
- E M Martin
- Departments of Psychiatry and Neurology, University of Illinois, Chicago, IL, USA.
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Abstract
OBJECTIVE We studied whether medium latency (ML) and long latency (LL) postural reflexes, which are abnormal in a number of neurological conditions including basal ganglia disorders, provide an early marker of CNS involvement in HIV-positive patients. METHODS Leg reflexes were elicited in 9 neurologically normal HIV-positive patients and 10 healthy controls who were standing upright, using toe-up forceplate rotations of varying amplitude (4 degrees and 10 degrees) and predictability (serial and random). RESULTS For predictable amplitude perturbations, posturally destabilizing ML and stabilizing LL responses in HIV-seropositives did not differ from controls. However, for unpredictable amplitude perturbations, HIV-positive patients inappropriately manifested a mid-size default LL response, in contrast to healthy subjects who showed a maximum size default response. CONCLUSIONS These results suggest that impaired modulation of LL reflex processing occurs in early stages of HIV infection, prior to the onset of clinical postural instability, and this dysregulation may be influenced by cognitive factors.
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Affiliation(s)
- D J Beckley
- Department of Neurology, School of Medicine, University of California, Davis, USA
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Jaovisidha S, Sartoris DJ, Martin EM, Foldes K, Szollar SM, Deftos LJ. Influence of heterotopic ossification of the hip on bone densitometry: a study in spinal cord injured patients. Spinal Cord 1998; 36:647-53. [PMID: 9773451 DOI: 10.1038/sj.sc.3100701] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate (1) the magnitude of falsely elevated bone density results caused by heterotopic ossification (HO) around the hip and (2) effect of age of patients when the measurement was taken, age of patients at injury, and age of injury (time since event) to the prevalence of HO. SUBJECTS AND METHODS We blindly analyzed plain radiographs of the hip [(obtained within 1 month of dual energy X-ray absorptiometry (DEXA)] in 107 spinal cord injured (SCI) patients for HO and matched the result to the three regions of interest (ROI): the femoral neck, Ward's triangle, and the trochanter. The influence of HO on bone densitometric values was determined by the analysis of variance (ANOVA) and post-hoc analysis. RESULTS Nineteen (18%) patients had HO; overlying the femoral neck (79%), trochanter (74%) and Ward's triangle (37%), respectively. Significant elevation of densitometric values (P < 0.05 or less) was observed in a various magnitude at each ROI, with the greatest elevation at Ward's triangle. The prevalence of HO was high when the patients were injured at age range of 20-39 years. CONCLUSIONS HO around the hip can cause significantly elevated bone densitometry results at all ROIs, which can obscure underlying osteoporosis, leading to underestimation of fracture risk. Determination of bone density in this region with corresponding plain radiographs would be of help. In SCI patients, prevalence of HO was high when the age of patients at injury was 20-39 years.
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Affiliation(s)
- S Jaovisidha
- Department of Radiology, Veterans Affairs Medical Center, San Diego, California, USA
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Martin EM, Pitrak DL, Pursell KJ, Andersen BR, Mullane KM, Novak RM. Information processing and antiretroviral therapy in HIV-1 infection. J Int Neuropsychol Soc 1998; 4:329-35. [PMID: 9656606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Computerized reaction time (RT) tasks are sensitive measures of subclinical HIV-related mental slowing. We previously reported that nondemented HIV-seropositive patients on antiretroviral therapy at the time of testing had faster choice RTs compared to matched untreated seropositive participants. In the present study, we evaluated the performance of 163 nondemented HIV-seropositive participants on a reaction time version of the Stroop task as a function of antiretroviral status. Persons on antiretroviral therapy at the time of testing had significantly faster reaction times than untreated individuals, although treated asymptomatic participants showed significantly less Stroop interference than treated symptomatic participants. These effects could not be attributed to differences in demographic variables, disease status, substance abuse, or psychological distress. These data indicate that central information processing is faster for patients treated with antiretroviral compounds compared to untreated patients, and suggest that reaction time tasks may have significant potential utility in clinical trials of neuroprotective compounds.
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Affiliation(s)
- E M Martin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago 60612, USA.
