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  1. Article: Benign Adrenocortical Tumors and the Detection of Nonadrenal Neoplasia.

    Hao, Meng / Luque-Fernandez, Miguel Angel / Lopez, Diana / Cote, Kathryn / Newfield, Jessica / Connors, Molly / Vaidya, Anand

    International journal of endocrinology

    2019  Volume 2019, Page(s) 9035407

    Abstract: Context: Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia.: Objective: To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected.!## ...

    Abstract Context: Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia.
    Objective: To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected.
    Design and participants: Case-control study of patients with benign adrenocortical tumors (cases;
    Main outcomes: Primary analyses: association between case-control status and benign abdominal neoplasia detected via cross-sectional imaging. Secondary analyses: association between case-control status and tumors detected via other imaging modalities.
    Results: The mean interval of abdominal imaging was 4.7 (SD = 3.8) years for cases and 5.9 (4.8) years for controls. Cases were more likely to have detected intraductal papillary mucinous neoplasms (IPMNs) of the pancreas (8.5% vs. 4.5%, adjusted OR = 2.22, 95% CI (1.11, 4.63)) compared with controls. In secondary analyses, cases were more likely to have detected thyroid nodules (25.5% vs. 17.0%, adjusted OR = 1.77, 95% CI (1.15, 2.74)), hyperparathyroidism or parathyroid adenomas (3.5% vs. 1.3%, adjusted OR = 3.00, 95% CI (1.00, 11.64)), benign breast masses (6.0% vs. 3.3%, adjusted OR = 3.25, 95% CI (1.28, 8.78)), and benign prostatic hyperplasia (20.5% vs. 5.3%, adjusted OR = 3.20, 95% CI (1.14, 10.60)). Using a composite outcome, cases had higher odds of detection of the composite of IPMN, thyroid nodules, parathyroid tumors, benign breast masses, and prostate hyperplasia (adjusted OR = 2.36, 95% CI: 1.60, 3.50) when compared with controls.
    Conclusions: Patients with benign adrenocortical tumors had higher odds of detected pancreatic IPMN, as well as thyroid nodules, parathyroid tumors, benign breast masses, and prostate hyperplasia compared with patients with normal adrenal glands. These associations may have important implications for patient care and healthcare economics, regardless of whether they reflect incidental discoveries due to imaging detection or frequency bias, or a common risk for developing multiple neoplasia.
    Language English
    Publishing date 2019-11-03
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 2502951-4
    ISSN 1687-8345 ; 1687-8337
    ISSN (online) 1687-8345
    ISSN 1687-8337
    DOI 10.1155/2019/9035407
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Angiotensin-Converting Enzyme Inhibition and Parathyroid Hormone Secretion.

    Zaheer, Sarah / Brown, Jenifer M / Connors, Molly / Williams, Jonathan S / Adler, Gail K / Vaidya, Anand

    International journal of endocrinology

    2017  Volume 2017, Page(s) 4138783

    Abstract: Background: Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion.: Objective: To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in ... ...

    Abstract Background: Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion.
    Objective: To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in participants with and without primary hyperparathyroidism (P-HPT).
    Methods: An open-label, single-arm, pilot study whereby participants with and without P-HPT had PTH were evaluated before and after 1 week of maximally tolerated lisinopril therapy.
    Results: A total of 12 participants with, and 15 participants without, P-HPT successfully completed the protocol. Following 1 week of lisinopril, participants with P-HPT had a decrease in systolic blood pressure (SBP) (-6.4 mmHg,
    Conclusion: In this short pilot investigation, 1 week of maximally titrated ACEi did not impact PTH in participants without P-HPT, but resulted in a modest and marginally significant reduction of PTH but not calcium, among participants with P-HPT. This trial is registered with ClinicalTrials.gov NCT01691781.
    Language English
    Publishing date 2017-07-20
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 2502951-4
    ISSN 1687-8345 ; 1687-8337
    ISSN (online) 1687-8345
    ISSN 1687-8337
    DOI 10.1155/2017/4138783
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Lateralizing Asymmetry of Adrenal Adenomas.

