Digital Commons Network^™

Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin., William C. Knowler, Elizabeth Barrett-Connor, Sarah E. Fowler, Richard F. Hamman, John M. Lachin, Elizabeth A. Walker, David M. Nathan, P. G. Watson, J. T. Mendoza, K. A. Smith, J. Caro, B. Goldstein, C. Lark, L. Menefee, L. Murphy, C. Pepe, J. M. Spandorfer

Department of Medicine Faculty Papers

BACKGROUND: Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes.

METHODS: We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least …

View Box Case--2 Mid-Colic Intussusception, I Masroor, R Hashmi

Department of Radiology

No abstract provided.

Oncolog, Volume 47, Number 02, February 2002, Kerry L. Wright, Charles F. Leverbeck Md

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Molecular Therapies Target Bone Metastasis
• "I'm Here to Help You" Patient Advocates Serve as Liaisons Between Patients and Care Centers
• DiaLog: Patient Advocates: Solving Problems and Building Bridges, by Charles F. Leverback, MD, Associate Professor, Department of Gynecologic Oncology
• House Call: Keeping the Heart Healthy in Patients with Cancer

Typical Symptoms Are Predictive Of Acute Coronary Syndromes In Women, Kerry A. Milner, Marjorie Funk, Amy L. Arnold, Viola Vaccarino

Nursing Faculty Publications

Background: Previous research suggests that the presentation of acute coronary syndromes (ACS) may differ in women and men. No study has prospectively evaluated the role of a comprehensive set of typical and atypical symptoms and whether different symptoms on presentation predict ACS diagnosis in women and men. Methods and Results: We directly observed 246 women and 276 men seen in the emergency department with symptoms suggestive of ACS and documented their symptoms verbatim. ACS was eventually diagnosed in 89 (36%) women and 124 (45%) men on the basis of standard electrocardiogram and cardiac enzyme criteria. Presence of typical symptoms (chest …

Cd8+-T-Cell Immunity Against Toxoplasma Gondii Can Be Induced But Not Maintained In Mice Lacking Conventional Cd4+ T Cells, Lori Casciotti, Kenneth H. Ely, Martha E. Williams, Imtiaz A. Khan

Dartmouth Scholarship

T-cell immunity is critical for survival of hosts infected with Toxoplasma gondii. Among the cells in the T-cell population, CD8⁺ T cells are considered the major effector cells against this parasite. It is believed that CD4⁺ T cells may be crucial for induction of the CD8⁺-T-cell response against T. gondii. In the present study, CD4^−/− mice were used to evaluate the role of conventional CD4⁺ T cells in the immune response against T. gondii infection. CD4^−/− mice infected with T. gondii exhibited lower gamma interferon (IFN-γ) messages in the majority of their …

Prostatic Carcinoma With Emphasis On Gleason’S Grading: An Institution Based Experience., Zaid Ahmed, Suhail Muzaffar

Department of Pathology and Laboratory Medicine

Abstract

Objective:To grade prostatic carcinomas according to the Gleason’s Grading System and see whether the frequency of incidental carcinoma is significant. Method:Retrospective study of all consecutive cases of prostatic adenocarcinoma diagnosed at Aga Khan University Hospital (AKUH) between January 1st, 1996 and December 31st, 1999. Setting:The histopathology section of AKUH, Karachi. Observation:Prostatic adenocarcinomas comprised 14.2% of all prostate specimens. There were 3 types of specimens i.e. transurethral resection, suprapubic prostatectomies and core bIopsies. The mean age was 72.1 years; 68.1% patients were 65 years or older. The majority of the tumours were moderately differentiated (Gleason’s scores 5,6 or 7). Grading …

Medical Education Digest, Vol. 4 No. 1 (January 15, 2002), Nova Southeastern University

Medical Education Digest

No abstract provided.

Com Outlook Winter 2001-2002, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Using Validation As A Consultant In A Richmond, Virginia Continuing Care Retirement Community, John Colletti

Case Studies from Age in Action

Educational Objectives

1. Familiarize readers with the intricacies of setting up a behavioral program for persons diagnosed with Alzheimer's type dementia in a long term care facility.

