Alan Holden

University of Texas Health Science Center at San Antonio | UT HSC · Institute for Health Promotion Research

Objective: To determine whether there is a relationship between prewash total motile count and live births in couples undergoing IUI. Design: Retrospective review in a single academic center. Setting: Not applicable. Patient(s): Couples with infertility undergoing ovulation induction with IUI between 2010 and 2014. Intervention(s): Not app...

U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5–10 years. Cancer recurrence risk is highest among obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)–α have been associated with cancer recurrence r...

U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5-10 years. Cancer recurrence risk is highest in obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)-α have been associated with cancer severity and re...

Background: Breast cancer is the leading cancer among women of Hispanic origin. It is expected to continue to be the leading cancer as the US Hispanic population grows towards 31% of all US citizens by 2060. Hispanic women (Latinas) experience significant disparities in breast cancer services resulting in lower breast cancer survival rates than the...

Background: U.S. breast cancer survivors (BCSs) are expected to increase from 3 to 4 million in the next 5-10 years. Cancer recurrence risk is highest in obese survivors. Pro-inflammatory biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)α have been associated with cancer s...

Latinos in South Texas (STX) are disproportionately diagnosed with Hepatocellular Carcinoma (HCC) compared to non-Hispanic whites (NHW) and Latinos in the U.S. The aims of this study were to characterize behavioral and clinical risk factors contributing to HCC incidence in our STX population. Methods: Controls and cases (104:51) were recruited from...

Purpose: This study examined interest in and attitudes toward genetic testing in 5 different population groups. Methods: The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametr...

Background: Patient navigation is a barrier-focused program of care coordination designed to achieve timely and high-quality cancer-related care for medically underserved racial-ethnic minorities and the poor. However, to the authors' knowledge, few studies to date have examined the relationship between satisfaction with navigators and cancer-rela...

Background: Depression has repeatedly been shown to be a barrier to cancer survivorship behavior. Depressed survivors appear to be unable to effectively follow health-related practices, whether directly recommended by health care providers or self-indicated. In addition to depression-related barriers, some cancer survivors are further inhibited by...

s: Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 9-12, 2014; San Antonio, TX Background: Patient Navigation has evolved to reduce cancer health disparities by eliminating barriers to diagnosis, treatment, and survivorship services. Attempts have been made to describ...

Background: Cancer health disparities research depends on access to biospecimens from diverse racial/ethnic populations. This multimethodological study, using mixed methods for quantitative and qualitative analysis of survey results, assessed barriers, concerns, and practices for sharing biospecimens/data among researchers working with biospecimen...

Background: Breast cancer is the leading cause of cancer deaths in Latinas, primarily due to screening and treatment disparities. Patient navigation has emerged as an effective means to reduce these disparities, although how this is achieved is insufficiently documented. Methods: We analyzed navigator logs of activities conducted on behalf of 42 na...

Background A previous study showed Hepatocellular Carcinoma (HCC) rates to be higher among Latinos in Texas and highest among South Texas Latinos compared to other non-Hispanic whites (NHW) and other Latinos in the United States (U.S.). We used more recent data to assess trends in HCC among Texas Latinos and to reassess the elevated HCC incidence r...

Introduction: The support and efficient management of cancer health disparities research, training, and infrastructure is highly dependent on biobanking of well-annotated biospecimens from different racial/ethnic populations. This pilot study assessed interests, attitudes and barriers of biomedical researchers in NCI Center to Reduce Cancer Health...

The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women. To address these disparities, t...

Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing care. Patient navigation (PN) is a potentially effective means of promoting timely breast cancer treatment, yet efficacy is insufficiently documented. Redes En Accin: The National Latino Cancer Research Netw...

Objective: This study evaluated genetic testing interest and specific attitudes to it in five population groups. We sought to identify differences in genetic testing interest and attitudes. Methods: This cross-sectional study utilized self-report data from five groups (African American, Asian American, Hispanic/Latina, Native American, or Appalac...

Background. Identification of BRCA genetic mutations offers early warning of disease potential. However Latinas comprise only 1-4% of women undergoing BRCA testing. Here we examine this disparity by determining the extent of interest in genetic testing among Latina and Non-Hispanic White (NHW) women, and explore factors associated with interest....

