161 research outputs found

    Natality and calf mortality of the Northern Alaska Peninsula and Southern Alaska Peninsula caribou herds

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    We studied natality in the Northern Alaska Peninsula (NAP) and Southern Alaska Peninsula (SAP) caribou (Rangifer tarandus granti) herds during 1996-1999, and mortality and weights of calves during 1998 and 1999- Natality was lower in the NAP than the SAP primarily because most 3-year-old females did not produce calves in the NAP Patterns of calf mortality in the NAP and SAP differed from those in Interior Alaska primarily because neonatal (i.e., during the first 2 weeks of life) mortality was relatively low, but mortality continued to be significant through August in both herds, and aggregate annual mortality was extreme (86%) in the NAP Predators probably killed more neonatal calves in the SAP, primarily because a wolf den (Canis lupus) was located on the calving area. Despite the relatively high density of brown bears (Ursus arctos) and bald eagles (Haliaeetus leucocephalus), these predators killed surprisingly few calves. Golden eagles (Aquila chrysaetos) were uncommon on the Alaska Peninsula. At least 2 calves apparently died from pneu¬monia in the range of the NAP but none were suspected to have died from disease in the range of the SAP. Heavy scav¬enging by bald eagles complicated determining cause of death of calves in both the NAP and SAP

    Serologic survey for phocid herpesvirus-1 and -2 in marine mammals from Alaska and Russia.

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    Blood samples were collected from 1,042 marine mammals off the coast of Alaska (USA) and Russia during the period 1978 to 1994. Eight species of pinnipeds were represented. Sera were tested for presence of neutralizing antibodies to both the PB84 isolate of phocid herpesvirus-1 (PhHV-1) and the 7848/Han90 strain of phocid herpesvirus-2 (PhHV-2). Species-specific antibody prevalences ranged from 22% to 77% for PhHV-1 and 11% to 50% for PhHV-2. Species-specific antibody prevalences for PhHV-1 were greater than or equal to prevalences for PhHV-2. For both viruses and each host species, differences in antibody prevalences were not related to: (1) sex, (2) location of capture, or (3) year of collection. Antibody prevalence of PhHV-1 in walruses (Odobenus rosmarus) could be quantitatively predicted as a function of age. These two viruses have distinct biological properties and based on current data the epizootiology of the two viruses is different, as well. No evidence of herpesvirus-induced mortality has been detected in areas included in this survey. Based on results of this survey, neither PhHV-1 nor PhHV-2 are considered significant mortality factors in mammals which inhabit the marine environment off the coast of Alaska or Russia

    Phocine Distemper Virus in Northern Sea Otters in the Pacific Ocean, Alaska, USA

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    Phocine distemper virus (PDV) has caused 2 epidemics in harbor seals in the Atlantic Ocean but had never been identified in any Pacific Ocean species. We found that northern sea otters in Alaska are infected with PDV, which has created a disease threat to several sympatric and decreasing Pacific marine mammals

    A randomized trial of mail vs. telephone invitation to a community-based cardiovascular health awareness program for older family practice patients [ISRCTN61739603]

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    BACKGROUND: Family physicians can play an important role in encouraging patients to participate in community-based health promotion initiatives designed to supplement and enhance their in-office care. Our objectives were to determine effective approaches to invite older family practice patients to attend cardiovascular health awareness sessions in community pharmacies, and to assess the feasibility and acceptability of a program incorporating invitation by physicians and feedback to physicians. METHODS: We conducted a prospective randomized trial with 1 family physician practice and 5 community pharmacies in Dundas, Ontario. Regular patients 65 years or older (n = 235) were randomly allocated to invitation by mail or telephone to attend pharmacy cardiovascular health awareness sessions led by volunteer peer health educators. A health record review captured blood pressure status, monitoring and control. At the sessions, volunteers helped patients to measure blood pressure using in-store machines and a validated portable device (BPM-100), and recorded blood pressure readings and self-reported cardiovascular risk factors. We compared attendance rates in the mail and telephone invitation groups and explored factors potentially associated with attendance. RESULTS: The 119 patients invited by mail and 116 patients contacted by telephone had a mean age of 75.7 (SD, 6.4) years and 46.8% were male. Overall, 58.3% (137/235) of invitees attended a pharmacy cardiovascular health awareness session. Patients invited by telephone were more likely to attend than those invited by mail (72.3% vs. 44.0%, OR 3.3; 95%CI 1.9–5.7; p < 0.001). CONCLUSION: While the attendance in response to a telephone invitation was higher, response to a single letter was substantial. Attendance rates indicated considerable interest in community-based cardiovascular health promotion activities. A large-scale trial of a pharmacy cardiovascular health awareness program for older primary care patients is feasible

    The effectiveness of health coaching, home blood pressure monitoring, and home-titration in controlling hypertension among low-income patients: protocol for a randomized controlled trial

