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Robinson-O'Brien R.,Minneapolis Medical Research Foundation | Gerald B.L.,Gerald Consulting LLC
Journal of the Academy of Nutrition and Dietetics | Year: 2013

Registered dietitians (RDs) and dietetic technicians, registered (DTRs) can implement environmentally responsible practices in their workplace and personal lives. RDs and DTRs who conserve natural resources while minimizing environmental degradation will help maintain sustainability of the food system, which requires knowledge of the external costs of operational and personal decisions. These external costs include energy to produce, transport, and process food; water for food production, preparation, and sanitation; removal of air pollutants; and waste management. As client and public educators, RDs and DTRs are uniquely positioned to meet the growing needs of those seeking guidance on food choices as they relate to ecological sustainability. In an effort to promote ecologically sustainable diets, it is important to consider natural resources as they relate to food production, transformation, distribution, access, and consumption. It is essential that the dietetics community takes a more active leadership role in support of ecological sustainability and social responsibility. RDs and DTRs can influence policy at the institutional, community, local, state, and national levels by presenting results of operational practices and science-based natural resource information. RDs and DTRs are encouraged to become educated and active in implementing sustainable practices and shaping policy in an effort to promote healthier individuals, communities, and the nation as a whole. © 2013 Academy of Nutrition and Dietetics.


News Article | November 11, 2016
Site: www.newsmaker.com.au

According to study results from Minneapolis Medical Research Foundation, in 2012, over 280,000 patients were living with bone metastasis in the U.S. with breast and prostate cancers being the most common primary tumor types. Metastasis is the unique hallmark of cancer cells which differentiates them from the benign tumors, which refers to the spread of cancer from its primary site to other body parts. Bone is the third most common site for the spread of cancer and invasion of such cancerous cells to bone gives rise to the deadly condition of bone metastasis. Bone metastasis is the third most common condition in metastatic cancers and occurs in 60-65% of patients with metastatic cancers. The spine is the most common site of bone metastasis. Other common sites include ribs, skull, pelvis (hip bone), femur (leg bone) and humerus (arm bone). Bone metastatic cancers are rarely able to be cured, and treatment of bone metastasis involves medications to shrink, stop or slow down the growth of the tumor. Treatment options available for bone metastasis are symptomatic treatments which are meant for pain control, treatment, and prevention of fractures, improvement in functional disability, etc. Randomized trials on metastatic patients by UBM Medica, LLC showed that 45-75% patients develop functional disability every 3-4 months, 10-15% patients develop hypercalcemia and 10-20% patients develop long bone fractures. Treatment of bone metastasis is the interdisciplinary field involving pain management, orthopedics, and other medical specialties. Primary factors driving the growth of bone metastasis therapeutics market are the global increase in cancer prevalence and delayed diagnosis of cancer in low-income countries. According to University of Texas Southwestern Medical Center Dallas, over 600,000 of bone metastasis are diagnosed in the U.S. every year. Rapid innovation in the field of personalized medicine and identification of new therapeutic targets for bone metastasis presents a huge opportunity to manufacturers of targeted therapy agents. A large number of treatment methods are still under investigation. However, heterogeneous nature of cancer and high development cost of neoplastic agents are the factors limiting the growth of global bone metastasis therapeutics market. Increasing investment by multinational companies in cancer research is expected to drive the growth of global bone metastasis therapeutics market during the forecast period. Based on treatment type, the global market for bone metastasis therapeutics has been classified as drug treatment, Tumor ablation therapy, and surgery. Drug treatment segment is foreseen to lead the market owing to easy availability of drugs and better reimbursement policies. Targeted therapeutic agents sub-segment of drug treatment segment is expected grow rapidly due to increasing acceptance of biological therapy owing to lesser side effects. By end user, the global bone metastasis therapeutics market has been segmented into hospitals, Clinics, cancer rehabilitation center and ambulatory surgical centers. Hospital end user segment is anticipated to contribute the maximum share among end users owing to the requirement of advanced healthcare infrastructure for management of bone metastasis symptoms. According to a study conducted by Amgen Inc., average hospitalization stay of cancer bone metastasis patients is 5.9 to 11.6 days, and almost 59% of the inpatient cost is attributed to skeletal-related events (SREs) such as radiation to the bone, spinal cord compression, pathologic fracture, etc. By regional presence, bone metastasis therapeutics market is segmented into five key regions viz.  North America, Latin America, Europe, Asia-Pacific, and the Middle East & Africa. North America will continue to dominate the global bone metastasis therapeutics market for due to high prevalence of malignant neoplasm. Europe is expected to hold second largest market share in global bone metastasis therapeutics market. Request TOC (desk of content material), Figures and Tables of the report: http://www.persistencemarketresearch.com/toc/11731 Some of the major players in global bone metastasis therapeutics market include F. Hoffmann-La Roche Ltd., Bayer AG, Merck & Co., Pfizer Inc. Novartis AG, Amgen Inc., Pharmalucence, Inc., Fresenius Kabi AG, Omega Laboratories Ltd., Eli Lilly and Company, and others. The majority of the key players are involved in development of new methods for treatment of cancer bone metastasis in collaboration with cancer research institutes such as M. D. Anderson Cancer Center, Memorial Sloan-Kettering Cancer Center, etc.