Introduction. From 2007-2009, new cancer diagnoses declined for men, but remained stable for women and increased slightly for children. Hepatocellular carcinoma (HCC) is an exception: incidence has increased in all groups. Moreover, HCC among South Texas Latinos has traditionally been higher than all other U.S. Latinos. This study compares incidenc...

This book is a roadmap of the exact health disparities that burden the health of South Texas residents, especially Hispanics, compared to the rest of Texas and nation. This type of knowledge has the potential to fuel and motivate researchers and public health leaders to create and shape interventions to reverse those health disparities. Most notabl...

Background: Depressed mood limits vigilance, risk avoidance or risk reduction. This may reflect inability to follow health care provider recommendations for screening for other cancers. We determined prevalence of depressive symptoms and its role in screening for other cancers in Latina breast cancer survivors. Study Design: A convenience sample of...

BACKGROUND: Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing cancer care. Patient navigation is a potentially effective means of promoting timely treatment of breast cancer, yet efficacy is insufficiently documented. Redes en Accion here evaluates a cultural...

Breast cancer is the leading cause of cancer-related deaths in Latinas, chiefly because of later diagnosis. The time from screening to diagnosis is critical to optimizing cancer care, yet the efficacy of navigation in reducing it is insufficiently documented. Here, the authors evaluate a culturally sensitive patient navigation program to reduce the...

Time delay after an abnormal screening mammogram may have a critical impact on tumor size, stage at diagnosis, treatment, prognosis, and survival of subsequent breast cancer. This study was undertaken to evaluate disparities between Latina and non-Hispanic white (NHW) women in time to definitive diagnosis of breast cancer after an abnormal screenin...

Background Breast cancer is the most commonly diagnosed cancer among Latinas: 14,200 diagnosed in 2009. Groundbreaking work has shown that patient navigation may assist minority patients to negotiate the Cancer Care Continuum. Here we report the efforts of Redes En Acción: The National Latino Cancer Research Network at the Institute for Health Prom...

BACKGROUND: Our controlled patient navigation trial in Latinas from six U.S. cities showed that navigated Latinas with BIRADS-3 abnormal screens achieve definitive diagnosis significantly faster than their non-navigated counterparts. Here we explore whether increased efficacy in diagnosis through navigation is clinically meaningful and why. METHODS...

Patient navigation (PN) is an emerging strategy to overcome barriers to cancer care. We evaluated the efficacy of PN in improving time of key events in cancer care, including positive screening tests, definitive diagnosis, initiation of therapy, and completion of initial therapy. We evaluated PN in a prospective observational study of predominantly...

Introduction. Hepatocellular carcinoma (HCC) has increased in the U.S. from 1975-2006 while overall cancer has declined. Moreover, HCC among South Texas Latinos is higher than other U.S. Latinos. In recent years a number of risk factors have been associated with HCC including hepatitis-C virus infection, heavy alcohol use, obesity, diabetes and oth...

Hepatocellular carcinoma (HCC) is increasing in the U.S. despite a decline in cancer overall. Latinos have higher rates of HCC than the general population according to the Surveillance, Epidemiology, and End Results (SEER) Program. Not included in SEER, Texas Latinos make up one-fifth of the U.S. Latino population. To determine whether HCC incidenc...

Introduction/Background: The MinorityBiospecimen/Biobanking-Geographic Management Program (BMaP) is supported by the CRCHD of the NCI, to create state-of-the-art networks/centers dedicated to ensuring the adequate and continuous supply of high-quality human biospecimens from multi-ethnic communities for cancer research. A regional hub infrastructur...

s: Thirty-Fourth Annual CTRC‐AACR San Antonio Breast Cancer Symposium‐‐ Dec 6‐10, 2011; San Antonio, TX Background Ten percent of all new cancers are diagnosed in cancer survivors and second cancers are the sixth leading cause of cancer deaths. Breast cancer survivorship brings to the fore concern that survivors obtain thorough preventive health s...

Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer...

Background: The Patient Navigation Research Program (PNRP) is a cooperative effort of nine research projects, with similar clinical criteria but with different study designs. To evaluate projects such as PNRP, it is desirable to perform a pooled analysis to increase power relative to the individual projects. There is no agreed-upon prospective met...