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Rentsch JL, Martin EM, Harrison LC, Wicks IP. Prolonged response of multicentric reticulohistiocytosis to low dose methotrexate. J Rheumatol 1998; 25:1012-5. [PMID: 9598911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We describe a case of multicentric reticulohistiocytosis complicated by central retinal vein thrombosis and trigeminal neuropathy. A variety of treatment modalities were tried in this patient. Both skin disease and arthritis responded to low dose methotrexate over 8 years of followup. Graduated compression gloves produced an excellent cosmetic improvement in the disfiguring skin lesions.
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Affiliation(s)
- J L Rentsch
- Walter and Eliza Hall Institute of Medical Research, Department of Occupational Therapy, The Royal Melbourne Hospital, Victoria, Australia
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Abstract
Numerous reports have assessed the neuropsychological functioning of medically asymptomatic HIV-1 infected men. However, to date there have been no published studies of the neuropsychological functioning of asymptomatic HIV-1 infected women, even though women represent the fastest-growing demographic group of HIV-1 infected individuals. In this investigation, 31 women (17 asymptomatic HIV-1 seropositive, 14 seronegative) were administered a battery of neurocognitive and neuropsychiatric instruments. Participants in both groups were matched for age, education, months since injection drug use, and substance use. Group comparisons revealed no significant differences in any of the neurocognitive or neuropsychiatric measures. The results of this preliminary study suggest that clinically significant differences in neurobehavioral function are unlikely in medically asymptomatic HIV-1 infected women compared to seronegative controls. However, additional studies are needed with larger sample sizes and with careful attention to possible confounding or masking variables.
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Affiliation(s)
- R A Stern
- Brown University School of Medicine, Providence, RI, USA.
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31
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Abstract
We evaluated the pattern of osteoporosis after spinal cord injury, determined the time-frame of the changes, and elucidated the relationship among parathyroid hormone levels, biochemical markers of bone formation, and the pattern of bone mass loss. We included 176 subjects with spinal cord injury and 62 subjects without spinal cord injury as controls in the study. Bone mineral density of the spine and the proximal femur was measured. The participants' age, level of injury, and length of time since injury were compared with the nonspinal cord-injured controls and with each other. Serum levels of calcium, calcitonin, biochemical markers of bone formation, and parathyroid hormone were determined. Our results revealed that bone mineral density of the proximal femur declined and reached fracture threshold at one to five years after injury. The decline was detected at 12 months after injury in all age groups. Spinal bone mineral density neither declined significantly nor reached fracture threshold. Parathyroid hormone levels declined before the end of the first year postinjury and increased at one to nine years postinjury in the 20- to 39-year age group. The increase correlated with the initial decline of bone mineral density of the proximal femur. Our studies in spinal cord-injured subjects revealed a pattern of osteoporosis similar to age and parathyroid dysfunction-related osteoporosis. No other correlation was detected between indexes of bone metabolism and bone mineral density measurements.
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Affiliation(s)
- S M Szollar
- Department of Orthopedic Rehabilitation, University of California, San Diego, USA
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32
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Bartok JA, Martin EM, Pitrak DL, Novak RM, Pursell KJ, Mullane KM, Harrow M. Working memory deficits in HIV-seropositive drug users. J Int Neuropsychol Soc 1997; 3:451-6. [PMID: 9322404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We studied the integrity of working memory operations in 38 HIV-seropositive and 20 seronegative drug users, using a modified version of the Tower of London task. This new task, the Tower of London-Working Memory version (TOL-WM), includes a delayed-response component in addition to the planning required for successful performance of the standard TOL. Symptomatic HIV-seropositive participants solved significantly fewer TOL-WM problems compared to matched seronegative controls. However, seropositive and seronegative subjects showed similar overall levels of planning efficiency, suggesting that the TOL-WM deficit may be associated primarily with failure to encode or maintain an adequate online memory representation. The results of this study confirm our previous report of a possible working memory deficit in HIV-1 infection and suggest that measures of working memory have particular utility in the evaluation of HIV-related cognitive deficits.
