Publications by authors named "Magda Shaheen"

41 Publications

Racial and ethnic disparities in chronic health conditions among women with a history of gestational diabetes mellitus.

Health Promot Perspect 2021 7;11(1):54-59. Epub 2021 Feb 7.

College of Medicine, Charles R. Drew University of Medicine and Science, CA, USA.

This study aims to examine and determine the role of race/ethnicity in chronic conditions in women diagnosed with gestational diabetes mellitus (GDM) during any of their previous pregnancies. We used the National Health and Nutrition Examination Survey (NHANES) from2007-2016 to identify women who self-reported prior GDM and chronic disease diagnoses such as cardiovascular disease, hypertension, depression, and type 2 diabetes mellitus (T2DM).We used bivariate analysis using the chi-square test (χ²) and multiple logistic regressions to perform statistical test for associations, taking into consideration design and sample weight. Among participants with prior GDM diagnoses, black women had a 74.4% prevalence of chronic disease, followed by Whites, 58.5% Hispanics, 58.0%, and Asians, 51.9% (P=0.009).Black women with prior GDM diagnoses had 2.4 odds of having chronic conditions compared to Whites (adjusted odds ratio [AOR]=2.40, 95% confidence interval [CI] = 1.28-4.50). In addition, they had higher odds of being former smokers (AOR=1.73, 95% CI=1.01-2.96),current smokers (AOR=1.96, 95% CI=1.06-3.61), having a body mass index (BMI) of 25-29.9(AOR=2.55, 95% CI=1.10-5.87), or a BMI ≥30 (AOR=4.09, 95% CI = 2.05-8.17) compared to their White counterparts. Hispanic women had lower odds of being diagnosed with GDM and associated chronic diseases. Black women with GDM were disproportionally affected and at higher risk to be diagnosed with chronic conditions. Smoking and obesity were strongly associated with chronic disease diagnoses. Our findings also suggest a 'Hispanic Paradox', requiring further study. These findings inform primary care clinicians and Obstetricians, and Gynecologists of at-risk patients who could benefit from lifestyle modification recommendations and counseling.
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http://dx.doi.org/10.34172/hpp.2021.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967138PMC
February 2021

Comp34 displays potent preclinical antitumor efficacy in triple-negative breast cancer via inhibition of NUDT3-AS4, a novel oncogenic long noncoding RNA.

Cell Death Dis 2020 12 11;11(12):1052. Epub 2020 Dec 11.

Division of Cancer Research and Training, Department of Internal Medicine, Charles Drew University of Medicine and Science, David Geffen UCLA School of Medicine and UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095, USA.

The abnormal PI3K/AKT/mTOR pathway is one of the most common genomic abnormalities in breast cancers including triple-negative breast cancer (TNBC), and pharmacologic inhibition of these aberrations has shown activity in TNBC patients. Here, we designed and identified a small-molecule Comp34 that suppresses both AKT and mTOR protein expression and exhibits robust cytotoxicity towards TNBC cells but not nontumorigenic normal breast epithelial cells. Mechanically, long noncoding RNA (lncRNA) AL354740.1-204 (also named as NUDT3-AS4) acts as a microRNA sponge to compete with AKT1/mTOR mRNAs for binding to miR-99s, leading to decrease in degradation of AKT1/mTOR mRNAs and subsequent increase in AKT1/mTOR protein expression. Inhibition of lncRNA-NUDT3-AS4 and suppression of the NUDT3-AS4/miR-99s association contribute to Comp34-affected biologic pathways. In addition, Comp34 alone is effective in cells with secondary resistance to rapamycin, the best-known inhibitor of mTOR, and displays a greater in vivo antitumor efficacy and lower toxicity than rapamycin in TNBC xenografted models. In conclusion, NUDT3-AS4 may play a proproliferative role in TNBC and be considered a relevant therapeutic target, and Comp34 presents promising activity as a single agent to inhibit TNBC through regulation of NUDT3-AS4 and miR-99s.
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http://dx.doi.org/10.1038/s41419-020-03235-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733521PMC
December 2020

How Clinically Relevant Is C-Reactive Protein for Blacks with Metabolic Syndrome to Predict Microalbuminuria?

Metab Syndr Relat Disord 2021 02 3;19(1):39-47. Epub 2020 Sep 3.

Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.

The metabolic syndrome (MetS) is associated with elevated urinary albumin (UA) excretion and C-reactive protein (CRP). However, potential differences in CRP levels on the association between individual components of the MetS and microalbuminuria (MA; 30-300 μg/mL) and/or UA (0-300 μg/mL) by race/ethnicity is unknown. We analyzed National Health and Nutrition Examination Surveys (NHANES) data, (1999-2010) for adults (≥20 years of age) with the MetS ( = 5700). The Sobel-Goodman mediation test examined the influence of CRP on the association between individual MetS components and both MA and UA by race/ethnicity. We applied machine learning models to predict UA. CRP mediated the association between waist circumference (WC) and MA in Whites and Hispanics but not in Blacks. However, in general, the proportion of the total effect of MetS components on UA, mediated by CRP, was: 11% for high-density lipoprotein cholesterol (HDL-C) and 40% for WC ( < 0.001). In contrast to MA, the mediation effect of CRP for WC and UA was highest for Blacks (94%) compared with Whites (55%) or Hispanics (18%),  < 0.05. The prediction of an elevated UA concentration was increased in Blacks (∼51%) with the MetS when CRP was added to the random forest model. CRP mediates the association between UA and both HDL-C and WC in Whites and Blacks and between UA and WC in Hispanics. Moreover, the machine learning approach suggests that the incorporation of CRP may improve model prediction of UA in Blacks. These findings may favor screening for CRP in persons with the MetS, particularly in Blacks.
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http://dx.doi.org/10.1089/met.2019.0121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891189PMC
February 2021

Racial and ethnic differences in patients involved in alcohol-impaired motor vehicle crashes and its related clinical outcomes among various age groups in the U.S.

Traffic Inj Prev 2020 5;21(2):115-121. Epub 2020 Feb 5.

College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California.

