Improvement in Renal Function and Reduction in Serum Uric Acid with Intensive Statin Therapy in Older Patients: A Post Hoc Analysis of the SAGE Trial.

BackgroundImprovement in renal function and decreases in serum uric acid (SUA) have been reported following prolonged high-intensity statin (HMG-CoA reductase inhibitor) therapy. This post hoc analysis of the SAGE trial examined the effect of intensive versus less intensive statin therapy on renal function, safety, and laboratory parameters, including SUA, in elderly coronary artery disease (CAD) patients (65-85 years) with or without chronic kidney disease (CKD).MethodsPatients were randomized to atorvastatin 80 mg/day or pravastatin 40 mg/day and treated for 12 months. Patients were stratified using Modification of Diet in Renal Disease (MDRD) estimated glomerular filtration rates (eGFRs) in CKD (eGFR <60 mL/min/1.73 m(2)) and non-CKD populations.ResultsOf the 893 patients randomized, 858 had complete renal data and 418 of 858 (49%) had CKD (99% Stage 3). Over 12 months, eGFR increased with atorvastatin and remained stable with pravastatin (+2.38 vs. +0.18 mL/min/1.73 m(2), respectively; p < 0.0001). MDRD eGFR improved significantly in both CKD treatment arms; however, the increased eGFR in patients without CKD was significantly greater with atorvastatin (+2.08 mL/min/1.73 m(2)) than with pravastatin (-1.04 mL/min/1.73 m(2)). Modest reductions in SUA were observed in both treatment arms, but a greater fall occurred with atorvastatin than with pravastatin (-0.52 vs. -0.09 mg/dL, p < 0.0001). Change in SUA correlated negatively with changes in eGFR and positively with changes in low-density lipoprotein cholesterol. Reports of myalgia were rare (3.6% CKD; 5.7% non-CKD), and there were no episodes of rhabdomyolysis. Elevated serum alanine and aspartate transaminase to >3 times the upper limit of normal occurred in 4.4% of atorvastatin- and 0.2% of pravastatin-treated patients.ConclusionIntensive management of dyslipidemia in older patients with stable coronary heart disease may have beneficial effects on renal function and SUA

The Ah receptor: adaptive metabolism, ligand diversity, and the xenokine model

Author Posting. © American Chemical Society, 2020. This is an open access article published under an ACS AuthorChoice License. The definitive version was published in Chemical Research in Toxicology, 33(4), (2020): 860-879, doi:10.1021/acs.chemrestox.9b00476.The Ah receptor (AHR) has been studied for almost five decades. Yet, we still have many important questions about its role in normal physiology and development. Moreover, we still do not fully understand how this protein mediates the adverse effects of a variety of environmental pollutants, such as the polycyclic aromatic hydrocarbons (PAHs), the chlorinated dibenzo-p-dioxins (“dioxins”), and many polyhalogenated biphenyls. To provide a platform for future research, we provide the historical underpinnings of our current state of knowledge about AHR signal transduction, identify a few areas of needed research, and then develop concepts such as adaptive metabolism, ligand structural diversity, and the importance of proligands in receptor activation. We finish with a discussion of the cognate physiological role of the AHR, our perspective on why this receptor is so highly conserved, and how we might think about its cognate ligands in the future.This review is dedicated in memory of the career of Alan Poland, one of the truly great minds in pharmacology and toxicology. This work was supported by the National Institutes of Health Grants R35-ES028377, T32-ES007015, P30-CA014520, P42-ES007381, and U01-ES1026127, The UW SciMed GRS Program, and The Morgridge Foundation. The authors would like to thank Catherine Stanley of UW Media Solutions for her artwork

Prospectus, March 1, 2000

https://spark.parkland.edu/prospectus_2000/1007/thumbnail.jp

Health care disparities for incarcerated adults after a suicide attempt

OBJECTIVE: Incarcerated adults have high rates of fatal and nonfatal suicidal behaviors. Suicide prevention recommendations stress the need for the provision of health care for incarcerated adults after suicide attempts, yet prison policies and practices often focus instead on punitive responses to suicidal behaviors. Existing research is limited regarding factors that predict the provision of health care to incarcerated adults post-suicide attempt. The current study examined individual, incident, and institutional factors as predictors of health care to incarcerated adults post-suicide attempt. METHOD: We used data from critical incidents reports for suicide attempts (NÂ =Â 495) to conduct mixed-effects logistical regression models. RESULTS: Staff responded to suicide attempts by placing incarcerated adults under direct observation (with no care) or in segregation at odds two and three times higher than of providing health care, particularly in prisons for men. Race was a significant factor; incidents involving Black men were less likely than incidents involving white men to include staff requesting health care, and incidents involving Black women were less likely than incidents involving white women to include requesting and providing health care. CONCLUSIONS: This study's findings highlight factors predicting health care responses to suicide attempts and the need to address and prevent health care disparities in prisons

Antibodies against pax6 immunostain amacrine and ganglion cells and neuronal progenitors, but not rod precursors, in the normal and regenerating retina of the goldfish

