31 results on '"K. Malcolm"'
Search Results
2. A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity
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Brooke A. Cunningham, James W. Begun, Linda M. Kahn, Sandra Potthoff, and Jan K. Malcolm
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medicine.medical_specialty ,Minnesota ,Hospitals, Community ,Population health ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Health care ,medicine ,Humans ,030212 general & internal medicine ,Social determinants of health ,Community standards ,030505 public health ,Health Equity ,business.industry ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,Health equity ,Population Surveillance ,Community health ,Needs assessment ,Public Health ,Business ,0305 other medical science ,Program Evaluation - Abstract
Context Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Objective Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. Design, setting, and participants We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota, metropolitan area in 2015. Main outcome measure Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. Results A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Conclusions Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.
- Published
- 2018
3. 392: M-CSF and GM-CSF matured macrophages demonstrate disparate bactericidal activity and inflammatory phenotype in response to infection by Mycobacterium abscessus
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W. Janssen, Jerry A. Nick, K. Malcolm, A. Ochoa, A. Simenauer, Katherine B. Hisert, and K. Skinner
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Pulmonary and Respiratory Medicine ,biology ,business.industry ,Pediatrics, Perinatology and Child Health ,Medicine ,Mycobacterium abscessus ,biology.organism_classification ,business ,medicine.disease ,Cystic fibrosis ,Phenotype ,Microbiology - Published
- 2021
4. A Case of Morvan's Syndrome Associated with Heavy Metal Poisoning after Ayurvedic Drug Intake
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S Mohanakkannan, Arunan S, Sowmini R Perumal, K Malcolm Jeyaraj, and Sakthi Velayudham
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medicine.medical_specialty ,Injury control ,peripheral nerve hyperexcitability ,Poison control ,Case Report ,lcsh:RC321-571 ,Morvan's syndrome ,03 medical and health sciences ,0302 clinical medicine ,Metal poisoning ,Peripheral nerve ,Medicine ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,biology ,business.industry ,General Neuroscience ,Ayurvedic drug intake ,Heavy metals ,medicine.disease ,Dermatology ,030205 complementary & alternative medicine ,heavy metal poisoning ,biology.protein ,Neurology (clinical) ,Antibody ,Drug intoxication ,business - Abstract
Morvan's syndrome is an autoimmune disorder of peripheral and central nervous system mediated by VGKC antibody. Here we report a case of Morvans syndrome who presented 1 month after ayurvedic drug intake. She presented with symptoms of peripheral nerve hyperexcitablity and autoimmune testing revealed positive result for VGKC antibody. Heavy metals level was also significantly raised. She improved after a course of steroids. This case report tries to highlight the association of VGKC mediated Morvans syndrome with heavy metal poisoning and its incidental occurence after Ayurvedic drug intake.
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- 2018
5. An automated computational biomechanics workflow for improving breast cancer diagnosis and treatment
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Poul M. F. Nielsen, Anthony Doyle, Duane T. K. Malcolm, Anna Mîra, Thiranja P. Babarenda Gamage, Martyn P. Nash, and Gonzalo D. Maso Talou
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medicine.medical_specialty ,Modalities ,business.industry ,0206 medical engineering ,Biomedical Engineering ,Biophysics ,Bioengineering ,02 engineering and technology ,Articles ,Computational biomechanics ,medicine.disease ,020601 biomedical engineering ,Biochemistry ,030218 nuclear medicine & medical imaging ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Workflow ,Breast cancer ,Medical imaging ,medicine ,Medical physics ,business ,Biotechnology - Abstract
Clinicians face many challenges when diagnosing and treating breast cancer. These challenges include interpreting and co-locating information between different medical imaging modalities that are used to identify tumours and predicting where these tumours move to during different treatment procedures. We have developed a novel automated breast image analysis workflow that integrates state-of-the-art image processing and machine learning techniques, personalized three-dimensional biomechanical modelling and population-based statistical analysis to assist clinicians during breast cancer detection and treatment procedures. This paper summarizes our recent research to address the various technical and implementation challenges associated with creating a fully automated system. The workflow is applied to predict the repositioning of tumours from the prone position, where diagnostic magnetic resonance imaging is performed, to the supine position where treatment procedures are performed. We discuss our recent advances towards addressing challenges in identifying the mechanical properties of the breast and evaluating the accuracy of the biomechanical models. We also describe our progress in implementing a prototype of this workflow in clinical practice. Clinical adoption of these state-of-the-art modelling techniques has significant potential for reducing the number of misdiagnosed breast cancers, while also helping to improve the treatment of patients.
