INGRID Pinzon - Academia.edu (original) (raw)

Papers by INGRID Pinzon

Research paper thumbnail of Sex and race factors in early-onset COPD

Current Opinion in Pulmonary Medicine, Mar 1, 2013

Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary diseas... more Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary disease (COPD) continues to increase. In recent years, COPD has evolved to increasingly affect women, minorities, and individuals from low socioeconomic groups. In women and African-Americans, evidence exists supporting the earlier development of COPD after less lifetime smoking. This review highlights new information on racial and sex differences in COPD. Recent findings-Sex and related hormonal changes affect T-cell phenotypes, immunity, and smoking-related metabolism of toxic intermediate metabolites. Alterations in the bronchoalveolar lavage proteome of women, but not of men, have allowed the differentiation of healthy female smokers from smokers with COPD. Sex significantly influences levels of inflammatory cytokines and correlates with different clinical and physiological parameters in female COPD patients. African-Americans with COPD are younger, smoke less, are more likely to currently smoke, and have worse health-related quality of life (QOL). African-Americans are more likely to report hospitalized exacerbations that impact QOL. African-Americans with COPD and asthma are nearly four times more likely to experience exacerbations. Summary-There are sex-specific and race-related differences in the manifestation of COPD. These differences warrant further physiologic, biologic, and genetic investigations.

Research paper thumbnail of Esophagus and Gastric Syphilis in an HIV-Infected Patient

The American Journal of Gastroenterology, Oct 1, 2012

Research paper thumbnail of Predictors of Time-to-Wean Among African Americans With Acute Respiratory Distress Syndrome

Research paper thumbnail of Esophagus and Gastric Syphilis in an HIV-Infected Patient

American Journal of Gastroenterology, 2012

Research paper thumbnail of Randomized Clinical Trial Comparing Soybean Oil-Based and Olive Oil-Based Lipid Emulsion in Medical-Surgical Patients Requiring Parenteral Nutrition

The Endocrine Society's 93rd Annual Meeting & Expo, June 4–7, 2011 - Boston, 2011

Research paper thumbnail of Predictors of Time-to-Wean Among African Americans With Acute Respiratory Distress Syndrome

Research paper thumbnail of Sex and race factors in early-onset COPD

Current Opinion in Pulmonary Medicine, 2013

Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary diseas... more Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary disease (COPD) continues to increase. In recent years, COPD has evolved to increasingly affect women, minorities, and individuals from low socioeconomic groups. In women and African-Americans, evidence exists supporting the earlier development of COPD after less lifetime smoking. This review highlights new information on racial and sex differences in COPD. Recent findings-Sex and related hormonal changes affect T-cell phenotypes, immunity, and smoking-related metabolism of toxic intermediate metabolites. Alterations in the bronchoalveolar lavage proteome of women, but not of men, have allowed the differentiation of healthy female smokers from smokers with COPD. Sex significantly influences levels of inflammatory cytokines and correlates with different clinical and physiological parameters in female COPD patients. African-Americans with COPD are younger, smoke less, are more likely to currently smoke, and have worse health-related quality of life (QOL). African-Americans are more likely to report hospitalized exacerbations that impact QOL. African-Americans with COPD and asthma are nearly four times more likely to experience exacerbations. Summary-There are sex-specific and race-related differences in the manifestation of COPD. These differences warrant further physiologic, biologic, and genetic investigations.

Research paper thumbnail of Prevalence, Quality of Care, and Complications in Long Term Care Residents With Diabetes: A Multicenter Observational Study

