bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etanercept Treatment in Children With New-Onset Type 1 Diabetes
Authors: Mastrandrea Lucy , Yu Jihnhee , Behrens Torsten , Buchlis John , Albini Christine , Fourtner Shannon , Quattrin Teresa 
Published: April 2009

OBJECTIVETo gather preliminary data on the feasibility and efficacy of etanercept therapy to prolong endogenous insulin production in pediatric patients with newly diagnosed type 1 diabetes.RESEARCH DESIGN AND METHODSThis was a 24-week double-blind, randomized, placebo-controlled study conducted at the Diabetes Center, Women and Children's Hospital of Buffalo. Eighteen subjects (11 male and 7 female, aged 7.8–18.2 years) were randomly assigned to receive either placebo or etanercept. Inclusion criteria included age 3–18 years, GAD-65 and/or islet cell antibody positivity, A1C &gt;6%, three insulin injections per day, white blood cell count 3,000–10,000, platelets &gt;100,000, and normal liver and renal function. Intention-to-treat analysis was used.RESULTSA1C at week 24 was lower in the etanercept group (5.91 ± 0.5%) compared with that in the placebo group (6.98 ± 1.2%; P &lt; 0.05) with a higher percent decrease from baseline than in the placebo group (etanercept 0.41 ± 0.1 vs. placebo 0.18 ± 0.21; P &lt; 0.01). The percent change in C-peptide area under the curve from baseline to week 24 showed a 39% increase in the etanercept group and a 20% decrease in the placebo group (P &lt; 0.05). From baseline to week 24 insulin dose decreased 18% in the etanercept group compared with a 23% increase in the placebo group (P &lt; 0.05). Seventeen patients completed the study, and none withdrew because of adverse events.CONCLUSIONSIn this small pilot study, treatment of pediatric patients newly diagnosed with type 1 diabetes with etanercept resulted in lower A1C and increased endogenous insulin production, suggesting preservation of β-cell function. A larger study is needed to further explore safety and efficacy.
Costs to Medicare of the Informatics for Diabetes Education and Telemedicine (IDEATel) Home Telemedicine Demonstration
Authors: Moreno Lorenzo , Dale Stacy B. , Chen Arnold Y. , Magee Carol A. 
Published: April 2009

OBJECTIVE
To estimate the impacts on Medicare costs of providing a particular type of home telemedicine to eligible Medicare beneficiaries with type 2 diabetes.

RESEARCH DESIGN AND METHODS
Two cohorts of beneficiaries (n = 1,665 and 504, respectively) living in two medically underserved areas of New York between 2000 and 2007 were randomized to intensive nurse case management via televisits or usual care. Medicare service use and costs covering a 6-year follow-up period were drawn from claims data. Impacts were estimated using regression analyses.

RESULTS
Informatics for Diabetes Education and Telemedicine (IDEATel) did not reduce Medicare costs in either site. Total costs were between 71 and 116% higher for the treatment group than for the control group.

CONCLUSIONS
Although IDEATel had modest effects on clinical outcomes (reported elsewhere), it did not reduce Medicare use or costs for health services. The intervention's costs were excessive (over $8,000 per person per year) compared with programs with similar-sized clinical impacts.
Microalbuminuria in Type 1 Diabetes Is Associated With Enhanced Excretion of the Endocytic Multiligand Receptors Megalin and Cubilin
Authors: Thrailkill Kathryn M. , Nimmo Teresa , Bunn R. Clay , Cockrell Gael E. , Moreau Cynthia S. , Mackintosh Samuel , Edmondson Ricky D. , Fowlkes John L. 
Published: April 2009

OBJECTIVE
Proteinuria is the hallmark of diabetic nephropathy; yet, glomerular histology does not fully explain mechanisms contributing to proteinuria. Our objective was to identify proteins in the urine of individuals with type 1 diabetes and microalbuminuria that might implicate a mechanistic pathway operative in proteinuria.

RESEARCH DESIGN AND METHODS
Using a GeLC/MS platform proteomics approach, we compared the urine proteome from 12 healthy nondiabetic individuals, 12 subjects with type 1 diabetes yet normal urinary albumin excretion rates, and 12 subjects with type 1 diabetes and microalbuminuria (type 1 diabetes + microalbuminuria).

RESULTS
The abundance of megalin and cubilin, two multiligand receptors expressed in kidney proximal tubule cells and involved with the reuptake of filtered albumin and megalin/cubilin ligands, was significantly increased in type 1 diabetes + microalbuminuria urine, compared with both nonalbuminuric groups.

