UMDNJ-Robert Wood Johnson Medical School Research Articles

Editorial introductions.

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Viral N. ShahViral N. ShahDr Shah is a Board-Certified Adult Endocrinologist and an Associate Professor at the Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, USA. His research is focused on improving glycemic control and reducing complications, with special interest in fracture prevention, in people with type 1 diabetes. Dr Shah has extensive experience in conducting clinical trials in field of diabetes. He has been the PI for many multicenter industry-sponsored, investigator-initiated, and nonprofit-funded clinical trials of diabetes technologies and therapeutics. He has been a part of landmark research such as REPLACE-BG, WISDM, Artificial pancreas Cambridge (ApCam), OP5 HCL, and Dexcom G6 pivotal that led to FDA approval of newer devices and changed the type 1 diabetes management. Moreover, his interest in understanding the effect of diabetes on bone fragility had led to two NIH-funded studies investigating effect of long-standing T1D on bone tissue material properties (AR075099) and factors affecting bone density (vBMD), bone mechanical properties in adults with type 1 diabetes (DK122554). Dr Shah has served on many leadership positions such as steering committee member for T1D Exchange Clinic Registry (2016–2017), Communication director for diabetes technology interest group at the American Diabetes Association (2019–2020), Ad hoc member of 79th AD annual meeting planning subcommittee for Diabetes Technology, and American College of Endocrinology Self-Assessment Program writing committee member (2020–2021). He is a recipient of prestigious AACE Rising Start in Endocrinology award (2021). He is well published with over 100 research publications including original article, invited reviews, editorials, and book chapters. He is reviewer for many peer-reviewed indexed journals and grant reviewer for JDRF, ADA and NIH. Peter GottliebPeter GottliebDr Peter Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes in 1995, USA where he is a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 155 publications in peer-reviewed journals, as well as several book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, islet transplantation and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Most recently, he has co-founded a biotech company to develop a small molecule therapy for Type 1 diabetes.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes, Aurora, USA in 1995, where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 140 publications, reviews and book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital, and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter A. Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes, Aurora, USA in 1995, where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 140 publications, reviews and book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A. GottliebPeter A. GottliebDr Peter A. Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving the First Gulf War, he returned to UMass, USA and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes in 1995, USA where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 110 publications in peer-reviewed journals, as well as several book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, islet transplantation and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School in Boston, MA, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, CO, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism.

