Biomedical subjects

Douglas Thompson

Publications and source records attributed to Douglas Thompson.

17 recordsLinked to original sources

PubMed2006

Modulation of the IL-12/IFN-gamma axis by IFN-alpha therapy for hepatitis C.

Although IFN-alpha forms the foundation of therapy for chronic hepatitis C, only a minority of patients has a sustained response to IFN-alpha alone. The antiviral activities of IFN-alpha formed the rationale for its use in viral hepatitis. However, IFN-alpha and the other Type I IFNs are also pleiotropic immune regulators. Type I IFNs can promote IFN-gamma production by activating STAT4 but can also inhibit production of IL-12, a potent activator of STAT4 and IFN-gamma production. The efficacy of IFN-alpha in the treatment of hepatitis C may therefore depend in part on the balance of IFN-gamma-inducing and IL-12-suppressing effects. We characterized the effects of pegylated IFN-alpha therapy for hepatitis C on the capacity of patients' PBMC to produce IL-12 and IFN-gamma ex vivo. Cells from patients with a sustained virological response to therapy had significantly greater levels of IFN-alpha-driven IFN-gamma production prior to treatment than those from nonresponding patients. No differences in pretreatment IL-12 productive capacity were seen between patient groups. However, therapy with IFN-alpha led to suppression of inducible IL-12 production throughout the course of therapy in both groups of patients.

CD4-Positive T-Lymphocytes↗

PubMed2006

Urinary biomarker profiling in transitional cell carcinoma.

Urinary biomarkers or profiles that allow noninvasive detection of recurrent transitional cell carcinoma (TCC) of the bladder are urgently needed. We obtained duplicate proteomic (SELDI) profiles from 227 subjects (118 TCC, 77 healthy controls and 32 controls with benign urological conditions) and used linear mixed effects models to identify peaks that are differentially expressed between TCC and controls and within TCC subgroups. A Random Forest classifier was trained on 130 profiles to develop an algorithm to predict the presence of TCC in a randomly selected initial test set (n = 54) and an independent validation set (n = 43) several months later. Twenty two peaks were differentially expressed between all TCC and controls (p < 10(-7)). However potential confounding effects of age, sex and analytical run were identified. In an age-matched sub-set, 23 peaks were differentially expressed between TCC and combined benign and healthy controls at the 0.005 significance level. Using the Random Forest classifier, TCC was predicted with 71.7% sensitivity and 62.5% specificity in the initial set and with 78.3% sensitivity and 65.0% specificity in the validation set after 6 months, compared with controls. Several peaks of importance were also identified in the linear mixed effects model. We conclude that SELDI profiling of urine samples can identify patients with TCC with comparable sensitivities and specificities to current tumor marker tests. This is the first time that reproducibility has been demonstrated on an independent test set analyzed several months later. Identification of the relevant peaks may facilitate multiplex marker assay development for detection of recurrent disease.

Adult↗

PubMed2006

Caffeine intake in eating disorders.

OBJECTIVE: The current study compares caffeine consumption in females with an eating disorder and females without an eating disorder. METHOD: Caffeine intake in three diagnostic groups (10 females with anorexia nervosa, 27 females with bulimia nervosa, and 42 females with binge eating disorder [BED]) was compared with caffeine intake in three comparison groups (n = 659 each). Data were obtained from a longitudinal study of Black and White girls. Three-day food records were examined for the years before the onset of the eating disorder, the onset year, and the years after the onset of the eating disorder. Data from the same years were used for the comparison groups. RESULTS: Caffeine intake increased over time between ages 9 and 19 years across all groups and this trend was not moderated by diagnostic status. For anorexia nervosa, relative to the non-eating disorder group, the proportional intake of caffeine from soda increased significantly before onset to onset to after onset and ingestion of chocolate-containing foods decreased sharply over time. CONCLUSION: Caffeine consumption in young girls with eating disorders differs from girls with no eating disorders only for anorexia nervosa, but not for bulimia nervosa or BED.

Adolescent↗

PubMed2006

Should night eating syndrome be included in the DSM?