1) to determine whether the proportion of alcohol-impaired patients involved in motor vehicle crashes (MVCs) varies by race/ethnicity within different age groups; 2) to explore the relationship between alcohol impairment, race/ethnicity and clinical outcomes among patients involved in MVCs across age groups. The 2012 National Trauma Data Bank (NTDB) queried for patients aged 16-55 involved in MVCs who received a blood ethanol test on admission. Of the 44,216 patients involved in MVC, 68% were White, 14% Black, and 13% were Hispanic. About 36% were 16-25years old, and 19% were 46-55years old. Alcohol-impaired patients constituted 34% of the patients. The multiple logistic regression analysis of HLOS ≥ 2days revealed that, when controlling for age, gender, race/ethnicity, insurance status, and the interaction between alcohol impairment and age as well as alcohol impairment and race/ethnicity, alcohol impairment positivity carried a 15% increase in probability of HLOS ≥ 2days (OR 1.15, p<0.0001). Additionally, using the 16-25 age group as reference, each of the older age groupings showed an increased probability of HLOS ≥ 2days with ORs of 1.15, 1.32, and 1.51 for ages 26-35, 36-45, and 46-55, respectively (p-values<0.0001). Blacks, Hispanics, and Asians/others were less likely than Whites to have HLOS ≥ 2days with OR of 0.88, 0.89, and 0.88, respectively (p<0.05). There was no statistically significant difference in the clinical outcome of mortality between races/ethnicities and alcohol-impaired driving. This study demonstrates that the proportions of alcohol-impaired driving and the associated clinical outcomes vary among race/ethnic groups in different age groups. More research is needed to determine the reasons for the observed differences in these vulnerable sub-groups.
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http://dx.doi.org/10.1080/15389588.2019.1688312DOI Listing
December 2020

Helmet use and bicycle-related trauma injury outcomes.

Brain Inj 2019 12;33(13-14):1597-1601. Epub 2019 Sep 12.

David Geffen School of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA.

: It is essential to identify factors that predict helmet use, so as to mitigate the injury and mortality from bicycle accidents.: To examine the relationship between helmet use and the bicycle-related trauma injury outcomes among bicyclists with head/neck injury in the US.: Data from the 2002-2012 National Trauma Data Bank were used, including all trauma bicycle riders involved in bicycle-related accidents whose primary reason for the hospital or Intensive Care Unit stay was head or neck injury. Using multiple logistic regression, the association between helmet use, Injury severity score (ISS), length of stay in hospital (HLOS) and Intensive Care Unit (ICULOS), and mortality was examined.: Of the 76,032 bicyclists with head/neck injury, 22% worn helmets. The lowest was among Blacks, Hispanics, and <17 years old. Wearing a helmet significantly reduces injury severity, HLOS, ICULOS, and mortality (i.e total and in-hospital). Males had a severe injury, longer HLOS, ICULOS, and higher mortality than female. Blacks and Hispanics had longer HLOS and ICULOS and higher total mortality than Whites, but had a similar chance for in-hospital mortality.: More effort is needed to enhance helmet use among at-risk bicycle riders, which may reduce injury severity, HLOS, ICULOS, and mortality.
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http://dx.doi.org/10.1080/02699052.2019.1650201DOI Listing
September 2020

Developing a Training Program to Diversify the Biomedical Research Workforce.

Acad Med 2019 08;94(8):1115-1121

D.M. Rubio is professor of medicine, biostatistics, nursing, and clinical and translational science, associate vice provost for faculty, and director, Institute for Clinical Research Education, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. M.E. Hamm is assistant professor of medicine and director, Qualitative, Evaluation, and Stakeholder Engagement Research Services, Center for Research on Health Care Data Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. C.A. Mayowski is assistant professor of medicine and clinical and translational science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. S.M. Nouraie is associate professor of pulmonary medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. A. Quarshie is professor of community health and preventive medicine, Morehouse School of Medicine, Atlanta, Georgia. T. Seto is associate professor of medicine, University of Hawaii John A. Burns School of Medicine, and medical director, Non-Invasive Cardiology Laboratory, The Queen's Medical Center, Honolulu, Hawaii. M. Shaheen is associate professor of surgery, Charles R. Drew University of Medicine and Science, Los Angeles, California. L.E. Soto de Laurido is professor, School of Health Professions, director, Hispanics in Research Capability Endowment, and director, Research Institute for Global Health Promotion and Health Education, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico. M.K. Norman is associate professor of medicine and clinical and translational science and director, IDEA Lab, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

The National Institutes of Health has made considerable investments to diversify the biomedical research workforce. Towards this goal, the authors partnered with representatives from several minority-serving institutions (MSIs) to develop training for the next generation of researchers. To ensure the most effective training program, the authors conducted a needs assessment with junior and senior investigators from the partnering MSIs. In 2016, the authors conducted focus groups and interviews with 23 junior investigators as well as in-depth interviews with 6 senior investigators from the partnering institutions with the goal of identifying specific areas of training and support that would help junior investigators at MSIs develop and sustain research careers. The data were transcribed and coded, and thematic analysis was conducted. The authors determined four areas in which training and support were needed: training in the "informal curriculum" (skills not covered in traditional clinical research courses), protected time for research training, opportunities to create career-advancing work products, and networking opportunities. The themes that were identified informed the development of the LEADS (Leading Emerging and Diverse Scientists to Success) program. The program consists of 10 instructor-led online modules each lasting approximately one month in duration with weekly synchronous sessions. Scholars are expected to be able to devote at least 20% of their time to the program.
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http://dx.doi.org/10.1097/ACM.0000000000002654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764096PMC
August 2019

Early improvement in SHIM scores with Revactin.

Int J Impot Res 2020 Mar 31;32(2):255-256. Epub 2019 Jan 31.

Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

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http://dx.doi.org/10.1038/s41443-019-0123-1DOI Listing
March 2020

Safety and efficacy of daily Revactin in men with erectile dysfunction: a 3-month pilot study.

Transl Androl Urol 2018 Apr;7(2):266-273

Department of Surgery, College of Medicine, Charles R Drew University, Los Angeles, CA, USA.

Background: The earliest sign of an ongoing change in a man's erectile function (EF) is the increase in his refractory period. This is due to the onset of an aging related apoptosis of the corporal smooth muscle cells (CSMC) as a result of oxidative stress (ROS) within the CSMC itself. In response, the CSMC begin to upregulate the inducible nitric oxide synthase (iNOS) enzyme presumably to achieve high levels of nitric oxide (NO) used to combat ROS. Treatment of aged rats for 2 months with the nutraceutical Revactin, known to stimulate the iNOS-NO-cGMP pathway in CSMC, resulted in (I) an increase in CSMC content with a decrease in corporal fibrosis, (II) decrease in systemic ROS, and (III) improvement in EF. To determine whether Revactin could be used in the clinical setting, a pilot safety study was conducted.

