Papers by Don Earl Sanders
Pediatrics, 2015
Cystic fibrosis transmembrane conductance regulator-related metabolic syndrome (CRMS) describes a... more Cystic fibrosis transmembrane conductance regulator-related metabolic syndrome (CRMS) describes asymptomatic infants with a positive cystic fibrosis (CF) newborn screen (NBS) but inconclusive diagnostic testing for CF. Little is known about the epidemiology and outcomes of CRMS. The goal of this study was to determine the prevalence, clinical features, and short-term outcomes of infants with CRMS. We analyzed data from the US CF Foundation Patient Registry (CFFPR) from 2010 to 2012. We compared demographic, diagnostic, anthropometric, health care utilization, microbiology, and treatment characteristics between infants with CF and infants with CRMS. There were 1983 infants diagnosed via NBS between 2010 and 2012 reported to the CFFPR. By using the CF Foundation guideline definitions, 1540 and 309 infants met the criteria for CF and CRMS, respectively (CF:CRMS ratio = 5.0:1.0). Of note, 40.8% of infants with CRMS were entered into the registry with a clinical diagnosis of CF. Infants ...
Thorax, Jan 24, 2015
Treatment of pulmonary exacerbations (PEx) in cystic fibrosis (CF) varies widely with no consensu... more Treatment of pulmonary exacerbations (PEx) in cystic fibrosis (CF) varies widely with no consensus on management practices or best indicators of therapeutic success. To design trials evaluating PEx treatment factors, we characterise the heterogeneity of PEx care in adults and paediatrics, and correlate it with measures of clinical response including short-term and long-term lung function changes, change in symptom severity score and time to next intravenous antibiotic therapy. Data were used from a prospective observational study of patients with CF ā„10ā
years of age enrolled at six sites between 2007 and 2010. All were started on intravenous antibiotics for a clinically diagnosed PEx. Analysis of variance, logistic and Cox regression were used to examine the association of treatment factors with short-term and long-term clinical response. Of 123 patients with CF (60% women, aged 23.1Ā±10.2ā
years), 33% experienced <10% relative improvement in FEV1 during treatment, which was associ...
American journal of respiratory and critical care medicine, 2014
Annals of the American Thoracic Society, 2015
B15. BEST OF PEDIATRICS, 2011
Page 1. / Mini Symposium / Monday, May 16/8:15 AM-10:45 AM / Centennial Ballroom D (Third Level),... more Page 1. / Mini Symposium / Monday, May 16/8:15 AM-10:45 AM / Centennial Ballroom D (Third Level), Hyatt B15 BEST OF PEDIATRICS Regency Denver Chest Ct Scores Of Severity Predict Future Lung Disease Progression In Children With Cf ...
Pediatric Pulmonology, 2008
Objectives:To compare the within day variation of spirometry between hospital admission, discharg... more Objectives:To compare the within day variation of spirometry between hospital admission, discharge, and outpatient follow up among children with cystic fibrosis (CF) hospitalized for a pulmonary exacerbation.Hypothesis:Within day variation of spirometry will be greater at hospital admission than at hospital discharge or outpatient follow up.Methods:We performed a retrospective review of spirometry data for all patients with CF ā„6 years old admitted to our pediatric CF center for a pulmonary exacerbation in 2004 or 2005. For patients who had previously performed spirometry successfully, measurements were used from one admission only during 2004ā2005 if the spirometry occurred within 3 days of hospital admission, 3 days of discharge, or at a follow up clinic visit when well. We compared the within day coefficients of variation (CV) for FVC, FEV1, and FEF25ā75 between time points using the Wilcoxon signed rankātest. We also determined the change in spirometry that is likely to be beyon...
Pediatric Pulmonology, 2010
Background:Patients with cystic fibrosis (CF) frequently experience pulmonary exacerbations that ... more Background:Patients with cystic fibrosis (CF) frequently experience pulmonary exacerbations that may lead to a faster subsequent decline in pulmonary function; however, this relationship has not been clearly established. The purpose of this study was to determine the association between the frequency of pulmonary exacerbations and subsequent forced expiratory volume in 1āsec (FEV1) decline in adults and children with CF.Methods:Cohort study of subjects followed in the Cystic Fibrosis Foundation Patient Registry from 2003 through 2006. Mixed effects modeling was used to estimate differences in rates of decline in FEV1 in 2004ā2006 for patients with 0, 1, 2, or 3+ pulmonary exacerbation(s) in 2003.Results:Of 8,490 subjects who met inclusion criteria, 60% had 0 exacerbations, 23% had 1, 10% had 2, and 7% had 3+ exacerbations in 2003. Compared to children with no pulmonary exacerbations in 2003, children with one or more exacerbations experienced a significantly (Pā<ā0.001) greater r...
