Biomedical Research Institute of New Mexico

Mexico City, Mexico

Biomedical Research Institute of New Mexico

Mexico City, Mexico
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Haaland K.Y.,University of New Mexico | Sadek J.R.,University of New Mexico | Keller J.E.,Biomedical Research Institute of New Mexico | Castillo D.T.,New Mexico Veterans Affairs Healthcare System
Journal of the International Neuropsychological Society | Year: 2016

Background: The influence of psychotherapy on neurocognition in post-traumatic stress disorder (PTSD) has not been examined methodically. This is despite evidence that pre-treatment learning and memory has been associated with treatment success and that executive function theories emphasize weak executive functions (especially inhibition/switching) are associated with PTSD. Objectives: To determine (1) if higher pre-treatment learning/memory, inhibition/switching, or both predict treatment success; and (2) if treatment success is associated with specific improvement in inhibition/switching and not learning/memory or working memory, another aspect of executive function. Methods: Pre-treatment neurocognition and neurocognitive changes (inhibition/switching, learning/memory, working memory) were examined in female veterans with PTSD. They were evaluated before and after 16-weeks of group psychotherapy for PTSD that included three counterbalanced modules (cognitive restructuring therapy, exposure therapy, skills training) with fidelity checks for therapist adherence. Results: Only pre-treatment learning/memory predicted better treatment outcome. Treatment success was associated with improvement in inhibition/switching only, even after controlling for mild traumatic brain injury, and changes in depressive symptoms, working memory, and learning/memory. Conclusions: Our finding that learning/memory predicted treatment success is consistent with previous studies. We extended these studies by showing that the effect was restricted to learning/memory, which is contrary to the executive function theory of PTSD. In contrast, the fact that only inhibition/switching significantly improved with better treatment success is consistent with its potential importance in maintaining PTSD symptoms. Future research should determine whether inhibition/switching abilities are a risk for development and maintenance of PTSD or whether such abilities have a broader reciprocal relationship with PTSD symptom change. (JINS, 2016, 22, 643-651) Copyright © The International Neuropsychological Society 2016.

Aguirre L.,Medicine and Research Services | Aguirre L.,Biomedical Research Institute of New Mexico | Napoli N.,University of Washington | Napoli N.,Biomedical University of Rome | And 10 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2014

Context: Although obesity is associated with high bone mass, recent reports suggest an increase in the incidence of fractures in obese patients. CopyrightObjectives: The objectives of the study were to evaluate the influence of increasing body fat on bone mineral density (BMD) and to determine the influence of the different adipokines on BMD in frail obese elderly patients.Design and Setting: This is a cross-sectional study of baseline characteristics of elderly obese patients participating in a lifestyle therapy with diet with or without exercise and conducted in a university setting.Patients: One hundred seventy-three, elderly (≥65 y old), obese (body mass index of ≥30 kg/m2) who were mostly frail participated in the study.Outcome Measures: BMD, percentage of total body fat, percentage of fat-free mass, percentage of lean mass, body mass index, adiponectin, leptin, IL-6, bone turnover markers (osteocalcin and C-telopeptide), high-sensitivity C-reactive protein, free estradiol, and 25-hydroxyvitamin D were measured.Results: Higher tertiles of percentagebodyfatandlower lean masswereassociated with a lowerBMD. High-sensitivity C-reactive protein levels were highest in the highest fat tertile (third, 5.5±5.4 vs first, 1.5±1.3 mg/L, P<.05) forwomen,whereas IL-6 levels were highest in the highest tertile inmen(third, 3.5±3.1 vs first, 1.7±0.8 pg/mL, P<.05). Leptin increased with increasing fat tertiles in both genders (P<.05),whereasadiponectinincreasedwithincreasing fat tertiles only inmen(P<.05).Amultivariate analysis revealed adiponectin as an important mediator of the effect of fat mass on BMD. Osteocalcin levels were highest in the highest fat tertile in women but not in men. Physical function test scores decreased with increasing fat tertiles in women (P < .05) but not in men.Conclusions: Increasing adiposity together with decreasing lean mass is associated with lower BMD, higher adipokine levels, and worsening frailty in elderly obese adults. © 2014 by the Endocrine Society.