2. Exemplify importance of interdisciplinary work.

3. Outline the future of the Validation Method in Virginia.

Older Adults, Social Techniques, And Memory, Karla K. Ziegenbalg

Case Studies from Age in Action

Educational Objectives

1. To use a social psychological perspective to examine memory abilities of older adults.

2. To understand in what ways the social environment, through direct social interaction, affects the memory performance of older adults.

3. To find out what, if any, social factors support memory performance in older adults.

Older Homeless Women: Beneath The Safety Net, Anne J. Kisor, Lynne Kendal-Wilson

Case Studies from Age in Action

Educational Objectives

1. Discuss how there is no stereotypical experience of, or explanation for, homelessness among older women.

2. Discuss why it is important to study the experiences of older homeless women.

3. Discuss policy and practice recommendations and specific ways to bridge efforts of aging and homeless service providers.

Are You At Risk For Blindness? Don't Keep Glaucoma A Family Secret! Older Age Is A Risk Factor, Mary Price

Case Studies from Age in Action

Educational Objectives

1. Raise awareness of risk factors for glaucoma.

2. Encourage health care providers to educate the patient about glaucoma risk factors.

3. Educate glaucoma patients to encourage family members to seek a glaucoma examination.

2001 Cancer Care Annual Report, Children's Mercy Hospital

Cancer Center Annual Reports

Annual report of cancer care and oncology services at the Children's Mercy Hospital, Kansas City MO, a pediatric medical center, with a focus on Wilms' Tumor.

The Long-Term Clinical Prognosis In Patients With Anterior Wall And Non-Anterior Wall Acute Myocardial Infarction Referred To Primary Percutaneous Transluminal Coronary Angioplasty, Mingzhong Zhao, Dayi Hu, Tianchang Li, Sanqing Jia

Journal of the Hong Kong College of Cardiology

Objective: To investigate the long-term clinical prognosis in patients with anterior wall acute myocardial infarction (AW-AMI) and non AW-AMI (NAW-AMI) referred to primary percutaneous transluminal coronary angioplasty (P-PTCA). Methods: 287 patients with AMI who underwent P-PTCA were divided into AW-AMI group (142 cases) and NAW AMI group (145 cases) according to different sites of AMI. The baseline characteristics and coronary artery lesions of patients were analysed. The primary end points were in-hospital mortality and the major cardiovascular events (MACE) during a mean 17.3±9.8 months follow-up including the occurrences of non-fatal myocardial infarction, non-fatal congestive heart failure, revascularization of target vessels …

Appropriate Use Of Clopidogrel, Cyrus R Kumana, Bernard Man-Yung Cheung, Ij Lauder

Journal of the Hong Kong College of Cardiology

Clopidogrel (Plavix®) is an orally administered pro-drug, whose pharmacology and therapeutic role has been extensively reviewed in recent publications.1-5 In essence, it results in selective and irreversible antagonism of ADP-induced platelet aggregation. Such aggregation normally results in the surface expression of platelet glycoprotein (GP) IIb/IIIa receptors, which facilitate fibrinogen binding as well as consequential further platelet aggregation – the final common pathway of vascular occlusion. Specific cytochrome P450 enzymes are thought to generate the responsible active metabolite (believed to persist transiently). However, dosage adjustment is not recommended in hepatic impairment (unless severe) and drug-drug interactions and co-administration with meals are …

Frequency Of Use Of Complementary And Alternative Medicine In Women With Breast Cancer, Cecile A. Lengacher, Mary Bennett, Kevin E. Kip, Rosemary Keller, Melisa S. Lavance, Lynette S. Smith, Charles E. Cox

Nursing Faculty Publications

No abstract provided.

The University Of Health Sciences College Of Osteopathic Medicine, Kansas City, Missouri, University Of Health Sciences College Of Osteopathic Medicine

Historical Postcards (1908-2007)

Postcard shows photographs of four buildings on the campus of the University of Health Sciences College of Osteopathic Medicine in 2002.

