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https://www.readbyqxmd.com/read/28821541/targeting-mir-423-5p-reverses-exercise-training-induced-hcn4-channel-remodeling-and-sinus-bradycardia
#1
Alicia D'Souza, Charles M Pearman, Yanwen Wang, Shu Nakao, Sunil Jit R Logantha, Charlotte Cox, Hayley J Bennett, Yu Zhang, Anne Berit Johnsen, Nora Linscheid, Pi C Poulsen, Jonathan Elliott, Jessica Coulson, Jamie S McPhee, Abigail C Robertson, Paula A da Costa Martins, Ashraf Kitmitto, Ulrik Wisloff, Elizabeth J Cartwright, Oliver Monfredi, Alicia Lundby, Halina Dobrzynski, Delvac Oceandy, Gwilym M Morris, Mark R Boyett
Rationale: Downregulation of the pacemaking ion channel, HCN4, and the corresponding ionic current, If, underlies exercise training-induced sinus bradycardia in rodents. If this occurs in humans, it could explain the increased incidence of bradyarrhythmias in veteran athletes and it will be important to understand the underlying processes. Objective: To test the role of HCN4 in the training-induced bradycardia in human athletes and investigate the role of micro-RNAs (miRs) in the repression of HCN4. Methods and Results: As in rodents, the intrinsic heart rate was significantly lower in human athletes than non-athletes and in all subjects the rate-lowering effect of the HCN selective blocker, ivabradine, was significantly correlated with the intrinsic heart rate, consistent with HCN repression in athletes...
August 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28820518/living-with-hepatocellular-carcinoma-near-the-end-of-life-family-caregivers-perspectives
#2
Lissi Hansen, Susan J Rosenkranz, Kathleen Wherity, Anna Sasaki
PURPOSE/OBJECTIVES: To explore family caregivers' perspectives of caring for patients with terminal hepatocellular carcinoma (HCC) as patients approached the end of life.
. RESEARCH APPROACH: Longitudinal, qualitative descriptive design.
. SETTING: Oregon Health and Science University in Portland and Veterans Affairs Portland Health Care System in Oregon.
. PARTICIPANTS: 13 family caregivers with a mean age of 56 years (range = 22-68 years)...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28818658/cue-dependent-inhibition-in-posttraumatic-stress-disorder-and-attention-deficit-hyperactivity-disorder
#3
Zachary W Adams, Michael Meinzer, Howard Mandel, Joshua Voltin, Blaine Caughron, Floyd R Sallee, Mark Hamner, Zhewu Wang
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are common among military veterans, but the comorbidity of these two psychiatric disorders remains largely unstudied. Evaluating response inhibition and cue-dependent learning as behavioral and neurocognitive mechanisms underlying ADHD/PTSD can inform etiological models and development of tailored interventions. METHOD: A cued go/no-go task evaluated response inhibition in 160 adult males...
August 9, 2017: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28818082/comparing-chronic-condition-rates-using-icd-9-and-icd-10-in-va-patients-fy2014-2016
#4
Jean Yoon, Adam Chow
BACKGROUND: Management of patients with chronic conditions relies on accurate measurement. It is unknown how transition to the ICD-10 coding system affected reporting of chronic condition rates over time. We measured chronic condition rates 2 years before and 1 year after the transition to ICD-10 to examine changes in prevalence rates and potential measurement issues in the Veterans Affairs (VA) health care system. METHODS: We developed definitions for 34 chronic conditions using ICD-9 and ICD-10 codes and compared the prevalence rates of these conditions from FY2014 to 2016 in a 20% random sample (1...