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- 2019
6. Alpha-1 Antitrypsin Imparts an Anti-Inflammatory Effect Without Increasing Bacterial Burden in Models of Antibiotic-Treated Cystic Fibrosis P. Aeruginosa Infection
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S. Caceres, K. Ward, N. Schaunaman, D.P. Nichols, H.W. Chu, K. Malcolm, S. Gellatly, and P.E. Bratcher
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medicine.drug_class ,business.industry ,Antibiotics ,Immunology ,medicine ,Alpha (ethology) ,medicine.disease ,business ,Cystic fibrosis ,Anti-inflammatory - Published
- 2019
7. Medication Discontinuation and Survival in Elderly Veterans on Antifibrotics for Idiopathic Pulmonary Fibrosis
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K. Malcolm, J.R. Greenland, E.D. Farrand, N.A. Kolaitis, J. Ryan, B.J. Ley, and J.K. Brown
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Idiopathic pulmonary fibrosis ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,medicine.disease ,business ,Medication Discontinuation - Published
- 2019
8. Policy-induced selection bias in pharmacoepidemiology: The example of coverage for Alzheimer's medications in British Columbia
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Ken Bassett, K. Malcolm Maclure, Colin R. Dormuth, Anat Fisher, and Greg Carney
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reimbursement policy ,cholinesterase inhibitors ,pharmacoepidemiology ,Epidemiology ,Office Visits ,media_common.quotation_subject ,Population ,Disease ,030226 pharmacology & pharmacy ,Reimbursement Mechanisms ,03 medical and health sciences ,0302 clinical medicine ,Alzheimer Disease ,Original Reports ,Medicine ,Humans ,Original Report ,Pharmacology (medical) ,selection bias ,030212 general & internal medicine ,Longitudinal Studies ,Medical diagnosis ,education ,Reimbursement ,media_common ,Aged ,Selection bias ,education.field_of_study ,British Columbia ,business.industry ,Interrupted Time Series Analysis ,drug reimbursement ,Pharmacoepidemiology ,Alzheimer's disease ,Confidence interval ,Accidental ,business ,Demography - Abstract
Purposes To assess the impact of a government‐sponsored reimbursement policy for cholinesterase inhibitors (ChEIs) on trends in physician visits with a diagnosis of Alzheimer's disease (AD). Methods Longitudinal population‐based study using interrupted time series methods. British Columbia outpatient claims data for individuals aged 65 and older were used to compute monthly AD visit rates and examine the impact of the ChEI reimbursement policy on the coding of AD. We examined trends in the number of patients with AD visits, the number of AD visits per patient, and visits with “competing” diagnoses (mental, neurological, and cerebrovascular disorders and accidental falls). Finally, we described demographic and clinical features of diagnosed patients. Results We analyzed 1.9 million AD visits. Faster growth in recorded AD visits was observed after the policy was implemented, from monthly growth of 7.5 visits per 100 000 person‐months before the policy (95% confidence interval [CI], 6.1‐8.9) to monthly growth of 16.5 per 100 000 person‐months after the policy (95% CI, 14.8‐18.3). After the implementation of the policy, we observed increased growth in the number of patients with recorded AD visits and the number of AD visits per patient, as well as a shift in diagnoses away from mental diseases and accidental falls to AD (diagnosis substitution). Conclusions British Columbia's reimbursement policy for ChEIs was associated with a significant acceleration in Alzheimer's visits. Evaluations of health services utilization and clinical outcomes following drug policy changes need to consider policy‐induced influences on the reliability of the data used in the analysis.
- Published
- 2019
9. Revisiting Post-stroke Epilepsy
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K Malcolm Jeyaraj
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Physical medicine and rehabilitation ,Post stroke epilepsy ,business.industry ,Medicine ,General Medicine ,030204 cardiovascular system & hematology ,business ,030217 neurology & neurosurgery - Abstract
How to cite this article: Jeyaraj KM. Revisiting Post-stroke Epilepsy. Bengal Physician Journal 2020;7(1):22.
- Published
- 2021
10. Polyradiculopathy and Multiple Cranial Nerve Palsies - Rare Manifestations of Cerebral Venous Sinus Thrombosis
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M Sathish Kumar, Sowmini Padmaja Raman, K Malcolm Jeyaraj, S Sakthi Velayutham, and K Mugundhan
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medicine.medical_specialty ,Medical treatment ,Nerve root ,business.industry ,Encephalopathy ,Cranial nerves ,medicine.disease ,Polyradiculopathy ,Thrombosis ,Surgery ,Neurology ,medicine ,Neurology (clinical) ,medicine.symptom ,Cerebral venous sinus thrombosis ,business ,Papilledema - Abstract
We report about two young males who developed significant proximal weakness of all four limbs secondary to intracranial hypertension due to intracranial venous sinus thrombosis. Intracranial venous sinus thrombosis can manifest in a variety of ways which includes isolated intracranial hypertension, focal neurological symptoms or signs and acute or subacute encephalopathy. Various false localising signs have been reported to occur in patients with raised intracranial pressure including cranial nerve palsies and extensive radiculopathy. In a patient presenting with flaccid areflexic quadriparesis and papilledema, the possibility of a potentially reversible dysfunction of the cranial nerves and spinal nerve roots due to a marked rise in intracranial and intraspinal pressure must be recognised. Lumboperitoneal shunt to reduce the intraspinal pressure on the spinal nerve roots has been advocated to reverse the symptoms of extensive radiculopathy in such patients. Both of our patients showed remarkable improvement in symptoms and signs with medical treatment of CVT.
- Published
- 2021
11. Comparative safety and tolerability of duloxetine vs. pregabalin vs. duloxetine plus gabapentin in patients with diabetic peripheral neuropathic pain
- Author
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Joel Raskin, Gordon Irving, Sandra K. Malcolm, R.C. Risser, and Robert J. Tanenberg
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Adult ,Male ,Cyclohexanecarboxylic Acids ,Gabapentin ,Nausea ,Pregabalin ,Peripheral edema ,Duloxetine Hydrochloride ,chemistry.chemical_compound ,medicine ,Humans ,Duloxetine ,Amines ,Adverse effect ,gamma-Aminobutyric Acid ,Aged ,Pain Measurement ,Aged, 80 and over ,Analgesics ,business.industry ,Weight change ,Peripheral Nervous System Diseases ,General Medicine ,Middle Aged ,Treatment Outcome ,chemistry ,Tolerability ,Anesthesia ,Neuralgia ,Drug Therapy, Combination ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