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Affiliation(s)
- J A Bartok
- Department of Psychiatry, University of Illinois College of Medicine, Chicago 60612, USA
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33
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Abstract
The purpose of the study was to use dual energy X-ray absorptiometry to measure bone mineral density (BMD) in the lumbar spine, the femoral neck, Ward's triangle, and the greater trochanter in 204 men (69 able-bodies controls and 135 spinal cord injured patients) stratified according to age (20-39, 40-59, and 60+ years old) in order to determine whether changes in BMD were age related, and to determine when these changes began to appear. The BMDs of the lumbar spine of both the 40-59 year old and the 60+ year old patients were significantly higher (P < or = 0.012) than the 40-59 year old and 60+ year old controls, respectively. The femoral region BMDs of the 20-39 year old and the 40-59 year old patients were all significantly lower (P < or = 0.027) than the 20-39 year old and 40-59 year old controls, respectively. When patients were grouped according to the time since their injury (0-1, 1-5, 6-9, 10-19, 20-29, 30-39, 40-49, and 50-59 years post injury) within the various age categories different results were obtained. In all the age categories, BMD loss occurred starting one year after spinal cord injury in the hip region. This bone loss took place gradually, reaching a significant plateau (P < or = 0.017) at 19 years post injury and then started improving. The spine BMD in our patient population never significantly decreased, and started improving as the age of the injury increased. Findings presented for the femoral regions were similar to other investigators' findings; however, the steady bone mass maintained in the lumbar area, which increased with age regardless of the age of the injury, with the bone mass loss in the hip area, were the most notable new findings.
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Affiliation(s)
- S M Szollar
- Department of Medicine, University of California San Diego, La Jolla, USA
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34
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Jaovisidha S, Sartoris DJ, Martin EM, De Maeseneer M, Szollar SM, Deftos LJ. Influence of spondylopathy on bone densitometry using dual energy X-ray absorptiometry. Calcif Tissue Int 1997; 60:424-9. [PMID: 9115159 DOI: 10.1007/s002239900257] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [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
Spinal cord injury (SCI), as well as other neuromuscular disorders, not only results in osteopenia but also induces various patterns of osseous, articular, and soft tissue alterations. In the spinal column, a variety of abnormalities occur. To evaluate the magnitude of discrepancy of bone densitometry results caused by spondylopathy in SCI patients, we analyzed anteroposterior (AP) radiographs of the lumbar spine [obtained within 1 month of dual energy X-ray absorptiometry (DXA)] in 116 SCI patients for various manifestations of spondylopathy, and matched the result to each vertebral level (L1, 2, 3, 4). The dataset was stratified by individual vertebra (totally 463 vertebrae) as valid (no demonstrable other abnormal density on plain radiograph except osteopenia), abnormal without, and abnormal with hardware. The influence of spondylopathy on bone densitometry results was determined by the analysis of variance (ANOVA) and post hoc analysis. Our results showed that 227 (49%) vertebrae were abnormal. Significant elevation (15%, 15%, 18%, 20%; P < 0.001-P < 0.05) of bone mineral density (BMD; g/cm2) was observed at all levels (L1, 2, 3, 4, respectively), particularly at those abnormal vertebrae without hardware compared with valid (no other abnormal density on radiograph except osteopenia (Table 1). The L4 level was most severely affected. We concluded that in SCI patients, owing to various secondary progressive skeletal abnormalities, particularly neuropathic spondylopathy, can have strongly and significantly elevated vertebral bone densitometry results, which can obscure underlying osteoporosis, leading to misinterpretation and underestimation of fracture risk. DXA, although characterized by improving spatial resolution, cannot replace radiography in establishing the magnitude of this skeletal pathology. Therefore, determination of bone density in this region with corresponding plain radiographs is highly recommended.
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Affiliation(s)
- S Jaovisidha
- Section of Osteoradiology (114), Department of Radiology, Veterans Affairs Medical Center; 3350 La Jolla Village Drive, San Diego, California 92161, USA
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35
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Abstract
The aim of the present study was to compare bone mineral density (BMD in g/cm2) in the lumbar spine and three hip regions of male spinal cord injured subjects at various times post injury to age-matched able-bodied controls and to correlate their BMDs to their age and level of their spinal cord lesion. Patients and controls were stratified into three 20 years age groups (20-39, 40-59, and 60+ years of age). BMD measurements were obtained using dual energy X-ray absorptiometry (DEXA, Lunar Model DPX). BMD levels taken within the first year of injury were not significantly lower than the age-matched able-bodies controls. The 20-39 year old patients injured longer than 1 year had significantly lower (P < or = 0.01) BMDs in their femoral region than both their age matched controls and the 20-39 year old acutely injured (injured for less than 1 year) patients. Although femoral BMDs of both paraplegic and quadriplegic patients 40-59 and 60+ years of age decreased over time, none showed significant bone loss in this regions until 10 years after their injury. These results indicate that spinal cord injury associated bone loss occurs most dramatically in the femoral region of young men. These results also indicate that initial bone mass loss does not occur prior to 1 year post-injury to the extent that it is detectable by densitometry, or at least it did not occur in our patients.