August 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28817498/an-interprofessional-approach-to-amyotrophic-lateral-sclerosis-care
#5
Jerri L Jaffa, Marlene Dufault, Mary Lavin
Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurodegenerative disease that is characterized by the death of motor neurons in the spinal cord, brain stem, and motor cortex that are responsible for voluntary movement. For unknown reasons, military veterans are approximately twice as likely as the public to be given a diagnosis of ALS. Currently, there is no cure for ALS. The only US Food and Drug Administration-approved disease-modifying medication is riluzole (Rilutek), which may slow ALS progression but only minimally increases survival time...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28817394/drivers-of-continuing-education-learning-preferences-for-veterans-affairs-women-s-health-primary-care-providers
#6
Jessica L Zuchowski, Alison B Hamilton, Donna L Washington, Arthur G Gomez, Laure Veet, Kristina M Cordasco
INTRODUCTION: Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest...
August 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28817300/patient-ratings-of-veterans-affairs-and-affiliated-hospitals
#7
Paul A Heidenreich, Aimee Zapata, Lisa Shieh, Nancy Oliva, Anju Sahay
OBJECTIVES: Hospital Compare, a website maintained by CMS, allows comparisons of outcomes and processes of care but not of patient satisfaction for hospitals within the Veteran Affairs (VA) Healthcare System. Therefore, we sought to compare online hospital ratings between VA hospitals and their local affiliated hospitals. STUDY DESIGN: Observational analysis. METHODS: We identified 39 VA hospitals and a non-VA affiliated hospital with at least 2 online Yelp ratings...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28816923/evaluation-of-concurrent-oral-and-long-acting-injectable-antipsychotic-prescribing-at-the-minneapolis-veterans-affairs-health-care-system
#8
Erica Dimitropoulos, Lisa Drogemuller, Kara Wong
BACKGROUND: Antipsychotic polypharmacy is defined as the concomitant prescribing of more than 1 antipsychotic medication for an individual patient. Despite clinical guideline recommendations, long-acting injectable antipsychotics (LAIAs) are often used together with oral antipsychotics (OAPs) to treat a variety of psychiatric illnesses. Little research exists to address this form of antipsychotic polypharmacy, and its role in therapy is poorly understood. The purpose of this evaluation was to determine the prevalence of this prescribing pattern at our facility, identify provider rationale for polypharmacy, and analyze trends...
August 15, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28816502/cost-of-malingering-mild-traumatic-brain-injury-related-cognitive-deficits-during-compensation-and-pension-evaluations-in-the-veterans-benefits-administration
#9
John H Denning, Robert D Shura
Given the high rates of exaggeration in those claiming long-term cognitive deficits as a result of mild traumatic brain injury (mTBI), the aim of this study was to evaluate the rates of malingering in those seeking disability through the Veterans Benefits Administration and estimate the financial burden of disability payments for those receiving compensation despite exaggerated mTBI-related cognitive deficits. Retrospective review included 74 veterans seen for Compensation and Pension evaluations for mTBI. Rates of malingering were based on failure of the Medical Symptom Validity Test (MSVT) and/or the Test of Memory Malingering (TOMM) trial 1 ≤ 40...
August 17, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/28815822/hepatitis-c-virus-related-complications-are-increasing-in-women-veterans-a-national-cohort-study
#10
J R Kramer, H B El-Serag, T J Taylor, D L White, S M Asch, S M Frayne, Y Cao, D L Smith, F Kanwal
There are gender-specific variations in the epidemiology and clinical course of hepatitis C virus (HCV) infection. However, few long-term longitudinal studies have examined trends in the incidence and prevalence of serious liver complications among women compared with men with HCV infection. We used the Veterans Administration Corporate Data Warehouse to identify all veterans with positive HCV viraemia from January 2000 to December 2013. We calculated gender-specific annual incidence and prevalence rates of cirrhosis, decompensated cirrhosis and hepatocellular cancer (HCC) adjusting for age, diabetes, HIV and alcohol use...