SUMMARY Objective: The safety and tolerability of three treatments for diabetic peripheral neuropathic pain (DPNP) were compared. Methods: A 12-week, randomized, open-label study confirming the non-inferiority of duloxetine (N = 138) vs. pregabalin (N = 134) and the combination of duloxetine plus gabapentin (N = 135) as the primary outcome was previously published. Patients had an inadequate pain response to a stable dose of gabapentin (≥ 900 mg/day) for ≥ 5 weeks prior to study enrolment. Data from that study were assessed in this current analysis for a detailed report of safety and tolerability. Results: Completion rates did not differ significantly between the groups. Discontinuation because of adverse events was significantly greater in the duloxetine (19.6%) vs. pregabalin group (10.4%; p = 0.04); no differences emerged between the duloxetine vs. duloxetine plus gabapentin (13.3%) groups (p = 0.19) or pregabalin vs. duloxetine plus gabapentin groups (p = 0.57). Adverse event rates varied: nausea, insomnia, hyperhidrosis and decreased appetite were reported significantly more often in patients treated with duloxetine vs. patients treated with pregabalin (each p ≤ 0.01); insomnia significantly more in patients treated with duloxetine vs. duloxetine plus gabapentin (p = 0.01); peripheral oedema significantly more in patients treated with pregabalin vs. duloxetine and duloxetine plus gabapentin (p ≤ 0.001 each) and nausea, hyperhidrosis, decreased appetite and vomiting significantly more in patients treated with duloxetine plus gabapentin vs. pregabalin (each p ≤ 0.05). At end-point, weight change differed significantly among treatment groups: patients in the pregabalin group on average gained weight (1.0 0.04 kg); while, patients in the duloxetine and duloxetine plus gabapentin groups on average lost weight (2.39 0.04 and 1.06 0.04 kg, respectively) (pregabalin vs. duloxetine, p ≤ 0.001; pregabalin vs. duloxetine plus gabapentin, p ≤ 0.001; duloxetine vs. duloxetine plus gabapentin, p = 0.01). Conclusion: Duloxetine, pregabalin and duloxetine plus gabapentin were generally safe and tolerable for the treatment of DPNP. What’s known
- Published
- 2014
12. In vitro and clinical evaluation of OATP-mediated drug interaction potential of sacubitril/valsartan (LCZ696)
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W Zhou, B Goswami, Gangadhar Sunkara, Thomas Langenickel, Surya Ayalasomayajula, I Hanna, N Alexander, K Malcolm, Adrienne Natrillo, Markus Hinder, and Y Han
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Adult ,Male ,Simvastatin ,Time Factors ,Cmax ,Tetrazoles ,Pharmacology ,Organic Anion Transporters, Sodium-Independent ,030226 pharmacology & pharmacy ,Sacubitril ,03 medical and health sciences ,Angiotensin Receptor Antagonists ,Inhibitory Concentration 50 ,Solute Carrier Organic Anion Transporter Family Member 1B3 ,Young Adult ,0302 clinical medicine ,Pharmacokinetics ,polycyclic compounds ,Medicine ,Humans ,Pharmacology (medical) ,Drug Interactions ,cardiovascular diseases ,Active metabolite ,business.industry ,Liver-Specific Organic Anion Transporter 1 ,organic chemicals ,Aminobutyrates ,Biphenyl Compounds ,nutritional and metabolic diseases ,Middle Aged ,Biphenyl compound ,Drug Combinations ,HEK293 Cells ,Valsartan ,030220 oncology & carcinogenesis ,Area Under Curve ,lipids (amino acids, peptides, and proteins) ,Female ,business ,Sacubitril, Valsartan ,medicine.drug - Abstract
SummaryWhat is known and objective Sacubitril/valsartan (LCZ696) has been recently approved for the treatment of heart failure (HF) patients with reduced ejection fraction. Several HF patients receive statins as co-medication. Methods Because clearance of statins is meditated via OATP1B1/1B3, the inhibition potential of these transporters by LCZ696 analytes was evaluated in vitro. Furthermore, an open-label, fixed-sequence clinical study was conducted to determine the effect of LCZ696 on the exposure of simvastatin and its active metabolite simvastatin acid. In this clinical study, 26 healthy subjects received simvastatin 40 mg alone or in combination with LCZ696 or after 1 or 2 h of LCZ696 dosing. Results and discussion Although no significant inhibition by LBQ657 (an active metabolite of sacubitril) and valsartan was observed, sacubitril inhibited OATP1B1 and OATP1B3 in vitro, with IC50 of 1·91 and 3·81 μm, respectively. Upon co-administration of simvastatin with LCZ696, the Cmax of simvastatin and simvastatin acid decreased by 7% and 13%, respectively. When administered 1 h after LCZ696 dosing, the corresponding Cmax of simvastatin and simvastatin acid decreased by 16% and 4%, respectively. When administered 2 h after LCZ696 dosing, the Cmax of simvastatin decreased by 33% and that of simvastatin acid increased by 16%. However, no notable changes were observed in the AUCs of simvastatin or simvastatin acid upon co-administration or time-separated administration with LCZ696. No notable impact of simvastatin co-administration was observed on the pharmacokinetics of LCZ696 analytes. LCZ696 and simvastatin were generally well tolerated when administered alone or in combination. What is new and conclusions Overall, the results of this study suggest that although sacubitril inhibited OATP1B1 and OATP1B3 in vitro, it does not translate into any clinically relevant in vivo effect.
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- 2016
13. An integrated genomic approach identifies ARID1A as a candidate tumor-suppressor gene in breast cancer
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Catherine Chabot, Patricia N. Tonin, Sukru Tuzmen, Ewa Przybytkowski, Mark Basik, Spyro Mousses, K. Malcolm, Luca Cavallone, Olli Kallioniemi, Aline Mamo, Cristiano Ferrario, Saima Hassan, Henrik Edgren, and Olga Aleynikova
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Cancer Research ,DNA Copy Number Variations ,ARID1A ,Nonsense mutation ,Breast Neoplasms ,Biology ,Transfection ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,SDG 3 - Good Health and Well-being ,Cell Line, Tumor ,Genetics ,medicine ,Humans ,Genes, Tumor Suppressor ,Molecular Biology ,Gene ,030304 developmental biology ,0303 health sciences ,Nuclear Proteins ,Cell cycle ,medicine.disease ,Phenotype ,Candidate Tumor Suppressor Gene ,DNA-Binding Proteins ,Chromosomes, Human, Pair 1 ,Codon, Nonsense ,030220 oncology & carcinogenesis ,Cancer research ,RNA ,Female ,Carcinogenesis ,Transcription Factors - Abstract
Tumor-suppressor genes (TSGs) have been classically defined as genes whose loss of function in tumor cells contributes to the formation and/or maintenance of the tumor phenotype. TSGs containing nonsense mutations may not be expressed because of nonsense-mediated RNA decay (NMD). We combined inhibition of the NMD process, which clears transcripts that contain nonsense mutations, with the application of high-density single-nucleotide polymorphism arrays analysis to discriminate allelic content in order to identify candidate TSGs in five breast cancer cell lines. We identified ARID1A as a target of NMD in the T47D breast cancer cell line, likely as a consequence of a mutation in exon-9, which introduces a premature stop codon at position Q944. ARID1A encodes a human homolog of yeast SWI1, which is an integral member of the hSWI/SNF complex, an ATP-dependent, chromatin-remodeling, multiple-subunit enzyme. Although we did not find any somatic mutations in 11 breast tumors, which show DNA copy-number loss at the 1p36 locus adjacent to ARID1A, we show that low ARID1A RNA or nuclear protein expression is associated with more aggressive breast cancer phenotypes, such as high tumor grade, in two independent cohorts of over 200 human breast cancer cases each. We also found that low ARID1A nuclear expression becomes more prevalent during the later stages of breast tumor progression. Finally, we found that ARID1A re-expression in the T47D cell line results in significant inhibition of colony formation in soft agar. These results suggest that ARID1A may be a candidate TSG in breast cancer.