OBJECTIVE: This article examines the status of the literature on night-eating syndrome (NES) according to five criteria that have been proposed by Blashfield, Sprock, and Fuller(1) (Compr Psychiatry 1990; 31:15-19) to determine whether NES warrants inclusion in the psychiatric nosology as a distinct eating disorder. METHOD: Relevant research papers were identified in Medline and PsychInfo using the search term "night-eating syndrome." RESULTS: None of the five criteria was met. Specifically, at the time of review, there were not yet 25 empirical papers on NES; no commonly accepted definition of or assessment approach to NES has been adopted; the utility and validity of NES need to be established, and NES needs to be differentiated more clearly from other eating disorder syndromes. CONCLUSION: This review suggests that the most pressing step toward clarifying the status of NES is to develop a uniform definition of NES. Once accomplished, research can progress to accumulating the necessary evidence to determine whether NES should be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Circadian Rhythm↗

PubMed2006

Correlates of beverage intake in adolescent girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVES: To examine longitudinal changes in consumption of 6 types of beverages (milk, diet and regular soda, fruit juice, fruit-flavored drinks, and coffee/tea) in girls and determine the relationship between beverage intake, body mass index (BMI), and nutrient intake. STUDY DESIGN: Three-day food diaries were included from black (1210) and white (1161) girls who participated in the National Heart, Lung, and Blood Institute Growth and Health Study. Diaries were recorded during annual visits beginning at ages 9 or 10 years until age 19 years. Mixed models estimated the association of (1) visit and race with average daily consumption of beverages and (2) beverage intake with BMI and average daily intake of total calories, sucrose, fructose, total sugars, and calcium. RESULTS: For girls of both races, milk consumption decreased and soda consumption increased with time. Changes in beverage intake with time varied by race for all beverages except fruit juice. For all beverage categories, consumption was associated with caloric intake. Of all beverages, increasing soda consumption predicted the greatest increase of BMI and the lowest increase in calcium intake. CONCLUSIONS: Public health efforts are needed to help adolescents gain access to and choose healthful beverages and decrease intake of beverages of minimal nutritional value.

Adolescent↗

PubMed2006

Night eating: prevalence and demographic correlates.

OBJECTIVE: To examine the prevalence and correlates of night eating, the core behavioral symptom of night eating syndrome among adolescents and adults, using two public access survey databases of nationally representative samples. RESEARCH METHODS AND PROCEDURES: Data were extracted for individuals age 13 years or older who completed food diary data for the National Health and Nutrition Examination Survey III (N = 18,407) or the Continuing Survey of Food Intakes by Individuals (N = 10,741). Prevalence estimates were calculated for three commonly used definitions of night eating. Logistic regression was used to examine correlates of night eating: type of day, season, gender, age, race/ethnicity, and BMI or obesity. RESULTS: With few exceptions, findings were similar in the two surveys. Night eating is most common during the weekend; prevalence is greatest among young adults (18 to 30 years of age) and least common among individuals age 65 years or older; and is not associated with BMI or obesity. Gender or ethnicity effects were not found to be stable across surveys. DISCUSSION: Experts need to consider type of day, age group, and possibly gender and race/ethnicity when examining population differences in night eating. Longitudinal studies are needed to further examine the link between night eating and obesity.

Adolescent↗

PubMed2006

EHR value: don't expect what you don't plan for.

A value planning approach to electronic health record implementation involves six strategies for success: Value framework development. Value modeling. Benefit requirement identification and risk mitigation. Integrated planning. Value measurement. Organizing for value.

Financial Management, Hospital↗

PubMed2005

Influences of blood sample processing on low-molecular-weight proteome identified by surface-enhanced laser desorption/ionization mass spectrometry.

