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Diaz GA, Christensen AB, Pusch T, Goulet D, Chang SC, Grunkemeier GL, McKelvey PA, Robicsek A, French T, Parsons GT, Doherty G, Laurenson C, Roper R, Hadlock J, Cover CJ, Footer B, Robinson P, Micikas M, Marfori JE, Cronenweth C, Mukkamala Y, Mackiewicz J, Rai E, Matson MD, Davila J, Rueda J, Tipton R, Algren H, Ward BC, Malkoski S, Gluckman T, Tallman GB, Arguinchona H, Hammond TC, Standaert S, Christensen J, Echaiz JF, Choi R, McClung D, Pacifico A, Fee M, Sarafian F, Berrington WR, Goldman JD. Remdesivir and Mortality in Patients with COVID-19. Clin Infect Dis 2021; 74:1812-1820. [PMID: 34409431 PMCID: PMC9155603 DOI: 10.1093/cid/ciab698] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background The impact of remdesivir (RDV) on mortality rates in coronavirus disease 2019 (COVID-19) is controversial, and the mortality effect in subgroups of baseline disease severity has been incompletely explored. The purpose of this study was to assess the association of RDV with mortality rates in patients with COVID-19. Methods In this retrospective cohort study we compared persons receiving RDV with those receiving best supportive care (BSC). Patients hospitalized between 28 February and 28 May 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection were included with the development of COVID-19 pneumonia on chest radiography and hypoxia requiring supplemental oxygen or oxygen saturation ≤94% with room air. The primary outcome was overall survival, assessed with time-dependent Cox proportional hazards regression and multivariable adjustment, including calendar time, baseline patient characteristics, corticosteroid use, and random effects for hospital. Results A total of 1138 patients were enrolled, including 286 who received RDV and 852 treated with BSC, 400 of whom received hydroxychloroquine. Corticosteroids were used in 20.4% of the cohort (12.6% in RDV and 23% in BSC). Comparing persons receiving RDV with those receiving BSC, the hazard ratio (95% confidence interval) for death was 0.46 (.31–.69) in the univariate model (P < .001) and 0.60 (.40–.90) in the risk-adjusted model (P = .01). In the subgroup of persons with baseline use of low-flow oxygen, the hazard ratio (95% confidence interval) for death in RDV compared with BSC was 0.63 (.39–1.00; P = .049). Conclusion Treatment with RDV was associated with lower mortality rates than BSC. These findings remain the same in the subgroup with baseline use of low-flow oxygen.
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Affiliation(s)
- George A Diaz
- Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USA.,Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Alyssa B Christensen
- Department of Pharmacy, Providence Oregon Region Shared Services, Portland, OR, USA
| | - Tobias Pusch
- Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USA
| | - Delaney Goulet
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA.,Division of Medicine, Section of Internal Medicine, Providence Regional Medical Center Everett, Everett, WA, USA
| | - Shu-Ching Chang
- Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USA
| | - Gary L Grunkemeier
- Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USA
| | - Paul A McKelvey
- Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence St. Joseph Health, Portland, Oregon, USA
| | - Ari Robicsek
- Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USA
| | - Tom French
- Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USA
| | - Guilford T Parsons
- Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USA
| | - Glenn Doherty
- Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USA
| | - Charles Laurenson
- Department of Clinical Analytics, Providence St. Joseph Health, Renton, WA, USA
| | - Ryan Roper
- Institute for Systems Biology, Seattle, WA, USA
| | | | - Cameron J Cover
- Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USA
| | - Brent Footer
- Department of Pharmacy, Providence Oregon Region Shared Services, Portland, OR, USA
| | - Philip Robinson
- Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USA
| | - Mary Micikas
- Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA.,Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Jennifer E Marfori
- Department of Internal Medicine, Section of Infectious Diseases, Providence St. Vincent Medical Center, Portland, OR, USA
| | - Charlotte Cronenweth
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Yogavedya Mukkamala
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Jamie Mackiewicz
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Ekra Rai
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Martha Dickinson Matson
- Washington State University Elson S. Floyd College of Medicine, Internal Medicine Residency, Spokane, WA, USA
| | - Jodie Davila
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Justin Rueda
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Reda Tipton
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Heather Algren
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Brittney C Ward
- Department of Internal Medicine, Spokane Teaching Health Clinic, Spokane, WA, USA
| | - Stephen Malkoski
- Sound Critical Care, Sacred Heart Medical Center, Spokane, WA, USA
| | - Tyler Gluckman
- Department of Cardiology, Providence St. Vincent Medical Center, Portland, OR, USA
| | | | | | - Terese C Hammond
- John Wayne Cancer Institute and Cancer Clinic, Providence St Johns Health Center, Santa Monica, CA, USA
| | | | | | - Jose F Echaiz
- Infectious Diseases, Kadlec Regional Medical Center, Richland, WA, USA
| | - Robert Choi
- Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USA
| | - Daniel McClung
- Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USA
| | - Albert Pacifico
- Division of Medicine, Section of Infectious Diseases, Providence Regional Medical Center Everett, Everett, WA, USA
| | - Martin Fee
- Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USA
| | - Farjad Sarafian
- Department of Hospital Medicine, Division of Infectious Diseases, Hoag Memorial Hospital Presbyterian, Newport Beach, CA USA
| | - William R Berrington
- Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA.,Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA
| | - Jason D Goldman
- Division of Infectious Diseases, Swedish Medical Center, Seattle, WA, USA.,Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, WA, USA.,Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
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Loomba R, Neuschwander-Tetri BA, Sanyal A, Chalasani N, Diehl AM, Terrault N, Kowdley K, Dasarathy S, Kleiner D, Behling C, Lavine J, Van Natta M, Middleton M, Tonascia J, Sirlin C, Allende D, Dasarathy S, McCullough AJ, Penumatsa R, Dasarathy J, Lavine JE, Abdelmalek MF, Bashir M, Buie S, Diehl AM, Guy C, Kigongo C, Kopping M, Malik D, Piercy D, Chalasani N, Cummings OW, Gawrieh S, Ragozzino L, Sandrasegaran K, Vuppalanchi R, Brunt EM, Cattoor T, Carpenter D, Freebersyser J, King D, Lai J, Neuschwander‐Tetri BA, Siegner J, Stewart S, Torretta S, Wriston K, Gonzalez MC, Davila J, Jhaveri M, Kowdley KV, Mukhtar N, Ness E, Poitevin M, Quist B, Soo S, Ang B, Behling C, Bhatt A, Loomba R, Middleton MS, Sirlin C, Akhter MF, Bass NM, Brandman D, Gill R, Hameed B, Maher J, Terrault N, Ungermann A, Yeh M, Boyett S, Contos MJ, Kirwin S, Luketic VA, Puri P, Sanyal AJ, Schlosser J, Siddiqui MS, Yost‐Schomer L, Brunt EM, Fowler K, Kleiner DE, Doo EC, Hall S, Hoofnagle JH, Robuck PR, Sherker AH, Torrance R, Belt P, Clark JM, Dodge J, Donithan M, Isaacson M, Lazo M, Meinert J, Miriel L, Sharkey EP, Smith J, Smith M, Sternberg A, Tonascia J, Van Natta ML, Wagoner A, Wilson LA, Yamada G, Yates K, Covarrubias Y, Gamst A, Hamilton G, Henderson W, Hooker J, Lavine JE, Loomba R, Middleton MS, Schlein A, Schwimmer JB, Shen W, Sirlin C, Wolfson T. Multicenter Validation of Association Between Decline in MRI-PDFF and Histologic Response in NASH. Hepatology 2020; 72:1219-1229. [PMID: 31965579 PMCID: PMC8055244 DOI: 10.1002/hep.31121] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/23/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Emerging data from a single-center study suggests that a 30% relative reduction in liver fat content as assessed by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) from baseline may be associated with histologic improvement in nonalcoholic steatohepatitis (NASH). There are limited multicenter data comparing an active drug versus placebo on the association between the quantity of liver fat reduction assessed by MRI-PDFF and histologic response in NASH. This study aims to examine the association between 30% relative reduction in MRI-PDFF and histologic response in obeticholic acid (OCA) versus placebo-treated patients in the FLINT (farnesoid X receptor ligand obeticholic acid in NASH trial). APPROACH AND RESULTS This is a secondary analysis of the FLINT trial including 78 patients with MRI-PDFF measured before and after treatment along with paired liver histology assessment. Histologic response was defined as a 2-point improvement in nonalcoholic fatty liver disease activity score without worsening of fibrosis. OCA (25 mg orally once daily) was better than placebo in improving MRI-PDFF by an absolute difference of -3.4% (95% confidence interval [CI], -6.5 to -0.2%, P value = 0.04) and relative difference of -17% (95% CI, -34 to 0%, P value = 0.05). The optimal cutoff point for relative decline in MRI-PDFF for histologic response was 30% (using Youden's index). The rate of histologic response in those who achieved less than 30% decline in MRI-PDFF versus those who achieved a 30% or greater decline in MRI-PDFF (MRI-PDFF responders) relative to baseline was 19% versus 50%, respectively. Compared with MRI-PDFF nonresponders, MRI-PDFF responders demonstrated both a statistically and clinically significant higher odds 4.86 (95% CI, 1.4-12.8, P value < 0.009) of histologic response, including significant improvements in both steatosis and ballooning. CONCLUSION OCA was better than placebo in reducing liver fat. This multicenter trial provides data regarding the association between 30% decline in MRI-PDFF relative to baseline and histologic response in NASH.
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Affiliation(s)
- Rohit Loomba
- University of California San Diego, La Jolla, CA, USA
| | | | - Arun Sanyal
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Norah Terrault
- University of California San Francisco, San Francisco, CA USA
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Davila J, Cruz F. Supplementary motor area low frequency repetitive transcranial magnetic stimulation in addition to left dorsolateral prefrontal cortex theta burst stimulation to enhance effectiveness of refractory depression treatment. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.554] [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: 11/26/2022] Open
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Moore GP, Byrne A, Davila J, Sarfi E, Bettolli M. Worsening anemia associated with volvulus in a stable neonate with intestinal obstruction. J Neonatal Perinatal Med 2018; 11:417-422. [PMID: 30584174 DOI: 10.3233/npm-17118] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Intrauterine intestinal obstruction complicated by midgut volvulus is a serious life-threatening diagnosis. Immediate surgical intervention is generally the course of action upon diagnosis to prevent morbidity and mortality. We report a case of intrauterine intestinal obstruction where the neonate then presented with an unusual onset of volvulus within the first 12 hours of life. The patient was born with generalized edema, a distended abdomen, and pallor. Unlike many cases, the patient did not present with typical signs of volvulus. Diagnostic imaging preceding delivery and the stable postnatal clinical course did not offer a justification for immediate laparotomy. Less than 24 hours later, the patient's hemoglobin significantly dropped leading to an emergent laparotomy. Findings included a volvulus of the terminal ileum and large amounts of intraluminal blood. Our case report includes an analysis of clinical observations that should be considered so that patients presenting with similar signs receive earlier surgical intervention.
