Wingate, NC, United States
Wingate, NC, United States

Wingate University is a private comprehensive university with nearly 2,700 students on three campuses in Wingate, Charlotte and Hendersonville, in North Carolina, United States. It was founded by Baptists in 1896 as Wingate School, an independent, co-educational institution and became a four-year college in 1977. In 1996, Wingate College became Wingate University.The university offers 34 undergraduate majors, 37 minors and career concentrations, numerous pre-professional programs, graduate degrees in business, accounting, education, physician assistant studies and sport administration, and doctorates in pharmacy, physical therapy and education.Wingate University is listed sixth among Best Value colleges and universities in the South based on quality and net cost according to the recently released ranking of the nation's top schools in U.S. News & World Report's 2012 Best Colleges. Wingate student athletes compete in 22 NCAA Division II sports, and the University has won the South Atlantic Conference Echols Athletic Excellence Award for the past seven years. Wingate University's main campus is located in Union County, North Carolina on a 400-acre campus 30 miles east of Charlotte. A high percentage of students live on campus all four years. Wikipedia.


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Koliscak L.,Wingate University
American Journal of Health-System Pharmacy | Year: 2012

Purpose. Published evidence on the incidence and predictors of venous thromboembolism (VTE) in patients with cirrhosis of the liver is reviewed. Summary. The frequently observed phenomenon of elevated International Normalized Ratio (INR) values in patients with cirrhosis has led to a theory of "autoanticoagulation" and the assertion that such patients may not benefit from the VTE risk-reduction therapies routinely used in other groups of hospitalized patients. A literature search identified six reports specifically addressing the issue of VTE risk in patients with cirrhosis. Reported rates of VTE development in such patients vary widely (0.5-8.2%) as a result of investigators' use of varying study methods and endpoints. The results of three studies (including two studies of longitudinal data on about 100,000 and nearly 450,000 patients) found no significant correlation of INR values and VTE risk. With regard to potential clinical markers of VTE risk in the context of cirrhosis, data from two studies suggested that serum albumin might serve as a reliable marker of coagulation status and, therefore, VTE risk. The results of other studies indicated that independent predictors of VTE in patients with cirrhosis include malnutrition and significant comorbidities such as chronic kidney disease and congestive heart failure. In aggregate, the available evidence does not support the autoanticoagulation theory. Conclusion. In hospitalized patients with cirrhosis who have elevated INR values, pharmacologic VTE prophylaxis should be strongly considered if there is no active or recent bleeding and if more than one risk factor for VTE is present. Copyright © 2012, American Society of Health-System Pharmacists, Inc. All rights reserved.


Amabile C.M.,Wingate University | Vasudevan A.,Neurology Hospitalist
Pharmacotherapy | Year: 2013

Epilepsy is defined as a tendency toward recurrent seizures unprovoked by any systemic or acute neurologic insults. It is a disruption of the electrical conductivity or activity in the brain, resulting in a seizure. In the United States, approximately 120 of every 100,000 people seek medical attention due to new seizure activity. Ezogabine, known as retigabine in Europe, is an ethyl N-(2- amino-4-[{fluorophenyl}methlamino]phenylcarbamate). The drug has been approved by the United States Food and Drug Administration (FDA) and European Medicines Agency for adjunctive treatment of partial-onset seizures in adults. Ezogabine exerts its therapeutic effect by enhancing transmembrane potassium channels (KCNQ ion channels), which is a novel mechanism in comparison with other antiepileptics. There are no specific documented contraindications to ezogabine. Warnings target patients that have benign prostatic hyperplasia or are receiving concomitant anticholinergic drugs due to a risk of urinary retention (2%). The FDA has required that ezogabine be part of a risk evaluation and mitigation strategy program in order to inform health care professionals of the risk of urinary retention. Prescribers should inform patients that ezogabine can cause urinary retention, including urinary hesitation, and instruct them to seek immediate medical attention if these symptoms occur. A medication guide has been developed for distribution to patients.


