Seven donkeys that died due to various health problems or were euthanased on a welfare ground were necropsied and the parasites were recovered and identified to the species level. The study was conducted during the periods 1996-1999.\n\nCoprological examination revealed 99% strongyle, 80% Fasciola, 51%

Parascaris, 30% Gastrodiscus, 11% Strongyloides westeri, 8% cestodes and 2% Oxyuris equi infection prevalence. Over 55% of donkeys had more than 1000 eggs per gram of faeces (epg). Forty two different species of parasites URMC-099 MAPK inhibitor consisting of 33 nematodes, 3 trematodes, 3 cestodes and 3 arthropod larvae were identified from postmortem examined Alvocidib Cell Cycle inhibitor donkeys. Among the nematodes 17 species of Cyathostominae and 7 species of Strongylinae were identified. Other parasites identified include, Habronema muscae, Draschia megastoma, Trichostrongylus axei, Strongyloides westeri, Anoplocephala perfoliata, Anoplocephala magna, Anoplocephaloides (Paranoplocephala) mamillana, Parascaris equorum, Fasciola hepatica, Fasciola gigantica, Gastrodiscus aegyptiacus, Dictyocaulus arnfieldi, Oxyuris equi, Probstmayria vivipara, Gasterophilus intestinalis, Gasterophilus nasalis, Rhinoestrus uzbekistanicus and Setaria equina. This study revealed that working donkeys in Ethiopia are infected with a range of helminths and arthropod

larvae, which are representatives of the important pathogenic parasites found in equids worldwide.”
“Changes in cropland have been the dominating land use changes in Central and Eastern Europe, with cropland abandonment frequently exceeding

cropland expansion. However, surprisingly little is known about the rates, spatial patterns, and determinants of cropland change in Eastern Europe. We study cropland changes between 1995 and 2005 in Arges, County in Pevonedistat price Southern Romania with two distinct modeling techniques. We apply and compare spatially explicit logistic regressions with artificial neural networks (ANN) using an integrated socioeconomic and environmental dataset. The logistic regressions allow identifying the determinants of cropland changes, but cannot deal with non-linear and complex functional relationships nor with collinearity between variables. ANNs relax some of these rigorous assumptions inherent in conventional statistical modeling, but likewise have drawbacks such as the unknown contribution of the parameters to the outcome of interest. We compare the outcomes of both modeling techniques quantitatively using several goodness-of-fit statistics. The resulting spatial predictions serve to delineate hotspots of change that indicate areas that are under more eminent threat of future abandonment.

These CagA activities may collectively contribute to the transformation of gastric epithelial cells. Indeed, transgenic expression of CagA in mice results in the development of gastrointestinal and hematological malignancies, indicating that CagA is the first bacterial oncoprotein that acts in mammalian cells. The oncogenic potential of CagA may be further potentiated in the presence of chronic inflammation, which aberrantly induces activation-induced cytidine deaminase (AID), a member of the DNA/RNA-editing enzyme family.

Ectopically expressed AID may contribute to H. pylori-initiated gastric carcinogenesis by increasing the risk of likelihood of epithelial cells acquiring mutations in cancer-related genes.”
“We report a patient with carcinomatous meningitis secondary to known transitional

cell carcinoma of the bladder. The patient presented with multiple focal neurological signs and symptoms. Diagnosis was suggested by magnetic resonance imaging TGF-beta inhibitor and confirmed by analysis of the cerebrospinal fluid. He received whole brain radiotherapy despite a poor prognosis. To our knowledge, this is only the fifth reported case of neoplastic meningitis due to bladder cancer with confirmatory imaging and cytology and only the fourth reported Birinapant supplier case that presented with cranial nerve involvement.”
“We studied the potential use of [F-18]fluorodeoxyglucose (F-18-FDG) whole body positron emission tomography (PET)-computed tomography for the diagnosis of device infection and extension of infection. Twenty-one patients with suspected device infection were prospectively included and compared with 14 controls free of infection. F-18-FDG uptake on the box and on the leads was visually and quantitatively interpreted (using