Foley R.N.,Minneapolis Medical Research Foundation | Foley R.N.,University of Minnesota | Collins A.J.,Minneapolis Medical Research Foundation | Collins A.J.,University of Minnesota
Clinical Journal of the American Society of Nephrology | Year: 2013

This article summarizes the administrative structure underlying the Unites States Renal Data System (USRDS); summarizes incidence, prevalence, patient characteristics, and treatment modalities; and describes data regarding clinical indicators and preventive care, hospitalization, survival, and costs. The USRDS recently instituted a comprehensive assessment system to characterize the transition to the new Centers for Medicare & Medicaid Services Prospective Payment System, which bundles into a single payment several integral components of dialysis care. This challenging initiative will be an important component of future USRDS Annual Data Reports. The main strengths of the USRDS are its size and representativeness, nearly complete inclusion of the US end-stage renal disease population, and linkage to Medicare claims. Limitations include lack of continuous validation of its methods, lack of complete comorbidity and laboratory data at registration, an initial survival bias, and lack of accuracy of cause-of-death reporting. © 2013 by the American Society of Nephrology.


Solid C.A.,Minneapolis Medical Research Foundation | Carlin C.,Medica Research Institute | Carlin C.,University of Minnesota
American Journal of Nephrology | Year: 2012

Background/Aims: Arteriovenous fistulas (AVFs) appear to be clinically superior to catheters as vascular access for maintenance hemodialysis, but higher insertion costs and high disease burden and mortality obscure the issue of whether AVF placement before hemodialysis initiation represents a net cost savings. We aimed to investigate Medicare costs for patients beginning maintenance hemodialysis, as related to timing of AVF placement. Methods: Data were from Medicare claims for incident hemodialysis patients aged ≥67 years in 2006. The study period extended from 2 years before to 1 year after dialysis initiation. Patients identified as having AVFs were categorized by timing of placement (mature AVF at dialysis initiation, maturing AVF at initiation, postinitiation AVF placement). Because timing may be influenced by factors that also influence overall costs, the model accounted for this nonrandom treatment assignment. An ordered probit extension of the classic Heckman correction was employed after identifying an appropriate instrumental variable. A cohort with Medicare coverage before and after dialysis initiation was identified, and Medicare claims were used to identify comorbid conditions and treatment costs. Results: Principal findings are that earlier AVF placement leads to lower costs, with the potential for about USD 500 million in savings. Additionally, the effect of nonrandom treatment assignment is real and significant. In our data, the impact of AVF placement timing was understated when treatment selection was ignored. Conclusions: For appropriate AVF candidates, having a mature AVF in place at the time of dialysis initiation appears to confer cost savings. Copyright © 2012 S. Karger AG, Basel.