Top left: Butterworth Alumni Center. Top right: Darwin J. and Suzanne Strickland Educational Pavilion. Bottom left: Leonard Smith Hall, which was originally the nurses' dormitory for Children's Mercy Hospital. Bottom right: Administration Building, originally Children's Mercy Hospital.

Children's Mercy Annual Report 2001, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

The Utilization Of Services Of Health Care Providers Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, Iqbal Azam, S. S. Ali, S. Ayub

Department of Family Medicine

Objective: To study the utilization of services of Health care providers among patients presenting to Family Physicians in a teaching hospital in Karachi.
Methodology: It was a cross sectional study. A questionnaire was developed to collect patient’s utilization of services of health care providers. The investigators administered the questionnaire to 387 patients, after purpose of the study was explained, written consent was taken and confidentiality was assured.
Results: The study population included more females than males, with average age of 32.6 years. The majority were married, well educated, in private and government service, were students or housewives. …

Factors Influencing Immunization Status In Primary Care Clinics, David Page, Jan Meires, Amy B. Dailey

Health Sciences Faculty Publications

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings.

Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status.

Results: The …

Ischemic Monomelic Neuropathy: A Complication Of Vascular Access Procedure, Malik Anas Rabbani, Aasim Ahmad, Syed Mansoor Ahmed Shah, Tahseen Mozzaffar, Mahesh Moolani, Syed Sohail Ali

Section of Nephrology

Ischemic monomelic neuropathy (IMN) is an infrequently recognized type of ischemic neuropathy produced by shunting blood or acute occlusion of a major proximal artery in the extremities. IMN predominantly occurs in diabetic patients with evidence of peripheral atherosclerotic vascular disease and neuropathy. We report a case of ischemic monomelic neuropathy occurring in a diabetic patient with end-stage renal disease following the placement of polytetrafluoroethylene (PTFE) graft as a vascular access in the proximal upper arm for chronic hemodialysis.

An Investigation Of The Effects Of A 12-Week Exercise Programme For People With Diabetes, Olive Fanning

Theses

To determine and examine the effects of a 12-week exercise programme for people with diabetes on their blood glucose control, physiological components and psychological well-being.

The purpose of the study was to examine a wide variety of physiological components including assessment of aerobic capacity, body composition, lung, function, flexibility and blood glucose control (HbAlc levels). Psychological well-being was also assessed which includes sub scales for depression, anxiety, energy and positive well being. This had the purpose of identifying exact levels of these variables so as to compare these to the general public norms. It additionally had the benefit of being …

A Hospital Based Preliminary Report On Sleep Disordered Breathing In Pakistani Population, R Haqqee, S F. Hussain, M Mujib, H R. Ahmad

Section of Pulmonary & Critical Care

Background: Sleep Disordered Breathing is an important medical condition leading to significant morbidity and mortality. Western studies have shown its prevalence in middle age to be 9% in women and 24% in men. The aim of this study was to have a preliminary assessment on the frequency of Sleep Disordered Breathing in Pakistani subjects.

METHOD: Patients attending a medical clinic were surveyed. A sleep questionnaire elicited information about snoring, witnessed apnea, nocturnal choking and excessive daytime sleepiness. Data were recorded for age, height, collar size and weight. Epworth Sleepiness Scale was used to assess excessive daytime sleepiness. Statistical analysis …

Psychological Impact Of Comprehensive Tumor Genomic Profiling Results For Advances Cancer Patients, Phyllis N. Butow, Megan Best, Grace Davies, Timothy Schlub, Christine Napier, Nicci Bartley, Mandy Ballinger, Ilona Juraskova, Bettina Meiser, David Goldstein, Barbara Biesecker, David Thomas

IES Papers and Journal Articles

Objective

Comprehensive tumor genomic profiling (CTGP) is increasingly used to personalize treatments, providing hope, but potentially disappointment, for patients. We explored psychological outcomes in patients with advanced, incurable cancer, after receiving CTGP results.

Methods

Participants with advanced, incurable cancer (n = 560, mean age 56, 43% university educated) in this longitudinal substudy of the Molecular Screening and Therapeutics Program (MoST), completed questionnaires before and after receiving CGP results. MoST participants, recruited from Australian oncology clinics, undergo CTGP, and if there are actionable findings, are offered treatment in a related therapeutic trial if available.