Methods: Fifty-four middle aged men (mean age 57.8±10.7; range, 33-77 years) were recruited for this safety study. Patients were given Revactin twice daily (total daily dose of 500 mg of ginger root, muira puama, and Paullinia cupana and 1,600 mg of L-citrulline) and were asked to complete the IIEF-15 questionnaire [domains: EF, orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS)] at baseline (B), 1 month (M1), 2 months (M2) and 3 months (M3) and report any side effects. Those on erectogenic medications at B were requested to stop taking them during the trial. Data were analyzed using Wilcoxon paired test and Friedman rank test for trend.

Results: Revactin was safe with only 5 patients reporting treatment side effects (e.g., dyspepsia, heartburn, migraine) and none considered severe. For those who stayed on the regimen (M1 =32; M2 =22; M3 =16), there was an increase in median domain scores for EF, OF, SD, IS, and OS over 3 months compared to baseline median scores but statistical significance was found only in the EF, IS, and OS median domain scores. Trend analysis indicated significant trend in EF, OS & IS (P<0.05). For the EF domain, the median scores were: M1 =21, M2 =22, M3 =19 relative to the B =16, 15.5, and 14.5, respectively (P<0.05). Overall, approximately 50% of the patients reported a significant improvement in EF (P<0.05). The major reason for trial discontinuation (M1 =22, M2 =9 and M3 =6) was non-compliance with pro-erectile medications.

Conclusions: Revactin, a combination of 3 nutraceuticals packaged with L-citrulline, appears to have the same excellent safety profile known for each of its individual four components. The early improvement in EF seen in about 50% of these patients may be due to the elevated levels of cGMP produced via this iNOS-cGMP pathway. Further longitudinal studies with Revactin appear warranted.
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http://dx.doi.org/10.21037/tau.2018.03.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911531PMC
April 2018

Insulin resistance and cognitive test performance in elderly adults: National health and nutrition examination survey (NHANES).

J Neurol Sci 2018 05 23;388:97-102. Epub 2017 Nov 23.

Loma Linda University Health, Department of Neurology, CA, United States.

Objectives: To examine the relationship between homeostatic model of insulin resistance (HOMA-IR) and cognitive test performance among population≥60years in a national database.

Hypothesis: Higher insulin resistance is associated with lower cognitive test performance score in the population≥60years.

Participants: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2000 and 2001-2002.

Measurements: Cognitive test performance was measured by the Digit Symbol Substitution (DSS) exercise score. The main independent variable was the homeostasis model assessment of insulin resistance (HOMA-IR). We used bivariate analysis and generalized linear model adjusting for age, gender, race, education, body mass index, and systolic and diastolic blood pressures; total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride levels; and physical activity, diabetes mellitus, stroke, and congestive heart failure. STATA 14 was used to analyze the data taking into consideration the design, strata and weight.

Results: Of the 1028 participants, 44% were male and 85% were white. The mean age was 70.0±0.28 (SE) years. Their average HOMA-IR was 3.6±0.14 and they had a mean of 49.2±0.8 correct DSS score in the cognitive test. Adjusting for the confounding variables, HOMA-IR was associated with decline in DSS score (B=-0.30, 95% confidence interval=-0.54 and -0.05, p=0.01). The model explained 44% of the variability of the DSS score (R=0.44). Significant predictors of decline in DSS score were age, gender, race, and education (p=0.01).

Conclusion: Insulin resistance as measured by HOMA-IR was independently associated with lower cognitive test performance score among elderly participants aged ≥60years. Longitudinal studies are needed to test the mechanism and the causal relationship.
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http://dx.doi.org/10.1016/j.jns.2017.11.031DOI Listing
May 2018

Biobran/MGN-3, an arabinoxylan rice bran, enhances NK cell activity in geriatric subjects: A randomized, double-blind, placebo-controlled clinical trial.

Exp Ther Med 2018 Mar 8;15(3):2313-2320. Epub 2018 Jan 8.

Department of Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA.

Aging is associated with a decline in natural killer (NK) and natural killer T (NKT) cell function that may contribute to increased susceptibility to malignancy and infection. A preliminary investigation was conducted examining the hypothesis that arabinoxylan rice bran (Biobran/MGN-3), a denatured hemicellulose with known immunomodulatory activity, could counteract this decline in NK/NKT cell activity in geriatrics. A total of 12 healthy geriatric subjects of both sexes and over 56 years old, participated in a randomized, double-blind, placebo-controlled clinical trial. A total of six subjects served as control and six subjects ingested Biobran/MGN-3 (500 mg/day) for 30 days. The effect of Biobran/MGN-3 supplementation on NK/NKT cell activity was assessed using the degranulation assay. All study subjects were monitored for the development of any inadvertent side effects. In addition, the pharmacological effects of Biobran/MGN-3 on blood cell components and liver and kidney functions were also assessed. Results demonstrated that Biobran/MGN-3 had no effect on the total percentage of NK cells, however it enhanced the cytotoxic activity of induced NK cell expression of cluster of differentiation 107a, when compared with baseline values and with the placebo group (P<0.05). Furthermore, there were no side effects observed, indicating that Biobran/MGN-3 supplementation was safe at the utilized dosage and for the duration of administration. Various additional beneficial effects were observed, including improved mean corpuscular volume and reduced hepatic aspartate aminotransferase enzyme levels, which suggested improved liver function. It was concluded that Biobran/MGN-3 induces a significant increase in NK activity which may increase resistance to viral infections and cancers in the geriatric population. However, additional clinical trials should be conducted in the future to verify these findings.
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http://dx.doi.org/10.3892/etm.2018.5713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5795547PMC
March 2018

46-Year Trends in Systemic Lupus Erythematosus Mortality in the United States, 1968 to 2013: A Nationwide Population-Based Study.

Ann Intern Med 2017 Dec 31;167(11):777-785. Epub 2017 Oct 31.

From University of California, Los Angeles, Charles R. Drew University of Medicine and Science, and UCLA Clinical and Translational Science Institute, Los Angeles, California.

Background: No large population-based studies have been done on systemic lupus erythematosus (SLE) mortality trends in the United States.

