James A Haley Veterans Administration Hospital

Tampa, FL, United States

James A Haley Veterans Administration Hospital

Tampa, FL, United States

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Bickford P.C.,James A Haley Veterans Administration Hospital | Bickford P.C.,University of South Florida | Flowers A.,University of South Florida | Grimmig B.,University of South Florida
Experimental Gerontology | Year: 2017

Aging is the primary risk factor for many neurodegenerative diseases. Thus, understanding the basic biological changes that take place with aging that lead to the brain being less resilient to disease progression of neurodegenerative diseases such as Parkinson's disease or Alzheimer's disease or insults to the brain such as stroke or traumatic brain injuries. Clearly this will not cure the disease per se, yet increasing the ability of the brain to respond to injury could improve long term outcomes. The focus of this review is examining changes in microglia with age and possible therapeutic interventions involving the use of polyphenol rich dietary supplements. © 2017.


Boyapalle S.,James A Haley Veterans Administration Hospital | Boyapalle S.,University of South Florida | Wong T.,University of South Florida | Garay J.,University of South Florida | And 3 more authors.
PLoS ONE | Year: 2012

Respiratory syncytial virus (RSV) nonstructural protein 1(NS1) attenuates type-I interferon (IFN) production during RSV infection; however the precise role of RSV NS1 protein in orchestrating the early host-virus interaction during infection is poorly understood. Since NS1 constitutes the first RSV gene transcribed and the production of IFN depends upon RLR (RIG-I-like receptor) signaling, we reasoned that NS1 may interfere with this signaling. Herein, we report that NS1 is localized to mitochondria and binds to mitochondrial antiviral signaling protein (MAVS). Live-cell imaging of rgRSV-infected A549 human epithelial cells showed that RSV replication and transcription occurs in proximity to mitochondria. NS1 localization to mitochondria was directly visualized by confocal microscopy using a cell-permeable chemical probe for His 6-NS1. Further, NS1 colocalization with MAVS in A549 cells infected with RSV was shown by confocal laser microscopy and immuno-electron microscopy. NS1 protein is present in the mitochondrial fraction and co-immunoprecipitates with MAVS in total cell lysatesof A549 cells transfected with the plasmid pNS1-Flag. By immunoprecipitation with anti-RIG-I antibody, RSV NS1 was shown to associate with MAVS at an early stage of RSV infection, and to disrupt MAVS interaction with RIG-I (retinoic acid inducible gene) and the downstream IFN antiviral and inflammatory response. Together, these results demonstrate that NS1 binds to MAVS and that this binding inhibits the MAVS-RIG-I interaction required for IFN production. © 2012 Boyapalle et al.


Zachariah B.,James A Haley Veterans Administration Hospital | Zachariah B.,University of South Florida | Gwede C.K.,University of South Florida | James J.,Statistical Center | And 8 more authors.
Journal of the National Cancer Institute | Year: 2010

Background In anorectal cancer patients, an acute side effect of chemoradiotherapy is gastrointestinal toxicity, which often impedes treatment delivery. Based on previous trials, octreotide acetate is widely recommended for the control of chemotherapy-induced diarrhea. However, the effectiveness of octreotide in preventing or controlling radiation- and chemoradiation-induced diarrhea is not known. Methods A randomized, double-blinded, placebo-controlled trial was designed to determine the efficacy of long-Acting octreotide acetate (LAO) in preventing the onset of acute diarrhea in patients undergoing chemoradiation therapy for rectal or anal cancer. Between 4 and 7 days before the start of radiation therapy, patients received a 30-mg dose of LAO (109 patients) or placebo (106 patients) via intramuscular injection. A second dose was given on day 22 (±3 days) of radiation treatment. A total of 215 patients were included in the final analysis. The primary endpoint was the incidence of grade 2-4 acute diarrhea; secondary endpoints included treatment compliance, medical resource utilization, patient-reported bowel function, and quality of life (QoL). Statistical tests were one- or two-sided, as specified. Results After a median follow-up time of 9.64 months, incidence rates of grades 2-4 acute diarrhea were similar in both groups (49% placebo vs 44% LAO; P = .21). No statistically significant treatment differences in chemotherapy or radiation delivery, medical resource utilization, patient-reported bowel function, or QoL were observed. Conclusion In this study, the prophylactic use of LAO did not prevent the incidence or reduce the severity of diarrhea and had no notable impact on patient-reported bowel function or QoL. © The Author 2010.