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Affiliation(s)
- S M Szollar
- Department of Orthopedic Rehabiliations, University of California San Diego, USA
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36
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Gomez-Tortosa E, Martin EM, Gaviria M, Charbel F, Ausman JI. Selective Deficit of One Language in a Bilingual Patient: Replies to Paradis and Hines. Brain Lang 1996; 54:174-175. [PMID: 8811948 DOI: 10.1006/brln.1996.0066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- E Gomez-Tortosa
- Department of Neurosurgery, University of Illinois at Chicago
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37
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Abstract
The localization of the maxima of activity of 36 patients with dementia of the Alzheimer type and 36 age-matched controls was calculated after Fourier transformation of EEG data in six frequency bands (4 Hz steps between 1 and 24 Hz). Patients were divided into three groups of severity (BCRS mean < 3,9, 4.0-4.9, and > 4.9). Significant differences were found in the beta frequency band. In the distribution of the maxima of the activity, the maxima of patients were located more frontally than the maxima of controls. The alterations were staged dependent. The beta activity in EEG is said to be correlated with cognitive processes; the correlation between cognitive decline and decreasing beta activity in dementia of the Alzheimer type might support this assumption. Differences in the location of the maxima between patients and controls might allow for differentiation between both groups.
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Affiliation(s)
- R Ihl
- Department of Psychiatry, University of Würzburg, Germany
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38
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Abstract
We administered a spatial version of the Delayed Recognition Span Test (DRST), a working memory task performed abnormally by patients with basal ganglia disease, to a group of 96 HIV-seropositive and 83 seronegative subjects with a high prevalence of substance abuse. For comparison purposes, we also administered the Symbol-Digit Modalities Test (SDMT) and the Trail Making Test (TMT), measures which detect HIV-related mental slowing efficiently in gay men but are nonspecifically impaired in subjects with a history of substance abuse. As predicted, scores on the TMT and the SDMT did not discriminate the groups, but HIV-seropositive subjects had significantly shorter spatial spans (p < .007) and DRST total scores (p < .005). These effects could not be attributed to differences in age, education, estimated intelligence, or psychological distress, because the groups were well matched on these variables. The DRST is a promising measure of HIV-related cognitive dysfunction in substance abusers, who are often nonspecifically impaired on psychomotor tasks. These preliminary data also indicate that working memory function should be studied further in HIV-seropositive subjects.
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Affiliation(s)
- E M Martin
- Department of Psychiatry, University of Illinois-Chicago 60612, USA.
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39
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Gomez-Tortosa E, Martin EM, Gaviria M, Charbel F, Ausman JI. Selective deficit of one language in a bilingual patient following surgery in the left perisylvian area. Brain Lang 1995; 48:320-325. [PMID: 7757449 DOI: 10.1006/brln.1995.1014] [Citation(s) in RCA: 33] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We report on a right-handed bilingual patient with a left perisylvian arteriovenous malformation that caused a mild naming deficit evident only on formal language testing in both languages. Sodium amytal injected in the left carotid artery (Wada test) before surgery resulted in speech arrest for both languages. Following surgery for removal of the lesion she developed additional deficits in her native language without alteration in her second language. Selective impairment in one language after surgery demonstrates that each language has different anatomical representation within the perisylvian dominant area.
