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Epidemiology of Surgical Site Infection in a Community Hospital Network
- Arthur W. Baker, Kristen V. Dicks, Michael J. Durkin, David J. Weber, Sarah S. Lewis, Rebekah W. Moehring, Luke F. Chen, Daniel J. Sexton, Deverick J. Anderson
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 37 / Issue 5 / May 2016
- Published online by Cambridge University Press:
- 11 February 2016, pp. 519-526
- Print publication:
- May 2016
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OBJECTIVE
To describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens
METHODSWe prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.
RESULTSA total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82–1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54–0.89) was largely responsible for this overall trend.
CONCLUSIONSThe prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.
Infect Control Hosp Epidemiol 2016;37:519–526
Short Operative Duration and Surgical Site Infection Risk in Hip and Knee Arthroplasty Procedures
- Kristen V. Dicks, Arthur W. Baker, Michael J. Durkin, Deverick J. Anderson, Rebekah W. Moehring, Luke F. Chen, Daniel J. Sexton, David J. Weber, Sarah S. Lewis
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 36 / Issue 12 / December 2015
- Published online by Cambridge University Press:
- 22 September 2015, pp. 1431-1436
- Print publication:
- December 2015
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OBJECTIVE
To determine the association (1) between shorter operative duration and surgical site infection (SSI) and (2) between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties.
DESIGNRetrospective cohort study
SETTINGA total of 43 community hospitals located in the southeastern United States.
PATIENTSAdults who developed SSIs according to National Healthcare Safety Network criteria within 365 days of first-time knee or hip arthroplasties performed between January 1, 2008 and December 31, 2012.
METHODSLog-binomial regression models estimated the association (1) between operative duration and SSI outcome and (2) between surgeon median operative duration and SSI outcome. Hip and knee arthroplasties were evaluated in separate models. Each model was adjusted for American Society of Anesthesiology score and patient age.
RESULTSA total of 25,531 hip arthroplasties and 42,187 knee arthroplasties were included in the study. The risk of SSI in knee arthroplasties with an operative duration shorter than the 25th percentile was 0.40 times the risk of SSI in knee arthroplasties with an operative duration between the 25th and 75th percentile (risk ratio [RR], 0.40; 95% confidence interval [CI], 0.38–0.56; P<.01). Short operative duration did not demonstrate significant association with SSI for hip arthroplasties (RR, 1.04; 95% CI, 0.79–1.37; P=.36). Knee arthroplasty surgeons with shorter median operative durations had a lower risk of SSI than surgeons with typical median operative durations (RR, 0.52; 95% CI, 0.43–0.64; P<.01).
CONCLUSIONSShort operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in our analysis.
Infect. Control Hosp. Epidemiol. 2015;36(12):1431–1436
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. 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Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
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- 05 August 2015
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- 27 April 2015, pp ix-xxx