CONCLUSIONS
Aberrant shedding of megalin and cubilin could contribute to albuminuria in diabetes and to deficiency states of important vitamins and hormones.
Insulin Analogs Versus Human Insulin in the Treatment of Patients With Diabetic Ketoacidosis
Authors: Umpierrez Guillermo E. , Jones Sidney , Smiley Dawn , Mulligan Patrick , Keyler Trevor , Temponi Angel , Semakula Crispin , Umpierrez Denise , Peng Limin , Cerón Miguel , Robalino Gonzalo 
Published: April 2009

OBJECTIVETo compare the safety and efficacy of insulin analogs and human insulins both during acute intravenous treatment and during the transition to subcutaneous insulin in patients with diabetic ketoacidosis (DKA).RESEARCH DESIGN AND METHODSIn a controlled multicenter and open-label trial, we randomly assigned patients with DKA to receive intravenous treatment with regular or glulisine insulin until resolution of DKA. After resolution of ketoacidosis, patients treated with intravenous regular insulin were transitioned to subcutaneous NPH and regular insulin twice daily (n = 34). Patients treated with intravenous glulisine insulin were transitioned to subcutaneous glargine once daily and glulisine before meals (n = 34).RESULTSThere were no differences in the mean duration of treatment or in the amount of insulin infusion until resolution of DKA between intravenous treatment with regular and glulisine insulin. After transition to subcutaneous insulin, there were no differences in mean daily blood glucose levels, but patients treated with NPH and regular insulin had a higher rate of hypoglycemia (blood glucose &lt;70 mg/dl). Fourteen patients (41%) treated with NPH and regular insulin had 26 episodes of hypoglycemia and 5 patients (15%) in the glargine and glulisine group had 8 episodes of hypoglycemia (P = 0.03).CONCLUSIONSRegular and glulisine insulin are equally effective during the acute treatment of DKA. A transition to subcutaneous glargine and glulisine after resolution of DKA resulted in similar glycemic control but in a lower rate of hypoglycemia than with NPH and regular insulin. Thus, a basal bolus regimen with glargine and glulisine is safer and should be preferred over NPH and regular insulin after the resolution of DKA.
Central Processing of Gut Pain in Diabetic Patients With Gastrointestinal Symptoms
Authors: Frøkjær Jens Brøndum , Søfteland Eirik , Graversen Carina , Dimcevski Georg , Egsgaard Line Lindhardt , Arendt-Nielsen Lars , Mohr Drewes Asbjørn 
Published: April 2009

OBJECTIVE
To evaluate the brain's responses to painful visceral and somatic stimuli in diabetic patients with gastrointestinal symptoms.

RESEARCH DESIGN AND METHODS
The sensitivity to electrical esophageal and median nerve stimulations was assessed in 15 healthy volunteers and 14 type 1 diabetic patients with autonomic neuropathy and gastrointestinal symptoms using a euglycemic-hyperinsulinemic clamp. Evoked brain potentials were recorded.

RESULTS
Patients had reduced sensitivity to esophageal (48%; P &lt; 0.001) and median nerve (80%; P &lt; 0.001) stimulations. They also had increased (8.8%; P = 0.007) and nonreproducible (P = 0.006) latencies of evoked potentials in response to esophageal stimulations, with 26% reduction in amplitude (P = 0.011). No potential differences were seen to median nerve stimulations. In diabetic patients, the topographic location of the first peak in potentials was more central (P &lt; 0.001) and gastrointestinal symptoms correlated with characteristics of brain potentials (P = 0.049).

CONCLUSIONS
This study supports that diabetes induces changes in peripheral visceral nerves as well as in the central nervous system.
A randomized controlled clinical trial of the use of benazepril and heparin for the treatment of chronic kidney disease in dogs
Authors: Tenhündfeld Jörg , Wefstaedt Patrick , Nolte Ingo J. A. 
Published: April 2009

