Search results

Title: Prevention of Hypertension and Diabetes in Ghana.
Creator: Jones, Sydney, College of Nursing
Date Issued: 2013
Identifier: FSU_migr_undergradresearch-0031
Format: Citation

Title: What is the Best Nonpharmacologic Therapy for Phantom Limb Pain?.
Creator: Miller, Michelle, Rodríguez, Jose
Abstract/Description: Nonpharmacologic therapies for phantom limb pain (PLP) that have demonstrated some success include motor imagery therapy (SOR C, extrapolated from a randomized controlled trial [RCT] that enrolled a heterogeneous patient sample); Farabloc® (SOR C, based on a single low-quality RCT); and eye movement desensitization and reprocessing (EMDR) in patients who also have depression and posttraumatic stress disorder (SOR C, based on a case series). Evidence is insufficient to support or refute the...
Show moreNonpharmacologic therapies for phantom limb pain (PLP) that have demonstrated some success include motor imagery therapy (SOR C, extrapolated from a randomized controlled trial [RCT] that enrolled a heterogeneous patient sample); Farabloc® (SOR C, based on a single low-quality RCT); and eye movement desensitization and reprocessing (EMDR) in patients who also have depression and posttraumatic stress disorder (SOR C, based on a case series). Evidence is insufficient to support or refute the use of transcutaneous electrical nerve stimulation (TENS), desensitization, scar mobilization, relaxation, or biofeedback.
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Date Issued: 2010
Identifier: FSU_migr_fmr-0020
Format: Citation

Title: What is the Best Treatment for Symptomatic PVD in the Elderly?.
Creator: LeFranc, Noemi, Rodríguez, Jose
Abstract/Description: In patients with peripheral vascular disease (PVD), a structured exercise program improves walking distances and is relatively low risk and low cost. Lipid-lowering therapy reduces the risk of cardiovascular events and also increases walking distances. Cilostazol and naftidrofuryl improve walking distance, but add an additional expense. Angioplasty appears to improve walking distance better than exercise at 6 months, but not at 2 or 6 years. (SOR A, based on a systematic reviews.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0026
Format: Citation

Title: What is the Best Treatment for Graves' Disease in Women Trying to Become Pregnant?.
Creator: Pearcy, Amanda, Rodríguez, Jose
Abstract/Description: It is recommended that pregnant women with Graves' disease and thyroid-stimulating hormone (TSH) antibodies be treated with an antithyroid drug, whereas those without TSH antibodies should simply be observed. Radioiodine treatment with iodine-131 (I-131) is contraindicated when a woman is attempting pregnancy and during pregnancy. Propylthiouracil (PTU) is the first-line drug therapy during the first trimester. (SOR B, from an evidence-based guideline.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0025
Format: Citation

Title: What Are the Best Nonpharmacologic Treatments for Urinary Incontinence in Women?.
Creator: Rojas, Christine, Rodríguez, Jose
Abstract/Description: Pelvic floor muscle training (PFMT) is superior to no treatment or inactive controls, and is effective in nonpregnant, pregnant, and postpartum women. (SOR A, based on meta-analyses.) The clinical value of habit retraining, timed voiding, or mechanical devices for treatment of urinary incontinence is unknown.
Date Issued: 2009
Identifier: FSU_migr_fmr-0013
Format: Citation

Title: What Are the Risks of Oral Contraceptives in Patients with Cardiovascular Disease Risk Factors?.
Creator: Love, Kaitlin, Miller, Michelle, Pemberton, Kenisha, Rodríguez, Jose
Abstract/Description: Women who smoke, have hypertension, hyperlipidemia, or factor V Leiden deficiency and take oral contraception (OC) are at increased risk of myocardial infarction (MI). Third-generation OCs and low-dose OCs are not associated with increased MI risk in women with or without other cardiovascular (CV) risk factors (SOR B, systematic review of cohort studies). OCs are contraindicated in women with preexisting congestive heart failure or CV disease, but may be used in otherwise healthy women with...
Show moreWomen who smoke, have hypertension, hyperlipidemia, or factor V Leiden deficiency and take oral contraception (OC) are at increased risk of myocardial infarction (MI). Third-generation OCs and low-dose OCs are not associated with increased MI risk in women with or without other cardiovascular (CV) risk factors (SOR B, systematic review of cohort studies). OCs are contraindicated in women with preexisting congestive heart failure or CV disease, but may be used in otherwise healthy women with diabetes, hypertension, or hyperlipidemia (SOR C, evidence-based guidelines derived from consensus and expert opinion).
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Date Issued: 2013
Identifier: FSU_migr_fmr-0047
Format: Citation

Title: What Are Effective Treatments for Painful Varicose Veins?.
Creator: Gonzalez, David, Rodríguez, Jose
Abstract/Description: Several ablative therapies are effective. However, endovenous laser ablation (EVLA) has a higher 5-year success rate than surgical stripping, ultrasound-guided foam sclerotherapy (UGFS), and radiofre-quency ablation (RFA). EVLA is also associated with less postoperative pain, and results a faster improvement in health-related quality of life when compared with surgery. (SOR A, based on a meta-analysis.) Compression stockings are not as effective as ablative therapy. (SOR A, based on a meta...
Show moreSeveral ablative therapies are effective. However, endovenous laser ablation (EVLA) has a higher 5-year success rate than surgical stripping, ultrasound-guided foam sclerotherapy (UGFS), and radiofre-quency ablation (RFA). EVLA is also associated with less postoperative pain, and results a faster improvement in health-related quality of life when compared with surgery. (SOR A, based on a meta-analysis.) Compression stockings are not as effective as ablative therapy. (SOR A, based on a meta-analysis.)
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Date Issued: 2010
Identifier: FSU_migr_fmr-0029
Format: Citation

Title: What Can Be Done to Slow Progression of Dementia in the Elderly?.
Creator: Parker, Alex, Rodríguez, Jose
Abstract/Description: Cholinesterase inhibitors alone or in combination with memantine delay the rate of nursing home admissions among elderly patients with Alzheimer's disease (AD), but have no statistical influence on mortality. (SOR B, based on an observational study.) Cholinesterase inhibitors are associated with small improvements in cognition and function in patients with AD when compared with placebo (SOR A, based on a meta-analysis.) The total societal medical cost of donepezil therapy is comparable to the...
Show moreCholinesterase inhibitors alone or in combination with memantine delay the rate of nursing home admissions among elderly patients with Alzheimer's disease (AD), but have no statistical influence on mortality. (SOR B, based on an observational study.) Cholinesterase inhibitors are associated with small improvements in cognition and function in patients with AD when compared with placebo (SOR A, based on a meta-analysis.) The total societal medical cost of donepezil therapy is comparable to the cost of placebo. (SOR B, based on 1 randomized controlled trial [RCT].)
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Date Issued: 2009
Identifier: FSU_migr_fmr-0015
Format: Citation

Title: Plasma BDNF Concentration, Val66Met Genetic Variant and Depression-Related Personality Traits.
Creator: Terracciano, Antonio, Martin, B., Ansari, D., Tanaka, Toshiko, Ferrucci, Luigi, Maudsley, S., Mattson, M., Costa, Paul
Abstract/Description: Brain-derived neurotrophic factor (BDNF) regulates synaptic plasticity and neurogenesis, and BDNF plasma and serum levels have been associated with depression, Alzheimer's disease, and other psychiatric and neurodegenerative disorders. In a relatively large community sample, drawn from the Baltimore Longitudinal Study of Aging (BLSA), we examine whether BDNF plasma concentration is associated with the Val66Met functional polymorphism of the BDNF gene (n = 335) and with depression-related...
Show moreBrain-derived neurotrophic factor (BDNF) regulates synaptic plasticity and neurogenesis, and BDNF plasma and serum levels have been associated with depression, Alzheimer's disease, and other psychiatric and neurodegenerative disorders. In a relatively large community sample, drawn from the Baltimore Longitudinal Study of Aging (BLSA), we examine whether BDNF plasma concentration is associated with the Val66Met functional polymorphism of the BDNF gene (n = 335) and with depression-related personality traits assessed with the NEO-PI-R (n = 391). Plasma concentration of BDNF was not associated with the Val66Met variant in either men or women. However, in men, but not in women, BDNF plasma level was associated with personality traits linked to depression. Contrary to the notion that low BDNF is associated with negative outcomes, we found lower plasma levels in men who score lower on depression and vulnerability to stress (two facets of Neuroticism) and higher on Conscientiousness and Extraversion. These findings challenge the prevailing hypothesis that lower peripheral levels of BDNF are a marker of depression.
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Date Issued: 2010
Identifier: FSU_migr_geriatrics_faculty_publications-0016, 10.1111/j.1601-183X.2010.00579.x
Format: Citation

