Medical Specialties Commons^™

Variation And Change Over Time In Promis-29 Survey Results Among Primary Care Patients With Type 2 Diabetes, Juell Homco, Kristin Rodriguez, David R. Bardach, Elizabeth A. Hahn, Suzanne Morton, Daren Anderson, David Kendrick, Sarah Hudson Scholle

Journal of Patient-Centered Research and Reviews

Purpose: We sought to describe results of patient-reported outcome measures implemented among primary care patients with diabetes and explore factors associated with changes in scores over time.

Methods: Two organizations serving diverse patient populations collected the PROMIS-29 survey at baseline and 3-month follow-up for patients with type 2 diabetes. Bayesian regression analysis was used to examine the relationship between patient characteristics and changes in PROMIS-29 scores. Exploratory analyses assessed relationships between goal-setting and changes in scores.

Results: The study population reported substantially more problems with physical functioning (mean: 42.5 at Site 1 and 38.9 at Site 2) and pain interference …

Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut

Journal of Patient-Centered Research and Reviews

Type 2 diabetes mellitus is an immense burden to the health of our population and to our current health care system, and the weight of this burden is only projected to multiply in coming years. A nutritious diet is an indispensable aspect of diabetes treatment, and the lack of access to food engenders poor disease-state control, which correlates with increased health care utilization. Interventions aimed at improving access to food through medically tailored meals (MTMs) have demonstrated effectiveness in improving the health of food-insecure type 2 diabetic patients and reducing health care costs. Further studies are necessary to increase the …

Cardio Metabolic Risk Factors For Atrial Fibrillation In Type 2 Diabetes Mellitus: Focus On Hypertension, Metabolic Syndrome And Obesity, Mihnea-Alexandru Gaman, Elena-Codruta Dobrica, Emilia G. Pascu, Matei-Alexandru Cozma, Mirela-Elena Epingeac, Amelia M. Gaman, Anca M. Pantea Stoian, Ovidiu G. Bratu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Objective. Atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM) has been little explored so far. However, there are several cardio metabolic risk factors for AF in T2DM patients, such as arterial hypertension, obesity or the metabolic syndrome. Our objective was to evaluate cardio metabolic risk factors for AF in T2DM patients. Methods. We studied the medical records of T2DM patients hospitalized in the Internal Medicine department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and carried out between January-June 2018. Results. The study group included 221 T2DM patients (with a mean age of 68.65 …

Early Maladjustment Schemas In Individuals With And Without Type 2 Diabetes Mellitus, Fazlolah Mirdrikvand, Mohamad Ali Sepahvandi, Siamak Khodarahimi, Simin Gholamrezaei, Mojtaba Rahimian Bougar, Pejman Shafikhani

Journal of Mind and Medical Sciences

Objective. This study explored Early Maladjustment Schemas (EMSs) among individuals with and without type 2 diabetes mellitus and examined potential moderating roles for gender, level of education, and occupation.

Methods. The sample included 371 adult participants (120 patients with diabetes and 251 individuals without diabetes), from Shiraz City, Fars province; Iran. The Young Schema Questionnaire-Short Form (YSQ-SF) was used to assess early maladjustment schemas.

Results. Findings showed that patients with type 2 diabetes had significantly higher scores than controls on a number of EMSs, including abandonment, failure, vulnerability, enmeshment, self-sacrifice, entitlement, and insufficient self-control schemas as well as the over-vigilance …

Postpartum Depression And Thyroid Dysfunction– Should Pregnant Women Be Screened For Thyroid Disorders?, Anca A. Simionescu, Erika Marin

Journal of Mind and Medical Sciences

The relationship between thyroid dysfunction and postpartum depression has been investigated for quite some time now, but no consensus has been reached regarding the need for screening for thyroid function during pregnancy. This paper aims to investigate whether thyroid hormone screening in pregnancy might contribute to the diagnosis of postpartum depression.

Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) - one of the most widely used measures in detecting postpartum depression and anxiety. Thyroid function was measured using the commonly recommended thyroid laboratory tests.

A structured questionnaire was given to 61 patients closely monitored during their pregnancy and …

Serum Markers Of Bone Fragility In Type-2 Diabetes Mellitus, Rucsandra Dănciulescu Miulescu, Loreta Guja, Lavinia Claudia Ochiana, Anca Ungurianu, Oana Cristina Șeremet, Emil Ștefănescu

Journal of Mind and Medical Sciences

Patients with type-2 diabetes mellitus (T2DM) have normal or increased bone mineral density (BMD) but despite that, they are characterized by an increased hip and vertebral fracture risk that involves the alteration of bone quality and not the reduction in bone mass. BMD is utilized for the diagnosis and evaluation of osteoporosis, but BMD itself cannot provide an accurate diagnosis of the individuals at increased risk of fracture and, therefore, studies have focused on identifying other risk factors that are partially or fully independent of BMD.