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Affiliation(s)
- E Gomez-Tortosa
- Department of Neurosurgery, University of Illinois at Chicago, USA
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40
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Gómez-Tortosa E, Sychra JJ, Martin EM, Arteaga M, Gaviria M, Pavel DG, Dujovny M, Ausman JI. Postoperative cognitive and single photon emission computed tomography assessment of patients with resection of perioperative high-risk arteriovenous malformations. Neurosurgery 1995; 36:447-57; discussion 457-8. [PMID: 7753344 DOI: 10.1227/00006123-199503000-00002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
We studied the outcome of 10 patients who had undergone high-risk surgery for an arteriovenous malformation at our institution between November 1991 and November 1993. All of the lesions were located in the dominant (left) hemisphere. Perioperative risk was assessed by the location of the lesion in functionally eloquent cortex (seven patients) or deep structures (two patients) or the lesion's large volume (two patients). Our patients included six women and four men, and their ages ranged from 22 to 53 years (mean, 35.8). Our follow-up study included the evaluation of neurological sequelae but mainly emphasized the study of cognitive deficits (seven major functional clusters), the incidence of depression and behavioral changes, and the assessment of regional cerebral blood flow with single photon emission computed tomography. Six patients returned to a seemingly "normal" daily life with some minor deficits postoperatively, three developed contralateral hemiparesis, and one had disabling cognitive deficits. Our comprehensive cognitive assessment, in particular, showed that although patients might appear "normal" on a routine neurological examination, most patients showed a mild deficit in at least one cognitive function and three were severely impaired. In addition, the single photon emission computed tomographic studies pointed out hypoperfusion in more extensive regions than the surgical defects shown by magnetic resonance imaging or computed tomographic studies. These single photon emission computed tomography images helped to explain some of the cognitive and behavioral changes better than the anatomic studies. This information will make it possible for the physician to offer continuing supportive care for the patient in postoperative transition to normal life activities.
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Affiliation(s)
- E Gómez-Tortosa
- Department of Neurosurgery, University of Illinois, Chicago, USA
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41
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Watanabe MD, Martin EM, DeLeon OA, Gaviria M, Pavel DG, Trepashko DW. Successful methylphenidate treatment of apathy after subcortical infarcts. J Neuropsychiatry Clin Neurosci 1995; 7:502-4. [PMID: 8555754 DOI: 10.1176/jnp.7.4.502] [Citation(s) in RCA: 33] [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: 01/31/2023]
Abstract
A patient with prominent apathy secondary to multiple subcortical infarcts was treated successfully with methylphenidate. SPECT and reaction time testing showed selective improvement of frontal system function, consistent with a recent model of frontal-subcortical circuits and behavior.
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Affiliation(s)
- M D Watanabe
- Department of Pharmacy Practice, University of Illinois-Chicago 60612, USA
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42
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Gomez-Tortosa E, Martin EM, Sychra JJ, Dujovny M. Language-activated single-photon emission tomography imaging in the evaluation of language lateralization--evidence from a case of crossed aphasia: case report. Neurosurgery 1994; 35:515-9; discussion 519-20. [PMID: 7800145 DOI: 10.1227/00006123-199409000-00023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We report a right-handed patient who developed a nonfluent aphasia after surgery for a right parietal arteriovenous malformation. Resting brain single-photon emission tomography displayed decreased regional cerebral blood flow only in the right hemisphere, with spared regional cerebral blood flow in the left hemisphere. Single-photon emission tomography performed after a language activation task (Boston Naming Task) showed a consistent area of increased regional cerebral blood flow in the right inferior and posterior frontal lobe, supporting a right hemisphere dominance for language. These results suggest a potential role for this noninvasive study in the evaluation of language lateralization.
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Affiliation(s)
- E Gomez-Tortosa
- Department of Neurosurgery, University of Illinois at Chicago
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43
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Abstract
Modern techniques have been applied to brain modeling, based on recent approaches in the artificial intelligence field that use brain-like "connectionistic" computational architectures. The model proposed by Cohen and Servan-Schreiber uses a gain parameter which they identify with dopamine function. They apply their model to neuroleptically treated schizophrenia patients who show improved task performance which they link to increased dopamine function and increased gain in the prefrontal cortex. However, evidence indicates that antipsychotic medications block dopamine (especially D2) receptors, decreasing mesolimbic and mesocortical dopamine function. If therapeutic dosages of neuroleptics diminish dopamine function, this would decrease gain in context modules needed for adequate task performance. Schizophrenia patients would perform more poorly by further reducing gain in their already compromised context modules. The current investigators suggest three possible ways to resolve this difficulty, to explain why normals perform more poorly when taking neuroleptics, although acute schizophrenia patients' performance may be enhanced in several areas. Evidence would suggest that multiple processes occur simultaneously in neuroleptically treated patients with some processes counterbalancing others.