Pediatric Pulmonology, 2010
ABSTRACT Rationale Lung function (FEV1) generally improves during treatment of pulmonary exacerba... more ABSTRACT Rationale Lung function (FEV1) generally improves during treatment of pulmonary exacerbations in patients with cystic fibrosis (CF) However, it is unclear how often return to previous baseline FEV1 is achieved Objectives. (1) To determine the proportion of pediatric patients with CF treated for a pulmonary exacerbation who fail to recover to baseline FEV1 and (2) to identify factors associated with this failure Methods. We performed a case control analysis of patients from a single pediatric CF center admitted for their first pulmonary exacerbation in 2001-2006 Patients were considered to have recovered to baseline FEV1 if their best FEV1 within the 3 months following treatment was &gt;= 95%, of the best FEV1 during the 6 months prior to treatment Logistic regression was used to estimate associations between clinical characteristics and failure to regain baseline FEV1 Results Of 104 patients, 24 (23 1%) did not recover to baseline FEV1 The adjusted odds ratio of failure to recover to baseline FEV1 was 1 49 (95% confidence interval (CI) 1 20, 1 86) for every 5% greater decline in FEV1 from baseline to admission In exploratory analyses, the adjusted odds ratios for the failure to recover to baseline were also significantly higher for patients who were evaluated in our CF clinic more frequently between the baseline measurement and admission, were younger, or were insured by Medicaid Conclusions Approximately one in four patients with CF failed to recover to baseline lung function after a pulmonary exacerbation despite treatment with intravenous antibiotics Failure to recover to baseline was associated with the degree of decline in FEV1 that had occurred prior to hospital admission, suggesting opportunities for earlier intervention to improve lung function outcomes Additional studies are needed to determine how the failure to recover to baseline affects subsequent FEV1 decline Pediatr Pulmonol 2010; 45.521-522. (C) 2010 Wiley-Liss Inc
Muscle & Nerve, 1980
The effects of 4āaminopyridine (4āAP) on neuromuscular transmission were studied in vitro in the ... more The effects of 4āaminopyridine (4āAP) on neuromuscular transmission were studied in vitro in the rat flexor digitorum longus muscles. 4āAP produced doseādependent increases in endplate potential (EPP) amplitude, in rise time to peak, and in the average number of acetylcholine quanta released by presynaptic nerve impulses. The neuromuscular blocking effects of dātubocurarine or low Ca2+/high Mg2+ concentrations could be completely reversed by 4āAP, and EPPs developed into muscle action potentials (APs). The drug had minimal effects on the amplitude or frequency of spontaneous miniature endplate potentials, but increased the duration of indirectly elicited muscle APs. The action of 4āAP required the presence of extracellular Ca2+; thus, its effect may be to promote Ca2+ entry into the motor nerve terminal, and thereby increase the neurally evoked transmitter release. 4āAP is effective in overcoming both presynaptic and postsynaptic blockade of neuromuscular transmission, suggesting a ...
JBIC Journal of Biological Inorganic Chemistry, 1997
Optical absorption, EPR and electrospray ionization mass spectrometries were used to characterize... more Optical absorption, EPR and electrospray ionization mass spectrometries were used to characterize a stoichiometric reaction between mercurials and the soluble ba 3āCuA protein from Thermus thermophilus. Either one Hg(II) or two RHg(II)ions react(s) to destroy the unique spectral properties of the CuA center. EPR spectra of the resulting product indicate that one Cu from the binuclear CuA center is released
Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society, 2011
BACKGROUND: Newborn screening (NBS) for CF has become widespread, although there are multiple str... more BACKGROUND: Newborn screening (NBS) for CF has become widespread, although there are multiple strategies. Little is known about outcomes such as age of diagnosis after different NBS methods. METHODS: We used the U.S. Cystic Fibrosis Foundation Patient Registry to identify infants with CF born between 2001 and 2008 in states that utilized NBS. We compared ages at diagnosis, genotyping, sweat test, and first visit to a CF Centre between states that used serial immunoreactive trypsinogen (IRT/IRT) levels and states that used IRT and DNA analysis (IRT/DNA). RESULTS: We identified 1288 infants with CF. Compared to infants born in IRT/IRT states, infants born in IRT/DNA states were younger at the time of diagnosis (median 2.3weeks versus 4.0weeks in IRT/IRT states, p<0.001), genotyping (0.7weeks versus 5.3weeks, p<0.001), and initial CF Centre visit (5.9weeks versus 7.7weeks, p=0.008). CONCLUSIONS: Although there is room to improve outcomes with both strategies, infants born in IRT/...
