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1. Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes.

Author

Jung, L, Fonseca, L, Sliwinski, M, Weinstock, R, Grinspoon, E, Xu, I, Strong, R, Singh, S, Van Dongen, H, Frumkin, M, Bulger, J, Cleveland, M, Janess, K, Kudva, Y, Pratley, R, Rickels, M, Rizvi, S, Chaytor, N, Germine, L, Hawks, Z, and Beck, Emorie

Abstract

Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations.

Published
2024

3. Work Intensity of Postoperative Care Following Implantation of Presbyopia-Correcting versus Monofocal Intraocular Lenses

Author

Maloney RK, Doane J, Weinstock R, and Donaldson KE

Subjects
aecos, presbyopia-correcting iols, multifocal iols, cataract surgery, work intensity of postoperative care., Ophthalmology, RE1-994
Abstract

Robert K Maloney,1 John Doane,2 Robert Weinstock,3 Kendall E Donaldson4 On behalf of AECOS Postoperative Care Study Group1Maloney-Shamie Vision Institute, Los Angeles, CA, USA; 2Discover Vision Centers, Kansas City, MO, USA; 3The Eye Institute of West Florida, Saint Petersburg, FL, USA; 4Bascom Palmer Eye Institute, Plantation, FL, USACorrespondence: Robert K Maloney, Maloney-Shamie Vision Institute, 10921 Wilshire Blvd, Suite 900, Los Angeles, CA, 90024, USA, Tel +1 310-208-3937, Fax +1 310-208-8058, Email info@maloneyshamie.comPurpose: To compare the work intensity of postoperative care following implantation of presbyopia-correcting intraocular lenses (IOLs) to that of standard monofocal IOLs.Patients and Methods: This open-label, multicenter, comparative study retrospectively reviewed the case records of cataract surgery patients who underwent bilateral implantation of either presbyopia-correcting IOLs (presby-IOL group; N=177) or standard monofocal IOLs (monofocal group; N=177). Outcome measures included the total time the patient spent in the office, number of visits, mean duration of visits, and the number of procedures and diagnostic tests during the first postoperative year. Outcome measures were compared between the first 90 days and days 91– 365 after surgery.Results: Mean (±SD) time spent in the office during the first postoperative year was 5:50 ± 3:35 hours (H:MM) over 6.6 ± 2.9 visits in the presby-IOL group, compared to 3:38 ± 1:36 hours over 4.9 ± 1.6 visits in the monofocal IOL group (p < 0.001). During the first 90 days, a presby-IOL patient spent 40 minutes longer in the office than a monofocal IOL patient (3:39 ± 1:38 hours vs 2.59 ± 1:13 hours) (p < 0.001). During days 91– 365, time in the office was 1:32 hours longer (p < 0.001), and the mean visit duration was 8 minutes longer for the presby-IOL patients (p=0.002) than those with monofocal IOL. In addition, the presby-IOL patients underwent more procedures and diagnostic tests (p ≤ 0.001) as compared with standard monofocal cataract surgery patients.Conclusion: Patients implanted with presbyopia-correcting IOLs require significantly more clinic time, diagnostic testing, and procedures postoperatively as compared with standard monofocal cataract surgery patients.Keywords: AECOS, presbyopia-correcting IOLs, multifocal IOLs, cataract surgery, work intensity of postoperative care

Published
2023

4. Real-World Experience with Intracapsular Administration of Dexamethasone Intraocular Suspension 9% for Control of Postoperative Inflammation

Author

McCabe C, Desai P, Nijm L, Osher R, and Weinstock R

Subjects
cataract, corticosteroids, inflammation, technique, Ophthalmology, RE1-994
Abstract

Cathleen McCabe,1 Priya Desai,2 Lisa Nijm,3 Robert Osher,4 Robert Weinstock5 1The Eye Associates; Eye Health America, Sarasota Memorial Hospital, Sarasota, FL, USA; 2Matossian Eye Associates, Pennington, NJ, USA; 3Warrenville Eye Care and LASIK Center, Northwestern Medicine, Warrenville, IL, USA; 4Cincinnati Eye Institute, University of Cincinnati, Cincinnati, OH, USA; 5The Eye Institute of West Florida, Weinstock Laser Eye Center, Largo, FL, USACorrespondence: Cathleen McCabe, The Eye Associates; Eye Health America, Sarasota Memorial Hospital, Sarasota, FL, USA, Tel +1 941 792-2020, Email mccabe13@hotmail.comAbstract: Corticosteroids and non-steroidal anti-inflammatory drugs are commonly used prophylactically to control inflammation after ocular surgery. When prescribed as eye drops, as has been longstanding tradition, anti-inflammatory success is out of surgeons’ hands, dependent on patient compliance and proper instillation technique. Sustained-release, intraoperatively administered anti-inflammatory drugs are emerging as another option. DEXYCU (dexamethasone intraocular suspension) 9% is the first and only intraocular corticosteroid FDA-approved for postoperative inflammation, whose sustained-release formulation provides a high initial release of drug, followed by a gradual tapering. Administration of the drug directly into the capsular bag following cataract surgery enables reliable placement proximal to target tissues, ensuring surgeon control and visibility of delivery, safety, and efficiency. This technique also minimizes contact with metabolically active tissues such as the corneal endothelium, iris, and ciliary body. In this paper, we review the available literature on dexamethasone intraocular suspension and summarize surgeons’ consensus on best practices for intracapsular administration.Keywords: cataract, corticosteroids, inflammation, technique

Published
2022

5. First Real-World, Multicenter, Post-Marketing, Retrospective Study of Dexamethasone Intraocular Suspension for Inflammation After Cataract Surgery

Author

Bacharach J, McCabe C, Jackson M, Rao S, Singh IP, Heersink S, Radcliffe N, Weinstock R, Paggiarino D, and Patel K

Subjects
cataract surgery, corticosteroids, dexamethasone, inflammation, intraocular suspension, ocular drug delivery systems, Ophthalmology, RE1-994
Abstract

Jason Bacharach,1 Cathleen McCabe,2 Mitchell Jackson,3 Sanjay Rao,4 I Paul Singh,5 Sebastian Heersink,6 Nathan Radcliffe,7 Robert Weinstock,8 Dario Paggiarino,9 Keyur Patel9 1North Bay Eye Associates Petaluma, Petaluma, CA, USA; 2The Eye Associates, Bradenton, FL, USA; 3Jacksoneye Ophthalmology, Lake Villa, IL, USA; 4DeKalb Eye Consultants - Hauser-Ross Eye Institute, Sycamore, IL, USA; 5The Eye Centers of Racine & Kenosha, Racine, WI, USA; 6Eye Center South, Dothan, AL, USA; 7New York Eye Surgery Center, Bronx, NY, USA; 8The Eye Institute of West Florida, Largo, FL, USA; 9EyePoint Pharmaceuticals, Watertown, MA, USACorrespondence: Jason Bacharach, North Bay Eye Associates, 104 Lynch Creek Way, Suite 15, Petaluma, CA, 94954, USA, Email jbacharach@northbayeye.comPurpose: To evaluate dexamethasone intraocular suspension 9% (intraocular DXM) in real-world clinical use to manage inflammation associated with cataract surgery.Setting: Patients who underwent cataract surgery and received intraocular DXM at 22 outpatient eye surgery centers in the US.Design: Retrospective, observational chart review.Methods: Records of all patients who received intraocular DXM from March to December 2019 at participating centers were reviewed.Main Outcome Measures: Outcomes included anterior chamber cell (ACC) grades, anterior chamber flare (ACF) grades, and visual acuity, as well as intraocular pressure (IOP) and adverse events (AEs) at postoperative days (PODs) 1, 8, 14, 30. Descriptive statistics were generated.Results: The study population included 527 patients (641 eyes), with glaucoma history in 66 patients (80 eyes). Among eyes with recorded ACC grades, the percentage with grade 0 increased from 40% at POD 1 to 89.7% at POD 30, with similar results in eyes with glaucoma history. Among eyes with recorded ACF grades, the percentage with grade 0 increased from 78.4% at POD 1 to 97.1% at POD 30. At POD 30, 96.6% eyes with recorded results achieved target acuity. Mean IOP was 18.6 mmHg at POD 1 but declined to ≤ 15.2 mmHg thereafter. Investigators reported 22 AEs in 20 patients, all reported mild or moderate, the most common: IOP increase (7 events).Conclusion: Patients undergoing cataract surgery and treated with intraocular DXM showed favorable inflammatory and visual outcomes, without unanticipated safety problems, consistent with results of previous controlled clinical trials.Keywords: cataract surgery, corticosteroids, dexamethasone, inflammation, intraocular suspension, ocular drug delivery systems

Published
2022

6. Predictors of serum polychlorinated biphenyl concentrations in Anniston residents

Author

Pavuk, M, Olson, JR, Wattigney, WA, Dutton, ND, Sjödin, A, Shelton, C, Turner, WE, Bartell, SM, Bartell, S, Carpenter, DO, Cash, J, Foushee, R, Percy, A, Frumkin, H, Lavender, M, Moysich, K, Olson, J, Rosenbaum, P, Silverstone, A, and Weinstock, R

Subjects
Environmental Sciences
Abstract

The Anniston Community Health Survey was a community-based cross-sectional study of Anniston, Alabama, residents who live in close proximity to a former PCB production facility to identify factors associated with serum PCB levels. The survey comprises 765 Anniston residents who completed a questionnaire interview and provided a blood sample for analysis in 2005-2007. Several reports based on data from the Anniston survey have been previously published, including associations between PCB exposure and diabetes and blood pressure. In this study we examine demographic, behavioral, dietary, and occupational characteristics of Anniston survey participants as predictors of serum PCB concentrations. Of the 765 participants, 54% were White and 45% were African-American; the sample was predominantly female (70%), with a mean age of 55. years. Serum PCB concentrations varied widely between participants (range for sum of 35 PCBs: 0.11-170.4. ng/g wet weight). Linear regression models with stepwise selection were employed to examine factors associated with serum PCBs. Statistically significant positive associations were observed between serum PCB concentrations and age, race, residential variables, current smoking, and local fish consumption, as was a negative association with education level. Age and race were the most influential predictors of serum PCB levels. A small age by sex interaction was noted, indicating that the increase in PCB levels with age was steeper for women than for men. Significant interaction terms indicated that the associations between PCB levels and having ever eaten locally raised livestock and local clay were much stronger among African-Americans than among White participants. In summary, demographic variables and past consumption of locally produced foods were found to be the most important predictors of PCB concentrations in residents living in the vicinity of a former PCB manufacturing facility.