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Affiliation(s)
- T H Jobe
- Dept. of Psychiatry, University of Illinois College of Medicine, Chicago 60612-7327
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44
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Affiliation(s)
- K M Link
- Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1022
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45
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Martin EM, Robertson LC, Sorensen DJ, Jagust WJ, Mallon KF, Chirurgi VA. Speed of memory scanning is not affected in early HIV-1 infection. J Clin Exp Neuropsychol 1993; 15:311-20. [PMID: 8491853 DOI: 10.1080/01688639308402565] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Thirty-seven nondemented HIV-seropositive and 17 seronegative control subjects were administered the Sternberg speed of memory scanning task, a procedure frequently employed to study mental slowing in patients with subcortical dementing disorders. Experimental and control subjects did not differ in speed of memory scanning, as indexed by the slopes of set size-reaction time functions, nor on mean 0-intercepts for the RT functions, which index stimulus detection and motor response time. Intercept values were significantly greater for subjects with a positive alcohol abuse history and for subjects with greater self-reported depression, but slopes were not significantly correlated with substance abuse history or psychological distress. Cognitive slowing in early HIV-1 infection is not a nonspecific effect observed across all measures of information processing speed. Underlying component functions measured must be carefully considered when selecting reaction time tasks for study with HIV-seropositive subjects. The term "subcortical" dementia may be too general a descriptor, and RT task performance may provide an alternative basis for classification of dementia types.
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Affiliation(s)
- E M Martin
- Department of Neurology, University of California-Davis
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46
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Abstract
Studies on EEG data in dementia of the Alzheimer type have mainly investigated parameters in the frequency domain. However, the EEG also reflects the momentary functional state of the brain. The EEG can be partitioned into segments of spatially stationary map landscapes as characterized by the locations of potential maxima and minima, to study the time domain of the EEG. We calculated the segment structure of 19-channel EEG recordings (1-30 Hz) from 10 patients with dementia of the Alzheimer type and 10 sex-matched geriatric controls. The EEG maps corresponding to global field power peaks were used for analysis. The locations of the potential maximum and minimum of the maps were determined over the course of 20 s and used for segmentation. The segments of EEG activity were significantly fewer (p < 0.05) and the segments lasted longer (p < 0.05) in patients compared to controls. This effect could be observed over the whole period of recording and thus was not caused by only a few long segments. The data may be linked to morphological and biochemical findings of neuronal loss and loss of synapses in dementia of the Alzheimer type.
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Affiliation(s)
- R Ihl
- Department of Psychiatry, University of Düsseldorf, FRG
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47
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Ihl R, Dierks T, Martin EM, Frölich L, Maurer K. [Importance of the EEG in early and differential diagnosis of dementia of the Alzheimer type]. Fortschr Neurol Psychiatr 1992; 60:451-9. [PMID: 1286843 DOI: 10.1055/s-2007-1000668] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The development of new parameters in the quantitative evaluation of EEG provides new diagnostic opportunities for the clinician. Reviewing all published papers on EEG and dementia over the last 10 years revealed 30 out of 428 studies discussing EEG alterations in relation to the severity of the disease. This approach provides useful information for early and differential diagnosis of dementia. Besides a generalised slowing-down represented by an increase of delta and theta and a decrease of alpha and beta in the frequency spectrum (also characterised by a reduction of the peak frequency), the topography of the alterations changes depending on the severity of the disease. For instance, the alpha activity loses its normally occipital orientation. In early stages of the disease, it is measured parietally ("anteriorized"). In advanced stages, the activity is equally distributed over the scalp. Some studies found significant alterations even in early stages of the disease, most pronounced in theta and beta activity, making the EEG a useful tool for the early diagnosis of dementia. But studies on the differential diagnostic value are lacking. The value of EEG could be improved after parameters like the EEG segmentation or the traditional parameters combined with cognitive stimulation have been sufficiently evaluated.