- Published
- 2011
14. Duloxetine, Pregabalin, and Duloxetine Plus Gabapentin for Diabetic Peripheral Neuropathic Pain Management in Patients With Inadequate Pain Response to Gabapentin: An Open-Label, Randomized, Noninferiority Comparison
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Michael J. Robinson, Sandra K. Malcolm, Jonna Ahl, Robert J. Tanenberg, R.C. Risser, Vladimir Skljarevski, and Gordon Irving
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Male ,Cyclohexanecarboxylic Acids ,Gabapentin ,Nausea ,Pregabalin ,Peripheral edema ,Thiophenes ,Duloxetine Hydrochloride ,chemistry.chemical_compound ,Diabetic Neuropathies ,Journal Article ,medicine ,Humans ,Duloxetine ,Amines ,Brief Pain Inventory ,gamma-Aminobutyric Acid ,Aged ,Pain Measurement ,Analgesics ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Treatment Outcome ,Peripheral neuropathy ,chemistry ,Anesthesia ,Neuralgia ,Drug Therapy, Combination ,Female ,medicine.symptom ,business ,medicine.drug - Abstract
OBJECTIVE To determine whether duloxetine is noninferior to (as good as) pregabalin in the treatment of pain associated with diabetic peripheral neuropathy. PATIENTS AND METHODS We performed a 12-week, open-label study of patients with diabetic peripheral neuropathic pain who had been treated with gabapentin (≥900 mg/d) and had an inadequate response (defined as a daily pain score of ≥4 on a numerical rating scale [0-10 points]). The first patient was enrolled on September 28, 2006, and the last patient visit occurred on August 26, 2009. Patients were randomized to duloxetine monotherapy (n=138), pregabalin monotherapy (n=134), or a combination of duloxetine and gabapentin (n=135). The primary objective was a noninferiority comparison between duloxetine and pregabalin on improvement in the weekly mean of the diary-based daily pain score (0- to 10-point scale) at end point. Noninferiority would be declared if the mean improvement for duloxetine was no worse than the mean improvement for pregabalin, within statistical variability, by a margin of –0.8 unit. RESULTS The mean change in the pain rating at end point was –2.6 for duloxetine and –2.1 for pregabalin. The 97.5% lower confidence limit was a –0.05 difference in means, establishing noninferiority. As to adverse effects, nausea, insomnia, hyperhidrosis, and decreased appetite were more frequent with duloxetine than pregabalin; insomnia, more frequent with duloxetine than duloxetine plus gabapentin; peripheral edema, more frequent with pregabalin than with duloxetine; and nausea, hyperhidrosis, decreased appetite, and vomiting, more frequent with duloxetine plus gabapentin than with pregabalin. CONCLUSION Duloxetine was noninferior to pregabalin for the treatment of pain in patients with diabetic peripheral neuropathy who had an inadequate pain response to gabapentin. Trial Registration: clinicaltrials.gov Identifier: NCT00385671
- Published
- 2011
15. Quantifying Normal Geometric Variation in Human Pulmonary Lobar Geometry From High Resolution Computed Tomography
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Merryn H. Tawhai, Ho-Fung Chan, Alys R. Clark, Duane T. K. Malcolm, and Eric A. Hoffman
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Male ,High-resolution computed tomography ,Biomedical Engineering ,Geometry ,Image processing ,Physiology (medical) ,Image Processing, Computer-Assisted ,medicine ,Humans ,Lung ,Mathematics ,Principal Component Analysis ,medicine.diagnostic_test ,Reproducibility of Results ,Middle Aged ,Research Papers ,Healthy Volunteers ,Lobe ,Diaphragm (structural system) ,Normal variation ,medicine.anatomical_structure ,Principal component analysis ,Female ,Tomography ,Tomography, X-Ray Computed ,Biomedical engineering - Abstract
Previous studies of the ex vivo lung have suggested significant intersubject variability in lung lobe geometry. A quantitative description of normal lung lobe shape would therefore have value in improving the discrimination between normal population variability in shape and pathology. To quantify normal human lobe shape variability, a principal component analysis (PCA) was performed on high resolution computed tomography (HRCT) imaging of the lung at full inspiration. Volumetric imaging from 22 never-smoking subjects (10 female and 12 male) with normal lung function was included in the analysis. For each subject, an initial finite element mesh geometry was generated from a group of manually selected nodes that were placed at distinct anatomical locations on the lung surface. Each mesh used cubic shape functions to describe the surface curvilinearity, and the mesh was fitted to surface data for each lobe. A PCA was performed on the surface meshes for each lobe. Nine principal components (PCs) were sufficient to capture >90% of the normal variation in each of the five lobes. The analysis shows that lobe size can explain between 20% and 50% of intersubject variability, depending on the lobe considered. Diaphragm shape was the next most significant intersubject difference. When the influence of lung size difference is removed, the angle of the fissures becomes the most significant shape difference, and the variability in relative lobe size becomes important. We also show how a lobe from an independent subject can be projected onto the study population’s PCs, demonstrating potential for abnormalities in lobar geometry to be defined in a quantitative manner.