the maximal standard uptake value). The final diagnosis was obtained either from bacteriological data after device culture (n = 11) or by a 6-month follow-up according to modified Duke’s criteria (n = 10). Ten patients finally showed infection on bacteriological study (n = 8) or during follow-up (n = 2). Sensitivity, Sapanisertib supplier specificity, positive predictive value and negative predictive value were, respectively, 80%, 100%, 100% and 84.6% on patient-based analysis (presence or absence of infection). They were 100%, 100%, 100% and 100% for boxes, but only 60%, 100%, 100% and 73% for leads. Quantitative analysis could be useful for boxes but not for leads, for which the presence of a mild hot spot was the best criterion of infection. The four false negatives on leads received antibiotics for longer than the six true positives (20 +/- 7.2 vs. 3.2 +/- 2.3 days, p < 0.01). Although the study was not designed for this purpose, management could have been modified by PET results in six of 21 patients. F-18-FDG PET imaging may be useful for the diagnosis of device infection, and could impact on clinical management. Interpretation of negative cases should be performed with caution if patients have received antibiotics.

Weight [OR 0.96 (0.91-0.99)], parenteral nutrition (PN) [OR 3.38 (1.40-8.19)] and indwelling time (IT) [OR 1.08 (1.02-1.14)] were CR-BSI risk factors. Practice changes aimed at reducing PN and IT were introduced. PN decreased from 49.8% [95% CI (49.7-49.9)] to 26.7% [(95% CI 26.6-26.8)] (p < 0.001),

and IT dropped from 9.92 (95% CI 9.09-10.75) to 8.13 AZD2014 cost (95% CI 7.47-8.79) days (p < 0.001). The CR-BSI rate was reduced to 3.05 (95% CI 0.93-5.17)/1,000 catheter-days. During the last period, PN and IT were no longer CR-BSI risk factors. Type of catheterisation (guide wire exchange) [OR 6.66 (1.40-31.7)] was the only CR-BSI risk factor. Conclusions: PN and IT were independent CR-BSI risk factors during the first period. An intervention focused on PN and IT reduction resulted in a sustained decrease of CR-BSI rates in our PICU.”
“During a comparison of 16S rDNA PCR-denaturant

gradient gel electrophoresis (DGGE) profiles of methanogenic archaea from rumen fluid, rabbit caecum and pig feces, a unique band common to all rabbit caecum samples was observed. DGGE profiling also showed that the methanogen community from the New Zealand White adult rabbits is different and less complex than the methanogen communities from the rumen and pig feces. Small subunit ribosomal gene sequences of methanogenic archaea were subsequently retrieved from the constructed rabbit caecum 16S rDNA gene library. Results of the phylogenetic analysis indicated that rabbit CB-839 clinical trial CH5183284 nmr caecum is inhabited by members of the genus Methanobrevibacter and is possibly one-species dominated, because all the retrieved sequences exhibited similarity values of 99% or higher. This species may well be a novel species of the genus Methanobrevibacter. It belongs to a distinct phylogenetic group containing Methanobrevibacter woesei, Methanobrevibacter thaueri and Methanobrevibacter gottschalkii strains isolated from animal feces, and Methanobrevibacter smithii from the predominating methanogen population of the human large bowel.”
“A critical soil mineral nitrogen concentration (N-min) for guiding fertilizer application and maximizing

maize grain yield is needed.\n\nA three-year field experiment with three N regimes, unfertilized (N0), optimized N management (Opt.) and conventional N practice (Con.) was performed in maize.\n\nThe mean soil N-min in 0-60 cm soil profile for N0, Opt. and Con. treatments was 2.0, 6.7 and 8.9 mg kg(-1) at V8-VT growth stages and 2.2, 6.1 and 11.2 mg kg(-1) on average over the whole growth season, respectively. Correspondingly, the soil N supplying capacity (soil N-min content + fertilizer N) of the three N treatments was smaller, identical or greater than the plant N accumulation at different growth stages. The Opt. treatment had significantly higher N use efficiency, N recovery efficiency and N partial factor productivity compared with the Con. treatment, while it did not cause maize yield loss.

