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New York City, NY, United States

Dominguez-Bello M.G.,University of Puerto Rico at San Juan | Blaser M.J.,NY | Blaser M.J.,New York Harbor Veterans Affairs Medical Center | Blaser M.J.,New York University | And 3 more authors.
Gastroenterology | Year: 2011

Little was known about the development of the gastrointestinal (GI) tract microbiota, until recently, because of difficulties in obtaining sufficient sequence information from enough people or time points. Now, with decreased costs of DNA sequencing and improved bioinformatic tools, we can compare GI tract bacterial communities among individuals, of all ages from infancy to adulthood. Some key recent findings are that the initial bacterial community, even in the GI tract, depends strongly on delivery mode; that the process of early development of the microbiota is highly unstable and idiosyncratic; that the microbiota differs considerably among children from different countries; and that older adults have substantially different GI tract communities than younger adults, indicating that the GI tract microbiota can change throughout life. We relate these observations to different models of evolution including the evolution of senescence and suggest that probiotics be selected based on patient age. Studies of the microbiota in older people might tell us which probiotics could increase longevity. Drug metabolism varies among individuals with different microbial communities, so age- and region-specific clinical trials are required to ensure safety and efficacy. © 2011 AGA Institute.

Luk J.,Yale University | Torrealday S.,Yale University | Neal Perry G.,NY | Neal Perry G.,Yeshiva University | Pal L.,Yale University
Human Reproduction | Year: 2012

The steroid hormone vitamin D is historically recognized for its relevance to bone health and calcium homeostasis. Recent years have witnessed a shift in focus to non-skeletal benefits of vitamin D; in this latter context, an accruing body of literature attests to a relevance of vitamin D to reproductive physiology. This article reviews the existing data about the diverse and previously underappreciated roles for vitamin D in reproductive health. A large body of available literature suggests that vitamin D deficiency may be detrimental to reproductive biology. However, given that our appreciation of vitamin D's role in reproductive physiology is almost entirely shaped by 'associative' studies and that data based on prospective interventional trials are limited, these concepts remain predominantly conjectural. Exact mechanisms whereby vitamin D may participate in the regulation of reproductive physiology remain far from clear. This review underscores a need for appropriately designed intervention trials to address the existing knowledge gaps and to delineate the specific roles of vitamin D signaling in reproductive biology. © 2012 The Author.

The past few decades have seen a very rapid change in the manner in which infrarenal aortic disease is diagnosed and dealt with. The approach has changed from open, large incision surgery with long and complicated postoperative courses to minimally invasive techniques in which the patient can go home the next day. A large number of devices have come and gone, and techniques to deal with aortic problems are ever changing. We have reviewed the past, current, and future technology to help make the treatment options more clear.

Bankole A.,Guttmacher Institute | Biddlecom A.E.,NY
AIDS Education and Prevention | Year: 2011

This article draws on biomarker data from Demographic and Health Surveys (2003-2007) in 10 sub-Saharan African countries to examine differences in fertility preferences and contraceptive behaviors by HIV status for women and men, taking into account whether or not they probably know their HIV status. The objective is to determine if there are common patterns in the associations between these variables across several countries. Women's and men's fertility preferences and contraceptive behaviors are relatively similar across HIV status and probable knowledge of that status. However, two consistent differences emerge in some of the countries: HIV positive women who probably know their status are less likely to want more children and are more likely to be using male condoms than women who are HIV-negative and probably know it. A similar association is observed for men for condom use but not for limiting childbearing. Other factors unrelated to HIV status seem to be shaping women's and men's unmet demand for contraception and use of methods other than the condom. © 2011 The Guilford Press.

To assess the role of having a primary care provider (PCP) in men's up-to-date receipt of recommended preventive services (colonoscopy, pneumococcal and seasonal influenza vaccination, cholesterol and blood pressure screenings), data from the 2005 and 2006 New York City Community Health Surveys (N = 3,728 [2006], 2,810 [2005]) were analyzed. PCP prevalence and men's uptake of each service, overall and by age, race/ethnicity, education, income, insurance status, marital status, and nativity, were evaluated. After controlling for insurance status and other factors, having a PCP significantly predicted receipt of each service (adjusted prevalence ratio from 1.12 [1.08, 1.16] to 1.72 [1.35, 2.22]) and total services. Colonoscopy and seasonal influenza and pneumococcal vaccination receipt were below 70% with or without a PCP. Efforts to increase the proportion of men having a PCP are needed to improve receipt of recommended services. Maximizing awareness and provision of low-use preventive services may be useful.

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