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- By Agoston T. Agoston, Syed Z. Ali, Mahul B. Amin, Daniel A. Arber, Pedram Argani, Sylvia L. Asa, Rebecca N. Baergen, Zubair W. Baloch, Andrew M. Bellizzi, Kurt Benirschke, Allen Burke, Kenneth B. Calder, Karen L. Chang, Rebecca D. Chernock, Wang Cheung, Thomas V. Colby, Byron P. Croker, Ronald A. DeLellis, Edward F. DiCarlo, Ralph C. Eagle, Hormoz Ehya, Brett M. Elicker, Tarik M. Elsheikh, Robert E. Fechner, Linda D. Ferrell, Melina B. Flanagan, Douglas B. Flieder, Christopher S. Foster, Lillian Gaber, Karuna Garg, Kim R. Geisinger, Ryan M. Gill, Eric F. Glassy, David J. Glembocki, Zachary D. Goodman, Robert O. Greer, David J. Grignon, Gerardo E. Guiter, Kymberly A. Gyure, Ian S. Hagemann, Michael R. Henry, Jason L. Hornick, Ralph H. Hruban, Phyllis C. Huettner, Peter A. Humphrey, Olga B. Ioffe, Edward C. Klatt, Michael J. Klein, Ernest E. Lack, James N. Lampros, Lester J. Layfield, Robin D. LeGallo, Kevin O. Leslie, James S. Lewis, Virginia A. LiVolsi, Alberto M. Marchevsky, Anne Marie McNicol, Mitra Mehrad, Elizabeth Montgomery, Cesar A. Moran, Christopher A. Moskaluk, George J. Netto, G. Petur Nielsen, Robert D. Odze, Arthur S. Patchefsky, James W. Patterson, Elizabeth N. Pavlisko, John D. Pfeifer, Celeste N. Powers, Richard A. Prayson, Anja C. Roden, Victor L. Roggli, Andrew E. Rosenberg, Sherif Said, Margie A. Scott, Raja R. Seethala, Carlie S. Sigel, Jan F. Silverman, Bruce R. Smoller, Edward B. Stelow, Nora C. J. Sun, Mark W. Teague, Satish K. Tickoo, Thomas M. Ulbright, Paul E. Wakely, Jun Wang, Lawrence M. Weiss, Mark R. Wick, Howard H. Wu, Rhonda K. Yantiss, Charles Zaloudek, Yaxia Zhang, Xiaohui Sheila Zhao
- Edited by Mark R. Wick, University of Virginia, Virginia A. LiVolsi, University of Pennsylvania School of Medicine, John D. Pfeifer, Washington University School of Medicine, St Louis, Edward B. Stelow, University of Virginia, Paul E. Wakely, Jr
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- Silverberg's Principles and Practice of Surgical Pathology and Cytopathology
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- 13 March 2015
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- By Nazia M. Alam, Enrico Alleva, Hiroyuki Arakawa, Robert H. Benno, Fred G. Biddle, D. Caroline Blanchard, Robert J. Blanchard, Richard J. Bodnar, John D. Boughter, Igor Branchi, Richard E. Brown, Abel Bult-Ito, Jonathan M. Cachat, Peter R. Canavello, Francesca Cirulli, Giovanni Colacicco, John C. Crabbe, Jacqueline N. Crawley, Wim E. Crusio, Sietse F. de Boer, Ekrem Dere, Brenda A. Eales, Robert T. Gerlai, Howard K. Gershenfeld, Thomas J. Gould, Martin E. Hahn, Peter C. Hart, Andrew Holmes, Joseph P. Huston, Allan V. Kalueff, Benjamin Kest, Robert Lalonde, Sarah R. Lewis-Levy, Hans-Peter Lipp, Sheree F. Logue, Stephen C. Maxson, Jeffrey S. Mogil, Douglas A. Monks, Dennis L. Murphy, Lee Niel, Timothy P. O’Leary, Susanna Pietropaolo, Peter K.D. Pilz, Claudia F. Plappert, Bernard Possidente, Glen T. Prusky, Laura Ricceri, Heather Schellinck, Herbert Schwegler, Burton Slotnick, Frans Sluyter, Shad B. Smith, Catherine Strazielle, Douglas Wahlsten, Hans Welzl, James F. Willott, David P. Wolfer, Armin Zlomuzica
- Edited by Wim E. Crusio, Université de Bordeaux, Frans Sluyter, Robert T. Gerlai, University of Toronto, Susanna Pietropaolo, Université de Bordeaux
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- Behavioral Genetics of the Mouse
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- 05 May 2013
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- 25 April 2013, pp ix-xii
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- By Yasir Abu-Omar, Matthew E. Atkins, Joseph E. Arrowsmith, Alan Ashworth, Rubia Baldassarri, Craig R. Bailey, David J. Barron, Christiana C. Burt, David Cardone, Coralie Carle, Jose Coddens, Alan M. Cohen, Simon Colah, Sarah Conolly, David J. Daly, Helen M. Daly, Stefan G. De Hert, Ravi J. De Silva, Mark Dougherty, John J. Dunning, Maros Elsik, Betsy Evans, Florian Falter, Nigel Farnum, Jens Fassl, Juliet E. Foweraker, Simon P. Fynn, Andrew I. Gardner, Margaret I. Gillham, Martin J. Goddard, Maximilien J. Gourdin, Jon Graham, Stephen