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PubMed | Karolinska Institutet, Instituto Nacional Of Ciencias Medicas Y Nutricion, New York University, University Institute of Health Sciences and 31 more.
Type: Journal Article | Journal: Rheumatology (Oxford, England) | Year: 2016

To determine nephritis outcomes in a prospective multi-ethnic/racial SLE inception cohort.Patients in the Systemic Lupus International Collaborating Clinics inception cohort (15 months of SLE diagnosis) were assessed annually for estimated glomerular filtration rate (eGFR), proteinuria and end-stage renal disease (ESRD). Health-related quality of life was measured by the Short Form (36 questions) health survey questionnaire (SF-36) subscales, mental and physical component summary scores.There were 1827 patients, 89% females, mean (s.d.) age 35.1 (13.3) years. The mean (s.d.) SLE duration at enrolment was 0.5 (0.3) years and follow-up 4.6 (3.4) years. LN occurred in 700 (38.3%) patients: 566/700 (80.9%) at enrolment and 134/700 (19.1%) during follow-up. Patients with nephritis were younger, more frequently men and of African, Asian and Hispanic race/ethnicity. The estimated overall 10-year incidence of ESRD was 4.3% (95% CI: 2.8%, 5.8%), and with nephritis was 10.1% (95% CI: 6.6%, 13.6%). Patients with nephritis had a higher risk of death (HR = 2.98, 95% CI: 1.48, 5.99; P = 0.002) and those with eGFR <30 ml/min at diagnosis had lower SF-36 physical component summary scores (P < 0.01) and lower Physical function, Physical role and Bodily pain scores. Over time, patients with abnormal eGFR and proteinuria had lower SF-36 mental component summary (P 0.02) scores compared to patients with normal values.LN occurred in 38.3% of SLE patients, frequently as the initial presentation, in a large multi-ethnic inception cohort. Despite current standard of care, nephritis was associated with ESRD and death, and renal insufficiency was linked to lower health-related quality of life. Further advances are required for the optimal treatment of LN.


Lallier M.,Gwynedd-Mercy University | Lallier M.,Basque Center on Cognition | Carreiras M.,Basque Center on Cognition | Carreiras M.,Ikerbasque | And 3 more authors.
Brain Research | Year: 2013

Grapheme-to-phoneme mapping regularity is thought to determine the grain size of orthographic information extracted whilst encoding letter strings. Here we tested whether learning to read in two languages differing in their orthographic transparency yields different strategies used for encoding letter-strings as compared to learning to read in one (opaque) language only. Sixteen English monolingual and 16 early Welsh-English bilingual readers undergoing event-related brain potentials (ERPs) recordings were asked to report whether or not a target letter displayed at fixation was present in either a nonword (consonant string) or an English word presented immediately before. Bilinguals and monolinguals showed similar behavioural performance on target detection presented in words and nonwords, suggesting similar orthographic encoding in the two groups. By contrast, the amplitude of ERPs locked to the target letters (P3b, 340-570 ms post target onset, and a late frontal positive component 600-1000 ms post target onset) were differently modulated by the position of the target letter in words and nonwords between bilinguals and monolinguals. P3b results show that bilinguals who learnt to read simultaneously in an opaque and a transparent orthographies encoded orthographic information presented to the right of fixation more poorly than monolinguals. On the opposite, only monolinguals exhibited a position effect on the late positive component for both words and nonwords, interpreted as a sign of better re-evaluation of their responses. The present study shed light on how orthographic transparency constrains grain size and visual strategies underlying letter-string encoding, and how those constraints are influenced by bilingualism. © 2013 Elsevier B.V.


McClain J.A.,University of Kentucky | McClain J.A.,Gwynedd-Mercy University | Nixon K.,University of Kentucky
Alcoholism: Clinical and Experimental Research | Year: 2016

Background: Changes in gene expression associated with alcohol-induced neuroadaptations are controlled in part by post translational histone modifications. Serine 10 phosphorylation of histone H3 (H3S10ph) has been implicated in drug-induced changes in gene expression; however, ethanol (EtOH)'s effects on H3S10ph have yet to be examined in brain. Therefore, hippocampal H3S10ph was examined after acute EtOH exposure and EtOH dependence. Methods: Adult male Sprague Dawley rats received an acute exposure of EtOH (0 to 5 g/kg) via gavage. Or, rats were made EtOH dependent by administering 25% w/v EtOH every 8 hours for 4 days following a modified Majchrowicz protocol. In both cases, rats were perfused transcardially and paraformaldehyde-fixed brains were collected and processed for immunohistochemistry to detect H3S10ph or c-fos. Results: Acute EtOH exposure dose dependently altered the number of H3S10ph-positive (+) cells in the hippocampus. Specifically, 1 g/kg EtOH increased the number of H3S10ph+ cells in all neuronal layers, while 2.5 and 5 g/kg EtOH reduced the number of H3S10ph+ cells, an effect that was confined to the granule cell layer. In EtOH-dependent rats, the number of H3S10ph+ cells in the granule cell layer was reduced by 66% during intoxication; however, H3S10ph+ cells were increased in all neuronal layers during peak withdrawal. Subsequent examination of c-fos, a gene known to be regulated by H3S10ph, revealed that EtOH and withdrawal-associated changes in c-fos closely paralleled changes in H3S10ph. Conclusions: These results suggest that H3S10ph regulates EtOH-mediated changes in c-fos expression, effects that likely have important implications for EtOH-induced changes in hippocampal neuronal plasticity. © 2016 Research Society on Alcoholism.