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Affiliation(s)
- G P Moore
- Division of Neonatology, Children's Hospital of Eastern Ontario, Canada
- Faculty of Medicine, University of Ottawa, Canada
| | - A Byrne
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Canada
| | - J Davila
- Faculty of Medicine, University of Ottawa, Canada
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, Canada
| | - E Sarfi
- Department of Medical Imaging, Children's Hospital of Eastern Ontario, Canada
| | - M Bettolli
- Faculty of Medicine, University of Ottawa, Canada
- Department of Surgery, Children's Hospital of Eastern Ontario, Canada
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5
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Abstract
BACKGROUND The effect of life stress on suicidal symptoms during adolescence is well documented. Stressful life events can trigger suicidality, but most adolescents are resilient and it is unclear which factors protect against the deleterious impact of stress. Social support is thought to be one such factor. Therefore, we investigated the buffering effect of specific sources of social support (parental and peer) on life stress (interpersonal and non-interpersonal) in predicting suicidal symptoms during adolescence. In order to test the specificity of this stress buffering, we also examined it with regard to dysphoric mood. METHOD Data come from the Adolescent Development of Emotions and Personality Traits (ADEPT) Project, a cohort of 550 adolescent females aged 13.5-15.5 recruited from Long Island. Self-reported social support, suicidality, and dysphoria were assessed at baseline and suicidality and dysphoria were assessed again at 9-month follow-up. Life stress was assessed by interview at the follow-up. RESULTS High levels of parental support protected adolescent girls from developing suicidal symptoms following a stressor. This effect was less pronounced for peer support. Also, social support did not buffer the pathogenic effects of non-interpersonal stress. Finally, social support did not buffer the effect of life stress on dysphoric symptoms. CONCLUSIONS Altogether, our results highlight a distinct developmental pathway for the development of suicidal symptoms involving parental support that differs from the development of dysphoria, and signifies the importance and specificity of social support in protecting against suicidality in adolescent girls.
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Affiliation(s)
- D M Mackin
- Stony Brook University,Stony Brook, NY,USA
| | - G Perlman
- Stony Brook University,Stony Brook, NY,USA
| | - J Davila
- Stony Brook University,Stony Brook, NY,USA
| | - R Kotov
- Stony Brook University,Stony Brook, NY,USA
| | - D N Klein
- Stony Brook University,Stony Brook, NY,USA
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6
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Campelo MD, Lorenzo J, Benlloch L, Lopez-Pavia M, Such E, Bernal T, Luño E, Davila J, Ramos F, Calabuig M, Pomares H, Gonzalez B, Merchan B, Barranco E, Tello RS, Callejas M, Requena M, Jimenez M, Pedreño M, Vicente A, Medina A, Campeny A, Sansa MC, Pedro C, Falantes J, Arilla M, Barez A, Garcia R, Arcos M, Gomez V, Muñoz C, Cervero C, Casaño J, de Paz R, Amigo L, Insunza A, Muñoz J, Cedena M, Gomez M, Font P, del Campo R, Lago CF, Hurtado JG, Latorre ML, Casado AM, Vahi M, Sanz G, Cañizo M. 211 SPANISH REGISTRY OF ERYTHROPOIETIC STIMULATING AGENTS STUDY: THE LARGEST RETROSPECTIVE STUDY OF ESAS FOR THE TREATMENT OF ANEMIA IN LOWER RISK MDS PATIENTS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30212-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Cunningham JM, Cicek MS, Larson NB, Davila J, Wang C, Larson MC, Song H, Dicks EM, Harrington P, Wick M, Winterhoff BJ, Hamidi H, Konecny GE, Chien J, Bibikova M, Fan JB, Kalli KR, Lindor NM, Fridley BL, Pharoah PPD, Goode EL. Clinical characteristics of ovarian cancer classified by BRCA1, BRCA2, and RAD51C status. Sci Rep 2014; 4:4026. [PMID: 24504028 PMCID: PMC4168524 DOI: 10.1038/srep04026] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/20/2014] [Indexed: 12/20/2022] Open
Abstract
We evaluated homologous recombination deficient (HRD) phenotypes in epithelial ovarian cancer (EOC) considering BRCA1, BRCA2, and RAD51C in a large well-annotated patient set. We evaluated EOC patients for germline deleterious mutations (n = 899), somatic mutations (n = 279) and epigenetic alterations (n = 482) in these genes using NGS and genome-wide methylation arrays. Deleterious germline mutations were identified in 32 (3.6%) patients for BRCA1, in 28 (3.1%) for BRCA2 and in 26 (2.9%) for RAD51C. Ten somatically sequenced patients had deleterious alterations, six (2.1%) in BRCA1 and four (1.4%) in BRCA2. Fifty two patients (10.8%) had methylated BRCA1 or RAD51C. HRD patients with germline or somatic alterations in any gene were more likely to be high grade serous, have an earlier diagnosis age and have ovarian and/or breast cancer family history. The HRD phenotype was most common in high grade serous EOC. Identification of EOC patients with an HRD phenotype may help tailor specific therapies.