Pediatric pulmonology, 2011
Progression of lung disease is a major event in children with cystic fibrosis (CF), but regional ... more Progression of lung disease is a major event in children with cystic fibrosis (CF), but regional differences in its evolution are unclear. We hypothesized that regional differences occur beginning in early childhood. We examined this issue by evaluating 132 patients followed in the Wisconsin Neonatal Screening Project between 1985 and 2010. We scored chest X-rays obtained every 1-2 years with the Wisconsin chest X-ray system, in which we divided the lungs into quadrants, and gave special attention to ratings for bronchiectasis (BX) and nodular/branching opacities. We compared the upper and lower quadrant scores, and upper right and left quadrant scores, as patients aged using a multivariable generalized estimation equation (GEE) model. We did a confirmatory analysis for a subset of 81 patients with chest computerized tomography (CT) images obtained in 2000 and scored using the Brody scoring system. The chest X-ray analysis shows that the upper quadrants have higher BX (Pā<ā0.001)...
Pediatric pulmonology, 2011
RATIONALE: Chest CT scans detect structural abnormalities in children with cystic fibrosis (CF), ... more RATIONALE: Chest CT scans detect structural abnormalities in children with cystic fibrosis (CF), even when pulmonary function tests (PFTs) are normal. The use of chest CT is limited in clinical practice, because of concerns over expense, increased resource utilization, and radiation exposure. Quantitative chest radiography scores are useful in detecting mild lung disease, but whether they are sensitive to the presence of CT scan abnormalities has not been evaluated. OBJECTIVE: To determine in a cross-sectional study if quantitative chest radiography is a more sensitive marker of chest CT abnormalities than other lung disease surrogates. METHODS: Brody chest CT scores were calculated for 81 children enrolled in the Wisconsin CF Neonatal Screening Project. We determined the sensitivity for Wisconsin (WCXR) and Brasfield (BCXR) chest radiography scores, PFTs, positive cultures for P. aeruginosa (PA), and parental report of symptoms to detect a Brody score worse than the median score fo...
Canadian Journal of Zoology, 1973
The Naval Arctic Research Laboratory wolf colony at Barrow, Alaska, originated from 15 pups taken... more The Naval Arctic Research Laboratory wolf colony at Barrow, Alaska, originated from 15 pups taken shortly after birth from dens near Anaktuvuk Pass, Alaska. Controlled breeding has resulted in 17 litters. Minimum breeding age for both sexes is 22 months. Maximum observed but not established breeding age for a Barrow colony female is 7 years and for a male is 9 years. An Anchorage, Alaska, zoo female wolf had young at 9 years. Birth dates extend from 19 May to 7 June. Rivalries, especially among females, increase just before the breeding season. Original breeding stock have passed their predominantly dark coloration to offspring.
BMJ, 2012
... Sanders DB, Li Z, Brody AS, Farrell PM. Chest computed tomography scores of severity are asso... more ... Sanders DB, Li Z, Brody AS, Farrell PM. Chest computed tomography scores of severity are associated with future lung disease progression in children with cystic fibrosis. Am J Respir Crit Care Med 2011;184:816-21. ...
The American Journal of Sports Medicine, 1989
Chronic recurrent subluxation of the peroneal tendons can be a disabling condition in the young a... more Chronic recurrent subluxation of the peroneal tendons can be a disabling condition in the young athlete. Con servative techniques of management, including taping, pads, or special shoes, are usually ineffective. Many authors have reported favorable results with surgical reconstruction. These repairs fall into four categories: periosteal reattachment, groove deepening, tenoplasty procedures, and bone block procedures. We are re porting the results of treatment of 12 patients with a sliding fibular graft procedure that has not previously been reported in the literature. Results were excellent in 11 of the 12 procedures. One patient with bilateral repairs reported recurrence of symptoms on one side and required reexploration.
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Papers by Don Earl Sanders