Objective: To identify secular trends and population characteristics associated with SLE mortality.

Design: Population-based study using a national mortality database and census data.

Setting: United States.

Participants: All U.S. residents, 1968 through 2013.

Measurements: Joinpoint trend analysis of annual age-standardized mortality rates (ASMRs) for SLE and non-SLE causes by sex, race/ethnicity, and geographic region; multiple logistic regression analysis to determine independent associations of demographic variables and period with SLE mortality.

Results: There were 50 249 SLE deaths and 100 851 288 non-SLE deaths from 1968 through 2013. Over this period, the SLE ASMR decreased less than the non-SLE ASMR, with a 34.6% cumulative increase in the ratio of the former to the latter. The non-SLE ASMR decreased every year starting in 1968, whereas the SLE ASMR decreased between 1968 and 1975, increased between 1975 and 1999, and decreased thereafter. Similar patterns were seen in both sexes, among black persons, and in the South. However, statistically significant increases in the SLE ASMR did not occur among white persons over the 46-year period. Females, black persons, and residents of the South had higher SLE ASMRs and larger cumulative increases in the ratio of the SLE to the non-SLE ASMR (31.4%, 62.5%, and 58.6%, respectively) than males, other racial/ethnic groups, and residents of other regions, respectively. Multiple logistic regression showed independent associations of sex, race, and region with SLE mortality risk and revealed significant racial/ethnic differences in associations of SLE mortality with sex and region.

Limitations: Underreporting of SLE on death certificates may have resulted in underestimates of SLE ASMRs. Accuracy of coding on death certificates is difficult to ascertain.

Conclusion: Rates of SLE mortality have decreased since 1968 but remain high relative to non-SLE mortality, and significant sex, racial, and regional disparities persist.

Primary Funding Source: None.
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http://dx.doi.org/10.7326/M17-0102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188647PMC
December 2017

Depression Symptoms, Acculturation, Needing Care, and Receiving Care: A Study of Adolescents Living in California.

J Health Dispar Res Pract 2016 ;9(3):45-66

Charles Drew University of Medicine and Science & David Geffen School of Medicine, University of California, Los Angeles.

Background: The objectives of this study are 1) to depict the prevalence of moderate depressive symptoms (MDS) in adolescents living in California, 2) to examine the role of acculturation in reported MDS, and 3) to identify any relationship between acculturation, "needing emotional help," and "receiving psychological or emotional counseling," as reported by adolescents with MDS.

Methods: We analyzed data from a cross-sectional population-based telephone survey for adolescents who completed the California Health Interview Survey (CHIS) in 2007, 2009, and 2011-2012. The primary predictor variable was level of acculturation. Outcome variables were 1) the presence of MDS, 2) whether participants needed help with emotional problems, and 3) whether they had received psychological or emotional counseling.

Results: Of the sample (n = 9816), 6.0% had MDS; 50% of these reported needing help for emotional problems, and 30% reported receiving psychological/emotional counseling. Multivariate analysis that included the interaction effects of race/ethnicity and acculturation showed that the latter was not associated with any of the outcome variables. However, Latino adolescent with MDS and moderate acculturation were less likely to report needing help for psychological/emotional problems, compared to their White counterparts with higher acculturation.

Conclusion: Our findings suggest disparities in reporting depression symptoms and receiving psychological/emotional help are not driven by adolescents' acculturation levels. However, more studies are needed to clarify what cultural factors facilitate or inhibit moderately acculturated Latino adolescents from reporting needing help for psychological/emotional problems.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440089PMC
January 2016

Association between secondhand smoke and obesity and glucose abnormalities: data from the National Health and Nutrition Examination Survey (NHANES 1999-2010).

BMJ Open Diabetes Res Care 2017 21;5(1):e000324. Epub 2017 Mar 21.

Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine , Charles R. Drew University of Medicine and Science , Los Angeles, California , USA.

Objective: The objective of this study is to investigate the relationship between cotinine level-confirmed secondhand smoke (SHS) exposure and glycemic parameters and obesity.

Research Design And Methods: We examined a cohort of 6472 adults from the National Health and Nutrition Examination Surveys, 1999-2010. Serum cotinine levels and self-reported data on smoking were used to determine smoking status. The outcome variables were body mass index (BMI) and glycemic status (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and fasting plasma glucose (FPG). Descriptive, bivariate, and multivariate analyses were conducted.

Results: Using cotinine level-confirmed smoking status, 1794 (27.4%) of the sample were current smokers, 1681 (25.0%) were former smokers, 1158 (17.8%) were secondhand smokers, and 1839 (29.8%) were non-smokers. In a generalized linear model after controlling for potential confounding variables, secondhand smokers had higher adjusted levels of HOMA-IR, FPG, and BMI compared with non-smokers (p<0.05). Adjustment for BMI demonstrated that some, but not all, of the detrimental effects of SHS on glycemic parameters are mediated by the increased body weight of secondhand smokers.

Conclusions: We conclude that SHS is associated with obesity and worsening glycemic parameters. More studies are needed to show a causal relationship between SHS and glycemic parameters and to understand the mechanisms involved in the association.
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http://dx.doi.org/10.1136/bmjdrc-2016-000324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372029PMC
March 2017

Arabinoxylan rice bran (Biobran) suppresses the viremia level in patients with chronic HCV infection: A randomized trial.

Int J Immunopathol Pharmacol 2016 Dec 31;29(4):647-653. Epub 2016 Oct 31.

Charles R Drew University of Medicine and Science, Department of Otolaryngology, Los Angeles, CA, USA

Current treatments for Hepatitis C virus (HCV) have severe side effects and are very expensive. There is a need to explore effective natural therapies against HCV that are less toxic and more cost-effective. In the current study, 37 chronic HCV patients were randomized into two groups and treated with either pegylated interferon (PEG IFN) plus ribavirin (n = 21) or Biobran, an arabinoxylan from rice bran (1 g/day) (n = 16). We examined viremia, liver enzymes, interferon-γ (IFN-γ) levels in serum, and toxicity before and three months after treatment. Both groups showed a significant and similar reduction in viral load after three months of treatment relative to the baseline viral load (P <0.05). In addition, treatment with Biobran resulted in a significant increase in the level of IFN-γ (P <0.001). Patients in the PEG IFN plus ribavirin group showed fever, anemia, thrombocytopenia, and easy fatigue. Patients in the Biobran group showed no side effects and reported good health. We conclude that Biobran is a potential novel therapeutic regimen that has a similar effect to PEG IFN plus ribavirin and is safe and cost-effective in the treatment of chronic HCV. Our finding of Biobran's efficacy against HCV infection warrants further investigation in multiple clinical trials (Clinical Trials Registration: NCT02690103).
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http://dx.doi.org/10.1177/0394632016674954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806823PMC
December 2016

The Association Between Diabetes and Dementia Among Elderly Individuals: A Nationwide Inpatient Sample Analysis.