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Affiliation(s)
- J. M. Cunningham
- Department of Laboratory Medicine and Pathology, Division of Experimental Pathology, Mayo Clinic, Rochester, Minnesota
| | - M. S. Cicek
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - N. B. Larson
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - J. Davila
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - C. Wang
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - M. C. Larson
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - H. Song
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - E. M. Dicks
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - P. Harrington
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - M. Wick
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - B. J. Winterhoff
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - H. Hamidi
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - G. E. Konecny
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles and Jonsson Comprehensive Cancer Center, Los Angeles, California
| | - J. Chien
- Department of Translational Genomics, University of Kansas Medical Center, Kansas City, Kansas
| | | | - J.-B. Fan
- Illumina Corporation, San Diego, California
| | - K. R. Kalli
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - N. M. Lindor
- Department of Health Science Research, Medical Genetics, Mayo Clinic, Scottsdale, Arizona
| | - B. L. Fridley
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas
| | - P. P. D. Pharoah
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - E. L. Goode
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
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Castelo-Branco C, Davila J, Perelló MF, Peguero A, Ros C, Martínez-Serrano MJ, Balasch J. Long-term effect of hormone therapy on bone in early menopause: vertebral fractures after 20 years. Climacteric 2014; 17:336-41. [DOI: 10.3109/13697137.2013.871511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Davila J, Martin R. SU-E-T-98: Towards a Three Dimensional Dosimetry Based On Diffusion Imaging Tools. Med Phys 2013. [DOI: 10.1118/1.4814533] [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: 11/07/2022] Open
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Villa-Cruz V, Davila J, Viana MT, Vazquez-Duhalt R. Effect of broccoli (Brassica oleracea) and its phytochemical sulforaphane in balanced diets on the detoxification enzymes levels of tilapia (Oreochromis niloticus) exposed to a carcinogenic and mutagenic pollutant. Chemosphere 2009; 74:1145-1151. [PMID: 19144376 DOI: 10.1016/j.chemosphere.2008.11.082] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Revised: 11/22/2008] [Accepted: 11/30/2008] [Indexed: 05/27/2023]
Abstract
Tilapia fish (Oreochromis niloticus) were fed with enriched diets containing broccoli and its phytochemical sulforaphane over 30 d. The levels of cytochrome P450, superoxide dismutase, catalase, lipid peroxidation and glutathione-S-transferase activities were measured. Basal value of cytochrome P450 activity was significantly increased as consequence of the broccoli and sulforaphane enriched diets, while no statistically significant changes were found on catalase and lipid peroxidation activities. After benzo(a)pyrene exposure, the cytochrome P450 activity increased to higher levels in the fish feed with broccoli and sulforaphane when compared with the control fish. Activities of antioxidant enzymes also varied but without significant difference with the control fish. Supported by the lower concentrations of BaP metabolites in bile from fish fed with broccoli or with sulforaphane enriched diets (indicating a better xenobiotic elimination) the cytochrome P450 induction could be considered beneficial for the detoxification because this transformation is the first step for PAH elimination by the phase II system. The protection of aquaculture organism against pollution effects by designing special diets able to modulate the enzymes involved in the phase-I and phase-II detoxification mechanism are discussed.
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Affiliation(s)
- V Villa-Cruz
- Centro de Investigación Científica y Educación Superior de Ensenada, CICESE, Ensenada BC, Mexico
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Bignozzi CA, Roffia S, Chiorboli C, Davila J, Indelli MT, Scandola F. Oligomeric dicyanobis(polypyridine)ruthenium(II) complexes. Synthesis, spectroscopic, and photophysical properties. Inorg Chem 2002. [DOI: 10.1021/ic00323a014] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The purpose of this paper is to report the use of total knee arthroplasty, a megaprosthesis, as a treatment in elderly patients who have a persistent nonunion of a supracondylar femur fracture. This case report includes two elderly patients who sustained supracondylar femur fractures that failed to unite with standard operative fixation methods. Despite multiple procedures during a long period, patients had a persistent nonunion. Both patients underwent total arthroplasty with a cemented kinematic rotating hinge and had significant clinical improvement. The Hospital for Special Surgery (HSS) knee scores increased from fifty-four points to seventy points in one patient and forty-two points to seventy-three points after surgery in the other patient. Both patients had excellent range of motion after surgery. A cemented megaprosthesis appears to be a viable treatment option for persistent nonunions of supracondylar femur fractures in elderly patients. It is well tolerated and permits early ambulation and return to activities of daily living.
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Affiliation(s)
- J Davila
- Department of Orthopaedic Surgery, University of Louisville School of Medicine, 550 South Jackson Street, ACB 3 Bridge, Louisville, KY 40202, U.S.A
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Abstract
The hypothesis that attachment insecurity would be associated with remaining in an unhappy marriage was tested. One hundred seventy-two newly married couples participated in a 4-year longitudinal study with multiple assessment points. Hierarchical linear models revealed that compared with spouses in happy marriages and divorced spouses, spouses who were in stable but unhappy marriages showed the highest levels of insecurity initially and over time. Spouses in stable, unhappy marriages also had lower levels of marital satisfaction than divorced spouses and showed relatively high levels of depressive symptoms initially and over time. Results suggest that spouses at risk for stable, unhappy marriages can be identified early and may benefit from interventions that increase the security of spouses' attachment to each other.
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Affiliation(s)
- J Davila
- Department of Psychology, State University of New York at Buffalo, Park Hall, Buffalo, New York 14260-4110, USA.
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Abstract
The authors examined 4 models of attachment change: a contextual model, a social-cognitive model, an individual-difference model, and a diathesis-stress model. Models were examined in a sample of newlyweds over the first 2 years of marriage, using growth curve analyses. Reciprocal processes, whereby attachment representations and interpersonal life circumstances affect one another over time, also were studied. On average, newlyweds became more secure over time. However, there was significant within-subject variability on attachment change that was predicted by intra- and interpersonal factors. Attachment representations changed in response to contextual, social-cognitive, and individual-difference factors. Reciprocal processes between attachment representations and marital variables emerged, suggesting that these factors influence one another in an ongoing way.