The fracture risk score tool-FRAX® models provide information about a 10-year probability of osteoporotic …

Immune And Inflammatory Pathways In Non-Alcoholic Steatohepatitis (Nash). An Update, Sorina Cezara Coste, Ionela Popovici, Andreea Maria Stefan, Iulia Breaban, Adela Sitar Taut, Simina Tarmure Sarlea, Angela Cozma, Dorel Sampelean, Olga Hilda Orasan, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test …

Management Options In The Sudden Hearing Loss Of A Diabetic Patient, Andreea Rusescu, Viorel Zainea, Oana Ruxandra Iana, Irina Ioniță, George Traian Alexandru Burcea-Dragomiroiu, Dragos Cristian Ștefănescu, Dumitru Cristinel Badiu, Florentina Gherghiceanu, Catalina Pietrosanu, Corina Silvia Pop, Razvan Hainarosie, Mura Hainarosie

Journal of Mind and Medical Sciences

The aim of our paper is to highlight the main therapeutic principles and the management options in the case of a diabetic patient who has had a sudden hearing loss. Mainly, the aim is to underline the sudden hearing loss treatment adjustment of the diabetic patient compared to the non-diabetic patient.

By understanding the mechanism of sudden hearing loss in a diabetic patient, namely the impact of glycemic variations and their implication on the microvascular structures of the inner ear, we try to underline the treatment principles and management options of the previously mentioned combined pathologies.

Thus, it is necessary …

Steroid Receptor Coactivator-1 Modulates The Function Of Pomc Neurons And Energy Homeostasis, Yongjie Yang, Agatha A Van Der Klaauw, Liangru Zhu, Tessa M Cacciottolo, Yanlin He, Lukas K J Stadler, Chunmei Wang, Pingwen Xu, Kenji Saito, Antentor Hinton, Xiaofeng Yan, Julia M Keogh, Elana Henning, Matthew C Banton, Audrey E Hendricks, Elena G Bochukova, Vanisha Mistry, Katherine L Lawler, Lan Liao, Jianming Xu, Stephen O'Rahilly, Qingchun Tong, Uk10k Consortium, Inês Barroso, Bert W O'Malley, I Sadaf Farooqi, Yong Xu

Children’s Nutrition Research Center Staff Publications

Hypothalamic neurons expressing the anorectic peptide Pro-opiomelanocortin (Pomc) regulate food intake and body weight. Here, we show that Steroid Receptor Coactivator-1 (SRC-1) interacts with a target of leptin receptor activation, phosphorylated STAT3, to potentiate Pomc transcription. Deletion of SRC-1 in Pomc neurons in mice attenuates their depolarization by leptin, decreases Pomc expression and increases food intake leading to high-fat diet-induced obesity. In humans, fifteen rare heterozygous variants in SRC-1 found in severely obese individuals impair leptin-mediated Pomc reporter activity in cells, whilst four variants found in non-obese controls do not. In a knock-in mouse model of a loss of function …

Type 2 Diabetes Mellitus (T2dm) “Remission” In Non-Bariatric Patients 65 Years And Older, Srikanth Tangelloju, Bert B. Little, Robert J. Esterhay, Guy Brock, A. Scott Lajoie

Faculty and Staff Scholarship

Objective: To analyze the factors associated with type 2 diabetes mellitus (T2DM) “remission” in non-bariatric Medicare patients 65 years and older.

Research Design and Methods: A retrospective cohort analysis of a Medicare Advantage health plan was conducted using administrative data. An individual was identified as T2DM if the individual had: ≥ 2 medical claims for T2DM coded 250.xx excluding type 1 diabetes; or ≥ 2 pharmacy claims related to T2DM; or ≥ 2 combined medical claims, pharmacy claims for T2DM in 12 months. A T2DM individual was in “remission” if they had no T2DM related claims for more than 12 …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

Metabolism During Pregnancy And Postpartum: How Does It Change And What Factors Influence It?, Kristin Yoho

Masters Theses & Specialist Projects

PURPOSE: Pregnancy is a physically impactful process in a woman’s life. During this time, a woman will gain weight and research has shown that many women will retain some extra weight after delivery. Because of this, recovery in the postpartum period is pivotal to avoiding the implications of weight retention. The postpartum period is vastly understudied in both the research and medical communities and this gap between pregnancy and postpartum research needs to be bridged. Therefore, the purpose of this study was to investigate metabolic changes from pregnancy to postpartum and to study how factors such as sleep and breastfeeding …

Sodium Glucose Co-Transporters Inhibition And Diabetic Kidney Disease, Radica Alicic

Books, Presentations, Posters, Etc.

No abstract provided.

Hnf1Β Diabetes Or Maturity-Onset Diabetes Of The Young Type 5 With Rare Hnf1Β Mutation: A Case Report., Autumn L Haynes, Amber M Healy

Ambulatory and Primary Care Articles

No abstract provided.