J Geriatr Psychiatry Neurol 2016 May 9;29(3):120-5. Epub 2016 Feb 9.

Department of Epidemiology, Charles R. Drew University, Los Angeles, CA, USA.

Background/aim: To date, few studies have cross-examined the relationship between diabetes mellitus (DM) and dementia nationally. There is also a lack of evidence regarding dementia subtypes and how this relationship changes among older individuals. The objective was to better delineate this relationship and influence of multiple comorbidities using a nationwide sample.

Methods: Data were obtained from the Nationwide Inpatient Sample 1998 to 2011 using appropriate International Classification of Diseases, Ninth Version codes. Descriptive and bivariate analysis was performed. Multivariate nominal logistic regression models adjusted for age, sex, race, and comorbidities explored the independent relationship between Alzheimer dementia (AD), non-Alzheimer dementia (VaD), and diabetes.

Results: 21% of the participants were diabetic patients, 3.7% had AD, and 2.2% had VaD. Diabetes prevalence in AD, VaD, and no dementia groups were 20.6%, 24.3%, and 26.2%, respectively. In the unadjusted model, those with DM had lower odds of AD (odds ratio [OR] 0.73; 95% confidence interval [CI] 0.72-0.74) and VaD (OR 0.91, 95% CI 0.89-0.92). Adjusting for age, sex, race, and comorbidities, diabetic patients had significantly higher odds of VaD (OR = 1.10, 95% CI 1.08-1.11) and lower odds of AD (OR 0.87, 95% CI 0.86-0.88). Inclusion of interaction terms (age, race/ethnicity, depression, stroke, and hypertension) made the relationship between diabetes and VaD not significant (OR 1.002, 95% CI 0.97-1.03), but the relationship of DM with AD remained significant (OR 0.57, 95% CI 0.56-0.58; P < .05).

Conclusion: Patients with a diagnosis of diabetes mellitus had lower odds of having AD. Age, race/ethnicity, depression, stroke, and hypertension modified the relationship between DM and both VaD and AD. Further exploration of the relationship between DM and AD is warranted.
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http://dx.doi.org/10.1177/0891988715627016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102621PMC
May 2016

Dementia in the Oldest-Old: A Nationwide Inpatient Sample Database Analysis.

J Aging Health 2016 Apr 17;28(3):426-39. Epub 2015 Jul 17.

Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

Objective: The aim of this study was to explore gender and race-specific mortality and comorbidities associated with dementia hospitalizations among the oldest-old.

Method: Using the 1999-2008 Nationwide Inpatient Sample, we identified the association between dementia mortality and hospital characteristics in the oldest-old population.

Results: The oldest-old population was mostly comprised of Whites (81.1%) and women (76.0%), had shorter length of hospital stay (6.12 days), and lower hospital charges (US$18,770.32) than the young-old, despite the higher in-hospital mortality. Crude in-hospital mortality was higher for White males in the young-old population, followed by Hispanics and African Americans. However, Hispanic males had the highest mortality, followed by Whites then African Americans in the oldest-old group. After adjusting for different variables, these relationships did not change.

Discussion: There should be a greater focus on potential pre-existing biases regarding hospital care in the elderly, especially the oldest-old and elderly minority groups.
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http://dx.doi.org/10.1177/0898264315594133DOI Listing
April 2016

Improving Diabetes Health Literacy by Animation.

Diabetes Educ 2014 05 27;40(3):361-372. Epub 2014 Mar 27.

Urban Health Institute, Charles R. Drew University of Medicine and Science, Lynwood, CA, USA (Dr Baker)

Purpose And Scope: To produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics.

Methods: Participatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to "easy to read" diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS).

Results: No significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant (F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy (P = .009).

Conclusions: The positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the English and Spanish versions of the video.
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http://dx.doi.org/10.1177/0145721714527518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309339PMC
May 2014

Racial and ethnic disparities in the incidence and mortality from septic shock and respiratory failure among elective neurosurgery patients.

Neurol Res 2014 Oct 12;36(10):857-65. Epub 2014 Mar 12.

Objectives: Septic shock (SS) and respiratory failure (RF) are serious complications after neurosurgical procedures. Research is limited in studying racial/ethnic disparities in incidence and mortality of SS and RF. The study aimed to determine the racial variation in incidence and mortality from SS and RF among elective neurosurgical patients in California.

Methods: Data were analyzed from 206 902 admissions of elective neurosurgical patients in California from 2001 to 2009. Variables included race/ethnicity, age, gender, insurance, procedure site, and co-morbidities. We used descriptive, bivariate, and multivariate statistics in SAS v9·3.

Results: Septic shock incidence was 0·30/1000/year and case fatality (CF) was 47·7%. Respiratory failure incidence was 4·7/1000/year and CF was 26·2%. Blacks had higher SS and RF (0·6 and 7·9%, respectively) compared to Whites (0·2 and 4·3%, respectively) (Chi-square, P < 0·01). In the adjusted logistic regression model, Blacks had higher odds of SS (Adjusted Odds Ratio [AOR]  =  1·56, 95% CI  =  1·16-2·10) and RF (AOR  =  1·22, 95% CI  =  1·11-1·33) relative to Whites. Although, Blacks had higher mortality from SS (58·9%) and RF (30·1%) compared to Whites (45·2 and 26·4%, respectively; P < 0·05), the AORs were not statistically significant (P > 0·05).

Discussion: Blacks had a higher incidence of SS and RF. A higher percentage of black patients died from SS-related mortality, followed by Hispanics, than other groups. The attenuation of differences after statistical adjustment suggests the excess mortality may be due to age, site of the procedures, and having neoplastic disease. Our findings support the need for prospective studies to assess specific pre-operative interventions driven by age and co-morbidities that might reduce the risk of complications after neurosurgical procedures.
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http://dx.doi.org/10.1179/1743132814Y.0000000343DOI Listing
October 2014

Association of race/ethnicity, inflammation, and albuminuria in patients with diabetes and early chronic kidney disease.