Editorial introductions

Current Opinion in Endocrinology and Diabetes was launched in 1994, with Obesity added to the title in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of endocrinology and diabetes are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce one of the Journal's Section Editors for this issue. SECTION EDITORS Peter A GottliebPeter A GottliebDr Gottlieb was born in Havana, Cuba, but at age 2 moved to New Jersey, USA, where he grew up. After receiving his undergraduate degree from the University of Pennsylvania, USA, he attended UMDNJ-Robert Wood Johnson Medical School, USA, from which he graduated in 1984. Dr Gottlieb completed his internship and residency in internal medicine at the University of Massachusetts Medical School, USA and then continued his fellowship training in endocrinology and metabolism there as well. In 1990, after completing his fellowship, he moved to the Weizmann Institute in Israel to do post-doctoral training in T cell immunology. After surviving Gulf War I, he returned to University of Massachusetts Medical School and joined the staff as Clinical Director of Diabetes. He subsequently joined the Barbara Davis Center for Childhood Diabetes, USA, in 1995, where he is now a Professor of Pediatrics and Medicine and the Director of the Translational Research Unit at the Barbara Davis Center. He has authored, co-authored and collaborated on more than 80 publications in peer-reviewed journals, as well as several book chapters and served as section editor for several journal editions. His research areas of interest include the immunology of type 1 diabetes, intervention trials to prevent or reverse type 1 diabetes, islet transplantation and the genetics of autoimmune disease. He had led several multi-center trials in new onset type 1 diabetes and is an active member of the Steering Committee for Type 1 Diabetes TrialNet and the Immune Tolerance Network, both NIH sponsored trial groups. Whitney WoodmanseeWhitney WoodmanseeDr Whitney Woodmansee is Director of the Clinical Neuroendocrine Program at Brigham and Women's Hospital and Assistant Professor of Medicine at Harvard Medical School in Boston, Massachusetts, USA. Dr Woodmansee received her medical degree and completed her clinical training in internal medicine and endocrinology at the University of Colorado Health Sciences Center (UCHSC) in Denver, Colorado, USA. After completing her training, she joined the faculty at UCHSC in 1999 where she performed basic science research in the neuroendocrine field, as well as directed the Pituitary Disorders Program. She currently manages an active clinical practice caring for patients with pituitary disorders as a member of the Brigham and Women's Hospital's multi-disciplinary Pituitary/Neuroendocrine Center. She also directs the Dynamic Endocrine Testing Unit at her hospital. Dr Woodmansee has more recently shifted her research efforts from understanding the molecular biology of the pituitary to more clinical studies, and has a particular interest in the management of hypopituitarism. Ursula KaiserUrsula KaiserDr Ursula Kaiser is Chief of the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women's Hospital and Professor of Medicine at Harvard Medical School in Boston, Massachusetts, USA. Dr Kaiser received her medical degree and completed her clinical training in internal medicine and endocrinology at University of Toronto School of Medicine in Canada. She joined the Brigham and Women's Hospital and Harvard Medical School in 1990 as a Research Fellow in Medicine and joined the faculty in 1993. She established a multidisciplinary neuroendocrine program in 1998 and has an active clinical practice managing patients with pituitary disorders. She was appointed to her current position as Chief of Endocrinology in 2007. Dr Kaiser has an active research program, supported continuously by the NIH for over fifteen years, focused on the genetic and molecular mechanisms underlying the neuroendocrine regulation of reproductive development and function. She is the Associate Director of the Harvard Reproductive Endocrine Sciences Center and the Program Director of a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) program to train junior faculty in women's health research. She is currently Vice-President (basic science) of The Endocrine Society.

The authors reply

Division of Pulmonary/Critical Care, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ The authors have not disclosed any potential conflicts of interest.

Red Blood Cell Transfusion

Letters20 November 2012Red Blood Cell TransfusionJeffrey L. Carson, MD, Sunil V. Rao, MD, and Louis M. Katz, MDJeffrey L. Carson, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, Sunil V. Rao, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this author, and Louis M. Katz, MDFrom UMDNJ–Robert Wood Johnson Medical School, New Brunswick, NJ 08903; The Duke Clinical Research Institute, Durham, NC 27705; and Americas Blood Centers, Washington, DC 20005.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-10-201211200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate the opportunity to reiterate that our guideline states that transfusion should be considered in specific patient subgroups when the nadir hemoglobin reaches 7 to 8 g/dL. In addition, the decision to transfuse should be influenced by signs and symptoms. We based our recommendations on the best available evidence: 19 randomized clinical trials in 6264 patients. However, clinical trials provide an average effect in the population studied. Thus, it is likely that some patients need more or less blood to improve outcomes.The “conundrum” is what clinical factors should influence the “routine titrated” transfusion decision. The largest ...

A Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Varenicline for Smoking Cessation in Patients With Schizophrenia or Schizoaffective Disorder