A New Paediatric Diabetes Knowledge Test - M-Wikad Development And Factor Analysis., Sarah Tsai, Susana Patton, Stephen Delurgio, David D. Williams, Kavitha Dileepan, Alexander Karmazin, Melinda Storm, Mark A. Clements

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. …

Usefulness Of An Expanded Health Belief Model With Added Constructs (Self-Efficacy And Ecological System Measures) In Modeling Compliance With Healthy Lifestyle Recommendations In Women With A Recent History Of Gestational Diabetes, Phyllis M. Woodson

Health Services Research Dissertations

Problem Statement: Gestational diabetes (GDM) has been reported to affect as many as 18% of all pregnancies in the U.S. This diagnosis is costly and presents health risks to both baby and mother. The main risk to the mother with a history of GDM is her increased risk for diabetes which has been estimated at 35% to 60% in the following 10 to 20 years; more recent studies report a 7 to 8 times occurrence in the following 3 to 6 years. It is recommended that lifestyle efforts of eating healthfully and exercise can reduce this risk

Methods: Subjects (n=153) …

Kinase Suppressor Of Ras 1 And Exo70 Promote Fatty Acid-Stimulated Neurotensin Secretion Through Erk1/2 Signaling, Stephanie Rock, Xian Li, Jun Song, Courtney M. Townsend, Heidi L. Weiss, Piotr G. Rychahou, Tianyan Gao, Jing Li, B. Mark Evers

Markey Cancer Center Faculty Publications

Neurotensin is a peptide hormone released from enteroendocrine cells in the small intestine in response to fat ingestion. Although the mechanisms regulating neurotensin secretion are still incompletely understood, our recent findings implicate a role for extracellular signal–regulated kinase 1 and 2 as positive regulators of free fatty acid-stimulated neurotensin secretion. Previous studies have shown that kinase suppressor of Ras 1 acts as a molecular scaffold of the Raf/MEK/extracellular signal–regulated kinase 1 and 2 kinase cascade and regulates intensity and duration of extracellular signal–regulated kinase 1 and 2 signaling. Here, we demonstrate that inhibition of kinase suppressor of Ras 1 attenuates …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

Adult-Onset Hypophosphatasia: Before And After Treatment With Asfotase Alfa, Angela Magdaleno Do, Sonum Singh Md, Sandhya Venkataraman Do, Ya-Yu Lee Md

Department of Medicine

No abstract provided.

Primary Hyperparathyroidism As Initial Presentation Of Stage Iv Breast Cancer, Angela Magdaleno Do, Angel Lopez Md, Thomas A. Diven Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

Management Of Pregestational Diabetes Insipidus In Pregnancy, Sandhya Venkataraman Do, Sharmila C. Koshy Md, Marc A. Vengrove Do, Facp

Department of Medicine

No abstract provided.

The Role Of Thyroglobulin In Thyroid Hormonogenesis, Cintia E. Citterio, Héctor M. Targovnik, Peter Arvan

Pharmacy Faculty Articles and Research

In humans, the thyroid hormones T₃ and T₄ are synthesized in the thyroid gland in a process that crucially involves the iodoglycoprotein thyroglobulin. The overall structure of thyroglobulin is conserved in all vertebrates. Upon thyroglobulin delivery from thyrocytes to the follicular lumen of the thyroid gland via the secretory pathway, multiple tyrosine residues can become iodinated to form mono-iodotyrosine (MIT) and/or di-iodotyrosine (DIT); however, selective tyrosine residues lead to preferential formation of T₄ and T₃ at distinct sites. T₄ formation involves oxidative coupling between two DIT side chains, and de novo T₃ formation involves …

Establishing A Preconception Counseling Program For Women With Diabetes In Primary Care Resident Clinics, Carly Waldman Ms4, Melissa M. Dion Md, Sandhya Venkataraman Do, Angela Magdaleno Do, Meredith Rochon Md, Gretchen A. Perilli Md, Marc A. Vengrove Do, Facp

USF-LVHN SELECT

No abstract provided.

Bisphosphonates Can Be Safely Given To Patients With Hypercalcemia And Renal Insufficiency Secondary To Multiple Myeloma, Matthew J. Miller

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Itou K, Fukuyama T, Sasabuchi Y, et al. Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. Journal of Anesthesia. 2012;26(1):20-27. doi: 10.1007/s00540-011-1261-x.

