Arshag D Mooradian

..The emergence of multiple insulin products has provided new opportunities to achieve diabetes control. However, the number of options has raised concerns about the optimal choices of products...

..Although drug therapy for dyslipidemia must be individualized, most people with diabetes mellitus are candidates for statin therapy, and often need treatment with multiple agents to achieve therapeutic goals...

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..The goals of diabetes care in older adults are to enhance quality of life without subjecting the residents to inappropriate interventions...

..Perhaps the most important feature that distinguishes academic medicine from the other businesses is that its workforce is medical professionals who have a fiduciary relationship with their customers...

..These observations provide a novel mechanistic explanation for the failure of antioxidant therapy in interventional clinical trials...

..The emergence of glucose intolerance or a genetic predisposition to familial combined hyperlipidemia will further modify the plasma lipid phenotype in obese people (11,12,13,14,15)...

..The goal of diabetes care in older adults is to enhance quality of life without subjecting individuals to complicated treatment regimens that may interfere with their independence in carrying out daily activities...

..Statins reduce albumin excretion rate and retard the progression of diabetic nephropathy. Whether statins alter size selectivity of glomerular filtration in diabetic rats is not known...

..Asymptomatic hyperthyroidism may well be a syndrome that is currently under-diagnosed...

..6 compared with 145+/-16.9, P<0.05). Co-transfection of THRP with wild-type c-Abl did not alter the effect of THRP on cell survival. It is concluded that THRP is an important factor in TH-induced neuronal cell death...

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..It is concluded that COX inhibition with INDO or ASA downregulates apoAI expression at the transcriptional level. This effect could not be attributed to either arachidonic acid excess or to a deficiency in various prostanoids tested...

..To test the extent of coupling between these two stresses, the effect of antioxidant vitamins on glucose-induced oxidative stress and ER stress in endothelial cells were studied...

..Gel shift assays showed that none of the treatments resulted in a change in site A binding activity. These results indicate that VDR modulators in hepatocytes and intestinal cells differentially regulate expression of the apo A-I gene...

..To investigate whether these cellular stresses are independent or causally linked, we determined whether or not specific glycolytic intermediates that induce oxidative stress also induce ER stress...

..3% +/- 1.6%). Stearic acid treatment did not alter Sp1-DNA binding as measured by gel shift analysis. Therefore, saturated fatty acids blunt Sp1 induction of apo AI promoter probably at a step beyond DNA binding...

..Whether similar changes may occur in vivo remains to be shown. However, these observations do not support the use of pharmacologic amounts of chromium supplementation to enhance the cardioprotective lipid profile...

..The hypothesis is that the neutraceutical glucosamine, when given in conventional doses (1,500 mg/day) may increase apoAI and HDL cholesterol levels in subjects with diabetes and low HDL cholesterol...

..6 to 16.6 hours. These findings suggest that increases in apoAI gene expression by glucosamine occur primarily through stabilizing apoAI mRNA...

..The present study underscores the paucity of TH responsive genes in adult cerebral tissue...

..These results indicate that dextrose-induced endoplasmic reticulum stress and superoxide generation are reversed by estradiol and testosterone; however, the latter requires aromatase-dependent conversion to estradiol...

..The previously described ARE is not a response element for the ascorbate or alpha-tocopherol...

..These results suggest that TNF alpha suppresses apoAI promoter activity through both the MEK/ERK and JNK pathways but is not mediated by either p38 MAP kinase activity or NF-kappaB activation...

..Because there are multiple mechanisms involved in the regulation of serum HDLc levels, changes in gene transcription do not necessarily correlate with clinical observations on serum levels of HDLc...

..This effect requires the VDR as well as a vitamin D response element in the apo AI promoter...

..280+/-0.030 vs. 0.956+/-0.038), P<0.001. It is concluded that aging in rats may alter the molecular anatomy of the BBB by altering the content of select structural proteins of tight junctions...

..CONCLUSIONS: Fatty acids have the ability to modulate oxidative load in hyperglycemia and this effect may be related to the length, saturation, and possibly cis/trans orientation of the FA...

..Nicotinic acid may increase apo A-I protein synthesis in the liver and small intestine. Induction of apo A-I gene by nicotinic acid requires a nicotinic acid responsive element in the apo A-I promoter...

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..In this review, several of these connections are described and cytokine signalling related to HDLc is examined...

..This study was undertaken to determine whether these rhGH-induced changes occur in obese subjects during rhGH supplementation...

..These studies suggest that inflammatory cytokines down-regulate apoAI expression at least partly through inhibition of binding of the nuclear factors to site A of the apoAI promoter...

..These findings suggest that CV not only prevents dextrose-induced SO generation in endothelial cells but may also have favorable effects on gene expression and cell survival...

..Identifying the mechanisms that modulate apo A-I gene expression will aid in the new development of therapeutic agents that increase plasma apo A-I and HDL concentrations...

..the effect of THRP on cell viability is not modulated by c-Abl tyrosine kinase; and (4). the effect of T(3 )treatment on PC12 cell survival may be mediated by THRP...