PubMed | Thomas Jefferson University, Biomedical Research Institute of New Mexico and University of New Mexico
Type: Journal Article | Journal: Journal of community psychology | Year: 2014

Through a CBPR partnership, university and American Indian (AI) tribal members developed and tested

PubMed | Thomas Jefferson University, Biomedical Research Institute of New Mexico and University of New Mexico
Type: Journal Article | Journal: Journal of community psychology | Year: 2014

An important predictor of youth well-being and resilience is the presence of nurturing adults in a youths life. Parents are ideally situated to fulfill this role but often face challenges and stressors that impede their ability to provide adequate support and guidance. American Indian parents may also be affected by intergenerational transmission of trauma and loss of traditional parenting practices, as a result of forced boarding school and/or relocation. Members of a community-university partnership sought to interrupt cycles of violence and poor mental health of youth through a culturally-grounded intervention for youth and their parents that focused on healing historical trauma, strengthening positive parenting practices and social skills, reconnecting to traditional cultural knowledge, and improving parent-child relationships/communication. This article describes parental involvement and its challenges and provides mixed-method results for 10 parents related to enculturation, parenting practices, parent-child communication, family cohesion, historical loss and associated symptoms, and community involvement.

PubMed | University of New Mexico, Lovelace Respiratory Research Institute, Biomedical Research Institute of New Mexico, Rutgers University and University of Iowa
Type: | Journal: Human genomics | Year: 2016

Chronic obstructive pulmonary disease (COPD) is characterized by an irreversible airflow limitation in response to inhalation of noxious stimuli, such as cigarette smoke. However, only 15-20 % smokers manifest COPD, suggesting a role for genetic predisposition. Although genome-wide association studies have identified common genetic variants that are associated with susceptibility to COPD, effect sizes of the identified variants are modest, as is the total heritability accounted for by these variants. In this study, an extreme phenotype exome sequencing study was combined with in vitro modeling to identify COPD candidate genes.We performed whole exome sequencing of 62 highly susceptible smokers and 30 exceptionally resistant smokers to identify rare variants that may contribute to disease risk or resistance to COPD. This was a cross-sectional case-control study without therapeutic intervention or longitudinal follow-up information. We identified candidate genes based on rare variant analyses and evaluated exonic variants to pinpoint individual genes whose function was computationally established to be significantly different between susceptible and resistant smokers. Top scoring candidate genes from these analyses were further filtered by requiring that each gene be expressed in human bronchial epithelial cells (HBECs). A total of 81 candidate genes were thus selected for in vitro functional testing in cigarette smoke extract (CSE)-exposed HBECs. Using small interfering RNA (siRNA)-mediated gene silencing experiments, we showed that silencing of several candidate genes augmented CSE-induced cytotoxicity in vitro.Our integrative analysis through both genetic and functional approaches identified two candidate genes (TACC2 and MYO1E) that augment cigarette smoke (CS)-induced cytotoxicity and, potentially, COPD susceptibility.

Stricker N.H.,VA Boston Healthcare System | Stricker N.H.,Boston University | Keller J.E.,Biomedical Research Institute of New Mexico | Keller J.E.,New Mexico VA Healthcare System | And 5 more authors.
Journal of Traumatic Stress | Year: 2015

Neurocognitive problems are common with posttraumatic stress disorder (PTSD) and are important to understand because of their association with the success of PTSD treatment and its potential neural correlates. To our knowledge, this is the first neurocognitive study in an all-female U.S. veteran sample, some of whom had PTSD. We examined neurocognitive performance and assessed whether learning deficits, common in PTSD, were associated with executive functioning. Veterans with PTSD (n = 56) and without (n = 53) were evaluated for psychiatric and neurocognitive status. The PTSD group had a lower estimated IQ (d = 0.53) and performed more poorly on all neurocognitive domains (d range = 0.57-0.88), except verbal retention (d = 0.04). A subset of the 2 groups that were matched on IQ and demographics similarly demonstrated poorer performance for the PTSD group on all neurocognitive domains (d range = 0.52-0.79), except verbal retention (d = 0.15). Within the PTSD group, executive functioning accounted for significant variance in verbal learning over and above IQ and processing speed (ΔR2 = .06), as well as depression (ΔR2 = .07) and PTSD severity (ΔR2 = .06). This study demonstrated that female veterans with PTSD performed more poorly than females without PTSD on several neurocognitive domains, including verbal learning, processing speed, and executive functioning. Replication of these results using a control group of veterans with more similar trauma exposure, history of mild traumatic brain injury, and psychiatric comorbidities would solidify these findings. Copyright © 2015 International Society for Traumatic Stress Studies.