- Published
- 2015
16. Polymorphism at Codon 72 of p53 Is Not Associated with Cervical Cancer Risk
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James C. Boyd, Mark H. Stoler, Gwen B. Baber, and Elsa K. Malcolm
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Oncology ,medicine.medical_specialty ,Pathology ,Arginine ,medicine.medical_treatment ,Uterine Cervical Neoplasms ,Adenocarcinoma ,Biology ,Bioinformatics ,Logistic regression ,Pathology and Forensic Medicine ,Gene Frequency ,Internal medicine ,Tumor Cells, Cultured ,medicine ,Humans ,Neoplasm Invasiveness ,Carcinoma, Small Cell ,Allele ,Codon ,Allelotype ,Alleles ,Cervical cancer ,Polymorphism, Genetic ,Homozygote ,DNA, Neoplasm ,Odds ratio ,Cervical conization ,medicine.disease ,Carcinoma, Squamous Cell ,Female ,Tumor Suppressor Protein p53 ,Restriction fragment length polymorphism ,Carcinoma in Situ ,Polymorphism, Restriction Fragment Length - Abstract
P53 allelic polymorphism at codon 72 has been studied as a possible predisposing factor for cervical carcinogenesis with inconsistent results. Storey and colleagues recently published the interesting finding of a 7-fold increased risk for cervical cancer in women homozygous for the arginine allele at codon 72. This stimulated a number of independent investigations, the majority of which found no association of cervical cancer and arginine homozygosity. With the use of a modified Storey method for determining codon 72 allelotypes, DNA was examined from 431 microdissected, formalin-fixed, archival cervical conization specimens ranging from low-grade squamous lesions to invasive cancer. An alternative independent method using restriction fragment length polymorphism analysis was performed on all arginine homozygotes and all indeterminate cases for confirmation and final allelotype assignment. With the use of Storey's method alone, logistic regression suggested an association (odds ratio, 1.42) between arginine homozygosity and invasive disease. However, with the use of the combined method for accurate allelotyping, this trend disappeared (odds ratio, 1.00), the discordance was clearly resolvable as being due to methodologic variables. With the use of two separate methods for codon 72 allelotyping and accounting for a number of the issues raised in previously published reports, there is no increased risk for invasive cervical cancer associated with arginine homozygosity at codon 72 of p53.
- Published
- 2000
17. A randomized, double-blind, placebo-controlled trial of duloxetine for the treatment of pain in patients with multiple sclerosis
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Sandra K. Malcolm, Timothy Vollmer, R.C. Risser, and Michael J. Robinson
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Adult ,Male ,Randomization ,Multiple Sclerosis ,Adolescent ,Analgesic ,Placebo-controlled study ,Pain ,Thiophenes ,Placebo ,Duloxetine Hydrochloride ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,Double-Blind Method ,law ,Medicine ,Duloxetine ,Humans ,Analgesics ,Depressive Disorder, Major ,business.industry ,Middle Aged ,Discontinuation ,Anesthesiology and Pain Medicine ,Treatment Outcome ,chemistry ,Tolerability ,Anesthesia ,Female ,business - Abstract
Background Patients with multiple sclerosis (MS) often report neuropathic pain (NP-MS). The purpose of this study was to assess the efficacy and tolerability of duloxetine as treatment for NP-MS. Methods In this study, 239 adults with NP-MS (duloxetine = 118, placebo = 121) were randomized to duloxetine 60 mg (30 mg for 1 week, then 60 mg for 5 weeks) or placebo once daily for a 6-week acute therapy phase, followed by a 12-week open-label extension phase (duloxetine 30 to 120 mg/day). Eligible patients had MS for ≥ 1 year and a score ≥ 4 on daily average pain intensity (API) ratings for ≥ 4 of 7 days immediately before randomization. Patients rated API daily on an 11-point numeric scale (0 [no pain] to 10 [worst possible pain]) in an electronic diary. The primary efficacy measure, change in weekly API ratings, was analyzed longitudinally with a mixed-model repeated-measures analysis. Completion, reasons for discontinuation, and treatment-emergent adverse event incidence were compared by Fisher's exact test. Results Duloxetine-treated patients had statistically greater mean improvement in API vs. placebo at Week 6 (−1.83 vs. −1.07, P = 0.001). Treatment completion did not significantly differ between groups. Discontinuation due to adverse events was statistically greater for duloxetine vs. placebo (13.6% vs. 4.1%, P = 0.012). Decreased appetite was reported significantly more often by duloxetine-treated patients (5.9% vs. 0%, P = 0.007). Conclusions This study found analgesic efficacy of duloxetine for NP-MS. Duloxetine is not approved for treatment of this condition. The duloxetine safety profile of this study was consistent with the known profile in other patient populations.
- Published
- 2013
18. P3‐429: Response to cholinesterase inhibitor medication at first renewal in a Canadian provincial drug coverage initiative: the British Columbia Alzheimer's Drug Therapy Initiative (BC ADTI) experience
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Ging-Yuek Robin Hsiung, Claudia Jacova, Kiran Rabheru, David Hosick, Neena L. Chappell, B. Lynn Beattie, Philip E. Lee, K. Malcolm Maclure, and Ron Mattson
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Drug ,Gerontology ,medicine.medical_specialty ,biology ,Epidemiology ,business.industry ,Health Policy ,media_common.quotation_subject ,Psychiatry and Mental health ,Cellular and Molecular Neuroscience ,Pharmacotherapy ,Developmental Neuroscience ,Family medicine ,medicine ,biology.protein ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,media_common ,Cholinesterase - Published
- 2010
19. Noninvasive Measurement of Lumbar Sagittal Mobility
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A. Kim Burton and K. Malcolm Tillotson
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Observer Variation ,Orthodontics ,Lumbar Vertebrae ,business.industry ,Movement ,Radiography ,Posture ,Limits of agreement ,Reproducibility of Results ,Anatomy ,Sagittal plane ,Biomechanical Phenomena ,Lumbar ,medicine.anatomical_structure ,Clinical investigation ,medicine ,Humans ,Orthopedics and Sports Medicine ,Lumbar spine ,Neurology (clinical) ,Range of Motion, Articular ,business ,Reliability (statistics) - Abstract
The use of flexicurves to measure lumbar sagittal mobility was subjected to a series of reliability and validation experiments. Appropriate statistical methods were described and used to quantify intraobserver and intrasubject variability and to determine limits of agreement with measurements from radiographs. It was shown that the traditional use of correlation coefficients can produce misleading or inadequate information. The flexicurve technique had an intraobserver variability of 3-4[degrees] of movement, was not significantly influenced by intrasubject variability, and provided measurements typically within 6[degrees] of radiographic measurements. The data suggest that the flexicurve technique is less biased than the inclinometric method. These results demonstrate the use of suitable statistical methods to assess the clinical usefulness, or level of interchangeability, of spinal measurement instruments.