Published
2014

7. Insulin Sensitivity and Diabetic Kidney Disease in Children and Adolescents With Type 2 Diabetes: An Observational Analysis of Data From the TODAY Clinical Trial

Author

McKay, S., Haymond, M., Anderson, B., Bush, C., Gunn, S., Holden, H., Jones, S.M., Jeha, G., McGirk, S., Thamotharan, S., Cuttler, L., Abrams, E., Casey, T., Dahms, W., Ievers-Landis, C., Kaminski, B., Koontz, M., MacLeish, S., McGuigan, P., Narasimhan, S., Geffner, M., Barraza, V., Chang, N., Conrad, B., Dreimane, D., Estrada, S., Fisher, L., Fleury-Milfort, E., Hernandez, S., Hollen, B., Kaufman, F., Law, E., Mansilla, V., Miller, D., Muñoz, C., Ortiz, R., Ward, A., Wexler, K., Xu, Y.K., Yasuda, P., Levitt Katz, L., Berkowitz, R., Boyd, S., Johnson, B., Kaplan, J., Keating, C., Lassiter, C., Lipman, T., McGinley, G., McKnight, H., Schwartzman, B., Willi, S., Arslanian, S., Bacha, F., Foster, S., Galvin, B., Hannon, T., Kriska, A., Libman, I., Marcus, M., Porter, K., Songer, T., Venditti, E., Goland, R., Gallagher, D., Kringas, P., Leibel, N., Ng, D., Ovalles, M., Seidman, D., Laffel, L., Goebel-Fabbri, A., Hall, M., Higgins, L., Keady, J., Malloy, M., Milaszewski, K., Rasbach, L., Nathan, D.M., Angelescu, A., Bissett, L., Ciccarelli, C., Delahanty, L., Goldman, V., Hardy, O., Larkin, M., Levitsky, L., McEachern, R., Norman, D., Nwosu, D., Park-Bennett, S., Richards, D., Sherry, N., Steiner, B., Tollefsen, S., Carnes, S., Dempsher, D., Flomo, D., Whelan, T., Wolff, B., Weinstock, R., Bowerman, D., Bristol, S., Bulger, J., Hartsig, J., Izquierdo, R., Kearns, J., Saletsky, R., Trief, P., Zeitler, P., Abramson, N., Bradhurst, A., Celona-Jacobs, N., Higgins, J., Kelsey, M., Klingensmith, G., Nadeau, K., Witten, T., Copeland, K., Boss, E., Brown, R., Chadwick, J., Chalmers, L., Chernausek, S., Hebensperger, A., Macha, C., Newgent, R., Nordyke, A., Olson, D., Poulsen, T., Pratt, L., Preske, J., Schanuel, J., Sternlof, S., Lynch, J., Amodei, N., Barajas, R., Cody, C., Hale, D., Hernandez, J., Ibarra, C., Morales, E., Rivera, S., Rupert, G., Wauters, A., White, N., Arbeláez, A., Jones, J., Jones, T., Sadler, M., Tanner, M., Timpson, A., Welch, R., Caprio, S., Grey, M., Guandalini, C., Lavietes, S., Rose, P., Syme, A., Tamborlane, W., Hirst, K., Edelstein, S., Feit, P., Grover, N., Long, C., Pyle, L., Linder, B., Marcovina, S.M., Harting, J., Shepherd, J., Fan, B., Marquez, L., Sherman, M., Wang, J., Nichols, M., Mayer-Davis, E., Liu, Y., Lima, J., Gidding, S., Puccella, J., Ricketts, E., Danis, R., Domalpally, A., Goulding, A., Neill, S., Vargo, P., Wilfley, D., Aldrich-Rasche, D., Franklin, K., Massmann, C., O’Brien, D., Patterson, J., Tibbs, T., Van Buren, D., Palmert, M., Ratner, R., Dremaine, D., Silverstein, J., Bjornstad, Petter, Nehus, Edward, El ghormli, Laure, Bacha, Fida, Libman, Ingrid M., McKay, Siripoom, Willi, Steven M., Laffel, Lori, Arslanian, Silva, and Nadeau, Kristen J.

Published
2018
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8. Cardiac Biomarkers in Youth with Type 2 Diabetes Mellitus: Results from the TODAY Study

Author

McKay, S., Haymond, M., Anderson, B., Bush, C., Gunn, S., Holden, H., Jones, S.M., Jeha, G., McGirk, S., Thamotharan, S., Cuttler, L., Abrams, E., Casey, T., Dahms, W., Ievers-Landis, C., Kaminski, B., Koontz, M., MacLeish, S., McGuigan, P., Narasimhan, S., Geffner, M., Barraza, V., Chang, N., Conrad, B., Dreimane, D., Estrada, S., Fisher, L., Fleury-Milfort, E., Hernandez, S., Hollen, B., Kaufman, F., Law, E., Mansilla, V., Miller, D., Muñoz, C., Ortiz, R., Ward, A., Wexler, K., Xu, Y.K., Yasuda, P., Levitt Katz, L., Berkowitz, R., Boyd, S., Johnson, B., Kaplan, J., Keating, C., Lassiter, C., Lipman, T., McGinley, G., McKnight, H., Schwartzman, B., Willi, S., Arslanian, S., Bacha, F., Foster, S., Galvin, B., Hannon, T., Kriska, A., Libman, I., Marcus, M., Porter, K., Songer, T., Venditti, E., Goland, R., Gallagher, D., Kringas, P., Leibel, N., Ng, D., Ovalles, M., Seidman, D., Laffel, L., Goebel-Fabbri, A., Hall, M., Higgins, L., Keady, J., Malloy, M., Milaszewski, K., Rasbach, L., Nathan, D.M., Angelescu, A., Bissett, L., Ciccarelli, C., Delahanty, L., Goldman, V., Hardy, O., Larkin, M., Levitsky, L., McEachern, R., Norman, D., Nwosu, D., Park-Bennett, S., Richards, D., Sherry, N., Steiner, B., Tollefsen, S., Carnes, S., Dempsher, D., Flomo, D., Whelan, T., Wolff, B., Weinstock, R., Bowerman, D., Bristol, S., Bulger, J., Hartsig, J., Izquierdo, R., Kearns, J., Saletsky, R., Trief, P., Zeitler, P., Abramson, N., Bradhurst, A., Celona-Jacobs, N., Higgins, J., Kelsey, M., Klingensmith, G., Nadeau, K., Witten, T., Copeland, K., Boss, E., Brown, R., Chadwick, J., Chalmers, L., Chernausek, S., Hebensperger, A., Macha, C., Newgent, R., Nordyke, A., Olson, D., Poulsen, T., Pratt, L., Preske, J., Schanuel, J., Sternlof, S., Lynch, J., Amodei, N., Barajas, R., Cody, C., Hale, D., Hernandez, J., Ibarra, C., Morales, E., Rivera, S., Rupert, G., Wauters, A., White, N., Arbeláez, A., Jones, J., Jones, T., Sadler, M., Tanner, M., Timpson, A., Welch, R., Caprio, S., Grey, M., Guandalini, C., Lavietes, S., Rose, P., Syme, A., Tamborlane, W., Hirst, K., Edelstein, S., Feit, P., Grover, N., Long, C., Pyle, L., Linder, B., Marcovina, S.M., Harting, J., Shepherd, J., Fan, B., Marquez, L., Sherman, M., Wang, J., Nichols, M., Mayer-Davis, E., Liu, Y., Lima, J., Gidding, S., Puccella, J., Ricketts, E., Danis, R., Domalpally, A., Goulding, A., Neill, S., Vargo, P., Wilfley, D., Aldrich-Rasche, D., Franklin, K., Massmann, C., O'Brien, D., Patterson, J., Tibbs, T., Van Buren, D., Palmert, M., Ratner, R., Dremaine, D., Silverstein, J., Gidding, Samuel S., Bacha, Fida, Bjornstad, Petter, Levitt Katz, Lorraine E., Levitsky, Lynne L., Lynch, Jane, Tryggestad, Jeanie B., Weinstock, Ruth S., El ghormli, Laure, and Lima, Joao A.C.