Effective smoking cessation treatments are needed for patients with schizophrenia, who, compared with the general population, have high rates of cigarette smoking and more difficulty quitting. We evaluated the safety and efficacy of varenicline for smoking cessation in outpatients with stable schizophrenia or schizoaffective disorder. In this 12-week, randomized, double-blind, multicenter trial (May 8, 2008, to April 1, 2010), 127 smokers (≥ 15 cigarettes/d) with DSM-IV-confirmed schizophrenia or schizoaffective disorder received varenicline or placebo (2:1 ratio). The primary outcome was safety and tolerability of varenicline assessed by adverse events frequency and changes in ratings on the Positive and Negative Syndrome Scale and other psychiatric scales from baseline to 24 weeks. Abstinence was defined as no smoking 7 days prior to weeks 12 and 24, verified by carbon monoxide level. Eighty-four participants received varenicline; 43, placebo. At 12 weeks (end of treatment), 16/84 varenicline-treated patients (19.0%) met smoking cessation criteria versus 2/43 (4.7%) for placebo (P = .046). At 24 weeks, 10/84 (11.9%) varenicline-treated and 1/43 (2.3%) placebo-treated patients, respectively, met abstinence criteria (P = .090). Total adverse event rates were similar between groups, with no significant changes in symptoms of schizophrenia or in mood and anxiety ratings. Rates of suicidal ideation adverse events were 6.0% (varenicline) and 7.0% (placebo) (P = 1.0). There was 1 suicide attempt by a varenicline patient with a lifetime history of similar attempts and no completed suicides. Varenicline was well tolerated, with no evidence of exacerbation of symptoms, and was associated with significantly higher smoking cessation rates versus placebo at 12 weeks. Our findings suggest varenicline is a suitable smoking cessation therapy for patients with schizophrenia or schizoaffective disorder. ClinicalTrials.gov identifier: NCT00644969.

575: Prenatal risk-drinking screening: T-ACER3 reduces T-ACE false positives

T-ACER3 reduces T-ACE false positives Lisa Chiodo, Robert Sokol, John Hannigan, James Janisse, Grace Patterson, Virginia Delaney-Black Wayne State University School of Medicine, Pediatrics, Detroit, MI, Wayne State University School of Medicine, Obstetrics and Gynecology, Detroit, MI, Wayne State University School of Medicine, Family Medicine, Detroit, MI, Wayne State University School of Medicine, Children’s Research Center of Michigan, Detroit, MI OBJECTIVE: Preventing Fetal Alcohol Spectrum Disorders (FASD) depends on obstetricians detecting maternal risk drinking during antenatal care. ACOG and NIAAA recommend using the T-ACE, an economical/sensitive screen. We have reported that a more stringent T-ACE total score cut-point (3 vs. 2) increased specificity in identifying maternal risk drinking & alcohol-related neurobehavioral dysfunction in children (Chiodo et al, 2010). Our aim was to assess how increasing the T-ACE cut-point could increase efficiency of clinical practice. STUDY DESIGN: Self-reported peri-conceptional & in-pregnancy drinking were assessed with semi-structured interviews and alcohol screens in a prospective sub-sample of 239 African-American mothers given an in-pregnancy T-ACE. The original T-ACE risk criterion (total score of 2) and the revised T-ACER3 criterion with a total score of 3 were analyzed. ANOVA and post-hoc comparisons compared preand in-pregnancy alcohol consumption quantity and frequency measures by risk category. Categories were: 1) No Risk Group (NRG) no risk for pregnancy alcohol use based on both T-ACE and T-ACER3 criteria (n 140); 2) At Risk Group (ARG) based on both T-ACE and T-ACER3 criteria (n 28); and 3) Change Risk Group (CRG) identified as at-risk with the original T-ACE criterion but not at-risk using the revised T-ACER3 criterion (n 71). RESULTS: The 71 women (30%) in the Change Risk Group (CRG) had patterns of alcohol use similar to the no risk group (NRG). As predicted, post-hoc analysis revealed that the at-risk group (ARG) had significantly more alcohol use both prior to and during pregnancy than either the NRG or CRG groups. CONCLUSION: The results provide further evidence that adjusting the T-ACE total score cut-point to 3 in the T-ACER3 is clinically appropriate. Using the T-ACER3 criteria, only 12% of women would require intervention, compared with 41% for T-ACE. Increasing the total T-ACE score criterion from 2 to 3 results in fewer “false positives,” allowing a more intensive targeted clinical response with pregnant women correctly identified by the T-ACER3 as drinking at fetal risk levels. 576 Excess gestational weight gain leads to post-partum weight retention Shilpi Mehta-Lee, Linzhi Xu, Jennifer Lischewski Goel, Mindy Brittner, Peter Bernstein, Karen Bonuck NYU Langone Medical Center, Obstetrics & Gynecology, New York, NY, Albert Einstein College of Medicine, Department of Family and Social Medicine, Bronx, NY, UMDNJRobert Wood Johnson Medical School, Medical School, New Brunswick, NJ, Albert Einstein College of Medicine/Montefiore Medical Center, Obstetrics & Gynecology and Women’s Health, Bronx, NY OBJECTIVE: Excessive gestational weight gain (GWG) has been linked to post-partum weight retention and long-term adverse health outcomes. We sought to determine if patients at 2 Bronx health clinics with excess GWG by Institute of Medicine (IOM) guidelines were more likely to have post-partum weight retention than those who gained at or under the recommended guidelines. STUDY DESIGN: Data are from participants in 2 randomized, controlled trials of pre-natal care based breastfeeding interventions. 941 women with 12-26 week, singleton pregnancies, were enrolled from 2008-2010. Those with pre-pregnancy self-reported weight and height, and a post-partum weight available were included. 2009 IOM guidelines were used to define excess GWG by BMI category. Postpartum weight retention was calculated using a measured weight at the first post-partum visit minus self-reported pre-pregnancy weight. Multivariate analysis of covariance was employed to compare the mean post-partum weight retention by normal v. excess GWG. RESULTS: 404 women met inclusion criteria. Demographic characteristics were similar between groups. Women with excess GWG were more likely to have higher pre-pregnancy BMI (28.6[6.2] v. 27.3[6.2]; p 0.041), deliver at a later gestational age (39.2[1.8] v. 38.6[2.4] weeks; p 0.009) and enroll in WIC (54% v 37%; p 0.001). (Table) In multivariate analysis adjusted for age, parity, race, pre-pregnancy BMI, WIC use, employment, education and the number of weeks post-partum, women gaining within recommended IOM guidelines had retained a mean of 7.2 lbs. at their first post-partum visit, whereas those with excess GWG had mean weight retention of 23.7 lbs, a difference of 16.6 lbs (p 0.001). CONCLUSION: In an urban prenatal population, excess GWG was predictive of higher post-partum weight retention regardless of age, weight, BMI, race, socioeconomic indicators, or weeks post-partum. This weight retention can have long-term consequences. This increased risk of weight retention should be added to the list of poor outcomes associated with excess GWG, and interventions are needed to address this issue postpartum. PosterSessionIV Epidemiology, Infectious Disease, Intrapartum Fetal Assessment, Operative Obstetrics, Obstetric Quality & Safety, Public Health-Global Health www.AJOG.org