..To determine if 24, 25-(OH)(2)D(3) modulates apo A-I gene expression, HepG2 hepatocytes and Caco-2 intestinal cells were treated with 24, 25-(OH)(2)D(3) or its precursor 25-OHD(3)...

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..Thus, the lack of aspirin protection in diabetes may be due to undefined aspects of platelet function...

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..Recent clinical trials suggest that diabetics treated with glucagon-like peptide-1 (GLP-1) have normalized lipid levels, including an increase in plasma high-density lipoprotein cholesterol (HDLc) levels...

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..To determine the molecular basis of this observation, the effect of activation of the aryl hydrocarbon receptor (AhR) on apo A-I gene expression was examined...

..In this review, the various pharmacologic agents available for the management of diabetes will be reviewed and some pertinent clinical guidelines will be suggested...

..038 respectively. These differences did not achieve statistical significance. It is concluded that diabetes alters the molecular anatomy of the tight junctions in cerebral tissue by altering the content of select structural proteins...

..Our objectives are to determine if plasma vitamin D levels correlate with plasma HDLc and apo A-I and, if so, offer speculation as to how apo A-I in the context of high vitamin D levels provides enhanced atheroprotection...

..However, peroxisome proliferator activator receptor (PPAR) agonists that have significant PPAR alpha activity in addition to their PPAR gamma effects, may well be able to induce apoA-I expression...

..It is concluded that increased oxidative load in sustained chronic hyperglycemia is probably the result of depletion of antioxidant pool rather than secondary to sustained increase in SO production...

..These results indicate that ECs directly suppress apo A-I gene expression in both hepatocytes and intestinal cells, contributing to the decrease in serum HDLc in obese individuals...

..However, the lack of a long-term safety record, and the cost, would limit the widespread acceptance of this class of agents as first-line therapy...

..We review important studies of the effects of four antioxidants (vitamins A, C, and E, and beta carotene) and analyze whether the current evidence supports or confirms or rejects the presumed protective role...

..Although novel insulin analogues are promising 'designer drugs' in our armamentarium to overcome some of the limitations of conventional insulin therapy, cost may be a limiting factor for some patients...

..Experimental evidence in the literature suggests that similar lipid changes may occur due to cytokines released during sepsis. Clinicians should be aware of these changes to avoid misdiagnosis of lipid disorders...

..These studies suggest that diabetes in humans may be associated with alterations in the BBB integrity that allow the emergence of antibodies against neuronal antigens...

..Future studies should focus on identifying reliable markers of oxidation to incorporate these measurements in the clinical interventional trial...

..In conclusion, in obesity, rhGH normalized IGF-I levels, induced loss of BW from BF, and improved lipid profile without untoward effects on insulin sensitivity...

..The purpose of this review was to better understand possible social, economic, cultural, behavioral, and systems barriers to breast cancer screening among minority women...

..The rate of unscheduled readmissions is an important quality indicator with financial implications for hospitals...

..This review describes the evidence that supports the hypothesis that high-density lipoprotein (HDL) is atheroprotective due to its antiinflammatory effects and benefits on vascular health...

..These observations suggest that THRP over-expression in early development is not compatible with completion of early embryogenesis and that a different strategy needs to be employed to investigate THRP function in this model...

..It remains to be established if the transcriptional effects we observed are mediated through an androgen response element...

..In this communication, some of these landmark studies are reviewed and some practical guidelines of management are suggested...

..Given the lack of data to substantiate the benefit and safety of ingestion of antioxidant vitamins in excess of the recommended dietary allowance, physicians should avoid the recommendation of vitamin supplementation to their patients...

..The advantages of combining several agents in one tablet include convenience and enhanced adherence to therapy. The main disadvantage is the loss of administration flexibility...

..The present communication briefly reviews the Diabetes-related changes in the central nervous system and discusses some of the mechanisms underlying these changes...

..Management should emphasize lifestyle modifications, while the use of pharmacologic agents such as sibutramine and orlistat should be reserved for select groups of patients who do not respond to lifestyle modification...

..Many with erectile failure, suffer silently regardless of its etiology. In this review, we suggest some practical guidelines for the management of these conditions...

..To determine if replacement of GH improves BMD in adult-onset GHD, we administered GH in physiologic amounts to men and women with GHD. GH replacement significantly increased spine BMD in the men by 3.8%...

..The benefits of black cohosh in the management of climacteric symptoms remain to be proven. Case studies suggest an additional unexplored area of adverse events that also needs to be addressed...

..We hypothesized that the medical home model is an effective intervention to decreasing health care disparities in minority patients with diabetes...

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..These studies demonstrate that THRP and Abi-2 have distinct tissue distribution and distinct biological properties...

..A bile acid binding agent is an option if the serum TG levels do not exceed 200 mg/dL (5.65 mmol/L), otherwise a fibrate or nicotinic acid should be considered. The decision to treat a particular person has to be individualised...

..These findings may add insight into the role of insulin-degrading enzymes in the etiology of subcutaneous insulin resistance syndromes...

..In summary, the IRCE alone can mediate the stimulatory effects of insulin, bpv, and PDBu, and Sp1 enhances these responses that may arise from phosphorylation of the protein...

..The potential role of leptin in initiation of pubertal development is not easily demonstrable in observational studies...