- Published
- 1991
20. Once-daily atomoxetine treatment for children with attention-deficit/hyperactivity disorder, including an assessment of evening and morning behavior: a double-blind, placebo-controlled trial
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Albert J. Allen, Virginia K. Sutton, Humberto Quintana, Calvin R. Sumner, Kory Schuh, Douglas Kelsey, Jill Gonzales, Sandra K. Malcolm, Daniel L. Coury, Keith E. Saylor, and Charles D. Casat
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Evening ,Placebo-controlled study ,Placebo ,Atomoxetine Hydrochloride ,Double-Blind Method ,Surveys and Questionnaires ,medicine ,Attention deficit hyperactivity disorder ,Humans ,Psychiatry ,Child ,Morning ,Norepinephrine Plasma Membrane Transport Proteins ,Propylamines ,Symporters ,business.industry ,Atomoxetine ,medicine.disease ,Treatment Outcome ,Attention Deficit Disorder with Hyperactivity ,Pediatrics, Perinatology and Child Health ,Electronic data ,Female ,business ,medicine.drug ,Atomoxetine hydrochloride - Abstract
Objectives. Atomoxetine seems to be as effective for treating attention-deficit/hyperactivity disorder (ADHD) when the daily dose is administered once in the morning as when the dose is divided and administered in the morning and evening. In the present study, the efficacy of atomoxetine administered once daily among children with ADHD was assessed throughout the day, including the evening and early morning. Another goal was to determine how early in treatment it was possible to discern a specific effect of the drug on ADHD symptoms.Methods. This study was a randomized, multicenter, double-blind, placebo-controlled trial conducted at 12 outpatient sites in the United States. A total of 197 children, 6 to 12 years of age, who had been diagnosed as having ADHD, on the basis of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria, were randomized to receive 8 weeks of treatment with atomoxetine or placebo, dosed once daily in the mornings. ADHD symptoms were assessed with parent and investigator rating scales. The primary outcome measure was the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV-Parent Version: Investigator-Administered and Scored total score. Daily parent assessments of children's home behaviors in the evening and early morning were recorded with an electronic data entry system. This instrument measures 11 specific morning or evening activities, including getting up and out of bed, doing or completing homework, and sitting through dinner.Results. Seventy-one percent of the children enrolled were male, 69% met criteria for the combined subtype (both inattentive and hyperactive/impulsive symptoms), and the most common psychiatric comorbidity was oppositional defiant disorder (35%). Once-daily atomoxetine (final mean daily dose of 1.3 mg/kg) was significantly more effective than placebo in treating core symptoms of ADHD. Mean reductions in the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV-Parent Version: Investigator-Administered and Scored total score were significantly greater for patients randomized to atomoxetine, beginning at the first visit after the initiation of treatment and continuing at all subsequent visits. Both inattentive and hyperactive/impulsive symptom clusters were significantly reduced with atomoxetine, compared with placebo. With continued treatment and dose titrations, core symptoms of ADHD continued to decrease throughout the 8-week study. Mean reductions in the daily parent assessment total scores for patients randomized to atomoxetine were superior during the first week, beginning with the first day of dosing, and were also superior at endpoint. Efficacy outcomes for the evening hours for atomoxetine-treated patients were superior to those for placebo-treated patients, as assessed with 2 different assessment scales. Decreases in the daily parent assessment morning subscores at endpoint showed a significant reduction in symptoms that lasted into the mornings. Rates of discontinuations attributable to adverse events were Conclusions. Among children 6 to 12 of age who had been diagnosed as having ADHD, once-daily administration of atomoxetine in the morning provided safe, rapid, continuous, symptom relief that lasted not only into the evening hours but also into the morning hours. Atomoxetine treatment was safe and well tolerated.
- Published
- 2004
21. April 2002: 35-year-old healthy man with enlarging right parotid mass
- Author
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Elsa K, Malcolm and M Beatriz S, Lopes
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,CASES OF THE MONTH: April to June 2002 ,Pathology and Forensic Medicine ,Pathognomonic ,Plexiform neurofibroma ,Internal medicine ,medicine ,Humans ,Parotid Gland ,Cranial Nerve Neoplasms ,Neurofibromatosis ,Neurofibroma, Plexiform ,Salivary gland ,business.industry ,General Neuroscience ,Parotid mass ,S100 Proteins ,Parotidectomy ,medicine.disease ,Facial nerve ,Magnetic Resonance Imaging ,Facial Nerve ,medicine.anatomical_structure ,Endocrinology ,Immunohistochemistry ,Neurology (clinical) ,Schwann Cells ,Facial Nerve Diseases ,business - Abstract
The April 2002 Case of the Month (COM). 35-year-old healthy man developed a mass in the right parotid gland. A superifical parotidectomy was performed for a 4.5 x 1.5 x 1.5 cm mass involving the intraparotid facial nerve. Grossly the tumor was multinodular, smooth and yellow with normal surrounding salivary gland. Microscopically, the tumor showed expanding nodules composed of proliferating fibroblasts, Schwann cells, and perineural-like cells in a myxoid stroma. Normal peripheral nerve twigs were identified in the periphery of the tumor. There was no increased mitotic activity, cellularity or nuclear pleomorphism. S-100 immunohistochemical stain was positive. The tumor was diagnosed as a solitary plexiform neurofibroma. Plexiform neurofibromas in this area have been described in children with von Recklinghausen's disease or neurofibromatosis 1 (NF 1). Plexiform neurofibromas typically involve deep seated nerve trunks and is considered pathognomonic for NF 1. This unusual case represents a solitary variant of plexiform neurofibroma presenting as a parotid mass in an adult patient without a personal stigmata or family history of NF 1.