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Affiliation(s)
- J Davila
- Department of Psychology, State University of New York at Buffalo 14260-4110, USA.
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Daley SE, Hammen C, Burge D, Davila J, Paley B, Lindberg N, Herzberg DS. Depression and Axis II symptomatology in an adolescent community sample: concurrent and longitudinal associations. J Pers Disord 1999; 13:47-59. [PMID: 10228926 DOI: 10.1521/pedi.1999.13.1.47] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The relationship between personality pathology and depression has been the focus of increasing attention, but few investigators have examined this issue prospectively or in adolescent community samples. The present study used both self report and interviewer assessments of personality disorder symptomatology and depression in a sample of 155 late adolescent women followed over three years. Personality pathology cluster and total scores demonstrated moderate to fairly high degrees of stability, indicating endurance of these traits in late adolescence. As predicted, Axis II symptoms were associated with concurrent depressive symptomatology. Overall, self-reported personality disorder symptoms, as well as those specifically in Clusters A and B, predicted interviewer-rated depression over two years beyond the contribution of initial depression, indicating that subclinical Axis II symptoms are a risk factor for subsequent depressive symptomatology.
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Affiliation(s)
- S E Daley
- Department of Psychology, University of California, Los Angeless 90095-1563, USA
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17
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Abstract
The authors examined 4 models of attachment change: a contextual model, a social-cognitive model, an individual-difference model, and a diathesis-stress model. Models were examined in a sample of newlyweds over the first 2 years of marriage, using growth curve analyses. Reciprocal processes, whereby attachment representations and interpersonal life circumstances affect one another over time, also were studied. On average, newlyweds became more secure over time. However, there was significant within-subject variability on attachment change that was predicted by intra- and interpersonal factors. Attachment representations changed in response to contextual, social-cognitive, and individual-difference factors. Reciprocal processes between attachment representations and marital variables emerged, suggesting that these factors influence one another in an ongoing way.
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Affiliation(s)
- J Davila
- Department of Psychology, State University of New York at Buffalo 14260-4110, USA.
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18
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Daley SE, Hammen C, Davila J, Burge D. Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood. J Consult Clin Psychol 1998. [PMID: 9735575 DOI: 10.1037//0022-006x.66.4.595] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner-reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported.
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Affiliation(s)
- S E Daley
- Department of Psychology, University of California, Los Angeles 90095-1563, USA
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19
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Daley SE, Hammen C, Davila J, Burge D. Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood. J Consult Clin Psychol 1998; 66:595-603. [PMID: 9735575 DOI: 10.1037/0022-006x.66.4.595] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner-reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported.
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Affiliation(s)
- S E Daley
- Department of Psychology, University of California, Los Angeles 90095-1563, USA
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20
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Abstract
The present study applied C.L. Hammen's (1991) stress generation model to depressive symptoms in the context of marriage. The authors predicted that depressive symptoms would lead to increased marital stress, which would in turn lead to increased depressive symptoms. Social support processes were hypothesized to function as a mechanism by which dysphoric spouses generate stress. Hypotheses were tested in a sample of 154 newlywed couples. Depressive symptoms, marital stress, support perceptions, and support behavior (assessed using observational procedures) were assessed initially and 1 year later. Results provided evidence of marital stress generation among wives, and social support processes functioned as a mechanism of stress generation for wives. Results highlight the cyclical course of dysphoria and stress among wives.
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Affiliation(s)
- J Davila
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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21
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Davila J, Bradbury TN, Cohan CL, Tochluk S. Marital functioning and depressive symptoms: evidence for a stress generation model. J Pers Soc Psychol 1997. [PMID: 9325596 DOI: 10.1037/0022–3514.73.4.849] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The present study applied C.L. Hammen's (1991) stress generation model to depressive symptoms in the context of marriage. The authors predicted that depressive symptoms would lead to increased marital stress, which would in turn lead to increased depressive symptoms. Social support processes were hypothesized to function as a mechanism by which dysphoric spouses generate stress. Hypotheses were tested in a sample of 154 newlywed couples. Depressive symptoms, marital stress, support perceptions, and support behavior (assessed using observational procedures) were assessed initially and 1 year later. Results provided evidence of marital stress generation among wives, and social support processes functioned as a mechanism of stress generation for wives. Results highlight the cyclical course of dysphoria and stress among wives.
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Affiliation(s)
- J Davila
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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22
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Abstract
The present study applied C.L. Hammen's (1991) stress generation model to depressive symptoms in the context of marriage. The authors predicted that depressive symptoms would lead to increased marital stress, which would in turn lead to increased depressive symptoms. Social support processes were hypothesized to function as a mechanism by which dysphoric spouses generate stress. Hypotheses were tested in a sample of 154 newlywed couples. Depressive symptoms, marital stress, support perceptions, and support behavior (assessed using observational procedures) were assessed initially and 1 year later. Results provided evidence of marital stress generation among wives, and social support processes functioned as a mechanism of stress generation for wives. Results highlight the cyclical course of dysphoria and stress among wives.
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Affiliation(s)
- J Davila
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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23
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Abstract
Adult attachment research has proceeded on the assumption that attachment style is relatively stable and affects future functioning. However, researchers have become interested in attachment instability and predictors of attachment style change. In this article, 2 conceptualizations of attachment style change were examined: Attachment style change is a reaction to current circumstances, and attachment style change is an individual difference in susceptibility to change that is associated with stable vulnerability factors. A total of 155 women were assessed after high school graduation, and 6 months and 2 years later. Results primarily supported the conceptualization of attachment style change as an individual difference. Specifically, some women may be prone to attachment fluctuations because of adverse earlier experiences, and women who show attachment fluctuations are similar to women with stably insecure attachments.