Published
2018
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9. Gli anziani

Author

Weinstock, R., Read, S., Leong, G. B., Silva, J. A., Simon, Robert I., and Tardiff, Kenneth

Published
2014
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11. Cardiac Biomarkers in Youth with Type 2 Diabetes Mellitus: Results from the TODAY Study

Author

Gidding, Samuel S., Bacha, Fida, Bjornstad, Petter, Katz, Lorraine E. Levitt, Levitsky, Lynne L., Lynch, Jane, Tryggestad, Jeanie B., Weinstock, Ruth S., El ghormli, Laure, Lima, Joao A.C., McKay, S., Haymond, M., Anderson, B., Bush, C., Gunn, S., Holden, H., Jones, S. M., Jeha, G., McGirk, S., Thamotharan, S., Cuttler, L., Abrams, E., Casey, T., Dahms, W., Ievers-Landis, C., Kaminski, B., Koontz, M., MacLeish, S., McGuigan, P., Narasimhan, S., Geffner, M., Barraza, V., Chang, N., Conrad, B., Dreimane, D., Estrada, S., Fisher, L., Fleury-Milfort, E., Hernandez, S., Hollen, B., Kaufman, F., Law, E., Mansilla, V., Miller, D., Muñoz, C., Ortiz, R., Ward, A., Wexler, K., Xu, Y. K., Yasuda, P., Katz, Levitt L., Berkowitz, R., Boyd, S., Johnson, B., Kaplan, J., Keating, C., Lassiter, C., Lipman, T., McGinley, G., McKnight, H., Schwartzman, B., Willi, S., Arslanian, S., Bacha, F., Foster, S., Galvin, B., Hannon, T., Kriska, A., Libman, I., Marcus, M., Porter, K., Songer, T., Venditti, E., Goland, R., Gallagher, D., Kringas, P., Leibel, N., Ng, D., Ovalles, M., Seidman, D., Laffel, L., Goebel-Fabbri, A., Hall, M., Higgins, L., Keady, J., Malloy, M., Milaszewski, K., Rasbach, L., Nathan, D. M., Angelescu, A., Bissett, L., Ciccarelli, C., Delahanty, L., Goldman, V., Hardy, O., Larkin, M., Levitsky, L., McEachern, R., Norman, D., Nwosu, D., Park-Bennett, S., Richards, D., Sherry, N., Steiner, B., Tollefsen, S., Carnes, S., Dempsher, D., Flomo, D., Whelan, T., Wolff, B., Weinstock, R., Bowerman, D., Bristol, S., Bulger, J., Hartsig, J., Izquierdo, R., Kearns, J., Saletsky, R., Trief, P., Zeitler, P., Abramson, N., Bradhurst, A., Celona-Jacobs, N., Higgins, J., Kelsey, M., Klingensmith, G., Nadeau, K., Witten, T., Copeland, K., Boss, E., Brown, R., Chadwick, J., Chalmers, L., Chernausek, S., Hebensperger, A., Macha, C., Newgent, R., Nordyke, A., Olson, D., Poulsen, T., Pratt, L., Preske, J., Schanuel, J., Sternlof, S., Lynch, J., Amodei, N., Barajas, R., Cody, C., Hale, D., Hernandez, J., Ibarra, C., Morales, E., Rivera, S., Rupert, G., Wauters, A., White, N., Arbeláez, A., Jones, J., Jones, T., Sadler, M., Tanner, M., Timpson, A., Welch, R., Caprio, S., Grey, M., Guandalini, C., Lavietes, S., Rose, P., Syme, A., Tamborlane, W., Hirst, K., Edelstein, S., Feit, P., Grover, N., Long, C., Pyle, L., Linder, B., Marcovina, S. M., Harting, J., Shepherd, J., Fan, B., Marquez, L., Sherman, M., Wang, J., Nichols, M., Mayer-Davis, E., Liu, Y., Lima, J., Gidding, S., Puccella, J., Ricketts, E., Danis, R., Domalpally, A., Goulding, A., Neill, S., Vargo, P., Wilfley, D., Aldrich-Rasche, D., Franklin, K., Massmann, C., O’Brien, D., Patterson, J., Tibbs, T., Van Buren, D., Palmert, M., Ratner, R., Dremaine, D., and Silverstein, J.

Published
2018
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16. Serum urate lowering with allopurinol and kidney function in type 1 diabetes

Author

Doria, A., Galecki, A. T., Spino, C., Pop-Busui, R., Cherney, D. Z., Lingvay, I., Parsa, A., Rossing, P., Sigal, R. J., Afkarian, M., Aronson, R., Caramori, M. L., Crandall, J. P., De Boer, I. H., Elliott, T. G., Goldfine, A. B., Haw, J. S., Hirsch, I. B., Karger, A. B., Maahs, D. M., McGill, J. B., Molitch, M. E., Perkins, B. A., Polsky, S., Pragnell, M., Robiner, W. N., Rosas, S. E., Senior, P., Tuttle, K. R., Umpierrez, G. E., Wallia, A., Weinstock, R. S., Wu, Chunyi, Mauer, M., Doria, A., Galecki, A. T., Spino, C., Pop-Busui, R., Cherney, D. Z., Lingvay, I., Parsa, A., Rossing, P., Sigal, R. J., Afkarian, M., Aronson, R., Caramori, M. L., Crandall, J. P., De Boer, I. H., Elliott, T. G., Goldfine, A. B., Haw, J. S., Hirsch, I. B., Karger, A. B., Maahs, D. M., McGill, J. B., Molitch, M. E., Perkins, B. A., Polsky, S., Pragnell, M., Robiner, W. N., Rosas, S. E., Senior, P., Tuttle, K. R., Umpierrez, G. E., Wallia, A., Weinstock, R. S., Wu, Chunyi, and Mauer, M.

Abstract

BACKGROUND: Higher serum urate levels are associated with an increased risk of diabetic kidney disease. Lowering of the serum urate level with allopurinol may slow the decrease in the glomerular filtration rate (GFR) in persons with type 1 diabetes and early-to-moderate diabetic kidney disease. METHODS: In a double-blind trial, we randomly assigned participants with type 1 diabetes, a serum urate level of at least 4.5 mg per deciliter, an estimated GFR of 40.0 to 99.9 ml per minute per 1.73 m2 of body-surface area, and evidence of diabetic kidney disease to receive allopurinol or placebo. The primary outcome was the baseline-adjusted GFR, as measured with iohexol, after 3 years plus a 2-month washout period. Secondary outcomes included the decrease in the iohexol-based GFR per year and the urinary albumin excretion rate after washout. Safety was also assessed. RESULTS: A total of 267 patients were assigned to receive allopurinol and 263 to receive placebo. The mean age was 51.1 years, the mean duration of diabetes 34.6 years, and the mean glycated hemoglobin level 8.2%. The mean baseline iohexol-based GFR was 68.7 ml per minute per 1.73 m2 in the allopurinol group and 67.3 ml per minute per 1.73 m2 in the placebo group. During the intervention period, the mean serum urate level decreased from 6.1 to 3.9 mg per deciliter with allopurinol and remained at 6.1 mg per deciliter with placebo. After washout, the between-group difference in the mean iohexol-based GFR was 0.001 ml per minute per 1.73 m2 (95% confidence interval [CI], -1.9 to 1.9; P = 0.99). The mean decrease in the iohexol-based GFR was -3.0 ml per minute per 1.73 m2 per year with allopurinol and -2.5 ml per minute per 1.73 m2 per year with placebo (between-group difference, -0.6 ml per minute per 1.73 m2 per year; 95% CI, -1.5 to 0.4). The mean urinary albumin excretion rate after washout was 40% (95% CI, 0 to 80) higher with allopurinol than with placebo. The frequency of serious adverse events was simi

Published
2020

17. Ethics

Author

Weinstock, R., primary, Leong, G.B., additional, and Silva, J.A., additional

Published
2013
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21. ETHICS

Author

Weinstock, R., primary, Leong, G.B., additional, and Silva, J.A., additional

Published
2000
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23. Novel, bilateral, two-bellied muscles span the extensor forearm, thenar eminence to insert on the proximal phalanx of the thumb: clinical and embryological significance.

Author

Mishall, P. L., Marsh, A. N., Perez, D., Quezada, X. H., Stahl, M. C., Weinstock, R. E., and Downie, S. A.

Abstract

Muscle and tendon variations in the forearm, wrist and hand are commonly reported in the anatomical and surgical literature. They are frequently the source of inflammatory conditions such as de Quervain's tenosynovitis or carpal tunnel syndrome. During academic dissection, a cadaver presented with bilateral, additional muscles running parallel to the abductor pollicis longus muscles (APL) in the extensor compartment of the forearm. Both additional muscles had two bellies, one proximal and one distal, with an intervening tendon. The proximal bellies were separate and distinct from the adjacent APLs. The tendons traversed the first dorsal compartments with the tendons of the APLs and the extensor pollicis brevis muscles (EPB). The distal bellies lay adjacent to the abductor pollicis brevis (APB) muscles in the thenar compartments, and inserted onto the volar base of the proximal phalanges of the thumbs. Following a thorough search of the literature, we determined that these additional muscles constitute a previously unreported variation. This report details the variation, compares it with other reported variations, presents the related embryology, and reviews the significance of this variation as it relates to inflammatory conditions and surgical procedures. [ABSTRACT FROM AUTHOR]

Published
2020
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24. Insulin Sensitivity and Diabetic Kidney Disease in Children and Adolescents With Type 2 Diabetes: An Observational Analysis of Data From the TODAY Clinical Trial