- Published
- 2002
22. Evidence that enviroxime targets multiple components of the rhinovirus 14 replication complex
- Author
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D. P. Smith, S. K. Malcolm, H. Hsiung, P. Brown-Augsburger, L. M. Vance, and B. A. Heinz
- Subjects
Rhinovirus ,Viral nonstructural protein ,Mutant ,Molecular Sequence Data ,Biology ,Viral Nonstructural Proteins ,medicine.disease_cause ,Virus Replication ,Antiviral Agents ,Virus ,law.invention ,law ,Virology ,Oximes ,medicine ,Animals ,Sulfonamides ,Base Sequence ,RNA ,Drug Resistance, Microbial ,General Medicine ,In vitro ,Mutation ,Recombinant DNA ,RNA, Viral ,Benzimidazoles ,Rabbits ,PI4KB - Abstract
Enviroxime and related analogs are potent inhibitors of rhinoviruses and enteroviruses in cell culture. Previous analyses of resistant mutants implicated the viral nonstructural protein 3A(B) as the likely target of drug activity. In this study, we used site-directed mutagenesis and selection of spontaneous rhinovirus 14 mutants with several enviroxime analogs to confirm the link between domains in rhinovirus 14 3A(B) and the function blocked by enviroxime. We also produced recombinant 3A and 3AB proteins for biochemical analyses. Despite extensive efforts, however, we were unable to demonstrate direct binding between enviroxime and any of several viral proteins, nor could we demonstrate binding of enviroxime to a host protein. In addition, enviroxime did not disrupt 3AB's ability to bind RNA or 3D polypeptide, the association of 3AB with membranes, or the cleavage of 3AB by 3C protease. Finally, we identified an enviroxime-resistant mutant with an increased level of resistance which apparently has mutations in multiple proteins or RNA sequences. Taken together, these results suggest that enviroxime targets a complex of proteins and/or cellular factors. Such a complex mechanism of inhibition might explain the low levels of viral resistance to these inhibitors as compared with other picornaviral inhibitors.
- Published
- 1999
23. Stable Transformed Human Cell Lines Exhibiting tat-Directed Expression of Tissue Plasminogen Activator
- Author
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J. Tang, S. K. Malcolm, T. W. Thais, P. A. Heffernan, J. M. Colacino, S. R. Jaskunas, and B. R. Warren
- Subjects
History and Philosophy of Science ,Chemistry ,General Neuroscience ,medicine ,Human cell ,Tissue plasminogen activator ,General Biochemistry, Genetics and Molecular Biology ,Cell biology ,medicine.drug - Published
- 1990
24. Psychosocial predictors of outcome in acute and subchronic low back trouble
- Author
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Chris J. Main, A. Kim Burton, Sally Hollis, and K. Malcolm Tillotson
- Subjects
Adult ,Male ,medicine.medical_specialty ,Disability Evaluation ,Epidemiology ,medicine ,Back pain ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Risk factor ,Prospective cohort study ,Socioeconomic status ,Pain Measurement ,business.industry ,Discriminant Analysis ,Low back pain ,Acute Disease ,Chronic Disease ,Physical therapy ,Female ,Neurology (clinical) ,medicine.symptom ,Presentation (obstetrics) ,business ,Psychosocial ,Low Back Pain ,Follow-Up Studies - Abstract
Study Design: A prospective survey of patients seeking primary care for low back pain. Clinical and psychosocial data, available at presentation, were explored for predictors of outcome at 1 year. Objectives: To determine the relative value of clinical and psychosocial variables for early identification of patients with a poor prognosis. Summary of Background Data: Current treatment strategies for low back pain have failed to stem the rising levels of disability. Psychosocial factors have been shown to be important determinants of response to therapy in chronic patients, but the contribution from similar data in acute or subchronic patients has not been comprehensively investigated. Methods: Two hundred fifty-two patients with low back pain, presenting to primary care, underwent a structured clinical interview and completed a battery of psychosocial instruments. Follow-up was done by mail at 1 year; outcome was measured using a back pain disability questionnaire. Predictive relationships were sought between the data at presentation and disability at follow-up. Results: Most patients showed improved disability and pain scores, although more than half had persisting symptoms. Eighteen percent showed significant psychological distress at presentation. Multiple regression analysis showed the level of persisting disability to depend principally on measures in the psychosocial domain; for acute cases outcome is also dependent on the absence or presence of a previous history of low back trouble. Discriminant models successfully allocated typically 76% of cases to recovered/not-recovered groups, largely on the basis of psychosocial factors evident at presentation. Conclusions: Early identification of psychosocial problems is important in understanding, and hopefully preventing, the progression to chronicity in low back trouble.
- Published
- 1995
25. Effect of fialuridine on replication of mitochondrial DNA in CEM cells and in human hepatoblastoma cells in culture
- Author
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S R Jaskunas, J. M. Colacino, and S K Malcolm
- Subjects
DNA Replication ,Hepatoblastoma ,T-Lymphocytes ,Duck hepatitis B virus ,Fialuridine ,Mitochondrion ,Antiviral Agents ,DNA, Mitochondrial ,In vivo ,medicine ,Tumor Cells, Cultured ,Humans ,Pharmacology (medical) ,Lactic Acid ,Cells, Cultured ,Pharmacology ,biology ,Zalcitabine ,Arabinofuranosyluracil ,Liver Neoplasms ,DNA replication ,medicine.disease ,biology.organism_classification ,Molecular biology ,In vitro ,Mitochondrial toxicity ,Infectious Diseases ,Cell culture ,Lactates ,medicine.drug ,Research Article - Abstract
Fialuridine (FIAU) is a nucleoside analog with potent activity against hepatitis B virus in vitro and in vivo. In this report, the effect of FIAU on mitochondrial DNA (mtDNA) replication in vitro was investigated. CEM cells, a cell line derived from human T cells, were incubated for 6 days in up to 20 microM FIAU. Total cellular DNA was isolated, normalized for the number of cells, and slot hybridized to a probe specific for mtDNA sequences. Treatment of CEM cells with FIAU did not result in a dose-dependent decrease in the amount of mtDNA. In contrast, dideoxycytidine (ddC) inhibited mtDNA replication by 50% at a concentration of approximately 0.1 microM. After 6 days of incubation, both compounds displayed a 50% toxic dose at a concentration of approximately 2 microM in CEM cells and approximately 34 microM in human hepatoblastoma cells (HepG2). In further experiments, CEM cells were incubated for 15 days in up to 2.5 microM FIAU, and again, no inhibition of mtDNA was observed. Over a 6-day incubation, FIAU, at concentrations of up to 200 microM, also failed to inhibit mtDNA replication in either HepG2 or HepG2 cells which constitutively replicate duck hepatitis B virus. In contrast, ddC inhibited mtDNA replication in these cells with a 50% inhibitory concentration of approximately 0.2 microM over a 6-day incubation. Treatment of cells with either FIAU or ddC resulted in a dose-dependent increase in lactate levels in the cell medium, indicating that any effect of FIAU on mitochondrial function may not be related to inhibition of mtDNA replication on the basis of the in vitro data. Alternative explanations for mitochondrial toxicity are considered.