Dirks-Naylor A.J.,Wingate University | Lennon-Edwards S.,University of Delaware
Journal of Steroid Biochemistry and Molecular Biology | Year: 2011

It is thought that every cell in the body expresses the vitamin D receptor, and therefore vitamin D may play a role in health and homeostasis of every organ system, including skeletal muscle. Human, animal, and cell culture studies have collectively shown that vitamin D affects muscle strength and function. Vitamin D functions in a plethora of cellular processes in skeletal muscle including calcium homeostasis, cell proliferation, cell differentiation, fiber size, prevention of fatty degeneration, protection against insulin resistance and arachidonic acid mobilization. These processes appear to be mediated by several signaling pathways affected by vitamin D. This review aims to explore the effects of vitamin D on skeletal muscle in each model system and to delineate potential cell signaling pathways affected by vitamin D. © 2011 Elsevier Ltd. All rights reserved.


Klibanov O.M.,Wingate University | Gale S.E.,Wingate University | Santevecchi B.,Wingate University
Annals of Pharmacotherapy | Year: 2015

Objective: To review the data with ombitasvir/paritaprevir/ritonavir and dasabuvir for the treatment of chronic hepatitis C virus (HCV) genotype 1 infection. Data Sources: Phase I, II, and III trials and review articles were identified through MEDLINE (1996-January 2015) and PubMed (1996-January 2015), conference abstracts, and US national clinical trials registry, using the keywords NS3/4A protease inhibitor, NS5A inhibitor, NS5B polymerase inhibitor, ABT-450, ABT-267, ABT-333, paritaprevir, ombitasvir, and dasabuvir. Study Selection and Data Extraction: Preclinical, phase I, II, and III studies describing pharmacology, pharmacokinetics, efficacy, safety, and tolerability were identified. Data Synthesis: Noncirrhotic patients with HCV genotype 1b experienced sustained virological response 12 weeks after completion of therapy (SVR12) rates of 96% to 100% when ombitasvir/paritaprevir/ritonavir and dasabuvir were administered for 12 weeks, regardless of inclusion of ribavirin. SVR12 rates of 95% to 97% were seen in noncirrhotic patients with HCV genotype 1a infection who received ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin for 12 weeks. Patients with Child-Pugh Class A cirrhosis also experienced high SVR12 rates (91.8%) when ombitasvir/paritaprevir/ritonavir and dasabuvir were administered with ribavirin for 12 weeks. Cirrhotic patients with HCV genotype 1a and a history of prior null response to peginterferon/ribavirin have higher SVR12 rates when ombitasvir/paritaprevir/ritonavir and dasabuvir and ribavirin are administered for 24 instead of 12 weeks (94.2% vs 88.6%). Adverse events are typically mild, most commonly consisting of fatigue, headache, nausea, and diarrhea. Conclusion: The regimen consisting of ombitasvir/paritaprevir/ritonavir and dasabuvir is highly efficacious in the treatment of HCV genotype 1 infection, with minimal adverse events. It is expected to play an important role in the armamentarium of novel agents that have a high chance of curing HCV infection. © The Author(s) 2015.


Harris K.B.,Wingate University | McCarty D.J.,Wingate University
Therapeutic Advances in Endocrinology and Metabolism | Year: 2015

Glucagon-like peptide-1 (GLP-1) has been evaluated for use in the treatment of type 2 diabetes mellitus (T2DM) due to its role in glucose regulation. Four GLP-1 receptor agonists (RAs) are currently indicated for T2DM in the USA. Exenatide and liraglutide are short-acting and require twice-daily and daily dosing, respectively. Two longer acting agents, exenatide long-acting release (LAR) and albiglutide, were formulated to allow for once-weekly dosing. All four GLP-1 RAs have demonstrated reductions in hemoglobin A1c, fasting blood glucose, and body weight both as monotherapy and in combination with first- and second-line diabetes agents including metformin, sulfonylureas, thiazolidinediones, and insulin. Greater glycemic control was seen with liraglutide compared with the other GLP-1 treatment options; however, the two long-acting agents were superior to exenatide twice daily. All agents were well tolerated with most adverse events being mild or moderate in nature. The most common adverse event was transient nausea which typically resolved 4–8 weeks after treatment initiation. Long-acting agents had lower rates of nausea but an increased incidence of injection site reactions. Trials have suggested GLP-1 RAs may improve cardiovascular risk factors including blood pressure, lipid parameters and inflammatory markers. Future trials are needed to confirm the clinical outcomes of these agents. Overall, GLP-1 RAs will provide benefit for patients with T2DM intolerable to or not reaching glycemic goals with first-line agents, especially in patients in need of weight loss. © The Author(s), 2014.