    Hao, Meng / Lopez, Diana / Luque-Fernandez, Miguel Angel / Cote, Kathryn / Newfield, Jessica / Connors, Molly / Vaidya, Anand

    Journal of the Endocrine Society

    2018  Volume 2, Issue 4, Page(s) 374–385

    Abstract: Context: It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry.: Objective: To investigate the symmetry in detection of ... ...

    Abstract Context: It is presumed that the incidence of adrenal adenomas is symmetric between the left and right adrenal gland; however, anecdotal observations suggest a potential lateralizing asymmetry.
    Objective: To investigate the symmetry in detection of adrenal adenomas and relevance to patient care.
    Design: Cross-sectional and longitudinal studies.
    Population and setting: One thousand three hundred seventy-six patients with abdominal computed tomography or magnetic resonance imaging demonstrating benign-appearing adrenal adenomas.
    Main outcome: Location and size of adrenal adenomas.
    Results: Left-sided adenomas were discovered in 65% of patients, right-sided in 21%, and bilateral adenomas in 14%. Among unilateral adenomas, 75% were left-sided. Left-sided adenomas were more prevalent than right-sided adenomas in each size category except the largest: <10 mm, 87%; 10 to 19 mm, 74%; 20 to 29 mm, 72%; ≥30 mm, 56% (
    Conclusions: Adrenal adenomas are substantially more likely to be identified on the left adrenal than the right. This observation may be due to detection bias attributed to the location of the right adrenal, which may preclude identification of right-sided adenomas until they are substantially larger. These findings suggest the potential for an underrecognition of right-sided adenomas that may also impair the accurate detection of bilateral adrenal diseases.
    Language English
    Publishing date 2018-03-16
    Publishing country United States
    Document type Journal Article
    ISSN 2472-1972
    ISSN (online) 2472-1972
    DOI 10.1210/js.2018-00034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Where is the leak in the pipeline? Investigating gender differences in academic promotion at an academic medical centre.

    Paulus, Jessica K / Switkowski, Karen M / Allison, Geneve M / Connors, Molly / Buchsbaum, Rachel J / Freund, Karen M / Blazey-Martin, Deborah

    Perspectives on medical education

    2016  Volume 5, Issue 2, Page(s) 125–128

    Abstract: Background: Women are still under-represented in the senior ranks of academic medicine. As local surveys represent a critical initial step in addressing the challenges of gender disparities in academic promotion within institutions, we surveyed faculty ... ...

    Abstract Background: Women are still under-represented in the senior ranks of academic medicine. As local surveys represent a critical initial step in addressing the challenges of gender disparities in academic promotion within institutions, we surveyed faculty at an academic medical centre to identify factors to improve the academic advancement of women.
    Methods: We conducted an electronic survey of all full-time faculty members in a Department of Medicine assessing academic rank and factors important in consideration for promotion.
    Results: 106 faculty members (46 %) responded to the survey; 40 % of the respondents were women. There was a statistically significant gender gap in faculty rank (p = 0.002), with only 2 of 17 full professor positions occupied by women. Among faculty who had not yet requested promotion, women were more likely to report that they did not think an academic promotion would benefit them (69 vs. 32 % in men, p = 0.01), and to report a lack of encouragement for requesting promotion (50 vs. 29 %, p = 0.08).
    Conclusions: Targeting the perceived value of academic promotion among women faculty, increasing junior faculty mentorship and modifying annual review processes could address gender disparities in academic medicine ranks.
    Language English
    Publishing date 2016-03-17
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2670231-9
    ISSN 2212-277X ; 2212-2761
    ISSN (online) 2212-277X
    ISSN 2212-2761
    DOI 10.1007/s40037-016-0263-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Heparin-Induced Thrombocytopenia in Healthy Individuals with Continuous Heparin Infusion.