- Published
- 1994
26. Comparative safety of duloxetine versus pregabalin versus duloxetine plus gabapentin in patients with diabetic peripheral neuropathic pain
- Author
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D. Hann, Sandra K. Malcolm, R.C. Risser, Joel Raskin, Gordon Irving, and Robert J. Tanenberg
- Subjects
Gabapentin ,business.industry ,Pregabalin ,Comparative safety ,Peripheral neuropathic pain ,chemistry.chemical_compound ,Anesthesiology and Pain Medicine ,Neurology ,chemistry ,Anesthesia ,medicine ,Duloxetine ,In patient ,Neurology (clinical) ,business ,medicine.drug - Published
- 2011
27. (185) A comparison of strategies for switching patients from amitriptyline to duloxetine for the management of diabetic peripheral neuropathic pain
- Author
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Michael E. Robinson, Sandra K. Malcolm, Jonna Ahl, R.C. Risser, and V. Whitmyer
- Subjects
chemistry.chemical_compound ,Anesthesiology and Pain Medicine ,Neurology ,chemistry ,business.industry ,Anesthesia ,Duloxetine ,Medicine ,Amitriptyline ,Neurology (clinical) ,business ,Peripheral neuropathic pain ,medicine.drug - Published
- 2008
28. Rapid reduction in hyperprolactinemia upon switching treatment to olanzapine from conventional antipsychotic drugs or risperidone
- Author
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Bruce J. Kinon, Jeff Wang, Sandra K. Malcolm, and Bruce R. Basson
- Subjects
Olanzapine ,Risperidone ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Pharmacology ,Reduction (complexity) ,Psychiatry and Mental health ,Endocrinology ,Medicine ,business ,Antipsychotic ,Biological Psychiatry ,medicine.drug - Published
- 2000
29. Multiple methods for the analysis of inhibitors of HIV-1 TAT-dependent transactivation
- Author
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M. C. Smith, T. W. Thais, P. A. Smanik, S. R. Jaskunas, and S. K. Malcolm
- Subjects
Pharmacology ,Transactivation ,business.industry ,Virology ,Medicine ,Multiple methods ,Hiv 1 tat ,business - Published
- 1991
30. Resistance to hygromycin B
- Author
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G. D. Gustafson, C. Waldron, S. K. Malcolm, S. L. Armour, J. L. Roberts, and E. B. Murphy
- Subjects
Genetics ,Genetic transfer ,Plant Science ,General Medicine ,Agrobacterium tumefaciens ,Biology ,medicine.disease_cause ,biology.organism_classification ,carbohydrates (lipids) ,Ti plasmid ,chemistry.chemical_compound ,Transformation (genetics) ,Plasmid ,chemistry ,medicine ,Agronomy and Crop Science ,Escherichia coli ,Hygromycin B ,Gene - Abstract
A bacterial gene encoding hygromycin phosphotransferase has been modified for expression in tobacco cells. The aphIV gene from Escherichia coli was inserted between the 5' sequence of an octopine synthase gene and the 3' sequence from a nopaline synthase gene. The new gene was incorporated between T-DNA border fragments in the broad-host-range vector pKT210 to form a micro-Ti plasmid. Agrobacterium tumefaciens containing this plasmid and a Ti plasmid as helper was used to incite crown gall tumors on aseptic tobacco plants. Samples of these galls could grow in the presence of hygromycin B, provided that the aph gene had been fused with the ocs gene to maintain the sense of the coding sequences. When the genes had been fused in the reverse 'antisense' orientation none of the gall samples could grow on hygromycin. Unlike wild-type galls the hygromycin-resistant tissue contained DNA sequences homologous to the aphIV gene. Thus the modified gene can be introduced into tobacco cells and confer on them the ability to grow in the presence of hygromycin B.
- Published
- 1985
31. Reference values for 'normal' regional lumbar sagittal mobility
- Author
-
A. Kim Burton and K. Malcolm Tillotson
- Subjects
Orthodontics ,medicine.medical_specialty ,business.industry ,Biophysics ,Biomechanics ,Age and sex ,Sagittal plane ,medicine.anatomical_structure ,Lumbar ,Reference values ,medicine ,Physical therapy ,Back pain ,Orthopedics and Sports Medicine ,Lumbar spine ,medicine.symptom ,business ,Low back - Abstract
From a sample of 958 individuals, a group with no anamnestic recall of notable low back trouble (n=510) was selected to provide reference values for lumbar sagittal mobility. The measurement technique employed a flexicurve to give angular measures for maximal sagittal mobility in upper (T12-L4) and lower (L4-S2) regions. The results are presented in the form of reference ranges and modal values, stratified by age and sex. A wide variation in the 'normal' range of mobility at all ages is confirmed. Males had higher values for flexion, whilst females showed higher values for extension and for mobility in the lower region. Sagittal mobility declined with age at different rates in males and females for both flexion/extension and upper/lower measures. Generally speaking, mobility was reduced by some 50% in old age compared with childhood, the reduction being most marked for measures of flexion and upper lumbar mobility.
- Published
- 1987
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