BACKGROUND: Profiling approaches in proteomics, such as surface-enhanced laser desorption/ionization (SELDI) mass spectrometry, are used in disease marker discovery. The aim of this study was to investigate the potential influence of selected preanalytical factors on the results obtained. METHODS: Plasma samples anticoagulated with EDTA, citrate, or heparin, and serum samples from healthy volunteers were profiled by SELDI on CM10, immobilized metal affinity capture (IMAC) array with copper, and H50 chip surfaces. Using linear mixed-effects models, we examined the influence of elapsed time between venipuncture and sample separation (immediate to 24 h) and the type of serum tube used (Greiner Vacuette activator, gel serum separator, or plain tubes). We analyzed purified platelets, as well as platelet-poor and platelet-rich plasma samples treated with calcium and/or thrombin to determine the platelet contribution, directly or via the clotting process, to the profiles generated. We then used cluster analysis to identify samples with similar peak profiles. RESULTS: Different plasma types and sera could be distinguished on the basis of cluster analyses of their spectral profiles. Elapsed time between venipuncture and separation of plasma and serum from blood samples altered the profiles obtained, particularly for serum samples and particularly on IMAC chips. The type of serum collection tube also affected the profiles because of differences in clotting time. In vitro manipulation of platelets revealed that specific peaks in IMAC profiles of serum appeared to be derived directly from platelets. Several other peaks, including some of those exhibiting time-dependent changes, arose during the clotting process. CONCLUSION: Preanalytical variables, such as sample handling, can markedly influence results.

Adult↗

PubMed2005

The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients. DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas. MAIN OUTCOME MEASURES: Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc. STATISTICAL ANALYSES: Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables. RESULTS: Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI. CONCLUSIONS: Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.

Adolescent↗

PubMed2005

Prevalence and comorbidity of major depressive disorder in young black and white women.

OBJECTIVE: This study reports the prevalence and comorbidity of depression in two large samples of black and white young adult women. METHOD: Clinical interviews of participants in a follow-up study of the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS-Wave II; N=378) were contrasted with a subsample of the National Comorbidity Survey (NCS; N=3749) to examine the rates and comorbidity of lifetime major depressive disorder in black and white women using methodology described by . The sequencing of disorders was also examined to determine which disorder was primary. Comorbidity and sequencing were examined for alcohol and drug use disorder, panic disorder, specific phobia, social phobia, and post-traumatic stress disorder. RESULTS: Prevalence estimates for depression, alcohol use disorder, and drug use disorder were higher for white women than for black women in both NGHS-Wave II and NCS. Over half of depressed participants in both samples had at least one comorbid disorder and depression was associated with an increased probability of all the investigated disorders. Only one ethnic difference was found in comorbidity, indicating that black women were more likely to have comorbid panic disorder than white women were. Depression was primary to alcohol and substance use disorders, whereas it was secondary to specific phobia and PTSD. CONCLUSIONS: High rates of comorbidity were found for both black and white women, though few ethnic differences in comorbidity were found. Preventive and treatment interventions are needed to address multiple disorders in young adult women.

Adult↗

PubMed2005

Does adolescent depression predict obesity in black and white young adult women?

BACKGROUND: To examine whether adolescent depressive symptoms predict young adult body mass index (BMI) and obesity in black and white women. METHOD: Participants included 1554 black and white adolescent girls from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) who completed the Center for Epidemiological Studies--Depression Scale (CES-D) at ages 16 and 18 years. RESULTS: Regression analyses showed that depressive symptoms at both ages 16 and 18 were associated with increased risk of obesity (BMI > or = 30) and elevated BMI in young adulthood (age 21) in both black and white girls. Black girls exhibited a significantly greater likelihood of obesity and higher BMI (i.e. a main effect of race), but the race x CES-D interaction was not significant in any analysis. CONCLUSIONS: Depressive symptoms in adolescence appear to be predictive of obesity and elevated BMI in early adulthood for both black and white girls, even when taking prior BMI into account, indicating that depressive symptoms confer risk for obesity above and beyond the known tracking of body weight. Obesity prevention studies might consider assessing depressive symptoms in adolescence in order to more fully capture important risk variables.

Adolescent↗

PubMed2005

An empirical study of the typology of bulimia nervosa and its spectrum variants.

