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Dobie R.A.,UTHSCSA | Dobie R.A.,University of California at Davis | Agrawal Y.,Johns Hopkins University
Audiology and Neurotology | Year: 2011

One can study occupational noise exposure by comparing hearing thresholds of exposed people to control data from national or international standards. ANSI S3.44 (1996) offers Annex C - thresholds for people without occupational noise exposure - as appropriate control data for such comparisons. Annex C is based on the false assumption that people who have had occupational noise exposure are similar in all other important ways to those without such exposures. In fact, people with noisy jobs are more likely than others to be smokers, diabetics, poorly educated, white and exposed to non-occupational noise. Taking these other risk factors into account, the appropriate thresholds for comparison to industrial study populations are closer to those of the unscreened population than to an 'Annex C' population that simply excludes occupationally noise-exposed persons. Copyright © 2010 S. Karger AG, Basel.

News Article | February 15, 2017

Amber Hills Dental is set to open its doors on February 6, 2017. The Henderson dental practice aims to provide a comfortable and convenient dental experience for the entire family. Dr. Aimee Villamayor leads the practice as a skilled dentist who carries training and experience throughout a wide range of dental specialties. Patients can take advantage of general and restorative dentistry as well as cosmetic dentistry and orthodontics. Beginning from a first dental visit at six months old to getting dental implants as a senior adult, Amber Hills Dental is uniquely qualified to meet oral health needs through all stages of life. Patient comfort is deeply valued at Amber Hills Dental. They have designed their office environment to include patient amenities, such as Netflix, a beverage bar, children’s play area and video games. The entire practice is centered around taking the stress and anxiety out of dental care. This also includes easy financing options, family block appointments and same day dentistry. Amber Hills will be offering the latest and most preferred dental treatments available, ranging from Invisalign clear orthodontics to implant overdentures. Dr. Villamayor also treats children with a full menu of pediatric dental services, including stainless steel crowns and emergency dental care. “Our team shares a passion to deliver the best possible dental care to the Henderson community. I believe we’ve equipped our practice to do just that. We look forward to welcoming new patients in February,” says Dr. Villamayor of Amber Hills Dental. Dr. Aimee Villamayor received her Bachelor of Science in Biology from the University of San Francisco (USF) and earned her dental degree at New York University College of Dentistry (NYUCD). She is an advocate for continuous learning and completed one year of advanced general dentistry residency at the University of Texas, San Antonio (UTHSCSA). Dr. Villamayor participated in extensive training in dental implants, oral surgeries and dental IV/ oral sedation. Her experience has equipped her to handle dental emergencies and treat medically complex patients. Dr. Villamayor is an active member of the Academy of General Dentistry, American Dental Association and Southern Nevada Dental Association. For more information about the practice or to schedule an appointment at Amber Hills Dental, please visit or call the Henderson office directly at (702) 830-7793.

Schwartz S.,University of Pennsylvania | Defronzo R.A.,UTHSCSA
Current Diabetes Reports | Year: 2014

Patients with hyperglycemia in hospital have increased adverse outcomes compared with patients with normoglycemia, and the pathophysiological causes seem relatively well understood. Thus, a rationale for excellent glycemic control exists. Benefits of control with intensive insulin regimes are highly likely based on multiple published studies. However, hypoglycemia frequency increases and adverse outcomes of hypoglycemia accrue. This has resulted in a 'push' for therapeutic nihilism, accepting higher glycemic levels to avoid hypoglycemia. One would ideally prefer to optimize glycemia, treating hyperglycemia while minimizing or avoiding hypoglycemia. Thus, one would welcome therapies and processes of care to optimize this benefit/ risk ratio. We review the logic and early studies that suggest that incretin therapy use in-hospital can achieve this ideal. We strongly urge randomized prospective controlled studies to test our proposal and we offer a process of care to facilitate this research and their use in our hospitalized patients. © 2014 Springer Science+Business Media New York.