Title: Should Coenzyme Q10 Be Used to Lower Blood Pressure in Asymptomatic Patients?.
Creator: Barker, Daniella, Rodríguez, Jose
Abstract/Description: Coenzyme Q10 (CoQ10) may lower systolic and diastolic blood pressures in patients with primary hypertension, but is not recommended as an antihypertensive treatment (SOR: C, systematic review of low-quality RCTs using disease-oriented outcomes).
Date Issued: 2013
Identifier: FSU_migr_fmr-0046
Format: Citation

Title: What is the Role of Carbohydrate-Restricted Diets for Patients with Obesity-Related Diseases (Hyperlipidemia, Diabetes, Hypertension, etc)?.
Creator: Nagy, Suzanne, Soberon, Angelica, Rodríguez, Jose
Abstract/Description: Compared with low-fat diets, carbohydrate-restricted diets (eg, Atkins) produce more weight loss in the short term (at 6 months but not at 1 year) and produce a greater reduction in glycosylated hemoglobin (HbA1C). (SOR A, based on a meta-analysis.) However, no studies have been published with more than 1 year duration or have focused on patient-oriented outcomes. The American Diabetes Association now recommends either low-carbohydrate or low-fat calorie-restricted diets for weight loss over...
Show moreCompared with low-fat diets, carbohydrate-restricted diets (eg, Atkins) produce more weight loss in the short term (at 6 months but not at 1 year) and produce a greater reduction in glycosylated hemoglobin (HbA1C). (SOR A, based on a meta-analysis.) However, no studies have been published with more than 1 year duration or have focused on patient-oriented outcomes. The American Diabetes Association now recommends either low-carbohydrate or low-fat calorie-restricted diets for weight loss over the short term. (SOR C, based on expert opinion.)
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Date Issued: 2008
Identifier: FSU_migr_fmr-0006
Format: Citation

Title: When is Heparin Indicated for the Management of Acute Stroke?.
Creator: Murphy, Shelley, Rodríguez, Jose
Abstract/Description: Heparin does not appear to improve overall outcomes when used for ischemic stroke or within the first 2 weeks of a cardioembolic stroke. (SOR B, extrapolated from meta-analyses of multiple heparinoids.)
Date Issued: 2009
Identifier: FSU_migr_fmr-0018
Format: Citation

Title: What is the Most Effective Treatment for Bell's Palsy Among Patients with Diabetes?.
Creator: Gonzalez, David, Rodríguez, Jose, Talbot, Richard
Abstract/Description: Patients with Bell's palsy have higher cure rates when treated with oral prednisolone within 72 hours of onset (SOR B, based on a single randomized controlled trial), but it is unclear what effect this therapy would have on patients with diabetes. Intravenous lipo-prostaglandin E1 (lipo-PGE1) may be an alternative to steroid therapy for Bell's palsy that does not effect blood glucose levels. (SOR C, based on a single small cohort study.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0024
Format: Citation

Title: Trait Antagonism and the Progression of Arterial Thickening: Women with Antagonistic Traits Have Similar Carotid Arterial Thickness as Men.
Creator: Sutin, Angelina, Scuteri, Angelo, Lakatta, Edward, Tarasov, Kirill, Ferrucci, Luigi, Costa, Paul, Schlessinger, David, Uda, Manuela, Terracciano, Antonio
Abstract/Description: A large body of evidence links antagonism-related traits with cardiovascular outcomes, but less is known about how psychological traits are associated with intermediate markers of cardiovascular disease. Using a large, community-based sample from Sardinia, Italy (n=5614), this study examined how trait antagonism (low agreeableness) and its facets are associated with carotid artery intima-media thickness, a measure of arterial thickening. Controlling for demographic and cardiovascular risk...
Show moreA large body of evidence links antagonism-related traits with cardiovascular outcomes, but less is known about how psychological traits are associated with intermediate markers of cardiovascular disease. Using a large, community-based sample from Sardinia, Italy (n=5614), this study examined how trait antagonism (low agreeableness) and its facets are associated with carotid artery intima-media thickness, a measure of arterial thickening. Controlling for demographic and cardiovascular risk factors, low agreeableness and, in particular, low straightforwardness and low compliance, were associated with greater carotid thickening, measured concurrently and prospectively, and with increases in intima-media thickness over 3 years. Indeed, those in the bottom 10% of agreeableness had a 40% increase in risk for elevated intima-media thickness. Although men have thicker arterial walls, women with antagonistic traits had similar carotid thickening as antagonistic men. Antagonistic individuals, especially those who are manipulative and aggressive, have greater increases in arterial thickening, independent of traditional cardiovascular risk factors.
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Date Issued: 2010
Identifier: FSU_migr_mhs-0022, 10.1161/HYPERTENSIONAHA.110.155317
Format: Citation

Title: What Methods Are Effective for Reducing the Incidence of Dental Caries?.
Creator: Gaar, Micah, Rodríguez, Jose, Alexiev, Elena
Abstract/Description: Fluoride mouth rinses and fluoride toothpastes used regularly at home reduce the incidence of dental caries about 25%. (SOR A, based on systematic reviews of RCTs.) Professionally applied fluoride varnishes reduce carries by about 50%. (SOR A, based on systematic reviews of RCTs.) Pit and fissure sealants provide additional protection beyond fluoride varnishes. (SOR B, based on a meta-analysis with a small number of patients.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0023
Format: Citation

Title: What Health Education Interventions Reduce the Progression of Prediabetes to Overt Diabetes in High-Risk Groups?.
Creator: Fabrizi, Meghan, Rodríguez, Jose
Date Issued: 2013
Identifier: FSU_migr_fmr-0053
Format: Citation

Title: What Treatments Are Effective for Symptomatic Benign Orthostatic Hypotension?.
Creator: Caporasco, Anthony, Chhabra, Ruchi, Qureshi, Hina, Rodríguez, Jose, Hitchcock, Kristin
Abstract/Description: Increased salt intake, compression stockings, and midodrine can reduce symptoms related to benign orthostatic hypotension. (SOR B, based on a single study of each intervention.) Counterpressure measures are safe, easy, reliable strategies to prevent syncope. (SOR A, based on 2 randomized controlled trials [RCTs] and a case series.) Drugs contributing to benign orthostatic hypotension should be discontinued or replaced if possible. (SOR C, based on expert opinion.)
Date Issued: 2009
Identifier: FSU_migr_fmr-0014
Format: Citation

Title: Does Dietary Fat Reduction Alter the Risk of Cardiovascular Events in Women?.
Creator: Smith, Joshua, Rodríguez, Jose
Abstract/Description: A decrease in dietary fat does not alter the risk of coronary heart disease (CHD), stroke, or cardiovascular disease (CVD) in postmenopausal women (SOR: B, based on a single RCT), nor does it significantly alter CHD in women aged 30 to 55. (SOR: B, based on a single cohort study.) However, CVD in women is epidemiologically linked to higher trans-fat consumption and lower polyunsaturated fat consumption.
Date Issued: 2010
Identifier: FSU_migr_fmr-0031
Format: Citation

Title: Cardiac Troponin Mutations and Restrictive Cardiomyopathy.
Creator: Parvatiyar, Michelle, Pinto, Jose, Dweck, David, Potter, James
Abstract/Description: Mutations in sarcomeric proteins have recently been established as heritable causes of Restrictive Cardiomyopathy (RCM). RCM is clinically characterized as a defect in cardiac diastolic function, such as, impaired ventricular relaxation, reduced diastolic volume and increased end-diastolic pressure. To date, mutations have been identified in the cardiac genes for desmin, alpha-actin, troponin I and troponin T. Functional studies in skinned muscle fibers reconstituted with troponin mutants...
Show moreMutations in sarcomeric proteins have recently been established as heritable causes of Restrictive Cardiomyopathy (RCM). RCM is clinically characterized as a defect in cardiac diastolic function, such as, impaired ventricular relaxation, reduced diastolic volume and increased end-diastolic pressure. To date, mutations have been identified in the cardiac genes for desmin, alpha-actin, troponin I and troponin T. Functional studies in skinned muscle fibers reconstituted with troponin mutants have established phenotypes consistent with the clinical findings which include an increase in myofilament Ca(2+) sensitivity and basal force. Moreover, when RCM mutants are incorporated into reconstituted myofilaments, the ability to inhibit the ATPase activity is reduced. A majority of the mutations cluster in specific regions of cardiac troponin and appear to be mutational "hot spots". This paper highlights the functional and clinical characteristics of RCM linked mutations within the troponin complex.
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Date Issued: 2010
Identifier: FSU_migr_biomed_faculty_publications-0053, 10.1155/2010/350706
Format: Citation