August 16, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28815132/precision-diagnosis-of-melanoma-and-other-skin-lesions-from-digital-images
#11
Abhishek Bhattacharya, Albert Young, Andrew Wong, Simone Stalling, Maria Wei, Dexter Hadley
Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28813562/polygenic-scores-for-major-depressive-disorder-and-risk-of-alcohol-dependence
#12
Allan M Andersen, Robert H Pietrzak, Henry R Kranzler, Li Ma, Hang Zhou, Xiaoming Liu, John Kramer, Samuel Kuperman, Howard J Edenberg, John I Nurnberger, John P Rice, Jay A Tischfield, Alison Goate, Tatiana M Foroud, Jacquelyn L Meyers, Bernice Porjesz, Danielle M Dick, Victor Hesselbrock, Eric Boerwinkle, Steven M Southwick, John H Krystal, Myrna M Weissman, Douglas F Levinson, James B Potash, Joel Gelernter, Shizhong Han
Importance: Major depressive disorder (MDD) and alcohol dependence (AD) are heritable disorders with significant public health burdens, and they are frequently comorbid. Common genetic factors that influence the co-occurrence of MDD and AD have been sought in family, twin, and adoption studies, and results to date have been promising but inconclusive. Objective: To examine whether AD and MDD overlap genetically, using a polygenic score approach. Design, Settings, and Participants: Association analyses were conducted between MDD polygenic risk score (PRS) and AD case-control status in European ancestry samples from 4 independent genome-wide association study (GWAS) data sets: the Collaborative Study on the Genetics of Alcoholism (COGA); the Study of Addiction, Genetics, and Environment (SAGE); the Yale-Penn genetic study of substance dependence; and the National Health and Resilience in Veterans Study (NHRVS)...
August 16, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28813305/trauma-and-ptsd-in-older-adults-prevalence-course-concomitants-and-clinical-considerations
#13
REVIEW
Joan M Cook, Vanessa Simiola
This review presents recent empirical developments on Posttraumatic Stress Disorder (PTSD) in older adults, highlighting some of the most interesting lines of investigation that have taken place over the past few years. The majority of the extant literature has focused on male veterans or former prisoners of war, Caucasians, and those from the United States. Major advances have taken place in terms longitudinal investigations of representative samples of veterans and their health and functioning in relation to traumatic exposure...
April 2017: Current Opinion in Psychology
https://www.readbyqxmd.com/read/28813218/five-year-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass
#14
A Laurie Shroyer, Brack Hattler, Todd H Wagner, Joseph F Collins, Janet H Baltz, Jacquelyn A Quin, G Hossein Almassi, Elizabeth Kozora, Faisal Bakaeen, Joseph C Cleveland, Muath Bishawi, Frederick L Grover
Background Coronary-artery bypass grafting (CABG) surgery may be performed either with cardiopulmonary bypass (on pump) or without cardiopulmonary bypass (off pump). We report the 5-year clinical outcomes in patients who had been included in the Veterans Affairs trial of on-pump versus off-pump CABG. Methods From February 2002 through June 2007, we randomly assigned 2203 patients at 18 medical centers to undergo either on-pump or off-pump CABG, with 1-year assessments completed by May 2008. The two primary 5-year outcomes were death from any cause and a composite outcome of major adverse cardiovascular events, defined as death from any cause, repeat revascularization (CABG or percutaneous coronary intervention), or nonfatal myocardial infarction...