Bond A.,University of Cardiff | Ahmed W.,Gwynedd-Mercy University
BMJ Case Reports | Year: 2016

Gastrointestinal (GI) angiodysplasia is an important and challenging cause of acute GI haemorrhage, particularly in the elderly. We present the case of an 83-year-old woman admitted with acute upper GI bleeding that was refractory to both endoscopic ablation with argon plasma coagulation and gastroduodenal artery embolisation. Administration of thalidomide 100 mg daily after failure of the above therapeutic procedures resulted in cessation of bleeding and avoided the need for further blood transfusion at 6-month follow-up. Copyright 2016 BMJ Publishing Group. All rights reserved.


McGovern S.T.,Bangor University | McGovern S.T.,Aberystwyth University | Evans C.D.,UK Center for Ecology and Hydrology | Dennis P.,Aberystwyth University | And 3 more authors.
Geoderma | Year: 2013

The effect of long-term changes in land-use, pollution deposition and climate change on upland soils was evaluated by resurveying a large set of sites in a mountain landscape in the UK, which were initially sampled forty years ago. Unexpectedly, despite the length of time between sampling dates, no significant changes in pH, soil exchangeable base cations or C and N percentage content by weight were observed across a range of soil type and parent material. This suggests that the soils have been relatively resistant to the large changes in the environmental pressures experienced in the past forty years, which include a 1.5. °C increase in mean temperature; the peak of UK sulphur deposition in around 1970, followed by ~90% deposition reduction; long-term increases in nitrogen deposition; and major changes in grazing intensity. These results suggest that upland soils may be considerably more resilient to the future environmental changes than many previous assessments have suggested. © 2012.


Conway K.P.,U.S. National Institute on Drug Abuse | McGrain P.,Gwynedd-Mercy University
Substance Use and Misuse | Year: 2016

Background: Heavy metal music is distinguished for its deep sound and lyrical fixation with dark themes including war, destruction, doom, and misery. Such subjects permeate the music of Black Sabbath, the band generally considered the pioneers of heavy metal. One theme–substance use–is recurrent in Black Sabbath's songs and personal lives of its members. Objective/Methods: This study explored the band's relationship with substance use though a content analysis of all songs containing lyrics written and recorded in studio by Black Sabbath. The analysis included 156 songs across 19 albums recorded from 1970 to 2013. Results: Three key findings emerged. First, a minority of songs (13%) contained substance references. Second, the songs with substance references were overwhelmingly (60%) negative, a pattern that increased over time. Third, despite many line-up changes over the band's 43-year period, every song referencing substance use except one featured vocalist Ozzy Osbourne and lyricist Geezer Butler. Conclusion: Contrary to the notion that heavy metal music glorifies or encourages substance use (Record Labeling, United States Senate, 1985), Black Sabbath's lyrics as a whole weave a cautionary tale of how persistent substance use can hijack free will, become the dominant focus of the affected individual, and produce myriad forms of human misery. The insidiousness of chronic substance use depicted by the lyrics mirrors findings from natural-history studies of individuals with substance use disorders and aligns with neurobiological heuristics of addiction. © 2016, This article not subject to US copyright law.


Bilder G.E.,Gwynedd-Mercy University
Side Effects of Drugs Annual | Year: 2014

The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the January 2012 to June 2013 publications on adverse reactions to thyroid hormones, iodine and antithyroid drugs (ATDs) covers levothyroxine, the thyroid hormone analogue eprotirome, iodine and radioactive iodine and thionamide ATDs. Until recently, liver transplantation was the only therapy available to suppress the main source of the transthyretin amyloidogenic mutant. However, several drug treatments are emerging, including transthyretin tetramer stabilisers, small molecules that bind to the native form of transthyretin, preventing its dissociation and subsequent aggregation and deposition. One of these compounds, tafamidis, has been approved by the European Medicines Agency for the treatment of transthyretin familial amyloid polyneuropathy. Other drug candidates are being evaluated. © 2014 Elsevier B.V.


Roberts N.,Gwynedd-Mercy University
Nursing in critical care | Year: 2011

Ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation after endotracheal intubation. The role of chlorhexidine and tooth-brushing has been considered as a clinical intervention to reduce infection rates, however, evidence to inform this needs appraising. This paper presents a critical review on the effect of chlorhexidine gluconate (CHX) and tooth-brushing in decreasing rates of VAP in mechanically ventilated adult patients cared for in intensive care settings. A literature search was conducted using a number of bibliographic databases (n = 6). A number of parameters were used to exclude irrelevant papers. A total n = 17 papers were located and accessed, which were directly related to the field. Eight studies that met the criteria and addressed the study aims were reviewed. CHX was successful in reducing the rate of VAP and using a combination of CHX and colistine resulted in better oropharyngeal decontamination which reduced and delayed VAP. Chlorhexidine was also effective in reducing dental plaque in patients cared for in intensive care and had the potential to reduce nosocomial infections. Results of studies investigating the use of tooth-brushing in reducing VAP incidence proved inconsistent, although all recommend tooth-brushing as important in maintaining good oral hygiene. The use of chlorhexidine has been proven to be of some value in reducing VAP, although may be more effective when used with a solution which targets gram-negative bacteria. Tooth-brushing is recommended in providing a higher standard of oral care to mechanically ventilated patients and reducing VAP when used with chlorhexidine. However, limitations in study design and inconsistency in results suggest that further research is required into the effects of tooth-brushing. © 2011 The Authors. Nursing in Critical Care © 2011 British Association of Critical Care Nurses.

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