Title: Racial Disparity in the Associations of Microalbuminuria and Macroalbuminuria with Odds of Hypertension: Results from the NHANES Study in the United States.
Creator: Liu, Xuefeng, Liu, Yali, Tsilimingras, Dennis, Campbell, Kendall
Abstract/Description: Background. Limited information is available on whether the associations of microalbuminuria and macroalbuminuria with the odds of hypertension differ among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. Methods. Cross-sectional data of 24,949 participants aged ≥18 years were collected from the National Health and Nutrition Examination Survey (NHANES) 1999–2008. Odds ratios of hypertension for microalbuminuria and macroalbuminuria were estimated by conducting weighted multiple...
Show moreBackground. Limited information is available on whether the associations of microalbuminuria and macroalbuminuria with the odds of hypertension differ among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. Methods. Cross-sectional data of 24,949 participants aged ≥18 years were collected from the National Health and Nutrition Examination Survey (NHANES) 1999–2008. Odds ratios of hypertension for microalbuminuria and macroalbuminuria were estimated by conducting weighted multiple logistic regression models. Results. After adjustment for extensive confounding factors, microalbuminuria is 1.45 (95% confidence interval (CI) [1.17, 1.80]), 2.07 (95% CI [1.52, 2.83]) and 2.81 (95% CI [2.06, 3.84]) times more likely to be associated with hypertension, and macroalbuminuria is 4.08 (95% CI [1.98, 8.38]), 8.62 (95% CI [3.84, 19.35]), and 4.43 (95% CI [2.13, 9.21]) times in non-Hispanic Whites, non-Hispanic Blacks, and Hispanics, respectively. The odds of hypertension for microalbuminuria (versus normalbuminuria) were 52% higher in non-Hispanic Blacks and 98% higher in Hispanics than in non-Hispanic Whites; the odds of hypertension for macroalbuminuria (versus normalbuminuria) did not differ among racial groups. Conclusion. Racial differences in the relation between microalbuminuria and hypertension are prevalent among non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. More screening efforts should be encouraged in normotensive non-Hispanic Blacks and Hispanics with microalbuminuria.
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Date Issued: 2013
Identifier: FSU_migr_fmr-0056, 10.5402/2013/390109
Format: Citation

Title: Analysis of the Molecular Pathogenesis of Cardiomyopathy-Causing cTnT Mutants I79N, ΔE96, and ΔK210.
Creator: Bai, Fan, Caster, Hannah, Pinto, Jose, Kawai, Masataka
Abstract/Description: Three troponin T (TnT) mutants that cause hypertrophic, restrictive, and dilated cardiomyopathy (I79N, ΔE96, and ΔK210, respectively), were examined using the thin-filament extraction/reconstitution technique. Effects of Ca(2+), ATP, phosphate, and ADP concentrations on force and its transients were studied at 25°C. Maximal Ca(2+) tension (THC) and Ca(2+)-activatable tension (Tact), respectively, were similar among I79N, ΔE96, and WT, whereas ΔK210 led to a significantly lower THC (∼20% less)...
Show moreThree troponin T (TnT) mutants that cause hypertrophic, restrictive, and dilated cardiomyopathy (I79N, ΔE96, and ΔK210, respectively), were examined using the thin-filament extraction/reconstitution technique. Effects of Ca(2+), ATP, phosphate, and ADP concentrations on force and its transients were studied at 25°C. Maximal Ca(2+) tension (THC) and Ca(2+)-activatable tension (Tact), respectively, were similar among I79N, ΔE96, and WT, whereas ΔK210 led to a significantly lower THC (∼20% less) and Tact (∼25% less) than did WT. In pCa solution containing 8 mM Pi and ionic strength adjusted to 200 mM, the Ca(2+) sensitivity (pCa50) of I79N (5.63 ± 0.02) and ΔE96 (5.60 ± 0.03) was significantly greater than that of WT (5.45 ± 0.04), but the pCa50 of ΔK210 (5.54 ± 0.04) remained similar to that of WT. Five equilibrium constants were deduced using sinusoidal analysis. All three mutants showed significantly lower K0 (ADP association constant) and larger K4 (equilibrium constant of force generation step) relative to the corresponding values for WT. I79N and ΔK210 were associated with a K2 (equilibrium constant of cross-bridge detachment step) significantly lower than that of ΔE96 and WT. These results demonstrated that at pCa 4.66, the force/cross-bridge is ∼18% less in I79N and ∼41% less in ΔK210 than that in WT. These results indicate that the molecular pathogenesis of the cardiac TnT mutation-related cardiomyopathies is different for each mutation.
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Date Issued: 2013
Identifier: FSU_migr_biomed_faculty_publications-0051, 10.1016/j.bpj.2013.04.001
Format: Citation

Title: Absence of Myocardial Thyroid Hormone Inactivating Deiodinase Results in Restrictive Cardiomyopathy in Mice.
Creator: Ueta, Cintia, Oskouei, Behzad, Olivares, Emerson, Pinto, Jose, Correa, Mayrin, Simovic, Gordana, Simonides, Warner, Hare, Joshua, Bianco, Antônio Carlos
Abstract/Description: Cardiac injury induces myocardial expression of the thyroid hormone inactivating type 3 deiodinase (D3), which in turn dampens local thyroid hormone signaling. Here, we show that the D3 gene (Dio3) is a tissue-specific imprinted gene in the heart, and thus, heterozygous D3 knockout (HtzD3KO) mice constitute a model of cardiac D3 inactivation in an otherwise systemically euthyroid animal. HtzD3KO newborns have normal hearts but later develop restrictive cardiomyopathy due to cardiac-specific...
Show moreCardiac injury induces myocardial expression of the thyroid hormone inactivating type 3 deiodinase (D3), which in turn dampens local thyroid hormone signaling. Here, we show that the D3 gene (Dio3) is a tissue-specific imprinted gene in the heart, and thus, heterozygous D3 knockout (HtzD3KO) mice constitute a model of cardiac D3 inactivation in an otherwise systemically euthyroid animal. HtzD3KO newborns have normal hearts but later develop restrictive cardiomyopathy due to cardiac-specific increase in thyroid hormone signaling, including myocardial fibrosis, impaired myocardial contractility, and diastolic dysfunction. In wild-type littermates, treatment with isoproterenol-induced myocardial D3 activity and an increase in the left ventricular volumes, typical of cardiac remodeling and dilatation. Remarkably, isoproterenol-treated HtzD3KO mice experienced a further decrease in left ventricular volumes with worsening of the diastolic dysfunction and the restrictive cardiomyopathy, resulting in congestive heart failure and increased mortality. These findings reveal crucial roles for Dio3 in heart function and remodeling, which may have pathophysiologic implications for human restrictive cardiomyopathy.
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Date Issued: 2012
Identifier: FSU_migr_biomed_faculty_publications-0052, 10.1210/me.2011-1325
Format: Citation

Title: Facets of Personality Linked to Underweight and Overweight.
Creator: Terracciano, Antonio, Sutin, Angelina, McCrae, Robert R., Deiana, Barbara, Ferrucci, Luigi, Schlessinger, David, Uda, Manuela, Costa, Paul
Abstract/Description: OBJECTIVE: Personality traits underlie maladaptive behaviors, and cognitive and emotional disturbances that contribute to major preventable causes of global disease burden. This study examines detailed personality profiles of underweight, normal, and overweight individuals to provide insights into the causes and treatments of abnormal weight. METHODS: More than half of the population from four towns in Sardinia, Italy (n = 5693; age = 14-94 years; mean +/- standard deviation = 43 +/- 17 years...
Show moreOBJECTIVE: Personality traits underlie maladaptive behaviors, and cognitive and emotional disturbances that contribute to major preventable causes of global disease burden. This study examines detailed personality profiles of underweight, normal, and overweight individuals to provide insights into the causes and treatments of abnormal weight. METHODS: More than half of the population from four towns in Sardinia, Italy (n = 5693; age = 14-94 years; mean +/- standard deviation = 43 +/- 17 years) were assessed on multiple anthropometric measures and 30 facets that comprehensively cover the five major dimensions of personality, using the Revised NEO Personality Inventory. RESULTS: High Neuroticism and low Conscientiousness were associated with being underweight and obese, respectively. High Impulsiveness (specifically eating-behavior items) and low Order were associated with body mass index categories of overweight and obese, and with measures of abdominal adiposity (waist and hip circumference). Those scoring in the top 10% of Impulsiveness were about 4 kg heavier than those in the bottom 10%, an effect independent and larger than the FTO genetic variant. Prospective analyses confirmed that Impulsiveness and Order were significant predictors of general and central measures of adiposity assessed 3 years later. CONCLUSIONS: Overweight and obese individuals have difficulty resisting cravings and lack methodical and organized behaviors that might influence diet and weight control. Although individuals' traits have limited impact on the current obesogenic epidemic, personality traits can improve clinical assessment, suggest points of intervention, and help tailor prevention and treatment approaches.
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Date Issued: 2009
Identifier: FSU_migr_mhs-0033, 10.1097/PSY.0b013e3181a2925b
Format: Citation

Title: Four Years of Group Visits Treating Obesity in an Under Served Urban Community: Health not Cosmetics.
Creator: Rodríguez, Jose, Painter, Kimberly, Bent, Gloria
Date Issued: 2007
Identifier: FSU_migr_fmr-0036
Format: Citation