N-acetylcysteine and acute renal failure: Are we doing too little too late?*

UMDNJ-Robert Wood Johnson Medical School, Department of Medicine, The Cooper Health System, Camden, NJ The author has not disclosed any potential conflicts of interest.

TFEBulous control of traffic by mTOR

Cell growth is accompanied by the synthesis of macromolecules and biogenesis of organelles. The protein kinase mTOR (mechanistic or mammalian target of rapamycin) controls these processes by sensing availability of growth signals. The targeting of macromolecules and trafficking of cargo‐containing vesicles into appropriate cellular compartments are also important processes that are highly controlled during growth versus stress conditions. In this issue of The EMBO Journal , Pena‐Llopis et al demonstrate that mTOR complex 1 (mTORC1) could regulate endocytosis by controlling the expression of endosomal proteins such as the vacuolar (V)‐ATPases. mTORC1 performs this novel function by modulating the phosphorylation and activity of the transcription factor EB (TFEB), which is required for expression of genes involved in autophagosome and lysosome biogenesis. This study, along with a related study in Science by Settembre et al , reveals how growth signals mediated by mTOR and other protein kinases such as mitogen‐activated protein kinase (MAPK) can converge on TFEB to direct endosome biogenesis and trafficking.

Basic Science for the Clinician: 50

From the Division of Rheumatology and Connective Tissue Research, Department of Medicine, Department of Pediatrics, and Department of Molecular Genetics & Microbiology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ. Correspondence: Leonard H. Sigal, MD, FACP, FACR, MEB 484, Division of Rheumatology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, 1 R W Johnson Place, New Brunswick, NJ 08903-001. E-mail: [email protected]

Optimizing sepsis care: Target the process or the patient?*

Department of Emergency Medicine, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School at Camden, Camden, NJ (Arnold) Department of Medicine, Division of Cardiology, Cooper University Hospital, UMDNJ-Robert Wood Johnson Medical School at Camden, Camden, NJ (Hollenberg) Dr Arnold received funding from the National Institutes of Health-Loan Repayment Program. Dr. Hollenberg has not disclosed any potential conflicts of interest.