Diabetes Care 2014 Apr 18;37(4):1060-8. Epub 2014 Feb 18.

Corresponding author: Satyesh K. Sinha,

OBJECTIVE African Americans (AAs) and Hispanics have higher diabetes and end-stage renal disease but similar or lower early chronic kidney disease (CKD) compared with whites. Inflammation plays a critical role in the pathogenesis of diabetes-related CKD. We postulated that in contrast to the general population, AAs and Hispanics have a higher prevalence of early diabetic CKD and systemic inflammatory markers compared with whites. RESEARCH DESIGN AND METHODS We analyzed the National Health and Nutrition Examination Survey 1999-2008 of 2,310 diabetic patients aged ≥20 years with fasting plasma glucose (FPG) ≥126 mg/dL. We performed multiple linear regression among patients with early CKD (urinary albumin excretion [UAE] ≥30 μg/mL and estimated glomerular filtration rate ≥60 mL/min/1.73 m(2)) to test the relationship between UAE and C-reactive protein (CRP) by race/ethnicity, adjusting for demographics, diabetes duration, FPG, hemoglobin A1c, uric acid, white blood cell count, medication use, cardiovascular disease, and related parameters. RESULTS In patients with diabetes, the prevalence of early CKD was greater among Hispanics and AAs than whites (P < 0.0001). AAs had higher adjusted odds ratio (AOR) for CRP ≥0.2 mg/dL (AOR 1.81 [95% CI 1.19-2.78]), and Hispanics had higher AOR for UAE ≥30 μg/mL (AOR 1.65 [1.07-2.54]). In a regression model adjusted for confounding variables, there was a significant association between UAE and CRP in the mid-CRP tertile (CRP 0.20-0.56 mg/dL, P = 0.001) and highest CRP tertile (CRP ≥0.57 mg/dL, P = 0.01) for Hispanics, but only in the mid-CRP tertile (P = 0.04) for AAs, compared with whites. CONCLUSIONS AAs and Hispanics with diabetes have a higher prevalence of early CKD compared with whites, which is significantly associated with UAE and/or CRP.
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http://dx.doi.org/10.2337/dc13-0013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069363PMC
April 2014

Traumatic brain injury related hospitalization and mortality in California.

Biomed Res Int 2013 13;2013:143092. Epub 2013 Nov 13.

Charles R Drew University of Medicine & Science, David Geffen School of Medicine at UCLA, 1731 East 120th Street, Los Angeles, CA 90059, USA.

Objective: The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.

Methods: This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.

Results: TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age ≥75 years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age ≤4 years old (53.5%), ≥75 years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15-19 and 20-24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14-1.41); males (AOR: 1.36, 95% CI: 1.27-1.46); and the ≥75-year-old group (AOR: 6.4, 95% CI: 4.9-8.4).

Conclusions: Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male ≥75 years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.
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http://dx.doi.org/10.1155/2013/143092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845866PMC
July 2014

The development and evaluation of a compassion scale.

J Health Care Poor Underserved 2013 Aug;24(3):1235-46

Compassion is the capacity for being moved by suffering of others and wanting to help alleviate it. Compassion may mediate health benefits and hazards of social networks/relationships. The monitoring/management of level of compassion across social networks/relationships may be critical to health benefits' preservation and social networks/relationships' health hazards prevention. We developed and evaluated the psychometric properties of 10-item self-report measure of compassion among 310 respondents from the University and surrounding communities. The mean total score was 3.62 (SD=1.09). The item-to-total correlations ranged from 0.50-0.71. The mean inter-item correlation was 0.33. The internal consistency was 0.82. The scale correlated well with Sprecher and Fehr's Compassionate Love Scale (r=0.66; p=.000). Two factors measuring same construct explained 57% of sample variance. The scale is user-friendly, easy to score, and characterized by good psychometric properties. It can be used to foster understanding of the impact of compassion on disease and outcomes across social networks/relationships.
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http://dx.doi.org/10.1353/hpu.2013.0148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915801PMC
August 2013

Additive effects of nicotine and high-fat diet on hepatic steatosis in male mice.

Endocrinology 2012 Dec 23;153(12):5809-20. Epub 2012 Oct 23.

Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA.

Smoking is a major risk factor for diabetes and cardiovascular disease and may contribute to nonalcoholic fatty liver disease. We hypothesize that in the presence of nicotine, high-fat diet (HFD) causes more severe hepatic steatosis in obese mice. Adult C57BL6 male mice were fed a normal chow diet or HFD and received twice daily injections of nicotine (0.75 mg/kg body weight, ip) or saline for 10 wk. Light microscopic image analysis revealed significantly higher lipid accumulation in livers from mice on HFD plus nicotine (190 ± 19 μm(2)), compared with mice on HFD alone (28 ± 1.2 μm(2)). A significant reduction in the percent volume of endoplasmic reticulum (67.8%) and glycogen (49.2%) was also noted in hepatocytes from mice on HFD plus nicotine, compared with mice on HFD alone. The additive effects of nicotine on the severity of HFD-induced hepatic steatosis was associated with significantly greater oxidative stress, increased hepatic triglyceride levels, higher incidence of hepatocellular apoptosis, inactivation (dephosphorylation) of AMP-activated protein kinase, and activation of its downstream target acetyl-coenzyme A-carboxylase. Treatment with acipimox, an inhibitor of lipolysis, significantly reduced nicotine plus HFD-induced hepatic lipid accumulation. We conclude that: 1) greater oxidative stress coupled with inactivation of AMP-activated protein kinase mediate the additive effects of nicotine and HFD on hepatic steatosis in obese mice and 2) increased lipolysis is an important contributor to hepatic steatosis. We surmise that nicotine exposure is likely to exacerbate the metabolic abnormalities induced by high-fat intake in obese patients.
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http://dx.doi.org/10.1210/en.2012-1750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512067PMC
December 2012

Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III.

BMJ Open 2012 24;2:e000494. Epub 2012 Feb 24.

Division of Endocrinology, Metabolism, and Molecular Medicine, Los Angeles, California, USA.

Objective: To determine the association between diabetes mellitus (DM) and marijuana use.