Abstract
Objective—To investigate the effects of benazepril and heparin on renal function and blood pressure in dogs with chronic kidney disease.
Design—Randomized controlled clinical trial.
Animals—26 dogs with chronic kidney disease.
Procedures—Dogs were randomly assigned to receive benazepril hydrochloride (0.5 mg/kg [0.23 mg/lb], PO, q 24 h; n = 10), benazepril and heparin (150 U/kg [68 U/lb], SC, q 8 h, for the first 6 days; 10), or a placebo (6) and were followed up for 180 days.
Results—Health status score at the end of the study (ie, day 180) was significantly higher for dogs in the 2 treatment groups than for dogs in the placebo group. In addition, glomerular filtration rate was significantly increased and the urine protein-to-creatinine ratio was significantly decreased, compared with baseline rates, at the end of the study for dogs in both treatment groups but not for dogs in the placebo group. Systolic and diastolic blood pressures were significantly decreased on day 6 for dogs in both treatment groups.
Conclusions and Clinical Relevance—Results suggested that administration of benazepril had beneficial effects in dogs with chronic kidney disease but that short-term administration of heparin in conjunction with benazepril did not appear to provide any additional benefit.
Diffuse osteopenia and myelopathy in a puppy fed a diet composed of an organic premix and raw ground beef
Authors: Taylor Mark B. , Geiger David A. , Saker Korinn E. , Larson Martha M. 
Published: April 2009

Abstract
Case Description—An 8-month-old Shetland Sheepdog was evaluated because of the sudden onset of signs of neck pain, collapse, and inability to rise. A cursory diet history indicated that the dog had been fed a raw meat–based diet.
Clinical Findings—Initial evaluation of the dog revealed small physical stature, thin body condition, and signs of cranial cervical myelopathy. Radiographically, diffuse osteopenia of all skeletal regions was identified; polyostotic deformities associated with fracture remodeling were observed in weight-bearing bones, along with an apparent floating dental arcade. Hypocalcemia and hypophosphatemia were detected via serum biochemical analyses. The dog's diet was imbalanced in macronutrients and macrominerals.
Treatment and Outcome—The dog received supportive care and treatment of medical complications; neurologic abnormalities improved rapidly without intervention. Dietary changes were implemented during hospitalization, and a long-term feeding regimen was established. Following discharge from the hospital, exercise restriction was continued at home. Serial follow-up evaluations, including quantitative bone density measurements, revealed that dietary changes were effective. After 7 months, the dog was clinically normal.
Clinical Relevance—In the dog of this report, vitamin D–dependent rickets type I and suspected nutritional secondary hyperparathyroidism developed following intake of a nutritionally incomplete and unbalanced diet. The raw meat–based, home-prepared diet fed to the dog was not feed-trial tested for any life stage by the Association of American Feed Control Officials, and its gross nutrient imbalance induced severe metabolic, orthopedic, and neurologic abnormalities. Inadvertent malnutrition can be avoided through proper diet assessment and by matching nutrient profiles with patients' nutritional needs.
Successful management of a dog that had severe rhabdomyolysis with myocardial and respiratory failure
Authors: Wells Raegan J. , Sedacca Cassidy D. , Aman Anna M. , Hackett Timothy B. , Twedt David C. , Shelton G. Diane 
Published: April 2009

Abstract
Case Description—A 6-year-old castrated male Llewelyn Setter was evaluated because of an acute onset of myalgia and respiratory distress.
Clinical Findings—Physical examination revealed a stiff stilted gait, swollen muscles that appeared to cause signs of pain, panting, and ptyalism. The dog had a decrease in palpebral reflexes bilaterally and a decrease in myotatic reflexes in all 4 limbs. The panniculus reflex was considered normal, and all other cranial nerve reflexes were intact. Serum biochemical analysis revealed markedly high cardiac troponin-I concentration and creatine kinase and aspartate aminotransferase activities. Urinalysis revealed myoglobinuria. Results for thoracic and abdominal radiography, blood pressure measurement, and an ECG were within anticipated limits. Echocardiographic findings were consistent with secondary systolic myocardial failure. Arterial blood gas analysis confirmed hypoxemia and hypoventilation. The dog had negative results when tested for infectious diseases. Examination of skeletal muscle biopsy specimens identified necrotizing myopathy.
Treatment and Outcome—Treatment included ventilatory support; IV administration of an electrolyte solution supplemented with potassium chloride; administration of dantrolene; vasopressor administration; parenteral administration of nutrients; use of multimodal analgesics; administration of clindamycin, furosemide, mannitol, and enrofloxacin; and dietary supplementation with L-carnitine and coenzyme Q10. Other medical interventions were not required, and the dog made a rapid and complete recovery.
Clinical Relevance—Necrotizing myopathy resulting in rhabdomyolysis and myoglobinuria can lead to life-threatening physical and biochemical abnormalities. Making a correct diagnosis is essential, and patients require intensive supportive care. The prognosis can be excellent for recovery, provided there is no secondary organ dysfunction.
Lipoprotein(a) in Chronic Renal Failure
Authors: Čabarkapa Velibor , Đerić Mirjana , Stošić Zoran , Sakač Vladimir , Kojić-Damjanov Sunčica , Eremić Nevena 
Published: April 2009