August 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28811048/receipt-of-nephrology-care-and-clinical-outcomes-among-veterans-with-advanced-ckd
#15
Enrica Fung, Tara I Chang, Glenn M Chertow, I-Chun Thomas, Steven M Asch, Manjula Kurella Tamura
BACKGROUND: Clinical practice guidelines recommend referral to nephrology when estimated glomerular filtration rate (eGFR) decreases to <30mL/min/1.73m(2); however, evidence for benefits of nephrology care are mixed. STUDY DESIGN: Observational cohort using landmark analysis. SETTINGS & PARTICIPANTS: A national cohort of veterans with advanced chronic kidney disease, defined as an outpatient eGFR≤30mL/min/1.73m(2) for January 1, 2010, through December 31, 2010, and a prior eGFR<60mL/min/1...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28810999/case-report-on-the-use-of-a-custom-myoelectric-elbow-wrist-hand-orthosis-for-the-remediation-of-upper-extremity-paresis-and-loss-of-function-in-chronic-stroke
#16
Stefanie Dunaway, D Brianna Dezsi, Jessica Perkins, Daniel Tran, Jonathan Naft
INTRODUCTION: This case study describes the application of a commercially available, custom myoelectric elbow-wrist-hand orthosis (MEWHO), on a veteran diagnosed with chronic stroke with residual left hemiparesis. The MEWHO provides powered active assistance for elbow flexion/extension and 3 jaw chuck grip. It is a noninvasive orthosis that is driven by the user's electromyographic signal. Experience with the MEWHO and associated outcomes are reported. MATERIALS AND METHODS: The participant completed 21 outpatient occupational therapy sessions that incorporated the use of a custom MEWHO without grasp capability into traditional occupational therapy interventions...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810987/deployment-length-inflammatory-markers-and-ambulatory-blood-pressure-in-military-couples
#17
Stephanie Brooks Holliday, Amy DeSantis, Anne Germain, Daniel J Buysse, Karen A Matthews, Wendy M Troxel
INTRODUCTION: Changes in the frequency, duration, and nature of military deployments over the past 14 years have spurred efforts to understand the effects of deployment on the health of military service members and their spouses. However, few studies have examined the impact of deployments on health outcomes in both veterans and their partners. This study aims to examine the association between deployment length and health, including ambulatory blood pressure (BP) and stress-related markers of inflammation, in military veterans and their spouses...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810986/cancer-incidence-among-patients-of-the-u-s-veterans-affairs-health-care-system-2010-update
#18
Leah L Zullig, Kellie J Sims, Rebecca McNeil, Christina D Williams, George L Jackson, Dawn Provenzale, Michael J Kelley
INTRODUCTION: Nearly 50,000 incident cancer cases are reported in Veterans Affairs (VA) Central Cancer Registry (VACCR) annually. This article provides an updated report of cancer incidence recorded in VACCR. MATERIALS AND METHODS: Data were obtained from VACCR for incident cancers diagnosed in the VA health care system, focusing on 2010 data. Cancer incidence among VA patients is described by anatomical site, sex, race, stage, and geographic location, and was compared to the general U...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810982/evaluation-of-the-validity-and-response-burden-of-patient-self-report-measures-of-the-pain-assessment-screening-tool-and-outcomes-registry-pastor
#19
Karon F Cook, Michael A Kallen, Chester Buckenmaier, Diane M Flynn, Steven R Hanling, Teresa S Collins, Kristin Joltes, Kyung Kwon, Sheila Medina-Torne, Parisa Nahavandi, Joshua Suen, Richard Gershon
BACKGROUND: In 2009, the Army Pain Management Task Force was chartered. On the basis of their findings, the Department of Defense recommended a comprehensive pain management strategy that included development of a standardized pain assessment system that would collect patient-reported outcomes data to inform the patient-provider clinical encounter. The result was the Pain Assessment Screening Tool and Outcomes Registry (PASTOR). The purpose of this study was to assess the validity and response burden of the patient-reported outcome measures in PASTOR...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810979/women-veterans-a-population-at-risk-for-fibromyalgia-the-associations-between-fibromyalgia-symptoms-and-quality-of-life
#20
Rita F D'Aoust, Alicia Gill Rossiter, Amanda Elliott, Ming Ji, Cecile Lengacher, Maureen Groer
BACKGROUND: The Institute of Federal Health Care recently published an executive summary from a round table discussion indicating that active duty and retired female military personnel are at high risk for adverse health outcomes unique to military service including complications related to post-traumatic stress disorder (PTSD), unreported sexual trauma, and musculoskeletal problems. In 2008, the Institute of Medicine began to review, evaluate, and summarize the literature on health outcomes in Gulf War-deployed and found sufficient evidence of a causal relationship with PTSD and suggestive evidence of an association with fibromyalgia (FM)...
July 2017: Military Medicine
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