Publications - Health Research and Policy, Institute for

Interaction Between Lycium barbarum (Goji) and Warfarin: A Case Report

Thu, 01 Mar 2012 06:00:00 GMT

Interaction Between Lycium barbarum (Goji) and Warfarin: A Case Report Rivera, Claudio A; Ferro, Carol L.; Bursua, Adam J.; Gerber, Ben S. A markedly elevated INR time was observed in a 71 year-old Ecuadorean-American woman hospitalized following the consumption of Himalayan Goji Juice. The woman was managed with warfarin following knee surgery three months prior. She reported no changes in dietary habits and lifestyle other than drinking goji juice four days prior to hospitalization. On presentation, she described symptoms of epistaxis, bruising, and rectal bleeding. Following discontinuation of the goji juice, warfarin, and the administration of phytonadione, her INR decreased from a markedly elevated, indeterminate level (prothrombin time greater than 120 seconds) to 2.6 over two days. Lycium barbarum is a Chinese herb that has been used as an herbal supplement for health benefits. Traditionally, Chinese ethnic communities have used the herb in the form of tea. This report highlights the consumption of L. barbarum through goji juice, a widely available beverage in the United States. This case report adds further evidence to two other reports with similar interactions described after ingestion of a tea beverage containing the herb. In the current case report, the INR time was markedly elevated accompanied by signs and symptoms of bleeding. The application of the Naranjo adverse drug reaction probability scale yielded a probable relationship between L. barbarum and warfarin (score of 6). A chart review and thorough patient interview did not yield any other potential contributing factors to this elevation of INR and associated bleeding events. The consumption of goji juice while on warfarin may have resulted in significant bruising, bleeding, and an elevated INR. Popular drinks such as goji juice containing L. barbarum should be avoided while taking warfarin. Before prescribing medications such 4 as warfarin, medical providers should probe patients about their use of various forms of herbal alternatives. Finally, documenting the use of alternative therapies in the medical chart while a patient is receiving warfarin would be of benefit to providers if an elevated INR level is observed during treatment. Post print version of article may differ from published version. The definitive version is available through IOS Press at DOI:10.1002/j.1875-9114.2012.01018.x

Mediators of effects of a selective family-focused violence prevention approach for middle school students.

Wed, 01 Feb 2012 06:00:00 GMT

Mediators of effects of a selective family-focused violence prevention approach for middle school students. Henry, David This study examined how parenting and family characteristics targeted in a selective prevention program mediated effects on key youth proximal outcomes related to violence perpetration. The selective intervention was evaluated within the context of a multi-site trial involving random assignment of 37 schools to four conditions: A universal intervention composed of a student social-cognitive curriculum and teacher training, a selective family-focused intervention with a subset of high-risk students, a condition combining these two interventions, and a no-intervention control condition. Two cohorts of sixth-grade students (total N = 1062) exhibiting high levels of aggression and social influence are the sample for this study. Analyses of pre-post change compared to controls using intent-to-treat analyses found no significant effects. However, estimates incorporating participation of those assigned to the intervention and predicted participation among those not assigned revealed significant positive effects on student aggression, use of aggressive strategies for conflict management, and parental estimation of student’s valuing of achievement. Findings also indicated intervention effects on two targeted family processes: Discipline practices and family cohesion. Mediation analyses found evidence that change in these processes mediated effects on some outcomes, notably aggressive behavior, and valuing of school achievement. Results support the notion that changing parenting practices and the quality of family relationships can prevent the escalation in aggression and maintain positive school engagement for high-risk youth. Post print version of article may differ from published version. The final publication is available at springerlink.com; DOI:10.1007/s11121-011-0245-2

Tea Catechin Epigallocatechin gallate inhibits Streptococcus mutans Biofilm Formation by Suppressing gtf Genes

Thu, 01 Dec 2011 06:00:00 GMT

Tea Catechin Epigallocatechin gallate inhibits Streptococcus mutans Biofilm Formation by Suppressing gtf Genes Xu, Xin; Zhou, Xue D.; Wu, Christine D. Objective: The anti-cariogenic properties of tea have been suggested for decades. Tea polyphenols, especially Epigallocatechin gallate (EGCG), have been shown to inhibit dental plaque accumulation, but the exact mechanisms are not clear at present. We hypothesize that EGCG suppresses gtf genes in S. mutans at the transcriptional level disrupting the initial attachment of S. mutans and thus the formation of mature biofilms. Design: In this study, the effect of EGCG on the sucrose-dependent initial attachment of S. mutans UA159 in a chemically defined medium was monitored over 4 h using a chamber slide model. The effects of EGCG on the aggregation and gtf B, C, D gene expression of S. mutans UA159 were also examined. Results: It was found that EGCG (7.8-31.25 μg/ml) exhibited dose-dependent inhibition of the initial attachment of S. mutans UA159. EGCG did not induce cellular aggregation of S. mutans UA159 at concentrations less than 78.125 μg/ml. Analysis of data obtained from real-time PCR showed that EGCG at sub-MIC level (15.6 μg/ml) significantly suppressed the gtf B, C, D genes of S. mutans UA159 compared with the non-treated control (p < 0.05). Conclusions: These findings suggest that EGCG may represent a novel, natural anti-plaque agent that inhibits the specific genes associated with bacterial biofilm formation without necessarily affecting the growth of oral bacteria. NOTICE: this is the author’s version of a work that was accepted for publication in Archives of Oral Biology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Archives of Oral Biology, Vol #, Issue #, (December 2011). http://dx.doi.org/10.1016/j.archoralbio.2011.10.021

Establishing a Baseline Measure of School Wellness-Related Policies Implemented in a Nationally Representative Sample of School Districts

Wed, 01 Jun 2011 05:00:00 GMT

Establishing a Baseline Measure of School Wellness-Related Policies Implemented in a Nationally Representative Sample of School Districts Brener, Nancy D.; Chriqui, Jamie F.; O'Toole, Terrence P.; Schwartz, Marlene B.; McManus, Tim The Child Nutrition and WIC Reauthorization Act of 2004 required school districts to establish a local school wellness policy by the first day of the 2006-2007 school year. To provide a baseline measure of the extent to which wellness-related policies were implemented in school districts nationwide in 2006, this study analyzed data from the 2006 School Health Policies and Programs Study (SHPPS). SHPPS used a cross-sectional design to measure policies and practices among a nationally representative sample of 538 public school districts. The authors applied a standardized wellness policy coding system to the data by matching each element to relevant questions from SHPPS and calculated the percentage of school districts meeting each element in the coding system. Statistical analyses included calculation of 95% confidence intervals for percentages and mean number of elements met in each area. In 2006, none of the districts met all elements included in the coding system for local wellness policies. In addition, the percentage of districts meeting each element varied widely. On average, districts met the greatest number of elements in the area of nutrition education, and the least number of elements in the area of physical activity. By applying a coding system for district policies to an existing dataset, this study used a novel approach to determine areas of strength and weakness in the implementation of local school wellness-related policies in 2006. NOTICE: this is the author’s version of a work that was accepted for publication in the Journal of the American Dietetic Association. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in the Journal of the American Dietetic Association, Vol 111, Issue 6, (June 2011) DOI: 10.1016/j.jada.2011.03.016. The original publication is available at www.elsevier.com.