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Affiliation(s)
- R Ihl
- Psychiatrische Klinik, Julius-Maximilians-Universität Würzburg
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48
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Abstract
Forty-nine patients with a clinical diagnosis of probable dementia of the Alzheimer type underwent an extensive test battery designed to evaluate cognitive deficits according to NINCDS/ADRDA criteria. All patients demonstrated signs of impairment on this test battery. One day later, they were administered a second test battery that consisted of the Mini-Mental State Examination (MMS), the Alzheimer's Disease Assessment Scale (ADAS), the SKT test (SKT), and the Brief Cognitive Rating Scale (BCRS) to assess the construct validity, sensitivity, and possible shortcomings of these tests. A control group of 47 age-matched persons was administered the same test battery to allow a comparison with reference values from other studies. Due to the design of the study, values of controls and patients did not overlap. Intercorrelations in patients were above 0.65 (p < 0.05 after Bonferroni correction) for all four cognitive tests. The ADAS and BCRS appeared to document the whole course of the disease in patients studied. The best differentiation with the SKT test could be obtained in mild to moderate dementia; however, due to the test's construction, a floor effect demonstrated its limitations in the case of severe dementia. Results obtained with the MMSE indicated the contrary: a ceiling effect showed its lack of differentiation in mild dementia. Therefore, a combination of tests should be used in the evaluation of cognitive deficits in the course of dementia of the Alzheimer type.
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Affiliation(s)
- R Ihl
- Department of Psychiatry, University of Würzburg, Germany
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49
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Martin EM, Robertson LC, Edelstein HE, Jagust WJ, Sorensen DJ, San Giovanni D, Chirurgi VA. Performance of patients with early HIV-1 infection on the Stroop Task. J Clin Exp Neuropsychol 1992; 14:857-68. [PMID: 1474150 DOI: 10.1080/01688639208402867] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
HIV-seropositive and seronegative control subjects performed a standard paper-and-pencil version and an experimental reaction time version of the Stroop Color-Word Naming Task. Results indicated that both symptomatic and asymptomatic HIV-positive subjects showed an exaggerated Stroop effect compared to controls, but this increase was only apparent on the RT version of the task. Analysis of components of the effect indicated that HIV-positive subjects showed increased inhibition compared to controls but normal facilitation. These results suggest that HIV-related cognitive slowing has an attentional component, most likely involving controlled processes. In addition, these results emphasize the utility and sensitivity of RT measures in the study of early HIV-1 infection.
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Affiliation(s)
- E M Martin
- Department of Neurology, University of California-Davis
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50
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Abstract
In order to investigate relationships between cognition and regional brain function, we studied 20 non-demented patients with idiopathic Parkinson's disease (PD), 21 mildly demented patients with Alzheimer's disease (AD) and 24 control subjects using cognitive testing and single photon emission computerized tomographic (SPECT) measurements of relative regional cerebral blood flow (rCBF). Neuropsychological tests were grouped into clusters reflecting frontal lobe executive abilities, perseveration, memory and visuospatial ability, with a summary score summarizing performance in all four of these spheres. SPECT imaging utilized the tracer [123I]N-isopropyl-p-iodoamphetamine with a relative measure of regional tracer uptake normalized to occipital radiotracer uptake (rCBF ratios). Patients with PD performed more poorly than controls in all cognitive domains, and were intermediate to AD patients and controls in tests of memory and overall cognitive functioning. Those PD patients who performed most poorly on neuropsychological testing showed lowest rCBF ratios in left and right temporal lobes. Using a stepwise multiple regression procedure, we examined patterns of correlations between cognitive clusters and predictor variables, including rCBF ratios, in the PD patients. We found that while patient age was a strong determinant of performance on the memory cluster and the summary score, dorsolateral frontal lobe perfusion and scores on a depression inventory accounted for a greater proportion of the variance of the frontal lobe and perseveration clusters than did age. These results imply that different neural mechanisms are responsible for the different aspects of cognitive decline seen in PD patients, with overall cognitive function closely related to age and temporal perfusion, while frontal lobe abilities are more linked to frontal perfusion and the presence of depression.
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Affiliation(s)
- W J Jagust
- Department of Neurology, University of California, Davis
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