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Charbonnel B, DeFronzo R, Davidson J, Schmitz O, Birkeland K, Pirags V, Scheen A. Pioglitazone use in combination with insulin in the prospective pioglitazone clinical trial in macrovascular events study (PROactive19). J Clin Endocrinol Metab 2010; 95:2163-71. [PMID: 20237169 DOI: 10.1210/jc.2009-1974] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In this post hoc analysis, we examined insulin requirements and regimens, glycemic control, cardiovascular outcomes, and safety in the patients treated with insulin at baseline in the Prospective Pioglitazone Clinical Trial in Macrovascular Events study. DESIGN The Prospective Pioglitazone Clinical Trial in Macrovascular Events study was a double-blind, placebo-controlled outcome study (mean follow-up 34.5 months) in 5238 high-risk patients with type 2 diabetes randomized to pioglitazone (force titrated to 45 mg) or placebo. One third of the total population (pioglitazone 864; placebo 896) were receiving insulin at baseline. RESULTS A rapid and sustained decrease in insulin dose was observed with pioglitazone vs. a progressive increase with placebo. By study end, the mean insulin dose was lower with pioglitazone (42 vs. 55 U/d with placebo; P < 0.0001). The insulin regimen (number on insulin, need for multiple injections, and reduction in oral agents) had been simplified vs. placebo; nevertheless, a greater glycosylated hemoglobin reduction was observed with pioglitazone (-0.93%) vs. placebo (-0.45%; P < 0.0001). At the final visit, insulin had been discontinued in 9% of pioglitazone vs. 2% of placebo patients (P < 0.0001). More insulin-resistant patients (defined as poorly controlled type 2 diabetes despite high doses of insulin) in the pioglitazone plus insulin group showed the greatest glycosylated hemoglobin decline. There were nonsignificant reductions with pioglitazone relative to placebo in the cardiovascular primary (hazard ratio 0.86; 95% confidence interval 0.71, 1.04; P = 0.1198) and main secondary (hazard ratio 0.85; 95% confidence interval 0.67, 1.08; P = 0.1831) end points in insulin-treated patients. The rates of overall heart failure, edema, and hypoglycemia were higher with pioglitazone [13.5 vs 10.5% (P = 0.0489); 30.8 vs. 18.2% (P < 0.0001); and 42.1 vs 29.0% (P < 0.0001), respectively], but there were no significant differences in serious events. CONCLUSIONS Pioglitazone use in combination with insulin resulted in a sustained improved glycemic control and allowed the treatment regimens to be simplified and the insulin doses reduced.
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Davidson J, Plumb A, Burnett H. Adult intestinal failure. Clin Radiol 2010; 65:395-402. [DOI: 10.1016/j.crad.2010.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 01/21/2010] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
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Knight C, Davidson J. Thermal Energy Harvesting for Wireless Sensor Nodes with Case Studies. LECTURE NOTES IN ELECTRICAL ENGINEERING 2010. [DOI: 10.1007/978-3-642-12707-6_10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Davidson J, Koenen C. Swinnen and DeVries: "Higher dose requirements with insulin detemir in type 2 diabetes-three cases and a review of the literature" [Diab. Res. Clin. Pract. 84 (May (2)) (2009) e24-6 (Epub 2009 February 28)]. Diabetes Res Clin Pract 2009; 86:e64-5. [PMID: 19674807 DOI: 10.1016/j.diabres.2009.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 06/15/2009] [Indexed: 11/26/2022]
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Vena D, Poon I, Kusano M, Banihashemi B, Balogh J, MacKenzie R, Davidson J, Higgins K, Enepekides D, Caldwell C. A Preliminary Analysis to Assess Intra-treatment FDG-PET Parameters that Predict for Locoregional Control in Advanced Head and Neck Cancer Treated with Chemoradiation. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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AboElkhair M, Synard S, Siah A, Pariseau J, Davidson J, Johnson G, Greenwood S, Casey J, Berthe F, Cepica A. Reverse transcriptase activity in tissues of the soft shell clam Mya arenaria affected with haemic neoplasia. J Invertebr Pathol 2009; 102:133-40. [DOI: 10.1016/j.jip.2009.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Revised: 06/22/2009] [Accepted: 06/25/2009] [Indexed: 11/25/2022]