Title: Functional Effects of a Restrictive-Cardiomyopathy-Linked Cardiac Troponin I Mutation (R145W) in Transgenic Mice.
Creator: Wen, Yuhui, Xu, Yuanyuan, Wang, Yingcai, Pinto, Jose, Potter, James, Kerrick, W.
Abstract/Description: The human cardiac troponin I (hcTnI) mutation R145W has been associated with restrictive cardiomyopathy. In this study, simultaneous measurements of ATPase activity and force in skinned papillary fibers from hcTnI R145W transgenic mice (Tg-R145W) were explored. Tg-R145W fibers showed an approximately 13-16% increase in maximal Ca(2+)-activated force and ATPase activity compared to hcTnI wild-type transgenic mice. The force-generating cross-bridge turnover rate (g) and the energy cost (ATPase...
Show moreThe human cardiac troponin I (hcTnI) mutation R145W has been associated with restrictive cardiomyopathy. In this study, simultaneous measurements of ATPase activity and force in skinned papillary fibers from hcTnI R145W transgenic mice (Tg-R145W) were explored. Tg-R145W fibers showed an approximately 13-16% increase in maximal Ca(2+)-activated force and ATPase activity compared to hcTnI wild-type transgenic mice. The force-generating cross-bridge turnover rate (g) and the energy cost (ATPase/force) were the same in all groups of fibers. Also, the Tg-R145W fibers showed a large increase in the Ca(2+) sensitivity of both force development and ATPase. In intact fibers, the mutation caused prolonged force and intracellular [Ca(2+)] transients and increased time to peak force. Analysis of force and Ca(2+) transients showed that there was a 40% increase in peak force in Tg-R145W muscles, which was likely due to the increased Ca(2+) transient duration. The above cited results suggest that: (1) there would be an increase in resistance to ventricular filling during diastole resulting from the prolonged force and Ca(2+) transients that would result in a decrease in ventricular filling (diastolic dysfunction); and (2) there would be a large (approximately 53%) increase in force during systole, which may help to partly compensate for diastolic dysfunction. These functional results help to explain the mechanisms by which these mutations give rise to a restrictive phenotype.
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Date Issued: 2009
Identifier: FSU_migr_biomed_faculty_publications-0060, 10.1016/j.jmb.2009.07.080
Format: Citation

Title: How Long Should Antibiotic Therapy Be Continued for an Uncomplicated, Symptomatic Lower UTI in an Elderly Woman?.
Creator: Radkay, Lisa, Rodríguez, Jose
Abstract/Description: Elderly women with symptomatic lower urinary tract infections (UTIs) should be treated for 3 to 6 days with oral antibiotics. This duration provides better short-term outcomes than 1-day therapy and has long-term outcomes equivalent to 7- to 14-day therapy. (SOR B, based on a systematic review of heterogeneous RCTs.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0028
Format: Citation

Title: How Are Thyroid Function Tests Altered by Thyroid Replacement Medications?.
Creator: Shah, Shawn, Rodríguez, Jose
Abstract/Description: Small changes in the dosing of levothyroxine (±25 mcg) are associated with large changes in serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) concentrations, but not with measurable changes in hypothyroid symptoms, well-being, or quality of life. (SOR: B, based on a single RCT.) Taking levothyroxine while fasting is associated with a higher serum FT4 and lower serum TSH compared with administration after a meal, but these differences are small. (SOR: C, based on a single RCT...
Show moreSmall changes in the dosing of levothyroxine (±25 mcg) are associated with large changes in serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) concentrations, but not with measurable changes in hypothyroid symptoms, well-being, or quality of life. (SOR: B, based on a single RCT.) Taking levothyroxine while fasting is associated with a higher serum FT4 and lower serum TSH compared with administration after a meal, but these differences are small. (SOR: C, based on a single RCT using disease-oriented outcomes.)
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Date Issued: 2010
Identifier: FSU_migr_fmr-0032
Format: Citation

Title: High Neuroticism and Low Conscientiousness Are Associated with Interleukin-6.
Creator: Sutin, Angelina, Terracciano, Antonio, Deiana, Barbara, Naitza, Silvia, Ferrucci, Luigi, Uda, Manuela, Schlessinger, David, Costa, Paul
Abstract/Description: BACKGROUND: High Neuroticism and low Conscientiousness are frequently implicated in health-risk behaviors, such as smoking and overeating, as well as health outcomes, including mortality. Their associations with physiological markers of morbidity and mortality, such as inflammation, are less well documented. The present research examines the association between the five major dimensions of personality and interleukin-6 (IL-6), a pro-inflammatory cytokine often elevated in patients with...
Show moreBACKGROUND: High Neuroticism and low Conscientiousness are frequently implicated in health-risk behaviors, such as smoking and overeating, as well as health outcomes, including mortality. Their associations with physiological markers of morbidity and mortality, such as inflammation, are less well documented. The present research examines the association between the five major dimensions of personality and interleukin-6 (IL-6), a pro-inflammatory cytokine often elevated in patients with chronic morbidity and frailty. METHOD: A population-based sample (n=4923) from four towns in Sardinia, Italy, had their levels of IL-6 measured and completed a comprehensive personality questionnaire, the NEO-PI-R. Analyses controlled for factors known to have an effect on IL-6: age; sex; smoking; weight; aspirin use; disease burden. RESULTS: High Neuroticism and low Conscientiousness were both associated with higher levels of IL-6. The findings remained significant after controlling for the relevant covariates. Similar results were found for C-reactive protein, a related marker of chronic inflammation. Further, smoking and weight partially mediated the association between impulsivity-related traits and higher IL-6 levels. Finally, logistic regressions revealed that participants either in the top 10% of the distribution of Neuroticism or the bottom 10% of conscientiousness had an approximately 40% greater risk of exceeding clinically relevant thresholds of IL-6. CONCLUSIONS: Consistent with the literature on personality and self-reported health, individuals high on Neuroticism or low on Conscientiousness show elevated levels of this inflammatory cytokine. Identifying critical medical biomarkers associated with personality may help to elucidate the physiological mechanisms responsible for the observed connections between personality traits and physical health.
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Date Issued: 2010
Identifier: FSU_migr_mhs-0026, 10.1017/S0033291709992029
Format: Citation

Title: Interventions for Heart Failure.
Creator: Glickman, Michael, Rodríguez, Jose
Abstract/Description: The following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial infarction (MI), and hospitalization rates • Beta-blockers and aldosterone blockers reduce mortality and hospitalization rates • Diuretics reduce mortality and hospitalization rates and improve exercise capacity • Digitalis treatment decreases hospitalization rates and clinical...
Show moreThe following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial infarction (MI), and hospitalization rates • Beta-blockers and aldosterone blockers reduce mortality and hospitalization rates • Diuretics reduce mortality and hospitalization rates and improve exercise capacity • Digitalis treatment decreases hospitalization rates and clinical deterioration • Aerobic exercise rehabilitation of at least 6 months in duration decreases hospitalization rates and improves quality of life. The following intervention improves important outcomes in African American patients with systolic heart failure (SOR: B, based on a single RCT): • Isosorbide dinitrate and hydralazine combination therapy reduces mortality and hospitalization rates and improves quality of life.
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Date Issued: 2011
Identifier: FSU_migr_fmr-0034
Format: Citation

Title: How Safe and Effective is Pramlintide in Improving Long-Term Glycemic Control and Weight Loss in Patients with Type 2 Diabetes Mellitus Receiving Insulin?.
Creator: Iyengar, Sanjana, Love, Kaitlin, Bauerband, Brian, Rodríguez, Jose
Date Issued: 2013
Identifier: FSU_migr_fmr-0052
Format: Citation

Title: Is Uterine Artery Embolization (UAE) Safe and Effective for Treatment of Uterine Fibroids?.
Creator: Davis, Laura, Provost, Bridgette, Rodríguez, Jose
Abstract/Description: Compared with hysterectomy or myomectomy, UAE for treating fibroids results in similar patient satisfaction. UAE is associated with fewer blood transfusions, shorter hospital stays, and quicker resumption of normal activities than surgical treatment. However, patients undergoing UAE are more likely to require further intervention at 2 and 5 years and are more likely to have minor complications than patients treated surgically (SOR: A, systematic review of RCTs).
Date Issued: 2012
Identifier: FSU_migr_fmr-0044
Format: Citation

