Intrathecal Opioids for Chronic Pain: A Call for Evidence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93560/1/j.1526-4637.2012.01456.x.pd

Intrathecal Opioids for Chronic Pain: A Call for Evidence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109561/1/pme12576.pd

The Impact of Muscular Strength on Cardiovascular Disease Risk Factors

The purpose of this study was to determine the associations between isokinetic leg muscular strength and cardiovascular disease (CVD) risk factor characterizations in Americans aged 50 and older. Using a publicly available dataset from the National Health and Nutrition Examination Survey (NHANES), a secondary analysis was conducted on participants (males ≥50 yrs; females ≥55 yrs; N=10,858) pooled from 1999 to 2002. CVD risk factors were determined using the American College of Sports Medicine (ACSM) cutoff values. CVD risk factor characterization was determined by creating CVD risk factor profiles (i.e., the total number of CVD risk factors an individual possesses), then separating participants into low (0-2 CVD risk factors), moderate (3-5), and high (6-8) risk groups. Muscular strength was determined by isokinetic maximal peak force (PF) of the leg extensors, both raw and normalized to body mass. Normalized, but not raw, muscular strength was shown to be significantly inversely associated with CVD risk factor characterization for both males and females (Phttps://digitalcommons.odu.edu/gradposters2022_education/1002/thumbnail.jp

A phase II study of capecitabine and oxalplatin combination chemotherapy in patients with inoperable adenocarcinoma of the gall bladder or biliary tract

Background: Advanced biliary tract carcinomas are associated with a poor prognosis, and palliative chemotherapy has only modest benefit. This multi-centre phase II study was conducted to determine the efficacy of capecitabine in combination with oxaliplatin in patients with inoperable gall bladder or biliary tract cancer. Methods: This was a Phase II, non-randomised, two-stage Simon design, multi-centre study. Ethics approval was sought and obtained by the North West MREC, and then locally by the West Glasgow Hospitals Research Ethics Com mittee. Eligible patients with inoperable locally advanced or metastatic adenocarcinoma of the gall bladder or biliary tract and with adequate performance status, haematologic, renal, and hepatic function were treated with capecit abine (1000 mg/m2 po, twice daily, days 1–14) and oxaliplatin (130 mg/m2 i.v., day 1) every 3 weeks for up to six cycles. The primary objective of the study was to determine the objective tumour response rates (complete and partial). The secondary objectives included assessment of toxicity, progression-free survival, and overall survival. Results: Forty-three patients were recruited between July 2003 and December 2005. The regimen was well tolerated with no grade 3/4 neutropenia or thrombocytopenia. Grade 3/4 sensory neuropathy was observed in six patients. Two-thirds of patients received their chemotherapy without any dose delays. Overall response rate was 23.8 % (95 % CI 12.05–39.5 %). Stable disease was observed in a further 13 patients (31 %) and progressive disease observed in 12 (28.6 %) of patients. The median progression-free survival was 4.6 months (95 % CI 2.8–6.4 months; Fig. 1) and the median overall survival 7.9 months (95 % CI 5.3–10.4 months; Fig. 2). Conclusion: Capecitabine combined with oxaliplatin has a lower disease control and shorter overall survival than the combination of cisplatin with gemcitabine which has subsequently become the standard of care in this disease. How ever, capecitabine in combination with oxaliplatin does have modest activity in this disease, and can be considered as an alternative treatment option for patients in whom cisplatin and/or gemcitabine are contra-indicated

Identification of a uridine nucleotide-selective G-protein-linked receptor that activates phospholipase C

Incubation of C6-2B rat glioma cells with UDP or UTP resulted in a time- and concentration-dependent increase in the accumulation of inositol phosphates. In contrast, ATP, ADP, and analogs of these nucleotides known to be effective agonists at P2U-, P2X-, P2Y-, P2T-, and P2Z-purinergic receptors all had no effect on inositol phosphate levels in C6-2B cells. Pyrimidine nucleotides stimulated inositol phosphate accumulation with an order of potency of UDP > 5-BrUTP > UTP > dTDP > UDP glucose. K0.5 values for UDP, 5-BrUTP, and UTP were 2.3 +/- 0.5, 9 +/- 3, and 57 +/- 10 microM, respectively. A similar uridine nucleotide selectivity was observed for arachidonic acid release presumably occurring as a consequence of activation of phospholipase A2. Cross-desensitization and additivity experiments indicated that UDP and UTP interact with the same population of receptors. The effect of uridine nucleotides on inositol phosphate accumulation was inhibited markedly by pretreatment of cells with pertussis toxin. UDP also caused a guanine nucleotide-dependent increase in inositol lipid hydrolysis in streptolysin-O-permeabilized cells. Taken together these results describe the existence of a novel uridine nucleotide receptor that is not activated by adenine nucleotides. This receptor is pharmacologically distinct from the previously described P2U- and other P2-purinergic receptors, and likely is a member of a new class of receptors for extracellular nucleotides

