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Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal 2016 Aurora Health Care

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Ahmed Dalmar, MD

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that ...


Glucose Metabolism Disorder Is Associated With Pulmonary Tuberculosis In Individuals With Respiratory Symptoms From Brazil, Jilson L. Almeida-Junior, Leonardo Gil-Santana, Carolina A.M. Oliveira, Simone Castro, Aparecida S. Cafezeiro, Carla Daltro, Eduardo M. Netto, Hardy Kornfeld, Bruno B. Andrade 2016 Fundação Oswaldo Cruz

Glucose Metabolism Disorder Is Associated With Pulmonary Tuberculosis In Individuals With Respiratory Symptoms From Brazil, Jilson L. Almeida-Junior, Leonardo Gil-Santana, Carolina A.M. Oliveira, Simone Castro, Aparecida S. Cafezeiro, Carla Daltro, Eduardo M. Netto, Hardy Kornfeld, Bruno B. Andrade

Open Access Articles

BACKGROUND: Diabetes mellitus (DM) has been associated with increased risk for pulmonary tuberculosis (PTB) in endemic settings but it is unknown whether PTB risk is also increased by pre-DM. Here, we prospectively examined the association between glucose metabolism disorder (GMD) and PTB in patients with respiratory symptoms at a tuberculosis primary care reference center in Brazil.

METHODS: Oral glucose tolerance test was performed and levels of fasting plasma glucose and glycohemoglobin (HbA1c) were measured in a cohort of 892 individuals presenting with respiratory symptoms of more than two weeks duration. Patients were also tested for PTB with sputum cultures. Prevalence ...


Examining Maternal Obesity Effects On Oogenesis, Follicular Development, And Embryonic Myogenesis, Chris Lindeman, Jennifer Wood 2016 University of Nebraska-Lincoln

Examining Maternal Obesity Effects On Oogenesis, Follicular Development, And Embryonic Myogenesis, Chris Lindeman, Jennifer Wood

UCARE Research Products

The CDC estimates that more than one-third of U.S. adults (approximately 78.6 million) are obese. Despite national efforts to combat this with diet and exercise, the number of obese adults and children continues to climb. It is critical to emphasize that obesity can lead to lifelong, chronic complications and health risks including hypertension, heart disease, and diabetes.

Diet and obesity also have important impacts on the reproductive health of female including the ability to become pregnant (fertility) and risk for complications during pregnancy. Furthermore, for women who do become pregnant, obesity can affect the development of the embryo ...


Stakeholder Perspectives On Changes In Hypertension Care Under The Patient-Centered Medical Home, Alison J. O'Donnell, Hillary R. Bogner, Peter F. Cronholm, Katherine Kellom, Michelle Miller-Day, Heather F. de Vries McClintock, Elise M. Kaye, Robert Gabbay 2016 University of Pennsylvania

Stakeholder Perspectives On Changes In Hypertension Care Under The Patient-Centered Medical Home, Alison J. O'Donnell, Hillary R. Bogner, Peter F. Cronholm, Katherine Kellom, Michelle Miller-Day, Heather F. De Vries Mcclintock, Elise M. Kaye, Robert Gabbay

Communication Faculty Articles and Research

Introduction

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patientcentered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control.

Methods

The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n ...


Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal 2016 Aurora Health Care

Racial Disparities In Outcomes Following Kidney Transplantation: A Single-Center Experience, Vani Nilakantan, Maharaj Singh, Ruth M. Perez, Yang Shi, Ahmed Dalmar, Brittany T. Last, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Purpose

Kidney transplantation remains the best treatment option for end-stage renal disease. However, despite overall improvements in patient and graft survival rates after kidney transplantation, differences in outcomes still exist among different racial and ethnic groups, with African-Americans having lower graft survival. Gaps continue to exist in the understanding of how demographic factors contribute to the varying outcomes among racial/ethnic groups.

Methods

We retrospectively evaluated kidney transplant outcomes in four racial/ethnic groups over a 12-year period at a large tertiary care center. Primary and secondary study outcomes were patient and graft survival across groups. To determine factors that ...


Diabetes Is Associated With Worse Clinical Presentation In Tuberculosis Patients From Brazil: A Retrospective Cohort Study, Leonardo Gil-Santana, Jilson L. Almeida-Junior, Carolina A.M. Oliveira, Lucas S. Hickson, Carla Daltro, Simone Castro, Hardy Kornfeld, Eduardo M. Netto, Bruno B. Andrade 2016 Fundação Oswaldo Cruz

Diabetes Is Associated With Worse Clinical Presentation In Tuberculosis Patients From Brazil: A Retrospective Cohort Study, Leonardo Gil-Santana, Jilson L. Almeida-Junior, Carolina A.M. Oliveira, Lucas S. Hickson, Carla Daltro, Simone Castro, Hardy Kornfeld, Eduardo M. Netto, Bruno B. Andrade

Open Access Articles

BACKGROUND: The rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil.