Results

Patients who received actionable results, (n …

Myths Regarding Treatment Of Hepatitis: The Vicious Cycle Of Increasing Morbidity, Waris Qidwai, Naureen Alim, Iqbal Azam

Department of Family Medicine

Viral hepatitis has high prevalence rates in Pakistan. It is a potentially serious condition with associated high morbidity and mortality. Studies from neighboring regions document significant utilization of the services of faith healers for the treatment of patients with hepatitis. This article is a short communication

Jadelle® Levonorgestrel Rod Implants: A Summary Of Scientific Data And Lessons Learned From Programmatic Experience, Irving Sivin, Harold A. Nash, Sandra N. Waldman

Formulation/Product Development

This scientific monograph provides a comprehensive summary of the clinical characteristics of Jadelle levonorgestrel (LNG) rod implants, as observed during clinical trials conducted by the Population Council. The monograph also reviews lessons learned about how to provide Jadelle, based partly on conclusions gleaned from the extensive experience with Norplant, the earlier implant system, and suggests practical ways in which to introduce Jadelle into family planning programs.

Are You My Parent? Are You My Child? The Role Of Genetics And Race In Defining Relationships After Reproductive Technological Mistakes, 5 Depaul J. Health Care L. 15 (2002), Raizel Liebler

UIC Law Open Access Faculty Scholarship

Imagine that you are a married woman who wants to have a genetically related child with your husband. Your doctor tells you that you are infertile, and therefore you and your husband go to XYZ fertility clinic to receive in vitro treatment. You have your eggs harvested, your husband supplies sperm, and ten embryos are created. Five embryos are implanted in your uterus and five are frozen and kept by the fertility clinic for your later use. You successfully conceive and give birth to twins. You notice that the children you give birth to are of a different race than …

A Point Mutation In Codon 76 Of Pfcrt Of P. Falciparum Is Positively Selected For By Chloroquine Treatment In Tanzania, A.G. Schneider, Zul Premji, I. Felger, T. Smith, S. Abdulla, H.-P. Beck, H. Mshinda

Pathology, East Africa

This study was undertaken to validate the relevance of Chloroquine (CQ) resistance markers pfert76 and pfmdrl86 in an endemic area in Tanzania. After treatment with CQ, recrudescence was distinguished from new infection by msp2 genotyping, and the number of concurrent infection was also determined. The rate of children with recrudescent parasites at day 7 and/or day 14 amounted to a parasitological failure rate of 22.4% using PCR. The mean multiplicity of infection at day 0 was 3.2 (n = 71). The allelic frequencies of the mutated pfert76 and pfmdrl86 were estimated to be 92 and 77%, respectively. Both values exceeded …

Il-12 Plasmid Delivery By In Vivo Electroporation For The Successful Treatment Of Established Subcutaneous B16.F10 Melanoma, M. Lee Lucus, Loree Heller, Domenico Coppola, Richard Heller

Bioelectrics Publications

Interleukin-12 (IL-12) has been used in numerous immunotherapy protocols against melanoma. However, delivery of IL-12 in the form of recombinant protein can result in severe toxicity, and gene therapy has had limited success against B16.F10 murine melanoma. The purpose of this study was to examine the effectiveness of in vivo electroporation for the delivery of plasmid DNA encoding IL-12 as an antitumor agent against B16.F10 melanoma. We treated mice bearing established B16.F10 melanoma tumors with intratumoral (i.t.) or intramuscular (i.m.) injections of a plasmid encoding IL-12, followed by in vivo electroporation. For i.t. treatments, we used an applicator containing six …

Oncolog, Volume 47, Number 01, January 2002, Dawn Chalaire, Mariann Crapanzano

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Preserving and Restoring the Ability to Swallow in Patients with Head and Neck Cancer Requires a Team Approach
• Modified Barium Swallow Helps Speech Pathologists Determine What Patients Are Able to Eat
• House Call: Common Cancers, Common Symptoms
• Portal Vein Embolization Offers More Pateints an Opportunity for Potentially Curative Hepatic Resection