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Satz P.,University of California at Los Angeles | Cole M.A.,VA Northern California Health Care System | Cole M.A.,University of California at Davis | Hardy D.J.,University of California at Los Angeles | And 2 more authors.
Journal of Clinical and Experimental Neuropsychology | Year: 2011

The concept of reserve has traditionally been defined on the basis of a single indicator (e.g., education or intracranial volume) that purports to moderate or buffer the effects of brain damage on different clinical outcomes. While studies have shown modest effects for some indicators, it has left the concept of reserve wanting as an explanatory construct. More recently efforts have been made to identify groups of indicators hypothesized to represent a construct for brain or cognitive reserve. These efforts have also proved wanting because of the lack of evidence to justify such a priori groupings of variables into a brain or cognitive reserve construct. This theoretical paper addresses the issue of construct validity (convergent and discriminant) for both brain and cognitive reserve as single or multiple reserve factors. Conceptual models are proposed that are (a) derived from the current extant reserve literature and (b) empirically testable in order to facilitate establishment of construct validity for the commonly used, and perhaps misused, brain and cognitive reserve concepts. © 2010 Psychology Press, an imprint of the Taylor & Francis Group. Source

Dall'Era M.A.,University of California at Davis | Cheng L.,Indiana University | Pan C.-X.,VA Northern California Health Care System | Pan C.-X.,University of California at Davis
Expert Review of Anticancer Therapy | Year: 2012

The current standard treatment for muscle-invasive nonmetastatic bladder cancer is neoadjuvant platinum-based chemotherapy followed by radical cystectomy. However, neoadjuvant chemotherapy is not widely accepted even with level 1 evidence. Adjuvant chemotherapy should be discussed if patients have not received neoadjuvant chemotherapy before surgery and have high-risk pathologic features. Although not considered standard of care, bladder-sparing therapy can be considered for highly selected patients and for those medically unfit for surgery. Even though there are no level 1 data, the treatment outcomes for highly select patients given bladder-sparing therapy appear promising, with many patients retaining a functional bladder. Personalized chemotherapy is currently being actively pursued to target the underlying molecular changes and tailor to individual needs. © 2012 Expert Reviews Ltd. Source

Kutter E.,Evergreen State College | De Vos D.,Burn Wound Center | Gvasalia G.,Tbilisi State Medical University | Alavidze Z.,Eliava Institute of Bacteriophages | And 3 more authors.
Current Pharmaceutical Biotechnology | Year: 2010

Phage therapy is the application of bacteria-specific viruses with the goal of reducing or eliminating pathogenic or nuisance bacteria. While phage therapy has become a broadly relevant technology, including veterinary, agricultural, and food microbiology applications, it is for the treatment or prevention of human infections that phage therapy first caught the world's imagination - see, especially, Arrowsmith by Sinclair Lewis (1925) - and which today is the primary motivator of the field. Nonetheless, though the first human phage therapy took place in the 1920s, by the 1940s the field, was in steep decline despite early promise. The causes were at least three-fold: insufficient understanding among researchers of basic phage biology; over exuberance, which led, along with ignorance, to carelessness; and the advent of antibiotics, an easier to handle as well as highly powerful category of antibacterials. The decline in phage therapy was neither uniform nor complete, especially in the former Soviet Republic of Georgia, where phage therapy traditions and practice continue to this day. In this review we strive toward three goals: 1. To provide an overview of the potential of phage therapy as a means of treating or preventing human diseases; 2. To explore the phage therapy state of the art as currently practiced by physicians in various pockets of phage therapy activity around the world, including in terms of potential commercialization; and 3. To avert a recapitulation of phage therapy's early decline by outlining good practices in phage therapy practice, experimentation, and, ultimately, commercialization. © 2010 Bentham Science Publishers Ltd. Source

Afari N.,University of California at San Diego | Ahumada S.M.,University of Minnesota | Wright L.J.,VA Northern California Health Care System | Golnari G.,University of California at San Diego | And 2 more authors.
Psychosomatic Medicine | Year: 2014

Objective: This meta-analysis systematically examined the association of reported psychological trauma and posttraumatic stress disorder (PTSD) with functional somatic syndromes including fibromyalgia, chronic widespread pain, chronic fatigue syndrome, temporomandibular disorder, and irritable bowel syndrome. Our goals were to determine the overall effect size of the association and to examine moderators of the relationship. Methods: Literature searches identified 71 studies with a control or comparison group and examined the association of the syndromes with traumatic events including abuse of a psychological, emotional, sexual, or physical nature sustained during childhood or adulthood, combat exposure, or PTSD. A random-effects model was used to estimate the pooled odds ratio and 95% confidence interval. Planned subgroup analyses and meta-regression examined potential moderators. Results: Individuals who reported exposure to trauma were 2.7 (95% confidence interval = 2.27-3.10) times more likely to have a functional somatic syndrome. This association was robust against both publication bias and the generally low quality of the literature. The magnitude of the association with PTSD was significantly larger than that with sexual or physical abuse. The association of reported trauma with chronic fatigue syndrome was larger than the association with either irritable bowel syndrome or fibromyalgia. Studies using nonvalidated questionnaires or self-report of trauma reported larger associations than did those using validated questionnaires. Conclusions: Findings are consistent with the hypothesis that traumatic events are associated with an increased prevalence of functional somatic syndromes. The analyses also highlight limitations of the existing literature and emphasize the importance of prospective studies, examining the potential similarities and differences of these conditions, and pursuing hypothesis-driven studies of the mechanisms underlying the link between trauma, PTSD, and functional somatic syndromes. Copyright © 2014 by the American Psychosomatic Society. Source

Han H.,University of California at Davis | Han H.,Peking Union Medical College | Kass P.H.,University of California at Davis | Wilsey B.L.,VA Northern California Health Care System | And 2 more authors.
Pharmacoepidemiology and Drug Safety | Year: 2014

Purpose: To examine the age and gender-specific trends of Schedule II opioid use among California residents, with special reference to multiple provider users (doctor shoppers). Methods: Utilizing data from the California Prescription Drug Monitoring Program, we examined age and gender-specific trends of Schedule II opioid use during calendar years 1999-2007. Specifically, we analyzed the following: (1) the prevalence of Schedule II opioid users among California's population and (2) the proportion of these opioid users who were doctor shoppers (defined as an individual who used more than five different prescribers for all Schedule II opioids he or she obtained in a calendar year). Results: Among all age and gender groups, the prevalence of Schedule II opioid users in California increased by 150%-280% and the prevalence of doctor shoppers among users increased by 111%-213% over 9years. The prevalence of opioid users was lowest among 18-44year old men (1.25%) and highest among 65-year and older women (5.31%) by 2007. The prevalence of doctor shoppers was approximately 1.4% among those up to age 64years and 0.5% among those 65years and older. The gender difference in doctor shoppers among all age groups was negligible. On average, the cumulative morphine-equivalent amount of Schedule II opioid per individual obtained per year was threefold to sixfold higher for doctor shoppers than for the general population across different age and gender groups. Conclusions: Age and gender differences in opioid use were relatively small, whereas the trends for use of opioids and multiple providers grew at a disquieting rate. © 2013 John Wiley & Sons, Ltd. Source

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