Biomedical subjects

Juanita Muller

Publications and source records attributed to Juanita Muller.

3 recordsLinked to original sources

PubMed2006

Association between osteopontin and human abdominal aortic aneurysm.

OBJECTIVES: In vitro and animal studies have implicated osteopontin (OPN) in the pathogenesis of aortic aneurysm. The relationship between serum concentration of OPN and variants of the OPN gene with human abdominal aortic aneurysm (AAA) was investigated. METHODS AND RESULTS: OPN genotypes were examined in 4227 subjects in which aortic diameter and clinical risk factors were measured. Serum OPN was measured by ELISA in two cohorts of 665 subjects. The concentration of serum OPN was independently associated with the presence of AAA. Odds ratios (and 95% confidence intervals) for upper compared with lower OPN tertiles in predicting presence of AAA were 2.23 (1.29 to 3.85, P=0.004) for the population cohort and 4.08 (1.67 to 10.00, P=0.002) for the referral cohort after adjusting for other risk factors. In 198 patients with complete follow-up of aortic diameter at 3 years, initial serum OPN predicted AAA growth after adjustment for other risk factors (standardized coefficient 0.24, P=0.001). The concentration of OPN in the aortic wall was greater in patients with small AAAs (30 to 50 mm) than those with aortic occlusive disease alone. There was no association between five single nucleotide polymorphisms or haplotypes of the OPN gene and aortic diameter or AAA expansion. CONCLUSIONS: Serum and tissue concentrations of OPN are associated with human AAA. We found no relationship between variation of the OPN gene and AAA. OPN may be a useful biomarker for AAA presence and growth.

Adult↗

PubMed2006

Abdominal aortic aneurysm: pathogenesis and implications for management.

Abdominal aortic aneurysm (AAA) affects approximately 5% of elderly men and is responsible for a significant number of deaths in Western Countries. At present surgery by open or endovascular means is the only widely used therapy for this condition. In this review we examine the risk factors, serum, and genetic associations of AAA. Epidemiology studies suggest that smoking cessation and control of cholesterol and blood pressure should reduce the number of patients developing AAA. Natural history studies suggest that smoking cessation should reduce the rate of progression of AAA. Clear level 1 evidence for drug treatments of AAA are presently lacking; however, animal and human in vitro studies suggest that medication targeted at reducing inflammation and proteolysis are most likely to be beneficial, with limited data to support the use of statins, Angiotensin II inhibitors, and macrolides. Work has commenced in understanding which patients, identified by clinical, serum, and genotype, are more at risk of AAA progression and thus should be selected out for aggressive treatment. Well designed large multicenter randomized controlled trials are required to examine the medical treatment of AAA.

Angiotensin II Type 1 Receptor Blockers↗

PubMed2003

Leaving high school: the influence and consequences for psychological well-being and career-related confidence.

This paper examines the well-being and career decision-making self-efficacy (CDMSE) of adolescents before and after leaving school, and tests for the changes in these variables as a result of leaving school. While at high school, 309 students were assessed on levels of school achievement, well-being (psychological distress, self-esteem, life satisfaction) and CDMSE. Nine months after leaving school, 168 of these students completed the above surveys and measures of their access to the latent (e.g. social contact, time structure) and manifest (i.e. financial) benefits of employment, and work commitment. At T2, 21% were full-time students, 35% were full-time students who were also working part-time, 22% were employed in full-time jobs, and 21% were in the labour market but not employed full-time. These groupings were differentiated at T2 on aspects of well-being, self-efficacy, and access to the latent and manifest benefits of work, and at T1 on aspects of well-being and confidence. Leaving school improved well-being and confidence for some. One group was disadvantaged by having poorer well-being while at school, which predisposed them to disadvantage in the labour market. Results are discussed in relation to models of well-being and drift/social causation.

Achievement↗