Background: In two previous studies, we observed that Latina women are unable to comply with recommendations for breast cancer care due in part to psychosocial barriers including inability to understand physicians and fear of recommendations. These are crucial findings, because ten percent of all new cancers are diagnosed in cancer survivors and se...

Introduction: Hepatocellular carcinoma (HCC) incidence is increasing in the U.S. for unknown reasons despite a decline in cancer overall during 1975–2006. Latinos have higher rates of HCC than other groups, and attributable risks for HCC among Latinos have been identified. This study compared HCC incidence and behavioral risk factors associated wit...

To identify Chlamydia trachomatis antigens that can be used to differentially diagnose tubal factor infertility in comparison with previously reported heat shock protein 60. In vitro study. Academic medical center. Infertile women with and without tubal pathology diagnosed laparoscopically. None. Antibody responses to C. trachomatis in infertile wo...

Background/Objectives: NCI CRCHD Region 4 BMaP (Arizona, Colorado, Oklahoma, New Mexico and Texas) was initiated in 2009. The overall goal is achieving measureable reductions in racial cancer health disparities through developing regional networks where resources can be pooled to facilitate team science approaches to cancer health disparity reducti...

The predictive value of serum beta hCG level for fetal cardiac motion and pregnancy outcome after IVF was evaluated. The serum hCG level 12 days after ET is a useful predictor of subsequent presence of fetal cardiac activity and live birth and may assist clinicians in counseling patients regarding their IVF outcome.

We sought to identify rates, associated morbidities, and preventable causes of late preterm birth (LPB) in a defined population. We conducted a retrospective cross-sectional analysis using deidentified delivery data for all who delivered in San Antonio/Bexar County, Texas between 2000 and 2008 (N  = 259,576). LPB was defined as a live birth from 34...

To assess the association of late preterm births (LPB [34(0/7)-36(6/7)]) and maternal risk factors with Neonatal Intensive Care Unit (NICU) admissions. A retrospective cross-sectional analysis was conducted using data of all who delivered between 2000 and 2008. Statistical analysis was done using Chi-square and multivariable logistic regression. Du...

The in vitro fertilization (IVF) outcomes, including clinical intrauterine gestation rate and live birth rate, between Hispanic and non-Hispanic white women were compared, and there were no differences. Hispanics were more likely to have a diagnosis of tubal factor infertility, whereas non-Hispanic white women were more likely to have endometriosis...

To evaluate the effects of ovarian stimulation and intracytoplasmic sperm injection (ICSI)-induced fertilization and efficacy of various culture systems on in vitro development of baboon embryos. In vitro study, animal model. Research laboratory. Baboons in laboratory animal research facility. Baboons received FSH (75 IU daily) for 7 to 8 days and...

Background: Patient satisfaction is an important outcome measure of quality of cancer care and 1 of the 4 core study outcomes of the National Cancer Institute (NCI)-sponsored Patient Navigation Research Program to reduce race/ethnicity-based disparities in cancer care. There is no existing patient satisfaction measure that spans the spectrum of ca...

Background. Breast cancer is a devastating disease. Identification of the BRCA1 and BRCA2 genetic mutations associated with it offer to provide an efficacious “early warning system”. However investigators question whether women are interested in knowing if they possess gene mutations, particularly minorities traditionally averse to dealing with a c...

The objective of the study was to assess antibodies against Chlamydia trachomatis heat shock proteins (HSP) in patients with tubal factor infertility (TFI), infertility controls (IFC), and fertile controls (FC). HSPs assist organisms in surviving caustic environments such as heat. Twenty-one TFI, 15 IFC, and 29 FC patients were enrolled after lapar...

Background: Breast cancer is a devastating disease. Identification of the BRCA1 and BRCA2 genetic mutations associated with it offer a potentially efficacious “early warning system.” However, investigators have expressed doubt that whether women are interested in knowing if they possess gene mutations, particularly minorities traditionally averse t...

The attachment of endometrial epithelial cells (EECs) and endometrial stromal cells (ESCs) to peritoneal mesothelial cells (PMCs) with and without inhibition of N- and O-linked glycosylation, the viability of EECs and ESCs, and the expression of CD44 surface density were evaluated. Inhibition of CD44 N- and O-linked glycosylation by using tunicamyc...