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Vena D, Poon I, Yu H, Kusano M, MacKenzie R, Balogh J, Banihashemi B, Higgins K, Enepekides D, Davidson J, Caldwell C. 89 THE USE OF AN AUTOMATED SEGMENTATION ALGORITHM AS A METHOD FOR WHOLE TUMOUR ROI DEFINITION TO IMPROVE THE ACCURACY AND STABILITY OF INTRA-TREATMENT FDG ASSESSMENT IN HEAD AND NECK CANCER. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72476-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Textoris J, Davidson J, Martin C, Leone M. [Role of genetics in anaesthesia-related variability]. ACTA ACUST UNITED AC 2009; 28:564-74. [PMID: 19539443 DOI: 10.1016/j.annfar.2009.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 04/15/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This review discusses variability among patients in anesthesia, due to genetic polymorphisms. DATA SOURCES Articles in French and English languages were retrieved from PubMed database. The initial request was "anesth* and (genotyp* or polymorphism* or genetic*)". STUDY SELECTION Original articles, general reviews and one case report. Letters were excluded. DATA EXTRACTION Rare genetic diseases were excluded from the scope of this review. We stressed on frequent genetic polymorphisms that may have a daily impact in anesthesiology. DATA SYNTHESIS Most results were related to pain studies. We selected various examples to describe how genetic polymorphisms impacts the pharmacology of a given drug, and what are the clinical consequences. CONCLUSION There is a growing field of pharmacogenetic related evidences in anesthesiology. The results from various animal and human studies underline the genetic origin of variability among individuals. How anaesthesists have to integrate these parameters for their daily practice is still unclear, but pharmacogenetic will obviously be a leading field of anesthesia research in the future.
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McLean S, Wood LJ, Montgomery IM, Davidson J, Jones ME. Promotion of responsible drinking in hotels. Drug Alcohol Rev 2009; 13:247-55. [PMID: 16818336 DOI: 10.1080/09595239400185341] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study reports on an intervention programme to promote responsible drinking in hotels. The licensees of eight hotels agreed to participate in a trial of measures designed to assist patrons to avoid drink-driving, and seven other hotels were used as controls. The interventions acceptable to licensees comprised commercial-quality promotional material with the theme "0.05 Know Your Limits", and a breath analysis machine and poster on its use. Patrons leaving the hotels on Thursday, Friday and Saturday nights were interviewed and breath-tested. Although the intervention material had been seen by one-third of patrons in the intervention hotels, there was no significant difference between them and control hotel patrons in either median BAC or the proportion who were going to drive with BAC over the legal limit. There was poor compliance by hotels with the intervention procedures, indicating that a major impediment to the implementation and evaluation of programmes to promote responsible drinking is a lack of motivation by many licensees, despite support by some licensees and the Australian Hotels Association.
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Wood LJ, McLean S, Davidson J, Montgomery IM. One for the road: On the utility of citation data for identifying problem hotels. Drug Alcohol Rev 2009; 14:115-24. [PMID: 16203302 DOI: 10.1080/09595239500185121] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Drink drivers arrested in Tasmania are routinely asked by police where they had last been drinking, and these data were examined for 716 drivers arrested in Southern Tasmania during a 4-month period in 1992. Nearly half (43%) of arrested drink drivers cited individual hotels as the place where they had last been drinking. This enabled a citation score to be assigned to each of the 82 hotels in metropolitan Hobart. The distribution of citation scores was highly skewed, with eight hotels accounting for 45% of hotel citations, and two accounting for 20%. The hotels' citation scores were compared in relation to the rank order of their licence fees, since better measures of patronage proved unobtainable. Some hotels with small total alcohol sales did appear to have an unexpectedly large number of citations, suggesting less than responsible serving practices. Hoteliers' comments were sought on the interpretation of citation scores, and incorporated into a discussion of the limitations of the data in determining the extent of individual hotel responsibility for drink drivers. Important questions remaining include (1) what is the validity of citations made by drink drivers at the time of arrest; (2) what appropriate and quantifiable denominator can be used to adjust the number of citations to the level of patronage; and (3) what level of citations is too high and requires action?