Foley R.N.,Minneapolis Medical Research Foundation | Foley R.N.,University of Minnesota | Chen S.-C.,Minneapolis Medical Research Foundation | Solid C.A.,Minneapolis Medical Research Foundation | And 3 more authors.
Kidney International | Year: 2014

Clinical experience suggests a heightened risk associated with the transition to maintenance dialysis but few national studies have systematically examined early mortality trajectories. Here we calculated weekly mortality rates in the first year of treatment for 498,566 adults initiating maintenance dialysis in the United States (2005-2009). Mortality rates were initially unexpectedly low, peaked at 37.0 per 100 person-years in week 6, and declined steadily to 14.8 by week 51. In both early (weeks 7-12) and later (weeks 13-51) time frames, multivariate mortality associations included older age, female, Caucasian, non-Hispanic ethnicity, end-stage renal disease (ESRD) from hypertension and acute tubular necrosis, ischemic heart disease, estimated glomerular filtration rate of 15 ml/min per 1.73 m2 or more, shorter duration of nephrologist care, and hemodialysis, especially with a catheter. For early mortality risk, adjusted hazard ratios of 2 or more were seen with age over 65 (5.80 vs. under 40 years), hemodialysis with a catheter (2.73 vs. fistula), and age 40-64 (2.33). For later mortality risk, adjusted hazard ratios of 2 or more were seen with age over 65 (4.32 vs. under 40 years), hemodialysis with a catheter (2.10 vs. fistula), and age 40-64 (2.00). Thus, low initial mortality rates question the accuracy of data collected and are consistent with deaths occurring in the early weeks after starting dialysis not being registered with the United States Renal Data System. © 2014 International Society of Nephrology.


Israni A.K.,Minneapolis Medical Research Foundation | Zaun D.A.,Minneapolis Medical Research Foundation | Rosendale J.D.,Minneapolis Medical Research Foundation | Snyder J.J.,Minneapolis Medical Research Foundation | Kasiske B.L.,Minneapolis Medical Research Foundation
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons | Year: 2015

The status of deceased organ donation is assessed using metrics such as donation/conversation rate, organ yield, and rate of organs recovered for transplant and not transplanted. These metrics are based on eligible deaths (brain death of a person aged 70 years or younger) as well as on actual donors. The 9132 eligible deaths reported in 2013 represented a slight increase over 2012. The donation/conversion rate was 71.3 eligible donors per 100 eligible deaths, a slight decline from 2012, and varied by donation service area from 50.0 to 87.0. The number of organs recovered per donor, 3.55, also varied by donation service area, from 2.79 to 4.10. The mean number of organs transplanted per donor was 3.08 in 2013, slightly higher than 3.02 in 2012. The mean observed/expected organ yield ratio for kidneys varied from 0.86 to 1.18; for pancreata, from 0.29 to 2.59; for livers, from 0.69 to 1.17; for hearts, from 0.68 to 1.41; and for lungs, from 0.33 to 1.41. The rate of organs recovered for transplant and not transplanted in 2013 for all organs combined was 0.13 per recovered organ, slightly lower than the rate of 0.14 in 2012. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.


Goldsmith S.R.,Hennepin County Medical Center | Gilbertson D.T.,Minneapolis Medical Research Foundation | MacKedanz S.A.,Hennepin County Medical Center | Swan S.K.,DaVita Clinical Research
Journal of Cardiac Failure | Year: 2011

Background: Loop diuretics, though often effective for treating congestion, have significant limitations. Discovering ways to limit exposure to loop diuretics while achieving effective decongestion is an important goal of current clinical research in heart failure (HF). Vasopressin antagonists are effective in removing large amounts of water, but not salt, in HF. Few data exist about the detailed renal and hormonal effects of these agents compared with or in combination with loop diuretics. This study investigated the renal and neurohormonal effects of loop diuretics, the mixed vasopressin antagonist conivaptan, and the combination in patients with chronic stable HF. Methods and Results: In 8 patients with chronic stable HF on standard medical treatment, heart rate, arterial pressure, systemic vascular resistance, and cardiac output (the latter 2 by using impedance cardiography), as well as glomerular filtration rate (iothalamate clearance), renal blood flow (para-aminohippurate clearance), urinary volumes and urinary sodium, plasma catecholamines, renin activity, arginine vasopressin, and B-type natriuretic peptide were assessed before and at hourly intervals for 4 hours after receiving furosemide, conivaptan, or the combination on 3 different study days at a minimum of 1-week intervals. There were no significant effects of conivaptan, furosemide, or the combination on any hemodynamic variable, neurohormonal level, renal blood flow, or glomerular filtration rate. Conivaptan and furosemide similarly increased urine volumes; the effect of the combination was significantly greater. Furosemide, but not conivaptan, increased urinary sodium excretion, and the combination was significantly greater than after furosemide alone. Conclusions: Without adversely affecting important hemodynamic variables, neurohormones, renal blood flow, or glomerular filtration rate, conivaptan significantly augmented both the diuretic and the natriuretic response to furosemide in patients with chronic HF. These results may have implications for the design of furosemide-sparing regimens in the treatment of acute HF. © 2011 Elsevier Ltd. All rights reserved.