Journal of the American Medical Directors Association, 2013

Few studies have reported on the quality of diabetes care and glycemic control adjusted for medic... more Few studies have reported on the quality of diabetes care and glycemic control adjusted for medication use in long term care (LTC) facilities. This observational study analyzed diabetes prevalence and management and the impact of glycemic control on clinical outcome in elderly subjects admitted to 3 community LTC facilities. Among 1409 LTC residents (age 79.7 ± 12 years), the prevalence of diabetes was 34.2%. Subjects with diabetes were either on no pharmacological agents (10%) or were treated with sliding scale regular insulin (SSI, 25%), oral antidiabetic drugs (OAD, 5%), insulin (34%), or with combination of OAD and insulin (26%). Patients with diabetes had a mean daily BG of 156 ± 39 mg/dL and a mean admission HbA1c of 6.7% ± 1.1%. Compared with nondiabetes, residents with diabetes had higher number of complications (54% vs 45%, P < .001), infections (26% vs 21%, P = .036), emergency room (ER) and hospital transfers (37% vs 30%, P = .003), but similar mortality (15% vs 14%, P = .56). A total of 43% of residents with diabetes had a BG less than 70 mg/dL, and those with hypoglycemia had longer median length of stay (LOS, 52 vs 29 days, P < .001), more ER or hospital transfers (56% vs 69%, P = .005), and mortality (20% vs 10%, P = .002) compared with residents without hypoglycemia. Diabetes is common in LTC residents and is associated with higher resource utilization and complications. Hypoglycemia is common and is associated with increased need of emergency room visits and hospitalization and higher mortality. Our findings emphasize the need for randomized trials evaluating the impact of different approaches to glycemic management on clinical outcome in LTC residents with diabetes.

Research paper thumbnail of Randomized Study Comparing a Basal-Bolus With a Basal Plus Correction Insulin Regimen for the Hospital Management of Medical and Surgical Patients With Type 2 Diabetes

Diabetes Care, 2013

OBJECTIVE Effective and easily implemented insulin regimens are needed to facilitate hospital gly... more OBJECTIVE Effective and easily implemented insulin regimens are needed to facilitate hospital glycemic control in general medical and surgical patients with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS This multicenter trial randomized 375 patients with T2D treated with diet, oral antidiabetic agents, or low-dose insulin (≤0.4 units/kg/day) to receive a basal-bolus regimen with glargine once daily and glulisine before meals, a basal plus regimen with glargine once daily and supplemental doses of glulisine, and sliding scale regular insulin (SSI). RESULTS Improvement in mean daily blood glucose (BG) after the first day of therapy was similar between basal-bolus and basal plus groups (P = 0.16), and both regimens resulted in a lower mean daily BG than did SSI (P = 0.04). In addition, treatment with basal-bolus and basal plus regimens resulted in less treatment failure (defined as >2 consecutive BG >240 mg/dL or a mean daily BG >240 mg/dL) than did treatment with SSI (0 ...

Research paper thumbnail of A double-blind, randomized clinical trial comparing soybean oil–based versus olive oil–based lipid emulsions in adult medical–surgical intensive care unit patients requiring parenteral nutrition*

Critical Care Medicine, 2012

Objective-Parenteral nutrition has been associated with metabolic and infectious complications in... more Objective-Parenteral nutrition has been associated with metabolic and infectious complications in intensive care unit patients. The underlying mechanism for the high risk of complications is not known but may relate to the proinflammatory effects of soybean oil-based lipid emulsions, the only Food and Drug Administration-approved lipid formulation for clinical use. Design-Prospective, double-blind, randomized, controlled trial. Setting-Medical-surgical intensive care units from a major urban teaching hospital and a tertiary referral university hospital. Patients-Adult medical-surgical intensive care unit patients. Intervention-Parenteral nutrition containing soybean oil-based (Intralipid) or olive oil-based (ClinOleic) lipid emulsions. Measurements-Differences in hospital clinical outcomes (nosocomial infections and noninfectious complications), hospital length of stay, glycemic control, inflammatory and oxidative stress markers, and granulocyte and monocyte functions between study groups. Results-A total of 100 patients were randomized to either soybean oil-based parenteral nutrition or olive oil-based parenteral nutrition for up to 28 days. A total of 49 patients received soybean oil-based parenteral nutrition (age 51 ± 15 yrs, body mass index 27 ± 6 kg/m 2 , and Acute Physiology and Chronic Health Evaluation II score 15.5 ± 7 [±SD]), and a total of 51 patients