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Affiliation(s)
- J Davila
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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Daley SE, Hammen C, Burge D, Davila J, Paley B, Lindberg N, Herzberg DS. Predictors of the generation of episodic stress: a longitudinal study of late adolescent women. J Abnorm Psychol 1997. [PMID: 9131845 DOI: 10.1037//0021-843x.106.2.251] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The effects of depression and Axis I comorbidity on subsequent self-generated life stress were examined in a longitudinal sample of 134 late adolescent women. The results indicated that specific forms of psychopathology constitute a risk factor for future self-generated episodic stress, even when controlling for prior chronic stress. Comorbid depression had a particularly salient effect in the prediction of stress related to interpersonal conflicts. The effects of family psychopathology and sociotropy were mediated through participant psychiatric status, whereas autonomy made an independent contribution to the prediction of episodic stress. These results support C. Hammen's (1991b) stress generation model in a community sample, demonstrating how individuals with depression play a role in the creation of stress, and also refine prior work by showing that only the comorbid form of depression is associated with subsequent conflict-related stress.
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Affiliation(s)
- S E Daley
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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25
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Daley SE, Hammen C, Burge D, Davila J, Paley B, Lindberg N, Herzberg DS. Predictors of the generation of episodic stress: a longitudinal study of late adolescent women. J Abnorm Psychol 1997; 106:251-9. [PMID: 9131845 DOI: 10.1037/0021-843x.106.2.251] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of depression and Axis I comorbidity on subsequent self-generated life stress were examined in a longitudinal sample of 134 late adolescent women. The results indicated that specific forms of psychopathology constitute a risk factor for future self-generated episodic stress, even when controlling for prior chronic stress. Comorbid depression had a particularly salient effect in the prediction of stress related to interpersonal conflicts. The effects of family psychopathology and sociotropy were mediated through participant psychiatric status, whereas autonomy made an independent contribution to the prediction of episodic stress. These results support C. Hammen's (1991b) stress generation model in a community sample, demonstrating how individuals with depression play a role in the creation of stress, and also refine prior work by showing that only the comorbid form of depression is associated with subsequent conflict-related stress.
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Affiliation(s)
- S E Daley
- Department of Psychology, University of California, Los Angeles 90095-1563, USA.
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26
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Burge D, Hammen C, Davila J, Daley SE, Paley B, Lindberg N, Herzberg D, Rudolph KD. The relationship between attachment cognitions and psychological adjustment in late adolescent women. Dev Psychopathol 1997; 9:151-67. [PMID: 9089129 DOI: 10.1017/s0954579497001119] [Citation(s) in RCA: 66] [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: 02/04/2023]
Abstract
This longitudinal study of 137 female high school seniors investigated the relationship of attachment cognitions, current psychological functioning, and psychological functioning 12 months later. Attachment cognitions, assessed with the Revised Adult Attachment Scale and the Inventory of Parent and Peer Attachment, were significantly associated with current symptomatology. The Revised Adult Attachment Scale, in interaction with initial symptomatology, predicted depression, substance abuse, eating disorders, and personality disorders 12 months later. The Inventory of Parent and Peer Attachment parent subscales predicted eating disorder and personality disorder symptomatology, whereas the peer subscales predicted substance abuse, eating disorder, and personality disorder symptomatology.
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Affiliation(s)
- D Burge
- Department of Psychology, University of California at Los Angeles 90024, USA.
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27
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Davila J, Hammen C, Burge D, Paley B, Daley SE. Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women. J Abnorm Psychol 1995; 104:592-600. [PMID: 8530761 DOI: 10.1037/0021-843x.104.4.592] [Citation(s) in RCA: 149] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors examined C. Hammen's (1991) model of stress generation in depression and the role of interpersonal problem-solving strategies (IPS) in the stress generation process in a longitudinal sample of 140 young women who entered the study at ages 17-18. Structural equation modeling was used to test a model in which IPS and subsequent interpersonal stress mediated the relationship between initial and later depressive symptoms. Results supported the main prediction of the stress generation model: Interpersonal stress mediated the relationship between initial and later depressive symptoms. In addition, IPS predicted interpersonal stress. However, no association was found between depressive symptoms and IPS. An alternative model in which IPS moderated the relationship between stress and depressive symptoms was tested; it was not supported.
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Affiliation(s)
- J Davila
- Department of Psychology, University of California, Los Angeles 90095, USA
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28
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Hammen CL, Burge D, Daley SE, Davila J, Paley B, Rudolph KD. Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress. J Abnorm Psychol 1995; 104:436-43. [PMID: 7673567] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women.
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Affiliation(s)
- C L Hammen
- Department of Psychology, University of California, Los Angeles 90095, USA
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29
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Hammen C, Davila J, Brown G, Ellicott A, Gitlin M. Psychiatric history and stress: predictors of severity of unipolar depression. J Abnorm Psychol 1992. [PMID: 1537972 DOI: 10.1037//0021-843x.101.1.45] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 year for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations.