Armamento-Villareal R.,Michael bakey Va Medical Center Medvamc And The Center For Translational Research On Inflammatory Diseases Ctrid At The Medvamc | Armamento-Villareal R.,Baylor College of Medicine | Aguirre L.E.,New Mexico VA Health Care System | Qualls C.,Biomedical Research Institute of New Mexico | And 3 more authors.
Journal of Nutrition, Health and Aging | Year: 2016

Objective: Obesity-associated hypogonadism is hypothesized to be due to the suppressive effect of high estradiol (from an increase in aromatase activity present in the abundant adipose tissue) on the hypothalamic-pituitary-gonadal unit resulting in low testosterone production. Although weight loss has been found to be effective in reducing estradiol and raising testosterone levels in studies of younger men, its effect in frail, obese older men is understudied. Thus, the objective of this study was to determine the effect of lifestyle intervention on hormone levels in frail, obese older men. Design: Randomized controlled trial of lifestyle intervention in frail, obese older men (≥65 yo) for 1 year. Setting: University hospital. Methods: Forty frail, obese elderly men were randomized, for a 52-week study, to any of the following treatment groups: (1) control group, (2) diet-induced weight loss group (diet group), (3) exercise training group (exercise group), and (4) diet-induced weight loss and exercise training group (diet.exercise group). The objective was to achieve a ∼10 % weight loss at 6 months and maintain this weight for an additional 6 months. Physical function was assessed by the modified physical performance testing (modified PPT). Estradiol was measured by radioimmunoassay, testosterone by automated immunoassay, and sex hormone-binding globulin by enzyme-linked immunoassay. Results: After 12 months of intervention, diet alone resulted in a weight loss of −10.1 ± 1.9 kg in the diet group and −9.1 ± 0.9 kg in the diet-exercise group. This resulted in a significant decrease (both p<0.05) in total estradiol compared to baseline among subjects in the diet (−2.5 ± 1.3 pg/ml) and diet-exercise group (−2.2 ± 4.0 pg/ml). Free estradiol index also significantly decreased (both p <0.05) in both the diet (−0.39 ± 0.14 pmol/nmol) and diet-exercise (−0.52 ± 0.12 pmol/nmol) group. Total testosterone significantly increased (p<0.05) in response to diet (71.0 ± 21.0 ng/dl) and diet-exercise (49.9 ± 15.5 pg/ml) resulting in values of 287.0 ± 28.1 ng/dl in the diet and 317.6 ± 33.1 ng/dl in the diet-exercise group. However, because there was a significant increase in sex hormone-binding globulin levels in both the diet and diet-exercise groups, free testosterone index and the changes in free testosterone index were not significant compared to baseline. Regardless of changes in hormonal levels, patients in the diet, exercise, and diet-exercise groups experienced significant improvements in the modified PPT from baseline. Conclusion: Weight loss from lifestyle intervention resulted in significant decreases in total and free estradiol levels in frail, obese older men, but this did not result in a clinically important increase in total testosterone nor a significant increase in free testosterone. Thus, alternative forms of treatment in addition to lifestyle intervention may be necessary to improve the hormonal profile among these patients. Nevertheless, whether further improvement in hormonal profile would result in better physical performance than what can be achieved by lifestyle alone in these subjects remains uncertain. © 2016, Serdi and Springer-Verlag France.

PubMed | University of New Mexico, New Mexico VA Health Care System and Biomedical Research Institute of New Mexico
Type: | Journal: International journal of endocrinology | Year: 2014