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McLean S, Wood LJ, Montgomery IM, Davidson J, Jones ME. Trends in hotel patronage and drink driving in Hobart, Tasmania. Drug Alcohol Rev 2009; 14:359-62. [PMID: 16203334 DOI: 10.1080/09595239500185481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
From 1990 to 1991 in the Hobart region there was a marked fall in both hotel patronage and the proportion of patrons subsequently driving with their blood alcohol concentration above the legal limit. This was associated with smaller falls in the number of drink drivers charged and alcohol-related road accidents, which continued in the following year. It appears that the pattern of drinking and driving is changing, presumably in response to random breath testing and tougher penalties for offences.
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Kreiner AJ, Thatar Vento V, Levinas P, Bergueiro J, Di Paolo H, Burlon AA, Kesque JM, Valda AA, Debray ME, Somacal HR, Minsky DM, Estrada L, Hazarabedian A, Johann F, Suarez Sandin JC, Castell W, Davidson J, Davidson M, Giboudot Y, Repetto M, Obligado M, Nery JP, Huck H, Igarzabal M, Fernandez Salares A. Development of a tandem-electrostatic-quadrupole accelerator facility for BNCT. Appl Radiat Isot 2009; 67:S266-9. [PMID: 19376714 DOI: 10.1016/j.apradiso.2009.03.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In this work we describe the present status of an ongoing project to develop a tandem-electrostatic-quadrupole (TESQ) accelerator facility for accelerator-based (AB) BNCT at the Atomic Energy Commission of Argentina in Buenos Aires. The project final goal is a machine capable of delivering 30 mA of 2.4 MeV protons to be used in conjunction with a neutron production target based on the (7)Li(p,n)(7)Be reaction slightly beyond its resonance at 2.25 MeV. These are the specifications needed to produce sufficiently intense and clean epithermal neutron beams, based on the (7)Li(p,n)(7)Be reaction, to perform BNCT treatment for deep-seated tumors in less than an hour. An electrostatic machine is the technologically simplest and cheapest solution for optimized AB-BNCT. The machine being designed and constructed is a folded TESQ with a high-voltage terminal at 1.2 MV intended to work in air. Such a machine is conceptually shown to be capable of transporting and accelerating a 30 mA proton beam to 2.4 MeV. The general geometric layout, its associated electrostatic fields, and the acceleration tube are simulated using a 3D finite element procedure. The design and construction of the ESQ modules is discussed and their electrostatic fields are investigated. Beam transport calculations through the accelerator are briefly mentioned. Likewise, work related to neutron production targets, strippers, beam shaping assembly and patient treatment room is briefly described.