Pabon M.M.,University of South Florida | Jernberg J.N.,Tulane University | Morganti J.,University of South Florida | Contreras J.,University of South Florida | And 4 more authors.
PLoS ONE | Year: 2012

Inflammation in the brain plays a major role in neurodegenerative diseases. In particular, microglial cell activation is believed to be associated with the pathogenesis of neurodegenerative diseases, including Parkinson's disease (PD). An increase in microglia activation has been shown in the substantia nigra pars compacta (SNpc) of PD models when there has been a decrease in tyrosine hydroxylase (TH) positive cells. This may be a sign of neurotoxicity due to prolonged activation of microglia in both early and late stages of disease progression. Natural products, such as spirulina, derived from blue green algae, are believed to help reverse this effect due to its anti-inflammatory/anti-oxidant properties. An adeno-associated virus vector (AAV9) for α-synuclein was injected in the substantia nigra of rats to model Parkinson's disease and to study the effects of spirulina on the inflammatory response. One month prior to surgeries, rats were fed either a diet enhanced with spirulina or a control diet. Immunohistochemistry was analyzed with unbiased stereological methods to quantify lesion size and microglial activation. As hypothesized, spirulina was neuroprotective in this α-synuclein model of PD as more TH+ and NeuN+ cells were observed; spirulina concomitantly decreased the numbers of activated microglial cells as determined by MHCII expression. This decrease in microglia activation may have been due, in part, to the effect of spirulina to increase expression of the fractalkine receptor (CX3CR1) on microglia. With this study we hypothesize that α-synuclein neurotoxicity is mediated, at least in part, via an interaction with microglia. We observed a decrease in activated microglia in the rats that received a spirulina- enhanced diet concomitant to neuroprotection. The increase in CX3CR1 in the groups that received spirulina, suggests a potential mechanism of action. © 2012 Pabon et al.


Ledford D.K.,James A Haley Va Hospital | Lockey R.F.,University of South Florida | Lockey R.F.,James A Haley Veterans Administration Hospital
Current Opinion in Allergy and Clinical Immunology | Year: 2013

PURPOSE OF REVIEW: This article summarizes the more common comorbidities which, in the opinion of the authors and supported by the medical literature, frequently affect asthma management. Optimal asthma control requires accurate diagnosis, implementation of effective therapy, and evaluation of coexisting conditions. Comorbidities refer to either coexisting conditions or interacting conditions, with the latter having a more significant influence on the management of asthma. This review provides the authors' clinical perspective of the more common comorbidities and relevant literature reviewed primarily from the past 4-5 years. RECENT FINDINGS: Optimizing rhinitis and rhinosinusitis management and addressing allergic sensitivity and allergen exposure are achievable measures for the most common asthma comorbidity. Psychological dysfunction and paradoxical vocal cord dysfunction are frequently associated with poor asthma control. The effects of obesity are inconsistent in the literature but obesity likely affects asthma symptoms and possibly its pathogenesis. Treatment of asymptomatic gastroesophageal reflux does not improve asthma. SUMMARY: Asthma is a common disease and other conditions frequently occur concomitantly in individuals with asthma. Asthma is usually very treatable and comorbidities should be considered and addressed or the asthma diagnosis questioned if treatment effects are not optimal. Evidence-based medicine is lacking as most asthma studies exclude comorbidities; additional studies are needed. Copyright © 2013 Lippincott Williams &Wilkins.


Kearns W.D.,University of South Florida | Fozard J.L.,University of South Florida | Schonfeld L.,University of South Florida | Scott S.,James A Haley Veterans Administration Hospital | Marshall K.,University of South Florida
Journal of Head Trauma Rehabilitation | Year: 2015

OBJECTIVE:: In comparison to veterans without a history of traumatic brain injury (TBI), we hypothesized that veterans with past TBI would have slower walking speed and more path tortuosity, TBI symptoms, problems with spatial orientation, and poorer executive function. SETTING:: Community nonclinical. PARTICIPANTS:: Seventeen males (mean age of 37.2 years) reporting prior TBI and 20 non-TBI (mean age of 42.9 years). The number of years separating date of discharge and testing was 10.8 and 15.4 for the TBI and non-TBI groups, respectively. DESIGN:: Small 2 groups without random assignment. MAIN MEASURES:: Brief Traumatic Brain Injury Screen, Trail Making Test-B, Clock Drawing Test, walking speed, and distance and path tortuosity in 30 minutes of voluntary outdoor walking wearing a small Global Positioning Systems recorder. RESULTS:: Those with TBI reported 4 Brief Traumatic Brain Injury Screen symptoms versus 0.4 for controls (F = 49.1; df = 1,35; P < .001) but did not differ on Trail Making Test-B or the Clock Drawing Test. Veterans with TBI walked shorter distances, 2.33 km versus 2.84 km (F = 4.8; df = 1,35; P < .05), and had greater path tortuosity (fractal D of 1.22 vs 1.15; F = 3.5; df = 1,35; P < .05) but did not differ on travel speed or time spent walking. CONCLUSIONS:: Traumatic brain injury has persistent symptomatic effects and significantly affects ambulation and spatial orientation years after the event. These findings corroborate and extend observations linking cognitive impairment and ambulation.