Title: Health Literacy as a Tool to Improve the Public Understanding of Alzheimer's Disease.
Creator: Kobylarz, Fred, Pomidor, Alice, Pleasant, Andrew F.
Abstract/Description: The ultimate goal of health literacy is to improve care by enhancing the patient's quality of life, maximizing clinical outcomes, and reducing inequities in health. Successful restructuring of the healthcare system to make it more effective, efficient, and equitable demands that health literacy be integrated as a key source of theoretical and empirical data regarding patients' needs and wishes. This applies across the life course, but it is especially true for the increasing numbers of older...
Show moreThe ultimate goal of health literacy is to improve care by enhancing the patient's quality of life, maximizing clinical outcomes, and reducing inequities in health. Successful restructuring of the healthcare system to make it more effective, efficient, and equitable demands that health literacy be integrated as a key source of theoretical and empirical data regarding patients' needs and wishes. This applies across the life course, but it is especially true for the increasing numbers of older adults who must deal with the medical care system the most, yet often comprehend medical information the least. Nearly nine out of ten people in the United States do not have the level of proficiency in health literacy skills necessary to successfully navigate the healthcare system. According to the National Assessment of Adult Literacy (NAAL), populations overrepresented at the lowest levels of health literacy (below basic level) in the United States include people over age 65, those who did not graduate from high school, persons who did not speak English before starting school, people who have poor health status, those who are of racial and ethnic minority groups, and individuals without medical insurance. An increasing number of efforts are ongoing across the United States and internationally to address health literacy. Significant national initiatives include Healthy People 2010, the Joint Commission's report "Improving Health Literacy to Protect Patient Safety," and the U.S. Department of Heath and Human Services Office of the Surgeon General's "Workshop on Improving Health Literacy." Other organizations attempting to address health literacy include the American Medical Association and the Partnership for Clear Health Communication. Many organizations are launching successful health literacy–based interventions such as the Canyon Ranch Institute's Life Enhancement Program, an integrated approach to prevention and wellness. Additionally, there are a growing number of curricula addressing health literacy being developed by a wide range of organizations and individuals. Equally significant efforts are ongoing in a number of countries around the world, particularly Canada, Australia, and Switzerland. The purposes of this article are to familiarize readers with the concept of health literacy; demonstrate how health literacy can serve as a tool to improve the public's understanding of Alzheimer's disease (AD), the seventh leading cause of death; and suggest generally applicable strategies for clinicians.
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Date Issued: 2010
Identifier: FSU_migr_geriatrics_faculty_publications-0041
Format: Citation

Title: Is Calcitonin Useful for Reducing the Pain of Acute Osteoporotic Fractures?.
Creator: Parker, Alex, Soberon, Angelica, Rodríguez, Jose
Abstract/Description: Calcitonin has been shown to improve acute pain at rest in patients with osteoporotic vertebral fractures, when compared with placebo, and reduce the use of other analgesic medications (SOR A, based on a meta-analysis of randomized controlled trials [RCTs]). However, calcitonin is not superior to placebo in patients with hip fracture who have undergone surgical repair. (SOR B, based on an RCT.)
Date Issued: 2009
Identifier: FSU_migr_fmr-0017
Format: Citation

Title: Late Onset Sporadic Dilated Cardiomyopathy Caused by a Cardiac Troponin T Mutation.
Creator: Morales, Ana, Pinto, Jose, Siegfried, Jill, Li, Duanxiang, Norton, Nadine, Hofmeyer, Mark, Vallin, Marta, Morales, Azorides R., Potter, James, Hershberger, Ray
Abstract/Description: Mutations in TNNT2, encoding cardiac troponin T, commonly shows early onset, aggressive dilated cardiomyopathy (DCM). This observation may influence the decision of whether to undertake clinical genetic testing for TNNT2 in later onset DCM. Further, the trigger for late onset DCM remains enigmatic. A 70-year-old woman, previously healthy with a left ventricular ejection fraction of 50%-55% at age 69, presented with DCM of unknown cause and a 4-month history progressive heart failure requiring...
Show moreMutations in TNNT2, encoding cardiac troponin T, commonly shows early onset, aggressive dilated cardiomyopathy (DCM). This observation may influence the decision of whether to undertake clinical genetic testing for TNNT2 in later onset DCM. Further, the trigger for late onset DCM remains enigmatic. A 70-year-old woman, previously healthy with a left ventricular ejection fraction of 50%-55% at age 69, presented with DCM of unknown cause and a 4-month history progressive heart failure requiring cardiac transplantation. Clinical genetic testing revealed a novel TNNT2 R139H mutation but no relevant variants in 18 other DCM genes. Her explanted heart showed partial fatty replacement in the right ventricle. Sequencing for five arrhythmogenic right ventricular dysplasia genes was negative. Functional studies in porcine cardiac skinned fibers reconstituted with the mutant R139H troponin T protein showed decreased Ca(2+) sensitivity at pH 7, characteristic of DCM. Because fatty infiltration may acidify the myocellular environment, maximal force development examined at pH 6.5 was diminished, suggesting a possible environmental trigger. We conclude that the TNNT2 R139H mutation was likely to be disease causing. Further, later age of onset may not be relevant to exclude genetic testing for TNNT2 mutations.
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Date Issued: 2010
Identifier: FSU_migr_biomed_faculty_publications-0054, 10.1111/j.1752-8062.2010.00228.x
Format: Citation

Title: Mobile Health Unit for Obesity Education: Attitudes and Perceptions Among Local Homeless Residents.
Creator: Soberon, Angelica, Brown, L., Rodríguez, Jose
Abstract/Description: Objective: Poverty is a risk factor for obesity. Using homelessness as a marker for poverty, we examined the prevalence of obesity in Leon County, Florida's homeless population to determine their attitudes and perceptions towards the disease. Methods: Our medical team equipped a mobile health unit with educational material before visiting homeless shelters, health fairs and shopping areas in Northwest Florida. Participants at these sites completed a short survey and our staff calculated Body...
Show moreObjective: Poverty is a risk factor for obesity. Using homelessness as a marker for poverty, we examined the prevalence of obesity in Leon County, Florida's homeless population to determine their attitudes and perceptions towards the disease. Methods: Our medical team equipped a mobile health unit with educational material before visiting homeless shelters, health fairs and shopping areas in Northwest Florida. Participants at these sites completed a short survey and our staff calculated Body Mass Index (BMI). The team also distributed lifestyle modification and obesity patient education. BMI and survey responses were compared and analyzed using statistical software. Results: Subjects were assigned to one of two groups: the homeless group or the "all others" group. The homeless group's responses and BMIs were compared to the "all others" group. Weight status in the homeless group was distributed as follows: normal weight (48.3%), overweight (39.7%) and obese (12.1%). The distribution among all other participants was: normal weight (34.8%), overweight (25.8%), and obese (39.3%). Homeless participants overestimated their BMI category as often as all others, were less likely to participate in weight loss interventions, and less likely to recognize overweight and obesity as a problem. Conclusion: Medical practitioners need to recognize the role of patients' attitudes about weight loss and clarify definitions of exercise. Obesity is less prevalent among the homeless; however, the same obesity trends exist. In addition, we learned that the homeless are eager to learn about obesity and healthy lifestyles, but may not be as willing to attempt interventions that have worked in other populations. Mobile health units can be used to reach out to them.
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Date Issued: 2009
Identifier: FSU_migr_fmr-0035
Format: Citation

Title: Molecular and Functional Characterization of Novel Hypertrophic Cardiomyopathy Susceptibility Mutations in TNNC1-encoded Troponin C.
Creator: Landstrom, Andrew, Parvatiyar, Michelle, Pinto, Jose, Marquardt, Michelle, Bos, J., Tester, David, Ommen, Steve, Potter, James, Ackerman, Michael
Abstract/Description: Hypertrophic Cardiomyopathy (HCM) is a common primary cardiac disorder defined by a hypertrophied left ventricle, is one of the main causes of sudden death in young athletes, and has been associated with mutations in most sarcomeric proteins (tropomyosin, troponin T and I, and actin, etc.). Many of these mutations appear to affect the functional properties of cardiac troponin C (cTnC), i.e., by increasing the Ca(2+)-sensitivity of contraction, a hallmark of HCM, yet surprisingly, prior to...
Show moreHypertrophic Cardiomyopathy (HCM) is a common primary cardiac disorder defined by a hypertrophied left ventricle, is one of the main causes of sudden death in young athletes, and has been associated with mutations in most sarcomeric proteins (tropomyosin, troponin T and I, and actin, etc.). Many of these mutations appear to affect the functional properties of cardiac troponin C (cTnC), i.e., by increasing the Ca(2+)-sensitivity of contraction, a hallmark of HCM, yet surprisingly, prior to this report, cTnC had not been classified as a HCM-susceptibility gene. In this study, we show that mutations occurring in the human cTnC (HcTnC) gene (TNNC1) have the same prevalence (~0.4%) as well established HCM-susceptibility genes that encode other sarcomeric proteins. Comprehensive open reading frame/splice site mutation analysis of TNNC1 performed on 1025 unrelated HCM patients enrolled over the last 10 years revealed novel missense mutations in TNNC1: A8V, C84Y, E134D, and D145E. Functional studies with these recombinant HcTnC HCM mutations showed increased Ca(2+) sensitivity of force development (A8V, C84Y and D145E) and force recovery (A8V and D145E). These results are consistent with the HCM functional phenotypes seen with other sarcomeric-HCM mutations (E134D showed no changes in these parameters). This is the largest cohort analysis of TNNC1 in HCM that details the discovery of at least three novel HCM-associated mutations and more strongly links TNNC1 to HCM along with functional evidence that supports a central role for its involvement in the disease. This study may help to further define TNNC1 as an HCM-susceptibility gene, a classification that has already been established for the other members of the troponin complex.
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Date Issued: 2008
Identifier: FSU_migr_biomed_faculty_publications-0058, 10.1016/j.yjmcc.2008.05.003
Format: Citation