Lipoprotein(a) in Chronic Renal Failure
Cardiovascular diseases are the leading cause of mortality in patients with chronic renal failure. Among the parameters contributing to cardiovascular disease development is the elevated serum concentration of lipoprotein(a) diagnosed in these patients, especially in the terminal stage of CRF. However, an elevated concentration of lipoprotein(a) could influence the renal failure progression. The objective of this study is to examine the lipoprotein(a) serum levels in chronic renal failure, and to establish the relation between the stage of renal function preservation and the level of this lipoprotein. In this study 127 subjects were included, divided into three groups. The first group contained 42 subjects (15 females and 27 males) in different CRF stages, the second group contained 32 subjects (7 females and 25 males) on a chronic hemodialysis program, and the control group contained 53 subjects (22 females and 31 males) with regular renal function. The results obtained point to significantly higher frequency of hyper-Lp(a) lipoproteinaemia in dialysed patients compared to the control group, as well as significantly higher Lp(a) values in both groups of patients compared to the control group. It can be concluded that for the risk assessment of premature atherosclerotic changes, but also renal failure progression in patients with CRF, determination of the Lp(a) serum concentration is recommendable.
Arthrosonography and the Biomarker Cartilage Oligomeric Matrix Protein in the Detection of Knee Osteoarthrosis Effusion
Authors: Živanović Sandra , Rackov Ljiljana , Vučetić Dušan , Mijušković Zoran 
Published: April 2009

Arthrosonography and the Biomarker Cartilage Oligomeric Matrix Protein in the Detection of Knee Osteoarthrosis Effusion
Osteoarthrosis of the knee is a degenerative disease with inflammatory episodes objectively shown by arthrosonography. Cartilage Oligomeric Matrix Protein - COMP is a useful biomarker for early cartilage destruction. The aim of this paper is a comparative analysis of the clinical, arthrosonographic findings and the COMP concentration in the sera of patients for the detection of joint inflammation. The analysis included 88 patients with knee OA. Clinical examination determined the outflow, arthrosonography the size of synovitis and effusion, and serum analysis the COMP concentration (ng/ml). Minimum outflow had 34.1% of patients, moderate 22.7%, and significant 4.5%. Sensitivity of the clinical diagnosis of outflow is 73%, and specificity 73% (p=0.000). Seventy five percent of patients had effusion; 28.4% of patients in the suprapatellar recessus (SR), 27.3% in the medial (MR), and 62.5% in the lateral (LR). In SR, effusion was 10.13±4.35 mm, MR 8.53±2.27 mm, LR 11.38±4.44 mm. Synovitis was found in 67% of patients, in SR the size of 4.84±3.57 mm, in MR 3.15±1.86 mm, in LR 6.09±2.80 mm. The average value of the size of effusion in patients with significant outflow in SR was 13.85 (10.36-17.43) mm (p=0.000), MR 4.9 (0-10.22) mm (p=0.008), LR 12.0 (11.34-14.50) mm (p=0.000), in LR with moderate outflow 6.94 (1.16-8.13) mm and minimum outflow 4.9 (0-7.25) mm. There is a significant correlation between the size of synovitis and effusion in the SR, MR and LR (p=0.000). The average value of the concentration of COMP in patients without effusion was 54 (44.5-58) ng/ml, with effusion 57 (48.75-64.25) ng/ml (p=0.030). Arthrosonography and the determination of the COMP concentration are sensitive methods for diagnosing joint effusion.
IEC/EN standards relating to diagnostic radiology equipment, and testing according to these standards
Authors: Porubszky Tamas , Barsai Janos 
Published: April 2009

IEC/EN standards relating to diagnostic radiology equipment, and testing according to these standards
The paper gives an outlook of history, present and future of international (IEC) and European (EN) standards relating to diagnostic radiology equipment. These standards may be safety, quality assurance or performance standards; all of them include testing methods. Elaboration and publication of a new series of safety standards is in progress.
Acceptance and conformance testing activity of the accredited Radiohygiene Department Laboratory of NRIRR according to these standards is reported.
An analysis of calibration coefficients measured in water and in air for Farmer-type cylindrical ionization chambers
Authors: Bulski Wojciech , Ulkowski Piotr , Gwiazdowska Barbara , Rostkowska Joanna 
Published: April 2009