The aetiology of IIH is not known. In this review we explore the literature investigating the pathogenesis of IIH and suggest additional hypotheses. Chronic inflammation is emerging as an aetiological factor in the pathogenesis of obesity and we propose that this may be a feature of IIH. Daporinad datasheet Obesity is also related to dysregulation of cortisol production by the pre-receptor enzyme, 11 beta-hydroxysteroid dehydrogenase, and we speculate that this may have a role in the pathogenesis of obesity and raised ICP seen in IIH. (c)

2008 Elsevier B.V. All rights reserved.”
“Insulin-degrading enzyme (IDE) selectively degrades the monomer of amyloidogenic peptides and contributes to clearance of amyloid beta (A beta). Thus, IDE retards the progression of Alzheimer’s disease. IDE possesses an enclosed catalytic chamber that engulfs

and degrades its peptide substrates; however, the molecular selleck kinase inhibitor mechanism of IDE function, including substrate access to the chamber and recognition, remains elusive. Here, we captured a unique IDE conformation by using a synthetic antibody fragment as a crystallization chaperone. An unexpected displacement of a door subdomain creates an similar to 18-angstrom opening to the chamber. This swinging-door mechanism permits the entry of short peptides into the catalytic chamber and disrupts the catalytic site within IDE door subdomain. Given the propensity of amyloidogenic peptides to convert into beta-strands for their polymerization into amyloid fibrils, they also use such beta-strands to stabilize the disrupted catalytic site resided at IDE door subdomain for their degradation by IDE. Thus, action of the swinging door allows IDE to recognize amyloidogenicity by substrate-induced stabilization of the IDE catalytic cleft. Small angle X-ray scattering (SAXS) analysis revealed that IDE exists as a mixture of closed and open states. These open states, which are distinct from the swinging door state, permit entry

of larger substrates (e. g., A beta, insulin) to the chamber and are preferred in solution. Mutational studies confirmed the AL3818 critical roles of the door subdomain and hinge loop joining the N- and C-terminal halves of IDE for catalysis. Together, our data provide insights into the conformational changes of IDE that govern the selective destruction of amyloidogenic peptides.”
“Object. This systematic review assesses the efficacy of epidural steroids on adults undergoing lumbar spine surgery for degenerative spinal disease.\n\nMethods. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase databases were searched for relevant articles. Search terms included “laminectomy,” “discectomy,” and “steroid.” Randomized and quasi-randomized controlled trials of adults undergoing lumbar spinal surgery for degenerative spinal disease were included.

Results: Between 2010 and 2013, the use of many strategies increased, but ERK inhibitor the use of only two strategies increased significantly: the percentage of hospitals providing regular training to Emergency Medical Service (EMS) providers about AMI care increased from 36% to 71% (P-value smaller than 0.001) and the percentage of hospitals using computerized assisted physician order entry more than doubled (P-value smaller than 0.001). Most, but not all, hospitals reported having environments conducive to communication, coordination and problem solving. Conclusions: We found few significant changes between 2010 and 2013 in hospital

strategies or in key features of organizational culture that have been associated with lower AMI mortality rates. Findings highlight several opportunities to help close remaining performance gaps in AMI mortality among hospitals.”
“Glyoxalases are known to play a very important role in abiotic stress tolerance. This two-step pathway detoxifies ubiquitously present cytotoxic metabolite methylglyoxal, which otherwise increases to

lethal concentrations under various stress conditions. Methylglyoxal initiates stress-induced signaling cascade via reactive oxygen species, resulting in the modifications of proteins involved in various signal transduction pathways, that eventually culminates in cell death or growth arrest. The associated mechanism of tolerance conferred by over-expression of methylglyoxal-detoxifying glyoxalase pathway mainly involves lowering of methylglyoxal levels, thereby reducing subsequently induced cellular toxicity. Apart from abiotic stresses, expression PXD101 clinical trial of glyoxalases is affected by a wide variety of other stimuli such as biotic, chemical and hormonal treatments. Additionally, alterations in cellular milieu during plant growth and development also affect expression of glyoxalases. The multiple

stress-inducible nature of these enzymes suggests a vital role for glyoxalases, associating them with plant defense mechanisms. In this context, we have summarized available transcriptome, Evofosfamide supplier proteome and genetic engineering-based reports in order to highlight the involvement of glyoxalases as important components of plant stress response. The role of methylglyoxal as signaling molecule is also discussed. Further, we examine the suitability of glyoxalases and methylglyoxal as potential markers for stress tolerance.”
“MK-6096 is an orexin receptor antagonist in clinical trials for the treatment of insomnia. Herein we describe its first kilogram-scale synthesis. Chirality on the a-methylpiperidine core was introduced in a biocatalytic transamination using a three-enzyme system with excellent enantioselectivity (>99% ee). Low diastereoselectivity of the lactam reduction was overcome by development of a camphor sulfonic acid salt formation and dr upgrade. A chemoselective O-alkylation with 5-fluoro-2-hydroxypyridine was optimized and developed. Overall, 1.