Author

Bjornstad, Petter, primary, Nehus, Edward, additional, El ghormli, Laure, additional, Bacha, Fida, additional, Libman, Ingrid M., additional, McKay, Siripoom, additional, Willi, Steven M., additional, Laffel, Lori, additional, Arslanian, Silva, additional, Nadeau, Kristen J., additional, McKay, S., additional, Haymond, M., additional, Anderson, B., additional, Bush, C., additional, Gunn, S., additional, Holden, H., additional, Jones, S.M., additional, Jeha, G., additional, McGirk, S., additional, Thamotharan, S., additional, Cuttler, L., additional, Abrams, E., additional, Casey, T., additional, Dahms, W., additional, Ievers-Landis, C., additional, Kaminski, B., additional, Koontz, M., additional, MacLeish, S., additional, McGuigan, P., additional, Narasimhan, S., additional, Geffner, M., additional, Barraza, V., additional, Chang, N., additional, Conrad, B., additional, Dreimane, D., additional, Estrada, S., additional, Fisher, L., additional, Fleury-Milfort, E., additional, Hernandez, S., additional, Hollen, B., additional, Kaufman, F., additional, Law, E., additional, Mansilla, V., additional, Miller, D., additional, Muñoz, C., additional, Ortiz, R., additional, Ward, A., additional, Wexler, K., additional, Xu, Y.K., additional, Yasuda, P., additional, Levitt Katz, L., additional, Berkowitz, R., additional, Boyd, S., additional, Johnson, B., additional, Kaplan, J., additional, Keating, C., additional, Lassiter, C., additional, Lipman, T., additional, McGinley, G., additional, McKnight, H., additional, Schwartzman, B., additional, Willi, S., additional, Arslanian, S., additional, Bacha, F., additional, Foster, S., additional, Galvin, B., additional, Hannon, T., additional, Kriska, A., additional, Libman, I., additional, Marcus, M., additional, Porter, K., additional, Songer, T., additional, Venditti, E., additional, Goland, R., additional, Gallagher, D., additional, Kringas, P., additional, Leibel, N., additional, Ng, D., additional, Ovalles, M., additional, Seidman, D., additional, Laffel, L., additional, Goebel-Fabbri, A., additional, Hall, M., additional, Higgins, L., additional, Keady, J., additional, Malloy, M., additional, Milaszewski, K., additional, Rasbach, L., additional, Nathan, D.M., additional, Angelescu, A., additional, Bissett, L., additional, Ciccarelli, C., additional, Delahanty, L., additional, Goldman, V., additional, Hardy, O., additional, Larkin, M., additional, Levitsky, L., additional, McEachern, R., additional, Norman, D., additional, Nwosu, D., additional, Park-Bennett, S., additional, Richards, D., additional, Sherry, N., additional, Steiner, B., additional, Tollefsen, S., additional, Carnes, S., additional, Dempsher, D., additional, Flomo, D., additional, Whelan, T., additional, Wolff, B., additional, Weinstock, R., additional, Bowerman, D., additional, Bristol, S., additional, Bulger, J., additional, Hartsig, J., additional, Izquierdo, R., additional, Kearns, J., additional, Saletsky, R., additional, Trief, P., additional, Zeitler, P., additional, Abramson, N., additional, Bradhurst, A., additional, Celona-Jacobs, N., additional, Higgins, J., additional, Kelsey, M., additional, Klingensmith, G., additional, Nadeau, K., additional, Witten, T., additional, Copeland, K., additional, Boss, E., additional, Brown, R., additional, Chadwick, J., additional, Chalmers, L., additional, Chernausek, S., additional, Hebensperger, A., additional, Macha, C., additional, Newgent, R., additional, Nordyke, A., additional, Olson, D., additional, Poulsen, T., additional, Pratt, L., additional, Preske, J., additional, Schanuel, J., additional, Sternlof, S., additional, Lynch, J., additional, Amodei, N., additional, Barajas, R., additional, Cody, C., additional, Hale, D., additional, Hernandez, J., additional, Ibarra, C., additional, Morales, E., additional, Rivera, S., additional, Rupert, G., additional, Wauters, A., additional, White, N., additional, Arbeláez, A., additional, Jones, J., additional, Jones, T., additional, Sadler, M., additional, Tanner, M., additional, Timpson, A., additional, Welch, R., additional, Caprio, S., additional, Grey, M., additional, Guandalini, C., additional, Lavietes, S., additional, Rose, P., additional, Syme, A., additional, Tamborlane, W., additional, Hirst, K., additional, Edelstein, S., additional, Feit, P., additional, Grover, N., additional, Long, C., additional, Pyle, L., additional, Linder, B., additional, Marcovina, S.M., additional, Harting, J., additional, Shepherd, J., additional, Fan, B., additional, Marquez, L., additional, Sherman, M., additional, Wang, J., additional, Nichols, M., additional, Mayer-Davis, E., additional, Liu, Y., additional, Lima, J., additional, Gidding, S., additional, Puccella, J., additional, Ricketts, E., additional, Danis, R., additional, Domalpally, A., additional, Goulding, A., additional, Neill, S., additional, Vargo, P., additional, Wilfley, D., additional, Aldrich-Rasche, D., additional, Franklin, K., additional, Massmann, C., additional, O’Brien, D., additional, Patterson, J., additional, Tibbs, T., additional, Van Buren, D., additional, Palmert, M., additional, Ratner, R., additional, Dremaine, D., additional, and Silverstein, J., additional

Published
2018
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25. Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus

Author

Scirica, B, Bhatt, D, Braunwald, E, Steg, P, Davidson, J, Hirshberg, B, Ohman, P, Frederich, R, Wiviott, S, Hoffman, E, Cavender, M, Udell, J, Desai, N, Mosenzon, O, Mcguire, D, Ray, K, Leiter, L, Raz, I, Abrahamsen, T, Grossman, M, Morin, S, Im, K, Gabovitch, D, Pricken, A, Buskila, A, Stahre, C, Price, D, Billing-Clason, S, Sabel, K, Monyak, J, Sjostrand, M, Wei, C, Lu, J, Miller, E, Raichlen, J, Fitt, S, Iqbal, N, Donovan, M, Aguilar-Salinas, C, Alvarsson, M, Amerena, J, Ardissino, D, Averkov, O, Avogaro, A, Barnett, A, Bretzel, R, Chiang, C, Codoceo, V, Corbalan, R, Dalby, A, Darius, H, Deerochanawong, C, Dellborg, M, Eliaschewitz, F, Garcia-Castillo, A, Gomis, R, Henry, P, Hoekstra, J, Jermendy, G, Kastelein, J, Keech, A, Kiss, R, Krempf, M, Laakso, M, Leitersdorf, E, Lewis, B, Litwak, L, Lopez-Sendon, J, Ma, R, Medina, F, Moses, R, Nicolau, J, Opolski, G, Ophuis, T, Paolasso, E, Ruda, M, Kumar, K, Shestakova, M, Sheu, W, Smahelova, A, Bhupathiraju, B, Spinar, J, Sritata, P, Strojeck, K, Villena-Chavez, J, Jia, W, Huo, Y, Lowe, C, Awtry, E, Berger, C, Desai, A, Gelfand, E, Leeman, D, Link, M, Ruberg, F, Vita, J, Rost, N, Silverman, S, Greenberger, N, Lerch, M, Gersh, B, Nesto, R, Del Prato, S, Tuomilehto, J, Kelsey, S, Alvarisqueta, A, Cuadrado, J, Rista, L, Hermida, S, Baccaro, C, Luquez, C, Lagrutta, M, Maffei, L, Bartolacci, I, Montana, O, Cutuli, H, Berli, M, Lorenzatti, A, Frechtel, G, La Greca, R, Fretes, O, Diaz, M, Papini, N, Farias, E, Issa, C, Elbert, A, Lehman, R, Arya, M, Singh, B, Colquhoun, D, Jayasinghe, R, de Looze, F, Blombery, P, Ward, G, Szto, G, Abhayaratna, W, Borges, J, Russo, L, Felicio, J, Santos, F, Guimaraes, F, Castro, M, Rossi, P, Armaganijan, D, Leaes, P, Bandeira, F, Franken, M, Rassi, N, Rea, R, Zanella, M, Amodeo, C, Cesar, L, Betti, R, Chacra, A, Schmid, H, Bell, A, Syan, G, Zadra, R, Conter, H, Dumas, R, Borts, D, Dattani, I, Poirier, P, Cha, J, Dzongowski, P, Labonte, R, St Pierre, B, Gaudet, D, Kouz, S, Lamy, A, Tishler, S, Chehayeb, R, Bedard, J, Hramiak, I, Teitelbaum, I, Fortin, C, Woo, V, Conway, J, Mehta, P, Robinson, S, Sussex, B, Chiasson, J, Muirhead, N, Bose, S, Ouellet, A, Yale, J, Bhargava, R, Lau, D, Tobe, S, Perron, P, Sigalas, J, Bilodeau, L, Tytus, R, Achyuthan, G, Pearce, M, Steele, A, Bailey, G, Ma, P, St-Maurice, F, Rupka, D, Houlden, R, Bailey, A, Rewa, G, Sohal, P, Ting, R, Prieto, J, Rodriguez, M, Godoy, G, Larenas, G, Pincetti, C, Cobos, L, Saavedra, V, Varleta, P, Lucero, F, Kuzmanic, O, Acevedo, M, Aguirre, M, Florenzano, F, Ma, J, Bao, Y, Jiang, M, Xu, W, Shi, Y, Zheng, M, Li, Y, Dong, Y, Zhao, W, Sun, M, Lei, M, Wang, J, Pistek, Z, Rihacek, I, Kucera, D, Brada, M, Naplava, R, Karasova, J, Vlasicova, H, Skopecek, J, Spinarova, L, Raclavska, L, Sarbochova, R, Okenka, L, Racicka, E, Urbancova, K, Oznerova, M, Lorenc, Z, Wasserburger, B, Zahumensky, E, Grunfeldova, H, Hradec, J, Lukac, M, Svacina, S, Podzimek, J, Hemzsky, L, Mikulkova, I, Pavlickova, J, Brychta, T, Chochola, J, Couffinhal, T, Elbaz, M, Petit, C, Faller, B, Marechaud, R, Moulin, P, Fendri, S, Nazeyrollas, P, Wendisch, U, Busch, K, Klausmann, G, Duengen, H, Appel, K, Toursarkissian, N, Jung, T, Ott, P, Schenkenberger, I, Kuesters, D, Landers, B, Nischik, R, Fischer, H, Tschoepe, D, Paschen, B, Krause, K, Derwahl, K, Wenzl-Bauer, V, Hamann, A, Strotmann, H, Milek, K, Mueller, S, Chu, D, Tan, K, Kung, K, Tsang, C, Tomlinson, B, Koranyi, L, Kerenyi, Z, Benczur, B, Illyes, L, Hidvegi, T, Somogyi, A, Valco, J, Ferenczi, S, Rapi, J, Voros, P, Winkler, G, Sydo, T, Hetey, M, Simon, K, Penzes, J, Kempler, P, Bako, B, Lengyel, Z, Witmann, I, Dudas, M, Vandorfi, G, Takacs, J, Matoltsy, A, Ladanyi, E, Gyimesi, A, Sadikot, S, Parikh, K, Jain, S, Yajnik, C, Sosale, A, Shamanna, P, Srikanta, S, Shah, S, Srinivas, A, Banker, D, Shah, P, Sharda, A, Makkar, B, Rais, N, Mardikar, H, Mishra, A, Bhupati, S, Menon, J, Sathe, S, Gupta, R, Sharma, V, Darawsha, M, Herskovits, T, Hamoud, S, Nikolsky, E, Adawi, F, Zimlichman, R, Tsalihin, D, Wainstein, J, Klainman, E, Mosseri, M, Yerushalmi, Y, Karnieli, E, Knobler, H, Benchetrit, S, Tsur, A, Yagil, Y, Atar, S, Beberashvili, I, Fuchs, S, Stern, N, Pollak, A, Chajek-Shaul, T, Rozenman, Y, Biton, A, Bramucci, E, Fiscella, A, Grassia, V, Piatti, P, De Cosmo, S, Di Lorenzo, L, Merlini, P, Mannucci, E, Frontoni, S, Trevisan, R, Zenari, L, Lambiase, C, Salvioni, A, Silvestri, O, Ambrosio, G, Di Bartolo, P, Fattore, L, Presbitero, P, Calabrese, M, Evola, R, Gamba, M, Ibarra, M, Munoz, E, Sanchez, D, Herrera, C, Rios, J, Llamas, E, Esperon, G, Cantu, E, Fragoso, J, Gonzalez, J, Martinez, G, Padilla, F, Mier, G, Marmolejo, D, Ruiz, J, Portilla, N, Rosas, E, Machado, G, Ramos, J, Briones, I, van Hessen, M, Strikwerda, S, The, S, Kooy, A, Ronner, E, Nierop, P, Remmen, J, Groenemeijer, B, Hamer, B, Basart, D, van Lennep, H, Nieuwdorp, M, van Dijk, M, Kentgens, S, van Kempen, W, Hoogendijk, J, Spiering, W, Voors-Pette, C, Kose, V, de Waard, D, Gonkel, F, Kaasjager, H, Lingan, G, Agous, I, Kruik, H, Imholz, B, Pieterse, M, Manrique, H, Villena, J, Leon, L, Kundert, K, Minchola, J, Pinto, M, Heredia, J, Rodriguez, A, Guerreros, C, Berrospi, P, Zubiate, C, Allemant, A, Arbanil, H, Ponciano, W, Calderon, J, Lisson, R, Segura, L, Sidorowicz-Bialynicka, A, Sciborski, R, Fares, I, Mader, P, Skierkowska, J, Stasinska, T, Pomiecko, W, Skorski, M, Krzyzagorska, E, Polaszewska-Muszynska, M, Sowinski, D, Strojek, K, Rosinska-Migda, J, Romanczuk, P, Golebiowski, G, Kubica, J, Mazurek, T, Wojnowski, L, Pasternak, D, Stachlewski, P, Trzepla, E, Bogdanowicz, G, Uzunow, A, Potakowska, I, Miszczyszyn, Z, Waszyrowski, T, Smolenskaya, O, Lukyanov, Y, Vorokhobina, N, Khalimov, Y, Orlikova, O, Rebrov, A, Kukharchuk, V, Boldueva, S, Arkhipov, M, Zhelninova, T, Pavlysh, E, Antsiferov, M, Panov, A, Pavlova, M, Shustov, S, Demchenko, E, Galyavich, A, Malakhina, E, Semenova, O, Kobalava, Z, Kotova, S, Gavrisheva, I, Oschepkova, E, Karpov, Y, Sidorenko, B, Kislyak, O, Ametov, A, Dreval, A, Grineva, E, Mkrtumyan, A, Tyurina, T, Sazonova, O, Bonnici, F, Ranjith, N, Burgess, L, Nortje, H, Distiller, L, Mitha, I, Moore, R, Conradie, M, Horak, A, Pillay, S, Wellmann, H, Berg, E, Pillai, P, Padayachee, T, Corbett, C, Makan, H, Wing, J, Vawda, Z, Ebrahim, I, Mitha, E, Bhorat, A, Fernandez, J, Munoz, C, Cortada, J, Conde, A, Calvo, C, Extremera, B, Delgado, E, Masmiquel, L, Puig, J, Parreno, L, Mauricio, D, Redon, J, Brito, M, Lopez, C, de la Morera, J, Linderfalk, C, Larnefeldt, H, Olsson, A, Lonneborg, L, Ekelund, M, Samad, B, Borgencrantz, B, Nilsson, J, Berglund, O, Svensson, M, Mooe, T, Curiac, D, Albin, J, Angesjo, E, Lannemyr, O, Chen, J, Tien, K, Ueng, K, Lai, W, Yin, W, Hung, Y, Shyu, K, Hou, J, Lam, H, Laothavorn, P, Kuanprasert, S, Khovidhunkit, W, Benjasuratwong, Y, Chotinaiwattarakul, C, Mamanasiri, S, Suraamornkul, S, Pratipanawatr, T, Nitiyanant, W, Heller, S, Pieters, R, Strang, C, Bodalia, B, Middleton, A, Hall, T, Chapman, G, Calvert, J, Reed, R, Tam, D, Butcher, G, Jones, N, Takhar, A, Turner, W, Mcnally, D, Corey, O, Chapman, J, Mohr, S, Edwards, S, Ocampo, A, Kandath, D, Aude, Y, Ervin, W, Savin, V, Anderson, R, Littlefield, R, Oberoi, M, Platt, G, Yazdani, S, Mangoo-Karim, R, Walder, J, Gogia, H, Chandrashekhar, Y, Boccalandro, F, Rogers, W, Bilazarian, S, Zieve, F, Siage, Y, O'Connor, T, Mudaliar, S, Nikas, A, Giusti, R, Glover, R, Chilka, S, French, W, Roth, E, Singh, N, Christofferson, R, Stich, M, Dagogo-Jack, S, Allison, J, Zengotita, G, Ison, R, Iteld, B, Sulistio, M, Gonzalez, E, Gorman, T, Hage-Korban, E, Reddy, R, Byars, W, Antonishen, M, Benjamin, S, First, B, Rosado, J, Bruschetta, H, Poling, T, Rosendorff, C, Kerstein, H, Saba, F, Willis, J, Adams, K, Vazquez, E, Ellison, H, Kahn, B, Kereiakes, D, Powell, S, Raskin, P, Smith, K, Varma, S, Whittier, F, Casanova, R, Isserman, S, Kaye, W, Mcguinn, W, Bartkowiak, A, Dworkin, L, Labrador, C, Podlecki, D, Popovtzer, M, Aronoff, S, Ballantyne, C, Ortiz, E, Mora, A, Pitts, T, Reinhardt, S, Soucie, G, Wainwright, W, Henson, B, Sklaver, N, Arakaki, R, Brown, J, Chalavarya, G, Chochinov, R, Dixon, T, Kutner, M, Perlman, R, Raisinghani, A, Salacata, A, Awasty, V, Elinoff, V, George, W, LaRochelle-Gryseels, A, Mercado, A, Miller, G, Qureshi, M, Steljes, A, Wefald, F, Wilson, J, Chinn, J, Chuang, R, Comulada-Rivera, A, Hartman, I, Narayan, P, Pacheco, T, Weiss, R, Beavins, J, Creevy, J, Hamroff, G, Hodson, R, Kosinski, E, Krichmar, P, Patel, R, Schneider, R, Shapiro, J, Sharp, D, Speer, J, Stegemoller, R, Waxman, F, Chang, F, Braun, E, Eder, F, Minor, S, Albert, M, Carr, K, Diaczok, B, Gastman, I, Gupta, V, Longshaw, K, Gonzalez-Campoy, J, Raikhel, M, Thomas, J, Wood, K, Diab, I, Furda, J, Gelernt, M, Halter, M, House, B, Kaster, S, Raad, G, Stamatin, R, Barker, B, Blonder, R, Bloomberg, R, Calderon, R, Carrol, A, Comerota, A, Feinglos, M, Henderson, D, Kastelic, R, Stonesifer, L, Talano, J, Lee, P, Brosseau, J, Clark, W, Cohen, E, Fialkow, J, Horton, K, Kozman, H, Mcgill, J, Mihills, C, Poonawala, R, Shore, K, Tejada, L, Torres, R, Wright, W, Calatayud, G, Chandna, H, Drozdiak, R, Fink, R, Gill, R, Glandt, M, Gottlieb, D, Hack, T, Kay, J, Mansouri, V, Mcknight, T, Mostel, E, Schmidt, L, Seide, H, Sonel, E, Taylor, R, Velasquez, M, Bretton, E, Feldman, R, Hartman, A, Hershon, K, Leach, C, Martin, E, Mohiuddin, F, Naygandhi, Y, Riske, T, Schima, S, Uzoaga, E, Ward, H, Weinstock, R, Williams, T, Altschuller, A, Aoki, T, Blumenthal, S, Cash, A, Eisner, G, Gutmann, J, Hagan, M, Kabour, A, Markus, T, Mckenzie, W, Moursi, M, Mystkowski, P, Ovalle, F, Perkins, R, Popeil, L, Saniuk, R, Sierra, Y, Alvarado, O, Anderson, J, Bajaj, M, Blank, R, Chu, A, Levinsky, L, Levy, P, Osborne, J, Pavon, H, Sanderlin, D, Schaer, G, Zarich, S, Atassi, K, Bayron, C, Casagrande, M, Das, D, Gimness, M, Handel, F, Kinstrey, T, Leu, S, Osei, K, Nouel, J, Soltani, Z, Sussman, H, Chiu, K, Duda, R, Farnsworth, K, Lano, M, Lee, F, Levin, P, Pratt, S, Richwine, R, Ruiz-Rivera, L, Turner, J, Wood, J, Zigrang, W, Baquerizo, H, Colon, C, Demattia, J, Desai, V, Fitz-Patrick, D, Goral, S, Odhav, A, Prentiss, A, Ruff, C, Wu, W, Wyne, K, Abbott, L, Applegate, R, Cabral, J, Kotha, P, Ortega, P, Simmons, D, Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, Ohman P, Frederich R, Wiviott SD, Hoffman EB, Cavender MA, Udell JA, Desai NR, Mosenzon O, McGuire DK, Ray KK, Leiter LA, Raz I, Desai N, Abrahamsen T, Grossman M, Morin S, Im K, Hoffman E, Gabovitch D, Pricken A, Buskila A, Stahre C, Price D, Billing-Clason S, Sabel K, Monyak J, Sjostrand M, Wei C, Lu J, Miller E, Raichlen J, Fitt S, Iqbal N, Donovan M, Davidson JA, Aguilar-Salinas C, Alvarsson M, Amerena J, Ardissino D, Averkov O, Avogaro A, Barnett A, Bretzel R, Chiang CE, Codoceo V, Corbalan R, Dalby A, Darius H, Deerochanawong C, Dellborg M, Eliaschewitz F, Garcia-Castillo A, Gomis R, Henry P, Hoekstra J, Jermendy G, Kastelein J, Keech A, Kiss R, Krempf M, Laakso M, Leiter L, Leitersdorf E, Lewis B, Litwak L, Lopez-Sendon J, Ma R, McGuire D, Medina F, Moses R, Nicolau JC, Opolski G, Ophuis TO, Paolasso E, Ruda M, Kumar KMP, Shestakova M, Sheu WHH, Smahelova A, Bhupathiraju BSR, Spinar J, Sritata P, Strojeck K, Villena-Chavez JE, Jia WP, Huo Y, Lowe C, Awtry E, Berger C, Desai AS, Gelfand E, Leeman D, Link M, Ruberg F, Vita J, Rost N, Silverman S, Greenberger NJ, Lerch MM, Gersh B, Nesto R, Del Prato S, Tuomilehto J, Kelsey S, Alvarisqueta A, Cuadrado J, Rista L, Hermida S, Baccaro C, Luquez C, Lagrutta M, Maffei L, Bartolacci I, Montana O, Cutuli H, Berli M, Lorenzatti A, Frechtel G, La Greca R, Fretes O, Diaz M, Papini NR, Farias E, Issa C, Elbert A, Lehman R, Arya M, Singh B, Colquhoun D, Jayasinghe R, de Looze F, Blombery P, Ward G, Szto G, Abhayaratna W, Borges J, Russo L, Felicio J, Santos F, Guimaraes F, Castro ML, Rossi P, Armaganijan D, Leaes P, Bandeira F, Franken M, Rassi N, Rea R, Zanella M, Amodeo C, Cesar L, Betti R, Chacra A, Schmid H, Bell A, Syan G, Zadra R, Conter H, Dumas R, Borts D, Dattani I, Poirier P, Cha J, Dzongowski P, Labonte R, St Pierre B, Gaudet D, Kouz S, Lamy A, Tishler S, Chehayeb R, Bedard J, Hramiak I, Teitelbaum I, Fortin C, Woo V, Conway J, Mehta P, Robinson S, Sussex B, Chiasson J, Muirhead N, Bose S, Ouellet A, Yale J, Bhargava R, Lau D, Tobe S, Perron P, Sigalas J, Bilodeau L, Tytus R, Achyuthan G, Pearce M, Steele A, Bailey G, Ma P, St-Maurice F, Rupka D, Houlden R, Bailey A, Rewa G, Sohal P, Ting R, Prieto J, Rodriguez M, Godoy G, Larenas G, Pincetti C, Cobos L, Saavedra V, Varleta P, Lucero F, Kuzmanic O, Acevedo M, Aguirre M, Florenzano F, Ma J, Bao Y, Jiang M, Xu W, Shi Y, Zheng M, Li Y, Dong Y, Zhao W, Sun M, Lei M, Wang J, Pistek Z, Rihacek I, Kucera D, Brada M, Naplava R, Karasova J, Vlasicova H, Skopecek J, Spinarova L, Raclavska L, Sarbochova R, Okenka L, Racicka E, Urbancova K, Oznerova M, Lorenc Z, Wasserburger B, Zahumensky E, Grunfeldova H, Hradec J, Lukac M, Svacina S, Podzimek J, Hemzsky L, Mikulkova I, Pavlickova J, Brychta T, Chochola J, Couffinhal T, Elbaz M, Petit C, Faller B, Marechaud R, Moulin P, Fendri S, Nazeyrollas P, Wendisch U, Busch K, Klausmann G, Duengen H, Appel K, Toursarkissian N, Jung T, Ott P, Schenkenberger I, Kuesters D, Landers B, Nischik R, Fischer H, Tschoepe D, Paschen B, Krause K, Derwahl K, Wenzl-Bauer V, Hamann A, Strotmann H, Milek K, Mueller S, Chu D, Tan K, Kung K, Tsang C, Tomlinson B, Koranyi L, Kerenyi Z, Benczur B, Illyes L, Hidvegi T, Somogyi A, Valco J, Ferenczi S, Rapi J, Voros P, Winkler G, Sydo T, Hetey M, Simon K, Penzes J, Kempler P, Bako B, Lengyel Z, Witmann I, Dudas M, Vandorfi G, Takacs J, Matoltsy A, Ladanyi E, Gyimesi A, Sadikot S, Parikh K, Jain S, Yajnik C, Sosale A, Shamanna P, Srikanta S, Shah S, Srinivas A, Banker D, Shah P, Sharda A, Makkar B, Rais N, Mardikar H, Mishra A, Bhupati S, Menon J, Sathe S, Gupta R, Sharma V, Darawsha M, Herskovits T, Hamoud S, Nikolsky E, Adawi F, 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D, Kouz S, Lamy A, Tishler S, Chehayeb R, Bedard J, Hramiak I, Teitelbaum I, Fortin C, Woo V, Conway J, Mehta P, Robinson S, Sussex B, Chiasson J, Muirhead N, Bose S, Ouellet A, Yale J, Bhargava R, Lau D, Tobe S, Perron P, Sigalas J, Bilodeau L, Tytus R, Achyuthan G, Pearce M, Steele A, Bailey G, Ma P, St-Maurice F, Rupka D, Houlden R, Bailey A, Rewa G, Sohal P, Ting R, Prieto J, Rodriguez M, Godoy G, Larenas G, Pincetti C, Cobos L, Saavedra V, Varleta P, Lucero F, Kuzmanic O, Acevedo M, Aguirre M, Florenzano F, Ma J, Bao Y, Jiang M, Xu W, Shi Y, Zheng M, Li Y, Dong Y, Zhao W, Sun M, Lei M, Wang J, Pistek Z, Rihacek I, Kucera D, Brada M, Naplava R, Karasova J, Vlasicova H, Skopecek J, Spinarova L, Raclavska L, Sarbochova R, Okenka L, Racicka E, Urbancova K, Oznerova M, Lorenc Z, Wasserburger B, Zahumensky E, Grunfeldova H, Hradec J, Lukac M, Svacina S, Podzimek J, Hemzsky L, Mikulkova I, Pavlickova J, Brychta T, Chochola J, Couffinhal T, Elbaz M, Petit C, Faller B, Marechaud R, Moulin 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Allemant A, Arbanil H, Ponciano W, Calderon J, Lisson R, Segura L, Sidorowicz-Bialynicka A, Sciborski R, Fares I, Mader P, Skierkowska J, Stasinska T, Pomiecko W, Skorski M, Krzyzagorska E, Polaszewska-Muszynska M, Sowinski D, Strojek K, Rosinska-Migda J, Romanczuk P, Golebiowski G, Kubica J, Mazurek T, Wojnowski L, Pasternak D, Stachlewski P, Trzepla E, Bogdanowicz G, Uzunow A, Potakowska I, Miszczyszyn Z, Waszyrowski T, Smolenskaya O, Lukyanov Y, Vorokhobina N, Khalimov Y, Orlikova O, Rebrov A, Kukharchuk V, Boldueva S, Arkhipov M, Zhelninova T, Pavlysh E, Antsiferov M, Panov A, Pavlova M, Shustov S, Demchenko E, Galyavich A, Malakhina E, Semenova O, Kobalava Z, Kotova S, Gavrisheva I, Oschepkova E, Karpov Y, Sidorenko B, Kislyak O, Ametov A, Dreval A, Grineva E, Mkrtumyan A, Tyurina T, Sazonova O, Bonnici F, Ranjith N, Burgess L, Nortje H, Distiller L, Mitha I, Moore R, Conradie M, Horak A, Pillay S, Wellmann H, Berg E, Pillai P, Padayachee T, Corbett C, Makan H, Wing J, Vawda Z, Ebrahim I, Mitha E, Bhorat A, Fernandez JC, Munoz C, Cortada JB, Conde AC, Calvo C, Extremera BG, Delgado E, Masmiquel L, Puig JG, Parreno LD, Mauricio D, Redon J, Brito M, Lopez C, de la Morera JS, Linderfalk C, Larnefeldt H, Olsson A, Lonneborg L, Ekelund M, Samad B, Borgencrantz B, Nilsson J, Berglund O, Svensson M, Mooe T, Curiac D, Albin J, Angesjo E, Lannemyr O, Chiang C, Sheu W, Chen J, Tien K, Ueng K, Lai W, Yin W, Hung Y, Shyu K, Hou J, Lam H, Laothavorn P, Kuanprasert S, Khovidhunkit W, Benjasuratwong Y, Chotinaiwattarakul C, Mamanasiri S, Suraamornkul S, Pratipanawatr T, Nitiyanant W, Heller S, Ray K, Pieters R, Strang C, Bodalia B, Middleton A, Hall T, Chapman G, Calvert J, Reed R, Tam D, Butcher G, Jones N, Takhar A, Turner W, McNally D, Corey O, Chapman J, Mohr S, Edwards S, Bhatt D, Ocampo A, Kandath D, Aude Y, Ervin W, Savin V, Anderson R, Littlefield R, Oberoi M, Platt GE, Yazdani S, Mangoo-Karim R, Walder J, Gogia H, Chandrashekhar Y, Boccalandro F, Rogers W, 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Blumenthal S, Cash A, Eisner G, Gutmann J, Hagan M, Kabour A, Markus T, McKenzie W, Moursi M, Mystkowski P, Ovalle F, Perkins R, Popeil L, Saniuk R, Sierra Y, Alvarado O, Anderson J, Bajaj M, Blank R, Chu A, Levinsky L, Levy P, Osborne J, Pavon H, Sanderlin D, Schaer G, Zarich S, Atassi K, Bayron C, Casagrande M, Das D, Gimness M, Handel F, Kinstrey T, Leu S, Osei K, Nouel JS, Soltani Z, Sussman H, Chiu K, Duda R, Farnsworth K, Lano M, Lee F, Levin P, Pratt S, Richwine R, Ruiz-Rivera L, Turner J, Wood J, Zigrang WD, Baquerizo HR, Colon CB, Demattia J, Desai V, Fitz-Patrick D, Goral S, Odhav A, Prentiss A, Ruff C, Wu W, Wyne K, Abbott LG, Applegate R, Cabral J, Kotha P, Ortega P, and Simmons D