METHODS: We performed a retrospective analysis of a TB patient cohort (treatment naive) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define ...


Is Topical Phenytoin Effective In Healing Diabetic Foot Ulcers In Patients Over Age 18?, Jordan Byrd 2016 Philadelphia College of Osteopathic Medicine

Is Topical Phenytoin Effective In Healing Diabetic Foot Ulcers In Patients Over Age 18?, Jordan Byrd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not topical phenytoin is effective in healing diabetic foot ulcers in patients over age 18.

STUDY DESIGN: Systematic review of three randomized controlled trials, published in 2011, 2013 and 2014.

DATA SOURCES: Three randomized controlled trials comparing the effectiveness of topical phenytoin to placebo in healing diabetic foot ulcers. Data sources found using PubMed and Google Scholar.

OUTCOMES MEASURED: Greater than 50% reduction in ulcer area measured via graph paper tracings and area reduction calculations, discontinuation of slough and discharge from ulcers via blind observer decision, complete ...


Effects Of Nox-1 Inhibition On Real-Time Blood Nitric Oxide And Hydrogen Peroxide In Acute Hyperglycemia, Ashley Mawhinney 2016 Philadelphia College of Osteopathic Medicine

Effects Of Nox-1 Inhibition On Real-Time Blood Nitric Oxide And Hydrogen Peroxide In Acute Hyperglycemia, Ashley Mawhinney

PCOM Biomedical Studies Student Scholarship

Hyperglycemia has been associated with vascular endothelial dysfunction in part by a reduction in nitric oxide (NO) production and increased oxidative stress (e.g., increased superoxide (SO) and hydrogen peroxide (H2O2). Endothelial-derived NO can be significantly reduced by increased SO/H2O2 in part by the activation of NADPH oxidase during hyperglycemia. Of the 7 NADPH oxidase isoforms, NADPH oxidase isoform 1 (NOX1) is mainly expressed in the vasculature and may play a major role in hyperglycemia induced oxidative stress and vascular endothelial dysfunction. This hypothesis was tested by measuring blood NO and H2O2 levels ...


Treatment Of Pasireotide Lar-Associated Hyperglycemia In A Patient With Acromegaly, Cheryl Rosenfeld 2016 Touro College of Osteopathic Medicine (Middletown)

Treatment Of Pasireotide Lar-Associated Hyperglycemia In A Patient With Acromegaly, Cheryl Rosenfeld

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Objective: Hyperglycemia was noted in pasireotide long-acting release (PAS LAR}-treated patients with acromegaly during clinical trials. We describe a clinical approach to hyperglycemia in a patient with acromegaly and diabetes mellitus type 2 (DM2) during PAS LAR initiation and treatment.

Methods: Clinical response to PAS LAR, including self­ monitored blood glucose (SMBG) levels, HbA1c, IGF-1, and adverse effects, was reported. Case Presentation: A 44-year-old male was referred for consultation in 2007 owing to uncontrolled DM2 despite maximum metformin (MET) dose. Testing led to a biochemical diagnosis of acromegaly. An 8-mm pituitary adenoma was seen on MRI. Transsphenoidal pituitary adenoma ...


An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe 2016 University of Kentucky

An Evaluation Of The Screening And Management Of Patients With Type 2 Diabetes, Laura A. Cahoe

DNP Projects

Purpose: This purpose of this project was to evaluate preventive screening practices and adherence to guidelines for patients with type 2 diabetes (T2DM) as recommended by the American Diabetes Association (ADA) and United States Preventive Services Task Force (USPSTF) in the primary care setting. The specific aims were to: 1) determine the percentage of patients who received recommended screenings from the ADA, 2) determine the percentage of patients who received recommended screenings from the USPSTF, and 3) determine if the proportion of patients to receive the recommended screenings met established benchmarks set by Healthy People 2020 (HP2020).

Methods: A retrospective ...


Identification Of The Effects Of Diabetes Mellitus On The Brain, Tryphina A. Mikhail 2016 University of Central Florida

Identification Of The Effects Of Diabetes Mellitus On The Brain, Tryphina A. Mikhail

Honors in the Major Theses

As more studies accumulate on the impact of diabetes mellitus on the central nervous system, they resound with the same conclusion - diabetes has a detrimental effect on cognition regardless of the presence of comorbidities. Less consistent however, are the specific mental processes wherein these declines are noticeable, and the structural changes that accompany these reductions in mental capacity. From global atrophy to changes in the volume of gray and white matter, to conflicting results regarding the effects of hypo- and hyperglycemic states on the development of the hippocampus, the studies display a variety of results. The goal of this research ...


Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook 2016 Touro University California

Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook

College of Osteopathic Medicine (TUC) Publications and Research

The authors highlight the latest changes in the ADA standards and review recommendations of particular relevance for family physicians.


Intervention For Diabetes With Education, Advancement And Support (Ideas) Study: Protocol For A Cluster Randomised Controlled Trial, Jun Yang Lee, Carina Ka Yee Chan, Siew Siang Chua, Chirk Jenn Ng, Thomas Paraidathathu, Kenneth Kwing Chin Lee, Shaun Wen Huey Lee 2016 Australian Catholic University

Intervention For Diabetes With Education, Advancement And Support (Ideas) Study: Protocol For A Cluster Randomised Controlled Trial, Jun Yang Lee, Carina Ka Yee Chan, Siew Siang Chua, Chirk Jenn Ng, Thomas Paraidathathu, Kenneth Kwing Chin Lee, Shaun Wen Huey Lee

Faculty of Health Sciences Publications

Background: The high market penetration of mobile phones has triggered an opportunity to combine mobile technology with health care to overcome challenges in today’s health care setting. Although Malaysia has a high Internet and mobile penetration rate, evaluations of the efficacy of incorporating this technology in diabetes care is not common. We report the development of a telemonitoring coaching system, using the United Kingdom (UK) Medical Research Council (MRC) framework, for patients with type 2 diabetes mellitus. Methods” The Intervention for Diabetes with Education, Technological Advancement and Support (IDEAS) study is a telemonitoring programme based on an empowerment philosophy ...


Bringing Diabetes Education To Your Home Via Your Smart Phones, Nazey Z. Gulec 2016 University of Vermont

Bringing Diabetes Education To Your Home Via Your Smart Phones, Nazey Z. Gulec

Family Medicine Clerkship Student Projects

No abstract provided.


The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang 2015 University of Nebraska Medical Center

The Feedforward And Feedback Controls On Gait In Adults With Diabetes, Chun-Kai Huang

Theses & Dissertations

There are nearly 26 million people with diabetes mellitus (DM) in the US, and half of chronic DMs develop somatosensory deficits due to diabetic polyneuropathy or diabetic peripheral neuropathy (DPN). The absence or impaired somatosensory feedback (e.g. touch sensation or joint proprioception) resulted from the damage of large nerve fiber, and motor deficits such as attenuated muscle strength and abnormal plantar pressure of lower extremity have been identified in DPN, and these sensorimotor impairments lead to an increased number of falls. To reduce the risk of falling, a well-coordinated and adapted limb movement driven by the feedforward (anticipatory) and ...


Gating Of The Polycystin Ion Channel Signaling Complex In Neurons And Kidney Cells, Patrick Delmas, Surya Nauli, Xiaogang Li, Bertrand Coste, Nancy Osorio, Marcel Crest, David Brown, Jing Zhou 2015 IFR Jean Roche

Gating Of The Polycystin Ion Channel Signaling Complex In Neurons And Kidney Cells, Patrick Delmas, Surya Nauli, Xiaogang Li, Bertrand Coste, Nancy Osorio, Marcel Crest, David Brown, Jing Zhou

David C. Brown

Mutations in either polycystin-2 (PC2) or polycystin-1 (PC1) proteins cause severe, potentially lethal, kidney disorders and multiple extrarenal (including brain) disease phenotypes. PC2, a member of the transient receptor potential channel superfamily, and PC1, an orphan membrane receptor of largely unknown function, are thought to be part of a common signaling pathway. Here, we show that in rat sympathetic neurons and kidney cells, coassembly of full-length PC1 with PC2 forms a plasmalemmal ion channel signaling complex in which PC1 stimulation simultaneously activates PC2 ion channels and G(i/o)-proteins. PC2 activation occurs through a structural rearrangement of PC1, independent ...