Pax6 is a developmental regulatory gene that plays a key role in the development of the embryonic brain, eye, and retina. This gene is also expressed in discrete groups of neurons within the adult brain. In this study, antibodies raised against a fusion protein from a zebra fish pax6 cDNA were used to investigate the expression of the pax6 gene in the mature, growing, and regenerating retina of the goldfish. On western blots of retinal proteins, the pax6 antibodies recognize a single band at the approximate size of the zebra fish pax6 protein. In retinal sections, the antibodies label the nuclei of mature amacrine and some ganglion cells. At the retinal margin, where neurogenesis and cellular differentiation continually occur in goldfish, the antibodies label neuronal progenitors and the newly postmitotic neurons. Following injury and during neuronal regeneration, the antibodies label mitotically active progenitors of regenerating neurons. Rod precursors, proliferating cells that normally give rise solely to rod photoreceptors and are the presumed antecedents of the injury-stimulated neuronal progenitors, are not immunostained by antibodies to the pax6 protein. The results of this study document the identity of pax6 -expressing cells in the mature retina and demonstrate that in the goldfish pax6 is expressed in neuronal progenitors during both retinal growth and regeneration. © 1996 John Wiley & Sons, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50087/1/10_ftp.pd

Experiences of a Novice Researcher Conducting Focus Group Interviews

The purpose of this paper is to report what I learned about how to conduct focus group interviews that produce insightful, revealing and informative data.  I will discuss my experiences facilitating focus group interviews as a novice researcher and compare these experiences with the literature.  I planned the focus groups in collaboration with a research team, recruited participants from various units at the local tertiary care hospital and set up the meeting rooms for the groups.  I then facilitated the focus groups with the support of an assistant.  Following the focus groups, I documented my field notes, as well as my personal reflective memos.  I downloaded the audio recordings, de-identified the written transcripts, and reviewed them for accuracy prior to analysis.  A number of concepts emerged that merit particular attention: challenges with recruitment, the use of field notes and reflective memos, the benefits and limitations of using a flip chart, importance of professional support, using homogenous groups, and attending to the set-up of the environment.  As the focus group interview becomes an increasingly popular data collection method in qualitative research, my experiences could inform the preparation of other novice researchers as they undertake their own focus groups

Unsteady Extinction of Opposed Jet Ethylene/Methane HIFiRE Surrogate Fuel Mixtures vs Air

A unique idealized study of the subject fuel vs. air systems was conducted using an Oscillatory-input Opposed Jet Burner (OOJB) system and a newly refined analysis. Extensive dynamic-extinction measurements were obtained on unanchored (free-floating) laminar Counter Flow Diffusion Flames (CFDFs) at 1-atm, stabilized by steady input velocities (e.g., U(sub air)) and perturbed by superimposed in-phase sinusoidal velocity inputs at fuel and air nozzle exits. Ethylene (C2H4) and methane (CH4), and intermediate 64/36 and 15/85 molar percent mixtures were studied. The latter gaseous surrogates were chosen earlier to mimic ignition and respective steady Flame Strengths (FS = U(sub air)) of vaporized and cracked, and un-cracked, JP-7 "like" kerosene for a Hypersonic International Flight Research Experimentation (HIFiRE) scramjet. For steady idealized flameholding, the 100% C2H4 flame is respectively approx. 1.3 and approx.2.7 times stronger than a 64/36 mix and CH4; but is still 12.0 times weaker than a 100% H2-air flame. Limited Hot-Wire (HW) measurements of velocity oscillations at convergent-nozzle exits, and more extensive Probe Microphone (PM) measurements of acoustic pressures, were used to normalize Dynamic FSs, which decayed linearly with pk/pk U(sub air) (velocity magnitude, HW), and also pk/pk P (pressure magnitude, PM). Thus Dynamic Flame Weakening (DFW) is defined as % decrease in FS per Pascal of pk/pk P oscillation, namely, DFW = -100 d(U(sub air)/U(sub air),0Hz)/d(pkpk P). Key findings are: (1) Ethylene flames are uniquely strong and resilient to extinction by oscillating inflows below 150 Hz; (2) Methane flames are uniquely weak; (3) Ethylene / methane surrogate flames are disproportionately strong with respect to ethylene content; and (4) Flame weakening is consistent with limited published results on forced unsteady CFDFs. Thus from 0 to approx. 10 Hz and slightly higher, lagging diffusive responses of key species led to progressive phase lags (relative to inputs) in the oscillating flames, and caused maximum weakening. At 20 to 150 Hz, diffusion-rate-limited effects diminished, causing flames to "regain strengnth," and eventually become completely insensitive beyond 300 Hz. Detailed mechanistic understanding is needed. Overall, ethylene flames are remarkably resilient to dynamic extinction by oscillating inflows. They are the strongest, with the notable exception of H2. For HIFiRE tests, the 64%/36% surrogate disproportionally retains the high dynamic FS of ethylene, so the potential for loss of scramjet flameholding (flameout) due to low frequency oscillations is significantly mitigated

Prospectus, October 27, 1999

https://spark.parkland.edu/prospectus_1999/1027/thumbnail.jp

Prospectus, February 2, 2000

https://spark.parkland.edu/prospectus_2000/1003/thumbnail.jp