0 +/- 5.0 mg. In multiple regression analysis, BMD loss at the spine was significantly associated with higher daily glucocorticoid dose and lower baseline 25-hydroxyvitamin D levels. BMD loss at the hip was associated with lower 25-hydroxyvitamin D levels at baseline, reduction of body mass index, and baseline use of antimalarials.\n\nIn this 6-year follow-up study, bone loss was remarkably low. A dose-dependent relationship between glucocorticoid use and spinal bone loss was found. In addition, the use of antimalarials STI571 and lower 25-hydroxyvitamin D levels at baseline were associated with BMD loss. These

findings underline the importance of prevention and treatment of vitamin D deficiency and osteoporosis in SLE, especially in patients using glucocorticoids or antimalarials.”
“Objectives: Regardless of the

proportion of missing values, complete-case analysis is most frequently applied, although advanced techniques such as multiple imputation (MI) are available. The objective of this study was to explore the performance of simple and more advanced methods for handling missing data in cases when some, many, Doramapimod or all item scores are missing in a multi-item instrument.\n\nStudy Design and Setting: Real-life- missing data situations were simulated in a multi-item variable used as a covariate in a linear regression model. Various missing data mechanisms were simulated with an increasing percentage of missing data. Subsequently, several techniques to handle missing data were applied to decide on the most optimal technique for each scenario. Fitted regression coefficients were compared using the bias and coverage as performance parameters.\n\nResults: Mean imputation caused biased estimates in every missing data scenario when data are missing SIS3 solubility dmso for more than 10% of the subjects. Furthermore, when a large percentage of subjects had missing items (>25%), MI methods applied to the items outperformed

methods applied to the total score.\n\nConclusion: We recommend applying MI to the item scores to get the most accurate regression model estimates. Moreover, we advise not to use any form of mean imputation to handle missing data. (C) 2014 Elsevier Inc. All rights reserved.”
“We investigated penetration-type semi-transparent hydrogenated amorphous silicon (a-Si:H) solar cells that incorporated cuprite (Cu2O) thin films, deposited by radio frequency magnetron sputtering, as the color-adjusting layer. Depending on the arrangement of the Cu2O and transparent conductive oxide layers in the cells, the cells could be classified as either inner-type or outer-type. By simulating and experimentally measuring the reflectance of both types of cells, it was found that the optical interference in the two cells had a more significant effect on the short-circuit current density than did the thickness of the incorporated Cu2O films. We fabricated a-Si:H cells whose transparency and color could be controlled simultaneously.

Here, we show that PGD(2) biosynthesis is augmented during platelet activation in humans and, although vascular expression of DP1 is conserved ABT-737 concentration between humans and mice, platelet DP1 is not present in mice. Despite this, DP1 deletion in mice augmented aneurysm formation and the hypertensive response to Ang II and accelerated atherogenesis and thrombogenesis. Furthermore, COX inhibitors in humans, as well as platelet depletion, COX-1 knockdown,

and COX-2 deletion in mice, revealed that niacin evoked platelet COX-1-derived PGD(2) biosynthesis. Finally, ADP-induced spreading on fibrinogen was augmented by niacin in washed human platelets, coincident with increased thromboxane (Tx) formation. However, in platelet-rich plasma, where formation selleck of both Tx and PGD(2) was increased, spreading was not as pronounced and was inhibited by DP1 activation. Thus, PGD(2), like PGI(2), may function as a homeostatic response to thrombogenic and hypertensive stimuli and may have particular relevance as a constraint on platelets during niacin therapy.”
“Eastern hemlock (Tsuga canadensis [L.] Carr.) is an ecologically important tree species experiencing severe mortality across much of its eastern

