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Institution

Veterans Health Administration

GovernmentWashington D.C., District of Columbia, United States
About: Veterans Health Administration is a government organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Population & Veterans Affairs. The organization has 63820 authors who have published 98417 publications receiving 4835425 citations. The organization is also known as: VHA.


Papers
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Journal ArticleDOI
TL;DR: The present results substantiate the idea that severity of memory impairment is dependent on locus and extent of damage within the hippocampal formation and that damage to the hippocampusal formation can cause temporally graded retrograde amnesia.
Abstract: Patient RB (Human amnesia and the medial temporal region: enduring memory impairment following a bilaterial lesion limited to field CA1 of the hippocampus, S. Zola-Morgan, L. R. Squire, and D. G. Amaral, 1986, J Neurosci 6:2950–2967) was the first reported case of human amnesia in which detailed neuropsychological analyses and detailed postmortem neuropathological analyses demonstrated that damage limited to the hippocampal formation was sufficient to produce anterograde memory impairment. Neuropsychological and postmortem neuropathological findings are described here for three additional amnesic patients with bilateral damage limited to the hippocampal formation. Findings from these patients, taken together with the findings from patient RB and other amnesic patients, make three important points about memory. (1) Bilateral damage limited primarily to the CA1 region of the hippocampal formation is sufficient to produce moderately severe anterograde memory impairment. (2) Bilateral damage beyond the CA1 region, but still limited to the hippocampal formation, can produce more severe anterograde memory impairment. (3) Extensive, temporally graded retrograde amnesia covering 15 years or more can occur after damage limited to the hippocampal formation. Findings from studies with experimental animals are consistent with the findings from amnesic patients. The present results substantiate the idea that severity of memory impairment is dependent on locus and extent of damage within the hippocampal formation and that damage to the hippocampal formation can cause temporally graded retrograde amnesia.

781 citations

Journal ArticleDOI
03 Jan 2007-JAMA
TL;DR: Screening for risk of falling during the clinical examination begins with determining if the patient has fallen in the past year, and patients who have not previously fallen or who have a gait or balance problem are at higher risk of future falls.
Abstract: ContextEffective multifactorial interventions reduce the frequent falling rate of older patients by 30% to 40%. However, clinical consensus suggests reserving these interventions for high-risk patients. Limiting fall prevention programs to high-risk patients implies that clinicians must recognize features that predict future falls.ObjectiveTo identify the prognostic value of risk factors for future falls among older patients.Data Sources and Study SelectionSearch of MEDLINE (1966-September 2004), CINAHL (1982-September 2004), and authors' own files to identify prospective cohort studies of risk factors for falls that performed a multivariate analysis of such factors.Data ExtractionTwo reviewers independently determined inclusion of articles and assessed study quality. Disagreements were resolved by consensus. Included studies were those identifying the prognostic value of risk factors for future falls among community-dwelling persons 65 years and older. Clinically identifiable risk factors were identified across 6 domains: orthostatic hypotension, visual impairment, impairment of gait or balance, medication use, limitations in basic or instrumental activities of daily living, and cognitive impairment.Data SynthesisEighteen studies met inclusion criteria and provided a multivariate analysis including at least 1 of the risk factor domains. The estimated pretest probability of falling at least once in any given year for individuals 65 years and older was 27% (95% confidence interval, 19%-36%). Patients who have fallen in the past year are more likely to fall again [likelihood ratio range, 2.3-2.8]. The most consistent predictors of future falls are clinically detected abnormalities of gait or balance (likelihood ratio range, 1.7-2.4). Visual impairment, medication variables, decreased activities of daily living, and impaired cognition did not consistently predict falls across studies. Orthostatic hypotension did not predict falls after controlling for other factors.ConclusionsScreening for risk of falling during the clinical examination begins with determining if the patient has fallen in the past year. For patients who have not previously fallen, screening consists of an assessment of gait and balance. Patients who have fallen or who have a gait or balance problem are at higher risk of future falls.

780 citations

Book
01 Jan 2001
TL;DR: In this paper, the authors discuss the breakdown of the will in decision science: do we make choices by destres or by judgments, and how the warp in how we evaluate the future can create involuntary behaviors.
Abstract: Preface Part I. Breakdowns of Will: The Puzzle of Akrasia: 1. Introduction 2. The dichotomy at the root of decision science: do we make choices by destres or by judgments? 3. The warp in how we evaluate the future 4. The warp can create involuntary behaviors: pains, hungers, emotions Part II. A Breakdown of the Will: The Components of Intertemporal Bargaining: 5. The elementary interaction of interests 6. Sophisticated bargaining among internal interests 7. The subjective experience of intertemporal bargaining 8. Getting evidence about a nonlinear motivational system Part III. The Ultimate Breakdown of Will: Nothing Fails Like Success: 9. The downside of willpower 10. An efficient will undermines appetite 11. The need to maintain appetite eclipses the will 12. Conclusions Notes References Indexes.

780 citations

Journal ArticleDOI
TL;DR: Hepatitis B e antigen and hepatitis B viral DNA disappeared from serum significantly more often in the patients given prednisone plus interferon or 5 million units of interferons alone than in the untreated controls.
Abstract: Background and Methods. Chronic hepatitis B is a common and often progressive liver disorder for which there is no accepted therapy. To assess the efficacy of treatment with interferon, we randomly assigned patients with chronic hepatitis B to one of the following regimens: prednisone for 6 weeks followed by 5 million units of recombinant interferon alfa-2b daily for 16 weeks; placebo followed by 5 million units of interferon daily for 16 weeks; placebo followed by 1 million units of interferon daily for 16 weeks; or observation with no treatment. Results. Hepatitis B e antigen and hepatitis B viral DNA disappeared from serum significantly more often in the patients given prednisone plus interferon (16 of 44 patients, or 36 percent) or 5 million units of interferon alone (15 of 41; 37 percent) than in the untreated controls (3 of 43; 7 percent; P<0.001); the difference between those given 1 million units of interferon (7 of 41; 17 percent) and the controls was not significant. The strongest indep...

779 citations


Authors

Showing all 63886 results

NameH-indexPapersCitations
Michael Karin236704226485
Paul M. Ridker2331242245097
Eugene Braunwald2301711264576
Ralph B. D'Agostino2261287229636
John Q. Trojanowski2261467213948
Fred H. Gage216967185732
Edward Giovannucci2061671179875
Rob Knight2011061253207
Frank E. Speizer193636135891
Stephen V. Faraone1881427140298
Scott M. Grundy187841231821
Paul G. Richardson1831533155912
Peter W.F. Wilson181680139852
Dennis S. Charney179802122408
Kenneth C. Anderson1781138126072
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202314
2022137
20216,161
20205,712
20195,171
20184,497