BACKGROUND: There is an ongoing debate about the best way to classify eating disorders. This study examined potential subtypes of bulimia nervosa. METHOD: Latent class analysis (LCA) was used to identify subtypes of bulimic symptomatology, utilizing data from 234 respondents in a cohort of black and white young women ( n =2054). Participants were administered gated screening questions from the Eating Disorders Examination to determine DSM-IV diagnoses of eating disorders. RESULTS: A 3-class solution was judged best. Class 1, the "purger subtype" ( n =116), was characterized by vomiting, the use of fasting/diet pills, and relatively little bingeing. Class 2, the "binger subtype" ( n =97) comprised women who engaged in bingeing but minimal compensatory behaviors. Class 3, the "binge-purger subtype" ( n =21) had relatively high rates of all symptoms. Findings of differences between the three subtypes on validator variables and differences between the three subtypes compared to non-eating disorder groups suggest validity of the three bulimic subtypes identified in our analyses. Ethnicity and class membership were associated [chi 2 (3)=21.89, p <0.0001], reflecting a greater percentage of white women than black women in Class 1 and a greater percentage of black women than white women in Class 2. CONCLUSIONS: LCA revealed one subtype that was similar to bulimia nervosa and two subtypes of bulimic symptomatology that did not meet criteria for bulimia nervosa yet appear to be clinically significant. Further study of the psychological correlates, course, and treatment response of these classes would be of clinical interest.

Adolescent↗

PubMed2005

Correlates of persistent thinness in black and white young women.

OBJECTIVE: To examine health and psychosocial correlates of persistent thinness in black and white young adult women. RESEARCH METHODS AND PROCEDURES: 1,830 females (n = 988 black, n = 842 white) who participated in the National Heart, Lung, and Blood Institute Growth and Health Study were asked to indicate their current body size from a series of nine pictograms (1, emaciated to 9, obese). Persistent thinness was defined as having at least seven non-missing measurement points between ages 9 to 18 with a body size rating of <4 at all points. Generalized linear models were used to examine whether persistently thin women differed from comparison women on cardiovascular disease risk factors measured at age 18.5 and psychosocial variables measured at age 21.5. Prospective associations between psychological measures in childhood and persistent thinness through the course of adolescence were also examined. RESULTS: In the sample, 145 women (7.9%) met criteria for persistent thinness and 1,685 women (92.1%) were classified as not persistently thin. Persistently thin women had a later age of menarche, fewer weight concerns, and healthier eating attitudes, were less likely to have had a child, came from higher socioeconomic backgrounds, and had significantly lower blood pressure and higher high-density lipoprotein-cholesterol than comparison women. Differences were not found on measures of depression or health services use. Girls with higher self-esteem in childhood were more likely to remain persistently thin throughout adolescence. DISCUSSION: Persistently thin women seem to be healthier on several indicators relative to comparison women, and race did not moderate these differences.

Adolescent↗

PubMed2004

Relationship of serum cardiac markers following successful percutaneous coronary intervention and subsequent exercise capacity in patients with chronic stable angina: a pilot study.

We performed a pilot study to assess the significance of modest, asymptomatic, elevated serum cardiac markers--troponin T (TnT) and creatinine kinase-MB (CK-MB)--18-24 h following successful elective percutaneous coronary intervention (PCI) and to explore their relationship with changes in aerobic exercise capacity, as measured by peak oxygen consumption (VO2), 6 weeks following the procedure. Twenty-three patients with single-vessel disease and chronic angina performed an incremental cardiopulmonary exercise test before and 6 weeks after successful uncomplicated PCI. A venous blood sample was taken at rest before PCI and 18-24 h after the procedure. Successful PCI resulted in a trend towards an increased peak VO2 [21.62 +/- 0.64 (pre) vs. 23.03 +/- 0.75 ml/ kg/min (post), p = 0.07; mean +/- SEM]. There was a significant increase [median (IQR)] in TnT, from 0.00 (0.00) microg/l at baseline increasing to 0.02 (0.03) microg/l at 18-24 h, p = 0.002. CK-MB levels showed no significant difference. In the group of 15/23 (65%) patients with an elevation in serum TnT (>/=0.01 microg/l), 18-24 h after successful PCI, there was no significant increase in peak VO2 [23.31 +/- 0.96 (pre) vs. 23.89 +/- 1.09 ml/kg/min (post), p = 0.57]. In 8 (35%) patients with no rise in TnT at 18-24 h, a significant increase in peak VO2 was observed following successful PCI [23.10 +/- 0.91 (pre) vs. 25.09 +/- 0.75 ml/kg/min (post), p = 0.02]. Although 7 of these 8 patients increased their peak VO2, the absence of a TnT rise at 18-24 h was not significantly associated with an increase in peak VO2 following successful PCI (p = 0.18). To confirm these interesting initial results and investigate the relationship of serum cardiac markers following successful PCI and subsequent exercise capacity, further studies are required.