UDP-Sugars as Extracellular Signaling Molecules: Cellular and Physiologic Consequences of P2Y14 Receptor Activation

UDP-sugars, which are indispensable for protein glycosylation reactions in cellular secretory pathways, also act as important extracellular signaling molecules. We discuss here the broadly expressed P2Y14 receptor, a G-protein–coupled receptor targeted by UDP sugars, and the increasingly diverse set of physiologic responses discovered recently functioning downstream of this receptor in many epithelia as well as in immune, inflammatory, and other cells

Design analysis of levitation facility for space processing applications

Containerless processing facilities for the space laboratory and space shuttle are defined. Materials process examples representative of the most severe requirements for the facility in terms of electrical power, radio frequency equipment, and the use of an auxiliary electron beam heater were used to discuss matters having the greatest effect upon the space shuttle pallet payload interfaces and envelopes. Improved weight, volume, and efficiency estimates for the RF generating equipment were derived. Results are particularly significant because of the reduced requirements for heat rejection from electrical equipment, one of the principal envelope problems for shuttle pallet payloads. It is shown that although experiments on containerless melting of high temperature refractory materials make it desirable to consider the highest peak powers which can be made available on the pallet, total energy requirements are kept relatively low by the very fast processing times typical of containerless experiments and allows consideration of heat rejection capabilities lower than peak power demand if energy storage in system heat capacitances is considered. Batteries are considered to avoid a requirement for fuel cells capable of furnishing this brief peak power demand

Phenotype-specific association of the TGFBR3 locus with nonsyndromic cryptorchidism

PURPOSE: Based on a genome-wide association study of testicular dysgenesis syndrome showing a possible association with TGFBR3, we analyzed data from a larger, phenotypically restricted cryptorchidism population for potential replication of this signal. MATERIALS AND METHODS: We excluded samples based on strict quality control criteria, leaving 844 cases and 2,718 controls of European ancestry that were analyzed in 2 separate groups based on genotyping platform (ie Illumina® HumanHap550, version 1 or 3, or Human610-Quad, version 1 BeadChip in group 1 and Human OmniExpress 12, version 1 BeadChip platform in group 2). Analyses included genotype imputation at the TGFBR3 locus, association analysis of imputed data with correction for population substructure, subsequent meta-analysis of data for groups 1 and 2, and selective genotyping of independent cases (330) and controls (324) for replication. We also measured Tgfbr3 mRNA levels and performed TGFBR3/betaglycan immunostaining in rat fetal gubernaculum. RESULTS: We identified suggestive (p ≤ 1× 10(-4)) association of markers in/near TGFBR3, including rs9661103 (OR 1.40; 95% CI 1.20, 1.64; p = 2.71 × 10(-5)) and rs10782968 (OR 1.58; 95% CI 1.26, 1.98; p = 9.36 × 10(-5)) in groups 1 and 2, respectively. In subgroup analyses we observed strongest association of rs17576372 (OR 1.42; 95% CI 1.24, 1.60; p = 1.67 × 10(-4)) with proximal and rs11165059 (OR 1.32; 95% CI 1.15, 1.38; p = 9.42 × 10(-4)) with distal testis position, signals in strong linkage disequilibrium with rs9661103 and rs10782968, respectively. Association of the prior genome-wide association study signal (rs12082710) was marginal (OR 1.13; 95% CI 0.99, 1.28; p = 0.09 for group 1), and we were unable to replicate signals in our independent cohort. Tgfbr3/betaglycan was differentially expressed in wild-type and cryptorchid rat fetal gubernaculum. CONCLUSIONS: These data suggest complex or phenotype specific association of cryptorchidism with TGFBR3 and the gubernaculum as a potential target of TGFβ signaling