North American distribution, caused by infestation of the exotic hemlock woolly adelgid (Adelges tsugae Annand). STI571 Protein Tyrosine Kinase inhibitor To guide gene conservation strategies for this imperiled conifer, we conducted a range-wide genetic variation study for eastern hemlock, amplifying 13 highly polymorphic nuclear microsatellite loci in 1,180 trees across 60 populations. The results demonstrate that eastern hemlock exhibits moderate inbreeding, possibly a signature of a prehistoric decline associated with a widespread insect outbreak. Contrary to expectations, populations in formerly glaciated regions are not less genetically diverse than in the putative southern refugial region. As expected, peripheral disjunct populations are less genetically diverse than main-range populations, but some are highly genetically differentiated or contain unique

alleles. Spatially explicit Bayesian clustering analyses suggest that three or four Pleistocene glacial refuges may have existed in the Southeastern United States, with a main post-glacial movement into the Northeast and the Great Lakes region. Efforts to conserve eastern hemlock genetic material should emphasize the capture of broad adaptability that occurs across the geographic range of the species, as well as genetic variability within regions with the highest allelic richness and heterozygosity, such as the Southern Appalachians and New England, and within disjunct populations that are genetically distinct. Much genetic variation exists in areas both infested and uninfested by the adelgid.

The lower sepal is funnel-form, ca. 4-4.5 cm deep, abruptly narrowed into a subulate spur ca. 2.5-3 cm long, straight, and only occasionally incurved in young buds. The left and right pairs of the lateral united petals are unequal in size thus the whole flower is oblique and asymmetrical. The lower petals of the lateral united petals are oblong and oblique unlike I. clavigera, which has obovate, lanceolate or oblanceolate leaves and bright yellow flowers. Its lower sepal is subsaccate, 2-3 cm deep, abruptly contracted into a narrow tubular spur which is 5-6 mm long, conspicuously incurved when flowering. The left and right pairs of the lateral united petals are almost equal in size, thus the whole flower is nearly symmetrical.

The lower petals of the lateral united petals are dolabriform. The new species is also similar to I. omeiana Hook. f. and I. pritzelii CAL-101 inhibitor Hook. f. in terms of rhizome, leaf and stem morphology, but the flower shape and bauplan are conspicuously different. Impatiens omeiana has enlarged tuberous rhizomes, yellow or pale yellow flowers with subsaccate to saccate lower sepals

that selleck chemicals llc gradually narrow into a short incurved spur, and dolabriform lower petals of the lateral united petals. Impatiens pritzelii has a procumbent tortuous subterranean stem with enlarged nodes, yellow or yellow-white flowers with saccate to widely saccate lower sepals which gradually narrow into a short incurved spur, and oblong or subdolabriform lower petals having a rounded apex. The new species is nested in the basal clade of the phylogentic tree of the genus, and thus represents one of the ancestral forms with important implications for understanding the evolution within the genus. Molecular phylogeny further indicated that nodular (moniliform) and tuberose rootstocks may have undergone Selleckchem CRT0066101 multiple independent origins and parallel evolution within the genus adaptive to the

seasonal dry habitats of the species.”
“Objective: To explore possible reasons for the incidence of a pituitary abscess following transsphenoidal surgery and determine the most effective treatment. Methods: A series of 12 patients who had undergone transsphenoidal surgery in other hospitals before being treated at Peking Union Medical College Hospital were reviewed. The presence of a pituitary abscess was confirmed when pus was intraoperatively observed within the sella turcica. All patients were treated with debridement of the abscess, nine among whom through a transsphenoidal approach and the other three via a craniotomy, followed by antibiotic treatment and hormone replacement therapy. The mean follow-up time was 27.0 months (range from 3.0 to 79.0 months). Results: Headache (92%), panhypopituitarism (58%) and visual disturbance (50%) were the most common clinical indicators of a pituitary abscess. Imaging tests demonstrated a pituitary mass in all patients, with seven (58%) manifested with typical magnetic resonance features of an abscess.

This was done by an in vitro study based on larvae from cod

(Gadus morhua). Ten larvae were placed in each of the culture containers containing agar that was separated into three segments of equal size. Three categories of agar were used containing 0, 2 and 7 % cod liver oil. A total of 900 larvae were included. The study consisted of three parts: The purpose of experiment I was to establish whether different lipid CCI-779 manufacturer concentrations influenced the migration pattern at all. Experiment II was intended to examine whether A. simplex L3-larvae were able to actively search for lipids. Experiment III was set up to analyse the short-distance dispersion of the L3-larvae. Experiment I indicated that the L3-larvae move randomly but do not stop randomly since the tendency to move out of the start area was inversely correlated with lipid concentration. Experiment II indicates that the larvae are almost unable to select areas of high lipid concentrations when more than a few centimetres away. Experiment III showed that the L3-larvae prefer high-fat content and can seek it out over short distances.”
“Aims: To disentangle the alcohol-related needs of short stay, revolving door, male prisoners,