    Williams, Jonathan S / Autori, Paula J / Kidd, Stephen K / Piazza, Gregory / Connors, Molly C / Czeisler, Charles A / Scheuermaier, Karine D / Duffy, Jeanne / Klerman, Elizabeth B / Scheer, Frank A / Kozak, Marjorie / Driscoll, Sheila M / Goldhaber, Samuel Z

    TH open : companion journal to thrombosis and haemostasis

    2018  Volume 2, Issue 1, Page(s) e49–e53

    Abstract: The risk for developing heparin-induced thrombocytopenia in healthy individuals is thought to be low, but monitoring recommendations remain controversial. Therefore, a retrospective cohort study was conducted to identify the incidence of thrombocytopenic ...

    Abstract The risk for developing heparin-induced thrombocytopenia in healthy individuals is thought to be low, but monitoring recommendations remain controversial. Therefore, a retrospective cohort study was conducted to identify the incidence of thrombocytopenic events in a healthy research population exposed and re-exposed to continuous intravenous (IV) unfractionated heparin. The Division of Sleep Medicine and the Centre for Clinical Investigations at Brigham and Women's Hospital, Boston, Massachusetts, United States, instituted a standardized platelet monitoring procedure for all research protocols that involved heparin to detect platelet count decreases. Protocol-related frequent blood sampling required use of continuous IV unfractionated heparin infusion (5,000 unit/L in 0.45% saline at 40 mL/h) to maintain line patency over extended periods of IV access. From the years 2009 to 2012, a total of 273 healthy volunteers enrolled in Sleep Medicine research protocols met study criteria as having been exposed and/or re-exposed to continuously infused intravenous heparin for at least 4 hours. The mean continuous heparin exposure time was 88 ± 82 SD hours with a total of 397 heparin exposure and re-exposure events. Platelet count measurements were obtained on 629 occasions, representing a range from 2 to 9 draws per participant. No platelet count decrease of more than 50% was detected. There were no detected adverse bleeding or thrombotic events. In this retrospective study of healthy volunteers involved in a rigorously applied inpatient platelet monitoring protocol, heparin exposure and re-exposure did not lower platelet concentration and, therefore, does not appear to be associated with increased risk of HIT in this population.
    Language English
    Publishing date 2018-01-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/s-0038-1624565
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Striatin Gene Polymorphic Variants Are Associated With Salt Sensitive Blood Pressure in Normotensives and Hypertensives.

    Gupta, Tina / Connors, Molly / Tan, Jia Wei / Manosroi, Worapaka / Ahmed, Noha / Ting, Pei Yee / Garza, Amanda E / Romero, Jose R / Hopkins, Paul N / Williams, Jonathan S / Williams, Gordon H

    American journal of hypertension

    2017  Volume 31, Issue 1, Page(s) 124–131

    Abstract: Background: Understanding the interactions between genetics, sodium (Na+) intake, and blood pressure (BP) will help overcome the lack of individual specificity in our current treatment of hypertension. This study had 3 goals: expand on the relationship ... ...