Adult↗

PubMed2004

Changes in weight and body image over time in women with eating disorders.

BACKGROUND: This study examined the changes in body image and weight in young women with an adolescent eating disorder, relative to women without an eating disorder (noED). METHOD: Three diagnostic groups, anorexia nervosa (AN; n = 10), bulimia nervosa (BN; n = 27), and binge eating disorder (BED; n = 42) and three comparison groups (noED; n = 659 each) were compared on body mass index (BMI) and self-reported current body size, ideal body size, and weight dissatisfaction. Dependent variables were examined 2 and 1 year before the onset, the onset year, and 1 and 2 years after the onset of the eating disorder in a model that was adjusted for ethnicity and BMI. RESULTS: BMI was lower in the AN group at all time points except 2 years before onset. AN girls evidenced a significantly stronger relation between BMI and current self-ratings and weight dissatisfaction than noED girls. BMI did not differ between the BN group and the noED group. Girls with BN reported larger current body sizes and greater weight dissatisfaction across all time points. The BED group had higher BMI than the noED group across time. BED girls reported greater current body size ratings and weight dissatisfaction than the noED girls. Girls with AN, BN, or BED did not differ from the noED girls on body ideal ratings. DISCUSSION: Body weight seems to influence perception of body size more so for girls with AN than for noED girls. No support was found for an accelerated weight gain over time for BN. Weight may increase over time for the BED group relative to the noED group, but larger studies are needed. Across all three groups, ideal body size appears to be unrelated to diagnostic status. Rather, the risk for developing an eating disorder appears to arise from size overestimation and related weight dissatisfaction.

Adolescent↗

PubMed2004

Definitions of night eating in adolescent girls.

OBJECTIVE: To describe the prevalence of night eating in a community cohort of black and white girls, using different definitions of night eating as described in the literature. RESEARCH METHODS AND PROCEDURES: Three-day food diaries collected as part of the National Growth and Health Study were examined to identify episodes of night eating, which was defined in five different ways: eating >25% of daily caloric intake after the last evening meal, eating >25% of daily caloric intake after 7 pm, eating >50% of daily caloric intake after the last evening meal, eating >50% of daily caloric intake after 7 pm, or eating between 11 pm and 4:59 am. RESULTS: Frequency of night eating varied tremendously depending on how the behavior was defined. For the least restrictive definition (>25% of total intake after last meal), 50% to 70% of girls reported one night eating event; for the most restrictive (>50% of total intake after last meal), only 1.5% of 11-year-old girls' diaries and 3.5% of 19-year-old girls' diaries contained a night eating event. The frequency of night eating decreased dramatically (typically by a factor of 10) if the inclusion criteria required multiple night eating events in a given week. DISCUSSION: A standard definition of night eating behavior is needed to advance the field. An agreed-on operationalized definition that includes time of day, amount of calories consumed, and a frequency criterion would enable cross-study comparisons and encourage the examination of developmental and clinical considerations of night eating behavior.

Adolescent↗

PubMed2002

Calciphylaxis, proteases, and purpura: an alternative hypothesis for the severe shock, rash, and hypocalcemia associated with meningococcal septicemia.

The hallmarks of severe meningococcal sepsis include the rapid onset of shock, purpuric rash, and metabolic derangement, in particular, hypocalcemia. The severe ecchymoses and purpura associated with meningococcal sepsis are usually attributed to acute thrombotic episodes, attributable to the associated procoagulation disorder. An alternative explanation for the rash is a sudden extravasation of calcium from the intravascular space into the tissues. We will argue that in meningococcal sepsis, cleavage of albumin into fragments by protease(s) occurs and these fragments, along with calcium, cross the endothelium into the interstitium. The fragmentation of albumin and its loss through the endothelium would also provide a more rational explanation for the rapidity of the shock and the hypocalcemia that is so characteristic of the disease.

Bacteremia↗