In this study, we evaluated the independent and combined effects of baseline circulating gonadal, anabolic hormones and adipokines on physical function in 107 frail, obese (BMI 30kg/m(2)), and older (65yr) subjects. Our results showed significant positive correlations between circulating testosterone and insulin growth factor-1 (IGF-1) with knee flexion, knee extension, one-repetition maximum (1-RM), and peak oxygen consumption (VO2 peak), while no correlation was observed with estradiol. Among the adipokines, high sensitivity C-reactive protein (Hs-CRP) and leptin negatively correlated with the modified physical performance testing (PPT), knee flexion, knee extension, 1-RM, and VO2 peak. Interleukin-6 ( Il-6) negatively correlated with knee flexion and VO2 peak and soluble tumor necrosis factors receptor-1 (sTNFr1) correlated with PPT, 1-RM, and VO2 peak. Adiponectin correlated negatively with 1-RM. Multiple regression analysis revealed that, for PPT, sTNFr1 was the only independent predictor. Independent predictors included adiponectin, leptin, and testosterone for knee flexion; leptin and testosterone for knee extension; adiponectin, leptin, and testosterone for 1-RM; and IGF-1, IL-6, leptin, and testosterone for VO2 peak. In conclusion, in frail obese older adults, circulating levels of testosterone, adiponectin, and leptin appear to be important predictors of physical strength and fitness, while inflammation appears to be a major determinant of physical frailty.

PubMed | New Mexico Veterans Affairs Health Care System, Biomedical Research Institute of New Mexico, University of New Mexico and Boston Veterans Affairs Health Care System
Type: Journal Article | Journal: Psychological trauma : theory, research, practice and policy | Year: 2016

Group delivery of posttraumatic stress disorder (PTSD) treatment has several advantages, however group research is not comparable to individual trials. This study extends the group literature by improving methodology in examining the efficacy of a 3-module (cognitive, exposure, skills) group treatment for PTSD, establishes a format for the delivery of group exposure therapy, and compares 3 treatment modules within the group.Eighty-six Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) women veterans were randomized to a 16-week, 3-member group treatment (Tx) or a waitlist (WL) condition. The primary (Clinician Administered PTSD Scale [CAPS]) and secondary (Medical Outcomes Study Short Form-36 [SF-36], Quality of Life Inventory [QOLI], and PTSD Checklist [PCL]) outcome measures were administered at baseline, post Tx/WL, and at 3- and 6-months post Tx (PCL additionally at pre/post for each treatment module).PTSD symptoms significantly improved in Tx arm participants (p < .001, ES = 1.72; unit of analysis group: n = 14), as did mental and physical life functioning (SF-36; p < .001), and quality of life (QOLI; p < .001). The WL significantly improved on the SF-36 (mental; p = .04) and QOLI (p = .02). Clinical improvement (CAPS) in the Tx arm reflected a treatment response (10-point decrease) in 77% and loss of PTSD diagnosis (<45) in 52% of participants, comparable to individual prolonged exposure (PE) treatment. Finally, PCL scores significantly lowered in exposure and cognitive modules.This study supports the use of group format for PTSD with 3 modules using improved methodology, with a novel, 3-member group which allows repeated in-session weekly imaginal exposures. The results suggest future examination of group delivered PE. (PsycINFO Database Record

Aguirre L.E.,New Mexico VA Health Care System | Aguirre L.E.,Biomedical Research Institute of New Mexico | Villareal D.T.,New Mexico VA Health Care System | Villareal D.T.,Baylor College of Medicine
Nestle Nutrition Institute Workshop Series | Year: 2015

Longitudinal studies demonstrate that regular physical exercise extends longevity and reduces the risk of physical disability. Decline in physical activity with aging is associated with a decrease in exercise capacity that predisposes to frailty. The frailty syndrome includes a lowered activity level, poor exercise tolerance, and loss of lean body and muscle mass. Poor exercise tolerance is related to aerobic endurance. Aerobic endurance training can significantly improve peak oxygen consumption by ∼ 10-15%. Resistance training is the best way to increase muscle strength and mass. Although the increase in muscle mass in response to resistance training may be attenuated in frail older adults, resistance training can significantly improve muscle strength, particularly in institutionalized patients, by ∼ 110%. Because both aerobic and resistance training target specific components of frailty, studies combining aerobic and resistance training provide the most promising evidence with respect to successfully treating frailty. At the molecular level, exercise reduces frailty by decreasing muscle inflammation, increasing anabolism, and increasing muscle protein synthesis. More studies are needed to determine which exercises are best suited, most effective, and safe for this population. Based on the available studies, an individualized multicomponent exercise program that includes aerobic activity, strength exercises, and flexibility is recommended to treat frailty. © 2015 Michael E. DeBakey VA Medical Center (US Government).

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