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Affiliation(s)
- C Hammen
- University of California, Los Angeles 90024
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30
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Hammen C, Davila J, Brown G, Ellicott A, Gitlin M. Psychiatric history and stress: Predictors of severity of unipolar depression. Journal of Abnormal Psychology 1992; 101:45-52. [PMID: 1537972 DOI: 10.1037/0021-843x.101.1.45] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Unipolar depression is frequently a recurrent or chronic disorder. In studies on predicting its course, outcomes are typically linked to either psychiatric features or stressful life events. In order to integrate the 2 approaches, 51 unipolar patients were assessed periodically over at least 1 year for symptoms, stressful events, and chronic stressors. It was hypothesized that adverse family history and early age of onset impair role functioning and coping capabilities, thereby contributing to stressful circumstances that predict severity of depressive reactions. Results of causal modeling analyses supported a model in which background factors were associated with severity of depressive outcomes as mediated by their effects on stress variables. Such a model implicates the self-perpetuating nature of clinical depression, both for the individual and across generations.
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Affiliation(s)
- C Hammen
- University of California, Los Angeles 90024
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31
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Abstract
The photophysical properties of merocyanine 540 have been determined in methanol solution over a modest temperature range. Triplet state population is inefficient (the limiting triplet quantum yield being 0.25) due to rapid isomerization of the central double bond from the first excited singlet state. Activation energies have been measured for isomerization from the excited singlet state (20 kJ mol-1) and for conversion of the resultant cis-isomer back to the original trans-form (63 kJ mol-1), both processes involving formation of a twisted species. The dye is easily oxidized to give an unstable adduct which decomposes on the sub-ms timescale. Reversible redox chemistry occurs upon excitation in the presence of electron acceptors. These various observations are discussed in terms of the known chemotherapeutic activity of MC540 and it is concluded that the most probable mechanisms for cytotoxicity involve either local thermal disruption of cell membranes or in situ photogeneration of toxins derived from breakdown of the dye.
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Affiliation(s)
- J Davila
- Center for Fast Kinetics Research, University of Texas, Austin 78712
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Mañas A, Extramiana J, Paniagua P, Mora M, González P, Pérez MJ, Pamplona M, Avila E, Davila J, García Castaño B. [In situ tumor excision of a renal neoplasm]. Actas Urol Esp 1990; 14:192-6. [PMID: 2239395] [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: 12/30/2022]
Abstract
The present work reviews the conservative surgical options to treat renal tumor formation in patients who still have both kidneys, and tries to clarify the diagnostic aspects, indications and therapeutical alternatives. The controversial items are analyzed versus treatments advocating a radical surgical approach, establishing a parallelism with current trends of surgical non-intervention in renal traumatism of moderate to severe condition (grade II). A case is presented where these two pathological circumstances are concurrent: Renal traumatism with complete parenchymatous rexhis and contralateral solid renal mass, both treated conservatively. Pre-surgical diagnosis was left renal traumatism grade II and righ renal neoformation and was based in findings with CAT and arteriographia. Histology of the piece from tumorectomy was renal angiomyolipoma. After a post-surgical evolution of twelve months, therapeutical results were assessed as excellent, with no evidence of either immediate not late complications. Considering data recently communicated by most authors, the concept of simple tumorectomy or renal tumoral enucleation is suggested as valid. However, arguments both clinical and surgical, in order to confirm its indication, require very rigorous criteria and a careful selection of patients.
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Affiliation(s)
- A Mañas
- Servicio de Urología y Radiología, Hospital de Móstoles, Madrid
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Abstract
The photophysical properties of tetrakis(4-sulfonatophenyl)porphyrin (H2TSPP), its tin (IV) complex (SnTSPP), aluminium(III) trisulfonatophthalocyanine (AIPCS), and the corresponding zinc(II) complex (ZnPCS), have been measured in H2O, D2O, and upon binding to human serum albumin (HSA). The triplet excited states of the various macrocyclic dyes generate singlet molecular oxygen, O2(1 delta g) in high quantum yield upon illumination in O2-saturated solution, even in the presence of HSA. The triplet states also abstract an electron from 4-aminophenol, forming the radical anion of the macrocycle. Quenching rate constants and quantum yields have been measured for the various processes in the presence and absence of HSA. It is found that HSA binds all the dyes at nonspecific sites close to the interface in such a manner that the dyes remain accessible to species residing in the solution phase. Dyes that do not possess axial ligands complexed to the central cation (e.g. H2TSPP, ZnPCS) are able to bind also at a deeper, more specific site on the protein where they are protected from species in solution. Under such conditions, triplet quenching by 4-aminophenol is restricted to long-distance electron tunnelling, for which the rate is relatively slow.
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Affiliation(s)
- J Davila
- Center for Fast Kinetics Research, University of Texas, Austin 78712
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Abstract
Aluminium trisulfonatophthalocyanine (A1PCS), a dye being widely advocated for use in photodynamic therapy, produces singlet oxygen with a quantum yield of 0.34 in oxygenated water at pH 7. Triplet A1PCS abstracts an electron from a variety of amines and phenols, the rate of electron transfer depending upon the thermodynamic driving force, forming the A1PCS radical anion. This latter species reduces molecular oxygen to superoxide ions with high efficiency. The triplet state also abstracts an electron from biological components, including NADH, vitamin C, cysteine, methionine, tyrosine, tryptophan, uracil, and guanine, but not from DNA. These results suggest that photoinduced electron abstraction from appropriate biomaterials could compete with singlet oxygen production under in vivo conditions.
