Rush University Medical Center

About: Rush University Medical Center is a healthcare organization based out in Chicago, Illinois, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 13915 authors who have published 29027 publications receiving 1379216 citations. The organization is also known as: Rush Presbyterian St. Luke's Medical Center.

Current and Remote Blood Pressure and Cognitive Decline

Abstract: ContextPrevious studies raise the possibility that blood pressure (BP) in middle age predicts later cognitive decline.ObjectiveTo examine prospectively the relationship of BP with level of and change in cognitive function in the elderly.DesignLongitudinal, population-based study comprising subjects enrolled in the East Boston component of the Established Populations for the Epidemiologic Study of the Elderly (EPESE) (1982-1983) and the Hypertension Detection and Follow-Up Program (HDFP) (1973-1974).SettingEast Boston, Mass.ParticipantsOf the 3657 participants in the EPESE with baseline BP measurements, 2068 also participated in the HDFP. Subjects were aged 65 to 102 years at baseline in the EPESE and had mental status and memory assessed at baseline and 3 and 6 years.Main Outcome MeasuresNumbers of errors on the Short Portable Mental Status Questionnaire and the East Boston Memory Test and rates of change in these numbers of errors. Subjects had BP measured both at baseline in the EPESE and 9 years before, as part of the HDFP.ResultsIn analyses adjusted for age, sex, and education, there was no strong linear association between BP and cognition. The associations found were fairly small in magnitude, and varied according to which test was used to measure cognition. There was little evidence for an effect of BP on change in cognitive function with either test, or for an effect on level of function on the memory test. In analyses of level of mental status questionnaire performance, however, elevated systolic BP (≥160 mm Hg) 9 years before baseline was associated with a 14% (95% confidence interval [CI], 4%-25%) increase in error rate, relative to the referent (130-139 mm Hg). Baseline systolic BP had a U-shaped association with the number of errors; error rates were 9% higher compared with the referent group among those with systolic BP lower than 130 mm Hg (95% CI, 1%-17%) and 7% greater (95% CI, 0%-15%) among those with elevated systolic BP. Diastolic BP 9 years before baseline also had a U-shaped association with errors on the mental status questionnaire.ConclusionThe findings do not suggest a linear association of BP with cognitive decline, but they are consistent with a more complex relationship between BP and cognition than previously appreciated.

Daoy medulloblastoma cells that express CD133 are radioresistant relative to CD133-cells, and the CD133+ sector is enlarged by hypoxia

Abstract: Purpose: Primary medulloblastoma and glioblastoma multiforme tumor cells that express the surface marker CD133 are believed to be enriched for brain tumor stem cells because of their unique ability to initiate or reconstitute tumors in immunodeficient mice. This study sought to characterize the radiobiological properties and marker expression changes of CD133+ vs. CD133− cells of an established medulloblastoma cell line. Methods and Materials: Daoy and D283 Med cell lines were stained with fluorescently labeled anti-CD133 antibody and sorted into CD133+ and CD133− populations. The effect of oxygen (2% vs. 20%) on CD133 expression was measured. Both populations were analyzed for marker stability, cell cycle distribution, and radiosensitivity. Results: CD133+ Daoy cells restored nearly native CD133+ and CD133− populations within 18 days, whereas CD133− cells remained overwhelmingly CD133−. Culturing Daoy cells in 2% oxygen rather than the standard 20% oxygen increased their CD133 expression 1.6-fold. CD133+ Daoy cells were radioresistant via the β-parameter of the linear-quadratic model relative to CD133− Daoy cells, although their α-parameters and cell cycle distributions were identical. Conclusions: Restoration of the original CD133+ and CD133− populations from CD133+ Daoy cells in serum is further evidence that CD133+ cells are functionally distinct from CD133− cells. The radioresistance of CD133+ compared with CD133− Daoy cells is consistent with better repair of sublethal damage. Enlargement of the CD133+ sector is a new feature of the hypoxic response.

Transfer of vancomycin-resistant enterococci via health care worker hands.

Abstract: Background:Therolesofthecontaminatedhospitalenvironment and of patient skin carriage in the spread of vancomycin-resistant enterococci (VRE) are uncertain. Transfer of VRE via health care worker (HCW) hands is assumed but unproved. We sought to determine the frequency of VRE transmission from sites in the environment or on patients’ intact skin to clean environmental orskinsitesviacontaminatedhandsofHCWsduringroutine care. Methods:We cultured sites on the intact skin of 22 patients colonized by VRE, as well as sites in the patients’ rooms, before and after routine care by 98 HCWs. Observers recorded sites touched by HCWs. Cultures were obtained from HCW hands and/or gloves before and after care. All isolates underwent pulsed-field gel electrophoresis. We defined a transfer to have occurred when a culture-negative site became positive with a VRE pulsotype after being touched by an HCW who had the same pulsotypeonhisorherhandsorglovesandwhohadpre

Fluorouracil-based Chemoradiation with Either Gemcitabine or Fluorouracil Chemotherapy after Resection of Pancreatic Adenocarcinoma: 5-Year Analysis of the U.S. Intergroup/RTOG 9704 Phase III Trial

Abstract: The impact of the addition of gemcitabine to 5-fluorouracil (5-FU) chemoradiation (CRT) on 5-year overall survival (OS) in resected pancreatic adenocarcinoma are presented with updated results of a phase III trial. After resection of pancreatic adenocarcinoma, patients were randomized to pre- and post-CRT 5-FU versus pre- and post-CRT gemcitabine. 5-FU was provided continuously at 250 mg/m2/day, and gemcitabine was provided at 1000 mg/m2 weekly. Both were provided over 3 weeks before and 12 weeks after CRT. CRT was provided at 50.4 Gy with continuously provided 5-FU. The primary end point was survival for all patients and for patients with tumor of the pancreatic head. Four hundred fifty-one patients were eligible. Univariate analysis showed no difference in OS. Pancreatic head tumor patients (n = 388) had a median survival and 5-year OS of 20.5 months and 22% with gemcitabine versus 17.1 months and 18% with 5-FU. On multivariate analysis, patients on the gemcitabine arm with pancreatic head tumors experienced a trend toward improved OS (P = 0.08). First site of relapse local recurrence in 28% of patients versus distant relapse in 73%. The sequencing of 5-FU CRT with gemcitabine as done in this trial is not associated with a statistically significant improvement in OS. Despite local recurrence being approximately half of that reported in previous adjuvant trials, distant disease relapse still occurs in ≥70% of patients. These findings serve as the basis for the recently activated EORTC/U.S. Intergroup RTOG 0848 phase III adjuvant trial evaluating the impact of CRT after completion of a full course of gemcitabine.