Research paper thumbnail of Sex and race factors in early-onset COPD

Current Opinion in Pulmonary Medicine, Mar 1, 2013

Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary diseas... more Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary disease (COPD) continues to increase. In recent years, COPD has evolved to increasingly affect women, minorities, and individuals from low socioeconomic groups. In women and African-Americans, evidence exists supporting the earlier development of COPD after less lifetime smoking. This review highlights new information on racial and sex differences in COPD. Recent findings-Sex and related hormonal changes affect T-cell phenotypes, immunity, and smoking-related metabolism of toxic intermediate metabolites. Alterations in the bronchoalveolar lavage proteome of women, but not of men, have allowed the differentiation of healthy female smokers from smokers with COPD. Sex significantly influences levels of inflammatory cytokines and correlates with different clinical and physiological parameters in female COPD patients. African-Americans with COPD are younger, smoke less, are more likely to currently smoke, and have worse health-related quality of life (QOL). African-Americans are more likely to report hospitalized exacerbations that impact QOL. African-Americans with COPD and asthma are nearly four times more likely to experience exacerbations. Summary-There are sex-specific and race-related differences in the manifestation of COPD. These differences warrant further physiologic, biologic, and genetic investigations.

Research paper thumbnail of Esophagus and Gastric Syphilis in an HIV-Infected Patient

The American Journal of Gastroenterology, Oct 1, 2012

Research paper thumbnail of Predictors of Time-to-Wean Among African Americans With Acute Respiratory Distress Syndrome

Research paper thumbnail of Esophagus and Gastric Syphilis in an HIV-Infected Patient

American Journal of Gastroenterology, 2012

Research paper thumbnail of Randomized Clinical Trial Comparing Soybean Oil-Based and Olive Oil-Based Lipid Emulsion in Medical-Surgical Patients Requiring Parenteral Nutrition

The Endocrine Society's 93rd Annual Meeting & Expo, June 4–7, 2011 - Boston, 2011

Research paper thumbnail of Predictors of Time-to-Wean Among African Americans With Acute Respiratory Distress Syndrome

Research paper thumbnail of Sex and race factors in early-onset COPD

Current Opinion in Pulmonary Medicine, 2013

Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary diseas... more Purpose of review-Unlike other major diseases, mortality for chronic obstructive pulmonary disease (COPD) continues to increase. In recent years, COPD has evolved to increasingly affect women, minorities, and individuals from low socioeconomic groups. In women and African-Americans, evidence exists supporting the earlier development of COPD after less lifetime smoking. This review highlights new information on racial and sex differences in COPD. Recent findings-Sex and related hormonal changes affect T-cell phenotypes, immunity, and smoking-related metabolism of toxic intermediate metabolites. Alterations in the bronchoalveolar lavage proteome of women, but not of men, have allowed the differentiation of healthy female smokers from smokers with COPD. Sex significantly influences levels of inflammatory cytokines and correlates with different clinical and physiological parameters in female COPD patients. African-Americans with COPD are younger, smoke less, are more likely to currently smoke, and have worse health-related quality of life (QOL). African-Americans are more likely to report hospitalized exacerbations that impact QOL. African-Americans with COPD and asthma are nearly four times more likely to experience exacerbations. Summary-There are sex-specific and race-related differences in the manifestation of COPD. These differences warrant further physiologic, biologic, and genetic investigations.

Research paper thumbnail of Prevalence, Quality of Care, and Complications in Long Term Care Residents With Diabetes: A Multicenter Observational Study