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    <p>Abstract</p> <p>Background</p> <p>Despite the many antihypertensive medications available, two-thirds of patients with hypertension do not achieve blood pressure control. This is thought to be due to a combination of poor patient education, poor medication adherence, and "clinical inertia." The present trial evaluates an intervention consisting of health coaching, home blood pressure monitoring, and home medication titration as a method to address these three causes of poor hypertension control.</p> <p>Methods/Design</p> <p>The randomized controlled trial will include 300 patients with poorly controlled hypertension. Participants will be recruited from a primary care clinic in a teaching hospital that primarily serves low-income populations.</p> <p>An intervention group of 150 participants will receive health coaching, home blood pressure monitoring, and home-titration of antihypertensive medications during 6 months. The control group (n = 150) will receive health coaching plus home blood pressure monitoring for the same duration. A passive control group will receive usual care. Blood pressure measurements will take place at baseline, and after 6 and 12 months. The primary outcome will be change in systolic blood pressure after 6 and 12 months. Secondary outcomes measured will be change in diastolic blood pressure, adverse events, and patient and provider satisfaction.</p> <p>Discussion</p> <p>The present study is designed to assess whether the 3-pronged approach of health coaching, home blood pressure monitoring, and home medication titration can successfully improve blood pressure, and if so, whether this effect persists beyond the period of the intervention.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov identifier: NCT01013857</p

    Renal Athersosclerotic reVascularization Evaluation (RAVE Study): Study protocol of a randomized trial [NCT00127738]

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    BACKGROUND: It is uncertain whether patients with renal vascular disease will have renal or mortality benefit from re-establishing renal blood flow with renal revascularization procedures. The RAVE study will compare renal revascularization to medical management for people with atherosclerotic renal vascular disease (ARVD) and the indication for revascularization. Patients will be assessed for the standard nephrology research outcomes of progression to doubling of creatinine, need for dialysis, and death, as well as other cardiovascular outcomes. We will also establish whether the use of a new inexpensive, simple and available ultrasound test, the renal resistance index (RRI), can identify patients with renal vascular disease who will not benefit from renal revascularization procedures[1]. METHODS/DESIGN: This single center randomized, parallel group, pilot study comparing renal revascularization with medical therapy alone will help establish an infrastructure and test the feasibility of answering this important question in clinical nephrology. The main outcome will be a composite of death, dialysis and doubling of creatinine. Knowledge from this study will be used to better understand the natural history of patients diagnosed with renal vascular disease in anticipation of a Canadian multicenter trial. Data collected from this study will also inform the Canadian Hypertension Education Program (CHEP) Clinical Practice Guidelines for the management of Renal and Renal Vascular Disease. The expectation is that this program for ARVD, will enable community based programs to implement a comprehensive guidelines based diagnostic and treatment program, help create an evidence based approach for the management of patients with this condition, and possibly reduce or halt the progression of kidney disease in these patients. DISCUSSION: Results from this study will determine the feasibility of a multicentered study for the management of renovascular disease

    Genomic agonism and phenotypic antagonism between estrogen and progesterone receptors in breast cancer

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    The functional role of progesterone receptor (PR) and its impact on estrogen signaling in breast cancer remain controversial. In primary ER+ (estrogen receptor–positive)/PR+ human tumors, we report that PR reprograms estrogen signaling as a genomic agonist and a phenotypic antagonist. In isolation, estrogen and progestin act as genomic agonists by regulating the expression of common target genes in similar directions, but at different levels. Similarly, in isolation, progestin is also a weak phenotypic agonist of estrogen action. However, in the presence of both hormones, progestin behaves as a phenotypic estrogen antagonist. PR remodels nucleosomes to noncompetitively redirect ER genomic binding to distal enhancers enriched for BRCA1 binding motifs and sites that link PR and ER/PR complexes. When both hormones are present, progestin modulates estrogen action, such that responsive transcriptomes, cellular processes, and ER/PR recruitment to genomic sites correlate with those observed with PR alone, but not ER alone. Despite this overall correlation, the transcriptome patterns modulated by dual treatment are sufficiently different from individual treatments, such that antagonism of oncogenic processes is both predicted and observed. Combination therapies using the selective PR modulator/antagonist (SPRM) CDB4124 in combination with tamoxifen elicited 70% cytotoxic tumor regression of T47D tumor xenografts, whereas individual therapies inhibited tumor growth without net regression. Our findings demonstrate that PR redirects ER chromatin binding to antagonize estrogen signaling and that SPRMs can potentiate responses to antiestrogens, suggesting that cotargeting of ER and PR in ER+/PR+ breast cancers should be explored.Hari Singhal, Marianne E. Greene, Gerard Tarulli, Allison L. Zarnke, Ryan J. Bourgo, Muriel Laine, Ya-Fang Chang, Shihong Ma, Anna G. Dembo, Ganesh V. Raj, Theresa E. Hickey, Wayne D. Tilley, Geoffrey L. Green

    Acute and Chronic Impact of Dynamic Exercise on Arterial Stiffness in Older Hypertensives

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    Arterial stiffness increases with ageing and hypertension. Regular physical activity has been recommended as an important management component of hypertension. The purpose of this study was to examine the acute impact of maximal dynamic exercise and the effect of 20 weeks of aerobic exercise on arterial stiffness of the carotid and brachial arteries in older hypertensives. Nine previously sedentary and treated older hypertensives (2 men and 7 women, age 68.2 ± 5.4 yrs) performed maximal treadmill exercise to volitional fatigue while arterial stiffness indices (arterial distensibility and β stiffness index) were measured prior to, immediately (about 10 min) following, and 24 h following maximal exercise. These measurements were repeated following 20 weeks of moderate intensity aerobic exercise training. Maximal exercise had no impact on arterial stiffness indices immediately and 24 h following exercise intervention. Following 20 weeks of training, arterial stiffness indices remained unchanged at rest and following maximal exercise. These data show that, in older hypertensives, 1) acute maximal dynamic exercise had no impact on arterial stiffness of the carotid and brachial arteries, and 2) 20 weeks of moderate intensity aerobic exercise training failed to modify arterial stiffness
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