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Institution

William Jennings Bryan Dorn VA Medical Center

HealthcareColumbia, South Carolina, United States
About: William Jennings Bryan Dorn VA Medical Center is a(n) healthcare organization based out in Columbia, South Carolina, United States. It is known for research contribution in the topic(s): Population & Warfarin. The organization has 41 authors who have published 41 publication(s) receiving 2091 citation(s). The organization is also known as: Dorn VAMC.
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Journal ArticleDOI
TL;DR: Current perspectives on the mechanisms that generate 24 h, short-term (<5 min), and ultra-short-term HRV are reviewed, and the importance of HRV, and its implications for health and performance are reviewed.
Abstract: Healthy biological systems exhibit complex patterns of variability that can be described by mathematical chaos. Heart rate variability (HRV) consists of changes in the time intervals between consecutive heartbeats called interbeat intervals (IBIs). A healthy heart is not a metronome. The oscillations of a healthy heart are complex and constantly changing, which allow the cardiovascular system to rapidly adjust to sudden physical and psychological challenges to homeostasis. This article briefly reviews current perspectives on the mechanisms that generate 24 h, short-term (~5 min), and ultra-short-term (<5 min) HRV, the importance of HRV, and its implications for health and performance. The authors provide an overview of widely-used HRV time-domain, frequency-domain, and non-linear metrics. Time-domain indices quantify the amount of HRV observed during monitoring periods that may range from ~2 min to 24 h. Frequency-domain values calculate the absolute or relative amount of signal energy within component bands. Non-linear measurements quantify the unpredictability and complexity of a series of IBIs. The authors survey published normative values for clinical, healthy, and optimal performance populations. They stress the importance of measurement context, including recording period length, subject age, and sex, on baseline HRV values. They caution that 24 h, short-term, and ultra-short-term normative values are not interchangeable. They encourage professionals to supplement published norms with findings from their own specialized populations. Finally, the authors provide an overview of HRV assessment strategies for clinical and optimal performance interventions.

1,560 citations


Journal Article
TL;DR: Probiotics have an important role in the maintenance of immunologic equilibrium in the gastrointestinal tract through the direct interaction with immune cells and are safe for infants, children, adults, and older patients, but caution is advised in immunologically vulnerable populations.
Abstract: Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and Saccharomyces. However, a lack of clear guidelines on when to use probiotics and the most effective probiotic for different gastrointestinal conditions may be confusing for family physicians and their patients. Probiotics have an important role in the maintenance of immunologic equilibrium in the gastrointestinal tract through the direct interaction with immune cells. Probiotic effectiveness can be species-, dose-, and disease-specific, and the duration of therapy depends on the clinical indication. There is high-quality evidence that probiotics are effective for acute infectious diarrhea, antibiotic-associated diarrhea, Clostridium difficile- associated diarrhea, hepatic encephalopathy, ulcerative colitis, irritable bowel syndrome, functional gastrointestinal disorders, and necrotizing enterocolitis. Conversely, there is evidence that probiotics are not effective for acute pancreatitis and Crohn disease. Probiotics are safe for infants, children, adults, and older patients, but caution is advised in immunologically vulnerable populations.

109 citations


Journal Article
TL;DR: A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia.
Abstract: OBJECTIVE: While trazodone is approved for the treatment of depression, the off-label use of this medication for insomnia has surpassed its usage as an antidepressant. In this systematic review, we examined the evidence for the efficacy and safety of trazodone for insomnia. METHODS: A literature search was conducted using MEDLINE/PubMed databases from the past 33 years (1983-2016) and the keywords insomnia, trazodone, sedative, treatment, and hypnotics. The results were restricted to English language and human subjects. All randomized clinical trials, meta-analyses, observational studies, and placebo-controlled trials regarding trazodone for the treatment of primary or secondary insomnia were reported, per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The study selection process yielded a total of 45 studies. RESULTS: Evidence for the efficacy of trazodone has been repeatedly demonstrated for primary insomnia, as well as secondary insomnia, including for symptoms that are a result of depression, dementia, and being a healthy man. Earlier studies (1980-2000) focused on utilizing trazodone at high doses (≥100mg/d) for the treatment of insomnia among the depressed population; however, since the 2000s, the utility of trazodone has been expanded to treat secondary insomnia among the non-depressed population as well. The side effects are dose-dependent, and the most common is drowsiness. CONCLUSION: A review of the literature suggests that there are adequate data supporting the efficacy and general safety of the low-dose use of trazodone for the treatment of insomnia.

48 citations


Journal ArticleDOI
TL;DR: This broadly targeted intervention strategy led to modest but statistically significant changes in several processes of care, indicating its potential for widespread dissemination to improve end-of-life care for thousands of patients who die each year in inpatient settings.
Abstract: Background Widespread implementation of palliative care treatment plans could reduce suffering in the last days of life by adopting best practices of traditionally home-based hospice care in inpatient settings.

47 citations


Journal ArticleDOI
TL;DR: The present review describes research in the laboratory that has focused on conditioned bradycardia as a model system of a rapidly acquired associative system and contrast it with the more slowly acquired Pavlovian conditioned eyeblink response.
Abstract: It has become clear from the study of different response systems during classical conditioning that some responses are acquired quite rapidly and others show a much slower rate of acquisition. The most often studied rapidly acquired responses have been classically conditioned autonomic changes (e.g., heart rate); the slowly acquired responses most often studied are skeletal responses, such as the eyeblink or leg flexion response. Although there are various other differences between rapidly acquired and slowly acquired responses, we have suggested that the most important difference is the possibility that they represent different stages of the learning process. In the present review I describe research in our laboratory that has focused on conditioned bradycardia as a model system of a rapidly acquired associative system and contrast it with the more slowly acquired Pavlovian conditioned eyeblink response. I also describe the generality of conditioned bradycardia and discuss the differential role of subdivisions of the prefrontal cortex as a substrate for mediating this response. Finally, I briefly discuss the other brain areas involved in conditioned bradycardia, and its functional significance as it relates to the learning process.

27 citations


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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20215
20205
20195
20189
20177
20161