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Owen D, Davidson J. Hubris syndrome: An acquired personality disorder? A study of US Presidents and UK Prime Ministers over the last 100 years. Brain 2009; 132:1396-406. [DOI: 10.1093/brain/awp008] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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114
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Chinoy H, Platt H, Lamb JA, Betteridge Z, Gunawardena H, Fertig N, Varsani H, Davidson J, Oddis CV, McHugh NJ, Wedderburn LR, Ollier WER, Cooper RG. The protein tyrosine phosphatase N22 gene is associated with juvenile and adult idiopathic inflammatory myopathy independent of the HLA 8.1 haplotype in British Caucasian patients. ARTHRITIS AND RHEUMATISM 2008; 58:3247-54. [PMID: 18821667 PMCID: PMC4568569 DOI: 10.1002/art.23900] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine single-nucleotide polymorphisms (SNPs) of the protein tyrosine phosphatase N22 gene (PTPN22) and to study the relationship between PTPN22 and the HLA region in patients with idiopathic inflammatory myopathies (IIMs). METHODS PTPN22 SNPs were assessed in a large, cross-sectional, case-control study from the UK involving patients with adult or juvenile IIM, comprising patients with polymyositis (PM) (n=114), dermatomyositis (DM) (n=102), myositis associated with another connective tissue disease (myositis-CTD overlap syndrome) (n=64), or juvenile DM (n=101), in comparison with 748 control subjects. Seventeen PTPN22 SNPs were genotyped using the Sequenom MassArray iPLEX platform. Serotyping for myositis-specific/myositis-associated autoantibodies (MSAs/MAAs) was performed by radioimmunoprecipitation. RESULTS A significant association was noted between the R620W variant (rs2476601) and IIM (corrected P [Pcorr]=0.0009 versus controls), and specifically with the clinical subgroup of PM (Pcorr=0.003 versus controls). A weaker association was noted with juvenile DM (Pcorr=0.009 versus controls). No significant associations were noted after stratification by serologic subgroups. The association with the R620W variant was independent of alleles forming the HLA 8.1 haplotype. No other PTPN22 SNPs were associated with IIM. The PTPN22 haplotype containing the R620W T allele was the only haplotype significantly associated with IIM. CONCLUSION The R620W variant is a significant risk factor for IIM, independent of the HLA 8.1 haplotype. Unlike that in the HLA region, risk is not increased in individuals possessing MSAs/MAAs. These results are further evidence that the PTPN22 gene confers autoimmune susceptibility.
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Davidson J, Plumb A, Liong S, Turnbull I. Radiology evidence portfolio: experience in the North West Deanery. Clin Radiol 2008; 63:1184. [PMID: 18774370 DOI: 10.1016/j.crad.2008.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 04/21/2008] [Indexed: 10/21/2022]
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Hyrich KL, Lal SD, Hinks A, Wedderburn LR, Gardner-Medwin J, Foster H, Chieng A, Davidson J, Baildam E, Thomson W. Association between IL2RA and juvenile idiopathic arthritis (JIA) disease severity at first presentation to paediatric rheumatology: results from the Childhood Arthritis Prospective Study (CAPS). Pediatr Rheumatol Online J 2008. [PMCID: PMC3333937 DOI: 10.1186/1546-0096-6-s1-p14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Cruikshank M, Tunc A, Walsh J, Galea P, Davidson J, Gardner-Medwin J. Arthritis in Down's syndrome is still being missed. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334115 DOI: 10.1186/1546-0096-6-s1-p54] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Martin N, Davidson J, Harris H, Gillett P. Gastroparesis associated with Juvenile Dermatomyositis. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334021 DOI: 10.1186/1546-0096-6-s1-p217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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120
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Davidson J. On the Occurrence of Intermediates in Aphis rumicis L. and their Relation to the Alate and Apterous Viviparous Females. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1096-3642.1927.tb02181.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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121
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Adib N, Hyrich K, Thornton J, Lunt M, Davidson J, Gardner-Medwin J, Foster H, Baildam E, Wedderburn L, Thomson W. Association between duration of symptoms and severity of disease at first presentation to paediatric rheumatology: results from the Childhood Arthritis Prospective Study. Rheumatology (Oxford) 2008; 47:991-5. [PMID: 18417527 PMCID: PMC2430218 DOI: 10.1093/rheumatology/ken085] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives. To study the association between disease severity at first presentation to paediatric rheumatology (PRh) and length of time since symptom onset in children recruited to the Childhood Arthritis Prospective Study. Methods. Children ≤16 yrs with inflammatory arthritis persisting ≥2 weeks were recruited from five UK hospitals. Data including demographics, disease features, Childhood Health Assessment Questionnaire (CHAQ), physician and parent global assessment and blood tests were collected at the first appointment with PRh (baseline). The association between symptom duration (defined as time from first reported symptom onset to presentation at PRh) and baseline disease characteristics was evaluated using non-parametric descriptive statistics and multivariable logistic regression analyses. Results. Five hundred and seven children (65% female) were included: median age at onset was 6.8 yrs. Two hundred and thirty-three had oligoarthritis, 68 had RF-negative polyarthritis, 27 had systemic onset arthritis and 29 had arthritis that was not JIA. The median symptom duration was 4.6 months. Median symptom duration was shortest for children presenting with systemic arthritis (1.6 months) and longest for those with PsA (8.6 months). Children with a longer duration of symptoms were older and had higher median active joint counts but lower median ESR. Symptom duration did not correlate with CHAQ score at presentation. Conclusions. Children who have systemic arthritis had the shortest delay to PRh presumably because they are profoundly unwell. Children with joint pain/stiffness but normal ESR had longer delays suggesting that if blood tests do not indicate inflammation, the diagnosis of JIA may be overlooked.