Determinants Of Racial/Ethnic Disparities In Incidence Of Diabetes In Postmenopausal Women In The U.S.: The Women's Health Initiative 1993-2009, Yunsheng Ma, James R. Hebert, JoAnn E. Manson, Raji Balasubramanian, Simin Liu, Michael J. Lamonte, Chloe E. Bird, Judith K. Ockene, Yongxia Qiao, Barbara C. Olendzki, Kristin L. Schneider, Milagros C. Rosal, Deidre M. Sepavich, Jean Wactawski-Wende, Marcia L. Stefanick, Lawrence S. Phillips, Ira S. Ockene, Robert C. Kaplan, Gloria E. Sarto, Lorena Garcia, Barbara V. Howard 2015 University of Massachusetts Medical School

Determinants Of Racial/Ethnic Disparities In Incidence Of Diabetes In Postmenopausal Women In The U.S.: The Women's Health Initiative 1993-2009, Yunsheng Ma, James R. Hebert, Joann E. Manson, Raji Balasubramanian, Simin Liu, Michael J. Lamonte, Chloe E. Bird, Judith K. Ockene, Yongxia Qiao, Barbara C. Olendzki, Kristin L. Schneider, Milagros C. Rosal, Deidre M. Sepavich, Jean Wactawski-Wende, Marcia L. Stefanick, Lawrence S. Phillips, Ira S. Ockene, Robert C. Kaplan, Gloria E. Sarto, Lorena Garcia, Barbara V. Howard

Barbara C. Olendzki

OBJECTIVE: To examine determinants of racial/ethnic differences in diabetes incidence among postmenopausal women participating in the Women's Health Initiative. RESEARCH DESIGN AND METHODS: Data on race/ethnicity, baseline diabetes prevalence, and incident diabetes were obtained from 158,833 women recruited from 1993-1998 and followed through August 2009. The relationship between race/ethnicity, other potential risk factors, and the risk of incident diabetes was estimated using Cox proportional hazards models from which hazard ratios (HRs) and 95% CIs were computed. RESULTS: Participants were aged 63 years on average at baseline. The racial/ethnic distribution was 84.1% non-Hispanic white ...


Marginal Structural Models For The Estimation Of The Risk Of Diabetes Mellitus In The Presence Of Elevated Depressive Symptoms And Antidepressant Medication Use In The Women's Health Initiative Observational And Clinical Trial Cohorts, Christine Frisard, Xiangdong Gu, Brian Whitcomb, Yunsheng Ma, Penelope Pekow, Martha Zorn, Deidre M. Sepavich, Raji Balasubramanian 2015 University of Massachusetts Medical School

Marginal Structural Models For The Estimation Of The Risk Of Diabetes Mellitus In The Presence Of Elevated Depressive Symptoms And Antidepressant Medication Use In The Women's Health Initiative Observational And Clinical Trial Cohorts, Christine Frisard, Xiangdong Gu, Brian Whitcomb, Yunsheng Ma, Penelope Pekow, Martha Zorn, Deidre M. Sepavich, Raji Balasubramanian

Yunsheng Ma

BACKGROUND: We evaluate the combined effect of the presence of elevated depressive symptoms and antidepressant medication use with respect to risk of type 2 diabetes among approximately 120,000 women enrolled in the Women's Health Initiative (WHI), and compare several different statistical models appropriate for causal inference in non-randomized settings. METHODS: Data were analyzed for 52,326 women in the Women's Health Initiative Clinical Trials (CT) Cohort and 68,169 women in the Observational Study (OS) Cohort after exclusions. We included follow-up to 2005, resulting in a median duration of 7.6 years of follow up after enrollment ...


The Esoteric Roles Of Bcl-2 Family Proteins In Glucose Homeostasis And Cell Survival., Shona L. Pfeiffer, Jochen Prehn 2015 Royal College of Surgeons in Ireland

The Esoteric Roles Of Bcl-2 Family Proteins In Glucose Homeostasis And Cell Survival., Shona L. Pfeiffer, Jochen Prehn

Physiology and Medical Physics Articles

No abstract provided.


Prescribing Patterns Of Metformin In High-Risk Patients With Prediabetes, Daniel Stirling, Ifeanyi Onor, Daniel Sarpong, Kristi Isaac Rapp, Lori Crawford 2015 Xavier University of Louisiana

Prescribing Patterns Of Metformin In High-Risk Patients With Prediabetes, Daniel Stirling, Ifeanyi Onor, Daniel Sarpong, Kristi Isaac Rapp, Lori Crawford

Ifeanyi Onor, PharmD, BCPS

Aims: The primary objective of this study is to examine the rates of metformin prescribing in patients with prediabetes who are either < 60 years of age, have a BMI ≥35 kg/m2, or women with a history of gestational diabetes mellitus (GDM). Secondary objectives include: 1) examination of the time from diagnosis of prediabetes to the initiation of metformin and 2) if metformin initiation status and length of time correlates to the patient having any other additional diabetes mellitus (DM) risk factors.

Methods: This was a single center, retrospective cohort study. This study included all patients with prediabetes, defined as ...


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