Medicine and Health Sciences Commons^™

Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

METHODS: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

RESULTS: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have …

Understanding The Role Of Promotora In A Latino Diabetes Education Program, Lynn Deitrick, Hannah Paxton, Alicia Rivera, Eric Gertner, Nyann Biery, Abby Letcher, Lissette Lahoz, Edgar Maldonado, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Hepatic Dysfunction Is Associated With Vitamin D Deficiency And Poor Glycemic Control In Diabetes Mellitus, Benjamin Nwosu, Zheni Stavre, Louise Maranda, Karen Cullen, Mary Lee

Mary M. Lee

Background/Aims: The effect of the rising prevalence of nonalcoholic fatty liver disease on the 25-hydroxylation of pre-vitamin D in the liver, and consequent glycemic control in children with diabetes mellitus is not known. Our aim was to determine whether mild hepatic dysfunction was associated with impaired 25-hydroxylation of pre-vitamin D, and if this vitamin D deficiency was associated with impaired glycemic control in children and adolescents with type 1 diabetes (TIDM) and type 2 diabetes (T2DM).

Methods: We analyzed simultaneously measured HbA1c, ALT, AST, and 25OHD levels and clinical parameters in 121 children and adolescents with T1DM (n=81) and T2DM …

Mullerian Inhibiting Substance Recruits Alk3 To Regulate Leydig Cell Differentiation, Xiufeng Wu, Ningning Zhang, Mary Lee

Mary M. Lee

Mullerian inhibiting substance (MIS) not only induces Mullerian duct regression during male sexual differentiation but also modulates Leydig cell steroidogenic capacity and differentiation. MIS actions are mediated through a complex of homologous receptors: a type II ligand-binding receptor [MIS type II receptor (MISRII)] and a tissue-specific type I receptor that initiates downstream signaling. The putative MIS type I receptors responsible for Mullerian duct regression are activin A type II receptor, type I [Acvr1/activin receptor-like kinase 2 (ALK2)], ALK3, and ALK6, but the one recruited by MIS in Leydig cells is unknown. To identify whether ALK3 is the specific type I …

The Increased Incidence Of Congenital Hypothyroidism: Fact Or Fancy?, Marvin Mitchell, Ho-Wen Hsu, Inderneel Sahai, Stuart Brink, Laurie Cohen, Rosalind Brown, Roger Eaton, Mary Lee, Lynne Levitsky, Edward Reiter, Abdollah Sadeghi-Nejad, Leslie Soyka, Joseph Wolfsdorf

Mary M. Lee

OBJECTIVE: The incidence of congenital hypothyroidism (CH) detected by newborn screening in the US has increased significantly since the early 1990s. We defined the characteristics associated with the increased incidence. PATIENTS: A cohort of children with CH born during an earlier period of low incidence (1991-94) was compared with a cohort born during a later period when the incidence of CH had doubled (2001-04). MEASUREMENTS: Screening was performed with T4 as the primary marker and thyroid stimulating hormone (TSH) on selected specimens. Follow-up on hypothyroid children determined whether they had permanent or transient hypothyroidism. Cases were classified based on laboratory …

Educating Diabetes Camp Counselors With A Human Patient Simulator: A Pilot Study, Susan Sullivan-Bolyai, Sybil Crawford, Kimberley Johnson, Bonny Huston, Mary Lee

Mary M. Lee

Purpose.  The purpose of this study was to pilot test the feasibility and efficacy of a novel method of teaching camp counselors hypoglycemia management.

Design and Methods.  During orientation, counselors were assigned to the experimental (n= 21) or control (n= 15) group and received hypoglycemia education. The experimental group received supplemental education with a human patient simulator (HPS).

Results.  Baseline demographics, knowledge, and self-efficacy were similar between groups. The experimental group had a significantly larger gain in diabetes knowledge than the control group. Within-participant change in self-efficacy did not differ by group. We observed a significant effect modification, with larger …

Evidence Of Insulin-Like Growth Factor Binding Protein-3 Proteolysis During Growth Hormone Stimulation Testing, Benjamin Nwosu, Leslie Soyka, Amanda Angelescu, Mary Lee

Mary M. Lee

OBJECTIVES: The ternary complex is composed of insulin-like growth factor (IGF)-I, IGF binding protein (IGFBP)-3 and acid labile subunit (ALS). Growth hormone (GH) promotes IGFBP-3 proteolysis to release free IGF-I, ALS, and IGFBP-3 fragments. Our aim was to determine whether elevated GH levels during GH stimulation testing would trigger IGFBP-3 proteolysis. DESIGN: This prospective study of 10 short prepubertal children (height standard deviation score -2.37 +/- 0.31) used arginine and GH releasing hormone stimulation to study dynamic changes in the ternary complex moieties. IGFBP-3 was measured in two assays: a radioimmunoassay (RIA) that detects both cleaved and intact IGFBP-3; and …

Dioxin And Polychlorinated Biphenyl Concentrations In Mother's Serum And The Timing Of Pubertal Onset In Sons, Olivier Humblet, Paige Williams, Susan Korrick, Oleg Sergeyev, Claude Emond, Linda Birnbaum, Jane Burns, Larisa Altshul, Donald Patterson, Wayman Turner, Mary Lee, Boris Revich, Russ Hauser

Mary M. Lee

BACKGROUND: Animal studies have demonstrated that timing of pubertal onset can be altered by prenatal exposure to dioxins or polychlorinated biphenyls (PCBs), but studies of human populations have been quite limited.