Olin J.L.,Wingate University | St. Pierre M.,Wingate University
Annals of Pharmacotherapy | Year: 2014

Objective: To review the literature evaluating the benefit and tolerability of aromatase inhibitors (AIs) in breast cancer risk reduction. Data Source: A PubMed search (1966-July 2014) was conducted using the key terms breast cancer risk reduction, with anastrozole, exemestane, or letrozole, or aromatase inhibitors. Abstracts from recent breast cancer symposia were reviewed. Study Selection and Data Extraction: All English-language articles were reviewed for inclusion. The references of articles were reviewed for additional studies. The review focused on AI trials in women without preexisting cancer; review articles, preclinical studies, and studies of AI use in early-stage cancer were excluded. Data Synthesis: Lifestyle modifications, surgery, and selective estrogen receptor modulators (SERMs) are options for women at high risk for breast cancer compared with the general population. Statements published by various organizations help guide appropriate patient selection. Toxicities with SERMs, including increased risk for endometrial cancer, thromboembolic events, and cataracts, have limited their utility. AIs inhibit the endogenous production of estrogen and are mechanistically distinct from SERMs. Placebo-controlled trials with exemestane and anastrozole in postmenopausal women with breast cancer risk factors demonstrated at least 50% efficacy in invasive breast cancer reduction and were well tolerated. Vasomotor symptoms were experienced, but no differences in fractures or cardiovascular events were observed. Summary: Exemestane and anastrozole appear to offer benefit for postmenopausal woman at high risk for invasive breast cancer and are well tolerated. AIs offer an alternative for high-risk postmenopausal women desiring chemoprevention but with SERM contraindications. More trials are warranted to help further guide appropriate patient selection. © The Author(s) 2014.


Taylor S.R.,Wingate University | Harris K.B.,Wingate University
Pharmacotherapy | Year: 2013

The use of currently available antihyperglycemic agents can be limited by contraindications; cost; renal and hepatic dosage adjustments; dosing schedules; and adverse effects such as gastrointestinal upset, weight gain, and hypoglycemia. These limitations have led the pharmaceutical industry to identify and pursue alternative therapies. Sodium glucose cotransporter-2 (SGLT-2) inhibitors belong to a new class of diabetes drugs and have a novel mechanism of action. These agents are unique in that they increase glucose excretion, independent of insulin secretion, by inhibiting the renal reabsorption of glucose, inducing glycosuria. To summarize the current evidence for SGLT-2 inhibitor therapy, we reviewed abstracts and published data from human trials evaluating the efficacy and safety of dapagliflozin, canagliflozin, and empagliflozin through February 2013. Data from these trials suggest that SGLT-2 inhibitors are able to lower hemoglobin A1c and fasting blood glucose when used as either monotherapy or combination therapy. Cardiometabolic benefits included a reduction in systolic blood pressure, reduction in triglycerides, and weight loss of up to 3 kg. Common and serious adverse effects including infections, cancer, and pollakiuria were identified and reviewed. Although these agents have generally demonstrated efficacy, the adverse effects associated with dapagliflozin have caused a delay in its regulatory approval. Continued research in this area will determine the risk:benefit ratio of SGLT-2 inhibitor therapy. © 2013 Pharmacotherapy Publications, Inc.


Harris K.,Wingate University | Smith L.,Wingate University
Annals of Pharmacotherapy | Year: 2013

