Monitoring inflammatory bowel disease activity: clinical activity is judged to be more relevant than endoscopic severity or biomarkers.

BACKGROUND: There is increasing evidence for the clinical relevance of mucosal healing (MH) as therapeutic treatment goal in inflammatory bowel disease (IBD). We aimed to investigate by which method gastroenterologists monitor IBD activity in daily practice. METHODS: A questionnaire was sent to all board-certified gastroenterologists in Switzerland to specifically address their strategy to monitor IBD between May 2009 and April 2010. RESULTS: The response rate was 57% (153/270). Fifty-two percent of gastroenterologists worked in private practice and 48% worked in hospitals. Seventy-eight percent judged clinical activity to be the most relevant criterion for monitoring IBD activity, 15% chose endoscopic severity, and 7% chose biomarkers. Seventy percent of gastroenterologists based their therapeutic decisions on clinical activity, 24% on endoscopic severity, and 6% on biomarkers. The following biomarkers were used for IBD activity monitoring: CRP, 94%; differential blood count, 78%; fecal calprotectin (FC), 74%; iron status, 63%; blood sedimentation rate, 3%; protein electrophoresis, 0.7%; fecal neutrophils, 0.7%; and vitamin B12, 0.7%. Gastroenterologists in hospitals and those with ≤ 10 years of professional experience used FC more frequently compared with colleagues in private practice (P=0.035) and those with > 10 years of experience (P<0.001). CONCLUSIONS: Clinical activity is judged to be more relevant for monitoring IBD activity and guiding therapeutic decisions than endoscopic severity and biomarkers. As such, the accumulating scientific evidence on the clinical impact of mucosal healing does not yet seem to influence the management of IBD in daily gastroenterologic practice.

How to Vote in Iowa, 2008

Take advantage of one of the following methods to cast your vote! Please open file for more information.

Consumer Advisory Bulletin, How to Deal With Credit Card Offers, October 2009

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: How to Deal With Credit Card Offers

Resolving the ortholog conjecture: orthologs tend to be weakly, but significantly, more similar in function than paralogs.

The function of most proteins is not determined experimentally, but is extrapolated from homologs. According to the "ortholog conjecture", or standard model of phylogenomics, protein function changes rapidly after duplication, leading to paralogs with different functions, while orthologs retain the ancestral function. We report here that a comparison of experimentally supported functional annotations among homologs from 13 genomes mostly supports this model. We show that to analyze GO annotation effectively, several confounding factors need to be controlled: authorship bias, variation of GO term frequency among species, variation of background similarity among species pairs, and propagated annotation bias. After controlling for these biases, we observe that orthologs have generally more similar functional annotations than paralogs. This is especially strong for sub-cellular localization. We observe only a weak decrease in functional similarity with increasing sequence divergence. These findings hold over a large diversity of species; notably orthologs from model organisms such as E. coli, yeast or mouse have conserved function with human proteins.

How to Secure and Dispose of Unused Medicines, 2009

Prescription and over-the-counter drug abuse is an increasing concern in Iowa, and is the fastest growing form of youth substance abuse in America. Medicines can pose a danger to those who abuse them, and the improper disposal of pharmaceuticals can harm the environment.

Consumer Advisory Bulletin, How to Avoid Buying a Salvage, Damaged or Flood Vehicle, August 2011

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: How to Avoid Buying a Salvage, Damaged or Flood Vehicle

Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results.

PurposeThe purpose of this study was to report the 2-year outcome of an individually tailored 'observe-and-plan' treatment regimen for neovascular age-related macular degeneration (nAMD), and to investigate its clinical value in terms of functional outcome. This regimen aimed to reduce the clinical burden (visits) by employing individually fixed injection intervals, based on the predictability of an individual's need for retreatment.MethodsThis prospective case series included 104 patients (115 eyes) with nAMD. Following three loading doses of ranibizumab, the disease recurrence interval was determined in monthly observation visits. Retreatment was applied in a series of three injections with individually fixed intervals (2 weeks shorter than the recurrence interval), combined with periodic adjustment of the intervals. The allowed injection intervals in treatment plans ranged from 1 to 3 months. If there was no recurrence at 3 months, the patient could change to monitoring alone.ResultsMean visual acuity (VA) improved by 8.7, 9.7, and 9.2 letters at months 3, 12, and 24, respectively. The mean number of injections was 7.8 and 5.8 during years 1 and 2, respectively, whereas the mean number of ophthalmic examinations was 4.0 and 2.9, respectively. The mean treatment interval (after the loading doses) was 2.0 months during year 1, and 2.2 months during year 2.ConclusionThe observe-and-plan regimen significantly improved and maintained VA over the course of 2 years. This favourable functional outcome was achieved with fewer clinic visits compared with other regimens. Therefore, this observe-and-plan regimen has the potential to alleviate the clinical burden of nAMD treatment.Eye advance online publication, 7 November 2014; doi:10.1038/eye.2014.258.

Institution Reentry Coordinators Proving to be Important Link, Data Download, Iowa Department of Corrections, March 2010

An offender reentry grant program funded through the Governor’s Office of Drug Control Policy supports one reentry coordinator at each of the following institutions: Mount Pleasant Correctional Facility (MPCF), Fort Dodge Correctional Facility and the Clarinda Correctional Facility. The reentry coordinators there engage in a myriad of activities, working with institution educators, counselors and medical personnel, probation/parole officers and counselors, and most importantly the offenders themselves. The program has not been in operation for very long, and only MPCF has operated long enough to be looking at outcomes. The early returns for MPCF show good promise.

Comment prévenir les chutes chez les personnes âgées vivant à domicile: revue Cochrane pour le praticien. [How to prevent falls among elderly living at home]

Free fulltex: http://www.res_franco.cochrane.org/Files/ResumesRMS2009/Chutespersagees.pdf

How to keep the brain awake? : pharmacogenomics and aging effects on sleep-wake regulation in inbred mice

ABSTRACT : Genetic approach in the sleep field is at the beginning of its wide expansion. Transitions between sleep and wakefulness, and the maintenance of these states are driven by complex neurobiologic mechanisms with reciprocal interactions. Impairment in both transitions and maintenance of behavioral states leads to debilitating conditions. The major symptom being excessive daytime sleepiness, characterizing most sleep disorders but also a wide variety of psychiatric and neurologic disorders, as well as the elderly. Until now, most wake-promoting drugs available directly (e.g., amphetamines and possibly modafinil) or indirectly (e.g., caffeine) provokes dopamine release which is believed to influence the abuse potential of these drugs. The effects of genetic components were assessed here, on drug-induced wakefulness and age-related sleep changes in three inbred mouse strains [AKR/J, C57BL/6J, DBA/2J] that differ in their major sleep phenotypes. Three wake-promoting drugs were used; d-amphetamine, a classical stimulant, modafinil, the most widely-prescribed stimulant, and YKP-10A, a novel wake-promoting agent with antidepressant proprieties. Electrical activity (Electroencephalogram) and gene expression of the brain were assessed and indicate a highly genotype-dependant response to wake promotion and subsequent recovery sleep. Aging effects on sleep-wake regulation were also strongly influenced by genetic determinants. By assessing the age-dependant effects at several time points (from 3 months to 2 years old mice), we found a strong genetic effect on vigilance states. These studies demonstrate a critical role for genetic factors neglected till now in the fields of pharmacology and aging effects on vigilance states.