METHODS: We assessed the association between maternal serum concentrations of dioxins and PCBs and the sons' age of pubertal onset in a prospective cohort of 489 mother-son pairs from Chapaevsk, Russia, a town contaminated with these chemicals during past industrial activity. The boys were recruited at ages 8 to 9 years, and 4 years of annual follow-up data were included in the analysis. Serum samples were collected at enrollment …

Farm Residence And Reproductive Health Among Boys In Rural South Africa, Rene English, Melissa Perry, Mary Lee, Elaine Hoffman, Steven Delport, Mohamed Dalvie

Mary M. Lee

BACKGROUND: Few studies have investigated reproductive health effects of contemporary agricultural pesticides in boys. OBJECTIVES: To determine the association between pesticide exposure and reproductive health of boys. METHODS: We conducted a cross-sectional study in rural South Africa of boys living on and off farms. The study included a questionnaire (demographics, general and reproductive health, phyto-estrogen intake, residential history, pesticide exposures, exposures during pregnancy); and a physical examination that included sexual maturity development ratings; testicular volume; height, weight, body mass index; and sex hormone concentrations. RESULTS: Among the 269 boys recruited into the study, 177 (65.8%) were categorized as farm (high …

Endocrine Disorders Of The Newborn, Mary Lee, Thomas Moshang

Mary M. Lee

Citation: Lee MM, Moshang T. “Endocrine Disorders of Newborn” In Avery GV, Flethcer MA and MadDonald MG, eds. Avery's Neonatology: Pathophysiology and Management of the Newborn, 6^th Edition. Philadelphia: Lippincott Williams & Wilkins, 2005, p.914-938.

A partial preview of this chapter is available via Google Books.

Neonatal Endocrinology, Elizabeth Catlin, Mary Lee

Mary M. Lee

Summary: This chapter covers common endocrine conditions and some of the more unusual endocrine disorders of newborns. Citation: Catlin EA and Lee MM. “Neonatal Endocrinology,” in McMillan JA (Ed-in-chief), DeAngelis CD, Feigin RD, and Jones MD, Jr, eds. Oski’s Pediatrics: Principles and Practice, 4th ed., Philadelphia: Lippincott, Williams & Wilkins, 2006, 411-423. A partial preview of this chapter is available via Google Books.

Comparison Of Insulin Infusion Protocols Targeting 110-140 Mg/Dl In Patients After Cardiac Surgery., Vasudev Magaji, Shriddha Nayak, Amy Donihi, Lauren Willard, Srinivasa Jampana, Parachur Nivedita, Raymond Eder, Jann Johnston, Mary Korytkowski

Vasudev G Magaji MD, MS

BACKGROUND: Continuous intravenous insulin infusion (CII) following coronary artery bypass graft (CABG) surgery reduces postoperative complications and hospitalization duration. Because of limited data evaluating outcomes of CII with revised glycemic targets (110-140 mg/dL) in cardiac surgery, this study compared efficacy and safety of two different CII protocols having revised targets. SUBJECTS AND METHODS: This is a retrospective study comparing two different protocols between August 2009 and March 2010. Protocol 1 consists of four algorithms, and Protocol 2 is a table to adjust CII. Blood glucose (BG) and CII rates were recorded for 48 h postoperatively or CII discontinuation. Efficacy was …

Efficacy And Safety Of Continuous Insulin Infusion Protocols With Glycemic Targets Of 110-140 Mg/Dl In Patients With And Without Diabetes Following Cardiac Surgery, Shriddha Nayak, Vasudev Magaji, Amy Donihi, Lauren Willard, Srinivasa Jampana, Parachur Nivedita, Raymond Eder, Jann Johnston, Mary Korytkowski

Vasudev G Magaji MD, MS

No abstract provided.

Inpatient Management Of Hyerglycemia And Diabetes, Vasudev Magaji, Jann Johnston

Vasudev G Magaji MD, MS

No abstract provided.

Short Term Unblinded Continuous Glucose Monitoring For Long Term Glucose Control, Vasudev Magaji, Adam Akers, Jann Johnston

Vasudev G Magaji MD, MS

No abstract provided.