Abstract

BACKGROUND: The cardiovascular safety and efficacy of many current antihyperglycemic agents, including saxagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, are unclear. METHODS: We randomly assigned 16,492 patients with type 2 diabetes who had a history of, or were at risk for, cardiovascular events to receive saxagliptin or placebo and followed them for a median of 2.1 years. Physicians were permitted to adjust other medications, including antihyperglycemic agents. The primary end point was a composite of cardiovascular death, myocardial infarction, or ischemic stroke. RESULTS: A primary end-point event occurred in 613 patients in the saxagliptin group and in 609 patients in the placebo group (7.3% and 7.2%, respectively, according to 2-year Kaplan-Meier estimates; hazard ratio with saxagliptin, 1.00; 95% confidence interval [CI], 0.89 to 1.12; P=0.99 for superiority; P<0.001 for noninferiority); the results were similar in the "on-treatment" analysis (hazard ratio, 1.03; 95% CI, 0.91 to 1.17). The major secondary end point of a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, coronary revascularization, or heart failure occurred in 1059 patients in the saxagliptin group and in 1034 patients in the placebo group (12.8% and 12.4%, respectively, according to 2-year Kaplan-Meier estimates; hazard ratio, 1.02; 95% CI, 0.94 to 1.11; P=0.66). More patients in the saxagliptin group than in the placebo group were hospitalized for heart failure (3.5% vs. 2.8%; hazard ratio, 1.27; 95% CI, 1.07 to 1.51; P=0.007). Rates of adjudicated cases of acute and chronic pancreatitis were similar in the two groups (acute pancreatitis, 0.3% in the saxagliptin group and 0.2% in the placebo group; chronic pancreatitis, <0.1% and 0.1% in the two groups, respectively). CONCLUSIONS: DPP-4 inhibition with saxagliptin did not increase or decrease the rate of ischemic events, though the rate of hospitalization for heart failure was

Published
2013

26. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus

Author

Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, Ohman P, Frederich R, Wiviott SD, Hoffman EB, Cavender MA, Udell JA, Desai NR, Mosenzon O, McGuire DK, Ray KK, Leiter LA, Raz I, Desai N, Abrahamsen T, Grossman M, Morin S, Im K, Hoffman E, Gabovitch D, Pricken A, Buskila A, Stahre C, Price D, Billing-Clason S, Sabel K, Monyak J, Sjostrand M, Wei C, Lu J, Miller E, Raichlen J, Fitt S, Iqbal N, Donovan M, Davidson JA, Aguilar-Salinas C, Alvarsson M, Amerena J, Ardissino D, Averkov O, Avogaro A, Barnett A, Bretzel R, Chiang CE, Codoceo V, Corbalan R, Dalby A, Darius H, Deerochanawong C, Dellborg M, Eliaschewitz F, Garcia-Castillo A, Gomis R, Henry P, Hoekstra J, Jermendy G, Kastelein J, Keech A, Kiss R, Krempf M, Laakso M, Leiter L, Leitersdorf E, Lewis B, Litwak L, Lopez-Sendon J, Ma R, McGuire D, Medina F, Moses R, Nicolau JC, Opolski G, Ophuis TO, Paolasso E, Ruda M, Kumar KMP, Shestakova M, Sheu WHH, Smahelova A, Bhupathiraju BSR, Spinar J, Sritata P, Strojeck K, Villena-Chavez JE, Jia WP, Huo Y, Lowe C, Awtry E, Berger C, Desai AS, Gelfand E, Leeman D, Link M, Ruberg F, Vita J, Rost N, Silverman S, Greenberger NJ, Lerch MM, Gersh B, Nesto R, Del Prato S, Tuomilehto J, Kelsey S, Alvarisqueta A, Cuadrado J, Rista L, Hermida S, Baccaro C, Luquez C, Lagrutta M, Maffei L, Bartolacci I, Montana O, Cutuli H, Berli M, Lorenzatti A, Frechtel G, La Greca R, Fretes O, Diaz M, Papini NR, Farias E, Issa C, Elbert A, Lehman R, Arya M, Singh B, Colquhoun D, Jayasinghe R, de Looze F, Blombery P, Ward G, Szto G, Abhayaratna W, Borges J, Russo L, Felicio J, Santos F, Guimaraes F, Castro ML, Rossi P, Armaganijan D, Leaes P, Bandeira F, Franken M, Rassi N, Rea R, Zanella M, Amodeo C, Cesar L, Betti R, Chacra A, Schmid H, Bell A, Syan G, Zadra R, Conter H, Dumas R, Borts D, Dattani I, Poirier P, Cha J, Dzongowski P, Labonte R, St Pierre B, Gaudet D, Kouz S, Lamy A, Tishler S, Chehayeb R, Bedard J, Hramiak I, Teitelbaum I, Fortin C, Woo V, Conway J, Mehta P, Robinson S, Sussex B, Chiasson J, Muirhead N, Bose S, Ouellet A, Yale J, Bhargava R, Lau D, Tobe S, Perron P, Sigalas J, Bilodeau L, Tytus R, Achyuthan G, Pearce M, Steele A, Bailey G, Ma P, St-Maurice F, Rupka D, Houlden R, Bailey A, Rewa G, Sohal P, Ting R, Prieto J, Rodriguez M, Godoy G, Larenas G, Pincetti C, Cobos L, Saavedra V, Varleta P, Lucero F, Kuzmanic O, Acevedo M, Aguirre M, Florenzano F, Ma J, Bao Y, Jiang M, Xu W, Shi Y, Zheng M, Li Y, Dong Y, Zhao W, Sun M, Lei M, Wang J, Pistek Z, Rihacek I, Kucera D, Brada M, Naplava R, Karasova J, Vlasicova H, Skopecek J, Spinarova L, Raclavska L, Sarbochova R, Okenka L, Racicka E, Urbancova K, Oznerova M, Lorenc Z, Wasserburger B, Zahumensky E, Grunfeldova H, Hradec J, Lukac M, Svacina S, Podzimek J, Hemzsky L, Mikulkova I, Pavlickova J, Brychta T, Chochola J, Couffinhal T, Elbaz M, Petit C, Faller B, Marechaud R, Moulin P, Fendri S, Nazeyrollas P, Wendisch U, Busch K, Klausmann G, Duengen H, Appel K, Toursarkissian N, Jung T, Ott P, Schenkenberger I, Kuesters D, Landers B, Nischik R, Fischer H, Tschoepe D, Paschen B, Krause K, Derwahl K, Wenzl-Bauer V, Hamann A, Strotmann H, Milek K, Mueller S, Chu D, Tan K, Kung K, Tsang C, Tomlinson B, Koranyi L, Kerenyi Z, Benczur B, Illyes L, Hidvegi T, Somogyi A, Valco J, Ferenczi S, Rapi J, Voros P, Winkler G, Sydo T, Hetey M, Simon K, Penzes J, Kempler P, Bako B, Lengyel Z, Witmann I, Dudas M, Vandorfi G, Takacs J, Matoltsy A, Ladanyi E, Gyimesi A, Sadikot S, Parikh K, Jain S, Yajnik C, Sosale A, Shamanna P, Srikanta S, Shah S, Srinivas A, Banker D, Shah P, Sharda A, Makkar B, Rais N, Mardikar H, Mishra A, Bhupati S, Menon J, Sathe S, Gupta R, Sharma V, Darawsha M, Herskovits T, Hamoud S, Nikolsky E, Adawi F, Zimlichman R, Tsalihin D, Wainstein J, Klainman E, Mosseri M, Yerushalmi Y, Karnieli E, Knobler H, Benchetrit S, Tsur A, Yagil Y, Atar S, Beberashvili I, Fuchs S, Stern N, Pollak A, Chajek-Shaul T, Rozenman Y, Biton A, Bramucci E, Fiscella A, Grassia V, Piatti P, De Cosmo S, Di Lorenzo L, Merlini P, Mannucci E, Frontoni S, Trevisan R, Zenari L, Lambiase C, Salvioni A, Silvestri O, Ambrosio G, Di Bartolo P, Fattore L, Presbitero P, Calabrese M, Evola R, Gamba MA, Ibarra MOD, Munoz EC, Sanchez DR, Herrera CH, Rios JP, Llamas EB, Esperon GL, Cantu EG, Fragoso JN, Gonzalez JG, Martinez GR, Padilla FP, Mier GM, Marmolejo DH, Ruiz JG, Portilla NC, Rosas EL, Machado GM, Ramos JC, Briones IR, van Hessen MWJ, Strikwerda S, The SHK, Kooy A, Ronner E, Nierop PR, Remmen JJ, Groenemeijer BE, Hamer BJB, Basart DCG, van Lennep HWOR, Nieuwdorp M, van Dijk MPM, Kentgens S, van Kempen WW, Hoogendijk J, Spiering W, Voors-Pette C, Kose V, de Waard DEP, Gonkel F, Kaasjager HAH, Lingan GMR, Agous I, Kruik HJ, Imholz BPM, Pieterse M, Manrique H, Villena J, Leon L, Kundert K, Minchola J, Pinto M, Heredia J, Rodriguez A, Guerreros C, Berrospi P, Zubiate C, Allemant A, Arbanil H, Ponciano W, Calderon J, Lisson R, Segura L, Sidorowicz-Bialynicka A, Sciborski R, Fares I, 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Feldman, R, Hartman, A, Hershon, K, Leach, C, Martin, E, Mohiuddin, F, Naygandhi, Y, Riske, T, Schima, S, Uzoaga, E, Ward, H, Weinstock, R, Williams, T, Altschuller, A, Aoki, T, Blumenthal, S, Cash, A, Eisner, G, Gutmann, J, Hagan, M, Kabour, A, Markus, T, Mckenzie, W, Moursi, M, Mystkowski, P, Ovalle, F, Perkins, R, Popeil, L, Saniuk, R, Sierra, Y, Alvarado, O, Anderson, J, Bajaj, M, Blank, R, Chu, A, Levinsky, L, Levy, P, Osborne, J, Pavon, H, Sanderlin, D, Schaer, G, Zarich, S, Atassi, K, Bayron, C, Casagrande, M, Das, D, Gimness, M, Handel, F, Kinstrey, T, Leu, S, Osei, K, Nouel, J, Soltani, Z, Sussman, H, Chiu, K, Duda, R, Farnsworth, K, Lano, M, Lee, F, Levin, P, Pratt, S, Richwine, R, Ruiz-Rivera, L, Turner, J, Wood, J, Zigrang, W, Baquerizo, H, Colon, C, Demattia, J, Desai, V, Fitz-Patrick, D, Goral, S, Odhav, A, Prentiss, A, Ruff, C, Wu, W, Wyne, K, Abbott, L, Applegate, R, Cabral, J, Kotha, P, Ortega, P, and Simmons, D