Kampschmidt J.C.,University of Texas Health Science Center at San Antonio | Brooks E.G.,UTHSCSA | Cherry D.C.,University of Washington | Guajardo J.R.,UTHSCSA | Wood P.R.,UTHSCSA
Pediatric Pulmonology | Year: 2016

Rationale The primary purpose of this study was to evaluate the feasibility of obtaining acceptable and reproducible spirometry data in preschool aged children (3-5 years) by technicians without prior experience with spirometry. Methods Two technicians were trained to perform spirometry testing (ndd Easy on-PC) and to administer standardized questionnaires. Preschool aged children were enrolled from two Head Start centers and a local primary care clinic. Subjects were trained in proper spirometry technique and tested until at least two acceptable efforts were obtained or the subject no longer produced acceptable efforts. Results 200 subjects were enrolled: mean age 4.0 years (± 0.7 SD); age distribution: 51 (25.5%) 3 years old, 103 (51.5%) 4 years old, and 46 (23%) 5 years old. Fifty-six percent male and 75% Hispanic. One hundred thirty (65%) subjects produced at least one acceptable effort on their first visit: 23 (45%) for 3 years old, 67 (65%) for 4 years old, and 40 (87%) for 5 years old. The number of acceptable efforts correlated with age (r = 0.29, P < 0.001) but not gender. The mean number of acceptable efforts on the first visit was 2.66 (± 2.54 SD; range 0-10). One hundred twenty subjects (60%) had two acceptable efforts; 102 had FEV0.5 within 10% or 0.1 L and 104 had FVC within 10% or 0.1 L of best effort. The Asthma Health Screening Survey (AHSS) was 78% sensitive when compared to a specialist exam and 86% compared to a self-reported prior diagnosis of asthma. Conclusions Technicians without prior experience were able to obtain acceptable and reproducible spirometry results from the preschool aged children; the number of acceptable efforts correlated significantly with age. Pediatr Pulmonol. 2016;51:258-266. © 2015 Wiley Periodicals, Inc.

Edrey Y.H.,City College of New York | Edrey Y.H.,Barshop Institute for Longevity and Aging Studies | Casper D.,Yeshiva University | Huchon D.,Tel Aviv University | And 8 more authors.
Aging Cell | Year: 2012

Naked mole-rats (Heterocephalus glaber), the longest-lived rodents, live 7-10 times longer than similarly sized mice and exhibit normal activities for approximately 75% of their lives. Little is known about the mechanisms that allow them to delay the aging process and live so long. Neuregulin-1 (NRG-1) signaling is critical for normal brain function during both development and adulthood. We hypothesized that long-lived species will maintain higher levels of NRG-1 and that this contributes to their sustained brain function and concomitant maintenance of normal activity. We monitored the levels of NRG-1 and its receptor ErbB4 in H. glaber at different ages ranging from 1day to 26years and found that levels of NRG-1 and ErbB4 were sustained throughout development and adulthood. In addition, we compared seven rodent species with widely divergent (4-32year) maximum lifespan potential (MLSP) and found that at a physiologically equivalent age, the longer-lived rodents had higher levels of NRG-1 and ErbB4. Moreover, phylogenetic independent contrast analyses revealed that this significant strong correlation between MLSP and NRG-1 levels was independent of phylogeny. These results suggest that NRG-1 is an important factor contributing to divergent species MLSP through its role in maintaining neuronal integrity. © 2011 The Authors. Aging Cell © 2011 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.

Seillier A.,UTHSCSA | Advani T.,UTHSCSA | Cassano T.,University of Foggia | Hensler J.G.,UTHSCSA | Giuffrida A.,UTHSCSA
International Journal of Neuropsychopharmacology | Year: 2010

The cannabinoid hypothesis of schizophrenia tulates that over-activity of the endocannabinoid system might contribute to the aetiology of schizophrenia. In keeping with this hypothesis, increased expression of CB1 receptors, elevation of the endocannabinoid anandamide (AEA) and cannabinoid-induced cognitive changes have been reported in animal models of schizophrenia and psychotic patients. In this study we measured brain endocannabinoid levels and [35S]GTPS binding stimulated by the CB receptor agonist CP55,940 in rats undergoing withdrawal from subchronic administration of phencyclidine (PCP), a well-established pharmacological model of schizophrenia. We also investigated whether systemic application of the fatty-acid amide hydrolase (FAAH) inhibitor URB597 or CB1 receptor blockade by AM251 affected the following PCP-induced behavioural deficits reminiscent of schizophrenia-like symptoms: (1) working-memory impairment (cognitive deficit), (2) social withdrawal (negative symptom), and (3) hyperactivity in response to d-amphetamine challenge (positive symptoms). PCP-treated rats showed increased endocannabinoid levels in the nucleus accumbens and ventral tegmental area, whereas CB1 receptor expression and CP55,940-stimulated [35S]GTPS binding were unaltered. URB597 reversed the PCP-induced social withdrawal but caused social withdrawal and working-memory deficits in saline-treated rats that were comparable to those observed after PCP treatment. Administration of AM251 ameliorated the working-memory deficit in PCP-treated rats, but impaired working memory in saline-injected controls. Taken together, these results suggest that FAAH inhibition may improve negative symptoms in PCP-treated rats but produce deleterious effects in untreated animals, possibly by disturbing endocannabinoid tone. A similar pattern (beneficial for schizophrenia-related cognitive deficits, but detrimental under normal conditions) accompanies CB1 receptor blockade. © 2009 CINP.