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Cubeddu LX, Hoffmann IS, Davila J, Barbella YR, Ordaz P. Clonidine reduces elevated cerebrospinal fluid catecholamine levels in patients with essential hypertension. Life Sci 1984; 35:1365-71. [PMID: 6482658 DOI: 10.1016/0024-3205(84)90393-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Cerebrospinal fluid (CSF) catecholamines were measured in normotensive patients and in patients with mild to moderate essential hypertension. CSF-norepinephrine (NE) concentrations were 50% lower in the normotensive individuals (127 +/- 28 vs. 240 +/- 23 pg/ml) (P less than 0.01). In hypertensive patients, CSF-NE was inversely related to age (r = -0.68; P less than 0.01) and directly related to plasma NE (r = 0.61; P less than 0.05). Clonidine (450 mcg/day for 2 weeks) significantly reduced CSF-NE (-40%) in hypertensive patients. In addition, it decreased blood pressure, plasma and urinary NE. Urinary VMA was not affected by clonidine. No correlation was observed between clonidine effects on BP and on plasma or CSF catecholamines. This study indicates that patients with essential hypertension have elevated levels of CSF-NE which are reduced after treatment with clonidine. The elevation of CSF-NE suggests that central (spinal?) noradrenergic activity may be increased in patients with mild to moderate essential hypertension, and that can be reduced by treatment with clonidine.
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36
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Weinhold C, Reichart B, Kemkes BM, Schaff J, Davila J, Eberhard C. Experimental studies of the anatomical and functional characteristics of kangaroo aortic valve bioprostheses. Life Support Syst 1984; 2:121-5. [PMID: 6482505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In many tests done in vitro and in vivo on porcine aortic valve grafts, high pressure gradients were found under normal as well as under stress conditions. The transvalvular pressure difference is due to the immobility of the right aortic porcine leaflet that is fixed tightly to the muscular septum of the ventricle. Our own studies of 24 kangaroo hearts show different anatomical features: the right leaflet is practically free in this movement. Thus the maximum orifice area of the kangaroo aortic valve is reduced by only 24.2 per cent, whereas the porcine valve shows a reduction of 36.5 per cent. This difference proved to be highly significant (P less than 0.001). Therefore, in cooperation with Hancock Laboratories, kangaroo aortic valve grafts were tested as xenotransplants, using a pulse duplicator. The first results show that larger orifice areas are achieved by kangaroo valves one or two sizes smaller than their porcine counterparts.
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Cubeddu LX, Davila J, Zschaeck D, Barbella YR, Ordaz P, Dominguez J. Cerebrospinal fluid and plasma dopamine-beta-hydroxylase activity in human hypertension. Hypertension 1981; 3:448-55. [PMID: 7309207 DOI: 10.1161/01.hyp.3.4.448] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cerebrospinal fluid (CSF) and plasma dopamine-beta-hydroxylase (DBH) activity was measured in 22 normotensive (NT), 31 essential hypertensive (EH), and 11 renal hypertensive (RH) patients. Although no differences were observed in their plasma DBH, the mean CSF-DBH activity and specific activity of EH were significantly lower than those of NT and RH patients. Very low CSF-DBH (less than 0.15 units/ml of CFS or less than 0.5 units/mg of CSF protein) was found only in EH (26% of EH). Of the 31 EH patients, 19(60%) had CSF-DHB activities lower than 0.5 units/ml, whereas only 5 of 22 NT (23%) and no RH fell within this range. Nevertheless, 20% of EH, 55% of NT, and 40% of RH patients had CSF-DBH activities above the mean value for NT (less than 0.9 units/ml). NT subjects with very low plasma DBH (less than 50 units/ml) had CSF-DBH activities that fell within normal range. With the exception of these subjects, the specific activity of CSF-DBH was always lower than that of the plasma enzyme. The concentration of albumin, alpha 1, beta, and gamma globulins was measured in plasma and CSF obtained from the last five NT, four EH, and two RH patients. A positive linear relationship was obtained when the log of the plasma/CSF concentration ratio for these proteins was plotted against their molecular weight. Similar slopes and intercepts were obtained for these patients, suggesting that no major differences seem to exist in their blood-brain-barrier permeability to proteins. The results suggest that measurements of CSF-DBH could be of help in the differential diagnosis of human hypertension and in the neurochemical characterization of EH. If CSF-DBH reflects central noradrenergic activity, its reduction might indicate the existence of a central catecholaminergic defect in a subgroup of EH patients.
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Vaziri ND, Thomas R, Sterling M, Seiff K, Pahl MV, Davila J, Wilson A. Toxicity with intravenous injection of crude marijuana extract. Clin Toxicol (Phila) 1981; 18:353-66. [PMID: 7237964 DOI: 10.3109/15563658108990042] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Intravenous injection of crude marijuana extract led to development of an acute illness with multisystem involvement. Gastrointestinal manifestations consisted of severe vomiting, diarrhea, and crampy abdominal pain. Hypotension, tachycardia, and peripheral vasodilation constituted the main cardiovascular manifestations of the disease. Moderate azotemia and oliguria, presumed to be of prerenal origin, were present and rapidly resolved with administration of intravenous fluids. Hematologic manifestations consisted of leukocytosis with a left shift, thrombocytopenia, prolonged partial thromboplastin time, increased fibrin degradation products, and positive protamine sulfate test. The observed coagulation abnormalities may suggest intravascular coagulation. C3, C4, and total hemolytic complement were reduced, suggesting possible activation of the complement system. Hyperventilation, hypoxemia, pulmonary edema, obstructive, and restrictive pulmonary function abnormalities and bilateral pleural effusions highlighted the pulmonary manifestations of the disease. Rhadbomyolysis and mild hepatic function abnormalities were also present. All observed abnormalities reversed in a few days with no significant sequelae.
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