Subjects
Male, Adamantane, Dipeptidyl peptidase-4 inhibitor, Type 2 diabetes, Kaplan-Meier Estimate, Saxagliptin, chemistry.chemical_compound, 80 and over, glucose, saxagliptin, Aged, 80 and over, Medicine (all), Hazard ratio, 11 Medical And Health Sciences, General Medicine, Dipeptides, Middle Aged, Hospitalization, Cardiovascular Diseases, Female, Aged, Diabetes Mellitus, Type 2, Dipeptidyl-Peptidase IV Inhibitors, Double-Blind Method, Heart Failure, Humans, Hypoglycemia, Hypoglycemic Agents, Pancreatitis, Alogliptin, Type 2, medicine.drug, insulin, medicine.medical_specialty, General & Internal Medicine, Internal medicine, Diabetes mellitus, medicine, Empagliflozin, Diabetes Mellitus, Intensive care medicine, glycosylated hemoglobin, business.industry, Semaglutide, SAVOR-TIMI 53 Steering Committee and Investigators, medicine.disease, chemistry, placebo, business
Abstract

BACKGROUND: The cardiovascular safety and efficacy of many current antihyperglycemic agents, including saxagliptin, a dipeptidyl peptidase 4 (DPP-4) inhibitor, are unclear. METHODS: We randomly assigned 16,492 patients with type 2 diabetes who had a history of, or were at risk for, cardiovascular events to receive saxagliptin or placebo and followed them for a median of 2.1 years. Physicians were permitted to adjust other medications, including antihyperglycemic agents. The primary end point was a composite of cardiovascular death, myocardial infarction, or ischemic stroke. RESULTS: A primary end-point event occurred in 613 patients in the saxagliptin group and in 609 patients in the placebo group (7.3% and 7.2%, respectively, according to 2-year Kaplan-Meier estimates; hazard ratio with saxagliptin, 1.00; 95% confidence interval [CI], 0.89 to 1.12; P=0.99 for superiority; P

Published
2013

27. Serum concentrations of polychlorinated biphenyls (PCBs) in participants of the Anniston Community Health Survey

Author

Pavuk, M, Olson, JR, Sjödin, A, Wolff, P, Turner, WE, Shelton, C, Dutton, ND, Bartell, S, Carter, S, Carpenter, DO, Cash, J, Percy, A, Frumkin, H, Lavender, M, Moysich, K, Rosenbaum, P, Silverstone, A, and Weinstock, R

Abstract

Serum concentrations of 35 ortho-substituted polychlorinated biphenyl congeners (PCBs) were measured in 765 adults from Anniston, Alabama, where PCBs were manufactured between 1929 and 1971. As part of the Anniston Community Health Survey (ACHS), demographic data, questionnaire information, and blood samples were collected from participants in 2005-2007. Forty-six percent of study participants were African-American, 70% were female, and the median age was 56. years. The median concentration of the sum of 35 PCB congeners (σPCBs) was 528. ng/g lipid, with a 90th percentile of 2600. ng/g lipid, minimum of 17.0. ng/g lipid, and maximum of 27,337. ng/g lipid. The least square geometric mean σPCBs was more than 2.5 times higher for African-American participants than for White participants (866. ng/g lipid vs. 331. ng/g lipid); this difference did not change materially after adjustment for age, sex, body mass index (BMI) and current smoking. In spite of large differences in absolute PCB levels, relative contributions of individual congeners to σPCBs were quite similar between race groups. Nevertheless, while percent contributions to σPCBs for most of the most abundant penta- to heptachlorobiphenyls were higher among African-Americans, the percentages were higher in Whites for the lower-chlorinated PCBs 28 and 74 and for octa- to decachlorinated PCBs. No major differences were observed in geometric mean σPCBs between women and men when adjusted for age, race, BMI and current smoking (516. ng/g lipid vs. 526. ng/g lipid). Principal component analysis revealed groups of co-varying congeners that appear to be determined by chlorine substitution patterns. These congener groupings were similar between ACHS participants and the National Health and Nutrition Examination Survey (NHANES) 2003-04 sample of the general United States population, despite ACHS participants having serum concentrations of σPCBs two to three times higher than those in comparable age and race groups from NHANES. © 2013 .

Published
2014
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29. Predictors of serum polychlorinated biphenyl concentrations in Anniston residents

Author

Pavuk, M., primary, Olson, J.R., additional, Wattigney, W.A., additional, Dutton, N.D., additional, Sjödin, A., additional, Shelton, C., additional, Turner, W.E., additional, Bartell, S.M., additional, Bartell, S., additional, Carpenter, D.O., additional, Cash, J., additional, Foushee, R., additional, Percy, A., additional, Frumkin, H., additional, Lavender, M., additional, Moysich, K., additional, Olson, J., additional, Pavuk, M., additional, Rosenbaum, P., additional, Silverstone, A., additional, and Weinstock, R., additional

Published
2014
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30. Multiple short bouts of exercise over 12-h period reduce glucose excursions more than an energy-matched single bout of exercise

Author

Holmstrup, M., Fairchild, T.J., Keslacy, S., Weinstock, R., Kanaley, J., Holmstrup, M., Fairchild, T.J., Keslacy, S., Weinstock, R., and Kanaley, J.

Abstract

Objective Long, uninterrupted bouts of sedentary behavior are thought to negatively influence postprandial glucose and insulin concentrations. We examined the effects of a 1-h bout of morning exercise versus intermittent walking bouts of short duration on glucose excursions and insulin secretion over 12-h. Materials/Methods Eleven young, obese individuals (18–35 years, BMI > 30 kg/m2) with impaired glucose tolerance were studied on three 12-h study days: 1) sedentary behavior (SED); 2) sedentary behavior with 1-h morning exercise (EX) at 60%–65% VO2peak; and 3) sedentary behavior with 12-hourly, 5-min intervals of exercise (INT) at 60%–65% VO2peak. Meals (1046 kJ/meal) were provided every 2-h. Blood samples were collected every 10 min and measured for glucose, insulin, and c-peptide concentrations. Results Glucose iAUC (12-h) was attenuated in the INT and SED conditions compared to the EX condition (P < 0.05). Glucose concentrations were higher in the EX compared to the SED condition for ~ 150 min (20% of the study day), and comparison of the EX-INT study days revealed that glucose concentrations were greater for ~ 240 min (~ 1/3 of the 12-h day). In the SED condition, the 12-h insulin iAUC was ~ 15% higher (P < 0.05) compared to the INT and EX conditions. Insulin production rate was found to increase ~ 20% with INT exercise vs. the SED and EX condition (P < 0.05). Conclusions Short, frequent periods of exercise attenuated glucose excursions and insulin concentrations in obese individuals to a greater degree than an equal amount of exercise performed continuously in the morning.

Published
2013

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