2,771 research outputs found
Helen Schleman standing with President Elliott and Dorothy Stratton
No full textHelen B. Schleman: USCGR, Captain Dorothy C. Stratton, President Edward C. Elliott, Lieutenant Commander Helen B. Schleman, USCGR (w). Review of SPARS, Dec. 4, 1943, Washington D.C. Photo by JC Allen and Son
Dorothy Stratton standing with others
No full textDorothy C. Stratton. (L to R): Lieutenant Commander Helen B. Schleman, USCGR (w), Rear Admiral Carl Michel, Medical Director, USPHS Vice Admiral R.R. Naesche, USCGR (w) Commander A. J. Hesford, USCG. Taken in Hall of Music, Purdue University, following the commencement exercises on February 27, 1944. Photo by JC and Allen and Son
Screening attendance, age group and diabetic retinopathy level at first screen
No full textAIMS:
To report on the relationships between age at diagnosis of diabetes, time from registration with the screening programme to first diabetic eye screening and severity of diabetic retinopathy.
METHODS:
Data were extracted from four English screening programmes and from the Scottish, Welsh and Northern Irish programmes. Time from diagnosis of diabetes to first screening and age at diagnosis were calculated.
RESULTS:
Time from registration with the screening programme to first screening episode is strongly related to age at registration. Within 18 months of registration 89% of 3958 young people under 18 years of age and 81% of 391 293 people over 35 years of age were seen. In 19 058 people between 18 and 34 years of age, 80% coverage was not reached until 2 years and 9 months. The time from diagnosis of diabetes to first screening is positively associated with severity of disease (P < 0.0001).
CONCLUSIONS:
This report is the first that to demonstrate that those in the 18-34 year age group are least likely to attend promptly for screening after registration with a higher risk of referable diabetic retinopathy being present at the time of first screen. Date of diagnosis should be recorded and prodigious efforts made to screen all people promptly after diagnosis. Screening programmes should collect data on those who have not attended within one year of registration
U.K. Prospective Diabetes Study. XV: Relationship of renin-angiotensin system gene polymorphisms with microalbuminuria in NIDDM.
No full textWe performed a case-control study to determine whether molecular variants of genes of the renin-angiotensin system were associated with the presence of albuminuria in non-insulin dependent diabetes mellitus (NIDDM). A total of 180 diabetic patients with persistent microalbuminuria [median urinary albumin (interquartile range) of 74 (54 to 126 mg/liter)] were matched with two control groups of diabetic patients without microalbuminuria [median urinary albumin 7 (5 to 10) mg/liter] for variables known to be associated with raised urinary albumin concentration including hemoglobin A1c and triglyceride. One control group was also matched for blood pressure and the other group was not, to allow assessment of interactions with hypertension. Association with the I/D polymorphism of the ACE gene and M235T variant of the angiotensinogen gene (AGT) with microalbuminuria and retinopathy was examined. There were no significant differences in genotype frequency between cases and controls for ACE or AGT irrespective of blood pressure matching. However, among subjects with microalbuminuria, those with the ACE DD genotype had a significantly greater urinary albumin excretion than individuals with a non-DD genotype [median 88 (68 to 170) mg/liter vs. 67 (53 to 113) mg/liter, P 100 mg/liter, twice the upper normal range (60% vs. 38%, P = 0.006). When increased albumin excretion occurs, the presence of the ACE DD genotype appears to be associated with higher urinary albumin levels. No association with retinopathy was observed
Incidence of AIDS and excess of mortality associated with HIV in haemophiliacs in the United Kingdom: report on behalf of the directors of haemophilia centres in the United Kingdom.
No full textOBJECTIVE--To estimate the cumulative incidence of AIDS by time since seroconversion in haemophiliacs positive for HIV and to examine the evidence for excess mortality associated with HIV in those who had not yet been diagnosed as having AIDS. DESIGN--Analysis of data from ongoing national surveys. SETTING--Haemophilia centres in the United Kingdom. PATIENTS--A total of 1201 men with haemophilia who had lived in the United Kingdom during 1980-7 and were positive for HIV. INTERVENTION--None. END POINTS--Diagnosis of AIDS; death in those not diagnosed as having AIDS. MEASUREMENTS AND MAIN RESULTS--Estimation of cumulative incidence of AIDS and number of excess deaths in seropositive patients not diagnosed with AIDS. Median follow up after seroconversion was 5 years 2 months. Eight five patients developed AIDS. Cumulative incidence of AIDS five years after seroconversion was 4% among patients aged less than 25 at first test positive for HIV, 6% among those aged 25-44, and 19% among those aged greater than or equal to 45. There was little evidence that type or severity of haemophilia or type of factor VIII or IX that had caused HIV infection affected the rate of progression to AIDS. Mortality was increased among those who had not been diagnosed as having AIDS, especially among those with "AIDS related complex." Thirteen deaths were observed among 36 patients diagnosed as having AIDS related complex against 0.65 expected, and 34 deaths in 1080 other patients against 22.77 expected; both calculations were based on mortality rates observed in haemophiliacs in the United Kingdom in the late 1970s. CONCLUSIONS--Rate of progression to AIDS depended strongly on age. There is a substantial burden of fatal disease among patients positive for HIV who have not been formally diagnosed as having AIDS
A prospective study of urinary androgen levels and ovarian cancer
No full textThe three major urinary androgen metabolites, dehydroepiandrosterone (DHEA), androsterone (ANDRO), and aetiocholanolone (AETIO) were measured in 1,484 volunteer women between 29 and 60 years of age on the island of Guernsey from 1962–1967. Twelve of these women subsequently developed ovarian cancer after a median interval of 130 months and a minimum interval of 19 months. All three androgen levels in these women were lower than those in controls matched for age and menopausal status. The results were most striking for DHEA, where half of the cases were below the 27th percentile of their matched controls (p = 0.007, two‐sided). The results for ANDRO were of marginal significance (p = 0.06), and those for AETIO were not significant (p= 0.033).</p
Development of a cost-effectiveness model for optimisation of the screening interval in diabetic retinopathy screening
No full textBACKGROUND:
The English NHS Diabetic Eye Screening Programme was established in 2003. Eligible people are invited annually for digital retinal photography screening. Those found to have potentially sight-threatening diabetic retinopathy (STDR) are referred to surveillance clinics or to Hospital Eye Services.