J. Gray, Cameron Graydon, Fabio Guarracino, Roger M. O. Hall, Michael Haney, Charles W. Hogue, Ben W. Howes, Bevan Hughes, Siân I. Jaggar, David P. Jenkins, Jörn Karhausen, Todd Kiefer, Khalid Khan, Andrew A. Klein, John D. Kneeshaw, Andrew C. Knowles, Catherine V. Koffel, R. Clive Landis, Trevor W. R. Lee, Clive J. Lewis, Jonathan H. Mackay, Amod Manocha, Jonathan B. Mark, Sarah Marstin, William T. McBride, Kenneth H. McKinlay, Alan F. Merry, Berend Mets, Britta Millhoff, Kevin P. Morris, Samer A. M. Nashef, Andrew Neitzel, Stephane Noble, Rabi Panigrahi, Barbora Parizkova, J. M. Tom Pierce, Mihai V. Podgoreanu, Hans-Joachim Priebe, Paul Quinton, C. Ramaswamy Rajamohan, Doris M. Rassl, Tom Rawlings, Fiona E. Reynolds, Andrew J. Richardson, David Riddington, Andrew Roscoe, Paul H. M. Sadleir, Ving Yuen See Tho, Herve Schlotterbeck, Maura Screaton, Shitalkumar Shah, Harjot Singh, Jon H. Smith, M. L. Srikanth, Yeewei W. Teo, Kamen P. Valchanov, Jean-Pierre van Besouw, Isabeau A. Walker, Stephen T. Webb, Francis C. Wells, John Whitbread, Charles Willmott, Patrick Wouters
- Edited by Jonathan H. Mackay, Joseph E. Arrowsmith
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- Core Topics in Cardiac Anesthesia
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- 15 March 2012, pp x-xiii
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- By Graeme J.M. Alexander, Heung Bae Kim, Michael Burch, Andrew J. Butler, Tanveer Butt, Roy Calne, Edward Cantu, Robert B. Colvin, Paul Corris, Charles Crawley, Hiroshi Date, Francis L. Delmonico, Bimalangshu R. Dey, Kate Drummond, John Dunning, John D. Firth, John Forsythe, Simon M. Gabe, Robert S. Gaston, William Gelson, Paul Gibbs, Alex Gimson, Leo C. Ginns, Samuel Goldfarb, Ryoichi Goto, Walter K. Graham, Simon J.F. Harper, Koji Hashimoto, David G. Healy, Hassan N. Ibrahim, David Ip, Fadi G. Issa, Neville V. Jamieson, David P. Jenkins, Dixon B. Kaufman, Kiran K. Khush, Heung Bae Kim, Andrew A. Klein, John Klinck, Camille Nelson Kotton, Vineeta Kumar, Yael B. Kushner, D. Frank. P. Larkin, Clive J. Lewis, Yvonne H. Luo, Richard S. Luskin, Ernest I. Mandel, James F. Markmann, Lorna Marson, Arthur J. Matas, Mandeep R. Mehra, Stephen J. Middleton, Giorgina Mieli-Vergani, Charles Miller, Sharon Mulroy, Faruk Özalp, Can Ozturk, Jayan Parameshwar, J.S. Parmar, Hari K. Parthasarathy, Nick Pritchard, Cristiano Quintini, Axel O. Rahmel, Chris J. Rudge, Stephan V.B. Schueler, Maria Siemionow, Jacob Simmonds, Peter Slinger, Thomas R. Spitzer, Stuart C. Sweet, Nina E. Tolkoff-Rubin, Steven S.L. Tsui, Khashayar Vakili, R.V. Venkateswaran, Hector Vilca-Melendez, Vladimir Vinarsky, Kathryn J. Wood, Heidi Yeh, David W. Zaas, Jonathan G. Zaroff
- Edited by Andrew A. Klein, Clive J. Lewis, Joren C. Madsen
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- Organ Transplantation
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- 07 September 2011
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- By Eric Adler, Anoushka Afonso, Dean B. Andropoulos, Adel Bassily-Marcus, Yaakov Beilin, Elliott Bennett-Guerrero, Howard H. Bernstein, Marc J. Bloom, David Bronheim, Albert T. Cheung, Samuel DeMaria, Deborah Dubensky, James B. Eisenkraft, Jonathan Elmer, Liza J. Enriquez, Jonathan Epstein, Jeffrey M. Feldman, Gregory W. Fischer, Brigid Flynn, Jennifer A. Frontera, Richard S. Gist, Glenn P. Gravlee, Christina L. Jeng, Ronald A. Kahn, Jenny Kam, Mukul Kapoor, Jung Kim, Roopa Kohli-Seth, Aaron F. Kopman, Tuula S. O. Kurki, Andrew B. Leibowitz, Matthew Levin, Adam I. Levine, Michael S. Lewis, Justin Lipper, Martin London, Michael L. McGarvey, Alexander J. C. Mittnacht, Timothy Mooney, Diana Mungall, Yasuharu Okuda, Peter J. Papadakos, Jayashree Raikhelkar, Lakshmi V. Ramanathan, David L. Reich, Meg A. Rosenblatt, Corey Scurlock, Tamas Seres, Linda Shore-Lesserson, Marc E. Stone, Daniel M. Thys, Judit Tolnai, David Wax, Nathaen Weitzel
