Biomedical subjects

Mary Beth Scholand

Publications and source records attributed to Mary Beth Scholand.

5 recordsLinked to original sources

PubMed2025

Psychometric Properties and Prognostic Value of the UCSD Shortness of Breath Questionnaire in Hypersensitivity Pneumonitis: A Prospective Cohort Study.

RATIONALE: Dyspnea is a prominent symptom of hypersensitivity pneumonitis (HP), limiting patients' activity and impairing their quality of life. The University of California San Diego Shortness of Breath questionnaire (UCSD) is a 24-item instrument used to assess dyspnea severity in patients with various respiratory conditions. OBJECTIVE: To examine the psychometric properties of the UCSD and assess the validity of its scores as measures of dyspnea severity and prognostic value in a prospective cohort with HP. METHODS: We evaluated the reliability, validity, and responsiveness of UCSD scores and assessed the association between score change and survival in a cohort of patients with HP who completed the UCSD and other HP severity metrics at baseline, 6 and 12 months. We introduce the reliable change index (RCI) and the likely change index (LCI) as ways to assess the statistical significance of within-individual change in UCSD scores and conducted analyses to provide context. RESULTS: At baseline, internal consistency (Cronbach's coefficient alpha) was 0.97; there were significant, moderately strong correlations between UCSD scores and percent predicted forced vital capacity (FVC%) r = -0.39, percent predicted diffusing capacity of the lung for carbon monoxide (DLCO%) r = -0.33), and Borg dyspnea scores (0.55). UCSD scores were significantly different between the lowest and highest FVC%, 64.9 ± 18.9 vs. 36.2 ± 22.9. A 10-point worsening in the UCSD score was associated with a nearly 15-fold increase in time-to-death over the follow-up period. CONCLUSION: The UCSD has acceptable psychometric properties for assessing dyspnea severity in patients with HP. Worsening dyspnea is associated with shortened survival.

Journal Article↗

PubMed2006

Relationship of BMPR2 mutations to vasoreactivity in pulmonary arterial hypertension.

BACKGROUND: Vasoreactivity tests are fundamental in evaluating pulmonary arterial hypertension (PAH). Mutations of the transforming growth factor-beta type II receptor gene, BMPR2, predispose to the development of pulmonary hypertension and may alter the response to vasodilators. Previous investigations have not examined the relationship of BMPR2 mutations to vasoreactivity. METHODS AND RESULTS: We identified 133 consecutive unrelated patients with either idiopathic or familial PAH. Sixty-six patients were excluded because we lacked either DNA samples (n=18) or complete data from a vasoreactivity test (n=48). The remaining 67 patients were screened for BMPR2 DNA sequence variations, and specific variations were confirmed by gene sequencing. The vasoreactivity of patients with nonsynonymous BMPR2 variations was compared with that of patients without nonsynonymous BMPR2 variations. We found nonsynonymous BMPR2 variations in 27 of 67 patients with idiopathic (n=16 of 52) or familial (n=11 of 15) PAH. Vasoreactivity was identified in 3.7% of 27 patients with nonsynonymous BMPR2 variations and in 35% of 40 patients without nonsynonymous BMPR2 variations (P=0.003). Five of the 27 nonsynonymous variations occur commonly in healthy individuals. None of the remaining 22 patients with BMPR2 variations demonstrated vasoreactivity, and the analysis remained unchanged when we assumed that nonsynonymous BMPR2 variations were present in all 15 patients with familial PAH. CONCLUSIONS: Patients with familial or idiopathic PAH and nonsynonymous BMPR2 variations are unlikely to demonstrate vasoreactivity. Further trials are required to determine whether long-term therapy can be directed by tests for BMPR2 variations.

Adolescent↗

PubMed2005

Associations between phenylthiocarbamide gene polymorphisms and cigarette smoking.

Phenotypic evidence indicates that the ability to taste the bitter compounds phenylthiocarbamide (PTC) and 6-n-propylthiouracil (PROP) may protect against cigarette smoking. In this study, PTC gene haplotypes were found to be associated with both the odds of being a smoker and the importance of cigarette taste as a smoking motive. Smokers (n = 384) and nonsmokers (n = 183) were genotyped for polymorphisms that affect taste sensitivity to PTC and PROP. The "taster" PAV haplotype, relative to the "nontaster" AVI haplotype, was predicted to be associated with reduced odds of being a smoker and lower taste motivation as measured by the Wisconsin Inventory of Smoking Dependence Motives-68 taste/sensory processes scale. The results did not support the predicted association between the PAV and AVI haplotypes and smoker odds, but the AAV haplotype, which confers intermediate PTC/PROP taste sensitivity, was associated with reduced smoker prevalence (49% vs. 70%), chi(2)(1, N = 567) = 10.392, p = .001. The predicted relationship between PAV and AVI and taste motivation was found, F(2, 348) = 3.303, p = .038. The results encourage further exploration of the role of taste/sensory processes in tobacco dependence.

Adult↗

PubMed2003

Hypercapnia increases core temperature cooling rate during snow burial.

Previous retrospective studies report a core body temperature cooling rate of 3 degrees C/h during avalanche burial. Hypercapnia occurs during avalanche burial secondary to rebreathing expired air, and the effect of hypercapnia on hypothermia during avalanche burial is unknown. The objective of this study was to determine the core temperature cooling rate during snow burial under normocapnic and hypercapnic conditions. We measured rectal core body temperature (T(re)) in 12 subjects buried in compacted snow dressed in a lightweight clothing insulation system during two different study burials. In one burial, subjects breathed with a device (AvaLung 2, Black Diamond Equipment) that resulted in hypercapnia over 30-60 min. In a control burial, subjects were buried under identical conditions with a modified breathing device that maintained normocapnia. Mean snow temperature was -2.5 +/- 2.0 degrees C. Burial time was 49 +/- 14 min in the hypercapnic study and 60 min in the normocapnic study (P = 0.02). Rate of decrease in T(re) was greater with hypercapnia (1.2 degrees C/h by multiple regression analysis, 95% confidence limits of 1.1-1.3 degrees C/h) than with normocapnia (0.7 degrees C/h, 95% confidence limit of 0.6-0.8 degrees C/h). In the hypercapnic study, the fraction of inspired carbon dioxide increased from 1.4 +/- 1.0 to 7.0 +/- 1.4%, minute ventilation increased from 15 +/- 7 to 40 +/- 12 l/min, and oxygen saturation decreased from 97 +/- 1 to 90 +/- 6% (P < 0.01). During the normocapnic study, these parameters remained unchanged. In this study, T(re) cooling rate during snow burial was less than previously reported and was increased by hypercapnia. This may have important implications for prehospital treatment of avalanche burial victims.

Adult↗

PubMed2002

Clinical approach to interstitial lung disease.

The term interstitial lung disease (ILD) encompasses a large variety of entities. The clinical diagnosis is often difficult and is a multidisciplinary process. Achieving the correct diagnosis often involves 3 elements: a clinical impression, radiologic evaluation, and a pathologic opinion. All 3 components play a critical role. Frequently, the goal is differentiating idiopathic pulmonary fibrosis (IPF) from more treatable entities. This article provides an overview of the input provided by the 3 specialties cited earlier, as well as the interrelationship among these specialties in the diagnosis of ILD. Additional consideration is given to the decision-making process involved in determining when to obtain a biopsy specimen from a patient with ILD, and a review of current treatment strategies.

Adrenal Cortex Hormones↗