An analysis of calibration coefficients measured in water and in air for Farmer-type cylindrical ionization chambers
A comparison of calibration coefficients of Farmer-type cylindrical ionization chambers calibrated in a Co-60 beam according to the IAEA Reports 277 and 398 formalisms.
91 calibration coefficients measured in air and in water.
The
398ND, W/277ND, W
ratios were calculated, taking into account the wall material of the chambers. The correlation between
398ND, W
and NK, ND, air
277ND, W
was made and the equations of the regression straight lines were determined.
Calibration coefficients, determined according to the IAEA Report 398, are higher by about 1% than those determined according to the IAEA Report 277, and they depend slightly on the wall material of the chamber.
The introduction of the IAEA dosimetry Report 398 resulted in an increase in the doses delivered to patients by about 1% as compared with the period of application of Report 277. The regression equations may assure increased accuracy in retrospective comparative calculation of doses according to both reports as compared with the correction based on mean percent values.
Spectrometric measurements of radioisotope activity in the thyroid
Authors: Osko Jakub , Golnik Natalia 
Published: April 2009

Spectrometric measurements of radioisotope activity in the thyroid
The results of measurements of iodine 131I and technetium 99mTc uptake in human thyroid, performed with scintillation or semiconductor detectors can exhibit a considerable uncertainty due to the differences in the thyroid position in the patient's neck. Basic physical laws of radiation attenuation and scattering show that the final shape of the registered spectrum should depends on the thyroid position in the neck and on the thickness of the tissue between the thyroid and the detector. The use of the spectrometric measuring method is proposed in this work for determination of the iodine gathering effective depth. The performed studies showed that the measurements results can be used for improving the accuracy of the iodine 131I activity in thyroid measurements and for selection of the group of patients for whom the anatomical position of the thyroid or the spatial distribution of the iodine gathering is much different than the standard one, assumed during the calibration of the counters. The results of the measurements were in agreement with Monte-Carlo calculations of the detector response. The method was used in routine monitoring of occupationally exposed persons, using the thyroid counter. A group of six persons with measurable internal contamination was selected and the measurements were performed on consecutive days, so the results could be registered at decreasing iodine activities in the thyroid. Larger series of measurements were performed at Brodno Regional Hospital in Warsaw, for a group of 95 patients after diagnostic administration of iodine 131I.
Entropy as a quality descriptor for the dose distribution — theory and practice for the patient target volume
Authors: Moravek Zdenek , Bogner Ludwig 
Published: April 2009

Entropy as a quality descriptor for the dose distribution — theory and practice for the patient target volume
The most common and established way to evaluate the quality of a radiotherapy plan is to use the dose-volume histogram (DVH). The evaluation of the DVH, however, is a subjective procedure. This may not be crucial as long as the two plans are significantly different. In the case of several plans obtained with different planning or optimisation strategies the differences are often subtle and therefore a more objective comparison method is desirable. A commonly used approach is based on evaluation of the conformity index, however we show how it can fail for plans of similar quality.
Therefore we propose a new method based on the similarity of DVH to statistical distributions, which can be characterised uniquely by their entropy. The concept is defined separately for target volumes, where it is derived from the Fermi-like distribution, and for organs at risk, where the traditional approach is also considered in its derivation. The artificial illustratory and clinical examples show the properties of the entropy as the quality descriptor and compare it to the conformity index. The examples are focused to the patient target volumes, where the advantage of the concept is more evident.
IMRT versus 3D-CRT for thyroid cancer
Authors: Gizynska Marta , Zawadzka Anna 
Published: April 2009

IMRT versus 3D-CRT for thyroid cancer
A 3D-CRT involving a 4-field (5-field, 6-field, etc.) technique (photon and electron beams) and an alternative IMRT 7-field technique with 6 MV photon fields for thyroid cancer were compared. The IMRT allows reduction in the dose to the spinal cord of about 12 Gy and permits better coverage of the target volume with smaller standard deviation (average 4.65% for 3D-CRT as compared with 1.81% for IMRT). The time needed to prepare therapy (TPS, dosimetry, preparing boluses and electron aperture) and the session time are about the same for both techniques.