OBJECTIVES:
To determine whether personalised screening intervals are cost-effective.
DESIGN:
Risk factors were identified in Gloucestershire, UK using survival modelling. A probabilistic decision hidden (unobserved) Markov model with a misgrading matrix was developed. This informed estimation of lifetime costs and quality-adjusted life-years (QALYs) in patients without STDR. Two personalised risk stratification models were employed: two screening episodes (SEs) (low, medium or high risk) or one SE with clinical information (low, medium-low, medium-high or high risk). The risk factor models were validated in other populations.
SETTING:
Gloucestershire, Nottinghamshire, South London and East Anglia (all UK).
PARTICIPANTS:
People with diabetes in Gloucestershire with risk stratification model validation using data from Nottinghamshire, South London and East Anglia.
MAIN OUTCOME MEASURES:
Personalised risk-based algorithm for screening interval; cost-effectiveness of different screening intervals.
RESULTS:
Data were obtained in Gloucestershire from 12,790 people with diabetes with known risk factors to derive the risk estimation models, from 15,877 people to inform the uptake of screening and from 17,043 people to inform the health-care resource-usage costs. Two stratification models were developed: one using only results from previous screening events and one using previous screening and some commonly available GP data. Both models were capable of differentiating groups at low and high risk of development of STDR. The rate of progression to STDR was 5 per 1000 person-years (PYs) in the lowest decile of risk and 75 per 1000 PYs in the highest decile. In the absence of personalised risk stratification, the most cost-effective screening interval was to screen all patients every 3 years, with a 46% probability of this being cost-effective at a £30,000 per QALY threshold. Using either risk stratification models, screening patients at low risk every 5 years was the most cost-effective option, with a probability of 99-100% at a £30,000 per QALY threshold. For the medium-risk groups screening every 3 years had a probability of 43-48% while screening high-risk groups every 2 years was cost-effective with a probability of 55-59%.
CONCLUSIONS:
The study found that annual screening of all patients for STDR was not cost-effective. Screening this entire cohort every 3 years was most likely to be cost-effective. When personalised intervals are applied, screening those in our low-risk groups every 5 years was found to be cost-effective. Screening high-risk groups every 2 years further improved the cost-effectiveness of the programme. There was considerable uncertainty in the estimated incremental costs and in the incremental QALYs, particularly with regard to implications of an increasing proportion of maculopathy cases receiving intravitreal injection rather than laser treatment. Future work should focus on improving the understanding of risk, validating in further populations and investigating quality issues in imaging and assessment including the potential for automated image grading
Hippocampal activation for autobiographical memories over the entire lifetime in healthy aged subjects: An fMRI study
No full textInternational audienceWe used functional magnetic resonance imaging to determine the cerebral structures required during the recollection of episodic autobiographical memories according to 5 time periods covering the whole lifespan to test the 2 concurring models of memory consolidation, which propose either a temporary (standard model) or a permanent (multiple-trace model) role of the hippocampus in episodic memory retrieval. The experimental paradigm was specially designed to engage subjects (67.17 +/- 5.22 years old) in the retrieval of episodic autobiographical memories, whatever the time period, from personally relevant cues selected by questioning a family member. Moreover, the nature of the memories was checked at debriefing by means of behavioral measures to control the degree of episodicity. Behavioral data showed that recollected memories were characterized by specificity and details whatever their remoteness. Main neuroimaging data (Statistical Parametric Mapping 99) revealed the activation of a network including the left superior frontal gyri, bilateral precuneus/posterior cingulate and lingual gyri, left angular gyrus, and left hippocampus, although the subtraction analyses detected subtle differences between certain time periods. Small volume correction centered on the hippocampus detected left hippocampal activation for all time periods and additional right hippocampal activation for the intermediate periods. Further confirmation was provided by using a 3-way analysis of variance on blood oxygen level-dependent values, which revealed hippocampal activation whatever the time interval. The present data challenge the standard model of memory consolidation and support the multiple-trace model, instead. The comparison with previous literature stresses the idea that a bilateral involvement of the hippocampus characterizes rich episodic autobiographical memory recollection
Concise Total Synthesis of Herqulines B and C
No full textA simple
total synthesis of herqulines B and C is reported, modeled
on the reductive biosynthesis reported previously by other researchers.
Commencing from tyrosine, these alkaloids were fashioned through a
dimerization, macrocyclization, and four consecutive reductions. Emerging
from these studies are strategic insights on the synthesis of these
strained alkaloids, as well as mild conditions for the exhaustive
reduction of diketopiperizines
Helen Schleman standing with President Elliott and two other people
No full textHelen B. Schleman: (Lto R), Captain Dorothy C. Stratton, USCGR, Vice Admiral R.R. Naesche (?), USCG, Commandant, US Coast Guard, President Edward C. Elliott, Lieutenant Commander Helen B. Schleman, USCGR (w). Taken in Hall of Music, Purdue University, following the commencement exercises on February 27, 1944. Photo by JC Allen and Son
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