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Thornton J, Lunt M, Ashcroft DM, Baildam E, Foster H, Davidson J, Gardner-Medwin J, Beresford MW, Symmons D, Thomson W, Elliott RA. Costing juvenile idiopathic arthritis: examining patient-based costs during the first year after diagnosis. Rheumatology (Oxford) 2008; 47:985-90. [PMID: 18417528 PMCID: PMC2430220 DOI: 10.1093/rheumatology/ken039] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives. There are few data on the treatment patterns and associated cost of treating children with inflammatory arthritis including juvenile idiopathic arthritis (JIA), in the short or long term. The aim of this study was to obtain patient-based costs for treating children with JIA in the UK, in the first year from diagnosis and from the secondary health care payer perspective. Methods. The Childhood Arthritis Prospective Study (CAPS) is an ongoing longitudinal study recruiting children with inflammatory arthritis from four UK hospital centres. Included children are newly diagnosed, ≤16 years old with inflammatory arthritis of one or more joints, which has persisted for at least 2 weeks. Health service resource use data were collected as part of routine clinical care at study entry, 6 months and 1 year. Reference unit costs were applied to these data and the cost of treatment per child calculated for the first year from diagnosis. Results. A total of 297 children attended a 12-month follow-up visit. The mean annual total cost per child was £1649 (s.d. £1093, range £401–£6967). The highest cost component was for appointments with paediatric rheumatologists. Mean total costs were highest for children with enthesitis-related, systemic JIA or extended oligoarthritis. Conclusions. In the first 12 months after diagnosis, children with all JIA disease subtypes consume large, but highly variable quantities of health service resources. Individual patient costs are required to reflect the wide variation in cost between patients and allow appropriate recouping of costs for contracted services and for assessing the economic impact of interventions.
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Baildam E, Davidson J. BSPAR position statement on professionals working in paediatric rheumatology. Rheumatology (Oxford) 2008; 47:743-4. [PMID: 18334524 DOI: 10.1093/rheumatology/ken069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Davidson J, Koro C, Arondekar B, Lee BH, Fedder D. A retrospective analysis of the fasting plasma glucose and glycosylated hemoglobin and pharmacotherapy change patterns among type 2 diabetes mellitus patients. Clin Ther 2008; 30:287-93. [DOI: 10.1016/j.clinthera.2008.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2007] [Indexed: 10/22/2022]
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Ligthelm R, Davidson J. Initiating insulin in primary care--the role of modern premixed formulations. Prim Care Diabetes 2008; 2:9-16. [PMID: 18684415 DOI: 10.1016/j.pcd.2008.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 12/11/2007] [Accepted: 01/08/2008] [Indexed: 12/25/2022]
Abstract
Starting insulin therapy earlier can help reduce the risk of micro- and macrovascular complications associated with the progression of type 2 diabetes mellitus (T2DM). However, barriers to the initiation of insulin have been identified. Premixed insulins offer a simpler regimen than basal-bolus therapy for T2DM. Modern premixes, which combine a rapid-acting soluble insulin with a protaminated form of the same insulin, have become increasingly popular. As primary care practitioners and diabetes specialists are encouraged to initiate insulin, premixes that can be used within flexible dosing regimens to improve glycaemic control could be beneficial.
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