Boyapalle S.,University of South Florida | Mohapatra S.,University of South Florida | Mohapatra S.,James A Haley Veterans Administration Hospital
Journal of Global Infectious Diseases | Year: 2012

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains one of the most serious threats to global health. Today there are no HIV vaccines which can prevent HIV infection. All of the candidates being studied are in the experimental stage. Preventive vaccine candidates are being tested in HIV-negative people to see if they can prevent infection. With of the development of a safe and effective vaccine still likely to be years away, topical microbicide formulations that are applied vaginally and rectally are receiving greater interest as an effective alternative to slow down the global spread of HIV. Current microbicide trials that aim to prevent the sexual transmission of HIV are using gels, creams, rings, films and there is also work underway to explore other types of 'delivery' systems. There have been numerous reports on safety and lack of toxicity of the application of nanotechnology for targeted delivery and slow, sustained release of drugs, proteins, peptides or nucleic acids by any route to maximize effectiveness and minimize adverse effects. The application of nanotechnology for targeting drugs and macromolecules to specific tissues or cells is one of the most important areas in nanomedicine research. Thus far nanoparticles provide a strong platform to combine protein and DNA based vaccines/microbicides and will facilitate the production, preclinical evaluation and clinical testing in the future.


Hoenemeyer L.A.,James A Haley Veterans Administration Hospital
Urologic nursing | Year: 2013

Agent Orange, an herbicide widely used during the Vietnam War, has been linked to various health risks, including urologic malignancy. Exposed veterans are at risk for prostate cancer and may be entitled to compensation if diagnosed with prostate cancer. Current research studies are aimed at mitigating prostate dysplasia and prostate cancer


Fitzhugh D.J.,University of South Florida | Fitzhugh D.J.,James A Haley Veterans Administration Hospital | Lockey R.F.,University of South Florida | Lockey R.F.,James A Haley Veterans Administration Hospital
Current Opinion in Allergy and Clinical Immunology | Year: 2011

Purpose of Review: To provide a historical perspective on the development of allergen immunotherapy and to describe the progress that has been made in both the clinical application and the scientific understanding of this therapeutic technique in the 100 years since its inception. Recent Findings: Although allergen immunotherapy has been part of allergy practice for a century, it is only in relatively recent years that the cellular and molecular mechanisms which underlie its clinical efficacy have been elucidated. Most recent studies implicate the T-regulatory cell response as central to the development of a tolerogenic state in response to allergen immunotherapy, with both IL-10 and TGF-β playing crucial roles in the development of this cell subset. The clinical application of immunotherapy continues to advance, with promising contemporary studies noting improved safety and efficacy with pretreatment using omalizumab prior to an immunotherapy program as well as the potential for innate immune system modulation with allergen conjugates which can stimulate pattern recognition receptors such as the toll-like receptors. Summary: After 100 years of clinical application, allergen immunotherapy remains the only treatment modality with the potential for long-term immunologic amelioration of atopic diseases. Future treatment advances in allergen immunotherapy will likely harness the increasing power of molecular and genomic medicine to achieve greater allergen specificity, while improving overall efficacy and minimizing the potential for systemic reactions. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Lamp K.,James A Haley Veterans Administration Hospital | Maieritch K.P.,Hines Veterans Administration Hospital | Winer E.S.,Mississippi State University | Hessinger J.D.,Hines Veterans Administration Hospital | Klenk M.,Duke University
Journal of Traumatic Stress | Year: 2014

The present study explored interest in treatment and treatment initiation patterns among veterans presenting at a VA posttraumatic stress disorder (PTSD) clinic. U.S. veterans who were referred for treatment of posttraumatic stress symptoms (N = 476) attended a 2-session psychoeducation and orientation class where they completed measures of demographic variables, PTSD and depression symptom severity, and interest in treatment. Consistent with previous literature and our hypotheses, Vietnam (OR = 1.78) and Persian Gulf veterans (OR = 2.05) were more likely than Iraq and Afghanistan veterans to initiate treatment. Veterans reporting more severe PTSD and depression symptoms were more likely to initiate treatment than not (OR for PTSD = 1.02, OR for depression = 1.02). Interest in treatment emerged as a strong predictor of treatment initiation. Specifically, interest in trauma-focused treatment showed a significant independent predictive effect on initiation such that veterans who expressed interest in trauma-focused treatment were significantly more likely to initiate treatment than those who did not express interest (OR = 2.13). Building interest in trauma-focused treatment may be a vital component for engaging veterans in evidence-based trauma-focused therapy. © 2014 International Society for Traumatic Stress Studies.

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