    Abstract Background: Understanding the interactions between genetics, sodium (Na+) intake, and blood pressure (BP) will help overcome the lack of individual specificity in our current treatment of hypertension. This study had 3 goals: expand on the relationship between striatin gene (STRN) status and salt-sensitivity of BP (SSBP); evaluate the status of Na+ and volume regulating systems by striatin risk allele status; evaluate potential SSBP mechanisms.
    Methods: We assessed the relationship between STRN status in humans (HyperPATH cohort) and SSBP and on volume regulated systems in humans and a striatin knockout mouse (STRN+/-).
    Results: The previously identified association between a striatin risk allele and systolic SSBP was demonstrated in a new cohort (P = 0.01). The STRN-SSBP association was significant for the combined cohort (P = 0.003; β = +5.35 mm Hg systolic BP/risk allele) and in the following subgroups: normotensives, hypertensives, men, and older subjects. Additionally, we observed a lower epinephrine level in risk allele carriers (P = 0.014) and decreased adrenal medulla phenylethanolamine N-methyltransferase (PNMT) in STRN+/- mice. No significant associations were observed with other volume regulated systems.
    Conclusions: These results support the association between a variant of striatin and SSBP and extend the findings to normotensive individuals and other subsets. In contrast to most salt-sensitive hypertensives, striatin-associated SSBP is associated with normal plasma renin activity and reduced epinephrine levels. These data provide clues to the underlying cause and a potential pathway to achieve, specific, personalized treatment, and prevention.
    MeSH term(s) Adult ; Animals ; Calmodulin-Binding Proteins/genetics ; Cohort Studies ; Female ; Genotype ; Humans ; Hypertension/genetics ; Male ; Membrane Proteins/genetics ; Mice ; Mice, Knockout ; Middle Aged ; Nerve Tissue Proteins/genetics ; Polymorphism, Genetic/genetics ; Sodium/metabolism ; Sodium Chloride, Dietary/adverse effects
    Chemical Substances Calmodulin-Binding Proteins ; Membrane Proteins ; Nerve Tissue Proteins ; STRN protein, human ; Sodium Chloride, Dietary ; Strn protein, mouse ; Sodium (9NEZ333N27)
    Language English
    Publishing date 2017-10-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639383-4
    ISSN 1941-7225 ; 1879-1905 ; 0895-7061
    ISSN (online) 1941-7225 ; 1879-1905
    ISSN 0895-7061
    DOI 10.1093/ajh/hpx146
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Heparin-Induced Thrombocytopenia in Healthy Individuals with Continuous Heparin Infusion

    Williams, Jonathan S. / Autori, Paula J. / Kidd, Stephen K. / Piazza, Gregory / Connors, Molly C. / Czeisler, Charles A. / Scheuermaier, Karine D. / Duffy, Jeanne / Klerman, Elizabeth B. / Scheer, Frank A. / Kozak, Marjorie / Driscoll, Sheila M. / Goldhaber, Samuel Z.

    TH Open

    2018  Volume 02, Issue 01, Page(s) e49–e53

    Abstract: The risk for developing heparin-induced thrombocytopenia in healthy individuals is thought to be low, but monitoring recommendations remain controversial. Therefore, a retrospective cohort study was conducted to identify the incidence of thrombocytopenic ...

    Abstract The risk for developing heparin-induced thrombocytopenia in healthy individuals is thought to be low, but monitoring recommendations remain controversial. Therefore, a retrospective cohort study was conducted to identify the incidence of thrombocytopenic events in a healthy research population exposed and re-exposed to continuous intravenous (IV) unfractionated heparin. The Division of Sleep Medicine and the Centre for Clinical Investigations at Brigham and Women's Hospital, Boston, Massachusetts, United States, instituted a standardized platelet monitoring procedure for all research protocols that involved heparin to detect platelet count decreases. Protocol-related frequent blood sampling required use of continuous IV unfractionated heparin infusion (5,000 unit/L in 0.45% saline at 40 mL/h) to maintain line patency over extended periods of IV access. From the years 2009 to 2012, a total of 273 healthy volunteers enrolled in Sleep Medicine research protocols met study criteria as having been exposed and/or re-exposed to continuously infused intravenous heparin for at least 4 hours. The mean continuous heparin exposure time was 88 ± 82 SD hours with a total of 397 heparin exposure and re-exposure events. Platelet count measurements were obtained on 629 occasions, representing a range from 2 to 9 draws per participant. No platelet count decrease of more than 50% was detected. There were no detected adverse bleeding or thrombotic events. In this retrospective study of healthy volunteers involved in a rigorously applied inpatient platelet monitoring protocol, heparin exposure and re-exposure did not lower platelet concentration and, therefore, does not appear to be associated with increased risk of HIT in this population.
    Keywords healthy volunteer ; heparin ; platelets ; thrombocytopenia
    Language English
    Publishing date 2018-01-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2901738-5
    ISSN 2512-9465 ; 2567-3459
    ISSN (online) 2512-9465
    ISSN 2567-3459
    DOI 10.1055/s-0038-1624565
    Database Thieme publisher's database

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