Title: Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese.
Creator: Rodríguez, Jose, Shearer, Barbara, Slawson, David C.
Abstract/Description: No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated body mass index (BMI), fasting insulin levels, and fasting glucose levels. (Strength of Recommendation [SOR]: C). However, metformin treatment is associated with nausea, abdominal pain, and diarrhea. (SOR: A). Because of the limited available data,...
Show moreNo studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated body mass index (BMI), fasting insulin levels, and fasting glucose levels. (Strength of Recommendation [SOR]: C). However, metformin treatment is associated with nausea, abdominal pain, and diarrhea. (SOR: A). Because of the limited available data, metformin is not recommended for diabetes prevention in adolescents. (SOR: C).
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Date Issued: 2007
Identifier: FSU_migr_fmr-0003
Format: Citation

Title: Myosin Cross-Bridges Do Not Form Precise Rigor Bonds in Hypertrophic Heart Muscle Carrying Troponin T Mutations.
Creator: Midde, K., Dumka, V., Pinto, Jose, Muthu, P., Marandos, P., Gryczynski, I., Gryczynski, Z., Potter, James, Borejdo, J.
Abstract/Description: Distribution of orientations of myosin was examined in ex-vivo myofibrils from hearts of transgenic (Tg) mice expressing Familial Hypertrophic Cardiomyopathy (FHC) troponin T (TnT) mutations I79N, F110I and R278C. Humans are heterozygous for sarcomeric FHC mutations and so hypertrophic myocardium contains a mixture of the wild-type (WT) and mutated (MUT) TnT. If mutations are expressed at a low level there may not be a significant change in the global properties of heart muscle. In contrast,...
Show moreDistribution of orientations of myosin was examined in ex-vivo myofibrils from hearts of transgenic (Tg) mice expressing Familial Hypertrophic Cardiomyopathy (FHC) troponin T (TnT) mutations I79N, F110I and R278C. Humans are heterozygous for sarcomeric FHC mutations and so hypertrophic myocardium contains a mixture of the wild-type (WT) and mutated (MUT) TnT. If mutations are expressed at a low level there may not be a significant change in the global properties of heart muscle. In contrast, measurements from a few molecules avoid averaging inherent in the global measurements. It is thus important to examine the properties of only a few molecules of muscle. To this end, the lever arm of one out of every 60,000 myosin molecules was labeled with a fluorescent dye and a small volume within the A-band (~1 fL) was observed by confocal microscopy. This volume contained on average 5 fluorescent myosin molecules. The lever arm assumes different orientations reflecting different stages of acto-myosin enzymatic cycle. We measured the distribution of these orientations by recording polarization of fluorescent light emitted by myosin-bound fluorophore during rigor and contraction. The distribution of orientations of rigor WT and MUT myofibrils was significantly different. There was a large difference in the width and of skewness and kurtosis of rigor distributions. These findings suggest that the hypertrophic phenotype associated with the TnT mutations can be characterized by a significant increase in disorder of rigor cross-bridges.
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Date Issued: 2011
Identifier: FSU_migr_biomed_faculty_publications-0055, 10.1016/j.yjmcc.2011.06.001
Format: Citation

Title: Myofilament Ca2+ Sensitization Causes Susceptibility to Cardiac Arrhythmia in Mice.
Creator: Baudenbacher, Franz, Schober, Tilmann, Pinto, Jose, Sidorov, Veniamin, Hilliard, Fredrick, Solaro, R. John, Potter, James, Knollmann, Björn C.
Abstract/Description: In human cardiomyopathy, anatomical abnormalities such as hypertrophy and fibrosis contribute to the risk of ventricular arrhythmias and sudden death. Here we have shown that increased myofilament Ca2+ sensitivity, also a common feature in both inherited and acquired human cardiomyopathies, created arrhythmia susceptibility in mice, even in the absence of anatomical abnormalities. In mice expressing troponin T mutants that cause hypertrophic cardiomyopathy in humans, the risk of developing...
Show moreIn human cardiomyopathy, anatomical abnormalities such as hypertrophy and fibrosis contribute to the risk of ventricular arrhythmias and sudden death. Here we have shown that increased myofilament Ca2+ sensitivity, also a common feature in both inherited and acquired human cardiomyopathies, created arrhythmia susceptibility in mice, even in the absence of anatomical abnormalities. In mice expressing troponin T mutants that cause hypertrophic cardiomyopathy in humans, the risk of developing ventricular tachycardia was directly proportional to the degree of Ca2+ sensitization caused by the troponin T mutation. Arrhythmia susceptibility was reproduced with the Ca2+-sensitizing agent EMD 57033 and prevented by myofilament Ca2+ desensitization with blebbistatin. Ca2+ sensitization markedly changed the shape of ventricular action potentials, resulting in shorter effective refractory periods, greater beat-to-beat variability of action potential durations, and increased dispersion of ventricular conduction velocities at fast heart rates. Together these effects created an arrhythmogenic substrate. Thus, myofilament Ca2+ sensitization represents a heretofore unrecognized arrhythmia mechanism. The protective effect of blebbistatin provides what we believe to be the first direct evidence that reduction of Ca2+ sensitivity in myofilaments is antiarrhythmic and might be beneficial to individuals with hypertrophic cardiomyopathy.
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Date Issued: 2008
Identifier: FSU_migr_biomed_faculty_publications-0050, 10.1172/JCI36642
Format: Citation

Title: Myofilament Calcium De-Sensitization and Contractile Uncoupling Prevent Pause-Triggered Ventricular Tachycardia in Mouse Hearts with Chronic Myocardial Infarction.
Creator: Venkataraman, Raghav, Baldo, Marcelo, Hwang, Hyun, Veltri, Tiago, Pinto, Jose, Baudenbacher, Franz, Knollmann, Björn C.
Abstract/Description: Myocardial infarction (MI) is a major risk for ventricular arrhythmia. Pause-triggered ventricular arrhythmia can be caused by increased myofilament Ca binding due to sarcomeric mutations or Ca-sensitizing compounds. Myofilament Ca sensitivity is also increased after MI. Here we hypothesize that MI increases risk for pause-triggered ventricular arrhythmias, which can be prevented by myofilament Ca-desensitization and contractile uncoupling. To test this hypothesis, we generated a murine...
Show moreMyocardial infarction (MI) is a major risk for ventricular arrhythmia. Pause-triggered ventricular arrhythmia can be caused by increased myofilament Ca binding due to sarcomeric mutations or Ca-sensitizing compounds. Myofilament Ca sensitivity is also increased after MI. Here we hypothesize that MI increases risk for pause-triggered ventricular arrhythmias, which can be prevented by myofilament Ca-desensitization and contractile uncoupling. To test this hypothesis, we generated a murine chronic MI model using male B6SJLF1/J mice (n=40) that underwent permanent ligation of the left anterior descending coronary artery. 4 weeks post MI, cardiac structure, function and myofilament Ca sensitivity were evaluated. Pause-dependent arrhythmia susceptibility was quantified in isolated hearts with pacing trains of increasing frequency, followed by a pause and an extra stimulus. Coronary ligation resulted in a mean infarct size of 39.6±5.7% LV and fractional shortening on echocardiography was reduced by 40% compared to non-infarcted controls. Myofilament Ca sensitivity was significantly increased in post MI hearts (pCa50: Control=5.66±0.03; MI=5.84±0.05; P
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Date Issued: 2013
Identifier: FSU_migr_biomed_faculty_publications-0057, 10.1016/j.yjmcc.2013.03.022
Format: Citation

Title: Are Group Visits Effective for the Treatment of Obesity?.
Creator: Hofmann, Mikel, Rodríguez, Jose, Shearer, Barbara
Abstract/Description: Weight loss therapy consisting of 20 to 30 lifestyle-modification group visits is associated with modest (4–8 kg) weight loss. (SOR A, based on homogeneous randomized controlled trials [RCTs].) For patients who participate in group visits, use of sibutramine (15 mg p.o. daily) and compliance with food journaling are both associated with greater weight loss. (SOR B, based on an RCT and an outcomes study.)
Date Issued: 2010
Identifier: FSU_migr_fmr-0021
Format: Citation