- David L. Reich, Mount Sinai School of Medicine, New York
- Edited by Ronald A. Kahn, Mount Sinai School of Medicine, New York, Alexander J. C. Mittnacht, Mount Sinai School of Medicine, New York, Andrew B. Leibowitz, Mount Sinai School of Medicine, New York, Marc E. Stone, Mount Sinai School of Medicine, New York, James B. Eisenkraft, Mount Sinai School of Medicine, New York
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- Monitoring in Anesthesia and Perioperative Care
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- 05 July 2011
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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- By Avishek Adhikari, Susanne E. Ahmari, Anne Marie Albano, Carlos Blanco, Desiree K. Caban, Jonathan S. Comer, Jeremy D. Coplan, Ana Alicia De La Cruz, Emily R. Doherty, Bruce Dohrenwend, Amit Etkin, Brian A. Fallon, Michael B. First, Abby J. Fyer, Angela Ghesquiere, Jay A. Gingrich, Robert A. Glick, Joshua A. Gordon, Ethan E. Gorenstein, Marco A. Grados, James P. Hambrick, James Hanks, Kelli Jane K. Harding, Richard G. Heimberg, Rene Hen, Devon E. Hinton, Myron A. Hofer, Matthew J. Kaplowitz, Sharaf S. Khan, Donald F. Klein, Karestan C. Koenen, E. David Leonardo, Roberto Lewis-Fernández, Jeffrey A. Lieberman, Michael R. Liebowitz, Sarah H. Lisanby, Antonio Mantovani, John C. Markowitz, Patrick J. McGrath, Caitlin McOmish, Jeffrey M. Miller, Jan Mohlman, Elizabeth Sagurton Mulhare, Philip R. Muskin, Navin Arun Natarajan, Yuval Neria, Nicole R. Nugent, Mayumi Okuda, Mark Olfson, Laszlo A. Papp, Sapana R. Patel, Anthony Pinto, Kristin Pontoski, Jesse W. Richardson-Jones, Carolyn I. Rodriguez, Steven P. Roose, Moira A. Rynn, Franklin Schneier, M. Katherine Shear, Ranjeeb Shrestha, Helen Blair Simpson, Smit S. Sinha, Natalia Skritskaya, Jami Socha, Eun Jung Suh, Gregory M. Sullivan, Anthony J. Tranguch, Hilary B. Vidair, Tor D. Wager, Myrna M Weissman, Noelia V. Weisstaub
- Edited by Helen Blair Simpson, Columbia University, New York, Yuval Neria, Columbia University, New York, Roberto Lewis-Fernández, Columbia University, New York, Franklin Schneier, Columbia University, New York
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- Anxiety Disorders
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- 26 August 2010, pp vii-xii
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- By Kateri Berasi, Carol A. Boyer, Diane R. Brown, Robyn Lewis Brown, Tony N. Brown, Padraic J. Burns, Cleopatra Howard Caldwell, Daniel L. Carlson, Cheryl Corcoran, Manuela Costa, Stephen Crystal, Gary S. Cuddeback, William W. Eaton, Adrianne Frech, Virginia Aldigé Hiday, Stevan E. Hobfoll, Allan V. Horwitz, Robert J. Johnson, Verna M. Keith, Ronald C. Kessler, Corey L. M. Keyes, Jacinta P. Leavell, Harriet P. Lefley, Mary Clare Lennon, Laura Limonic, Bruce G. Link, Athena McLean, David Mechanic, Elizabeth G. Menaghan, Barret Michalec, John Mirowsky, Shirin Montazer, Joseph P. Morrissey, Carles Muntaner, Bernice A. Pescosolido, Christopher Peterson, Jo C. Phelan, Michael Polgar, Sarah Rosenfield, Catherine E. Ross, Ebony Sandusky, Jaime C. Sapag, Teresa L. Scheid, Mark F. Schmitz, Sharon Schwartz, Dena Smith, David T. Takeuchi, Peggy A. Thoits, R. Jay Turner, Edwina S. Uehara, Jerome C. Wakefield, James Walkup, Emily Walton, Blair Wheaton, David R. Williams, Kristi Williams
- Edited by Teresa L. Scheid, University of North Carolina, Charlotte, Tony N. Brown, Vanderbilt University, Tennessee
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- A Handbook for the Study of Mental Health
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Steroid hormone receptors and dietary ligands: a selected review
- Miriam N. Jacobs*, David F. V. Lewis