Velligan D.,UTHSCSA | Mintz J.,UTHSCSA | Maples N.,UTHSCSA | Li X.,UTHSCSA | And 3 more authors.
Schizophrenia Bulletin | Year: 2013

Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed. © The Author 2012. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.

Akopian A.N.,UTHSCSA
Current Pharmaceutical Biotechnology | Year: 2011

TRPV1 and TRPA1 have traditionally been considered to function independently from each other as homomers, but their extensive co-expression in sensory neurons and recent evidence suggest that these channels can functionally interact and may form a complex as part of their normal function. Although TRPA1 and TRPV1 do not absolutely require interaction to maintain function in expression systems or even sensory neurons, their heteromerization may still result in dramatic effects on channel biophysical properties, pharmacology, signaling, regulation, and ultimately function. Understanding the regulation and functional significance of TRPA1-TRPV1 interaction is of tremendous clinical importance since first, both channels are the potential molecular targets for numerous therapeutic drugs; and second, TRPA1-TRPV1 co-expression is far more specific for nociceptive sensory neurons than expression patterns of TRPA1 or TRPV1 considered separately. © 2011 Bentham Science Publishers Ltd.

Mann M.,UTHSCSA | Cortez V.,UTHSCSA | Vadlamudi R.K.,UTHSCSA
Cancers | Year: 2011

Estrogen receptor (ERα) signaling plays a key role in hormonal cancer progression. ERα is a ligand-dependent transcription factor that modulates gene transcription via recruitment to the target gene chromatin. Emerging evidence suggests that ERα signaling has the potential to contribute to epigenetic changes. Estrogen stimulation is shown to induce several histone modifications at the ERα target gene promoters including acetylation, phosphorylation and methylation via dynamic interactions with histone modifying enzymes. Deregulation of enzymes involved in the ERα-mediated epigenetic pathway could play a vital role in ERα driven neoplastic processes. Unlike genetic alterations, epigenetic changes are reversible, and hence offer novel therapeutic opportunities to reverse ERα driven epigenetic changes. In this review, we summarize current knowledge on mechanisms by which ERα signaling potentiates epigenetic changes in cancer cells via histone modifications. © 2011 by the authors; licensee MDPI, Basel, Switzerland.

DeFronzo R.A.,UTHSCSA | Stonehouse A.H.,Amylin Pharmaceuticals Inc. | Han J.,Amylin Pharmaceuticals Inc. | Wintle M.E.,Amylin Pharmaceuticals Inc.
Diabetic Medicine | Year: 2010

Aims: Baseline glycated haemoglobin (HbA1c) concentrations vary between clinical trials of glucose-lowering agents and this may affect interpretation of clinical efficacy. The objective of this study is to quantify the relationship between baseline HbA1c and reduction of HbA 1c in clinical trials. Methods: PubMed literature searches from 1991 to 2007. Randomized controlled studies with placebo-controlled or comparator arms [≥ 9 patients in the intent-to-treat (ITT) population] ranging in duration from 23 to 52 weeks, in which baseline and change in glycated haemoglobin (HbA1c) were reported. The relationship between baseline HbA1c and change in HbA1c was analysed by a weighted least-squared regression model accounting for ITT population and variance of HbA1c change. Fourteen per cent of independently abstracted studies met the selection criteria. Results: Meta-analysis from 59 clinical trials (8479 patients) produced weighted R2 of 0.35 (P < 0.0001) for the association of baseline HbA1c and absolute change in HbA 1c. Subanalysis of eight metformin clinical trials demonstrated a stronger association [weighted R2 of 0.67 (P = 0.0130)]. Exclusion of metformin clinical trials from the overall meta-analysis (n = 51) yielded a weighted R2 of 0.31 (P < 0.0001). Subanalyses of clinical trials of glucose-lowering therapies predominantly targeting fasting (n = 37) or postprandial (n = 22) blood glucose produced weighted R2 values of 0.27 (P < 0.001) and 0.42 (P < 0.005), respectively. Conclusions: These data demonstrate a positive relationship between baseline HbA1c and the magnitude of HbA1c change across 10 categories of glucose-lowering therapies, irrespective of class or mode of action. These observations should be considered when assessing clinical efficacy of diabetes therapies derived from clinical trials. © 2010 The Authors.

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