Design: Cross-sectional study.

Setting: Data from the National Health and Nutrition Examination Survey (NHANES III, 1988-1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

Participants: The study included participants of the NHANES III, a nationally representative sample of the US population. The total analytic sample was 10 896 adults. The study included four groups (n=10 896): non-marijuana users (61.0%), past marijuana users (30.7%), light (one to four times/month) (5.0%) and heavy (more than five times/month) current marijuana users (3.3%). DM was defined based on self-report or abnormal glycaemic parameters. We analysed data related to demographics, body mass index, smoking status, alcohol use, total serum cholesterol, high-density lipoprotein, triglyceride, serum 25-hydroxy vitamin D, plasma haemoglobin A1c, fasting plasma glucose level and the serum levels of C reactive protein and four additional inflammatory markers as related to marijuana use.

Main Outcome Measures: OR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).

Results: Marijuana users had a lower age-adjusted prevalence of DM compared to non-marijuana users (OR 0.42, 95% CI 0.33 to 0.55; p<0.0001). The prevalence of elevated C reactive protein (>0.5 mg/dl) was significantly higher (p<0.0001) among non-marijuana users (18.9%) than among past (12.7%) or current light (15.8%) or heavy (9.2%) users. In a robust multivariate model controlling for socio-demographic factors, laboratory values and comorbidity, the lower odds of DM among marijuana users was significant (adjusted OR 0.36, 95% CI 0.24 to 0.55; p<0.0001).

Conclusions: Marijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.
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http://dx.doi.org/10.1136/bmjopen-2011-000494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289985PMC
October 2012

A multiinstitutional, multidisciplinary model for developing and teaching translational research in health disparities.

Clin Transl Sci 2011 Dec 7;4(6):434-8. Epub 2011 Nov 7.

School of Health Professions, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Health disparities may affect any person in any community in the world, resulting from a multitude of factors including socioeconomic status, race, ethnicity, environment, and genetics. The impact of health disparities is felt by affected individuals, their families, communities, and the greater health care system. There is a critical need to increase health disparities research activities. This may be achieved by expanding and strengthening the training, education and career development of motivated clinicians, physicians and basic scientists, engaging them in clinical and translational research. Translational research relies on collaboration across disciplines, facilitating the dissemination and transfer of knowledge to populations for the overall improvement of health while decreasing the economic burden of health care. The University of Puerto Rico Medical Sciences Campus (UPR-MSC), Schools of Health Professions and Medicine joint initiatives, Clinical Research Education and Career Development (CRECD) and Hispanics in Research Capability (HiREC) programs, convened health disparities experts, faculty and scholars from multiple disciplines, cultural backgrounds and institutions. Together, they created a model for teaching translational research in health disparities that spans disciplines without boundaries.
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http://dx.doi.org/10.1111/j.1752-8062.2011.00346.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252201PMC
December 2011

Sitagliptin compared with thiazolidinediones as a third-line oral antihyperglycemic agent in type 2 diabetes mellitus.

Endocr Pract 2011 Sep-Oct;17(5):691-8

Charles R. Drew University of Medicine and Science, Los Angeles, California, USA.

Objective: To compare sitagliptin and thiazolidinediones as third-line oral antihyperglycemic agents among ethnic minority patients with poorly controlled type 2 diabetes mellitus.

Methods: In an open-label, single-arm design, we treated type 2 diabetic patients who had suboptimal diabetes control on maximum tolerated dosages of metformin plus sulfonylureas with the addition of sitagliptin, 100 mg daily, and compared their responses with findings from a historical control group of similar patients treated with rosiglitazone, 8 mg daily, or pioglitazone, 45 mg daily, as their third-line oral agent. Patients were assessed bimonthly, and those who achieved hemoglobin A1c levels less than 7.5% at 4 months continued through 1 year of follow-up.

Results: One hundred eight patients were treated with sitagliptin, and 104 patients constituted the historical control group treated with rosiglitazone or pioglitazone. At baseline, sitagliptin- and thiazolidinedione-treated patients had identical hemoglobin A1c levels (mean ± SD) (9.4 ± 1.8% and 9.4 ± 1.9%, respectively) and similar known diabetes duration (6.7 ± 5.0 years and 7.6 ± 5.8 years, respectively). Hemoglobin A1c was reduced in both groups at 4 months (P<.001), but the reduction was greater with thiazolidinediones than with sitagliptin (-2.0 ± 1.7% vs -1.3 ± 1.8%; P = .006), as was the proportion of patients achieving a hemoglobin A1c level less than 7.5% (62% vs 46%; P = .026). Of all patients achieving a hemoglobin A1c level less than 7.5% at 4 months, the same proportions in each group sustained their hemoglobin A1c level less than 7.5% by 12 months (59% vs 58%). Sitagliptin was well tolerated.

Conclusions: Among ethnic minority patients with poorly controlled type 2 diabetes while taking maximum tolerated dosages of metformin and sulfonylureas, third-line add-on therapy with a thiazolidinedione controlled hyperglycemia more effectively than sitagliptin after 4 months.
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http://dx.doi.org/10.4158/EP10405.ORDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452112PMC
May 2012

Arabinoxylan rice bran (MGN-3) enhances the effects of interventional therapies for the treatment of hepatocellular carcinoma: a three-year randomized clinical trial.

Anticancer Res 2010 Dec;30(12):5145-51

Department of Hepatogastroenterology,The 108 Military Central Hospital, Hanoi, Vietnam.

Background And Aims: This study examined the efficacy of arabinoxylan rice bran (MGN-3) in conjunction with an interventional therapy (IT) for the treatment of hepatocellular carcinoma patients.

Patients And Methods: A total of sixty-eight patients with hepatocellular carcinoma (stages I and II) participated in the study. Patients were randomized to receive IT (30 patients, control group) or IT+MGN-3 (38 patients), and randomly divided into two groups using a computer-generated randomization list. Patients and investigators were blinded. IT included transarterial oily chemoembolization (TOCE) or a combination of TOCE and percutaneous ethanol injection treatment (PEIT).