Objective: To evaluate the safety and efficacy of metformin in patients with type 2 diabetes mellitus (T2DM) and chronic hepatitis C virus (HCV) with or without cirrhosis and hepatocellular carcinoma (HCC). Data Sources: A PubMed (1946-August 2013) search using the keywords type 2 diabetes mellitus, metformin, hepatitis C virus, cirrhosis, and hepatocellular carcinoma was conducted. The references in published articles were reviewed to identify additional references for inclusion. Study Selection and Data Extraction: Studies written in English, evaluating metformin use in human patients with T2DM and chronic HCV were included. Data Synthesis: Eight studies met criteria for inclusion. Two prospective, randomized controlled trials showed increased benefit with metformin on virological response in patients with insulin resistance receiving HCV treatment. A prospective observational study evaluated metformin exclusively in patients with T2DM and HCV and showed significant reductions in the occurrence of HCC, liver-related death, and liver transplant. Four retrospective case control studies showed a decreased risk of HCC with metformin treatment in patients with T2DM and chronic liver disease. Finally, a retrospective cohort study indicated an increased survival rate in patients with diabetes and HCC undergoing radiofrequency ablation. Although diarrhea was increased in patients receiving metformin, no serious adverse effects, including lactic acidosis, were reported. Conclusions: Metformin may provide benefit in the treatment of HCV and in reducing the risk of HCC in patients with T2DM and HCV. Further long-term, randomized controlled trials are needed to adequately assess the safety and efficacy of metformin therapy in patients with comorbid diabetes and chronic HCV. © The Author(s) 2013.


Dirks-Naylor A.J.,Wingate University
Life Sciences | Year: 2013

Doxorubicin (Dox) is an effective chemotherapeutic agent, however, its use is limited by cardiotoxicity. The mechanisms causing cardiotoxicity have not been clearly elucidated, but known to involve, at least in part, oxidative stress, mitochondrial dysfunction and apoptosis. More recently, it has been suggested that dysregulation of autophagy may also play an important role in Dox-induced cardiotoxicity. Autophagy has dual functions. Under physiological conditions, autophagy is essential for optimal cellular function and survival by ridding the cell of damaged or unwanted proteins and organelles. Under pathological conditions, autophagy may be stimulated in order to protect the cell from stress stimuli or, alternatively, to contribute to cell death. Thus, appropriate regulation of autophagy can be a matter of life or death. The role of autophagy in Dox-induced cardiotoxicity has recently been explored, however, conflicting reports on the effects of Dox on autophagy and its role in cardiotoxicity exist. Most, but not all, of the studies conclude that Dox upregulates cardiac autophagy and contributes to the pathogenesis of Dox-induced toxicity. Dox may induce autophagy by suppressing the expression of GATA4 and/or S6K1, which may directly or indirectly regulate expression of essential autophagy genes such as Atg12, Atg5, Beclin1 and Bcl-2. Interestingly, the Dox-induced autophagic response may be species specific as Dox treatment has been shown to stimulate autophagy in rat models, but suppress autophagy in mouse models. Additional studies will elucidate this possibility. © 2013 Elsevier Inc.


Tzefos M.,Wingate University | Olin J.L.,Wingate University
Journal of Clinical Lipidology | Year: 2011

Objective: To review efficacy and safety data of 3-hydroxyl-3- methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (also known as statins) in adult patients with chronic liver disease. Data Source: A MEDLINE search (2005 to March 2011) was conducted with use of the keywords: statin, nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, hepatitis C, chronic liver disease, and HMG-CoA reductase inhibitor. Study Selection and Data Extraction: All articles written in English identified from data sources were evaluated and reviewed for inclusion. Original research and retrospective cohorts were included in this review. The references of articles that we identified were examined for any additional studies appropriate for review. Data Synthesis: Cardiovascular disease is a major cause of morbidity and mortality worldwide. Reducing cholesterol levels has been shown to reduce the development of atherosclerosis and incidence of cardiovascular disease. The HMG-CoA reductase inhibitors (also known as statins) are the most effective agents available in the management of hyperlipidemia and prevention of major cardiovascular events. The most common hepatic adverse effect associated with statin use is a transient asymptomatic elevation of serum aminotransferases in the first 12 weeks of therapy. Although the positive benefits of statin therapy are well recognized, the concerns of potential hepatotoxicity with statin therapy have limited use not only in the general population but also in patients with a history of chronic liver disease. Clinical trials in which the authors evaluated statin therapy in patients with nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and hepatitis C virus demonstrated improved and/or normalization of aminotransferases and improved lipid levels without any reported adverse effects attributable to statin therapy. Conclusions: Available clinical data suggest that statin therapy in nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and hepatitis C virus is a safe option in the management of dyslipidemia. © 2011 National Lipid Association. All rights reserved.

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