Operationalization Of Bi-Directional Screening For Tuberculosis And Diabetes In Private Sector Healthcare Clinics In Karachi, Pakistan, Mashal S. Basir, Shifa Salman Habib, Syed M A. Zaidi, Saira Khowaja, Hamidah Hussain, Rashida A. Ferrand, Aamir J. Khan

Community Health Sciences

Background: Many countries are facing overlapping epidemics of tuberculosis (TB) and diabetes mellitus (DM). Diabetes increases the overall risk of developing Tuberculosis (TB) and contributes to adverse treatment outcomes. Active screening for both diseases can reduce TB transmission and prevent the development of complications of DM. We investigated bi-directional TB-DM screening in Karachi, Pakistan, a country that ranks fifth among high TB burden countries, and has the seventh highest country burden for DM.
Methods: Between February to November 2014, community-based screeners identified presumptive TB and DM through verbal screening at private health clinics. Individuals with presumptive TB were referred for …

Deciphering The Consequences Of Yolk Testosterone Metabolism In Birds, Nicole A. Campbell

Theses and Dissertations

Maternal steroids transferred to eggs can elicit permanent effects on various aspects of offspring phenotype. Although, testosterone was thought to be a key mediator of maternal effects in birds, we now know that vertebrate embryos actively regulate their exposure to maternal testosterone through steroid metabolism, suggesting testosterone metabolites may elicit the observed phenotypic effects. To address the role steroid metabolism plays in mediating yolk testosterone effects, we used European starling (Sturnus vulgaris) eggs to characterize the timing of testosterone metabolism and determine whether etiocholanolone, a prominent testosterone metabolite in avian embryos, is capable of influencing early embryonic development. Tritiated testosterone …

Cardiovascular Disease Risk Factors In Pakistani Population With Newly Diagnosed Type 2 Diabetes Mellitus: A Cross-Sectional Study Of Selected Family Practitioner Clinics In Four Provinces Of Pakistan (Cardip Study), Syed Abbas Raza, Mariam Hassan, Farhana Badar, Farah Rasheed, Fouzia Meerza, Sumeyya Azam, Ali Jawa, Imtiaz Hassan, Faisal Masood Qureshi, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Objective: To explore cardiovascular risk factors in people with newly-diagnosed type 2 diabetes mellitus.

Methods: The cross-sectional, prospective, multicentre, study was conducted from June 2014 till July 2015 at family practice clinics in 27 cities across Pakistan, and comprised individuals aged 30-50 years diagnosed with type 2 diabetes mellitus within the preceding six months. Laboratory investigations were conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and Aga Khan University Hospital, Karachi. The 10-year absolute risk of fatal or non-fatal coronary heart disease and stroke was calculated using the United Kingdom Prospective Diabetes Study Risk Engine version 2.0. …

Rationale And Protocol For Estimating The Economic Value Of A Multicomponent Quality Improvement Strategy For Diabetes Care In South Asia, Kavita Singh, Mohammed K. Ali, Raji Devarajan, Roopa Shivashankar, Dimple Kondal, Vamadevan S. Ajay, V. Usha Menon, Premlata K. Varthakavi, Vijay Viswanathan, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Background: Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide. We describe the economic evaluation protocol within a randomised controlled trial that tested a multi-component quality improvement (QI) strategy for individuals with poorly-controlled type 2 diabetes in South Asia.

Methods/Design: This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and Pakistan. The economic evaluation comprises both a within-trial cost-effectiveness analysis (mean 2.5 years follow up) and a microsimulation model-based cost-utility analysis (life-time horizon). …

Ectopic Pituitary Adenoma Presenting As A Clival Mass., Juan J Altafulla, Joshua Prickett, Graham Dupont, R Shane Tubbs, Zachary Litvack

Articles, Abstracts, and Reports

Pituitary adenomas are well described in the literature and are frequently observed and treated in clinical practice by neurosurgeons. On the other hand, ectopic adenomas are a diagnostic enigma; a good understanding of anatomy and radiological characteristics is crucial for the successful management of such pathologies. In this paper, we describe the case of a 77-year-old woman who presented with a clival mass invading the left cavernous sinus; we also discuss the associated diagnostic techniques, approaches, imaging options, and characteristics.

Can An Exercise-Based Educational And Motivational Intervention Be Durably Effective In Changing Compliance To Physical Activity And Anthropometric Risk In People With Type 2 Diabetes? A Follow-Up Study, Francesca Gallè, Jesse C. Krakauer, Nir Krakauer, Giuliana Valerio, Giorgio Liguori

Publications and Research

Aims. A nine-month motivational exercise-based intervention was previously offered to subjects with type 2 diabetes (T2D). A year after the end of the intervention, compliance to physical activity (PA) and anthropometric indices of participants were analyzed to evaluate the durability of its effects. Methods. PA levels, expressed as total energy expenditure per week, were assessed with the International Physical Activity Questionnaire (IPAQ). Changes in Body Mass Index (BMI), A Body Shape Index (ABSI), Hip Index (HI) z-scores, the relative mortality risk related to each of these measures, and a combined Anthropometric Risk Index (ARI) were also evaluated. Results. Of a …