Title: Collagen XIV Is Important for Growth and Structural Integrity of the Myocardium.
Creator: Tao, Ge, Levay, Agata, Peacock, Jacqueline, Huk, Danielle, Both, Sarah, Purcell, Nicole, Pinto, Jose, Galantowicz, Maarten, Koch, Manuel, Lucchesi, Pamela, Birk, David E.,...
Show moreTao, Ge, Levay, Agata, Peacock, Jacqueline, Huk, Danielle, Both, Sarah, Purcell, Nicole, Pinto, Jose, Galantowicz, Maarten, Koch, Manuel, Lucchesi, Pamela, Birk, David E., Lincoln, Joy
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Abstract/Description: Collagen XIV is a fibril-associated collagen with an interrupted triple helix (FACIT). Previous studies have shown that this collagen type regulates early stages of fibrillogenesis in connective tissues of high mechanical demand. Mice null for Collagen XIV are viable, however formation of the interstitial collagen network is defective in tendons and skin leading to reduced biomechanical function. The assembly of a tightly regulated collagen network is also required in the heart, not only for...
Show moreCollagen XIV is a fibril-associated collagen with an interrupted triple helix (FACIT). Previous studies have shown that this collagen type regulates early stages of fibrillogenesis in connective tissues of high mechanical demand. Mice null for Collagen XIV are viable, however formation of the interstitial collagen network is defective in tendons and skin leading to reduced biomechanical function. The assembly of a tightly regulated collagen network is also required in the heart, not only for structural support but also for controlling cellular processes. Collagen XIV is highly expressed in the embryonic heart, notably within the cardiac interstitium of the developing myocardium, however its role has not been elucidated. To test this, we examined cardiac phenotypes in embryonic and adult mice devoid of Collagen XIV. From as early as E11.5, Col14a1(-/-) mice exhibit significant perturbations in mRNA levels of many other collagen types and remodeling enzymes (MMPs, TIMPs) within the ventricular myocardium. By post natal stages, collagen fibril organization is in disarray and the adult heart displays defects in ventricular morphogenesis. In addition to the extracellular matrix, Col14a1(-/-) mice exhibit increased cardiomyocyte proliferation at post natal, but not E11.5 stages, leading to increased cell number, yet cell size is decreased by 3 months of age. In contrast to myocytes, the number of cardiac fibroblasts is reduced after birth associated with increased apoptosis. As a result of these molecular and cellular changes during embryonic development and post natal maturation, cardiac function is diminished in Col14a1(-/-) mice from 3 months of age; associated with dilation in the absence of hypertrophy, and reduced ejection fraction. Further, Col14a1 deficiency leads to a greater increase in left ventricular wall thickening in response to pathological pressure overload compared to wild type animals. Collectively, these studies identify a new role for type XIV collagen in the formation of the cardiac interstitium during embryonic development, and highlight the importance of the collagen network for myocardial cell survival, and function of the working myocardium after birth.
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Date Issued: 2012
Identifier: FSU_migr_biomed_faculty_publications-0056, 10.1016/j.yjmcc.2012.08.002
Format: Citation

Title: Collaboration with Pharmacy Services in a Family Practice for the Medically Underserved.
Creator: Enfinger, Fallon, Campbell, Kendall, Taylor, James
Abstract/Description: Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed. Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse...
Show moreObjectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed. Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twentytwo patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C) was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP) was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages. Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for pharmacists and providers to form a trusted relationship while providing enhanced care and potentially improved outcomes for patients.
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Date Issued: 2009
Identifier: FSU_migr_fmr-0037
Format: Citation

Title: Chronic Inflammation and Quality of Life in Older Adults: A Cross-Sectional Study Using Biomarkers to Predict Emotional and Relational Outcomes.
Creator: Nowakowski, Alexandra
Abstract/Description: BACKGROUND: This study explores relationships between chronic inflammation and quality of life, making a case for biopsychosocial modeling of these associations. It builds on research from social and clinical disciplines connecting chronic conditions, and inflammatory conditions specifically, to reduced quality of life. METHODS: Data from Wave I of the National Social Life, Health, and Aging Project are modeled using ordinal logistic and ordinary least-squares regression techniques....
Show moreBACKGROUND: This study explores relationships between chronic inflammation and quality of life, making a case for biopsychosocial modeling of these associations. It builds on research from social and clinical disciplines connecting chronic conditions, and inflammatory conditions specifically, to reduced quality of life. METHODS: Data from Wave I of the National Social Life, Health, and Aging Project are modeled using ordinal logistic and ordinary least-squares regression techniques. Inflammation is measured using C-reactive protein; quality of life is conceptualized as happiness with life overall as well as intimate relationships specifically. RESULTS: For most NSHAP participants, chronic inflammation significantly predicts lower odds of reporting high QoL on both emotional and relational measures. Social structural factors do not confound these associations. Inconsistent results for participants with very high (over 6 mg/L) CRP measurements suggest additional social influences. CONCLUSIONS: Findings echo strong theoretical justification for investigating relationships between CRP and QoL in greater detail. Further research should explore possible mediation of these associations by sociomedical sequelae of chronic disease as well as social relationship dynamics. Elaboration is also needed on the mechanisms by which social disadvantage may cause chronic inflammation.
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Date Issued: 2014
Identifier: FSU_migr_mhs-0043, 10.1186/s12955-014-0141-0
Format: Citation

Title: Clinical and Functional Characterization of TNNT2 Mutations Identified in Patients with Dilated Cardiomyopathy.
Creator: Hershberger, Ray, Pinto, Jose, Parks, Sharie, Kushner, Jessica, Li, Duanxiang, Ludwigsen, Susan, Cowan, Jason, Morales, Ana, Parvatiyar, Michelle, Potter, James
Abstract/Description: BACKGROUND: A key issue for cardiovascular genetic medicine is ascertaining if a putative mutation indeed causes dilated cardiomyopathy (DCM). This is critically important as genetic DCM, usually presenting with advanced, life-threatening disease, may be preventable with early intervention in relatives known to carry the mutation. METHODS AND RESULTS: We recently undertook bidirectional resequencing of TNNT2, the cardiac troponin T gene, in 313 probands with DCM. We identified 6 TNNT2 protein...
Show moreBACKGROUND: A key issue for cardiovascular genetic medicine is ascertaining if a putative mutation indeed causes dilated cardiomyopathy (DCM). This is critically important as genetic DCM, usually presenting with advanced, life-threatening disease, may be preventable with early intervention in relatives known to carry the mutation. METHODS AND RESULTS: We recently undertook bidirectional resequencing of TNNT2, the cardiac troponin T gene, in 313 probands with DCM. We identified 6 TNNT2 protein-altering variants in 9 probands, all who had early onset, aggressive disease. Additional family members of mutation carriers were then studied when available. Four of the 9 probands had DCM without a family history, and 5 probands had familial DCM. Only 1 mutation (Lys210del) could be attributed as definitively causative from previous reports. Four of the 5 missense mutations were novel (Arg134Gly, Arg151Cys, Arg159Gln, and Arg205Trp), and one was previously reported with hypertrophic cardiomyopathy (Glu244Asp). Based on the clinical, pedigree, and molecular genetic data, these 5 mutations were considered possibly or likely disease causing. To further clarify their potential pathophysiologic impact, we undertook functional studies of these mutations in cardiac myocytes reconstituted with mutant troponin T proteins. We observed decreased Ca(2+) sensitivity of force development, a hallmark of DCM, in support of the conclusion that these mutations are disease causing. CONCLUSIONS: We conclude that the combination of clinical, pedigree, molecular genetic, and functional data strengthen the interpretation of TNNT2 mutations in DCM.
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Date Issued: 2009
Identifier: FSU_migr_biomed_faculty_publications-0059, 10.1161/CIRCGENETICS.108.846733
Format: Citation

Title: Personality and Obesity Across the Adult Life Span.
Creator: Sutin, Angelina, Ferrucci, Luigi, Zonderman, Alan, Terracciano, Antonio
Abstract/Description: Personality traits contribute to health outcomes, in part through their association with major controllable risk factors, such as obesity. Body weight, in turn, reflects our behaviors and lifestyle and contributes to the way we perceive ourselves and others. In this study, the authors use data from a large (N = 1,988) longitudinal study that spanned more than 50 years to examine how personality traits are associated with multiple measures of adiposity and with fluctuations in body mass index ...
Show morePersonality traits contribute to health outcomes, in part through their association with major controllable risk factors, such as obesity. Body weight, in turn, reflects our behaviors and lifestyle and contributes to the way we perceive ourselves and others. In this study, the authors use data from a large (N = 1,988) longitudinal study that spanned more than 50 years to examine how personality traits are associated with multiple measures of adiposity and with fluctuations in body mass index (BMI). Using 14,531 anthropometric assessments, the authors modeled the trajectory of BMI across adulthood and tested whether personality predicted its rate of change. Measured concurrently, participants higher on Neuroticism or Extraversion or lower on Conscientiousness had higher BMI; these associations replicated across body fat, waist, and hip circumference. The strongest association was found for the impulsivity facet: Participants who scored in the top 10% of impulsivity weighed, on average, 11Kg more than those in the bottom 10%. Longitudinally, high Neuroticism and low Conscientiousness, and the facets of these traits related to difficulty with impulse control, were associated with weight fluctuations, measured as the variability in weight over time. Finally, low Agreeableness and impulsivity-related traits predicted a greater increase in BMI across the adult life span. BMI was mostly unrelated to change in personality traits. Personality traits are defined by cognitive, emotional, and behavioral patterns that likely contribute to unhealthy weight and difficulties with weight management. Such associations may elucidate the role of personality traits in disease progression and may help to design more effective interventions.
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Date Issued: 2011
Identifier: FSU_migr_mhs-0016, 10.1037/a0024286
Format: Citation