Journal of the American Medical Directors Association, 2013

Few studies have reported on the quality of diabetes care and glycemic control adjusted for medic... more Few studies have reported on the quality of diabetes care and glycemic control adjusted for medication use in long term care (LTC) facilities. This observational study analyzed diabetes prevalence and management and the impact of glycemic control on clinical outcome in elderly subjects admitted to 3 community LTC facilities. Among 1409 LTC residents (age 79.7 ± 12 years), the prevalence of diabetes was 34.2%. Subjects with diabetes were either on no pharmacological agents (10%) or were treated with sliding scale regular insulin (SSI, 25%), oral antidiabetic drugs (OAD, 5%), insulin (34%), or with combination of OAD and insulin (26%). Patients with diabetes had a mean daily BG of 156 ± 39 mg/dL and a mean admission HbA1c of 6.7% ± 1.1%. Compared with nondiabetes, residents with diabetes had higher number of complications (54% vs 45%, P < .001), infections (26% vs 21%, P = .036), emergency room (ER) and hospital transfers (37% vs 30%, P = .003), but similar mortality (15% vs 14%, P = .56). A total of 43% of residents with diabetes had a BG less than 70 mg/dL, and those with hypoglycemia had longer median length of stay (LOS, 52 vs 29 days, P < .001), more ER or hospital transfers (56% vs 69%, P = .005), and mortality (20% vs 10%, P = .002) compared with residents without hypoglycemia. Diabetes is common in LTC residents and is associated with higher resource utilization and complications. Hypoglycemia is common and is associated with increased need of emergency room visits and hospitalization and higher mortality. Our findings emphasize the need for randomized trials evaluating the impact of different approaches to glycemic management on clinical outcome in LTC residents with diabetes.

Research paper thumbnail of Randomized Study Comparing a Basal-Bolus With a Basal Plus Correction Insulin Regimen for the Hospital Management of Medical and Surgical Patients With Type 2 Diabetes

Diabetes Care, 2013

OBJECTIVE Effective and easily implemented insulin regimens are needed to facilitate hospital gly... more OBJECTIVE Effective and easily implemented insulin regimens are needed to facilitate hospital glycemic control in general medical and surgical patients with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS This multicenter trial randomized 375 patients with T2D treated with diet, oral antidiabetic agents, or low-dose insulin (≤0.4 units/kg/day) to receive a basal-bolus regimen with glargine once daily and glulisine before meals, a basal plus regimen with glargine once daily and supplemental doses of glulisine, and sliding scale regular insulin (SSI). RESULTS Improvement in mean daily blood glucose (BG) after the first day of therapy was similar between basal-bolus and basal plus groups (P = 0.16), and both regimens resulted in a lower mean daily BG than did SSI (P = 0.04). In addition, treatment with basal-bolus and basal plus regimens resulted in less treatment failure (defined as >2 consecutive BG >240 mg/dL or a mean daily BG >240 mg/dL) than did treatment with SSI (0 ...

Research paper thumbnail of A double-blind, randomized clinical trial comparing soybean oil–based versus olive oil–based lipid emulsions in adult medical–surgical intensive care unit patients requiring parenteral nutrition*

Critical Care Medicine, 2012

Objective-Parenteral nutrition has been associated with metabolic and infectious complications in... more Objective-Parenteral nutrition has been associated with metabolic and infectious complications in intensive care unit patients. The underlying mechanism for the high risk of complications is not known but may relate to the proinflammatory effects of soybean oil-based lipid emulsions, the only Food and Drug Administration-approved lipid formulation for clinical use. Design-Prospective, double-blind, randomized, controlled trial. Setting-Medical-surgical intensive care units from a major urban teaching hospital and a tertiary referral university hospital. Patients-Adult medical-surgical intensive care unit patients. Intervention-Parenteral nutrition containing soybean oil-based (Intralipid) or olive oil-based (ClinOleic) lipid emulsions. Measurements-Differences in hospital clinical outcomes (nosocomial infections and noninfectious complications), hospital length of stay, glycemic control, inflammatory and oxidative stress markers, and granulocyte and monocyte functions between study groups. Results-A total of 100 patients were randomized to either soybean oil-based parenteral nutrition or olive oil-based parenteral nutrition for up to 28 days. A total of 49 patients received soybean oil-based parenteral nutrition (age 51 ± 15 yrs, body mass index 27 ± 6 kg/m 2 , and Acute Physiology and Chronic Health Evaluation II score 15.5 ± 7 [±SD]), and a total of 51 patients