Grebenstein P.E.,University of Florida | Grebenstein P.E.,Minneapolis Medical Research Foundation | Thompson I.E.,University of Florida | Rowland N.E.,University of Florida
Psychopharmacology | Year: 2013

Rationale: Increased appetite and weight gain after cessation is a deterrent for quitting smoking. Attempts to understand the mechanism for these effects using animals have been hampered by the difficulty or inconsistency of modeling the effects seen in humans. Objective: To examine the effects of extended daily access to intravenous nicotine, via programmed infusions, on body weight and meal patterns in rats. Methods: Intravenous (IV) nicotine infusions (0.06 mg/kg/inf) were administered noncontingently, every 30 min throughout the dark cycle and the last 3 h of the light cycle, to emulate self-administration. The effect of these infusions on food intake, meal patterns, and weight change were examined relative to a control group during treatment and in a post-nicotine phase. Results: Nicotine-treated rats gained half the weight that vehicle treated animals gained and ate approximately 20 % less food overall than vehicle-treated rats. Whereas a compensatory increase in meal frequency occurred during the dark period to account for smaller meals, no compensation was observed throughout the light period. In a post-nicotine phase, the nicotine group maintained a lower weight for 1 week and then gained weight back to control levels. The rate of weight gain post-cessation was faster in animals that had received nicotine compared to controls. Conclusion: Compared to previous studies examining the effects of minipump or intraperitoneal injections of nicotine on food intake, the present study was able to detect previously unknown circadian differences in meal patterns which will be important in the development of smoking cessation and weight gain prevention drugs. © 2013 Springer-Verlag Berlin Heidelberg.


Murray A.M.,Hennepin County Medical Center | Murray A.M.,University of Minnesota | Murray A.M.,Minneapolis Medical Research Foundation | Seliger S.,University of Maryland, Baltimore | And 5 more authors.
Journal of the American Society of Nephrology | Year: 2013

The incidence of stroke is substantially higher among hemodialysis patients than among patients with earlier stages of CKD, but to what extent the initiation of dialysis accelerates the risk for stroke is not well understood. In this cohort study, we analyzed data from incident hemodialysis and peritoneal dialysis patients in 2009 whowere at least 67 years old and hadMedicare as primary payer.We notedwhether each of the 20,979 hemodialysis patients initiated dialysis as an outpatient (47%) or inpatient (53%). One year before initiation, the baseline stroke rate was 0.15%-0.20% of patients per month (ppm) for both outpatient and inpatient initiators. Among outpatient initiators, stroke rates began rising approximately 90 days before initiation, reached 0.5% ppm during the 30 days before initiation, and peaked at 0.7% ppm (8.4% per patient-year) during the 30 days after initiation. The pattern was similar among inpatient initiators, but the stroke rate peaked at 1.5%ppm (18%per patient-year). For both hemodialysis groups, stroke rates rapidly declined by 1-2 months after initiation, fluctuated, and stabilized at approximately twice the baseline rate by 1 year. Among the 620 peritoneal dialysis patients, stroke rates were slightly lower and variable, but approximately doubled after initiation. In conclusion, these data suggest that the process of initiating dialysis may cause strokes. Further studies should evaluate methods to mitigate the risk for stroke during this high-risk period. Copyright © 2013 by the American Society of Nephrology.


Patent
Minneapolis Medical Research Foundation and University of Minnesota | Date: 2013-09-17

The present invention relates to conjugates and vaccine compositions for treatment of opioid addiction, and methods of use of these conjugates and compositions.

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