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- Proceedings of the Nutrition Society / Volume 61 / Issue 1 / February 2002
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- 28 February 2007, pp. 105-122
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Members of the nuclear steroid hormone superfamily mediate essential physiological functions. Steroid hormone receptors (SHR) act directly on DNA, regulate the synthesis of their target genes and are usually activated by ligand binding. Both endogenous and exogenous compounds and their metabolites may act as activators of SHR and disruptors of endocrine, cellular and lipid homeostasis. The endogenous ligands are generally steroids such as 17β-oestradiol, androgens, progesterone and pregnenolone. The exogenous compounds are usually delivered through the diet and include non-steroidal ligands. Examples of such ligands include isoflavanoids or phyto-oestrogens, and food contaminants such as exogenous oestrogens from hormone-treated cattle, pesticides, polychlorinated biphenyls and plasticisers. Certain drugs are also ligands; so nuclear receptors are also important drug targets for intervention in disease processes. The present review summarises recent reports on ligand-activated SHR that describe the selective regulation of a tightly-controlled cross-talking network involving exchange of ligands, and the control of major classes of cytochrome P450 (CYP) isoforms which metabolise many bioactive exogenous compounds. Many CYP have broad substrate activity and appear to be integrated into a coordinated metabolic pathway, such that whilst some receptors are ligand specific, other sensors may have a broader specificity and low ligand affinity to monitor aggregate levels of inducers. They can then trigger production of metabolising enzymes to defend against possible toxic nutrients and xenobiotic compounds. The influence of dietary intakes of nutrients and non-nutrients on the human oestrogen receptors (α and β), the aryl hydrocarbon receptor, the pregnane X receptor, the constitutive androstane receptor, and the peroxisome proliferator-activated receptors (α and γ), can be examined by utilising computer-generated molecular models of the ligand–receptor interaction, based on information generated from crystallographic data and sequence homology. In relation to experimental and observed data, molecular modelling can provide a scientifically sound perspective on the potential risk and benefits to human health from dietary exposure to hormone-mimicking chemicals, providing a useful tool in drug development and in a situation of considerable public concern.
An open letter to the President
- Louis Appleby, Glyn Lewis, R. H. Cawley, Isaac Marks, Pamela Taylor, Raymond Levy, Klaus Bergmann, Nick Temple, Brian Toone, Stephen Wolkind, Eileen Joyce, Michael Gill, E. Guinness, Michael Farrell, V. L. Nimgaonkar, Deborah Chee, L. Mynors-Wallis, Peter Jones, Penny Thompson, Rachel Brown, H. Ring, Claire Gerada, Jenny Bearn, S. G. Potts, B. C. Beats, Lyn Pilowsky, Judith Jackson, G. F. Searle, Keith Lloyd, Helena Fox, Parimela Moodley, Tony Maden, S. W. Lewis, M. W. Orrell, D. Murphy, W. J. Levy, Brian Green, Alex Buchanan, Marian J. Perkins, Peter Misch, Gillian Mezey, M. Murphy, Anthony David, Robert Kerwin, Shirine Pezeshgi, M. Abas, P. Silverstone, J. H. Stone, G. O. 'Sullivan, R. Araya, R. Ball, E. Palazidou, Jane Milton, Anthony J. Pelosi, Janet Carrick, Dinesh Bhugra, Chris Hollis, Mark Berelowitz, N. R. Fisher, Deborah Brooke, Charles Hindler, Malcolm Battersby, Abigail Seltzer
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- Journal:
- Psychiatric Bulletin / Volume 12 / Issue 12 / December 1988
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- 02 January 2018, p. 554
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- December 1988
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