Results: Patients in the IT+MGN-3 group showed: (i) lower recurrence of the disease, 31.6% (12/38), as compared to 46.7% (14/30) for the control; (ii) higher survival after the second year, 35%, as compared to 6.7% for the control; (iii) significantly lower alpha-fetoprotein level, a 38% decrease (p = 0.0001), as compared to baseline value, while the control showed no significant change; and (iv) a significant decrease in tumor volume, in contrast to the control, which showed no significant change. When the results were analyzed according to each IT modality, MGN-3+IT sub-groups displayed a greater response to treatment, in every aspect examined, than the IT sub-groups alone. However, the patients in the MGN-3+TOCE+PEIT sub-group demonstrated greater reduction in AFP levels and longer survival time than the MGN-3+TOCE sub-group.

Conclusion: MGN-3 in conjunction with IT may be useful for the treatment of hepatocellular carcinoma and warrants further investigation in multiple clinical trials.
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December 2010

The sun sense study: an intervention to improve sun protection in children.

Am J Health Behav 2010 Jul-Aug;34(4):500-10

Laughing with Dr Alice: Promoting Heath and Wellness Through Therapeutic Humor, Los Angeles, CA, USA.

Objectives: To assess the effect of a multicomponent intervention on parental knowledge, sun avoidance behaviors, and sun protection practices in children 3-10 years.

Methods: A randomized trial at a pediatric clinic recruited 197 caregiver-child pairs (90% parents). Intervention included a brief presentation and brochure for the parent and educational video and sun protection incentives for the child.

Results: Significant improvements were observed in sun protection practices and parental knowledge but not in sun avoidance behaviors.

Conclusions: Although results support the intervention's effect on parent-child pairs for sun protection practices and parental knowledge, increasing sun avoidance behaviors may require further study.
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http://dx.doi.org/10.5993/ajhb.34.4.11DOI Listing
March 2010

MRN-100, an Iron-based Compound, Possesses Anti-HIV Activity In Vitro.

Evid Based Complement Alternat Med 2010 Dec 20;7(4):427-32. Epub 2008 Mar 20.

Department of Otolaryngology, Drew University of Medicine and Science, 1621 E. 120 Street, Los Angeles, CA 90059, USA.

We examined the in vitro anti-human immunodeficiency virus (HIV) activity of MRN-100, an iron-based compound derived from bivalent and tervalent ferrates. MRN-100 action against HIV-1 (SF strain) was tested in primary cultures of peripheral blood mononuclear cells (MNC) by analyzing p24 antigen production and percent survival of MNC infected with HIV. MRN-100 at a concentration of 10% (v/v) inhibited HIV-1 replication in 11 out of 14 samples (79%). The percentage of suppression of p24 antigen was -12.3 to 100% at 10 days post-treatment. MRN-100 also exhibited a significant protective effect in the survival of HIV-1-infected MNC. MNC survival post-treatment was dose dependent, 70.4% ± 8.4, 83.6% ± 10.7 and 90% ± 11.4, at concentrations 2.5, 5 and 10% (v/v), respectively, as compared with 53% ± 4 for HIV-1-infected MNC without treatment. The effect was detected as early as 4 days and continued up to 11 days. Treatment with MRN-100 caused no significant change in proliferative response of MNC alone or cocultured with different mitogens: PHA and Con-A (activators of T cell function) and PWM (activator of CD4(+) T cell-dependent B cells). We concluded that MRN-100 possesses anti-HIV activity in vitro and without an increase in lymphocyte proliferation, MRN-100 may be a useful agent for treating patients with acquired immunodeficiency syndrome.
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http://dx.doi.org/10.1093/ecam/nen019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892344PMC
December 2010

Organ failure associated with acute pancreatitis in African-American and Hispanic patients.

J Natl Med Assoc 2007 Dec;99(12):1402-6

Charles R. Drew University of Medicine and Science, 2594 Industry Way, Lynwood, CA 90262, USA.

Objective: We studied the relationship between acute pancreatitis and organ failure in African-American and Hispanic patients.

Methods: The medical records of 760 (417 African-American and 343 Hispanic) patients aged 19-85 years diagnosed with acute pancreatitis over 15 years were reviewed retrospectively. We abstracted and analyzed data related to demographics, etiology, type of pancreatitis, organ failure and mortality.

Results: Of the 760 patients, 24% had organ failure. Of the 182 patients with organ failure, 125 patients (69%) had multiple organ failure, whereas 57 patients (31%) had single type. Cardiovascular system failure was the common organ dysfunction (28%). Of the 760 patients, 14% died. Patients with organ failure had a higher mortality (40%) compared with those without it (6%) (OR=9.6, 95% CI: 6.0-15.3) (P=0.001). Mortality was higher among those with multiple organ failure (46%) compared with those with single type (25%). Mortality was highest among those with pulmonary failure (57%).

Conclusion: The prevalence of organ failure in our study was slightly higher than the general population (20%). Mortality from single type was higher than that reported in previous studies (8-11%), especially mortality from pulmonary failure (18%). Prevention, early diagnosis and prompt treatment of organ failure may improve the clinical outcome.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575932PMC
December 2007

Jaundice in African-American and Hispanic patients with AIDS.

J Natl Med Assoc 2007 Dec;99(12):1381-5

Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.

Although abnormalities in hepatic biochemical tests are common in patients with acquired immunodeficiency syndrome (AIDS), overt jaundice is infrequent. The aim of this study was to investigate the etiology and outcome of jaundice in African-American and Hispanic patients with AIDS. We retrospectively reviewed medical records of 1,238 HIV-infected patients with abnormal liver chemistry over a 10-year period. Data were abstracted and analyzed for demography, medications, laboratory tests, abdominal ultrasonography, computerized tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC) and liver biopsy results. Of 1,238 patients with abnormal liver chemistry and HIV infection, 1,040 (84%) had AIDS. Of the 1,040 AIDS patients, 102 (10%) had jaundice (serum bilirubin >3 mg/dL). Of the 198 HIV-positive patients without AIDS and with abnormal liver chemistry, none had jaundice. The common causes of jaundice were drugs (29%) and infections (28%). Liver biopsy was performed in 20 AIDS patients, and the common findings included granulomas, Mycobacterium avium complex (25%) and Kaposi's sarcoma (25%). Of 102 patients with AIDS and jaundice, 72 (70%) died. Of the 198 patients without AIDS and without jaundice, 14 (7%) died. In conclusion, liver-associated enzyme abnormality was common among our patients with AIDS; however, jaundice was infrequent and associated with a high mortality; drugs, infections and alcohol were the common culprits.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2575931PMC
December 2007