A Brief Self-Report Measure to Assess Antidepressant Adherence Among Spanish-Speaking Latinos

A Brief Self-Report Measure to Assess Antidepressant Adherence Among Spanish-Speaking Latinos

Journal Digest

Journal Digest

Role of clevidipine butyrate in the treatment of acute hypertension in the critical care setting: a review

Acutely elevated blood pressure in the critical care setting is associated with a higher risk of acute end-organ damage (eg, myocardial ischemia, stroke, and renal failure) and perioperative bleeding. Urgent treatment and careful blood pressure control are crucial to prevent significant morbidity. Clevidipine butyrate (Cleviprex) is an ultrashort-acting, third-generation intravenous calcium channel blocker. It is an arterial-selective vasodilator with no venodilatory or myocardial depressive effects. Clevidipine has an extremely short half-life of approximately 1 minute as it is rapidly metabolized by blood and tissue esterases. These metabolites are then primarily eliminated through urine and fecal pathways. The rapid onset and the short duration of action permit tighter and closer adjustment of the blood pressure than is possible with other intravenous agents.

The Impact of Antidepressant Treatment on Cognitive Functioning in Depressed Patients with Parkinson's Disease

The Impact of Antidepressant Treatment on Cognitive Functioning in Depressed Patients with Parkinson's Disease

Magnetic resonance imaging of the anteroposterior position and thickness of the aging, accommodating, phakic, and pseudophakic ciliary muscle

To quantify accommodative and age-related changes in the anteroposterior position and thickness of the ciliary muscle in phakic and pseudophakic eyes. Department of Surgery/Bioengineering, UMDNJ-Robert Wood Johnson Medical School, Piscataway; Institute of Ophthalmology and Visual Science UMDNJ-New Jersey Medical School, Newark, New Jersey; MRI Research, Inc., Middleburg Heights, Ohio, USA. Magnetic resonance images were taken of phakic and pseudophakic eyes. The cohort comprised 32 phakic volunteers and 8 volunteers with a monocular intraocular lens (IOL) aged 22 to 91 years. No anteroposterior accommodative movement of the ciliary muscle apex occurred in either group. The muscle moved closer to the cornea with advancing age in phakic eyes; IOL implantation returned the muscle to a youthful position. An age-dependent increase in ciliary muscle anteroposterior thickness occurred that was not mitigated by IOL implantation. Muscle thickness increased with accommodation in only phakic eyes. Presbyopia-correction strategies cannot rely on accommodative anterior movement of the ciliary muscle. Forces on the uvea by crystalline lens-pupillary margin contact may increase with accommodation and lens growth, producing accommodative and age-dependent increases in muscle thickness and significant age-dependent anterior muscle displacement. Intraocular lens implantation removed these forces, allowing choroidal elasticity to restore the muscle to a youthful position; however, the increase in thickness was permanent and likely due to an age-dependent increase in connective tissue. This supports the geometric theory of presbyopia development and that the mechanical forces in human accommodation and presbyopia are very different from those in the rhesus monkey model.

Ethics and Principles in Medical Monitoring of Populations Exposed to Environmental Hazards

In this issue Wones et al.1 describe a comprehensive medical monitoring program (MMP) for community residents in proximity to the Fernald facility, long operated for the Department of Energy as part of the nuclear weapons complex. The extensive contamination of the thousand acre Fernald facility has been remediated, though much of the contamination is confined in place, but the legacy of community exposure has weighed heavily on people’s minds. The MMP described in this issue is a pioneering example of how such a program can operate and how it should be evaluated.

DRINKING WATER QUALITY: Better Biomarker of DBP Exposure

DRINKING WATER QUALITY: Better Biomarker of DBP Exposure