and offer a theoretically driven NVP-AUY922 inhibitor but practical approach for allocation of scarce service resources. Methods: A prospective longitudinal interview, questionnaire and records study of pre-trial men newly imprisoned in Wales and SW England. Results: Two hundred and

forty-one pre-trial men completed an interview and questionnaires within a week of a new reception into prison; 170 completed follow-up 3 weeks later. Questions about problems with alcohol or illicit drugs revealed that problem drinkers were less likely than problem drug users to recognize their difficulty or seek or get help for this during their first month of imprisonment. Co-morbidity was common, but a third of the men had alcohol problems alone. Use of the Alcohol Use Disorders Identification Test (AUDIT) questionnaire identified 80% (195/241) men likely to require some intervention, twice the number identified by direct questions relying on prisoners’ judgment about problem use. Furthermore it allowed categorization according to likely risk (dependency), need (problem recognition) and responsivity (wish HSP990 in vitro for help). Conclusion: Alcohol misuse is recognized, worldwide, as fuelling crime and more common among prisoners than the general population. In England and Wales, it is a particular factor in brief but recurrent periods of imprisonment. There have been calls to pay more attention to its use in this context, albeit without any increase in resources. Adding two questions to standard screening enables application of the risk-need-responsivity model to problem drinkers and may identify those most likely to benefit from treatment.”
“OBJECTIVE.

“
“Introduction: We have previously reported that bacterial toxins, especially endotoxins such as lipopolysaccharides (LPS), might be important causative agents in the pathogenesis of rheumatoid arthritis (RA) in an in vitro model that simulates the potential effects of residing in damp buildings. Since numerous inflammatory processes are linked with the nuclear factor-kappa B (NF-kappa B), we investigated in detail the effects of LPS on the NF-kappa B pathway and the postulated formation of procollagen-endotoxin complexes.\n\nMethods: An in vitro model of human chondrocytes was used to investigate LPS-mediated inflammatory signaling.\n\nResults: Immunoelectron microscopy revealed that

LPS physically interact with collagen type II in the extracellular SN-38 datasheet matrix (ECM) and anti-collagen type II significantly reduced this interaction. BMS-345541 (a specific inhibitor of I kappa B kinase (IKK)) or wortmannin (a specific inhibitor of phosphatidylinositol 3-kinase (PI-3K)) inhibited the LPS-induced degradation of the ECM and apoptosis in chondrocytes. This effect was completely inhibited by combining BMS345541 and wortmannin. Furthermore, BMS-345541 and/or wortmannin suppressed the LPS-induced upregulation of catabolic enzymes that mediate ECM degradation (matrix

metalloproteinases-9, -13), cyclooxygenase-2 and apoptosis (activated caspase-3). These proteins are regulated by NF-kappa BTSA1 research buy B, suggesting that the NF-kappa B and PI-3K pathways are involved in LPS-induced cartilage degradation. The induction of NF-kappa B correlated with activation of I kappa B alpha kinase, I kappa B alpha phosphorylation, I kappa B alpha degradation, p65 phosphorylation and p65 nuclear translocation. Further upstream, LPS induced the expression of

Toll-like receptor 4 (TLR4) and bound with TLR4, indicating that LPS acts through TLR4.\n\nConclusion: These results suggest that molecular associations SRT2104 chemical structure between LPS/TLR4/collagen type II in chondrocytes upregulate the NF-kappa B and PI-3K signaling pathways and activate proinflammatory activity.”
“P>Purpose:\n\nTo determine the prevalence of epilepsy and seizures in the Navajo.\n\nMethods:\n\nWe studied 226,496 Navajo residing in the Navajo Reservation who had at least one medical encounter between October 1, 1998 and September 30, 2002. We ascertained and confirmed cases in two phases. First, we identified patients with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes signifying epilepsy or seizures using Indian Health Service (IHS) administrative data. Second, we reviewed medical charts of a geographic subpopulation of identified patients to confirm diagnoses and assess the positive predictive value of the ICD-9-CM codes in identifying patients with active epilepsy.