Title: Personality and Metabolic Syndrome.
Creator: Sutin, Angelina, Costa, Paul, Uda, Manuela, Ferrucci, Luigi, Schlessinger, David, Terracciano, Antonio
Abstract/Description: The prevalence of metabolic syndrome has paralleled the sharp increase in obesity. Given its tremendous physical, emotional, and financial burden, it is of critical importance to identify who is most at risk and the potential points of intervention. Psychological traits, in addition to physiological and social risk factors, may contribute to metabolic syndrome. The objective of the present research is to test whether personality traits are associated with metabolic syndrome in a large...
Show moreThe prevalence of metabolic syndrome has paralleled the sharp increase in obesity. Given its tremendous physical, emotional, and financial burden, it is of critical importance to identify who is most at risk and the potential points of intervention. Psychological traits, in addition to physiological and social risk factors, may contribute to metabolic syndrome. The objective of the present research is to test whether personality traits are associated with metabolic syndrome in a large community sample. Participants (N = 5,662) from Sardinia, Italy, completed a comprehensive personality questionnaire, the NEO-PI-R, and were assessed on all components of metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose). Logistic regressions were used to predict metabolic syndrome from personality traits, controlling for age, sex, education, and current smoking status. Among adults over age 45 (n = 2,419), Neuroticism and low Agreeableness were associated with metabolic syndrome, whereas high Conscientiousness was protective. Individuals who scored in the top 10% on Conscientiousness were approximately 40% less likely to have metabolic syndrome (OR = 0.61, 95% CI = 0.41-0.92), whereas those who scored in the lowest 10% on Agreeableness were 50% more likely to have it (OR = 1.53, 95% CI = 1.09-2.16). At the facet level, traits related to impulsivity and hostility were the most strongly associated with metabolic syndrome. The present research indicates that those with fewer psychological resources are more vulnerable to metabolic syndrome and suggests a psychological component to other established risk factors.
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Date Issued: 2010
Identifier: FSU_migr_mhs-0020, 10.1007/s11357-010-9153-9
Format: Citation

Title: Optimal management of type 2 diabetes in patients with increased risk of hypoglycemia.
Creator: Anderson, Morgan, Powell, Jason, Campbell, Kendall, Taylor, James
Abstract/Description: With the number of individuals diagnosed with type 2 diabetes on the rise, it has become more important to ensure these patients are effectively treated. The Centers for Disease Control and Prevention estimated that 8.3% of all Americans were diagnosed with diabetes in 2011 and this number will likely continue to rise. With lifestyle interventions, such as proper diet and exercise, continuing to be an essential component of diabetes treatment, more patients are requiring medication therapy to...
Show moreWith the number of individuals diagnosed with type 2 diabetes on the rise, it has become more important to ensure these patients are effectively treated. The Centers for Disease Control and Prevention estimated that 8.3% of all Americans were diagnosed with diabetes in 2011 and this number will likely continue to rise. With lifestyle interventions, such as proper diet and exercise, continuing to be an essential component of diabetes treatment, more patients are requiring medication therapy to help them reach their therapeutic goals. It is important for the clinician, when determining the treatment strategy for these individuals, to find a balance between reaching treatment goals and limiting the adverse effects of the treatments themselves. Of all the adverse events associated with treatment of diabetes, the risk of hypoglycemia is one that most therapies have in common. This risk is often a limiting factor when attempting to aggressively treat diabetic patients. This manuscript will review how hypoglycemia is defined and categorized, as well as discuss the prevalence of hypoglycemia among the many different treatment options.
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Date Issued: 2014
Identifier: FSU_migr_fmr-0054, 10.2147/DMSO.S48896
Format: Citation

Title: Perceived Weight Discrimination and Obesity.
Creator: Sutin, Angelina, Terracciano, Antonio
Abstract/Description: Weight discrimination is prevalent in American society. Although associated consistently with psychological and economic outcomes, less is known about whether weight discrimination is associated with longitudinal changes in obesity. The objectives of this research are (1) to test whether weight discrimination is associated with risk of becoming obese (Body Mass Index≥30; BMI) by follow-up among those not obese at baseline, and (2) to test whether weight discrimination is associated with risk...
Show moreWeight discrimination is prevalent in American society. Although associated consistently with psychological and economic outcomes, less is known about whether weight discrimination is associated with longitudinal changes in obesity. The objectives of this research are (1) to test whether weight discrimination is associated with risk of becoming obese (Body Mass Index≥30; BMI) by follow-up among those not obese at baseline, and (2) to test whether weight discrimination is associated with risk of remaining obese at follow-up among those already obese at baseline. Participants were drawn from the Health and Retirement Study, a nationally representative longitudinal survey of community-dwelling US residents. A total of 6,157 participants (58.6% female) completed the discrimination measure and had weight and height available from the 2006 and 2010 assessments. Participants who experienced weight discrimination were approximately 2.5 times more likely to become obese by follow-up (OR = 2.54, 95% CI = 1.58–4.08) and participants who were obese at baseline were three times more likely to remain obese at follow up (OR = 3.20, 95% CI = 2.06–4.97) than those who had not experienced such discrimination. These effects held when controlling for demographic factors (age, sex, ethnicity, education) and when baseline BMI was included as a covariate. These effects were also specific to weight discrimination; other forms of discrimination (e.g., sex, race) were unrelated to risk of obesity at follow-up. The present research demonstrates that, in addition to poorer mental health outcomes, weight discrimination has implications for obesity. Rather than motivating individuals to lose weight, weight discrimination increases risk for obesity.
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Date Issued: 2013
Identifier: FSU_migr_mhs-0009, 10.1371/journal.pone.0070048
Format: Citation

Department of Family Medicine and Rural Health (28)	+ -
Department of Biomedical Sciences (11)	+ -
Department of Behavioral Sciences and Social Medicine (7)	+ -
Department of Geriatrics (2)	+ -
Showcase of Undergraduate Research Excellence (1)	+ -

Medical sciences (48)	+ -
Cardiovascular system (22)	+ -
Metabolism (16)	+ -
Cardiology (12)	+ -
Diabetes (12)	+ -

Endocrinology (12)	+ -
Amino acids (10)	+ -
Chemicals (10)	+ -
Disorders (10)	+ -
Peptides (10)	+ -
Proteins (10)	+ -
Drugs (9)	+ -
Pathology (9)	+ -
Symptoms (9)	+ -
Genetics (8)	+ -
Macromolecules (8)	+ -
Medicine, Preventive (8)	+ -
Psychology (8)	+ -
Public health (8)	+ -
Endocrine glands (7)	+ -
Investigations (7)	+ -
Civilization (6)	+ -
Community health services (6)	+ -
Human behavior (6)	+ -
Mental health (6)	+ -
Musculoskeletal system (6)	+ -
Netherlands (6)	+ -
Nutrition (6)	+ -
Personality (6)	+ -

Rodríguez, Jose (25)	+ -
Pinto, Jose (11)	+ -
Potter, James (7)	+ -
Terracciano, Antonio (7)	+ -
Ferrucci, Luigi (6)	+ -

Sutin, Angelina (6)	+ -
Costa, Paul (5)	+ -
Schlessinger, David (4)	+ -
Uda, Manuela (4)	+ -
Campbell, Kendall (3)	+ -
Parvatiyar, Michelle (3)	+ -
Soberon, Angelica (3)	+ -
Baudenbacher, Franz (2)	+ -
Deiana, Barbara (2)	+ -
Gonzalez, David (2)	+ -
Hershberger, Ray (2)	+ -
Knollmann, Björn C. (2)	+ -
Li, Duanxiang (2)	+ -
Love, Kaitlin (2)	+ -
Miller, Michelle (2)	+ -
Morales, Ana (2)	+ -
Parker, Alex (2)	+ -
Shearer, Barbara (2)	+ -
Taylor, James (2)	+ -
Ackerman, Michael (1)	+ -
Alexiev, Elena (1)	+ -
Anderson, Morgan (1)	+ -
Ansari, D. (1)	+ -
Bai, Fan (1)	+ -
Baldo, Marcelo (1)	+ -

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