We compared the male sexual partners of teen girls of age 15 to 19 years, currently infected with a sexually transmitted infection (STI) versus the male partners of adult women of age 20 to 41 years, with an STI to determine risk factors in these high-risk sexual dyads related to the male partner. Interview of 514 men who were partnered with 152 te...

The objective was to determine the acceptability and use patterns of potential microbicides among African American (AA), acculturated Hispanic (AH), and less acculturated Hispanic (LAH) women. We measured baseline sexual risk-taking and the likelihood of behavioral change, given effective microbicides. Interview of 506 Mexican-American and AA women...

We previously demonstrated that adherence of endometrial epithelial (EECs) and stromal cells (ESCs) to peritoneal mesothelial cells (PMCs) is partly regulated by ESC/EEC CD44 interactions with PMC associated hyaluronan. CD44, a transmembrane glycoprotein and major ligand for hyaluronan, has numerous splice variants which may impact hyaluronan bindi...

A randomized controlled trial of SAFE, a cognitive/behavioral intervention, revealed that it significantly reduces reinfection and behavioral risks among participants compared with controls. However, studies suggest that depression may moderate intervention efficacy among affected persons because of impaired information processing, failure to recog...

To determine factors associated with partner notification (PN) of sexually transmitted infection (STI) exposure among low-income Mexican American and African American women and their male sexual partners. To identify women most likely to notify their partners about an STI exposure. Cross-sectional analysis of 775 women with a nonviral STI. The prim...

This an erratum originally published in IJSTD (2007) 18:748-753

To compare the efficacy of a randomized controlled trial of the Sexual Awareness For Everyone (SAFE) behavioral intervention on teenagers (aged 14 to 18 years) compared with adult rates of reinfection with Neiserria gonorrhea or Chlamydia trachomatis cervicitis, and to identify behaviors associated with recurrent infection. Mexican-American and Afr...

The object of this study was to determine the factors associated with partner notification (PN) of sexually transmitted infection (STI) exposure among pregnant, low income, Mexican-American (MA) and African-American (AA) women and their male sexual partners. We used a cross-sectional analysis of 166 pregnant women with an STI, enrolled in a randomi...

In situ estrogen synthesis is implicated in tumor cell proliferation through autocrine or paracrine mechanisms especially in postmenopausal women. Several recent studies demonstrated activity of aromatase, an enzyme that plays a critical role in estrogen synthesis in breast tumors. Proline-, glutamic acid-, and leucine-rich protein-1 (PELP1/MNAR) i...

Sexually transmitted infection (STI), including AIDS disproportionately affects minority women with a history of physical or sexual abuse. The objective of this study was to evaluate the efficacy of gender- and culture-specific behavioural interventions and interactive STI counselling for high-risk minority women with a history of physical or sexua...

Proline-, glutamic acid-, leucine-rich protein 1 (PELP1), a novel nuclear receptor coactivator, and its expression is deregulated in hormone-dependent cancers, including those of the breast, endometrium, and ovary. PELP1 interacts with estrogen receptor and modulates its genomic and nongenomic functions. In this study, we examined whether PELP1 fun...

Abbreviations: E2, estrogen, NR, Nuclear receptor; ERR, Estrogen-related receptor; MNAR, modulator of nongenomic actions of estrogen receptor; ER, estrogen receptor; PELP1, Proline, glutamic acid, and leucine-rich protein-1; PNRC2, Proline-rich nuclear receptor coregulatory protein2.

Mycoplasma genitalium has been associated with male urethritis. We sought to relate M. genitalium to genitourinary signs and symptoms in women. We compared 26 culture-positive women (group 1), 257 additional polymerase chain reaction-positive women (group 2), and 107 negative control women. We used logistic regression to evaluate signs and symptoms...

In women with polycystic ovary syndrome, chromium picolinate (200 microg/d) improves glucose tolerance compared with placebo but does not improve ovulatory frequency or hormonal parameters. This pilot study indicates that future studies in the polycystic ovary syndrome population should examine higher dosages or longer durations of treatment.